Division of Rheumatology, Department of Medicine, University of Washington, Seattle, WA, United States.
Front Immunol. 2020 Nov 13;11:593891. doi: 10.3389/fimmu.2020.593891. eCollection 2020.
More than 200 human disorders include various manifestations of autoimmunity. The molecular events that lead to these diseases are still incompletely understood and their causes remain largely unknown. Numerous potential triggers of autoimmunity have been proposed over the years, but very few of them have been conclusively confirmed or firmly refuted. Viruses have topped the lists of suspects for decades, and it seems that many viruses, including those of the Herpesviridae family, indeed can influence disease initiation and/or promote exacerbations by a number of mechanisms that include prolonged anti-viral immunity, immune subverting factors, and mechanisms, and perhaps "molecular mimicry". However, no specific virus has yet been established as being truly causative. Here, we discuss a different, but perhaps mechanistically related possibility, namely that retrotransposons or retroviruses that infected us in the past and left a lasting copy of themselves in our genome still can provoke an escalating immune response that leads to autoimmune disease. Many of these loci still encode for retroviral proteins that have retained some, or all, of their original functions. Importantly, these endogenous proviruses cannot be eliminated by the immune system the way it can eliminate exogenous viruses. Hence, if not properly controlled, they may drive a frustrated and escalating chronic, or episodic, immune response to the point of a frank autoimmune disorder. Here, we discuss the evidence and the proposed mechanisms, and assess the therapeutic options that emerge from the current understanding of this field.
超过 200 种人类疾病包括各种自身免疫表现。导致这些疾病的分子事件仍不完全清楚,其病因在很大程度上仍然未知。多年来,人们提出了许多潜在的自身免疫触发因素,但其中很少有被明确证实或否定。病毒数十年来一直是嫌疑犯之首,似乎许多病毒,包括疱疹病毒科的病毒,确实可以通过多种机制影响疾病的起始和/或加重,包括延长抗病毒免疫、免疫颠覆因素和机制,也许还有“分子模拟”。然而,到目前为止,还没有一种特定的病毒被确认为真正的致病因素。在这里,我们讨论一种不同的、但可能在机制上相关的可能性,即过去感染我们的逆转录转座子或逆转录病毒在我们的基因组中留下了持久的自身拷贝,仍然可以引发加剧的免疫反应,导致自身免疫性疾病。这些基因座中的许多仍然编码具有保留部分或全部原始功能的逆转录病毒蛋白。重要的是,这些内源性前病毒不能像免疫系统消除外源性病毒那样被免疫系统消除。因此,如果不能得到适当的控制,它们可能会导致受挫和加剧的慢性或间歇性免疫反应,直至出现明显的自身免疫紊乱。在这里,我们讨论了证据和提出的机制,并评估了从该领域当前理解中出现的治疗选择。