Division of Clinical Immunology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Immunology Reserach Core Facility, Gemelli Science and Technology Park - Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome, Italy; Università Cattolica del Sacro Cuore, Rome, Italy.
Immunology Reserach Core Facility, Gemelli Science and Technology Park - Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome, Italy.
Autoimmun Rev. 2022 Jun;21(6):103102. doi: 10.1016/j.autrev.2022.103102. Epub 2022 Apr 19.
Multiple Sclerosis (MS) has been shown to be linked to Epstein Barr Virus (EBV) infection, a virus that infects B cells inside the CNS. The seminal study raises a key interest into the infectious origin of several other autoimmune inflammatory diseases.We will discuss here the infectious agents that have been studied over the years in Rheumatoid Arthritis (RA), a crippling arthritis that was treated a century ago with gold salts (anti mycobacterial agent), chloroquine (anti malarial agent), or sulphasalazine (an antibacterial-antiinflammatory agent). Several infectious agents have been taken into consideration, i.e. Streptococcus group A, Proteus, Mycobacterium tuberculosis-MTB, Parvovirus B19, Epstein Barr virus, Porphyromonas gingivalis-Pg, Aggregatibacter actinomycetescomitans, and finally Haemophilus-Glaesserella parasuis-Hps. Of these agents only three satisfy the Witebski's criteria as possible pathogenetic causes of an autoimmune disease, i.e. MTB, Pg, Hps. We will discuss here how the immune tolerance might be broken, which could be the neoantigen or autoantigen involved, how the infectious agent was studied as a trigger capable of inducing arthritis in animal models. The preventive measures that should be adopted to lessen the impact of the infections, to prevent the burden and the severity of the illness are described.
多发性硬化症 (MS) 已被证明与 Epstein Barr 病毒 (EBV) 感染有关，该病毒感染中枢神经系统内的 B 细胞。这项开创性的研究引起了人们对其他几种自身免疫性炎症性疾病的感染起源的极大兴趣。我们将在这里讨论多年来在类风湿关节炎 (RA) 中研究过的病原体，类风湿关节炎是一种致残性关节炎，一个世纪前曾用金盐（抗分枝杆菌剂）、氯喹（抗疟药）或柳氮磺胺吡啶（抗菌-抗炎药）治疗。已经考虑了几种感染因子，即 A 组链球菌、变形杆菌、结核分枝杆菌-MTB、细小病毒 B19、Epstein Barr 病毒、牙龈卟啉单胞菌-Pg、伴放线放线杆菌和最终的嗜血杆菌-Glaesserella parasuis-Hps。在这些病原体中，只有三种符合 Witebski 的标准，可作为自身免疫性疾病的可能病因，即 MTB、Pg、Hps。我们将在这里讨论免疫耐受如何被打破，可能涉及的新抗原或自身抗原是什么，以及如何将感染因子作为一种能够在动物模型中诱导关节炎的触发因素进行研究。还描述了应采取哪些预防措施来减轻感染的影响，预防疾病的负担和严重程度。
