Herrmann M, Neidhart M, Gay S, Hagenhofer M, Kalden J R
Friedrich-Alexander University of Erlangen-Nuremberg, Department of Internal Medicine III, Germany.
Curr Opin Rheumatol. 1998 Jul;10(4):347-54. doi: 10.1097/00002281-199807000-00012.
The influence of environmental factors in the initiation of autoimmune rheumatic diseases is still under debate. Infections with viruses (e.g., retroviruses) or expression of gene products encoded by endogenous retroviruses are believed to contribute to both loss of tolerance for autoantigens and immunosuppression. In various rheumatic disorders the detection of retroviral antibodies provides evidence for retroviral gene expression and suggests a role in the etiopathogenesis. Molecular mimicry, defects in apoptosis, altered autoantigens, and alterations of monocyte or macrophage as well as dendritic cell functions may contribute to the molecular mechanisms causing the loss of tolerance. On the other hand, destruction of lymphocytes during lytic retrovirus infections as well as envelope gene-env derived immunosuppressive retroviral gene products may prevent chronic inflammatory diseases and tissue destruction. Furthermore, retrovirus encoded super-antigens with the potency to skew the T-cell repertoire may seriously modify the host's immune system.
环境因素在自身免疫性风湿性疾病发病中的影响仍存在争议。病毒感染(如逆转录病毒)或内源性逆转录病毒编码的基因产物的表达被认为既导致对自身抗原的耐受性丧失,又导致免疫抑制。在各种风湿性疾病中,逆转录病毒抗体的检测为逆转录病毒基因表达提供了证据,并提示其在发病机制中的作用。分子模拟、细胞凋亡缺陷、自身抗原改变以及单核细胞或巨噬细胞以及树突状细胞功能的改变可能有助于导致耐受性丧失的分子机制。另一方面,溶细胞性逆转录病毒感染期间淋巴细胞的破坏以及包膜基因env衍生的免疫抑制性逆转录病毒基因产物可能预防慢性炎症性疾病和组织破坏。此外,具有使T细胞库发生偏差能力的逆转录病毒编码超抗原可能会严重改变宿主的免疫系统。