1
|
Kim L, Lashnits E, Breitschwerdt EB, Elam A, Grade N, Miller J, Shikhman AR. Antibodies to Borrelia burgdorferi and Bartonella species in serum and synovial fluid from people with rheumatic diseases. Microbiol Spectr 2024; 12:e0165323. [PMID: 38483477 PMCID: PMC10986562 DOI: 10.1128/spectrum.01653-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 02/03/2024] [Indexed: 04/06/2024] Open
Abstract
Vector-borne infections may underlie some rheumatic diseases, particularly in people with joint effusions. This study aimed to compare serum and synovial fluid antibodies to B. burgdorferi and Bartonella spp. in patients with rheumatic diseases. This observational, cross-sectional study examined paired synovial fluid and serum specimens collected from 110 patients with joint effusion between October 2017 and January 2022. Testing for antibodies to B. burgdorferi (using CDC criteria) and Bartonella spp. via two indirect fluorescent antibody (IFA) assays was performed as part of routine patient care at the Institute for Specialized Medicine (San Diego, CA, USA). There were 30 participants (27%) with positive two-tier B. burgdorferi serology and 26 participants (24%) with IFA seroreactivity (≥1:256) to B. henselae and/or B. quintana. Both B. burgdorferi IgM and IgG were detected more frequently in synovial fluid than serum: 27% of patients were either IgM or IgG positive in synovial fluid, compared to 15.5% in serum (P = 0.048). Conversely, B. henselae and B. quintana antibodies were detected more frequently in serum than synovial fluid; overall only 2% of patients had positive IFA titers in synovial fluid, compared to 24% who had positive IFA titers in serum (P < 0.001). There were no significant associations between B. burgdorferi or Bartonella spp. seroreactivity with any of the clinical rheumatological diagnoses. This study provides preliminary support for the importance of synovial fluid antibody testing for documenting exposure to B. burgdorferi but not for documenting exposure to Bartonella spp. IMPORTANCE This study focuses on diagnostic testing for two common vector-borne diseases in an affected patient population. In it, we provide data showing that antibodies to B. burgdorferi, but not Bartonella spp., are more commonly found in synovial fluid than serum of patients with joint effusion. Since Lyme arthritis is a common-and sometimes difficult to diagnose-rheumatic disease, improving diagnostic capabilities is of utmost importance. While our findings are certainly not definitive for changes to practice, they do suggest that synovial fluid could be a useful sample for the clinical diagnosis of Lyme disease, and future prospective studies evaluating this claim are warranted.
Collapse
Affiliation(s)
- Lisa Kim
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Erin Lashnits
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Edward B. Breitschwerdt
- Intracellular Pathogens Research Laboratory and Comparative Medicine Institute, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | - Amanda Elam
- Galaxy Diagnostics, Research Triangle, North Carolina, USA
| | - Neenah Grade
- Galaxy Diagnostics, Research Triangle, North Carolina, USA
| | | | | |
Collapse
|
2
|
Bruno D, Tanti G, Cingolani A, Ria F, Gremese E, Mirone L. Simultaneous Onset of Mycobacterium kansasii Pulmonary Infection and Systemic Lupus Erythematosus: A Case Report. AMERICAN JOURNAL OF CASE REPORTS 2021; 22:e929866. [PMID: 34006819 PMCID: PMC8141339 DOI: 10.12659/ajcr.929866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Patient: Female, 19-year-old Final Diagnosis: Systemic lupus erythematosus Symptoms: Cough • Fever • malaise and fatigue • polyarthralgia • skin rash Medication: — Clinical Procedure: — Specialty: Rheumatology
Collapse
Affiliation(s)
- Dario Bruno
- Division of Rheumatology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giacomo Tanti
- Division of Rheumatology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Antonella Cingolani
- Department of Laboratory and Infectious Disease Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Department of Safety and Bioethics, Section of Infectious Diseases, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Francesco Ria
- Department of Medicine and Translational Surgery, Università Cattolica del Sacro Cuore, Rome, Italy.,Department of Laboratory Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Elisa Gremese
- Division of Rheumatology, Università Cattolica del Sacro Cuore, Rome, Italy.,Division of Rheumatology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Luisa Mirone
- Division of Rheumatology, Università Cattolica del Sacro Cuore, Rome, Italy.,Division of Rheumatology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| |
Collapse
|
3
|
Hashempour A, Moayedi J, Musavi Z, Ghasabi F, Halaji M, Hasanshahi Z, Nazarinia MA. First report of HHV-8 viral load and seroprevalence of major blood-borne viruses in Iranian patients with systemic sclerosis. Mult Scler Relat Disord 2021; 51:102872. [PMID: 33711714 DOI: 10.1016/j.msard.2021.102872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 02/22/2021] [Accepted: 02/25/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Systemic sclerosis (SSc) is characterized by autoimmune manifestations, and viral infections may have a key role in the development and progression of it. This study aimed to investigate the seroprevalence of major blood-borne viruses and HHV-8 viral load in Iranian SSc patients. METHODS In this cross-sectional study, 90 patients with a confirmed history of SSc and 90 healthy blood donors were enrolled. The frequency of HHV-8, CMV, EBV, HIV, HBV, and HCV antibodies and HHV-8 viral load were evaluated by enzyme-linked immunosorbent assay and real-time PCR assay, respectively. RESULTS HHV-8 IgG antibody was diagnosed in 61 (67.8%) patients and 3 (3.3%) healthy individuals (p<0.0001), but its genomic DNA was not detected in the patients or healthy blood donors. CMV and EBV antibodies were detected in 100% and 88.9% of SSc patients without any significant difference with healthy population (p>0.05). None of the patients or healthy population was positive for HBsAg and HIVAb; however, HCVAb was detected in two patients. CONCLUSION According to the results, HHV-8 antibody was uniquely increased in SSc population while its frequency in healthy population was very low. Since none of the SSc patients were positive for HHV-8 genomic DNA, the high prevalence of HHV-8 antibody in this group was not related to the real history of infection. Therefore, antibody-mediated epitope mimicry can play a role to get the high rate of seropositivity and lead to pathogeneses of SSc. Besides, CMV and EBV viral load monitoring in SSc patients can help the physician to prescribe the viral drugs to suppress the viral replication and avoid the crucial effect of reactivation.
Collapse
Affiliation(s)
- Ava Hashempour
- Shiraz HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Javad Moayedi
- Shiraz HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Zahra Musavi
- Shiraz HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Farzaneh Ghasabi
- Shiraz HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehrdad Halaji
- Department of Microbiology, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran; Shiraz HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Hasanshahi
- Shiraz HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | | |
Collapse
|
4
|
Houen G, Trier NH. Epstein-Barr Virus and Systemic Autoimmune Diseases. Front Immunol 2021; 11:587380. [PMID: 33488588 PMCID: PMC7817975 DOI: 10.3389/fimmu.2020.587380] [Citation(s) in RCA: 136] [Impact Index Per Article: 45.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 11/19/2020] [Indexed: 12/11/2022] Open
Abstract
Epstein-Barr Virus (EBV) is an extremely successful human herpes virus, which infects essentially all human beings at some time during their life span. EBV infection and the associated immune response results in production of antibodies (seroconversion), which occurs mainly during the first years of life, but may also happen during adolescence or later in life. Infection of adolescents can result in infectious mononucleosis, an acute serious condition characterized by massive lymphocytosis. Transmission of EBV mainly occurs through saliva but can rarely be spread through semen or blood, e.g. through organ transplantations and blood transfusions. EBV transmission through oral secretions results in infection of epithelial cells of the oropharynx. From the epithelial cells EBV can infect B cells, which are the major reservoir for the virus, but other cell types may also become infected. As a result, EBV can shuttle between different cell types, mainly B cells and epithelial cells. Moreover, since the virus can switch between a latent and a lytic life cycle, EBV has the ability to cause chronic relapsing/reactivating infections. Chronic or recurrent EBV infection of epithelial cells has been linked to systemic lupus erythematosus and Sjögren’s syndrome, whereas chronic/recurrent infection of B cells has been associated with rheumatoid arthritis, multiple sclerosis and other diseases. Accordingly, since EBV can shuttle between epithelial cells and B cells, the systemic autoimmune diseases often occur as overlapping syndromes with symptoms and characteristic autoantibodies (e.g. antinuclear antibodies and rheumatoid factors) reflecting epithelial and/or B cell infection.
Collapse
Affiliation(s)
- Gunnar Houen
- Department of Biochemistry and Molecular Biology, University of Southern Denmark, Odense, Denmark.,Department of Neurology, Rigshospitalet, Glostrup, Denmark
| | | |
Collapse
|
5
|
Cosse C, Kernéis S, Lescoat A, Pugnet G, Truchetet ME, Priollet P, Diot E, Martin M, Maurier F, Viallard JF, Agard C, Granel B, Berthier S, Fagedet D, Watelet B, Toquet S, Luque Paz D, Giret C, Cerles O, Dion J, Nguyen C, Raffray L, Bertolino J, Jourde W, Le Jeunne C, Mouthon L, Chaigne B. Osteitis in Systemic Sclerosis: a nationwide case-control retrospective study (SCLEROS Study). Arthritis Care Res (Hoboken) 2020; 74:809-817. [PMID: 33278067 DOI: 10.1002/acr.24530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 11/05/2020] [Accepted: 12/01/2020] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Systemic sclerosis (SSc) is an autoimmune (AI) connective tissue disorder characterized by skin fibrosis, vasculopathy and dysimmunity. Data regarding osteitis in SSc are scarce. METHOD We performed a nationwide multicentre retrospective case-control study including patients with SSc according to the 2013 ACR/EULAR classification, with a diagnosis of osteitis. The objectives of the study were to describe, to characterize, and to identify associated factors for osteitis in patients with SSc. RESULTS Forty-eight patients were included. Twenty-six patients (54.1%) had osteitis beneath digital tip ulcers. Physical symptoms included: pain (36/48, 75%), erythema (35/48, 73%), and local warmth (35/48, 73%). Thirty-one (65%) patients had C-reactive protein levels >2 mg/L (8 [2.7 - 44.3] mg/L). On X-ray, CT-scans or MRI, osteitis was characterized by swelling or abscess of soft tissues with acro-osteolysis or lysis in 28 patients (58%). Microbiological sampling was performed in 45 (94%) patients. Most pathogens were Staphylococcus aureus (43.8%); anaerobes and Enterobacteriaceae (29.1%) and Pseudomonas aeruginosa (10.4%). Management comprised antibiotics in 37 (77.1%) patients and/or surgery in 26 (54.2%). Fluoroquinolones were used in 22 (45.8%) patients and amoxicillin + beta-lactamase inhibitor in 7 (14.6%). Six (12.6%) patients relapsed, 6 (12.6%) patients had osteitis recurrence, 15 (32%) sequelae, and 2 patients had septic shock and died. CONCLUSION This study confirmed digital tip ulcers as an associated factor for osteitis, and revealed a high rate of functional sequelae. Antimicrobial therapy with oral fluoroquinolone or intravenous amoxicillin and beta-lactamase inhibitor are used as first-line antibiotherapy in SSc patients with osteitis.
Collapse
Affiliation(s)
- Cyril Cosse
- Service de Médecine Interne, Centre de Référence Maladies systémiques auto-immunes rares d'Ile de France, Hôpital Cochin, Université Paris Descartes, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Solen Kernéis
- Antimicrobial Stewardship Team, APHP, Cochin hospital, University of Paris, Paris, France
| | - Alain Lescoat
- Université Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000 Rennes, France; Department of Internal Medicine and Clinical Immunology, Rennes University Hospital, 35203, Rennes, France
| | - Gregory Pugnet
- Service de Médecine Interne, CHU Toulouse, Toulouse, France ; Centre d'Investigation Clinique 1436, CHU Toulouse, Toulouse, France
| | - Marie-Elise Truchetet
- Rheumatology department and national center of reference for rare autoimmune diseases, Bordeaux University Hospital, France
| | - Pascal Priollet
- Service de médecine vasculaire, Hôpital Saint Joseph, Paris, France
| | - Elisabeth Diot
- Service de médecine Interne, Hôpital Bretonneau, Tours Cedex, France
| | - Mickael Martin
- Service de Médecine Interne, Maladies Infectieuses et Tropicales, CHU de Poitiers, Poitiers, France
| | - François Maurier
- Centre de compétence des maladies rares, Hôpitaux privés de Metz, Metz, France
| | - Jean François Viallard
- Département de Médecine Interne et Maladies Infectieuses, Centre Hospitalier Universitaire Haut Lévêque, Université de Bordeaux, Pessac, France
| | - Christian Agard
- Service de médecine interne, Hôtel-Dieu, CHU Nantes, Hôpital, Université de Nantes, France
| | - Brigitte Granel
- Service de Médecine Interne, Hôpital Nord, Aix-Marseille Université, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | - Sabine Berthier
- Service de Médecine Interne et Immunologie Clinique, CHU F MITTERRAND, Dijon, France
| | - Dorothée Fagedet
- Service de Médecine Interne - CHICAS, hôpital de GAP, Paris, France
| | | | | | - David Luque Paz
- Service des Maladies Infectieuses et Réanimation Médicale, CHU Rennes, France, Rennes
| | - Cloé Giret
- Service de médecine Interne, Hôpital Bretonneau, Tours Cedex, France
| | - Olivier Cerles
- Service de Médecine Interne, Centre de Référence Maladies systémiques auto-immunes rares d'Ile de France, Hôpital Cochin, Université Paris Descartes, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Jérémie Dion
- Service de Médecine Interne, Centre de Référence Maladies systémiques auto-immunes rares d'Ile de France, Hôpital Cochin, Université Paris Descartes, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Christelle Nguyen
- Service de Rééducation et de Réadaptation de l'Appareil Locomoteur et des Pathologies du Rachis, Hôpitaux Universitaires Paris Centre-Groupe Hospitalier Cochin, Assistance Publique-Hôpitaux de Paris, 75014, Paris, France.,Université de Paris, Faculté de Santé, UFR Médecine Paris Descartes, Sorbonne Paris Cité, 75006, Paris, France.,INSERM UMRS 1124, Toxicité Environnementale, Cibles Thérapeutiques, Signalisation Cellulaire et Biomarqueurs, UFR Sciences Fondamentales et Biomédicales, Centre Universitaire des Saints-Pères, 75006, Paris, France
| | - Loïc Raffray
- Service Médecine Interne et Dermatologie, CHU Réunion- Hôpital Félix Guyon, Saint Denis, France
| | - Julien Bertolino
- Service de Médecine Interne, Hôpital Nord, Aix-Marseille Université, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | - Wendy Jourde
- Département de Médecine Interne et Maladies Infectieuses, Centre Hospitalier Universitaire Haut Lévêque, Université de Bordeaux, Pessac, France
| | - Claire Le Jeunne
- Service de Médecine Interne, Centre de Référence Maladies systémiques auto-immunes rares d'Ile de France, Hôpital Cochin, Université Paris Descartes, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Luc Mouthon
- Service de Médecine Interne, Centre de Référence Maladies systémiques auto-immunes rares d'Ile de France, Hôpital Cochin, Université Paris Descartes, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Benjamin Chaigne
- Service de Médecine Interne, Centre de Référence Maladies systémiques auto-immunes rares d'Ile de France, Hôpital Cochin, Université Paris Descartes, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| |
Collapse
|
6
|
Kawahara H, Nakashima A, Zoshima T, Kawano M. Contribution of HLA-DRB1 * 09: 01 allele to development of minocycline induced antineutrophil cytoplasmic antibody (ANCA)-associated cutaneous vasculitis: report of two cases. Mod Rheumatol Case Rep 2020; 4:267-271. [PMID: 33086995 DOI: 10.1080/24725625.2020.1738983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
We report two cases of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) that developed after long-term oral administration of minocycline and consider the contribution of human leukocyte antigen (HLA)-DRB 1 * 09: 01 allele to its development. Case 1; A 47-year-old man receiving minocycline for palmoplantar pustulosis for 24 months developed fever, arthralgia, and irregular livedo on the bilateral lower legs. Skin biopsy demonstrated vasculitis, while a blood test showed positivity of myeloperoxidase (MPO)-ANCA. Discontinuation of minocycline and oral administration of prednisolone relieved the symptoms promptly. Case 2; A 53-year-old woman developed reddish-brown livedo reticularis with tenderness on the bilateral lower legs after administration of minocycline to treat palmoplantar pustulosis for 24 months. Although skin biopsy did not demonstrate vasculitis, a blood test showed MPO-ANCA positivity. Cessation of minocycline resulted in rapid improvement of the cutaneous lesions and constitutional symptoms. We diagnosed both cases as having Drug-associated ANCA-associated Vasculitis (DAV) caused by minocycline according to the diagnostic criteria proposed by Cluver et al. Further examination revealed the presence of HLA-DRB1 * 09:01 allele in both cases. This allele has been implicated in the genetic background of idiopathic microscopic polyangiitis (MPA) in the Japanese population. Our finding suggests a relationship between the development of MPO-ANCA or DAV caused by minocycline and HLA-DRB1 * 09:01 allele, but will have to confirmed by further studies with larger numbers of patients.
Collapse
Affiliation(s)
- Hiroyuki Kawahara
- Division of Nephrology and Rheumatology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan
| | - Akikatsu Nakashima
- Division of Nephrology and Rheumatology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan
| | - Takeshi Zoshima
- Department of Rheumatology, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan
| | - Mitsuhiro Kawano
- Department of Rheumatology, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan
| |
Collapse
|
7
|
Ehrenfeld M, Tincani A, Andreoli L, Cattalini M, Greenbaum A, Kanduc D, Alijotas-Reig J, Zinserling V, Semenova N, Amital H, Shoenfeld Y. Covid-19 and autoimmunity. Autoimmun Rev 2020; 19:102597. [PMID: 32535093 PMCID: PMC7289100 DOI: 10.1016/j.autrev.2020.102597] [Citation(s) in RCA: 330] [Impact Index Per Article: 82.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 05/25/2020] [Indexed: 01/08/2023]
Affiliation(s)
- Michael Ehrenfeld
- The Zabludowicz Center for autoimmune diseases, Sheba Medical Center, Israel.
| | - Angela Tincani
- I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation, Sechenov University, Russia; U.O. Reumatologia e Immunologia Clinica, ASST-Spedali Civili di Brescia, Università degli Studi di Brescia, Italy
| | - Laura Andreoli
- U.O. Reumatologia e Immunologia Clinica, ASST-Spedali Civili di Brescia, Università degli Studi di Brescia, Italy
| | - Marco Cattalini
- Pediatrics Clinic, ASST Spedali Civili di Brescia, Brescia, Italy; Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Assaf Greenbaum
- The Hebrew University, Hadassah Medical School, Jerusalem, Israel
| | - Darja Kanduc
- Department of Biosciences, Biotechnologies, and Biopharmaceutics, University of Bari, Italy
| | - Jaume Alijotas-Reig
- Hospital Universitari Vall d'Hebron & Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Vsevolod Zinserling
- V.A. Almazov Research Center and S.P. Botkin infectious Hospital, Saint-Petersburg, Russia
| | - Natalia Semenova
- V.A. Almazov Research Center and S.P. Botkin infectious Hospital, Saint-Petersburg, Russia
| | - Howard Amital
- The Zabludowicz Center for autoimmune diseases, Sheba Medical Center, Israel; The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yehuda Shoenfeld
- The Zabludowicz Center for autoimmune diseases, Sheba Medical Center, Israel; The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation, Sechenov University, Russia
| |
Collapse
|
8
|
Gkoutzourelas A, Liaskos C, Simopoulou T, Katsiari C, Efthymiou G, Scheper T, Meyer W, Tsirogianni A, Tsigalou C, Dardiotis E, Daoussis D, Sakkas LI, Bogdanos DP. A study of antigen-specific anti-cytomegalovirus antibody reactivity in patients with systemic sclerosis and concomitant anti-Ro52 antibodies. Rheumatol Int 2020; 40:1689-1699. [DOI: 10.1007/s00296-020-04643-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Accepted: 07/03/2020] [Indexed: 12/18/2022]
|
9
|
Abstract
PURPOSE OF REVIEW To highlight recent findings on pathogenic mechanisms and clinical associations which characterize the role of infectious agents as triggers for Sjögren's syndrome development. RECENT FINDINGS Several candidate infectious agents have been identified to induce the autoimmune and inflammatory pathways leading to Sjögren's syndrome clinical appearance in the setting of a genetic background. This is reinforced by the demonstration that Sjögren's syndrome patients are characterized by higher prevalence of seropositivity to virus and bacterial agents in comparison with general population. Moreover, these agents may infect salivary gland epithelial cells. Stronger evidence confirmed the role of some viruses, like Epstein-Barr, as triggers of the disease and different mechanisms have been demonstrated to interplay. Recent experimental and clinical studies supported the adjunctive role of an altered buccal and intestinal microbial composition and chronic inflammatory response to Helicobacter pylori in disease induction. Finally, latent viral infections and immune system chronic stimulation induced by persistent infections may participate in disease lymphoproliferative evolution. SUMMARY Different viral and bacterial agents have been identified as triggers in Sjögren's syndrome induction and contributors to the chronic immune system stimulation underlying lymphoproliferative complication. Deeper knowledge of involved microbial agents and pathogenic mechanisms linking Sjögren's syndrome and infections may help the identification of preventive therapeutic strategy.
Collapse
|
10
|
Sjögren's Syndrome: Concerted Triggering of Sicca Conditions. J Immunol Res 2019; 2019:2075803. [PMID: 30723748 PMCID: PMC6339734 DOI: 10.1155/2019/2075803] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 09/22/2018] [Accepted: 09/30/2018] [Indexed: 12/24/2022] Open
Abstract
Aim The aim of this study was to evaluate the expression of persistence of mumps virus and some cells that interact with viral infection in the focus of the autoimmune epithelitis and peripheral blood of Sjögren's syndrome patients in comparison to patients with rheumatoid arthritis (RA) and nonautoimmune sicca syndrome (nSS). Materials and Methods 126 patients (119 women and 7 men) were grouped into four groups: (1) patients with primary Sjögren's syndrome (pSS), (2) patients with secondary Sjögren's syndrome due to rheumatoid arthritis (sSS), (3) patients with rheumatoid arthritis (RA), and (4) patients with nonautoimmune sicca syndrome (nSS). Immunohistochemical analysis of immune response to the suggested silent persistence of mumps virus in the minor labial salivary gland biopsies and flow cytometric analysis of blood cells was done. Results Immunohistochemical signs of mumps virus persistence were found in the minor salivary glands of all study groups. Also, a significantly different immune response to virus infection (protein IFI16, interferons gamma and beta, dendritic cells, and receptor for natural killers) was revealed in the minor salivary glands of the study groups. Cytometric analysis of the blood cells revealed a dropping amount of circulating natural killers and dendritic cells in patients with SS. Significant correlations between immunohistochemical staining and serological findings were revealed. Conclusions Abundant immunohistochemical signs of mumps virus protein in the salivary glands and depletion of circulating immune cells make a background for thought of presumable mumps or/and other virus participation in epithelial damage causing sicca syndrome in predisposed patients.
Collapse
|
11
|
Bogdanos DP, Sakkas LI. Enterococcus gallinarum as a component of the Autoinfectome: the gut-liver-autoimmune rheumatic disease axis is alive and kicking. Mediterr J Rheumatol 2018; 29:187-189. [PMID: 32185324 PMCID: PMC7045934 DOI: 10.31138/mjr.29.4.187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 12/02/2018] [Accepted: 12/14/2018] [Indexed: 12/12/2022] Open
Affiliation(s)
- Dimitrios P Bogdanos
- Department of Rheumatology and Clinical Immunology, University General Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, Greece
| | - Lazaros I Sakkas
- Department of Rheumatology and Clinical Immunology, University General Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, Greece
| |
Collapse
|
12
|
Kent ML, Tighe PJ, Belfer I, Brennan TJ, Bruehl S, Brummett CM, Buckenmaier CC, Buvanendran A, Cohen RI, Desjardins P, Edwards D, Fillingim R, Gewandter J, Gordon DB, Hurley RW, Kehlet H, Loeser JD, Mackey S, McLean SA, Polomano R, Rahman S, Raja S, Rowbotham M, Suresh S, Schachtel B, Schreiber K, Schumacher M, Stacey B, Stanos S, Todd K, Turk DC, Weisman SJ, Wu C, Carr DB, Dworkin RH, Terman G. The ACTTION-APS-AAPM Pain Taxonomy (AAAPT) Multidimensional Approach to Classifying Acute Pain Conditions. PAIN MEDICINE 2018; 18:947-958. [PMID: 28482098 PMCID: PMC5431381 DOI: 10.1093/pm/pnx019] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Objective With the increasing societal awareness of the prevalence and impact of acute pain, there is a need to develop an acute pain classification system that both reflects contemporary mechanistic insights and helps guide future research and treatment. Existing classifications of acute pain conditions are limiting, with a predominant focus on the sensory experience (e.g., pain intensity) and pharmacologic consumption. Consequently, there is a need to more broadly characterize and classify the multidimensional experience of acute pain. Setting Consensus report following expert panel involving the Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks (ACTTION), American Pain Society (APS), and American Academy of Pain Medicine (AAPM). Methods As a complement to a taxonomy recently developed for chronic pain, the ACTTION public-private partnership with the US Food and Drug Administration, the APS, and the AAPM convened a consensus meeting of experts to develop an acute pain taxonomy using prevailing evidence. Key issues pertaining to the distinct nature of acute pain are presented followed by the agreed-upon taxonomy. The ACTTION-APS-AAPM Acute Pain Taxonomy will include the following dimensions: 1) core criteria, 2) common features, 3) modulating factors, 4) impact/functional consequences, and 5) putative pathophysiologic pain mechanisms. Future efforts will consist of working groups utilizing this taxonomy to develop diagnostic criteria for a comprehensive set of acute pain conditions. Perspective The ACTTION-APS-AAPM Acute Pain Taxonomy (AAAPT) is a multidimensional acute pain classification system designed to classify acute pain along the following dimensions: 1) core criteria, 2) common features, 3) modulating factors, 4) impact/functional consequences, and 5) putative pathophysiologic pain mechanisms. Conclusions Significant numbers of patients still suffer from significant acute pain, despite the advent of modern multimodal analgesic strategies. Mismanaged acute pain has a broad societal impact as significant numbers of patients may progress to suffer from chronic pain. An acute pain taxonomy provides a much-needed standardization of clinical diagnostic criteria, which benefits clinical care, research, education, and public policy. For the purposes of the present taxonomy, acute pain is considered to last up to seven days, with prolongation to 30 days being common. The current understanding of acute pain mechanisms poorly differentiates between acute and chronic pain and is often insufficient to distinguish among many types of acute pain conditions. Given the usefulness of the AAPT multidimensional framework, the AAAPT undertook a similar approach to organizing various acute pain conditions.
Collapse
Affiliation(s)
- Michael L Kent
- Department of Anesthesiology, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
| | - Patrick J Tighe
- Department of Anesthesiology, College of Medicine, University of Florida, Gainesville, Florida, FL, USA
| | - Inna Belfer
- Food and Drug Administration, Center for Drug Evaluation and Research, Silver Spring, MD, USA
| | - Timothy J Brennan
- Department of Anesthesiology, University of Iowa, Iowa City, Iowa, IA, USA
| | - Stephen Bruehl
- Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee, TN, USA
| | - Chad M Brummett
- Department of Anesthesiology, University of Michigan Health System, Ann Arbor, Michigan, USA
| | - Chester C Buckenmaier
- Defense and Veteran's Center for Integrative Pain Management, Uniformed Services University, Bethesda, Maryland, USA
| | - Asokumar Buvanendran
- Department of Anesthesiology, Rush University Medical Center, Chicago, Illinois, USA
| | - Robert I Cohen
- Department of Anesthesiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | | | - David Edwards
- Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee, TN, USA
| | - Roger Fillingim
- Community Dentistry and Behavioral Science, University of Florida, Gainesville, Florida, USA
| | - Jennifer Gewandter
- Department of Anesthesiology, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | - Debra B Gordon
- Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, USA
| | - Robert W Hurley
- Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Henrik Kehlet
- Section of Surgical Pathophysiology, Rigshospitalet, Copenhagen University, Copenhagen, Denmark
| | - John D Loeser
- Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, USA.,Neurological Surgery, University of Washington, Seattle, Washington, USA
| | - Sean Mackey
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Palo Alto, California, USA
| | - Samuel A McLean
- Departments of Anesthesiology and Emergency Medicine, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Rosemary Polomano
- Department of Biobehavioral Sciences, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
| | - Siamak Rahman
- Department of Anesthesiology, University of California, Los Angeles, California, USA
| | - Srinivasa Raja
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Michael Rowbotham
- Department of Anesthesia and Perioperative Care, University of California, San Francisco, San Francisco, California, USA
| | - Santhanam Suresh
- Department of Anesthesiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Bernard Schachtel
- Yale School of Public Health, New Haven, Connecticut, USA.,Schachtel Associates, Inc., Jupiter, Florida, USA
| | - Kristin Schreiber
- Department of Anesthesiology and Pain Management, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Mark Schumacher
- Department of Anesthesia and Perioperative Care, University of California, San Francisco, San Francisco, California, USA
| | - Brett Stacey
- Center for Pain Relief, University of Washington Medical Center, Seattle, Washington, USA
| | - Steven Stanos
- Swedish Pain Services, Swedish Health System, Seattle, Washington, USA
| | - Knox Todd
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Dennis C Turk
- Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, USA
| | - Steven J Weisman
- Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.,Children's Hospital of Wisconsin, Milwaukee, Wisconsin, USA
| | - Christopher Wu
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Daniel B Carr
- Department of Anesthesiology, Tufts University School of Medicine, Boston, Massachusetts, USA
| | - Robert H Dworkin
- School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, New York, USA
| | - Gregory Terman
- Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, USA
| |
Collapse
|
13
|
The ACTTION-APS-AAPM Pain Taxonomy (AAAPT) Multidimensional Approach to Classifying Acute Pain Conditions. THE JOURNAL OF PAIN 2018; 18:479-489. [PMID: 28495013 DOI: 10.1016/j.jpain.2017.02.421] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE With the increasing societal awareness of the prevalence and impact of acute pain, there is a need to develop an acute pain classification system that both reflects contemporary mechanistic insights and helps guide future research and treatment. Existing classifications of acute pain conditions are limiting, with a predominant focus on the sensory experience (eg, pain intensity) and pharmacologic consumption. Consequently, there is a need to more broadly characterize and classify the multidimensional experience of acute pain. SETTING Consensus report following expert panel involving the Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks (ACTTION), American Pain Society (APS), and American Academy of Pain Medicine (AAPM). METHODS As a complement to a taxonomy recently developed for chronic pain, the ACTTION public-private partnership with the US Food and Drug Administration, the APS, and the AAPM convened a consensus meeting of experts to develop an acute pain taxonomy using prevailing evidence. Key issues pertaining to the distinct nature of acute pain are presented followed by the agreed-upon taxonomy. The ACTTION-APS-AAPM Acute Pain Taxonomy will include the following dimensions: 1) core criteria, 2) common features, 3) modulating factors, 4) impact/functional consequences, and 5) putative pathophysiologic pain mechanisms. Future efforts will consist of working groups utilizing this taxonomy to develop diagnostic criteria for a comprehensive set of acute pain conditions. PERSPECTIVE The ACTTION-APS-AAPM Acute Pain Taxonomy (AAAPT) is a multidimensional acute pain classification system designed to classify acute pain along the following dimensions: 1) core criteria, 2) common features, 3) modulating factors, 4) impact/functional consequences, and 5) putative pathophysiologic pain mechanisms. CONCLUSIONS Significant numbers of patients still suffer from significant acute pain, despite the advent of modern multimodal analgesic strategies. Mismanaged acute pain has a broad societal impact as significant numbers of patients may progress to suffer from chronic pain. An acute pain taxonomy provides a much-needed standardization of clinical diagnostic criteria, which benefits clinical care, research, education, and public policy. For the purposes of the present taxonomy, acute pain is considered to last up to seven days, with prolongation to 30 days being common. The current understanding of acute pain mechanisms poorly differentiates between acute and chronic pain and is often insufficient to distinguish among many types of acute pain conditions. Given the usefulness of the AAPT multidimensional framework, the AAAPT undertook a similar approach to organizing various acute pain conditions.
Collapse
|
14
|
Fiore M, Leone S, Maraolo AE, Berti E, Damiani G. Liver Illness and Psoriatic Patients. BIOMED RESEARCH INTERNATIONAL 2018; 2018:3140983. [PMID: 29546055 PMCID: PMC5818942 DOI: 10.1155/2018/3140983] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 10/30/2017] [Accepted: 01/04/2018] [Indexed: 12/12/2022]
Abstract
Psoriasis is a chronic inflammatory disease of the skin affecting approximately 2% of the world's population. Systemic treatments, including methotrexate and cyclosporin, are associated with potential hepatotoxicity, due to either direct liver damage or immunosuppression or both immunomediated and a direct liver injury; therefore, treatment of patients with psoriasis poses a therapeutic challenge. The aim of this minireview is to help clinicians in the management of psoriatic patients who develop signs of liver dysfunction. To find relevant articles, a comprehensive search was performed on PubMed, EMBASE, and Cochrane with appropriate combinations of the following keywords being considered: viral hepatitis, nonalcoholic fatty liver disease, psoriasis, hepatotoxicity, drug toxicity, cholestasis, and autoimmune liver diseases.
Collapse
Affiliation(s)
- Marco Fiore
- Department of Anaesthesiological, Surgical and Emergency Sciences, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Sebastiano Leone
- Department of Medicine, Division of Infectious Diseases, “San Giuseppe Moscati” Hospital, Avellino, Italy
| | - Alberto Enrico Maraolo
- Department of Clinical Medicine and Surgery, Section of Infectious Diseases, University of Naples Federico II, Naples, Italy
| | - Emilio Berti
- Department of Pathophysiology and Transplantation, Dermatology Unit, IRCCS Ca' Granda, University of Milan, Milan, Italy
| | - Giovanni Damiani
- Department of Pathophysiology and Transplantation, Dermatology Unit, IRCCS Ca' Granda, University of Milan, Milan, Italy
- Study Center of Young Dermatologists Italian Network (YDIN), Bergamo, Italy
| |
Collapse
|
15
|
Takeno M, Kitagawa S, Yamanaka J, Teramoto M, Tomita H, Shirai N, Itoh S, Hida S, Hayakawa K, Onozaki K, Takii T. 5-Hydroxy-2-methylpyridine Isolated from Cigarette Smoke Condensate Aggravates Collagen-Induced Arthritis in Mice. Biol Pharm Bull 2018; 41:877-884. [PMID: 29863076 DOI: 10.1248/bpb.b17-00982] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The risk of rheumatoid arthritis (RA) is linked to environmental and genetic factors. Cigarette smoking is an established environmental risk factor for the disease that contributes to its development and severity. Previously, we found that cigarette smoke condensate (CSC), both mainstream and sidestream, aggravates collagen type II-induced arthritis (CIA), which was observed following either intraperitoneal inoculation or nasal exposure. In the present study, we aimed to identify the compound in CSC, which aggravates CIA. By sequential fractionation and analysis, extraction with water/ether in different pH values, silica gel column chromatography, TLC, octadecyl silica (ODS) HPLC, GC/MS, and NMR, the active compound was identified as 5-hydroxy-2-methylpyridine (5H2MP). Its isomer 2-hydroxy-3-methylpyridine, but not 3-hydroxy-2-methylpyridine, was also active. 5H2MP was not mutagenic, and did not exhibit aryl hydrocarbon receptor-dependent activity. Our data help clarify the mechanism underlying the pathogenic effects of cigarette smoking on RA.
Collapse
Affiliation(s)
- Masafumi Takeno
- Department of Hygienic Chemistry, Graduated School of Pharmaceutical Sciences, Nagoya City University
| | - Shinya Kitagawa
- Department of Life Science and Applied Chemistry, Graduate School of Engineering, Nagoya Institute of Technology
| | - Junpei Yamanaka
- Department of Physical Chemistry of Colloid and Polymer, Graduated School of Pharmaceutical Sciences, Nagoya City University
| | - Mayumi Teramoto
- Department of Hygienic Chemistry, Graduated School of Pharmaceutical Sciences, Nagoya City University
| | - Haruka Tomita
- Department of Hygienic Chemistry, Graduated School of Pharmaceutical Sciences, Nagoya City University
| | - Naohiro Shirai
- Department of Synthetic Supramolecular Chemistry, Graduated School of Pharmaceutical Sciences, Nagoya City University
| | - Saotomo Itoh
- Department of Hygienic Chemistry, Graduated School of Pharmaceutical Sciences, Nagoya City University
| | - Shigeaki Hida
- Department of Hygienic Chemistry, Graduated School of Pharmaceutical Sciences, Nagoya City University
| | - Kazuichi Hayakawa
- Institute of Nature and Environmental Technology, Kanazawa University
| | - Kikuo Onozaki
- Department of Hygienic Chemistry, Graduated School of Pharmaceutical Sciences, Nagoya City University
| | - Takemasa Takii
- Department of Hygienic Chemistry, Graduated School of Pharmaceutical Sciences, Nagoya City University
- Department of Mycobacterium Reference & Research, the Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association
| |
Collapse
|
16
|
López-Mato P, Zamora-Martínez C, Carbajal S, Estevez M, Rodriguez-Pinto I, Cervera R, Prieto-González S, Espinosa G. All that glitters is not lupus. Lupus 2017; 27:1047-1048. [PMID: 29153011 DOI: 10.1177/0961203317742713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- P López-Mato
- Department of Autoimmune Diseases, 16493 Hospital Clinic, Barcelona , Spain
| | - C Zamora-Martínez
- Department of Autoimmune Diseases, 16493 Hospital Clinic, Barcelona , Spain
| | - S Carbajal
- Department of Autoimmune Diseases, 16493 Hospital Clinic, Barcelona , Spain
| | - M Estevez
- Department of Autoimmune Diseases, 16493 Hospital Clinic, Barcelona , Spain
| | - I Rodriguez-Pinto
- Department of Autoimmune Diseases, 16493 Hospital Clinic, Barcelona , Spain
| | - R Cervera
- Department of Autoimmune Diseases, 16493 Hospital Clinic, Barcelona , Spain
| | - S Prieto-González
- Department of Autoimmune Diseases, 16493 Hospital Clinic, Barcelona , Spain
| | - G Espinosa
- Department of Autoimmune Diseases, 16493 Hospital Clinic, Barcelona , Spain
| |
Collapse
|
17
|
Peñafiel-Sam J, Alarcón-Guevara S, Chang-Cabanillas S, Perez-Medina W, Mendo-Urbina F, Ordaya-Espinoza E. Infective endocarditis due to Bartonella bacilliformis associated with systemic vasculitis: a case report. Rev Soc Bras Med Trop 2017; 50:706-708. [DOI: 10.1590/0037-8682-0042-2017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Accepted: 05/05/2017] [Indexed: 11/22/2022] Open
Affiliation(s)
| | | | | | | | - Fernando Mendo-Urbina
- Universidad Peruana de Ciencias Aplicadas, Peru; Hospital Nacional Edgardo Rebagliati Martins, Perú
| | | |
Collapse
|
18
|
Lerner A, Arleevskaya M, Schmiedl A, Matthias T. Microbes and Viruses Are Bugging the Gut in Celiac Disease. Are They Friends or Foes? Front Microbiol 2017; 8:1392. [PMID: 28824555 PMCID: PMC5539691 DOI: 10.3389/fmicb.2017.01392] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 07/10/2017] [Indexed: 12/17/2022] Open
Abstract
The links between microorganisms/viruses and autoimmunity are complex and multidirectional. A huge number of studies demonstrated the triggering impact of microbes and viruses as the major environmental factors on the autoimmune and inflammatory diseases. However, growing evidences suggest that infectious agents can also play a protective role or even abrogate these processes. This protective crosstalk between microbes/viruses and us might represent a mutual beneficial equilibrium relationship between two cohabiting ecosystems. The protective pathways might involve post-translational modification of proteins, decreased intestinal permeability, Th1 to Th2 immune shift, induction of apoptosis, auto-aggressive cells relocation from the target organ, immunosuppressive extracellular vesicles and down regulation of auto-reactive cells by the microbial derived proteins. Our analysis demonstrates that the interaction of the microorganisms/viruses and celiac disease (CD) is always a set of multidirectional processes. A deeper inquiry into the CD interplay with Herpes viruses and Helicobacter pylori demonstrates that the role of these infections, suggested to be potential CD protectors, is not as controversial as for the other infectious agents. The outcome of these interactions might be due to a balance between these multidirectional processes.
Collapse
Affiliation(s)
- Aaron Lerner
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion Israel Institute of TechnologyHaifa, Israel.,Department of Research, AESKU.KIPP InstituteWendelsheim, Germany
| | - Marina Arleevskaya
- Central Research Laboratory, Kazan State Medical Academy KazanKazan, Russia
| | - Andreas Schmiedl
- Department of Research, AESKU.KIPP InstituteWendelsheim, Germany
| | - Torsten Matthias
- Department of Research, AESKU.KIPP InstituteWendelsheim, Germany
| |
Collapse
|
19
|
|