Role of infectious agents in systemic rheumatic diseases

Howard Amital, Marcello Govoni, Ram Maya, Pier Luigi Meroni, Barzilai Ori, Yehuda Shoenfeld, Angela Tincani, Francesco Trotta, Piercarlo Sarzi-Puttini, Fabiola Atzeni

Research output: Contribution to journalArticle

70 Citations (Scopus)

Abstract

The relationship between infection and autoimmunity has been increasingly defined over the last twenty years or so. It is now quite clear that, in genetically susceptible individuals, environmental factors (mainly infections) play a critical role in the pathogenesis of autoimmune diseases. It is believed that infections contribute to the maturation of the immune system from the innate to adoptive phases, and that bacterial and viral infections are arthritogenic stimulants leading to various rheumatic conditions. A failure to isolate these microorganisms is probably due to the action of the immune system, but often casts doubt on their role in the pathogenesis of autoimmune diseases. Among bacteria, Helicobacter pylori has been associated with diseases such as autoimmune gastritis, Sjögren's syndrome, atherosclerosis, immune thrombocytopenia purpura, inflammatory bowel diseases and autoimmune pancreatitis, in each of which it seems to play a pathogenatic, but it has also been suggested that it may help to protect against the development of autoimmune gastritis, multiple sclerosis, systemic lupus erythemathosus and inflammatory bowel diseases. Infectious agents may play a dual role in the etiopathogenesis of antiphospholipid syndrome (APS): they may be the initial trigger of the production of antibodies cross-reacting with beta 2 glycoprotein I (β2GPI) and infectious peptides, and also induce an inflammatory response. According to the two-hit theory, pathogenetic anti-β2GPI antibodies act as the first hit whereas inflammatory responses may represent the second hit The slowly growing Propionibacterium acnes may be involved in the etiopathogenesis of SAPHO syndrome by triggering the non-specific activation of cell-mediated immunity. Its ability to persist in bone lesions in a form that is incompatible with culturing suggests the possibility an arthritis that is secondary to a "persistent" infection.

Original languageEnglish
JournalClinical and Experimental Rheumatology
Volume26
Issue number1 SUPPL. 48
Publication statusPublished - 2008

Fingerprint

Rheumatic Diseases
Gastritis
Infection
Inflammatory Bowel Diseases
Autoimmune Diseases
Immune System
Acquired Hyperostosis Syndrome
beta 2-Glycoprotein I
Propionibacterium acnes
Purpura
Idiopathic Thrombocytopenic Purpura
Antiphospholipid Syndrome
Virus Diseases
Autoimmunity
Bacterial Infections
Helicobacter pylori
Cellular Immunity
Pancreatitis
Multiple Sclerosis
Arthritis

Keywords

  • Antiphospholipid syndrome
  • H. pylori
  • Infections
  • Rheumatoid arthritis
  • SAPHO syndrome

ASJC Scopus subject areas

  • Rheumatology
  • Immunology

Cite this

Amital, H., Govoni, M., Maya, R., Meroni, P. L., Ori, B., Shoenfeld, Y., ... Atzeni, F. (2008). Role of infectious agents in systemic rheumatic diseases. Clinical and Experimental Rheumatology, 26(1 SUPPL. 48).

Role of infectious agents in systemic rheumatic diseases. / Amital, Howard; Govoni, Marcello; Maya, Ram; Meroni, Pier Luigi; Ori, Barzilai; Shoenfeld, Yehuda; Tincani, Angela; Trotta, Francesco; Sarzi-Puttini, Piercarlo; Atzeni, Fabiola.

In: Clinical and Experimental Rheumatology, Vol. 26, No. 1 SUPPL. 48, 2008.

Research output: Contribution to journalArticle

Amital, H, Govoni, M, Maya, R, Meroni, PL, Ori, B, Shoenfeld, Y, Tincani, A, Trotta, F, Sarzi-Puttini, P & Atzeni, F 2008, 'Role of infectious agents in systemic rheumatic diseases', Clinical and Experimental Rheumatology, vol. 26, no. 1 SUPPL. 48.
Amital H, Govoni M, Maya R, Meroni PL, Ori B, Shoenfeld Y et al. Role of infectious agents in systemic rheumatic diseases. Clinical and Experimental Rheumatology. 2008;26(1 SUPPL. 48).
Amital, Howard ; Govoni, Marcello ; Maya, Ram ; Meroni, Pier Luigi ; Ori, Barzilai ; Shoenfeld, Yehuda ; Tincani, Angela ; Trotta, Francesco ; Sarzi-Puttini, Piercarlo ; Atzeni, Fabiola. / Role of infectious agents in systemic rheumatic diseases. In: Clinical and Experimental Rheumatology. 2008 ; Vol. 26, No. 1 SUPPL. 48.
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