Activation of autoimmunity following use of immunostimulatory herbal supplements
Activation of autoimmunity following use of immunostimulatory herbal supplements
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DOI：
10.1001/archderm.140.6.723
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发表时间：
2004-06-01
影响因子：
--
通讯作者：
Werth, VP
中科院分区：
文献类型：
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作者：
Lee, AN;Werth, VP
背景：关于草药补充剂的治疗效果和副作用的科学依据的证据在不断增加。许多草药补充剂被吹捧其免疫刺激特性，体外和体内实验都支持这一说法。虽然这解释了它们在预防或减少疾病方面的有益作用，但据我们所知，没有免疫刺激性草药补充剂会加剧免疫系统过度活跃的疾病。观察：我们描述了3例自身免疫性疾病的发病和/或发作与摄入已证实具有免疫刺激作用的草药补充剂相关的患者。两名寻常型天疱疮患者的发作与紫锥菊和藻螺旋藻有关，第三名患者在皮肌炎发作和严重发作前几天摄入了含有藻螺旋藻和水藻的补充剂。第三例患者显示肿瘤坏死因子α (tnf - α)启动子多态性（-308A）的杂合性，导致tnf - α的产生增加，这可能使她易患皮肌炎。结论：免疫刺激性草药补充剂可能会加重先前存在的自身免疫性疾病，或在遗传上易患此类疾病的人群中引发自身免疫性疾病。虽然需要更多的研究来阐明这种现象的机制，但增加的tnf - α的产生可能起作用。
Background: Evidence for the scientific basis of purported therapeutic effects and adverse effects of herbal supplements continues to grow. Many herbal supplements are touted for their immunostimulatory properties, and both in vitro and in vivo experiments have supported this claim. Although this explains their beneficial effects in preventing or curtailing disease, to our knowledge, no immunostimulatory herbal supplements have been reported to exacerbate disorders of immune system overactivity.Observations: We describe 3 patients whose autoimmune disease onset and/or flares correlated with ingestion of herbal supplements with proven immunostimulatory effects. Echinacea and the alga Spirulina platensis are implicated in 2 patients' flares of pemphigus vulgaris, and a supplement containing the algae Spirulina platensis and Aphanizomenon flos-aquae was ingested by a third patient days before both onset and a severe flare of dermatomyositis. The third patient showed heterozygosity for a tumor necrosis factor alpha (TNF-alpha) promoter polymorphism (-308A), leading to increased production of TNF-alpha, which may have predisposed her to developing dermatomyositis.Conclusions: Immunostimulatory herbal supplements may exacerbate preexisting autoimmune disease or precipitate autoimmune disease in persons genetically predisposed to such disorders. Increased production of TNF-alpha may play a role, although more research is needed to clarify the mechanisms of such phenomena.