Infection, vaccines and other environmental triggers of autoimmunity
Infection, vaccines and other environmental triggers of autoimmunity
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DOI：
10.1080/08916930500050277
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发表时间：
2005-05-01
期刊：
影响因子：
3.5
通讯作者：
Shoenfeld, Y
中科院分区：
文献类型：
--
作者：
Molina, V;Shoenfeld, Y
自身免疫性疾病的病因尚不清楚，但遗传、免疫、激素和环境因素被认为是重要的触发因素。大多数情况下，自身免疫性疾病不会出现临床症状，除非有额外的事件，如环境因素有利于明显的表达。已知许多环境因素会影响免疫系统，并可能作为自身免疫嵌合体的触发因素发挥作用。感染：已知细菌、病毒和寄生虫感染主要通过分子模拟机制诱发和加重自身免疫性疾病。这是研究了一些综合征之间的联系，如SLE和EBV感染，儿童自身免疫性神经精神疾病与链球菌感染等。在几份报告中，发现疫苗在时间上随后发生新的自身免疫性疾病。在宿主的感染性入侵中起作用的相同机制同样适用于宿主对疫苗接种的反应。它已被接受用于白喉和破伤风类毒素、脊髓灰质炎和麻疹疫苗以及GBS。这一理论也被接受为MMR疫苗接种和自身免疫性血小板减少症的发展，MS与HBV疫苗接种有关。职业和其他化学暴露被认为是自身免疫的触发因素。硅胶植入物在诱导硬皮病样疾病中的作用仍存在争议，不仅外来化学品和试剂与诱导自身免疫有关，而且与内源性激素暴露（如雌激素）有关。这可能解释了自身免疫性的性别二态性。更好地了解这些环境危险因素可能会解释自身免疫性疾病的发病和进展机制，并可能导致对特定高危人群的有效预防干预。因此，通过诊断新的自身免疫性疾病患者，应该做广泛的既往工作。
The etiology of autoimmune diseases is still not clear but genetic, immunological, hormonal and environmental factors are considered to be important triggers. Most often autoimmunity is not followed by clinical symptoms unless an additional event such as an environmental factor favors an overt expression.Many environmental factors are known to affect the immune system and may play a role as triggers of the autoimmune mosaic. Infections: bacterial, viral and parasitic infections are known to induce and exacerbate autoimmune diseases, mainly by the mechanism of molecular mimicry. This was studied for some syndromes as for the association between SLE and EBV infection, pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection and more. Vaccines, in several reports were found to be temporally followed by a new onset of autoimmune diseases. The same mechanisms that act in infectious invasion of the host, apply equally to the host response to vaccination. It has been accepted for diphtheria and tetanus toxoid, polio and measles vaccines and GBS. Also this theory has been accepted for MMR vaccination and development of autoimmune thrombocytopenia, MS has been associated with HBV vaccination.Occupational and other chemical exposures are considered as triggers for autoimmunity. A debate still exists about the role of silicone implants in induction of scleroderma like disease.Not only foreign chemicals and agents have been associated with induction of autoimmunity but also an intrinsic hormonal exposure, such as estrogens. This might explain the sexual dimorphism in autoimmunity.Better understanding of these enviromnental risk factors will likely lead to explanation of the mechanisms of onset and progression of autoimmune diseases and may lead to effective preventive involvement in specific high-risk groups.So by diagnosing a new patient with autoimmune disease a wide anamnesis work should be done.