THE VIRAL AUTOIMMUNITY RELATIONSHIP
THE VIRAL AUTOIMMUNITY RELATIONSHIP
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DOI：
10.1089/vim.1995.8.1
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发表时间：
1995-01-01
期刊：
影响因子：
2.2
通讯作者：
SHOENFELD, Y
中科院分区：
文献类型：
--
作者：
COHEN, AD;SHOENFELD, Y
病毒一直被认为是自身免疫性疾病的病因学候选者。大量的间接数据支持病毒引起自身免疫性疾病的假设，但在大多数情况下，仍然缺乏令人信服的直接证据。新发现的病毒不断增加关于未知病因疾病的信息（6，48，55）[例如，丙型肝炎病毒可能与原发性混合型冷球蛋白血症有关（24），最近的报告表明逆转录病毒在干燥综合征中可能起作用，如Fox（30），Kalden和Gay（45），Garry（33）和Talal等人（73）所述]。病毒感染和自身免疫性疾病之间因果关系的证明，最好是在病因和后果之间存在时间相关性时，特别是当疾病是其可归因效应物所特有时。然而，大多数疾病并不是唯一的，并且旨在确定病毒感染作为某些实体的原因的回顾性分析需要相当大的统计功效。病毒感染和自身免疫之间的关系是复杂的。自身免疫性疾病是由某种病毒引发的，它涉及免疫反应的深刻变化，这使得确认其病毒病因成为一项复杂的任务。更令人困惑的是，一种综合征可能由一种以上的感染因子引起，一种病毒可能涉及一种以上疾病的病理生理学。有人认为，病毒可能会引发自身免疫性疾病，然后消失（“打了就跑理论”）;此外，潜伏或持续的病毒感染有时极难证明。
Viruseshave long been considered candidates in the etiology of autoimmune disorders. A substantial body of indirect data supports the hypothesis that viruses cause autoimmune disorders, but in most instances, convincing direct evidence is still lacking. Newly discovered viruses continually add information regarding diseases of unknown etiology (6, 48, 55)[eg, hepatitis C virus was potentially linked to essential mixed cryoglobulinemia (24) and recent reports suggested the possible role of retroviruses in Sjögren's syndrome, as was reviewed by Fox (30), Kalden and Gay (45), Garry (33), and Talal et al (73)]. Demonstration of a casual relationship between a viral infection and autoimmune disorder is best obtained when there is a temporal correlation between the cause and its consequence, in particular when the disorder is unique to its attributable effector. However, most disorders are not unique, and retrospective analyses aimed to identify a viral infection as the cause of certain entity require considerable statistical power.The relationship between viral infection and autoimmunity is complex. Autoimmune disease that suppos-edly had been triggered by a certain viral agent involve profound changes in the immune response, making it a complex task to affirm its viral causation. Making it even more puzzling is the fact that one syndrome may be caused by more than one infectious agent, and that one virus may be involved in the pathophysiol-ogy of more than one disorder. It was suggested that viruses might trigger an autoimmune disease and then vanish (" hit and run theory"); in addition, latent or persistent viral infection is sometimes extremely diffi-cult to demonstrate.