RESEARCH - The curiously suspicious: infectious disease may ameliorate an ongoing autoimmune destruction in SLE patients

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J Autoimmun. 2007 Dec 22 [Epub ahead of print]

The curiously suspicious: Infectious disease may ameliorate an ongoing

autoimmune destruction in systemic lupus erythematosus patients.

Praprotnik S, Sodin-Semrl S, Tomsic M, Shoenfeld Y.

University Medical Centre, Division of Internal Medicine, Department of

Rheumatology, Vodnikova 62, SI-1000 Ljubljana, Slovenia.

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease, which

can arise from a combination of genetic and environmental factors. In the

past, infections (Epstein Barr virus, parvovirus B-19) have been indicated

to play a causative role in the development of autoimmune diseases, such as

SLE. On the other hand, with the emergence of the " hygiene hypothesis "

infections have also shown to play a protective role in autoimmune diseases.

Two case studies are presented which provide clinical evidence of SLE

patients with severe, long-term disease, despite immunosuppresive therapy.

The course of both diseases changed remarkably after they experienced

infections with multiple microbes (bacterial, viral and fungal).

Surprisingly, their clinical and laboratory signs of SLE normalized and they

are now symptom-free after 5 and 3year follow-ups. The second patient has

even had a normal pregnancy, which was a trigger factor for disease flare in

the past. The infections presumably changed the host immune systems and the

mechanisms of their protective effects are most likely multifactorial. Our

cases illustrate that infections could be beneficial in SLE patients and

re-directing research toward novel innate-based SLE therapy should be

explored.

PMID: 18158235

http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve & db=PubMed & list_uids=18

158235

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