Autoimmunity induced by human cytomegalovirus in patients with systemic lupus erythematosus

Cecilia Söderberg-Nauclér

doi:10.1186/ar3525

Abstract

Human cytomegalovirus is a common herpesvirus that is linked to autoimmunity, especially in genetically predisposed persons. The article by Hsieh and colleagues in a previous issue of Arthritis Research & Therapy suggests that a C-terminal peptide of the human cytomegalovirus protein pp65 is highly immunogenic in patients with systemic lupus erythematosus and that antibodies against this peptide cross-react with nuclear proteins and double-stranded DNA, which are highly frequent autoantibodies in systemic lupus erythematosus patients. These observations highlight the fact that immunization with one small cytomegalovirus-specific peptide results in multiple autoreactive antibodies, probably through molecular mimicry and epitope spreading, in genetically predisposed persons.

Highlights

In healthy people, a primary infection with human cytomegalovirus (HCMV) is often mild or even asymptomatic, but may cause a mononucleosis-like syndrome with fever, arthralgia, fatigue, thrombocytopenia, and anemia
Active HCMV infections are frequent in patients with systemic lupus erythematosus (SLE), and the virus has been implicated in both development and progression of the disease
Cytomegalovirus RNA has been detected in endothelial cells in skin biopsies from patients with autoimmune sclerosis, and HCMV infection is associated with higher disease activity scores in SLE patients [2]

Summary

Introduction

A primary infection with human cytomegalovirus (HCMV) is often mild or even asymptomatic, but may cause a mononucleosis-like syndrome with fever, arthralgia, fatigue, thrombocytopenia, and anemia. Even though the virus may not trigger autoimmune disease, it may be reactivated by an initial inflammatory insult and thereafter sustain and exacerbate inflammatory processes by producing type I cytokines and by specific mechanisms that induce inflammation and autoimmune reactions. Suggests that HCMV proteins are common in tissues affected by autoimmunity and that both molecular mimicry and viral antigens may sustain immune reactions.

Results

Conclusion