Infectious Serologies and Autoantibodies in Wegener's Granulomatosis and Other Vasculitides

Abstract

In this study we assess the presence of antibodies against infectious agents as well as for a variety of autoantibodies in an attempt to establish associations between various vasculitides and infections in order to shed light on the etiopathogenesis of these diseases and perhaps implicate a potential cure. Sera from patients with Wegener's granulomatosis (WG), polyarteritis nodosa, microscopic polyangiitis, Churg Strauss, and giant cell arteritis were compared to healthy control sera. Serum samples were assessed, using the Bio-Rad BioPlex 2200, for the presence of Toxoplama gondii, cytomegalovirus (CMV), Epstein-Barr virus (EBV), Treponema pallidum, and Saccharomyces cerevisiae. Hepatitis B virus (HBV), hepatitis C virus (HCV), and anti-Helicobacter pylori antibodies were assessed by ELISA. In addition, sera were tested for a panel of antibodies associated with thrombophilia as well as various autoantibodies. The prevalence of antibodies toward HCV and H. pylori was significantly higher among patients with WG. IgG antibodies toward T. gondii and IgM antibodies toward CMV were significantly more common among WG patients than among controls. WG patients exhibited more antibodies toward EBV viral capsid antigen IgG and EBV early antigen IgG compared to sera from healthy controls. In WG, positive associations were disclosed between CMV IgG antibodies and the presence of gastrointestinal manifestations and renal involvement, and there was a higher Birmingham vasculitis activity score in association with elevated titers of EBV viral capsid antigen IgG antibodies. Otorhinolaryngeal manifestations were more common in those with positive IgG antibodies for EBV early antigen. Our results unveil novel associations between WG and various infectious agents, including HCV, H. pylori, T. gondii, CMV, and EBV. In addition to putative roles in initiation and exacerbation of the vasculitic process, it seems that these infectious agents also modulate the clinical phenotype of the disease.

Infections and autoimmunity – friends or foes?

“…In recent years, the compound interplay between infections and autoimmunity has been studied extensively. Here, we summarize the current literature and preliminary results from our international study on this issue [4][5][6][7][8][9][10][11][12][13] (Figure 1). The versatile interactions of ADs with different infectious agents, the burden of infections from childhood to adulthood, immune and genetic mechanisms, and the possibility that infections also confer protection from autoimmunity are also discussed (Box 1).…”

CMV and transfusions, an old story that's not quite over yet

“…These include post-SOT type I (autoimmune) diabetes mellitus, cryoglobulinemia, antiphospholipid antibodies, scleroderma, systemic lupus erythematosus, and cytoplasmic antineutrophil cytoplasmic antibodies-positive vasculitis. [64][65][66][67] Significantly, some of these autoimmune conditions have improved with anti-CMV treatment. 68 How CMV induces autoimmune phenomena is imperfectly understood.…”

Advantages of Multiplex Proteomics in Clinical Immunology

“…Wegener's granulomatosis (WG) in patients is suspected tied to the presence of nasal Staphylococcus aureus, with increased risk of relapse being reduced by applied antibiotics [87]. It is important to consider increasing susceptibility of a patient with autoimmune disease to pathogen infection resulting from immunosuppressive treatment and also immune dysregulation.…”