The Role of Infections in the Immunopathogensis of Systemic Sclerosis–Evidence from Serological Studies

Abstract

Infections are believed to often play a role in the immunopathogenesis of autoimmune disorders; such is the case in systemic sclerosis (SSc). In order to evaluate the potential role infections may have on the pathogenesis of SSc, we assessed serological reactivity against various infectious agents in patients with SSc and compared them with healthy controls. Serological samples obtained from 80 patients with SSc were compared with 296 compatible healthy controls. Both groups were of European origin. All samples were tested for the presence of antibodies directed against hepatitis B virus, hepatitis C virus, toxoplasmosis, rubella, CMV, EBV, and Treponema pallidum. We applied Bio-Rad commercial and experimental kits to assess most antigens and ELISA assays to complete the panel. Patients with SSc had elevated IgM and IgG against Toxoplasma gondii and against CMV. Higher titers were also detected against the hepatitis B virus core protein (recombinant HBc antigen) using MONOLISA anti-HBc Plus commercial kit (Bio-Rad). A significantly higher rate of IgM antibodies against the capsid antigen of the EBV was detected in SSc patients compared with healthy controls, as well. These data demonstrate that antibodies against CMV, HBV, and toxoplasmosis were detected more often in patients with SSc. This association implies that infectious agents may have a role in disease pathogenesis and expression.

Serum markers of infections in patients with primary biliary cirrhosis: evidence of infection burden

“…Infections have an important role in human autoimmunity, and almost every autoimmune disease investigated is linked to one or more infectious agents (Agmon-Levin et al, 2009b;Arnson et al, 2009;Barzilai et al, 2007;Berkun et al, 2009;Grossman et al, 2011;Kivity et al, 2009;Lidar et al, 2009a;Tozzoli et al, 2008). In the present study we found a significantly elevated seroprevalence of four anti-infectious agents Abs, namely ATxA, anti-H. Pylori, EBV-EA, and CMV Abs, among PBC patients when compared with healthy controls.…”

Fresh Insights into Disease Etiology and the Role of Microbial Pathogens

“…A persistent widespread infection and frequent EBV reactivation was found in patients with SSc [18,21,[25][26][27][28][29]. While the hypothesis of molecular mimicry between several EBV antigens and self-antigens clearly links EBV infection to autoimmunity in SSc, there are mechanisms related to the viral pathology which make EBV unique in its contribution to the induction of autoimmunity [30].…”

“…Specifically, SSc patients more often exhibited high titers of EBV antibodies including increased titers of anti-viral capsid antigen (VCA)-Ig(VCA)-IgG antibodies that suggest that a recent EBV infection or reactivation occurred in SSc [25,31,40]. Moreover, a recent study showed that antibodies to distinct EBV antigens were detected more frequently than specific SSc and systemic lupus erythematosus (SLE) autoantibodies in these patients.…”

Update on morphea

“…53 Patients with systemic sclerosis have been found to have increased levels of antibodies to CMV compared to normal healthy controls. [53][54][55] No studies have been performed to assess CMV as an etiologic factor in morphea.…”