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Autoimmune disease: A role for new anti-viral therapies?

Abstract
Many chronic human diseases may have an underlying autoimmune mechanism. In this review, the author presents a case of autoimmune CIU (chronic idiopathic urticaria) in stable remission after therapy with a retroviral integrase inhibitor, raltegravir (Isentress). Previous reports located using the search terms "autoimmunity" and "anti-viral" and related topics in the pubmed data-base are reviewed suggesting that novel anti-viral agents such as retroviral integrase inhibitors, gene silencing therapies and eventually vaccines may provide new options for anti-viral therapy of autoimmune diseases. Cited epidemiologic and experimental evidence suggests that increased replication of epigenomic viral pathogens such as Epstein-Barr Virus (EBV) in chronic human autoimmune diseases such as rheumatoid arthritis (RA), systemic lupus Erythematosus (SLE), and multiple sclerosis (MS) may activate endogenous human retroviruses (HERV) as a pathologic mechanism. Memory B cells are the reservoir of infection of EBV and also express endogenous retroviruses, thus depletion of memory b-lymphocytes by monoclonal antibodies (Rituximab) may have therapeutic anti-viral effects in addition to effects on B-lymphocyte presentation of both EBV and HERV superantigens. Other novel anti-viral therapies of chronic autoimmune diseases, such as retroviral integrase inhibitors, could be effective, although not without risk.
AuthorsDavid H Dreyfus
JournalAutoimmunity reviews (Autoimmun Rev) Vol. 11 Issue 2 Pg. 88-97 (Dec 2011) ISSN: 1873-0183 [Electronic] Netherlands
PMID21871974 (Publication Type: Journal Article, Review)
CopyrightCopyright © 2011 Elsevier B.V. All rights reserved.
Chemical References
  • Antibodies, Monoclonal, Murine-Derived
  • Antiviral Agents
  • Integrase Inhibitors
  • Pyrrolidinones
  • RNA, Small Interfering
  • Viral Vaccines
  • Raltegravir Potassium
  • Rituximab
Topics
  • Antibodies, Monoclonal, Murine-Derived (administration & dosage, therapeutic use)
  • Antiviral Agents (therapeutic use)
  • Autoimmunity (genetics, immunology)
  • B-Lymphocytes (drug effects, immunology, virology)
  • Chronic Disease
  • Endogenous Retroviruses (drug effects, immunology, metabolism)
  • Epstein-Barr Virus Infections (drug therapy, genetics, immunology, prevention & control, virology)
  • Herpesvirus 4, Human (drug effects, genetics, immunology)
  • Humans
  • Immunologic Memory (drug effects)
  • Integrase Inhibitors
  • Lupus Erythematosus, Systemic (drug therapy, genetics, immunology, prevention & control, virology)
  • Lymphoproliferative Disorders
  • Multiple Sclerosis (drug therapy, genetics, immunology, prevention & control, virology)
  • Pyrrolidinones
  • RNA, Small Interfering (genetics, pharmacology)
  • Raltegravir Potassium
  • Rituximab
  • Urticaria (drug therapy, genetics, immunology, virology)
  • Vaccination
  • Viral Vaccines (administration & dosage, therapeutic use)

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