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.
Copyright © 2011 Elsevier B.V. All rights reserved.
MeSH terms
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Antibodies, Monoclonal, Murine-Derived / administration & dosage
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Antibodies, Monoclonal, Murine-Derived / therapeutic use
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Antiviral Agents / therapeutic use*
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Autoimmunity / genetics
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Autoimmunity / immunology*
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B-Lymphocytes / drug effects*
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B-Lymphocytes / immunology
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B-Lymphocytes / virology
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Chronic Disease
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Endogenous Retroviruses / drug effects
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Endogenous Retroviruses / immunology
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Endogenous Retroviruses / metabolism
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Epstein-Barr Virus Infections / drug therapy
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Epstein-Barr Virus Infections / genetics
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Epstein-Barr Virus Infections / immunology
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Epstein-Barr Virus Infections / prevention & control*
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Epstein-Barr Virus Infections / virology
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Herpesvirus 4, Human / drug effects
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Herpesvirus 4, Human / genetics
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Herpesvirus 4, Human / immunology
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Humans
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Immunologic Memory / drug effects
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Integrase Inhibitors
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Lupus Erythematosus, Systemic / drug therapy
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Lupus Erythematosus, Systemic / genetics
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Lupus Erythematosus, Systemic / immunology
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Lupus Erythematosus, Systemic / prevention & control*
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Lupus Erythematosus, Systemic / virology
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Lymphoproliferative Disorders
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Multiple Sclerosis / drug therapy
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Multiple Sclerosis / genetics
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Multiple Sclerosis / immunology
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Multiple Sclerosis / prevention & control*
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Multiple Sclerosis / virology
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Pyrrolidinones
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RNA, Small Interfering / genetics
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RNA, Small Interfering / pharmacology
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Raltegravir Potassium
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Rituximab
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Urticaria / drug therapy*
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Urticaria / genetics
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Urticaria / immunology
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Urticaria / virology
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Vaccination*
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Viral Vaccines / administration & dosage
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Viral Vaccines / therapeutic use
Substances
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Antibodies, Monoclonal, Murine-Derived
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Antiviral Agents
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Integrase Inhibitors
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Pyrrolidinones
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RNA, Small Interfering
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Viral Vaccines
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Raltegravir Potassium
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Rituximab