title: 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.
authors.affiliation: Pediatrics, Yale University School of Medicine, New Haven, CT, United States. dhdreyfus@pol.net
authors.forename: David H
authors.initials: DH
authors.lastname: Dreyfus
mesh_terms: D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use*; D015551:Autoimmunity / Q000235:genetics / Q000276:immunology*; D001402:B-Lymphocytes / Q000187:drug effects* / Q000276:immunology / Q000821:virology; D002908:Chronic Disease; D020077:Endogenous Retroviruses / Q000187:drug effects / Q000276:immunology / Q000378:metabolism; D020031:Epstein-Barr Virus Infections / Q000188:drug therapy / Q000235:genetics / Q000276:immunology / Q000517:prevention & control* / Q000821:virology; D004854:Herpesvirus 4, Human / Q000187:drug effects / Q000235:genetics / Q000276:immunology; D006801:Humans; D007156:Immunologic Memory / Q000187:drug effects; D019429:Integrase Inhibitors; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy / Q000235:genetics / Q000276:immunology / Q000517:prevention & control* / Q000821:virology; D008232:Lymphoproliferative Disorders; D009103:Multiple Sclerosis / Q000188:drug therapy / Q000235:genetics / Q000276:immunology / Q000517:prevention & control* / Q000821:virology; D011760:Pyrrolidinones; D034741:RNA, Small Interfering / Q000235:genetics / Q000494:pharmacology; D000068898:Raltegravir Potassium; D000069283:Rituximab; D014581:Urticaria / Q000188:drug therapy* / Q000235:genetics / Q000276:immunology / Q000821:virology; D014611:Vaccination; D014765:Viral Vaccines / Q000008:administration & dosage / Q000627:therapeutic use
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D000998:Antiviral Agents; D019429:Integrase Inhibitors; D011760:Pyrrolidinones; D034741:RNA, Small Interfering; D014765:Viral Vaccines; D000068898:Raltegravir Potassium; D000069283:Rituximab