title: Infection and Lupus: Which Causes Which?
abstract: Infection is a leading cause of morbidity and mortality among patients with systemic lupus erythematous (SLE). Dysfunction of the innate and adaptive immune systems increases the risk of infection in patients with SLE. Infectious agents have also been theorized to play a role in the pathogenesis of SLE. This article summarizes our current knowledge of the infectious risk SLE patients face as a result of their underlying disease including abnormal phagocytes and T cells as well as the increased risk of infection associated with immunosuppressive agents used to treat disease. Pathogens thought to play a role in the pathogenesis of disease including EBV, CMV, human endogenous retroviruses (HERVs), and tuberculosis will also be reviewed, as well as the pathologic potential of microbial amyloids and the microbiome.
authors.affiliation: Division of Rheumatology, University of California Los Angeles (UCLA), 1000 Veteran Ave, Room 32-59, Los Angeles, CA, 90024, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Doaty
authors.affiliation: Division of Cardiology, University of Missouri, One Hospital Drive, Columbia, MO, 65201, USA.
authors.forename: Harsh
authors.initials: H
authors.lastname: Agrawal
authors.affiliation: Division of Rheumatology, University of California Los Angeles (UCLA), 1000 Veteran Ave, Room 32-59, Los Angeles, CA, 90024, USA.
authors.forename: Erin
authors.initials: E
authors.lastname: Bauer
authors.affiliation: Division of Rheumatology, University of California Los Angeles (UCLA), 1000 Veteran Ave, Room 32-59, Los Angeles, CA, 90024, USA. defurst@mednet.ucla.edu.|University of Washington, Seattle, WA, USA. defurst@mednet.ucla.edu.|University of Florence, Piazza di San Marco, 4, 50121, Firenze, Italy. defurst@mednet.ucla.edu.
authors.forename: Daniel E
authors.initials: DE
authors.lastname: Furst
mesh_terms: D056704:Adaptive Immunity; D003937:Diagnosis, Differential; D006801:Humans; D007113:Immunity, Innate; D007166:Immunosuppressive Agents / Q000009:adverse effects; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000235:genetics / Q000276:immunology; D064307:Microbiota; D009894:Opportunistic Infections / Q000150:complications* / Q000175:diagnosis / Q000276:immunology
chemical_list: D007166:Immunosuppressive Agents
keywords: Immunosuppression; Infection; Microbiome; Systemic lupus erythematosus