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Article Dans Une Revue Journal of Translational Autoimmunity Année : 2022

SARS-Cov2 acute and post-active infection in the context of autoimmune and chronic inflammatory diseases

Résumé

The clinical and immunological spectrum of acute and post-active COVID-19 syndrome overlaps with criteria used to characterize autoimmune diseases such as rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). Indeed, following SARS-Cov2 infection, the innate immune response is altered with an initial delayed production of interferon type I (IFN-I), while the NF-kappa B and inflammasome pathways are activated. In lung and digestive tissues, an alternative and extrafollicular immune response against SARS-Cov2 takes place with, consequently, an altered humoral and memory T cell response leading to breakdown of tolerance with the emergence of autoantibodies. However, the risk of developing severe COVID-19 among SLE and RA patients did not exceed the general population except in those having pre-existing neutralizing autoantibodies against IFN-I. Treatment discontinuation rather than COVID-19 infection or vaccination increases the risk of developing flares. Last but not least, a limited number of case reports of individuals having developed SLE or RA following COVID-19 infection/vaccination have been reported. Altogether, the SARS-Cov2 pandemic represents an unique opportunity to investigate the dangerous interplay between the immune response against infectious agents and autoimmunity, and to better understand the triggering role of infection as a risk factor in autoimmune and chronic inflammatory disease development.
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Dates et versions

hal-03652760 , version 1 (13-06-2023)

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Regina Larionova, K. Byvaltsev, Оlga Kravtsova, Elena Takha, Sergei Petrov, et al.. SARS-Cov2 acute and post-active infection in the context of autoimmune and chronic inflammatory diseases. Journal of Translational Autoimmunity, 2022, 5, pp.100154. ⟨10.1016/j.jtauto.2022.100154⟩. ⟨hal-03652760⟩
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