The ouroboros of autoimmunity

被引:18
作者
Casanova, Jean-Laurent [1 ,2 ,3 ,4 ,5 ]
Peel, Jessica [1 ]
Donadieu, Jean [6 ]
Neehus, Anna-Lena [3 ,4 ]
Puel, Anne [1 ,3 ,4 ]
Bastard, Paul [1 ,3 ,4 ,5 ]
机构
[1] Rockefeller Branch, St Giles Lab Human Genet Infect Dis, New York, NY 10065 USA
[2] Howard Hughes Med Inst, New York, NY 10065 USA
[3] Necker Hosp Sick Children, INSERM, Necker Branch, Lab Human Genet Infect Dis, Paris, France
[4] Paris Cite Univ, Imagine Inst, Paris, France
[5] Necker Hosp Sick Children, Assistance Publ Hop Paris AP HP, Pediat Hematol Immunol & Rheumatol Unit, Paris, France
[6] Trousseau Hosp Sick Children, Assistance Publ Hop Paris AP HP, Ctr Reference Neutropenies Chron, Paris, France
基金
美国国家卫生研究院;
关键词
CHRONIC MUCOCUTANEOUS CANDIDIASIS; PULMONARY ALVEOLAR PROTEINOSIS; IFN-GAMMA AUTOANTIBODIES; STIMULATING FACTOR AUTOANTIBODIES; GM-CSF AUTOANTIBODIES; C-3 NEPHRITIC FACTOR; NEUTRALIZING ANTIBODIES; INTERFERON-GAMMA; INBORN-ERRORS; COMPLEMENT DEFICIENCIES;
D O I
10.1038/s41590-024-01815-y
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Human autoimmunity against elements conferring protective immunity can be symbolized by the 'ouroboros', a snake eating its own tail. Underlying infection is autoimmunity against three immunological targets: neutrophils, complement and cytokines. Autoantibodies against neutrophils can cause peripheral neutropenia underlying mild pyogenic bacterial infections. The pathogenic contribution of autoantibodies against molecules of the complement system is often unclear, but autoantibodies specific for C3 convertase can enhance its activity, lowering complement levels and underlying severe bacterial infections. Autoantibodies neutralizing granulocyte-macrophage colony-stimulating factor impair alveolar macrophages, thereby underlying pulmonary proteinosis and airborne infections, type I interferon viral diseases, type II interferon intra-macrophagic infections, interleukin-6 pyogenic bacterial diseases and interleukin-17A/F mucocutaneous candidiasis. Each of these five cytokine autoantibodies underlies a specific range of infectious diseases, phenocopying infections that occur in patients with the corresponding inborn errors. In this Review, we analyze this ouroboros of immunity against immunity and posit that it should be considered as a factor in patients with unexplained infection. In this Review, the authors analyze evidence for autoimmunity against components of antimicrobial immunity, metaphorically represented by the mythical ouroboros snake eating its own tail.
引用
收藏
页码:743 / 754
页数:12
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