Environmental Epidemiology and Risk Factors for Autoimmune Disease

M. A. Dooley, MD, MPH, S. L. Hogan, PhD, MPH


Curr Opin Rheumatol. 2003;15(2) 

In This Article


Infection as a possible trigger for autoimmune disorders has long been proposed.[36] Viral infections have received particular attention in SLE studies, with findings of virus-like inclusions in renal biopsy tissue. Previous studies have noted associations of SLE with history of herpes zoster[37] and Epstein-Barr infections.[38] Vaccination against hepatitis B has been noted to predate the diagnosis of SLE in some instances.[39] A recent model linking environmental exposures and autoimmunity invokes interferon- as a superantigen.[40*]

Evaluations of infectious exposures in studies of RA[16*] are inconsistent and difficult to interpret. Urinary tract infections and rubella were found to be associated with decreased risk and pneumonia with an increased risk of RA in women, but no type of infection was associated with the onset of RA in men. Also, no associations were observed between vaccinations, exposure to pets, previous operations, or other kinds of trauma and the onset of RA in this study.[16*] The CLU study included assessments of infectious exposures in SLE but the findings are in press.[41*]


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