raltegravir-potassium and Epstein-Barr-Virus-Infections

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.

Topics: Antibodies, Monoclonal, Murine-Derived; Antiviral Agents; Autoimmunity; B-Lymphocytes; Chronic Disease; Endogenous Retroviruses; Epstein-Barr Virus Infections; Herpesvirus 4, Human; Humans; Immunologic Memory; Integrase Inhibitors; Lupus Erythematosus, Systemic; Lymphoproliferative Disorders; Multiple Sclerosis; Pyrrolidinones; Raltegravir Potassium; Rituximab; RNA, Small Interfering; Urticaria; Vaccination; Viral Vaccines