viruses Review Viral Infections and Systemic Lupus Erythematosus: New Players in an Old Story Marco Quaglia 1,2, Guido Merlotti 1,2 , Marco De Andrea 2,3 , Cinzia Borgogna 2,4 and Vincenzo Cantaluppi 1,2,* 1 Nephrology and Kidney Transplantation Unit, Department of Translational Medicine, University of Piemonte Orientale (UPO), “Maggiore della Carità” University Hospital, Via P. Solaroli 17, 28100 Novara, Italy;
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[email protected] (G.M.) 2 Center for Translational Research on Autoimmune and Allergic Disease-CAAD, 28100 Novara, Italy;
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[email protected] (C.B.) 3 Department of Public Health and Pediatric Sciences, Medical School, University of Turin, 10126 Turin, Italy 4 Department of Translational Medicine, University of Piemonte Orientale (UPO), 28100 Novara, Italy * Correspondence:
[email protected] Abstract: A causal link between viral infections and autoimmunity has been studied for a long time and the role of some viruses in the induction or exacerbation of systemic lupus erythematosus (SLE) in genetically predisposed patients has been proved. The strength of the association between different viral agents and SLE is variable. Epstein–Barr virus (EBV), parvovirus B19 (B19V), and human endogenous retroviruses (HERVs) are involved in SLE pathogenesis, whereas other viruses such as Cytomegalovirus (CMV) probably play a less prominent role. However, the mechanisms of viral–host interactions and the impact of viruses on disease course have yet to be elucidated. In addition to classical mechanisms of viral-triggered autoimmunity, such as molecular mimicry and Citation: Quaglia, M.; Merlotti, G.; epitope spreading, there has been a growing appreciation of the role of direct activation of innate De Andrea, M.; Borgogna, C.; response by viral nucleic acids and epigenetic modulation of interferon-related immune response.