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Bras J Rheumatol 2009;49(5):487-91 T he association of infectious diseases with autoimmunity, either presenting with clinical manifestations, or only detected by the emergence of autoantibodies, has been widely documented.1 Viral, bacterial, and parasite infections may be involved in the arousal, flare, and even be involved in the prevention of autoimmune disease.1,2 This issue of the RBR features two studies on the prevalence of autoantibodies in patients with infectious diseases. Ribeiro et al. evaluated the frequency of rheumatoid factor (RF), anti-cyclic citrullinated peptide antibodies (anti-CCP), antinuclear antibodies (ANA), antineutrophil cytoplsmic antibodies (ANCA), anticardiolipin (aCL) antibodies, and anti-β2 glycoprotein I (anti-β2GPI) antibodies in patients with leprosy. Among the 158 patients evaluated, 76 patients had articular manifestations, while 82 patients had no articular involvement. The control group consisted of 129 healthy adults, matched for age and sex, and residing in the same geographical area as the patients. The majority of the patients in both groups, (with and without articular involvement), had the generalized leprosy presentation (VV). The authors found a low, and not significantly different frequency of RF, anti-CCP, ANA, and ANCA in leprosy patients, (in both groups), and in normal controls. But the prevalence of aCL and anti-β2GPI antibodies was significantly elevated in the leprosy patients as compared to the controls, although there was no significant association with articular involvement. IgM was the predominant isotype for both antibodies. Almost half of the leprosy patients (48.7%) had at least one antiphospholipid antibody. In addition, the authors found an association between aCL positivity and clinical manifestation, as patients harboring aCL antibodies more frequently had the generalized VV type of disease (p = 0.002). There was no association between the presence of aCL or anti-β2GPI antibodies and reaction episodes, but among the patients with reactions, those who were aCL-positive, had Autoantibodies in leprosy and leishmania patients – more evidence on the association of infections and autoimmunity

Autoanticorpos em pacientes com hanseníase e leishmaniose: mais evidência da associação entre infecções e autoimunidade