About this Research Topic
SARS-CoV-2 infection represents an emergency scenario that unveiled an old challenge that is the complex and interwoven link between infections and autoimmunity.
Patients with chronic autoimmune arthritis have an increased risk of infections, due to the immune-dysregulation of the disease itself and due to the use of various immunosuppressive therapeutic agents. Furthermore, infections in these patients are characterized by a more severe clinical outcome, eventually with prolonged viral persistence compared to the general population and can also lead to disease flare-ups.
On the other hand, infections can trigger autoimmune diseases via different immunologic mechanisms such as molecular mimicry, epitope spreading and by-stander activation. Examples of pathogens historically implicated in eliciting autoimmunity are the Hepatitis C virus for cryoglobulinemia and Epstein Barr virus for various autoimmune diseases, including systemic lupus erythematosus and Sjogren’s syndrome. Whereas, more recently, several publications report correlations between the predominance of Porhyromonas gingivalis in the oral mucosa or infection by the Chikungunya virus with autoimmune arthritis outbreak.
The current ongoing pandemic caused by SARS-CoV-2 is a major challenge for researchers and clinicians worldwide. Despite the global containment measures, the increasing knowledge of SARS-CoV-2 infection and progression, and the efforts made in the development of new therapeutic weapons, the virus is continuing its worldwide growth. In an attempt to manage the aberrant inflammatory immune response of the host, secondary to SARS-CoV-2 infection, several groups are currently working on the difficult task of defining the optimal use of immunosuppressive agents commonly adopted in chronic autoimmune arthritis for COVID-19 treatment.
The chance to have several SARS-CoV-2 vaccine formulations represents a major step forward, but raises some questions and special concerns for patients with autoimmune arthritis. Common vaccinations (such as influenza and pneumococcus) are strongly recommended in these patients considering that they can reduce the overall burden of both infections and related complications. Nevertheless, in the absence of scientific data in this specific population, the safety and effectiveness of vaccines raises concerns on vaccine formulation and schedule in the context of the patient’s ongoing immunosuppressive treatment and their disease activity.
This Research Topic welcomes Original Research, Systematic Review, Perspective, Opinion and Clinical Trial articles focusing on, but not limited to:
• Multifaceted associations between infections, vaccines and chronic autoimmune arthritis
• Role of the host immune imprinting during infectious diseases
• Insights into the mechanisms of the immune escape and development of autoimmunity
• Biomarkers for diagnosis, and therapeutic outcome, of infection in autoimmune chronic arthritis
• Novel therapeutic approaches for treatment of infectious disease in the context of autoimmune conditions
• Prevalence, risk factors and outcome of COVID-19 in patients with chronic autoimmune arthritis
• Double edge role of immunosuppressive agents in COVID-19 onset and treatment
• Effectiveness and safety of vaccines in patients with chronic autoimmune arthritis
Keywords: SARS-CoV-2, COVID19, autoimmunity, chronic autoimmune arthritis, infections, vaccines
Important Note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.