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NIAID Workshop: Infections and Autoimmune Diseases

There is mounting evidence of the connections between autoimmunity and infectious disease.

  • Geographic differences in the prevalence of autoimmune diseases that can’t be explained by genetics
  • Seasonality that affects the onset and severity of autoimmune diseases
  • Associations between neonatal and postnatal infections and autoimmune diseases

To explore the connections between autoimmune diseases and infections, scientists and physicians met at an NIAID workshop held on September 11-12, 2024, to discuss.

The meeting report documents key areas, including:

  • Epstein-Barr virus (EBV) and autoimmune diseases: EBV has been associated with many autoimmune diseases including systemic lupus erythematosus, multiple sclerosis, rheumatoid arthritis, and Sjogren’s syndrome. Researchers propose that this happens because of molecular mimicry where molecules from the virus appear similar to molecules from the body. Then, the immune system mistakenly targets self. 
  • Connections between autoimmune diseases and other infections: Many other infections – either bacterial or viral – have been associated with autoimmune diseases including autoimmune gastritis, spondyloarthropathies, rheumatic heart disease
  • How the microbiome affects autoimmunity: Scientists have found that specific microbes that tend to be in the gut microbiome of rheumatoid arthritis patients, that antibiotics treatment exacerbates autoimmune diseases in preclinical models, and that enteroviral infections may be related to celiac disease. Oral microbes also have a connection to rheumatoid arthritis.

The workshop also discussed whether any causation can be established (ex: does infection cause autoimmune disease vs. does autoimmune disease and infections coincide because of another reason). While many infections seem involved in autoimmune diseases, these infections also happen to people that don’t develop autoimmune diseases. Another challenge is that symptoms of autoimmune diseases often don’t appear until later in life. In the future, it’s possible that advances in fields such as AI could help researchers better understand the relationship between autoimmune disease and infections.

Citation:

Ferguson, S.E., et al. (2025). NIAID workshop on infections and autoimmune diseases. Nature immunology. https://doi.org/10.1038/s41590-024-02066-7