Autoimmune Disease Pathogenesis

Konrad Schauenstein, Institute for Functional Pathology, Karl-Franzens University, Graz, Austria

Copyright © 1998 Elsevier Ltd. All Rights Reserved.

Now as ever, autoimmune diseases constitute one of the main unsolved problems in human clinical medicine. This is because our knowledge of their etiology and pathogenesis is still not sufficient to provide new concepts towards specific therapy. They are considered to be pathological consequences of immune reactions directed towards autologous antigens.

Over 30 years ago, Witebsky and Milgrom formulated their well-known criteria for autoimmune diseases, the most important of which are that: 1) antibodies or lymphocytes specifically reacting with a defined autoantigen can be detected; 2) immunization of animals with an autoantigen results in an autoimmune disease corresponding to its original tissue distribution, and 3) experimental autoimmune disease is inducible in healthy recipients by passive transfer of autoreactive antibodies or lymphocytes. These postulates, essentially still valid today, pointed to the importance of animal models, and our present knowledge about etiopathogenesis is indeed mainly derived from the study of animals, in which autoimmune diseases are either experimentally induced by immunization with autoantigen, or occur spontaneously at high incidence.

Autoimmune diseases are a heterogeneous group of diseases. According to manifestation we can distinguish systemic diseases affecting various different tissues from organ-specific diseases, where the autoimmune process is restricted to single organ systems. There is good evidence that these two types differ considerably in etiology and pathogenesis.

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