Journal
JOURNAL OF AUTOIMMUNITY
Volume 83, Issue -, Pages 95-112Publisher
ACADEMIC PRESS LTD- ELSEVIER SCIENCE LTD
DOI: 10.1016/j.jaut.2017.07.003
Keywords
Autoantibodies; Autoimmune diseases; Primary biliary cirrhosis; SLE; Rheumatoid arthritis; Autoimmune hepatitis; Tolerance; Epigenetics; Environment
Categories
Funding
- National Natural Science Foundation of China [81430034, 91542123]
- National Basic Research Program of China (973 Program) [2013C6944900]
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The etiology of autoimmune diseases is due to a combination of genetic predisposition and environmental factors that alter the expression of immune regulatory genes through various mechanisms including epigenetics. Both humoral and cellular elements of the adaptive immune system play a role in the pathogenesis of autoimmune diseases and the presence of autoantibodies have been detected in most but not all autoimmune diseases before the appearance of clinical symptoms. In some cases, the presence or levels of these autoantibodies portends not only the risk of developing a corresponding autoimmune disease, but occasionally the severity as well. This observation is intriguing because it suggests that we can, to some degree, predict who may or may not develop autoimmune diseases. However, the role of autoantibodies in the pathogenesis of autoimmune diseases, whether they actually affect disease progression or are merely an epiphenomenon is still not completely clear in many auto immune diseases. Because of these gaps in our knowledge, the ability to accurately predict a future autoimmune disease can only be considered a relative risk factor. Importantly, it raises the critical question of defining other events that may drive a patient from a preclinical to a clinical phase of disease. (C) 2017 Elsevier Ltd. All rights reserved.
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