Acquisition by mammals of an adaptive immune system was an evolutionary leap, but occurred at the cost of autoimmunity.

The necessity for self-recognition was appreciated in 1900, but autoimmune disease did not become a clinical reality until the 1950s-still the perimeters are indistinct.

Autoimmune responses recapitulate the complex events of normal immune responses but cannot shut down.

Immune tolerance is established during repertoire development centrally in thymus or bone marrow by deletion of self-reactive immunocytes, and is supplemented peripherally by regulatory T cells (TREGs).

Associations

 primary immune deficiencies

• Wiskott-Aldrich syndrome (WAS)
• IPEX syndrome

See also

 molecular mimicry
 dysimmune diseases

• autoimmune diseases

References

 Mackay IR. The etiopathogenesis of autoimmunity. Semin Liver Dis. 2005 Aug;25(3):239-50. PMID: #16143941#

 Bach JF. The effect of infections on susceptibility to autoimmune and allergic diseases. N Engl J Med. 2002 Sep 19;347(12):911-20. PMID: #12239261#

 Zinkernagel RM. Maternal antibodies, childhood infections, and autoimmune diseases. N Engl J Med. 2001 Nov 1;345(18):1331-5. PMID: #11794153#

 Siegel RM, et al: The multifaceted role of Fas signaling in immune cell homeostasis and autoimmunity. Nat Immunol 1:469, 2000.