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J Autoimmun. 2017 Sep;83:95-112. doi: 10.1016/j.jaut.2017.07.003. Epub 2017 Jul 21.

Development of autoantibodies precedes clinical manifestations of autoimmune diseases: A comprehensive review.

Author information

1
Chronic Disease Laboratory, Institutes for Life Sciences and School of Medicine, South China University of Technology, Guangzhou 510006, China; Liver Immunology Laboratory, School of Life Sciences, University of Science and Technology of China, Hefei 230027, China; College of Veterinary Medicine, Northwest Agriculture and Forestry University, Yangling 712100, China.
2
Division of Rheumatology, Allergy and Clinical Immunology, University of California at Davis, Davis, CA, USA.
3
Division of Rheumatology, Allergy and Clinical Immunology, University of California at Davis, Davis, CA, USA. Electronic address: megershwin@ucdavis.edu.
4
Chronic Disease Laboratory, Institutes for Life Sciences and School of Medicine, South China University of Technology, Guangzhou 510006, China; Liver Immunology Laboratory, School of Life Sciences, University of Science and Technology of China, Hefei 230027, China; Innovation Center for Cell Signaling Network, Hefei National Laboratory for Physical Sciences at Microscale, Hefei, Anhui, China. Electronic address: zxlian1@ustc.edu.cn.

Abstract

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 autoimmune 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.

KEYWORDS:

Autoantibodies; Autoimmune diseases; Autoimmune hepatitis; Environment; Epigenetics; Primary biliary cirrhosis; Rheumatoid arthritis; SLE; Tolerance

PMID:
28739356
DOI:
10.1016/j.jaut.2017.07.003
[Indexed for MEDLINE]

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