How infection can trigger autoimmunity

The role of infection in the development of autoimmunity is discussed in view of recent advances in the field of immunologic tolerance. Infectious agents may directly damage immune function by impairing the mechanisms of discrimination between self and non-self antigens; alternatively they may "deceive" the immune system by presentation of self-determinants in an immunogenic form or by uncovering of normally sequestered antigenic determinants. The first of these two pathogenetic mechanisms may be responsible for generalized and the second for selective autoimmune reactions. Different clinical conditions are evaluated on the basis of these concepts. The interaction of personal factors with infection and autoimmunity is also taken into consideration.