Autoimmunity since the 1957 clonal selection theory: a little acorn to a large oak

Knowledge on autoimmunity is examined from the launch of clonal selection theory 1957-1959. Crucial elements then were 'forbidden clones' of immunocytes as agents of tissue damage, somatic mutations that generated such clones and 'homeostatic mechanisms' that controlled them. The understanding of autoimmunity over the succeeding 50 years has expanded immensely, and many more diseases now come under this rubric. Examined here are current problems of definition including 'adaptive' and 'innate' types of autoimmunity, estimations of population burdens of autoimmune diseases, the nature of autoepitopes in the context of the diabetes autoantigen GAD65, and the complexities of immune tolerance and the genetic influences thereon, leading to the nomination of multiple 'tolerance/autoimmunity' genes as critical components of pathogenesis. Burnet's concept of mutagenesis as a basic feature of various pathologies including autoimmunity is given a contemporary focus, his views on deletional tolerance have been well vindicated, his 'forbidden clones' remain as unphysiological as before albeit phenotypically resembling normal lymphocytes, and his 'homeostatic mechanisms' can be now interpreted in terms of immunoregulatory networks.