Pathophysiology of autoimmune diseases

Immune reactions towards self antigens can lead to cell destruction and autoimmune disease. In this review it is summarized, how autoimmune diseases are classified from a clinical standpoint into organ-specific and systemic involvement and how our understanding has evolved during recent history. The experimental basis is discussed with transfer models, T-cell suppressor control, T-cell recognition of antigen presenting cells, T-cell clones and more recent transgenic mouse models. It is finally concluded that autoimmunity develops due to the direct activation of autoreactive CD4 positive T-cells. Monoclonal antibodies interfering with this interaction may prove a useful immune-intervention. However, antigens and relevant epitopes for autoimmune induction still need to be identified and characterized.