Autoimmunity and the diverse pathways to B-cell unresponsiveness

In many chronic diseases there is some degree of disturbance of the immunological self/non-self discriminatory mechanism. Before a rational approach to therapy can be made, it is necessary to know what factors are involved in the pathogenesis of these diseases and thus what requires manipulation. This is the prime reason for trying to understand why an animal does not normally make deleterious immune responses to its own antigens. Many possible mechanisms have come to light from studies of unresponsiveness induced by foreign antigens. In such slates animals may fail to make an antibody response because either their T cells or B cells are unavailable or because the activity of these cells is suppressed. There is controversy over which of these mechanisms contributes to self-unresponsiveness. In this article Chris Elson reviews their importance in the prevention or control of harmful autoantibody responses.