Autoimmune pre-disease.

Area of Science:

• Immunology
• Autoimmunity
• Disease Pathogenesis

Background:

• Autoimmune diseases affect 5% of the global population, posing significant treatment challenges and economic burdens.
• Disease development is a multi-year process involving autoantigen-specific lymphocytes and autoantibodies, but not all individuals with autoantibodies develop clinical symptoms.
• Identifying and intervening in the transition from harmless autoimmunity to inflammatory conditions is a critical unmet need.

Purpose of the Study:

• To review the current understanding of autoimmune disease progression from health to clinically manifest disease.
• To identify knowledge gaps in defining and modulating the autoimmune predisease phase.
• To outline future research perspectives for targeting autoimmune predisease.

Main Methods:

• Review of published scientific literature on autoimmune disease development.
• Analysis of factors influencing the transition from harmless to inflammatory autoimmune responses.
• Synthesis of current status, missing knowledge, and future directions in autoimmune predisease research.

Main Results:

• The switch to inflammatory autoantigen-specific T and B-cell responses is a key factor in disease manifestation.
• Biomarkers predicting progression from autoantibody presence to clinical disease are lacking.
• Environmental and genetic factors significantly influence disease progression.

Conclusions:

• Defining and targeting the autoimmune predisease phase holds significant therapeutic potential.
• Further research is needed to develop predictive biomarkers and therapeutic strategies for autoimmune predisease.
• Understanding the transition from harmless autoimmunity to inflammatory disease is essential for effective intervention.