[Autoimmune diseases - immunological bases]

Autosensibilisations are essentially more frequent than hitherto was assumed. They, in the main, can be led back to 3 basic mechanisms: 1. Autosensibilisations by determination of the antibodies, where no immunotolerance was present, 2. fraction of the immunotolerance by antibodies (e. g. due to cross-reactions or adjuvant effects), 3. fraction of the immunotolerance by primary changes of immunocompetent cells (e. g. lymphoproliferation diseases). Even the natural immunotolerance is possibly maintained by enhancement effects of blocking autoantibodies. Pathogenic effects (auto-immune diseases) are above all to be expected, if the autoantibodies or by endogenic substances sensibilised T-lymphocytes may react with the antigen and these immune reactions lead to lesions of cells or other structures. Finally for the progression is also necessary the persistence and the autonomisation of the autosensibilisation. Finally is discussed in which range the criteria for the diagnostics of an auto-immune disease derived by Milgrom and Witebsky from the animal experiment may be transposed to the clinic.