Immunologic derangement preceding clinical autoimmunity

Immunologic derangement preceding clinical autoimmunity

Author Dellavance, A. Google Scholar
Coelho Andrade, L. E. Autor UNIFESP Google Scholar
Institution Fleury Med & Hlth Labs
Universidade Federal de São Paulo (UNIFESP)
Abstract Autoantibodies are valuable markers for the recognition of autoimmune diseases. Over the last 25 years, several investigators have consistently shown that autoantibodies precede the clinical onset of cognate diseases by years or decades. This phenomenon, regularly observed in the natural history of autoimmune diseases, indicates that autoimmunity develops through successive stages across a variable period of time until the characteristic manifestations of disease are clinically apparent. Recent evidence indicates that the pre-clinical stages of autoimmune diseases involve a series of immunologic derangements and that this process is dynamic and progressive. During the years preceding clinical disease onset, there is progressive intensification in the humoral autoimmune response, characterized by increases in autoantibody titer, avidity, number of immunoglobulin isotypes, and spread of epitopes and of autoantigens targeted. This scenario is reminiscent of cancer processes that develop slowly by means of progressive stages, and may be interrupted by early detection and therapeutic intervention. Therefore, it might be reasoned that early intervention may be more effective in reverting the less firmly established autoimmune abnormalities at the pre-clinical stage of autoimmunity. With the continuous progress in novel immunologic therapeutic strategies, one can envision the possibility that early intervention at pre-clinical stages may lead to prevention of overt disease development and even cure of the autoimmune disorder.
Keywords Autoimmunity
immunological tolerance
autoimmune diseases
mechanisms of disease
Language English
Sponsor Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
Grant number FAPESP: 2009/51887-0
CNPq: 476356/2008-3
Date 2014-10-01
Published in Lupus. London: Sage Publications Ltd, v. 23, n. 12, p. 1305-1308, 2014.
ISSN 0961-2033 (Sherpa/Romeo, impact factor)
Publisher Sage Publications Ltd
Extent 1305-1308
Access rights Closed access
Type Article
Web of Science ID WOS:000342741700025

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