Immune diseases - A new way of thinking about them

[disulfiram_effect]

McGonagle & McDermott ( PLoS Medicine, 2006) recently published a new schema for the categorisation of immune diseases that fits them all onto a continuum from purely autoimmune to purely "autoinflammatory"; I found this model really helpful in review for exams, so I'm posting it here.

Generic Definition of Autoimmunity

Self-directed inflammation, whereby aberrant dendritic cell, B and T cell, responses in primary and secondary lymphoid organs lead to breaking of tolerance, with development of immune reactivity towards native antigens. The adaptive immune response plays the predominant role in the eventual clinical expression of disease. Organ-specific autoantibodies may predate clinical disease expression by years and manifest before target organ damage is discernible.

Definition of Autoinflammation

Self-directed inflammation, whereby local factors at sites predisposed to disease lead to activation of innate immune cells, including macrophages and neutrophils, with resultant target tissue damage.

For example, disturbed homeostasis of canonical cytokine cascades (as in the periodic fevers), aberrant bacterial sensing (as in Crohn disease), and tissue microdamage predispose one to sitespecific inflammation that is independent of adaptive immune responses.

[jaqmart]

I think this is a very intellectually satisfying way to classify immune conditions. It may ruffle the feathers of some immunologists with entrenched ideas, but that may be no bad thing.

[doctor_b]

This is a really refreshing way to look at immune disease and clears up what was fairly muddy in my own mind! I wonder what other "disease continuua" are out there waiting to be linked up.

Great find disulfiram_effect! Keep up the good work.

[coke]

thanks for the info