Causes of autoimmunity

Every day, the body is exposed to a number of factors, which alone, or in combination, under the correct conditions may initiate the development of an autoimmune disease. In addition, it is also a normal consequence of ageing and may be induced by certain drugs or microorganisms (especially viruses). The exact cause of most autoimmune diseases is largely unknown as are the factors that control the severity of the disease, the range of autoantigens or the target organs involved. However, a number of parameters are known to be generally

Table 5.5 Factors affecting the development of autoimmune disease

Agent

Effects/associated autoimmune disease

Genetic make-up

Viruses Hormones

Stress/trauma

Pharmaceuticals Lithium Penicillin Penicillamine a-Methyldopa

Chemicals and organic solvents Hydrazine Vinyl chloride Silica dust

Heavy metals Gold Cadmium Mercury

Food additives Tartrazine

HLA-DR4 - rheumatoid arthritis HLA-DR2, 3 - SLE

HLA-DQ3 - insulin-dependent diabetes mellitus e.g. Epstein-Barr virus

Oestrogen aggravates autoimmune disease; androgens are immunosuppressive

Neurochemicals and hormones are involved in rapid onset of autoimmune disease in response to these agents

Autoimmune thyroid disease Autoimmune haemolytic disease Myasthenia gravis, pemphigus, autoimmune thyroid disease, autoimmune haemolytic anaemia Autoimmune haemolytic anaemia, autoimmune hepatitis

Systemic lupus erythematosus Systemic sclerosis Systemic sclerosis

Immune-complex glomerulonephritis Immune-complex glomerulonephritis Immune-complex glomerulonephritis

Systemic lupus erythematosus associated with autoimmune disease and these are discussed briefly in the following sections (Table 5.5).

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