The molecular biology of autoimmune disease

Abstract The occurence of autoimmune disease has been a challenging paradox ever since Ehrlich first elaborated the concept of ‘horror autotoxicus'. Over the past 35 years the list of known or suspected autoimmune diseases has expanded to include Graves' disease, myasthenia gravis, multiple sclerosis and insulin-dependent diabetes mellitus (IDDM). However, the precise pathogenesis of the autoimmune process of many of these diseases has, for the most part, remained an enigma. Many of these diseases show associations with alleles of the major histocompatibility complex (MHC) class I, II or III loci and with immunoglobulin (lg) allotypes. Immune dysfunction can often be demonstrated — for example abnormal levels of T cells expressing MHC class II antigens and altered CD4: CD8 ratios. The application of molecular biology to elucidate the genes coding for the molecules paramount in eliciting the immune (or autoimmune) response and recently the cloning of the genes coding for the putative autoantigens of certain diseases may at last allow the autoimmune response to be dissected at the molecular level. At the recent NATO Advanced Study Workshop held in Athens