How does autoimmune disease occur?

Anthony L. Komaroff, MD
Internal Medicine
Autoimmune disease occurs when the immune system attacks its own body's cells. This happens when components of the adaptive immune response, namely T and B cells, fail to distinguish between "self" and "nonself." That is, they attack the body's own tissues in the same way they would an invading germ. Normally, immature T cells that fail to learn the difference between "self" and "nonself" are eliminated. Theoretically, the body should have no lymphocytes that can't make the distinction. But the process isn't perfect. Some failing-grade cells slip past this weeding-out process and remain in circulation, which means they then have the potential to produce auto-antibodies and autoreactive T cells that can go on to destroy tissues. This doesn’t necessarily happen with every lymphocyte that fails to distinguish self from nonself.

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