martes, 20 de noviembre de 2018

Autoimmunity Classification

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By Ananya Mandal, MDReviewed by Sally Robertson, B.Sc.

Several diseases and disorders are caused by autoimmune mechanisms. Autoimmune diseases can generally be divided into those that are systemic and those that are localised and only affect a certain tissue or organ.

Systemic disorders

Systemic disorders involve autoantibodies that are not specific to antigens found on certain tissues. Examples include:

Systemic lupus erythematosus (SLE)
Goodpasture’s syndrome
Sarcoidosis
Scleroderma
Rheumatoid arthritis
Dermatomyositis

Local disorders

Examples of local disorders that are specific to a particular tissue or organ can be divided into the following groups:

Dermatologic diseases
- Sjögren's Syndrome
- Scleroderma
- Dermatomyositis
- Psoriasis
- Vitiligo
- Alopecia areata

Endocrinologic diseases
- Type 1 diabetes mellitus
- Autoimmune pancreatitis
- Hashimoto’s thyroiditis
- Addison’s disease

Neurologic diseases
- Multiple sclerosis
- Myasthenia gravis

Hematologic diseases
- Polyarteritis nodosa
- Idiopathic thrombocytopenic purpura
- Hemolytic anemia
- Antiphospholipid antibody syndrome
- Pernicious anemia

Gastrointestinal diseases
- Celiac disease
- Inflammatory bowel disease
- Autoimmune hepatitis
- Primary biliary cirrhosis

This organ-specific and non-organ specific classification system means that chronic inflammatory diseases are often categorized as autoimmune even if they lack the associated pathology driven by T and B cells.

Over the last decade, there has been a growing recognition that the inflammation that occurs against self tissues is not necessarily dependent on abnormal T and B cell responses. It has now been suggested that the autoimmunity should be viewed in terms of a disease continuum, where the classic autoimmune disorders lie at one end of the scale and diseases driven by innate immune mechanisms lie at the other end. This classification system is hoped to improve understanding of disease mechanisms and the development of therapies.