Autoimmune disease: Pathogenesis, Genetics, Immunotherapy, Microbial triggers, Prophylaxis

Pasteur's correct Germ Theory of Disease led to discovery of the Immunity System that exists for defence against diseases caused by bacterial or viral infections.In order to cope with the huge diversity of microbial infections, the immune system needs a flexibility of immune response.This is provided by use of semi-random somatic gene mutations in lymphocytes, the cells that recognise invading bacteria and viruses.Burnet realised that this flexibility leads to development of the Forbidden Clones of lymphocytes that cause the autoimmune diseases by accidentally being reactive with a host antigen instead of a microbial one.Ebringer has recently discovered the microbial triggers of rheumatoid arthritis and ankylosing spondylitis and has determined the amino acid sequences of the antigens on them that trigger the related autoimmune diseases.This has explained how histocompatibility antigens can predispose to autoimmune diseases.The Salk and Sabin anterior poliomyelitis vaccines have prevented the leg paralyses of the polio epidemics.We postulate that these paralyses were rare autoimmune complications of virtually universal poliovirus infection.As autoimmune diseases are triggered by microbial infections, we suggest that the triggering bacteria or viruses be sought, so that prophylaxis of the autoimmune diseases can be achieved by vaccination against their triggering microbes.