Figure 2. Evolution of an autoimmune disease from a "state of autoimmunity" may require the participation of diverse elements consisting of environmental, hormonal, immunological and genetic effects. These factors may act in concert or each one a part, to render an individual prone to autoimmune disease following an inciting 'triggering event'. It is probably the combined action of these factors, rather than the existence of each, that results in an autoimmune disease.
it may be implemented in the future for targeted immunomodulation of neoplasms.
9. CONCLUDING REMARKS-THE "MOSAIC" OF AUTOIMMUNITY
As could be viewed from the above, the ability to distinguish self from non-self is a key inherent property of the immune system engaging in normal preserva tion of immunological homeostasis , However, an interplay of predisposing conditions which indeed have been found to occur frequently in autoimmmue diseases render an individual prone to experience an attack of his immune system on his own self constituents ,
No consistent condition has been shown to accompany all autoimmune states, yet it may be so that a unique set of terms are fulfilled in an individual, combining in a 'mosaic' pattern that results in diverting an immune mediated inflammatory process to damage self-structures. Thus, incriminated predisposing factors include hormonal, environmental, immunologic and genetic elements (Figure 2), which collectively constitute a milieu which enable a seemingly innocent triggering event to activate a vicious cascade resulting in autoimmune disease. Thus, for example, two members of the same family (first degree relatives) indeed 'inherit' the same preponderance to develop autoimmunity as determined by their HLA status. However, the different frequencies of AI diseases among these apparently 'equally prone' subjects could well be explained by the existence of additional factors (environmental, hormonal and immunologic). These observations lend further support to the concept of mosaicism as predominating in autoimmunity.
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