Immunol Res. 2013 Jul;56(2-3):200-5. doi: 10.1007/s12026-013-8429-4.
The pathogenesis of autoimmune diseases (ADs) is characterized by a complex interaction between genetic, immune defects, environmental and hormonal factors. The concept of "mosaic of autoimmunity" deals with the multi-factorial origin and diversity of expression of ADs in humans. Genetic leads to a predisposition in developing an autoimmune syndrome, but the presence of an external or endogenous environmental factor, recently called "exposome," is essential in triggering the immune response. Infections as well as the expositions to different other external environmental agents have been identified as potential trigger for ADs. A new syndrome, namely the autoimmune/inflammatory syndrome induced by adjuvants, has recently been defined alluding to the key role of adjuvant in inducing an immune-mediated condition. Aluminum and silicone, respectively found in vaccines and breast implants, are the most commonly known adjuvants charged with development of autoimmune conditions. Similarly to playing chess, unraveling the pathogenesis of autoimmune diseases with every new discovery is adding a move to the game aiming at checkmating ADs.
自身免疫性疾病（AD）的发病机制的特征是遗传、免疫缺陷、环境和激素因素之间的复杂相互作用。“自身免疫马赛克”的概念涉及 AD 在人类中的多因素起源和表达多样性。遗传导致自身免疫综合征的易感性，但外部或内源性环境因素的存在，最近被称为“外显组”，对于触发免疫反应是必不可少的。感染以及对不同其他外部环境因素的暴露已被确定为 AD 的潜在触发因素。最近定义了一种新的综合征，即佐剂引起的自身免疫/炎症综合征，这暗示了佐剂在诱导免疫介导的疾病方面的关键作用。铝和硅，分别存在于疫苗和乳房植入物中，是最常见的已知佐剂，它们会引发自身免疫疾病。就像下棋一样，每一次新发现都为解析自身免疫性疾病的发病机制增添了一个动作，旨在将自身免疫疾病逼入绝境。
