Incumbent of the Laura Schwarz-Kipp Chair for Research of Autoimmune Diseases, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel,
Clin Rev Allergy Immunol. 2013 Oct;45(2):149-51. doi: 10.1007/s12016-013-8385-8.
It is astounding to consider that virtually, every textbook of physiology in every medical school in the world does not include a chapter on immunology. On the other hand, virtually, in every textbook in internal medicine, immunology and immune response overlaps with every tissue and every organ. Indeed, historically, the concept of the immune response was recognized primarily in the setting of allergy and/or anaphylaxis. Indeed, the very concepts of infection, microbiology and host protection are relatively new sciences. In fact, it was little more than 100 years ago when washing hands became what is now coined "standard of care." How different it is in 2013, where one finds Handi Wipes for shoppers to use at grocery stores to protect themselves from the flora on shopping cart handles. Autoimmunity is even a newer concept without going into the well-known history of Paul Ehrlich and hemolytic anemias, the LE cell, and the beginning field of serology (and rheumatoid factor discovery). It is apparent that our understanding of autoimmunity has become linked hand-in-glove with new tools and investigational probes into serology and, more recently, the cellular immune response. With such discoveries, a number of key observations stand out. Firstly, there are a great deal more autoantibodies than there are autoimmune diseases. Second, there are a great deal more of autoimmune diseases than was believed in 1963 on the occasion of the publication of the first textbook of autoimmune diseases. Third, autoimmune diseases are, for the most part, orphan diseases, with many entities afflicting too few patients to excite the financial limb of pharmaceutical companies. In this special issue, we have grouped a number of papers, many of which were presented at the recent Congress of Autoimmunity that focus on issues that are not commonly discussed in autoimmunity. It reminds us that due to the ubiquitous nature of the innate and adaptive response, that there are a large number of diseases that have either an inflammatory and/or specific autoimmune response, we have to keep an open eye because everything is potentially autoimmune until proven otherwise.
令人惊讶的是，几乎世界上每一所医学院的每一本生理学教材都没有包含免疫学章节。另一方面，几乎每一本内科学教材都涵盖了免疫学和免疫反应，涉及到每一个组织和器官。事实上，从历史上看，免疫反应的概念主要是在过敏和/或过敏反应的背景下被认识到的。事实上，感染、微生物学和宿主保护的概念都是相对较新的科学。事实上，仅仅在 100 多年前，洗手就成为了现在所说的“标准护理”。在 2013 年，人们会发现有 Handi Wipes 供购物者在杂货店使用，以保护自己免受购物车手柄上的菌群的侵害，这是多么不同。自身免疫甚至是一个更新的概念，更不用说保罗·埃尔利希和溶血性贫血、LE 细胞以及血清学（和类风湿因子发现）的开始领域的著名历史了。很明显，我们对自身免疫的理解已经与血清学和最近的细胞免疫反应的新工具和研究探针紧密结合在一起。有了这些发现，许多关键的观察结果就凸显出来了。首先，自身抗体的数量远远超过自身免疫性疾病的数量。其次，与 1963 年第一本自身免疫性疾病教材出版时相比，自身免疫性疾病的数量要多得多。第三，自身免疫性疾病在很大程度上是孤儿病，许多实体疾病的患者太少，无法激发制药公司的财务分支。在这个特刊中，我们汇集了许多论文，其中许多是在最近的自身免疫学会大会上提交的，这些论文集中讨论了在自身免疫中通常不讨论的问题。这提醒我们，由于先天和适应性反应的普遍存在，有许多疾病既有炎症反应，又有特定的自身免疫反应，我们必须保持警惕，因为在没有证据证明相反的情况下，一切都可能是自身免疫性的。
