Vojdani Aristo, Vojdani Elroy
Immunosciences Lab, Inc., Los Angeles, CA 90035, USA.
Cyrex Laboratories, LLC, Phoenix, AZ 85034, USA.
Pathophysiology. 2021 Dec 18;28(4):513-543. doi: 10.3390/pathophysiology28040034.
Autoimmune diseases affect 5-9% of the world's population. It is now known that genetics play a relatively small part in the pathophysiology of autoimmune disorders in general, and that environmental factors have a greater role. In this review, we examine the role of the exposome, an individual's lifetime exposure to external and internal factors, in the pathophysiology of autoimmune diseases. The most common of these environmental factors are toxic chemicals, food/diet, and infections. Toxic chemicals are in our food, drink, common products, the air, and even the land we walk on. Toxic chemicals can directly damage self-tissue and cause the release of autoantigens, or can bind to human tissue antigens and form neoantigens, which can provoke autoimmune response leading to autoimmunity. Other types of autoimmune responses can also be induced by toxic chemicals through various effects at the cellular and biochemical levels. The food we eat every day commonly has colorants, preservatives, or packaging-related chemical contamination. The food itself may be antigenic for susceptible individuals. The most common mechanism for food-related autoimmunity is molecular mimicry, in which the food's molecular structure bears a similarity with the structure of one or more self-tissues. The solution is to detect the trigger, remove it from the environment or diet, then repair the damage to the individual's body and health.
自身免疫性疾病影响着全球5%至9%的人口。现在已知，一般而言，遗传学在自身免疫性疾病的病理生理学中所起的作用相对较小，而环境因素发挥着更大的作用。在本综述中，我们探讨了暴露组（即个体一生中接触的外部和内部因素）在自身免疫性疾病病理生理学中的作用。这些环境因素中最常见的是有毒化学物质、食物/饮食和感染。有毒化学物质存在于我们的食物、饮料、日常用品、空气中，甚至我们行走的土地中。有毒化学物质可直接损伤自身组织并导致自身抗原释放，或可与人体组织抗原结合形成新抗原，从而引发自身免疫反应导致自身免疫性。有毒化学物质还可通过细胞和生化水平的各种效应诱导其他类型的自身免疫反应。我们每天吃的食物通常含有色素、防腐剂或与包装相关的化学污染物。食物本身可能对易感个体具有抗原性。与食物相关的自身免疫最常见的机制是分子模拟，即食物的分子结构与一种或多种自身组织的结构相似。解决办法是检测触发因素，将其从环境或饮食中去除，然后修复对个体身体和健康造成的损害。
