Shared and unique immune alterations in pre-clinical autoimmunity

• Published in: Current opinion in immunology Vol. 61; pp. 60 - 68
• Main Authors: Slight-Webb, Samantha, Bourn, Rebecka L, Holers, V Michael, James, Judith A
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.12.2019
• ISSN: 0952-7915; 1879-0372
• DOI: 10.1016/j.coi.2019.08.006

[Display omitted] •Autoantibody accrual, specificity, and epitope spreading precede disease transition.•Plasma cytokines first increase preclinically, before autoantibody seroconversion.•Type II IFN is linked to initial loss of self-tolerance in many autoimmune diseases.•Type I IFN signatures precede symptoms in a subset of patients.•Preclinical cytokine and autoantibody elevations likely reflect immune dysregulation in mucosa, tissues and/or lymphatics. Progression from health to a classified autoimmune disease is an evolving process that can happen rapidly in some diseases, but usually takes years to develop. Specific immune alterations predate pathogenic autoimmunity and can be used as disease biomarkers to identify high-risk individuals for prevention studies applied in the pre-clinical state. Here we discuss recent findings that illuminate specific immune pathways that are altered in the earliest phases of pre-clinical autoimmunity as well as those mediators more closely associated with later clinically apparent and classified disease onset.