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Cutting edge: issues in autoimmunity

Guest Editors: Prof Yehuda Shoenfeld and Dr Nancy Agmon-Levin

Collection published: 4 April 2013

Last updated: 4 September 2013

antibody therapy Logo During the last three decades a significant increase in the prevalence of autoimmune diseases was noted. More diseases apparently thought to be either genetically or environmentally induced were found to have an autoimmune origin - for example narcolepsy, depression, duodenal ulcer, etc. However, not all the autoimmune diseases fulfill Noel Rose's criteria (Shoenfeld Y, Cervera R, Gershwin M.E. Diagnostic Criteria in Autoimmune Diseases. Humana Press, Springer Science + Business Media, LLC, USA. pp 1-593, 2008).

In some of the diseases, indirect criteria allude to their autoimmune etiology, i.e. the co-appearance with other autoimmune diseases, specific HLA common to autoimmunity, presence of autoantibodies, etc. The fact that narcolepsy could be induced by autoantibodies extracted from patients to mice, fulfilled N. Rose's criteria, and therefore helped to classify narcolepsy as a classical autoimmune disease. Analyzing the mechanisms by which autoimmune disease is induced, leads to a better therapies than just immunosuppression or corticosteroids. Hence the role of the new biologics, where each type is aimed in counteracting a key point in the autoinflammatory process.

Unfortunately, not all the etiologies of autoimmune diseases have been revealed. Moreover there are some autoimmune diseases such as systemic sclerosis in which the pathogenetic mechanisms have not been deciphered, and therefore these conditions are still devastating and require extensive research. The aim of this article collection is to review some of the forefront issues in autoimmunity and which may lead to better diagnosis and therapies in the future.

If you would like your work to be considered as part of this article collection, you can send a pre-submission query to bmcmedicineeditorial@biomedcentral.com.

		Minireview What is next after the genes for autoimmunity? John Castiblanco, Mauricio Arcos-Burgos, Juan-Manuel Anaya BMC Medicine 2013, 11:197 (4 September 2013) Abstract \| Full text \| PDF \| Editor’s summary Autoimmune diseases have complex etiology and are known to aggregate in families; Juan-Manuel Anaya and colleagues review the genetic components of autoimmunity and discuss the challenges associated with genetic analysis and disease prediction.
		Opinion The Hyperferritinemic Syndrome: macrophage activation syndrome, Still’s disease, septic shock and catastrophic antiphospholipid syndrome Cristina Rosário, Gisele Zandman-Goddard, Esther G Meyron-Holtz, David P D’Cruz, Yehuda Shoenfeld BMC Medicine 2013, 11:185 (22 August 2013) Abstract \| Full text \| PDF \| PubMed \| Editor’s summary Yehuda Shoenfeld and colleagues discuss the similar features in macrophage activation syndrome, Still’s disease, antiphospholipid syndrome and septic shock, and propose that they should be grouped together as the Hyperferritinemic Syndrome.
		Research article Hospital admissions for vitamin D related conditions and subsequent immune-mediated disease: record-linkage studies Sreeram V Ramagopalan, Raph Goldacre, Giulio Disanto, Gavin Giovannoni, Michael J Goldacre BMC Medicine 2013, 11:171 (25 July 2013) Abstract \| Full text \| PDF \| PubMed \| Editor’s summary Patients admitted to hospital for vitamin D (vitD) deficiency are more likely to have immune-mediated diseases including Crohn's disease, diabetes and rheumatoid arthritis, suggesting that vitD deficiency could be involved in autoimmunity pathogenesis
		Research article Vitamin D receptor ChIP-seq in primary CD4+ cells: relationship to serum 25-hydroxyvitamin D levels and autoimmune disease Adam E Handel, Geir K Sandve, Giulio Disanto, Antonio J Berlanga-Taylor, Giuseppe Gallone, Heather Hanwell, Finn Drabløs, Gavin Giovannoni, George C Ebers, Sreeram V Ramagopalan BMC Medicine 2013, 11:163 (12 July 2013) Abstract \| Full text \| PDF \| PubMed \| Editor’s summary There is a correlation between vitamin D (vitD) levels and the number of vitD receptor binding sites, which are enriched at autoimmune disease-associated loci when vitD levels are sufficient, providing a link between vitD and disease.
		Review Novel therapeutic agents in clinical development for systemic lupus erythematosus Natasha Jordan, Pamela MK Lutalo, David P D’Cruz BMC Medicine 2013, 11:120 (3 May 2013) Abstract \| Full text \| PDF \| PubMed \| Editor’s summary Traditional treatments for systemic lupus erythematosus (SLE) are associated with toxicity and resistance problems; David D’Cruz and colleagues review novel therapies in clinical development for SLE and discuss results from recent clinical trials.
		Question and Answer Video Q&A: what is ASIA? An interview with Yehuda Shoenfeld Yehuda Shoenfeld BMC Medicine 2013, 11:118 (1 May 2013) Abstract \| Full text \| PDF \| PubMed \| Editor’s summary In this Q&A we talk to Yehuda Shoenfeld about the syndrome, ASIA (Autoimmune or Autoinflammatory Syndrome Induced by Adjuvants) and discuss his recommendations regarding further research in the field.
		Research article Slow CCL2-dependent translocation of biopersistent particles from muscle to brain Zakir Khan, Christophe Combadière, François-Jérôme Authier, Valérie Itier, François Lux, Christopher Exley, Meriem Mahrouf-Yorgov, Xavier Decrouy, Philippe Moretto, Olivier Tillement, Romain K Gherardi, Josette Cadusseau BMC Medicine 2013, 11:99 (4 April 2013) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central \| Editor’s summary Vaccine-derived aluminium and alum-particle fluorescent surrogates are well tolerated in mice, but are transported via monocyte lineage cells from muscle to the brain and spleen, where they accumulate, so higher doses of the adjuvant may be unsafe.
		Research article Anti-ribosomal P protein IgG autoantibodies in patients with systemic lupus erythematosus: diagnostic performance and clinical profile Diana Carmona-Fernandes, Maria Santos, Helena Canhão, João Fonseca BMC Medicine 2013, 11:98 (4 April 2013) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central \| Editor’s summary Anti-ribosomal P antibodies (anti-Rib-P) can identify patients with systemic lupus erythematosus (SLE) with high specificity and positive predictive value, indicating that these antibodies could be used in the clinic to improve accuracy of SLE diagnosis.
		Research article Associations between selected immune-mediated diseases and tuberculosis: record-linkage studies Sreeram V Ramagopalan, Raph Goldacre, Andrew Skingsley, Chris Conlon, Michael J Goldacre BMC Medicine 2013, 11:97 (4 April 2013) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central \| Editor’s summary An analysis of hospital admissions and death certificates across England reveals the risk of tuberculosis (TB) is significantly increased in patients with immune-mediated diseases, highlighting the need for TB screening in these patients.
		Review Phosphodiesterase 4-targeted treatments for autoimmune diseases Neal Kumar, Ari M Goldminz, Noori Kim, Alice B Gottlieb BMC Medicine 2013, 11:96 (4 April 2013) Abstract \| Full text \| PDF \| PubMed \| Editor’s summary Phosphodiesterase (PDE) 4-targeted therapies are a promising option to treat a range of autoimmune diseases; Alice Gottlieb and colleagues review the development of PDE4 inhibitors for chronic conditions and discuss recent clinical trial data.
		Review Renal involvement in autoimmune connective tissue diseases Andreas Kronbichler, Gert Mayer BMC Medicine 2013, 11:95 (4 April 2013) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central \| Editor’s summary Andreas Kronbichler and Gert Mayer discuss renal impairment in autoimmune connective tissue disorders (CTDs) caused by underlying disease or drug reactions, and explain how physicians should take kidney function into account when treating CTDs.
		Commentary Age-related autoimmunity Zahava Vadasz, Tharwat Haj, Aharon Kessel, Elias Toubi BMC Medicine 2013, 11:94 (4 April 2013) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central \| Editor’s summary Elias Toubi and colleagues explore why autoimmunity is high in the elderly, and suggest that increased T-regulatory cells, which compensate for lower levels of thymic T-cells, may lead to a pro-inflammatory response, thereby increasing autoimmunity.
		Review Novel aspects of Sjögren’s syndrome in 2012 Angela Tincani, Laura Andreoli, Ilaria Cavazzana, Andrea Doria, Marta Favero, Maria-Giulia Fenini, Franco Franceschini, Andrea Lojacono, Giuseppe Nascimbeni, Amerigo Santoro, Francesco Semeraro, Paola Toniati, Yehuda Shoenfeld BMC Medicine 2013, 11:93 (4 April 2013) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central \| Editor’s summary Angela Tincani and colleagues review the latest developments in Sjogren's Syndrome research and therapies, and highlight a possible link between Vitamin D levels and development of the disease.
		Research article Coagulopathy triggered autoimmunity: experimental antiphospholipid syndrome in factor V Leiden mice Aviva Katzav, Nikolaos C Grigoriadis, Tania Ebert, Olga Touloumi, Miri Blank, Chaim G Pick, Yehuda Shoenfeld, Joab Chapman BMC Medicine 2013, 11:92 (4 April 2013) Abstract \| Full text \| PDF \| PubMed \| Editor’s summary Transgenic mice induced to develop antiphospholipid syndrome exhibit behavioral and cognitive dysfunction in correlation to the mutation allele load, indicating that the elevated circulating antibodies lead to neurodegeneration.
		Commentary Discoveries in the pathophysiology of neuropsychiatric lupus erythematosus: consequences for therapy Takahisa Gono, Yasushi Kawaguchi, Hisashi Yamanaka BMC Medicine 2013, 11:91 (4 April 2013) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central \| Editor’s summary Takahisa Gono and colleagues comment on a study in mice in which 16/6 idiotype (Id) antibody impairs memory, and argue antibody cross-reactivity could explain the diverse clinical features in SLE with the autoantibody targets as potential therapies.
		Research article 16/6-idiotype expressing antibodies induce brain inflammation and cognitive impairment in mice: the mosaic of central nervous system involvement in lupus Shaye Kivity, Aviva Katzav, Maria Arango, Moran Landau-Rabi, Yaron Zafrir, Nancy Agmon-Levin, Miri Blank, Juan-Manuel Anaya, Edna Mozes, Joab Chapman, Yehuda Shoenfeld BMC Medicine 2013, 11:90 (4 April 2013) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central \| f1000 \| Editor’s summary Injection of 16/6 idiotype antibodies in brains of mice induces lupus symptoms, including cognitive impairment and brain inflammation, suggesting involvement of human anti-DNA antibody in cognitive decline and neuropsychiatric symptoms in lupus patients.
		Research article The thrombophilic network of autoantibodies in celiac disease Aaron Lerner, Nancy Agmon-Levin, Yinon Shapira, Boris Gilburd, Sandra Reuter, Idit Lavi, Yehuda Shoenfeld BMC Medicine 2013, 11:89 (4 April 2013) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central \| Editor’s summary Autoantibodies against thrombogenic factors are present at higher levels in children with celiac disease compared with healthy controls, suggesting these antibodies could be a therapeutic target for thrombophilia in celiac patients.
		Review Biologic therapy for autoimmune diseases: an update Ziv Rosman, Yehuda Shoenfeld, Gisele Zandman-Goddard BMC Medicine 2013, 11:88 (4 April 2013) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central \| Editor’s summary Gisele Zandman-Goddard and colleagues review the advantages and drawbacks of biologic therapies for autoimmune disease, and discuss the importance of having a range of drugs available to treat patients with severe or resistant disease.
		Editorial Novel pebbles in the mosaic of autoimmunity Carlo Perricone, Nancy Agmon-Levin, Yehuda Shoenfeld BMC Medicine 2013, 11:101 (4 April 2013) Abstract \| Full text \| PDF \| PubMed \| Editor’s summary Yehuda Shoenfeld and colleagues launch our new article collection, Autoimmunity, with an editorial discussing the evolution of autoimmunity research and emerging concepts in the pathology of autoimmune diseases.
		Review Requirements for innate immune pathways in environmentally induced autoimmunity Kenneth Pollard, Dwight H Kono BMC Medicine 2013, 11:100 (4 April 2013) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central \| Editor’s summary Kenneth Pollard and Dwight Kono review the immune pathways involved in idiopathic and environmentally induced autoimmunity, and highlight that further investigation is needed to understand the mechanistic pathways underlying this elusive condition.
		Research article How do autoimmune diseases cluster in families? A systematic review and meta-analysis Jorge Cárdenas-Roldán, Adriana Rojas-Villarraga, Juan-Manuel Anaya BMC Medicine 2013, 11:73 (18 March 2013) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central \| Editor’s summary Evidence from a systematic review and meta-analysis shows autoimmune diseases, particularly autoimmune thyroid disease and systemic lupus erythematosus, aggregate in families, indicating that shared genetic factors may be responsible.
		Research article Month of birth, vitamin D and risk of immune-mediated disease: a case control study Giulio Disanto, George Chaplin, Julia M Morahan, Gavin Giovannoni, Elina Hyppönen, George C Ebers, Sreeram V Ramagopalan BMC Medicine 2012, 10:69 (6 July 2012) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central \| 1 comment \| Editor’s summary A large study finds a link between month of birth and prevalence of common immune-mediated diseases, which may be mediated by UVB light exposure and vitamin D status during gestation, providing insight for disease prevention strategies.

		Minireview What is next after the genes for autoimmunity? John Castiblanco, Mauricio Arcos-Burgos, Juan-Manuel Anaya BMC Medicine 2013, 11:197 (4 September 2013) Abstract \| Full text \| PDF \| Editor’s summary Autoimmune diseases have complex etiology and are known to aggregate in families; Juan-Manuel Anaya and colleagues review the genetic components of autoimmunity and discuss the challenges associated with genetic analysis and disease prediction.
		Opinion The Hyperferritinemic Syndrome: macrophage activation syndrome, Still’s disease, septic shock and catastrophic antiphospholipid syndrome Cristina Rosário, Gisele Zandman-Goddard, Esther G Meyron-Holtz, David P D’Cruz, Yehuda Shoenfeld BMC Medicine 2013, 11:185 (22 August 2013) Abstract \| Full text \| PDF \| PubMed \| Editor’s summary Yehuda Shoenfeld and colleagues discuss the similar features in macrophage activation syndrome, Still’s disease, antiphospholipid syndrome and septic shock, and propose that they should be grouped together as the Hyperferritinemic Syndrome.
		Research article Hospital admissions for vitamin D related conditions and subsequent immune-mediated disease: record-linkage studies Sreeram V Ramagopalan, Raph Goldacre, Giulio Disanto, Gavin Giovannoni, Michael J Goldacre BMC Medicine 2013, 11:171 (25 July 2013) Abstract \| Full text \| PDF \| PubMed \| Editor’s summary Patients admitted to hospital for vitamin D (vitD) deficiency are more likely to have immune-mediated diseases including Crohn's disease, diabetes and rheumatoid arthritis, suggesting that vitD deficiency could be involved in autoimmunity pathogenesis
		Research article Vitamin D receptor ChIP-seq in primary CD4+ cells: relationship to serum 25-hydroxyvitamin D levels and autoimmune disease Adam E Handel, Geir K Sandve, Giulio Disanto, Antonio J Berlanga-Taylor, Giuseppe Gallone, Heather Hanwell, Finn Drabløs, Gavin Giovannoni, George C Ebers, Sreeram V Ramagopalan BMC Medicine 2013, 11:163 (12 July 2013) Abstract \| Full text \| PDF \| PubMed \| Editor’s summary There is a correlation between vitamin D (vitD) levels and the number of vitD receptor binding sites, which are enriched at autoimmune disease-associated loci when vitD levels are sufficient, providing a link between vitD and disease.
		Review Novel therapeutic agents in clinical development for systemic lupus erythematosus Natasha Jordan, Pamela MK Lutalo, David P D’Cruz BMC Medicine 2013, 11:120 (3 May 2013) Abstract \| Full text \| PDF \| PubMed \| Editor’s summary Traditional treatments for systemic lupus erythematosus (SLE) are associated with toxicity and resistance problems; David D’Cruz and colleagues review novel therapies in clinical development for SLE and discuss results from recent clinical trials.
		Question and Answer Video Q&A: what is ASIA? An interview with Yehuda Shoenfeld Yehuda Shoenfeld BMC Medicine 2013, 11:118 (1 May 2013) Abstract \| Full text \| PDF \| PubMed \| Editor’s summary In this Q&A we talk to Yehuda Shoenfeld about the syndrome, ASIA (Autoimmune or Autoinflammatory Syndrome Induced by Adjuvants) and discuss his recommendations regarding further research in the field.
		Research article Slow CCL2-dependent translocation of biopersistent particles from muscle to brain Zakir Khan, Christophe Combadière, François-Jérôme Authier, Valérie Itier, François Lux, Christopher Exley, Meriem Mahrouf-Yorgov, Xavier Decrouy, Philippe Moretto, Olivier Tillement, Romain K Gherardi, Josette Cadusseau BMC Medicine 2013, 11:99 (4 April 2013) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central \| Editor’s summary Vaccine-derived aluminium and alum-particle fluorescent surrogates are well tolerated in mice, but are transported via monocyte lineage cells from muscle to the brain and spleen, where they accumulate, so higher doses of the adjuvant may be unsafe.
		Research article Anti-ribosomal P protein IgG autoantibodies in patients with systemic lupus erythematosus: diagnostic performance and clinical profile Diana Carmona-Fernandes, Maria Santos, Helena Canhão, João Fonseca BMC Medicine 2013, 11:98 (4 April 2013) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central \| Editor’s summary Anti-ribosomal P antibodies (anti-Rib-P) can identify patients with systemic lupus erythematosus (SLE) with high specificity and positive predictive value, indicating that these antibodies could be used in the clinic to improve accuracy of SLE diagnosis.
		Research article Associations between selected immune-mediated diseases and tuberculosis: record-linkage studies Sreeram V Ramagopalan, Raph Goldacre, Andrew Skingsley, Chris Conlon, Michael J Goldacre BMC Medicine 2013, 11:97 (4 April 2013) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central \| Editor’s summary An analysis of hospital admissions and death certificates across England reveals the risk of tuberculosis (TB) is significantly increased in patients with immune-mediated diseases, highlighting the need for TB screening in these patients.
		Review Phosphodiesterase 4-targeted treatments for autoimmune diseases Neal Kumar, Ari M Goldminz, Noori Kim, Alice B Gottlieb BMC Medicine 2013, 11:96 (4 April 2013) Abstract \| Full text \| PDF \| PubMed \| Editor’s summary Phosphodiesterase (PDE) 4-targeted therapies are a promising option to treat a range of autoimmune diseases; Alice Gottlieb and colleagues review the development of PDE4 inhibitors for chronic conditions and discuss recent clinical trial data.
		Review Renal involvement in autoimmune connective tissue diseases Andreas Kronbichler, Gert Mayer BMC Medicine 2013, 11:95 (4 April 2013) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central \| Editor’s summary Andreas Kronbichler and Gert Mayer discuss renal impairment in autoimmune connective tissue disorders (CTDs) caused by underlying disease or drug reactions, and explain how physicians should take kidney function into account when treating CTDs.
		Commentary Age-related autoimmunity Zahava Vadasz, Tharwat Haj, Aharon Kessel, Elias Toubi BMC Medicine 2013, 11:94 (4 April 2013) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central \| Editor’s summary Elias Toubi and colleagues explore why autoimmunity is high in the elderly, and suggest that increased T-regulatory cells, which compensate for lower levels of thymic T-cells, may lead to a pro-inflammatory response, thereby increasing autoimmunity.
		Review Novel aspects of Sjögren’s syndrome in 2012 Angela Tincani, Laura Andreoli, Ilaria Cavazzana, Andrea Doria, Marta Favero, Maria-Giulia Fenini, Franco Franceschini, Andrea Lojacono, Giuseppe Nascimbeni, Amerigo Santoro, Francesco Semeraro, Paola Toniati, Yehuda Shoenfeld BMC Medicine 2013, 11:93 (4 April 2013) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central \| Editor’s summary Angela Tincani and colleagues review the latest developments in Sjogren's Syndrome research and therapies, and highlight a possible link between Vitamin D levels and development of the disease.
		Research article Coagulopathy triggered autoimmunity: experimental antiphospholipid syndrome in factor V Leiden mice Aviva Katzav, Nikolaos C Grigoriadis, Tania Ebert, Olga Touloumi, Miri Blank, Chaim G Pick, Yehuda Shoenfeld, Joab Chapman BMC Medicine 2013, 11:92 (4 April 2013) Abstract \| Full text \| PDF \| PubMed \| Editor’s summary Transgenic mice induced to develop antiphospholipid syndrome exhibit behavioral and cognitive dysfunction in correlation to the mutation allele load, indicating that the elevated circulating antibodies lead to neurodegeneration.
		Commentary Discoveries in the pathophysiology of neuropsychiatric lupus erythematosus: consequences for therapy Takahisa Gono, Yasushi Kawaguchi, Hisashi Yamanaka BMC Medicine 2013, 11:91 (4 April 2013) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central \| Editor’s summary Takahisa Gono and colleagues comment on a study in mice in which 16/6 idiotype (Id) antibody impairs memory, and argue antibody cross-reactivity could explain the diverse clinical features in SLE with the autoantibody targets as potential therapies.
		Research article 16/6-idiotype expressing antibodies induce brain inflammation and cognitive impairment in mice: the mosaic of central nervous system involvement in lupus Shaye Kivity, Aviva Katzav, Maria Arango, Moran Landau-Rabi, Yaron Zafrir, Nancy Agmon-Levin, Miri Blank, Juan-Manuel Anaya, Edna Mozes, Joab Chapman, Yehuda Shoenfeld BMC Medicine 2013, 11:90 (4 April 2013) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central \| f1000 \| Editor’s summary Injection of 16/6 idiotype antibodies in brains of mice induces lupus symptoms, including cognitive impairment and brain inflammation, suggesting involvement of human anti-DNA antibody in cognitive decline and neuropsychiatric symptoms in lupus patients.
		Research article The thrombophilic network of autoantibodies in celiac disease Aaron Lerner, Nancy Agmon-Levin, Yinon Shapira, Boris Gilburd, Sandra Reuter, Idit Lavi, Yehuda Shoenfeld BMC Medicine 2013, 11:89 (4 April 2013) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central \| Editor’s summary Autoantibodies against thrombogenic factors are present at higher levels in children with celiac disease compared with healthy controls, suggesting these antibodies could be a therapeutic target for thrombophilia in celiac patients.
		Review Biologic therapy for autoimmune diseases: an update Ziv Rosman, Yehuda Shoenfeld, Gisele Zandman-Goddard BMC Medicine 2013, 11:88 (4 April 2013) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central \| Editor’s summary Gisele Zandman-Goddard and colleagues review the advantages and drawbacks of biologic therapies for autoimmune disease, and discuss the importance of having a range of drugs available to treat patients with severe or resistant disease.
		Editorial Novel pebbles in the mosaic of autoimmunity Carlo Perricone, Nancy Agmon-Levin, Yehuda Shoenfeld BMC Medicine 2013, 11:101 (4 April 2013) Abstract \| Full text \| PDF \| PubMed \| Editor’s summary Yehuda Shoenfeld and colleagues launch our new article collection, Autoimmunity, with an editorial discussing the evolution of autoimmunity research and emerging concepts in the pathology of autoimmune diseases.
		Review Requirements for innate immune pathways in environmentally induced autoimmunity Kenneth Pollard, Dwight H Kono BMC Medicine 2013, 11:100 (4 April 2013) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central \| Editor’s summary Kenneth Pollard and Dwight Kono review the immune pathways involved in idiopathic and environmentally induced autoimmunity, and highlight that further investigation is needed to understand the mechanistic pathways underlying this elusive condition.
		Research article How do autoimmune diseases cluster in families? A systematic review and meta-analysis Jorge Cárdenas-Roldán, Adriana Rojas-Villarraga, Juan-Manuel Anaya BMC Medicine 2013, 11:73 (18 March 2013) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central \| Editor’s summary Evidence from a systematic review and meta-analysis shows autoimmune diseases, particularly autoimmune thyroid disease and systemic lupus erythematosus, aggregate in families, indicating that shared genetic factors may be responsible.
		Research article Month of birth, vitamin D and risk of immune-mediated disease: a case control study Giulio Disanto, George Chaplin, Julia M Morahan, Gavin Giovannoni, Elina Hyppönen, George C Ebers, Sreeram V Ramagopalan BMC Medicine 2012, 10:69 (6 July 2012) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central \| 1 comment \| Editor’s summary A large study finds a link between month of birth and prevalence of common immune-mediated diseases, which may be mediated by UVB light exposure and vitamin D status during gestation, providing insight for disease prevention strategies.