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Guidelines
Topic – Immune Cells as Villains: Misdirected Immune Attack During Autoimmune
Diseases
Cells of our immune system often serve as “heroes,” playing protective roles in our bodies against
various pathogens and diseases. However, failure of tolerance to self-antigens elicits “villainous”
immune activity by an individual’s T cells and antibodies, resulting in destructive tissue damage
and disease. These misdirected immune attacks are called autoimmunity, and the diseases they
cause are called autoimmune diseases.
Autoimmune diseases, like allergic reactions, are more common in countries with more
prosperous economies. The incidence of autoimmune diseases in these countries has steadily
increased over the last 80 years and is largely explained by the impact of lifestyle and a hyper-sanitized environment on the immune system. Researchers are trying to elucidate what makes
some people more susceptible to autoimmunity. Genes that control self-tolerance mechanisms
play an important part, but a trigger is necessary to prompt the autoimmune process. The main
culprits are viral infections, and data from the current Covid pandemic have reinforced this idea.
However, changes in microbiome composition are also starting to emerge as possible contributors
to autoimmune susceptibility. Autoimmune diseases are generally more common in women than
in men but the reasons for this observation are unclear.
Various immune effectors, mainly autoantibodies and autoreactive T cells cause tissue injury in
different autoimmune diseases. The clinical manifestation of the disease depends on whether the
site of the autoimmune attack is localized to a particular organ/tissue or is more systemic.
Autoimmunity tends to be discovered after years of the initial immune attack when the tissue
damage has escalated to cause a disease that becomes chronic and self-perpetuating since the
target of immune attack are self-antigens that cannot be eliminated.

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