The time period between the onset of markers of autoimmunity and the development of disease has been termed “pre-clinical” or “incomplete” disease. It can be difficult to study as the stages of illness are not well-defined and there is considerable overlap between different disease conditions and between pre-clinical disease and the healthy population. Nonetheless, this is an important topic to study. Dissection of aberrant immunological and metabolic pathways early in disease prior to the onset of widespread organ pathology is a key element in understanding the ‘signals’ driving autoimmunity without the ‘noise’ of the immune system responding to tissue and organ pathology. It offers the opportunity to more carefully describe the heterogeneity of immune dysregulation that ultimately results in similar clinical phenotypes. This provides the key to finding specific and early interventions at the individual patient level to prevent, rather than treat, autoimmune disease. The aim of this Research Topic is to review the most current and exciting research in pre-clinical autoimmunity across a number of conditions including, but not limited to type 1 diabetes, multiple sclerosis, rheumatoid arthritis and systemic lupus erythematosus.
Although individual autoimmune diseases are uncommon, as a group, they affect approximately 5% of the US population. They range from organ-specific conditions such as type 1 diabetes mellitus and multiple sclerosis to systemic conditions including systemic lupus erythematosus and Sjögren’s syndrome. Together, these diseases account for significant organ damage, disability and shortened lifespan.
The diagnosis of autoimmune disorders is often difficult, as early features of disease mimic other conditions and laboratory or radiographic changes lack specificity for the disease under study. Nonetheless, longitudinal studies of select cohorts as well as cross-sectional studies have illustrated that there is typically a slow progression of disease features from healthy individuals to individuals with biomarkers of autoimmunity (e.g., autoantibodies) but no clinical features to early and finally late disease manifestations. This progression from health to disease may take up to a decade and is marked by the demonstration of not only autoreactive T and B cells, but changes in cytokine, chemokine and signaling molecule expression at the protein and RNA level.
This Research Topic welcomes Original Research, Systematic Review, Perspective, Opinion and Clinical Trial articles focusing on, but not limited to:
• Early modulation of inflammatory pathways involving cytokines, chemokines, macrophage polarization, regulatory lymphocytes, etc., prior to the development of autoreactive T and B cells.
• Genetic, epigenetic and transcriptional changes in individuals at risk for the development of autoimmunity
• Effect of different microbiomes on the risk of developing autoimmunity
• Therapeutic strategies for halting the progression of autoimmunity at the pre-clinical stage
The time period between the onset of markers of autoimmunity and the development of disease has been termed “pre-clinical” or “incomplete” disease. It can be difficult to study as the stages of illness are not well-defined and there is considerable overlap between different disease conditions and between pre-clinical disease and the healthy population. Nonetheless, this is an important topic to study. Dissection of aberrant immunological and metabolic pathways early in disease prior to the onset of widespread organ pathology is a key element in understanding the ‘signals’ driving autoimmunity without the ‘noise’ of the immune system responding to tissue and organ pathology. It offers the opportunity to more carefully describe the heterogeneity of immune dysregulation that ultimately results in similar clinical phenotypes. This provides the key to finding specific and early interventions at the individual patient level to prevent, rather than treat, autoimmune disease. The aim of this Research Topic is to review the most current and exciting research in pre-clinical autoimmunity across a number of conditions including, but not limited to type 1 diabetes, multiple sclerosis, rheumatoid arthritis and systemic lupus erythematosus.
Although individual autoimmune diseases are uncommon, as a group, they affect approximately 5% of the US population. They range from organ-specific conditions such as type 1 diabetes mellitus and multiple sclerosis to systemic conditions including systemic lupus erythematosus and Sjögren’s syndrome. Together, these diseases account for significant organ damage, disability and shortened lifespan.
The diagnosis of autoimmune disorders is often difficult, as early features of disease mimic other conditions and laboratory or radiographic changes lack specificity for the disease under study. Nonetheless, longitudinal studies of select cohorts as well as cross-sectional studies have illustrated that there is typically a slow progression of disease features from healthy individuals to individuals with biomarkers of autoimmunity (e.g., autoantibodies) but no clinical features to early and finally late disease manifestations. This progression from health to disease may take up to a decade and is marked by the demonstration of not only autoreactive T and B cells, but changes in cytokine, chemokine and signaling molecule expression at the protein and RNA level.
This Research Topic welcomes Original Research, Systematic Review, Perspective, Opinion and Clinical Trial articles focusing on, but not limited to:
• Early modulation of inflammatory pathways involving cytokines, chemokines, macrophage polarization, regulatory lymphocytes, etc., prior to the development of autoreactive T and B cells.
• Genetic, epigenetic and transcriptional changes in individuals at risk for the development of autoimmunity
• Effect of different microbiomes on the risk of developing autoimmunity
• Therapeutic strategies for halting the progression of autoimmunity at the pre-clinical stage
