Drug-induced autoimmunity.
OBJECTIVE
Presentation of different mechanism of drug-induced autoimmunity and highlighting of new developments.


RESULTS
Drugs can induce autoimmune diseases by their pharmacological properties. Injection of certain drugs into the thymus can alter positive selection in the thymus and elicit autoimmune reactions. Peripheral tolerance can be broken by increasing the expression of LFA-1 adhesion molecule on T cells. This can be related to the inhibition of intracellular kinases. Alternatively, a drug specific immune response might elicit autoimmunity by cross-reactivity: the drug reactive T cells might be cross-reactive with certain peptide antigens and possibly autoantigens.


CONCLUSIONS
Drug-specific immune responses are well described. They have a great tendency to be cross-reactive with peptide antigens. This 'immunological' cause of autoimmunity elicited by drugs may occur more frequently than thought. It connects the field of drug hypersensitivity with drug-induced autoimmunity.
Pichler
Werner J
WJ
Clinic for Rheumatology, University of Bern, Bern, Switzerland. werner.pichler@insel.ch
D000938:Antigen-Presenting Cells; D015551:Autoimmunity / Q000276:immunology*; D003429:Cross Reactions; D004342:Drug Hypersensitivity / Q000276:immunology*; D006801:Humans; D007108:Immune Tolerance; D013601:T-Lymphocytes