Annals of the Russian academy of medical sciencesAnnals of the Russian academy of medical sciencesВестник Российской академии медицинских наук0869-60472414-3545"Paediatrician" Publishers LLC127610.15690/vramn1276IMMUNOLOGY: CURRENT ISSUESАКТУАЛЬНЫЕ ВОПРОСЫ ИММУНОЛОГИИResearch ArticleHyperstimulation of the immune system as a cause of autoimmune diseasesГиперстимуляция иммунной системы как причина аутоиммунных заболеванийhttps://orcid.org/0000-0001-6973-99018991-9240RyabkovaVarvara A.РябковаВарвара Александровна
Russian Federation
varvara-ryabkova@yandex.ruhttps://orcid.org/0000-0001-6359-00268879-0875ChurilovLeonid P.ЧуриловЛеонид Павлович
Russian Federation

MD, PhD, Professor

к.м.н., профессор

elpach@mail.ruhttps://orcid.org/0000-0003-2802-40905950-3930ShoenfeldYehudaШенфельдИегуда
Israel

MD, PhD, Professor

д.м.н, профессор, академик Израильской академии естественных и гуманитарных наук

shoenfel@post.tau.ac.ilSaint Petersburg State UniversityСанкт-Петербургский государственный университетTel-Aviv University School of MedicineУниверситет Тель-АвиваThe First I.M. Sechenov Moscow State Medical University (Sechenov University)Первый Московский государственный медицинский университет имени И.М. Сеченова Минздрава России (Сеченовский Университет)310820207532042132901202002062020Copyright ©; 2020, "Paediatrician" Publishers LLCCopyright ©; 2020, Издательство "Педиатръ"2020"Paediatrician" Publishers LLCИздательство "Педиатръ"https://vestnikramn.spr-journal.ru/jour/about/submissionshttps://vestnikramn.spr-journal.ru/jour/article/view/1276

The pathogenesis of autoimmune diseases is very complex and multi-factorial. The concept of “Mosaics of Autoimmunity” was introduced to the scientific community 30 years ago by Y. Shoenfeld and D.A. Isenberg, and since then new tiles to the puzzle are continuously added. This concept specifies general pathological ideas about the multifactorial threshold model for polygenic inheritance with a threshold effect by the action of a number of external causal factors as applied to the field of autoimmunology. Among the external factors that can excessively stimulate the immune system, contributing to the development of autoimmune reactions, researchers are particularly interested in chemical substances, which are widely used in pharmacology and medicine. In this review we highlight the autoimmune dynamics — i.e. a multistep pathogenesis of autoimmune diseases and the subsequent development of lymphoma in some cases. In this context several issues are addressed — namely, genetic basis of autoimmunity; environmental immunostimulatory risk factors; gene/environmental interaction; pre-clinical autoimmunity with the presence of autoantibodies; and the mechanisms, underlying lymphomagenesis in autoimmune pathology. We believe that understanding the common model of the pathogenesis of autoimmune diseases is the first step to their successful management.

Аутоиммунопатии являются мультифакториальными заболеваниями со сложным патогенезом. Понятие «мозаика аутоиммунитета», конкретизирующее общепатологические представления о концепции аддитивно-полигенного наследования с пороговым эффектом по действию ряда внешних причинных факторов, применительно к сфере аутоиммунологии было представлено научному сообществу 30 лет назад И. Шенфельдом и Д.А. Айзенбергом. С тех пор к «мозаике» постоянно добавляются новые элементы. Среди внешних факторов, способных избыточно стимулировать иммунную систему, внося свой вклад в развитие аутоиммунных реакций, особое внимание исследователей привлекают химические вещества, широко используемые в фармакологии и медицине. В данном обзоре освещена динамика развития аутоиммунных заболеваний, т.е. их патогенез рассматривается как многоэтапный процесс, в рамках которого также становится возможным объяснить повышенный риск развития лимфом при аутоиммунной патологии. При описании этого многоэтапного процесса уделено внимание следующим аспектам: генетическая основа нарушений аутоиммунитета; экологические иммуностимулирующие факторы риска развития аутоиммунопатий; взаимодействие генетических и средовых факторов; стадия субклинического заболевания с присутствием аутоантител; механизмы, лежащие в основе лимфомагенеза при аутоиммунной патологии. Мы считаем, что создание общей модели патогенеза аутоиммунных заболеваний является первым шагом к их успешному лечению.

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