New Insights Into the Phenomenon of Remissions and Relapses in Autoimmune Diseases and the Puzzle of Benign Autoantibodies in Healthy Individuals

May 2025 in “ Frontiers in Immunology ”

Zeev Elkoshi

alopecia areata autoimmune diseases autoantibodies immune privilege stem cell activity

TLDR Autoimmune diseases with high tissue recovery often relapse and remit, while those with low recovery rarely remit.

The document examines the dynamics of remissions and relapses in autoimmune diseases (AIDs), emphasizing the role of tissue regenerative capacity. It highlights that AIDs affecting tissues with high recovery rates, such as alopecia areata (AA) and multiple sclerosis (MS), often exhibit relapsing-remitting patterns and are associated with benign autoantibodies found in healthy individuals. In contrast, diseases like advanced Type 1 Diabetes (T1D) and primary biliary cholangitis (PBC), which target tissues with low regenerative capacity, rarely experience remissions. The study underscores the importance of understanding tissue recovery and destruction rates for managing AIDs and achieving remissions, suggesting that factors like immune privilege and stem cell activity are crucial. It also discusses the potential protective role of certain autoantibodies and the complex interplay of immune responses in AIDs.

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