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Review Article
Advances in Immunology
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Volume 344:655-664 March 1, 2001 Number 9
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Tolerance and Autoimmunity
Thomas Kamradt, M.D., and N. Avrion Mitchison, Ph.D.

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The immunologic specificity of the antigen receptors of T cells and B cells is the result of random shuffling of the many genes that form the DNA code for the antigen-binding site of these receptors.1,2,3 Theoretically, this process could generate 109 different T-cell receptors, including some that can bind to autoantigens (these cells are often called self-reactive T cells). Tolerance is the process that eliminates or neutralizes such autoreactive cells, and a breakdown in the working of this system can cause autoimmunity.

B-Cell Tolerance

Autoantibodies are characteristic of many autoimmune diseases and may be the direct cause of the lesions in some . . . [Full Text of this Article]

Central T-Cell Tolerance

Peripheral T-Cell Tolerance

Ignorance

Deletion

Regulation

            Anergy

            Inhibition

            Suppression and Deviation

Breakdown of Tolerance

Genetic Susceptibility to Autoimmunity

Therapeutic Implications

Immunomodulation

Purging Autoreactive T Cells from the T-Cell Repertoire

Conclusions


Source Information

From the Deutsches Rheumaforschungszentrum Berlin and Universitätsklinikum Charité, Medizinische Klinik mit Schwerpunkt Rheumatologie and Klinische Immunologie, Berlin, Germany (T.K.); and the Department of Immunology, University College London Medical School, London (N.A.M.).

Address reprint requests to Dr. Kamradt at the Deutsches Rheumaforschungszentrum, Schumannstr. 21/22, 10117 Berlin, Germany, or at kamradt@drfz.de.

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