I often marvel at how lucky I am to be studying autoimmune diseases. This is a rapidly developing ﬁeld that provides huge opportunities to have a signiﬁcant impact on the quality and length of people’s lives.
The normal immune system is like a well-armed and very clever sleuth, looking for things that should not be there and then blasting them away. Unfortunately, sometimes the sleuth loses its focus and becomes confused into thinking that a person’s own tissues are a foreign invader. When the immune system attacks its own body, the illness is called autoimmune disease.
When I was a medical student, I saw the enormous damage that the immune system could mistakenly inﬂict on the body in these diseases, sometimes shutting down the kidneys, causing deep, ugly, and painful skin sores, or destroying the joints with severe arthritis. These diseases range from lupus to rheumatoid arthritis to scleroderma.
Tissues and organs, from the skin to the heart to the brain, can become inﬂamed and damaged. Someone suffering from an autoimmune disease may have a fever and feel very tired, just as if they were ﬁghting a real infection by a virus or bacterium.
As a physician who specializes in diagnosing and treating autoimmune diseases, I am fascinated by following the trail of one of the most gifted “sleuths” known, learning from watching it at work, and trying to design new therapies to outsmart it when it goes awry. Much of the work my colleagues and I do involves people with autoimmune diseases, and it is a privilege to be the recipient of their generosity when they allow us to take blood and pieces of tissue for our studies.
Although the causes of autoimmune diseases are still unknown, the diseases are quite common, and almost all of us have a relative or friend affected by one of them. During the past twenty years, science has advanced dramatically in understanding the methods the immune system uses to recognize its targets, and the tools it uses to destroy perceived attackers. This understanding has helped us identify new ways to diagnose and treat autoimmune diseases, in some cases with spectacular results. For instance, doctors recently discovered that certain drugs can act on the immune system so as to essentially turn off rheumatoid arthritis, an autoimmune disease characterized by pain and swelling in the joints. The discovery has revolutionized the treatment of this previously devastating condition. This is just one example of the exciting recent developments in immunology.