1 Consequently, immunologists adjusted their focus from trying to determine why autoreactive cells escape deletion to exploring how the immune system maintains a homeostatic balance and why it sometimes fails. It seems clear that understanding this balance - a peaceful coexistence of protective immunity without self-destructing - will reveal how the immune system really works and how autoimmunity is triggered.

The challenge resides in the complexity of the biochemical and cellular pathways involved in tolerance, which is the immune system's ability to distinguish self from non-self, allowing the body to recognize and destroy invading viruses, bacteria, and other pathogens while ignoring the body's own tissue and organs. Moreover, genetic and environmental influences that we don't fully understand multiply the complications of the pathways. The discovery and characterization of the regulatory pathways, however, will lead to new drugs and cell therapies for autoimmune diseases.2-4

Distinguishing the Diseases

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