Autoimmunity: A history of the early struggle for recognition

During the early days of immunology, Paul Ehrlich’s theories dominated the field. These included his concept of horror autotoxicus, which held that the individual could not form antibodies against its own tissues. In addition, the view that the “protective” immune mechanisms might cause disease seemed dysteleological, so that even the early demonstration of an autoimmune hemolytic disease, paroxysmal cold hemoglobinuria, failed to convert the field. Then, as notable successes became rarer, immunological research moved to more chemical approaches, and for some 40 years, biology and medicine became less prominent. Notions of autoimmunity or of immunogenic disease in general, if made at all, did not attract the attention of immunochemically oriented investigators. Only when conceptual biological challenges to the contemporary chemical paradigm could not be explained did immunology return to more medical and biological pursuits in the 1950s and 1960s. This led to a renaissance of interest in autoimmunity and in the mechanisms of regulation of tolerance, whose success prevents autoimmune disease and whose failure elicits it.