Hal Scofield from the Oklahoma Research Foundation, USA, discusses recent evidence suggesting that autoantibodies (antibodies that attack the body's own tissue) are often apparent several years before an illness becomes manifest. He cites recent research among people with rheumatoid arthritis where specific autoantibodies were detected more than four years before the onset of disease symptoms.
Professor Scofield comments: "the data indicate that autoimmune disease is preceded by a long preclinical phase in which individuals can be identified by the presence of autoantibodies. Such identification might allow immunological treatment whereby disease is prevented, as is already being studied in diabetes. Alternatively, even if disease cannot be prevented, perhaps life-threatening but treatable conditions could be avoided, such as diabetic coma as well as severe, acute complications of untreated Addison's disease (adrenal-gland failure) or Graves' disease (overactive thyroid gland). For all these diseases, except type 1 diabetes, further work is needed to assess the natural history of disease progression and predictive value of autoantibodies in healthy individuals".
Contact: Professor Hal Scofield MD, Oklahoma Medical Research Foundation, 825 NE 13th Street, Oklahoma City, OK 73014, USA, T) +1 405 271 7061, F) +1 405 271 7063; E) Hal-Scofield@omrf.ouhsc.edu
Lancet 2004; 363: 1544-46