The danger model approach to the pathogenesis of the rheumatic diseases

J Immunol Res. 2015:2015:506089. doi: 10.1155/2015/506089. Epub 2015 Apr 20.

Abstract

The danger model was proposed by Polly Matzinger as complement to the traditional self-non-self- (SNS-) model to explain the immunoreactivity. The danger model proposes a central role of the tissular cells' discomfort as an element to prime the immune response processes in opposition to the traditional SNS-model where foreignness is a prerequisite. However recent insights in the proteomics of diverse tissular cells have revealed that under stressful conditions they have a significant potential to initiate, coordinate, and perpetuate autoimmune processes, in many cases, ruling over the adaptive immune response cells; this ruling potential can also be confirmed by observations in several genetically manipulated animal models. Here, we review the pathogenesis of rheumatic diseases such as systemic lupus erythematous, rheumatoid arthritis, spondyloarthritis including ankylosing spondylitis, psoriasis, and Crohn's disease and provide realistic approaches based on the logic of the danger model. We assume that tissular dysfunction is a prerequisite for chronic autoimmunity and propose two genetically conferred hypothetical roles for the tissular cells causing the disease: (A) the Impaired cell and (B) the paranoid cell. Both roles are not mutually exclusive. Some examples in human disease and in animal models are provided based on current evidence.

Publication types

  • Review

MeSH terms

  • Autoimmunity / immunology*
  • DNA Damage / genetics
  • DNA Damage / immunology
  • DNA Repair / genetics
  • Humans
  • Immunity, Innate / immunology
  • Interleukin-17 / immunology
  • Models, Theoretical
  • Receptors, Pattern Recognition / immunology
  • Rheumatic Diseases / immunology*
  • Rheumatic Diseases / pathology*
  • Self Tolerance / immunology*
  • Signal Transduction / immunology

Substances

  • Interleukin-17
  • Receptors, Pattern Recognition