Idiotypic network dysregulation - A common etiopathogenesis of diverse autoimmune diseases

The pathogenesis of autoimmune disease is still an enigma. Whereas the dive rse clinical manifestations of many autoimmune diseases cannot be explained by the existence of autoantibodies, idiotypic dysregulation may provide an alternative explanation. Experimental models, serum level changes of patho genic idiotypes during exacerbation and remission, and the increased expres sion of pathogenic idiotypes following common infections all support this n otion. In this article we review experimental models of autoimmune disease induction (systemic lupus erythematosus, antiphospholipid syndrome, Goodpas ture's syndrome, autoimmune thyroiditis, and vasculitis) by manipulation of the idiotypic network, and discuss the utilization of idiotypes for the im munotherapy of autoimmune diseases and other conditions that involve the im mune system (e.g., atherosclerosis).