The immune system is a powerful force for protecting the body from infections. It fights germs when we catch them, but sometimes the immune system can cause disease when it attacks our own bodies, which is called autoimmunity. The autoimmune diseases are different depending on which tissues and organs are damaged. Collectively, these conditions affect those of all ages and touch virtually every part of the body, often with devastating consequences. Many autoimmune diseases occur more frequently in women than in men. Some are more common or more severe in certain minority groups.

Treatment and understanding

Over the past several decades, research supported by the National Institutes of Health has improved understanding of the immune system and its role in autoimmunity. We have identified fundamental similarities among autoimmune conditions: abnormalities in immune cells, inflammation, and organ damage.

Additionally, we now know that genetic, environmental, and other factors affect the risk and severity of autoimmune disease. This knowledge has led to a number of treatments that block harmful immune responses. These advances have increased life expectancy and significantly improved quality of life for affected patients.

A call for new therapies

Despite considerable progress, safer and more effective therapies are needed. Some individuals do not respond to treatments or eventually stop responding. Furthermore, most therapies are not specific to a particular disease or affected organ; they broadly dampen the immune system, which can interfere with the body’s overall ability to protect against infections.

Our immediate goal is to develop treatment options that precisely target disease-causing immune responses without compromising the properly functioning parts of the immune system. We are developing new approaches to identify specific targets in affected tissues, for example, the lining of the joints in patients with rheumatoid arthritis, the skin or kidney in lupus patients, or hair follicles in patients with alopecia areata. This research will enable the development of treatments that target disease-causing molecules in the affected tissues. Long-term, we hope to understand the roots of autoimmunity, which might allow us to stop autoimmune conditions from progressing or even prevent them entirely.

New frontiers  

Four years ago, the National Institutes of Health began the Accelerating Medicines Partnership in rheumatoid arthritis and systemic lupus erythematosus, a public-private partnership with several pharmaceutical companies and non-profit organizations to overcome challenges of drug and diagnostic development for autoimmune diseases. While this highly collaborative effort began with a focus on two autoimmune diseases, rheumatoid arthritis and systemic lupus erythematosus, its results may shed light on many others. The program, which combines basic and clinical research with cutting-edge technology, represents a sea-change in how we study autoimmune diseases because it looks at inflamed tissues in patients. Over time, we hope this promising approach will improve the health and quality of life for millions of individuals with these diseases.