Weighing in on autoimmune disease: Big data tip the scale

Modern medicine keeps unraveling new ways to investigate autoimmunity, leading to the production of boundless amounts of genetic, cellular and imaging data. Although the precision with which this information can define the etiology and mechanisms of a particular autoimmune disease is encouraging, much work lies ahead until all the knowledge acquired can be translated into the clinic. In 'Bedside to Bench', Calliope A. Dendrou, John I. Bell and Lars Fugger discuss the promises and limitations of genome-wide and next-generation genetic studies to provide further understanding of mechanisms driving autoimmune disorders and the role of experimental medicine in the new era of integrative clinical practice and personalized medicine. In 'Bench to Bedside', Lawrence Steinman argues the concept of a 'hub and spoke' pattern of T cell activation and organ targeting in multiple sclerosis, inflammatory bowel disease and type 1 diabetes. This paradigm suggests new ways to develop drugs to keep autoreactive T cells in the organ where activation occurs and preclude them from reaching the target organ and cause disease.

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Figure 1: Genetic risk factors and established points of drug intervention in the interleukin-23 (IL-23)–IL-17 axis in psoriasis.


  1. 1

    Lewis, T. Lancet 243, 649–651 (1944).

    Article  Google Scholar 

  2. 2

    Kitley, J. et al. Brain 135, 1834–1849 (2012).

    Article  Google Scholar 

  3. 3

    Klareskog, L., Gregersen, P.K. & Huizinga, T.W. Ann. Rheum. Dis. 69, 2062–2066 (2010).

    CAS  Article  Google Scholar 

  4. 4

    Curtis, C. et al. Nature 486, 346–352 (2012).

    CAS  Article  Google Scholar 

  5. 5

    Su, F. et al. N. Engl. J. Med. 366, 207–215 (2012).

    CAS  Article  Google Scholar 

  6. 6

    Dixon-Salazar, T.J. et al. Sci. Transl. Med. 4, 138ra78 (2012).

    Article  Google Scholar 

  7. 7

    Tsoi, L.C. et al. Nat. Genet. 44, 1341–1348 (2012).

    CAS  Article  Google Scholar 

  8. 8

    Griffiths, C.E.M. et al. N. Engl. J. Med. 362, 118–128 (2010).

    CAS  Article  Google Scholar 

  9. 9

    Leonardi, C. et al. N. Engl. J. Med. 366, 1190–1199 (2012).

    CAS  Article  Google Scholar 

  10. 10

    Gregory, A.P. et al. Nature 488, 508–511 (2012).

    CAS  Article  Google Scholar 

  11. 11

    Cortes, A., Robinson, P. & Brown, M.A. Arthritis Rheum. 64, S1053–S1054 (2012).

    Google Scholar 

  12. 12

    Braun, J. et al. Lancet 359, 1187–1193 (2002).

    CAS  Article  Google Scholar 

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Correspondence to Lars Fugger.

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Dendrou, C., Bell, J. & Fugger, L. Weighing in on autoimmune disease: Big data tip the scale. Nat Med 19, 138–139 (2013). https://doi.org/10.1038/nm.3087

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