Human Autoimmunity, with Pernicious Anemia as a Model

Abstract

Many investigators consider pernicious anemia an autoimmune disease. Cellular and humoral immunity to gastric antigens, particularly intrinsic factor, has been found in most patients with this disorder. Although a cause-effect relation between these immune abnormalities and the disease process is unproved, current evidence suggests that cell-mediated immune mechanisms may be responsible for the atrophic gastritis in pernicious anemia. Like several other presumed autoimmune disorders, this disease occurs with increased frequency in immunodeficiency states; this association raises the possibility that autoimmunity may be the consequence of a deficient rather than a heightened immune response. Thus, pernicious anemia appears to represent an excellent model to study the interrelations between autoimmune disease, cellular and humoral immune mechanisms, and immunodeficiency states.