Students of autoimmune diseases are witnessing a revolutionary movement that can be summarized by the difference between etiology and pathogenesis. Before the revolution, hazy images of “forbidden clones” and a faulty understanding of immunologic tolerance led to the assumption that autoimmunization was the etiology — the cause — of certain diseases. Now, however, the process of immunologic self-destruction seems better understood as a pathogenesis — i.e., as a mechanism that produces a lesion. The distinction that we draw is more than semantic. For example, there is abundant evidence from animal models that clinically silent, chronic viral infections can lead to. . .
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