Though men and women suffer misery-making allergic reactions to countless things, from ragweed pollen to wheat or eggs or the Rh factor from a husband's blood, medical researchers are confident that no one person can be allergic to another. But now there is a fast-growing body of evidence that something much more insidious and harder to understand may cause some of man's most common and crippling disorders. People, it seems, can become allergic to parts of themselves.
This arcane process of "auto-allergy" may be an important factor in many cases of anemia, in rheumatoid arthritis and myasthenia gravis, and in kidney and thyroid diseases. Last week, at the second of two Manhattan conferences on what many doctors prefer to call "autoimmune disease," researchers added impressive evidence on two recent additions to the catalogue of such ills: ulcerative colitis and pernicious anemia.
"Know Thyself." Boston Hematologist Dr. William Dameshek of the Tufts-New England Medical Center pioneered the concept of autoimmune disease. It has long been accepted dogma that in ordinary healthy immune reactions the body is using a birthright of every living creature. This is a set of biochemical sentries which raise an alarm when the body is invaded by a foreign substance, especially a protein, so that the system can make antibody to neutralize the invader. "Normally," says Dr. Dameshek, "the body has safeguards so it can recognize 'self as opposed to 'not-self,' and it will not damage 'self materials. Occasionally these safeguards break down." Dr. Dameshek detected such a breakdown in 1937 when he was treating three patients for severe hemolytic ("blood-destroying") anemia. They needed transfusions, but in the blood of each patient the doctor found a factor that made cross-matching difficult. He discovered that both the donors' blood cells and the patients' own were being destroyed by an antibody mechanism. Dr. Dameshek deduced that the patients had developed antibodies against their own cells.
"This started us off on the idea that some people, for some reason, somehow develop antibody mechanisms which act against one of their own body constituents—which may be red cells, white cells or whole organs. For years we cried in the wilderness. We were called wild-eyed visionaries. Critics asserted that the human body should not, cannot and will not develop such a mechanism of self-destruction." By now Dr. Dameshek has far more supporters than detractors. Many of the supporters, Dr. Dameshek complains, accept his concept only if they can give it another name, "auto-allergy."
From Eye to Eye. The most clear-cut and comprehensible autoimmune diseases form a small, exceptional group. Thousands of the body's countless proteins circulate in the blood or are washed by it, but a few are "sequestered": the fluid in the eye's lens, sperm secreted in the testicles, and thyroglobulin (an iodine-containing protein), which usually stays locked in the thyroid gland. If lens fluid leaks into the bloodstream after injury, its proteins start the antibody factory working and the body seeks to destroy the lens proteins.