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That this is actually an autoimmune reaction, with antibody circulating in the blood, is shown by the fact that if only one eye is injured, the antibody gets to the other eye and attacks the proteins in its lens. Thus injury to one eye may lead to blindness in both. Injury or inflammation of the testicles may force sperm proteins into the bloodstream, which then sets about destroying them—a process that causes temporary or even permanent sterility. If the thyroid gland is damaged or diseased, thyroglobulin may escape from its sequestered state, and a clearly defined form of thyroid disease results.
Fascinating Mono. In these three cases, it is easy enough to understand how the body can regard the escaping antigen-protein as "new" or "foreign," because it has been sequestered for years, perhaps since the fetal stage. Far more knotty are the questions that arise so often in Dr. Dameshek's practice as a hematologist. No less than 50% of all blood-destroying anemias acquired after infancy, he believes, are the results of autoimmune reactions. He is so confident of this that he abbreviates the disorders to AIHA—autoimmune hemolytic anemias.
Among victims of the half-dozen or more familiar forms of leukemia, he says, it is common for an AIHA process to develop at some stage of the disease. In the AIHA phase, though red cells are the likeliest victims of autoimmune destructive processes, it is not unusual for the platelets (the tiniest solids in the blood, essential for clotting) to be destroyed.
"From this," Dr. Dameshek told the New York Academy of Sciences, "it is only a step to the thought that autoimmune reactions and certain types of leukemia might occur simultaneously, and in fact be one and the same thing." What makes this possibility especially intriguing is the fact that no "cause" of leukemia is known, though there is increasing evidence that it may be triggered by a virus.
Dr. Dameshek has built a research bridge from the leukemias, or "blood cancers," to infectious mononucleosis, which he calls a "fascinating disease." It is, he says, at one and the same time an infection (presumably caused by a virus), a complex immune reaction, and an atypical, self-limiting form of leukemia. In "mono," several abnormal types of antibody are found at the times when the patient's lymph glands are overactive. Where the "not-self" or foreign proteins come from to start this process is not certain, but the likeliest source is the original virus, acting on lymph cells. And Dr. Dameshek notes that in three familiar diseases definitely known to be caused by viruses—German measles, viral pneumonia and poliomyelitis—there is occasionally a temporary autoimmune phase with blood-cell destruction.