Autoimmune Diseases of the Skin

Hundred years ago, Paul Ehrlich speculated whether an individual is able to produce toxic autoantibodies and about the implications of such antibodies for disease. The contention that an alteration of the body fluids causes disease followed the traditional teachings of Hipppocrates and Galen that disease results from dysfunction of the four humors. However, Ehrlich introduced the novel concept of antigen specificity that was based on his side chain theory of antibody formation: (1) antibodies are naturally occuring substances that serve as receptors on the cell surface; (2) the specificity of antibody for antigen is determined by a unique stereochemical configuration of atoms that permits the antibody to bind tightly and chemically to its appropriate antigen; (3) the number of different combining sites structures available is so great that each one differs from the others, with little or no cross reactivity among them; (4) and in order to induce active antibody formation, it is only necessary that appropriate receptors be present on the cells for antigen to interact with them and so stimulate their overproduction and liberation into the blood. According to this description by Paul Ehrlich, the antibody appeared to be a polymorphous cytoplasmic agent with a unique feature a highly organized combining site (the haptophore group) that determined its unique antigen specificity.

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