Abstract
Autoimmune diseases are a diverse group of approximately 100 disorders that are characterized by abnormal reactivity of B and T cells against self-antigens.1 Clinical manifestations can vary greatly, from organ-specific to systemic, and from life-threatening to subclinical. Autoimmune conditions affect about 5-9% of the world’s population,2 and occur more frequently in women than men.3,4 A 2020 study of the prevalence of antinuclear antibodies (ANAs) found a 50% overall increase in this biomarker of autoimmunity over the course of 25 years, suggesting that autoimmunity is on the rise in the United States.5 Interestingly, the increase in ANA prevalence was notable among adolescents (ages 12-19), lending some credence to the hygiene hypothesis, which posits that improved hygiene practices and cleaner environments in childhood reduce exposure to immune challenges, and may result in aberrant immune responses when exposed to infections later in life.
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