{"doi":"10.3389/fimmu.2022.983310","title":"Editorial: Understanding the concept of pre-clinical autoimmunity","abstract":"The concept of autoimmune disease covers at least 80 different conditions. Each of these diseases is relatively rare, but together they have been estimated to occur in 7.6-9.4 percent of the US population (1). Autoimmune diseases occur most often in females, typically during childbearing years, and contribute substantially to morbidity and mortality in this age group (2). Over the last two decades, a combination of translational, clinical, and epidemiological research has led to the concept in Figure One of the central tenants of immunology is tolerance to self, with central and peripheral immunologic mechanisms designed to prevent the occurrence of self-reactive T or B cells. Thus, the \"normal\" immune system is envisioned as one without demonstrable high affinity IgG autoantibodies or activated self-reactive T cells. However, some types of asymptomatic autoimmunity are relatively common. For example, anti-nuclear antibodies are found in at least 15% of asymptomatic individuals (3), including young children (4). The boundary between autoantibody-negative and autoantibody-positive (Transition 1) is clear-cut, as it is defined with standardized laboratory testing. What is less clear is the importance, if any, of the presence of laboratory defined autoimmunity in the absence of signs or symptoms of immune-mediated pathology in an individual patient.","journal":"Frontiers in Immunology","year":2022,"id":298004,"datarank":0.3453877639491069,"base_score":2.302585092994046,"endowment":2.302585092994046,"self_citation_contribution":0.3453877639491069,"citation_network_contribution":0.0,"self_endowment_contribution":0.3453877639491069,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":9,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9499,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":382482,"name":"Darin T. Okuda","orcid":"0000-0002-6499-1523","position":1,"is_corresponding":false},{"id":41942,"name":"V. Michael Holers","orcid":"0000-0002-5634-7746","position":2,"is_corresponding":false},{"id":367560,"name":"David R. Karp","orcid":"0000-0002-9005-1690","position":3,"is_corresponding":false},{"id":292940,"name":"Nancy J. Olsen","orcid":"0000-0002-6588-3364","position":0,"is_corresponding":true}],"reference_count":6,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T00:31:31.270564Z","pmid":"35935944","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}