Autoimmune diseases occur when the immune system, which is tasked with protecting the body from pathogens, mistakenly recognizes some part of the body as foreign and mounts an immune response against it. This condition results in the immune system attacking and damaging its own tissues, as in the case of vitiligo where there is destruction of skin pigment cells, leading to patches of lost pigmentation 1.

2 discusses immunotherapy and checkpoint inhibitors, drugs that manipulate the immune response in the context of cancer treatment. These drugs can take the brakes off the immune system, allowing it to attack cancer cells more effectively, but this action can also lead to autoimmune reactions due to the unleashing of the immune system.

The concept of thymic selection is key to understanding how the body learns not to attack itself. During infancy, the thymus educates T cells on what is self, a process by which T cells that react against the body's own tissues are eliminated. This mechanism minimizes autoimmune reactions, but it is not perfect, and autoimmunity can still occur 3.

Landmark Cancer Drug Study

Peter discusses a groundbreaking study on a class of drugs that have shown promise in reducing cancer mortality. He highlights the remarkable nature of the immune system and its ability to detect harmful pathogens while sparing the self. The study offers hope for future advancements in cancer treatment.

The Peter Attia Drive Podcast

286‒Journal club with Andrew Huberman: light exposure on mental health & an immunotherapy for cancer

These clips from the and The Peter Attia Drive provide insights into the complexity of the immune system, the delicate balance between immune protection and autoimmunity, and the implications for disease treatment and prevention.


Can you explain the causes of autoimmune diseases?


Autoimmune diseases can arise from complex interactions between genetic, environmental, and immunological factors. One key principle is that these conditions result from a malfunction in the immune system, causing it to attack the body's own tissues.

In the context of discussing immunotherapy treatments for cancer, and touch upon the concept of immunomodulation—adjusting the immune system's activity levels. For instance, certain drugs for cancer therapy may work by "taking the brakes off" of the immune system, empowering it to combat cancer cells more aggressively. However, this action could also provoke autoimmune reactions, due to the increased activity of the immune system 1.

This relationship between heightened immune response and autoimmunity suggests that dysregulation of immune function, whether due to genetic predisposition or as a side effect of treatment, can be a cause of autoimmune disease. In some cases, individuals who experience autoimmune responses may have a better outcome in terms of their cancer treatment, indicating a complex relationship between the immune system's ability to fight disease and the risk of developing an autoimmune condition.

However, this information doesn't cover the full breadth of reasons why autoimmune diseases occur. They often involve a multifactorial etiology, including genetic susceptibility coupled with environmental or lifestyle triggers, which together lead to an inappropriate immune response targeting one's own tissues.

Autoimmunity and Immunotherapy

Discover the correlation between autoimmunity and response rates in immunotherapy treatments as Peter and Andrew delve into the potential side effects and benefits of immunomodulators.

The Peter Attia Drive Podcast

286‒Journal club with Andrew Huberman: light exposure on mental health & an immunotherapy for cancer

How does the immune system malfunction in autoimmune diseases?

The malfunction of the immune system in autoimmune diseases involves a misdirected response where the body's immune system mistakenly identifies its own tissues as foreign and begins to attack them. While has not specifically addressed the detailed mechanisms of this malfunction, common elements in autoimmune conditions include:

  • Loss of Tolerance: The immune system normally distinguishes between self and non-self. In autoimmune diseases, this tolerance is lost, and the immune system attacks self-antigens.

  • Autoantibodies: The body produces antibodies against its own proteins and cells, which can cause inflammation and tissue damage.

  • T Cell Activity: Auto-reactive T cells can also contribute to tissue destruction in autoimmune diseases.

  • Genetic Factors: Certain genes predispose individuals to autoimmune conditions, affecting immune regulation.

  • Environmental Triggers: Infections, drugs, or environmental chemicals might trigger an abnormal immune response in genetically susceptible individuals.

  • Chronic Inflammation: Persistent inflammation may compound the damage to tissues and organs.

  • Immune Complex Formation: Some autoimmune diseases involve immune complexes (antibodies bound to antigens) depositing in tissues, leading to inflammation.

Understanding the precise mechanisms often requires medical diagnostics and insights from immunology experts. Researchers continue to study the complexities of autoimmune diseases to uncover causes, mechanisms, and treatments.