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See Inside March 2007

New Predictors of Disease

Molecules called predictive autoantibodies appear in the blood years before people show symptoms of various disorders. Tests that detected these molecules could warn of the need to take preventive action

A middle-aged woman--call her Anne--was taken aback when one day her right hand refused to hold a pen. A few weeks later her right foot began to drag reluctantly behind her left. After her symptoms worsened over months, she consulted a neurologist. Anne, it turned out, was suffering from multiple sclerosis, a potentially disabling type of autoimmune disease. The immune system normally jumps into action in response to bacteria and viruses, deploying antibodies, other molecules and various white blood cells to recognize and destroy trespassers. But in autoimmune disorders, components of the body's immune system target one or more of the person's own tissues. In Anne's case, her defensive system had begun to turn against her nerves, eroding her ability to move.

Every story of autoimmune disease is sad--but collectively the impact of these illnesses is staggering. More than 40 autoimmune conditions have been identified, including such common examples as type 1 (insulin-dependent) diabetes, rheumatoid arthritis and celiac disease. Together they constitute the third leading cause of sickness and death after heart disease and cancer. And they afflict between 5 and 8 percent of the U.S. population, racking up an annual medical bill in the tens of billions of dollars.

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