An evolution-based hypothesis on the origin and mechanisms of autoimmune disease

The pathogenesis of autoimmune disease remains an enigma. Here, the condition is analysed from an evolutionary standpoint, and the thesis developed that viruses, in particular retroviruses, are important to our evolution, and that their inappropriate re‐expression by repetitive (? ischaemic) cell damage in individuals of appropriate major histocompatibility type, leads to autoimmune disease. Such a view requires a slight adjustment to traditional ways of seeing Darwinian evolution, but one which makes real sense of the MHC‐restricted nature of the adaptive immune response.