The Common Thread

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As the boundaries between science and big business increasingly blur, and researchers race to patent medical discoveries, the international community needs to find a common protocol for the protection of the wider human interest. This extraordinary enterprise is a glimpse of our shared human heritage, offering hope for future research and a fresh outlook on our understanding of ourselves.

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And when we speak of why disease occurs, we speak of something else, and that is what we call etiology. Etiology means cause, why the disease occurs. If we are concerned with curing disease and possibly even preventing disease, the etiology is the most important information. Why have we been able to control so many infectious diseases? Because we now know the bacteria and the viruses and the parasites that cause these diseases, and we can develop antibiotics and other drugs that will specifically attack that organism.

Discovering the etiology has allowed medicine to progress to its present state where we can successfully treat and even cure many diseases. Within the lifetime of most of us, we have ways of effectively treating infectious disease.

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Until World War II, until antibiotics were introduced, we did not have methods that cured disease. With the introduction of antibiotics—penicillin, streptomycin, and other substances—we now have a way of treating. Here are a few other groups of diseases which are now defined by their etiology. Allergies are an example. You may go to an allergist because all of these diseases have the same etiology. They have different anatomies, but they have the same etiology.

Autoimmunity is an etiology: it is a cause of disease. They may be rheumatologists who are interested in joints; they may be dermatologists who are interested in skin; they may be cardiologists who are interested in the heart; they may be gastroenterologists who are interested in the gastrointestinal tract. A major aim of the American Autoimmune Related Diseases Association is to help us to understand that all of these diseases, diverse as they are, in their anatomical location, in their clinical manifestation, are related because they have the same etiology; they are all caused by autoimmunity.

The symptoms are late; the symptoms are at the end of the train of events. We want to get on the train at the very beginning.

Now, what are some of the specifics of this relationship? Let me lay out some of the principles that we now understand about the etiology of autoimmune disease. Unlike some diseases, autoimmune diseases do not generally have a simple, single cause. There are usually two major categories of factors that are involved in causing autoimmune diseases: genetics and environment. Virtually every autoimmune disease combines these two. Let me explain more of what I mean. First, genetics. Genetics is involved in the development of autoimmune disease, but autoimmune diseases are not typical genetic diseases.

What is a typical genetic disease? If you inherit this mutation from one parent, you have sickle cell trait; and if you inherit it from both parents, you have sickle cell disease.

We know what the gene is, and we even know a great deal of how that works; so we know the etiology of that disease. In autoimmune disease, multiple genes are involved; we have genes that collectively increase the vulnerability or susceptibility to autoimmune disease.

What is inherited is not a specific gene that causes a specific defect in metabolism; several genes increase vulnerability or susceptibility to autoimmune disease. How do we know that there is a genetic basis of autoimmune disease? I can cite three kinds of evidence.


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The first is autoimmune diseases tend to occur in families. However, it is not a particular autoimmune disease; it is generally a tendency to autoimmunity. So we need to look further.

The Common Thread – Episode 1: INTRODUCTION

These examples are from the Cambridge English Corpus and from sources on the web. Any opinions in the examples do not represent the opinion of the Cambridge Dictionary editors or of Cambridge University Press or its licensors. Another common thread is the power of personality. From Cambridge English Corpus.

A common thread ran through the study described here. There is one common thread in the narratives : the temporality of human life. Their dedication to expanding trade, perhaps for personal gain, became a common thread in their relationship. There seems to be a common thread unifying at least some of the above results. However, there is a common thread to the analysis of each language. So that missing feature, the melody, can't be part of the common thread. There is a common thread , he asserts, that is tied up in the often imponderable definition of character.