Abstract

Immune tolerance is a crucial aspect of immune system regulation that prevents autoimmunity by ensuring that the body does not attack its own tissues. Defects in immune tolerance mechanisms are closely linked to the development of autoimmune diseases. This review explores the molecular mechanisms underlying immune tolerance, highlighting the roles of central and peripheral tolerance processes. Central tolerance occurs in the thymus and bone marrow, where self-reactive lymphocytes are eliminated or rendered anergic. Peripheral tolerance mechanisms, including regulatory T cells (Tregs), checkpoint molecules, and the role of the microbiome, ensure that self-reactive cells are controlled in the periphery. Additionally, we discuss the role of genetic predispositions, environmental factors, and epigenetic modifications in the pathogenesis of autoimmune diseases. Understanding these mechanisms provides insights into potential therapeutic strategies for treating autoimmune conditions by restoring immune tolerance. This review aims to offer a comprehensive overview of immune tolerance's molecular underpinnings in autoimmune disease pathogenesis.