For more than 2,000 years, it was thought that malignant spirits caused diseases. By the end of nineteenth century, these beliefs were displaced by more modern concepts of disease, namely, the formulation of the "germ theory," which asserted that bacteria or other microorganisms caused disease. With the emergence of chronic degenerative and of autoimmune diseases in the last century, the causative role of microorganisms has been intensely debated; however, no clear explanatory models have been achieved. In this review, we examine the current available literature regarding the relationships between infections and 16 autoimmune diseases. We critically analyzed clinical, serological, and molecular associations, and reviewed experimental models of induction of and, alternatively, protection from autoimmune diseases by infection. After reviewing several studies and reports, a clinical and experimental pattern emerges: Chronic and multiple infections with viruses, such as Epstein-Barr virus and cytomegalovirus, and bacteria, such as H. pylori, may, in susceptible individuals, play a role in the evolvement of autoimmune diseases. As the vast majority of infections pertain to our resident microbiota and endogenous retroviruses and healthy carriage of infections is the rule, we propose to focus on understanding the mechanisms of this healthy carrier state and what changes its configurations to infectious syndromes, to the restoration of health, or to the sustaining of illness into a chronic state and/or autoimmune disease. It seems that in the development of this healthy carriage state, the infection or colonization in early stages of ontogenesis with key microorganisms, also called 'old friends' (lactobacilli, bifidobacteria among others), are important for the healthy living and for the protection from infectious and autoimmune syndromes.

Historically, immunology emerged as a biomedical science, concerned with host defense and production of anti-infectious vaccines. In the late 50s, selective theories were proposed and from then on, immunology has been based in a close association with the neo-Darwinian principles, such as random generation of variants (lymphocyte clones), selection by extrinsic factors (antigens)—and, more generally, on genetic determinism and functionalism. This association has had major consequences: (1) immunological jargon is full of “cognitive” metaphors, founded in the idea of “foreignness”; (2) the immune system is described with a random clonal origin, coupled to selection by random encounters; and (3) physiological events are virtually absent from immunological descriptions. In the present manuscript, we apply systemic notions to bring forth an explanation including systemic mechanisms able to generate immunological phenomena. We replace “randomness plus selection” and the notion of foreignness by a history of structural changes which are determined by the coherences of the system internal architecture at any given moment. The importance of this systemic way of seeing is that it explicitly attends to the organization that defines the immune system, within which it is possible to describe the conservative physiology of the immune system. Understanding immune physiology in a systemic way of seeing also suggests mechanisms underlying the origin of immunopathogeny and therefore suggests new insights to therapeutic approaches. However, if seriously acknowledged, this systemic/historic approach to immunology goes along with a global conceptual change which modifies virtually everything in the domain of biology, as suggested by Maturana.

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How to explain, in an underdeveloped country, the appearance of an avant-garde and justify it not as symptomatic alienation, but as a decisive factor in collective progress?" Helio Oiticica, 1967. At the end of the 1960s a movement in Brazilian culture bloomed, it manifested itself in several sectors, such as visual arts, poetry, cinema and theater, with consequences and repercussions in the whole national panorama and the future of the own country's thinking. It was an avant-garde, culturally exuberant, original and inspiring movement, seen now as a cultural revolution: the tropicalism. The name was given after the installation "Tropicália" exhibited by the artist Helio Oiticica in the Rio de Janeiro Museum of Modern Art in 1967 (Basualdo 2005). All happened in spite of the violent military dictatorship which has tortured, killed, exiled or repressed most of the local intelligentsia. Among the many references of tropicalism, one stood for its great importance: "The Anthropophagic Manifesto" written by Oswald de Andrade in 1928, as an echo of the seminal modernist week of art that happened in 1922 in São Paulo. De Andrade proclaimed anthropophagy as the basic principle for the construction of Brazilian identity, to devour myths and ideas that prevent this country from confronting its reality and inventing its history, to rethink its own cultural identity (de Andrade 1928). He evoked the history of the Caraíba tribe of Brazilian Indians who had the practice of eating enemies killed in their territory (Carneiro da Cunha 1992). The second Latin American Congress of Autoimmunity reminded us on the Latin-American scientific originality, quality, and also here, the

The patient is a 60-year-old female with functional class III/ IV (NYHA) heart failure of an immunomediated etiology (autoimmune myocarditis). After unsuccessful therapeutic attempts, intravenous immunoglobulin was used, leading to deterioration in renal function, a rare complication of that therapy. After hemodialysis, the patient's renal function was restored, and the chronic heart failure improved to functional class I.Myocardites constitute a group of diseases characterized by immuno-inflammatory aggression against the myocardium. The anatomicopathological substrate of this aggression has been classically described as a cellular infiltration of lymphocytes, macrophages, and other leukocytes, with destruction of cardiomyocytes, myocytolysis (Dallas criteria) 1 . In past years, advances in understanding of the complex pathophysiology of the disease and low sensitivity of the histopathological criteria have forced us to widen the model of aggression to beyond the immune response of the classical cellular type (Th1). Currently, we believe that an immunomediated aggression against the myocardium occurs, even when the infiltration of immunologic cells is absent. The characterization of pathogenic autoantibodies specific for more than a dozen autoantigens has led us to a new model 2 . The etiology of those diseases is still obscure. Activation of the immunologic system is known to occur, resulting in different forms of myocardial injury. The pathogenic stimuli that lead to the development of that cardiospecific aggression are yet to be elucidated.The current major hypothesis is based on the model of viral infection as the promoter of the immune reaction directed against the heart. Different types of viruses, such as coxsackievirus, parvovirus, adenovirus, cytomegalovirus, Epstein-Barr virus, and parvovirus B19, have often been implicated. However, most clinical studies have shown great variability and low positivity in evidencing the viruses 1 . Other clinical phenomena, such as skin diseases (eg, psoriasis and vitiligo), systemic autoimmune diseases, and even intestinal diseases, such as celiac disease, have been significantly associated with myocardites, suggesting, therefore, a wide and complex pathophysiological model 3 .The clinical findings of myocardites are highly varied. Their symptoms may range from fever and malaise to cardiac symptoms, such as palpitation, dyspnea, and chest pain. The physical examination, and laboratory and radiological findings are not specific, making the diagnosis difficult, which requires an elevated clinical suspicion.The most accurate noninvasive diagnostic method is indium-111 antimyosin myocardial scintigraphy 4 . This technique is not available in our country. However, another technique of nuclear medicine that uses gallium 67, a marker of inflammation, has been used despite its lower sensitivity and specificity.The endomyocardial biopsy, using Dallas histopathologic criteria, has been the standard diagnostic method, despite its low sensitivity. That technique has been boosted...