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What is it?
An autoimmune disease is a condition that results from an abnormal response from the immune system of the body. The immune system is the complex network of various cells, tissues, and organs that collectively protect the body from harmful bacteria, viruses or pathogens. Foreign species (antigens) and dead or faulty cells are sensed out and removed or deactivated by the immune system, by the body’s defense system, comprising of antibodies.
When the immune system is unable to tell the difference between foreign and local cells, it can generate auto-antibodies that attack healthy cells and affect the body’s sound functioning. This condition is referred to as an autoimmune disease.
In simpler terms, when the defense of the body is confused and end up attacking own healthy cells, instead of those that cause harm, an autoimmune disease arises.
There are over 80 types of autoimmune diseases with some targeting only a single organ as is the case with Type 1 Diabetes while others may attack multiple systems at once. Some of the more commonly occurring types are psoriasis, rheumatoid arthritis, multiple sclerosis, alopecia areata, Sjögren’syndrome, vasculitis, Hashimoto’s disease, lupus, and celiac disease.
How common is it and who is at risk?
Millions of people worldwide suffer from autoimmune diseases in one form or another. An estimated 24 million are affected in the US only. Women are twice as likely to have autoimmune diseases as men, with the disease usually starting during the early years from the ages of 15 to 44.
Ethnicity is also a factor as Caucasians are less likely to be vulnerable to some forms of autoimmune diseases than Hispanics or African Americans. Obesity can also increase the chances of a person developing autoimmune diseases like rheumatoid arthritis and psoriatic arthritis. Moreover, smoking and the use of certain medications can increase the risk of developing diseases like lupus. It is also reported that autoimmune diseases are one of the leading causes of death among women of all age groups, up to 65 years, in the US.
It is suspected that genetics play a role in susceptibility to autoimmune diseases, which means those with first-degree relatives who have a diagnosed autoimmune disease, may be highly likely to develop it themselves. While those with second-degree relatives with a diagnosis have lesser susceptibility to contract the disease. Risk of contracting an autoimmune disease may also be linked to exposure to certain environmental factors like chemicals or viruses.
These diseases mostly tend to be chronic, debilitating and life-threatening.
What are the symptoms?
Signs and symptoms are characterized by one of the three main characteristics:
Basic symptoms of most autoimmune diseases are quite similar. Many of those suffering from some autoimmune disease or other may experience regular bouts of fatigue, swelling, and redness over affected areas of the body, muscle pains, numbness in the extremities, rashes, hair loss or fevers.
Aside from the ones mentioned above, different diseases can present different symptoms. For instance, Sjögren’s syndrome can cause dryness of the eyes and mouth while Type 1 diabetes can cause extreme thirst and weight loss.
Symptoms of autoimmune diseases are known to flare up or go away from time to time.
How is it diagnosed?
The diagnosis process for autoimmune diseases can be quite difficult. This is so because no single test exists that can diagnose most of the diseases. The procedure is made harder by the fact that many autoimmune diseases present the same initial symptoms. However, a family medical history can help in the diagnosis.
Doctors may conduct physical examinations to check swelling, inflammation or rashes on the body sometimes including imaging tests like X – rays and MRIs to help get a more detailed view. These imaging tests can help in diagnosing diseases like rheumatoid arthritis or in ruling out diseases with similar symptoms.
Blood tests can also help in the diagnosis. Some tests are conducted to rule out diseases that could present similar physical signs but the antinuclear antibody test is conducted specifically to determine whether an autoimmune disease exists. A positive test result indicates that the patient is suffering from some form of an autoimmune disease although it cannot define which one it is. Further tests aimed at rooting out the specific antibodies that cause specific types of autoimmune diseases are then taken. The entire diagnosis process may take a long time.
It is necessary to be able to differentiate between autoimmune diseases and inflammatory diseases, as their symptoms might appear to be the same, but, while autoimmune diseases are caused by a malfunction of T cells and B cells, inflammatory diseases cause tissue damage via recruitment of cytokines and chemokines.
Why does the body attack itself?
The body contains lymphocytes, T cells, and B cells, which are its main line of defense. These cells have self-antigens, which are activated when the cells are no longer functional. In some cases, these antigens are activated before the cells lose all functionality.
In other cases, such as that of the Campylobacter jejuni, the antigens are very similar to the body’s own molecules. Therefore, when antibodies are released, they not only attack the C. jejuni antigens but also similar bodily molecules.
Another issue is autoimmunity. This is caused by auto-antibodies or self-reactive T-cells. This attack might be restricted to a specific organ or certain tissues in different places. An example of autoimmunity is the Goodpasture’s disease, which affects the basement membranes of the kidneys and lungs, both.
Molecular mimicry is a situation where an antigen initiates an immune response. The problem arises when the T cell or the B cell cross-recognizes itself, and therefore, attacks its own kind.
Moreover, the hygiene hypothesis suggests children today are exposed to higher levels of cleanliness, which causes their immune systems to become overactive, leading to an increase in the misidentification of own molecules as foreign molecules, such as in the case of asthma.
What are the treatment options available?
There are no treatments currently available that can cure autoimmune diseases but options exist to control the abnormal response of the overactive immune system and suppress symptoms to reduce pain and inflammation. Common medications for these conditions are nonsteroidal anti-inflammatory drugs like ibuprofen and immune-suppressing drugs like corticosteroids.
For some cases like celiac disease patients, lifestyle and diet changes are necessary to keep symptom flare-ups under control. Those suffering from rheumatoid or psoriatic arthritis and other joint or bone related autoimmune disease can be recommended physical therapy and regular exercise to prevent stiffening of the joints. They have also been suggested changes in lifestyle, such as an increase in calcium intake, as well as, reducing strenuous work.
Overall, it is recommended that those with autoimmune diseases conduct regular doctor visits to keep track of the progression or regression of the disease as the body’s response may develop and adapt to the changing conditions and medications may need to be evolved.
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