General facts about autoimmune disease?
In the human body the immune system is composed of an elaborate network of cells, tissues and organs. There all function in an organised fashion in order to protect the body from harmful organisms for example; viruses and bacteria which can cause diseases and infections. For an individual with an autoimmunity, the body’s natural immune cells are unable to distinguish between its own cells and foreign cells, this will lead to the body accidentally attacking its own normal cells by mistake.
Researchers are still unsure what the causes of many of the different autoimmune diseases, but there are lots of evidence to suggest that past infections, genetic factors and also there are many different factors of the environmental which can be responsible. Currently, there are more than 100 autoimmune diseases that have been identified and the listed is increasing continually. Some of the most common examples include; rheumatoid arthritis, lupus, ulcerative colitis and Crohn’s disease.
Even though they are a large number of these diseases, many of these display symptoms that are common such as; swollen glands, fatigue and tiredness, skin problems, joint swelling and pain, dizziness, recurring fever, headaches, rashes, nausea, digestive issues and abdominal pain. This makes it difficult during the diagnosis process since these symptoms are also very common in many other conditions which people often experience.
Some of the common characteristics that are shared by many autoimmune diseases are listed below:
- Majority are a result of a genetic predisposition.
- They display a similar model which is duplicated in animal models.
- High concentration of sensitised lymphocytes or autoantibodies titre is found in blood samples of patients.
- The intensity of the autoimmune and the corresponding disease are known to be closely related.
- Autoantibodies interact with specific antigens within cells and tissues, this ultimately leads to dysfunction and damage occurring within the corresponding tissues and organs.
The treatment for long term is designed to target reducing the strength of the immune response. Also due to the fact that the diseases are not bacterial infections then the use of antibiotics is not a viable option.
Risk factors for autoimmune diseases
There are many risk factors that are known to increases the chances of developing a certain autoimmune conditions. However, it is not possible to pin-point a specific factor that may put an individual at a greater risk when compared to another factor. These risk factors are thought to have a direct impact on the immune cell tolerance and this is believed to result in developing a particular autoimmune disorder.
The risk factors that are involved tend to vary between the different types of autoimmunity conditions. Listed below are some of the common factors which increases the chances of developing autoimmunity diseases.
(A). Gender/Sex: Generally, 80% of the people that are affected tend to be female instead of males and this is predominately due to hormonal factors. In these cases autoimmunity usually occurs during child-bearing years. Some specific examples of this include: Sjogren’s syndrome and systemic lupus erythematosus (SLE) where greater than 95% patients that are affected are female; multiple sclerosis and arthritis is occurring 60% more in females compared to males. It is believed that specific factors that are different between the sexes play an important role in elevating prevalence of autoimmune disorders in females examples of this include: presence of additional X chromosome, changes in reproductive function, hormones, immune responses, organ vulnerability and differing effects on environmental agents.
(B). Family History: There are certain conditions that tend to run in families, for example if you have a family member or a close relative who has an autoimmune disease then this will increase the chances of you developing a condition. Examples include: multiple sclerosis (MS) and lupus. In these cases an individual could have inherited specific genes even at the time of child birth that will pre-dispose them to a particular condition, however, they will only develop this condition after they have been exposed to a particular combinations of triggers.
(C). Age: It is common to find majority of autoimmune conditions affecting young to middle aged individuals. Due to the nature of the disease, there are also examples where it is more common as people get older for example rheumatoid arthritis.
(D). Environmental Agents: There are publications which indicate that chances of developing autoimmunity is elevated following exposed to certain environmental factors, however, this is not conclusive and still needs further investigation. For example: specific metals (such as mercury, silver and gold), medications (e.g. statins, antibiotics, hydroxyzine and procainamide), toxins (ultraviolet radiations, tobacco, air pollutants, organic solvents and crystalline silica).
(E). Ethnicity/Race: Plays a vital role for particular autoimmune conditions. Examples for this are: Type 1 diabetes is more common in white Caucasians whereas lupus is severe in Hispanic and African American population.
(F). Obesity/Weight: Excess weight is believed to be linked to more than 10 autoimmune diseases. It is suggested that obesity leads to the body going into a chronic state of low grade inflammation and this results in damaging/ compromising a healthy immune system which eventually can lead to metabolic syndrome, organ damage and various autoimmunity diseases.
(G). Previous Infections: Previous exposure to specific infections can make an individual more susceptible to a particular autoimmune disease. Common examples of this are: Epstein Barr Virus (EBV) is linked to Sjorgen’s syndrome, lupus and rheumatoid arthritis, Streptococcus can trigger many brain associated autoimmunity disorders for example; rheumatic heart disease and acute rheumatic fever, SARS-CoV-2 virus is associated to a number of conditions for example lupus, anti-phospholipid syndrome, Guillain-Barre syndrome and many other different types of diseases (gastrointestinal disease, hepatitis, colorectal cancer, lupus nephritis, lymph adenapathy). It is thought that particular viruses are able to interact with the genetic material of an individual using a variety of mechanisms. This results in many cases switching on specific genes in order to affect the immune systems to distinguish between self and non self, leading to autoimmunity reaction being triggered.
Facts on most common autoimmune diseases
- Rheumatoid Arthritis: This results from an autoimmunity attack of the lining of the joints (also called synovium). It can lead to discomfort and inflammation of the surrounding tissues. Rheumatoid arthritis usually affects the knees, hand and wrists. Some of the symptoms that are experienced include: swelling, tenderness, weakness, sprained ankle, osteoarthritis, pain, aching, stiffness, periodic fever syndrome, warmth, redness, fatigue, lumps of tissue beneath the skin, weight loss and anemia. The typical treatment process of arthritis involves the use of immunosuppressants (for example prednisone). These tend to be only effective for a short term relief but not be that effective over a longer period of time.
- Hashimoto’s Autoimmune Thyroiditis: This is when the autoimmune disease attacks the thyroid gland, resulting in a deficiency or slow production of thyroid hormone. In many cases this results in an under-active thyroid. Some of the common symptoms that are experience under these conditions include: swelling of thyroid at the front of the neck (also called goiter), weight gain, stiff joints, muscle aches, weakness, fatigue, slowed heart rate, facial swelling, sensitivity to cold, hair loss, constipation, depression and irregular or heavy menstruation. One of the main treatment that is available is a daily prescribed dose of levothyroxine, this will help in increasing the levels of thyroid hormone present.
- Celiac Disease: Occurs when an individual’s immune system has a reaction towards gluten (it is aimed especially at gliadin). Gluten is frequently present in food products such as pasta, wheat, barley, rye and bread. Following the consumption of gluten, this leads to the immune system attacking normal/healthy tissues that are present in the small intestines, over time this can lead to organ damage (including damage to the intestinal lining) which can prevent it from properly absorbing essential nutrients. Many suffers of this condition overcome this problem by eliminating the consumption of gluten from their diet (also referred to as a gluten-free diet), this has been found to help control and manage the symptoms of celiac diseases. Patients tend to suffer from food and lactose intolerance and experience various gluten related disorders. Some of the most signs and symptoms that are experienced by a person suffering from celiac disease following gluten intake include: weight loss, pain and abdominal bloating, joint pain, itchy rash, fatigue, constipation or diarrhea, irregular and missed periods.
- Systemic Lupus Erythematosis (SLE): It is the most frequent type of lupus. This autoimmunity is responsible for causing a wide range of conditions leading to inflammation (joints and skin) or tissue damage and in severe cases affects internal organs (kidneys, lungs and brain). At present there is no real cure that is available for lupus, however, there are some lifestyle changes and medical interventions that can help in controlling and managing it. Some of the most common symptoms include: skin rashes, swelling and pain in the joints or muscles, colour blindness, oral ulcers, stomach cancer, a fever, sensitivity to sun, kidney problems, lung cancer, heart problems, immunological and blood cell abnormalities, tiredness, arthritis and seizures.
- Psoriasis: It is essentially a skin condition that can lead to flaky, red, crusty patches of the skin which is found to be covered in silvery scales. Majority of these patches are on the scalp, elbows, lower back and knees. In the UK psoriasis is known to affect about 2 % of the population. It tends to develop both women and men equally and in most case under the age of 35. There is evidence to indicate that psoriasis can be passed on within a given family, however, little is known about the precise genetic that is responsible for this autoimmune condition. Some of the common triggers for this disease include: infections, various environmental factors and stress.
- Multiple Sclerosis (MS): This is a condition that is affecting the spinal cord, nervous system and the brain. It is an autoimmune disease that attacks myelin which is the protective sheath that function in covering the nerve fibers. This will result in problems in communication between the brain and rest of the body, eventually causing the nerves to deteriorate or damage them permanently. Common symptoms of MS include: weakness and numbness in the limbs, lack of co-ordination, tremor, dementia, electric shock sensations with some neck movements, unsteady gait, slurred speech, blurry vision, myocardial infarction, tingling sensation, problem’s with bladder, bowel and sexual function. The therapy which can be offered for this condition largely depends on the difficulties and specific symptoms that an individual suffers. Steroid medicine is often used to treat relapses of MS symptoms or various disease modifying therapies can be used to help reduce the number of relapses.
- Type 1 Diabetes: This is a condition when the pancreas is unable to produce insulin, this is due to the beta cells of the pancreas being destroyed. Insulin plays an important role in regulating the body’s blood glucose levels. High blood sugar levels in the body can result in damaging the blood vessels, as well as important organs such as kidneys, heart, nerves and eyes. Another term that is also often used to describe this condition is insulin dependent diabetes. People with this disorder will regular administration of insulin by either using an insulin pump or by injection (insulin pens). Common symptoms include: weight loss, tiredness, genital itchiness, greater thirst and needing to pee more frequently.
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