Autoimmune Disease In Humans

Proven Lupus Treatment By Dr Gary Levin

Proven Lupus Treatment by Dr. Gary Levin

Get Instant Access

Autoimmune diseases affect about 1 in 15 people in the United States. A partial list of some of the more common human autoimmune disorders is shown in Table 12.1. Almost every organ and tissue in the body can be a target for autoimmune disease.

There are a number of generalizations about autoimmune disease that seem to hold true. Although there are some relatively organ-specific autoimmune diseases, in fact almost all autoimmune diseases affect more than one system in the body. The relatively restricted diseases are just that—relatively restricted. Patients with table 12.1

Some Representative Human Autoimmune Diseases.

table 12.1

Some Representative Human Autoimmune Diseases.

Ankylosing spondylitis3

Myasthenia gravis3

Autoimmune hemolytic anemiaa

Pemphigus vulgaris

Autoimmune hepatitisb

Pernicious anemia

Autoimmune inner ear disease

Polychondritis

Autoimmune lymphoproliferative

Polymyositisb

syndromeb

Primary biliary cirrhosisa

Autoimmune thrombocytopenic

Psoriasisa

purpuraa

Raynaud's syndrome

Bullous pemphigus

Reiter's syndrome

Cardiomyopathy8

Rheumatic fevera

Crohn's disease2

Rheumatoid arthritisb

Diabetes (type I)

Sarcoidosis

Degos' disease

Sclerodermab

Dermatomyositis

Sjogren's syndromeb

Fibromyalgia

Stiff-man syndrome

Goodpasture's syndromea

Systemic lupus erythematosus

Grave's diseasea

Ulcerative colitis

Hashimoto's thyroiditisa

Uveitis

Idiopathic pulmonary fibrosis

Vasculitis

Meniere's disease

Vitiligo8

Multiple sclerosisb

Wegener's granulomatosisb

a Relatively tissue restricted.

b Relatively non-tissue restricted. (Unmarked: intermediate.)

a Relatively tissue restricted.

b Relatively non-tissue restricted. (Unmarked: intermediate.)

insulin-dependent (Type 1) diabetes, for example, almost always have other autoimmune problems. The spectrum of diabetes-associated autoimmune diseases (pernicious anemia, Grave's disease, Hashimoto's thyroiditis, to name just a few) is so broad that sometimes it's easier to think of diabetes as just one part of a broad-spectrum "pan-autoimmunity" that happens in a particular individual to affect the pancreas more than other organs.

Those diseases that almost always affect many different tissues in the body, such as lupus (systemic lupus erythematosus [SLE]), Sjogren's syndrome, or rheumatoid arthritis, have one peculiar feature in common: they tend to affect women much more than men. Whereas hemolytic anemia affects men and women more or less equally, arthritis is two or three times more frequent in women; lupus, 6 to 10 times more. Even some of the relatively tissue-restricted autoimmune diseases, such as myasthenia gravis (which we will talk about shortly), affect predominantly women. But, strangely, Type I diabetes, like hemolytic anemia, is an exception to this rule; it too affects men and women equally.

In autoimmune diseases affecting women more strongly, the disease appears relatively early in life, usually during the child-bearing years. There has been speculation that women are more prone than men to develop autoimmune disease because they have developed more powerful immune systems to protect their fetuses. Whatever the reason, it is clear that such autoimmune diseases are regulated by sex hormones. Studies in strains of mice in which the females spontaneously develop a lupus-like disease have shown that manipulating sex hormones can drastically alter the disease. In humans, males born with an extra X chromosome (XXY; Klinefelter's syndrome) have more lupus-type autoimmune disease.

In addition to the gender bias, most autoimmune disorders appear to have a genetic basis, in that they tend to "run in families." But the genetic link is only partial. In studies of genetically identical twins, only about a third would both have multiple sclerosis; half might both have diabetes; a quarter could both develop SLE. At autopsy—in the case of accidental death, for example— the apparently healthy twin often shows subclinical signs of the disease, suggesting that the genetic linkage is stronger than it appears from clinical diagnoses. And finally, as we will discuss later, there is very definitely an interplay between the mind and the immune system in autoimmunity. So these are very complicated conditions, indeed. Just talk to the 7% or so of Americans who suffer from them!

Most autoimmune damage is caused by low-grade, chronic inflammation, driven by both B cells and T cells, CD4 as well as CD8. It is very similar to the immunopathology seen in unresolved infectious diseases or immunopathologies. On one level, this makes perfectly good sense. It's like graft versus host (GVH) disease, where foreign, immunocompetent T cells are transplanted into an immunocompetent person: the T cells find themselves surrounded by a gigantic foreign graft, and they begin to reject it. In autoimmune disease, our own T cells suddenly find themselves surrounded by a seemingly endless universe of foreign material. Is it a transplant? Is it a microbial infection? No, it is us. But the immune system sets about mounting exactly the same types of reactions as if we were our own transplant, or a sea of microbes. For reasons that are not clear, autoimmune damage, although quite serious in some cases, is only rarely fatal. But it can be very miserable, indeed.

In order to get a feeling for the range of disorders with an autoimmune basis, let's take a brief tour of a few of the major human autoimmune diseases.

Was this article helpful?

0 0
Delicious Diabetic Recipes

Delicious Diabetic Recipes

This brilliant guide will teach you how to cook all those delicious recipes for people who have diabetes.

Get My Free Ebook


Post a comment