What is autoimmunity?
Autoimmunity is a condition in which the immune system is unable to tell the difference between healthy parts of the self and invaders such as bacteria, viruses, and parasites. According to Douglas Kerr in a Foreword to The Autoimmune Epidemic by Donna Jackson Nakazawa:
The numbers are staggering: 1 in 12 Americans—and 1 in 9 women—will develop an autoimmune disorder. And since it is clear that not every patient with an autoimmune disease is correctly diagnosed, the prevalence is certainly higher than that. The American Heart Association estimates that by comparison, only 1 in 20 Americans will have coronary heart disease. Similarly, according to the National Center for Health Statistics, 1 in 14 American adults will have cancer at some time in their life. This means that an American is more likely to get an autoimmune disease than either cancer or heart disease.
Some autoimmune diseases are rather specialized, attacking just one part of the healthy self. Others, like systemic lupus erythematosus, aren't so picky. They are equal-opportunity destroyers, going after any part of the body. Autoimmune diseases can be hard to diagnose not only because of the subjective nature of the symptoms but also because they like to travel with other autoimmune conditions. If you have one autoimmune disease, you probably have others. This has led some scientists to consider the notion that there is one disease—autoimmunity—that takes on many different manifestations.
The American Autoimmune Related Diseases Association lists over 100 autoimmune and related disorders. Many people are surprised when they find out just how many diseases are autoimmune. Here are a few: alopecia, celiac diseasesprue, Crohn's disease, type 1 diabetes, Graves' disease and Hashimoto's thyroiditis, juvenile arthritis, multiple sclerosis, psoriasis and psoriatic arthritis, rheumatoid arthritis, and Sjogren's syndrome. Many other diseases are suspected of having their basis in autoimmunity.
How are autoimmune diseases managed?
At this time, there are no cures for autoimmune diseases. There are treatment goals, however. Immunosuppressive drugs[1] are used to calm and weaken the immune system and prevent long-term damage. Cancer chemotherapies whose side effect is to weaken the immune system are sometimes used to treat autoimmune diseases. Newer drugs for the treatment of autoimmunity include biologics. Biologics are genetically engineered proteins from human genes and are designed to target very specific parts of the immune system. These same drugs may address the cause of the symptoms. For symptoms like pain and neuropathy, other medications may be included to minimize the symptoms further. Earlier immunosuppressive drugs could be likened to tossing a hand grenade into the body to disrupt the autoimmune activity. Newer drugs are more specific and can target the immune system problems in more particular ways. Much research still needs to be done. Nakazawa addresses the need for more funding for autoimmune research: "Though the NIH [National Institutes of Health] has expanded funding for autoimmunity significantly over the last several years, the 2003 expenditure of $591.2 million is still only a fraction of the money spent for heart disease and cancer. The NIH budget for cancer is over 5 billion dollars ... for cardiovascular disease [the budget] is over 2 billion dollars."
Each time the immune system encounters a substance that is a human made chemical, it has to figure out if this chemical is safe or hurtful.
Regular medical monitoring is essential in managing autoimmune disease. The autoimmune activity can increase, causing permanent damage of which the patient may be unaware. Medications are adjusted to reflect changes in the level of disease activity.
The patient's role in managing autoimmunity is crucial. Since stress stimulates the immune system, the patient must learn to reduce stress whenever possible and manage the stress that cannot be reduced (see Question 62). In addition to managing stress, a healthy diet is essential. One of the results of autoimmune disease is inflammation, which includes inflammation of the blood vessels. High blood pressure and atherosclerosis (hardening of the arteries) can result. Steroids are commonly used as a first line of defense in the presence of inflammatory autoimmune disease. Steroids cause weight gain, exacerbating the risk of heart attack, stroke, and high blood pressure. A healthy eating plan and maintaining optimal weight help reduce these risks. Minimizing artificial additives is wise. Each time the immune system encounters a substance that is a human-made chemical, it has to figure out if this chemical is safe or hurtful. If you give your immune system a lot of these chemicals, it will be stressed trying to figure out what to do.
- [1] Drugs designed to treat autoimmunity by weakening a person's immune system.
