I’m going to break this post up into a few days. It occurred to me while I was writing this thing that the conference was six hours long, and it’s a lot of information to impart in one blog post. If I break up the posts, I can also get the information out as I process it, so no one who has been anticipating this information has to wait too long or read too much in one sitting.
A few weekends ago, I went to a conference sponsored by the American Autoimmune Diseases Association. It was held at one of the hospitals where I go for my visits with specialists, the University of Colorado Anschutz Medical Campus. I was exposed to a lot of speakers who explained the immune system, how the immune system gets out of control, the new research on treatments, and how to work effectively with your doctor. All interesting stuff. Much of this information can be found on AARDA’s website.
The first speaker explained to us that he was there to explain and defend the immune system, given that all the other speakers were there to tell you how the immune system fails and ruins your life. I found a document from the NIH that explains this in great detail, but I will give you the short version given to me by the speaker.
The immune system can be broken down into three layers.
The innate immune system is the inflammatory response to an antigen (an antigen is anything foreign in the body, from viruses to pollen or even food). This is the first line of defense you have to fight off infectious agents, and it can be a good thing. It pretty much burns up any foreign body before it can become harmful.
The second immune response is the formation of antibodies. B-cells start in your bone marrow. They come into contact with an antigen, digest it, and replicate. They also call other complement factors such as neutrophils to help it destroy the invader. The B-cells then present the invader to T-cells. The T-cells then determine if the thing the B-cell found is indeed a foreign element (non-self) or if it belongs there (self). If the T-cell decides that the B-cell presented a non-self item, it signals the B-cell to mature and replicate as an antibody producing entity. There are other kinds of T-cells as well. Some T-cells activate other T-cells, and yet other T-cells call these little janitorial units called “phagocytes” to eat the antigens.
A third thing that happens in an infection is that antigens, especially viruses, embed themselves into self cells to hide from the rest of the immune system. The body has these cells called “Killer T-cells” which see bits of the invader peeking out of the self cells, then signals that cell to start the programmed cell death called “apoptosis“.
I’m sure this is an over-simplification, but the speaker only had twenty minutes to describe a complex chain of events, so this will suffice.
So, if we have this wonderfully complex system already built into our bodies, why do we need antibiotics? The speaker gave two reasons for this: a) sometimes viruses and bacteria replicate more quickly than our immune system can respond, thus overwhelming the body, and b) if we allow an infection to go on too long, you will create a lot of antibodies that, when they have finished the intended job, will get bored and look for something else to do. Bored antibodies can lead to autoimmune conditions.
I’m going to attempt to combine what I heard from each speaker in order to give you the most comprehensive view of the other subjects addressed at the conference. The above information was from only one speaker, but the stuff below is going to be mixed and matched.
What is an autoimmune disease? Basically, autoimmunity happens when something goes wrong with the immune system as described above. Your body starts to identify self cells as non-self, and all hell breaks loose. Your body’s immune system will attack a specific organ, often to the point where it interferes with the function of said organ. Autoimmune diseases are chronic and can be life threatening – they are the leading cause of death of female children and women up to the age of 64.
So then, what causes autoimmune disease? All autoimmune diseases have a common etiology (causation or origination), and it seems to be a combination of genetics and environment. Autoimmune diseases tend to cluster in families and in individuals. If you have a relative with an autoimmune disease, your chance of developing and autoimmune disease is increased. Likewise, if you already have an autoimmune disease, you are more likely to develop another one. The thing is, even if you have a genetic predisposition to develop autoimmune disease, you won’t actually get one unless you are exposed to an environmental trigger. Most of the researchers say they don’t know what the triggers are, save for smoking. They all agreed that if you personally smoke or are exposed to second hand smoke, you are far more likely to trigger an autoimmune disease. I think though, that these researchers are missing the bigger picture. I think it’s really any process that causes oxidative stress in the body (the process that defines aging) faster than your body can repair it. This includes exposures to too many infectious agents (viruses and bacteria) or a long infection; allergens, especially food allergens (and even more especially, soy, gluten and corn); pollutants like smog and toxic waste; neurotoxins such as pesticides and heavy metals; certain pharmaceuticals (it is known that certain drugs can induce lupus); and excess hormones.
How common are autoimmune diseases? There are 80-100 identified autoimmune diseases, and there are 40 more chronic diseases suspected of having an autoimmune basis. Each one of these diseases is classified as a rare disease (affects fewer than 1 in 1,500 people); however, roughly 5-8% of Americans have an autoimmune disease. This is twice the number of people who have been diagnosed with cancer, and just as many as have heart disease. What’s more is that the prevalence, not just the awareness of autoimmune disease is increasing at an exponential rate. This suggests to me there is something serious going on in our ecosystem that so many people are getting so sick.
How are autoimmune diseases treated? They aren’t. I define treatment as getting to the source of the problem in order to prevent complications and perhaps even cure the condition. Currently, the symptoms of the autoimmune diseases are being treated according to which organ is affected, but no one is really addressing the cause of the diseases. Many patients are give immunosuppressant drugs (like corticosteroids or chemotherapy), but these drugs often have serious and even fatal side effects. If a hormone secreting organ is affected, you will be given replacement hormones (like insulin or thyroid hormone). The good news is that the researchers who spoke at the conference are aware of the lack of proper treatment, and they suggest that this is really the next frontier of autoimmune disease research.
I’ll end this post now, but I have a lot more to say in (hopefully) the near future. I will talk about who is likely to develop autoimmune disease and why, the obstacles of diagnosis, prevention of autoimmune diseases, and mechanisms of certain diseases that were specifically addressed (like type 1 diabetes, Rheumatoid Arthritis, and Multiple Sclerosis). Stay tuned!