Disease

Autoimmune diseases

Autoimmune diseases are the most complex and difficult to treat diseases caused by malfunctions of the immune system. They occur when the immune system attacks healthy cells in the body.

General characteristics

The human immune system is a complex of tissues, organs and cells. Its task is to protect the body from pathogens in the form of infections, bacteria, fungi and foreign bodies. But sometimes the recognition system of "friends" and "strangers" fails. Then the immune system perceives the healthy cells of the body as enemies and begins to attack them with the help of autoantibodies, in other words, it develops antibodies against "their own" ones.

Today, specialists do not have enough knowledge to say exactly why autoimmune diseases occur. In addition, they are quite difficult to diagnose and treat. However, autoimmune diseases are very common. According to preliminary estimates by American experts, in the United States alone, there are about 24 million people suffering from at least one disease from this group. These diseases can be either localized on one organ or tissue, or systemic - affect different parts of the body. Nevertheless, even localized ailments often cause complications, affecting other organs. Interestingly, almost a quarter of people with autoimmune diseases have a tendency to develop other diseases from this group. If a patient has three or more autoimmune processes, they speak of the development of multiple autoimmune syndrome (MAS). But while it’s hard for experts to say why some people have MAC.

Varieties of autoimmune diseases

There are several types of autoimmune diseases that can affect different organs and systems of the body. Today, experts are aware of nearly 80 types of autoimmune diseases. Some of them, such as autoimmune thyroiditis (Hashimoto's thyroiditis), are diagnosed quite often, while others are less common. Below we consider the most famous autoimmune diseases.

Systemic (affect several organs at once)

  1. Systemic lupus erythematosus. This is a chronic auto-inflammatory disease that occurs more often in women. The main triggers of exacerbation of the disease: ultraviolet radiation, viral infections, stress. Against the background of the disease, problems arise with the skin, joints, kidneys, heart, brain, and the blood formation process is also disrupted.
  2. Acquired autoimmune disorders caused by human immunodeficiency virus. HIV infection causes total destruction of the immune system, which leads to damage to most systems, organs and tissues of the body.

Other common types of systemic autoimmune diseases:

  • dermatomyositis - affects the skin and muscles;
  • rheumatoid arthritis - joints, lungs, skin, eyes suffer;
  • scleroderma - skin, intestines, lungs, kidneys are damaged;
  • Sjogren's syndrome - salivary and lacrimal glands, joints are affected.

Eye-affecting apparatus

  1. Acute anterior uveitis. This is the most common inflammatory disease of the iris. It is usually associated with the presence of the HLA-B27 antigen in the body.
  2. Sjogren's syndrome. This is a disease in which the immune system attacks the endocrine glands (responsible for the production of tears and saliva).

Affecting the gastrointestinal tract

  1. Autoimmune hepatitis. It affects liver cells. Autoimmune hepatitis occurs in 1-2 people out of 100 thousand, and women are much more likely than men (7 out of 10 patients are women). Scientists have proven a genetic predisposition to this disease.
  2. Celiac disease. A condition in which the intestines inadequately respond to products containing gluten. In this disorder, the mucous membrane of the small intestine becomes inflamed every time after eating food containing a specific protein.
  3. Inflammatory bowel disease. This is a generic name for several diseases that cause chronic inflammation in the digestive tract. The most common ailments from this group are Crohn's disease and ulcerative colitis.
  4. Primary biliary cirrhosis. With this violation, the immune system slowly destroys the bile ducts of the liver.

Affecting blood formation and blood vessels

  1. Nodular polyarteritis. A serious disease in which small and medium arteries become inflamed and affected. The risk of the disease increases with hepatitis B and C.
  2. Antiphospholipid antibody syndrome. Leads to blood vessel damage.
  3. Hemolytic anemia. This type of anemia occurs when immune cells attack blood cells.
  4. Idiopathic thrombocytopenic purpura. Causes platelet destruction.

Damage to the skin

  1. Scleroderma. This autoimmune disorder affects the connective tissues of the skin and blood vessels, as well as muscles and internal organs. The disease is more often diagnosed in women aged 30 to 50 years.
  2. Dermatomyositis. This condition leads to muscle inflammation and is accompanied by a skin rash. Often appears in people with malignant tumors in the lungs or abdomen.
  3. Psoriasis. A common autoimmune disease that causes the formation of flakes and dry, itchy spots on the skin. Often the disease is accompanied by joint pain. The main triggers of the disease: stress, poor ecology, infectious diseases.
  4. Vitiligo. In this condition, the destruction of cells containing skin pigment occurs, due to which white spots appear on the body. More often affects people with dark skin.
  5. Focal alopecia. It develops when the immune system attacks the hair follicles.

Hormone dependent

  1. Type 1 diabetes. This disease occurs because autoantibodies affect pancreatic cells that are responsible for insulin production. As a result, there is a lack of insulin, which increases the level of glucose in the blood and urine.
  2. Autoimmune pancreatitis and hepatitis. This is an inflammation of the pancreas and liver caused by the pathogenic activity of immune cells.
  3. 21-hydroxylase deficiency. This disease affects the adrenal glands and leads to excessive production of male androgen hormones.
  4. Autoimmune thyroiditis. During this violation, the cells of the thyroid gland are destroyed, which leads to its lack of activity. This disease can occur at any age, but is more common among middle-aged women.
  5. Bazedova’s disease (hyperthyroidism, Graves disease). This autoimmune disorder causes hyperthyroidism.

Affecting the nervous system

  1. Multiple sclerosis. In the process of the disease, the cells of the brain and the nervous system fall under the attack of immunity. Autoimmune cells damage the myelin sheaths, which serve as a protective coating for nerve cells.
  2. Myasthenia gravis With this violation, the immune system attacks the nerve endings and muscles, which leads to severe weakness.

Arthritis

  1. Ankylosing spondylitis (ankylosing spondylitis). This is a common form of chronic arthritis caused by autoimmune pathology. The disease damages the joints of the spine and pelvis (sacroiliac joints) and paravertebral soft tissues. The progression of the disease leads to severe pain, skeletal deformity and disability.
  2. Reuters Syndrome. This is an inflammation that affects the joints, which often develops as a complication of certain infectious diseases (nasopharyngeal, genitourinary, intestinal). The disease, as a rule, affects large joints (knees and lower back), but at the same time causes inflammation of the eyes (conjunctivitis, uveitis), in men - urethritis (inflammation of the urethra), in women - cervicitis (inflammation of the cervix).
  3. Rheumatoid arthritis. This is one of the most common autoimmune diseases. As a result of this ailment, joint tissues suffer. The disease leads to inflammation and serious damage to cartilage. During the progression of the disease, the lungs, pleura, sclera of the eyes may be damaged or pericarditis may begin.

Autoimmune Disease Risk Factors

Autoimmune disorders can affect almost any person. But researchers do acknowledge that some groups of people have a higher risk of getting sick.

The main risk factors:

  1. Genetics. Studies show that children whose parents suffer from autoimmune disorders are also at increased risk for the disease. For example, multiple sclerosis and lupus are often transmitted by inheritance.
  2. Floor. Women are usually more susceptible to autoimmune disorders. Perhaps the reason is in hormones or in the fact that women have immunity, as a rule, stronger than men. In addition, scientists have found that women of childbearing age are more likely to fall ill.
  3. Age. Most often, diseases of this group occur at a young and middle age.
  4. Ethnicity. American experts have found that autoimmune disorders are much more common in Native Americans, Hispanics, and blacks than in Europeans and Asians. If we talk about statistics on the types of diseases, then type 1 diabetes is more often manifested in white-skinned people, and lupus erythematosus, for example, in representatives of the Negroid race and the indigenous inhabitants of Hispanic countries (23 countries in Latin America, Africa and the Pacific basin). Scientists explain the influence of this factor by the presence of common genes among representatives of one ethnic group, as well as by the influence of the environment in which they live, including solar activity.
  5. Infection. If a person with a genetic predisposition suffers from specific viral or bacterial infections, the risk that in the future he may develop an autoimmune disease increases even more.

Diagnostic Methods

Since many autoimmune diseases have similar symptoms, diagnosing them is often difficult. For example, lupus affects joints by the same principle as rheumatoid arthritis, although the symptoms are less severe. Joint stiffness and inflammation, as in RA, also cause Lyme disease, although this disease does not belong to autoimmune disease (its causative agent is a tick-borne bacterium). Inflammatory bowel disease often has symptoms similar to celiac disease. The only difference is that in the first case, digestive problems cause non-gluten. Much easier to identify thyroid disease. As a rule, to make a diagnosis it is enough to analyze the level of hormones produced by the gland and do some other specific tests.

Diagnosis of autoimmune diseases in each case may require its own methods. For example, in order to make a diagnosis, a patient with rheumatoid arthritis will have to undergo a physical examination, donate blood for analysis and take an X-ray. These studies will help determine the type of arthritis and its severity.

The main analysis to determine any autoimmune disease is testing for the presence of a specific autoantibody. A complete blood count is also important, because when the immune system is struggling with something, the number of red blood cells and white blood cells always deviates from the norm. A blood test for the erythrocyte sedimentation rate and for C-reactive protein will help determine the presence in the body of an inflammatory process that accompanies all types of autoimmune disorders.

The most dangerous thing is that sometimes it may take years for a patient with autoimmune disorders to make an accurate diagnosis, since in the early stages many diseases are similar to each other.

Traditional and modern treatments

A fairly common question is: which doctor treats autoimmune diseases? In fact, there is no one doctor who would deal with the treatment of all types of autoimmune disorders. Depending on the type of disease, a variety of specialists can deal with the treatment of such a patient. So, if a patient has lupus, the kidneys are affected, then he is observed by a nephrologist. With multiple sclerosis and myasthenia gravis, a neurologist is referred. With arthritis and scleroderma - to a rheumatologist. If an autoimmune condition causes hormonal imbalances, the patient should consult an endocrinologist. A dermatologist treats skin diseases such as psoriasis, and a gastroenterologist treats inflammation in the digestive tract.

Also, there are no universal methods for treating autoimmune diseases. In medical practice, different types of drugs can be used. While some methods of therapy are aimed at alleviating the symptoms of the disease (relieving pain and inflammation), others directly affect the process of the disease.

In drug therapy, several groups of drugs are usually used:

  1. Medications that relieve symptoms of the disease in the form of pain and inflammation. These are usually non-steroidal anti-inflammatory drugs or common painkillers.
  2. Corticosteroids. Drugs in this group suppress immunity and prevent inflammatory reactions. This treatment method is usually used for autoimmune arthritis and psoriasis.
  3. Agents for restoring a deficient hormone. With autoimmune disorders such as diabetes or thyroiditis, the production of vital components is disrupted in the body. Therefore, in this case, the goal of therapy is to make up for the missing hormones. In diabetes, this is insulin, with insufficient thyroid activity - hormones in the gland.
  4. Immunosuppressants. This is a group of drugs used to suppress the increased activity of the immune system.
  5. TNF inhibitors. Used to treat psoriasis and autoimmune arthritis.

In addition to drug therapy, for some types of autoimmune disorders, physiotherapy exercises are useful, which helps maintain optimal joint mobility. In some cases, surgical methods help to improve the patient's condition. Surgical treatment is usually resorted to in case of intestinal obstruction caused by Crohn's disease, as well as when it becomes necessary to replace a damaged joint.

Scientific discoveries made in recent years allow specialists to develop new methods for the treatment of autoimmune diseases. For example, modern medicine resorts to the use of modulators of the immune system, cellular methods of treatment, as well as the so-called tissue engineering. Stem cell transplantation is considered one of the most promising treatment strategies. This procedure is aimed at restoring the proper functioning of the immune system. Scientists are also working on the creation of specific antigens that would help in the treatment of multiple sclerosis, rheumatoid arthritis, scleroderma, systemic lupus erythematosus. In addition to developing new therapeutic methods, research is also underway to develop new biomarkers. They can be useful for determining the stage, activity and progression of the disease, as well as show the body's response to therapy.

Autoimmune diseases are incurable today. Using a well-designed program, you can slow down the progression of the disease and alleviate the patient’s condition during periods of exacerbation. But it is still impossible to completely cure the patient. In addition to drug therapy, people with autoimmune diseases should also adhere to a special lifestyle.For such patients it is very important to eat balanced and healthy foods, maintain a healthy body weight, engage in appropriate types of physical activity, avoid stressful situations and do not forget about healthy rest.

The author of the article:
Furmanova Elena Alexandrovna

Specialty: doctor pediatrician, infectious disease specialist, allergist-immunologist.

Total experience: 7 years.

Education: 2010, Siberian State Medical University, pediatric, pediatrics.

Experience as an infectious disease specialist for more than 3 years.

He has a patent on the subject "A method for predicting a high risk of the formation of a chronic pathology of the adeno-tonsillar system in frequently ill children." As well as the author of publications in the journals of the Higher Attestation Commission.

Other articles by the author

Watch the video: Autoimmune Diseases Research at Johns Hopkins (October 2019).

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