Autoimmune Disease
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What Is Automimmunity?When your body is attacked?perhaps by a virus or germs on a nail you stepped on?your immune system defends you. It sees and kills the germs that might hurt you. But when the system doesn?t work right, this process can cause harm. Immune cells can mistake your body?s own cells as invaders and attack them. This 'friendly fire' can affect almost any part of the body. It can sometimes affect many parts of the body at once. This is called autoimmunity (meaning self-immunity). What Causes Autoimmunity?No one knows why the immune system treats some body parts like germs. We do know that you can?t catch autoimmune diseases from another person. Most scientists think that our genes and things in the environment are involved. If you have a certain gene or combination of genes, you may be at higher risk for autoimmune disease. But you won?t get the disease until something around you turns on your immune system. This may include the sun, infections, drugs, or, in some women, pregnancy. What Kinds of Problems Are Caused by Autoimmunity?Autoimmunity can affect almost any organ or body system. The exact problems one has with autoimmunity (or its diseases) depends on which tissues are targeted. If the skin is the target, you may have skin rashes, blisters, or color changes. If it?s the thyroid gland, you may be tired, gain weight, be more sensitive to cold, and have muscle aches. If it?s the joints, you may have joint pain, stiffness, and loss of function. You may know which organ or system is affected from the start. But you may not know the site of the attack. In many people, the first symptoms are fatigue, muscle aches, and low fever. Where Does Autoimmunity Strike?Because autoimmune diseases can affect almost any organ or system of the body, one way to group them is by the body system(s) they attack. The following is a list (not inclusive) of body systems and the autoimmune diseases that can affect them. Blood and blood vessels * Autoimmune hemolytic anemia * Pernicious anemia * Polyarteritis nodosa * Systemic lupus erythematosus * Wegener?s granulomatosis Digestive tract (including the mouth) * Autoimmune hepatitis * Behcet?s disease * Crohn?s disease * Primary bilary cirrhosis * Scleroderma * Ulcerative colitis Eyes * Sjogren syndrome * Type 1 diabetes mellitus * Uveitis Glands * Graves disease * Thyroiditis * Type 1 diabetes mellitus Heart * Myocarditis * Rheumatic fever * Scleroderma * Systemic lupus erythematosus Joints * Ankylosing spondylitis * Rheumatoid arthritis * Systemic lupus erythematosus Kidneys * Glomerulonephritis * Systemic lupus erythematosus * Type 1 diabetes mellitus Lungs * Rheumatoid arthritis * Sarcoidosis * Scleroderma * Systemic lupus erythematosus Muscles * Dermatomyositis * Myasthenia gravis * Polymyositis Nerves and brain * Guillain-Barre syndrome * Multiple sclerosis * Systemic lupus erythematosus Skin * Alopecia areata * Pemphigus/pemphigoid * Psoriasis * Scleroderma * Systemic lupus erythematosus * Vitiligo How Are Autoimmune Diseases Diagnosed?Autoimmune diseases often don?t show a clear pattern of symptoms at first. So diagnosing them can be hard. But with time, a diagnosis can usually be made by using: * Medical history?The doctor will ask about your symptoms and how long you have had them. Your symptoms may not point to one disease. But they can be a starting point for your doctor. You should tell your doctor if you have a family member with autoimmune disease. You may not have the same disease as your family member. But having a family history of any autoimmune disease makes you more likely to have one. * Physical exam?During the exam, the doctor will check for any signs. Inflamed joints, swollen lymph nodes, or discolored skin might give clues. * Medical tests?No one test will show that you have an autoimmune disease. But doctors may find clues in a blood sample. For example, people with lupus or rheumatoid arthritis often have certain autoantibodies in their blood. Autoantibodies are blood proteins formed against the body?s own parts. Not all people with these diseases have these autoantibodies. And some people without autoimmune disease do have them. So blood tests alone may not always help. But if a person has disease symptoms and autoantibodies, the doctor can be more sure of a diagnosis. The key is patience. Your doctor may be able to diagnose your condition quickly based on your history, exam, and test results. But the process often takes time. It may take several visits to find out exactly what?s wrong and the best way to treat it. How Are Autoimmune Diseases Treated?Autoimmunity takes many forms. There are also many treatments for it. Treatment depends on the type of disease, how severe it is, and its symptoms. Generally, treatments have one of three goals: * Relieving symptoms?If your symptoms bother you, your doctor may suggest treatments that give some relief. Relieving symptoms may be as simple as taking a drug for pain relief. It may also be as involved as having surgery. * Preserving organ function?When autoimmune diseases threaten organs, treatment may be needed to prevent damage. Such treatments may include drugs to control an inflamed kidney in people with lupus. Insulin injections can regulate blood sugar in people with diabetes. These treatments don?t stop the disease. But they can save organ function. They can also help people live with disease complications. * Targeting disease mechanisms?Some drugs may also be used to target how the disease works. In other words, they can suppress the immune system. These drugs include cyclophosphamide (Cytoxan) and cyclosporine (Neoral and Sandimmune). The same immune-suppressing drug may be used for many diseases. Your doctor may not prescribe a treatment. If your symptoms are mild, the risks of treatment may be worse than the symptoms. You may choose to put off treatment for now. But you should watch for signs that your disease is progressing. Visit your doctor regularly. You need to catch changes before they lead to serious damage. What Types of Doctors Treat Autoimmune Diseases?Treatments for autoimmune diseases vary. So do the types of doctors who provide them. For some people, one doctor will be enough to manage their disease. Others may require a team approach. One doctor might coordinate and give care, and others would treat specific organ problems. For example, a person with lupus might be seen by a rheumatologist. But that person might also see a nephrologist for related kidney problems and a dermatologist for skin problems. Specialists you may need to see include: * A rheumatologist, who treats arthritis and other rheumatic diseases. These include scleroderma and systemic lupus erythematosus (lupus or SLE). * An endocrinologist, who treats gland and hormone problems. These include diabetes and thyroid disease. * A neurologist, who treats nerve problems. These include multiple sclerosis and myasthenia gravis. * A hematologist, who treats diseases that affect the blood. These include pernicious anemia and autoimmune hemolytic anemia. * A gastroenterologist, who treats problems with the digestive system. These include Crohn?s disease and ulcerative colitis. * A dermatologist, who treats problems of the skin, hair, and nails. These include psoriasis, pemphigus/pemphigoid, and alopecia areata. * A nephrologist, who treats kidney problems. These include glomerulonephritis, inflamed kidneys associated with lupus. What Are Some Other Problems Related to Autoimmune Diseases?Having a chronic disease can affect almost every part of your life. The problems you might have with an autoimmune disease vary. They may include: * How you look and your self-esteem?Depending on your disease, you may have discolored or damaged skin or hair loss. Your joints may look different. These can all affect how you look and your selfesteem. Such problems can?t always be prevented. But their effects can be reduced with treatment. Cosmetics, for example, can hide a skin rash. Surgery can correct a malformed joint. * Caring for yourself?Painful joints or weak muscles can make it hard to do simple tasks. You may have trouble climbing stairs, making your bed, or brushing your hair. If doing daily tasks is hard, talk with a physical therapist. The therapist can teach you exercises to improve strength and function. An occupational therapist can show you new ways to do things or tools to make tasks easier. Sometimes regular exercise or simple devices can help you do more things on your own. * Family relationships?Family members may not understand why you don?t have energy to do things you used to do. They may even think you are just being lazy. But they may also be overly concerned and eager to help you. They may not let you do the things you can do. They may even give up their own interests to be with you. Learn as much as you can about your disease. Share what you learn with your family. Involve them in counseling or a support group. It may help them better understand the disease and how they can help. * Sexual relations?Sexual relationships can also be affected. For men, diseases that affect blood vessels can lead to problems with erection. In women, damage to glands that produce moisture can lead to vaginal dryness. This makes intercourse painful. In both men and women, pain, weakness, or stiff joints may make it hard for them to move the way they once did. They may not be sure about how they look. Or they may be afraid that their partner will no longer find them attractive. With communication, good medical care, and perhaps counseling, many of these issues can be overcome or at least worked around. * Pregnancy and childbearing?In the past, women with some autoimmune diseases were told not to have children. But better treatments and understanding have changed that advice. Autoimmune diseases can affect pregnancy, and pregnancy can affect autoimmune diseases. But women with many such diseases can safely have children. How a pregnancy turns out can vary by disease and disease severity. If you have an autoimmune disease, you should consult your doctor about having children.
Source: National Institutes of Health
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Scientists at Harvard University, Center for Neurologic Diseases report research in encephalomyelitis therapy
2007 NOV 19 -- Researchers detail in 'Anti-thymocyte globulin (ATG) prevents autoimmune encephalomyelitis by expanding myelin antigen-specific Foxp3+ regulatory T cells,' new data in encephalomyelitis. "The T cell-depleting polyclonal antibody, anti-thymocyte globulin (ATG) has long been used in organ transplantation to treat acute rejection episodes. More recently, it is also being used as part of an induction regimen to protect allografts," researchers in the United States report. "It has been proposed that ATG might deplete effector T cells (T-effs) while sparing regulatory T cells (T-regs). In order to test whether ATG is effective in autoimmune disease, we used Foxp3gfp 'knock-in' mice in combination with a myelin oligodendrocyte glycoprotein (MOG)(35-55)/IA(b) tetramer to study more closely the effect of ATG treatment on antigen-specific T cell responses in vivo during MOG-induced experimental autoimmune encephalomyelitis (EAE), an animal model for Multiple Sclerosis. ATG treatment enhanced the expansion of MOG-specific T-regs (CD4(+)Foxp3(+)) in MOG-immunized mice. T-effs were depleted, but on a single-cell basis, the effector function of residual T-effs was not compromised by ATG. Thus, ATG tipped the balance of T-effs and T-regs and skewed an auto-antigen-specific immune reaction from a pathogenic T cell response to a potentially protective T-reg response. In both acute and relapsing remitting disease models, ATG treatment resulted in the attenuation from EAE, both in a preventive and early therapeutic setting," wrote D.T. Chung and colleagues, Harvard University, Center for Neurologic Diseases. The researchers concluded: "We conclude that ATG treatment enforces the development of a dominant immunoregulatory environment which may be advantageous for the treatment of T cell-driven autoimmune diseases." Chung and colleagues published their study in International Immunology (Anti-thymocyte globulin (ATG) prevents autoimmune encephalomyelitis by expanding myelin antigen-specific Foxp3+ regulatory T cells. International Immunology, 2007;19(8):1003-10). For additional information, contact D.T. Chung, Brigham and Women's Hospital, Center for Neurologic Diseases, Harvard Medical School, 77 Avenue Louis Pasteur, HIM 780, Boston, MA 02115 USA.. Publisher contact information for the journal International Immunology is: Oxford University Press, Great Clarendon St., Oxford OX2 6DP, England. Keywords: United States, Boston, Encephalomyelitis Therapy, Autoimmune Disease, Autoimmune Disorder, Central Nervous System Disease, Encephalomyelitis, Immunology, Therapy, Treatment. This article was prepared by Pain & Central Nervous System Week editors from staff and other reports. Copyright 2007, Pain & Central Nervous System Week via NewsRx.com.
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