Autoimmune Disease: Clinical Facts

Author Name : Dr. MR. ANIL NAYAK

Rheumatology

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The immune system acts as a barrier by involving different immune cells to help the body in fighting external infections. However, there could be some instances which may cause these protective cells to act against their own cells leading to a condition of autoimmune disorder. Around 80 different autoimmune disorders are noted with mild to disabling severity. It has been found that women are more susceptible to autoimmune disorders than men, particularly during their childbearing years. Although the reason for this is unknown, but the sex hormones are partly considered to be responsible. These health disorders do not have any treatment but the symptoms can be managed. The risk factors include genetics, a family history of autoimmune disorders, environmental factors that work in conjunction with genetic factors, gender of the individuals, sex hormones as most of the autoimmune disorders occur during the childbearing years and major hormonal changes affect the disorders from better or worse, infections and others. The research conducted by National Institute of Environmental Health Sciences (NIEHS) provides an understanding on how these factors work together on the body's immune system. NIEHS hopes to find clues for treating and preventing autoimmune diseases. It has developed an interdisciplinary group of experts to evaluate the interconnection between the risk factors and the autoimmune diseases.

The findings of NIEHS include:

1.Exposure to some solvents that are found in products like paint thinners, cleaning supplies, nail polish and others can cause systemic sclerosis

2.Smoking may lead to rheumatoid arthritis

3.Fine particles of crystalline silica which is a basic component of many minerals like quartz, granite may lead to several autoimmune diseases

4.Gluten intake can cause celiac disease

5.Supplements containing L-tryptophan may cause eosinophilia myalgia syndrome. The pathophysiology of autoimmune diseases indicate that the T cells and B cells become self-reactive when they fail to be removed from the immune system by different mechanisms and a negative selection process occurs within the thymus.

A lot of theories are provided regarding the cause of autoimmune disease which include:

1. Cryptic determinants/molecular sequestration suggesting the immune system have a high-affinity repertoire to the poorly expressed self-antigen or cryptic determinants

2. Molecular Mimicry suggesting that the foreign antigens can cause the immune response to cross-recognize self-components

3. Altered Glycan Theory suggesting the alterations in their glycosylation profile can favor proinflammatory immune response as it is considered that the glycans displayed by the cells mediate the immune responses

4. Hygiene hypothesis suggests that high levels of cleanliness cause the children to get exposed to fewer antigens making the immune systems overactive and misidentify own tissues.

Autoimmune disorders cannot be easily recognized or diagnosed as they can have a variety of signs and symptoms which can change in severity over time. Some of the common symptoms include fatigue, general feeling of being unwell (malaise), dizziness, joint pain, rash, and low grade fever. Laboratory tests including blood tests for autoantibodies, CRP, ESR etc may help in diagnosis depending on the disorder and on the suspects of the health practitioner


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