Autoimmune Diseases

WHAT IS AUTOIMMUNE DISEASE?

A healthy immune system defends the body against infectious agents and disease.^1,4In people with autoimmune disease, the immune system cannot distinguish ‘self from non-self’ and as a result attacks its own healthy cells, tissue and organs.^2,3,4,7,9

There are more than a 100 AUTOIMMUNE DISEASES recognised globally !^1,2,7,9

HOW DOES AUTOIMMUNE DISEASE DEVELOP?

The exact cause of autoimmune disease is not known but there are certain known factors that contribute to the development of some common disorders. Genetic characteristics (race, gender, ethnicity), environmental factors, certain viruses or bacteria can in some ways be linked to the development of an autoimmune disease as well as overuse of antibiotics.^1,2,4,5,7

GENETIC PREDISPOSITION (RACE, GENDER & AGE)

Gender
Did you know that autoimmune disease affects women more than men? More than 75 % of people affected by autoimmune disease are female.^3,9
Genetics
There is a strong link between genetics and autoimmune disease. If an autoimmune disease occurs in the family history, then it predisposes an individual in future generations to developing one.^3,9
Race
Race also plays a role in the prevalence of autoimmune disease. Lupus and systemic sclerosis are more common in African Americans compared to Europeans, also experiencing disease earlier in life and to a more severe extent. However, the same populations also have a lower risk for type 1 diabetes, multiple sclerosis and thyroiditis.⁹

There are currently no genetic tools to predict the risk of developing an autoimmune disease

ENVIRONMENTAL FACTORS

There is increased evidence suggesting that autoimmune disease development results from interaction with certain environmental factors.^1,4
These factors may include:

Harmful pathogens (viruses or bacteria)⁴
A disrupted natural microbiome – especially in the gut, lungs or skin, often caused by the overuse of antibiotics⁴
Nutrition like vitamin D, iodine and gluten⁴
Tobacco smoke or exposure to heavy metals.^4,5Smoking has specifically been identified as a risk factor for developing rheumatoid arthritis & lupus.⁴

HOW ARE AUTOIMMUNE DISEASES DIAGNOSED?

The diagnosis of autoimmune disorders presents a challenge to both doctors and patients. Early signs and symptoms can be non-specific, adding to the possibility of a variety of illnesses.⁶ Symptoms may also be intermittent, and present in different ways in different individuals. This leads to a complicated diagnostic process that can place a stressful and a psychological burden on patients.^5,6,7,9
A thorough family disease history is needed followed by a proper physical examination.⁶ If an autoimmune disease is suspected, further diagnostic blood tests will be performed.^4,6,7
Imaging tests, like magnetic resonance imaging (MRI) (detailed images of organs, tissue and bones) and ultrasound (creates pictures of internal structures), may also be conducted to rule out any infections, fractures or tumours that may cause similar symptoms to those of autoimmune disease.⁶

HOW COMMON ARE AUTOIMMUNE DISEASES?

In general, autoimmunity affects 5 – 9 % of the population. Collectively, autoimmune diseases are considered common with an increasing incidence, the reason for which is unclear.^1,4,9

COMMON AUTOIMMUNE DISEASES

Body cells use glucose to produce energy for normal bodily functions. The body’s reaction to sugar (glucose) we ingest through food, is to produce insulin, a hormone produced by beta cells in the pancreas.¹⁰
In patients suffering from Type 1 Diabetes Mellitus, the body produces antibodies that attack and destroy these pancreatic beta cells – the result being that they are unable to produce any insulin.¹⁰Before diagnosis, these patients usually suffer from excessive thirst, frequent urination, weight loss, high blood glucose levels and delayed growth in infants.¹⁰
Type 1 diabetes can be managed by insulin injections diet, exercise and close monitoring of blood glucose levels. Frequent screenings for diabetic complications (high blood pressure, high cholesterol, visual loss and neuropathy) must be carried out.¹⁰

MULTIPLE SCLEROSIS (MS)

Back to topMULTIPLE SCLEROSIS (MS)

Multiple sclerosis is a chronic inflammatory disorder of supposed autoimmune etiology, that can be divided into three broad disease stages:¹¹

Due to good progress made in understanding the complexity of MS, treatments for the relapsing and inflammatory stage of the disease are readily available.¹¹

IRRITABLE BOWEL SYNDROME (IBS)

Irritable Bowel Syndrome (IBS) is an umbrella term for both abdominal discomfort (or pain) with disrupted defecation (as either diarrhoea or constipation).¹²

Patients suffering from IBS can suffer from predominant constipation or diarrhoea or a combination of both.¹²
IBS is considered to be one of the most common ADs and straightforward to diagnose.¹² Treatment does not target the underlying cause but rather focuses on the symptoms.¹² Fibre supplements and adequate fluid intake can be effective for those with constipation and can help firm up stools in patients with predominant diarrhoea.¹²
Antispasmodic agents are helpful for abdominal pain or cramps and antidiarrheals such as loperamide are of value in patients with predominant diarrhoea.¹²Prescribed medications can be used for patients with resistant symptoms.¹²
The link between IBS and INTESTINAL MICROBIOME
Alteration in the gut microbiome (flora) is accepted as a cause for IBS. Subsequently, changes in gut flora are linked to low-grade INFLAMMATION. An overgrowth of bacteria in the small intestines is also present in some patients presenting with IBS symptoms.¹⁶ A general consensus under healthcare professionals is the addition of probiotics supplements for patients suffering from IBS as studies found that probiotics decreases IBS symptoms globally and provide promising results by maintaining gut BALANCE.^12,16
Systemic Lupus Erythematosus
Systemic Lupus Erythematosus (called Lupus for short) is a chronic, inflammatory autoimmune disease that affects multiple organs and up to 5 million people globally. In patients with Lupus, the immune system produces antibodies that attack healthy tissue in organs throughout the body resulting in a variety of clinical conditions.
Lupus is 10 x more likely in women compared to men. Lupus can lead to the development of atherosclerosis, infections, cancer and organ damage, especially end-stage kidney disease.¹³ Treatment is directed to the patient’s specific organ system involvement.¹³ Drugs used in the treatment of Lupus include anti-inflammatories, corticosteroids and other immunosuppressants.^4,13

RHEUMATOID ARTHRITIS (RA)

Rheumatoid Arthritis is an autoimmune disease that affects the joints. This disease mostly affects the same joints on both sides of the body (for example the hands, wrists, knees, jaw and feet). Immune cells attack the body’s joint tissue, resulting in swelling, inflammation, joint stiffness and pain.¹⁴
Symptoms and risk factors
Patients with undiagnosed RA may experience occasional low-grade fever, a loss of appetite and feel unusually tired. Joint stiffness (for more than 30 minutes) and joint pain (during movement and rest) are also an indication of RA.¹⁴ Symptom flare-ups may be caused by stress, excessive physical activity and the sudden withdrawal of certain medications.¹⁴
People that are at risk include:¹⁴

The elderly
Female gender
Family history
Obesity
Tobacco smoke
Gum disease

Treatment is focussed on reducing pain, inflammation and swelling and improving quality of life by ultimately preventing joint damage.¹⁴Management of RA also focuses on stress and mental health management, daily monitoring of symptoms, healthy diet, joint care and appropriate rest and exercise routines.¹⁴