Autoimmune diseases

Definition

Autoimmune diseases (AIDs) are a group of diseases in which the immune system attacks the body’s own tissues and organs, causing chronic inflammation and damage.

General information

AIDs are not a single pathology but a whole class of health disorders characterized by loss of tolerance to intrinsic antigens. The exact mechanism of their origin is unclear, but many internal and external factors are known to trigger these conditions. Autoantibodies cause damage to organs and systems because they destroy autoantigens—substances from the body’s own cells that are recognized by the immune system as foreign.

This group is quite common among all known diseases – 5-7% of the world’s population have AIDs. The pathology affects people of any age and has a gender preference: there are twice as many women with this problem as men.

AIDs have a large number of nosologic forms (about 100) and forms clinically severe complications with life-threatening consequences. Detection of such pathologies at early stages will allow to take control over the pathological process and slow it down, preventing severe and dangerous consequences.

Symptoms and signs of autoimmune diseases

Knowing what an autoimmune disease is, you can assume the multiplicity and non-specificity of symptoms peculiar to a large class of pathologies.

But there are some signs of AID, which should be taken into account and in time to seek medical advice:

• Problems with hair, nails, skin: severe hair loss, allergic skin reactions without reason, rashes, alopecia, baldness, itching, etc.
• Joint inflammation, joint pain.
• Problems with the functioning of the GI tract.
• Thyroid dysfunction.
• Infertility, regular spontaneous abortions.
• Blood vessel thrombosis, varicose veins, trophic ulcers on the lower leg, cramps, and tremors of the limbs.
• Weakness, rapid fatigue.
• In women, menstrual irregularities.
• Abdominal pain.
• Abrupt weight loss or gain.
• Bulimia.
• Subfebrile body temperature.
• Noticeable violations of the psycho-emotional sphere.

Causes, risk factors

What is an autoimmune disease? In simple words, it is an aggression of the body’s cells against itself. It is as if the body is fighting itself, unable or having learned to distinguish between foreign agents and its own cells.

This “promiscuity” of immunity is called immunologic tolerance. It can be formed for the following reasons:

• Abnormal intrauterine development of the fetus.
• Disruption of T and B lymphocytes, which are responsible for acting against their own cells.
• The defense mechanisms of organs and tissues are disrupted for unknown reasons, so the immune system begins attacking them.
• Disruption of the immune response.
• Bad heredity, genetic predisposition.
• Pregnancy, when fetal cells form an autoimmune response of the mother’s body because they have antigens from the baby’s father.

There are several risk groups for AID in which, according to scientific studies, pathologic conditions occur more frequently:

• Anyone who has had a bacterial or viral infection may subsequently acquire AID.
• Women get the disease almost twice as often as men, so it is a gender-dependent disease. In the vast majority of cases, the disease occurs in the fertile age, during pregnancy, and after childbirth.
• A hereditary pattern of occurrence of cases of pathologies has been found. For example, systemic lupus erythematosus and multiple sclerosis often have a familial clinical picture.
• People who regularly come in contact with toxins and harmful substances and get intoxicated have a higher risk of developing autoimmune diseases.
• Damage to tissue-hematic barriers due to inflammation contributes to the risk of AID.

Diagnosis of autoimmune diseases

The diagnostic program always begins with the collection of anamnesis. The doctor clarifies information about hereditary pathologies, infectious diseases, harmful work factors, etc.

• Physical examination of the body – performed to assess the condition of the skin, lymph nodes, veins, rash, venous pattern, reticular livedo on the lower extremities, swollen joints, and hematomas.
• Immunofluorescence laboratory test for detecting autoantibodies that will be isolated in a sample of biological tissue (blood) using fluorescent staining agents.
• A multi-complex blood test to help detect autoantibodies.
• An enzyme-linked immunosorbent assay (ELISA) detects autoantibodies or autoantigens with quantification.

To assess the work of internal organ systems, the following diagnostic tests are also performed:

• Radiography.
• MR.
• CT.
• Ultrasound.
• Endoscopic studies.

All examination results are evaluated comprehensively. In case of ambiguous data, additional studies are performed. The patient is referred for consultation with doctors of subspecialties to clarify the diagnosis.

Treatment of autoimmune diseases

An immunologist examines and counsels AID patients, although the patient’s management is performed by a specialized physician corresponding to the disease group: a nephrologist, cardiologist, dermatologist, endocrinologist, etc.

Autoimmune disease cannot be eliminated entirely. Treatment aims to achieve a long-lasting remission with continuous comprehensive therapy.

There is no universal cure for AID. However, some methods are most commonly used in treatment:

• Antiparasitic, anti-infectious therapy to treat the infestation and infections that are the trigger for the pathology.
• Nonsteroidal anti-inflammatory drugs.
• Painkillers.
• Corticosteroid hormones.
• Hormone replacement therapy (insulin for diabetes).
• Immunosuppressants, cytostatics.
• Immunomodulators.
• TNF inhibitors.
• Monoclonal antibodies

Surgical treatment is necessary when complications arise that can be corrected by radical methods: for example, to eliminate intestinal obstruction in Crohn’s disease, kidney transplantation in organ failure, and endoprosthetics in joint damage.

All these treatment options are available in more than 320 hospitals worldwide (https://doctor.global/results/diseases/autoimmune-diseases). For example, Monoclonal antibodies therapy (mAbs) can be done in 21 clinics across Germany (https://doctor.global/results/europe/germany/all-cities/all-specializations/procedures/monoclonal-antibodies-therapy-mabs). 

Types of pathologies

AI pathologies should be distinguished from autoimmune syndrome, formed in a healthy organism and is not a cause but a consequence of diseases. It aims to eliminate diseased, damaged cells. Autoimmune disease is precisely a disease that generates other pathological processes.

Doctors distinguish three main groups of autoimmune diseases:

Organ-specific, when autoantibodies are directed against one or more autoantigens in the cells of a particular organ.

Diseases belonging to this group:

• Hashimoto’s thyroiditis;
• Addison’s disease;
• myasthenia gravis;
• thyrotoxicosis;
• Vesicular vesicularis vulgaris, or bullous dermatosis;
• myocarditis;
• multiple sclerosis;
• pernicious anemia.

Organ-nonspecific, or systemic, in which autoantibodies are directed against substances in different tissues and organs of the body.

List of systemic autoimmune diseases:

• rheumatoid arthritis;
• scleroderma;
• systemic lupus erythematosus;
• Sjögren’s syndrome;
• a group of systemic vasculitides;
• polymyositis;
• sarcoidosis.

Some diseases, such as celiac disease and chronic hepatitis, can be categorized in both this and the next group.

Mixed, which have both autoantibody mechanisms of action at the same time.

These pathologies include:

• mixed connective tissue disease;
• type 1 diabetes;
• ulcerative colitis;
• biliary cirrhosis;
• gluten enteropathy;
• Goodpasture’s syndrome;
• autoimmune bronchial asthma.

Pathology due to autoimmune reaction of the body, in some cases, can exist for a short time and suddenly disappear, but more often, it has a chronic course and leads to severe complications in which a person without constant medical care cannot survive.

Prevention measures

There is no specific prevention of autoimmune pathology. But to reduce the risks, all viral, bacterial, and acute respiratory viral infections should be completely treated.

You need to adjust your diet, bring your body weight to normal, and learn to cope with stress. Available physical activity and moderate, regular sports activities are very helpful.

Implementing all medical recommendations, organizing nutrition and lifestyle correctly, and refusing bad habits are all ways to prevent relapses.