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These are very puzzling conditions. They occur when our immune system turns against ourselves and begins to destroy our own tissues and organs. This type of self-harm is much more common in women. The causes of the disorder remain unknown and the number of cases is increasing.
Sometimes it happens that our body turns against us. As a result of a malfunction of the immune system (immune system), there is a situation in which cells that defend us against foreign particles (e.g. viruses, bacteria, cancer cells) appearing in our body begin to recognize the body’s own tissues as foreign. The body begins to fight itself, and the result of this fight is damage to various tissues and organs. There are various ailments, which are a symptom of an autoimmune disease, i.e. one that results from the destructive activity of the immune system, directed against healthy cells in our body, mistakenly recognized as foreign.
It is estimated that autoimmune diseases affect a few percent of the population (2-8%). The overwhelming majority of the sick are women. It is reported that 75% of autoimmune diseases are female representatives. The disease can develop at any age. However, observations show that these diseases are less common in children, while the incidence increases with age. They most often appear in women of childbearing age. American statistics (no precise data in Poland) show that autoimmune diseases are the fourth most common cause of disability in women and are among the leading causes of death in young and middle-aged women. There are, however, exceptions to this general rule. Type 1 diabetes appears to affect both genders equally frequently, with the disease developing most frequently in childhood. In turn, ankylosing spondylitis is a disease that predominantly affects men.
Note that the term “autoimmune disease” refers to a very heterogeneous group of conditions. This term explains the mechanism of disease development, in which the self-destructive effect of the immune system plays a major role. However, depending on what organ is damaged as a result of it, various diseases develop. Basically, autoimmune diseases, which include over 100 different diseases, are divided into two groups: restricted to a specific organ (so-called organ-specific) and those in which the inflammatory process takes place throughout the body (so-called systemic). Examples of organ specific diseases are: type I diabetes, Hashimoto’s disease (hypothyroidism caused by lymphocytic inflammation of this organ), Graves’ disease (hyperthyroidism), Addison’s disease (adrenal insufficiency), myasthenia gravis, pemphigus, celiac disease and many others. Systemic diseases include rheumatoid arthritis, visceral lupus, systemic sclerosis, vasculitis (Wegener’s granulomatosis, Takayashu’s disease, polyarteritis nodosa) and many others. Due to the fact that in the course of autoimmune disease, various organs may be damaged, patients are looked after by doctors of various specialties – endocrinologists, neurologists, rheumatologists and gastroenterologists.
The mechanisms leading to the development of autoimmune diseases are not fully understood. It is known that a significant percentage of people have antibodies in their blood against their own body tissues, yet they do not develop the disease. Research also shows that the incidence of this type of antibody increases with age. It is also known that our body naturally contains lymphocytes – white blood cells, which are “allergic” to the body’s own tissues. However, their self-destructive activity is under the control of various other immune mechanisms and cells of the immune system. Autoaggressive lymphocytes are either eliminated, retained a state of so-called immune ignorance, or their action is restricted by other cells of the immune system. It is a very complex system of self-control of the body, but if its normal function is disturbed at some stage, autoimmune lymphocytes can get out of control and cause disease. Therefore, in each of us there is a certain potential tendency towards self-harm.
What are the reasons for the disturbance of this intricate control system is not fully known. Certainly, a certain genetic predisposition to autoimmunity plays a significant role in the development of the disease. Autoimmune diseases often run in families, although different conditions can develop in different generations. Moreover, the observations show that in a person who has developed one autoimmune disease, there is a significantly greater risk of developing another disease caused by the self-destructive activity of the immune system. Autoimmune diseases also tend to change into various forms and coexist, e.g. in a person whose symptoms of antiphospholipid syndrome are dominant at first, the features of visceral lupus develop over time, or in patients with Sjögren’s syndrome, symptoms develop as the disease progresses. rheumatoid arthritis. Research into the human genome has identified several genes where mutations lead to autoimmune disorders. However, research in this direction is more scientific than it is used in everyday practice for making a diagnosis.
It is certainly no coincidence that the vast majority of autoimmune diseases affect women. However, the results of the research conducted so far do not give an unequivocal answer to the question of the gender mechanism in which the susceptibility to this type of diseases is determined. The role of sex hormones (estrogens) is postulated, which are to modulate the activity of cells of the immune system, preventing autoreactive lymphocytes from being naturally eliminated, but becoming immortal and multiplying. Attention is also paid to the role of pregnancy – causing a huge immune storm in the woman’s body, requiring the re-tuning of the immune system so that it can tolerate the child’s organism that is “foreign” to her developing in a woman’s body – as a potential factor increasing the risk of developing immune diseases.
Research is also ongoing into the potential role of infection as a causative agent of disease. This aspect is perhaps the most questionable. Recently, there has been an increasing number of cases of autoimmune diseases. One theory is that it is related to the excessive hygiene of our time. Scientific observations show that in countries with a high incidence of infectious diseases, autoimmune diseases occur less frequently than in highly developed Western countries. On the other hand, there are well-documented cases of association of infection with disease development. The flagship example are organ complications (kidney, cardiac) occurring after a streptococcal infection (the so-called streptococcal angina). The phenomenon is explained by the similarity of the antigens of the bacteria causing the infection (in this case the streptococcus bacteria) and the body’s own antigens (which have not been identified so far), which means that antibodies against the bacteria turn out to be ultimately combined with the antigens of our body, and deposited in In various organs, particles made of antibodies linked to their antigen cause the development of inflammation that destroys a given organ. The role of viral infections in the development of type I diabetes, multiple sclerosis and other diseases is also emphasized. Apart from infections, other environmental factors may also play an important role, such as diet (playing a special role in the development of celiac disease), smoking or the presence of certain micronutrients in our environment (e.g. iodine supply plays an important role in the development of autoimmune thyroid diseases).
Certainly, the origin of an autoimmune disease cannot be explained by a single mechanism. Moreover, different pathologies of the immune system are behind different diseases. Scientific research into the causes and treatment of these diseases is ongoing, and looking at the increasing frequency of their occurrence, you can count on the fact that their results will not be long in coming.
Text: lek. Paulina Jurek
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