Autoimmune Disease.pdf

Tuesday, March 12, 2024 Autoimmune Disease Also called inflammatory disease - Self-cells are being attacked and damaged but synthesis never stops = constant/chronic inflammation - Attacking specific cells, organs, or areas Inflammation: Body’s reaction to infection, irritation or other injuries - Pa...

Tuesday, March 12, 2024 Autoimmune Disease Also called inflammatory disease - Self-cells are being attacked and damaged but synthesis never stops = constant/chronic inflammation - Attacking specific cells, organs, or areas Inflammation: Body’s reaction to infection, irritation or other injuries - Part of the immune response - Allows for different components of the immune response to be brought to the compromised site CLASSIFICATION OF AUTOIMMUNE DISEASE 1. Systemic Autoimmune Diseases 2. Localized Autoimmune Diseases SYSTEMIC AUTOIMMUNE DISEASES Non-organ-specific/Systemic Autoimmune Diseases: damage many organs - Rheumatoid arthritis (RA) (all joints) - Sjogren's syndrome - Lupus Erythematosus (blood/red blood cells) - Scleroderma LOCALIZED AUTOIMMUNE DISEASES Organ-specific/Localized Autoimmune Disease: are those where only a single organ or tissue is directly damaged by the autoimmune process - Type 1 Diabetes Mellitus (pancreas) - Hashimoto's thyroiditis (thyroid) - Celiac disease (intestinal) - Crohn's disease (small intestine) In some cases, a person may have more than one autoimmune disease; for example, persons with Addison's disease often have type 1 diabetes, while persons with sclerosing cholangitis often have ulcerative colitis Often runs in families (not necessarily the same but another AID) 1 Tuesday, March 12, 2024 CAUSE The cause of autoimmune diseases is unknown, but it appears that there is an inherited predisposition to develop autoimmune disease in many cases. In a few types of autoimmune disease (such as rheumatic fever), a bacteria or virus triggers an immune response, and the antibodies or T-cells attack normal cells because they have some part of their structure that resembles a part of the structure of the infecting microorganism RISK FACTORS - Genetic factor , Environmental toxins, Gender, Heredity, viruses, Drugs, Stress, poor diet, lack of exercise, lack of sleep, abuse of alcohol and use of tobacco Most are stress or habit related factors Gender A person's sex also seems to have a major role in the development of autoimmunity - most of the known autoimmune diseases tend to show a female preponderance - Ankylosing spondylitis = male preponderance - Crohn's disease = males and females SYMPTOMS OF AUTOIMMUNE DISEASES The symptoms and signs vary by specific autoimmune disease. The common symptoms are: - Fatigue - Affect on Weight - Muscle pain - Insomnia (not able to sleep) - Inflammation In ammatory Disorders Crohn’s disease: inflammation of the gastro-intestinal tract - Genetic risk factor - Environmental risk factor - Affects 400,000 to 600,000 people in North America fl 2 Tuesday, March 12, 2024 Rheumatoid arthritis: inflammation of synovial joints, often leads to destruction of articular cartilage - Some genetic risk factor - About 1% of the world’s population - Man-Woman ratio of 1:3 Multiple Sclerosis: inflammation leading to demyelination of axons in the brain and spinal cord - Results in physical and cognitive disabilities - Genetic variations and environmental risk factors - Infections as triggers - Affects 2 to 150 per 100,000 in the world Systemic Lupus Erythematosus: inflammation occurs almost anywhere in the body including heart, lungs and nervous system because it is transmitted through red blood cells - More common in non-European descent - Man-Woman ratio of 1:9 genetic and environmental risk factors Autoimmune Diseases (AD) - Heterogeneous group of 70 to 80 inflammatory disorders - AD classified according to the organ, tissue, or system targeted - Occurs when the immune response damages tissues in the body - Affects 3-8% of the population in the United States and tends to be chronic - 80% women HOW COULD STRESS PREDISPOSE TO THE DEVELOPMENT OF AUTOIMMUNE DISEASE? 1. Alteration of one or many components of the immune system Prenatally, stress affects the foetus, leading to synthesis of immune system - Inability to distinguish between self- and invader cells Immune system mysfunctions, attacking self-cells 2. Increased susceptibility to infectious diseases Stress leads to higher likelihood of catching cold Inability to fight off infections, leading to less efficient immune system Immune system weakened by stress = less efficient to fight it off = more prone to viruses HPA AND IMMUNE SYSTEM Direct communication between hypothalamus and lymph node Indirect communication by cortisol, epinephrine and norepinephrine which modulates the creation of lymphocytes 3 Tuesday, March 12, 2024 Study — Multiple Sclerosis Respiratory viral infection frequently precede exacerbation of MS Stress as a common denominator ✓ Stress induced changes in the immune system function ✓ Latent viral infection is activated due to immune suppression ✓ Infections that were fought off hide in the body that can be triggered to activate ✓ Stress suppressed immune function and increased susceptibility to viral infection followed by immune response Study — Childhood stress and later AD Early life experiences (adverse) can affect the immune system later on ✓ 2+ adverse childhood events increase the risk of developing AD ✓ Caused long term changes in immune response ✓ Decreased glucocorticoid levels Repeated stressors in childhood activates continuously the central nervous system- and endocrine-mediated = differences in immune function ✓ Repeated activation during development Amplification of environmental factors such as infections ✓ Social stress before viral infection increases inflammatory heart disease in rodents, especially in females Study — Lupus Erythematosus Daily stress: ✓ Increase in perceived symptomatology of lupus patients ✓ Prolactin increase Stressful life events ✓ No association ✓ Possible beneficial effect of major stressors Results: No relationship between life events and lupus Stress-vulnerability rheumatoid arthritis Question: Does stress affect the course of the disease activity? Found that ‘coping with stress’ and ‘social support’ are two factors strongly related ✓ Low social support = increased disease activity (vs high) ✓ Avoidance coping = increased disease activity (vs low) The presence or the lack of a social support can cause stress to the person with the disease Stress and personal mastery in relation to arthritis Questions: Does the level of personal mastery one has predict stress reactivity - internal locus and self control Hypothesis: Higher personal mastery should then reduce the levels of stress and would reduce the occurrence of flairs as a result 4 Tuesday, March 12, 2024 Results: those classified as high control or low fatalism show less stress = less flare ups Stress and Crohn’s Disease - People with the disease are more stressed than healthy controls - Of the people with the disease, those who are labeled as poorly functioning are even more stressed than their average functioning counterparts - Is the fact that they are poorly functioning what makes them stressed? Study — Stress and Crohn’s disease 5