Autoimmune Diseases Include Common And Rare Diseases
Autoimmune diseases are a broad range of more than eighty related disorders, ranging from common to very rare. They affect around 5% of people and are an important health issue in Australia and New Zealand:
Common autoimmune diseases include thyroiditis, rheumatoid arthritis and diabetes.
Less commone autoimmune diseases include systemic lupus erythematosus , also known as lupus, and vasculitis disorders .
Response To Maintenance Therapy
Presence of autoantibodies in the lungs could be one of the mechanisms that contribute to the observed steroid subsensitivity in severe asthmatics . The prednisone-sparing effect of classical autoimmune drugs in severe eosinophilic prednisone-dependent patients with biopsy evidence of granulomas is indicative of the same, even though airway autoantibody titers were not investigated. One of the potential mechanisms may be attributed to the increase in autoantibody titers in an eosinophil-rich tissue, and the consequent autoantibody-induced eosinophil degranulation with EETs. As discussed earlier in previous section, the event was shown to be a steroid-unresponsive ex vivo, and therefore could explain the concurrent presence of high eosinophil activity and sputum autoantibodies despite intake of daily prednisone in those patients. In an autoimmune tissue, increased doses of corticosteroid will be able to reduce the lymphocytic infiltration and eosinophils, but will not be efficient in reducing the number of autoantibodies or suppressing their immediate mechanism of action on effector cells . Again, in the same microenvironment of increased IgG load, the cross-linking of Fc-gamma receptors on eosinophils can negatively affect glucocorticosteroid-induced apoptosis, promoting survival., Furthermore, earlier studies could address impaired response to bronchodilators in patients who showed circulating autoantibodies to beta-2-adrenergic receptors.,
Future Challenges And Prospects For Asthma Therapy
In vitro and in vivo asthma models and clinical studies have disclosed much information regarding asthma pathogenesis including many targets amenable to therapeutic intervention. However, there is still no cure for asthma and progress in the development of effective new compounds for asthma therapy has been comparatively slow. The cornerstones of current asthma therapy -agonists and inhaled corticosteroids) provide symptomatic relief and some physiological improvements for most asthma sufferers . Whilst this approach has been reasonably effective, incidences of steroid resistant asthma is a major drawback and the side effects of steroid therapy can lead to poor patient compliance . Furthermore, asthma symptoms return as soon as corticosteroid therapy is withdrawn . Consequently, there is a need for more tailored and specific therapies that target the local pathways involved in asthma pathogenesis.
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Regulation And Resolution Of Allergic Inflammation
The majority of research into asthma has focussed on elucidating the pro-inflammatory pathways underlying disease pathogenesis and consequently many of the current therapeutic targets focus on blocking the initiating or amplifying components . Paradoxically, the necessity of appropriate termination and resolution of inflammation has comparatively recently been recognised . This has led to the concept that chronic inflammation may arise as a result of a lack of specific stop signals for inflammatory responses. Coupled with continued presence of allergens, this might explain the chronic nature of allergic disease. Natural resolution of inflammation is a dynamic process which requires the removal of stimulus, down regulation of mediators and elimination of dead cells . Dysregulation or failure of this process prevents a return to homeostasis and can contribute to the pathogenesis and progression of chronic inflammatory disorders such as asthma . Many of the endogenous, pro-resolving and anti-inflammatory mechanisms which co-ordinate the resolution process have begun to be defined and are thought to originate from the inflammatory response .
Signs Symptoms And Complications
How often signs and symptoms of asthma occur may depend on how severe, or intense, the asthma is and whether you are exposed to allergens. Some people have symptoms every day, while others have symptoms only a few days of the year. For some people, asthma may cause discomfort but does not interfere with daily activities. If you have more severe asthma, however, your asthma may limit what you are able to do.
When asthma is well controlled, a person shows few symptoms. When symptoms worsen, a person can have what is called an asthma attack, or an exacerbation. Over time, uncontrolled asthma can damage the airways in the lungs.
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What Are The Types Of Immunity
There are three different types of immunity:
- Innate immunity is the protection that you are born with. It is your body’s first line of defense. It includes barriers such as the skin and mucous membranes. They keep harmful substances from entering the body. It also includes some cells and chemicals which can attack foreign substances.
- Active immunity, also called adaptive immunity, develops when you are infected with or vaccinated against a foreign substance. Active immunity is usually long-lasting. For many diseases, it can last your entire life.
- Passive immunity happens when you receive antibodies to a disease instead of making them through your own immune system. For example, newborn babies have antibodies from their mothers. People can also get passive immunity through blood products that contain antibodies. This kind of immunity gives you protection right away. But it only lasts a few weeks or months.
What Can Go Wrong With Your Immune System
When your immune system doesn’t work the way it should, it is called an immune system disorder. You may:
Be born with a weak immune system. This is called primary immune deficiency.
Get a disease that weakens your immune system. This is called acquired immune deficiency.
Have an immune system that is too active. This may happen with an allergic reaction.
Have an immune system that turns against you. This is called autoimmune disease.
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How Is Asthma Connected To The Immune System
Scientists are still studying exactly how asthma is connected to the immune system. They think the immune system has a role in the asthma response and the development of asthma.1
Scientists do not know exactly why some people develop asthma. Some think asthma could be caused by an immune response to viruses. They believe standard viruses could cause the immune system to develop the behavior that leads to asthma in some people.5,6
The causes of intrinsic asthma are not well understood. This is because it can be triggered by so many things. But some scientists also think an autoimmune response may have a role in causing it. This potential link could help people with intrinsic asthma, who are sometimes more difficult to treat. It is possible that intrinsic asthma could respond to treatment with medicine used for autoimmune conditions.1
New Knowledge On The Development Of Asthma
- Karolinska Institutet
- Researchers have studied which genes are expressed in overactive immune cells in mice with asthma-like inflammation of the airways. Their results suggest that the synthesis and breakdown of fats plays an important part in the process.
Researchers at Karolinska Institutet in Sweden have studied which genes are expressed in overactive immune cells in mice with asthma-like inflammation of the airways. Their results, which are published in the journal Immunity, suggest that the synthesis and breakdown of fats plays an important part in the process.
The job of the human immune system is to read our environment and react to potentially harmful substances. In asthma, the immune system is overactive, causing inflammation in the lungs and symptoms such as coughing, wheezing and shortness of breath.
A kind of immune T cell called a Th2 cell plays a vital part in asthma-related inflammation, but the rarity of these cells and a lack of sensitivity technology has made these cells hard to study in any detail.
They found that in the mouse lung, the T cells express a unique profile of hundreds of genes, many of which are linked to how the cells make and break down fat. When they then gave mice a drug to block fat metabolism, the lung inflammation decreased relative to controls.
“Our observation is that the T cells change a great deal over time and seem to undergo a kind of reprogramming in the lungs that makes them highly inflammatory,” says Dr Coquet.
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How Can Immunodeficiency Disorders Be Prevented
Primary immunodeficiency disorders can be controlled and treated, but they cant be prevented.
Secondary disorders can be prevented in a number of ways. For example, its possible to prevent yourself from getting AIDS by not having unprotected sex with someone who carries HIV.
Sleep is very important for a healthy immune system. According to the Mayo Clinic, adults need about eight hours of sleep per night. Its also important that you stay away from people who are sick if your immune system isnt working properly.
If you have a contagious immunodeficiency disorder like AIDS, you can keep others healthy by practicing safe sex and not sharing bodily fluids with people who arent infected.
New Drug Target For Asthma Autoimmune Disorders Identified
Using a new tool for probing the molecular makeup of cells, researchers have discovered that PD-1 a marker that already serves as a drug target for some cancers may also serve as a drug target for asthma and other autoimmune disorders.
The researchers, led by a group from the Wellcome Trust Sanger Institute in the United Kingdom, report their work in the journal Nature.
Immune disorders arise because the immune system either fails such as by not removing unwanted cells during infection or cancer or becomes too active.
When it is too active, the immune system attacks healthy cells and tissue, giving rise to autoimmune diseases or allergies such as asthma, where the airways become swollen or inflamed.
In the new study, the researchers examine a recently discovered group of cells in the immune system called innate lymphoid cells . Within this group, there is a subgroup called ILC2 cells that influences immune responses during infections and asthma.
Scientists have observed that levels of ILC2 cells shoot up when triggered by pollen or toxins, causing lung inflammation.
However, as yet, they know little about how ILC2 cells develop from ILC progenitor cells in bone marrow, and whether they sport distinguishing markers once activated.
For the first time, the study team used a new tool called single-cell RNA sequencing to investigate ILC cells.
- There is no cure for asthma, but it can be managed with drugs and by avoiding triggers
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What Happens If I Have An Autoimmune Disease
There are many different autoimmune diseases with different treatments and consequences for people with these diseases. It is important to find out as much as possible about your autoimmune disease by asking questions of your treating doctor.
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ASCIA resources are based on published literature and expert review, however, they are not intended to replace medical advice. The content of ASCIA resources is not influenced by any commercial organisations.
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Immunologic And Autoimmune Lung Disease
Respiratory problems are common and can be serious in patients who have a connective tissue or autoimmune disease such as rheumatoid arthritis or lupus. With an autoimmune disease, a persons own immune system attacks the lungs, causing inflammation and scarring that can impair lung function and breathing. Rheumatoid arthritis may lead to a group of lung conditions categorized as rheumatoid lung disease. These include shortness of breath or dyspnea caused when the lung lining gets inflamed and filled with fluid . Common lung problems for people with connective tissue disease are interstitial lung disease , including pulmonary fibrosis and pulmonary sarcoidosis, and pulmonary hypertension. Patients with autoimmune disease may also present with bronchiectasis and lung nodules.
Board-certified pulmonologists and thoracic surgeons at the Brigham and Womens Hospital Lung Center provide specialized medical and surgical services for immunologic and autoimmune lung diseases. They collaborate with a multidisciplinary team that crosses many specialties: rheumatology, radiology, pathology and pulmonary rehabilitation. Together with our diagnostic microbiology and rheumatology laboratories, we provide patients with accurate diagnosis and comprehensive disease treatment and management.
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Medical History And Physical Exam
Your doctor will ask about your risk factors for asthma and your symptoms. They may ask also about any known allergies. This includes how often symptoms occur, what seems to trigger your symptoms, when or where symptoms occur, and if your symptoms wake you up at night.
During the physical exam, your doctor may:
- Listen to your breathing and look for symptoms of asthma
- Look for allergic skin conditions, such as eczema
An Overactive Immune System
If you are born with certain genes, your immune system may react to substances in the environment that are normally harmless. These substances are called allergens. Having an allergic reaction is the most common example of an overactive immune system. Dust, mold, pollen, and foods are examples of allergens.
Some conditions caused by an overactive immune system are:
Asthma. The response in your lungs can cause coughing, wheezing, and trouble breathing. Asthma can be triggered by common allergens like dust or pollen or by an irritant like tobacco smoke.
Eczema. An allergen causes an itchy rash known as atopic dermatitis.
Allergic rhinitis. Sneezing, a runny nose, sniffling, and swelling of your nasal passages from indoor allergens like dust and pets or outdoor allergens like pollens or molds.
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What Are The Parts Of The Immune System
The immune system has many different parts, including
- Your skin, which can help prevent germs from getting into the body
- Mucous membranes, which are the moist, inner linings of some organs and body cavities. They make mucus and other substances which can trap and fight germs.
- White blood cells, which fight germs
- Organs and tissues of the lymph system, such as the thymus, spleen, tonsils, lymph nodes, lymph vessels, and bone marrow. They produce, store, and carry white blood cells.
Tests That Diagnose Autoimmune Diseases
No single test can diagnose most autoimmune diseases. Your doctor will use a combination of tests and a review of your symptoms and physical examination to diagnose you.
The antinuclear antibody test is often one of the first tests that doctors use when symptoms suggest an autoimmune disease. A positive test means you may have one of these diseases, but it wont confirm exactly which one you have or if you have one for sure.
Other tests look for specific autoantibodies produced in certain autoimmune diseases. Your doctor might also do nonspecific tests to check for the inflammation these diseases produce in the body.
BOTTOM LINE: A positive ANA blood test may be indicative of an autoimmune disease. Your doctor can use your symptoms and other tests to confirm the diagnosis.
Treatments are also available to relieve symptoms like pain, swelling, fatigue, and skin rashes.
Eating a well-balanced diet and getting regular exercise may also help you feel better.
BOTTOM LINE: The main treatment for autoimmune diseases is with medications that bring down inflammation and calm the overactive immune response. Treatments can also help relieve symptoms.
More than 80 different autoimmune diseases exist. Often their symptoms overlap, making them hard to diagnose.
Autoimmune diseases are more common in women, and they often run in families.
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What Is Primary Immunodeficiency Disease
Primary immunodeficiency disease is a group of more than 300 disorders in which part of the immune system is absent or not functioning properly. People with PIDD may be more susceptible to illnesses sinusinfections, bronchitis or pneumonia and may experience recurring infections. Sometimes symptoms are mistaken for asthma or allergies.
Normally, the immune system protects the body from bacteria, viruses and fungi. When the immune system fails, infections can occur.
The first clue of an infection might be recurrent pneumonia or difficult-to-treat sinus, ear, skin or gastrointestinal infections.
A pattern of severe, repeat infections could point to a primary immunodeficiency disease, also known as PIDD.
Common Sense Laboratory Testing For Immunodeficiency
- Generally, patients with T-cell disorders have opportunistic infections, whereas patients with antibody, phagocytic cell or complement deficiencies usually have recurrent infections due to encapsulated bacteria.
- Screening for primary immunodeficiency is not currently performed at birth. Fortunately, many immunologic defects can be easily assessed with a simple blood count. For example, a complete blood cell count with differential with a normal absolute neutrophil count will rule out congenital or acquired neutropenia.
- If the patients absolute lymphocyte count is normal, a severe T-cell defect is unlikely.
- General blood chemistry panels often reveal low total protein but normal albumin in agammaglobulinemia due to very low gammaglobulin levels. A low uric acid level may be indicative of Adenosine deaminase deficiency or purine nucleoside phosphorylase deficiency, while a low serum calcium level may suggest DiGeorge Syndrome due to associated hypoparathyroidism.
Normal quantitative immunoglobulins will rule out most B-cell immunoglobulin deficiencies.
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Targeting The Brain’s Immune Cells May Help Prevent Or Treat Alzheimer’s Disease
A gene mutation linked to Alzheimer’s disease alters a signaling pathway in certain immune cells of individuals with the disease, according to a new study by scientists at Weill Cornell Medicine. The team also found that blocking the pathwaywith a drug that’s currently being tested in cancer clinical trialsprotects against many features of the condition in a preclinical model. The results could lead to new strategies to block the development of Alzheimer’s disease or slow its progression.
The study, published Dec. 1 in Science Translational Medicine, focused on microglia, immune cells of the central nervous system that are the first to respond when something goes wrong in the brain. Studies have identified many genetic variants linked to Alzheimer’s disease that are highly expressed in microglia, providing compelling evidence that alterations within these cells may play a role in the disease’s onset and progression.
Alzheimer’s disease is the most prevalent neurodegenerative disease in aging, affecting approximately 46 million people worldwide. Theories point to a number of potential causes, including age-related changes in the brain, along with genetic, environmental, and lifestyle factors. These lead to the accumulation of toxic proteins in the brainand according to recent evidence, immune system changesthat result in loss of neurons and their connections.