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Daniel P. Malito

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Explained: What Are Autoimmune Diseases?

Posted: 09/23/11 09:18 AM ET

If anyone asked you what genre of diseases is the second most common cause of chronic illness in the U.S., what would your answer be? Hopefully you'd get the correct answer and say autoimmune disease, but I have a feeling that is very unlikely. It seems that while more and more people are being diagnosed with autoimmune illnesses, there is still a huge lack of understanding and awareness of this plethora of diseases.

What is autoimmune disease? If we break down the word, you can see that it starts with "aut," which comes from the ancient Greek word for "self." I would hope you know that "immune" refers to the body's immune system. So, autoimmune or "self-immune-system" diseases are those in which a patient's immune system is attacking itself. The body's mechanisms can no longer differentiate between foreign bodies and friendly bodies. Normally, the system's white blood cells help protect the body, but the immune response in autoimmune patients destroys normal body tissue and foreign tissue alike. Think of it as friendly fire on a very minute scale.

Your next question might be to ask why the body is attacking itself. The answer is simple: We don't know. There are theories that some bacteria or virii might trigger the autoimmune response in patients who are genetically predisposed, but nothing has been confirmed. The simple fact is that doctors and medical researchers have very few answers as to why the immune system is switched on full-time in autoimmune patients, nor do they have any idea how to switch off the specific mechanism causing the immune system anomaly.

Because drug companies have not been able to target the specific characteristic of the immune system that makes it attack friendly cells, the treatment for autoimmune illness until as of late has been to, in effect, beat down the entire immune system -- good and bad parts alike. It's sort of like using a sledgehammer to put in a thumbtack. Yes, the job will get done, but everything around the thumbtack will be destroyed in the process. Immuno-suppressant medications function in a very similar fashion, shutting off the entire immune system instead of just the broken parts. The patient does obtain relief from the symptoms of the disease but also becomes susceptible to any illness that comes along. Since the immune response is next to nothing, a common cold could mean a hospital trip.

Lately, though, there have been a slew of "bio-drugs," also called disease modifying agents, which target a very specific group of molecules in the body. These molecules are thought to be the cause of autoimmune disease, but there is no way to tell which one of the possible culprits is responsible for the autoimmune disease in the specific patient in question. Discovering this individual molecule type is a matter of trial and error. As of now, the only way to discover which possible molecule is causing a patient's arthritis is to wait and see if a certain bio-drug works for the patient. If the symptoms lessen, then it is assumed that the patient has the specific form of autoimmune disease that the drug is designed for. Talk about circular logic!

Part of the reason that so little is known about autoimmune disease is because until recently, there has not been much media time devoted to any of the illnesses. Within the last few months, though, that has changed. Two cases of autoimmune disease have unfortunately afflicted two very public sports stars. They are suffering from different afflictions, but both are classified as autoimmune diseases.

About a year ago, Phil Mickelson, one of the top professional golfers in the world, was diagnosed with psoriatic arthritis. Psoriatic arthritis is a form of arthritis that affects some people who have psoriasis. Psoriasis is a condition which produces red, flaky patches of skin that eventually develop silvery scales. Skin lesions develop early in the disease, but joint pain and swelling can occur before any lesions appear at all. The arthritis can affect any part of the body, including the spine and the fingertips, and can be severe enough to seriously constrict movement -- not a good thing for a pro golfer. There is no cure, as with most autoimmune diseases, and treatment is to control the symptoms only.

Within the last month, another sports star has announced that they have been afflicted with an autoimmune disease. Venus Williams, one of the best tennis players in the world, revealed that she has been diagnosed with Sjogren's Syndrome. Sjogren's mainly affects the moisture glands of the eye and mouth. These glands are attacked by the body's own immune system, and because of this the mucus production is seriously curtailed. Sjogren's can occur in patients without any other autoimmune illness, but it is common for patients who have another autoimmune disease to develop Sjogren's. Besides the glands, other parts of the body can be affected as well. Pain and stiffness in the joints along with mild swelling can occur, as in Venus Williams' case.

To help spread information about autoimmune illnesses and to help protect yourself, it is smart to familiarize yourself with some of the facts of this genre of diseases. For instance, more women than men are affected by autoimmune disease -- the specific amount varies with the actual diagnosis. Many autoimmune diseases present gradually and are usually shrugged off as injury or a passing illness, such as the flu. Joint pain and stiffness are characteristic for a great many autoimmune diseases, and that including fingers, toes, feet, the spine and the collarbones. Fever and general fatigue are also prevalent in most of the autoimmune afflictions. If you suffer from any of these symptoms and they are as-yet-unexplained, it may be time to see a rheumatologist.

As you can see, autoimmune disease is more than just a minor annoyance. Now that two very public, very successful individuals have been diagnosed with autoimmune illnesses, hopefully more information about the entire class of diseases will trickle down to the public at large. Finding a cure begins with money, and to discover the reason the body is attacking itself we need as much exposure as possible. I, myself, have rheumatoid arthritis, so this is a subject that is close to my heart. Many of us have renewed hope that a cure or better treatments will be found now that autoimmune illness is in the media's crosshairs, at least for the time being. If you want more information you can check out CreakyJoints.org, OnCourseWithPhil.com, ArthritisFoundation.org and Sjogrens.org.

 

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