Autoimmune diseases are diseases in which an abnormal immune response, i.e., the immune system, is directed against a normal body part. This response leads to inflammation, cell damage, or dysfunction with accompanying symptoms. The part of the body that is the object of the immune system's attack is called an autoantigen.
In contrast, a foreign antigen is a molecule from an infecting organism that stimulates the immune response. We divide autoimmune diseases into acute or chronic.
Autoimmune diseases happen when the immune system incorrectly attacks the body’s tissues and cells. This misguided immune response stems from the mechanisms that normally allow the immune system to effectively respond to foreign antigens, such as viruses and bacteria.
In simple terms, individuals with autoimmune diseases have immune systems that confuse their cells with outside threats. As a result, the immune system launches a response intended to neutralize what it perceives as invaders.
Autoimmune diseases can affect individuals of any age and gender. Nevertheless, they are more typically diagnosed in women than in men. It is also possible for a single individual to have multiple autoimmune diseases at the same time.
Individuals with close relatives who have an autoimmune disease generally have a higher risk of developing one themselves. However, having a genetic predisposition to a particular autoimmune disease does not guarantee that a person will become sick.
Most autoimmune diseases typically affect women of reproductive age, raising necessary inquiries about their influence on fertility and pregnancy. In general, these diseases do not impede the chances of successful fertilization. Many of them may go into remission during pregnancy, particularly in the first trimester.
However, lupus erythematosus is an exception that presents significant risks during pregnancy. Previously, this condition was regarded as an absolute contraindication to pregnancy due to its potential complications, such as miscarriages or premature births.
One concern is that the anti-Ro and anti-La antibodies associated with lupus can cross the placenta, potentially leading to congenital lupus erythematosus and congenital third-degree atrioventricular block, which can be fatal.
Currently, it is believed that pregnancy is possible for those with lupus, but it requires careful planning with your doctor. Throughout the nine months of pregnancy, the mother’s and child’s health must be closely and regularly monitored.
Another condition to be cautious about is antiphospholipid syndrome (APS). This disease can result in dangerous vascular thrombosis in pregnant women and may contribute to habitual miscarriages or the death of otherwise healthy fetuses after the 20th week of pregnancy. Consequently, pregnancy in patients with lupus and APS is considered high-risk.
A significant challenge is managing autoimmune diseases during pregnancy, as many medications are unsafe to use. For example, immunosuppressive drugs, should be discontinued, and any treatments involving this drug must be completed at least six months before conception, as it can cause miscarriages and congenital defects.
It is also important to note that autoimmune diseases can flare up with increased intensity after pregnancy during the postpartum period, even if they were well-managed or in remission while waiting for the child.
The occurrence of a disease is usually caused by many factors. In the case of some autoimmune diseases, it has been proven that the risk of getting sick is increased by:
Autoimmune diseases can be generalized, such as systemic rheumatic diseases, or concern specific tissues and organs. It can be acute or chronic and involve all organs and systems of the organism.
Autoimmune diseases include:
Those include:
Symptoms of autoimmune diseases are diverse, different, and specific to each disease entity. To put it very simply, patients may experience symptoms such as:
In fact, however, this list is much longer.
Diagnosis of autoimmune diseases can be difficult, especially in the early stages of their development. Diagnosis of immunological diseases is complicated by situations in which various organs and systems have been attacked. Depending on the disease, methods of diagnosis may include:
In long-term and not always properly profiled diagnostic procedures, the patient may be subjected to various tests. Many of them show abnormalities, but do not effectively explain their cause. For example, in many autoimmune diseases, elevated CRP (reactive protein) or abnormal morphology are found, but such results are also noted in other inflammatory diseases.
Ultimately, the most important are autoimmune tests, which involve the determination of antibodies in the blood, although even they are not always conclusive.
For this very reason, it is so important for doctors to compare the results obtained with the clinical picture and complementary tests (e.g. a reduced cortisol level is typical for Addison's disease).
In practice, the most frequently detected antibodies include:
Generally, the treatment of autoimmune disease involves the use of medications that reduce the activity of the immune system (immunosuppressive drugs) or inhibit inflammation (anti-inflammatory drugs), which leads to tissue damage.
Sometimes the occurrence of autoimmunity, i.e., an abnormal response of the immune system, is preceded by an infection. Then the treatment will also incorporate the use of drugs that manage a given condition.
In some cases, the treatment concerns functional conditions, if a given organ has been damaged by an abnormal response of the immune system and does not fulfill its function.
Currently, great hopes are pinned on biological drugs. These medications have biologically produced molecules that naturally appear in the human organism and can regulate the functions responsible for our immunity.
The treatment of autoimmune disorders is aimed at:
Usually, the treatment of autoimmune diseases is symptomatic and long-term because in most cases they are chronic diseases. However, autoimmune diseases can have a very different course and in some people, there are remissions, i.e., periods free from symptoms, which can last a very long time, even years.
Pharmacological treatment is just one of the pillars of therapy. Other activities are also necessary, such as appropriate nutrition. The diet in autoimmune diseases should be designed with a doctor and a dietician.
Recommendations for individual diseases may differ, but in many cases, the general goals remain common. The key is to alleviate inflammation or prevent it. Products that can stimulate the immune system and exacerbate symptoms are removed from the diet.
The gut microbiome, or the so-called “good bacteria” that inhabit our intestines, plays a huge role in immune processes. Although it may be surprising, our intestines contain over a kilogram of bacteria – considering their size, that's a lot! Our intestines also contain about 70% of the tissue responsible for immune processes. Therefore, changes in the gut microbiome (dysbiosis) can have a direct impact on the functioning of the immune system. In turn, our diet can contribute to these changes to a large extent. Hence the impact of diet on autoimmune diseases.
Autoimmune diseases are not a homogeneous group of diseases, but they are based on inflammatory processes caused by improper functioning of the immune system. In some diseases, such as the previously mentioned celiac disease, the only effective treatment is to eliminate certain ingredients from the diet. In the case of other autoimmune diseases, it is effective to use a diet that excludes the consumption of ingredients that contribute to the disruption of the gut microbiome (dysbiosis) and limits inflammatory processes in the body.
The diet for autoimmune diseases is based primarily on limiting the consumption of certain proteins, which can contribute to the exacerbation of the disease. It is called a low-antigen diet. The most important foods to eliminate are grains, legumes and dairy products.
Sometimes it is also necessary to exclude nuts, eggs, seeds (drinking coffee is also not recommended in the course of autoimmune diseases), nightshade plants (e.g. potatoes) or yeast. It has also been shown that alcohol consumption can have a negative impact on the course of autoimmune diseases.
In return, a low-antigen diet should include vegetables, preferably raw. The most beneficial is eating green leafy vegetables and cruciferous vegetables. Cruciferous vegetables contain compounds with anti-inflammatory and detoxifying effects. They are also a great source of food for bacteria living in the intestines. Such a diet should also include fish, good quality meat, healthy fats and moderate amounts of fruit. It is also important to ensure an adequate supply of vitamin D.
There is also a certain relationship between food intolerances and autoimmune diseases. In food intolerances, the immune system malfunctions and starts attacking undigested food residues. The immune system is overloaded, which is already malfunctioning as a result of the autoimmune disease, which can result in the symptoms of the disease becoming more severe.
Autoimmune diseases are rich in far-reaching effects. In themselves, they are a source of serious ailments and often lead to further complications. In many circumstances, they can be responsible for shortening life. The consequences of each of them are different and additionally multiple, which makes the scale of possible threats enormous.
Patients suffering from autoimmune diseases must also take into account various contraindications and limitations. They are different for individual diseases and it is impossible to list them all here.
However, a few circumstances can be mentioned:
Those include:
Autoimmune diseases are challenging to predict and prevent. To a large extent, they are associated with genetic predispositions, which no one can influence. However, it is possible to partially limit the impact of potential factors triggering the disease and then exacerbating it. As mentioned above, these are primarily: stress, improper diet, bacterial and viral infections, ultraviolet radiation, or some medications.
Recommendations in this regard are therefore quite general and not always effective. It is impossible to fully control all of these areas, and it is also impossible to always predict which factor and when may potentially play a negative role. Nevertheless, following the basic rules of life hygiene can in this case reduce the risk of disease.
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