Autoimmune Diseases

Autoimmune diseases pertain to a variety of conditions, all of which have in common that they result from immune reactions against the body's own structures. In a nutshell, the body attacks itself in various places – with far-reaching consequences, as we can see from the following clinical conditions:

1. Chronic Fatigue Syndrome (CFS) 
2. Ulcerative colitis
3. Multiple Chemical Sensitivity Syndrome (MCS)
4. Crohn's disease
5. Multiple sclerosis (MS)
6. Polyneuropathy (toxic)
7. Rheumatoid arthritis and its numerous manifestations

Autoimmune diseases are chronic inflammatory processes. Today around 5 to 8% of the world's population is affected by some 80 to 100 different autoimmune diseases. Following cardiovascular and tumor diseases, they form the third most common disease group. In recent years, however, the frequency of these diseases has been increasing steadily (e.g., diabetes mellitus type 1, multiple sclerosis).

Interference in the immune system plays a central causal role, resulting in loss of tolerance to the body's own tissue structures. The immune system, which protects healthy people from viruses, bacteria, parasites or other foreign substances, can no longer distinguish between "foreign" and "self" (auto) in autoimmune diseases. As a result, the immune system attacks healthy, endogenous tissue.

Untreated autoimmune disease can lead to severe inflammatory reactions that destroy the affected organ and, in severe cases (with systemic involvement), even death. That is why early diagnosis and therapy are crucial. This requires the participation of physicians from almost all disciplines, ranging from general practitioners to specialists including rheumatologists, nephrologists, neurologists, cardiologists, pediatricians, and dermatologists.

Organ-specific and systemic autoimmune diseases

When the immune system either selectively targets a specific organ (e.g., thyroid gland, pancreas, intestines, skin, nerves), this is referred to as an organ-specific autoimmune disease. If it targets the entire system, it causes non-organ-specific, systemic autoimmune disease. In this case, the immune system attacks multiple organs of the body. Some examples are given below:

Organ-specific autoimmune diseases:

• Multiple sclerosis (autoantibodies/autoimmune response affecting myelin sheath of nerve fibers)
• Diabetes mellitus type 1 (autoimmune response affecting islet cells of the pancreas) 
• Colitis ulcerosa (autoimmune response affecting the intestinal mucosa)
• Pemphigus vulgaris (autoimmune response affecting the uppermost skin layer = epidermis)
• Myasthenia gravis (autoimmune response affecting acetylcholine receptors at motor endplates) 
• Graves' disease (autoimmune response affecting thyroid TSH receptors) 

Systemic autoimmune diseases:
(inflammatory rheumatic diseases)

• Rheumatoid arthritis (chronic polyarthritis, "articular rheumatism")
• Lupus erythematosus (SLE, reactions affecting numerous organs)
• Polymyositis (inflammation of the musculature)
• Sjögren's syndrome (autoimmune response affecting exocrine glands)
• Scleroderma (hardening of the connective tissue of skin, vessels and internal organs)
• Systemic vasculitis (inflammation of blood vessels)
• Anti-Phospholipid Syndrome (blood clotting disorder)

You can find an overview of autoimmune diseases, their associated clinical aspects and more detailed information on the homepage of the German Society for Autoimmune Diseases: www.autoimmun.org/erkrankungen

The reasons that autoimmune diseases occur are multifaceted and complex. An autoimmune disease can only be triggered by a combination of multiple factors. The basis is always a disruption of the life-sustaining immunological balance. Some of the causes include:

• disrupted immune system regulation, loss of tolerance
• exogenous (triggering) factors, e.g.
  • stress
  • viruses, bacteria, parasites
  • medications
  • environmental toxins
• gender (female > male)
• genetic factors (HLA-associated diseases)
• a special immunological situation, e.g., pregnancy
• ancillary disease associated with malignancies