What is an autoimmune disease?
introduction
The term autoimmune disease encompasses a whole group of different diseases. He designates one Overreaction of the cells of our immune system towards the body's own cells, which lead to damage to the respective organ.
Our immune system experiences the beginning of human development an imprint in the thymus. This organ plays a central role in the Selection of the so-called T cells. Only those cells that are able to recognize the body's own cells are allowed to survive. All others are sorted out. This is how the body creates one Mechanism for defense against foreign structures. These include viruses and bacteria, but also other microorganisms and substances supplied from outside.
The immune system is said to be able to recognize and tolerate its own cells, while at the same time protecting the body from "intruders". The so-called MHC molecules has a special function here. They are located on the outer cell wall and serve the Detection of unknown cells. Embossing does not always work smoothly. In some cases errors occur, so that certain T cells direct their humoral and cellular response not to foreign structures but to the body's own cells. They lead to Formation of antibodies, so-called autoantibodies.
The affected organ is initially damaged and can be completely destroyed if left untreated. If there is no therapy, it is usually a lifelong process. The exact causes that contribute to the development of an autoimmune disease are not yet known. One goes from one genetic predisposition and an incorrect selection of T cells in the thymus. Different triggers trigger the onset of the disease. Which includes viral infections or the infection with a certain pathogen, but also hormonal changes in the body. In the diagnosis of autoimmune diseases, the level of the respective autoantibody in the blood is determined. So-called Limit titre define the value from when it is considered to be pathological. Treatment is usually symptomatic. A cure is not yet possible.
A total of around 400 autoimmune diseases are known, which are divided into three different groups: diseases against a specific organ, diseases against specific body structures and mixed forms.
Autoimmune Disease Symptoms
The symptoms at the onset of an autoimmune disease are mostly unspecific and are often not recognized as such. Symptoms characteristic of certain autoimmune diseases are usually not apparent. The symptoms that occur include skin symptoms such as Itching, rash and redness.
In some cases, those affected complain vegetative complaints, so symptoms of the involuntary nervous system. Increased tiredness or reduced need for sleep, changes in temperature sensation, diarrhea or constipation and abnormalities in the heart rate fall into this range. Concentration disorders, increased feverish temperatures and unspecific abdominal complaints can also be observed. But it also occurs Joint problems and neurological abnormalities like discomfort and tingling in hands and feet. Loss of libido is also observed in connection with some diseases. Visual disturbances how double vision come with the Multiple sclerosis and the Graves disease in front.
Autoimmune diseases of the liver
The autoimmune liver diseases are subject to a faulty reaction of the body's immune system, which leads to Destruction of the cells of the liver and biliary tract leads. A distinction is made between three liver diseases that are subject to autoimmune malfunctions: the pmarginal sclerosing cholangitis, the primary biliary cirrhosis and the autoimmune hepatitis. The three clinical pictures have no typical symptoms. Those affected often complain of unspecific abdominal pain, nausea and vomiting, increased tiredness, pressure in the liver and itching. In addition, a Yellowing of the skin and eyes stand out as well reduced body hair in men.
The primary sclerosing cholangitis is associated with a chronic inflammatory reaction of the biliary tract. The ongoing inflammation causes an increased production of connective tissue, which increasingly squeezes the biliary tract. The passage of bile is made difficult. The primary sclerosing cholangitis occurs more often in connection with inflammatory bowel disease on. These include Crohn's disease and Ulcerative colitiswhich, like cholangitis, progress in flares. Men are affected by the disease much more often than women. If the disease remains undetected or untreated, cirrhosis of the liver can develop over time. In addition, the lifetime risk increases for one Carcinoma of the biliary tract.
The Autoimmune hepatitis is a rare autoimmune disease that accounts for about one fifth of all liver diseases. It occurs at every age. However, women between 20 and 40 years of age are affected significantly more often than men of the same age. The trigger have autoimmune hepatitis usually not to be clearly identified. Environmental factors as well as Antigens from viruses and bacteria seem to play a role in the pathogenesis. Salmonella, the hepatitis viruses A, B, C, and D as well as herpes viruses are suspected to be triggers. In many cases it is one Incidental finding, which is part of routine Blood tests by increased liver values is discovered. In particular, the Transaminases and the Gamma globulins noticeable. Antibodies against various cell components can also be detected.
The primary biliary cirrhosis affects the small bile ducts of the liver. It is also a chronic inflammation that, if left untreated, leads to cirrhotic modification the liver leads. The majority of those affected are female. Diagnosis and therapy are possible even in slightly advanced stages. In this way, cirrhosis of the liver can be prevented in most cases.
Commonly used in the therapy of autoimmune liver diseases Drugs used to suppress the immune system used.
Autoimmune diseases of the thyroid
A distinction is made between two autoimmune diseases of the thyroid gland: the Hashimoto's thyroiditis and the Graves disease.
Hashimoto's thyroiditis is the most common chronic thyroiditis. As a result of a malfunction of the immune system, antibodies (TPO and Tg AK) against thyroid cells. These are gradually destroyed and are no longer able to produce Thyroid hormones. Hashimoto's thyroiditis can occur at any age, but usually manifests itself between the ages of 40 and 50. Women are more often affected than men. It is divided into two different forms. While one of the autoimmune diseases of the thyroid with a Enlargement of the thyroid gland (Goiter) goes hand in hand, the other leads to one Regression (atrophy) of the thyroid tissue. The triggering factors include excessive iodine intake, stress, severe viral infections and environmental factors. The symptoms of an overactive thyroid gland typically appear at the onset of the disease. The destroyed cells release more thyroid hormones. Have affected Insomnia, weight loss despite food cravings, one increased heart rate, changed temperature sensation and complain about increased nervousness. As the disease progresses, one develops Hypothyroidism (Hypothyroidism), which is accompanied by the following characteristic symptoms: feeling very cold, tired, weight gain, depressive moods, difficulty concentrating, feeling lumpy and dry skin and mucous membranes. In addition, women often have menstrual cycle disorders. A cure for Hashimoto's thyroiditis is not possible. The substitution of thyroid hormones in tablet form, however, allows in the vast majority of cases symptom-free life.
Graves' disease or Graves ‘Disease is also an autoimmune disease of the thyroid. Autoantibodies, especially so-called TRAK, stimulate the thyroid cells increased hormone production on. The onset of the disease is observed between the ages of 20 and 40, and women are mostly affected. Usually it is one Overactive thyroidthat with a Organ enlargement (Goiter) and one unilateral or bilateral Eye involvement (endocrine orbitopathy) can occur together. The triggers of Graves' disease cannot be clearly identified. Genetic components, viral infections, environmental factors and stress all play a role. In addition to organ enlargement and endocrine orbitopathy with protrusion of the eyeball (Exophthalmos), are the Symptoms of an overactive thyroid to observe. There is also one in Graves' disease Healing not yet possible. In addition to therapy with thyroid drugs, symptomatic treatment measures for the accompanying complaints are used. With the help of a radical removal of the thyroid gland or radioiodine therapy, the cause is not eliminated, but the process is stopped.
Autoimmune diseases of the skin
Autoimmune diseases can also affect the skin as part of a systemic disease or be limited to the skin only. The so-called collagenoses are not only directed against the skin, but also against other endogenous structures. This includes scleroderma, a hardening of the skin that can spread to other organs, and dermatomyositis, a disease with muscle and skin involvement. Lupus erythematosus, with its diverse forms of skin and organ complaints, is also a collagenosis.
Vasculitides are inflammatory changes in the blood vessels of the skin and other organs. Autoimmune blistering diseases are caused by the reaction of autoantibodies against cellular components of the epidermis. Not only the skin can be affected, but also the mucous membranes in the mouth and eye area and in the genital region. This includes the Pemphigus vulgaris and the bullous pemphigoid.
Autoimmune diseases restricted to the skin are, for example, white spot disease, the Vitiligo, Psoriasis (Psoriasis) or the circular hair loss (Alopecia areata). In the latter, the hair falls out in circular spots. Psoriasis is based on a malfunction of the immune system. Neurodermatitis has a similar development of the disease.
Read more on the topic: Lupus erythematosus.
Autoimmune diseases of the kidney
Behind the term Glomerulonephritis hides a group of different Kidney corpuscles disorders both kidneys. Generally it is an inflammation of the so-called Glomeruli the renal cortex, the one Filter function of the blood fulfill. Glomerulonephritis can appear as a disease of the kidney alone or in association with another disease. About two-thirds of the cases are autoimmune diseases that affect the kidneys only. The body's own Immune system produces antibodies, often so-called IgA antibodies, which are found in the Deposit loops of glomeruli. They lead to one impaired filter function of the kidney corpuscles. Affected people are usually painless. Since the kidney's barrier no longer works, they can red blood cells and proteins in the urine prove. In turn, harmful metabolic products remain in the bloodstream. In addition to a immunosuppressive Therapy, come depending on the stage antihypertensive and nutritional measures for use. If glomerulonephritis is not treated or if it remains undetected for a long time, there is a risk of kidney failure.
Autoimmune diseases of the lungs
In the context of systemic autoimmune diseases, a Involvement of the lungs to be watched. It is primarily about Collagenoses and Vasculitis. Especially in connection with the systemic Lupus erythematosus, of the rheumatoid arthritis and the Sarcoid a reduction in functional lung tissue can occur. One speaks of one Fibrosis of the lung tissue. Chronic remodeling processes, mostly caused by inflammation, transform the thin wall of the alveoli into connective tissue that is impassable for oxygen. Shortness of breath and persistent, dry cough are characteristic symptoms. Some systemic vasculitides are also associated with lung involvement. The specific antibodies of autoimmune diseases are directed against small vessels and provoke one inflammatory reaction of the tissue of airways and lung tissue. Mostly these are diseases with so-called Anti-neutrophil antibodies (ANCA) are associated. These include Wegner's granulomatosis, microscopic polyangiitis and Churg-Strauss syndrome.
Autoimmune diseases of the gut
Crohn's disease and ulcerative colitis are autoimmune diseases of the intestine. Both diseases are chronic inflammatory reactions of the intestinal mucosa. A characteristic feature of Crohn's disease is the irregular involvement of the mucous membrane from the mouth to the anus. Most often the disease is localized in the lower part of the small intestine and the large intestine. It is possible that individual healthy sections of the intestine lie between the diseased mucous membrane. In addition to the classification as an autoimmune disease, genetic components, a defect in the barrier between the intestinal wall and microorganisms and the presence of a certain mycobacterium play a role. Typical symptoms are Abdominal pain and sometimes bloody diarrhea. In therapy, the Treatment of the acute phase and the prevention different thrusts. This is an attempt to weaken the immune system's response.
Also Ulcerative colitis progresses in flares and will immunosuppressive treated. The symptoms are similar to those of Crohn's disease. Until now, ulcerative colitis was also considered an autoimmune disease. The latest findings suggest that it is rather a Malfunction of the defense against intestinal bacteria acts. The even infestation of the intestinal mucosa is limited to the large intestine. From a therapeutic point of view, if there is no response to medicinal measures, there is the option of surgical removal of the colon.
Life expectancy
Life expectancy is the same for most autoimmune diseases not restricted with appropriate therapy. If the disease is not recognized for a long time, the organ damage can result in a lower life expectancy. The same applies if there is no therapy. The autoantibodies formed cause irreversible damage to the respective tissue. The further this has progressed, the more difficult a successful treatment can be. Less common diseases such as lupus erythematosus can be treated much better than before thanks to modern therapy options. About 80 percent of those affected survive the first ten years after starting therapy.
Since there are no definitive healing measures to date, one should definitely be taken to maintain life expectancy adequate therapy takes place.
Lupus
Systemic lupus erythematosus (SLE) is a collagenosis. He is distinguished by Inflammatory reactions throughout the body which can be in acute as well as chronic phases. Besides the systemic form, there are others that limited to the skin only are. In the blood of those affected can Autoantibodies, so-called ANA (anti-nuclear antibodies) and detect increased inflammatory cells. These mistakenly attack the body's own cells. The antibodies in lupus erythematosus are directed not against a specific organbut against every cell in the body. In addition to the skin, the heart, kidneys, lungs and nervous system as well as joints can be affected. The female sex is ten times more likely to get sick. The onset of the disease is possible at any age, but is more common between the ages of 20 and 40. In addition to environmental and genetic factors, certain drugs can also be considered as triggers. The Symptoms are organ-dependent. Those affected complain of tiredness, increased body temperature, joint pain, gastrointestinal complaints and inflammatory changes in the skin and mucous membranes. Inflammation of the pericardium and lung membrane also occurs. Most of the cases develop a so-called Butterfly erythema, a red rash on the face. The respective therapy depends on the organ involvement and is usually symptomatic. The overreaction of the immune system will also help with immunosuppressive Medicines reduced.
