Autoimmune diseases: when the body attacks itself

Autoimmune diseases affect millions of people worldwide and can occur at any age. Some of us may be affected ourselves or know people who suffer from them. This is because autoimmune diseases are widespread and are among the most common chronic illnesses in Germany. But what exactly are autoimmune diseases? What types are there, what is behind them – and what does all this have to do with the immune system? Here we take a look at the different diseases, causes, symptoms and how to deal with autoimmune diseases.

What are autoimmune diseases?

Generally speaking, autoimmune disorders are a group of disorders in which the immune system mistakenly attacks the body's own tissues and cells. There are various autoimmune disorders that can attack any tissue and any organ, depending on the type of disease. Some affect only one, for example the thyroid, pancreas, intestines, skin or nerves, but some are also systemic and attack several organs. [1]

Normally, our immune system protects us from harmful intruders such as bacteria or viruses. However, in the case of an autoimmune disease, the immune system gets out of control and turns against the body. It does not recognize the difference between foreign and the body's own structures and therefore attacks healthy cells and organs. This can cause chronic inflammation and tissue damage. These attacks can also cause a variety of symptoms that are often unspecific and difficult to diagnose. However, autoimmune diseases should not be confused with allergies. In allergies, the immune system overreacts to external stimuli that are actually present, whereas autoimmune reactions mistakenly occur against the body's own tissues.

The cause of this misdirected immune response is not yet fully understood, but a multifactorial combination of genetic and hormonal factors, environmental factors, physical and/or mental stress, and possibly also errors in immune regulation play a role. Why autoimmune diseases occur more frequently in women than in men has also not yet been sufficiently researched; it could be related to hormonal balance. [2, 3, 4]

What diseases are considered autoimmune diseases?

Autoimmune diseases have a wide range of clinical pictures, but they all have one thing in common: the immune system develops a defense reaction against the body's own antigens. There are over 80 different autoimmune diseases in which the immune system turns against the body's own structures. We have compiled a list of some common autoimmune diseases at a glance:

Organ-specific autoimmune diseases:

Type 1 diabetes: In type 1 diabetes, the immune system destroys the insulin-producing cells in the pancreas.

Multiple sclerosis (MS): A chronic inflammatory disease of the central nervous system that affects the brain and spinal cord.

Crohn's disease: A chronic inflammation of the digestive tract that affects the entire digestive tract.

Ulcerative colitis: A chronic inflammation of the colon mucosa that can lead to the formation of ulcers.

Hashimoto's thyroiditis: An autoimmune disease in which the immune system attacks the thyroid gland.

Graves' disease: This is another thyroid disorder that causes an overactive thyroid (hyperthyroidism).

Systemic autoimmune diseases:

Rheumatoid Arthritis (RA): In rheumatoid arthritis, the joints are affected and permanently inflamed, which is why it is also called chronic polyarthritis.

Lupus erythematosus (SLE): SLE is a condition known as systemic lupus that can affect the skin, joints and internal organs.

Polymyositis: This primarily affects the muscles, leading to muscle weakness and inflammation. The disease can also affect the lungs, heart and digestive tract.

Less common or rare diseases that attack the body's own cells include Guillain-Barré syndrome (which affects the peripheral nerves), Goodpasture's syndrome (which affects the lungs and kidneys), Addison's disease (the adrenal glands are attacked), Sjögren's syndrome (which affects the lacrimal and salivary glands) or myasthenia gravis (the communication between nerves and muscles is disturbed). [3, 5, 6, 7, 8]

What are the symptoms of an autoimmune disease?

The symptoms vary greatly depending on the affected disease and the organs under attack. They are often non-specific and difficult to recognize. Nevertheless, there are some general signs that are among the common symptoms:

Chronic fatigue (does not improve despite adequate sleep)
joint pain and swelling (e.g. stiff joints)
Skin lesions (e.g. rashes, inflammations)
Recurrent fever
Digestive problems (e.g. frequent diarrhea or blood in the stool)
Muscle weakness
Hormone disorders (e.g. in Hashimoto's disease)
Weight changes
Hair loss

Since many of these symptoms also occur in other diseases, diagnosis is often difficult and requires extensive testing. If several of these symptoms are present and no obvious cause can be identified, this could be an indication of an autoimmune disease and should be investigated by a doctor. [1, 5]

How are autoimmune diseases diagnosed?

Diagnosing an autoimmune disease can be challenging because the symptoms are often broad, nonspecific, and highly variable. To make an accurate diagnosis, other possible causes must first be ruled out. A central part of the diagnostic process is to look for specific autoantibodies in the blood, as these are often associated with the disease's inflammatory processes.

However, these laboratory results alone do not constitute a diagnosis. Elevated autoantibody levels can also occur in healthy people, and not all autoimmune diseases show these markers in the blood. Therefore, the interpretation of laboratory values is carried out in combination with the clinical symptoms in order to obtain a comprehensive picture. Further diagnostic tools include imaging techniques such as ultrasound, CT (computed tomography) or MRI (magnetic resonance imaging), which can help visualize the affected organs and detect changes. In some cases, a biopsy may also be necessary to verify the diagnosis and determine the type of autoimmune reaction more precisely. [1, 9]

How long can you live with an autoimmune disease?

Most autoimmune diseases are lifelong conditions. Patients with a diagnosis in the category of these diseases are therefore primarily concerned with one question: What is the life expectancy with the disease? This always depends on the type of autoimmune disease and its severity. However, many symptoms can be treated and those affected usually have a relatively unrestricted life expectancy and a largely good quality of life. However, some autoimmune diseases can be fatal if left untreated. It is therefore important to recognize them early and to treat them properly with modern therapies. There have also been advances in the treatment of diseases such as lupus or multiple sclerosis, which significantly improve quality of life. It is important that sufferers work closely with their doctors and are examined regularly. [9, 10]

What causes an autoimmune disease?

The exact cause of autoimmune diseases is not (yet) fully understood, but researchers suspect that a combination of genetic and environmental factors plays a role:

Genetic predisposition: People with a family history of autoimmune diseases are at a higher risk of developing them themselves.

Environmental factors: Infections, any kind of stress, hormonal changes (e.g. pregnancy) and environmental toxins could increase the risk of developing an autoimmune disease.

Gender: Women are affected more often than men, presumably due to hormonal influences.

Lifestyle: Smoking, poor hygiene, an unhealthy diet and too little exercise can also be risk factors.

We can hardly influence most of these factors – except for some environmental factors and our lifestyle. So there are some ways to strengthen the immune system in general and to protect the body from harmful environmental influences.

The following 10 tips may be helpful:

Take any symptoms or infections seriously and get them checked out and treated.
Avoid chemicals of concern.
Protect your gut flora with a balanced, healthy diet and make sure you drink enough fluids (preferably unsweetened drinks, about 2 liters a day).
Überanstrengung.Don't expose yourself to stress , including physical stress such as overexertion.
Get enough sleep.
Make sure you get enough exercise and physical activity in your life (at least 3 times 30 minutes per week).
Avoid alcohol and cigarettes if possible.
Maintain a healthy body weight.
Pay attention to your vitamin D levels, especially in winter.
Washing your hands regularly can help prevent infections.

[1, 5, 6, 7]

Which treatment will restore the body's equilibrium?

The treatment of autoimmune diseases aims to regulate the immune system and reduce inflammation. The choice of therapy always depends on the specific disease and the individual course of the disease. Commonly used therapies include immunosuppressants, which are used to slow down an overactive immune system, anti-inflammatories, which can reduce pain and inflammation, physiotherapy to support mobility, for example in the case of joint diseases, a general change in diet that can alleviate symptoms of Crohn's disease or rheumatoid arthritis, for example, and optimal stress management. Light therapy can also lead to improvements for skin diseases.

Substitution therapy also plays an important role in the treatment of autoimmune diseases. If the body does not produce enough hormones due to limited organ function, these hormones are replaced by tablets or injections. For example, people with Hashimoto's thyroiditis take thyroid hormones, while people with type 1 diabetes inject insulin.

In addition, psychological support can help. This is important to remember, as chronic pain and psychological stress caused by autoimmune diseases can be underestimated. Behavioral therapy can help you to cope better with your illness and make your life easier. [1, 7, 9, 11]

A better quality of life through knowledge and attention

Autoimmune diseases are challenging for many of those affected. However, thanks to advances in medicine, autoimmune disorders can be treated and managed more effectively than ever before. Although a cure is not yet possible, targeted therapies and a proactive approach to one's own health can significantly improve the lives of those affected.

Being aware of the symptoms and acting early are crucial to minimizing the effects of these diseases. By taking care of ourselves and working closely with our doctors, we can meet the challenges of autoimmune diseases and sustainably improve the quality of our lives. Take your health seriously and stay informed. This is the best way to lead a fulfilled life – even with the challenges of an autoimmune disease.

Sources:
[1] https://www.netdoktor.de/krankheiten/autoimmunerkrankung/
[2] https://pubmed.ncbi.nlm.nih.gov/18190880/
[3] https://onlinelibrary.wiley.com/doi/10.1111/joim.12395
[4] https://www.deutsche-apotheker-zeitung.de/daz-az/2007/daz-14-2007/allergien-und-autoimmunerkrankungen
[5] https://www.msd-gesundheit.ch/de/immunologie/Definition-und-h%C3%A4ufigste-Formen
[6] https://www.imd-berlin.de/spezielle-kompetenzen/autoimmunshyerkrankungen
[7] https://www.autoimmun.org/erkrankungen
[8] https://flexikon.doccheck.com/de/Autoimmunerkrankung
[9] https://www.onmeda.de/krankheiten/autoimmunerkrankungen-id203223/
[10] https://www.wissenschaft.de/bedeuten-seltene-autoimmunerkrankungen-eine-kurze-lebenserwartung/
[11] Autoimmunerkrankungen Therapieoptionen