When we talk about autoimmune (AI) conditions, we focus on the body’s immune responses and what causes the body to attack itself. An autoimmune attack is commonly believed to be the body’s inability to recognize its own tissues and cells as separate from something else that’s not normally found within the body. An AI attack can also be due to either the body missing some essential elements that help provide balanced responses or a loss of regulation of the immune system, leading to exaggerated responses. In short, the “enemy” within may be something foreign, or it may just be a sign of an imbalance that needs to be addressed.
The first tissues of the body are derived from the embryonic cells of a developing baby. These cells give rise to all the other cells and tissues that will make up the body and, in the process, establish what is a normal part of the body—the self—and what is not a normal part of the body—the non-self. The ability to recognize self versus non-self is considered to be at the heart of most autoimmune conditions. Like one big family, the system recognizes who is a part of the family and who isn’t.
The self, or human body, is an immensely complex organism that interacts and intersects through a vast network of checks and balances. Like a giant spider web, every cell, tissue, organ, and system is connected via a multitude of pathways. Anything that stimulates one part of this system is registered by every other part of the system. Each system of the self plays a vital role in creating a peaceful coexistence with every other part of the self.
The complexity of the human body is thought by some to be finite given that it contains only so many cells, tissues, etc. Others view its complexity as infinite because it is engaged in a constantly evolving process that navigates the infinite complexity of the building blocks of life. However one views it, our understanding of it is extremely limited.
Within the self, the immune system is in charge of maintaining law and order. It helps ensure that we can go about our daily routines and operations without interference from outsiders. Armed with a wide variety of tools, it is prepared to respond to and meet any threat that should appear from an outside, or non-self, source. In order to do this, it has to be able to recognize not only self from non-self, but also human self from non-human self.
Man doesn’t typically consider himself to be anything other than human: flesh and blood, brain, liver, kidneys, stomach, and other organs, and all the cells that make up each and every one of these. Each of them is a by-product of the master blueprint contained within the genetics of the first embryonic cells that formed us after conception. One grows out of the other until the human form takes shape and matures from there on. The thought of being a composite, or chimera, of different species is not usually a part of most people’s viewpoint.
The chimera is a monstrous beast from Greek mythology. It is typically shown to have the head and body of a lion and a serpent tail, with the head of a goat arising from its back. The sphinx is one of the best known examples of a chimera.
Through observation and reflection, early man defined himself primarily by what was visible only to the eyes. Everything else was inconsequential. The man in the mirror, however, turned out to be a façade to an even more amazing and complex shadow in and around him. Instead of being a pureblood, man is a hybrid. The human self has a shadow side, the non-human self.
The nonhuman self consists of all the microbes that are found on and in the body. There are over 100 trillion of them and they outnumber human cells by a factor of at least 10 to 1. Their genetics are more complex than human cells and outnumber man’s genes by a factor of 360 to 1. With such an impressive resume, some scientists are stating that man is more microbe than he is human, while others call him a super-organism.
These microbes play a vital role in the health of humans, and it can be argued that humans wouldn’t exist without them, while they are not dependent on humans to exist. They have even been shown to ensure a full pregnancy, without which man would not exist. They inhabit the human body from birth and are with us throughout life and long afterward.
The use of any medication is considered in terms of a risk-to-benefit ratio. The short-term effect of antibiotics may be life-saving, but the long-term effect could be life-threatening. Always make sure the use of antibiotics is necessary, and never use them when it is not. Antibiotic resistance is the third leading threat to humanity.
The immune system matures and develops under the influences of these microbes. They help create and develop tolerance within the immune system. In some autoimmune diseases, it is the loss of tolerance that can create the autoimmune response and subsequent damage that follows. Early theories stated that the immune system tolerates the presence of these microbes within the human body, but it is beginning to look like this relationship is much more complex and sophisticated than this simplistic viewpoint. It is beginning to look like man and microbe are simply two sides of the same coin. If you can’t see both sides of the coin, one could make the mistake of thinking that the side being viewed is the only side, as was the case with early medicine.
Non-self can be anything that is not normally found in or on the body in the purest sense. It was originally believed to be anything that was not a human cell or fluid, but now we have developed a broader appreciation of what constitutes “man.” If you consider the “good” microbes to be the ones that benefit man and thus are a part of the self, then the “bad” microbes are the ones that would harm the self or any of its components, and would be considered as non-self. In reality, this is another oversimplification, as the overall balance of the internal ecosystem that plays host to these 100 trillion microbes is a more important consideration than any one microbe alone.
The human gut is considered “the densest ecosystem known in nature” by microbiologist Jeffrey Gordon. Certain bacteria have been associated with obesity, diabetes, and other conditions and functions, but these associations can shift as soon as the ecosystem within shifts. The sum effect can be more powerful than the individual effects.
Beyond microbes, non-self can also be the chemicals and heavy metals that find their way into the body and often create havoc for the body’s tissues and cells. These substances can create an overwhelming burden on the body that can take time to resolve. Their presence is likely to cause a dysregulation of the immune system that leads to excessive responses and tissue damage.
In terms of the immune system, non-self elicits very powerful and rapid immune responses so as to maintain the overall balance and homeostasis of the body. When the response is excessive or dysregulated, autoimmunity results. In figuring out the best approach to resolving autoimmune conditions, it can be helpful to understand which part of the immune system is contributing to or causing the autoimmune reaction.
The immune system’s toolbox is like an orchestra composed of many instruments with each one playing a thousand notes, all synchronized perfectly to create a harmonious movement. The complexity of the immune system is something that cannot be addressed in its entirety here, but a brief introduction to some of the components that play a role in inflammation, and therefore autoimmune diseases, can help create a clearer understanding of what takes place.
Understanding how the immune system functions can help you make better choices about your lifestyle. Knowledge can be a tremendous tool for living a long, healthy life. Take time to learn more about the body so that you can make better decisions that empower and sustain your health. Complex knowledge requires baby steps in the beginning.
The first immune cells are unsophisticated, simple, naive cells that give rise to more sophisticated cells designed to produce a specific effect in an orchestrated immune response. This process of differentiation and maturation gives rise to the two arms of the immune system known as the innate and adaptive immune responses. Together, these two responses create immunity in the body. Although historically the adaptive response was considered the key player in autoimmunity, the innate response has now also been shown to play a vital role. These two arms of the immune system employ a host of mediators that help fine-tune the specific responses of each of the cells.
The innate, or nonspecific, response of the immune system is a very rapid response that does not create long-lasting protection. It is a spontaneous reaction by the immune system designed to eliminate any foreign substance that shouldn’t be in the body. The innate cells include macrophages, neutrophils, dendritic cells, and the appropriately named natural killer (NK) cells, among others. Once the innate cells have done as much as possible to capture and render an intruder harmless, they then present samples of their victim’s remains to the adaptive immune cells. These remnants are called antigens and help develop the adaptive immune response that follows.
Macrophages, from the Greek words meaning “big eater,” are present in all tissues of the body. They roam around looking for foreign substances to eat, or engulf, a process called phagocytosis. They play a role in removing dead tissues and cells, orchestrating immune cell responses, repairing wounds, and maintaining homeostasis. They can be either inflammatory (M1 macrophages) or anti-inflammatory (M2 macrophages) in their response, depending on the environment they find themselves in and the signals they receive.
The spleen is a large reservoir for the body’s macrophages. In addition to their immune system roles, macrophages that are stored in the spleen have been found to play a role in the repair of heart tissues after a heart attack. The spleen’s other roles include filtering blood, weeding out parasites and old cells, and recycling iron.
Macrophages have different forms and functions as well as names, depending on the tissues in which they exist. They are known as Kupffer and stellate cells in the liver, microglia in the brain, Langerhans in the skin, and so on. Macrophages are a vital part of the immune system response, powerhouses capable of devouring most anything in their path. The macrophage isn’t without its Achilles’ heel, however, as some pathogens are able to exploit the macrophage for their own growth and development. Candida albicans is a good example of a pathogen that can manipulate the macrophage at will.
Neutrophils are the most abundant white blood cells present in humans. They reside predominantly in the blood stream until they are recruited via special proteins called chemokines to enter the tissues and assist in elimination of pathogens.
They are strong drivers of inflammation and can be responsible for tissue damage if left unchecked. Neutrophils are true killing machines that utilize a wide variety of tools to accomplish their tasks. Like the macrophages, they can engulf and neutralize substances. When this is not possible, they can secrete enzymes, peptides, reactive oxygen species, and even their own DNA into surrounding fluids and tissues. Neutrophil extracellular traps (NETs) are composed of secreted neutrophil DNA that entraps pathogens in a web to immobilize them for other immune cells to finish off.
Dendritic cells (DCs) engulf substances and then present their antigen remnants to other cells of the adaptive immune system. In this role, like macrophages, they are called antigen-presenting cells (APCs), and act as a messenger between the two sides of the immune response.
Dendritic cells, like all other white blood cells, come from the bone marrow. Most are formed in the red marrow of bones while some are formed in the yellow marrow. Yellow marrow is higher in fat and tends to replace red marrow as we age.
When not acting as a messenger they can be found directing other immune responses like the general of an army. While there is still much to be learned about these immune cells, research implicates them in the development of most autoimmune conditions.
The appropriately named natural killer (NK) cells are specialized immune cells that target cancer cells and cells infected with viruses. They can be found interacting with macrophages, DCs, and T cells to accomplish this task and others. Like other immune cells, they can increase or decrease immune system responses, especially those involving inflammation. NK cells are believed to play a role in causing, maintaining, or increasing autoimmune diseases. The exact role is not yet known, but some studies show that it is a deficiency of NK cells that may be associated with the excessive responses found in autoimmunity.
Other innate immune cells include mast cells, eosinophils, basophils, and even the cells of the body’s natural barriers in the skin, urinary, respiratory, and intestinal tracts. Apart from acting as natural barriers, much of what these cells do, when not engulfing foreign intruders, has been associated with conditions like allergies and asthma through their pro-inflammatory responses. Though small in number, their influence can be mighty, as anyone with asthma and seasonal allergies can attest to. Depending on the environment and the signals they receive, they can play a role in both innate and adaptive immunity.
The adaptive response is wired to produce a long-lasting memory of previous infections. While initially slower than the innate response, once memory has been developed, it allows for a fast and specifically targeted response to any repeat exposures to previously encountered infectious agents, chemicals, or other non-self substances.
The specific, or adaptive, immune response is not yet present when babies are born. This response develops over time and is one reason that vaccines aren’t believed to be as effective in newborns as they are in adults.
It is the adaptive response and its production of antibodies that is most commonly associated with autoimmunity. The commonly held belief is that the body misidentifies its own tissue as a foreign substance or antigen and then produces antibodies to the cells and tissues of the body. This point of view is unlikely to be sustained, as it views the body as not knowing what it is doing (a common perspective in medicine when faced with a lack of understanding and knowledge about what’s taking place in the body). It is more likely that something else is taking place that science has yet to decipher and the immune system is simply doing what it is designed to do, albeit under conditions that render it incapable of functioning in a regulated way.
T cells are white blood cells that are named after the thymus gland where they mature after being birthed in the bone marrow. There are several types of T cells, also known as T helper (Th) cells. Some of the main ones frequently discussed include Th1, Th2, Th17, and Tregs.
T cells are produced in the bone marrow and travel to the thymus gland, where most of them mature. A small amount of T cells mature in the tonsils. The thymus gland shrinks during the aging process, which can lead to immune system dysregulation and autoimmune disease.
Th1 and Th17 are typically considered to be very pro-inflammatory in their function, whereas Th2 and Tregs are more likely to help modulate or decrease inflammatory responses. Of course, it’s never just one way in the body and all of these cells, under the right conditions, may switch their roles. Given such diversity, it is no wonder that science is still unable to produce consistent results with any reliability.
The B cells are primarily involved in the production of antibodies, except when they’re not. B cells can also fill in as antigen-presenting cells (APCs) when needed. Once the B cell has become activated, it can turn into either a plasma cell or a memory cell. The plasma cells are efficient at producing large amounts of antibodies, while the memory cells are conditioned to respond to specific antigens/intruders for a long time. These two cells can play a role in lifelong immunity and health or lifelong autoimmunity and disease.
Chemokines, interleukins, complement proteins, antibodies, etc., make up the list of mediators, or cytokines, that form a cascade of responses from immune cells throughout the body, or locally within specific tissues. The list of immune cell mediators is a work in progress. Science is continually discovering new mediators and the immune cells that produce them. In keeping with much of the common battle terminology used when speaking about the immune system, immune cells are the guns and the mediators are the bullets.
Yes, cytokines tend to be a primary target for reducing inflammation. One problem that arises from their use is that even cytokines that are very pro-inflammatory will also play an anti-inflammatory role and often help maintain homeostasis of the immune system. Targeting cytokines often creates other problems.
In general, someone who is ill produces more cytokines more frequently and is likely to be more symptomatic. Certain mediators are pro-inflammatory, while others are anti-inflammatory. In a balanced response, the pro-inflammatory response will be regulated and buffered by the anti-inflammatory response. In immune system dysregulation, inflammation will be unchecked, prolonged, and more likely to create disease.
Interleukins are cytokines that play a large role in the function of the immune system, especially as communicators between white blood cells, also known as leukocytes. As many of them activate certain white blood cells, they play a role in the inflammatory process. IL-1, IL-6, and IL-17 are especially known for their ability to stimulate inflammation in the body. IL-10 on the other hand is anti-inflammatory by its ability to inhibit the production of many cytokines.
Chemokines are signaling proteins that help direct cells where to go. As far as the immune system is concerned, they act as guide dogs that enable white blood cells to home in on infected tissues. This migration toward a site is called chemotaxis. Chemokines can recruit specific immune cells needed to handle specific infections, as is the case with neutrophils being recruited to eliminate a candida infection. In response, candida has developed the ability to block the release of chemokines in order to avoid having to deal with neutrophils.
TNF-alpha is a powerful cytokine and a strong driver of inflammation and tissue destruction in the body. Like everything else, it is not completely understood yet, but it has a variety of functions. It can destroy tumor cells and induce fevers or even cause cell death. It is commonly involved in runaway bloodstream infections called sepsis and the wasting away of the body as seen in AIDS and cancers.
Complement proteins are a group of small proteins that are typically produced by the liver and function as a part of both the innate and adaptive immune responses. They help amplify immune responses and function via three known pathways that determine their role in an immune response.
Complement proteins can make a bad situation worse by amplifying inflammation levels. This happens in sepsis when infections set up in the bloodstream. The immune response amplified by complement proteins can lead to death. In this case, the immune response can be more dangerous than the infection.
Complement proteins are believed to play a role in many autoimmune diseases. It is a tightly regulated systemic network that can create a lot of tissue damage in autoimmune diseases.
Antibodies are proteins produced in response to antigens. As such they help direct specific responses that target future exposures to the same antigens. When antibodies are developed against human tissues, autoimmunity develops. Antibodies, or immunoglobulins (Ig), are typically secreted by the large plasma cells. There are five main types of antibodies:
IgM is associated with early infection responses, while IgG develops later. A positive finding of IgM on a blood test can indicate that someone has a current infection, while IgG indicates a previous infection. IgA indicates that cells of the mucus system are involved and is generally found with intestinal, respiratory, and urinary tract infections. IgE is commonly found with allergic reactions and also parasites, while IgD is not usually considered, as it relates to B cells that have yet to be activated.
Many doctors only look for elevated levels of Igs on blood tests and will miss out on the significance of suppressed or, occasionally, normal levels. A blood test is only a snapshot in time and should be referenced against previous or later blood tests for a more accurate picture.
Elevated levels of Igs on blood tests generally indicate some type of disease or infectious process. If an infection has been around for a long time, however, the immune response becomes exhausted and can alter the findings on blood tests.
The immune system plays a vital role in protecting you from external and internal threats, as it differentiates friend from foe. It must have the ability to defend the body against massive attacks, and at the same time be able to hunt down the smallest cell or substance that doesn’t belong. At all times, it must be able to regulate its own activity and modify its responses so that no collateral damage is done to friendly tissues or even to itself. It must develop a tolerance to the 100 trillion microbial cells that are a part of the human body and be able to recognize self from non-self. When these abilities break down, autoimmunity can develop.
The prevailing opinion on autoimmunity that you’re likely to hear from your doctor is that the body mistakes its own tissues as being the cause of an imbalance and thereafter attacks that tissue, resulting in a disease or condition. This is known as molecular mimicry. The body tissue being attacked is similar to, or mimicking, part of a virus, bacteria, or other pathogen, and the body can’t tell the difference.
Another way that this can happen is that during an infection of some tissue of the body, the white blood cells identify both the infectious pathogen and the body’s tissue together and so create antibodies to both. From that point on, it will attack either one should they reappear, and in the case of a tissue in the body, it’s always present and so lifelong autoimmunity develops.
Molecular mimicry has been a popular theory in autoimmune diseases for over 30 years and is still considered the primary hypothesis as to how autoimmune disease develops. Rheumatic fever is the classic model for molecular mimicry as it typically develops after a respiratory infection with streptococcus bacteria that cross-react with cardiac tissues.
One challenge to this theory is that the body has always known the tissue as self and so therefore it should continue to recognize it as self and not attack it.
Senescence of the immune system is a process of deterioration that occurs with aging. The immune system requires tight regulation. Deterioration of any one part or several parts, as happens with aging, can lead to a loss of the regulation needed to maintain balance and tolerance. Without homeostasis the system begins to collapse upon itself.
Chronic low-grade inflammation is common in the elderly. Pro-inflammatory levels of IL-6 and TNF-alpha are increased. Antibody production by B cells often decreases. The aging body can struggle to create balance in the immune system. This can also be due to decreased absorption of nutrients needed to sustain proper immune system function.
Stress can cause dysregulation of the immune system. Stress and trauma can increase cortisol and other stress-related hormone levels in the body, which in turn suppress and dysregulate immune system function via altered cytokine production. Stress therapies have been shown to improve autoimmune conditions. Autoimmune conditions themselves create stress, which then adds to the disease process.
Stress is often associated with playing a role in almost all diseases, either as a causative or an exacerbating agent. Some sources state that 80–90 percent of all diseases are caused by stress. Heart disease is commonly associated with the effects of stress on the body.
Carnegie Mellon University researcher Sheldon Cohen states: “When under stress, cells of the immune system are unable to respond to hormonal control, and consequently, produce levels of inflammation that promote disease.” Stress and trauma can cause ongoing, lifelong imbalances that can be reflected in an autoimmune disease. That stress promotes autoimmune disease is generally accepted, but how that happens is still not clear.
Many medications are linked to autoimmune diseases. Antibiotics are linked to several autoimmune diseases due to their effect on the 100 trillion bacteria of the intestinal tract, wherein lies approximately 70 percent of the body’s immune system. Chemotherapy can often cause autoimmune conditions. Drugs that seek to suppress certain immune responses can cause autoimmune disease. Statin drugs for high cholesterol have been linked to autoimmune disease. With an average of over 398 side effects per medication, medications can be a leading cause of autoimmune disease.
Nutritional imbalances are another cause of autoimmune diseases. Vitamins, minerals, proteins, and fats can all affect immune system homeostasis. Antioxidant minerals and vitamins can help repair autoimmune damage and modulate immune system function. Vitamins A, C, D, and E play a role in both innate and adaptive immunity.
Vitamin D is one of the most important vitamins when it comes to inflammation and autoimmunity. It is considered the anti-autoimmune vitamin. Making sure to get plenty of exposure to sunshine on a daily basis is an excellent way to prevent vitamin D deficiency.
Researchers at St. Thomas’s Hospital in London have stated, “Nutrition and nutritional status can have profound effects on immune functions, resistance to infection and autoimmunity in man and other animals. Nutrients enhance or depress immune function depending on the nutrient and level of its intake.”
The body accumulates toxins quite easily over a lifetime from ongoing daily exposures. Chemicals and heavy metals have both been associated with increased levels of autoimmunity via their effects on both innate and adaptive immunity. Mercury, cadmium, aluminum, and lead have been linked with autoimmune diseases. Chemicals in excess of 140,000 are added to the environment each year with very little research into their effects on immunity and other areas of health. A few like dioxins, carbon monoxide, polychlorinated biphenyls (PCBs), polycyclic aromatic hydrocarbons (PAHs), and many others are known to alter immune responses.
Food-related toxins and compounds are also linked to autoimmunity. Gluten and genetically modified organisms can influence immunity and inflammation. Sugar is a strong promoter of inflammation in the body.
A large area of current scientific interest is the effects of microbes on health and immunity. Oversterilization of our environment has altered the normal habitat in which man has coexisted with microbes for millions of years. Lifestyle changes in industrialized countries and the constant use of antimicrobials and disinfectants, along with decreased exposure to infectious agents, has resulted in increases in autoimmune and allergic diseases. This orientation toward excessive cleanliness and its effect on health is called the hygiene hypothesis, or “old friends” theory.
Studies have shown that the incidence of autoimmune allergic diseases is higher in countries with more sanitation, not less. Autoimmune conditions like type 1 diabetes, atopic dermatitis, multiple sclerosis, irritable bowel syndrome, Crohn’s, and others, have a greater association with more hygienic environments. Making matters worse, medicine has not been able to find an answer to the rising toll of these diseases on society.
Studies have shown that where the exposure to parasites is higher, the occurrence of autoimmune diseases is lower. This appears to be particularly true of helminth parasites, a type of parasite that is known to live in the intestinal tract of humans without causing any disease or sickness.
Helminth and certain other types of worms are known to down-regulate and block inflammation and autoimmune disease in the body much in the same way as some of the body’s interleukins. It is reasoned that helminths have been a part of the human digestive tract for thousands of years, helping keep humans healthy, as opposed to other types of worms that can be problematic.
Researchers around the globe have found that giving helminths to sick individuals can induce a high cure rate. At the University of Iowa, Dr. Joel Weinstock found that giving test subjects with Crohn’s disease a weekly drink containing thousands of parasite eggs could induce an almost 75 percent cure rate. Elsewhere, similar studies at Harvard, University of California San Francisco, Trinity College Dublin, Glasgow and Edinburgh Universities, and others found high success rates with autoimmune conditions such as multiple sclerosis, autism, celiac, allergies, type 1 diabetes, and dermatitis.
The success of helminthic therapy has generated the establishment of support groups on the Internet at such sites as Facebook and Yahoo!, where members share their stories and successes on a daily basis.
Helminth therapy is used for its suppressive effects on the immune system. Anyone with an immunosuppressive condition, like HIV, hepatitis, cancer, or Lyme disease, should consult with a doctor before beginning helminth therapy. Diarrhea is a common side effect when first starting helminth therapy.
In one sense, autoimmunity may simply be an indication that humans are no longer in sync with their environment. In the past, humans feared their environment and sought to separate themselves from it as much as possible, fearing that bacteria, parasites, and other organisms could only cause illness. Now, that trend is reversing itself as many people are getting back to healthier choices that include interacting more with nature and all the microbes that are a part of that natural environment. Getting dirty is being appreciated in new ways.