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Author, creator, mistake-maker :) .. Natalie Willis

 


How does an Immune System become ineffective .. Immune Dysfunction:

The Immune System is a remarkably effective structure that incorporates specificity, inducibility and adaptation.  When functioning optimally, a healthy Immune system can quickly distinguish between our own healthy tissue (and proteins) and ‘external’ pathogens, such as viruses, bacterias, fungis and parasites.  But, in some people, the Immune system fails (due to a number of reasons), causing Immune Dysfunction.   Immune Dysfunction fall into three broad categories: Immune deficiencies, Hypersensitivities, and Autoimmunity.

Immune deficiencies occur when one or more of the components of the immune system are inactive. The ability of the immune system to respond to pathogens is diminished in both the young and the elderly, with immune responses declining at around 50 years of age.  Diets lacking sufficient protein are also associated with impaired cell-mediated immunity, complement activity, phagocyte function, IgA antibody concentrations, and cytokine production. Additionally, the loss of the Thymus, at an early age through genertic mutation or surgical removal results in severe immunodeficiency and a high susceptibility to infection.   Immunodeficiencies can also be inherited or ‘acquired’.  Chronic granulomasatous disease, AIDS and some types of cancer cause acquired immunodeficiency.

Hypersensitivities occur when an immune response damages the body’s own tissues. They are divided into four classes (Type 1 – 4) based on the mechanisms involved and the time course of the (hypersensitive) reactions.
Type I hypersensitivity: causes an immediate or anaphalactic reaction, often associated with allergy. Symptoms can range from mild discomfort to death.
Type 2 hypersensitivity is mediated by IgE, which triggers degranulation of mast cells and basophils when cross-linked by antigen.
Type 3 hypersensitivity occurs when antibodies bind to antigens on the patient’s own cells, marking them for destruction. This is also called antibody-dependent (or cytotoxic) hypersensitivity.
Type 4 hypersensitivity (also known as cell-mediated or delayed type hypersensitivity) usually ta kes between two and three days to develop. Type IV reactions are involved in many autoimmune and infectious diseases.

Autoimmunity occurs by an ‘overactive’ immune response, triggering an ‘automatically turned on’ response.  Cells called T lymphocytes normally help fight against infection and other material foreign to the body (“non-self”). However, certain rogue cells called “autoreactive T lymphocytes” respond to the body’s own tissues and organs as if they were foreign; that is, they lose “tolerance” to the body’s own cells and tissues, switching and staying on in ‘automatic’ response.  Usually the body destroys such cells soon after the immune system makes them, but when such autoreactive T lymphocytes evade elimination and mature, they can cause serious diseases to tissues and organs.

From the American Auto Immune Related Diseases Association (www.aarda.org),  the term “autoimmune disease” refers to a varied group of illnesses that involve almost every human organ system.  From diseases of the nervous, gastrointestinal, and endocrine systems, to the organs of the skin (Scleroderma), thyroid (Hashimotos Thyroidism), bones (Rheumotoid Arthritis/Ankylosing spondylitis/Fibromyalgia), pancreas (Diabetes Type 1),  the liver (AutoImmune hepatitis), to body tissues (Lupus), to the eyes, blood and blood vessels.



What causes Auto Immune disorders … what are the triggers ..

There seem so many triggers – environmental, allergy/gluten, intestinal fortitude, stress, long-term imbalance of diet, genetic predisposition, hormones, inflammation, gut health … “Genetic characteristics can predispose people to  react to certain environmental triggers such as infections, stress, smoking, UV light and pollution,” says Dr Frank Golik, GP and board member of Mindd Foundation (www.mindd.org), which offers holistic education and support to professionals and patients.  But just what pulls the trigger, and when, is still a mystery.

Others in the bio-scientific community suggest there is no one conclusive trigger but a (highly) inflammed body causes long-term damage to the gut and in turn the immune system, and leads it to dysfunction.   What causes inflammation is often an infection, or an overtly stressed organ.

As these diseases become better understood, and bio-medicine becomes proactive, we will be able to test individuals and identify exactly what tripped the immune system.  Being able to work out exactly what has caused the’trip’ will hopefully help determine a more specific course of treatment. “A lot of treatments have remained static over the past few decades but it’s an active area of research,” says Professor Tom Gordon, head of clinical immunology at Flinders Medical Centre, South Australia. “In the future I’d envisage genetic markers [a way to identify specific gene or DNA patterns linked with autoimmune diseases] that you could use in conjunction with current blood tests. Until we do, we’re going to have delayed diagnosis and confusion about what a patient has and suboptimal treatment.”

From Oxford University in the UK, comes Professor Richard Cornall, who reasearches AutoImmunity and the causes.  From this link (www.ndm.ox.ac.uk/richard-cornall-autoimmunity) and reproduced here, is Professor Richards opinion about the cause of AI disease:  Autoimmune diseases occur typically when two things arise: one, you have to have the abnormal cell which will arise by chance, and then you have to have some defect in the normal control mechanisms which are there in all of us to prevent those cells from damaging us.  That is the basic answer.  In addition sometimes, in fighting off particular pathogens we get cross reactions between the pathogens and our cells.  For example in rheumatic fever where you can have a bacterium causing a sore throat you can afterwards get an autoimmune disease effecting the heart due to a cross reactivity.  The same is true for a disease called Guillain-Barré syndrome which causes paralysis, sometimes affects young people, quite a number of those people have had an infection in their gut  from another bacteria then there is a cross-reaction between the pathogen and nerve cells.


Why are women targeted so frequently

In all of these diseases, the underlying problem is similar – the body’s immune system becomes misdirected and attacks the very tissues and organs it was designed to protect.  With this in mind, the gender imbalance is staggering, according to the Australasian Society of Clinical Immunology and Allergy, females are 9 times more likely to be targeted over men.  One common school of thought is the fact that women have enhanced immune systems compared to men, and while this increases women’s resistance to many types of infection, it also makes them more susceptible to autoimmune diseases.   In fact, of the 50 million Americans living with autoimmunity, 30 million people are women, some estimates say.  AutoImmune diseases have been cited in the top ten leading causes of all deaths among U.S. Women (aged 65 and younger).   Moreover, these diseases represent the fourth largest cause of disability among women in the United States.



Why is there so little AutoImmune focus or awareness ..

As Auto Immune diseases prright esent across medical specialties, such as rheumatology, endocrinology, hematology, neurology, cardiology, gastroenterology, and dermatology, these are the specialists you (initially/primarily) will see.   But just be aware, these specialists usually focus on historic singular diseases and often their knowledge and skill of working with autoimmunity within their filed of speciality, is often limited (ie. a Hepatologist will focus upon well researched/historic liver diseases and may have very little knowledge or expereince with the AutoImmune branch of liver disease).  But this is changing.  In the US the John Hopkins Medical Institute developed the AutoImmune Research Centre (1999) to foster a ‘collective’ approach to understanding and treating Auto Immune diseases.  But as I share on the next page, this new collaborative knowledge trickles down very slowly to the specialist and even your GP, many of whom have never experienced a patient with an Auto Immune disorder .. and that’s where to some degree this community comes into its own as we all grow our knowledge, try things that resonate and are active in our health and well-being.




So, what are Auto Immune disorders ..

Auto Immune disorders generally they fall into 2 categories: Organ Specific and Systemic.  Here is a list of the most common Organ Specific disorders:

Addison’s disease (adrenal)                                        Hashimotos Thyroiditis (thryoid)

Autoimmune Hepatitis (liver)                                       Multiple Sclerosis (nervous system)

Celiac disease (gastrointestinal tract)                         Pernicious (stomach)

Crohn’s disease (gastrointestinal tract)                     Primary Biliary Cirrohsis (liver)

Diabetes Type 1a (pancreas)                                            Myasthenia Gravis (nerves, muscles)

Grave’s disease (thyroid)                                                  Rheumatoid Arthritis

Guillain-Barre syndrome (nervous system)               Sclerosing Cholangitis (liver)

Ulcerative Colitis (gastro tract)




Systemic Auto Immune disorders can affect (many) body organs and tissues at the same time. They can be broadly classified into Rheumatological (connective tissue disease) and Vasculitis (inflammation of blood vessels).

Common (Systemic) Auto Immune disorders include:

Antiphospholipid syndromes (blood cells)          Primary Raynaud’s (blood vessels)

Dermatomyositis (skin, muscles)                            Rheumatic fever

         Mixed connective tissue disease                             Rheumatoid Arthritis (joints, lungs,
skin, eyes)

Polymyositis (skin, muscles)                                     Scleroderma (skin)

         Polymyalgia Rheumatics (large muscle)               Sjogrens Syndrome (salvary glands,
teat glands, joints)

Systemic Lupus Erythematosus (skin, joints, kidneys, heart, brain, red blood cells, other)

         Vasculitis (blood vessels)

Vasculitis disorders are relatively rare and result from inflammation of blood vessels.  They have many clinical presentations, sometimes affecting only the skin but not infrequently affecting internal organs. Symptoms include fatigue, weight loss, rashes, sore joints or night sweats.



At this stage there is no cure for AutoImmune Disorders, but the symptoms are commonly treated with immuno suppressives — chemotherapy medication that decreases the immune response. There are 100 recognised Auto Immune diseases, some rare and some common..  But, today’s doctors and scientists also have a more sophisticated understanding of how the immune system can go awry. One of the top experts in the field is Alessio Fasano, MD, the director of the Center for Celiac Research & Treatment at Massachusetts General Hospital for Children in Boston. Decades of research led him to deduce that every autoimmune disease has three basic ingredients: a genetic predisposition, an environmental trigger, and a leaky gut.


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Closer to the source … is Donna Jackson Nakazawa,  an American, award winning science journalist, and public speaker.  She ALSO has Guillain-Barre syndrome, an AutoImmune disorder.  In her second book, ‘The Autoimmune Epidemic’ (Touchstone, 2009) her description is similar, whilst the foreword in her book written by Md, PhD Douglas Kerr adds yet more insight into this disorder.

Kerr states: “Our wonderfully complex immune system can successfully protect our bodies while recognising and eliminating billions of distinct infections with which we come in contact.  When functioning well, our increasingly sophisticated immune system immediately recognizes a virus or bacteria (antigens) that has gotten into our body and initiates a spirited and robust attack on the invader.  Firstly the macrophages (white cells of the tissues) and antibodies in our skin and mucous membranes digest the foreign antigens, while the antibodies are giant sweepers and trap any antigens that got away.  If the invader breaks through that barrier of protection, then our bodies produce lymphocytes (B and T cells) that are programmed to kill the invading antigen.  But this precisely choreographed dance between the immune system and the tissues it is designed to protect goes badly awry in autoimmune diseases.  In such diseases, the immune system’s B amd T cells, mistake ‘self’ from invader (antigen) and sadly attack the very tissues it was designed to protect.  But what triggers autoimmunity to occur? Throughout human history our exposure to such myriad infectious agents have triggered an evolutionary (in speed and sophistication) arms race.” (Kerr, p. xvi)





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Australian GP, Dr Carol Hungerford, as described in her book: ‘Good Health in the 21st Century’ (Hungerford, C. Dr., Scribe, 2006) states…”The job of the immune system is to stand between us and ill-health.   Generally there are 3 immune mal-adaptations: Immune Deficiency, Immune Hypersensitivity and Auto Immune disorders.  Both Hypersensitivity and Autoimmune disorders represent immune dysfunction, in particular dysfunction of T-cell responses, resulting in the immune system not recognising ‘self’ from ‘non-self’, and then sets to work attacking (it)self.

Hungerford (C,2006) goes on to suggest many ‘factors’ affect the development of AutoImmune disorders, those being: bacterial, genetics, heavy metal poisoning, synthetic chemicals, medications, trace element deficiency, vitamin deficiencies, leaky gut syndrome and genetic malfunctions, which usually present in 80% more women than men, and often activate (kick in) around age 40 yrs old.

                            


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