Autoimmune disease treatment in India

The immune system is a collection of special cells and chemicals that fight infection-causing agents such as bacteria and viruses. An autoimmune disorder occurs when a person's immune system mistakenly attacks their own body tissues.

Autoimmune disorders are broadly grouped into two categories- 'organ-specific' means one organ is affected, while in 'non-organ-specific' disorders, multiple organs or body systems may be affected.

There are around 80 different autoimmune disorders ranging in severity from mild to disabling, depending on which system of the body is under attack and to what degree. For unknown reasons, women are more susceptible than men, particularly during their childbearing years. It is thought that sex hormones may be at least partly responsible. There is generally no cure, but the symptoms of autoimmune disorders can be managed.

Autoimmune disease happens when the body’s natural defense system can’t tell the difference between your own cells and foreign cells, causing the body to mistakenly attack normal cells. There are more than 80 types of autoimmune diseases that affect a wide range of body parts.

The most common autoimmune diseases are:

Diabetes: The pancreas releases the insulin hormone, which aidsin the regulation of blood sugar levels. In this disease, the immune system attacks and destroys insulin-producing cells in the pancreas.

Rheumatoid Arthritis (RA): In rheumatoid arthritis, the immune system attacks the joints. This attack causesstiffness in the joints, redness, soreness, and warmth.

Psoriasis or Psoriatic Arthritis: Skin cells usually grow and then shed when they are no longer required. In psoriasis, skin cells multiply too quickly. This causes the extra cellsto build up and form scaly, red patches known as scales or plaques on the skin.

Multiple Sclerosis: This disease damages the myelin sheath, which is the protective coating that borders the nerve cells. Harm to the myelin sheath disturbs the transmission of messages between the brain and body.

Systemic Lupus Erythematosus (Lupus): Even though lupus was first described as a skin disease because of the rash it produces, it hampers many organs, including the heart, brain, joints, and kidneys.

While the symptoms of common autoimmune diseases can vary widely depending on the particular organ or organs affected, there are some symptoms that are common with many of these diseases. Since these symptoms are non-specific, they may be a sign of non-autoimmune conditions as well.

General Symptoms

General symptoms may include:

1. Muscle pain, joint pain or weakness
2. Insomnia, weight loss, heat intolerance or rapid heartbeat
3. Recurrent rashes or hives, sun-sensitivity, a butterfly-shaped rash across the nose and cheeks
4. Hair loss or white patches on the skin or inside the mouth
5. Dry mouth, eyes or skin
6. Tingling in the feet or hands and numbness
7. Difficulty in concentrating
8. Abdominal pain, blood or mucus in the stool, or diarrhoea
9. Mouth ulcers
10. Blood clots
11. Multiple miscarriages

There are a number of factors that are thought to underlie the development of autoimmune diseases as well as factors that are associated with an elevated risk.

Possible causes of autoimmune disease and/or flare-ups include:

Infectious diseases: It's thought that autoimmunity may occur when a component of a virus or bacteria resembles proteins in the body, or instead, by the infection upregulating the immune system. Some specific microorganisms linked with autoimmune disease include: the Epstein-Barr virus, cytomegalovirus (CMV), and group A Streptococcus.

Environmental factors: Lack of sunlight, vitamin D deficiency, chemical exposure, and other environmental factors have been linked to different types of autoimmune diseases. A number of studies have also linked a more sterile environment (fewer pets, cleaner homes, etc.) with the development of some autoimmune conditions. The theory behind the “hygiene hypothesis" is that as people are exposed to fewer antigens (such as dust mites, animal hair, etc.), an overactive immune system attacks itself.

Lifestyle: Smoking appears to triple the risk of developing rheumatoid arthritis and has also been linked with other autoimmune conditions such as Grave's disease and MS. Obesity is considered a “pro-inflammatory" state that may account for its role as a risk factor. The Western diet (high fat, high sugar, high protein, high salt), in general, is thought to possibly promote the development of autoimmune diseases.

Gut bacteria: More and more, research is pointing to a connection between the bacteria that live in a person's digestive tract (gut flora) and a number of health conditions, including autoimmune diseases.

Genetics: Several autoimmune diseases appear to run in families to varying degrees, with research in progress looking at specific genes.

Autoimmune disorders are a collection of conditions in which the body's immune system mistakenly produces antibodies that attack a person's own organs and tissues. While researchers are fairly certain that a combination of genetic susceptibility and environmental influences cause most autoimmune disorders, they are still looking into the role that different factors may play in the development of autoimmune disorders.

Autoimmune disorders affect people of all genders, races, and ages, but certain people have an increased risk of developing autoimmune disorders. If you have any of the following risk factors, your chance of developing an autoimmune disorder is elevated:

Gender: Many autoimmune conditions are more common in women. In addition, hormonal factors can play a role in flare-ups of many of these conditions.

Age: Many autoimmune conditions first appear during the childbearing years.

Weight: Some autoimmune conditions are more common in people who are overweight, while others are more common in people who have a history of eating disorders.

Ethnicity: Different conditions vary, with type I diabetes being more common in white people, and severe autoimmune conditions being more prevalent in African-American, Hispanic, and Native-American women.

Geography: Some autoimmune diseases such as multiple sclerosis, inflammatory bowel disease, and type I diabetes are more common in northern latitudes, especially the pacific northwest (geographical differences could, in turn, be linked with vitamin D exposure (there is an inverse relationship between UV exposure and MS) or ethnicity (such as Scandinavian heritage).

Smoking: Tobacco use is associated with an increased risk of many of these conditions.

Medications: Some medications may increase risk of certain conditions, such as is the case with procainamide and lupus.

It can be hard to diagnose an autoimmune disorder, especially in its earlier stages and if multiple organs or systems are involved. Depending on the disorder, diagnosis methods may include:

1. physical examination
2. medical history
3. blood tests, including those to detect autoantibodies
4. biopsy
5. x-rays.

Autoimmune disorders in general cannot be cured, but the condition can be controlled in many cases. Historically, treatments include:

Anti-inflammatory drugs: to reduce inflammation and pain

Corticosteroids: to reduce inflammation. They are sometimes used to treat an acute flare of symptoms

Pain-killing medication: such as paracetamol and codeine

Immunosuppressant drugs: to inhibit the activity of the immune system

Physical therapy: to encourage mobility

Treatment for the deficiency: for example, insulin injections in the case of diabetes

Surgery: for example, to treat bowel blockage in the case of Crohn's disease

High dose immunosuppression: the use of immune system suppressing drugs (in the doses needed to treat cancer or to prevent the rejection of transplanted organs) have been tried recently, with promising results. Particularly when intervention is early, the chance of a cure with some of these conditions seems possible.