Enigma of Autoimmune Diseases – Misplaced Immunity or Hypersensitivity or Allergy or Something Else???
Autoimmune Diseases are considered to originate due to faulty immune response but actually they are a type of hypersensitivity according to medicine. Actually there are more than one view about their pathogenesis in medicine or how do they start to afflict the body, what their cause is. Their knowledge and consideration is vital to understand these disorders. And it could lead and influence Ayurvedic treatment for autoimmunity and resulting disorders, perhaps in a better manner.
I, Dr. Vikrama Aditya Tomar, want to share my views about Ayurveda and Autoimmunity through a series of articles. I don’t consider that this broad topic will be justified by a single article. So this series of presented for all persons who are seeking Holistic, Natural and Ayurvedic treatment of autoimmune diseases.
If you keep aside the horror and dread and mortality of Cancer, Stroke and Heart Attacks, the group of disorders commonly known as Autoimmune diseases is not lacking behind as becoming one of the most significant chronic health and life disrupting factor.
Of course, these disorders are not fatal and donâ€™t have an emergency or critical state from the beginning but they are nothing less than pandemic in their presence all over the world. Autoimmune disorders are the top 10 leading causes of death. (1)
What are Autoimmune Diseases?
In my opinion, the phrase â€˜Autoimmuneâ€™ is a misnomer. The better word could be â€˜Auto-hostilityâ€™ or â€˜Auto-Hypersensitivityâ€™ or â€˜Self-Hostile-Responseâ€™.
What do come to your mind when you hear the word immunity?
Immunity is perceived as the ability of body to defend against invaders. Mostly these are â€˜outsidersâ€™ such as some chemicals, virus, bacteria, fungi and other microbes and parasites. Immunity also protects us against â€˜insidersâ€™ like cancer cells.
When I read one statement in my Pathology textbook during graduation, â€œOur body produces cancerous cells on a daily basis and they are easily countered with the help of our immunityâ€, I was deeply surprised.
Shouldnâ€™t all of us express our gratitude for the immune system of our body for doing this favor for us on a daily basis and protecting us?
So immunity is considered protective by nature.
In Autoimmune diseases, the immune response is geared toward tissues of body. That is why these disorders are called Autoimmunity caused disorders.
You can understand autoimmunity clearly with this exampleâ€¦
You put armed guards to protect your house and family members. The guards do recognize you as insiders. They ask every one else for their identity and match the records with you. Whenever, the record is not matched for â€˜outsidersâ€™, they stop and attack the guests.
However, due to some reasons, that are unknown exactly in medical science despite several theories are pushed, the guards starts to recognize you or someone else in the family as â€˜outsidersâ€™ and begin to attack them.
This is what exactly happens in Autoimmune disorders. Our guards, the immune system, somehow, starts to recognized parts of body as â€˜outsiderâ€™ and begins to attack those body tissues.
This is kind of fight-against-self!
This is like some members of a community turned violent and militant against the community.
Autoimmune disorders are examples of misplaced loyalty and faulty memory of immune system. That is why I used the term â€œAuto-Hostilityâ€. But it doesnâ€™t matter actually what you name it.
More than 80 Conditions Put under Autoimmune Diseases:
There are more than eighty illnesses caused by autoimmunity. A good percentage of population is suffering from these chronic, debilitating and life-threatening conditions.
You can ask what are the criteria for putting a disease under Autoimmunity.
Yes, there is.
Ernst Witebsky postulated in 1957 Witebsky postulates and it was modified in 1994 for putting a disorder under Autoimmune disease. (2,3) There are three considerationsâ€¦
- Direct evidence from transfer of pathogenic antibody or pathogenic T cells
- Indirect evidence based on development of the autoimmune disease in experimental animals
- Conditional evidence from clinical clues, from signs and symptoms of patient
Is there any relationship between Allergy or Hypersensitivity and Autoimmune Diseases?
Yes, there is. You know allergy as hypersensitivity. Actually allergic response or hypersensitivity can be of four types. (4,5,6,7)
In each type of allergic response or hypersensitivity, there is antigen and antibody. Antigen is generally a foreign substance â€“ chemical or microbe. Antibodies are produced to defend body against antigen. In autoimmune disorders, antigen is usually a part of our body, a faulty recognition of our immune system.
Type I hypersensitivity (or immediate hypersensitivity) results from allergic reaction caused by re-exposure of body to a foreign substance. The exposure can be through diet, breathing, injection and direct contact of skin.
Allergic asthma, Conjunctivitis, Rhinitis (“hay fever”), Anaphylaxis, Angioedema, Urticaria (hives), Eosinophilia, Allergy to drugs, Allergy to food come under this group.
Rest of the three Types of Hypersensitivity (2, 3 and 4) can be present in Autoimmune diseases.
In type II Hypersensitivity (or cytotoxic hypersensitivity), the antibodies are bound to antigens. Antigens are present inside body cells and can be either a part of our cells or can be a foreign substance. Examples are Myasthenia Gravis and Acute Rheumatic Fever.
Type III Hypersensitivity occurs when there is little antibody and an excess of antigen. It leads to formation of various sizes â€“ small, medium and large â€“ antigen-antibody complexes. Our immune cells can tackle large complexes and but small complexes float in the circulation and tend to deposit in small blood vessels, joints, and glomeruli. These often tend to be very pathogenic. This reaction can take hours, days, or even weeks to develop. Common examples are SLE or Systemic Lupus Erythematosus and Polyarteritis Nodosa.
Type IV Hypersensitivity is often called delayed type hypersensitivity as the reaction takes two to three days to develop. Unlike the other types, it is not antibody mediated but rather is a type of cell-mediated response. In this type, the antigen is usually a protein found in our own cells. Examples are Diabetes Type1, Multiple Sclerosis, Rheumatoid Arthritis, Crohnâ€™s disease and others.
So you can see how all Autoimmune diseases come under Type 2, 3 and 4 hypersensitivity or allergic response.
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- Noel R. Rose and Ian R. MacKay, â€œThe Autoimmune Diseasesâ€ fourth edition.
- Witebsky E, Rose NR, Terplan K, Paine JR, Egan RW (1957). “Chronic thyroiditis and autoimmunization”. J. Am. Med. Assoc. 164 (13): 1439â€“47. doi:10.1001/jama.1957.02980130015004. PMID 13448890.
- Rose NR, Bona C (September 1993). “Defining criteria for autoimmune diseases (Witebsky’s postulates revisited)”. Immunol. Today 14 (9): 426â€“30. doi:10.1016/0167-5699(93)90244-F. PMID:8216719.
- Mitchell, Richard Sheppard; Kumar, Vinay; Abbas, Abul K.; Fausto, Nelson. Robbins Basic Pathology. Philadelphia: Saunders. ISBN:1-4160-2973-7. 8th edition.
- Pike B, Boyd A, Nossal G (1982). Clonal anergy: the universally anergic B lymphocyte”.Proc Natl Acad Sci USA 79 (6): 2013â€“7. doi:10.1073/pnas.79.6.2013. PMC:346112. PMID:6804951.
- Jerne N (1974). “Towards a network theory of the immune system”. Ann Immunol (Paris) 125C (1â€“2): 373â€“89. PMID:4142565.
- Tolerance and Autoimmunity Edwards JC, Cambridge G, Abrahams VM (1999). “Do self perpetuating B lymphocytes drive human autoimmuity?”. Immology 97: 1868â€“1876.