Autoimmune disease

Autoimmunity is the failure of an organism to recognize its own constituent parts (down to the sub-molecular levels) as "self", which results in an immune response against its own cells and tissues. Any disease that results from such an aberrant immune response is termed an autoimmune disease.

Autoimmune diseases arise from an overactive immune response of the body against substances and tissues normally present in the body. In other words, the body attacks its own cells. Today there are more than 40 human diseases classified as either definite or probable autoimmune diseases, and they affect 5% to 7% of the population. Almost all autoimmune diseases appear without warning or apparent cause, and most patients suffer from fatigue.

Some studies provided clear evidence that autoimmune diseases are a result of loss of tolerance. An essential prerequisite for the pathogenesis of autoimmune diseases is indeed the breakage of immunological tolerance, which is the ability of an individual to differentiate 'self' from 'non-self'. This breakage leads to the immune system mounting an effective and specific immune response against self determinants.

Other factors involved in ethiopatholgy of immune diseases include:

• Genetic: it is now well-established that certain individuals are genetically susceptible to the development of autoimmune diseases.
• Sex: most of the known autoimmune diseases tend to show a female preponderance, the most important exceptions being ankylosing spondylitis which has a male preponderance, and Crohn's disease, which has a roughly equal prevalence in males and females. The reasons for this are unclear.
• Environmental Factors: An interesting inverse relationship exists between infectious diseases and autoimmune diseases. In areas where multiple infectious diseases are endemic, autoimmune diseases are quite rarely seen. The hygiene hypothesis attributes these correlations to the immune manipulating strategies of pathogens, to certain chemical agents and drugs, to conditions which simulate autoimmune diseases, or over exposure to pesticides and .

Autoimmune diseases can be broadly divided into systemic and organ-specific or localised autoimmune disorders, depending on the principal clinico-pathologic features of each disease:

• Systemic syndromes: it include all those diseases that affect the whole body and cause an immune reaction against antigens within tiissue cells. Systemic syndromes include SLE, Sjögren's syndrome, Scleroderma, Rheumatoid Arthritis and polymyositis.
• Organ-specfic syndromes: some immune reactions affect specific antigens within single organs or systems of the body. These include ddison's disease, diabetes mellitus type I, Hashimoto's thyroiditis, pemphigus vulgaris, alopecia aerata, autoimmune haemolytic anaemia, celiac diseases, Basedow's disease, Crohn's disease.

Accepted Autoimmune Diseases

• Acute disseminated encephalomyelitis (ADEM): it's a form of encephalitis caused by an autoimmune reaction and typically occurring a few days or weeks after a viral infection or a vaccination
• Addison's disease:  it's often caused by autoimmune destruction of the adrenal cortex
• Ankylosing spondylitis: it's a chronic, painful, progressive inflammatory arthritis primarily affecting spine and sacroiliac joints, causing eventual fusion of the spine.
• Antiphospholipid antibody syndrome: it affects the blood-clotting process. It causes blood clots to form in veins and/or arteries
• Aplastic anemia: it's often caused by an autoimmune attack on the bone marrow.
• Autoimmune hepatitis: it's a disorder wherein the liver is the target of the body's own immune system
• Autoimmune Oophoritis: it's a disorder in which the immune system attacks the female reproductive organs
• Coeliac disease: it's a disease characterized by chronic inflammation of the proximal portion of the small intestine caused by exposure to certain dietary gluten proteins
• Crohn's disease: it's a form of inflammatory bowel disease characterized by chronic inflammation of the intestinal tract. Major symptoms include abdominal pain and diarrhea
• Diabetes mellitus type 1: when it is characterized by a deficiency or absence of insulin production (Type I), is often the consequence of an autoimmune attack on the insulin-producing beta cells in the islets of Langerhans of the pancreas
• Gestational pemphigoid: it's a pregnancy-related blistering condition where autoantibodies are directed against the skin
• Goodpasture's syndrome: it's a disease characterised by rapid destruction of the kidneys and haemorrhaging of the lungs through autoimmune reaction against an antigen found in both organs
• Graves' disease: it's the most common form of hyperthyroidism, and is caused by anti-thyroid antibodies that have the effect of stimulating (agonist) the thyroid into overproduction of thyroid hormone
• Guillain-Barré syndrome (GBS): it's an acquired immune-mediated inflammatory disorder of the peripheral nervous system (i.e., not the brain and spinal column). It is also called acute inflammatory demyelinating polyneuropathy, acute idiopathic polyradiculoneuritis, acute idiopathic polyneuritis and Landry's ascending paralysis.
• Hashimoto's disease: it's a common form of hypothyroidism, characterised by initial inflammation of the thyroid, and, later, dysfunction and goiter
• Idiopathic thrombocytopenic purpura: it's an autoimmune disease where the body produces anti-platelet antibodies resulting in a low platelet count
• Kawasaki's Disease: it's often caused by an autoimmune attack on the arteries around the heart.
• Lupus erythematosus: it's a chronic (long-lasting) autoimmune disease wherein the immune system, for unknown reasons, becomes hyperactive and attacks normal tissue. This attack results in inflammation and brings about symptoms. This is a "Non-organ-specific" type of autoimmune disease
• Multiple sclerosis: it's a disorder of the central nervous system (brain and spinal cord) characterised by decreased nerve function due to myelin loss and secondary axonal damage
• Myasthenia gravis: it's a disorder of neuromuscular transmission leading to fluctuating weakness and fatigue. Weakness is caused by circulating antibodies that block (antagonist) acetylcholine receptors at the neuromuscular junction.
• Opsoclonus myoclonus syndrome (OMS): it's a neurological disorder that appears to the result of an autoimmune attack on the nervous system. Symptoms include opsoclonus, myoclonus, ataxia, intention tremor, dysphasia, dysarthria, mutism, hypotonia, lethargy, irritability or malaise. About half of all OMS cases occur in association with neuroblastoma.
• Optic neuritis: it's an inflammation of the optic nerve that may cause a complete or partial loss of vision.
• Ord's thyroiditis: it's a thyroiditis similar to Hashimoto's disease, except that the thyroid is reduced in size. In Europe, this form of thyroid inflammation is more common than Hashimoto's disease.
• Pemphigus: it's an autoimmune disorder that causes blistering and raw sores on skin and mucous membranes
• Pernicious anaemia: is an autoimmune disorder characterised by anaemia due to malabsorption of vitamin B12
• Polyarthritis in dogs: it's an immune reaction severely affecting the joints of dogs. Although rare and of unknown cause it can render a dog immobile even at a very young age
  
• Primary biliary cirrhosis: it appears to be an autoimmune disease that affects the biliary epithelial cells (BECs) of the small bile duct in the liver. Although the cause is yet to be determined, most of the patients  appear to have auto-mitochondrial antibodies
• Rheumatoid arthritis: it's an autoimmune disorder that causes the body's immune system to attack the bone joints
• Reiter's syndrome: it seems to be an autoimmune attack on various body systems in response to a bacterial infection
• Sjögren's syndrome: it's an autoimmune disorder in which immune cells attack and destroy the exocrine glands that produce tears and saliva
• Takayasu's arteritis: it's a disorder that results in the narrowing of the lumen of arteries
• Temporal arteritis (aka "giant cell arteritis"): it's an inflammation of blood vessels, most commonly the large and medium arteries of the head. Untreated, the disorder can lead to significant vision loss.
• Warm autoimmune hemolytic anemia: it's a disorder characterized by immunoglobulin M attack against red blood cells
• Wegener's granulomatosis: it's a form of vasculitis that affects the lungs, kidneys and other organs

Suspected Autoimmune Diseases

• Alopecia universalis: it's a medical disorder in which the afflicted are unable to grow hair on the entire body
• Behçet's disease: it's a chronic condition due to disturbances in the body’s immune system that becomes overactive and produces unpredictable outbreaks of exaggerated inflammation affecting blood vessels
• Chagas' disease (aka American trypanosomiasis): it's a human tropical parasitic disease which occurs in the Americas, particularly in South AmericaThe symptoms of Chagas' disease vary over the course of the infection. In the early, acute stage symptoms are mild and are usually no more than local swelling at the site of infection. As the disease progresses, over as much as twenty years, the serious chronic symptoms appear, such as heart disease and malformation of the intestines. If untreated, the chronic disease is often fatal
• Chronic fatigue syndrome: the disorder is marked by severe, chronic mental and physical exhaustion, arising in a previously healthy and active person, as well as other specific symptoms. Other symtoms may include muscle weakness, cognitive dysfunction, hypersensitivity, orthostatic intolerance, digestive disturbances, depression, poor immune response, and cardiac and respiratory problems
• Dysautonomia: it's any disease or malfunction of the autonomic nervous system. This includes postural orthostatic tachycardia syndrome (POTS), neurocardiogenic syncope, mitral valve prolapse dysautonomia, pure autonomic failure, multiple system atrophy (Shy-Drager syndrome), autonomic instability and a number of lesser-known disorders
• Endometriosis: in endometriosis, the tissue that lines the uterus is found to be growing outside the uterus, on or in other areas of the body
• Hidradenitis suppurativa(or HS, aka Acne Conglobata): it's a skin disease that affects areas bearing apocrine sweat glands and hair follicles; such as the underarms, groin and buttocks, and under the breasts in women
• Interstitial cystitis: it's a urinary bladder disease of unknown cause characterised by urinary frequency (as often as every 10 minutes), urgency, pressure and/or pain in the bladder and/or pelvis
• Lyme disease: it's a bacterial infection with a spirochete from the species complex Borrelia burgdorferi, which is most often acquired from the bite of an infected Ixodes, or black-legged, tick, also known as a deer tick. The disease varies widely in its presentation, which may include a rash and flu-like symptoms in its initial stage, followed by the possibility of musculoskeletal, arthritic, neurologic, psychiatric and cardiac manifestations
• Neuromyotonia (aka Isaacs' Syndrome): it's spontaneous muscular activity resulting from repetitive motor unit action potentials of peripheral origin.As a result of muscular hyperactivity patients may present with muscle cramps, myotonia-like symptoms, excessive sweating, myokymia and fasciculations.
• Narcolepsy: it's a neurological condition most characterized by Excessive Daytime Sleepiness (EDS). A narcoleptic will most likely experience disturbed nocturnal sleep, confused with insomnia, and disorder of REM or rapid eye movement sleep. It is a type of dyssomnia.
• Psoriasis: it's a disease which affects the skin and joints. It commonly causes red scaly patches to appear on the skin.
• Sarcoidosis (aka Besnier-Boeck disease): it's an immune system disorder characterised by non-caseating granulomas (small inflammatory nodules) that most commonly arises in young adults. The cause of the disease is still unknown. Virtually any organ can be affected; however, granulomas most often appear in the lungs or the lymph nodes.
• Schizophrenia: it's a psychiatric diagnosis that describes a mental illness characterized by impairments in the perception or expression of reality, most commonly manifesting as auditory hallucinations, paranoid or bizarre delusions or disorganized speech and thinking in the context of significant social or occupational dysfunction
• Scleroderma: it's a rare, chronic disease characterized by excessive deposits of collagen in the skin or other organs. The localized type of the disease tends not to be fatal. Diffuse scleroderma or systemic sclerosis, the generalized type of the disease, can be fatal as a result of heart, kidney, lung or intestinal damage
• Ulcerative colitis: some medical authorities  class Colitis as an Autoimmune disease. It's a form of inflammatory bowel disease (IBD). Ulcerative colitis is a form of colitis, a disease of the intestine, specifically the large intestine or colon, that includes characteristic ulcers, or open sores, in the colon. The main symptom of active disease is usually diarrhea mixed with blood, of gradual onset. Ulcerative colitis is, however, a systemic disease that affects many parts of the body outside the intestine
• Vitiligo: Researchers have detected anti-melanocyte antibodies in some cases of vitiligo, so it seems likely that at least some instances of this condition are the result of autoimmune problems. Leukodermia is a chronic skin condition that causes loss of pigment, resulting in irregular pale patches of skin. The precise cause of vitiligo is complex and not fully understood. There is some evidence suggesting it is caused by a combination of auto-immune, genetic, and environmental factors
• Vulvodynia: it refers to a disorder of vulvar pain, burning, and discomfort that interferes with the quality of life. No discernible physical lesion other than perhaps some redness of the skin is present. The cause can sometimes be attributed to trauma, but in other cases its origin is unknown.

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