Autoimmune disease

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Autoimmune diseases
ICD-9 279.4
OMIM 109100
DiseasesDB 28805
MedlinePlus 000816
MeSH D001327

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]


Overview

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. This may be restricted to certain organs (e.g. in thyroiditis) or involve a particular tissue in different places (e.g. Goodpasture's disease which may affect the basement membrane in both the lung and the kidney). The treatment of autoimmune diseases is typically with immunosuppression—medication which decreases the immune response.

Occurrence and onset

Hormone levels have been shown to affect the severity of some autoimmune diseases such as multiple sclerosis.[1] Other causes may include the presence of fetal cells in the maternal bloodstream, i.e. microchimerism. [2]

Autoimmune diseases

It is possible to classify autoimmune diseases by corresponding type of hypersensitivity: type II, type III, or type IV. (No type of autoimmune disease mimics type I hypersensitivity.)[3]

Name Accepted/
suspected
Hypersensitivity Autoantibody
Acute disseminated encephalomyelitis (ADEM) Accepted[4]
Addison's disease Accepted[4]
Alopecia areata Accepted[4]
Ankylosing spondylitis Doubtful[4]
Antiphospholipid antibody syndrome (APS) Accepted[4]
Autoimmune hemolytic anemia Accepted[5] II
Autoimmune hepatitis Accepted[4] Anti-Smooth Muscle Actin
Autoimmune inner ear disease Suspected[6]
Bullous pemphigoid Accepted[5] II Anti-Bullous Pemphigoid Antigen 1 and 2 (Hemidesmosome antigens)
Coeliac disease Accepted[7][8][9] IV?? Anti-transglutaminase
Chagas disease Suspected[10]
Chronic obstructive pulmonary disease Suspected[11] [12]
Crohns Disease (one of two types of idiopathic inflammatory bowel disease "IBD") Accepted[4] IV
Dermatomyositis Accepted[13]
Diabetes mellitus type 1 Accepted[4] IV
Endometriosis Suspected[14]
Goodpasture's syndrome Accepted[4] II Anti-Basement Membrane Collagen Type IV Protein
Graves' disease Accepted[4] II
Guillain-Barré syndrome (GBS) Accepted[4] IV Anti-ganglioside
Hashimoto's disease Accepted[4] IV
Hidradenitis suppurativa Suspected[15]
Kawasaki disease Suspected
IgA nephropathy Suspected
Idiopathic thrombocytopenic purpura Accepted[4] II
Interstitial cystitis Suspected[16]
Lupus erythematosus Accepted[4] III
Mixed Connective Tissue Disease Accepted[4]
Morphea Suspected[17]
Multiple sclerosis (MS) Accepted[4] IV Anti-Myelin Basic Protein
Myasthenia gravis Accepted[4] II
Narcolepsy Suspected[18]
Neuromyotonia Suspected[19]
Pemphigus Vulgaris Accepted[4] II Anti-Desmogein 3
Pernicious anaemia Accepted[20] II
Psoriasis Suspected[21]
Psoriatic Arthritis Suspected[22]
Polymyositis Accepted[13]
Primary biliary cirrhosis Accepted[23] Anti-p62, Anti-sp100, Anti-Mitochondrial(M2)
Rheumatoid arthritis Accepted[4] III Rheumatoid factor
Schizophrenia Suspected[24][25][26]
Scleroderma Suspected[17] Anti-topoisomerase
Sjögren's syndrome Accepted[4]
Stiff person syndrome Suspected
Temporal arteritis (also known as "giant cell arteritis") Accepted[4] IV
Ulcerative Colitis (one of two types of idiopathic inflammatory bowel disease "IBD") Accepted[4] IV
Vasculitis Accepted[5] III
Vitiligo Suspected[27][28]
Wegener's granulomatosis Accepted[29] Anti-neutrophil cytoplasmic(cANCA)

Development of therapies

In both autoimmune and inflammatory diseases the condition arises through aberrant reactions of the human adaptive or innate immune systems. In autoimmunity, the patient’s immune system is activated against the body's own proteins. In inflammatory diseases, it is the overreaction of the immune system, and its subsequent downstream signaling (TNF, IFN, etc), which causes problems.

A substantial minority of the population suffers from these diseases, which are often chronic, debilitating, and life-threatening. There are more than eighty illnesses caused by autoimmunity. It has been estimated that autoimmune diseases are among the ten leading causes of death among women in all age groups up to 65 years.[30]

Currently, a considerable amount of research is being conducted into treatment of these conditions. According to a report from Frost & Sullivan, the total alliance payouts in the autoimmune/inflammation segment from 1997 to 2002 totaled $489.8 million, where Eli Lilly, Suntory, Procter & Gamble, Encysive, and Novartis together account for 98.6 percent of alliance payouts.[31]

References

  1. "A Gender Gap in Autoimmunity". Retrieved 2007-10-19. 
  2. "JAMA -- Abstract: Microchimerism: An Investigative Frontier in Autoimmunity and Transplantation, March 3, 2004, Adams and Nelson 291 (9): 1127". Retrieved 2007-10-19. 
  3. Parham, Peter (2005). The immune system. New York: Garland Science. p. 344. ISBN 0-8153-4093-1. 
  4. 4.00 4.01 4.02 4.03 4.04 4.05 4.06 4.07 4.08 4.09 4.10 4.11 4.12 4.13 4.14 4.15 4.16 4.17 4.18 4.19 4.20 4.21 MeSH Autoimmune+Diseases
  5. 5.0 5.1 5.2 "Autoimmune Disorders: Immune Disorders: Merck Manual Home Edition". 
  6. "Autoimmune Inner Ear Disease, Baylor College of Medicine". 1993. 
  7. "Celiac Disease". 
  8. Meize-Grochowski R (2005). "Celiac disease: a multisystem autoimmune disorder". Gastroenterol Nurs. 28 (5): 394–402; quiz 403–4. PMID 16234635. doi:10.1097/00001610-200509000-00005. 
  9. Sollid LM, Jabri B (2005). "Is celiac disease an autoimmune disorder?". Curr. Opin. Immunol. 17 (6): 595–600. PMID 16214317. doi:10.1016/j.coi.2005.09.015. 
  10. Hyland KV, Engman DM (2006). "Further thoughts on where we stand on the autoimmunity hypothesis of Chagas disease". Trends Parasitol. 22 (3): 101–2; author reply 103. PMID 16446117. doi:10.1016/j.pt.2006.01.001. 
  11. Agustí A, MacNee W, Donaldson K, Cosio M. (2003). "Hypothesis: does COPD have an autoimmune component?". Thorax. 58 (10): 832–834. PMID 14514931. doi:10.1136/thorax.58.10.832. 
  12. Lee SH, Goswami S, Grudo A; et al. (2007). "Antielastin autoimmunity in tobacco smoking-induced emphysema". Nat. Med. 13 (5): 567–9. PMID 17450149. doi:10.1038/nm1583. 
  13. 13.0 13.1 "Polymyositis and Dermatomyositis: Autoimmune Disorders of Connective Tissue: Merck Manual Home Edition". 
  14. Gleicher N, el-Roeiy A, Confino E, Friberg J (1987). "Is endometriosis an autoimmune disease?". Obstetrics and gynecology. 70 (1): 115–22. PMID 3110710. 
  15. "Clinical Trial: Etanercept in Hidradenitis Suppurativa". Retrieved 2007-07-08. 
  16. Kárpáti F, Dénes L, Büttner K (1975). "[Interstitial cystitis=autoimmune cyatitis? Interstitial as a participating disease in lupus erythematosus]". Zeitschrift für Urologie und Nephrologie (in German). 68 (9): 633–9. PMID 1227191. 
  17. 17.0 17.1 Takehara K, Sato S (2005). "Localized scleroderma is an autoimmune disorder". Rheumatology (Oxford, England). 44 (3): 274–9. PMID 15561734. doi:10.1093/rheumatology/keh487. 
  18. Carlander, B., Eliaou J.F., Billiard M. (1993). "Autoimmune hypothesis in narcolepsy.". Neurophysiol. Clin. 23: 15. doi:10.1016/S0987-7053(05)80279-5. 
  19. Maddison P (2006). "Neuromyotonia". Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology. 117 (10): 2118–27. PMID 16843723. doi:10.1016/j.clinph.2006.03.008. 
  20. "MedlinePlus Medical Encyclopedia: Pernicious anemia". Retrieved 2008-04-05. 
  21. National Psoriasis Foundation, http://www.psoriasis.org/home/learn01.php
  22. National Psoriasis Foundation, http://www.psoriasis.org/home/learn02.php
  23. Eaton WW, Byrne M, Ewald H; et al. (2006). "Association of schizophrenia and autoimmune diseases: linkage of Danish national registers". The American journal of psychiatry. 163 (3): 521–8. PMID 16513876. doi:10.1176/appi.ajp.163.3.521. 
  24. Jones AL, Mowry BJ, Pender MP, Greer JM (2005). "Immune dysregulation and self-reactivity in schizophrenia: do some cases of schizophrenia have an autoimmune basis?". Immunol. Cell Biol. 83 (1): 9–17. PMID 15661036. doi:10.1111/j.1440-1711.2005.01305.x. 
  25. Strous RD, Shoenfeld Y (2006). "Schizophrenia, autoimmunity and immune system dysregulation: a comprehensive model updated and revisited". J. Autoimmun. 27 (2): 71–80. PMID 16997531. doi:10.1016/j.jaut.2006.07.006. 
  26. "Questions and Answers about Vitiligo". Retrieved 2007-08-06. 
  27. "A New Gene Linked to Vitiligo and Susceptibility to Autoimmune Disorders - Journal Watch Dermatology". Retrieved 2007-08-06. 
  28. Sánchez-Cano D, Callejas-Rubio JL, Ortego-Centeno N (2008). "Effect of rituximab on refractory Wegener granulomatosis with predominant granulomatous disease". J Clin Rheumatol. 14 (2): 92–3. PMID 18391678. doi:10.1097/RHU.0b013e31816b4487. 
  29. Noel R. Rose and Ian R. MacKay, “The Autoimmune Diseases” fourth edition
  30. Frost & Sullivan Report, “Antibody Technology Developments” September 2005

External links

See also

de:Autoimmunerkrankunghr:Autoimune bolesti

he:מחלת חיסון עצמי nl:Auto-immuunziektesk:Autoimunitná choroba fi:Autoimmuunisairausuk:Автоімунітет



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