Wednesday, 27 July 2016

A Smile A Day - July 28th

Autoimmune Diseases: All You Need to Know

Written by Brandon May
Reviewed by Alana Biggers, MD

Autoimmune diseases are some of the most troubling and hard-to-treat immune system-related diseases. They occur when the immune system attacks healthy cells in the body.
Autoimmune disorders can be diagnosed wrongly or remain undiagnosed for years because many share similar symptoms. Once one is correctly diagnosed, a specialist helps the patient manage their illness with the right therapy.

What is an autoimmune disease?
The immune system is a network of tissues, organs, and cells. Its role is to defend the body from invaders, protecting against infections and disease.

An autoimmune disease results from a mistake made by the immune system. The body's immune system accidentally recognizes healthy cells as foreign invaders and begins to attack them. Research shows that autoimmune diseases tend to have underlying genetic, racial, and gender components.

Common autoimmune diseases
According to the National Institutes of Health (NIH), around 24 million Americans have at least one autoimmune disease. The NIH only include 24 diseases in this statistic, so this number may not represent the total number of people who have these disorders.

Here are some of the most common autoimmune diseases:

Autoimmune disease with pills and a syringe.
The NIH estimate that around 24 million Americans have an autoimmune disease.
Celiac disease: Also known as gluten intolerance. Celiac disease is an autoimmune disease where the lining of the small intestine becomes inflamed after eating foods that contain the gluten protein. Examples include wheat, rye, and barley.
Rheumatoid arthritis (RA): One of the most common long-term autoimmune disorders. It causes the immune system to attack tissue, often affecting joints in the hands and feet.
Psoriasis: An autoimmune disorder thought to be triggered by stress, infections, or environmental factors. Psoriasis causes scales and dry, itchy patches on the skin.
Inflammatory bowel disease (IBD): Long-term inflammation of the gut and lining of the large intestine. There are two main types of IBD. Crohn's disease is inflammation that affects areas of the gut. Ulcerative colitis is long-term inflammation of the gut.
Addison's disease: A condition that occurs when the adrenal glands fail to produce enough cortisol and aldosterone hormones. Addison's disease leads to low blood pressure, tiredness, dizziness upon standing, nausea, and skin darkening.
Type 1 diabetes: Often referred to as insulin-dependent diabetes. This autoimmune disease occurs when the pancreas makes insufficient or no insulin, resulting in uncontrolled blood sugar.
Vitiligo: A condition marked by loss of skin pigment or the loss of large batches of skin color.
Hashimoto's disease: A condition that affects the thyroid gland. Hashimoto's disease causes inflammation of the gland, resulting in underproduction of thyroid hormone.
Graves' disease: Similar to Hashimoto's disease, Graves' disease affects the thyroid. It causes the gland to produce too much thyroid hormone.
Risk factors for autoimmune diseases
Autoimmune diseases can affect practically anyone, but there are certain factors that increase risk. These include:

Genetics. There is a strong genetic aspect to almost all autoimmune disorders. Research suggests that a family history of autoimmune disease is a strong risk factor.
Gender. Women are at a greater risk of autoimmune disease than men. Researchers are unsure as to why, but hormonal factors or the fact that women tend to have stronger immune systems may play a role.
Age. Autoimmune disorders often occur in young adults and those in middle age.
Ethnicity. Native American, Latino, and African-Americans generally develop autoimmune disorders at a much higher rate than Caucasians.
Infection. If a genetically predisposed individual has suffered from specific viral or bacterial infections, there is a greater risk that they will also get an autoimmune disease in the future. While the reason behind this risk remains unclear, research continues to examine the role of previous infections on at-risk immune systems.
Autoimmune disease symptoms
Symptoms of autoimmune disease vary and depend on the type of autoimmune disease. Here is a quick overview of some of the symptoms of the most common autoimmune diseases:

Celiac disease: Inflammation and pain in the abdomen, chest burning, tiredness, weight loss, vomiting, and diarrhea.
Rheumatoid arthritis: Painful swelling and stiffness of the joints, particularly in the hands and feet.
Psoriasis: Joint pain, dry skin, skin rashes, and itchiness.
Inflammatory bowel disease: Stomach cramps, bloating, bloody diarrhea, nausea, and constipation.
Addison's disease: Tiredness, low blood pressure, low blood sugar, dizziness, dehydration, and loss of appetite.
Type 1 diabetes: Frequent urination, increased thirst, loss of energy, blurred vision, hunger, and nausea.
Vitiligo: Loss of skin color (especially noticeable in darker-skinned patients).
Hashimoto's disease: Weight gain, tiredness, depression, joint stiffness, and increased sensitivity to cold.
Graves' disease: Weight loss, anxiety, shaky hands, high blood pressure, and sweating.
Lupus: Muscle and joint pain, rash, tiredness, and fever.
Since many autoimmune diseases share similar symptoms, diagnosis is often challenging.

For example, lupus affects the joints in a similar way to RA but tends to be less severe. Lyme disease also causes joint stiffness and inflammation similarly to RA but is caused by a tick.

IBD has similar symptoms to celiac disease but is not typically caused by eating foods containing gluten.

Cutaneous T cell lymphoma (CTCL) is a type of immune system cancer. It is caused by a mutation of T cells and presents symptoms such as skin rashes and itchiness. CTCL is sometimes missed during its early stages because its symptoms are so similar to psoriasis.

Diagnosis of autoimmune diseases
The diagnosis of autoimmune disease differs based on the specific disease. Rheumatoid arthritis, for example, may be diagnosed after a physical exam, blood test, or X-ray. These tests can determine the type of arthritis as well as how severe it is.

A hand holds a test tube of blood.
Blood tests measure the amount of white and red blood cells. These cells signal whether or not the immune system is fighting something.
Diseases can sometimes take years to diagnose because many symptoms of autoimmune disorders mimic other diseases. Conditions like lupus and celiac disease may be misdiagnosed in their early stages because their symptoms are so similar to other diseases.

Hashimoto's disease and Graves' disease are a bit simpler to diagnose as they usually rely on a simple thyroid test. This test determines levels of thyroid hormone.

An autoimmune disease usually centers around the immune system and the antibodies produced by this system. As a result, diagnosis often involves testing for specific antibodies.

A complete blood count may be ordered to measure the amount of white and red blood cells. When the immune system is fighting something, the number of white and red blood cells will differ from normal levels.

Other tests can determine if there is any unusual inflammation in the body. Inflammation is a symptom that is fairly common among all autoimmune diseases. These tests include a C-reactive protein test and an erythrocyte sedimentation rate test.

A doctor should be seen right away as soon as symptoms begin. While symptoms may not always be caused by an autoimmune disease, it's best to tackle any issues right away than wait for them to get worse.

New Study Links Gut Bacteria and Chronic Fatigue Syndrome

 Chronic fatigue syndrome—a condition that continues to baffle doctors—may be influenced by a person’s intestinal bacteria—sometimes called gut microbiome, new research finds.
“Patients with chronic fatigue syndrome have a different profile of bacterial species in their gut microbiome than healthy individuals,” said the study’s senior author, Maureen Hanson. She’s a professor of molecular biology and genetics at Cornell University, in Ithaca, N.Y.
In the small study, she and her colleagues found that people with chronic fatigue syndrome had less diversity or different types of bacteria, compared to healthy people without chronic fatigue syndrome. People with chronic fatigue syndrome also had more species of bacteria that promote inflammation and fewer bacteria that dampen inflammation, the researchers found.
The new findings provide evidence to refute what Hanson calls “the ridiculous concept that the disease is psychological in origin.” For years, she said, some have suggested that chronic fatigue syndrome is simply psychological and can be helped by therapy. Not so, she said.
Even so, “I would not say we found the cause,” Hanson said. Rather, her team has found “another biological abnormality.”
Not everyone with chronic fatigue syndrome has the skewed microbiome, she said. Some of the study volunteers had fairly normal microbiomes.
Between 1 million and 4 million Americans have chronic fatigue syndrome, also known as myalgic encephalomyelitis, according to the U.S. Centers for Disease Control and Prevention. But only about 20 percent of people with the condition have been diagnosed. Symptoms may include overwhelming fatigue not helped by rest, sleep that is not restorative, malaise, joint and muscle pain, headaches, and gastrointestinal problems such as irritable bowel syndrome.
In the study, the Cornell researchers evaluated 48 people diagnosed with chronic fatigue syndrome and 39 healthy controls. All provided stool and blood samples. The researchers tested stool samples for bacterial DNA. In chronic fatigue syndrome patients they found bacterial profiles with less diversity. This is similar to those seen in people with two bowel diseases: Crohn’s disease and ulcerative colitis, the researchers said.
“A lot of bacteria in our gut are beneficial,” Hanson said.
If patients with chronic fatigue syndrome don’t have as diverse a population of bacteria, she said, that could cause problems. The researchers also found markers of inflammation in the blood samples of chronic fatigue syndrome patients, likely due to a “leaky gut” from intestinal problems that let bacteria enter the blood. Bacteria in the blood could trigger an immune response and worsen symptoms, the researchers said.
Using the microbiome findings, the researchers said they were able to correctly classify whether 83 percent of the study volunteers had chronic fatigue syndrome or didn’t. If these findings are confirmed in a larger study, the authors suggested that the gut microbiome could be used as an additional test to determine if it’s likely that someone has chronic fatigue syndrome.
The new research “is yet another study that proves this is not a psychological disease,” said Zaher Nahle, vice president for research and scientific programs at the Solve ME/CFS Initiative, a nonprofit organization focusing on myalgic encephalomyelitis/chronic fatigue syndrome.
More and more research on various health conditions has focused on what experts call the gut-brain axis, Nahle said. Other research has suggested the gut microbiome might be linked with anxiety, depression, autism and other conditions. “It’s a promising avenue of research,” he said.
If the research progresses and bears out for chronic fatigue syndrome, Nahle said, adjusting the diet might be one way to help symptoms.
Remedies such as probiotics are often suggested to patients, Hanson said. Probiotics are foods or supplements with live “good” bacteria that may alter and improve the gut environment. But it’s too soon to know if it would have an effect.
“Really, we don’t know whether probiotics will help or not,” Hanson said. There is not enough research currently, and more research on probiotics would be helpful, she said.