Autoimmune Disease – Why Does the Body Attack Itself?

Autoimmune Disease: Why Is My Immune System Attacking Itself? With this title, Dr. Ana Maria Orbai published an article on autoimmune diseases on the Johns Hopkins Medicine website. Let’s now analyze why, in these diseases, the body starts to attack itself.¹⁾Orbai, A. M. Autoimmune Disease: Why Is My Immune System Attacking Itself? John Hopkins Medicine

According to Dr. Orbai, a rheumatologist at the Johns Hopkins Arthritis Center, autoimmune diseases affect 23.5 million Americans, and almost 80% of them are women. If you are one of the millions of women affected by this group of diseases – which includes lupus, rheumatoid arthritis and thyroid disease – you may wonder why your immune system attacks you.

There are several theories about what can cause an autoimmune disease, including infection, tissue damage and genetics. The rheumatologist explains that doctors aren’t sure why autoimmune disease occurs more in women than in men. One theory is that the higher levels of hormones in women, especially in the childbearing years, may make them more susceptible to autoimmune diseases.

However, she notes that there are many factors that affect autoimmunity, both genetic and environmental. Researchers are still at a loss to explain why women develop these diseases more than men.

To put it simply, autoimmune disease arises because the body’s natural defenses – i.e. immune system cells – attack the body’s own healthy tissue. When the body senses the danger of a virus or infection, the immune system goes into action and attacks it. This is called an immune response. Sometimes, healthy cells and tissues are caught up in this action, resulting in autoimmune disease. Many scientists believe that this is what causes rheumatoid arthritis, a type of autoimmune disease that attacks the joints.

It’s also more common after having pharyngitis to develop psoriasis, which is an autoimmune disease that causes thick, scaly patches of skin. Some scientists think that when the immune system gets rid of a type of cancer, there is an inflammatory response left over from that fight. They think that the lesion that arises may play a role in some types of autoimmune disease, such as psoriatic arthritis – which is when the joints of some people with psoriasis become affected.

Research has shown that in parts of the body subjected to high stress, an autoimmune response occurs following damage to tendons, which are structures that connect muscle to bone. For example, the heel of a runner is an area where the muscle is constantly pulling on the bone to create movement.

Dr. Orbai says that this repeated stress can expose tissue that shouldn’t normally be in contact with blood cells. And when that tissue is exposed, it’s like a small wound. The blood cells try to heal it, but an abnormal immune response causes inflammation of the joints and tendons. Genetics plays an important role in autoimmune disease, but researchers still don’t fully understand how.

For example, having a family member with lupus or multiple sclerosis increases the risk of contracting these diseases. Some families have several members affected by different autoimmune diseases. However, genetics alone are not enough to cause autoimmune diseases. Dr. Ana Maria – as I said, a rheumatologist at Johns Hopkins – says that we know that genes are important, but they’re not everything.

She says that you can have family members with lupus or multiple sclerosis and never develop these diseases. You can even test positive for lupus-specific genes and still not have the disease.

It is possible that autoimmune disease occurs based on the immune system’s ability to cope with stress. The rheumatologist raises the question: when does the stress in your body exceed your immune system’s ability to cope with it? And she answers it herself, saying that if we knew this, it could be the key to preventing autoimmune diseases before they develop.

Our body has trillions of cells and, when they are sick and dying, they need to be removed. Macrophages are a type of cell that consume dying or infected cells to keep the body healthy. The body’s cells can detect when they are infected by a bacterium or virus because of the presence of foreign molecules produced by the infecting agent. The infected cell uses these foreign molecules to ask macrophages to come and eliminate it.

When the infected cell is digested, the virus and bacteria will also die and won’t be able to reproduce and infect other cells. But sometimes the immune system gets the wrong message and attacks cells that aren’t infected or aren’t dying. This causes allergic reactions or so-called autoimmune diseases.

So, this question arises that scientists are trying to answer: what hinders the immune system from distinguishing between the good cells and the sick ones that need to be removed?

On Harvard University’s health publications website, Dr. Robert Shmerling, a rheumatologist and researcher at the university, comments on a study of the relationship between stress and autoimmune disease.²⁾Schmerling R. Autoimmune disease and stress: Is there a link? Harvard Health Blog, October 27, 2020

Stress, in the popular sense, is when the resources you have – whether physical, psychological, social or spiritual – to deal with a situation are not enough to obtain what you need. And from there, some unhealthy change arises in your body or mind.

In the study cited by this scientist, the researchers analyzed more than 100,000 people diagnosed with a stress disorder and compared their tendency to develop autoimmune diseases (for at least a year afterwards) with 126,000 of their siblings and another million people without stress-related disorders. The study found that individuals diagnosed with a stress-related disorder were more likely to be diagnosed with an autoimmune disease and had a higher rate of autoimmune disease if they were younger.³⁾Song H et. al. Association of Stress-Related Disorders With Subsequent Autoimmune Disease. doi:10.1001/jama.2018.7028

It is important to emphasize that a study of this kind, called an observational study, cannot conclude that stress-related disorders actually cause autoimmune diseases. There may be other explanations. For example, it is often impossible to pinpoint a precise date when an autoimmune disease or stress-related disorder began.

Therefore, despite the researchers’ requirement that the autoimmune disease be diagnosed well after the stress-related disorder, it is possible that the autoimmune condition was already present before the disorder was diagnosed. If this were the case, the stress-related disorder could not have caused the autoimmune disease. In addition, it is possible that something other than the stress-related disorder was responsible for the higher rate of autoimmune disease.

For example, people who have experienced severely stressful circumstances may be more likely to smoke, and smoking has been associated with an increased risk of certain autoimmune diseases, including rheumatoid arthritis and multiple sclerosis.

In any case, if you have an autoimmune disease, try to reduce stress. Treat yourself well emotionally. Avoid holding grudges. Forgive people and yourself. Cultivate gratitude, develop your religious faith, help people voluntarily. This will help your immune system to improve and function better.