Autoimmune disease: The body against itself
Autoimmune diseases are those in which the immune system turns against the body it is supposed to protect ( “auto” means “self”), attacking healthy cells and tissues. They’re the medical equivalent of friendly fire, and they can cause serious damage.
There are 50 known autoimmune diseases affecting two million Canadians, says Dr. Edward Keystone, director of The Rebecca MacDonald Centre for Arthritis and Autoimmune Diseases at Mt. Sinai Hospital in Toronto. Autoimmunity disproportionately affects women; ratios vary by disease, but overall, almost 80 percent of people with autoimmune disorders are female.
While we don’t yet understand the causes of autoimmunity or how to cure it, “there is a huge sense of optimism,” says Dr. Keystone. Researchers are learning more about the immune system and why it becomes overactive, including the role of genetics. New medications for certain diseases, including lupus and rheumatoid arthritis, target specific problems in the body, acting like “guided missiles”-an improvement over the “carpet bombing” approach of older therapies. “The truth is,” says Dr. Keystone, “this is the most exciting time in the history of the treatment of autoimmune diseases, in terms of new therapies and improving patients’ outcomes.”
Here’s a look at some of the autoimmune diseases that affect Canadians:
Also referred to as “systemic lupus erythematosus,” this autoimmune disorder attacks healthy organs and tissues, including the joints, skin, blood cells, lungs, heart, kidneys and brain. Ninety percent of people with lupus are female, and the disease typically starts between the ages of 15 and 40.
The causes of lupus aren’t known, but the prevailing theory is that it involves a combination of factors. These may include a genetic predisposition and exposure to environmental triggers, such as a virus, an infection or UV light. No two cases of lupus are identical, but common symptoms include: joint stiffness, pain and swelling; fatigue; fever; a butterfly-shaped rash across the nose and cheeks; skin lesions; dry eyes; and cognitive problems such as confusion and memory loss. Many people with lupus are sensitive to sunlight.
Doctors treat lupus with medications, including immunosuppressants and corticosteroids. Exercise, a healthy diet and adequate rest also play a role in managing the disease. Learn more about this complex illness from Lupus Canada.
In rheumatoid arthritis (RA), the immune system attacks healthy joints and the surrounding tissue, leading to inflammation that causes pain, swelling and stiffness, and may limit mobility. Typically, people with RA experience ongoing symptoms, plus spikes of disease activity ( “flares”) alternating with quieter periods. The disease causes progressive, permanent damage, especially in the hands and feet. It may also cause fatigue and affect other organs.
According to The Arthritis Society, about one in 100 Canadians has RA. It most often affects people in middle age, though it can begin at any stage of life. It often starts gradually, with only minor joint pain and stiffness in the beginning. Other symptoms can include morning stiffness; warm and/or tender joints; dry eyes and mouth; numbness, tingling or burning sensations in the hands and feet; and sleep difficulties. Treatment may include medications, physical therapy, exercise, a change in diet, or surgery.
Visit The Arthritis Society to learn more about the warning signs, diagnosis and treatment of rheumatoid arthritis.
Most often diagnosed in young adults (ages 15 to 40), multiple sclerosis (MS) is a complex, unpredictable and progressive neurological condition. It develops when the immune system attacks the nervous system, causing inflammation and damaging the myelin sheath that protects and envelops nerve cells in the brain, spinal cord or optic nerve.
Over time, MS can affect a person’s hearing, vision, balance, mobility, speech and memory, and cause problems such as fatigue, muscle spasms, numbness, tremors, and bowel and bladder symptoms. People with MS experience attacks that can last from days to months, alternating with periods of remission (little or no disease activity).
Canada has one of the world’s highest rates of MS. Women are three times as likely as men to develop the disease. To learn more about the diagnosis and treatment of MS, visit the MS Society website.
Crohn’s disease involves inflammation in the gastrointestinal tract, and may affect the large or small intestine, rectum or mouth. The causes of Crohn’s are not known, but factors may include genetics and environmental factors. It most often strikes people between the ages of 15 and 35, but it can start at any age.
The main symptoms include abdominal pain, pain when passing stools, persistent diarrhea, fatigue, fever and weight loss. Additional symptoms include joint pain and swelling, eye inflammation, mouth ulcers, constipation, rectal bleeding and other problems. Treatment helps people with Crohn’s disease manage their condition.
If you notice a change in your bowel habits or experience Crohn’s symptoms, see your doctor. Learn more about living with the disease from the Crohn’s and Colitis Foundation of Canada.
With Sjögren’s (pronounced “SHOW-grens”), the immune system attacks the glands that make tears and saliva, eventually causing them to stop working. This causes dry eyes and mouth, which can be very uncomfortable and painful.
Dry eyes may appear crusty, the eyelids may stick together in the morning, and bright lights can cause discomfort. Frequent application of eyedrops (artificial tears) is necessary. Dry mouth can cause problems with speech and swallowing, and also lead to serious oral health problems, including tooth deterioration. People with Sjögren’s also experience fatigue, as well as inflammation in other parts of the body (such as the lungs, skin, gastrointestinal system, nerves and joints).
Sjögren’s syndrome can occur on its own or as part of another autoimmune disorder, such as lupus, rheumatoid arthritis or scleroderma. It’s estimated that 430,000 Canadians live with Sjögren’s. For more information, visit the Sjögren’s Society of Canada.