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.