The Autoimmune Disease Crisis in America
-- A Silent Epidemic
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June 20, 2015, last updated June 29, 2016
By Joseph Strongoli, Contributing Columnist

[Health and fitness articles are reviewed by our team of Doctors and
Registered Nurses, Certified fitness trainers and other members of our
Editorial Board.]

Your immune system is a highly-evolved and complex
mechanism essential to your survival. In order to defend the
body against exotic, deadly and highly-specialized foreign
pathogens that cause disease and infection, your immune
system itself must be highly specialized, ruthless, and deadly.
But what happens when this robust, advanced defense system
turns in on itself? What happens when the guard dogs attack
their master?

An autoimmune disease, by definition, is a dangerous
condition where your immune system attacks healthy cells in
your body by mistake, confusing them for foreign antigens.

Auto-immune diseases can attack virtually every part of the
body, including the endocrine system, gastrointestinal tract,
the heart, skin, kidneys, and connective tissue. When the
immune system is made to attack a specific part of the body,
the disease in question is categorized as a local autoimmune
disease. When the attack is system wide, the condition is
categorized as a systemic autoimmune disease.

There are over 80 types of auto-immune diseases, and many
of them bear the classic signs: inflammation, redness, heat,
fatigue, muscle aches, low fever, pain and swelling. Prominent
examples of auto-immune disease include Addison’s Disease,
Celiac disease, Lupus, Sjogren’s syndrome, alopecia areata,  
scleroderma, psoriasis, rheumatoid arthritis and diabetes
mellitus type 1, among others.

The Silent Epidemic

According to the CDC, autoimmune diseases are the third most
common category of disease in the United States after cancer
and heart disease. The American Autoimmune Related
Diseases Association, or AARDA, estimates that over 50 million
Americans suffer from this condition, compared to 9 million for
cancer and 22 million for heart disease. The annual health care
costs for each reflects this disparity: the National Institutes of
Health puts autoimmune diseases in the $100 billion range,
with cancer at $57 billion and heart and stroke costs at $200

In spite of the prevalence of autoimmune conditions, there are
many obstacles in diagnosis, treatment, research, and our
understanding of this disease. Diagnosis and treatment can
prove difficult as symptoms can overlap many specialties and
can affect all body organs. Combine this with the fact that
initial symptoms are often intermittent and unspecific until the
disease becomes acute, and you have a cluster of related but
disparate diseases that are nebulous and hard to detect,
define, and grasp.

The AARDA indicates that the problem is exacerbated by the
fact that medical schools provide minimal learning about
autoimmune disease in their curriculums, and that research is
usually disease-specific and limited in scope, and that more
information-sharing and crossover among research projects
on different autoimmune diseases is needed.

Often times specialists are generally unaware of
interrelationships among the different autoimmune diseases or
advances in treatment outside their own specialty area. This
could be why research funding is comparatively scarce, even
though auto-immune disease affects more people than cancer
and heart disease combined, and is more costly than cancer.
In 2003 the National Institutes of Health awarded $591 million
in research funding for auto-immune diseases, compared to
$6.1 billion for cancer research and $2.4 billion for heart
disease and stroke research.

This type of disease has proven difficult to define, detect, and
diagnose. It is a nebulous condition that underlies many wide-
ranging illnesses.

Because autoimmunity underlies so many diverse and
disparate conditions, immunologists debate over definitions
and where to draw lines. Research is ongoing as the scientific
community grapples with this enigmatic condition. The
following are 7 notable causes of your immune system going

Bad Genes

1. The risk for autoimmune disease depends on a complex
interaction between genetic, environmental, and endogenous
factors. But your genetic background can go a long way in
determining whether or not your immune system will mutiny.
A 2004 study at Johns Hopkins University by Dr. N. Rose et
al.,  found that your genes account for 35% of the risk of
autoimmune disease in general.

In some autoimmune diseases, however, such as
disease, that number can climb to 80%, according to a 2001
study of the immune systems of identical twins at the Odense
University  Hospital in Denmark. In many cases this disease is
really just a matter of luck at the genetic lottery.


Just as you can’t choose your genes, you also can’t choose
your sex. And, unfortunately, autoimmune diseases are
drastically biased towards women.

According to the CDC, 79% of auto-immune disease cases are
female. It has long been known that the basic immune
response in men and women differs significantly, with women
producing a more vigorous immune response and increased
antibody production.

While the reason for this is poorly understood, a 2001 study
at The Ohio State University by Dr. CC Whitacre suggests that
hormones such as estrogen and androgen directly influence
immune cells, specifically by increasing proinflammatory
cytokine production, a fundamental immune system
mechanism. The presence at higher levels of these hormones
could explain why women suffer more frequently from auto-
immune diseases.


Certain viral and bacterial infections have been found to
trigger the immune system way more than a normal infection
would. In effect, they make the immune system go so haywire
that autoimmunity results.

A 2001 study by Dr. M. Regner et al., at the Centre Medical
Universitaire in Switzerland, showed that auto-immune
diseases could be transmitted between animals, following the
transmittance of infectious agents.

The 2004 study at Johns Hopkins from above reviewed the
literature and found that many different microorganisms, both
bacterial and viral, such as streptococci, trypanosoma,
cytomegalovirus, coxsackievirus, campylobacter spp., E. coli,
and mycobacteria induced a range of auto-immune diseases
such as myocarditis, rheumatoid arthritis, Type I diabetes,
multiple sclerosis, and lupus, among others.

Cigarette Smoking

Your tobacco habit might be messing with your immune
system. A 2007 study at the Chaim Sheba Medical Center in
Israel by Dr. Y Sherer et al., found that cigarette smoking
modulates the immune system through various mechanisms,
including the induction of the inflammatory response, immune
suppression, alteration of cytokine balance, induction of
apoptosis, and DNA damage that results in the formation of
DNA antibodies.

The authors linked tobacco smoke to the development of
rheumatic autoimmune diseases, in particular systemic lupus
erythematosus and rheumatoid arthritis.

If you’re already at an elevated auto-immune disease risk,
smoking increases that risk. If you already suffer from auto-
immune disease, smoking can exacerbate your symptoms and
make managing your condition all the more difficult.

Drug-Induced Autoimmunity

The most prominent example of a drug-induced autoimmune
condition is "Drug-induced lupus erythematosus", or DILE.
This condition is brought on
solely by the use of certain drugs.

According to the Lupus Foundation, there are 38 known
medications that can cause DILE. The three with the highest
incidence are hydralazine, a high blood pressure medicine,
procainamide, an anti-arrthymic, and isoniazid, a treatment for

While the mechanism behind drug-induced lupus is not well
understood, studies show that the symptoms generally tend to
recede after discontinuing use of the drugs.

Environmental Toxins

A number of industrial contaminants that make their way into
the environment can cause auto-immune disease.

Asbestos is one such contaminant. Asbestos exerts a
powerful, adverse effect on your immune system.

A 2006 study by Dr. CW Noonan and a team of researchers
from the University of Montana found that asbestos and silica
exposure in occupational capacities increases your risk for
lupus and scleroderma by 54% and increases your risk for
rheumatoid by 65% arthritis.

The authors suggested that these compounds are "cytotoxic",
so they kill cells in a way that generates a lot of cellular debris.

[Editor's note:

Similarly, the toxic dust to which 911 first responders were
exposed is believed to have put them at greater risk for auto-
immune disease. A 2005 study lead by Dr. Weber of
Montefiore Medical Center and the Albert Einstein School of
Medicine, both in New York, New York, examined the health
records of first responders (firemen and policemen). The team
discovered that these first responders at Ground Zero
experienced unusually high rates of auto-immune diseases.

For example, the researchers discovered that 37% of first
responders suffer from rheumatoid arthritis.

In comparison, only 0.5 to 1% of the general population
suffers  from rheumatoid arthritis, according to the U.S.
Centers for Disease Control.  Thus, the first responders have a
37 times higher incidence of this auto-immune disease.

Also, first responders suffer from" spondyloarthritis (22%),
inflammatory myositis (14%), systemic lupus erythematosus
(12%), systemic sclerosis (5%), Sjögren's syndrome (5%),
antiphospholipid syndrome (3%), and granulomatosis with
polyangiitis (Wegener's) (2%)". In each case, the rates of
these auto-immune diseases among first responders are
significantly higher than the general population.

The evidence linking smoking, Ground Zero dust and asbestos
exposure to the development of auto-immune diseases
suggests that respiratory irritants -- heavy air pollution --
should be investigated as a possible triggering cause of the
auto-immune response.]

Your immune system reacts and "loses tolerance" to the
buildup of self-material, i.e, the cell debris, and goes on to
produce antibodies matched to that debris that then go on to
target healthy cells throughout the body.

Another study in 2006 at the University of Arkansas by Dr.
Gilbert et al., found that the industrial solvent
trichloroethylene (TCE), a ubiquitous groundwater
contaminant, altered immune function and promoted auto-
immunity in mice. After 32 weeks of drinking TCE-
contaminated water, the mice developed auto-antibodies and
pathological evidence of auto-immune hepatitis.

Adjuvants in Vaccines

Adjuvants are pharmocological agents added to vaccines to
boost the immune response to the target antigen (germ),
stimulating the release of more antibodies and thus
maximizing protection and minimizing the amount of vaccine
injected into the body.

There are various types of adjuvants that work in a number of
ways, such as acting for a depot for the antigens, presenting
them to the body in a steady and controlled release.

These adjuvants can also act as irritants, triggering the
immune system to a greater degree. In such cases, the body’s
defense wakes up with all hands on deck and encounters the
antigens, to which it then creates the desired antibodies. But
without the help of the irritant adjuvant, the immune system
would not have been sufficiently triggered in order to
encounter the antigens and make the antibodies.  

Adding adjuvants to vaccines is common practice, and
necessary for certain vaccinations to work at all. But it is not
without risk; irritating the immune system too much could
have its consequences.

A 2005 study by Dr. D. Fairweather et al., at Johns Hopkins
School of Medicine suggests that because adjuvants stimulate
immune responses non-specifically, i.e., system-wide, they
could be a risk factor for initiating autoimmune disease,  an
occurrence called the ‘adjuvant effect’.


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Exposure to cigarette smoke and
contaminants in the air pollution may
trigger auto-immune diseases.