Autoimmunity

The human body is continuously exposed to various microorganisms which can cause disease. The ability of the human body to defend against infections caused by microorganisms and other agents is known as immunity, and the system of this defense is known as the immune system. Immunity is of 2 types: innate (nonspecific) or inborn, and acquired (specific) that develops after birth. Innate immunity is represented by various natural barriers such as skin, acidic environment (sweat and gastric fluid), fever (raised temperature), the release of chemicals such as histamine at the site of inflammation (red hot swelling), and cellular responses. Cells such as macrophages engulf and destroy microbes. The human body has natural killer cells too. Acquired immunity can be passive (mother-to-child, passive immunization) or active (active immunization or contracting a disease).

White cells in our blood are responsible for acquired immunity. White cells are of 5 different types. Monocytes and neutrophils form the initial lines of defense. Eosinophils and basophils are involved in allergic responses, whereas lymphocytes are cells of acquired immunity. The T lymphocytes form cell-mediated immune system, which defends the body against microorganisms and tumor cells. B lymphocytes are the mainstay of the humoral immune system, which comprises antibodies directed against microorganisms and other non-self elements. T cells are thus soldiers of this battle, whereas antibodies produced by B cells are the weapons. The acquired immune mechanism has a specific ability to recognize and differentiate a wide variety of foreign molecules and save this ability as memory cells forever.

Antigens are foreign to our body and can be toxins, microorganisms, cancer cells, or cells of transplanted organs. An antigen elicits an immune response which includes the formation of antibodies by B cells. Antigen and antibody interlock with each other to form an antigen-antibody complex, which helps in detoxification and removal of the antigen.

Our immune system can also differentiate between our cells or tissues and foreign particles or invaders. Recognizing self and avoiding response to own tissues is known as autoimmunity. This inertness is also known as immune tolerance. Failure of immune tolerance can result in one or more of over 100 autoimmune diseases. Regulatory systems fail, and autoantibodies are formed, which attack normal cells. The damage thus caused is known as autoimmune disease. The situation here is like the war between Kauravas and Pandavas – a fight between family members. Biting by your dog is also a similar example. Many rheumatologic diseases such as systemic lupus erythematosus, scleroderma, Sjögren's syndrome, and rheumatoid arthritis are classified as systemic autoimmune diseases. These diseases affect many systems of our body at the same time.

Autoimmune diseases affect women more frequently than men and are known to run in families. Environmental factors, microorganisms, and physical or psychological stress trigger autoimmune reactions in these diseases. Diagnosis is often delayed, and management requires specialized rheumatology care. Some drugs suppress the immune system, control disease, and preserve organ function. Many high-end new medicines are now available as a result of continuous research in this field. These drugs control the diseases well but do not cure them. Treatment must, therefore, continue throughout life. A healthy lifestyle, balanced nutritious diet, regular physical exercise, enough rest, reduction of stress, and quitting smoking are all important in managing these diseases.

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