We Are Suffering From More And More Autoimmune Diseases. What Are We Doing Wrong?

The autoimmune diseases are pathological processes in which the immune system, our immune system, attacking normal components of the individual.

Its incidence has tripled in recent decades: rheumatoid arthritis, lupus, multiple sclerosis, type 1 diabetes, inflammatory bowel disease, psoriasis, vitiligo, hypothyroidism … are increasingly common autoimmune diseases.

We do something wrong. How can it be that a machinery as perfect as our immune system presents more and more alterations? More than 80 types of autoimmune diseases have been described at the present time, but the number may not stop growing.

It is a disease whose origin is the immune system: it attacks the healthy cells of the body itself. Being a woman is a clear risk factor. Although autoimmune diseases affect 8% of the population, among women the prevalence reaches 20%. More than 75% of cases occur in women. It is thought to be because they have a stronger immune reaction.

Also, some genes that predispose to these diseases are on the X chromosome, and women have two X chromosomes.

The gut microbiota in key in autoimmune diseases

Our immune system is a complex of cells and molecular signals that protects us against external pathogens (viruses, bacteria, fungi, parasites …) and against internal pathogens (tumor cells).

But you must recognize and respect the healthy cells of the body. It is allowed to assist in the removal of damaged or depleted cells and molecules (a healthy level of autoimmunity), but it should not touch healthy cells.

The immune system sometimes acts by default (immunodeficiencies, congenital or acquired), by excess (hypersensitivity such as allergies), or against the wrong target (it attacks healthy cells in the body, leading to autoimmune diseases).

Recent studies indicate that, in the formation of this immune tolerance (respect for one’s own self), the role of intestinal bacteria (intestinal microbiota) already in the newborn is very important.

The prestigious journal Science considers this function one of the ten most important discoveries of the first decade of the 21st century.

Each person has a unique microbiota

The approximately 2 kg of bacteria with which we usually live are known as microbiota. And the DNA of these bacteria is called the microbiome.

They are found on the skin and in the female vagina, but mainly colonize the digestive system, from the mouth to the anus. In total, they number more than 100 billion bacteria.

Each of us has a unique microbiota, as well as our fingerprint, and this microbiota affects our predisposition to become ill. All these bacteria influence the maturation of the immune and endocrine systems.

The intestinal bacteria are considered more an organ of our body. They are responsible for metabolizing indigestible residues from the diet, endogenous mucus, and cellular debris; they produce vitamins: K, B ₁₂ , biotin and folic acid; they synthesize amino acids from ammonia and urea.

They protect us from the implantation of external bacteria and play an essential role in the development of the immune system, being very important in shaping the state of active immunotolerance mediated by regulatory T cells.

It all begins in the womb

When these bacteria are altered, what we know as dysbiosis or intestinal imbalance occurs .

According to the most recent studies, the bacterial colonization of our intestine would begin within the womb, through the placenta and the amniotic fluid, but would have its greatest development during vaginal delivery.

At that time, the bacteria present in the mother’s vagina and perianal area enter the baby’s oral cavity and begin their journey and intestinal colonization, in a harmonious relationship that should last a lifetime. That is why the flora tends to be similar to the maternal one.

If this does not happen, for example in children born by cesarean section, in which there is no contact with the mother’s bacteria through the birth canal, there is the possibility that, in the future, these children will suffer from different diseases such as attention deficit hyperactivity disorder, obesity, asthma, allergies, type 1 diabetes, and autism.

About 2 years later, the bacterial flora is similar to that of the adult. The flora would then be determined by the route of birth (delivery or cesarean section), the type of feeding (breastfeeding or commercial milk) and contact with environmental bacteria.

In this regard, there is much talk of the “hygiene hypothesis”, which postulates that, in Westernized societies, the increasing incidence of atopias (eczema, asthma, rhinitis, allergies), inflammatory bowel disease, and autoimmune disorders (sclerosis multiple, type 1 diabetes) could be explained by a decrease in the microbial load in the first months and years of life.

Therefore, having siblings, living on a farm, having pets, and playing with other children from an early age are considered very healthy for immunity.

The immune system gets confused

We already have the main components of immune disorders: genetics and intestinal bacteria. Combined, they could cause the immune system to stop recognizing your healthy cells as such.

These alterations would produce a mechanism known as “mimicry”, by which the immune system would mistake healthy cells for external agents that would resemble it, and attack them.

Genetics (individual predisposition of each person) and the state of health of the immune system, something closely related to the state of health of the microbiota, would be involved in this confusion .

We must not forget that stress is also a very important component in these diseases, because it is one of the main triggers of outbreaks. It would act through the secretion of the hormone cortisol and the decrease in the action of regulatory T lymphocytes, responsible for ordering this autoimmune chaos.

What autoimmune diseases are there?

Among the more than 80 types of autoimmune diseases that have been described at the present time, some are very infrequent and are included in the so-called “rare diseases” (which groups around 7,000 pathologies).

But others are very frequent in our society the following diseases:

• Multiple sclerosis. It is a chronic inflammatory disease of the central nervous system, which affects about 46,000 people in Spain, in which an autoimmune destruction of myelin occurs.
• Rheumatoid arthritis. There are between 200,000 and 250,000 affected in Spain. This disease destroys the synovial fluid in the joints.
• Hashimoto’s thyroiditis. Antithyroid antibodies are produced that cause inflammation and destruction of the thyroid gland. It is the most common endocrine autoimmune disorder and affects up to 10% of women over 60 years of age.
• Type 1 diabetes . It is known as insulin-dependent diabetes. Antibodies are produced against beta-pancreatic cells, causing an insulin deficit.
• Ankylosing spondylitis. It is a chronic and progressive autoimmune disease that, unlike other autoimmune diseases, affects more males, and in which the joints are damaged, especially the axial ones (spine and sacroiliac). It is estimated that in Spain it affects about 500,000 people.
• Systemic lupus erythematosus. It affects the connective tissue and can attack any organ and system (40,000 affected in our country). Autoimmune are also psoriasis and vitiligo, which affect the skin.
• Celiac Disease. A permanent intolerance to gluten occurs that ends up destroying intestinal cells. There are up to 75% of people who suffer from it and who are undiagnosed because it can present manifestations different from those of its classic form (non-celiac gluten intolerance or neurological symptoms, which is known as neurogluten), or even be asymptomatic .
• Intestinal problems. Inflammatory bowel disease today encompasses three disorders: Crohn’s disease, ulcerative colitis and indeterminate colitis (between 84,000 and 120,000 affected in Spain).

They can be autoimmune diseases

The list of diseases that may have an immune or derived cause continues to grow.

There is a disease, narcolepsy (more than 3 million affected in the world), of which today we know its autoimmune origin. And some nonspecific musculoskeletal disorders (fasciitis, frozen shoulder …) also seem to have an autoimmune origin.

One of the latest candidates to enter this list of autoimmune diseases could be Parkinson’s : some studies seem to already suggest this possibility. Autoantibodies have been identified that would be responsible for neuronal loss. Some 150,000 people suffer from it in Spain.

And there are also other diseases that, although their pathogenesis is not autoimmune, do present a clear basic immune alteration that could be closely related to the state of our intestinal health: fibromyalgia, chronic fatigue syndrome and multiple chemical sensitivity. They are immune-based diseases in which intestinal bacteria also play an important role. ?