Our human defenses are primarily designed to protect us from infections. In order to be able to do this, the system is able to recognize proteins and other substances typical of our body and differentiate them from substances that are not our own (such as microbes).
The process of recognizing what is or is not proper is actually very complex. Autoimmune diseases arise when this recognition system fails, forming "defenses" (antibodies or defense cells) that attack the body itself.
Why does the immune system fail in autoimmune diseases?
This question is the subject of intense research. Often you need to have a genetic predisposition and a trigger (infectious, toxic, or other) to develop a certain autoimmune disease.
There are many different types of autoimmune diseases. Some affect only one organ, such as juvenile diabetes, which is caused by antibodies to the pancreatic islets, where insulin is manufactured. Other diseases affect multiple organs, what we call "systemic autoimmune diseases"
Many systemic autoimmune diseases predominate in young adults of the female sex, but this is not always the case. Many systemic autoimmune diseases have a chronic, fluctuating course, with outbreaks of activity and remission stages. Systemic autoimmune diseases often affect the musculoskeletal system in the form of joint pain. Other times the skin or internal organs are affected. In order to treat these diseases, a comprehensive overview of the whole body and a broad knowledge of the pathophysiology of the immune system and of immunomodulatory and immunosuppressive treatments are always needed.
Are autoimmune diseases rare?
The immune system is involved in almost all pathological processes, and autoimmune diseases are not uncommon.
Numerous autoimmune diseases have been described and many classifications have been made. Among the diseases that predominantly affect an organ are juvenile diabetes, various forms of hyper or hypothyroidism, pernicious anemia, pemphigus, vitiligo, and multiple sclerosis. Systemic autoimmune diseases include lupus erythematosus, scleroderma, inflammatory myopathies, Sjögren's syndrome, and different forms of vasculitis. Some diseases, such as rheumatoid arthritis, would be halfway between them.
Diagnosis of many autoimmune diseases is not easy and often requires a high degree of expertise.
In many systemic autoimmune diseases, internationally recognized diagnostic criteria have been developed (some of them can be consulted in the web site of the American College of Reumathology or Johns Hopkins University website).
Treatment of systemic autoimmune diseases should be monitored by expert physicians. In our center, the Parc Taulí Health Corporation of Sabadell, has been working for more than 15 years a team of internist doctors who have been dedicated to the study and control of systemic autoimmune diseases.
Although there are treatment guidelines for numerous systemic autoimmune diseases, given the heterogeneity of these processes, an individualized approach is often required when recommending a particular treatment.
In recent years, many new drugs have been introduced in the treatment of autoimmune diseases. This makes us optimistic as it is allowing us to improve the quality of life of many of our patients.