What are autoimmune diseases? Autoimmune diseases: list of diseases

Olga Lukinskaya

Autoimmune diseases- these are hundreds of dissimilar diagnoses. They occur as a result of the immune system mistakenly attacking its own tissues or organs - but the reasons for this are often unknown, and the manifestations can be very different. Among autoimmune diseases there are both very rare and more common diseases; We talked to patients and asked rheumatologists about when to seek help, the dangers of self-medication, and what difficulties people with autoimmune diseases face in Russia.

There is no one doctor for everyone

The human immune system normally recognizes “self” and “foreign” - but sometimes this ability can be impaired. Then the immune system perceives its own tissues or cells as foreign and begins to damage or destroy them. As rheumatologist Irina Babina notes, almost any doctor encounters autoimmune diseases: gastroenterologists, pulmonologists, nephrologists, endocrinologists, neurologists, dermatologists. In such a situation, mainly one organ or one system is affected - for example, the skin or thyroid, - therefore they are dealt with by specialists of a specific specialty. But there are autoimmune diseases in which absolutely all organs and systems are damaged - they are called systemic, and rheumatologists work with them. This is, for example, systemic red or Sjögren's disease. Rheumatologists also work with patients who are affected by musculoskeletal system- for example, with rheumatoid arthritis.

The patient may not understand who to contact, and there is a long-established system in the world: a person goes to a general practitioner (GP), who determines what other examination to conduct and to which to a specialist direct. In Russia, the function of a general practitioner is usually performed by a general practitioner. True, this system is not ideal and there are two extremes in it. It happens that everyone who finds it difficult to make a diagnosis is sent with the words: “Go to a rheumatologist, you have some unknown disease, let them figure it out.” After an examination, a disease of a completely different profile may be discovered - infectious or, for example, oncological. The opposite situation is even more offensive - when precious time is lost and several months or years pass between the first symptoms and getting to the rheumatologist. Oleg Borodin, rheumatologist medical center Atlas adds that this problem is global, and there are few good general practitioners not only in Russia. Doctors, in principle, must have a broad outlook, constantly improve and understand new nuances.

Associate Professor, Candidate of Medical Sciences, rheumatologist at the K+31 Medical Center Ilya Smitienko notes that most still do not know who rheumatologists are and what they do. There are many rheumatic diseases, more than a hundred, and they are very diverse; the most common are osteoarthritis, osteoporosis, rheumatoid arthritis, gout, ankylosing spondylitis, psoriatic arthritis, fibromyalgia, Paget's disease. It is important to understand that rheumatic diseases are not always autoimmune; for example, gout is a problem in the joints associated with metabolic disorders uric acid. Rheumatologists also treat and diagnose rare autoimmune diseases that affect the entire body at once, including systemic vasculitis(inflammatory diseases blood vessels) and such diseases connective tissue, like systemic lupus erythematosus. It may seem counterintuitive, but immunologists do not deal with autoimmune diseases - their area of responsibility includes allergic diseases and immunodeficiencies.

Alexandra B.

Four years ago I started having pain in my joints, so unexpectedly that I got scared and went to the therapist. For two months I was dragged around offices and forced to undergo various tests, including paid ones. Over time, in addition to pain in the joints, hair began to fall out, sweating increased, and due to huge amount Anti-inflammatory, my stomach began to hurt.

Soon gastritis came, then erosive damage to the esophagus, and after another year gallbladder filled three-quarters with stones and the question arose about its removal. I spent all my free time either at home or in clinics, and stopped communicating with friends. There was no longer enough money for new clothes, basic necessities, and cafes or cinemas. This year I had my gallbladder removed, and then my tonsils - it was believed that they were the starting point for arthritis. Now the problem is that I can’t get to a free rheumatologist: my test results have returned to normal and I can’t get a referral from a therapist.

Risk group - women

Rheumatic diseases are more common in women, although not all; For example, psoriatic arthritis affects men and women equally often. No one knows for sure why the immune system fails. Harmful bacteria and viruses, as well as heredity, play a certain role - but it is not known why some people have a genetic predisposition to the disease, while others do not. For some factors, it is simply clear that they play a role - but what role is not yet clear.

According to Oleg Borodin, some of these little-studied factors are gender and corresponding hormones. The expert explains that women’s immune systems are more advanced than men’s, and women, for example, are more easily able to tolerate infectious diseases. And since women’s immunity is “stronger” than men’s, it is susceptible to failures more often.

Ekaterina G.

I developed rheumatoid arthritis at age four, but was not diagnosed until I was thirteen. I lived in a small town in the Chelyabinsk region with an appropriate level of medicine. When my legs started to hurt terribly at night, they took me to a regular children's clinic. The pediatric rheumatologist said it was a “growing disease”; no medications were prescribed and no examinations were performed. They told me to just wait it out.

Difficult to recognize

Rheumatic diseases are among the most difficult to diagnose and treat. They manifest themselves very differently, and it is difficult to suspect them, especially when we are talking about rare diseases or those that progress slowly. For example, joint pain or high fever are nonspecific - that is, they can be signs of the most different problems with health. Before the cause of the malaise is found, many examinations will have to be carried out - after all, more common and obvious causes must first be excluded.

Of course, on psychological state Patients are also affected by these difficulties. According to Irina Babina, any person wants to understand why he got sick and whether it is possible to prevent such a disease in children and relatives, but today doctors do not have answers to these questions. At the same time, the prospect of taking medications is frightening - in rheumatology, these are drugs with serious effects, including side effects, and treatment requires constant monitoring by a doctor. A separate difficulty is to understand and accept the fact that now you will have to deal with health constantly, throughout your life.

Tatiana T.

In 2002, I began to feel unwell: my legs hurt, my head hurt, I had shortness of breath, everything was blurry before my eyes. I went to the doctor, they did some tests, but they didn’t find anything. We examined the thyroid gland - everything is normal. They sent me to the Institute of Immunology - they did it there skin tests for allergies, nothing dangerous was found. The shortness of breath continued, and in response to my complaints about the fear of suffocation at night, the doctor laughed and asked me not to tell anyone about this again - otherwise they would send me to a psychiatric hospital.

Then I didn’t go to the doctors for almost ten years - after all, on the first attempt they didn’t find anything for me. At the same time, I constantly felt bad, but in 2010 everything worsened: my blood pressure was constantly jumping, my joints could barely move. I couldn’t go to the doctor in winter because my head would pound when I tried to put on a hat. At night my whole body went numb, and the dryness in my mouth was almost unbearable. In the mornings, I opened the door first thing - I was afraid that I would faint and not have time to call an ambulance, and I hoped for neighbors. This went on for several months.

Medicines and difficulties with them

Medicine is not the most exact science, and, by and large, the clear causes of pathology are only clear in the case of infections or injuries. True, for successful treatment you may not even know the cause - it is enough to understand the mechanism, that is, how the process develops. Since we are talking about an attack by the body’s own immune system, the essence of treatment is to suppress this attack. For this purpose, immunosuppressive agents are used - these include drugs different groups and generations, including corticosteroids ( hormonal agents) and cytostatics (drugs that inhibit processes in cells and are also used in oncology). In addition to the therapeutic effect, they also have negative effects; Given that long-term or even lifelong therapy is required, these effects must be constantly monitored.

There is also another group of drugs: these are modern biological agents obtained using genetic engineering. With their help, you can influence the subtle mechanisms of autoimmune reactions, although they are not without side effects (however, not a single medicine in the world is without them). Treatment with biological agents can cost 50-100 thousand rubles a month and must be long-term - and for it to become available at the expense of the state, you need to go through many formalities, including registering for disability. This may take several years - the disease does not wait and progresses during this time. However, not all modern drugs generally registered in Russia, their appearance is often delayed by several years. People who have financial and physical ability, buy drugs in other countries.

Now we can talk about decent successes: the same systemic lupus erythematosus was considered lethal half a century ago, and pregnancy was out of the question - it led to the death of both the fetus and the mother. Today, women with lupus work, lead active life and give birth to children. However, for some rheumatic diseases there are still no drugs with proven effectiveness. A separate complexity is processes with so-called catastrophic, or lightning-fast, development; in a very short time against the background full health severe failure of many organs develops at once. To make a diagnosis and begin treatment, the doctor has a matter of hours or even minutes - and in such situations the mortality rate is still very high.

Experts agree that the active participation of the patient himself and his cooperation with the doctor is very important. Work is underway to make treatment more accessible, and common and severe rheumatic diseases are included in the lists of preferential medications. True, there are difficulties here: often, instead of original drugs, the lists include generics, which are theoretically just as effective, but in practice do not behave ideally.

Irina Babina talks about a patient with systemic lupus erythematosus who needed a drug that was not on the list. The Research Institute of Rheumatology assembled a commission of reputable doctors and scientists to examine this particular case - and as a result, the woman began to receive free the right medicine. Probably, one day such problems will be solved in a working manner, but for now such cases are rare. According to Oleg Borodin, another problem is the disappearance of some drugs from the market, which for one reason or another do not have their registration renewed in the country. If a drug that works well for a patient disappears, doctors must look for a replacement, retest tolerability and effectiveness—and there is no guarantee that the replacement will be equivalent.

Ekaterina G.

There were interruptions in the supply of the drug a couple of times, and I managed to get it out almost at the last moment. You could say I was lucky. During my treatment, I met several people who similar drugs They just stopped issuing them - and some of them cost 40 thousand rubles, others - 80. On permanent basis Most residents of the Chelyabinsk region, of course, are unable to buy this. Until now, before each time I receive a new batch of the drug (that is, four to six times a year), I experience extreme stress: what if they don’t give it? What if they don’t have time to deliver it and I start to get worse?

A year and a half ago, due to frequent relapses of uveitis (an eye disease that often accompanies rheumatoid arthritis), I was switched to another medicine. It is more expensive, it needs to be administered every two weeks (the previous one was once every two to three months), and must be stored only in the refrigerator (out of fear for the expensive drug, I even bought a new refrigerator). This significantly limits my travel, since cooler bags are bulky and unreliable, and I have not yet found another way to transport the drug.

Self-medication

With the advent of the Internet, people with rare diseases it became easier to find support. There are groups for communication between patients on websites, forums and social networks - and, unfortunately, in addition to support and communication, you can find a lot of advice there in the spirit of “stop poisoning yourself with chemistry” and recommendations to switch to a raw food diet or go to. Oleg Borodin notes that self-medication is typical during the period of denial of the disease, when a person does not yet understand that the situation is really serious. People are afraid of side effects - and it is difficult to realize that they may not develop, but the disease is already real and harmful to health. Folk remedies may initially alleviate the condition - the placebo effect plays a significant role here - but at the same time the disease continues to progress, and precious time is lost.

Irina Babina remembers a patient with systemic scleroderma, who applied almost ten years after the onset of the disease. With this diagnosis, swelling of the hands and forearms, inflammation of the joints, chilliness of the hands and feet, periodic spasm of blood vessels with pallor and then blue discoloration of the fingers, and non-healing painful ulcers on the fingertips are noted. “The most terrible discovery awaited me when examining my feet,” notes the doctor. - The fingers were completely black, due to the cessation of blood supply, their dry gangrene developed. It turned out that for almost ten years the woman tried to be treated with traditional methods - she applied cabbage leaves and took baths with chamomile. The result was the amputation of the toes of both feet.”

Self-treatment is not limited to traditional methods. According to Ilya Smitienko, there are cases of abuse of hormonal anti-inflammatory drugs: prednisolone and its analogues. When a person has severely inflamed joints, these hormones provide temporary relief, and the person feels like he did everything right. But in the end, instead of treating the disease, only the symptoms are smoothed out - but undesirable effects may include bone fragility and development.

Tatiana T.

When I finally got to the clinic and they began to examine me, the therapist was very excited about the results of the blood test: she said that one of the indicators deviates very much from the norm and this happens with pneumonia, cancer or systemic diseases. I was referred to several doctors at once, including an infectious disease specialist and a neurologist. The hematologist suspected myeloma (a malignant tumor of the bone marrow); I was very scared.

I went home to “die.” Then I decided that it would help healthy eating- did it all the time fresh juices, ate everything boiled, nibbled apples. But then I still donated blood for a complex test, and it turned out that I did not have myeloma. Then, I don’t remember why, I again ended up seeing a neurologist - and she said that this happens with rheumatic diseases. Again a therapist, again tests, and only after that I managed to get a referral to a rheumatologist. After hospitalization and a bunch of other examinations, it turned out that I have Sjogren's disease - an autoimmune disease.

Social difficulties

It is impossible for a healthy person to imagine a situation where the most ordinary action - chewing, shaking hands, typing on a keyboard, walking - is accompanied by discomfort or sharp pain. To get assistive devices like a wheelchair for free, you need to go through many authorities - patients joke that a person with a disability must be in enviable health in order to receive the benefits due to him social benefits. It's no secret that few are equipped with ramps and lifts - and sometimes they are made as if they were designed for stuntmen, and not for people with disabilities. disabilities. In addition, those who often take sick leave have problems with work.

And even this is just the tip of the iceberg; on patient forums there are discussions about everyday difficulties that people encounter at home or during hospitalization. The list of “what to take to the hospital” includes such non-obvious things as warm woolen bandages for warmth hip joints, a tray that can be placed on a chair and put things on it (so as not to reach for an inconveniently standing bedside table), as well as dishes, a small kettle, a lot of napkins and toilet paper - it is difficult to trust the cleanliness of toilets in Russian hospitals.

There is still no way to objectively assess pain - that is, doctors have no way to either confirm or deny its presence or determine its intensity. Our heroine has fibromyalgia and is unable to register her disability because the pain is not registered by any objective instruments. This is a disease at the intersection of rheumatology, neurology and psychiatry - and often works best for pain psychotropic drugs. At the same time, according to Irina Babina, the need to take them is not always adequately perceived: the patient regards the referral to a psychiatrist as distrust, refuses treatment, and the pain only intensifies.

Alexandra B.

The number of doctors I saw in four years is difficult to even count: therapists, endocrinologists, dermatologists, gynecologists, rheumatologists, neurologists, otolaryngologists, surgeons - this is just part of the list. Every day I struggle with pain in my muscles, joints, and stomach - all to no avail. Huge waste of money on one medicine translates into another. There is no improvement, but there are new diagnoses. Trying to cure one thing, I kill something else.

My life has changed, I can’t go outside for a long time, I go to the pharmacy, clinic or store, have difficulty returning, and then fall on the bed with incredible shortness of breath, dizziness, tachycardia and panic attack. The bottom line is a huge bouquet various diseases, a large number of medicines in the medicine cabinet, and the morning begins with the thought that no one can help me except myself.

How is it treated in other countries?

Experts agree: the knowledge and approaches of our doctors are not inferior to Western ones, but the structure of the healthcare system leaves much to be desired. It is difficult to treat pain when a person is prescribed opioid analgesics, but the system does not allow the rheumatologist to prescribe them. Problems with the availability of modern biological drugs, monstrous bureaucracy when registering disability or any benefits.

A separate difficulty for Russian patients is that they do not have a comprehensive psychological support. Any chronic illness- a lot of stress, and it is difficult for a person to realize and accept that he is unwell, that he will have to be examined frequently and treated for the rest of his life. With rheumatic diseases, the body and appearance, self-perception changes, many restrictions appear - for example, you cannot be under the bright sun. Ideally, you need support groups to help you overcome stress. So far, this role is played by groups on social networks: patients share tips on how to stop reacting to giggles, comments or sidelong glances, and many say that being different from your passport photo raises questions at airports.

Ekaterina G.

My main complaint about Russian medicine the fact that there are practically no doctors here who would operate with such concepts as “evidence-based medicine” and “patient’s quality of life.” Those who at least tried to explain to me what was happening to me and how they were going to treat me, and did not just throw statements at me, were less than a dozen in twenty-six years of illness.

AUTOIMMUNE DISEASES AND DISEASES OF IMMUNE COMPLEXES

AUTOIMMUNE DISEASES

Autoimmune diseases are quite widespread in the human population: they affect up to 5% of the world's population. For example, 6.5 million people in the United States suffer from rheumatoid arthritis; in large cities in England, up to 1% of adults are disabled with multiple sclerosis; juvenile diabetes affects up to 0.5% of the world's population. The sad examples can be continued.

First of all, it should be noted the difference between autoimmune reactions, or autoimmune syndrome And autoimmune diseases, which are based on the interaction between the components of the immune system and one’s own healthy cells and tissues. The former develop in a healthy body, proceed continuously and eliminate dying, aging, diseased cells, and also arise in any pathology, where they act not as its cause, but as a consequence. Autoimmune diseases, of which there are currently about 80, are characterized by a self-sustaining immune response to the body’s own antigens, which damages cells containing self-antigens. Often the development of an autoimmune syndrome further develops into an autoimmune disease.

Classification of autoimmune diseases

Autoimmune diseases are conventionally divided into three main types.

1. Organ-specific diseases, which are caused by autoantibodies and sensitized lymphocytes against one or a group of autoantigens of a specific organ. Most often, these are barrier antigens to which there is no natural (innate) tolerance. These include Hoshimoto's thyroiditis, myasthenia gravis, primary myxedema (thyrotoxicosis), pernicious anemia, autoimmune atrophic gastritis, Addison's disease, early menopause, male infertility, pemphigus vulgaris, sympathetic ophthalmia, autoimmune myocarditis and uveitis.

2. For non-organ-specific diseases autoantibodies to autoantigens of cell nuclei, cytoplasmic enzymes, mitochondria, etc. interact with different tissues of a given or even another

type of organism. In this case, autoantigens are not isolated (are not “barrier”) from contact with lymphoid cells. Autoimmunization develops against the background of pre-existing tolerance. Such pathological processes include systemic lupus erythematosus, discoid erythematous lupus, rheumatoid arthritis, dermatomyositis (scleroderma).

3. Mixed diseases involve both of these mechanisms. If the role of autoantibodies is proven, then they should be cytotoxic against the cells of the affected organs (or act directly through the AG-AT complex), which, when deposited in the body, cause its pathology. These diseases include primary biliary cirrhosis, Sjogren's syndrome, ulcerative colitis, celiac enteropathy, Goodpasture's syndrome, type 1 diabetes mellitus, autoimmune form of bronchial asthma.

Mechanisms of development of autoimmune reactions

One of the main mechanisms that prevents the development of autoimmune aggression in the body against its own tissues is the formation of unresponsiveness to them, called immunological tolerance. It is not congenital, it is formed in the embryonic period and consists of negative selection, those. elimination of autoreactive cell clones that carry autoantigens on their surface. It is the violation of such tolerance that is accompanied by the development of autoimmune aggression and, as a consequence, the formation of autoimmunity. As Burnet noted in his theory, during the embryonic period, contact of such autoreactive clones with “their” antigen causes not activation, but cell death.

However, not all so simple.

Firstly, it is important to say that the antigen recognition repertoire located on T lymphocytes preserves all clones of cells carrying all types of receptors for all possible antigens, including autoantigens, on which they are complexed together with their own HLA molecules, which makes it possible to distinguish “own” and “foreign” cells. This is the stage of "positive selection" followed by negative selection autoreactive clones. They begin to interact with dendritic cells carrying the same complexes of HLA molecules with thymic autoantigens. This interaction is accompanied by signal transmission to autoreactive thymocytes, and they undergo death through the mechanism of apoptosis. However, not all autoantigens are present in the thymus, so some

autoreactive T cells are still not eliminated and move from the thymus to the periphery. They are the ones who provide the autoimmune “noise.” However, as a rule, these cells have reduced functional activity and do not cause pathological reactions, just like autoreactive B lymphocytes, which are subject to negative selection and escape elimination, also cannot cause a full autoimmune response, since they do not receive a costimulatory signal from T helper cells, and in addition, they can be suppressed by special suppressor drugs veto -cells.

Secondly, despite negative selection in the thymus, some autoreactive lymphocyte clones still survive due to the imperfection of the elimination system and the presence of long-term memory cells, circulate in the body for a long time and cause the subsequent development of autoimmune aggression.

After the creation of Erne's new theory in the 70s of the last century, the mechanisms of development of autoimmune aggression became even more clear. It was assumed that the body constantly operates a system self-control including the presence on lymphocytes of receptors for antigens and special receptors for these receptors. Such antigen-recognizing receptors and antibodies to antigens (which are also actually their soluble receptors) were called idiots, and the corresponding antireceptors, or antiantibodies - anti-idiotypes.

Currently the balance between idiotype-antiidiotype interactions seen as critical system self-recognition, which is a key process in maintaining cellular homeostasis in the body. Naturally, a violation of this balance is accompanied by the development of autoimmune pathology.

Such a disorder may be caused by: (1) a decrease in the suppressor activity of cells, (2) the appearance in the bloodstream of barrier (“sequestered” antigens of the eye, gonads, brain, cranial nerves, with which the immune system normally does not have contact and when it occurs reacts to them as foreign, (3) antigenic mimicry due to microbial antigens that have common determinants with normal antigens, (4) mutation of autoantigens, accompanied by modification of their specificity, (5) increase in the number of autoantigens in circulation, (6) modification of autoantigens by chemical agents, viruses, etc. with the formation of biologically highly active superantigens.

The key cell of the immune system in the development of autoimmune diseases is the autoreactive T-lymphocyte, which reacts to a specific autoantigen in organ-specific diseases and then, through the immune cascade and the involvement of B-lymphocytes, causes the formation of organ-specific autoantibodies. In the case of organ-nonspecific diseases, most likely, autoreactive T lymphocytes interact not with the epitope of the autoantigen, but with the antigenic determinant of anti-idiotypic autoantibodies to it, as indicated above. Moreover, autoreactive B lymphocytes, which cannot be activated in the absence of a T cell costimulatory factor and synthesize autoantibodies, themselves have the ability to present a mimic antigen without an Ag-presenting cell and present it to non-autoreactive T lymphocytes, which turn into T helper cells and activate B cells for the synthesis of autoantibodies.

Among the autoantibodies produced by B lymphocytes, the following are of particular interest: natural autoantibodies to autologous antigens, which in a significant percentage of cases are detected and persist for a long time in healthy people. As a rule, these are autoantibodies of the IgM class, which, apparently, should still be considered precursors of autoimmune pathology. For this reason, in order to understand the detailed situation and establish the pathogenic role of autoantibodies, the following criteria for diagnosing autoaggression are proposed:

1. Direct evidence of circulating or associated autoAbs or sensitized Lf directed against autoAgs associated with the disease.

2. Identification of the causative autoAG against which the immune response is directed.

3. Adoptive transfer of the autoimmune process by serum or sensitized Lf.

4. The possibility of creating an experimental model of the disease with morphological changes and the synthesis of AT or sensitized Lf when modeling the disease.

Be that as it may, specific autoantibodies serve as markers of autoimmune diseases and are used in their diagnosis.

It should be noted that the presence of specific autoantibodies and sensitized cells is not yet sufficient for the development of an autoimmune disease. A major role is played by pathogenic environmental factors (radiation, force fields, polluted

products, microorganisms and viruses, etc.), genetic predisposition of the body, including those linked to HLA genes (multiple sclerosis, diabetes, etc.), hormonal levels, use of various medications, immune disorders, including cytokine balance.

At present, a number of hypotheses for the mechanism of induction of autoimmune reactions can be proposed (the information given below is partially borrowed from R.V. Petrov).

1. Despite the self-control system, the body contains autoreactive T- and B-lymphocytes, which, under certain conditions, interact with antigens of normal tissues, destroy them, promoting the release of hidden autoantigens, stimulants, mitogens that activate cells, including B-lymphocytes.

2. For injuries, infections, degenerations, inflammation, etc. “sequestered” (barrier) autoantigens are released, to which autoantibodies are produced that destroy organs and tissues.

3. Cross-reacting “mimicking” antigens of microorganisms, common with autoantigens of normal tissues. Staying in the body for a long time, they eliminate tolerance and activate B cells to synthesize aggressive autoantibodies: for example, group A hemolytic streptococcus and rheumatic disease of the heart valves and joints.

4. “Superantigens” - toxic proteins formed by cocci and retroviruses that cause strong activation of lymphocytes. For example, normal antigens activate only 1 in 10,000 T cells, and superantigens activate 4 out of 5! The autoreactive lymphocytes present in the body will immediately trigger autoimmune reactions.

5. The presence in patients of a genetically programmed weakness of the immune response to a specific antigen immunodeficiency. If it is contained by a microorganism, a chronic infection occurs, destroying tissue and releasing various autoags, to which an autoimmune response develops.

6. Congenital deficiency of T-suppressor cells, which abolishes the control of B-cell function and induces their response to normal antigens with all the consequences.

7. Autoantibodies under certain conditions “blind” Lf, blocking their receptors that recognize “self” and “foreign”. As a result, natural tolerance is canceled and an autoimmune process is formed.

In addition to the above mechanisms of induction of autoimmune reactions, it should also be noted:

1. Induction of the expression of HLA-DR antigens on cells that previously did not have them.

2. Induction by viruses and other agents of modification of the activity of autoantigens-oncogenes, regulators of cytokine production and their receptors.

3. Reduced apoptosis of T-helper cells that activate B-lymphocytes. Moreover, in the absence of a proliferative stimulus, B lymphocytes die from apoptosis, whereas in autoimmune diseases it is suppressed and such cells, on the contrary, accumulate in the body.

4. Mutation of the Fas ligand, which leads to the fact that its interaction with the Fas receptor does not induce apoptosis in autoreactive T cells, but suppresses the binding of the receptor to the soluble Fas ligand and thereby delays the cell apoptosis induced by it.

5. Deficiency of special T-regulatory CD4+CD25+ T-lymphocytes with FoxP3 gene expression, which block the proliferation of autoreactive T-lymphocytes, which significantly enhances it.

6. Disruption of the binding site on chromosomes 2 and 17 of the special regulatory protein Runx-1 (RA, SLE, psoriasis).

7. Formation in the fetus of autoantibodies of the IgM class to many components of autocells, which are not eliminated from the body, accumulate with age and cause autoimmune diseases in adults.

8. Immune drugs, vaccines, immunoglobulins can cause autoimmune disorders (dopegite - hemolytic anemia, apressin - SLE, sulfonamides - periarteritis nodosa, pyrazolone and its derivatives - agranulocytosis).

A number of drugs can, if not induce, then intensify the onset of immunopathology.

It is very important for physicians to know that the following drugs have immunostimulating potencies: antibiotics(Eric, amphotericin B, levorin, nystatin),nitrofurans(furazolidone),antiseptics(chlorophyllipt),metabolism stimulants(orotate K, riboxin),psychotropic drugs(nootropil, piracetam, phenamine, sydnocarb),plasma replacement solutions(hemodez, rheopolyglucin, gelatinol).

The association of autoimmune diseases with other diseases

Autoimmune disorders (rheumatic diseases) may be accompanied by tumor lesions lymphoid tissue and neop-

lasers of other localizations, but patients with lymphoproliferative diseases often exhibit symptoms of autoimmune conditions (Table 1).

Table 1. Rheumatic autoimmune pathology in malignant neoplasms

Thus, with hypertrophic osteoarthropathy, cancer of the lungs, pleura, diaphragm is detected, less often gastrointestinal tract, with secondary gout - lymphoproliferative tumors and metastases, with pyrophosphate arthropathy and monoarthritis - bone metastases. Often polyarthritis and lupus-like and scleral-like syndromes are accompanied by malignant tumors of various localizations, and polymyalgia rheumatica and cryoglobulinemia are accompanied, respectively, by cancer of the lungs, bronchi and hyperviscosity syndrome.

Often malignant neoplasms are manifested by rheumatic diseases (Table 2).

With rheumatoid arthritis, the risk of developing lymphogranulomatosis, chronic myeloid leukemia, and myeloma is increased. Tumors more often occur during the chronic course of the disease. The induction of neoplasms increases with the duration of the disease, for example, in Sjögren's syndrome, the risk of cancer increases by 40 times.

These processes are based on the following mechanisms: expression of the CD5 antigen on B cells that synthesize organ-specific antibodies (normally this antigen is presented on T lymphocytes); excessive proliferation of large granular lymphocytes, having

Table 2. Malignant tumors and rheumatic diseases

those with the activity of natural killer cells (phenotypically they belong to CD8 + lymphocytes); infection with retroviruses HTLV-1 and Epstein-Barr viruses; polyclonal activation of B cells with loss of regulation of this process; hyperproduction of IL-6; long-term treatment cytostatics; disruption of natural killer cell activity; deficiency of CD4+ lymphocytes.

In primary immunodeficiencies, signs of autoimmune processes are often found. High frequency autoimmune disorders identified in sex-linked hypogammaglobulinemia, IgA deficiency, immunodeficiency with overproduction of IgA, ataxia-telangiectasia, thymoma, and Wiskott-Aldrich syndrome.

On the other hand, there are a number of autoimmune diseases in which immunodeficiencies have been identified (primarily related to T-cell function). In persons with systemic diseases, this phenomenon is expressed more often (with SLE in 50-90% of cases) than with organ-specific diseases (with thyroiditis in 20-40% of cases).

Autoantibodies occur more often in older people. This applies to the determination of rheumatoid and antinuclear factors, as well as antibodies detected in the Wasserman reaction. In asymptomatic 70-year-olds, autoantibodies against various tissues and cells are detected in at least 60% of cases.

What is common in the clinical picture of autoimmune diseases is their duration. There are chronic progressive or chronically relapsing course of pathological processes. Information about the features of the clinical expression of individual autoimmune diseases is presented below (partial information provided is borrowed from S.V. Suchkov).

Characteristics of some autoimmune diseases

Systemic lupus erythematosus

An autoimmune disease with systemic damage to connective tissue, with collagen deposition and the formation of vasculitis. It is characterized by polysymptoms and usually develops in young people. Almost all organs and many joints are involved in the process, and kidney damage is fatal.

With this pathology, antinuclear autoantibodies are formed to DNA, including native DNA, nucleoproteins, cytoplasmic and cytoskeletal antigens, and microbial proteins. It is believed that autoAbs to DNA appear as a result of the formation of its immunogenic form in complex with a protein, or an IgM autoantibody of anti-DNA specificity, which arose in the embryonic period, or the interaction of idiotype-antiidiotype and cell components during microbial or viral infection. Perhaps a certain role belongs to cell apoptosis, which in SLE causes, under the influence of caspase 3, the cleavage of the nucleoproteasome complex of the nucleus with the formation of a number of products that react with the corresponding autoantibodies. Indeed, the content of nucleosomes is sharply increased in the blood of patients with SLE. Moreover, autoantibodies to native DNA are the most diagnostically significant.

An extremely interesting observation is the discovery that DNA-binding autoantibodies also have the enzymatic ability to hydrolyze a DNA molecule without complement. This antibody was called a DNA abzyme. There is no doubt that this fundamental pattern, which, as it turns out, is realized not only in SLE, plays a huge role in the pathogenesis of autoimmune diseases. In this model, the anti-DNA autoantibody has cytotoxic activity towards the cell, which is realized by two mechanisms: receptor-mediated apoptosis and DNA abzyme catalysis.

Rheumatoid arthritis

Autoantibodies are formed against extracellular components that cause chronic inflammation of the joints. Autoantibodies belong mainly to the IgM class, although IgG, IgA and IgE are also found, are formed against the Fc fragments of immunoglobulin G and are called rheumatoid factor (RF). In addition to them, autoantibodies are synthesized to keratohyalin grains (antiperinuclear factor), keratin (antikeratin antibodies), and collagen. It is significant that autoantibodies to collagen are nonspecific, while antiperinuclear factor may be a precursor to the formation of RA. It should also be noted that the detection of IgM-RF allows one to classify seropositive or seronegative RA, and IgA-RF turns out to be a criterion for a highly active process.

In the synovial fluid of the joints, autoreactive T-lymphocytes were found that cause inflammation, which involves macrophages, which enhance it with proinflammatory cytokines, followed by the formation of synovial hyperplasia and cartilage damage. These facts have led to the emergence of a hypothesis that allows the initiation of the autoimmune process by T-helper type 1 cells, activated by an unknown epitope with a costimulatory molecule, which destroy the joint.

Hoshimoto's autoimmune thyroiditis

Disease of the thyroid gland, accompanied by its functional disability with aseptic inflammation of the parenchyma, which is often infiltrated with lymphocytes and is subsequently replaced by connective tissue that forms compactions in the gland. This disease manifests itself in three forms - Hoshimoto's thyroiditis, primary myxedema and thyrotoxicosis, or Graves' disease. The first two forms are characterized by hypothyroidism, the autoantigen in the first case is thyroglobulin, and in myxedema - proteins of the cell surface and cytoplasm. In general, autoantibodies to thyroglobulin, thyroid-stimulating hormone receptor and thyroid peroxidase have a key influence on the function of the thyroid gland; they are also used in the diagnosis of pathology. Autoantibodies suppress the synthesis of hormones by the thyroid gland, which affects its function. At the same time, B lymphocytes can bind to autoantigens (epitopes), thereby influencing the proliferation of both types of T helper cells, which is accompanied by the development of an autoimmune disease.

Autoimmune myocarditis

In this disease, the key role is played by a viral infection, which is most likely its trigger. It is with this that the role of mimicking antigens is most clearly seen.

In patients with this pathology, autoantibodies to cardiomyosin, receptors of the outer membrane of myocytes and, most importantly, to proteins of Coxsackie viruses and cytomegaloviruses are detected. It is significant that during these infections a very high viremia is detected in the blood; viral antigens in a processed form accumulate on professional antigen-presenting cells, which can activate unprimed clones of autoreactive T-lymphocytes. The latter begin to interact with non-professional antigen-presenting cells, because do not require a costimulatory signal, and interact with myocardial cells, on which, due to activation by antigens, the expression of adhesion molecules (ICAM-1, VCAM-1, E-selectin) sharply increases. The process of interaction between autoreactive T lymphocytes is also sharply enhanced and facilitated by increased expression of HLA class II molecules on cardiomyocytes. Those. autoantigens of myocardiocytes are recognized by T helper cells. The development of an autoimmune process and viral infection behaves very typically: initially, powerful viremia and high titers of antiviral autoantibodies, then a decrease in viremia down to virus negativity and antiviral antibodies, an increase in antimyocardial autoantibodies with the development of autoimmune heart disease. The experiments clearly demonstrated the autoimmune mechanism of the process, in which the transfer of T lymphocytes from infected mice with myocarditis induced disease in healthy animals. On the other hand, T cell suppression was accompanied by a dramatic positive therapeutic effect.

Myasthenia gravis

In this disease, a key role is played by autoantibodies to acetylcholine receptors, which block their interaction with acetylcholine, completely suppressing the function of the receptors or sharply enhancing it. The consequence of such processes is a disruption in the transmission of nerve impulses up to severe muscle weakness and even respiratory arrest.

A significant role in the pathology belongs to T-lymphocytes and disturbances in the idiotypic network; there is also a sharp hypertrophy of the thymus with the development of thymoma.

Autoimmune uveitis

As in the case of myasthenia gravis, infection with protozoa plays a significant role in the development of autoimmune uveitis, in which autoimmune chronic inflammation of the uvearetinal tract develops Toxoplasma gondii and cytomegaly and herpes simplex viruses. In this case, a key role belongs to mimicking antigens of pathogens that have common determinants with eye tissues. With this disease, autoantibodies appear to autoantigens of the eye tissue and microbial proteins. This pathology is truly autoimmune, since the introduction of five purified eye antigens to experimental animals causes the development of classical autoimmune uveitis in them due to the formation of corresponding autoantibodies and damage to the uveal membrane.

Insulin-dependent diabetes mellitus

A widespread autoimmune disease in which immune autoaggression is directed against the autoantigens of the cells of the islets of Langerhans; they are destroyed, which is accompanied by suppression of insulin synthesis and subsequent profound metabolic changes in the body. This disease is mediated mainly by the functioning of cytotoxic T lymphocytes, which are sensitized, apparently, to intracellular glutamic acid decarboxylase and p40 protein. In this pathology, autoantibodies to insulin are also detected, but their pathogenetic role is not yet clear.

Some researchers propose to consider autoimmune reactions in diabetes from three positions: (1) diabetes is a typical autoimmune disease with autoaggression against beta cell autoantigens; (2) in diabetes, the formation of anti-insulin autoantibodies is secondary, forming the syndrome of autoimmune insulin resistance; (3) with diabetes, other immunopathological processes develop, such as the appearance of autoantibodies to the tissues of the eye, kidneys, etc. and their respective lesions.

Crohn's disease

Otherwise, granulomatous colitis is a severe recurrent autoimmune inflammatory disease mainly of the colon

with segmental damage to the entire intestinal wall by lymphocytic granulomas with subsequent formation of penetrating slit-like ulcers. The disease occurs with a frequency of 1:4000, young women are more often affected. It is associated with the HLA-B27 antigen and is caused by the formation of autoantibodies to the tissues of the intestinal mucosa with a decrease in the number and functional activity of suppressor T-lymphocytes and to mimicking microbial antigens. An increased number of IgG-containing lymphocytes specific to tuberculosis was found in the colon. IN last years There have been encouraging reports about successful treatment of this disease using antibodies to β-TNF, which suppress the activity of autoreactive T lymphocytes.

Multiple sclerosis

In this pathology, autoreactive T cells also play a key role with the participation of type 1 T helper cells, which cause the destruction of the myelin sheath of the nerves with the subsequent development of severe symptoms. The target autoantigen is most likely myelin basic protein, to which sensitized T cells are formed. A significant role in pathology belongs to apoptosis, the manifestations of which can determine different types of the process - progressive or remitting. In an experimental model (experimental encephalomyelitis) it is reproduced when animals are immunized with myelin basic protein. A certain role of viral infection in the etiology of multiple sclerosis cannot be ruled out.

The body's defenses are aimed at maintaining its stable state and destroying pathogenic agents. Special cells fight pests and promote their removal from the internal environment. It happens that a disturbance occurs in the body, and its own cells begin to be perceived as foreign. In science, such phenomena are called autoimmune diseases: in simple words, the body destroys itself. Over the years, the number of patients with such diagnoses is only growing.

What are autoimmune diseases

The essence of the phenomenon described above comes down to the fact that an overly active immune system begins to attack individual tissues, organs or entire systems, which causes their functioning to malfunction. Autoimmune diseases, what are they and why do they occur? The mechanism of origin of such processes is still not completely clear to researchers in the field of medicine. There are a number of reasons why the immune system may fail. In addition, it is important to recognize the symptoms in time in order to be able to correct the course of the disease.

Symptoms

Each pathology in this group triggers its own characteristic autoimmune processes, so the symptoms may differ. However there is general group conditions, which suggests the development of autoimmune diseases:

Abrupt loss weight.
Increased body weight combined with rapid fatigue.
Pain in joints and muscles for no obvious reason.
Decrease in the quality of mental activity - a person has difficulty concentrating on work, he experiences foggy consciousness.
Common auto immune reaction- skin rash. The condition is aggravated by exposure to the sun and consumption of certain foods.
Dry mucous membranes and skin. The eyes and mouth are mainly affected.
Loss of sensation. Tingling in the limbs, insensitivity of any part of the body often indicates that the autoimmune system has launched its mechanisms.
Increased blood clotting up to the formation of blood clots, spontaneous abortions.
Severe hair loss, baldness.
Digestive disorders, stomach pain, changes in the color of stool and urine, the appearance of blood in them.

Markers

Diseases of the defense system arise due to the activation of special cells in the body. What are autoantibodies? This is a group of cells that destroy healthy structural units organism, mistaking them for foreign. The task of specialists is to appoint lab tests and determine which highly active cells are present in the blood. When making a diagnosis, the attending physician relies on the presence of markers of autoimmune diseases - antibodies to substances that are natural to the human body.

Markers of autoimmune diseases are agents whose action is aimed at neutralizing:

yeast Saccharomyces cerevisiae;
double-stranded native DNA;
extractable nuclear antigens;
neutrophil cytoplasmic antigens;
insulin;
cardiolipnin;
prothrombin;
basement membrane glomeruli (determines kidney disease);
Fc fragment of immunoglobulin G ( rheumatoid factor);
phospholipids;
gliadin.

Causes

All lymphocytes develop mechanisms for recognizing foreign proteins and methods for combating them. Some of them eliminate “native” proteins, which is necessary if the cellular structure is damaged and needs to be eliminated. The defense system strictly controls the activity of such lymphocytes, but sometimes they fail, which becomes the cause of an autoimmune disease.

Among other probable factors of autoimmune disorders, scientists identify:

Gene mutations, the occurrence of which is influenced by heredity.
Past severe infections.
Penetration into the internal environment of viruses capable of taking the form of body cells.
Adverse influence environment– radiation, atmospheric, water and soil pollution with chemicals.

Consequences

Almost all cases of autoimmune diseases occur in women; women are especially vulnerable childbearing age. Men suffer from lymphocyte disorientation much less frequently. However, the consequences of these pathologies are equally negative for everyone, especially if the patient does not undergo maintenance therapy. Autoimmune processes threaten the destruction of body tissue (one or more types), uncontrolled organ growth, and changes in organ functions. Some diseases significantly increase the risk of cancer of any location and infertility.

List of human autoimmune diseases

Failures in the body’s defense system can provoke damage to any organ, so the list autoimmune pathologies wide. They disrupt the functioning of hormonal, cardiovascular, nervous system, cause diseases of the musculoskeletal system, affecting the skin, hair, nails and more. These diseases cannot be cured at home; the patient requires qualified assistance medical personnel.

Blood

Hematologists are involved in treatment and prognosis of the success of therapy. The most common diseases in this group are:

hemolytic anemia;
autoimmune neutropenia;
thrombocytopenic purpura.

Skin

A dermatologist will treat patients for autoimmune skin diseases. The group of these pathologies is wide:

psoriasis disease (in the photo it looks like red, too dry, raised spots above the skin that merge with each other);
isolated cutaneous vasculitis;
some types of alopecia;
discoid lupus erythematosus disease;
pemphingoid;
chronic urticaria.

Thyroid gland

Autoimmune thyroid disease can be cured if you seek qualified help in time. There are two groups of pathologies: the first, in which the amount of hormones is increased (Graves' disease, or Graves' disease), the second, hormones are less than normal (Hashimoto's thyroiditis). Autoimmune processes in the thyroid gland lead to primary hypothyroidism. Patients are examined by an endocrinologist or family therapist. A marker of autoimmune thyroid diseases are antibodies to TPO (thyroid peroxidase).

Symptoms of autoimmune thyroiditis:

often the disease is asymptomatic and is detected during examination of the thyroid gland;
when the disease develops into hypothyroidism, apathy, depression, weakness, swelling of the tongue, hair loss, joint pain, slow speech, etc. are observed.
when the disease thyrotoxicosis occurs, the patient experiences mood swings, rapid heartbeat, fever, disruptions in menstrual cycle, decrease in strength bone tissue etc.

Liver

Common autoimmune liver diseases:

primary biliary;
autoimmune hepatitis disease;
primary sclerosing cholangitis;
autoimmune cholangitis.

Nervous system

Neurologists treat the following diseases:

Guillain-Bart syndrome;
Myasthenia Gravis.

Joints

This group of diseases, especially, affects even children. The process begins with inflammation of the connective tissue, which leads to joint destruction. As a result, the patient loses the ability to move. Autoimmune diseases of the joints also include spondyloarthropathy - inflammatory processes of the joints and entension.

Treatment methods

For a specific autoimmune disease, specialized treatment is prescribed. A referral is issued for a blood test, which identifies pathological markers. For systemic diseases (systemic lupus erythematosus, Sjögren's syndrome), it is necessary to consult several specialists and approach treatment comprehensively. This process will be lengthy, but with proper therapy it will allow you to live a quality and long life.

Drugs

Mostly, the treatment of diseases is aimed at strongly reducing the activity of the immune system, for which the patient needs to take special drugs - immunosuppressants. These include the following medicines, like Prednisolone, Cyclophosphamide, Azathioprine. Doctors weigh the factors that determine the benefit-harm ratio. The immune system is suppressed, and this condition is very dangerous for the body. The patient is under the supervision of specialists at all times. The use of immunomodulators, on the contrary, is often considered a contraindication for such therapy.

Using autoimmune therapy

For autoimmune diseases, corticosteroid drugs are also used. They are also aimed at suppressing the body’s defenses, but also have an anti-inflammatory effect. It is not advisable to use these drugs long time because they have many side effects. In some cases, blood transfusions – plasmapheresis – are used to treat autoimmune diseases. Highly active antibodies are removed from the blood, then it is transfused back.

Folk remedies

It is important to adjust your lifestyle - moderately monitor hygiene, do not give up walking in sunny weather, drink natural green tea, use less deodorants and perfumes, stick to an anti-inflammatory diet. Each individual disease allows the use of specific folk remedies, but it is imperative to consult a doctor, since different cases the same recipe can be disastrous.

Video about autoimmune system disease

Autoimmune diseases are such a broad group of pathologies that we can talk about it for a very long time. Scientists from all over the world are still arguing about the origin, treatment methods and manifestations of individual diseases. We present to your attention an episode of the “Be Healthy” program, in which experts talk about the essence of autoimmune processes, the most common pathologies, and recommendations for maintaining health.

What are autoimmune diseases?

As you can guess from the name, autoimmune diseases are diseases provoked by our own immunity. For some reason, white blood cells begin to consider a certain type of cell in our body to be foreign and dangerous. That is why autoimmune diseases are complex, or systemic in nature. Affected immediately whole organ or group of organs. Human body launches, figuratively speaking, a program of self-destruction. Why does this happen, and is it possible to protect yourself from this disaster?

Among the lymphocytes, there is a special “caste” of orderly cells: they are tuned to the protein of the body’s own tissues, and if some part of our cells dangerously changes, gets sick or dies, the orderlies will have to destroy this unnecessary garbage. At first glance, very useful feature, especially considering that special lymphocytes are under strict control of the body. But alas, the situation sometimes develops as if according to the script of an action-packed action movie: everything that can get out of control gets out of control and takes up arms.

The reasons for the uncontrolled reproduction and aggression of lymphocytes can be divided into two types: internal and external.

Internal reasons:

Type I gene mutations, when lymphocytes cease to identify a certain type of cell or organism. Having inherited such genetic baggage from his ancestors, a person is likely to develop the same autoimmune disease that his closest relatives suffered from. And since the mutation concerns the cells of a specific organ or organ system, it will be, for example, toxic goiter or thyroiditis;

Type II gene mutations, where nurse lymphocytes multiply uncontrollably and cause a systemic autoimmune disease such as lupus or multiple sclerosis. Such ailments are almost always hereditary.

External reasons:

Very severe, protracted infectious diseases, after which immune cells begin to behave inappropriately;

Disastrous physical impact from the environment, for example, radiation or solar radiation;

The “cunning” of disease-causing cells that pretend to be very similar to our own, only diseased cells. Lymphocyte nurses cannot figure out who is who, and take up arms against both.

Because the autoimmune diseases very diverse, highlight general symptoms it is extremely difficult for them. But all diseases of this type develop gradually and haunt a person throughout his life. Very often, doctors are at a loss and cannot make a diagnosis, because the symptoms seem erased, or turn out to be characteristic of many other, much more well-known and widespread diseases. But the success of treatment or even saving the patient’s life depends on timely diagnosis: autoimmune diseases can be very dangerous.

Let's look at the symptoms of some of them:

Rheumatoid arthritis affects joints, especially small ones in the hands. It manifests itself not only with pain, but also with swelling, numbness, high temperature, a feeling of tightness in the chest and general muscle weakness;

Multiple sclerosis- it's a disease nerve cells, as a result of which a person begins to experience strange tactile sensations, lose sensitivity, and see worse. Sclerosis is accompanied muscle spasms and numbness, as well as memory impairment;

Type 1 diabetes makes a person dependent on insulin for life. And its first symptoms are frequent urination, constant thirst and a voracious appetite;

Vasculitis is a dangerous autoimmune disease that affects the circulatory system. The vessels become fragile, organs and tissues seem to be destroyed and bleed from the inside. The prognosis, alas, is unfavorable, and the symptoms are pronounced, so diagnosis is rarely difficult;

Lupus erythematosus is called systemic because it harms almost all organs. The patient experiences heart pain, cannot breathe normally, and is constantly tired. Red round spots appear on the skin raised spots irregular shape that itch and become scabby;

Pemphigus is a terrible autoimmune disease, the symptoms of which are huge blisters on the surface of the skin filled with lymph;

Hashimoto's thyroiditis is an autoimmune disease of the thyroid gland. Its symptoms: drowsiness, coarseness skin, strong increase weight, fear of cold;

Hemolytic anemia is an autoimmune disease in which white blood cells turn against red blood cells. A lack of red blood cells leads to increased fatigue, lethargy, drowsiness, fainting;

Graves' disease is the opposite of Hashimoto's thyroiditis. With it, the thyroid gland begins to produce too much of the hormone thyroxine, so the symptoms are the opposite: weight loss, heat intolerance, increased nervous excitability;

Myasthenia gravis affects muscle tissue. As a result, a person is constantly tormented by weakness. They get tired especially quickly eye muscles. Symptoms of myasthenia gravis can be combated with the help of special medications that increase muscle tone;

Scleroderma is a disease of connective tissues, and since such tissues are found almost everywhere in our body, the disease is called systemic, like lupus. Symptoms are very varied: they occur degenerative changes joints, skin, blood vessels and internal organs.

The long and sad list of autoimmune diseases would hardly fit entirely in our article. We will name the most common and well-known of them. Based on the type of damage, autoimmune diseases are divided into:

System;

Organ-specific;

Mixed.

Systemic autoimmune diseases include:

Lupus erythematosus;

Scleroderma;

Some types of vasculitis;

Rheumatoid arthritis;

Behçet's disease;

Polymyositis;

Sjögren's syndrome;

Antiphospholipid syndrome.

Organ-specific, that is, affecting a specific organ or system of the body, autoimmune diseases include:

Joint diseases - spondyloarthropathy and rheumatoid arthritis;

Endocrine diseases - diffuse toxic goiter, Graves' syndrome, Hashimoto's thyroiditis, type 1 diabetes mellitus;

Nervous autoimmune diseases – myasthenia gravis, multiple sclerosis, Guillain-Baré syndrome;

Liver and gastrointestinal diseases - biliary cirrhosis, ulcerative colitis, Crohn's disease, cholangitis, autoimmune hepatitis and pancreatitis, celiac disease;

Diseases circulatory system– neutropenia, hemolytic anemia, thrombocytopenic purpura;

Autoimmune kidney diseases - some types of vasculitis affecting the kidneys, Goodpasture's syndrome, glomerulopathies and glomerulonephritis (a whole group of diseases);

Skin ailments - vitiligo, psoriasis, lupus erythematosus and vasculitis with skin localization, pemphingoid, alopecia, autoimmune urticaria;

Pulmonary diseases - again vasculitis with damage to the lungs, as well as sarcoidosis and fibrosing alveolitis;

Autoimmune heart diseases - myocarditis, vasculitis and rheumatic fever.

Diagnosis of autoimmune diseases

The diagnosis can be made using a special blood test. Doctors know what types of antibodies indicate a particular autoimmune disease. But the problem is that sometimes a person suffers and gets sick long years, before the primary care physician even thinks of referring the patient to the laboratory for testing for autoimmune diseases. If you experience strange symptoms, be sure to consult several reputable specialists at once. You should not rely on the opinion of one doctor, especially if he doubts the diagnosis and choice of treatment methods.

Which doctor treats autoimmune diseases?

As we said above, there are organ-specific autoimmune diseases, which are treated by specialized doctors. But when it comes to systemic or mixed forms, you may need the help of several specialists at once:

Neurologist;

Hematologist;

Rheumatologist;

Gastroenterologist;

Cardiologist;

Nephrologist;

Pulmonologist;

Dermatologist;

It still remains an unsolved mystery for modern science. Their essence is to counteract immune cells the body's own cells and tissues, from which human organs are formed. The main reason for this failure is various systemic disorders in the body, as a result of which antigens are formed. The natural reaction to these processes is increased production leukocytes, which are responsible for devouring foreign bodies.

Classification of autoimmune diseases

Disorders caused by a violation of the histohematic barrier (for example, if sperm enters a cavity not intended for it, the body will respond by producing antibodies - diffuse infiltration, encephalomyelitis, pancreatitis, endophthalmitis etc.);

The second group occurs as a result of transformation of body tissues under physical, chemical or viral influence. The cells of the body undergo deep metamorphoses, as a result of which they are perceived as foreign. Sometimes in the tissues of the epidermis there is a concentration of antigens that entered the body from the outside, or exoantigens (drugs or bacteria, viruses). The body's reaction will be directed towards them, but this will cause damage to the cells that retain antigenic complexes on their membrane. In some cases, interaction with viruses leads to the formation of antigens with hybrid properties, which can cause damage to the central nervous system;

The third group of autoimmune diseases is associated with the coalescence of body tissues with exoantigens, which causes a natural reaction against the affected areas;

The fourth species is most likely generated genetic abnormalities or influence unfavorable factors external environment, entailing rapid mutations of immune cells (lymphocytes), manifested in the form lupus erythematosus.

Main symptoms of autoimmune diseases

initial stage

Autoimmune diseases are often accompanied by other diseases in the body, which sometimes complicates the process of primary diagnosis

Spasm the smallest vessels fingers, accompanied by a change in their color as a result of exposure to low temperature or stress, clearly indicates symptoms of an autoimmune disease called Raynaud's syndrome – scleroderma. The lesion begins in the extremities and then spreads to other parts of the body and internal organs, mainly the lungs, stomach and thyroid gland.

Autoimmune diseases were first studied in Japan. In 1912, Scientist Hashimoto gave a comprehensive description of diffuse infiltration - a disease of the thyroid gland, which results in its intoxication with thyroxine. This disease is otherwise called Hashimoto's disease.

vasculitis

poor appetite

Thyroiditis– inflammatory processes of the thyroid gland, causing the formation of lymphocytes and antibodies that attack the affected tissue. The body organizes a fight against the inflamed thyroid gland.

Observations of people with various spots on their skin were carried out even before our era. The Ebers Papyrus describes two types of discolored spots:
1) accompanied by tumors
2) typical spots without any other manifestations.
In Rus', vitiligo was called “dog,” thereby emphasizing the similarity of people suffering from this disease to dogs.
In 1842, vitiligo was identified as a separate disease. Until this point, it was confused with leprosy.

Vitiligo

Multiple sclerosis– a disease of the nervous system that is chronic in nature, in which foci of decay of the myelin sheath of the brain and spinal cord. In this case, multiple scars form on the surface of the central nervous system (CNS) tissue - neurons are replaced by connective tissue cells. Around the world, about two million people suffer from this disease.

Alopecia– disappearance or thinning hairline on the body as a result of its pathological loss.

Crohn's disease– chronic inflammatory damage to the gastrointestinal tract.

Autoimmune hepatitis– chronic liver disease inflammatory in nature, accompanied by the presence of autoantibodies and ᵧ-particles.

Allergy– the body’s immune response to allergens that it recognizes as potentially hazardous substances. It is characterized by increased production of antibodies, which cause various allergenic manifestations on the body.

Common diseases of autoimmune origin are rheumatoid arthritis, diffuse infiltration of the thyroid gland, multiple sclerosis, diabetes mellitus, pancreatitis, dermatomyositis, thyroiditis, vitiligo. Modern medical statistics record their growth rates in arithmetic order and without a downward trend.

- Rheumatoid arthritis;
- Ankylosing spondylitis;
- Nodular periarthritis;
- Systemic lupus.

The first two diseases affect the joints in various parts body, often accompanied by pain and inflammation cartilage tissue. Periarthritis destroys arteries, systemic lupus erythematosus destroys internal organs and manifests itself on the skin.

Expectant mothers belong to a special category of patients. Women are five times more likely to naturally develop autoimmune lesions than men, and most often they appear during reproductive age, particularly during pregnancy. The most common among pregnant women are: multiple sclerosis, systemic lupus erythematosus, Hashimoto's disease, thyroiditis, thyroid diseases.

Some diseases experience remission during pregnancy and exacerbation during the postpartum period, while others, on the contrary, manifest themselves as a relapse. In any case, autoimmune diseases carry increased risk for the development of a full-fledged fetus, completely dependent on the mother’s body. Timely diagnosis and treatment when planning pregnancy will help identify all risk factors and avoid many negative consequences.

The peculiarity of autoimmune diseases is that they occur not only in people, but also in domestic animals, in particular cats and dogs. The main diseases of pets include:

- Autoimmune hemolytic anemia;
- Immune thrombocytopenia;
- Systemic lupus erythematosus;
- Immune polyarthritis;
- Myasthenia gravis;
- Pemphigus foliaceus.

A sick animal may well die if it is not promptly injected with corticosteroids or other immunosuppressants to reduce the hyperreactivity of the immune system.

Autoimmune complications

pure form

viral hepatitis

Autoimmune diseases that accompany various diseases that caused their appearance usually go away along with the underlying disease.

The first person to study multiple sclerosis and characterize it in his notes was the French psychiatrist Jean-Martin Charcot. The peculiarity of the disease is indiscriminateness: it can occur in both older people and young people, and even children. Multiple sclerosis affects several parts of the central nervous system simultaneously, which entails manifestations in patients various symptoms neurological nature.

Causes of the disease

external

internal factors

Likely external factors are stress, and adverse influences environment.

Diagnosis and treatment of autoimmune diseases

immune factor

The second step should be a blood test for biochemistry and rheumatic tests. In 90% they give an affirmative answer to rheumatoid arthritis, in more than 50% they confirm Sjogren's syndrome and in a third of cases they indicate other autoimmune diseases. Many of them are characterized by the same type of development dynamics.

For residual confirmation of the diagnosis, immunological tests are required. In the presence of an autoimmune disease, there is an increased production of antibodies by the body against the background of the development of pathology.

Modern medicine does not have a single and perfect method for treating autoimmune diseases. Her methods are aimed at the final stage of the process and can only alleviate symptoms.

Treatment of an autoimmune disease should be strictly supervised by an appropriate specialist, because existing drugs cause suppression of the immune system, which, in turn, can lead to the development of cancer or infectious diseases.

The main methods of modern treatment:

Suppression of the immune system;
- Regulation metabolic processes body tissues;
- Plasmapheresis;
- Prescription of steroidal and non-steroidal anti-inflammatory drugs, immunosuppressants.

Treatment of autoimmune diseases is a long-term systematic process under the supervision of a physician.