What are autoimmune diseases. Autoimmune diseases: a 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-treatment, and what difficulties people with autoimmune diseases face in Russia.

There is no one doctor for all

The human immune system normally recognizes "own" 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 faces 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 in a particular 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, for example, systemic red or Sjögren's disease. Rheumatologists also work with patients who are affected musculoskeletal system such as 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 (general practitioner, or GP), who determines what other examination to conduct and which narrow specialist direct. In Russia, the function of a general practitioner is usually performed by a general practitioner. True, this system is not ideal and it meets two extremes. It happens that everyone who is difficult to diagnose is sent with the words: “Go to a rheumatologist, you have some kind of incomprehensible disease, let them figure it out.” After the examination, a disease of a completely different profile may be detected - 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 a 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, should have a broad outlook, constantly improve and understand all the new nuances.

Associate Professor, Candidate of Medical Sciences, rheumatologist at the K + 31 Medical Center Ilya Smitienko notes that the majority 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, and Paget's disease. It is important to understand that rheumatic diseases are not always autoimmune; for example, gout is a joint problem 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 illogical, 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 a therapist. For two months they dragged me around the offices and forced me 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 began to hurt the stomach.

Soon came gastritis, then erosive damage to the esophagus, and after another year gallbladder filled with stones by three quarters and the question arose of its removal. I spent all my free time either at home or in clinics, I stopped getting in touch with friends. Money for new clothes, basic necessities and a cafe or a movie was no longer enough. This year, my gallbladder was removed, and then the tonsils - they considered that they were the starting point for arthritis. Now the problem is that I can’t get to a free rheumatologist: the 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 is equally common in men and women. Why there is a failure in the immune system - no one knows for sure. A certain role is played by harmful bacteria and viruses, as well as heredity - 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 is not yet clear.

According to Oleg Borodin, one of these little-studied factors is gender and related hormones. The expert explains that the immune system of women is more perfect than that of men, and women, for example, are easier to tolerate infectious diseases. And since the immunity of women is “stronger” than that of men, then it is subject to failures more often.

Ekaterina G.

I developed rheumatoid arthritis at the age of 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 began to hurt terribly at night, I was taken to a regular children's clinic. The pediatric rheumatologist said that it was a “growing pain”, no medications were prescribed, no examinations were carried out. They said just wait.

hard to recognize

Rheumatic diseases are among the most difficult to diagnose and treat. They manifest themselves in very different ways, and it is difficult to suspect them, especially when it comes to rare diseases or those that are slowly progressing. For example, joint pain or high fever are non-specific - that is, they may be signs of the most different problems with health. Before the cause of the ailment is found, many examinations will have to be carried out - after all, the more common and obvious causes must first be ruled out.

Of course, on psychological state patients, these difficulties are also affected. According to Irina Babina, any person wants to understand why he fell ill and whether such a disease can be prevented in children and relatives, but today doctors do not have answers to these questions. At the same time, the prospect of taking medications is also 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 all the time, all your life.

Tatyana T.

In 2002, I began to feel bad: my legs hurt, my head hurt, I was short of breath, everything was blurry before my eyes. I went to the doctor, they did some tests, but nothing was found. They 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. Shortness of breath continued, and the doctor laughed at my complaints about the fear of suffocating at night and asked me not to tell anyone else about this - otherwise they would be sent to a psychiatric hospital.

Then for almost ten years I did not go to the doctors - after all, at the first attempt, nothing was found in me. At the same time, I constantly felt bad, but in 2010 everything worsened: the pressure constantly jumped, the joints barely moved. I couldn't go to the doctor in winter because my head hurt when I tried to put on a hat. At night, my whole body was numb, and the dryness in my mouth was almost unbearable. In the mornings, the first thing I did was open the door - I was afraid that I would faint and not have time to call an ambulance, and hoped for the neighbors. This went on for several months.

Medications and difficulties with them

Medicine is not the most exact science, and, by and large, the unambiguous causes of pathology are understood only with infections or injuries. True, for successful treatment, the cause may not be known - it is enough to understand the mechanism, that is, how the process develops. Since we are talking about attacking the body with its own immune system, the essence of treatment is to suppress this attack. For this, 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 another group of medicines: these are modern biological agents obtained by methods 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 deprived of them at all). Treatment with biological agents can cost 50-100 thousand rubles a month and should be long - and in order for it to become available at the expense of the state, you need to go through many formalities, including applying for disability. It may take several years - the disease does not wait and progresses during this time. At the same time, not all modern drugs generally registered in Russia, often their appearance is 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 fatal half a century ago, and there was no question of pregnancy - 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. True, for some rheumatic diseases, there are still no drugs with proven effectiveness. A separate complexity is processes with the so-called catastrophic, or lightning-fast, development; in a very short time on the background full health severe insufficiency of many organs develops at once. To make a diagnosis and start treatment, the doctor has a few hours or even minutes - and in such situations, mortality is still very high.

Experts agree that the active participation of the patient himself, his cooperation with the doctor is very important. Work is underway to make treatment more accessible, and to include common and severe rheumatic diseases in the lists of reimbursed drugs. True, there are difficulties here too: often, instead of original drugs, generic drugs are included in the lists, which are theoretically just as effective, but in practice behave imperfectly.

Irina Babina talks about a patient with systemic lupus erythematosus who needed an off-list drug. At the Research Institute of Rheumatology, a commission was assembled from reputable doctors and scientists to analyze this particular case, and as a result, the woman began to receive free the right medicine. Probably, once such problems will be solved in the working order, but so far such cases are rare. According to Oleg Borodin, another problem is the disappearance from the market of some drugs that, for one reason or another, are not renewed in the country. If a well-suited drug disappears, doctors must look for a replacement, re-test tolerability and efficacy - and there is no guarantee that this replacement will be equivalent.

Ekaterina G.

A couple of times there were interruptions with the drug, and I managed to knock it out almost at the last moment. You can say that I was lucky. During my treatment, I met several people who similar preparations they just stopped giving out - and some of them cost 40 thousand rubles, others - 80. permanent basis to buy such a majority of the inhabitants of the Chelyabinsk region, of course, is beyond the power. Until now, before each receipt of a new batch of the drug (that is, four to six times a year), I experience wild stress: what if they don’t give me? What if they don’t have time to bring it and I start to get aggravated?

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

Self-treatment

With the advent of the Internet, people rare diseases it became easier to find support. There are groups for patients to communicate on websites, forums and social networks - and, unfortunately, in addition to support and communication, you can find a lot of advice 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 for 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 can alleviate the condition at first - the placebo effect plays a significant role here - but the disease continues to progress, and precious time is lost.

Irina Babina remembers a patient with systemic scleroderma, who turned 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, intermittent vasospasm with blanching and then blue of the fingers, non-healing painful ulcers on the fingertips are noted. “The most terrible discovery awaited me when examining the feet,” the doctor notes. - 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 folk methods - she applied cabbage leaves, made baths with chamomile. The result was the amputation of the toes of both feet.

They are independently treated not only by folk methods. According to Ilya Smitienko, there are cases of abuse of hormonal anti-inflammatory drugs: prednisolone and its analogues. When a person's joints become very inflamed, these hormones temporarily bring relief, and it seems to the person that he did everything right. But in the end, instead of treating the disease, only the symptoms are smoothed out - but undesirable effects can include bone fragility and development.

Tatyana 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 deviated from the norm very much and this happens with pneumonia, cancer or systemic diseases. I was sent to several doctors at once, including an infectious disease specialist and a neurologist. The hematologist suspected myeloma (this is a malignant tumor of the bone marrow); I was very scared.

I went home to "die". Then I thought it would help. healthy eating- always did fresh juices, ate everything boiled, gnawed apples. But then, after all, I donated blood for a complex analysis, and it turned out that I didn’t have any myeloma. Then, I don’t remember why, I again went to the 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 had Sjögren's disease - an autoimmune disease.

Social complexities

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 bypass many instances - patients joke that a person with a disability must be in enviable health in order to receive social benefits. It's no secret that few things are equipped with ramps and lifts - and sometimes they are made as if they were designed for stuntmen, and not for people with handicapped. In addition, those who often take sick leave have problems with work.

And even this is just the tip of the iceberg, there are discussions on the patient forums of everyday difficulties that people face at home or during hospitalization. The list of "what to take to the hospital" includes such non-obvious things as warm woolen bandages to keep warm hip joints, a tray that can be put on a chair and put things on it (so as not to reach for an uncomfortable 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.

Until now, there is no way to objectively assess pain - that is, doctors have no way to either confirm or deny its presence or determine the intensity. Our heroine has fibromyalgia, and she is unable to register her disability because the pain is not recorded by any objective devices. It 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 to be treated, and the pain only intensifies.

Alexandra B.

The number of doctors I visited in four years is hard to even count: therapists, endocrinologists, dermatologists, gynecologists, rheumatologists, neurologists, otolaryngologists, surgeons - this is only part of the list. Every day I struggle with pain in the muscles, joints, stomach - all to no avail. Huge spending of money on one drug grows into another. There is no improvement, but there are new diagnoses. Trying to cure one, 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, come back with difficulty, and then fall on the bed with incredible shortness of breath, dizziness, tachycardia and panic attack. In the bottom line - a huge bouquet various diseases, a large number of medicines in the first aid kit, and the morning begins with the thought that no one can help me except myself.

How are they treated in other countries?

Experts agree: the knowledge and approaches of our doctors are not inferior to Western ones, but the organization 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 preparations, a monstrous bureaucracy when applying for disability or any benefits.

A separate difficulty for Russian patients - 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 all his life. With rheumatic diseases, the body and appearance change, the perception of oneself changes, many restrictions appear - for example, one cannot be under the bright sun. Ideally, support groups are needed, help in overcoming stress. So far, groups on social networks play this role: patients share tips on how to stop reacting to chuckles, comments or sidelong glances, and many say that being different from a passport photo raises questions at airports.

Ekaterina G.

My main complaint is Russian medicine that there are practically no doctors here who would operate with such concepts as "evidence-based medicine" and "quality of life of the patient." There were less than a dozen of those who even tried to explain to me what was happening to me and how they were going to treat me, and not just throwing statements, there were less than a dozen in twenty-six years of illness.

AUTOIMMUNE AND IMMUNE COMPLEX DISEASES

AUTOIMMUNE DISEASES

Autoimmune diseases are quite widespread in the human population: up to 5% of the world's population suffers from them. For example, 6.5 million people in the United States suffer from rheumatoid arthritis, up to 1% of adults in large cities in England are disabled with multiple sclerosis, and juvenile diabetes affects up to 0.5% of the world's population. 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 their own healthy cells and tissues. The former develop in a healthy body, proceed continuously and carry out the elimination of dying, aging, diseased cells, and also occur 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 autoantigens. Often, the development of an autoimmune syndrome further turns 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 particular organ. Most often, these are trans-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. With non-organ-specific 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 (they 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 lupus erythematosus, 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, deposited in the body, cause its pathology. These diseases include primary biliary cirrhosis, Sjögren's syndrome, ulcerative colitis, celiac disease, Goodpasture's syndrome, type 1 diabetes mellitus, an autoimmune form of bronchial asthma.

Mechanisms of development of autoimmune reactions

One of the main mechanisms that prevent the development of autoimmune aggression in the body against its own tissues is the formation of non-response to them, called immunological tolerance. It is not congenital, it is formed in the embryonic period and consists in 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 result, the formation of autoimmunity. As Burnet noted in his theory, in the embryonic period, the contact of such autoreactive clones with "their" antigen causes not activation, but cell death.

However, not all so simple.

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

autoreactive T cells are still not eliminated and come from the thymus to the periphery. It is they who provide the autoimmune "noise". However, as a rule, these cells have a reduced functional activity and do not cause pathological reactions, just like autoreactive B-lymphocytes, which are subjected to negative selection and avoided elimination, also cannot cause a full-fledged autoimmune response, since they do not receive a costimulatory signal from T-helpers, and in addition, they can be suppressed by special suppressor veto -cells.

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

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

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

Such a violation can be caused by: (1) a decrease in the suppressor activity of cells, (2) the appearance in the bloodstream of trans-barrier ("sequestered" antigens of the eye, gonads, brain, cranial nerves, with which the immune system normally does not have contact even 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 a modification of their specificity, (5) an 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 non-organ-specific diseases, autoreactive T-lymphocytes most likely 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 T-cell co-stimulatory factor and synthesize autoantibodies, themselves have the ability to present mimic antigen without an AH-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 formed by B-lymphocytes, of particular interest are natural autoantibodies to autologous antigens, which in a considerable percentage of cases are detected and stored 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 auto-Abs or sensitized LF directed against auto-AG associated with this 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 antibodies or sensitized LF in the modeling of 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 still insufficient for the development of an autoimmune disease. 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, the use of various medications, immunity disorders, including cytokine balance.

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

1. Despite the self-control system, there are autoreactive T- and B-lymphocytes in the body, which, under certain conditions, interact with the antigens of normal tissues, destroy them, contributing to the release of latent autoantigens, stimulants, mitogens that activate cells, including B-lymphocytes.

2. In case of injuries, infections, degenerations, inflammation, etc. "sequestered" (beyond the barrier) autoantigens are isolated, against which autoantibodies are produced that destroy organs and tissues.

3. Cross-reactive "mimic" AG of microorganisms, common with autoantigens of normal tissues. Being in the body for a long time, they eliminate tolerance, activate B-cells for the synthesis of aggressive autoantibodies: for example, group A hemolytic streptococcus and rheumatic damage to the heart valves and joints.

4. "Superantigens" - toxic proteins formed by cocci and retroviruses, causing the strongest activation of lymphocytes. For example, normal antigens only activate 1 in 10,000 T cells, while 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 the microorganism contains it, a chronic infection occurs, destroying tissues and releasing various autoAGs, to which an autoimmune response develops.

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

7. Under certain conditions, autoantibodies “blind” LF by blocking their receptors that recognize “own” 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 modifying the activity of autoantigens-oncogenes, regulators of cytokine production and their receptors.

3. Decreased apoptosis of T-helpers that activate B-lymphocytes. Moreover, in the absence of a proliferative stimulus, B-lymphocytes die from apoptosis, while in autoimmune diseases it is suppressed and, on the contrary, such cells 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 specific T-regulatory CD4+CD25+ T-lymphocytes with the expression of the FoxP3 gene, which block the proliferation of autoreactive T-lymphocytes, which significantly enhances it.

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

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

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

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

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

Association of autoimmune diseases with other diseases

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

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

Table 1. Rheumatic autoimmune pathology in malignant neoplasms

So, 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 sclero-like syndromes are accompanied by malignant tumors of various localization, and polymyalgia rheumatica and cryoglobulinemia, respectively, by cancer of the lungs, bronchi and a syndrome of increased blood viscosity.

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 often occur in 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 is increased by 40 times.

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

Table 2. Malignant tumors and rheumatic diseases

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

In primary immunodeficiencies, signs of autoimmune processes are often found. High frequency autoimmune disorders revealed in sex-linked hypogammaglobulinemia, IgA deficiency, immunodeficiencies with hyperproduction of IgA, ataxia-telangiectasia, thymoma, 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 more pronounced (with SLE in 50-90% of cases) than in organ-specific diseases (with thyroiditis in 20-40% of cases).

Autoantibodies are more common in the elderly. This applies to the determination of rheumatoid and antinuclear factors, as well as antibodies detected in the Wasserman reaction. In 70-year-old people without corresponding clinical manifestations, autoantibodies against various tissues and cells are found in at least 60% of cases.

Common in the clinic 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 (in part, the information provided is borrowed from S.V. Suchkov).

Characteristics of some autoimmune diseases

Systemic lupus erythematosus

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

With this pathology, antinuclear autoantibodies are formed to DNA, including native, nucleoproteins, antigens of the cytoplasm and cytoskeleton, microbial proteins. It is believed that auto-ATs to DNA appear as a result of the formation of its immunogenic form in a complex with a protein, or an IgM autoantibody of anti-DNA specificity that arose in the embryonic period, or the interaction of an idiotype-anti-idiotype and cell components during a microbial or viral infection. Possibly, a certain role belongs to cell apoptosis, which in SLE, under the influence of caspase 3, causes cleavage of the nucleoproteosome 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 in DNA-binding autoantibodies also of the enzymatic ability to hydrolyze the DNA molecule without complement. Such an antibody was called a DNA abzyme. There is no doubt that this fundamental regularity, which, as it turned out, is realized not only in SLE, is of great importance in the pathogenesis of autoimmune diseases. With this model of anti-DNA, the autoantibody has cytotoxic activity against 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 Fc fragments of immunoglobulin G and are called rheumatoid factor (RF). In addition to them, autoantibodies to keratohyalin grains (antiperinuclear factor), keratin (antikeratin antibodies), and collagen are synthesized. Significantly, 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 makes it possible to classify seropositive or seronegative RA, and IgA-RF is a criterion for a highly active process.

In the synovial fluid of the joints, autoreactive T-lymphocytes were found that cause inflammation, in which macrophages are involved, enhancing it with secreted pro-inflammatory cytokines, followed by the formation of synovial hyperplasia and cartilage damage. These facts led to the emergence of a hypothesis that allows the initiation of the autoimmune process by type 1 T-helper cells activated by an unknown epitope with a co-stimulatory molecule, which destroy the joint.

Autoimmune thyroiditis Hoshimoto

thyroid disease associated with functional inferiority with aseptic inflammation of the parenchyma, which is often infiltrated with lymphocytes and subsequently replaced by connective tissue that forms seals 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 with myxedema, cell surface and cytoplasmic proteins. In general, autoantibodies to thyroglobulin, thyroid-stimulating hormone receptor and thyroperoxidase have a key effect on thyroid function, they are also used in the diagnosis of pathology. Autoantibodies inhibit the synthesis of thyroid hormones, which affects its function. At the same time, B-lymphocytes can bind to autoantigens (epitopes), thereby affecting the proliferation of both types of T-helpers, which is accompanied by the development of an autoimmune disease.

Autoimmune myocarditis

In this disease, a key role belongs to a viral infection, which is most likely its trigger. It is with him that the role of mimicking antigens is most clearly traced.

Patients with this pathology have autoantibodies to cardiomyosin, myocyte outer membrane receptors, and, most importantly, to Coxsackie virus proteins and cytomegaloviruses. It is significant that during these infections a very high viremia is detected in the blood, viral antigens in the 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, tk. do not need 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 of autoreactive T-lymphocytes is also sharply enhanced and facilitated by an increase in the expression of class II HLA molecules on cardiomyocytes. Those. autoantigens of myocardiocytes are recognized by T-helpers. The development of an autoimmune process and a viral infection behaves very typically: at first, a powerful viremia and high titers of antiviral autoantibodies, then a decrease in viremia up to virus negativity and antiviral antibodies, an increase in antimyocardial autoantibodies with the development of an 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, the suppression of T-cells was accompanied by a sharp positive therapeutic effect.

Myasthenia gravis

In this disease, autoantibodies to acetylcholine receptors play a key role, blocking their interaction with acetylcholine, completely suppressing the function of the receptors or sharply enhancing it. The consequence of such processes is a violation of the translation of the nerve impulse up to a sharp muscle weakness and even respiratory arrest.

A significant role in the pathology belongs to T-lymphocytes and disruption 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, the key role belongs to the mimic antigens of pathogens that have common determinants with eye tissues. With this disease, autoantibodies to autoantigens of the eye tissue and microbial proteins appear. This pathology is truly autoimmune, since the introduction of five purified eye antigens into experimental animals causes the development of classical autoimmune uveitis in them due to the formation of the corresponding autoantibodies and their 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 appear to be sensitized to intracellular glutamic acid decarboxylase and the 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 perspectives: (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) other immunopathological processes develop in diabetes, 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 relapsing autoimmune inflammatory disease primarily of the colon

with segmental lesions of the entire intestinal wall with lymphocytic granulomas, followed by the formation of penetrating slit-like ulcers. The disease occurs with a frequency of 1:4000, young women are more likely to suffer. It is associated with the HLA-B27 antigen and is due to 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 mimic 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 of successful treatment this disease with antibodies to β-TNF, which suppress the activity of autoreactive T-lymphocytes.

Multiple sclerosis

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

The body's defenses are aimed at maintaining its stable state and destroying pathogenic agents. Special cells fight pests and contribute to their removal from the internal environment. It happens that a violation 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 boils down to the fact that an overly active immune system begins to attack individual tissues, organs or entire systems, due to which their work fails. Autoimmune diseases, what is it and why do they occur? The mechanism of the origin of such processes is still not completely clear to researchers in the field of medicine. There are a number of reasons for failures in the immune system. 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 vary. However, there general group conditions, which suggests the idea of the development of autoimmune diseases:

drastic loss weight.
Weight gain in combination with rapid fatigue.
Joint and muscle pain for no apparent reason.
A decrease in the quality of mental activity - a person does not concentrate well at work, he has a cloudy mind.
Common auto immune response- rash on the skin. The condition is exacerbated by sun exposure and the consumption of certain foods.
Dryness of mucous membranes and skin. The eyes and mouth are mostly 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, discoloration of feces 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 alien. The task of specialists is to appoint lab tests and determine which highly active cells are present in the blood. When diagnosing, the attending physician relies on the presence of markers of autoimmune diseases - antibodies to substances that are natural for the human body.

Autoimmune disease markers are agents whose action is aimed at neutralizing:

yeast Saccharomyces cerevisiae;
double-stranded native DNA;
extractable nuclear antigens;
neutrophilic 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 dealing with 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 causes an autoimmune disease.

Among other likely factors of autoimmune disorders, scientists identify:

Gene mutations that are influenced by heredity.
Transferred severe infections.
Penetration into the internal environment of viruses that can take the form of body cells.
Adverse Influence environment– radiation, atmospheric, water and soil pollution by chemicals.

Consequences

Nearly all autoimmune diseases occur in women, women are especially vulnerable childbearing age. Men suffer from disorientation of lymphocytes much less frequently. However, the consequences of these pathologies are equally negative for everyone, especially if the patient does not receive maintenance therapy. Autoimmune processes threaten the destruction of body tissues (one or more types), uncontrolled growth of an organ, and changes in organ functions. Some diseases significantly increase the risk of cancer of any localization 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 interfere with hormonal, cardiovascular, nervous system, cause diseases of the musculoskeletal system, affect the skin, hair, nails and more. At home, these diseases cannot be cured, the patient needs qualified help. medical personnel.

Blood

Hematologists are involved in the 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 spots raised 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 (Basedow's disease, or Graves' disease), the second hormones are less than normal (Hashimoto's thyroiditis). Autoimmune processes in the thyroid gland lead to the occurrence of primary hypothyroidism. Patients are examined by an endocrinologist or family therapist. Anti-TPO (thyroid peroxidase) antibodies are a marker of autoimmune thyroid disease.

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 a thyrotoxicosis disease occurs, the patient experiences mood swings, heart palpitations, fever, disruptions in menstrual cycle, strength reduction 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:

Hyena-Bare syndrome;
myasthenia gravis.

joints

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

Treatment Methods

With a specific autoimmune disease, specialized treatment is prescribed. A referral for a blood test is issued, which reveals markers of pathology. In case of systemic diseases (, systemic lupus erythematosus, Sjögren's syndrome), it is necessary to get advice from several specialists and approach treatment in a complex manner. This process will be lengthy, but with proper therapy it will allow you to live quality and long.

drugs

Mostly, the treatment of diseases is aimed at a strong decrease in the activity of the immune system, for which the patient needs to take special drugs - immunosuppressants. These include such 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 all the time. The use of immunomodulators, on the contrary, is often considered a contraindication for such therapy.

With autoimmune therapy

In autoimmune diseases, corticosteroid drugs are also used. They are also aimed at suppressing the body's defenses, but still have an anti-inflammatory effect. It is undesirable to use these drugs long time because they give a lot of side effects. In some cases, for the treatment of autoimmune diseases resort to blood transfusion - plasmapheresis. Highly active antibodies are removed from the blood, then it is transfused back.

Folk remedies

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

Video about the disease of the autoimmune system

Autoimmune diseases are such a broad group of pathologies that one can talk about it for a very long time. Scientists from all over the world are still arguing about the origin, methods of treatment and manifestations of individual diseases. Your attention is presented to the release of the program "Be Healthy", in which experts talk about the essence of autoimmune processes, the most common pathologies, recommendations for maintaining health.

What are autoimmune diseases?

As the name suggests, autoimmune diseases are diseases caused by our own immune system. For some reason, white blood cells begin to consider a certain type of cell in our body as foreign and dangerous. That is why autoimmune diseases are complex or systemic. Amazed immediately whole organ or group of organs. Human body launches, figuratively speaking, a program of self-destruction. Why is this happening, and is it possible to protect yourself from this disaster?

Among lymphocytes, there is a special "caste" of orderly cells: they are tuned to the protein of the body's own tissues, and if any 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 the strict control of the body. But alas, the situation sometimes develops, as if according to the scenario of an action-packed action movie: everything that can get out of control, gets out of it and takes up arms.

The causes of uncontrolled reproduction and aggression of paramedical lymphocytes can be divided into two types: internal and external.

Internal reasons:

Gene mutations of type I, when lymphocytes cease to identify a certain type of cells of the organism. Having inherited such genetic baggage from their ancestors, a person is more likely to get sick with the same autoimmune disease that his immediate family had. And since the mutation concerns the cells of a particular organ or organ system, it will be, for example, toxic goiter or thyroiditis;

Type II gene mutations, when 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;

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

The "trick" of disease-causing cells that pretend to be very similar to our own, only diseased cells. Lymphocytes-orderlies 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 pursue a person all his life. Very often, doctors are at a loss and cannot make a diagnosis, because the symptoms seem to be erased, or they 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 the timely diagnosis: autoimmune diseases can be very dangerous.

Consider the symptoms of some of them:

Rheumatoid arthritis affects the joints, especially the small ones in the hands. It manifests itself not only with pain, but also with swelling, numbness, high temperature, a feeling of pressure 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 wolfish appetite;

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

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

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 thyroid disease. Its symptoms: drowsiness, roughness skin, strong increase weight, fear of cold;

Hemolytic anemia is an autoimmune disease in which white blood cells turn against red ones. The lack of red blood cells leads to 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 thyroxin, so the symptoms are opposite: weight loss, heat intolerance, increased nervous excitability;

Myasthenia gravis affects muscle tissue. As a result, a person is constantly tormented by weakness. Tired especially quickly eye muscles. The symptoms of myasthenia gravis can be treated with special medications that increase muscle tone;

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

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

Systemic;

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-Bare syndrome;

Diseases of the liver and gastrointestinal tract - biliary cirrhosis of the liver, 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, glomerolupatia and glomerol nephritis (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 lung damage, as well as sarcoidosis and fibrosing alveolitis;

Autoimmune heart disease - myocarditis, vasculitis and rheumatic fever.

Diagnosis of autoimmune diseases

Diagnosis can be made with a special blood test. Doctors know which types of antibodies are indicative of a particular autoimmune disease. But the problem is that sometimes a person suffers and gets sick long years before the GP even thinks of sending the patient to a lab to be tested for autoimmune diseases. If you have strange symptoms, be sure to consult several specialists with a high reputation at once. Do 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 that are treated by specialized doctors. But when it comes to system or mixed forms, you may need the help of several specialists at once:

Neurologist;

Hematologist;

Rheumatologist;

Gastroenterologist;

Cardiologist;

Nephrologist;

Pulmonologist;

Dermatologist;

Until now, they remain an unsolved mystery for modern science. Their essence is to resist immune cells organism to its own cells and tissues, from which human organs are formed. The main reason for this failure are various systemic disorders in the body, as a result of which antigens are formed. The natural response to these processes is increased production leukocytes, which are responsible for devouring foreign bodies.

Classification of autoimmune diseases

Disorders caused due to 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 arises as a result of the 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 alien. Sometimes in the tissues of the epidermis there is a concentration of antigens that have entered the body from the outside, or exoantigens (drugs or bacteria, viruses). The reaction of the body will be directed at them, but in this case, damage will occur to cells that retain antigenic complexes on their membranes. 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 adverse 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 smallest vessels fingers, accompanied by a change in their color as a result of exposure to low temperature or stress, clearly indicates the symptoms of an autoimmune disease called Raynaud's syndrome – scleroderma. The lesion begins in the limbs and then moves to other parts of the body and internal organs, mainly the lungs, stomach and thyroid gland.

For the first time, autoimmune diseases began to be studied in Japan. In 1912, the scientist Hashimoto gave an exhaustive description of diffuse infiltration - a disease of the thyroid gland, which results in its intoxication with thyroxine. Otherwise, this disease is called Hashimoto's disease.

vasculitis

poor appetite

Thyroiditis- inflammatory processes of the thyroid gland, which cause the formation of lymphocytes and antibodies that attack the affected tissues. The body arranges the fight against the inflamed thyroid gland.

Observations of people with various spots on the skin were made 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 with dogs.
In 1842, vitiligo was isolated as a separate disease. Up to this point, it was confused with leprosy.

Vitiligo

Multiple sclerosis- a disease of the nervous system, which is chronic in nature, in which foci of decay of the Myelin sheath of the head and spinal cord. At the same time, multiple scars are formed on the surface of the tissue of the central nervous system (CNS) - neurons are replaced by cells of the connective tissue. 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 prolapse.

Crohn's disease- Chronic inflammation of the gastrointestinal tract.

autoimmune hepatitis- chronic liver disease inflammatory nature accompanied by the presence of autoantibodies and ᵧ-particles.

Allergy- the body's immune response to allergens that it recognizes as potentially dangerous 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 records the rate of their growth in arithmetic order and no downtrend.

- 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 the arteries, systemic lupus erythematosus destroys the internal organs and manifests itself on the skin.

Future mothers belong to a special category of patients. Women are five times more likely to have autoimmune lesions than men, and most commonly appear during their reproductive years, particularly during pregnancy. The most common in pregnant women are: multiple sclerosis, systemic lupus erythematosus, Hashimoto's disease, thyroiditis, thyroid disease.

Some diseases have remission during pregnancy and exacerbation in the postpartum period, while others, on the contrary, are manifested by 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.

A feature of autoimmune diseases is that they occur not only in humans, but also in domestic animals, in particular in 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 injected with corticosteroids or other immunosuppressive drugs in time to reduce the overactivity of the immune system.

Autoimmune Complications

pure form

viral hepatitis

Autoimmune diseases associated with various diseases that caused their appearance usually disappear along with the underlying disease.

The first to study multiple sclerosis and characterize it in his notes was the French psychiatrist Jean-Martin Charcot. A feature of the disease is indiscriminateness: it can occur both in the elderly and in the young and even in children. Multiple sclerosis affects several parts of the central nervous system at the same time, which entails the manifestation in patients various symptoms neurological nature.

Causes of the disease

external

internal factors

probable external factors are stress and adverse influences environment.

Diagnostics 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 in rheumatoid arthritis, more than 50% confirm Sjögren's syndrome and in a third of cases indicate other autoimmune diseases. Many of them are characterized by the same type of development dynamics.

Residual confirmation of the diagnosis requires the delivery of immunological tests. 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 of treating autoimmune diseases. Its methods are aimed at the final stage of the process and can only alleviate the 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 oncological or infectious diseases.

The main methods of modern treatment:

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

The treatment of autoimmune diseases is a long systematic process under the supervision of a physician.