Not too many people realize that many forms of diabetes are caused by our immune system going haywire. Normally, the immune system is our first line of defence against invasive bacterium. But what happens when our system cannot tell friend from foe? In this blog we identify some of the leading autoimmune diseases and the current state of our research, and a potential cure using nanotechnology as the transport mechanism.
What is an Autoimmune Disease?
Autoimmune diseases are inflammatory response diseases caused by our immune system attacking us. They are non-discriminating and can be found in almost every organ and system in the human body. They tend to be chronic conditions continuing throughout the lifetime of the individual. There can be periods of remission followed by reappearance of symptoms. They tend to strike women more than men. Hormones may play a role. But there are some autoimmune disorders that are more prevalent in men such as Type 1 Diabetes.
How significant is the problem? It is estimated that 24 million Americans and 5 percent of the population in Western countries suffer from autoimmune diseases. Compare that to cancer at 12 million Americans and you begin to see the enormity of the problem.
There appears to be a correlation between our genetic inheritance and autoimmune diseases with children tending to develop diseases that appear in parents, and close relatives exhibiting common autoimmune diseases within extended family groups. Multiple sclerosis represents one of the most common autoimmune diseases that tends to run in families.
What confounds the medical field today about autoimmune diseases is finding the smoking gun or guns, the direct causal link that triggers the immune system response. Lots of circumstantial evidence points to viruses, chemical exposure, foods and environmental toxins but doctors and researchers continue to investigate what triggers these diseases. Having a family member who continues to experience an autoimmune disease has made studying this subject very personal to me.
Autoimmune diseases attack every part of the body. The American National Institute of Health identifies at least 80 different autoimmune diseases that include many familiar conditions you probably never thought were caused by our immune system. See how many you know from this partial list.
- Actinic Prurigo – an autoimmune response to the sun
- Addison’s disease – the autoimmune destruction of the Adrenal Gland – a disease that President John Fitzgerald Kennedy suffered from
- Ankylosing Spondylitis – an arthritic condition that attacks the pelvis and spine
- Autoimmune Myocarditis – a condition that effects the heart muscle
- Behcet’s Disease – a disease that causes oral and genital ulcers, and skin and ocular lesions, and can affect arteries and veins throughout the body
- Birdshot Chorioretinopathy – a disease of the retina in the eye that causes flashing lights and night blindness
- Chronic Urticaria and Angioedema – a condition that causes persistent eruptions of hives traced to drug, food reactions, pressure, infection or toxin response
- Celiac Disease – a disorder of the small intestine
- Crohn’s Disease – a disease that effects the entire digestive tract in the body
- Drug Hypersensitivity – a response to drugs leading to fever, skin rash, and internal organ reactions such as hepatitis, pancreatitis, myocarditis, nephritis, intestinal lung disease and muscle inflammation
- Graves’ Disease – a disease of the Thyroid Gland that leads to hyperthyroidism and goiters
- Guillain-Barre Syndrome – a response to infection that results in nerve inflammation, muscle weakness and potential paralysis
- Hemochromatosis – an adult onset disease resulting in progressive iron overload in the body with complications such as cirrhosis of the liver, diabetes, cardiomyopathy, arthritis, and testicular failure
- Hashimoto’s Thyroiditis – a disease of the Thryoid Gland that leads to hypothyroidism
- Hemolytic Anemia – a disease that attacks red blood cells destroying them prematurely
- Juvenile and Type 1 Diabetes – a disease caused by destruction of insulin-producing Pancreatic Islet cells
- Lupus or SLE (Systemic Lupus Erythematosus) – a disease that predominantly strikes women and causes skin, joint, haematologic, neurologic, renal and other organ problems and leads to seizures, psychiatric symptoms, peripheral neuropathies or stroke.
- Multiple Sclerosis – a neurodegenerative disease more common in women that attacks the myelin sheath surrounding nerves affecting coordination, balance and vision as well as many organs in the body
- Myasthenia Gravis – a neuromuscular disease that causes muscle weakness and fatigue.
- Polyarthralgia – a disease that causes inflammation in the joints and is associated with osteoarthritis
- Psoriasis – a chronic inflammatory skin disease
- Raynaud’s Disease – a response associated with other autoimmune disorders that causes blood vessels in the hands and feet to overreact to cold temperatures
- Rheumatic Fever – a disease that may occur after a Streptococcal or other infection causing lesions in connective tissue, particularly the heart
- Rheumatoid Arthritis – a chronic inflammatory arthritis that causes deformation of joints
- Scleroderma – a disease that affects tissue fibre, particularly the skin, lungs, gastrointestinal tract, heart, small blood vessels and capillaries
- Sjogrens – a disease that attacks the salivary and tear glands
- Thrombocytopenia – a disease that effects blood platelet production leading to abnormal bleeding
- Ulcerative Colitis – a disease that causes inflammation and ulcers in the large intestine
- Uveitis – an eye disease that leads to blindness
Today’s Autoimmune Controls Create Their Own Problems
Currently autoimmune disease treatment is all about reducing or reversing symptoms. In the case of diabetes we treat sufferers with insulin rather than restore pancreatic cell function. In the case of many of the inflammatory responses from autoimmune diseases we treat patients with a cocktail of drugs that include prednisone and other corticosteroids, anti-inflammatories like aspirin, acid blockers, antihistamines and immune suppression drugs (the kind used to stop rejection in organ transplants). In many cases the side affects of these drug cocktails proves to be worse than the diseases.
HLA, T and B, Autoimmune Diseases and a Potential Cure
When scientists and researchers talk about the immune system the letters in the above title become part of the conversation.
What is HLA?
What does T refer to?
What is the B all about?
HLA stands for Human Leukocyte Antigen, the genes that reside on the 6th chromosome in our cells and that govern immune response. The proteins associated with these genes are called antigens.
The T and B refer to different types of leukocytes, the white blood cells that reside in our circulatory systems and marshal our response to infections. The T and the B refer to T-cells, and B-cells. In addition there are sub-categories to leukocyte groups. One is the T-regulatory cell or T-reg and researchers study it because these cells play a role in regulating the level of immune response by other leukocytes.
If we could develop a technology to stop specific unhelpful autoimmune reactions while allowing our normal immune response to deal with unwanted bacterium and viruses then we would be making a big leap forward in our ability to deal with autoimmune diseases. That’s exactly what researchers at the University of Calgary in Alberta, Canada, have been working on using nanotechnology as the delivery mechanism for a vaccine that cures Type 1 Diabetes and has implications for other autoimmune disorders.
Dr. Pere Santamaria works at the Julia McFarlane Diabetes ResearcherCentre in the University’s Faculty of Medicine.
Working with mice with Type 1 Diabetes, Dr. Santamaria and his team looked at stopping the autoimmune response that damages the pancreas leading to the condition. They studied the behaviour of specific T-cells responsible for the disease and the T-reg cells whose role is to inhibit the former from attacking healthy host tissue. Their goal was to strengthen the T-reg cells to stop the destructive autoimmune response. Using synthetic iron oxide nanoparticles and a cocktail of antigens from insulin producing cells, the team created a vaccine that could be directed at the autoimmune attack, strengthening the T-reg cells. The treatment not only restored normal blood sugar and insulin levels in the mice, it also prevented the onset of the disease. At the same time the vaccine treatment did not compromise the rest of the immune system.
The implication of using nanovaccines such as the one Dr. Santamaria’s team developed to treat other chronic autoimmune diseases is enormous. For those who suffer from one or more of that long list of autoimmune diseases described above, this is technology with great promise.