About Autoimmune Disease
Background - what are autoimmune diseases?
Autoimmune diseases occur when the body’s immune system mistakenly attacks its own healthy cells and tissues. Instead of targeting external threats like viruses or bacteria, the immune system becomes overactive or misdirected, leading to inflammation and damage.
There are over 80 types of autoimmune diseases, with several listed in the table below. Some of the more well-known autoimmune diseases include rheumatoid arthritis, type 1 diabetes, lupus, and multiple sclerosis. Symptoms often include fatigue, inflammation, pain, and organ-specific issues, depending on the condition.
Autoimmune diseases are a group of conditions where the immune system plays a major role in the development of disease by attacking ‘self’.
| Examples of autoimmune diseases |
|---|
| Hashimoto’s thyroiditis/hypothyroidism Type 1 diabetes Rheumatoid arthritis Systemic lupus erythematosus Scleroderma Ankylosing spondylitis Multiple sclerosis Crohn’s disease Ulcerative colitis Autoimmune hepatitis Autoimmune interstitial lung disease |
In total, autoimmune diseases affect up to 10% of the population and lead to substantial morbidity, mortality and financial costs. As such, prevention of autoimmune diseases would be a substantial benefit to public health.
There is a growing understanding that many autoimmune diseases have “preclinical” stages of disease development that can be identified by the presence of biomarkers or other risk factors for disease (e.g. family history) in the absence of clinically-apparent organ injury. In other words, individuals who are at-risk for many autoimmune diseases can be identified before they feel ‘sick’.
Examples of preclinical stages of autoimmune diseases include the following:
- Circulating rheumatoid arthritis-related autoantibodies (including antibodies to citrullinated protein antigens [ACPA]) in absence of inflammatory arthritis.
- Family history of rheumatoid arthritis conferring a 3-5-fold increased risk for future RA
- Circulating autoantibodies to pancreatic antigens prior to abnormal blood sugar in type 1 diabetes
- Circulating anti-thyroid antibodies prior to clinical loss of thyroid function
Importantly, while the specific etiologies differ across types of autoimmune diseases, in general these diseases develop through interactions between genetics and the environment – factors which can be studied to identify ways to understand how autoimmune diseases – and ultimately to understand how to prevent future ‘full-blown’ disease.
Excitingly, the discovery of ‘preclinical’ periods of autoimmune diseases has led to clinical prevention trials for several autoimmune diseases including type 1 diabetes, rheumatoid arthritis and systemic lupus erythematosus. Notably, there is now a Food and Drug Administration-approved medication that can be used to delay the onset of type 1 diabetes.
The ADPC focuses on rheumatic autoimmune diseases with a particular focus at this time in RA and pre-RA.