The immune system is complex and researchers are still trying to fully understand its mechanisms of action. If you're struggling to understand what “autoimmune” means, you're not alone. Implicated in the development of autoimmune disease are a combination of genetics, exposures to antigens and leaky gut (intestinal permeability). Natural therapies aim to support the digestive system and reduce inflammation through diet, probiotics and supportive nutrients.
Acute immunity and Autoimmune disease
It is helpful to have a basic understanding about the differences between an acute illness and an autoimmune disease.
Acute illness
Acute illness is simple enough – a pathogen (i.e. bad guys like a parasite, bacteria or virus) invades the body, and the immune system mounts a response to seek and destroy the bad guys.
On a molecular level, we know that B-cells stay put in the lymphatic system, and produce antibodies that go forth through the blood and attack the bad guys on their behalf.
T-cells are the front-line defenders who race to the site of infection and directly attack the pathogens. In normal circumstances, if these cells begin to attack the body itself, they are eliminated by other cells.
Autoimmune disease
Autoimmune disease is more complicated. It can be simplified by saying that the body is “attacking itself”. There is a healthy level of autoimmunity – for example, the recognition and destruction of cancer cells by CD8+ T cells is an important function of healthy autoimmunity. But when these self-regulating functions get the wrong message, an autoimmune cascade occurs. This results in damage or total destruction of the body's own tissue, with altered organ function and/or growth. For example, in type 1 diabetes, autoantibodies attack the pancreas, destroying the cells that are needed to produce insulin.
What Causes Autoimmune Disease?
We don't completely understand what causes autoimmune diseases, but the “Autoimmune Triad” was identified by Alessio Fasano, M.D., a renowned gastroenterologist. He stated that all autoimmune disease have three things in common:
- genetic predisposition
- exposure to antigens and
- increased intestinal permeability [1]
Genetic Predisposition
“It runs in the family”. Genes hold all the possibilities of what could develop in your body through your lifetime – autoimmune conditions may be in there! The nature of autoimmune genetics is complex, but we do know that there must be genes in place in order for an autoimmune condition to occur. If your family tree is free from autoimmune conditions, then it is impossible for you to develop one.
However the more family members you have with autoimmune conditions of any kind, the more likely you will be to develop one. The strange thing is that not every member in the family will get the same autoimmune condition. One relative may suffer from Hashimoto's thyroiditis, another from rheumatoid, asthma, and another from SLE. And another may not develop any at all!
Exposure to antigens
Genes are like a loaded gun, and particular antigens are the trigger that sets it off. For an immune cell to attack anything, it must first be exposed to an antigen – a “flag” on the cell membrane that signals the immune system to attack. Viruses, fungi, bacteria, toxins, drugs, and foreign bodies all contain antigens that the immune system can recognise and mount a response against.
Our own cell membranes also present antigens, but for most of us our immune systems learn to recognise these are harmless and does not react against them. In autoimmune conditions, the immune system mistakes self-antigens for a look-alike foreign antigen that it has attacked in the past. It then mounts an attack on the actually-harmless tissue or cell.
This kind of response can be as a result of:
- infection by certain pathogens that “confuse” the immune system. Viruses, such as Epstein-Barr or cytolomegaly viruses, have been implicated in the onset of type 1 diabetes, for example.
- a chronically disregulated immune system due to nutritional deficiencies, or long-term inflammation or infection.
- leaky gut, as large foreign pathogens get into the body through intestinal permeability
Increased Intestinal Permeability
Increased intestinal permeability (aka “leaky gut”) refers to gaps between the cells of the large intestine, which act as “channels” for large pathogenic antigens to enter the body. It is associated with many autoimmune conditions including multiple sclerosis, Chrons disease and Hashimoto's thyroiditis [1].
According to Alessio Fasano, leaky gut also contributes to dysfunction of the immune system in all individuals [1]. As our largest area of defence against environmental pathogens, the gut wall is an important regulator of the immune system. Compromise to this barrier (as in leaky gut) puts the immune system on “high alert”, thereby increasing the chances of immune cells mistaking self-antigens for pathogens, and triggering an autoimmune attack.
What Does Inflammation Have to do with Autoimmune Disease?
Inflammation in the gut is a major cause of leaky gut and a symptom of it. Throughout the rest of the body, inflammation propels the immune system to stay in a heightened autoimmune state, and contributes to painful and sometimes debilitating symptoms.
The symptoms and continued destruction of autoimmune activity is propelled through a feedback loop of inflammation – the inflammation causes organ destruction, and organ destruction results in more inflammation. Reducing inflammation throughout the body may prevent the onset of a genetic autoimmune condition, and managing inflammation may help to reduce symptoms after an autoimmune condition has been triggered.
Treating Autoimmune Disease with natural therapies
Gut flora
The bacteria within the large bowel ferments food as it passes through our systems. The bi-products of this fermentation differs between types of bacteria, and can either help or hinder the health of our intestinal cells. By supporting the activity of “healthy” bacteria in our gut, we can prevent or treat leaky gut, thereby reducing inflammation, pathogenic antigens, and immune system reactivity.
A diet rich in fibre, antioxidants and healthy fats will support beneficial bacteria, while refined sugar, alcohol, caffeine and stress kill the good bugs and feed the bad guys.
A good quality probiotic. Once a supportive diet is in place, you can boost levels of good bacteria by taking a high quality probiotic. Species to look for include Lactobacillus rhamnosus and Bifidobacterium breve which have been shown to modulate immune function in autoimmune disease [2]. Seek advice from a qualified naturopath or nutritionist to identify which strains will help your particular autoimmune picture.
Fish Oil
A recent meta-analysis of 18 randomized controlled trials showed that supplementing with fish oil can significantly reduce inflammation throughout the body, particularly in people suffering from autoimmune conditions [5]. It has also been suggested that the incorporation of omega-3 into the membrane of immune cells may positively alter their function [6]. It may be through this modulation of inflammation and immune function that fish consumption has been shown to reduce the risk of onset of many autoimmune conditions such as latent autoimmune diabetes in adults [7], thyroiditis [8], and inflammatory bowel disease [9].
Turmeric
This bright orange root has been getting a lot of press recently, and with good reason. Numerous studies have shown it to be a powerful anti-inflammatory with direct impact on immune cell reactions in autoimmune conditions [3] [4]. Note that reducing inflammation throughout the body also includes reducing inflammation in the gastrointestinal system – thereby creating a nice habitat for beneficial bacteria, and reducing leaky gut!
Boswellia
Boswellia, also known as frankincense, is a sacred herb used for centuries for its pain-relieving properties. Not only is its gum an effective analgesic, but recent research has shown that its active component, boswellic acid, also reduces self-antibodies in autoimmune conditions. This may be due to its anti-inflammatory action, or by acting directly on the immune system [10].
The information provided is not intended to be used for diagnosis or treatment. If you are experiencing any health concerns, please consult your doctor for advice.
References
- [1] Fassano, A. (2012) Leaky gut and autoimmune diseases. Clin Rev Allergy Immunol., 42:1, 71 – 78. https://www.ncbi.nlm.nih.gov/pubmed/22109896
- [2] Braat, H., et al. (2004) Lactobacillus rhamnosus induces peripheral hyporesponsiveness in stimulated CD4+ T cells via modulation of dendritic cell function. American Journal of Clinical Nutrition, 80:6, 1618 – 1625. http://ajcn.nutrition.org/content/80/6/1618.full
- [3] Zheng, M., et al. (2013) Curcumin induces apoptotic cell death of activated human CD4+ T cells via increasing endoplasmic reticulum stress and mitochondrial dysfunction. Int Immunopharmacol., 15:3, 517 – 523. https://www.ncbi.nlm.nih.gov/pubmed/23415873
[4] Bright, J. J. (2007) Curcumin and autoimmune disease. Adv Exp Med Biol., 595, 425 – 451. https://www.ncbi.nlm.nih.gov/pubmed/17569223
- [5] Jiang, J., et al. (2016) Effect of Marine-Derived n-3 Polyunsaturated Fatty Acids on Major Eicosanoids: A Systematic Review and Meta-Analysis from 18 Randomized Controlled Trials. PLoS One. https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/26808318/
- [4] Calder, P. C. (2013) n-3 fatty acids, inflammation and immunity: new mechanisms to explain old actions. Proc Nutr Soc., 72:3, 326 – 336. https://www.ncbi.nlm.nih.gov/pubmed/23668691
- [7] Löfvenborg, J. E. (2014) Fatty fish consumption and risk of latent autoimmune diabetes in adults. Nutr Diabetes, 4:10, e139. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4216999/
- [8] Benvenga, S., et al. (2016) Type of fish consumed and thyroid autoimmunity in pregnancy and postpartum. Endocrine, 52:1, 120 – 129.https://dx.doi.org/10.1007/s12020-015-0698-3
- [9] Parian, A. & Limketkai, B. N. (2016) Dietary Supplement Therapies for Inflammatory Bowel Disease: Crohn's Disease and Ulcerative Colitis. Curr Pharm Des., 22:2, 180 – 188. https://www.ncbi.nlm.nih.gov/pubmed/26561079
- [10] Ammon, H. P. (2010) Modulation of the immune system by Boswellia serrata extracts and boswellic acids. Phytomedicine, 17:11, 862 – 867. https://www.ncbi.nlm.nih.gov/pubmed/20696559
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