Medicine: Autoimmune Diseases and the potential role of Chinese Herbal Medicine

Autoimmune Diseases and the potential role of Chinese Herbal Medicine

Medicine: Autoimmune Diseases

Autoimmune diseases are chronic disorders that have been difficult, and often impossible, to cure. There can be remission of symptoms - spontaneously or as the result of applied therapies - but the potential for return of the disease remains in almost all cases. The characteristic of these diseases is immune system targeting of body components, so that these components are damaged, either temporarily or permanently, or their activities are altered. The autoimmune diseases almost always have a significant genetic component; in addition many of the diseases in this category appear to have a viral or other infectious agent as a trigger for onset of the autoimmune status. There may be a variety of other factors that are important to finally set off a pattern of symptomatic disease so that its first manifestation may be after age 20 (there are also late-onset autoimmune diseases). In fact, if the disease appears much earlier than that (i.e.., prior to the teen years), it is usually a very aggressive form with a strong genetic component.

There are dozens of diseases that are classified as involving autoimmune responses or suspected of having an autoimmune basis. In many of the diseases, there is a significant difference in incidence among men and women; overall, women are about 3 times as likely as men to suffer from autoimmune disorders (however, in some disorders, such as MS, men appear to have a more severe disease pattern). If the initial symptoms are mild or if the disease progresses slowly or develops its symptoms in an unusual pattern, diagnosis is difficult. Some patients relay experiences of pursuing medical diagnosis and treatment for a decade before getting a definitive disease name. A greater number of tests that can suggest or confirm presence of an autoimmune disease have become available so that it is now easier to make a diagnosis than ever before, but some disorders suspected of being autoimmune diseases still lack reliable tests, especially for their early stages.

The incidence of autoimmune diseases in the U.S. has been estimated to be just over 3%, with a current affected population of about 10 million people. Societies representing people suffering from autoimmune diseases consistently over-report the incidence rates, using the upper limits from the highest estimate ranges; thus, the incidence rates given in these circumstances��often relayed by the news media��must be interpreted cautiously. Some of the common autoimmune disorders are outlined below.

Connective Tissue Diseases

The most prevalent autoimmune disorders are connective tissue diseases, accounting for nearly half of all the cases; rheumatoid arthritis is the dominant one. The main connective tissue diseases are:

RHEUMATOID ARTHRITIS

This is a systemic disorder in which immune cells attack and inflame the membrane around joints (it also can affect the heart, lungs, and eyes, though rarely). The incidence in women is far higher than men for younger individuals, but the difference is less with disease onset after age 50. Symptoms: Inflamed and/or deformed joints, loss of strength, swelling, pain.

SYSTEMIC LUPUS ERYTHEMATOSUS (SLE)

SLE can affect virtually any organ system, producing inflammation. It is up to 9 times more common in women than men and occurs in black women 3 times as often as white women. Symptoms: 90% of patients experience joint inflammation similar to rheumatoid arthritis. Fifty percent develop a classic "butterfly" rash on the nose and cheeks. Raynaud's phenomenon (extreme sensitivity to cold in the hands and feet) appears in about 20 percent of people with SLE. Other symptoms include fever, weight loss, hair loss, mouth/nose sores, malaise, fatigue, and brain disorders. Exposure to UV light can promote the disease process.

SYSTEMIC SCLEROSIS (SCLERODERMA)

Scleroderma results from attack of immune cells that produce scar tissue in the skin, internal organs, and small blood vessels. It affects women three times more often than men overall, but increases to a rate 15 times greater for women during childbearing years, and appears to be more common among black women. Symptoms: In most patients, the first symptoms are Raynaud's phenomenon and swelling and puffiness of the fingers or hands. Skin thickening follows a few months later. Other symptoms include skin ulcers on the fingers, joint stiffness in the hands, pain, sore throat, and diarrhea.

SJoGREN'S SYNDROME

Sjogren's syndrome is a chronic, slowly progressing inability to secrete saliva and tears, and is usually a late-onset disease. It can occur alone or with rheumatoid arthritis, scleroderma, or SLE. About 90% of cases occur in women, most often at or around the menopausal years. Symptoms: Dryness of the eyes and mouth, swollen neck glands, difficulty swallowing or talking, unusual tastes or smells, thirst, tongue ulcers, and severe dental caries (which occur because of the lack of saliva).

The other autoimmune diseases fall into several groupings, among the most common are these:

NEUROMUSCULAR DISEASES

The neuromuscular diseases are mainly those involving immune attack affecting the nerves, which has the result of impairing muscle responses. The primary response is usually muscular paralysis, but there can also be tremor and/or tonic spasm where nerve transmission is partially blocked.

MULTIPLE SCLEROSIS (MS)

A disease of the central nervous system that usually first appears between the ages of 20 and 30, and affects women twice as often as men. MS is the leading cause of disability among young adults, and it causes irreversible scarring of the myelin sheath to varying extents. The primary form is remitting/relapsing, but there is also a "progressive" form, which worsens regularly. Symptoms: Numbness, weakness, tingling or paralysis in one or more limbs, impaired vision and eye pain, tremor, lack of coordination or unsteady gait, and loss of control of urination.

MYASTHENIA GRAVIS

This is characterized by gradual muscle weakness, often appearing first in the face, particularly at the eyes and then affecting the mouth and throat. Symptoms: Drooping eyelids, double vision, and difficulty breathing, talking, chewing, and swallowing.

ENDOCRINE DISEASES

The endocrine diseases involve attack of the immune system against one of the glands, sometimes with rapidly progressing destruction (as in diabetes or Addison's disease). However, in Grave's disease, antibodies attach to a hormone stimulating receptor on thyroid cells and don't destroy the cells but rather stimulate their production of thyroid hormone.

HASHIMOTO'S THYROIDITIS

This is a type of autoimmune disease in which the immune system destroys the thyroid gland. It is primarily a disease suffered by women (50 times more often than men). Symptoms: Low levels of thyroid hormone cause mental and physical slowing, greater sensitivity to cold, weight gain, coarsening of the skin, and goiter (a swelling of the neck due to an enlarged thyroid gland).

GRAVES' DISEASE

Graves' disease is one of the most common autoimmune diseases, affecting about 1% of people in the U.S, frequently appearing during childhood, and affecting women 7 times as often as men. Patients with Graves' disease produce an excessive amount of thyroid hormone. Symptoms: Weight loss due to increased energy expenditure; increased appetite, heart rate, and blood pressure; tremors, nervousness and sweating; frequent bowel movements.

INSULIN-DEPENDENT (TYPE 1) DIABETES

Type 1 diabetes is caused by autoimmune attack against the pancreatic islet cells that produce insulin, resulting in very low levels of insulin production, usually too little to survive without providing exogenous sources (insulin shots). The disease usually occurs in children and young adults (differentiated from Type 2 diabetes that does not originate from autoimmune processes, and most often affects those who are obese), and affects boys and girls at about the same rate, a slightly higher incidence in boys. Symptoms: Increased thirst, increased urination, weight loss, fatigue, nausea, frequent infections.