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1.
Front Immunol ; 12: 722979, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34489972

RESUMO

The immunopathology of type I diabetes (T1D) presents a complicated case in part because of the multifactorial origin of this disease. Typically, T1D is thought to occur as a result of autoimmunity toward islets of Langerhans, resulting in the destruction of insulin-producing cells (ß cells) and thus lifelong reliance on exogenous insulin. However, that explanation obscures much of the underlying mechanism, and the actual precipitating events along with the associated actors (latent viral infection, diverse immune cell types and their roles) are not completely understood. Notably, there is a malfunctioning in the regulation of cytotoxic CD8+ T cells that target endocrine cells through antigen-mediated attack. Further examination has revealed the likelihood of an imbalance in distinct subpopulations of tolerogenic and cytotoxic natural killer (NK) cells that may be the catalyst of adaptive immune system malfunction. The contributions of components outside the immune system, including environmental factors such as chronic viral infection also need more consideration, and much of the recent literature investigating the origins of this disease have focused on these factors. In this review, the details of the immunopathology of T1D regarding NK cell disfunction is discussed, along with how those mechanisms stand within the context of general autoimmune disorders. Finally, the rarer cases of latent autoimmune, COVID-19 (viral), and immune checkpoint inhibitor (ICI) induced diabetes are discussed as their exceptional pathology offers insight into the evolution of the disease as a whole.


Assuntos
Doenças Autoimunes/imunologia , Diabetes Mellitus Tipo 1/imunologia , Diabetes Mellitus Tipo 1/patologia , Células Matadoras Naturais/imunologia , Células Matadoras Naturais/patologia , Autoanticorpos/imunologia , Doenças Autoimunes/patologia , COVID-19/complicações , Diabetes Mellitus Tipo 1/etiologia , Humanos , Insulina/metabolismo , Células Secretoras de Insulina/imunologia , Viroses/complicações
2.
J Am Podiatr Med Assoc ; 111(4)2021 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-34478539

RESUMO

Triamcinolone acetonide is a synthetic glucocorticoid used to treat numerous acute and chronic inflammatory conditions. The various side effects of this drug from parenteral administration are well documented in the literature. In this study, three patients present with a rare side effect of violaceous dermal pigmentation. To the best of the authors' knowledge, this finding is rarely presented in the current literature. The purpose of this study is to provide awareness of a less-documented, delayed side effect from triamcinolone acetonide administration. Although all patients presenting in this study had a known history of autoimmune disease (eg, lupus, psoriatic arthritis) further research is needed to suggest a possible association between dermal violaceous change and the use of triamcinolone.


Assuntos
Doenças Autoimunes , Triancinolona Acetonida , Doenças Autoimunes/induzido quimicamente , Doenças Autoimunes/tratamento farmacológico , Glucocorticoides/efeitos adversos , Humanos , Triancinolona Acetonida/efeitos adversos
3.
Adv Exp Med Biol ; 1325: 205-218, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34495537

RESUMO

Autoimmune diseases are accompanied by changes in protein glycosylation, in both the immune system and target tissues. The best-studied alteration in autoimmunity is agalactosylation of immunoglobulin G (IgG), characterized primarily in rheumatoid arthritis (RA), and then detected also in systemic lupus erythematosus (SLE), inflammatory bowel disease (IBD), and multiple sclerosis (MS). The rebuilding of IgG N-glycans in RA correlates with the relapses and remissions of the disease, is associated with physiological states such as pregnancy but also depends on applied anti-inflammatory therapy. In turn, a decreased core fucosylation of the whole pool of IgG N-glycans is a serum glycomarker in autoimmune thyroid diseases (AITD) encompassing Hashimoto's thyroiditis (HT) and Grave's disease (GD). However, fucosylation of anti-thyroglobulin IgG (an immunological marker of HT) was elevated in HT serum. Core fucosylation of IgG oligosaccharides was also lowered in MS and SLE. In AITD and IBD, chronic inflammation T lymphocytes showed the reduced expression of MGAT5 gene encoding ß1,6-N-acetylglucosaminyltransferase V (GnT-V) responsible for ß1,6-branching of N-glycans, which is important for T cell receptor activation. Structural changes of glycans have a profound effect on the pro-inflammatory activity of immune cells and serum immune proteins, including IgG in autoimmunity.


Assuntos
Doenças Autoimunes , Doença de Hashimoto , Lúpus Eritematoso Sistêmico , Glicosilação , Humanos , Imunoglobulina G
4.
Adv Exp Med Biol ; 1325: 265-283, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34495540

RESUMO

The diversity of glycan presentation in a cell, tissue and organism is enormous, which reflects the huge amount of important biological information encoded by the glycome which has not been fully understood. A compelling body of evidence has been highlighting the fundamental role of glycans in immunity, such as in development, and in major inflammatory processes such as inflammatory bowel disease, systemic lupus erythematosus and other autoimmune disorders. Glycans play an instrumental role in the immune response, integrating the canonical circuits that regulate innate and adaptive immune responses. The relevance of glycosylation in immunity is demonstrated by the role of glycans as important danger-associated molecular patterns and pathogen-associated molecular patterns associated with the discrimination between self and non-self; also as important regulators of the threshold of T cell activation, modulating receptors signalling and the activity of both T and other immune cells. In addition, glycans are important determinants that regulate the dynamic crosstalk between the microbiome and immune response. In this chapter, the essential role of glycans in the immunopathogenesis of inflammatory disorders will be presented and its potential clinical applications (diagnosis, prognosis and therapeutics) will be highlighted.


Assuntos
Doenças Autoimunes , Lúpus Eritematoso Sistêmico , Glicosilação , Humanos , Ativação Linfocitária , Polissacarídeos
5.
Rinsho Ketsueki ; 62(8): 900-908, 2021.
Artigo em Japonês | MEDLINE | ID: mdl-34497229

RESUMO

A huge number of indigenous commensal bacteria reside in the intestines of humans and animals. However, the host animals do not unconditionally accept gut microbiota. In order to contain gut microbiota by secreting immunoglobulin A, the intestine is equipped with the intestinal immune system, literally the largest peripheral lymphoid tissue in the body where 60 to 70% of peripheral immune cells are accumulated. On the other hand, the gut microbiota greatly impact the host physiology and pathology. Normal development of the host immune system relies on interaction with the gut microbiota. In addition, abnormal gut microbiota, or dysbiosis, is known to be associated with various disease statuses including autoimmune diseases. Understanding of the causal relationship between the pathophysiology of these diseases and dysbiosis is still limited, but verification experiments using animal models have been clarifying that gut microbiota is an important regulatory factor the pathogenesis and progression of these diseases.


Assuntos
Doenças Autoimunes , Microbioma Gastrointestinal , Animais , Disbiose , Humanos , Sistema Imunitário , Intestinos
6.
Int J Mol Sci ; 22(16)2021 Aug 04.
Artigo em Inglês | MEDLINE | ID: mdl-34445091

RESUMO

Acquired idiopathic generalized anhidrosis (AIGA) is a rare disorder in which systemic anhidrosis/hypohidrosis occurs without causative dermatological, metabolic or neurological disorder. Most cases of AIGA have been reported in Asia, especially in Japan, but there have been only a few reports in Europe and the United States. Severe AIGA may result in heatstroke and can reduce quality of life due to restriction of exercise and outdoor works. AIGA is often accompanied by cholinergic urticaria (CholU), and it is thought that AIGA and CholU with anhidrosis/hypohidrosis belong to the same spectrum of the disease. However, the pathophysiology of AIGA has not yet been clarified. Decreased expression of cholinergic receptor M3 on the epithelial cells of eccrine sweat glands is often accompanied by T cell infiltration around eccrine apparatus, suggesting an immunological mechanism of disordered perspiration. AIGA is occasionally associated with various complications indicative of autoimmune disorders. The association of autoimmune complications further suggests that AIGA is an autoimmune disorder. Studies on complications may lead to a better understanding of the pathophysiology of AIGA.


Assuntos
Doenças Autoimunes/patologia , Hipo-Hidrose/patologia , Animais , Doenças Autoimunes/complicações , Doenças Autoimunes/imunologia , Humanos , Hipo-Hidrose/complicações , Hipo-Hidrose/imunologia , Receptor Muscarínico M3/análise , Receptor Muscarínico M3/imunologia , Receptores Colinérgicos/análise , Receptores Colinérgicos/imunologia , Urticária/etiologia , Urticária/imunologia , Urticária/patologia
7.
Int J Mol Sci ; 22(16)2021 Aug 18.
Artigo em Inglês | MEDLINE | ID: mdl-34445599

RESUMO

Not long ago, self-reactive immune activity was considered as pathological trait. A paradigm shift has now led to the recognition of autoimmune processes as part of natural maintenance of molecular homeostasis. The immune system is assigned further roles beneath the defense against pathogenic organisms. Regarding the humoral immune system, the investigation of natural autoantibodies that are frequently found in healthy individuals has led to further hypotheses involving natural autoimmunity in other processes as the clearing of cellular debris or decrease in inflammatory processes. However, their role and origin have not been entirely clarified, but accumulating evidence links their formation to immune reactions against the gut microbiome. Antibodies targeting highly conserved proteins of the commensal microflora are suggested to show self-reactive properties, following the paradigm of the molecular mimicry. Here, we discuss recent findings, which demonstrate potential links of the commensal microflora to the immunological homeostasis and highlight the possible implications for various diseases. Furthermore, specific components of the immune system, especially antibodies, have become a focus of attention for the medical management of various diseases and provide attractive treatment options in the future. Nevertheless, the development and optimization of such macromolecules still represents a very time-consuming task, shifting the need to more medical agents with simple structural properties and low manufacturing costs. Synthesizing only the biologically active sites of antibodies has become of great interest for the pharmaceutical industry and offers a wide range of therapeutic application areas as it will be discussed in the present review article.


Assuntos
Autoanticorpos/imunologia , Doenças Autoimunes/imunologia , Desenvolvimento de Medicamentos , Microbioma Gastrointestinal , Homeostase , Sistema Imunitário/imunologia , Inflamação/imunologia , Animais , Doenças Autoimunes/tratamento farmacológico , Doenças Autoimunes/patologia , Autoimunidade , Humanos , Sistema Imunitário/efeitos dos fármacos , Inflamação/tratamento farmacológico , Inflamação/patologia
8.
BMC Womens Health ; 21(1): 285, 2021 08 05.
Artigo em Inglês | MEDLINE | ID: mdl-34353326

RESUMO

BACKGROUND: Consequences of long-term B cell depletion with rituximab are not well understood. We describe inflammatory vaginitis as a potential side effect of long-term rituximab treatment, distinct from previously described vulvovaginal pyoderma gangrenosum. METHODS: We performed a retrospective analysis of women treated with rituximab for more than 1 year to determine the prevalence and clinical characteristics of vaginitis cases. We conducted a case-control analysis with up to 3 controls for each vaginitis case. RESULTS: We identified sixteen inflammatory vaginitis cases. Women with vaginitis were age 23-68 (median 42), primarily being treated for ANCA-associated vasculitis (11/16; 69%). Most reported copious vaginal discharge (100%) and pain with sex (75%). All women with return of circulating B-cells to > 10 cells/mL had complete (5/9) or significant (4/9) improvement in symptoms. In case-control analysis there was no significant difference in length of B-cell depletion, immune parameters, creatinine levels, and history of neutropenia. CONCLUSION: Inflammatory vaginitis is a potential side effect of prolonged continuous B cell depletion with rituximab. More studies are needed to characterize the incidence and etiology of vaginitis among women on long term rituximab therapy and establish a causal relationship.


Assuntos
Doenças Autoimunes , Descarga Vaginal , Vaginite , Adulto , Idoso , Feminino , Humanos , Pessoa de Meia-Idade , Estudos Retrospectivos , Rituximab/efeitos adversos , Vaginite/tratamento farmacológico , Vaginite/epidemiologia , Adulto Jovem
9.
FEBS J ; 288(16): 4728-4729, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34398531

RESUMO

With the current issue of The FEBS Journal, we are introducing a new category of invited review article contributions on Emerging Methods and Technologies. These articles provide an overview and discussion of recent, emerging methods that significantly advance and improve research efforts in the different fields of molecular and cellular research of our The FEBS Journal authors and readers. Deputy Editorial Manager Manuel Breuer and our Emerging Methods and Technologies Commissioning Editor Eric Chevet introduce the series.


Assuntos
Doenças Autoimunes/imunologia , Proteínas de Membrana/metabolismo , Neoplasias/imunologia , Polietilenotereftalatos/metabolismo , Polissacarídeos/imunologia , Humanos , Proteínas de Membrana/análise , Neoplasias/terapia , Polissacarídeos/química
10.
Int J Mol Sci ; 22(16)2021 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-34445670

RESUMO

While first and foremost considered a respiratory infection, COVID-19 can result in complications affecting multiple organs. Immune responses in COVID-19 can both protect against the disease as well as drive it. Insights into these responses, and specifically the targets being recognised by the immune system, are of vital importance in understanding the side effects of COVID-19 and associated pathologies. The body's adaptive immunity recognises and responds against specific targets (antigens) expressed by foreign pathogens, but not usually to target self-antigens. However, if the immune system becomes dysfunctional, adaptive immune cells can react to self-antigens, which can result in autoimmune disease. Viral infections are well reported to be associated with, or exacerbate, autoimmune diseases such as multiple sclerosis (MS) and systemic lupus erythematosus (SLE). In COVID-19 patients, both new onset MS and SLE, as well as the occurrence of other autoimmune-like pathologies, have been reported. Additionally, the presence of autoantibodies, both with and without known associations to autoimmune diseases, have been found. Herein we describe the mechanisms of virally induced autoimmunity and summarise some of the emerging reports on the autoimmune-like diseases and autoreactivity that is reported to be associated with SARS-CoV-2 infection.


Assuntos
Doenças Autoimunes/imunologia , Doenças Autoimunes/virologia , COVID-19/imunologia , Imunidade Adaptativa , Artrite Reumatoide/imunologia , Autoanticorpos/imunologia , Autoantígenos/imunologia , Autoimunidade , COVID-19/virologia , Humanos , Lúpus Eritematoso Sistêmico/imunologia , SARS-CoV-2/imunologia
11.
Medicina (Kaunas) ; 57(8)2021 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-34441024

RESUMO

Background and Objectives: Linear IgA disease (LAD) is a rare autoimmune blistering disease with linear IgA deposits along the basement membrane zone. Direct immunofluorescence remains the gold standard for diagnosis, but other diagnostic measures reported in recent literature have proven useful in the setting of inconclusive preliminary results. Dapsone is a commonly used treatment, but many therapeutic agents have emerged in recent years. The objective of this study is to provide a comprehensive overview of updates on the diagnosis and management of LAD. Materials and Methods: A literature search was conducted from May to June of 2021 for articles published in the last 5 years that were related to the diagnosis and management of LAD. Results: False-negative results in cases of drug-induced LAD and the presence of IgG and IgM antibodies on immunofluorescence studies were reported. Serration pattern analysis has been reported to be useful in distinguishing LAD from sublamina densa-type LAD. Rituximab, omalizumab, etanercept, IVIg, sulfonamides, topical corticosteroids, and others have been used successfully in adult and pediatric patients with varying disease severity. Topical corticosteroids were preferred for pediatric patients while rituximab and IVIg were used in adults with recalcitrant LAD. Sulfonamides were utilized in places without access to dapsone. Conclusion: In cases where preliminary biopsy results are negative and clinical suspicion is high, repeat biopsy and additional diagnostic studies should be used. Patient factors such as age, medical comorbidities, and disease severity play a role in therapeutic selection.


Assuntos
Doenças Autoimunes , Imunoglobulina A , Adulto , Biópsia , Criança , Dapsona/uso terapêutico , Humanos
12.
Ned Tijdschr Geneeskd ; 1652021 06 24.
Artigo em Holandês | MEDLINE | ID: mdl-34346619

RESUMO

Systemic autoimmune diseases are characterized by their heterogenic clinical presentations and often poorly understood pathogenesis. As such, the diagnosis process may be complex and the final diagnosis is made by an expert, after considering a differential diagnosis. Classification criteria are developed for research purposes to select homogenous populations of already diagnosed patients. In clinical practice, these classification criteria are sometimes misused as diagnostic criteria. We describe three patient histories. Two patients met the classification criteria of several separate diseases, emphasizing the amount of overlap between different sets of criteria and the necessity of making a diagnosis before using classification criteria. A third patient was diagnosed with systemic sclerosis and later developed rheumatoid arthritis; a diagnosis that could have been overlooked if classification criteria were used diagnostically. We describe the correct use of classification criteria in systemic autoimmune diseases and discuss what the diagnostic process is supposed to entail.


Assuntos
Artrite Reumatoide , Doenças Autoimunes , Artrite Reumatoide/diagnóstico , Doenças Autoimunes/diagnóstico , Diagnóstico Diferencial , Humanos
14.
Nat Rev Rheumatol ; 17(9): 550-564, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34345021

RESUMO

Interactions between lymphocytes and stromal cells have an important role in immune cell development and responses. During inflammation, stromal cells contribute to inflammation, from induction to chronicity or resolution, through direct cell interactions and through the secretion of pro-inflammatory and anti-inflammatory mediators. Stromal cells are imprinted with tissue-specific phenotypes and contribute to site-specific lymphocyte recruitment. During chronic inflammation, the modified pro-inflammatory microenvironment leads to changes in the stromal cells, which acquire a pathogenic phenotype. At the site of inflammation, infiltrating B cells and T cells interact with stromal cells. These interactions induce a plasma cell-like phenotype in B cells and T cells, associated with secretion of immunoglobulins and inflammatory cytokines, respectively. B cells and T cells also influence the stromal cells, inducing cell proliferation, molecular changes and cytokine production. This positive feedback loop contributes to disease chronicity. This Review describes the importance of these cell interactions in chronic inflammation, with a focus on human disease, using three selected autoimmune and inflammatory diseases: rheumatoid arthritis, psoriatic arthritis (and psoriasis) and systemic lupus erythematosus. Understanding the importance and disease specificity of these interactions could provide new therapeutic options.


Assuntos
Doenças Autoimunes/patologia , Inflamação/patologia , Linfócitos/patologia , Doenças Reumáticas/patologia , Células Estromais/patologia , Animais , Doenças Autoimunes/imunologia , Humanos , Inflamação/imunologia , Doenças Reumáticas/imunologia
15.
Front Immunol ; 12: 642127, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34394071

RESUMO

Anti-myeloperoxidase vasculitis (MPO-AAV) is a life-threatening autoimmune disease which causes severe inflammation of small blood vessels, mainly in the kidney. As for many other autoimmune diseases, current treatments, which consist of general immunosuppressants, are partially effective, toxic and broadly immunosuppressive, causing significant and serious adverse effects in many patients. Therefore, there is an urgent need for more targeted and less harmful therapies. Tolerogenic dendritic cells, regulatory T cells and stem cells have emerged as attractive, new and safer options for the treatment for various autoimmune diseases due to their unique and selective immunosuppressive capacity. In this review, we will discuss how these cellular therapies offer potential to become novel and safer treatments for MPO-AAV.


Assuntos
Vasculite Associada a Anticorpo Anticitoplasma de Neutrófilos/terapia , Doenças Autoimunes/terapia , Terapia Baseada em Transplante de Células e Tecidos/métodos , Peroxidase/imunologia , Animais , Vasculite Associada a Anticorpo Anticitoplasma de Neutrófilos/imunologia , Doenças Autoimunes/imunologia , Humanos
16.
Nat Immunol ; 22(9): 1163-1174, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34426690

RESUMO

The immunosuppressive function of regulatory T (Treg) cells is dependent on continuous expression of the transcription factor Foxp3. Foxp3 loss of function or induced ablation of Treg cells results in a fatal autoimmune disease featuring all known types of inflammatory responses with every manifestation stemming from Treg cell paucity, highlighting a vital function of Treg cells in preventing fatal autoimmune inflammation. However, a major question remains whether Treg cells can persist and effectively exert their function in a disease state, where a broad spectrum of inflammatory mediators can either inactivate Treg cells or render innate and adaptive pro-inflammatory effector cells insensitive to suppression. By reinstating Foxp3 protein expression and suppressor function in cells expressing a reversible Foxp3 null allele in severely diseased mice, we found that the resulting single pool of rescued Treg cells normalized immune activation, quelled severe tissue inflammation, reversed fatal autoimmune disease and provided long-term protection against them. Thus, Treg cells are functional in settings of established broad-spectrum systemic inflammation and are capable of affording sustained reset of immune homeostasis.


Assuntos
Doenças Autoimunes/imunologia , Autoimunidade/imunologia , Fatores de Transcrição Forkhead/metabolismo , Síndrome de Resposta Inflamatória Sistêmica/imunologia , Linfócitos T Reguladores/imunologia , Animais , Autoimunidade/genética , Diferenciação Celular/imunologia , Feminino , Fatores de Transcrição Forkhead/genética , Regulação da Expressão Gênica/genética , Homeostase/imunologia , Mediadores da Inflamação/metabolismo , Ativação Linfocitária/imunologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Síndrome de Resposta Inflamatória Sistêmica/patologia
17.
Dtsch Arztebl Int ; 118(24): 413-420, 2021 06 18.
Artigo em Inglês | MEDLINE | ID: mdl-34369370

RESUMO

BACKGROUND: Bullous autoimmune dermatoses are a clinically and immunopatho - logically heterogeneous group of diseases, characterized clinically by blisters or erosions of the skin and/or mucous membranes. In Germany, their prevalence is approximately 40 000 cases nationwide, and their incidence approximately 20 new cases per million people per year. METHODS: This review is based on publications that were retrieved by a selective search of the literature focusing on the current German and European guidelines. RESULTS: Recent years have seen the publication of guidelines, controlled prospective clinical trials, and multicenter diagnostic studies improving both diagnosis and therapy. Specific monovalent and multivariate serological test systems and pattern analysis of tissue-bound autoantibodies allow identification of the target antigens in 80-90% of patients. This enables the precise classification of disease entities, with implications for treatment selection and disease outcome. In 2019, the anti-CD20 antibody rituximab was approved by the European Medicines Agency for the treatment of moderate and severe pemphigus vulgaris, with an ensuing marked improvement in the care of the affected patients. To treat mild and moderate bullous pemphigoid, topical clobetasol proprionate is recommended, in severe disease, combined with systemic treatment, i.e. usually (a) prednisolone p.o. at an initial dose of 0.5mg/kg/d , (b) an immunomodulant, e.g. dapsone or doxycycline, or (c) prednisolone plus an immunomodulant. CONCLUSION: The early recognition and precise diagnostic evaluation of bullous autoimmune dermatoses now enables improved, often interdisciplinary treatment, in accordance with the available guidelines. Current research projects are focused on new treatment approaches, an improved understanding of the underlying pathophysiology, and further refinements of diagnostic techniques.


Assuntos
Doenças Autoimunes , Penfigoide Bolhoso , Pênfigo , Dermatopatias Vesiculobolhosas , Doenças Autoimunes/diagnóstico , Doenças Autoimunes/tratamento farmacológico , Doenças Autoimunes/epidemiologia , Humanos , Estudos Multicêntricos como Assunto , Estudos Prospectivos , Dermatopatias Vesiculobolhosas/diagnóstico , Dermatopatias Vesiculobolhosas/tratamento farmacológico , Dermatopatias Vesiculobolhosas/epidemiologia
18.
Int J Mol Sci ; 22(16)2021 Aug 08.
Artigo em Inglês | MEDLINE | ID: mdl-34445238

RESUMO

The trace element selenium (Se) is an essential part of the human diet; moreover, increased health risks have been observed with Se deficiency. A sufficiently high Se status is a prerequisite for adequate immune response, and preventable endemic diseases are known from areas with Se deficiency. Biomarkers of Se status decline strongly in pregnancy, severe illness, or COVID-19, reaching critically low concentrations. Notably, these conditions are associated with an increased risk for autoimmune disease (AID). Positive effects on the immune system are observed with Se supplementation in pregnancy, autoimmune thyroid disease, and recovery from severe illness. However, some studies reported null results; the database is small, and randomized trials are sparse. The current need for research on the link between AID and Se deficiency is particularly obvious for rheumatoid arthritis and type 1 diabetes mellitus. Despite these gaps in knowledge, it seems timely to realize that severe Se deficiency may trigger AID in susceptible subjects. Improved dietary choices or supplemental Se are efficient ways to avoid severe Se deficiency, thereby decreasing AID risk and improving disease course. A personalized approach is needed in clinics and during therapy, while population-wide measures should be considered for areas with habitual low Se intake. Finland has been adding Se to its food chain for more than 35 years-a wise and commendable decision, according to today's knowledge. It is unfortunate that the health risks of Se deficiency are often neglected, while possible side effects of Se supplementation are exaggerated, leading to disregard for this safe and promising preventive and adjuvant treatment options. This is especially true in the follow-up situations of pregnancy, severe illness, or COVID-19, where massive Se deficiencies have developed and are associated with AID risk, long-lasting health impairments, and slow recovery.


Assuntos
Doenças Autoimunes/tratamento farmacológico , COVID-19/tratamento farmacológico , Sistema Imunitário/efeitos dos fármacos , Selênio/farmacologia , Oligoelementos/farmacologia , Suplementos Nutricionais , Feminino , Humanos , Gravidez
19.
J Assoc Physicians India ; 69(7): 11-12, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34431274

RESUMO

There are innumerable theories proposed for the cause of autoimmune diseases. Repeatedly it is stated that it is multifactorial inheritance, i.e., polygenes and environment factors together are responsible. That is another way of saying that the cause is not known. None of the causes proposed so far can satisfy the basic requirement that the cause should always precede and be consistently present for the occurrence of a given disease. brbrA concept is presented here that there is no cause for autoimmune diseases. They are, in reality, an integral part of cell program. It is an established fact that the cell doubling capacity in vivo and in vitro is finite. What is proposed here is that on exhaustion of that capacity one of the preprogrammed alternatives for the cells is to alter their morphology of "identity as self " within the body in such a manner that invites immune system to react on them as foreign elements. This is the basis of all varied autoimmune diseases in the body which can be put together under one heading as autoimmune disease group in the same way as it is done for cancer or vascular diseases. This preprogrammed alteration in morphology can involve any cell system of body including those of immune system. This phenomenon is cell specific and hence can manifest as organ specific disease or system specific disease depending on the type of cell involved. This built-in program makes autoimmune disease group a time-governed intrinsic, senescent process. This concept accounts for all the common features of varied autoimmune diseases in the group of autoimmune disease.brbrThey are seen in the cellular systems in plant and animal kingdoms. In humankind, they are universal and democratic. They affect all the races and both sexes. Their incidence progressively increases with age. In a given population, the distribution, the incidence, and varied features of any given autoimmune disease follow normal distribution curves. Each normal distribution curve of any one characteristic of a given autoimmune disease is independent of their other characteristics and their normal distributions. This makes each autoimmune disease unique. The total incidence of autoimmune disease group remains fixed in a given population. The herd determines its random distribution at individual level. Therefore, one can predict total incidence of autoimmune disease group in a given population but at an individual level - who, when, where, what, why and how - can be predictable only in terms of probability. The features of its being chronic, acute exacerbation and/or constant deterioration can also be accounted by being a cellular built-in program.brbrAll the varied types of autoimmune diseases show these common features. These observations establish that they are an integral part of the biological trajectory and follow biological principles in their manifestations. The autoimmune disease group operates at bio-cosmic level displaying order in apparent chaos and making it a trans-science and trans-technique phenomenon.


Assuntos
Doenças Autoimunes , Animais , Feminino , Incidência , Masculino
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