Preface
This booklet contains information about autoimmune diseases.
You will not find everything there is to know about autoimmune diseases
here, however. In fact, the information presented here may prompt you
to think of more questions about autoimmune diseases because autoimmune
diseases are complex.
We have tried to anticipate which terms will need further definition
and clarification. Those terms, when they first appear in the text,
are in italics. Italicized words and phrases are defined in the Glossary
at the end of the booklet.
You will find more in-depth and detailed resources at your local library
or through your health care provider. The Internet is a valuable source
of information as well. Start by doing a search on the National Institutes
of Health (NIH) Web site at http://www.nih.gov
for information on the broad range of research conducted by NIH, including
autoimmune diseases.
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What
Are Autoimmune Diseases?
The word "auto" is the Greek word for self. The immune system is a complicated
network of cells and cell components (called molecules) that
normally work to defend the body and eliminate infections caused by bacteria,
viruses, and other invading microbes. If a person has an autoimmune disease,
the immune system mistakenly attacks self, targeting the cells, tissues,
and organs of a person's own body. A collection of immune system cells
and molecules at a target site is broadly referred to as inflammation.
There are many different autoimmune diseases, and they can each affect
the body in different ways. For example, the autoimmune reaction is
directed against the brain in multiple sclerosis and the gut in Crohn's
disease. In other autoimmune diseases such as systemic lupus erythematosus
(lupus), affected tissues and organs may vary among individuals with
the same disease. One person with lupus may have affected skin and joints
whereas another may have affected skin, kidney, and lungs. Ultimately,
damage to certain tissues by the immune system may be permanent, as
with destruction of insulin-producing cells of the pancreas in
type 1 diabetes mellitus.
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Who
Is Affected by Autoimmune Diseases?
Many of the autoimmune diseases are rare. As a group, however, autoimmune
diseases afflict millions of Americans. Most autoimmune diseases strike
women more often than men; in particular, they affect women of working
age and during their childbearing years.
Some autoimmune diseases occur more frequently in certain minority
populations. For example, lupus is more common in African-American and
Hispanic women than in Caucasian women of European ancestry. Rheumatoid
arthritis and scleroderma affect a higher percentage of residents in
some Native American communities than in the general U.S. population.
Thus, the social, economic, and health impact from autoimmune diseases
is far-reaching and extends not only to family but also to employers,
co-workers, and friends.
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What
Are the Causes of Autoimmune Diseases?
Are they contagious? No autoimmune
disease has ever been shown to be contagious or "catching." Autoimmune
diseases do not spread to other people like infections. They are not related
to AIDS, nor are they a type of cancer.
Are they inherited? The genes
people inherit contribute to their susceptibility for developing an
autoimmune disease. Certain diseases such as psoriasis can occur among
several members of the same family. This suggests that a specific gene
or set of genes predisposes a family member to psoriasis. In addition,
individual family members with autoimmune diseases may inherit and share
a set of abnormal genes, although they may develop different autoimmune
diseases. For example, one first cousin may have lupus, another may
have dermatomyositis, and one of their mothers may have rheumatoid arthritis.
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Examples of Autoimmune Diseases:
(Listed by the Main Target Organ)
| Nervous System: |
Gastrointestinal System: |
| Multiple sclerosis |
Crohn's Disease |
| Myasthenia gravis |
Ulcerative colitis |
| Autoimmune neuropathies such as Guillain-Barré |
Primary biliary cirrhosis |
| Autoimmune uveitis |
Autoimmune hepatitis |
| |
|
| Blood: |
Endocrine Glands: |
| Autoimmune hemolytic anemia |
Type 1 or immune-mediated diabetes
mellitus |
| Pernicious anemia |
Grave's Disease |
| Autoimmune thrombocytopenia |
Hashimoto's thyroiditis |
| |
Autoimmune oophoritis and orchitis |
| Blood Vessels: |
Autoimmune disease of the adrenal
gland |
| Temporal arteritis |
|
| Anti-phospholipid syndrome |
Multiple Organs Including
the Musculoskeletal System:* |
| Vasculitides such as Wegener's granulomatosis |
Rheumatoid arthritis |
| Behcet's disease |
Systemic lupus erythematosus |
| |
Scleroderma |
| Skin: |
Polymyositis, dermatomyositis |
| Psoriasis |
Spondyloarthropathies such as ankylosing
spondylitis |
| Dermatitis herpetiformis |
Sjogren's syndrome |
| Pemphigus vulgaris |
|
| Vitiligo |
|
| |
|
| *These diseases are also called connective
tissue (muscle, skeleton, tendons, fascia, etc.) diseases. |
The development of an autoimmune disease may be influenced
by the genes a person inherits together with the way the person's immune
system responds to certain triggers or environmental influences.
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What other factors may influence the development
of autoimmune diseases? Some autoimmune diseases are known
to begin or worsen with certain triggers such as viral infections. Sunlight
not only acts as a trigger for lupus but can worsen the course of the
disease. It is important to be aware of the factors that can be avoided
to help prevent or minimize the amount of damage from the autoimmune disease.
Other less understood influences affecting the immune system and the course
of autoimmune diseases include aging, chronic stress, hormones, and pregnancy.
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How
Does the Immune System Work?
The immune system defends the body from attack by invaders recognized
as foreign. It is an extraordinarily complex system that relies on an
elaborate and dynamic communications network that exists among the many
different kinds of immune system cells that patrol the body. At the heart
of the system is the ability to recognize and respond to substances called
antigens whether they are infectious agents or part of the body
("self antigens").
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Cells and molecules of the immune system
protect the nose from attack by a virus.


T cell (lymphocyte) with a T-cell receptor on its surface
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T and B Cells
Most immune system
cells are white blood cells, of which there are many types. Lymphocytes
are one type of white blood cell, and two major classes of lymphocytes
are T cells and B cells. T cells are critical immune
system cells that help to destroy infected cells and coordinate the
overall immune response. The T cell has a molecule on its surface called
the T-cell receptor. This receptor interacts with molecules
called MHC (major histocompatibility complex). MHC molecules
are on the surfaces of most other cells of the body and help T cells
recognize antigen fragments. B cells are best known for making antibodies.
An antibody binds to an antigen and marks the antigen for destruction
by other immune system cells. Other types of white blood cells include
macrophages and neutrophils.
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Macrophages and Neutrophils
Macrophages and neutrophils circulate in the blood and survey the body
for foreign substances. When they find foreign antigens, such as bacteria,
they engulf and destroy them. Macrophages and neutrophils destroy foreign
antigens by making toxic molecules such as reactive oxygen intermediate
molecules. If production of these toxic molecules continues unchecked,
not only are the foreign antigens destroyed, but tissues surrounding
the macrophages and neutrophils are also destroyed. For example, in
individuals with the autoimmune disease called Wegener's granulomatosis,
overactive
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A macrophage engulfing a bacterium
and releasing packets of toxic molecules (reactive oxygen intermediates)
that break down and destroy the bacterium.
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Macrophages and neutrophils that invade blood vessels produce many toxic
molecules and contribute to damage of the blood vessels. In rheumatoid
arthritis, reactive oxygen intermediate molecules and other toxic molecules
are made by overproductive macrophages and neutrophils invading the joints.
The toxic molecules contribute to inflammation, which is observed as warmth
and swelling, and participate in damage to the joint.
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MHC and Co-Stimulatory Molecules
MHC molecules are found on all cell surfaces and are an active part
of the body's defense team. For example, when a virus infects a cell,
a MHC molecule binds to a piece of a virus (antigen) and displays the
antigen on the cell's surface. Cells that have the capability of displaying
antigen with MHC are called antigen-presenting cells. Each MHC molecule
that displays an antigen is recognized by a matching or compatible T-cell
receptor. Thus, an antigen-presenting cell is able to communicate
with a T cell about what may be occurring inside the cell.
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Upper left: a virus attacking a nerve
cell. Lower right: a T cell with a T-cell receptor recognizing a piece
of a virus (antigen) on the MHC of the infected nerve cell.
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However, for the T cell to respond to a foreign antigen on the MHC,
another molecule on the antigen-presenting cell must send a second signal
to the T cell. A corresponding molecule on the surface of the T cells
recognizes the second signal. These two secondary molecules of the antigen-presenting
cell and the T cell are called co-stimulatory molecules. There are several
different sets of co-stimulatory molecules that can participate in the
interaction of antigen-presenting cell with a T cell.
Once the MHC and the T-cell receptor interact, and the co-stimulatory
molecules interact, there are several possible paths that the T cell
may take. These include T cell activation, tolerance, or T cell death.
The subsequent steps depend in part on which co-stimulatory molecules
interact and how well they interact. Because these interactions are
so critical to the response of the immune system, researchers are intensively
studying them to find new therapies that could control or stop the immune
system attack on self tissues and organs.
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An antigen-presenting cell (for example,
a macrophage) with a foreign antigen on its MHC is recognized by a T-cell
receptor. In addition, co-stimulatory molecules on the antigen-presenting
cell and the T cell interact.

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Cytokines and Chemokines
One
way T cells can respond after the interaction of the MHC and the T-cell
receptor, and the interaction of the co-stimulatory molecules, is to
secrete cytokines and chemokines. Cytokines are proteins that may cause
surrounding immune system cells to become activated, grow, or die. They
also may influence non-immune system tissues. For example, some cytokines
may contribute to the thickening of the skin that occurs in people with
scleroderma.
After the antigen-presenting cell and
T cell interact through the MHC, T-cell receptor and co-stimumlatory and
molecules, the T cell becomes activated, sending cytokine signals to other
cells.

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Chemokines are small cytokine molecules that attract cells of the immune
system. Overproduction of chemokines contributes to the invasion and inflammation
of the target organ, which occurs in autoimmune diseases. For example,
overproduction of chemokines in the joints of people with rheumatoid arthritis
may result in invasion of the joint space by destructive immune system
cells such as macrophages, neutrophils, and T cells.
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Antibodies
B cells are
another critical type of immune system cell. They participate in the
removal of foreign antigens from the body by using a surface molecule
to bind the antigen or by making specific antibodies that can search
out and destroy specific foreign antigens. However, the B cell can only
make antibodies when it receives the appropriate command signal from
a T cell. Once the T cell signals the B cell with a type of cytokine
that acts as a messenger molecule, the B cell is able to produce a unique
antibody that targets a particular antigen.
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A T cell sends messenger molecules,
e.g. cytokines, to the B cell, which allows the B cell to start making
antibodies.

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Autoantibodies
In some
autoimmune diseases, B cells mistakenly make antibodies against tissues
of the body (self antigens) instead of foreign antigens. Occasionally,
these autoantibodies either interfere with the normal function of the
tissues or initiate destruction of the tissues. People with myasthenia
gravis experience muscle weakness because autoantibodies attack a part
of the nerve that stimulates muscle movement. In the skin disease pemphigus
vulgaris, autoantibodies are misdirected against cells in the skin.
The accumulation of antibodies in the skin activates other molecules
and cells to break down, resulting in skin blisters.
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Immune Complexes and the Complement System
When many antibodies are bound to antigens in the bloodstream, they
form a large lattice network called an immune complex. Immune
complexes are harmful when they accumulate and initiate inflammation
A large immune complex.

within small blood vessels that nourish tissues. Immune complexes, immune
cells, and inflammatory molecules can block blood flow and ultimately
destroy organs such as the kidney. This can occur in people with systemic
lupus erythematosus.
If immune complexes accumulate in the
kidney, they may promote movement of other inflammatory cells and molecules
into the kidney.
A group of specialized molecules that form the complement system
helps to remove immune complexes. The different types of molecules of
the complement system, which are found in the bloodstream and on the surfaces
of cells, make immune complexes more soluble. Complement molecules prevent
formation and reduce the size of immune complexes so they do not accumulate
in the wrong places (organs and tissues of the body). Rarely, some people
inherit defective genes for a complement molecule from their parents.
Because these individuals cannot make a normal amount or type of complement
molecule, their immune systems are unable to prevent immune complexes
from being deposited in different tissues and organs. These people develop
a disease that is not autoimmune but resembles lupus erythematosus.
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Genetic Factors
Genetic factors
can affect an individual's immune system and its responses to foreign
antigens in several ways. Genes determine the variety of MHC molecules
that individuals carry on their cells. Genes also influence the potential
array of T-cell receptors present on T cells. In fact, some MHC genes
are associated with autoimmune diseases. However, genes are not the
only factors involved in determining a person's susceptibility to an
autoimmune disease. For example, some individuals who carry disease-associated
MHC molecules on their cells will not develop an autoimmune disease.
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How
Are Autoimmune Diseases Diagnosed?
The diagnosis of an autoimmune disease is based on an individual's symptoms,
findings from a physical examination, and results from laboratory tests.
Autoimmune diseases can be difficult to diagnose, particularly early in
the course of the disease. Symptoms of many autoimmune diseasessuch
as fatigueare nonspecific. Laboratory test results may help but
are often inadequate to confirm a diagnosis.
If an individual has skeletal symptoms such as joint pain and a positive
but nonspecific lab test, she or he may be diagnosed with the confusing
name of early or "undifferentiated" connective tissue disease. In this
case, a physician may want the patient to return frequently for follow
up. The early phase of disease may be a very frustrating time for both
the patient and physician. On the other hand, symptoms may be short-lived,
and inconclusive laboratory tests may amount to nothing of a serious
nature.
In some cases, a specific diagnosis can be made. A diagnosis shortly
after onset of a patient's symptoms will allow for early aggressive medical
therapy; and for some diseases, patients will respond completely to treatments
if the reason for their symptoms is discovered early in the course of
their disease.
Although autoimmune diseases are chronic, the course they take is unpredictable.
A doctor cannot foresee what will happen to the patient based on how
the disease starts. Patients should be monitored closely by their doctors
so environmental factors or triggers that may worsen the disease can
be discussed and avoided and new medical therapy can be started as soon
as possible. Frequent visits to a doctor are important in order for
the physician to manage complex treatment regimens and watch for medication
side effects.
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How
Are Autoimmune Diseases Treated?
Autoimmune diseases are often chronic, requiring lifelong care and monitoring,
even when the person may look or feel well. Currently, few autoimmune
diseases can be cured or made to "disappear" with treatment. However,
many people with these diseases can live normal lives when they receive
appropriate medical care.
Physicians most often help patients manage the consequences of inflammation
caused by the autoimmune disease. For example, in people with Type 1
diabetes, physicians prescribe insulin to control blood sugar levels
so that elevated blood sugar will not damage the kidneys, eyes, blood
vessels, and nerves. However, the goal of scientific research is to
prevent inflammation from causing destruction of the insulin-producing
cells of the pancreas, which are necessary to control blood sugars.
On the other hand, in some diseases such as lupus or rheumatoid arthritis,
medication can occasionally slow or stop the immune system's destruction
of the kidneys or joints. Medications or therapies that slow or suppress
the immune system response in an attempt to stop the inflammation involved
in the autoimmune attack are called immunosuppressive medications. These
drugs include corticosteroids (prednisone), methotrexate, cyclophosphamide,
azathioprine, and cyclosporin. Unfortunately, these medications also
suppress the ability of the immune system to fight infection and have
other potentially serious side effects.
In some people, a limited number of immuno-suppressive medications
may result in disease remission. Remission is the medical term used
for "disappearance" of a disease for a significant amount of time. Even
if their disease goes into remission, patients are rarely able to discontinue
medications. The possibility that the disease may restart when medication
is discontinued must be balanced with the long-term side effects from
the immunosuppressive medication.
A current goal in caring for patients with autoimmune diseases is to
find treatments that produce remissions with fewer side effects. Much
research is focused on developing therapies that target various steps
in the immune response. New approaches such as therapeutic antibodies
against specific T cell molecules may produce fewer long-term side effects
than the chemotherapies that now are routinely used.
Ultimately, medical science is striving to design therapies that prevent
autoimmune diseases. To this end, a significant amount of time and resources
are spent studying the immune system and pathways of inflammation.
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What
Are Some Examples of Autoimmune Diseases?
Rheumatoid Arthritis
In
people with rheumatoid arthritis, the immune system predominantly targets
the lining (synovium) that covers various joints. Inflammation of the
synovium is usually symmetrical (occurring equally on both sides of
the body) and causes pain, swelling, and stiffness of the joints. These
features distinguish rheumatoid arthritis from osteoarthritis, which
is a more common and degenerative "wear-and-tear" arthritis.
An inflamed jointthe synoviumis
attacked by cells and molecules of the immune system.

Currently available therapy focuses on reducing inflammation of the
joints with anti-inflammatory or immunosuppresssive medications. Sometimes,
the immune system may also target the lung, blood vessels, or eye; occasionally
patients may also develop symptoms of other autoimmune diseases such as
Sjogren's the inflammation, itching, and scaling. For more severe cases,
oral medications are used. Psoriasis is common and may affect more than
2 out of 100 Americans. Psoriasis often runs in families.
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Multiple Sclerosis
Multiple
sclerosis is a disease in which the immune system targets nerve tissues
of the central nervous system. Most commonly, damage to the central
nervous system occurs intermittently, allowing a person to lead a fairly
normal life. At the other extreme, the symptoms may become constant,
resulting in a progressive disease with possible blindness, paralysis,
and premature death. Some medications such as beta interferon are helpful
to people with the intermittent form of multiple sclerosis.
In young adults, multiple sclerosis is the most common disabling disease
of the nervous system. Multiple sclerosis afflicts 1 in 700 people in
this country. Researchers continue to search for triggers of the disease.

Immune-Mediated or Type 1 Diabetes Mellitus
Type 1 diabetes mellitus results from autoimmune destruction of the
insulin-producing cells of the pancreas. Insulin is required by the
body to keep the blood sugar (glucose) level under control. High levels
of glucose are responsible for the symptoms and the complications of
the disease. However, most of the insulin-producing cells are destroyed
before the patient develops symptoms of diabetes. Symptoms include fatigue,
frequent urination, increased thirst, and possible sudden confusion.
Type 1 diabetes mellitus
is usually diagnosed before the age of 30
and may be diagnosed as early as the first month of life. Together with
type 2 diabetes
(not considered an autoimmune disease), diabetes mellitus
is the leading cause of kidney damage, loss of eyesight, and leg amputation.
Close control of sugar levels decreases the rate at which these events
occur. There is a genetic predisposition to Type 1 diabetes, which occurs
in 1 out of 800 people in the United States. Among individuals who have
a close relative with Type 1 diabetes, those at high risk for developing
disease can be identified. Efforts are now under way to evaluate prevention
strategies for these family members at risk.
Sunlight is one of the triggers of
lupus and can worsen the progression of the disease.
Inflammatory Bowel Diseases
This
medical term is used for both Crohn's disease and ulcerative colitis,
two diseases in which the immune system attacks the gut (intestine).
Patients may have diarrhea, nausea, vomiting, abdominal cramps, and
pain that can be difficult to control. Illness in afflicted individuals
can result from intestinal inflammation and from side effects of the
drugs used for the disease. For example, daily use of high-dose corticosteroid
(prednisone) therapy, which is needed to control severe symptoms of
Crohn's disease, can predispose patients to infections, bone thinning
(osteoporosis), and fractures. For patients with ulcerative colitis,
surgical removal of the lower intestine (colon) will eliminate the disease
and their increased risk for colon cancer. More than 1 in 500 Americans
has some type of inflammatory bowel disease.

Systemic Lupus Erythematosus
Patients
with systemic lupus erythematosus most commonly experience profound
fatigue, rashes, and joint pains. In severe cases, the immune system
may attack and damage several organs such as the kidney, brain, or lung.
For many individuals, symptoms and damage from the disease can be controlled
with available anti-inflammatory medications. However, if a patient
is not closely monitored, the side effects from the medications can
be quite serious. Lupus occurs in 1 out of 2,000 Americans and in as
many as 1 in 250 young, African-American women.
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Psoriasis
Psoriasis is an
immune system disorder that affects the skin, and occasionally the eyes,
nails, and joints. Psoriasis may affect very small areas of skin or
cover the entire body with a buildup of red scales called plaques. The
plaques are of different sizes, shapes, and severity and may be painful
as well as unattractive. Bacterial infections and pressure or trauma
to the skin can aggravate psoriasis. Most treatments focus on topical
skin care to relieve the inflammation, itching, and scaling. For more
severe cases, oral medications are used. Psoriasis is common and may
affect more than 2 out of 100 Americans. Psoriasis often runs in families.
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Scleroderma
This autoimmune
disease results in thickening of the skin and blood vessels. Almost
every patient with scleroderma has Raynaud's, which is a spasm of the
blood vessels of the fingers and toes. Symptoms of Raynaud's include
increased sensitivity of the fingers and toes to the cold, changes in
skin color, pain, and occasionally ulcers of the fingertips or toes.
In people with scleroderma, thickening of skin and blood vessels can
result in loss of movement and shortness of breath or, more rarely,
in kidney, heart, or lung failure. The estimated number of people with
any type of scleroderma varies from study to study but may range from
1 to 4 affected individuals for every 10,000 Americans (or as many as
1 out of 2500 individuals).
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Autoimmune Thyroid Diseases
Hashimoto's
thyroiditis and Grave's disease result from immune system destruction
or stimulation of thyroid tissue. Symptoms of low (hypo-) or overactive
(hyper-) thyroid function are nonspecific and can develop slowly or
suddenly; these include fatigue, nervousness, cold or heat intolerance,
weakness, changes in hair texture or amount, and weight gain or loss.
The diagnosis of thyroid disease is readily made with appropriate laboratory
tests.
The thyroid gland affect many parts
of the body.
The symptoms of hypothyroidism are controlled with replacement thyroid
hormone pills; however, complications from over- or under-replacement
of the hormone can occur. Treatment of hyperthyroidism requires long-term
anti-thyroid drug therapy or destruction of the thyroid gland with radioactive
iodine or surgery. Both of these treatment approaches carry certain risks
and long-term side effects. Autoimmune thyroid diseases afflict as many
as 4 out of 100 women and are frequently found in families where there
are other autoimmune diseases.
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What
Research Is Under Way on Autoimmune Diseases?
The National Institute of Allergy and Infectious Diseases (NIAID) supports
research studies on the function of the immune system in various diseases.
A basic understanding of the human immune system is central to the understanding
of the development of an autoimmune disease (disease pathogenesis). Scientists
searching for ways to prevent and treat autoimmune disease are studying
disease pathogenesis and investigating new ways to modify the immune system.
Specifically, investigators supported by NIAID are focusing on: 1)
studies of the immune system during the progression of an autoimmune
disease; 2) analysis of the influence of genetics on autoimmune disease
expression and progression; 3) the role of infectious agents in autoimmune
diseases; 4) studies of animal models of autoimmune diseases; and 5)
the effects of therapeutic intervention on the immune system in an autoimmune
disease.
In addition, studies of a specific autoimmune disease such as multiple
sclerosis can provide new and additional insights into the pathogenesis
of autoimmune diseases affecting other organ systems. Therefore, NIAID
also supports studies on specific autoimmune diseases in cooperation
with other Institutes of the National Institutes of Health that focus
on organ-specific autoimmune diseases.
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Resources
National Institutes of Health (NIH) Resources
The
following NIH components support medical research and/or provide information
on varying aspects of autoimmune diseases.
National Institute of Allergy and Infectious Diseases
Office of Communications
Bldg. 31/Rm. 7A50
31 Center Drive, MSC 2520
Bethesda, MD 20892-2520
(301) 496-5717
http://www.niaid.nih.gov/publications/
and
http://www.niaid.nih.gov/recruit/recruit.htm
(for clinical trials information)
National Institute of Arthritis and Musculoskeletal and Skin Diseases
Information Clearinghouse/NIH
1 AMS Circle
Bethesda, MD 20892-3675
Fast Facts: (301) 881-2731 (to receive information by fax)
Clearinghouse: (301) 495-4484
http://www.nih.gov/niams/healthinfo/
National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK)
Information Clearinghouse
1 Information Way
Bethesda, MD 20892-3560
Diabetes, Digestive, and Kidney Diseases Information:
(301) 654-3810
NIDDK Information Office (Thyroid Diseases)
Bldg. 31/Rm. 9A04
31 Center Drive
Bethesda, MD 20892-3560
(301) 496-3583
http://www.niddk.nih.gov
National Institute of Neurological Disorders and Stroke
Office of Scientific and Health Reports
P.O. Box 5801
Bethesda, MD 20824
(301) 496-5751
http://www.ninds.nih.gov/hlthinhp.htm
NIH Clinical Center
Patient Recruitment and Referral Centerfor specific NIH clinical
trials information
4 West Drive, MSC 2655
Quarters 15 D-2
Bethesda, MD 20892-2655
(301) 411-1222
http://clinicalstudies.info.nih.gov/referring_patient.html
Office of Rare Diseases, NIH
Bldg. 31/Rm. 1B03
31 Center Drive
Bethesda, MD 20892
(301) 402-4336
http://cancernet.nci.nih.gov/ord/p_home.htm
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Other Resources Sponsored by the Department of Health and Human
Services
National Health Information Center
(800) 336-4797 or (301) 565-4167
Health Finder: http://www.healthfinder.gov
Combined Health Information Database
http://chid.nih.gov
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Private Sector Organizations
The following list
is astarting point for additional information on autoimmune diseases.
Many of the organizations have extensive educational resources, local
chapters, and support groups. The Internet Web site of many organizations
can refer you to other disease-oriented groups (for example, the Arthritis
Foundation has alink to the Lupus Foundation).
American Autoimmune Related Diseases Association
15475 Gratiot Avenue
Detroit, MI 48205
(800) 598-4668 or (313) 371-8600
http://www.aarda.org
American Diabetes Association
1660 Duke Street
Alexandria, VA 22314
(800) 232-3472 or (703) 549-1500
http://www.diabetes.org
American Liver Foundation
1425 Pompton Avenue
Cedar Grove, NJ 07009
(800) 233-0179 and (973) 256-2550
http://sadieo.ucsf.edu/alf/alffinal/homepagealf.html
American Thyroid Association Montefiore Medical Center
111 East 210th Street
Bronx, NY 10467
Fax: (718) 882-6085
http://www.thyroid.org
Arthritis Foundation
1650 Bluegrass Lakes Pkwy.
Alpharetta, GA 30009
(800) 283-7800 or (800) 207-8633
http://www.arthritis.org
Crohn's and Colitis Foundation of America
National Headquarters
386 Park Avenue South, 17th Floor
New York, NY 10016-8804
(800) 932-2423
(800) 343-3637 (Warehouse)
http://www.ccfa.org
Juvenile Diabetes Foundation International
120 Wall Street
New York, NY 10005-4001
(800) JDF-CURE or (800) 533-2873
http://www.jdfcure.com
Lupus Foundation of America
1300 Piccard Drive, Suite 200
Rockville, MD 20850-4303
(800) 558-0121 and (301) 670-9292
http://www.lupus.org/lupus
Myasthenia Gravis Foundation of America
1821 University Ave W, Ste S256
St. Paul, MN 55104-2897
(800) 541-5454
(651) 917-6256
(651) 917-1835 fax
mgfa@myasthenia.org
www.myasthenia.org
Myositis Association of America
1420 Huron Court
Harrisonburg, VA 22801
(540) 433-7686
http://www.myositis.org
National Alopecia Areata Foundation
14 Mitchell Boulevard
San Rafael, CA 94915-0760
or
P.O. Box 150760
San Rafael, CA 94915-0760
(415) 472-3780
Fax: (415) 472-5343
http://www.alopeciaareata.com/
National Multiple Sclerosis Society
733 Third Avenue, 6th Floor
New York, NY 10017-3288
(800) 344-4867 or (212) 986-3240
Fax: (212) 986-7981
http://www.nmss.org
e-mail: ire@nmss.org
National Organization for Rare Disorders
P.O. Box 8923
New Fairfield, CT 06812-1783
(800) 999-6673
http://www.nord-rdb.com/~orphan
National Psoriasis Foundation
6600 SW 92nd Avenue, Suite 300
Portland, OR 97223
(800) 723-9166 or (503) 244-7404
http://www.psoriasis.org
National Sjogren's Syndrome Association
5815 N. Black Canyon Highway, Suite 103
Phoenix, AZ 85015-2200
(602) 433-9844
http://www.sjogrens.org
National Vitiligo Foundation
P.O. Box 6337
Tyler, TX 75703
(903) 531-0074
Fax: (903) 531-9767
http://www.nvfi.org
Sjogren's Syndrome Foundation
333 N. Broadway
Jericho, NY 11753
1-800-4-SJOGRENS or (516) 933-6365
http://www.sjogrens.com
Spondylitis Association of America
P.O. Box 5872
Sherman Oaks, CA 91413
(800) 777-8189 or (888) 777-1594
http://www.spondylitis.org/
The S.L.E. Foundation
149 Madison Avenue, Suite 205
New York, NY 10016
(800) 745-8787
http://www.lupus.org/lupus
United Scleroderma Foundation
89 Newbury Street, Suite 201
Danvers, MA 01923
800) 722-HOPE
Fax: (978) 750-9902
http://www.scleroderma.org
Wegener's Granulomatosis Association International
P.O. Box 28660
Kansas City, MO 64188-8660
(800) 277-9474
Fax: (816) 436-8211
Email: wga@wgassociation.org
Wegener's Granulomatosis Support Group
P.O. Box 28660
Kansas City, MO 64188-8668
(800) 277-9474
Fax: (816) 436-8211
http://www.wgsg.org
[Top]
Glossary
antibody: a molecule (also called an immunoglobulin) produced
by a B cell in response to an antigen. The binding of antibody to antigen
leads to the antigen's destruction.
antigen: a substance or molecule that is recognized by the
immune system. The molecule can be from a foreign material such as a
bacterium or virus, or the molecule can be from the same organism (one's
own body) and called a self antigen.
antigen-presenting cell: a cell that displays an antigen with
an MHC molecule on the cell surface.
autoantibody: antibodies that are made against the body's own
organs and tissues rather than foreignparts of bacteria or viruses.
autoimmune disease: condition in which the immune system mistakenly
attacks the body's own organs and tissues.
B cell: a type of lymphocyte, which is an immune system cell.
Among its many roles, the B cell produces antibodies that bind antigens.
cells: the building blocks that make up tissues, organs, and
bloodstream of the body. Immune system cells normally move throughout
the bloodstream and reside temporarily in the lymph nodes, spleen, and
thymus.
chemokine: a substance manufactured by cells and tissues,
that stimulates movement and activation of immune system cells to the
area where the chemokine is produced.
clinical trial: a prospective, scientific evaluation in human
volunteers of a treatment regimen, device, or procedure used for the
prevention, diagnosis, or treatment of a disease.
complement system: this series of molecules works together
to perform many immune system functions. For example, the complement
system helps to dissolve and remove immune complexes and to kill foreign
cells.
co-stimulatory molecules: pairs of molecules on the surfaces
of two cells that work together with the MHC and T-cell receptors of
those cells. The co-stimulatory molecules help to stimulate or decrease
the immune response produced by the two cells.
cytokines: chemical substances that have varied effects on
many cells of the body. For example, some cytokines can cause growth
and activation of immune system cells.
gene: a unit of genetic material that is inherited from a
parent. A gene carries the directions that a cell uses to perform a
specific function.

immune complex: a cluster of interlocking antigens and antibodies
forming a large network of molecules.
inflammation: a collection of immune system cells and molecules
that invade tissues and organs as part of an immune system response.
lymphocyte: a type of white blood cell of the immune system.
T cells and B cells are lymphocytes that look similar under the microscope
but have different functions.
macrophage: a type of white blood cell that functions as a
patrol cell and engulfs and kills foreign infectious invaders.
MHC (major histocompatibility complex) molecules: molecules
that are found on cell surfaces and display antigen; the antigen-MHC
molecules may then interact with a T-cell receptor.
molecule: a small physical unit made up of chemical substances
such as proteins, sugars or fats. Molecules are the building blocks
of a cell.
neutrophil: a type of immune system cell that combats infectious
agents, in particular bacteria. Neutrophils contain granules filled
with potent chemicals that can destroy bacteria or other nearby cells
when the chemicals are released.
reactive oxygen intermediate molecules: toxic molecules that
are released by immune cells and help to destroy invading microbes.
These molecules can sometimes destroy healthy body tissues nearby.

T-cell: a type of lymphocyte. T cells have T-cell receptors
and, sometimes, co-stimulatory molecules on their cell surfaces. The T
cell helps to orchestrate the immune system and can issue "orders" for
other cells to make cytokines and chemokines.
T-cell receptor: a molecule found on the surface of T cells.
The T-cell receptor can recognize and interact with a corresponding
MHC molecule that is displaying an antigen.
tolerance: a state in which the T cell can no longer respond
to antigen.
From the
National Institute of Allergy and Infectious Diseases
NIH Publication No. 98-4273
May 1998
Last Updated June 30, 2003
http://www.niaid.nih.gov/publications/autoimmune/autoimmune.htm
Also see
Other webpages about
autoimmune disorders