Autoimmune diseases table

Autoimmune Disease. Table 1 Autoimmune diseases Organ-specific autoimmune diseases... 

A recent report by the National Institutes of Health estimated that at 14 to 22 million people in the United States are affected by an autoimmune disease.1 As a group, these diseases represent a leading cause of death among women under age 65, with systemic lupus erythematosus, multiple sclerosis, and type 1 diabetes being the major sources of this impact on mortality.2 The autoimmune thyroid diseases, type 1 diabetes and rheumatoid arthritis are the most common of the autoimmune diseases (Table 25.1).3-5 Most autoimmune diseases disproportionately affect women. In the thyroid diseases, primary biliary cirrhosis, scleroderma, systemic lupus erythematosus, and Sjogren s syndrome, more than 85% of patients are female, but it is not known why the female predominance is so high in these specific diseases. 

This chapter reviewed current research pertaining to selected environmental agents and autoimmune diseases (Table 25.3). Other infectious agents (e.g., parvovirus, varicella), occupational exposures (e.g., mercury), dietary factors (dietary supplements, nutrients such as antioxidants, and specific proteins in wheat and other grains implicated in celiac disease), and stress have been the focus of additional research that was not included in this review. 

Autoimmune diseases may inflict on each organ or cell. Manifestations range from affecting a single cell type and its specific function (such as the (3-cell of the islands in the pancreas) to systemic diseases which have a detrimental effect on an entire organ system (e.g. the vasculature) of even many different organs. Table 1 summarizes some clinically important diseases. 

A number of chimerized, humanized, and one human mAb have now been approved for therapeutic use in humans in the treatment of autoimmunity, malignancy, infection and cardiovascular disease (Table 1). Some of the currently licensed mAb will be discussed here. A much larger number of mAb are currently being evaluated in Phase I, II and III trials. In general, chimeric, humanized and human mAb are very well tolerated with few side effects. Chimeric or humanized mAb still have the potential to evoke host immune response to the variable domains or CDRs of the antibody so-called HACA (human anti-chimeric antibody) or HAHA (human anti-human antibody) responses, although these responses are uncommon. Short-lived and occasionally severe infusion-related acute hypersensitivity reactions such as fever, skin itching, shivering, respiratory compromise and low blood pressure sometimes occur-. Such effects may... 

Non-infectious causes of meningitis include malignancy, medications, autoimmune disease (such as lupus), and trauma.8,9 The most common pathogens causing bacterial meningitis, by age group and other risk factors, are found in Table 67-1. 

For some autoimmune diseases, little is known about environmental factors involved in the initiation or progression of the disease. For other diseases, however, considerable research has been conducted on one or more types of exposures. Most epidemiologic studies of environmental influences have focused on multiple sclerosis, rheumatoid arthritis, scleroderma, systemic lupus erythematosus, and small vessel vasculitis, but experimental studies using murine models of these diseases is limited (Table 25.1). 

Issues regarding the influence of duration or intensity of exposure in relation to effect on autoimmune disease processes are questions that have not been established, with some inconsistencies seen in the epidemiologic studies (Table 25.2). Dose or intensity of silica exposure affects the clearance from the lung and silica-containing macrophages can be translocated to pulmonary lymph nodes. Increased production of immunoglobulins and of lymphocyte-derived interferon-gamma is seen at these sites.49... 

A list of autoimmune diseases for which immunosuppressive therapy is commonly used can be found in Table 57.1. 

Inflammatory influences 1865 Table 31 -3 Some Autoimmune Diseases... 

S100A12 is associated with several pathological states including psoriasis (together with S100A7), inflammation, Mooren s ulcer, an autoimmune disease of the human cornea, and Kawasaki s disease, an acute multisystem vasculitits, occurring in children usually under 5 years of age (Table 2). 

Linomide (A/-phenylmethyl-l,2-dihydro-4-hydroxyl-l-methyl-2-oxo-qui-noline-3-carboxamide, structure given in Table 1) has been proven to be an immunomodulator [32], In clinical trials, it has been shown to be a potential treatment for autoimmune diseases such as rheumatoid arthritis, systemic lupus erythematosis and multiple sclerosis [37-39]. It has also been reported to possess antiangiogenic activity [33,40]. 

In reviewing specific autoimmune diseases, the primary involvement is often not the nervous system. However, neurologic symptoms and involvement frequently accompany most autoimmune disorders (Table 21.2). 

Table 21.2. Primai-y tissue and neui ologic involvement in autoimmune diseases.

Clinical experience with leflunomide in patients with other autoimmune diseases is limited. Extended indications for the use of leflunomide include treatment of Crohn s disease in patients who are intolerant of standard immunomodulator therapy (31), chronic sarcoidosis (32), maintenance therapy of complete or partial remission in Wegener s granulomatosis (30), and mild to moderate systemic lupus erythematosus (29) (Table 1). 

Gene therapy is under evaluation for many diseases, ranging from rare inherited single gene defects to common disease such as HIV, deafness, autoimmune diseases, bone regeneration, and many others " " (Tables 5 and 7). 

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