Disease states autoimmune diseases

The role of CCR5 in the trafficking of leukocytes during CNS autoimmune diseases is poorly understood. Studies indicate that under noninflamed, physiologic states, few T cells enter the CNS and there is minimal CNS engraftment of blood-derived... 

Jacobson, D.L. et al., Epidemiology and estimated population burden of selected autoimmune diseases in the United States, Clin. Immunol. Immunopathol., 84, 223, 1997. 

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. 

Walsh, S.J. and Rau, L.M., Autoimmune diseases a leading cause of death among young and middle-aged women in the United States, Am. J. Public Health, 90, 1463, 2000. 

Worldwide, the most common thyroid disorder is hypothyroidism resulting from dietary iodine deficiency. In iodine-replete areas of the world, most thyroid disorders are the result of autoimmune disease. The symptoms manifested in hypothyroid and hyperthyroid states are largely independent of any underlying disorder of the thyroid gland itself they are a function of the degree of hormone deficiency or excess. 

Persons with type 1 diabetes constitute approximately ten percent of the diabetics in the United States. The disease is characterized by an absolute deficiency of insulin caused by an autoimmune attack on the 3 cells of the pancreas. This destruction requires a stimulus from the environment (such as a viral infection) and a genetic determinant that allows the P cell to be recognized as "non-self."... 

Cytokines and antagonists (2—4), intercellular proteins produced by immune cells, play an important role in the regulation of immune responses. Cytokines are present in a variety of tissues under normal conditions. Through insufficient or excessive production, these macromolecules can mediate chronic inflammatory diseases. An inability to respond to cytokines, eg, interleukin 1 (IL-1) or interleukin 2 (IL-2), may lead to an immunosuppressive state, whereas over-production can result in severe shock, autoimmune disease, or immunopathological conditions, such as leukemia and rheumatoid arthritis (RA). Specific communications between immune cells are constantly modulated by naturally occurring inhibitors. 

Although a mutation in an annexin has never been categorically proven to be the cause of a disease state, they have been implicated in pathologies as diverse as autoimmunity, infection, heart disease, diabetes and cancer. Annexinopathies were first described by Jacob H. Rand to describe the pathological sequelae in two disease states, die overexpression of annexin 2 in a patients with a haemorrhagic form of acute promyelocytic leukaemia, and the under-expression of annexin 5 on placental trophoblasts in the antiphospholipid syndrome. In this chapter we will outline some of the more recent observations in regard to these conditions, and describe the involvement of annexins in some other major causes of human morbidity... 

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). 

Therapists also deal with the rehabilitation of musculoskeletal disorders that are caused by an autoimmune response. Many of these diseases attack connective tissues, and autoimmune diseases such as rheumatoid arthritis, dermatomyositis, and systemic lupus erythematosus are often the primary reason that patients undergo rehabilitation. Patients with a compromised immune system may develop musculoskeletal problems related to their immunodeficient state. Hence, immunomodulating drugs are frequently used in many patients receiving physical therapy and occupational therapy. 

Our knowledge of how the immune system functions in both normal and disease states has increased dramatically over the last several decades, and we now have drugs that can moderate the effects of the immune response in certain clinical situations. Immunosuppressants are a mainstay in preventing tissue rejection, and much of the current success of organ transplants is due to the judicious use of immunosuppressive drugs. These drugs are also beneficial in a number of diseases that have an autoimmune basis, and immunosuppressants can help alleviate symptoms or possibly even reverse the sequelae of certain diseases... 

AE Silverstone State University of New York SUNY, Syracuse, NY Determine how activation of the Ah receptor or the ER can lead to thymic atrophy and the appearance of T-cells that could promote autoimmune disease in selected mouse strains ... 

In fetal life, if an immature antibody-producing cell displays cell-surface antibody that binds a normal body component, then the cell dies. Thus, usually, in the adult animal, no cells exist that can make antibodies against the animal s own macromolecules. This inability to make antibodies against self is called self-tolerance. However, in some disease states (the so-called autoimmune diseases) the immune system loses its tolerance against self-antigens. 

Disease states can also influence normal receptor function. For example, modified receptor function occurs in certain autoimmune diseases. Myasthenia gravis is a neuromuscular disease characterized by weakness and marked fatigability of skeletal muscles. The defect in myasthenia gravis is in synaptic transmission at the neuromuscular junction. Initial responses in the myasthenic patient may be normal, but they diminish rapidly, which explains the difficulty in maintaining voluntary muscle activity for more than brief periods. 

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