Systemic sclerosis etiology

Scleroderma (systemic sclerosis) is a disease of unknown etiology characterized by abnormally increased collagen deposition in the skin and visceral organs, alterations in the microvasculature, and numerous cellular and humoral immune abnormalities. A recent study in the United States estimated the disease prevalence to be approximately 25 per 100 000 (Mayes et al., 2003). Besides a racial... 

Sjogren syndrome. Chronic inflammatory autoimmune disease of the exocrine glands of unknown etiology. Its primary symptoms are keratoconjunctivitis sicca and xerostomia. Two types of Sjogren syndrome are distinguished a primary (isolated) type and a secondary type associated with another underlying autoimmune disease (e.g. rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis, primary biliary cirrhosis, autoimmune hepatitis, multiple sclerosis, thyroiditis, autoimmune, etc.). Ro/SS-A and La/SS-B autoantibodies are used as classification criteria. 

The connective tissue diseases (CTDs) are a heterogeneous group of immuno-logically mediated inflammatory conditions of unknown etiology, accompanied by diverse autoantibodies and affecting multiple organ systems. In adults, the more frequent CTDs comprise rheumatoid arthritis (RA), systemic sclerosis (SSc), Sjogren s syndrome (SjS), systemic lupus erythematosus (SLE), polymyositis/ dermatomyositis (PM/DM), and mixed CTD (MCTD). 

There has been considerable interest in the role of Epstein-Barr virus in the etiology of several autoimmune diseases, particularly systemic lupus erythematosus and multiple sclerosis. Epstein-Barr virus is a common infection. Most people (90% or more) are infected, without symptoms or with only mild, nonspecific symptoms, during childhood. When people are exposed as teenagers or as adults, however, infection may result in mononucleosis. Of importance with respect to autoimmune diseases, Epstein-Barr virus infects B cells and results in a latent infection. A close similarity between a peptide sequence in the Epstein-Barr nuclear antigen-1 and a sequence in the Sm autoantigen, one of the autoantibodies seen in systemic lupus erythematosus, has been reported (Sabbatini et al., 1993). In addition, several epidemiological studies have demonstrated strong associations between exposure to Epstein-Barr virus, as demonstrated by virus-specific IgG or IgA antibodies, and risk of systemic lupus erythematosus in children (James et al., 1997) and adults (James et al., 2001 Parks et al., 2005). 

Parkinson s disease (PD), Alzheimer s disease (AD), multi-infarct dementia and motoneuron disease (e.g. amyotrophic lateral sclerosis, ALS) represent typical neurodegenerative diseases for which no known etiology has been put forward. Parkinson s disease is characterized by reduced size and velocity of movements. In AD, cognitive impairment is the cardinal clinical symptom. In motoneuron disease, a degeneration of the central pyramidal, the peripheral motor system or both is the reason for the clinical picture. A significant overlap exists between these three disorders. 

Clinical herbalists have reported differing information on the use of Echinacea species in autoimmune conditions. Exacerbation of symptoms has been reported in systemic lupus, ulcerative colitis (autoimmune etiology uncertain), glomerular nephritis, and multiple sclerosis. In "some" cases, effects reoccurred on rechallenge. In rheumatoid arthritis, treatment with Echinacea species for 10 days did not exacerbate the condition (Upton and Graff 2007). A survey of 25 medical herbalists indicated that 12 had used Echinacea species in persons with autoimmune conditions. Of these 12, 11 indicated a beneficial effect and 1 indicated a worsening of symptoms (Upton and Graff 2007). 

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