Millions with autoimmune disease need better solutions

[Marky90]

To call something an autoimmune disease I think one needs to have good evidence for an adaptive immune response to self antigen - either an autoantibody or anti-self T cells. The innate response cannot really be 'auto' becuase it never changes and does not discriminate self from non-self in an 'optional' way.
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That seems like a good definition..

However let me immunobabble a bit..

Is it possible that some MEs are due to immune systems so dysfunctional, that the mere dysfunction cause lack of physical function. I mean, that is the case with MDS, but I`m thinking that it can occur without the cause originating in the bone marrow as well? And maybe then it can be very hard to find the precise disease mechanism.

..Babble babble..

 

[Jonathan Edwards]

This is interesting.. I first developed ME 2 years ago, and some months ago psoriasis around my eye (which other family members also have had). You might remember me saying that i had a huge amount of t-cells with CD45RA and CDRO double positive phenotypes, which at least some researchers think might predispose for autoimmunity. May it be that such a phenotype predisposed me? It`s hard to say when a lot of patients have that phenotype without ME.. Is it right to say that such a phenotype is down to genetic expression? Anyway, I think you are right that genetics probably play a role, but not the whole role.

I am not aware of any genetic influence on CD45RA and RO expression. That sounds more like part of an effect, not a cause.

 

[Jonathan Edwards]

That seems like a good definition..

However let me immunobabble a bit..

Is it possible that some MEs are due to immune systems so dysfunctional, that the mere dysfunction cause lack of physical function. I mean, that is the case with MDS, but I`m thinking that it can occur without the cause originating in the bone marrow as well? And maybe then it can be very hard to find the precise disease mechanism.

..Babble babble..

I can't follow that I am afraid. What is MDS?

 

[Marky90]

I am not aware of any genetic influence on CD45RA and RO expression. That sounds more like part of an effect, not a cause.

Oooh, sorry. I thought such expression was decided by immunological genetics, don`t know why, as I don`t know immunology

 

[Marky90]

I can't follow that I am afraid. What is MDS?

No worries^^

MDS (myeloysplastic syndromes) is a group of diseases where the bone marrow progressively produces dysplastic cells, which often leads to cytopenia, and sometimes cancer. The cause is not known, but is seen more often after chemotherapy and exposure to other toxins or radiation. Most common in the elderly.

 

[user9876]

Someone mentioned that you can have type 2 diabetes and be thin. I think that may just be a reflection of the fact that these terms (type 1 and type2) are made up categories based on speculation and may turn out to be wrong. Maybe if you are thin then by definition you should be called type 1, or maybe it is more complicated.

Isn't there a type 3 diabetes now just to add to the confusion?

 

[Jonathan Edwards]

Isn't there a type 3 diabetes now just to add to the confusion?

Looking on the net, type 3 diabetes seems to be a new catchy name for Alzheimer's disease. But it is not even diabetes - defined originally as a tendency to pee a lot from the diuretic effect of sugar. We may now define it as hyperglycaemia due to inadequate insulin for the sensitivity of the system but in Alzheimer's you do not even need a high blood sugar. I don;t think this nomenclature will catch on.. Or if it does only for a while as a buzz word. I think we should stick to diabetes as it has always been defined. And probably expect type 1 and 2 to be replaced by something more intelligent in due course.

 

[Mel9]

To call something an autoimmune disease I think one needs to have good evidence for an adaptive immune response to self antigen - either an autoantibody or anti-self T cells. The innate response cannot really be 'auto' becuase it never changes and does not discriminate self from non-self in an 'optional' way.

In type 1 diabetes I gather there that antibodies to insulin or other islet proteins are found transiently in some cases but they do not seem to be a consistent finding as in the autoimmune diseases where we think the antibodies are actualy pathogenic. People also talk of T cell responses to islet cell proteins but the trouble is that you can get T cell responses to anything if you jigger the culture up a bit with cytokines. To my mind convincing evidence of pathogenic autoimmunity ought to be backed up by a sufficiently solid assay for anti-self activity to provide a clinical diagnostic test and as far as I know there is nothing like that for diabetes.

People often talk about diseases being autoimmune with very flimsy evidence. MS is not a typical autoimmune disease because nobody has found consistent anti-sefl antibody. There are antibodies in the wrong place but that is another matter. There is an assumption that there are antibrain T cells but I don;t think they have ever been found.

The other odd thing about Type 1 diabetes is that it occurs in childhood, and most autoimune diseases increase in incidence as you get older and are specifically more common in women. That is not the same for all but T1D is very anomalous.

Someone mentioned that you can have type 2 diabetes and be thin. I think that may just be a reflection of the fact that these terms (type 1 and type2) are made up categories based on speculation and may turn out to be wrong. Maybe if you are thin then by definition you should be called type 1, or maybe it is more complicated.

That is really interesting to me. My father 's mother died of Type 1 diabetes. When dad was in his 40s he became overweight and developed 'Type 2' diabetes. By the time he died, his doctors suggested that he may have had Type 1 diabetes all his life after all.