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Triggers of autoimmune ..?  Autoimmunity

Triggers of Autoimmune Disease

There are several suspects in the search for triggers. In fact, there is quite a lot of evidence for several types of triggers, so it seems there may be multiple triggers for autoimmune diseases. Some of the suspects include:

  • Viruses: These are probably the most studied candidate for autoimmune diseases. However, results have been somewhat unconvincing. Finding viruses directly inside the autoimmune infection site has been difficult, though perhaps the viral-infected cells are already destroyed, especially if the virus only starts the early phases of autoimmunity. Thus a key question is whether viruses simply initiate AI diseases, or whether they must stay around to continue the AI reaction. It is also unclear if viruses cause their effects because of the immune reaction against the virus specifically, or simply because of the extra inflammation their infection causes at a site. Evidence of viral-AI links is quite strong and there are some AI diseases that can actually be caused by viruses in animal experiments. Some of the diseases with associated viral suspects include:
    • Type 1 Diabetes and Coxsackie B virus
    • Autoimmune hepatitis andhepatitis C virus (HCV) or hepatitis D virus (HDV)
    • Rheumatoid arthritis andEpstein-Barr virus (EBV)
    • Autoimmune myocarditis in mice and Coxsackie B virus
    • Theiler's myrine encephalomyelitis virus (TMEV) and encephalitis in mice

  • Bacteria: There is not a strong link between autoimmunity and bacteria  as a trigger. However, a few examples have been found:
    • Autoimmune myocarditis and Group A streptococcal M bacteria.
    • Autoimmune myocarditis and thesyphilis spirochete Treponema pallidum
  • Parasites: These are very rarely regarded as an autoimmune disease trigger. However, there are a few rare examples of a relationship between an AI disease and a parasite:
    • Chagas' heart disease and Trypanosoma cruzi
    • SLE/Sojgren's syndrome and the Ochocerca volvulus nematode.
    • Pemphigus foliaceous and the Simulium nigraimanum blackfly
  • Diet: There are some examples where the presence of a particular substance in the diet might possibly be related to an autoimmune disease:
    • Cow's milk andType 1 diabetes: Somewhat controversial, but there is some evidence of an association between cow's milk and Type 1 diabetes. This idea is tied to the idea of molecular mimicry theory as the underlying cause, because a particular sequence of milk protein matches the proteins of the islet cells.
    • Celiac disease and gluten: There is a clear relationship between gluten (in wheat) and celiac disease. But is this a trigger of celiac disease or a secondary issue.
  • Chemicals: There are examples where toxins and chemicals have been linked to AI diseases in humans and laboratory animals.
    • Scleroderma and metals: the risk of scleroderma to miners is high, particular silica; other possible metals involved are mercury, copper, iron.
    • Mercury and kidney autoimmunity in rats
    • Iodine andautoimmune thyroiditis: if not causal, at least contributes to the development of AI.
    • Silicon breast implants and SLE:
  • Medicines: There have been some examples of medications that may trigger autoimmunity as a side effect.
    • ANAs from hydralazine and procaine amide
    • Erytherocyte autoantibodies and alpha methyl dopa
    • Cytochrome antibodies and tienilic acid
    • acetylcholine receptor antibodies and D-penicillamine
    • halothane (an anesthetic) causes AI through creating a new antigen in the liver
  • Genetics: Familial and individual clustering: There are several key facts that show a role of genetics in autoimmunity. The first is that getting one AI disease makes it more likely that you are at risk for a second AI disease. The second fact is that the families, siblings, and children of people with an AI disease are at risk of that AI disease, and of other AI diseases. Thirdly, certain genetically modified animals get AI diseases (e.g. NOD mice get Type 1 diabetes), and this is in fact used to study AI diseases in animal models of the disease. The study of genetics and AI diseases has found numerous genes that are involved in different AI diseases.