What is autoimmunity? Why does our own body turn against us?

Have you ever heard that our own body's defense system, the soldiers who are supposed to protect us from disease, sometimes misbehaves and attacks us? It's strange, isn't it? But it's true. It's like the guard dog in our house not recognizing us and coming to bite us. This is what is called autoimmunity in medicine. Let's talk about this in a simple, easy-to-understand way today.

What is the Immune System - our body's super defender?

Simply put, our immune system is like an army inside our bodies. This army has many different soldiers. That is, it is made up of specialized organs, various types of cells (especially white blood cells), and proteins such as antibodies .

Their main job is to detect enemies entering the body from outside. That is:

• Bacteria
• Viruses
• Fungi
• Other germs and foreign substances

Once these enemies are identified, our immune system attacks and destroys them. Or it weakens their power. This is why we don't get sick often. Even if we do get sick, it is this immune system that helps us recover quickly. Isn't this mechanism in our body very amazing?

So, what is this confusion about autoimmunity?

Now imagine, our defense force, the immune system, starts attacking its own soldiers, the healthy cells and tissues of our body, due to a small mistake. That's what we call autoimmunity . "Auto" means "self." "Immunity" means immunity. So you understand, this is one where your own immunity attacks itself.

This is like the army, which is supposed to protect the country, accidentally shooting innocent people in its own country. What happens is that parts of our own body are gradually destroyed.

What happens in this is not that the immune system is weakened, but that it goes astray. That is, it cannot distinguish between "self" and "foreign." As a result, it begins to produce antibodies , or, let's say, "misunderstood weapons," against its own body parts, thinking that they are "enemies." We also call these autoantibodies .

Why does this happen to our bodies? What are the reasons?

The exact cause of these autoimmune conditions is still unknown, but scientists believe that a combination of factors may play a role.

• Genetic predisposition: If some people have conditions like this in their families, they may also have a predisposition to develop them. This means that our genes may give us a small boost. But it cannot be said that it develops simply because of the genes.
• Environmental triggers: Sometimes things in our environment, such as an infection, certain medications, smoking, or high levels of stress, can trigger the "first shot" of an autoimmune reaction. This means that someone with a genetic predisposition is more likely to develop the condition when they are exposed to an environmental factor.
• Hormones: Some autoimmune diseases are more common in women, so it is thought that female hormones play a role.
• Some infections: There is also a theory that after some bacterial or viral infections, the immune system becomes a little dysfunctional, and this condition can begin.

The most important thing is that this is not a contagious disease. That means it cannot be spread from person to person, either through touching or sharing food and drinks. Also, this is not your fault.

What are the types of autoimmune diseases? Let's look at some examples.

It is said that there are more than 80 types of autoimmune diseases. Some are well-known, some are not so well-known. These diseases can affect almost any part of the body. Let's look at some of the most common examples.

• Type 1 Diabetes: In this, our immune system destroys the cells in the pancreas that produce the hormone insulin . Insulin is essential for controlling our body's sugar levels. So when these cells are destroyed, insulin is no longer produced.
• Rheumatoid Arthritis: In this condition, our immune system attacks the joints. The joints become swollen, stiff, and painful. Over time, the shape of the joints may even change.
• Lupus (SLE - Systemic Lupus Erythematosus): Lupus is a complex autoimmune disease that can affect not just one area of ​​the body, but many organ systems, such as the skin, joints, kidneys, brain, and heart.
• Multiple Sclerosis (MS): In this disease, the immune system attacks the protective covering (myelin sheath) around nerve fibers in the brain and spinal cord. This causes problems with the transmission of messages through the nerves.
• Hashimoto's Thyroiditis: In this condition, the immune system attacks the thyroid gland, a butterfly-shaped gland in our neck. This causes a decrease in the production of thyroid hormones, resulting in hypothyroidism.
• Graves' Disease: This is also an autoimmune disease that affects the thyroid gland. However, in this case, the thyroid gland becomes overactive and produces too much thyroid hormone (hyperthyroidism).
• Inflammatory Bowel Disease (IBD): This includes conditions like Crohn's Disease and Ulcerative Colitis. These cause chronic inflammation of the digestive system, especially the intestines.

These are just a few examples. The symptoms and effects of each of these diseases are different.

What are the common symptoms of this condition?

The symptoms of an autoimmune disease vary greatly depending on the type of disease and what part of the body it affects. However, there are some common symptoms that can be seen in many autoimmune diseases.

• Frequent fatigue and tiredness: Feeling tired despite sleeping well.
• Joint pain, swelling, stiffness.
• Skin problems: Various rashes, redness of the skin, sometimes butterfly-shaped spots on the face (like in lupus).
• Abdominal pain or digestive issues.
• Recurrent low-grade fever.
• Swollen lymph nodes.
• Numbness in the limbs or a feeling like ants are running around.
• Hair loss.

Just because you have one or two of these symptoms doesn't mean you have an autoimmune disease. These can also be caused by other simple reasons. But if these symptoms persist or worsen, it's best to see a doctor for advice.

Another thing is that the symptoms of these autoimmune diseases can suddenly appear (flare-ups) and then subside for a while (remission). Therefore, even while receiving treatment, the disease can suddenly worsen.

How does a doctor diagnose an autoimmune condition? (Diagnosis)

Diagnosing an autoimmune disease can sometimes be a bit complicated because the symptoms are very vague and similar to other diseases.

Typically, a doctor will do things like this:

1. You will be asked details: what symptoms you have, how long you have had them, and whether anyone in your family has had similar illnesses.

2. Performs a physical examination: Examines the body.

3. Blood tests: These are very important.

• Tests like ESR (Erythrocyte Sedimentation Rate) and CRP (C-Reactive Protein) to check for inflammation in the body.
• Tests that look for specific autoantibodies , that is, antibodies that are produced against our own bodies. For example, the ANA (Antinuclear Antibody) test. If this is positive, an autoimmune condition is suspected.
• There are also specific antibody tests for some autoimmune diseases.

4. Other tests: Sometimes, depending on the organ affected , imaging tests such as X-rays, scans, or a biopsy (which involves taking a small piece of tissue and looking at it under a microscope) may be done.

After doing all this, the doctor comes to a conclusion.

Is there a treatment for this? How to manage it? (Treatment & Management)

Although many autoimmune diseases cannot be completely cured, there are effective treatments that can help control the disease, reduce symptoms, and make life easier. The main goals of treatment are to:

• Symptom reduction: Controlling things like pain, swelling, and fatigue.
• Controlling autoimmune processes: Stopping or reducing the immune system's attack on its own body.
• Protecting the body's ability to fight real diseases: Controlling the immune system to the extent necessary, without over-suppressing it.
• Reducing or preventing damage to organs.

The following are mainly used as treatments:

• Anti-inflammatory drugs: Painkillers like NSAIDs (Nonsteroidal Anti-inflammatory Drugs) reduce pain and swelling.
• Corticosteroids: For example, Prednisolone. These can quickly control the immune system and inflammation. However, they can cause side effects when used long-term, so they should be taken only as directed by a doctor.
• Immunosuppressants: These medications work by reducing the activity of the immune system, preventing it from damaging your own body. These should also be used under medical supervision.
• Biologic drugs: These are newer, targeted treatments that help control the disease by affecting only specific parts of the immune system. These can be a bit more expensive.
• Specific treatments for symptoms: For example, diabetes requires insulin. Joint pain can be treated with physiotherapy.

In addition to medication, lifestyle changes are also very important:

• A balanced diet: nutritious food and drink.
• Regular exercise: As appropriate for the body.
• Stress management: Things like meditation and yoga.
• Getting enough sleep.
• Avoid smoking.

About living with an autoimmune condition

It's normal to feel sad and scared when you learn that you have an autoimmune disease, because many of these are chronic diseases, meaning they last a long time.

But remember, you are not alone. Millions of people around the world are living successfully with these conditions.

The most important thing is:

• Maintain a good relationship with your doctor. Go to clinics as scheduled, take your medications as prescribed, and tell your doctor if you have any questions.
• Educate yourself about your illness. Then you will understand how to live with it.
• Get support from family and friends. Tell them about your situation.
• It's also a great help if you can join support groups with people in similar situations.
• Understand that there may be periods of increased symptoms (flare-ups) and periods of decreased symptoms (remissions). Prepare for this in advance.
• Take care of your mental health as well. Seek counseling if necessary.

Finally, things to remember (Take-Home Message)

Okay, so let's review the most important points about autoimmunity that we talked about today.

• Autoimmunity is when our own body's immune system mistakenly attacks our own healthy cells and tissues.
• This is not your fault, nor is it something you did. And it is not a contagious disease.
• There are many types of autoimmune diseases, which can affect different parts of the body.
• Symptoms can be varied and vague. If in doubt or if symptoms persist, it is wise to seek medical advice.
• Although many autoimmune diseases cannot be completely cured, there are effective treatments that can control symptoms and improve quality of life.
• It is very important to diagnose the disease early and receive continuous, correct treatment.
• You are not alone in this journey. With proper medical advice and support, you can live well with this condition.

If you have any further questions about this, don't be afraid to talk to your family doctor or a specialist.

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