Autoimmune Disorders

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Autoimmune disorders include a vast number of chronic ailments, of which a common feature is the malfunction of the immune system.

[10].

In particular the immune system aims to protect the body against infections, viruses and environmental agents that can harm it (antigens). To perform this function the immune system produces antibodies, these are specific molecules that bind the antigens. However people suffering from autoimmune diseases, incorrectly produce antibodies that are directed against the healthy cells, tissues and organs of the body. Depending of the different types of organs and tissues that are hidden, there are different autoimmune disorders such as [10]:

  • Multiple sclerosis
  • Pernicious anaemia
  • Rheumatoid arthritis
  • Dermatomyositis
  • Graves disease
  • Systemic lupus erythematosus
  • Myasthenia gravis

Unfortunately what causes the malfunction of the immune system is unknown, however a combination of genetic (a lot of immune disorders run in families) and environmental factors seem to play an important role.

Often there is not a specific cure for these conditions; however there are treatments that can alleviate the symptoms.

In this article the attention will be focused on three autoimmune diseases:

  • Multiple sclerosis (MS)
  • Rheumatoid arthritis (RA)
  • Systemic lupus erythematosus (SLE)

Multiple Sclerosis

MS is an inflammatory and autoimmune disease of the central nervous system [7, 8] affecting more than 100,000 people across the UK. Its onset is usually occurs between 20-40 years of age [2]. Women are also more likely to suffer from MS in comparison to men [8]. People suffering from this condition produce antibodies against the brain and/or the spinal cord. In particular there is a disruption of the material around the nerve fibres, called myelin [5]. Due to this, the messages sent through the nerves are disrupted. [9,11].

This condition can be experienced with different degrees of severity and can appear under different forms. However 8/10 people have the relapsing remitting form [9].

The common symptoms associate with this condition are: [2,11].

  • Fatigue
  • Difficulty to walk
  • Double vision
  • Muscle stiffness and spasm
  • Problems with balance and coordination
  • Bladder problems

The principal treatments for this disorder (in particular for the relapsing/remitting form) are [11]:

  • Steroid medications to accelerate the recovery
  • Specific treatments address to specific symptoms
  • Disease modifying therapies (to reduce the number of relapses)

Furthermore people suffering from this condition are strongly recommended to stop smoking. Being physically active and consuming a healthy and balanced diet can really help to manage the symptoms of MS.

If you suffer from MS, you could find it useful to follow these indications:

  • Consume the correct intake of Vitamin D. In particular people with insufficient

levels of Vitamin D seems to be more prone to develop this condition.[2,4,6].

  • Consume an adequate intake of carbohydrates and proteins. [2]
  • Try to avoid to eating lots of fatty and sugary foods because they can increase the postprandial inflammation. [8]
  • Decreasing salt intake can be useful because a high intake of salt induces the production of some pathogenic cells (Th17) that can have a role in the MS [2].
  • Eat a good amount of polyunsaturated fatty acids. They may help in reducing the frequency of relapses [2].
  • Eat more fruits and vegetables that contain antioxidants. They can help the body to cope with the oxidative stress that is characterised with this condition. [2].
  • Eat small and frequent meals. [2]
  • Avoid drinking alcohol on the basis that it has a pro-inflammatory action. [8]

Systemic lupus erythematosus

This is a very complicated autoimmune disease affecting approximately 15,000 people in the UK (90% of them are women in childbearing age) [11]. This condition can affect different organs such as: joints, internal organs and skin. The severity of symptoms can vary a lot from person to person and the majority of them experience periods of relapsing and remission.

The principal symptoms are [11]:

  • Joint pain
  • Fatigue
  • Rashes, in particular on the face

Similarly to MS, the cause of this ailment is not well understood. However it seems that genetic components, alongside environmental factors (exposure to sun light, hormonal changes, smoking, and certain infections) play an important role [11].

Even if there is not a precise and definitive cure, some medications are generally prescribed to alleviate the symptoms such as [11]:

  • Hydroxycloroquine
  • Non steroidal anti-inflammatory drugs
  • Corticosteroids (anti-inflammatory)
  • Immunosuppressants

It can be useful in controlling the symptoms to follow the below advice [2,3]:

  • Have a good intake of Vitamin D, because Vitamin D helps mediate immunity. People with an insufficient intake of it have a higher risk developing this condition. [3]. Furthermore because of people with SLE are advised to avoid the sun exposure (due to photosensitivity), Vitamin D supplements can be useful to guarantee its correct intake.
  • Do not exceed your daily amount of carbohydrates and saturated fats.
  • Fish oil and antioxidant supplementations can help the management of the condition.
  • Taking a multivitamin and mineral supplement can be useful.
  • Eat your daily recommended amount of fruits and vegetables.
  • Use spices to increase the intake of phytochemicals.
  • Green tea with EGCG and conjugated linoleic acid can also be useful.

Rheumatoid arthritis (RA)

This is another form of autoimmune disease that affects approximately 400,000 UK people. Its onset is commonly between 40-50 years of age. This disease causes predominantly pain, swelling (redness and warm) and stiffness in the joints. The joints that are mainly affected are the wrists, hands and feet. These are the most common symptoms; however people can also have other problems like fatigue, weight loss, fever, etc. Patients often experience moments of relapse and remission [13].

People suffering from this disorder produce antibodies directed against the cells in the joints, causing the inflammation of the synovium, the thin layer that surrounds the joints. Due to this inflammation, some chemicals are released causing damage in the synovium itself and also in the cartilage, bones, tendons and ligaments [13].

There is not a specific cure for this condition; however the principal treatments to alleviate the symptoms include [13]:

  • Medications
  • Supportive treatments (physiotherapy and occupational therapy)
  • Surgery

It seems that both genetic and environmental (as smoking) factors play an important role in the onset and the development of this disorder. In particular women are more prone to develop this condition in comparison to men due to the presence of high levels of oestrogen.

For people suffering from this condition it could be helpful to: [2,13]:

  • Avoid foods that exacerbate the symptoms (some people feel that their symptoms become worse after eating specific foods).
  • Calcium and Vitamin D can help to reduce the risk of osteoporosis (especially if you are taking steroids)
  • Folic acid and Vitamin B12 supplements can be useful to contrast the side effects of methotrexate (a medicine used to treat RA) and to offset elevated plasma homocysteine.
  • There is some evidence that taking fish oil supplements can reduce joint pain and stiffness.
  • Eat the recommended amounts of antioxidants (this pathology in fact is characterised by an increased oxidative stress)
  • The use of probiotics seems to be beneficial for some people to decrease some symptoms such as joints problems [1].
  • It is very important to do physical activity because it helps to maintain active and robust muscles that support joints. It is important to choose exercises that do not have an excessive impact on the joints. In particular swimming, cycling and walking are all good types of exercises.

Some patients find it useful to consume botanical supplements such as Borago officinalisOenothera blennis and Ribes migrum. It seems that their high levels of acid gamma linoleic can improve the pain and the disease activity [1].

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  1. Comella, N. F. L., Matilla, M. F., & Cuesta, J. A. C. (2016). Have complementary therapies demonstrated effectiveness in rheumatoid arthritis?. Reumatología Clínica (English Edition)12(3), 151-157.
  2. Escott-Stump, S. (2015). Nutrition and diagnosis-related care. Wolters Kluwer.
  3. Iruretagoyena, M., Hirigoyen, D., Naves, R., & Burgos, P. I. (2015). Immune response modulation by vitamin D: role in systemic lupus erythematosus. Frontiers in immunology6.
  4. Jahromi, S. R., Sahraian, M. A., Togha, M., Sedighi, B., Shayegannejad, V., Nickseresht, A., ... & Etemadifar, M. (2016). Iranian consensus on use of vitamin D in patients with multiple sclerosis. BMC Neurology16(1), 1.
  5. Masullo, L., Papas, M. A., Cotugna, N., Baker, S., Mahoney, L., & Trabulsi, J. (2015). Complementary and alternative medicine use and nutrient intake among individuals with multiple sclerosis in the United States. Journal of community health40(1), 153-160.
  6. Najafipoor, A., Roghanian, R., Zarkesh-Esfahani, S. H., Bouzari, M., & Etemadifar, M. (2015). The beneficial effects of vitamin D3 on reducing antibody titers against Epstein–Barr virus in multiple sclerosis patients.Cellular immunology294(1), 9-12.
  7. O’Connor, K., Weinstock-Guttman, B., Carl, E., Kilanowski, C., Zivadinov, R., & Ramanathan, M. (2012). Patterns of dietary and herbal supplement use by multiple sclerosis patients. Journal of neurology259(4), 637-644.
  8. Riccio, P., & Rossano, R. (2015). Nutrition facts in multiple sclerosis. ASN neuro7(1), 1759091414568185.
  9. Webster-Gandy, J., Madden, A., & Holdsworth, M. (Eds.). (2011). Oxford handbook of nutrition and dietetics. OUP Oxford.
  10. https://www.nlm.nih.gov/medlineplus/ency/article/000816.htm
  11. http://www.nhs.uk/Conditions/multiple-sclerosis/Pages/Introduction.aspx
  12. http://www.nhs.uk/conditions/lupus/pages/introduction.aspx
  13. http://www.nhs.uk/conditions/Rheumatoid-arthritis/Pages/Introduction.aspx

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