Autoimmunity - are microbes the true cause of self-destructive illnesses?

Autoimmunity has long been considered a disease which attacks self-tissue, and there are many theories in relation to the cause of these sapping conditions. Most notably, where the body’s immune system confuses some form of 'self' tissue for a foreign particular and attacks it as it would if it were an infection, in most cases causing severe damage to its own tissue. There has also been much talk of genetic susceptibility to these autoimmune conditions, which is evidenced by its presentation in related family members.

However, new research is suggesting that there may be more to autoimmune disease than first meets the eye, as microbes have been shown to be able to penetrate our cells and tinker with our gene expression in ways that we didn’t realise were possible before.

Here I will explain the current theory on the microbial role in autoimmune conditions, and considerations of therapies for future treatment and prevention of these life-changing inflammatory conditions.

Who is controlling our gene expression?

Gene expression has a vast influence on human health, as the genes encode proteins which impact the function of our cells, so ensuring that the right genes are expressed at the right time is vital for optimum wellness and prevention of body process dysfunction which is apparent in autoimmune disease.

One example of this is angiotensin converting enzyme (“ACE”) which is linked to Alzheimer’s disease, heart failure, diabetes and sarcoidosis, and, interestingly, in the presence of the beneficial gut bacteria Lactobacillus and Bifidobacteria (which are present in some dairy products and you can find in supplementary probiotics). ACE’s expression is down-regulated, which may mean that such bacteria may have advantageous effects on the prevention of progression of such chronic diseases.

It has also been shown that in patients with autoimmune diseases such as psoriasis, diabetes, and Crohn’s disease, they have an altered composition of microbiomes in the body which suggests that there is a link between dysbiosis of microbes in the body and the onset of autoimmune conditions.

The vitamin D link

Many research papers have suggested that there is a link between vitamin D deficiency and the trigger for autoimmunity, as vitamin D plays a crucial role in immune tolerance and has anti-inflammatory affects in the body.

What is interesting is that current findings suggest that pathogens are able to alter gene expression by impacting the vitamin D nuclear receptor (VDNR), which plays an important role in the expression of thousands of genes and, most importantly, it is important for fighting off pathogens which are harbouring in our cells. The Epstein Barr Virus, which causes Glandular Fever, is one such virus which slows the expression of VDNR, as well as other common viruses. This can lead to a significant suppression of the innate immune system, which is the body’s first line of defence when it comes under attack from infection. Patients with both sarcoidosis and Crohn’s disease have been shown to have an impaired innate immune system response.

Successive infection leading to autoimmunity onset

Once the dysregulation of the VDNR occurs, the host is then more susceptible to other infections which cause further disruption to the body as the microbes have more power over our body’s gene expression, leading to total unbalance in the body known as 'successive infection'. As the levels of microbes increase, the individual will begin to present with symptoms of autoimmune disease. The particular autoimmune disease which is presented, such as sarcoidosis, alopecia, or multiple sclerosis, will be determined by the different types of microbes present in the body, and their strength and control over the body at that time.

Why it's often more than one

A lot of people who suffer with autoimmune disease often present symptoms of more than one condition, which would align to the microbes' theory as everyone would have caught different infections at different stages in their lives and would likely have differing ratios of these microbes in the body. However, very interestingly, some autoimmune diseases are shown to be linked, so, for example, if you suffer from lupus, you may be more likely to show symptoms of vitiligo as well, as these conditions may be triggered by similar microbes in the body. Research would suggest that obesity causes diabetes, however, is the real association just that obesity and diabetes are caused by the same microbes built up in the body rather than just one causing the other?

How to combat chronic conditions

Currently, the main method to manage autoimmune disease is to suppress the immune system to prevent it from attacking self-tissue - this seems sensible in terms of handling the symptoms, but it does not target the underlying root cause of the condition.

Should we not try to focus on correcting the damages to the immune system rather than suppressing it all together to ensure a full recovery from these challenging diseases? I know it’s easier said than done, but it does pose some interesting questions in respect of the future treatment of these conditions. Would patients have a longer-term recovery if these microbes are targeted in the first instance? It would likely be a 'getting worse before getting better' scenario as the body fights off all the 'dormant' infections, but would it be worth it in the long run? I suppose it depends on the severity of the condition, and whether the risks associated with triggering further impact of the disease would be too much to recover from.

Whatever the belief, it is now apparent that autoimmune disease sufferers should be doing everything that they can to fight off infection with a strong and robust immune system. Give your body the best chance to win the battle against the microbes, which means including lots of purple berries and vegetables in the diet, eating a good source of protein daily, and getting a plentiful amount of sunshine and vitamin D.