Autoimmune Disease: The Common Threads AARDA Conference Topic

I promised that I would share some of the goodness from last Saturday's Autoimmune Disease conference sponsored by the AARDA, National Psoriasis Foundation, and OHSU, and here's a sample.

I was impressed in particular with this speaker: Dr. Noel R. Rose, Director, Center for Autoimmune Research at Johns Hopkins University.

Dr. Rose's discussion examined the far-reaching effects of autoimmune disease on several populations, affecting far more people than I had imagined:

And it's an expensive disease in more ways than one:

I wish I would have taken a better picture of this excellent graph below, which dramatically illustrates the comparison of females to males in various autoimmune diseases. The picture is a bit blurry, so I will list the diseases from left to right. Keep in mind that the pink bar represents women and the blue men.
From the left:
Sjogren's Syndrome
SLE -- Systemic Lupus Erythematosis
Thyroid disease
Scleroderma
Myasthenia Gravis
Rheumatoid Arthritis
Multiple Sclerosis
Sarcoid
Ulcerative Colitis
Diabetes Mellitus

The next graph shows the incidence of autoimmune disease in the US back in 1995. These numbers have increased considerably and consistently since then:

In looking at our little Sjogren's blip on the graph above, I understood just a bit more why our disease is unknown to so many. Doesn't excuse it.....just explains it. We do make up a fairly small piece of the autoimmune pie.

Dr. Rose went on to explain that current theories about the development of autoimmunity are three-pronged:

He commented that in his opinion, even though there are three factors in the causation of AI, environmental factors are more than half the risk.

One of the environmental factors which is not listed on the above slide, is the proximity to the equator: if you live in a temperate climate, your chances of having an autoimmune disease is higher. If you live closer to the equator, the chances are less. In the picture below, the pink and cream areas represent a lower occurrence than do the grey and green. Interesting.

To summarize the development of autoimmune disease, Dr. Rose explained...

Which brought us to the topic of how we can prevent this train wreck:

Early intervention is important, but also a difficult issue to address, since appearance of many biomarkers which indicate development of the disease may precede the actual symptoms and diagnosis by many years, which frustrates both patients and the physicians attempting to diagnose and treat them.

The graph above shows the gradual increase in autoantibodies over several years before symptoms and diagnosis of SLE.

Biomarkers of early disease need to be identified much more quickly than at present, and additional and more specific biomarkers need to be identified, according to Dr. Rose.

New treatment modalities are generally focused on those drugs that can interrupt the immune chain of events. Various drugs target various players in this chain:

Notice that the rituximab target is listed as Anti-CD20, which is a surface antigen -- or specialized protein -- found on B lymphocyte blood cells. I've written previously about why B cells, antibodies, and antigens are important to sjoggies, read this and this.

So. To summarize:

Autoimmune disease is HUGE. There's lots of them -- at least 80, and they affect lots of people, women more than men.

While it is not known exactly what causes AD, the current theory is that a combination of heredity, hormones, and environmental factors are to blame; with environmental factors taking up more than their fair share. It is strongly suspected that seemingly unrelated diseases such as diabetes and heart disease AND Sjogren's syndrome may all be far more similar than had previously been thought in that their causes are autoimmune in nature.

The future of research and treatment of these diseases, which all may share similar etiology, hinges on the ability to identify these diseases much sooner than at present, since we now know that the immune system begins to develop autoimmune processes and cells long before some symptoms and thus, diagnosis, appear.

A better understanding of biochemicals and their tasks in the immune response is vital to developing medications that will block these specific problematic biochemicals.

I wish that Dr. Rose could have addressed us for at least another two hours, or two days. He has an enormous amount of experience working in this field of research. I would love to know more specifics about which of these biochemicals and thus biomarkers for disease are the latest and greatest targets of research.