Are there more autoimmune diseases now than before?

The term “autoimmune disease” has become popular in recent years. It would seem that any pathology is related to this diagnosis, from coeliac disease to psoriasis, or even food intolerances. At least this is currently reflected in Google and social media. However, medical reality is often more complex. We spoke to Dr Mariel Silva, an expert in Integrative Medicine, Anti-Ageing and Digestive Health at SHA Wellness Clinic to find the most accepted definition of autoimmune disease.

These diseases, Dr Silva explains, are a kind of misguided attack that the body commits against itself. “Autoimmune diseases are disorders in which the immune system mistakenly attacks its own tissues and cells, instead of protecting them against external invaders such as bacteria and viruses”.

Has the definition of autoimmune disease changed much over the years?

Yes, in the past, these diseases were misunderstood. They were often not recognised as separate medical entities and their causes were mistakenly believed to be unknown, or even psychological in origin. Treatments were limited and focused on relieving symptoms rather than addressing the causes. Advances in medical research have led to a better understanding of the genetic and immunological basis of these diseases. New autoimmune diseases have also been identified and biomarkers have been developed that have improved their diagnosis and treatment. Although challenges remain, the definition and classification of autoimmune diseases has evolved, and now reflects a much more precise and detailed understanding of these disorders.

Why is it so difficult to treat an autoimmune disease?

We have to think about the complexity of the immune system, which is deregulated with these pathologies, so understanding the mechanisms underlying these diseases is a real challenge. In addition, there is often a great deal of variability in symptoms, and there is rarely a single cause behind the disease. This makes it difficult to get an early and accurate diagnosis.

On the other hand, many treatments for autoimmune diseases involve suppressing the activity of the immune system, which makes patients more susceptible to infections and drug side effects. Moreover, not all patients respond equally to treatment, which requires an individualised approach.

What are the best-known autoimmune diseases?

Systemic lupus erythematosus, Hashimoto’s thyroiditis, rheumatoid arthritis, Crohn’s disease, coeliac disease, type 1 diabetes and multiple sclerosis.

What diseases are suspected to be autoimmune, although not yet fully proven?

Some diseases are still under study, including fibromyalgia and chronic fatigue syndrome. Although, I insist, its autoimmune origin has not been fully demonstrated.

Does the Western lifestyle have an impact on the increased incidence of these pathologies?

Yes, it can have an impact in several ways. Lack of physical activity, chronic stress and exposure to environmental chemicals are elements of the Western lifestyle that may contribute to chronic inflammation and the triggering or exacerbation of autoimmune diseases. Specifically, chronic stress can have a negative impact on immune function. One of the crucial factors is diet, which in the West is often rich in saturated fats, refined sugars and processed foods. This type of diet has been linked to intestinal dysbiosis, and chronic dysbiosis can lead to autoimmune disease.

And what is gut dysbiosis?

It is an imbalance of the microbiota that can trigger a chronic inflammatory response in the gut, leading to inappropriate immune responses. This situation of chronic inflammation can negatively affect immune regulation. In addition, an imbalance in the microbiota increases the permeability of the intestinal lining, allowing unwanted substances to enter the bloodstream. All this activates the immune system inappropriately, contributing to the development of autoimmune diseases.

Is there an effective way to prevent these diseases?

Aiming for total prevention of autoimmune diseases may be too ambitious, as genetic, environmental and lifestyle factors are involved. However, some measures can be taken to reduce their risk or to delay their onset.

A healthy lifestyle, a balanced diet rich in fruits, vegetables and foods with anti-inflammatory properties, not including processed foods, staying physically active, learning to manage stress and avoiding exposure to environmental toxins are essential. Finally, avoid smoking and excessive alcohol consumption.

Good gut health is crucial for immune regulation, so eating foods rich in fibre and probiotics can help maintain a healthy balance in the microbiota. Adequate control of viral and bacterial infections is also important to prevent infection-associated autoimmune diseases. For people with a family history of autoimmune diseases, early monitoring and diagnosis is essential, as identifying and treating autoimmune conditions in their early stages can help prevent serious complications.

What treatments are most effective for these pathologies?

This is a diverse and complex field involving a variety of therapeutic approaches. The choice of treatment will depend on the disease and the organ that is primarily affected. For example, treatment for type 1 diabetes is different from that for Crohn’s disease.

For type 1 diabetes, insulin replacement therapy is required, as the immune system attacks the insulin-producing cells in the pancreas. For other autoimmune diseases such as Crohn’s disease, immunosuppressive drugs, biological therapies or dietary changes may be used to control inflammation and intestinal symptoms.

Acupuncture, physiotherapy and meditation can play an important role in the management of autoimmune diseases by helping to control symptoms and reduce stress. Lifestyle changes such as eating a balanced diet rich in anti-inflammatory foods, exercising regularly, managing stress and avoiding exposure to environmental toxins are crucial in these diseases.