Autoimmune Diseases
The word "auto" is the Greek word for
self. The immune system is a complicated network of cells and cell components
(called molecules) that normally work to defend the body and eliminate infections
caused by bacteria, viruses, and other invading microbes. If a person has
an autoimmune disease, the immune system mistakenly attacks self, targeting
the cells, tissues, and organs of a person's own body. A collection of immune
system cells and molecules at a target site is broadly referred to as inflammation.
There are many different autoimmune diseases, and they can each affect the
body in different ways. For example, the autoimmune reaction is directed against
the brain in multiple sclerosis and the gut in Crohn's disease. In other autoimmune
diseases such as systemic lupus erythematosus (lupus), affected tissues and
organs may vary among individuals with the same disease. One person with lupus
may have affected skin and joints whereas another may have affected skin,
kidney, and lungs. Ultimately, damage to certain tissues by the immune system
may be permanent, as with destruction of insulin-producing cells of the pancreas
in Type 1 diabetes mellitus.
Who Is Affected by Autoimmune Diseases? Many of the autoimmune diseases
are rare. As a group, however, autoimmune diseases afflict millions of Americans.
Most autoimmune diseases strike women more often than men; in particular,
they affect women of working age and during their childbearing years.
Some autoimmune diseases occur more frequently in certain minority populations.
For example, lupus is more common in African-American and Hispanic women than
in Caucasian women of European ancestry. Rheumatoid arthritis and scleroderma
affect a higher percentage of residents in some Native American communities
than in the general U.S. population. Thus, the social, economic, and health
impact from autoimmune diseases is far-reaching and extends not only to family
but also to employers, co-workers, and friends.
What Are the Causes of Autoimmune Diseases? Are
they contagious? No autoimmune disease has ever been shown to be contagious
or "catching." Autoimmune diseases do not spread to other people
like infections. They are not related to AIDS, nor are they a type of cancer.
Are they inherited? The genes people inherit contribute to their susceptibility
for developing an autoimmune disease. Certain diseases such as psoriasis can
occur among several members of the same family. This suggests that a specific
gene or set of genes predisposes a family member to psoriasis. In addition,
individual family members with autoimmune diseases may inherit and share a
set of abnormal genes, although they may develop different autoimmune diseases.
For example, one first cousin may have lupus, another may have dermatomyositis,
and one of their mothers may have rheumatoid arthritis.
Examples of Autoimmune Diseases:
(Listed by the Main Target Organ)
--------------------------------------------------------------------
Nervous System: Gastrointestinal System:
Multiple sclerosis Crohn's Disease
Myasthenia gravis Ulcerative colitis
Autoimmune neuropathies such as Guillain-Barré Primary biliary cirrhosis
Autoimmune uveitis Autoimmune hepatitis
Blood: Endocrine Glands:
Autoimmune hemolytic anemia Type 1 or immune-mediated diabetes mellitus
Pernicious anemia Grave's Disease
Autoimmune thrombocytopenia Hashimoto's thyroiditis
Autoimmune oophoritis and orchitis
Blood Vessels: Autoimmune disease of the adrenal gland
Temporal arteritis
Anti-phospholipid syndrome Multiple Organs Including the Musculoskeletal System:*
Vasculitides such as Wegener's granulomatosis Rheumatoid arthritis
Behcet's disease Systemic lupus erythematosus
Scleroderma
Skin: Polymyositis, dermatomyositis
Psoriasis Spondyloarthropathies such as ankylosing spondylitis
Dermatitis herpetiformis Sjogren's syndrome
Pemphigus vulgaris
Vitiligo
*These diseases are also called connective tissue (muscle, skeleton, tendons,
fascia, etc.) diseases.
The development of an autoimmune disease may be influenced by the genes a
person inherits together with the way the person's immune system responds
to certain triggers or environmental influences. What other factors may influence
the development of autoimmune diseases? Some autoimmune diseases are known
to begin or worsen wit hcertaintriggerssuchasviralinfections.Sunlightnotonly
acts as a trigger for lupus but can worsen the course of the disease. It is
important to be aware of the factors that can be avoided to help prevent or
minimize the amount of damage from the autoimmune disease. Other less understood
influences affecting the immune system and the course of autoimmune diseases
include aging, chronic stress, hormones, and pregnancy.
How Does the Immune System Work? The immune system
defends the body from attack by invaders recognized as foreign. It is an extraordinarily
complex system that relies on an elaborate and dynamic communications network
that exists among the many different kinds of immune system cells that patrol
the body. At the heart of the system is the ability to recognize and respond
to substances called antigens whether they are infectious agents or part of
the body (self antigens).
Cells and molecules of the immune system protect the nose from attack by a
virus.
T cell (lymphocyte) with a T-cell receptor on
its surface T and B Cells
Most immune system cells are white blood cells, of which there are many types.
Lymphocytes are one type of white blood cell, and two major classes of lymphocytes
are T cells and B cells. T cells are critical immune system cells that help
to destroy infected cells and coordinate the overall immune response. The
T cell has a molecule on its surface called the T-cell receptor. This receptor
interacts with molecules called MHC (major histocompatibility complex). MHC
molecules are on the surfaces of most other cells of the body and help T cells
recognize antigen fragments. B cells are best known for making antibodies.
An antibody binds to an antigen and marks the antigen for destruction by other
immune system cells. Other types of white blood cells include macrophages
and neutrophils.
Macrophages and Neutrophils
Macrophages and neutrophils circulate in the blood and survey the body for
foreign substances. When they find foreign antigens, such as bacteria, they
engulf and destroy them. Macrophages and neutrophils destroy foreign antigens
by making toxic molecules such as reactive oxygen intermediate molecules.
If production of these toxic molecules continues unchecked, not only are the
foreign antigens destroyed, but tissues surrounding the macrophages and neutrophils
are also destroyed. For example, in individuals with the autoimmune disease
called Wegener's granulomatosis, overactive
A macrophage engulfing a bacterium and releasing packets of toxic molecules
(reactive oxygen intermediates) that break down and destroy the bacterium.
macrophages and neutrophils that invade blood vessels produce many toxic molecules
and contribute to damage of the blood vessels. In rheumatoid arthritis, reactive
oxygen intermediate molecules and other toxic molecules are made by overproductive
macrophages and neutrophils invading the joints. The toxic molecules contribute
to inflammation, which is observed as warmth and swelling, and participate
in damage to the joint.
MHC and Co-Stimulatory Molecules
MHC molecules are found on all cell surfaces and are an active part of the
body's defense team. For example, when a virus infects a cell, a MHC molecule
binds to a piece of a virus (antigen) and displays the antigen on the cell's
surface. Cells that have the capability of displaying antigen with MHC are
called antigen-presenting cells. Each MHC molecule that displays an antigen
is recognized by a matching or compatible T-cell receptor. Thus, an antigen-presenting
cell is able to communicate with a T cell about what may be occurring inside
the cell.
Upper left: a virus attacking a nerve cell.
Lower right: a T cell with a T-cell receptor recognizing a piece of
a virus (antigen) on the MHC of the infected nerve cell.
However, for the T cell to respond to a foreign antigen on the MHC, another
molecule on the antigen-presenting cell must send a second signal to the T
cell. A corresponding molecule on the surface of the T cells recognizes the
second signal. These two secondary molecules of the antigen-presenting cell
and the T cell are called co-stimulatory molecules. There are several different
sets of co-stimulatory molecules that can participate in the interaction of
antigen-presenting cell with a T cell.
Once the MHC and the T-cell receptor interact, and the co-stimulatory molecules
interact, there are several possible paths that the T cell may take. These
include T cell activation, tolerance, or T cell death. The subsequent steps
depend in part on which co-stimulatory molecules interact and how well they
interact. Because these interactions are so critical to the response of the
immune system, researchers are intensively studying them to find new therapies
that could control or stop the immune system attack on self tissues and organs.
An antigen-presenting cell (for example, a macrophage) with a foreign antigen
on its MHC is recognized by a T-cell receptor. In addition, co-stimulatory
molecules on the antigen-presenting cell and the T cell interact.
Cytokines and Chemokines
One way T cells can respond after the interaction of the MHC and the T-cell
receptor, and the interaction of the co-stimulatory molecules, is to secrete
cytokines and chemokines. Cytokines are proteins that may cause surrounding
immune system cells to become activated, grow, or die. They also may influence
non-immune system tissues. For example, some cytokines may contribute to the
thickening of the skin that occurs in people with scleroderma.
After the antigen-presenting cell and T cell interact through the MHC, T-cell
receptor and co-stimumlatory and molecules, the T cell becomes activated,
sending cytokine signals to other cells.
Chemokines are small cytokine molecules that attract cells of the immune system.
Overproduction of chemokines contributes to the invasion and inflammation
of the target organ, which occurs in autoimmune diseases. For example, overproduction
of chemokines in the joints of people with rheumatoid arthritis may result
in invasion of the joint space by destructive immune system cells such as
macrophages, neutrophils, and T cells.
Antibodies
B cells are another critical type of immune system cell. They participate
in the removal of foreign antigens from the body by using a surface molecule
to bind the antigen or by making specific antibodies that can search out and
destroy specific foreign antigens. However, the B cell can only make antibodies
when it receives the appropriate command signal from a T cell. Once the T
cell signals the B cell with a type of cytokine that acts as a messenger molecule,
the B cell is able to produce a unique antibody that targets a particular
antigen.
A T cell sends messenger molecules, e.g. cytokines, to the B cell, which allows
the B cell to start making antibodies.
Autoantibodies
In some autoimmune diseases, B cells mistakenly make antibodies against tissues
of the body (self antigens) instead of foreign antigens. Occasionally, these
autoantibodies either interfere with the normal function of the tissues or
initiate destruction of the tissues. People with myasthenia gravis experience
muscle weakness because autoantibodies attack a part of the nerve that stimulates
muscle movement. In the skin disease pemphigus vulgaris, autoantibodies are
misdirected against cells in the skin. The accumulation of antibodies in the
skin activates other molecules and cells to break down, resulting in skin
blisters.
Immune Complexes and the Complement System
When many antibodies are bound to antigens in the bloodstream, they form a
large lattice network called an immune complex. Immune complexes are harmful
when they accumulate and initiate inflammation
A large immune complex.
within small blood vessels that nourish tissues. Immune complexes, immune
cells, and inflammatory molecules can block blood flow and ultimately destroy
organs such as the kidney. This can occur in people with systemic lupus erythematosus.
If immune complexes accumulate in the kidney, they may promote movement of
other inflammatory cells and molecules into the kidney.
A group of specialized molecules that form the complement system helps to
remove immune complexes. The different types of molecules of the complement
system, which are found in the bloodstream and on the surfaces of cells, make
immune complexes more soluble. Complement molecules prevent formation and
reduce the size of immune complexes so they do not accumulate in the wrong
places (organs and tissues of the body). Rarely, some people inherit defective
genes for a complement molecule from their parents. Because these individuals
cannot make a normal amount or type of complement molecule, their immune systems
are unable to prevent immune complexes from being deposited in different tissues
and organs. These people develop a disease that is not autoimmune but resembles
lupus erythematosus.
Genetic Factors
Genetic factors can affect an individual's immune system and its responses
to foreign antigens in several ways. Genes determine the variety of MHC molecules
that individuals carry on their cells. Genes also influence the potential
array of T-cell receptors present on T cells. In fact, some MHC genes are
associated with autoimmune diseases. However, genes are not the only factors
involved in determining a person's susceptibility to an autoimmune disease.
For example, some individuals who carry disease-associated MHC molecules on
their cells will not develop an autoimmune disease.
How Are Autoimmune Diseases Diagnosed? The diagnosis
of an autoimmune disease is based on an individual's symptoms, findings from
a physical examination, and results from laboratory tests. Autoimmune diseases
can be difficult to diagnose, particularly early in the course of the disease.
Symptoms of many autoimmune diseases-such as fatigue-are nonspecific. Laboratory
test results may help but are often inadequate to confirm a diagnosis.
If an individual has skeletal symptoms such as joint pain and a positive but
nonspecific lab test, she or he may be diagnosed with the confusing name of
early or "undifferentiated" connective tissue disease. In this case,
a physician may want the patient to return frequently for follow up. The early
phase of disease may be a very frustrating time for both the patient and physician.
On the other hand, symptoms may be short-lived, and inconclusive laboratory
tests may amount to nothing of a serious nature.
In some cases, a specific diagnosis can be made. A diagnosis shortly after
onset of a patient's symptoms will allow for early aggressive medical therapy;
and for some diseases, patients will respond completely to treatments if the
reason for their symptoms is discovered early in the course of their disease.
Although autoimmune diseases are chronic, the course they take is unpredictable.
A doctor cannot foresee what will happen to the patient based on how the disease
starts. Patients should be monitored closely by their doctors so environmental
factors or triggers that may worsen the disease can be discussed and avoided
and new medical therapy can be started as soon as possible. Frequent visits
to a doctor are important in order for the physician to manage complex treatment
regimens and watch for medication side effects.
How Are Autoimmune Diseases Treated? Autoimmune
diseases are often chronic, requiring lifelong care and monitoring, even when
the person may look or feel well. Currently, few autoimmune diseases can be
cured or made to "disappear" with treatment. However, many people
with these diseases can live normal lives when they receive appropriate medical
care.
Physicians most often help patients manage the consequences of inflammation
caused by the autoimmune disease. For example, in people with Type 1 diabetes,
physicians prescribe insulin to control blood sugar levels so that elevated
blood sugar will not damage the kidneys, eyes, blood vessels, and nerves.
However, the goal of scientific research is to prevent inflammation from causing
destruction of the insulin-producing cells of the pancreas, which are necessary
to control blood sugars.
On the other hand, in some diseases such as lupus or rheumatoid arthritis, medication can occasionally slow or stop the immune system's destruction of the kidneys or joints. Medications or therapies that slow or suppress the immune system response in an attempt to stop the inflammation involved in the autoimmune attack are called immunosuppressive medications. These drugs include corticosteroids (prednisone), methotrexate, cyclophosphamide, azathioprine, and cyclosporin. Unfortunately, these medications also suppress the ability of the immune system to fight infection and have other potentially serious side effects.
In some people, a limited number of immuno-suppressive medications may result in disease remission. Remission is the medical term used for "disappearance" of a disease for a significant amount of time. Even if their disease goes into remission, patients are rarely able to discontinue medications. The possibility that the disease may restart when medication is discontinued must be balanced with the long-term side effects from the immunosuppressive medication.
A current goal in caring for patients with autoimmune diseases is to find treatments that produce remissions with fewer side effects. Much research is focused on developing therapies that target various steps in the immune response. New approaches such as therapeutic antibodies against specific T cell molecules may produce fewer long-term side effects than the chemotherapies that now are routinely used.
Ultimately, medical science is striving to design
therapies that prevent autoimmune diseases. To this end, a significant amount
of time and resources are spent studying the immune system and pathways of
inflammation.
What Are Some Examples of Autoimmune Diseases?
Rheumatoid Arthritis
In people with rheumatoid arthritis, the immune system predominantly targets
the lining (synovium) that covers various joints. Inflammation of the synovium
is usually symmetrical (occurring equally on both sides of the body) and causes
pain, swelling, and stiffness of the joints. These features distinguish rheumatoid
arthritis from osteoarthritis, which is a more common and degenerative "wear-and-tear"
arthritis.
An inflamed joint-the synovium-is attacked by cells and molecules of the immune
system.
Currently available therapy focuses on reducing inflammation of the joints
with anti-inflammatory or immunosuppresssive medications. Sometimes, the immune
system may also target the lung, blood vessels, or eye; occasionally patients
may also develop symptoms of other autoimmune diseases such as Sjogren's the
inflammation, itching, and scaling. For more severe cases, oral medications
are used. Psoriasis is common and may affect more than 2 out of 100 Americans.
Psoriasis often runs in families.
Multiple Sclerosis
Multiple sclerosis is a disease in which the immune system targets nerve tissues
of the central nervous system. Most commonly, damage to the central nervous
system occurs intermittently, allowing a person to lead a fairly normal life.
At the other extreme, the symptoms may become constant, resulting in a progressive
disease with possible blindness, paralysis, and premature death. Some medications
such as beta interferon are helpful to people with the intermittent form of
multiple sclerosis.
In young adults, multiple sclerosis is the most
common disabling disease of the nervous system. Multiple sclerosis afflicts
1 in 700 people in this country. Researchers continue to search for triggers
of the disease.
Immune-Mediated or Type 1 Diabetes Mellitus
Type 1 diabetes mellitus results from autoimmune destruction of the insulin-producing
cells of the pancreas. Insulin is required by the body to keep the blood sugar
(glucose) level under control. High levels of glucose are responsible for
the symptoms and the complications of the disease. However, most of the insulin-producing
cells are destroyed before the patient develops symptoms of diabetes. Symptoms
include fatigue, frequent urination, increased thirst, and possible sudden
confusion.
Type 1 diabetes mellitus is usually diagnosed
before the age of 30 and may be diagnosed as early as the first month of life.
Together with Type 2 diabetes (not considered an autoimmune disease), diabetes
mellitus is the leading cause of kidney damage, loss of eyesight, and leg
amputation. Close control of sugar levels decreases the rate at which these
events occur. There is a genetic predisposition to Type 1 diabetes, which
occurs in 1 out of 800 people in the United States. Among individuals who
have a close relative with Type 1 diabetes, those at high risk for developing
disease can be identified. Efforts are now under way to evaluate prevention
strategies for these family members at risk.
Sunlight is one of the triggers of lupus and can worsen the progression of
the disease. Inflammatory Bowel Diseases
This medical term is used for both Crohn's disease and ulcerative colitis,
two diseases in which the immune system attacks the gut (intestine). Patients
may have diarrhea, nausea, vomiting, abdominal cramps, and pain that can be
difficult to control. Illness in afflicted individuals can result from intestinal
inflammation and from side effects of the drugs used for the disease. For
example, daily use of high-dose corticosteroid (prednisone) therapy, which
is needed to control severe symptoms of Crohn's disease, can predispose patients
to infections, bone thinning (osteoporosis), and fractures. For patients with
ulcerative colitis, surgical removal of the lower intestine (colon) will eliminate
the disease and their increased risk for colon cancer. More than 1 in 500
Americans has some type of inflammatory bowel disease.
Systemic Lupus Erythematosus
Patients with systemic lupus erythematosus most commonly experience profound
fatigue, rashes, and joint pains. In severe cases, the immune system may attack
and damage several organs such as the kidney, brain, or lung. For many individuals,
symptoms and damage from the disease can be controlled with available anti-inflammatory
medications. However, if a patient is not closely monitored, the side effects
from the medications can be quite serious. Lupus occurs in 1 out of 2,000
Americans and in as many as 1 in 250 young, African-American women.
Psoriasis
Psoriasis is an immune system disorder that affects the skin, and occasionally
the eyes, nails, and joints. Psoriasis may affect very small areas of skin
or cover the entire body with a buildup of red scales called plaques. The
plaques are of different sizes, shapes, and severity and may be painful as
well as unattractive. Bacterial infections and pressure or trauma to the skin
can aggravate psoriasis. Most treatments focus on topical skin care to relieve
the inflammation, itching, and scaling. For more severe cases, oral medications
are used. Psoriasis is common and may affect more than 2 out of 100 Americans.
Psoriasis often runs in families.
Scleroderma
This autoimmune disease results in thickening of the skin and blood vessels.
Almost every patient with scleroderma has Raynaud's, which is a spasm of the
blood vessels of the fingers and toes. Symptoms of Raynaud's include increased
sensitivity of the fingers and toes to the cold, changes in skin color, pain,
and occasionally ulcers of the fingertips or toes. In people with scleroderma,
thickening of skin and blood vessels can result in loss of movement and shortness
of breath or, more rarely, in kidney, heart, or lung failure. The estimated
number of people with any type of scleroderma varies from study to study but
may range from 1 to 4 affected individuals for every 10,000 Americans (or
as many as 1 out of 2500 individuals).
Autoimmune Thyroid Diseases
Hashimoto's thyroiditis and Grave's disease result from immune system destruction
or stimulation of thyroid tissue. Symptoms of low (hypo-) or overactive (hyper-)
thyroid function are nonspecific and can develop slowly or suddenly; these
include fatigue, nervousness, cold or heat intolerance, weakness, changes
in hair texture or amount, and weight gain or loss. The diagnosis of thyroid
disease is readily made with appropriate laboratory tests.
The thyroid gland affect many parts of the body.
The symptoms of hypothyroidism are controlled with replacement thyroid hormone
pills; however, complications from over- or under-replacement of the hormone
can occur. Treatment of hyperthyroidism requires long-term anti-thyroid drug
therapy or destruction of the thyroid gland with radioactive iodine or surgery.
Both of these treatment approaches carry certain risks and long-term side
effects. Autoimmune thyroid diseases afflict as many as 4 out of 100 women
and are frequently found in families where there are other autoimmune diseases.
What Research Is Under Way on Autoimmune Diseases? The National Institute
of Allergy and Infectious Diseases (NIAID) supports research studies on the
function of the immune system in various diseases. A basic understanding of
the human immune system is central to the understanding of the development
of an autoimmune disease (disease pathogenesis). Scientists searching for
ways to prevent and treat autoimmune disease are studying disease pathogenesis
and investigating new ways to modify the immune system.
Specifically, investigators supported by NIAID are focusing on: 1) studies
of the immune system during the progression of an autoimmune disease; 2) analysis
of the influence of genetics on autoimmune disease expression and progression;
3) the role of infectious agents in autoimmune diseases; 4) studies of animal
models of autoimmune diseases; and 5) the effects of therapeutic intervention
on the immune system in an autoimmune disease.
In addition, studies of a specific autoimmune
disease such as multiple sclerosis can provide new and additional insights
into the pathogenesis of autoimmune diseases affecting other organ systems.
Therefore, NIAID also supports studies on specific autoimmune diseases in
cooperation with other Institutes of the National Institutes of Health that
focus on organ-specific autoimmune diseases.
Resources National Institutes of Health (NIH) Resources
The following NIH components support medical research and/or provide information
on varying aspects of autoimmune diseases.
National Institute of Allergy and Infectious
Diseases
Office of Communications
Bldg. 31/Rm. 7A50
31 Center Drive, MSC 2520
Bethesda, MD 20892-2520
(301) 496-5717
http://www.warts.org/library/health-and-science-topics.htm
and
http://www.niaid.nih.gov/recruit/recruit.htm (for clinical trials information)
National Institute of Arthritis and Musculoskeletal
and Skin Diseases
Information Clearinghouse/NIH
1 AMS Circle
Bethesda, MD 20892-3675
Fast Facts: (301) 881-2731 (to receive information by fax)
Clearinghouse: (301) 495-4484
http://www.nih.gov/niams/healthinfo/
National Institute of Diabetes and Digestive
and Kidney Diseases (NIDDK)
Information Clearinghouse
1 Information Way
Bethesda, MD 20892-3560
Diabetes, Digestive, and Kidney Diseases Information:
(301) 654-3810
NIDDK Information Office (Thyroid Diseases)
Bldg. 31/Rm. 9A04
31 Center Drive
Bethesda, MD 20892-3560
(301) 496-3583
http://www.niddk.nih.gov
National Institute of Neurological Disorders
and Stroke
Office of Scientific and Health Reports
P.O. Box 5801
Bethesda, MD 20824
(301) 496-5751
http://www.ninds.nih.gov/hlthinhp.htm
NIH Clinical Center
Patient Recruitment and Referral Center-for specific NIH clinical trials information
4 West Drive, MSC 2655
Quarters 15 D-2
Bethesda, MD 20892-2655
(301) 411-1222
http://clinicalstudies.info.nih.gov/referring_patient.html
Office of Rare Diseases, NIH
Bldg. 31/Rm. 1B03
31 Center Drive
Bethesda, MD 20892
(301) 402-4336
http://cancernet.nci.nih.gov/ord/p_home.htm
Other Resources Sponsored by the Department of Health and Human Services
National Health Information Center
(800) 336-4797 or (301) 565-4167
Health Finder: http://www.healthfinder.gov
Combined Health Information Database
http://chid.nih.gov
Private Sector Organizations
The following list is astarting point for additional information on autoimmune
diseases. Many of the organizations have extensive educational resources,
local chapters, and support groups. The Internet Web site of many organizations
can refer you to other disease-oriented groups (for example, the Arthritis
Foundation has alink to the Lupus Foundation).
American Autoimmune Related Diseases Association
15475 Gratiot Avenue
Detroit, MI 48205
(800) 598-4668 or (313) 371-8600
http://www.aarda.org
American Diabetes Association
1660 Duke Street
Alexandria, VA 22314
(800) 232-3472 or (703) 549-1500
http://www.diabetes.org
American Liver Foundation
1425 Pompton Avenue
Cedar Grove, NJ 07009
(800) 233-0179 and (973) 256-2550
http://sadieo.ucsf.edu/alf/alffinal/homepagealf.html
American Thyroid Association Montefiore Medical
Center
111 East 210th Street
Bronx, NY 10467
Fax: (718) 882-6085
http://www.thyroid.org
Arthritis Foundation
1650 Bluegrass Lakes Pkwy.
Alpharetta, GA 30009
(800) 283-7800 or (800) 207-8633
http://www.arthritis.org
Crohn's and Colitis Foundation of America
National Headquarters
386 Park Avenue South, 17th Floor
New York, NY 10016-8804
(800) 932-2423
(800) 343-3637 (Warehouse)
http://www.ccfa.org
Juvenile Diabetes Foundation International
120 Wall Street
New York, NY 10005-4001
(800) JDF-CURE or (800) 533-2873
http://www.jdfcure.com
Lupus Foundation of America
1300 Piccard Drive, Suite 200
Rockville, MD 20850-4303
(800) 558-0121 and (301) 670-9292
http://www.lupus.org/lupus
Myasthenia Gravis Foundation of America
222 S. Riverside Plaza, Suite 1540
Chicago, IL 60606
(800) 541-5454 or (312) 258-0522
http://www.med.unc.edu/mgfa/
Myositis Association of America
1420 Huron Court
Harrisonburg, VA 22801
(540) 433-7686
http://www.myositis.org
National Alopecia Areata Foundation
14 Mitchell Boulevard
San Rafael, CA 94915-0760
or
P.O. Box 150760
San Rafael, CA 94915-0760
(415) 472-3780
Fax: (415) 472-5343
http://www.alopeciaareata.com/
National Multiple Sclerosis Society
733 Third Avenue, 6th Floor
New York, NY 10017-3288
(800) 344-4867 or (212) 986-3240
Fax: (212) 986-7981
http://www.nmss.org
e-mail: ire@nmss.org
National Organization for Rare Disorders
P.O. Box 8923
New Fairfield, CT 06812-1783
(800) 999-6673
http://www.nord-rdb.com/~orphan
National Psoriasis Foundation
6600 SW 92nd Avenue, Suite 300
Portland, OR 97223
(800) 723-9166 or (503) 244-7404
http://www.psoriasis.org
National Sjogren's Syndrome Association
5815 N. Black Canyon Highway, Suite 103
Phoenix, AZ 85015-2200
(602) 433-9844
http://www.sjogrens.org
National Vitiligo Foundation
P.O. Box 6337
Tyler, TX 75703
(903) 531-0074
Fax: (903) 531-9767
http://www.nvfi.org
Sjogren's Syndrome Foundation
333 N. Broadway
Jericho, NY 11753
1-800-4-SJOGRENS or (516) 933-6365
http://www.sjogrens.com
Spondylitis Association of America
P.O. Box 5872
Sherman Oaks, CA 91413
(800) 777-8189 or (888) 777-1594
http://www.spondylitis.org/
The S.L.E. Foundation
149 Madison Avenue, Suite 205
New York, NY 10016
(800) 745-8787
http://www.lupus.org/lupus
United Scleroderma Foundation
89 Newbury Street, Suite 201
Danvers, MA 01923
800) 722-HOPE
Fax: (978) 750-9902
http://www.scleroderma.org
Wegener's Granulomatosis Association International
P.O. Box 28660
Kansas City, MO 64188-8660
(800) 277-9474
Fax: (816) 436-8211
Email: wga@wgassociation.org
Wegener's Granulomatosis Support Group
P.O. Box 28660
Kansas City, MO 64188-8668
(800) 277-9474
Fax: (816) 436-8211
http://www.wgsg.org
Glossary antibody: a molecule (also called an immunoglobulin) produced by
a B cell in response to an antigen. The binding of antibody to antigen leads
to the antigen's destruction.
antigen: a substance or molecule that is recognized by the immune system.
The molecule can be from a foreign material such as a bacterium or virus,
or the molecule can be from the same organism (one's own body) and called
a self antigen.
antigen-presenting cell: a cell that displays an antigen with an MHC molecule on the cell surface.
autoantibody: antibodies that are made against the body's own organs and tissues rather than foreignparts of bacteria or viruses.
autoimmune disease: condition in which the immune
system mistakenly attacks the body's own organs and tissues.
B cell: a type of lymphocyte, which is an immune system cell. Among its many
roles, the B cell produces antibodies that bind antigens.
cells: the building blocks that make up tissues, organs, and bloodstream of
the body. Immune system cells normally move throughout the bloodstream and
reside temporarily in the lymph nodes, spleen, and thymus.
chemokine: a substance manufactured by cells and tissues, that stimulates movement and activation of immune system cells to the area where the chemokine is produced.
clinical trial: a prospective, scientific evaluation in human volunteers of a treatment regimen, device, or procedure used for the prevention, diagnosis, or treatment of a disease.
complement system: this series of molecules works together to perform many immune system functions. For example, the complement system helps to dissolve and remove immune complexes and to kill foreign cells.
co-stimulatory molecules: pairs of molecules on the surfaces of two cells that work together with the MHC and T-cell receptors of those cells. The co-stimulatory molecules help to stimulate or decrease the immune response produced by the two cells.
cytokines: chemical substances that have varied effects on many cells of the body. For example, some cytokines can cause growth and activation of immune system cells.
gene: a unit of genetic material that is inherited
from a parent. A gene carries the directions that a cell uses to perform a
specific function.
immune complex: a cluster of interlocking antigens and antibodies forming
a large network of molecules.
inflammation: a collection of immune system cells and molecules that invade
tissues and organs as part of an immune system response.
lymphocyte: a type of white blood cell of the immune system. T cells and B cells are lymphocytes that look similar under the microscope but have different functions.
macrophage: a type of white blood cell that functions as a patrol cell and engulfs and kills foreign infectious invaders.
MHC (major histocompatibility complex) molecules: molecules that are found on cell surfaces and display antigen; the antigen-MHC molecules may then interact with a T-cell receptor.
molecule: a small physical unit made up of chemical substances such as proteins, sugars or fats. Molecules are the building blocks of a cell.
neutrophil: a type of immune system cell that combats infectious agents, in particular bacteria. Neutrophils contain granules filled with potent chemicals that can destroy bacteria or other nearby cells when the chemicals are released.
reactive oxygen intermediate molecules: toxic
molecules that are released by immune cells and help to destroy invading microbes.
These molecules can sometimes destroy healthy body tissues nearby.
T-cell: a type of lymphocyte. T cells have T-cell receptors and, sometimes,
co-stimulatory molecules on their cell surfaces. The T cell helps to orchestrate
the immune system and can issue "orders" for other cells to make
cytokines and chemokines.
T-cell receptor: a molecule found on the surface of T cells. The T-cell receptor
can recognize and interact with a corresponding MHC molecule that is displaying
an antigen.
tolerance: a state in which the T cell can no
longer respond to antigen.
Do you live with a Chronic Illness and need answers?
West Michigan Chronic Illness Support Group is here for you!
Meetings held the 3rd Wednesday of each month at 7pm @
Spring Lake Wesleyan Church.
Stop in and see what we are all about! Or feel free to visit
our website:
http://www.myfibrosite.com/users/wmci/index.html
For information please call (616) 844-4427 or email wmchronicillness@yahoo.com
Fibro Insite Educational Studies and Support website:
http://www.myfibrosite.com/users/fibroinsiteeducationalstudiesandsupport/index.html