One of the most complex (if not THE most complex) systems in the body is the immune system. For those with an autoimmune disease, understanding the basics of how the immune system works might help you understand your disease a little bit better. So, let’s take a journey through Immunology 101!
The immune system is divided into two parts: the INNATE immune system and the ADAPTIVE immune system.
When you are exposed to an invader (like a bacteria or virus), the innate immune system is the first line of defense. It includes physical barriers, such as your skin, to keep the bugs out. It also includes certain immune cells, such as macrophages and others (neutrophils, eosinophils, etc). When the innate immune system recognizes an invader, it sounds an alarm. This “wakes up” the adaptive immune system, which is made up of B cells and T cells. This “alarm” comes in the form of cytokines, of which interleukins are on example. These cytokines are turned on by the innate immune system when it first encounters an invader. The cytokines have many different jobs, but one job is to bring more immune cells to the area of invasion. The other is to “wake up” the T cells and B cells.
[As a side note, for more advanced readers, this is where Th1 and Th2 come into play. T cells are divided into T killer cells and T helper cells. T helper cells have a few different subgroups, but Th1, Th2, and Th17 are the most relevant to the autoimmune patient. Different cytokines will induce either a Th1, Th2, or Th17 dominant immune reaction. There are also regulatory T cells which downregulate excessive immune responses. These are primed in the gut, which is why gut health is so important for immune regulation. Those with gut inflammation have less regulatory T cell activity]
Once B cells and T cells are awake, they will further amplify the immune fight against the invader. The B cells will make antibodies to help the fight. The T cells will also perform further actions to enhance the immune response.
Antibodies are a common finding in patients with autoimmune diseases. Antibodies are Y shaped molecules made by plasma cells (basically fancy B cells) that help promote immune defense. They can surround an invader and make it more palatable for an immune cell to eat. They can also bind to the antigen (i.e. the invader) and form an immune complex. Immune complexes can deposit into joints when they are in excess – this is what happens in Rheumatoid Arthritis to cause joint pain and swelling.
This is a very, very simplified view of how the immune system works on a regular day in a regular person who encounters an invader. What would happen if your body recognized your own self as an invader?
- The body purposely prepares for this situation. As T cells are maturing inside your thymus gland, they are put through a series of challenges, like a CIA agent in training! Any T cell that recognizes YOU as an invader is not allowed to continue training! He is terminated and sent away. However, this process may be faulty in autoimmune patients. The next fail-safe is regulatory T cells. Regulatory T cells are a special type of T cell that reduces excessive immune reactions. However, patients with gut inflammation may have problems with regulatory T cells.
- There are genetic predispositions to autoimmunity as well. Many patients have heard of HLA genes. Some common ones are HLAB27, HLADQ8, and more. What does this mean? Having these HLA genes essentially makes your body more likely to have an excessive reaction to an invader of some kind, such as a bacteria. This may explain why some patients’ autoimmune disease came on after an infection.
** When it comes to interventions for autoimmune patients, there is one important rule: Don’t take herbs and nutrients that boost the immune system!
Boosters: Echinacea, Andrographis, vitamin C (in some), Phytolacca, and more.
Immunosuppressants are agents that turn off cytokines and B cells/Tcells to make the immune system dampened down. This is what methotrexate and steroids do, for example. Immunomodulators, or immune modulators, balance the immune system. This means they turn down an immune reaction that is too excessive (like in the autoimmune patient) and turn up an immune system that is too weak. Examples include vitamin D, probiotics, Astragalus, Hops, Rehmannia, Chinese Thundergod Vine, vitamin A, and more.
Dr. Kimberly Sanders is an expert in natural and functional medicine for autoimmunity, arthritis, and immune dysfunction. She is adjunct faculty at the University of Bridgeport, where she teaches Biochemistry, Nutrition, and Biomedical Integration. She treats private patients in Milford, CT and also consults with patients all over the world via telemedicine.