Autoimmunity
Autoimmune conditions & 'Leaky gut'
We know there are more than 80 autoimmune diseases and the antibodies relating to these conditions are often being made by the immune system as early as 10 years before the condition is diagnosed. The well known ones are type 1 diabetes, Coeliac disease, lupus, multiple sclerosis, and rheumatoid arthritis, but many are rare and tricky to diagnose. Treatment typically involves managing the individual’s immune system which has gone awry, in mistakenly attacking the organ or tissue in question as if it’s a foreign pathogen.
What causes an autoimmune reaction has remained a mystery – until recently, when scientists pieced together the three components that invariably underlie the autoimmune dysfunction:
- a genetic susceptibility
- a bacterial/viral infection
- a hyper-permeable intestine
The diagnostic label given to most autoimmune conditions may indicate which specific organ or tissue is being attacked by the immune system, but a preceding bacterial or viral infection (like Epstein Barr) often exists in a patient’s health timeline. Viruses that invade organs or tissue cells create a chronic inflammatory stimuli, leading to auto reactive T cells, and ‘bystander activation’ of the immune system, meaning that to get at the virus hidden within, the immune system ends up damaging the organ or cells of the tissue hosting it.
Another theory of how autoimmunity develops involves molecular mimicry, whereby the peptide structure of a pathogen may look so similar to the peptide structure of a particular tissue or organ, that a really vigilant immune system decides to play safe and attack the tissue – as well as the pathogen.
Immune tolerance
Our ‘mucosal’ tissues (the moist tissues lining the nasal passages, lungs, mouth, intestines, genital tract), have a critical role to play in our immune function, because these tissues have to interact with the outside world. They come in contact with – and absorb – all sorts of things from our environment, the food we eat, the air and chemicals we breathe and they have to determine what gets tolerated, are these things friend or foe?
Our lungs for example whilst giving passage to oxygen and carbon dioxide have to block dust, pollen, and air-born debris. Likewise gut tissue gives passage to fluids (both ways) and food nutrients (in), whilst also trying to maintain a barrier against bacteria, viruses, pathogens, and not yet digested foods.
Our immune system stands guard just the other side of all these tissues, sampling all that passes through, knowing to tolerate some, but recognising and reacting against others, directing an army of immune ‘pac-men’ type blood cells to engulf and destroy all it perceives might harm us. The levels to which the immune system reacts is partly determined by our genetics.
In terms of the gut, when fully digested food nutrients, i.e. proteins fully broken down to single amino acids for example, are absorbed in the intestines, they will be recognised, deemed harmless, well tolerated and shouldn’t provoke an immune response. But if the gut is inflamed or damaged, and therefore becomes overly leaky, it may give passage to larger, only partially digested food particles, amino acids still clumped together as protein peptides, or even allow through opportunistic viruses, bacteria and their by-products, and these can all trigger immune reactions. In the genetically susceptible, this reaction can raise risk of autoimmunity because if the protein structure of the invading particles are similar enough to the protein structure of any host tissue – the immune system may opt to play safe and attack both.
So looking upstream at the health of a person’s mucosal tissues is foundational when investigating autoimmunity. Is there systemic inflammation eroding the barrier function of any mucosal tissue? Is medication or dietary factors affecting the integrity of the barrier function? Does the individual have really effective digestion to break down all food into the smallest constituent parts – before absorption? Is there a gut microflora problem, perhaps a fungal overgrowth affecting barrier function or a complete lack of microbiome – maybe post antibiotic use? Is a chronic use of NSAIDs and painkillers damaging the integrity of the gut lining?
Finding the upstream root cause of overly-leaky, hyper-permeable mucosal tissue is foundational when addressing autoimmune conditions, or looking to reduce the risk of them.
Gut health has always been at the heart of nutritional therapy and research focusing on the intestinal lining, particularly the health of its ‘barrier function’, (which requires a healthy layer of microflora), is giving strength to the argument that an overly leaky gut lining, with an ineffective barrier function, can both trigger and perpetuate autoimmune conditions, particularly if the individual has a genetic susceptibility. Nutritional therapy has a good evidence base for restoring gut mucosal health, which along with supporting a diverse healthy microbiome, can help to restore good barrier function, stemming the flow of triggering antigens, and if caught early enough can even reverse the progression of some autoimmune pathology.
I employ Functional testing to assess both the health and diversity of an individual’s gut microbiome, as well as the integrity of their gut lining. I use Cyrex Lab in the States to investigate an individual’s autoantibodies. It’s worth repeating, sometimes symptoms – and definitely autoantibodies – precede the emerging autoimmune condition sometimes years before sufficient tissue damage enables a condition to be diagnosed.
To find out more about how we can help investigate and support your autoimmune health issues, please contact us or book an initial appointment.
