Damping Down Diabetes

PrevalenceSRxA’s Word on Health was very excited to learn of some amazing new research coming out of UC San Francisco.  Scientists there have identified a new way to manipulate the immune system and keep it from attacking the body’s own molecules in autoimmune diseases such as type 1 diabetes, rheumatoid arthritis and multiple sclerosis.

More than 100 different autoimmune diseases have been discovered and they disproportionately affect women.  Of the 50 million Americans living and coping with autoimmune disease  more than 75% are women.  Autoimmune diseases are one of the top 10 leading causes of death of women under the age of 65 and are responsible for more than $100 billion in direct health care costs annually.   Crohn’s disease, ulcerative colitis, lupus, multiple sclerosis, rheumatoid arthritis, psoriasis and scleroderma by themselves account for > $50 billion.

eTACBut now, researchers, led by immunologist Mark Anderson, MD, PhD, a professor with the UCSF Diabetes Center, have discovered a type of immune cell called an extrathymic Aire-expressing cell (eTAC), which puts a damper on immune responses.  eTAC’s are a type of  dendritic cell – which make up less than 3% of the cells in the immune system. And, eTAC cells themselves account for a small fraction of all dendritic cells. eTACs reside in lymph nodes and spleen in both humans and mice.

In this study, Anderson’s team determined that eTAC’s can counteract the overactive immune response in autoimmune diseases and, in a mouse model of diabetes, can be manipulated to stop the destruction of the pancreas.

By displaying “self” molecules to T cells that target them, and permanently turning off these T cells, eTACs help the immune system tolerate the molecules naturally present within us.  “The mouse model we are working with involves using T cells that normally attack the islet cells of the pancreas, specifically by recognizing a molecule called chromagranin A that is present on islet cells,” Anderson said. “But if the eTACs can get to the T cells first and display chromagranin A, they can prevent T cells from attacking the islets.”

mouse diabetesAnderson aims to exploit eTACs therapeutically by finding out how to grow them in large numbers outside the body. “We need to figure out how to grow a lot of these cells, to load them up with whatever molecule it is that we want to induce tolerance to, and then to load them back into a patient,” he said. “Such a strategy could help selectively shut down an unwanted immune response, such as the anti-islet immune response in type 1 diabetes.”

Dendritic cells work with T cells a bit like a sheriff working with a bloodhound.  But instead of presenting an article of clothing, dendritic cells present a specific molecule. If the molecule displayed by the dendritic cell matches the one the T cell was born to target, then that T cell would be activated to expand its numbers and to attack cells or tissues where the molecule is present.

When the interaction is between eTACs and T cells, however, the targeted T cell instead is turned off forever, and never seeks its molecular prey.

Diabetes wordcloudGiven that the prevalence and incidence of and type 1 diabetes and other autoimmune diseases, such as Crohn’s, lupus and celiac disease are on the rise, this new research is extremely important, both from a public health and economic perspective.  With as many as three million Americans having type one diabetes and the incidence growing by more than 3% per year a cure is desperately needed.

SRxA-logo for web

Lady Gaga Knows Her Autoimmune Quotient – Do You Know Yours?

Over the last two weeks the Web has been abuzz with questions about Lady Gaga’s health. Turns out, we are informed, that she has a family history of lupus and has tested borderline positive for the disease.

The Lady Gaga story underlines an important message for millions of other Americans who have a history of autoimmune disease in their families. According to Virginia Ladd, President and Executive Director of the American Autoimmune Related Diseases Association (AARDA) “Lupus is one of more than 100 autoimmune diseases and these diseases cluster in families.  Having a family member with lupus could mean you are at increased risk for lupus and other autoimmune diseases.

That’s why it’s important, just as Lady Gaga has done, to know your family history, to inform your doctors, and take proactive steps to ensure your future health.

Evidence suggests that people need to take responsibility for their own autoimmune health. An AARDA study of autoimmune patients found that the average time for diagnosis of a serious autoimmune disease is 4.6 years. During that period, the patient typically has seen 4.8 doctors; and 46% of the patients were told initially that they were too concerned about their health or that they were chronic complainers.

One of the factors that makes getting a correct autoimmune disease diagnosis so difficult is that symptoms can vary widely, notably from one disease to another, but even within the same disease. The medical community’s lack of knowledge of autoimmune disease compounds the problem. Even though these diseases share a genetic background and tend to run in families, most health questionnaires at doctors’ offices do not ask whether there is a family history of autoimmune disease.

AARDA has devised an eight-step plan to help people increase their awareness of autoimmune diseases and calculate their Autoimmune Quotient (AQ):

1. Understand that autoimmune disease constitutes a major U.S. health crisis affecting 50 million Americans.

2. Get educated about the 100+ autoimmune diseases.

3. Be aware that autoimmune diseases target women 75% more often than men.

4. Know that autoimmune diseases run in families.

5. Do your own family medical history and inform your physician if you find that you have a history of autoimmune disease.

6. Keep a “symptoms” list if you believe you may have an autoimmune
disease.

7. Realize that getting an autoimmune disease diagnosis is often
challenging.

8. Hold the power to protect your family’s future health and well-being
in your hands – be proactive about your health.

To find out more about autoimmune diseases, or how to calculate your AQ, visit the AARDA Web Site.