Unlocking the Mystery of Autoimmune Disease

A key feature of the immune system is its ability to discriminate between self and non-self.

When the mechanisms that prevent the immune system from attacking itself break down, it can result in autoimmune disorders such as multiple sclerosis, rheumatoid arthritis, Crohn’s disease and diabetes.

Now researchers at Columbia University Medical Center claim they have not only found out why people with autoimmune diseases attack their own tissues and organs, but also how to correct the problem.

According to a study just published in The Journal of Clinical Investigation scientists have identified a defect in the T cell regulatory pathway which normally controls autoreactive T cells.  The majority of people with Type 1 diabetes who were tested were found to have a defect in CD8+ T cells that impacted their recognition of a common target structure known as HLA-E/Hsp60sp. More importantly, researchers were able to successfully correct the defect in-vitro.

For decades, autoimmune diseases have been treated by reducing overall immune response. That’s been effective in extending life spans, but has been hard on the quality of life for many of those patients,” said lead researcher Hong Jiang, M.D. Ph.D.

Current therapies for treating autoimmune disease include steroids, which systemically suppress the immune system, resulting in multiple side effects, including weight gain and increased susceptibility to infections.  Therapies based on this new research are designed to selectively suppress immune responses to self-antigens without damaging the body’s normal anti-infection and anti-tumor responses.

This research is significant. The Columbia University scientists believe that this greater understanding of the defect could eventually lead to prevention of autoimmune diseases altogether.

SRxA’s Word on Health is keeping everything crossed.

Prozac Pilots take to the Happy Skies

Flying in the US just got a whole lot easier…at least for pilots!

The US Federal Aviation Administration (FAA) has lifted a 70 year old rule that banned pilots from taking antidepressants because of the risks of sedation. The ban had endured because earlier generations of antidepressants caused side effects, such as drowsiness and seizures.  However, a panel of medical experts for the FAA found during two years of research that newer versions don’t cause side effects in everyone. When they do occur, they tend to subside over time.

This policy turnaround means that pilots taking selective serotonin reuptake inhibitors (SSRIs), including fluoxetine (Prozac), sertraline (Zoloft) citalopram (Celexa) and escitalopram (Lexapro) or their generic equivalents and who show success controlling their depression for 12 months, without side effects that could pose a safety hazard in the cockpit, will be able to seek permission to fly.

This rule change may benefit up to 10,000 grounded pilots.  It also includes a degree of amnesty for pilots who have lied about their diagnosis and treatment on medical certification forms. Previously, airline and other pilots who suspected they were depressed but wanted or financially needed to fly faced a choice: seek no medication for treatment, because doing so would disqualify them, or self-medicate and lie about it on a required medical certification form.

The National Institute of Mental Health estimates that about 9.5 percent of people 18 and older suffer from a mood disorder. A 2009 study by Columbia University showed that as many as 10% of Americans were taking antidepressants. FAA officials assume the percentage is about the same among pilots but has no hard numbers because the ban gave pilots a disincentive to report depression or treatment.

”We need to change the culture and remove the stigma associated with depression,” said an FAA official. ”Pilots should be able to get the medical treatment they need so they can safely perform their duties.”

SRxA’s Word on Health wonders if this will mean fewer delayed flights or more happy flight crews. What do you think?