Photo Credit: by Gundula Vogel, Pexels.com
Do you ever wonder what keeps you well while the person next to you gets a cold or infection? You have your immune system to thank for that. Foreign bodies, like germs, enter your body daily, but your immune system plays a critical role in fighting these invaders. It also eliminates potentially harmful molecules and cells from the body. The immune system keeps you well and helps you heal when you get sick.
But what happens when your immune system starts attacking the healthy parts of your body instead of the dangerous invaders and harmful cells? These attacks are known as autoimmune diseases; unfortunately, they are not rare. A 2022 paper by scientist Frederick W Miller notes that 12.5% of people have an autoimmune disease. These autoimmune diseases can attack any part of the body, weakening bodily function and even becoming life-threatening. Perhaps the most concerning fact about autoimmune diseases is that their prevalence seems to be increasing.
Common Autoimmune Diseases
Autoimmune diseases can manifest in almost any way. They can affect your joints, muscles, skin, blood vessels, digestive, endocrine, and nervous systems.
According to the National Institute of Environmental Health Sciences, scientists know about over 80 autoimmune diseases. Some common examples of autoimmune diseases are:
• Of the joints and muscles: rheumatoid arthritis and lupus
• Of skin and blood vessels: psoriasis and vitiligo
• Of the digestive system: celiac disease and Crohn’s disease
• Of the endocrine system: type 1 diabetes and Addison’s disease
• Of the nervous system: multiple sclerosis and Guillain-Barré syndrome
The Rising Prevalence of Autoimmune Diseases
In Miller’s paper, he estimates that the yearly increase in the worldwide incidence of autoimmune diseases is 19.1%. There are issues in obtaining accurate numbers, but an overall trend of rising cases is clear. For example, one well-studied autoimmune disease is type 1 diabetes. In this case, scientists have found a 3-4% annual increase in cases over the last three decades.
It’s not fully understood why autoimmune diseases are rising, but one common theory is called the hygiene hypothesis. Andrew Wang, MD, PhD, associate professor of internal medicine (rheumatology, allergy, and immunology) and immunobiology at Yale School of Medicine, explains the hygiene hypothesis like this:
“People noticed that issues with our immune systems started increasing when we improved sanitation. The thought is that because the immune system doesn’t have much to do in this cleaner environment, it finds inappropriate work without dealing with dirt and germs. Some studies show that people who grow up on farms or live in rural areas are less likely to have allergies or autoimmune diseases than people who live in urban areas.”
The Mind-Immune Connection: How Stress Affects Autoimmunity
“Stress” is a word commonly used but rarely thoughtfully pondered. When looking at the effects of stress on your immune system, it’s worth remembering that stress is considered to be both challenging or difficult circumstances (stressors) and physiological or psychological responses to such circumstances (stress responses). Stress is something that we all experience, but it affects some of us more than others.
Psychological stress is empirically linked to dysregulation of the immune system; however, the relationship is not simple as it varies by situation and population. For example, during acute stress, such as one lasting a matter of minutes, certain kinds of cells are mobilized into the bloodstream, potentially preparing the body for injury or infection during “fight or flight.” This can be beneficial for the immune system.
However, when stress lasts long, such as from days to years, while the physical changes are similar, the health effects are different. For example, stress increases inflammation. Inflammation is good in acute cases where it can help with healing, but chronic inflammation causes long-term dysregulation of the immune system, which increases your risk for chronic diseases, including atherosclerosis (plaque buildup on the artery walls) and frailty.
So, when you feel stressed over a long period, your immune system is in danger. You are at risk of the above plus:
• The activation of latent viruses
• Autoimmune diseases like rheumatoid arthritis
• Schizophrenia and schizophrenia-related brain alterations
• Exacerbated symptoms of both physical and psychological illnesses
Once you have an autoimmune disease, you may then also have an impaired reaction to stress. In other words, if you have an autoimmune disease, your body may have trouble regulating itself in the face of stress. This, then, can worsen your autoimmune disease further. This forms a vicious cycle.
But everyday stress isn’t the only factor that can contribute to getting an autoimmune disease. Stress-related disorders (such as posttraumatic stress disorder [PTSD]) and childhood stress can also contribute to autoimmune disorders.
For example, one 2018 study by Song et al. found that people with stress-related disorders were at a 36% greater risk of autoimmune diseases when compared to those without a stress disorder. The risk was 46% greater for those diagnosed with PTSD. Those with PTSD also had more than double the risk of having three or more autoimmune diseases.
While many of us want to believe we leave negative childhood experiences behind, adverse childhood experiences like childhood physical, emotional, or sexual abuse; witnessing domestic violence; growing up with household substance abuse, mental illness, parental divorce, and/or an incarcerated household member can have ramifications that follow us into adulthood. For example, a 2009 study by Dube et al. found that childhood traumatic stress increased the likelihood of hospitalization with a diagnosed autoimmune disease decades into adulthood. In fact, when compared to a person with no childhood adverse events, people with more than two such events were between 70-100% more likely to be hospitalized with an autoimmune disease.
Unfortunately, stress at any time in your life can hurt your health.
Autoimmune Disease Factors in the Environment
An additional factor affecting autoimmune diseases few consider is climate change.
Global warming and climate change have affected the environment and how humans experience the environment in myriad ways. For example:
• Increased pollen burden
• Increased soot from wildfires
• A loss of nutrient content in staple crops due to high levels of carbon dioxide in the atmosphere
• An increased risk of skin and mucus membrane disruption
• Harm to a healthy gut microbiota
This, and many related factors, cause persistent inflammation and immune dysregulation and are contributing to a rise in immune-mediated diseases such as asthma and other allergic diseases, autoimmune diseases, and cancer.
According to one article in Frontiers in Science,
“There is also a pressing need for collaborative, multidisciplinary research to better understand the pathophysiology of immune diseases in the context of climate change. New data science techniques, biomarkers, and economic models should be used to measure the impact of climate change on immune health and disease, to inform mitigation and adaptation efforts, and to evaluate their effectiveness.”
Unfortunately, while most of us understand that climate change is negatively affecting the planet and the people on it, few think about the direct health effects like the rise in autoimmune disorders.
Managing Stress and Getting Treatment for Autoimmune Health
While some risk factors for autoimmune diseases can’t be mitigated, everyday stress is one that we can. For example, mindfulness meditation is one stress-relieving technique that has been shown to benefit the immune system. With mindfulness meditation, one is taught to be mindful in everyday life. According to the American Psychological Association,
“. . . it is training your attention to achieve a mental state of calm concentration and positive emotions.”
A 2016 review of randomized controlled trials examining the effects of mindfulness meditation on the immune system found that mindfulness meditation showed a possible positive impact on specific markers of inflammation, cell-mediated immunity, and biological aging; however, more research is needed.
If you want to include more mindfulness in your life, consider acting on its two components:
1. Tuning into what is happening in the present moment. You might focus on your breath, your thoughts, the physical sensations in your body, and your feelings.
2. Observing and accepting what is happening without judgment. Instead of reacting to what you have tuned into, you simply note it and let it go.
There are many programs available that can teach you about mindfulness meditation. They can involve breathing exercises, yoga, and guided lessons. If you want to learn more about mindfulness, the best place to turn to is a therapist who is trained in either mindfulness-based stress reduction or mindfulness-based cognitive therapy. Many resources are available online, but make sure you pick one designed by a professional and backed by science before you get going.
However, just trying to destress your life isn’t enough for many people with an autoimmune disease. Some people need medical interventions like medication. The type of medication prescribed will vary depending on the condition, as many medicines are used to regulate the immune system, reduce inflammation, and manage symptoms.
Some examples of autoimmune disease medications include:
• Corticosteroids like prednisone (Deltasone) or dexamethasone (multiple brand names) may be used to treat autoimmune diseases like lupus or rheumatoid arthritis.
• Nonsteroidal anti-inflammatory drugs (NSAIDs) like celecoxib (Celebrex) or naproxen (multiple brand names) may be used to treat illnesses like ankylosing spondylitis or lupus.
• Disease-modifying anti-rheumatic drugs (DMARDs) like methotrexate (multiple brand names) or sulfasalazine (numerous brand names) may be used to treat autoimmune diseases like psoriasis or Crohn’s disease.
Other drugs used to treat autoimmune diseases include biologics, JAK Inhibitors (small molecule targeted therapies), immunosuppressants, and monoclonal antibodies.
The Future of Autoimmune Disease Research: Stem Cell Treatments
While, as noted above, there are many interventions currently being used to treat autoimmune diseases, these aren’t sufficient for everyone, and some people still suffer daily. For this reason, the future of autoimmune disease research is so critical.
One new area of research on autoimmune disease is stem cell treatments. This is an encouraging study area, although it is still in its infancy.
Currently, clinical results are not precise about overall therapeutic efficacy and potential side effects. That said, there appears to have been a recent world-first breakthrough in which two men and one woman received treatment using bioengineered and CRISPR-modified immune cells and had their severe autoimmune diseases go into remission.
Xu Huji, a rheumatologist at Shanghai's Naval Medical University, headed the experiment. He claims,
“The patients stayed in remission for almost six months following treatment . . . another two dozen people have had the donor-derived treatment along with a slightly altered product . . . most of the outcomes have been favorable.”
The clinical outcomes are considered “phenomenal” and could mark the beginning of mass manufacturing of these treatments. However, because so few patients have been treated so far, it’s recognized that not all the risks have been identified.
The Future of Autoimmune Disease and Your Health
Autoimmune diseases are becoming increasingly common, with factors like stress, environmental changes, and even climate change playing a role in their rise. While researchers continue to explore new treatments, including promising stem cell therapies, managing stress and seeking appropriate medical interventions remain key for those affected. Understanding the immune system and its complexities can empower you to take proactive steps toward better health. If you suspect you have an autoimmune disease, consult a healthcare provider to discuss testing and treatment options tailored to your needs.
Sources
1. Agache, I., Akdis, C., Akdis, M., Al-Hemoud, A., Annesi-Maesano, I., Balmes, J., Cecchi, L., Damialis, A., Haahtela, T., Haber, A. L., Hart, J. E., Jutel, M., Mitamura, Y., Mmbaga, B. T., Oh, J., Ostadtaghizadeh, A., Pawankar, R., Prunicki, M., Renz, H., . . . Nadeau, K. C. (2024). Immune-mediated disease caused by climate change-associated environmental hazards: mitigation and adaptation. Frontiers in Science, 2. https://doi.org/10.3389/fsci.2024.1279192
2. American Psychological Association, Creswell, J. D., PhD, & Khoury, B., PhD. (2019, October 30). Mindfulness meditation: A research-proven way to reduce stress. American Psychological Association. Retrieved January 29, 2025, from https://www.apa.org/topics/mindfulness/meditation
3. Autoimmune diseases. (2024a, November 12). Cleveland Clinic. Retrieved January 28, 2025, from https://my.clevelandclinic.org/health/diseases/21624-autoimmune-diseases
4. Autoimmune diseases. (2024b, December 17). National Institute of Environmental Health Sciences. Retrieved January 28, 2025, from https://www.niehs.nih.gov/health/topics/conditions/autoimmune
5. Cgtn. (2024, October 6). First, therapy using donor cells puts autoimmune disorders in remission. CGTN. https://news.cgtn.com/news/2024-10-06/First-therapy-using-donor-cells-puts-autoimmune-disorders-in-remission-1xtWIzxngUU/p.html
6. Delves, P. J. (2024). MSD Manual: Overview of the immune system [Online]. In MSD Manual (Professional). Merck & Co. https://www.msdmanuals.com/professional/immunology-allergic-disorders/biology-of-the-immune-system/overview-of-the-immune-system
7. Dube, S. R., Fairweather, D., Pearson, W. S., Felitti, V. J., Anda, R. F., & Croft, J. B. (2009). Cumulative childhood stress and autoimmune diseases in adults. Psychosomatic Medicine, 71(2), 243–250. https://doi.org/10.1097/psy.0b013e3181907888
8. Miller, F. W. (2022). The increasing prevalence of autoimmunity and autoimmune diseases: an urgent call to action for improved understanding, diagnosis, treatment, and prevention. Current Opinion in Immunology, 80, 102266. https://doi.org/10.1016/j.coi.2022.102266
9. Morey, J. N., Boggero, I. A., Scott, A. B., & Segerstrom, S. C. (2015). Current directions in stress and human immune function. Current Opinion in Psychology, 5, 13–17. https://doi.org/10.1016/j.copsyc.2015.03.007
10. Song, H., Fang, F., Tomasson, G., Arnberg, F. K., Mataix-Cols, D., De La Cruz, L. F., Almqvist, C., Fall, K., & Valdimarsdóttir, U. A. (2018). Association of Stress-Related Disorders with subsequent autoimmune disease. JAMA, 319(23), 2388. https://doi.org/10.1001/jama.2018.7028
11. Why are autoimmune and allergic diseases rising? (2024, February 7). Yale School of Medicine. https://medicine.yale.edu/news-article/why-are-autoimmune-and-allergic-diseases-rising-andrew-wang/