15.7: Abnormal and Disease Conditions - Autoimmune Diseases
- Page ID
- 84130
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\(\newcommand{\avec}{\mathbf a}\) \(\newcommand{\bvec}{\mathbf b}\) \(\newcommand{\cvec}{\mathbf c}\) \(\newcommand{\dvec}{\mathbf d}\) \(\newcommand{\dtil}{\widetilde{\mathbf d}}\) \(\newcommand{\evec}{\mathbf e}\) \(\newcommand{\fvec}{\mathbf f}\) \(\newcommand{\nvec}{\mathbf n}\) \(\newcommand{\pvec}{\mathbf p}\) \(\newcommand{\qvec}{\mathbf q}\) \(\newcommand{\svec}{\mathbf s}\) \(\newcommand{\tvec}{\mathbf t}\) \(\newcommand{\uvec}{\mathbf u}\) \(\newcommand{\vvec}{\mathbf v}\) \(\newcommand{\wvec}{\mathbf w}\) \(\newcommand{\xvec}{\mathbf x}\) \(\newcommand{\yvec}{\mathbf y}\) \(\newcommand{\zvec}{\mathbf z}\) \(\newcommand{\rvec}{\mathbf r}\) \(\newcommand{\mvec}{\mathbf m}\) \(\newcommand{\zerovec}{\mathbf 0}\) \(\newcommand{\onevec}{\mathbf 1}\) \(\newcommand{\real}{\mathbb R}\) \(\newcommand{\twovec}[2]{\left[\begin{array}{r}#1 \\ #2 \end{array}\right]}\) \(\newcommand{\ctwovec}[2]{\left[\begin{array}{c}#1 \\ #2 \end{array}\right]}\) \(\newcommand{\threevec}[3]{\left[\begin{array}{r}#1 \\ #2 \\ #3 \end{array}\right]}\) \(\newcommand{\cthreevec}[3]{\left[\begin{array}{c}#1 \\ #2 \\ #3 \end{array}\right]}\) \(\newcommand{\fourvec}[4]{\left[\begin{array}{r}#1 \\ #2 \\ #3 \\ #4 \end{array}\right]}\) \(\newcommand{\cfourvec}[4]{\left[\begin{array}{c}#1 \\ #2 \\ #3 \\ #4 \end{array}\right]}\) \(\newcommand{\fivevec}[5]{\left[\begin{array}{r}#1 \\ #2 \\ #3 \\ #4 \\ #5 \\ \end{array}\right]}\) \(\newcommand{\cfivevec}[5]{\left[\begin{array}{c}#1 \\ #2 \\ #3 \\ #4 \\ #5 \\ \end{array}\right]}\) \(\newcommand{\mattwo}[4]{\left[\begin{array}{rr}#1 \amp #2 \\ #3 \amp #4 \\ \end{array}\right]}\) \(\newcommand{\laspan}[1]{\text{Span}\{#1\}}\) \(\newcommand{\bcal}{\cal B}\) \(\newcommand{\ccal}{\cal C}\) \(\newcommand{\scal}{\cal S}\) \(\newcommand{\wcal}{\cal W}\) \(\newcommand{\ecal}{\cal E}\) \(\newcommand{\coords}[2]{\left\{#1\right\}_{#2}}\) \(\newcommand{\gray}[1]{\color{gray}{#1}}\) \(\newcommand{\lgray}[1]{\color{lightgray}{#1}}\) \(\newcommand{\rank}{\operatorname{rank}}\) \(\newcommand{\row}{\text{Row}}\) \(\newcommand{\col}{\text{Col}}\) \(\renewcommand{\row}{\text{Row}}\) \(\newcommand{\nul}{\text{Nul}}\) \(\newcommand{\var}{\text{Var}}\) \(\newcommand{\corr}{\text{corr}}\) \(\newcommand{\len}[1]{\left|#1\right|}\) \(\newcommand{\bbar}{\overline{\bvec}}\) \(\newcommand{\bhat}{\widehat{\bvec}}\) \(\newcommand{\bperp}{\bvec^\perp}\) \(\newcommand{\xhat}{\widehat{\xvec}}\) \(\newcommand{\vhat}{\widehat{\vvec}}\) \(\newcommand{\uhat}{\widehat{\uvec}}\) \(\newcommand{\what}{\widehat{\wvec}}\) \(\newcommand{\Sighat}{\widehat{\Sigma}}\) \(\newcommand{\lt}{<}\) \(\newcommand{\gt}{>}\) \(\newcommand{\amp}{&}\) \(\definecolor{fillinmathshade}{gray}{0.9}\)Recall that aging is accompanied by a decrease in the balanced regulation of the immune system and an increase in the production of new autoantibodies. The autoantibodies produced as part of aging are of little-known importance. In addition, there is only a small increase in the incidence of new-onset autoimmune diseases among the elderly. However, the damage that seems to result from excess inflammation and autoimmune response activities that are part of abnormal or disease conditions often become more serious with age. This occurs largely because chronic inflammation and many autoimmune responses initiated during childhood or young adulthood continue to injure or destroy body components for many years. Some age-related diseases associated with chronic inflammation and autoimmune responses are atherosclerosis, valvular heart disease, chronic obstructive pulmonary diseases, Alzheimer's disease, and chronic renal diseases.
Some abnormal autoimmune responses follow a steady course and cause unremitting progressive damage (e.g., atrophic gastritis). Other autoimmune diseases occur as periodic or occasional flare-ups separated by periods of remission (e.g., rheumatoid arthritis). In these disorders the affected individual's condition worsens in a stepwise manner. However, in all autoimmune disorders there is great variability among individuals regarding the rate at which deleterious effects develop.
A few abnormal autoimmune conditions important in the elderly have been described in Chaps. 9 and 10 (e.g., atrophic gastritis, rheumatoid arthritis). Other abnormal and disease conditions important to older people that seem to involve autoimmune responses and are serious and relatively common will be mentioned briefly here.
Bullous pemphigoid causes blistering of the skin and accompanying itching and discomfort. Rheumatic heart disease results when rheumatic fever leads to autoimmune damage to valves in the heart. Common outcomes include the failure of one or more chambers of the heart and respiratory problems from pulmonary edema. Multiple sclerosis involves patchy deterioration of myelin in the CNS and can result in diverse deficits depending on the portions of the CNS affected. This disorder is characterized by flare-ups and remissions of varying duration. Myasthenia gravis involves autoimmune damage to receptors for acetylcholine at neuromuscular junctions and leads to progressive muscle weakness and paralysis, including the muscles for respiration. Regional enteritis (Crohn's disease), which often involves flare-ups and remissions, causes inflammation of the small intestine and large intestine and often results in decreased absorption of nutrients, pain, and diarrhea. Ulcerative colitis is similar to regional enteritis; though it affects only the large intestine, it often causes intestinal bleeding and increases the risk of developing colorectal cancer. Graves' disease results in abnormally high blood levels of thyroid hormone which increase the metabolic rate and cause bulging and deterioration of the eyes.