Is GERD linked to pulmonary fibrosis. What are the potential causes of lung scarring. How does GERD impact lung health. What role do autoimmune conditions play in pulmonary fibrosis. Can environmental factors contribute to lung damage.

The Complex Relationship Between GERD and Pulmonary Fibrosis

Gastroesophageal reflux disease (GERD) and pulmonary fibrosis have a complex, intertwined relationship that researchers are still working to fully understand. Dr. Tessy K. Paul, medical director of the Interstitial Lung Disease Program at UVA Health, sheds light on this connection.

GERD occurs when stomach acid flows back into the esophagus, causing heartburn and other symptoms. Pulmonary fibrosis, on the other hand, involves scarring of the lung tissue, making it difficult to breathe. The question arises: does one condition lead to the other?

Current research is exploring two possibilities:

• GERD may increase the risk of developing pulmonary fibrosis
• Pulmonary fibrosis may lead to or exacerbate GERD

Dr. Paul explains, “With GERD, someone inhales small amounts of stomach contents into the lungs. This can cause inflammation and may promote scarring over time. And the other piece to the puzzle is whether having the lung fibrosis itself makes it more likely for these patients to develop GERD.”

While the exact nature of this relationship remains unclear, experts agree on the importance of managing GERD in patients with pulmonary fibrosis. Controlling GERD symptoms may help prevent further lung damage and improve overall quality of life for those affected by both conditions.

Unraveling the Mystery of Pulmonary Fibrosis Causes

Pulmonary fibrosis is a complex condition with numerous potential causes. Understanding these factors is crucial for proper diagnosis and treatment. Let’s explore some of the known and suspected causes of this lung disorder.

Idiopathic Pulmonary Fibrosis: When the Cause Remains Unknown

In many cases, the underlying cause of pulmonary fibrosis cannot be identified. This is referred to as idiopathic pulmonary fibrosis (IPF). Despite ongoing research, the exact mechanisms leading to IPF remain elusive, highlighting the need for continued scientific investigation in this field.

Environmental Factors and Occupational Hazards

Exposure to certain environmental toxins and pollutants can significantly contribute to the development of pulmonary fibrosis. These harmful substances can cause chronic inflammation and scarring in the lungs over time. Some common culprits include:

• Silica dust
• Asbestos fibers
• Hard metal dusts
• Coal dust
• Grain dust
• Bird and animal proteins
• Mold
• Tobacco smoke and e-cigarette vapor
• Microwave popcorn flavoring

Individuals working in industries such as mining, construction, and agriculture may be at higher risk due to prolonged exposure to these substances. Implementing proper safety measures and using protective equipment can help mitigate these risks.

Medical Treatments and Their Impact on Lung Health

Certain medical treatments, while necessary for addressing other health issues, can potentially contribute to lung damage and fibrosis. It’s essential to be aware of these risks and discuss them with healthcare providers.

Radiation Therapy and Lung Damage

Patients who undergo radiation therapy for lung or breast cancer may experience lung damage as a side effect. This damage can manifest months or even years after the initial treatment. The risk of developing pulmonary fibrosis following radiation therapy depends on factors such as the radiation dose, the area treated, and individual susceptibility.

Medications with Potential Lung-Damaging Effects

Several medications used to treat various conditions can potentially harm the lungs. These include:

• Chemotherapy drugs (e.g., methotrexate and cyclophosphamide)
• Heart rhythm medications (e.g., amiodarone)
• Certain antibiotics (e.g., nitrofurantoin or ethambutol)
• Anti-inflammatory drugs (e.g., rituximab or sulfasalazine)

It’s crucial for patients and healthcare providers to weigh the benefits of these treatments against the potential risks to lung health. Regular monitoring and prompt intervention can help minimize the impact of medication-induced lung damage.

Autoimmune Diseases and Their Role in Pulmonary Fibrosis

Autoimmune conditions play a significant role in the development of pulmonary fibrosis. These disorders occur when the body’s immune system mistakenly attacks healthy tissues, including those in the lungs. Several autoimmune diseases are associated with an increased risk of pulmonary fibrosis:

• Dermatomyositis
• Polymyositis
• Mixed connective tissue disease
• Systemic lupus erythematosus
• Scleroderma
• Rheumatoid arthritis
• Sarcoidosis

Patients with these conditions often require close monitoring of their lung function. Early detection and management of pulmonary involvement can help prevent or slow the progression of fibrosis.

The Interplay Between Autoimmune Diseases and Lung Health

Autoimmune diseases can affect the lungs in various ways. For example, rheumatoid arthritis can lead to the formation of nodules in the lungs, while scleroderma can cause widespread fibrosis throughout the body, including the lungs. Understanding the specific mechanisms by which each autoimmune condition impacts lung health is crucial for developing targeted treatment strategies.

The Impact of COVID-19 on Pulmonary Fibrosis

The COVID-19 pandemic has brought increased attention to pulmonary fibrosis. Dr. Paul notes a significant increase in referrals for pulmonary fibrosis following the outbreak. However, the relationship between COVID-19 and lung fibrosis is not straightforward.

Two main scenarios are being considered:

1. COVID-19 directly causing lung fibrosis
2. COVID-19 exacerbating or uncovering pre-existing lung conditions

Regardless of the exact mechanism, severe COVID-related lung fibrosis has emerged as a significant concern, with some patients requiring lung transplants as a result.

Long-Term Pulmonary Effects of COVID-19

As the pandemic continues, researchers are studying the long-term effects of COVID-19 on lung health. Some patients experience persistent respiratory symptoms and abnormal lung function months after recovering from the acute infection. Ongoing research aims to understand the mechanisms behind these long-term effects and develop appropriate treatment strategies.

Diagnosing and Managing Pulmonary Fibrosis: A Multifaceted Approach

Accurate diagnosis and effective management of pulmonary fibrosis require a comprehensive approach. Dr. Paul emphasizes the importance of thorough evaluation and individualized treatment plans.

The Challenge of Misdiagnosis

Pulmonary fibrosis can often be misdiagnosed or appear more severe than it actually is. Dr. Paul shares that some patients come to her terrified, believing they have only 3-5 years to live. However, a thorough evaluation often reveals a different picture.

“Sometimes they don’t have ILD at all. They might have had repeated pneumonia or something else masquerading as ILD,” Dr. Paul explains. This underscores the importance of seeking expert evaluation and obtaining a second opinion when faced with a diagnosis of pulmonary fibrosis.

Personalized Treatment Approaches

Treatment for pulmonary fibrosis varies depending on the underlying cause and the severity of the condition. Options may include:

• Medications to slow disease progression
• Oxygen therapy
• Pulmonary rehabilitation
• Lifestyle modifications
• Management of comorbidities, including GERD

In some cases, lung transplantation may be considered for patients with advanced disease who meet specific criteria.

The Importance of Ongoing Research and Patient Education

As our understanding of pulmonary fibrosis continues to evolve, ongoing research and patient education play crucial roles in improving outcomes for those affected by this condition.

Advancing Scientific Understanding

Researchers are continually working to uncover new insights into the causes, progression, and treatment of pulmonary fibrosis. Areas of focus include:

• Genetic factors influencing disease susceptibility
• Novel therapeutic targets
• Biomarkers for early detection and disease monitoring
• The role of environmental factors in disease development

These efforts aim to develop more effective treatments and potentially find ways to prevent the onset of pulmonary fibrosis in high-risk individuals.

Empowering Patients Through Education

Patient education is a critical component of managing pulmonary fibrosis. Informed patients are better equipped to:

• Recognize early symptoms and seek timely medical attention
• Adhere to treatment plans and lifestyle recommendations
• Participate in shared decision-making with their healthcare providers
• Cope with the emotional and psychological challenges associated with chronic lung disease

Support groups and patient advocacy organizations play valuable roles in providing education, resources, and emotional support to those affected by pulmonary fibrosis.

Conclusion: Navigating the Complexities of Pulmonary Fibrosis

Pulmonary fibrosis, with its diverse causes and complex relationship with conditions like GERD, presents significant challenges for patients and healthcare providers alike. However, advances in research and clinical care offer hope for improved outcomes.

Key takeaways include:

• The relationship between GERD and pulmonary fibrosis is complex and not fully understood
• Multiple factors, including environmental exposures, medical treatments, and autoimmune conditions, can contribute to the development of pulmonary fibrosis
• Accurate diagnosis is crucial, as pulmonary fibrosis can be misdiagnosed or confused with other conditions
• Personalized treatment approaches and ongoing research offer hope for better management and outcomes
• Patient education and support play vital roles in navigating the challenges of living with pulmonary fibrosis

As research continues to unravel the mysteries surrounding pulmonary fibrosis, patients and healthcare providers can work together to optimize lung health and quality of life. By staying informed about the latest developments and maintaining open communication, those affected by pulmonary fibrosis can navigate this complex condition with greater confidence and hope for the future.

GERD & Other Pulmonary Fibrosis Causes You Need to Know

Most of us have had heartburn — that feeling when stomach acid flows (refluxes) up into the esophagus. If you have gastroesophageal reflux disease (GERD), or the severe form of acid reflux, you need to know about its connection to lung scarring (pulmonary fibrosis).

Turns out there are lots of pulmonary fibrosis causes. GERD falls into a ‘maybe’ category.

We turned to lung disorder expert, Tessy K. Paul, MD, to explain the many potential pulmonary fibrosis causes. She also explains the lung connection with GERD.

Paul is medical director of the Interstitial Lung Disease Program at UVA Health. She’s also the center director for the Pulmonary Fibrosis Foundation Care Center Network at UVA Health.

What Is Pulmonary Fibrosis?

With pulmonary fibrosis (PF), the tissue around and between the airways in your lungs get scarred and thick. It’s the predominant finding in different chronic lung disorders. We call these interstitial lung disease (ILD).

This damage makes it hard to breathe and for your body to get the oxygen it needs. The terms interstitial lung disease and pulmonary fibrosis are often used interchangeably.

“Interstitial lung disease is an umbrella term. It encompasses a wide range of inflammatory and fibrotic lung diseases,” Paul says. “The cause can range from environmental exposures such as mold or having birds indoors to autoimmune diseases like scleroderma or rheumatoid arthritis. Or ILD can be ‘idiopathic’ where we don’t know the cause.”

GERD: Chicken Or the Egg?

GERD and pulmonary fibrosis are a “chicken or egg” puzzle researchers haven’t yet solved. Researchers are looking to see:

• If GERD increases your risk for pulmonary fibrosis
• Or if pulmonary fibrosis leads to GERD and makes the condition worse

Paul explains: “With GERD, someone inhales small amounts of stomach contents into the lungs. This can cause inflammation and may promote scarring over time. And the other piece to the puzzle is whether having the lung fibrosis itself makes it more likely for these patients to develop GERD.”

With COVID-19, doctors saw a big increase in referrals for pulmonary fibrosis. Like with GERD, it’s hard to know if COVID caused the lung fibrosis. Or if the disease was already there and COVID made it worse or helped uncover it.

We do know this: Severe COVID-related lung fibrosis is one of the reasons people need a lung transplant.

More Possible Pulmonary Fibrosis Causes

In some cases, we can’t find a cause. We call this idiopathic pulmonary fibrosis. But, in addition to GERD, it’s important to know about things that can inflame and scar your lungs.

Breathing In Toxins at Work, Home or Outside

Many toxins and pollutants can damage your lungs over the long run. These include:

• Silica dust
• Asbestos fibers
• Hard metal dusts
• Coal dust
• Grain dust
• Bird and animal proteins
• Mold
• Smoking tobacco & e-cigs (vaping)
• Microwave popcorn flavoring

Radiation

to the Chest for Cancer

Some people who receive radiation therapy for lung or breast cancer may show signs of lung damage months or sometimes years after the first treatment.

Medication for Cancer, Heart, & Other Conditions

Many drugs can damage your lungs, especially any of these medications you might need to take:

• Chemotherapy drugs designed to kill cancer cells, such as methotrexate and cyclophosphamide
• Irregular heartbeat medications such as amiodarone
• Antibiotics such as nitrofurantoin or ethambutol
• Anti-inflammatory drugs such as rituximab (Rituxan) or sulfasalazine (Azulfidine)

Autoimmune & Other Medical Conditions

Many medical conditions can damage the lungs. These include:

• Dermatomyositis
• Polymyositis
• Mixed connective tissue disease
• Systemic lupus erythematosus
• Scleroderma
• Rheumatoid arthritis
• Sarcoidosis

Important to Control GERD

Paul sees a lot of pulmonary fibrosis patients with GERD. Experts are looking to see if pulmonary fibrosis changes a person’s anatomy, making them more likely to have GERD.  

Here’s what we do know. “It’s important to control GERD when present and symptomatic in pulmonary fibrosis patients,” Paul says.

Breathe Easier

Find top pulmonary fibrosis experts.

Get a Second Opinion at UVA Health

Worried About Pulmonary Fibrosis?

Pulmonary fibrosis often gets misdiagnosed or seems worse than it is. Some patients come to Paul terrified, thinking they have 3-5 years to live. “But many times, we’re able to uncover more about the potential pulmonary fibrosis causes and the potential trajectory and natural history of their disease so they can get a better sense of their future.”

She adds, “Sometimes they don’t have ILD at all. They might have had repeated pneumonia or something else masquerading as ILD.” And not all patients with ILD have a dire prognosis.

“It’s also important for patients to know we have ways to treat ILD,” Paul says. “We recommend removing any potential exposure that may be culprits. Medical therapies can stabilize or even improve lung function in many cases. Supplemental oxygen and pulmonary rehabilitation are also important measures. And in advanced cases, patients may need a lung transplant.”

No matter the pulmonary fibrosis cause, ILD is challenging to diagnose and manage, Paul notes. “That’s why it’s important for patients to be seen in an academic medical center, and particularly UVA Health. “Here, they get access to experts and specialists to provide the multidimensional, comprehensive, and complex care they need.”

Scleroderma – Esophageal Health | UCLA Health

What is scleroderma?

Scleroderma is group of rare connective tissue diseases generally classified as autoimmune rheumatological disorders. Scleroderma comes from the Greek words sclero (hard) and derma (skin). In fact, hardening or tightening of the skin is a common and striking manifestation scleroderma.

What causes scleroderma?

Scleroderma results from the overproduction and accumulation of collagen, a connective tissue, in the skin and other body organs like the lungs, kidneys, heart, blood vessels, joints, muscles and gastrointestinal tract. While the cause is not fully understood, there are genetic and environmental factors that play a role in its pathogenesis.

What are the symptoms of scleroderma?

Scleroderma can affect any of the GI organs. It does so by replacing the muscles and nerves that make up the wall of these organs with collagen. This leads to stiffening of the wall, and loss or discoordination of gastrointestinal contractions (motility). Gastrointestinal symptoms depend upon which GI organs are involved. Involvement of the anal sphincter can predispose to fecal incontinence. Scleroderma of the colon might cause diarrhea and/or constipation. Motor dysfunction of the small intestine can lead to stasis of intestinal contents, and overgrowth of bacteria in the small bowel.  This produces symptoms of bloating, gas and diarrhea. It can also cause intestinal pseudo-obstruction, which is defined as signs and symptoms of intestinal obstruction without mechanical obstruction. Scleroderma involving the stomach produces gastroparesis, which is failed or very slow gastric emptying of ingested food. The symptoms of gastroparesis include early satiety (filling up quickly), nausea, vomiting and abdominal pain.

Esophageal dysfunction is a common feature of scleroderma. There is a ring of muscle positioned at the junction of the esophagus and stomach (the esophagogastric junction or EGJ) called the lower esophageal sphincter (LES). When swallowing is not occurring it is contracted, closing the EGJ and producing a barrier to the reflux of injurious gastric contents back into the esophagus. Scleroderma patients often have a weak or incompetent LES, which predisposes them to gastroesophageal reflux disease (GERD). Pathological acid reflux frequently produces symptoms of heartburn (a burning sensation in the chest) and/or regurgitation (the unforced return of stomach or esophageal contents to the mouth or throat). Left untreated, GERD can cause esophagitis, esophageal ulceration, esophageal strictures or Barrett’s esophagus, which can be a precursor to esophageal cancer. Gastroparesis associated with scleroderma makes GERD worse because the stomach remains filled with noxious materials for a longer time after eating. This prolongs the time over which gastroesophageal reflux can occur. The combination of GERD and gastroparesis can predispose patients to aspiration of gastric contents into the airway, which can be manifest as cough, pneumonia and/or worsening lung function.

Normally, swallowing produces a ring of esophageal contraction called peristalsis, which sweeps swallowed materials down the esophagus and into the stomach.  Patients with scleroderma of the esophagus typically lack this peristaltic contraction, which is called aperistalsis. When this occurs, foods, particularly solids, hang up in the esophagus and produce dysphagia (the sensation that food is stuck in the chest). Aperistalsis also worsens GERD because the esophagus cannot clear injurious, refluxed gastric contents back into the stomach. This prolongs the time acid injury can occur in the esophagus.

How is scleroderma diagnosed?

A number of diagnostic tools are used assess patients with presumed scleroderma of the esophagus and stomach. Alarm symptoms or findings require endoscopic evaluation. These include dysphagia, odynophagia (painful swallowing), nausea and vomiting, anemia, weight loss and blood in the stool. Patients with dysphagia, odynophagia or regurgitation who have no obvious esophageal pathology during endoscopy should have an esophageal manometry. Manometry allows doctors to evaluate function of the esophagus in response to swallowing liquid, viscous solution and solid food. It identifies weakness of the LES, abnormalities of esophageal peristalsis, like aperistalsis, and in some cases abnormalities of pharyngeal function. Patients with heartburn that is not responsive to therapy with medications that inhibit gastric acid production are candidates for esophageal pH testing. There are several techniques to accomplish esophageal pH testing.  These tests can confirm the diagnosis of GERD and/or determine if the patient’s therapy is working. It is also important to do a test that determines how well the stomach empties, since GERD is worse in patients with delayed gastric emptying. This is done with a scintigraphic gastric emptying study or a wireless motility capsule study.

How is scleroderma treated?

Treating the esophageal symptoms of scleroderma can be quite challenging. Medical therapy includes medications that suppress acid production by the stomach (proton pump inhibitors and h3 receptor antagonists), and medications that improve gastric emptying (dopamine antagonists and 5-HT4 receptor agonists). Dietary changes can improve esophageal symptoms. Eating smaller and more frequent meals can help with gastric emptying problems. Not eating or drinking for several hours before bed can decrease the volume of stomach contents when the patient is asleep. This decreases the risk of gastroesophageal reflux and aspiration at night. We put these patients on a low fat and low fiber diet. Fatty/fried foods slow gastric emptying and relax the LES. High fiber foods are more difficult for the stomach to empty. Patients with GERD should avoid caffeine containing foods and chocolate because they contain chemicals called phosphodiesterase inhibitors that relax gastrointestinal muscle. They can weaken esophageal contractions, relax the LES and slow gastric emptying. Alcohol and mints also weaken the GI muscles. We instruct patients with GERD to elevate the head of the bed by 4-6 inches. When GERD symptoms are intractable or complications arise from GERD like worsening lung function, surgical therapy is considered. There are two surgical approaches used in this patient population. A surgery called the Toupet fundoplication improves the barrier to gastroesophageal reflux and roux-en-Y gastric bypass treats both gastric emptying problems and GERD. Taking this approach requires careful patient selection and evaluation.

understand the complex and complete list of diseases

Learn more about what autoimmune diseases are. The article presents a list of common diseases and their manifestations. Everything is explained in simple terms.

Every person is faced with diseases. Someone takes them away from their thoughts for a moment, and someone fights them for many years. Autoimmune disease is one of the types of diseases when not the body is alkalized, but our immune system.

By remembering how our immune response works, the topic of such diseases becomes more understandable. Normally, our immune system recognizes and attacks infections and foreign substances that could harm the body. However, in the case of autoimmune diseases, it ceases to distinguish its own cells from those of others and begins to attack its own body.

“According to this issue, patients do not initially realize that they have an autoimmune disease, since the first signs may appear as normal symptoms such as fatigue, rashes or stomach problems. «

As for the symptoms of each individual disease, it depends on which part of the body is attacked. Some types of diseases affect the skin, others affect the joints, and others manage to damage pneumonia, the eyes, and other organs. Below is a list of some of the most common autoimmune diseases.

Autoimmune diseases: what is it?

Autoimmune diseases are a group of diseases in which the body’s immune system mistakenly starts attacking and destroying its own healthy tissues and organs, perceiving them as hostile. Serious and even dangerous health consequences can result from such attacks.

Autoimmune diseases can affect various tissues and organs of the body, such as the skin, joints, thyroid gland, pancreas, intestines, bladder, etc. Patients with autoimmune diseases often experience symptoms associated with inflammation and deformity of the affected tissues and organs, such as pain, swelling, redness, impaired movement, etc.

Among the most common autoimmune diseases are rheumatoid arthritis, systemic lupus erythematosus, Hashimoto’s thyroiditis, Sögren’s syndrome, celiac disease, type 1 diabetes mellitus, systemic sclerosis, etc. Their total number can reach several dozen different types, which may have similar symptoms, but differ in their specific manifestation and treatment.

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Autoimmune diseases: definition and essence of the problem

Autoimmune diseases are a group of pathologies in which the human immune system attacks its own tissues and organs, believing them to be foreign objects. The process of development of autoimmune diseases is associated with an imbalance in the system of immunoregulation – the control of the immune system. As a result of this attack on one’s own tissues, inflammatory processes occur, which can lead to disturbances in the functioning of human organs and systems.

Common autoimmune diseases include: rheumatoid arthritis, dry eye, systemic lupus erythematosus, Crohn’s disease, Addison’s disease, Hashimoto’s thyroiditis and many others.

Autoimmune diseases can appear at any age and symptoms typically include inflammation, pain, swelling, fatigue and fever. If you suspect such a disease, you should consult a rheumatologist, immunologist or other specialist.

Autoimmune diseases do not have clear causes, but the most common risk factors are genetic predisposition, immune system disorders, and some external factors such as infections or stress. The treatment of such diseases requires an integrated approach and depends on the general condition of the patient, the form of the disease and other factors.

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Examples of autoimmune diseases in the human body

Autoimmune diseases can affect various organs and systems of the human body. Consider some of them:

• Rheumatoid arthritis is a chronic inflammatory disease that affects the joints and can lead to their deformity.
• Systemic lupus erythematosus is a disease in which the immune system attacks the connective tissue of the body, leading to inflammation of blood vessels, joints and other organs.
• Chronic autoimmune hepatitis is a chronic inflammatory liver disease in which the immune system attacks liver cells.
• Systemic scleroderma is a chronic disease that causes inflammation and damage to the connective tissue of the skin, joints and internal organs.

These are just a few of the many autoimmune diseases that can occur in the human body. The treatment for each of them can vary, so it is important to seek the help of a doctor and get individual advice and treatment according to the diagnosis.

Causes and development of autoimmune diseases

Autoimmune diseases occur when the immune system mistakenly begins to attack its own cells and tissues, mistaking them for hostile ones. At the moment, the causes of this process remain unknown, but there are a number of factors that can predispose to the development of autoimmune diseases.

Hereditary factors play a significant role in the occurrence of autoimmune diseases. If close relatives have such diseases, then the person has an increased risk of developing them.

External influences can also influence the occurrence of autoimmune diseases. It can be any infection, toxic substances, stress, changes in hormonal balance.

Often the appearance of the first signs of autoimmune diseases is associated with dysfunction of the gastrointestinal tract. Excessive presence of bacteria, fungi, viruses in the intestine leads to its damage and disruption of the protective function. As a result, parts of microorganisms penetrate into the blood and cause the appearance of specific pathogenic antibodies.

Treatment of autoimmune diseases: basic methods

Basic principles of treatment of autoimmune diseases

Treatment of autoimmune diseases is aimed at reducing the activity of the immune system by suppressing inflammation and reducing the formation of antibodies.

The main goals in the treatment of autoimmune diseases are:

• Reducing symptoms;
• Slowing the progression of the disease;
• Stopping the processes leading to the destruction of tissues and organs;
• Maintenance of remission;
• Improving the quality of life of patients.

Primary treatments for autoimmune diseases

Treatment for autoimmune diseases may include a variety of treatments and medications that will be prescribed depending on the specific disease and its severity. The main treatments for autoimmune diseases include:

1. Glucocorticosteroids are drugs that reduce inflammation in the body;
2. Immunosuppressants – drugs that suppress the activity of the immune system and reduce the progression of the disease;
3. Immunosuppressive drugs – drugs that reduce the amount of expression of genes responsible for the activation of immunity;
4. Interleukin inhibitors – drugs that can stop the development of autoimmune diseases associated with interleukin-6 dysfunction;
5. Biologicals – drugs based on genetic engineering technologies and aimed at reducing the activity of immune system components that are involved in the development of autoimmune diseases.

The treatment of autoimmune diseases is lengthy and requires constant monitoring by a doctor. With proper treatment and compliance with all the recommendations of patients, a significant improvement in the quality of life can be achieved.

Prognosis and opportunities for a fulfilling life in autoimmune diseases

Predictions

Autoimmune disease prognosis ranges from moderate to severe. Some autoimmune diseases can be easily controlled with medication, while others can be life-threatening. Prognosis directly depends on the type of disease, its stage and the presence of complications. Early medical attention and proper treatment significantly improve the prognosis of autoimmune diseases.

Opportunities for a fulfilling life

Although autoimmune diseases can significantly limit life and the ability to perform certain activities, there are certain opportunities for achieving a fulfilling life. In addition to medical treatment, lifestyle changes can significantly affect the health and well-being of a patient with an autoimmune disease. This may include proper nutrition, regular physical activity, adequate rest, stress management, and avoidance of certain habits such as smoking and drinking alcohol.
Also, an important part of a fulfilling life is the support of family, friends and medical staff. Patients with autoimmune diseases can face many challenges, including physical and emotional ones. This can lead to depression, anxiety, and feelings of loneliness. Support and understanding of those around you can help ease the burden on patients and improve their quality of life.
Table of possible limitations in daily activities caused by autoimmune diseases:

ActionPossible restrictions

Walking	Joint pain can make walking painful or difficult. Progressive disease may lead to the use of crutches or a wheelchair.
Personal care	Some patients may have difficulty performing independent activities such as dressing, bathing, and combing their hair.
Work	Autoimmune diseases can cause poor performance and absenteeism. This may lead to a reduction in working hours, a change in position or dismissal.
Communication	Avoidance of communication due to contagiousness, as well as associated depression and anxiety, can lead to social isolation of patients with autoimmune diseases.

Rheumatoid arthritis: how it manifests and what causes it

Rheumatoid arthritis (RA) is a chronic autoimmune disease, which is an inflammatory process in the joints and a violation of their functioning. In RA patients, there are complex changes in the body associated with the activity of the immune system and damage to the connective tissue. The main symptoms of RA are soreness, swelling and stiffness of the joints, which are especially evident in the morning and after prolonged immobilization (for example, in a sitting position at work).

RA is unique in that it is a chronic disease that can lead to critical impairments in the ability to move and communicate if left untreated. In addition, it is often accompanied by other symptoms such as loss of energy, loss of appetite, fever, and eye pain. The risk of getting RA increases with age and is 1-3% in the total number of diseases, and also has risk factors such as genetics, smoking and viruses.

• Symptoms: soreness, swelling and stiffness of the joints, loss of strength, loss of appetite, fever and pain in the eye area.
• Treatment: medications, physiotherapy and stress relief.
• Prevention: smoking cessation, moderate alcohol consumption and a balanced diet.

Treatment for RA begins with taking steps to reduce joint inflammation and associated pain, swelling, and stiffness. This can be achieved in a variety of ways, such as medication, physical therapy, and stress relief. Preventive measures such as smoking cessation, moderate alcohol consumption, and a balanced diet can also help prevent the development of RA.

Type of drug Examples of drugs

Nonsteroidal anti-inflammatory drugs
Biologics	Infliximab, adalimumab.
Chondroprotectors	Chondroitin sulfate, glucosamine.

Given the severity and range of symptoms associated with RA, it is important to find the right treatment under the supervision of a specialist. This may include choosing certain medications, changing your diet, and adding special exercises to your exercise routine. At the moment, there is no method that would guarantee a complete cure for RA, but regular monitoring and treatment of identified symptoms can help control the disease and maintain a high quality of life.

Autoimmune Disorders: Hashimoto’s Thyroiditis

Hashimoto’s Thyroiditis is a chronic autoimmune thyroid disease in which the body’s immune system attacks and destroys thyroid cells, which can cause it to malfunction.

Among the main symptoms of Hashimoto’s thyroiditis are an increase in the level of iodine in the blood, an enlarged thyroid gland, metabolic disorders, fatigue, drowsiness, weight loss or gain, constipation, increased sensitivity to cold.

Diagnosis of Hashimoto’s thyroiditis, like other autoimmune diseases, can be done with blood tests for the presence of autoantibodies, which are usually necessary for the thyroid gland to work, but the immune system becomes aggressive on them.

The goal of treatment for Hashimoto’s thyroiditis is to reduce autoantibody levels, reduce thyroid inflammation, and restore thyroid function. Treatment may include medication, diet, lifestyle changes, and other methods.

Hashimoto’s thyroiditis is one of the most common autoimmune diseases that affects women much more often than men. It is often diagnosed in people between the ages of 30 and 50 and can occur on its own or in combination with other autoimmune diseases.

• Important to know:
• Hashimoto’s thyroiditis is not inherited, but some genes may influence the risk of developing it;
• The thyroid gland plays an important role in the body, controlling metabolism, temperature, and other functions;
• Factors that can increase the risk of Hashimoto’s thyroiditis include stress, viruses, bacteria, excess iodine, and others.

Systemic lupus erythematosus

Systemic lupus erythematosus is a chronic autoimmune disease that can affect various organs and systems of the body, including the skin, lungs, kidneys, and cardiovascular system.

The main symptom of systemic lupus erythematosus is a red rash on the skin, which may be accompanied by itching and flaking of the skin. Joint pain, fever, fatigue, and hair loss may also occur.

Treatment of systemic lupus erythematosus includes the use of immunosuppressive and anti-inflammatory drugs, as well as courses of glucocorticoids. Regular consultation with a rheumatologist and nutritionist can also help control symptoms and improve the patient’s quality of life.

It is important to note that systemic lupus erythematosus is not a hereditary disease, but patients with relatives who have an autoimmune disease may be at a higher risk of developing this disease than other people.

• Rare symptoms may include:
  • Seizures
  • Breathing problems
  • Dry eyes
  • Memory loss
• lupus erythematosus may involve intensive care and hospitalization.

Scleroderma

Scleroderma is an autoimmune disease that affects connective tissue and can affect the skin, joints, internal organs, and blood vessels.

Patients with scleroderma experience thickening of the skin and discoloration, which can lead to dryness, itching and cracking. In addition, many suffer from painful joints and muscle weakness.

Internal organs such as the lungs, kidneys, heart, stomach and intestines can also be affected by scleroderma. This can lead to various problems such as difficulty breathing, high blood pressure, and decreased organ function.

There are two main types of scleroderma: localized and diffuse. Localized scleroderma is mostly limited to the skin and joints, while diffuse scleroderma is a more severe and rapidly progressive form that also affects internal organs.

• Symptoms of scleroderma:
  1. Thickening and discoloration of the skin;
  2. Painful joints and muscle weakness;
  3. Difficulty breathing and high blood pressure;
  4. Low functionality of internal organs.

Treatment of scleroderma is symptomatic and possibly difficult due to its diversity. As a rule, patients are prescribed immunosuppressive drugs, as well as drugs aimed at reducing symptoms. In more severe cases, surgery or an organ transplant may be required.

Stevens-Johnson syndrome

Stevens-Johnson syndrome is a rare autoimmune disease that affects the skin and mucous membranes. It manifests itself as a scalding rash that can spread throughout the body, as well as swelling and redness of the eyes and mouth.

Symptoms of the syndrome can be caused by a variety of factors, including infections, medications, or other allergens. However, the exact cause of its occurrence is unknown.

Treatment of Stevens-Johnson syndrome includes discontinuation of offending medications and continued supportive care. In severe cases, hospitalization and treatment in intensive care may be necessary.

Stevens-Johnson Syndrome is a serious condition requiring immediate medical attention. It can have serious complications such as infections and organ damage. Therefore, maintaining a healthy lifestyle and monitoring health status are important steps to prevent the onset of this disease.

Psoriasis

What is this disease?

Psoriasis is a chronic autoimmune disease that manifests itself in the form of dry skin, burning and itching, as well as the presence of red spots on the skin, covered with silvery-white scales.

In psoriasis, the immune system attacks the skin’s own cells, which leads to an increase in their number and the formation of so-called “psoriatic lesions”.

What are the symptoms of psoriasis?

• Dry skin;
• Burning and itching;
• Presence of red spots on the skin covered with silvery white scales;
• Spotted flaking;
• Fissures and soreness in affected areas.

How to treat psoriasis?

Treatment of psoriasis depends on the severity and nature of the disease and may include the use of topical ointments and creams, laser therapy, systemic medications, and lifestyle changes to reduce stress and improve nutrition.

Other experimental treatments include skin moisturizing, phototherapy, and the use of biologics to block immune system activity.

Q&A:

What are autoimmune diseases?

Autoimmune disease is when the immune system attacks the body’s own tissues, mistaking them for the enemy.

What are autoimmune diseases?

There are more than 80 types of autoimmune diseases, including multiple sclerosis, rheumatoid arthritis, systemic lupus erythematosus, Still’s syndrome, and others.

How do autoimmune diseases occur?

The causes of autoimmune diseases are still not fully understood, but their occurrence is influenced by genetic and environmental factors (viruses, bacteria, stress, etc.).

Can an autoimmune disease be cured?

Autoimmune diseases cannot be completely cured, but remission and improved quality of life can be achieved with treatment.

What symptoms accompany autoimmune diseases?

Symptoms of autoimmune diseases may vary depending on the disease, but fatigue, joint pain, skin rashes, digestive problems, etc. are common.

What treatments are used for autoimmune diseases?

Treatment for autoimmune disorders may include anti-inflammatory and immunosuppressive drugs, physical therapy, diet, and lifestyle changes.

Autoimmune diseases – causes, symptoms, treatment, prevention

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A group of diseases in which the immune system begins to attack its own healthy cells and tissues is called autoimmune (AID). The Israeli clinic Hadassah Medical Moscow successfully uses unique comprehensive treatment programs that allow you to control the immune system and correct the patient’s condition. It keeps health and improves quality

the lives of our patients. Autoimmune diseases are an uprising of one’s own immunity against the body, when the immune system (IS) suddenly sees foreign agents in healthy cells and directs all its strength to fight them. Different systems and organs of the body can be affected, the most severe complications are the failure of the functioning of vital organs, multiple organ failure.

To date, the exact mechanisms of the occurrence of this condition have not been established, but modern medicine can offer successful treatment of symptoms, normalize the patient’s condition and prevent complications. The Hadassah Medical Moscow clinic uses the latest treatment methods and unique drugs that have proven themselves in the largest medical centers in Israel and Europe. Therefore, AID treatment here achieves better results than in other medical centers.

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Physicians of department

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Zhukova
Daria Grigoryevna

Allergist-immunologist, Ph.D.

Work experience: 14 years

Cost of admission: from 9000 ₽

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Zaitseva
Galina Valerievna

Allergist-immunologist

Work experience: 10 years

Cost of admission: from 6500 ₽

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Benefits of treating autoimmune diseases at the Hadassah Clinic

International Standards for Treatment Programs

When determining the treatment regimen, we rely on the best examples of treatment algorithms from the experience of Israeli and European clinics. Each patient receives the maximum, so the result will be as positive as possible.

Medical councils

Each decision in treatment measures is taken collectively. Specialists organize consultations with Israeli colleagues, medical experts from abroad take part in the management of patients.

High-tech treatment and progressive technologies

The medical center is equipped with the most modern diagnostic and treatment equipment. We use high-tech methods of treatment, we use modern equipment to increase the effectiveness of the chosen medical tactics.

Unique drugs

Our clinic uses drugs that have shown their high efficiency in foreign clinics, but are not yet registered in Russia. You get world-class treatment without leaving the country.

Comprehensive treatment with coordination of all stages

We always monitor the results of treatment in dynamics, and, if necessary, adjust treatment tactics. The patient is treated by doctors of different specialties, so a look at a clinical case is not a private opinion of one doctor, but an objective assessment of a medical consultation. Specialists keep in touch with patients even after treatment, in order to monitor their health and correct possible deviations in time.

Healing environment

Within the walls of our clinic, patients feel easy, comfortable and convenient, because the whole interior is thought out to the smallest detail. Patients receive full attention, assistance and support from the staff, and if necessary, professional care.

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Autoimmune diseases – what is it?

AID is not one pathology, but a whole class of health disorders, which is characterized by a loss of tolerance to self antigens (AH). The exact mechanism of their origin is unclear, but many internal and external factors are known to be triggers for these conditions. Autoantibodies (autoantibodies) cause damage to organs and systems, because they are aimed at the destruction of autoantigens (autoAG) – substances of the body’s own cells, which are recognized by the immune system as foreign.

The consequences of this are organ or systemic pathological processes that occur under the influence of one’s own immunity, which has rebelled against native healthy cells.

This group is the most common among all known diseases – AIDs have 5-7% of the world’s population. The pathology affects people of any age and has a gender preference: there are twice as many women with this problem as men.

AID has a large number of nosological forms (about 100) and forms clinically severe complications with life-threatening consequences. Identification of such pathologies at an early stage will allow taking control over the pathological process and slowing it down, preventing severe and dangerous consequences.

Symptoms and signs of autoimmune diseases

Knowing what an autoimmune disease is, one can assume the multiplicity and non-specificity of symptoms characteristic of a large class of pathologies.
But there are some signs of AID that should be taken into account and consulted by doctors in time:

• Problems with hair, nails, skin: severe hair loss, causeless skin reactions like allergic, rash, alopecia, baldness, itching, etc.
• Inflammation of the joints, joint pain.
• Problems with the functioning of the gastrointestinal tract.
• Thyroid dysfunction.
• Infertility, regular spontaneous abortions.
• Thrombosis of blood vessels, varicose veins, trophic ulcers on the lower leg, convulsions, tremor of the extremities.
• Weakness, fatigue.
• In women – menstrual irregularities.
• Abdominal pain.
• Sudden weight loss or gain.
• Bulimia.
• Subfebrile body temperature.
• Noticeable disorders of the psycho-emotional sphere.

Even before the appearance of obvious symptoms corresponding to the lesion of a certain organ, a person feels constant chilliness of the lower extremities, his skin is pale. There may be signs of pathologies of the heart and blood vessels, cold allergies.

Causes, risk factors

What is an autoimmune disease? In simple terms, this can be called the aggression of body cells against itself. The body seems to be fighting with itself, unable or having forgotten how to distinguish between foreign agents and its own cells.

This “promiscuity” of immunity is called immunological tolerance. It can be formed for the following reasons:

• Incorrect intrauterine development of the fetus.
• Violation of the vital activity of T and B lymphocytes responsible for actions against their own cells.
• For unknown reasons, the protective mechanisms of organs and tissues are violated, as a result of which the immune system begins to attack them.
• Impaired immune response.
• Poor heredity, genetic predisposition.
• Bacteria and viruses have formed an immune response, which is also directed against their own cells similar in proteins.
• Pregnancy, when the cells of the fetus form an autoimmune reaction of the mother’s body, because they have the antigens of the father of the child.

There are several risk groups for AIDs in which, according to scientific research, pathological conditions occur more often:

• Anyone who has had a bacterial or viral infection can acquire AIDs in the future.
• Women are affected almost twice as often as men, so this is a gender-specific disease. In the vast majority of cases, the disease occurs during childbearing age, during pregnancy and after childbirth.
• A hereditary regularity in the appearance of cases of pathologies has been discovered. For example, systemic lupus erythematosus, multiple sclerosis often have a family clinical picture.
• People who regularly come into contact with toxins, harmful substances, get intoxicated, have a greater risk of developing autoimmune diseases.
• Damage to tissue-blood barriers due to inflammation contributes to the risk of AID.

The favorite age of pathology is from 18 to 50 years.

To some extent, black, Hispanic, and Indian ethnic groups are also at risk because AID is more likely to affect their members.

Diagnosis of autoimmune diseases

The diagnostic program always starts with an anamnesis. The doctor clarifies information about hereditary pathologies, past infectious diseases, harmful factors at work, etc.

Medical examination of the body

is performed to assess the condition of the skin, lymph nodes, veins, the presence of a rash, venous pattern, livedo reticularis on the lower extremities, swelling of the joints, hematomas.

Immunofluorescent laboratory test for the detection of autoAT

which in a biological tissue (blood) sample will be isolated using fluorescent staining preparations.

Multicomplex blood test

helps to detect autoAT.

Enzyme-linked immunosorbent assay (ELISA)

detecting autoAT or autoAG with quantitative assessment.

Solid-phase ELISA study

this method is accessible and easy to perform, and also has a quantitative format

Multicomplex analysis

a modern diagnostic method that aims to detect autoAT

To assess the work of internal organs, systems, registration of pathological foci and disorders, the following is performed:

• Radiography.
• MRI.
• CT.
• ultrasound.
• Endoscopic diagnostics.

All survey results are assessed comprehensively. In case of ambiguous data, additional studies are performed. The patient is sent for a consultation to the doctors of narrow specializations to clarify the diagnosis.

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Treatment of autoimmune diseases

Examination and counseling of patients with AID is carried out by an immunologist, although the patient is managed by a specialized doctor corresponding to the group of diseases: nephrologist, cardiologist, dermatologist, endocrinologist, etc.

Is it possible to cure an autoimmune disease?

It is impossible to completely get rid of an autoimmune disease. The goal of treatment is to achieve long-term remission with constant complex therapy.

It may be thought that such an autoimmune disease progresses rapidly and is a variant of oncology. But no, modern medical methods and means can not only eliminate most of the unpleasant symptoms, alleviate the condition during periods of exacerbations, but also restore the patient’s ability to work, improve the quality of life. To do this, it is very important to consult a doctor in time and follow all the recommendations for diagnosis and treatment.

How to stop the autoimmune process in the body?

There is no universal cure for AID. However, there are methods that are most often used in treatment:

• Antiparasitic, anti-infective therapy for the treatment of invasion and infections that are the trigger of pathology.
• Non-steroidal anti-inflammatory drugs.
• Painkillers.
• Corticosteroid hormones.
• Hormone replacement therapy (insulin for diabetes).
• Immunosuppressants, cytostatics.
• Immunomodulators.
• TNF inhibitors.
• Therapeutic exercise, physiotherapy, balneotherapy, diet therapy, vitamin therapy.

Surgical treatment is necessary in case of complications that can be corrected by radical methods: for example, elimination of intestinal obstruction in Crohn’s disease, kidney transplantation in case of organ failure, arthroplasty in case of joint damage.

This is interesting! Modern scientific research is aimed at studying gene and cell technologies. Donor stem cell transplantation has been shown to be effective in some diseases, such as Crohn’s disease, as well as beta-cell transplantation of the islets of Langerhans of the pancreas for the treatment of type 1 diabetes. It is likely that these technologies will soon be widely used in the treatment of autoimmune diseases.

Types of pathologies

AI pathology must be distinguished from the autoimmune syndrome, which is formed in a healthy body, is not a cause, but a consequence of diseases and is aimed at eliminating diseased, damaged cells. An autoimmune disease is precisely a disease that gives rise to other pathological processes.
Doctors distinguish three main groups of autoimmune diseases:

Organ-specific when auto-ATs are directed against one or more auto-AGs in the cells of a particular organ.

Diseases belonging to this group:

• Hoshimoto’s thyroiditis;
• b-n Addison, or bronze;
• myasthenia gravis, or bulbar palsy;
• thyrotoxicosis;
• atrophic gastritis AI nature;
• pemphigus vulgaris, or bullous dermatosis;
• myocarditis;
• multiple sclerosis;
• pernicious anemia.

This group also includes pathological conditions: early onset of menopause in women, sympathetic ophthalmia, some forms of male infertility, uveitis.

Non-organ-specific , or systemic, in which auto-ATs are directed against substances located in different tissues and organs of the body.

List of autoimmune diseases:

• rheumatoid arthritis;
• scleroderma;
• systemic lupus erythematosus;
• Sjögren’s syndrome;
• group of systemic vasculitis;
• polymyositis;
• Sarcoidosis.

Some diseases, such as celiac disease and chronic hepatitis, can be included in this and the next group.

Mixed that simultaneously have both mechanisms of action of autoAT.

These pathologies include:

• mixed connective tissue disease;
• type 1 diabetes mellitus;
• ulcerative colitis;
• biliary cirrhosis;
• celiac disease;
• Goodpasture’s syndrome;
• AI bronchial asthma.

Pathology caused by the AI ​​reaction of the body, in some cases, may exist for a short time and disappear unexpectedly, but more often it has a chronic course and leads to severe complications in which a person cannot survive without constant medical care.

Preventive measures

There is no specific prevention of AI pathology. But in order to reduce the risks, all viral, bacterial infections, SARS should be completely cured.

You need to adjust your diet, bring your body weight back to normal, learn how to cope with stress. Affordable physical activity, moderate regular sports activity help a lot.

Prevention of relapses is the implementation of all medical recommendations and the proper organization of nutrition, lifestyle, and the rejection of bad habits.

AID treatment at Hadassah Clinic

Highly qualified doctors of the Israeli clinic Hadassah Medical Moscow select the optimal treatment program for each patient on an individual basis, taking into account the characteristics of his disease, comorbidities, age, and other factors.

Medicines and treatment methods used in our clinic are modern, effective and safe. Many of the methods and drugs are used only in the Hadassah clinic, because they are not yet registered in Russia.

Our patients achieve stable remission, positive results of complex maintenance therapy, if they follow the medical recommendations of expert doctors.

Text checked by an expert doctor

Zhukova
Daria Grigorievna

Allergist-immunologist, Ph. D.

Work experience: 14 years

Published: 06/22/2022

Updated: 06/22/2022

The information presented on the site is for reference and cannot serve as a basis for making a diagnosis or prescribing treatment. Internal consultation of the expert is necessary.

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