PARIS, August 26 (EDITIONS) –
An autoimmune disease is a disease in which the immune system, i.e. the patient’s defences, attacks its own structures, organs and different systems, ultimately causing inflammation and, if left untreated, damage to the body.
“We believe that today we have more and better diagnostic tools and that is why it is believed that they are more frequent today,” says Dr. Patricia Fanlo, president of the Spanish Multidisciplinary Society for Systemic Autoimmune Diseases (SEMAIS), in an interview with Infosalus.
Furthermore, she points out that new diseases are discovered and diagnostic and classification criteria improvebecome more sensitive and, therefore, making it possible to diagnose these pathologies earlier and better.Early diagnosis is essential in this disease in order to start treatment as early as possible and anticipate complications.
However, she says that there are no exact data on the prevalence and incidence of these diseases.and that there is a lack of robust records at the national level. “Most of them are rare diseases that meet the criterion of 5 people diagnosed per 10,000 inhabitants,” he adds.
HOW THEY AFFECT ACCORDING TO SEX
In this sense, the SEMAIS expert warns once morest the fact that not all autoimmune diseases affect both genders equally. Although most systemic autoimmune diseases (MAIS) are known to be more common in women, there are exceptions such as ankylosing spondylitis or Behçet’s disease, which are more common in men.
« The most representative systemic autoimmune disease is systemic lupus erythematosus. and it is in this disease that the greatest differences between the sexes are observed. 10 women for every man are more commonly affected by lupus. Hormonal factors linked to the appearance of certain SADs have been described,” says Dr. Fanlo.
She also refers to a recent study published in ‘Nature’, carried out in Sweden, where she claims that it is postulated that Testosterone may have some protective effect once morest systemic autoimmune diseases.It appears that testosterone can suppress the BAFF protein, which benefits B cells, which are major players in lupus and other autoimmune diseases. Therefore, if testosterone is suppressed, BAFF is increased and spleen B cells are stimulated and survive to a greater extent.”
THERE HAS BEEN GENDER BIAS ABOUT EASE
The problem in this respect, according to the expert, is that diseases that have affected women have been studied less and, as a result, autoimmune diseases have suffered from what has been called a “gender bias in health care.”
“Traditionally, studies and clinical trials have focused primarily on men, and this data has then been extrapolated to both genders, making the mistake that women start and suffer from diseases differently. This lead to gender bias in the diagnosis and treatment of these diseases. There has also been a greater delay in the diagnosis of these diseases in women”, regrets the president of SEMAIS.
Today, these prejudices are increasingly being overcome, according to Dr Fanlo, and patients are receiving adequate health care, although she warns that there is still “a lot to do and improve”, especially in the field of research.
CAUSES OF THE APPEARANCE
Especially, the causes that can lead to the development of this type of pathology can range from infections to drugs and toxic products.although she acknowledges that those of genetic cause are exceptionalbecause most ASDs are polygenic rather than monogenic, with an autosomal dominant or recessive mode of inheritance.
“Among the causes we can find viruses, such as HIV, hepatitis virus, infectious mononucleosis; or bacteria like Staphylococcus aureus or pneumococcus, as well as medications or drugs as a cause or trigger of systemic autoimmune diseases,” he adds.
In turn, Fanlo points out that, generally, the age of onset of SAEs in young adults is between 20 and 40 years old. “Yes, some start at a late or advanced age, as in the case of giant cell arteritis. The fact that they start at such a young age means that there is a decrease in the quality of family and professional life for these patients,” he warns.
THE MOST FREQUENT EASE FOR WOMEN
At this stage, it highlights the most common EAS in women:
1. systemic lupus erythematosus: usually occurs in young women, it is associated with damage to the skin and joints; ANA antibodies are positive in the blood test.
2. Sjogren’s syndrome: is usually caused by damage to the salivary and lacrimal glands resulting in symptoms of dry eyes and mouth; it is associated with the presence of positive Ro and La antibodies.
3. Scleroderma: usually in women, is caused by damage to skin collagen and vasculopathy, hardening of the skin, mainly localized on the skin of the hands, feet and mouth; may cause pulmonary hypertension, interstitial lung disease and esophageal disorders.
4. Giant Cell Arteritis: type of vasculitis, that is, an inflammation of the vessels that affects the large vessels, the aorta and its main branches; it typically appears in patients over 55 and affects the temporal artery, causing headache, jaw claudication, and sometimes blindness and stroke in patients with poor disease control; in the analysis, as markers, we can find an elevation of acute phase reactants such as CRP and ESR.
5. Antiphospholipid syndrome: is characterized by arterial and venous thrombosis and fetal loss associated with the presence of antiphospholipid antibodies in the blood.
EAS AND PREGNANCY
A question that many women with this type of pathology have is whether they can be mothers and how their disease can affect a pregnancy or even their own baby.
In this sense, the president of the SEMAIS remarks that, “of course”, “of course”. women with systemic autoimmune diseases can become pregnant and have pregnancies with normal delivery and postpartum. “But they must be followed in collaboration with obstetricians and specialists in rheumatology or internal medicine to prepare them for pregnancy,” they add.
To this end, this expert considers that it is always necessary to carry out a preconception consultation to prepare them for a possible pregnancy: “In this preliminary preparation, it is necessary to evaluate the treatments that the patients are taking and which can be toxic for the fetus, in order to change them for therapeutic methods authorized during pregnancy. In addition, patients must have been stable for the past 6 months with no onset of disease”.
Subsequently, Dr. Fanlo reports that once the patient is pregnant, she will go to a consultation for high-risk pregnancy where she will benefit from more frequent and more specific checks, generally in reference centers, where there are usually a multidisciplinary consultation between gynecologists, obstetricians, rheumatologists and internists.
“In the same way, today, patients with systemic autoimmune diseases can opt for pregnancy without any problem through assisted reproduction techniques”, explains this specialist in TAS.
