The body’s civil war: Understanding autoimmune conditions

Our immune system does a remarkable job of keeping most of us mostly healthy for most of the time. After all, we live surrounded by parasites: bacteria, viruses, fungi, pathogens and archaea. Usually, the immune system mounts devastating attacks on pathogens and malignancies, while limiting collateral damage to healthy tissues (self-tolerance). Sometimes, however, the immune system provokes an damaging reaction against triggers (antigens) expressed by healthy, normal tissue, such as the skin, pancreas or joints.¹

This immunological civil war underlies about 80-100 autoimmune diseases.^{2, 3} Some are part of nurses’ everyday caseload, including psoriasis; multiple sclerosis (MS); inflammatory bowel disease (IBD); rheumatoid arthritis (RA); and type 1 diabetes. You may only occasionally, if ever, encounter others, such as epidermolysis bullosa acquisita,⁴ Vogt-Koyanagi-Harada disease⁵ and Parry Romberg syndrome.³ Autoimmune mechanisms also contribute other conditions, such as chronic obstructive pulmonary disease (COPD),⁶ Cardiovascular disease⁷ and certain cancers.^8,9 This feature outlines the processes that underlie autoimmune diseases to help nurses appreciate the importance of rapid diagnosis, referral and treatment.