Dix­ie-Ann Dick­son

Au­toim­mune dis­eases are a large and grow­ing prob­lem, par­tic­u­lar­ly in the Caribbean and the Unit­ed States(US), as it is the pri­ma­ry cause of cer­tain ail­ments, such as rheuma­toid arthri­tis, lu­pus and type1 di­a­betes. So said Dr Noel Rose, di­rec­tor, Cen­tre for Au­toim­mune Dis­ease Re­search at John Hop­kins Uni­ver­si­ty, who pre­sent­ed on Au­toim­mune Dis­ease: The Com­mon Thread, dur­ing the Caribbean Au­toim­mune Dis­eases Sum­mit 2011, at the Hilton Trinidad, St Anns, yes­ter­day. Rose ex­plained that au­toim­mune dis­eases are high­ly di­verse and af­fect every part of the body. "It's a dis­ease caused or sig­nif­i­cant­ly pro­mot­ed by au­to-im­mu­ni­ty." He said while they did not have a cure, treat­ments for these di­verse dis­eases were get­ting bet­ter.

The rea­son why there was a chal­lenge in find­ing a cure, it's be­cause on­ly when the dam­age was done, the dis­ease was recog­nised, he added. Rose said they need­ed to de­vel­op ef­fec­tive treat­ments, that would treat the cause of the dis­ease and not the symp­toms be­cause the symp­toms were at the end of the train of events. "We need to get on the train at the very be­gin­ning," he added. He point­ed out that the top ten au­toim­mune dis­eases in the US in­clud­ed Graves dis­ease, rheuma­toid arthri­tis, Hashimo­to thy­roidi­tis, vi­tili­go and per­ni­cious anaemia. "In the US, 14.7 to 23.5 mil­lion peo­ple have au­toim­mune dis­ease and its preva­lence is the same as heart dis­eass (22 mil­lion) and twice as can­cer (nine mil­lion)."

He fur­ther ex­plained that au­toim­mune dis­ease may re­sult from ge­net­ic pre­dis­po­si­tion trig­gered by en­vi­ron­men­tal fac­tors such as drugs, stress, food, pol­lu­tants and virus­es, but the en­vi­ron­ment was more than half of the risk. How­ev­er, Lawrence Phillips, as­sis­tant pro­fes­sor of med­i­cine, di­vi­sion of Car­di­ol­o­gy at NYU Lan­gone Med­ical Cen­tre, pre­sent­ed specif­i­cal­ly on clin­i­cal man­i­fes­ta­tions of heart dis­ease in au­toim­mune dis­or­ders. He said au­toim­mune dis­eases as­so­ci­at­ed with chron­ic in­flam­ma­tion would put pa­tients at high­er risk of heart at­tacks. Dis­ease of the heart, he said, was the lead­ing cause of death in T&T. "Heart dis­ease ac­count­ed for 24.8 per cent of deaths in 2004, es­sen­tial­ly un­changed from the pri­or year," Phillips said.

"Many au­toim­mune dis­eases can have di­rect ef­fects on the heart, such as struc­tur­al heart dis­ease, but al­so can in­di­rect­ly in­creased risk of is­chemic heart dis­ease," he ex­plained. Al­so the di­rec­tor of nu­clear car­di­ol­o­gy, Phillips agreed that more ac­tive re­search need­eds to be done for au­toim­mune dis­ease treat­ment. He point­ed out that there were tra­di­tion­al risk fac­tors that im­pact­ed on au­toim­mune dis­eases. They in­clude hy­per­ten­sion, to­bac­co use, di­a­betes, obe­si­ty and lack of phys­i­cal ac­tiv­i­ty. Sev­er­al stud­ies, he said, have shown in­creased risk fac­tors in those pa­tients with chron­ic in­flam­ma­to­ry con­di­tions.