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Autoimmune Diseases


Leaky Gut and Autoimmune Diseases What is the Link?
By Dr. Scot Lewey



Has the link to the leaky gut and autoimmune disease become more clear? I believe it has and researchers from Canada have helped by a nice review on intestinal permeability in the British journal Gut.

Dr. J. B. Medding and his colleagues in Edmonton, Alberta Canada (Arrieta, Gut, 2006) describe how the intestine serves as a barrier when normal but becomes a source of the genesis of autoimmune diseases when it becomes abnormally permeable. That is, when your gut becomes leaky ("the leaky gut syndrome") several autoimmune diseases are known to occur.

Intestinal permeability (how leaky the gut has become) can be evaluated in a manner specific to various sites in the gut. That is, the different areas of the gut, from stomach to large intestine, can be evaluated by specific tests for leakiness and related to damage and disease in those areas. Areas of leaky gut can be observed prior to the onset of disease and appear to be involved in the development of disease, especially autoimmune diseases like Celiac disease, diabetes, Crohn's disease, as well as skin diseases like atopic dermatitis, rheumatologic conditions, and even irritable bowel syndrome.

The authors propose a new paradigm consisting of "three main features...

(1) A genetically susceptible immune system (the mucosal immune system), that allows the host to react abnormally to an environmental antigen.

(2) An environmental product that triggers the disease process.

(3) The ability for the environmental agent to interact with the mucosal immune system. Since the purpose of the epithelial barrier is to keep these two factors separate, and we measure this function of the barrier by permeability, the corollary of this is that an increase in permeability is a requirement for disease expression."


What does this mean in lay terms and in relationship to the concept of the leaky gut syndrome? The gut or intestine is supposed to be a barrier to foreign proteins like foods and bacteria. If your immune system is genetically predisposed to react adversely to a certain food proteins and/or bacteria in your gut (or nerves, skin or joints) you may react with activation of damaging chemicals intended to protect you from foreign invaders that instead damage your gut making it more leaky and more vulnerable as well as your nerves, skin, and joints.

Leaky gut begets leaky gut. What results is more damage to your gut. Food and bacterial proteins can act together to damage the gut and allow toxic protein complexes to get through the gut that is normally supposed to be resistant to such a breach. Once in your blood stream, foreign proteins may initiate abnormal reactions that cause irritation to your brain, nerves, skin and/or joints.

What many of you and I experience then are symptoms such as abdominal pain and bloating, gas, diarrhea, headaches, nerve pain, skin rashes and joint aches. The diagnoses that result are Celiac disease, Crohn's disease and irritable bowel syndrome, multiple sclerosis, migraines, attention deficit, autism, depression, eczema, acne, rheumatoid arthritis, fibromyalgia, diabetes, chronic fatigue etc. etc.

What really concerns some of us with personal and professional experience with this and who are passionately interested in this area is that there is an explosion of autoimmune diseases occurring right under our nose yet most doctors and lay public are missing the connection. Many people are being diagnosed with multiple conditions without anyone making the connection of the overload of our gut with certain foods that may be causing much of these illnesses. All of the problem foods have specific food proteins or lectins that are difficult to digest and potentially toxic to the gut. In particular if the food has been genetically engineered or modified their lectins may be more toxic to humans. Stay tuned for more on this exciting area, as I continue writing on the relationship of food, gut and disease. As your food doctor, the food doc, I hope to help you find the information you need to eat right to feel right even if your doctors are not making the connection.

Bibliography:

Arrieta MC, Bistritz L, Meddings, JB. Recent advances in clinical practice. Alterations in intestinal permeability. Gut 2006;55:1512-1520.

Copyright 2006 The Food Doc, LLC http://www.thefooddoc.com



Leaky Gut and Autoimmune Diseases Result From The Failing of Your Immune System
By Dr. Scot Lewey

HOW YOUR IMMUNE SYSTEM WORKS AND FAILS

This article reviews the basic function of your immune system and how it can fail. The results can be devastating. To understand the immune system I have used an analogy of a military defense system.

THE TWO COMPONENTS OF THE HUMAN IMMUNE DEFENSE SYSTEM:

The human immune defense system consists of two main components, the innate and adaptive. The innate component is so named because it is a general defense system. It is not specialized or specific but consists of basic defenses such as barriers, guard cells and an alarm system. The adaptive component is also aptly named because it develops or adapts over time as a more specialized and specific response.

THE INNATE IMMUNE SYSTEM AS A SECURITY SYSTEM:

The innate immune response is the automatic defense mechanism against potential foreign invaders such as bacteria, viruses, molds or parasites. It is analogous to defensive barriers, alarms and guards intended to protect or defend us personally or as a society. Such defensive barriers around our borders or sites of value to us may include protective walls, electric fences, locked doors, security guards and automatic alarm systems. Such systems may include automatic motion activated lighting and alarm systems, and low level security guards. This defense though highly effective for most threats, is not very specific, highly trained or lethal against serious threats. It also can be penetrated or breached easily though it may be linked to an alarm system that can signal for help. Therefore, we need the protection of more highly trained and specific defenses of the adaptive immune response.

THE INNATE IMMUNE SYSTEM CALLS FOR HELP, THE SWAT TEAM, DELTA AND GREEN BERETS:

With the ability of the innate system to signal for help and the adaptive systems ability to develop over time highly trained and specialized cells and antibodies our body has a better protection against various infections and diseases. In out culture, our adaptive protective system includes specially trained police or military such as SWAT teams, green berets, and the delta force. These forces are mobilized when there is an alarm or request for highly specialized and trained protection or defense. Though they may simply arrest or contain a threat they have the ability to mobilize a lethal force when necessary. However, with this amount of power or force available, innocent bystanders can be injured or killed if there is poor communication or identification of threats or potential invaders. This is how the adaptive immune response works.

INNATE IMMUNE SYSTEM COMPONENTS AND CELLS EXPLAINED:

Our innate immune defense response is then automatic and a nonspecific system. It consists of the barriers such as the skin and the intact intestinal wall of the digestive tract. The intact intestinal wall is similar to a fence or wall. It is patrolled by certain immune cells that are like security guards or rent-a-cops, guarding the body. This includes white blood cells circulating in the blood or present in the intestinal lining. Circulating white blood cells typically include cells known as neutrophils, eosinophils, and natural killer T lymphocytes. Lining the intestinal wall (skin and respiratory tract) are other white blood cells and immune cells such as basophils, dendritic cells, phagocytes and macrophages. In the intestine white blood cells present in small numbers may be mobilized to the area for specific threats. These include eosinophils, mast cells and neutrophils.

THE BERLIN WALL OF THE GUT:

The intestinal lining is normally an intact barrier except when signaled to allow some bigger particles through such as certain proteins or other nutrients. The intestinal tract lining has a single layer of cells of the epithelial cell type. These cells are joined tightly, shoulder to shoulder, through a scaffolding of proteins, such as occludens. These tight junctions can open up on signal, from proteins such as zonulin. Certain normal signals permit the opening of the gaps between the lining cells, the paracellular spaces, or decrease the tight junctions resulting in increase intestinal permeability transiently. However, abnormal stimuli can trigger opening of the tight junctions resulting in abnormally increased intestinal permeability or leaky gut. When tight junctions open up wall of the gut may become abnormally permeable or leaky allowing it to be penetrated by foreign proteins including bacteria, viruses, molds, parasites and intact food proteins or lectins. Impairment of gut wall integrity or barrier function is an abnormal innate immune defense. It is like an insecure border, fence or wall.

KILLER CELLS AND THEIR WEAPONS OF IMMUNE WARFARE:

Various immune cells of the innate response can release chemicals to contain or destroy invaders if they are near the area of an impaired barrier or they recognize that an invader is trying to get through just like a border patrol or roving security guard. Some of the tissue based immune cells destroy the invaders by actually eating them (phagocytes, eating cells and macrophages, large eating cells). They also are able to clean up left over debris and promote healing in a nonspecific manner.

HIGHLY SPECIALIZED IMMUNE FIGHTER'S MISTAKES RESULTS IN DANGEROUS FRIENDLY FIRE:

The adaptive response is one that is highly developed and specialized (trained) in humans. It has a memory. When combined with alarm systems from the innate immune system, a rapid, specific, and directed immune response that is also quite powerful can be activated or triggered. However, when such a system is activated, it can also lead to serious collateral damage to the surrounding tissues and cells. If the response bogs down and cannot deactivate itself an ongoing autoimmune condition without an exit strategy can result. This can result in chronic injury to the cells and tissues that is characteristic of what we know as autoimmune disease.

SPECIAL FORCES OF ANTIBODIES CAN MAKE IDENTITY MISTAKES:

The adaptive response includes the development of specific antibodies or immunoglobulin (IgE, IgM, IgG, IgD, IgA) to infectious agents and proteins the body recognizes as foreign (antigens). Sometimes the body misinterprets or mistakes self-proteins or tissues as foreign. When antibodies are made against self-proteins they are called autoantibodies. Examples include antinuclear antibodies (ANA) of lupus and rheumatoid factors or antibodies of rheumatoid arthritis. The result is these classic autoimmune disorders.

SPECIAL KILLER CELLS NECESSARY FOR DEFENSE AGAINST INVADERS:

The adaptive immune system also includes specialized activated lymphocytes: natural killer T cells, T helper lymphocyte cells, and gamma delta lymphocytes. The latter are also part of innate immune system. Tiny brief lived cell called the plasma cell are also part of the adaptive system. Because the adaptive system has a memory, and is highly trained for future anticipated attacks it can increase its response over time. That makes the adaptive system highly effective in defending us against foreign invaders such as serious infections but also highly dangerous to us if it becomes activated against our own cells or tissues.

AUTOIMMUNE DISEASE RESULTS FROM WELL INTENTION DEFENSES GONE AWRY:

The analogies used should help you better understand how our immune system works and how it can fail. It also helps explain how we can develop autoimmune diseases, new abnormal reactions to foreign proteins such as foods resulting in food allergies or sensitivities and how an abnormal gut barrier or leaky gut can be dangerous. Certain good bacteria residing in our gut actually help maintain our intestinal wall barrier function, act as antibiotics killing bad bacteria and inhibit other bacteria and yeast from taking over our system.

To learn more about how to maintain a healthy gut, healthy life visit http://www.theFoodDoc.com today.


Author Report

Dr. Lewey is a gastroenterology physician (specialist in digestive diseases) and an expert doctor in the diagnosis and treatment of food related and leaky gut disorders. His areas of expertise include Celiac, colitis, Crohn's disease, IBS, mastocytic enterocolitis and eosinophilic or allergic digestive problems. Dr. Lewey is an adjunct clinical faculty for Rocky Vista University, College of Osteopathic Medicine and was recently promoted to Clinical Associate Professor of Medicine. He is physician reviewer for the American Journal of Gastroenterology. He holds several board certifications and honors including election as a Fellow of the American College of Gastroenterology. Though he is in active private practice he continues to conduct clinical research, teach medical students, write and speak extensively on the connection between the digestive tract, food, microbes and health and disease. He is a featured author on celiac.com and has an educational website thefooddoc.com and several blogs. He and his family live gluten free in Colorado.

Blog URL:   http://thefooddoc.blogspot.com
Business URL:   http://www.thefooddoc.com, http://www.gacsonline.com
Ezine URL:   The Food Doc Journal


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