The link between infections and autoimmune disease

By naturopath Margaret Jasinska

Autoimmune disease is incredibly common, particularly in women. It occurs when the immune system mistakenly attacks components of your own body – such as your organs or tissues. The most common autoimmune diseases are Hashimoto’s thyroiditis, psoriasis, iritis, arthritis, lupus, inflammatory bowel disease and Graves’ disease.

What causes a person to develop an autoimmune condition? The short answer is several things, including genetic predisposition, poor intestinal health (leaky gut and dysbiosis) and environmental triggers. An example of an environmental trigger is an infection.

Infections are a very common trigger of autoimmune disease, and they can also cause a flare up of an existing autoimmune disease. There is a great deal of research to support this fact. Infection with certain bacteria, viruses, fungi or parasites doesn’t cause an autoimmune disease directly, like a virus causes the flu. Instead, these infections are more like the straw that broke the camel’s back. They trigger the development of an autoimmune disease in a person who was at high risk of developing it sooner or later.

Certain infections have been linked with specific autoimmune diseases. This is probably because certain viruses or bacteria closely resemble specific parts of the human body. Therefore after making antibodies against a specific bug, your immune system gets confused and starts making antibodies against your own body. This phenomenon is known as molecular mimicry and is a leading theory as to why autoimmune disease happens in the first place.

As we travel through life we are exposed to more and more infections; this, coupled with nutrient deficiencies and stress can make autoimmune disease more likely to develop as we get older.

There are good and bad infections when it comes to autoimmune disease. Some infections are actually known to have a protective role, and it also depends on when you become infected. Infection with the stomach bacterium Helicobacter pylori in childhood can reduce the risk of autoimmune disease, while infection in adulthood may raise it.

You have probably heard of the hygiene hypothesis. This theory states that exposure to certain bugs and microbes in childhood reduces the risk of allergies and autoimmune disease in adulthood. Children who grow up with pets or grow up on farms and are exposed to dirt usually suffer less allergies and autoimmune disease in adulthood.

Some studies have been carried out on the use of  hookworms in people with inflammatory bowel disease and coeliac disease with very positive results. Research participants were given capsules to swallow that contained worm eggs, and then had their inflammatory bowel disease or coeliac disease monitored. Results of these studies were overwhelmingly positive; the worms dampened down excessive inflammation and balanced the immune system. In some instances people with coeliac disease did not experience any harmful consequences from eating gluten while they had hookworms in their intestines.

We don’t suggest you start eating dirt or stop worming your pets, as you may acquire a harmful gut parasite that worsens your health problems. Instead, this highlights the significance of the gastrointestinal tract in autoimmune disease. You can get similar benefits from including probiotic rich foods such as fermented vegetables in your diet regularly. The good bacteria help to regulate and calm down an over active immune system.

You can’t prevent yourself from ever catching an infection. The types of infections linked with autoimmune disease are common infections that nearly everyone gets exposed to. It is far more important to strengthen your immune system with a healthy diet and the right nutrients in order to overcome these infections. Chronic infections that linger in your body and continually irritate your immune system are the worst at triggering autoimmune disease.

Examples of common infections that can trigger autoimmune disease

Epstein Barr virus (Glandular fever/mononucleosis)

This virus is in the herpes family of viruses and is an extremely common infection that just about everyone has suffered from at some point in their life. It’s quite a sinister virus though; it is capable of triggering 33 different autoimmune diseases. Obviously not everyone who has had glandular fever goes on to develop 33 autoimmune diseases, let alone one. This virus is simply one of the known triggers.

The Epstein Barr virus is most closely linked with the development of multiple sclerosis, systemic lupus erythematosus, rheumatoid arthritis and Sjogren’s syndrome. Research has shown that some people with systemic lupus erythematosus have an elevated Epstein Barr viral load in their bloodstream. It may be more than 15 times greater than in healthy individuals. This means that some people are unable to clear the virus from their bloodstream because they have a weak immune system. The chronic stimulation of the immune system by the virus may go on for many years, and eventually lead to the development of an autoimmune disease.

Cytomegalovirus

Cytomegalovirusis also in the herpes family and it’s a very common infection that approximately 40 percent of adults have had. Most people who get this virus don’t get any symptoms, so they are completely unaware. If your immune system is weak, you may suffer with mild symptoms such as a sore throat, mild fever, swollen glands and a mildly swollen liver. Cytomegalovirus increases the risk of developing multiple sclerosis and Guillain-Barre syndrome.

Helicobacter pylori

This is the bacterium that increases the risk of stomach ulcers and stomach cancer. It is thought that more than half the world’s population has this bacteria in their stomach, but most people do not develop symptoms or disease. If very high levels of Helicobacter pylori are present in the stomach, it can cause an inflamed stomach lining (gastritis) and symptoms of indigestion such as burping, bloating, nausea, stomach pain, reflux or heartburn.

There is a breath test, stool test and blood test for this bacteria. People who are treated for a stomach ulcer are typically given two different antibiotics, which are designed to kill this bug. That treatment is often not very effective; it either doesn’t kill Helicobacter pylori adequately, or it does but the bacteria returns soon afterwards. Diet changes and nutritional supplements are usually more effective than antibiotics over the long term. It is important to improve the health of the digestive system, so it is no longer a hospitable environment for Helicobacter pylori.

Infection with this bacteria raises the risk of developing thrombocytopenia (low blood platelets), sarcoidosis, atherosclerosis, systemic sclerosis, antiphospholipid syndrome (can result in infertility), rheumatoid arthritis and psoriasis. Some research has shown that eradication of Helicobacter pylori can result in amelioration of autoimmune disease.

Streptococcal infections (Strep)

Streptococcal infections are very common. Strep throat is sometimes responsible for a sore throat, fever and enlarged lymph glands in the neck. The most common cause of a sore throat is a viral infection, while streptococcus is a type of bacteria. It is thought to be responsible for approximately 37 percent of cases of sore throat in children and only 5 to 15 percent in adults.

A small percentage of people who have had a strep infection go on to develop rheumatic fever, which is an autoimmune disease caused by antibody cross reactivity. The white blood cells had been producing antibodies against the strep bacteria, but for some reason the immune cells become confused and start making antibodies against the heart, skin, joints or brain. The surface molecules on the strep bacteria are so similar to some molecules of the human body, that a small percentage of people who get a strep infection go on to develop an autoimmune disease. Rheumatic fever can cause arthritis, myocarditis (inflammation of the heart), a skin rash and Sydenham chorea (a brain disease that causes involuntary movements of the face and arms).

Strep infections are also capable of triggering autoimmune kidney disease (glomerulonephritis), PANDAS (Paediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections) and Tourette syndrome.

Norovirus

Noroviruses are the most common cause of viral gastroenteritis (stomach flu). The most common symptoms of infection are vomiting, diarrhoea, nausea and abdominal pain. Some people also experience a low grade fever, muscle aches and headaches. There is a strong relationship between infection with norovirus and subsequent development of Crohn’s disease.

It is also not uncommon for a bad cold or flu to trigger a flare up of an autoimmune disease in a person currently in remission. Fortunately there is so much that can be done to improve the health of a person with autoimmune disease, and many people are able to recover fully. For more information see our book Healing Autoimmune Disease: A plan to help your immune system and reduce inflammation.

References:
– Moon UY, et al. Arthritis Res Ther. 2004;6:R295-302
– Antonio Gasbarrini, et al. Disappearance of APS after helicobacter pylori eradication. The American Journal of Medicine 2001, 111:163