Sunday 9, April 2023
Old Friends
I have had a number of close friends and relations suffer from Crohn’s Disease and similar autoimmune conditions (including the most common of all, coeliac disease). My best friend from school had Crohn’s, as did his brother. It’s a pretty terrible thing, and used to be treated by repeatedly removing sections of gut. Another friend, who I met later, had the disease, and had so much gut removed that he had to be fed intravenously.
The UK has an epidemic of autoimmune diseases. Diabetes Mellitus, of which there is an epidemic in the UK is one, as is rheumatoid arthritis, virtiligo, multiple sclerosis, and Hashimoto’s disease. There are many, many others. There are suggestions that depression and some types of heart diseases are autoimmune in origin.
The general public is aware that they are common, especially diabetes, and know that there is an environmental link, although probably some sort of genetic link too. My friend with Crohn’s had a sister with rheumatoid arthritis.
I used to have more medical friends, but I have never heard any of them discussing the problem in general terms (rather than discussing the individual diseases in isolation).
A popular theory is that our immune systems develop without exposure to a range of microorganisms and parasites (such as helminthic worms) that have co-existed with us since the dawn of time. This is a variation on the ‘hygiene hypothesis’ that simply says that we need exposure to more dirt (microbes in general). Of course, it’s hard to be selective about friends of this sort, so the practical implications are few.
Drug companies are well aware of the importance of this class of disease. Humira (adalimumab) is the world’s most profitable drug. It works by blocking a protein (TNF-alpha) found in the body’s immune system that causes joint swelling and inflammation. But, as is so often the case, it’s a drug that is a treatment, but not a cure.
I do not have the background to decide on how important these theories are. I know that the NHS website, and websites dedicated to these diseases never mention early years conditioning of the immune system as a causative factor. Actually, I don’t know if this is never mentioned, but it is completely absent from this website, which is devoted to explaining the causes and treatment of rheumatoid arthritis. I don’t want to speculate on the reasons for this possible omission, but I am sure that readers can think of some conflicts of interest that could be at play.
Further Reading
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