Autos, in Greek, encompasses the meaning of “same” or “self” so, aptly, autoimmune disease relates to the unhappy state when one’s own bodily immune response, designed to recognise and neutralise foreign invaders, attacks its own tissues, cells or molecules instead. Common variable immune deficiency (CVID) however, refers to an impairment of one of the vital immune system functions, which is to manufacture antibodies after foreign invaders have been identified.
With either impediment, autoimmune or CVID, vulnerability to infections is present but in the case of autoimmune diseases, in addition to foreign invaders, the body is attacking and damaging its own tissues. CVID can be associated with autoimmune disorders in the case of anaemia, arthritis, and endocrine disorders where there is also a low number of platelets or white blood cells. Evidencing in abdominal pain, gastrointestinal issues like chronic diarrhoea, nausea, vomiting and weight loss. Understandably, people with CVID have no viable defence mechanism and are particularly susceptible to infection from bacteria and viruses that develop in the lungs, sinuses and ears.
How do malfunctions, such as CVID and autoimmune disease come about? There could be primary defects innate to the immune system and then there are also secondary defects acquired in the course of life due to contracting diseases. Let’s take a closer look at two key responses of a functional immune system to get a better understanding.
The Innate And The Adaptive Immune System
The innate immune response refers to the cellular capability of particular protein cells, natural killer cells, neutrophils and monocytes, which require no ‘training’ to carry out their function. They are fast-acting and reliable – unless, as in the case of autoimmune disease or CVID, they have been ‘turned’ into an enemy. Babies need good innate immune responses as their bodies adapt to life outside the womb. They carry antibodies from their mother’s milk and won’t be making any of their own for a few weeks.
Adaptive immune responses involve B-cells and T-cells, which actually require ‘education’ or ‘training’ not to auto-attack our own cells! They seem like ‘loose cannons’ in the defence force armoury but they are the exact cells needed because of their adaptive capacity and long memory capability.
Clearly, what hangs in the balance here is that both systems need the ability to distinguish between what to attack – foreign invaders, and what to protect – our own cells. Here is where autoimmune disease and CVID responses veer off course. Due to the speed at which innate cells can respond, they are usually the first to rise to the occasion and their activity serves to trigger the adaptive response unit, which may take a couple of days to fully activate.
While the adaptive immune response is fully functional at the time of our birth, there is little experience for it to exercise its long memory capability, but it makes up for that in rapid immunologic gains within the first three years of our lives. Never meant to malfunction as in the case of CVID or autoimmune reactions, each exposure to infections foreign invaders ideally trains the cells. They then remember and act twice as fast the next time they ‘see’ the same invaders.
Living With CVID Or Autoimmune Disease
With over 100 types of confirmed autoimmune diseases, it is vital for a sufferer to get to know his or her own particular variation. Some of the most common autoimmune diseases are Crohn’s disease, Hashimoto’s disease, lupus, multiple sclerosis, psoriasis and ulcerative colitis. Treatment is as individual as it is varied, but never be afraid to ask for second opinions. Some doctors are better than others at keeping up with the latest research.
Treatment for CVID usually involves antibiotics and possibly immunoglobulin replacement but the management of your everyday life will depend on you more than ever.
Because the coping skills needed for either CVID or autoimmune diseases, we’ll list the management tips together:
- Learn to say, ‘No!’ for your health’s sake.
- Get enough sleep – during sleep the body works tirelessly at restoration.
- Stay organised – sounds mundane but keeping accurate medical records on hand goes miles in any crisis.
- Spoil yourself – no joke. Cry when you need to even if a silly movie is what helps you do that without embarrassing the children, watch a match on telly and shout when someone plays well.
In summary, you need emotional resilience as much as your recommended treatment protocol to live with CVID or any autoimmune disease, a sense of humour will be your best defence for sure.
Author: Dr. Steven Gunn
Dr Steven Gunn (MB.ChB.BSc.CVIT.) Integrative Medicine Physician and General Practitioner at LifeXMed Clinic in Pretoria, Gauteng, South Africa. He has studied in South Africa, the UK, Germany and Latvia EU and practiced Emergency Medicine and Orthopedic Surgery in London and the UK . He holds a BSc Science Degree in Clinical Psychology and Microbiology and a MBChB Medical qualifications. Dr Gunn has a special interest in anti-ageing medicine, cancer treatment, enhancement of mental and physical performance, nutrition and innovative technology including Cancer Viro-Immunotherapy and Integrative Medicine.
