February 7, 2001

t seems just about everywhere I turn this time of year, I run into someone with a cold or the flu, and I'm thankful for my hard-working immune system that fights off viruses, bacteria, and other bugs that could make me sick. But sometimes our defense department wages battle against us, a process called autoimmunity, which for millions of women results in diseases such as rheumatoid arthritis, lupus, or multiple sclerosis.

Her Health   By Debra Wood, R.N.

The destructive process is somewhat akin to the Army believing the guys in the sailor suits to be foes, rather than friends, and declaring war on the Navy. But instead of torpedoing ships, the immune system attacks the joints, skin, kidneys, lungs, liver, heart, or other organs. Each of the 80 or so autoimmune diseases is different. They include multiple sclerosis, type 1 diabetes mellitus, psoriasis, and rheumatic fever.

Overall, women are more likely than men to suffer from an autoimmune condition. Ninety percent of lupus sufferers are women, as are 1.5 million of the 2.1 million Americans with rheumatoid arthritis. Many women suffering from autoimmune conditions don't realize their disease has immune-system origins. Collectively, autoimmune diseases rank as one of the 10 leading causes of death in women younger than 65.

What makes our immune systems turn traitor and why most of the conditions occur more frequently in women remain mysteries that researchers struggle to unravel. Hormones undoubtedly contribute in some way. Researchers at Harvard have uncovered a genetic malfunction that may help explain women's tendency for developing the disorders.

The destructive process is somewhat akin to the Army believing the guys in the sailor suits to be foes, rather than friends, and declaring war on the Navy. But instead of torpedoing ships, the immune system attacks the joints, skin, kidneys, lungs, liver, heart, or other organs.

Autoimmune conditions occur more frequently in some families. But unlike cystic fibrosis and other diseases caused by a single mutation, several genes seem to take part in creating a proclivity for autoimmunity. And this predisposition may not be for a specific illness; it's quite common members to suffer from different -- and sometimes multiple -- autoimmune diseases.

Dr. Noel R. Rose, a pioneer in autoimmune research at Johns Hopkins University, estimates that genetic predisposition accounts for about 30 percent of the risk, with the rest attributable to something we acquire in the environment. It may be an infection, a dietary ingredient, sunshine, a medication, stress, perhaps even fetal cells left in the mother or maternal cells remaining in the adult child. As we learn more about environmental triggers, it may be possible for women with the genetic tendency to avoid exposure.

Symptoms of autoimmune diseases often creep up gradually. With many of the disorders you feel tired or achy, complaints that could have a number of origins. If autoimmune diseases run in your family, stay attuned to your body and its messages, and keep the doctor apprised of new symptoms. Putting a name on the condition can prove difficult, but an early, accurate diagnosis allows for more aggressive treatment, which can reduce the risk of long-term consequences.

"I'm more optimistic than I've ever been [about treatment]," says Dr. Rose, citing newer drugs that control and regulate defects in immune response without suppressing it. "Enormous advances have come along in managing patients."

While solutions to the autoimmune puzzle may be down the road, women with the diseases are benefiting from new treatments, while managing the conditions and maintaining control of their lives.

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