People with autoimmune disease face a number of challenges – their condition can cause pain, skin problems, digestive issues, weakness, muscle aches, stiff joints, and more. Autoimmune diseases and their treatments can weaken immune systems to leave patients vulnerable to infections. These conditions can also cause inflammation around the body, and even in vital organs, such as the lungs. In patients with COVID-19, an unhealthy immune response can damage the lungs to cause serious complications, including severe breathing problems.
Autoimmune Diseases and Inflammation
The immune system protects the body from disease and infection. In people with autoimmune disorders, though, the immune system can attack healthy body cells by mistake.
There are more than 80 types of autoimmune diseases, according to the National Library of Medicine. Autoimmune diseases include rheumatoid arthritis, psoriasis, inflammatory bowel disease, lupus, Sjogren’s disease, multiple sclerosis, Hashimoto’s disease, Celiac disease and type 1 diabetes.
Some autoimmune diseases target just one organ, such the pancreas; other autoimmune conditions affect the entire body. Many of autoimmune diseases share similar symptoms. A large number of autoimmune conditions cause inflammation, characterized by redness, heat, pain and swelling. In fact, inflammation is the classic sign of an autoimmune disease.
COVID-19 and Inflammation
The virus, known as SARS-CoV-2 or simply “coronavirus,” causes a wide variety of symptoms associated with COVID-19 disease. Most notably, the virus causes cough, fever, and shortness of breath. Coronavirus is highly contagious, already infecting at least 2 million people in the United States by the middle of June 2020, and claiming the lives of 113,000.
While people with autoimmune disorders are not more likely to contract coronavirus than are the rest of the general population, they are more likely to develop severe complications if they do contract COVID-19 if they have a suppressed immune system due to their autoimmune disease or treatment for their autoimmune disorder. One of the most serious complications of COVID-19 is severe inflammation throughout the body, including the lungs, heart and brain.
The body reacts to the presence of the SARS-CoV-2 virus with a robust inflammatory response; health professionals now regard this excessive inflammatory response as a hallmark symptom of COVID-19.
The excessive immune response triggered by SARS-CoV-2 can cause hyper-inflammation of the lungs and of other organs. Severe inflammation of the lungs can prevent the proper exchange of oxygen and carbon dioxide, which makes it difficult for patients to get the oxygen they need.
How Autoimmune Diseases Cause Inflammation
Special receptors cover the exterior surface of body cells. Proteins bind to these receptors to change the way the cell works.
A specific type of protein, known as cytokines, binds to certain receptors to regulate the body’s immune response. Cytokines are mediators, which mean they trigger and control a body response. Specifically, cytokines mediate the inflammation response to tissue injury or infection. In other words, cytokines promote inflammation as a response to tissue injury or infection.
There are several types of cytokines, and each type can work alone, work together, or work against each other to regulate the immune response. A special type of cytokine, known as interleukin or IL, may play an important role in the immune response in COVID-19 patients.
There are 40 interleukins, IL-1 through IL-40, and each performs a function. Interleukins normally help the immune system fight off viruses and bacteria in the body, but an overactive immune system can cause interleukins to attack the body instead. This can lead to chronic inflammatory conditions.
In a significant physiological event, known as a cytokine storm, can cause the release of a flood of interleukin that leads to widespread and dangerous inflammation. Research shows that COVID-19 can cause a cytokine storm that releases IL-6, IL-1, IL-12, and IL-18.
The excessive number of cytokines can damage tissue and could lead to the breakdown of the protective lining in the lungs and blood vessels. The breakdown and weakening of this protective lining can allow fluid and proteins to leak from blood vessels and into the tiny air sacs of the lungs. This fluid displaces air, which prevents the air sacs from filling with oxygen. The resulting lack of oxygen causes the patient to experience shortness of breath, and puts the patient at a higher risk for complications and a more severe case of COVID-19.
Inflammation related to autoimmune disease can have serious consequences for patients. This is especially true for those who contract COVID-19.
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Frank Magliochetti owes his professional success to his expertise in two areas: medicine and finance. After obtaining a BS in pharmacy from Northeastern University, he stayed on to enroll in the Masters of Toxicology program. He later specialized in corporate finance, receiving an MBA from The Sawyer School of Business at Suffolk University. His educational background includes completion of the Advanced Management Program at Harvard Business School and the General Management Program at Stanford Business School. Frank Magliochetti has held senior positions at Baxter International, Kontron Instruments, Haemonetics Corporation, and Sandoz. Since 2000, he has been a managing partner at Parcae Capital, where he focuses on financial restructuring and interim management services for companies in the healthcare, media, and alternative energy industries. Earlier this year, he was appointed chairman of the board at Grace Health Technology, a company providing an enterprise solution for the laboratory environment.