# Global Autoimmune Institute > Empowering Solutions for Autoimmune Disease > Generated by All in One SEO Pro v5.0.4, this is an llms-full.txt file, used by LLMs to index the site. ## Posts ### [Living with Autoimmune Gastritis: What You Need to Know ](https://www.autoimmuneinstitute.org/articles/living-with-autoimmune-gastritis-what-you-need-to-know) **Published:** December 9, 2024 **Author:** Carolyn Serraino **Excerpt:** Struggling with autoimmune gastritis? Discover symptoms, triggers, and expert tips to manage this complex condition and reclaim your health and energy. **Content:** *Sandy, a 52-year-old woman, faced an uphill battle after being diagnosed with autoimmune gastritis. Everyday foods like grains, starchy vegetables, and even a small amount of sugar triggered a host of uncomfortable symptoms—nausea, bloating, constipation, and a painful burning sensation. Despite her best efforts to stick to a[ strict diet](https://www.autoimmuneinstitute.org/gai-library/#ad-food " strict diet"), Sandy still found herself waking up several times a night, leaving her feeling exhausted and overwhelmed. It wasn’t just the physical symptoms that took a toll. The stress of constantly monitoring her diet and dealing with the unpredictability of her health weighed heavily on her mental and emotional well-being. Sandy’s journey with [autoimmune gastritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-gastritis/) is a testament to the complex ways in which this condition can affect every aspect of a person’s life.* ## What is Autoimmune Gastritis? Like Sandy, it’s estimated that 0.5%-4.5% of adults worldwide have autoimmune gastritis ([1](https://link.springer.com/article/10.1007/s11938-023-00406-4)). Autoimmune gastritis is a chronic inflammatory condition of the stomach lining. The body’s antibodies, autoantibodies, attack the acid-producing cells that make up the stomach lining. The symptoms of autoimmune gastritis can be non-specific and, therefore, are often ignored or misdiagnosed. As a result, in many cases, diagnosis isn’t made until later in the disease. ## What Causes Autoimmune Gastritis? The exact cause of autoimmune gastritis is unknown, although genetics seem to be a significant factor ([2](https://www.nature.com/articles/s41572-020-0187-8)). #### Other risk factors: Older age Female sex Having another autoimmune disease Family history While [older age](https://www.autoimmuneinstitute.org/articles/aging-and-autoimmune-disease "Aging and Autoimmune Disease") increases the risk of developing autoimmune gastritis, it can also appear in [children and teens](https://www.autoimmuneinstitute.org/articles/understanding-autoimmune-disease-in-children "Understanding Autoimmune Disease in Children"). A lack of research on youth may be one reason that the disease has been under-recognized in this group. #### The [gut microbiome](https://www.autoimmuneinstitute.org/gai-library/#microbiome) might also play a role in autoimmune gastritis. According to Kellie Blake RDN, LD, IFNCP, a registered dietitian specializing in functional nutrition, an unbalanced gut microbiome contributes to increased intestinal permeability (leaky gut) and inflammation. Research has shown a connection between a leaky gut and some autoimmune diseases like autoimmune gastritis. ## How Do I Know if I Have Autoimmune Gastritis? #### *Early disease* Early in the disease, individuals who have autoimmune gastritis may experience general stomach complaints. However, these symptoms are non-specific and can indicate problems other than autoimmune gastritis. If you’re experiencing such complaints, it’s important to talk to your healthcare provider for a correct diagnosis. #### Common symptoms: Upper abdominal pain Heartburn Bloating Feeling full quickly #### *Late disease* The destruction of acid-producing cells interferes with vitamin B12 absorption, a key component of red blood cell production. In later stages of autoimmune gastritis, vitamin B12 deficiency can lead to pernicious anemia, which results from decreased red blood cell production. #### Vitamin deficiency and pernicious anemia symptoms Fatigue Shortness of breath Weakness Problems with thinking and physical functioning Sensory changes Balance problems Depression and anxiety People with autoimmune gastritis are at increased risk of certain stomach cancers. Regular follow-up with a healthcare provider is essential to manage symptoms and monitor for cancer ([1](https://link.springer.com/article/10.1007/s11938-023-00406-4)). #### **The following conditions may warrant screening for autoimmune gastritis:** Unexplained iron deficiency anemia Pernicious anemia First-degree family history of AIG Another autoimmune disease Blood cell abnormalities Unexplained stomach complaints Unexplained neuropsychiatric changes Infertility or recurrent miscarriage #### Your healthcare provider will ask you about your symptoms, do a physical exam, and may order tests for further study: - **Laboratory tests:** Blood tests can look for vitamin deficiencies related to anemia or autoantibodies associated with autoimmune gastritis ([1](https://link.springer.com/article/10.1007/s11938-023-00406-4)). - **Endoscopy and biopsy:** A small camera passes through the mouth and throat into the stomach. Signs of inflammation, such as redness or swelling of the stomach lining, might be visible. In later stages of the disease, signs of shrinkage might be visible, as well as a pale, thinned stomach lining ([1](https://link.springer.com/article/10.1007/s11938-023-00406-4)). A biopsy of stomach tissue may be taken and examined under the microscope for damage to or loss of specific stomach cells ([1](https://link.springer.com/article/10.1007/s11938-023-00406-4)). ## Does Having Another Autoimmune Disease Make it More Likely to Have Autoimmune Gastritis? Autoimmune gastritis is more common in people with certain autoimmune diseases, specifically [thyroid diseases](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/hashimotos-thyroiditis/), [type 1 diabetes](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/diabetes-type-1/), [hemolytic anemia](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-hemolytic-anemia/), [vitiligo](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/vitiligo/), [alopecia](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/alopecia-areata/), [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/), [psoriasis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/psoriasis/), [autoimmune hepatitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-hepatitis/), [myasthenia gravis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/myasthenia-gravis/), and [Sjögren’s syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sjogren-syndrome/) ([3](https://www.mdpi.com/2075-4418/11/11/2113/review_report)). People with one of these conditions should see their health provider immediately if they have any signs of autoimmune gastritis. ## How is Autoimmune Gastritis Treated? *Sandy finally found relief through a multi-faceted approach to her care. She began practicing yoga, which helped her manage stress and improve her sleep. With the guidance of her healthcare provider, she adopted a customized diet and supplement plan tailored to her food sensitivities. After several weeks of this treatment, Sandy experienced a significant improvement—her digestive symptoms nearly disappeared, her anxiety lessened, and her sleep improved dramatically.* Since there currently isn’t a cure for autoimmune gastritis, treatment approaches focus on symptom relief, treatment of anemia, and lifestyle modifications. #### Micronutrient supplementation  Healthcare providers may recommend taking vitamin B12 for pernicious anemia or iron supplements for iron deficiency anemia ([2](https://www.nature.com/articles/s41572-020-0187-8)). #### Symptom relief  Management of stomach symptoms such as dyspepsia, bloating, pain, and altered colonic transit can have a big impact on quality of life. Some things to try include ([1](https://link.springer.com/article/10.1007/s11938-023-00406-4)): - Eating a healthy diet rich in vegetables, grains, and fruits - Consuming smaller meals spread throughout the day - Avoiding high-protein meals - Avoiding trigger foods such as spicy and fatty foods, citrus fruits, caffeine, alcohol, and carbonated beverages ([4](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10496934/)) - Taking prokinetics for early fullness - Taking Rifaximin and/or probiotics for bacterial overgrowth in the stomach #### Lifestyle practices  Some lifestyle behaviors can exacerbate symptoms. Addressing these behaviors may improve disease management and quality of life. Lifestyle changes often focus on weight management, stress reduction, and smoking cessation ([4](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10496934/)). In her practice, Blake recommends following a diet tailored to each individual’s unique triggers, such as [allergies](https://www.autoimmuneinstitute.org/articles/allergies-and-autoimmunity "Allergies and Autoimmunity") and [food sensitivities](https://www.autoimmuneinstitute.org/articles/food-sensitivity-intolerance-or-allergy-whats-the-difference "Food Sensitivity, Intolerance, or Allergy: What’s the Difference?"). She notes, “My goals with autoimmune gastritis (and any autoimmune disease really) are to reduce the immune system burden, reduce inflammation, and support gut microbiome balance.” She also advises that avoiding certain foods and ingredients can be helpful. #### What to avoid with autoimmune gastritis: ultra-processed foods processed meats inflammatory fats (soybean/canola oil) alcohol excess sugar fast food, spicy foods Blake notes that an [elimination diet](https://www.autoimmuneinstitute.org/articles/elimination-diets-what-you-need-to-know "Elimination Diets: What You Need to Know") might help identify problematic foods and ingredients for some. #### Natural remedies Despite limited evidence of their effectiveness, some people experience improvement using [alternative or integrative approaches](https://www.autoimmuneinstitute.org/articles/explained-holistic-vs-modern-western-medicine "Explained: Holistic vs Modern Western Medicine") for managing symptoms. It’s crucial to discuss integrating any [alternative therapies](https://www.autoimmuneinstitute.org/the-spectrum-of-autoimmune-disease-treatments/ "The Spectrum of Autoimmune Disease Treatments") with a healthcare provider to make sure they’re safe and won’t negatively interact with conventional treatments. Acupuncture, herbal medicine, and mind-body techniques such as relaxation exercises, meditation, and yoga may offer some benefits ([3](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10496934/)). Blake includes the [gut microbiome](https://www.autoimmuneinstitute.org/articles/the-relationship-between-autoimmune-disease-and-the-gut-microbiome "The Relationship Between Autoimmune Disease and the Gut Microbiome") in her treatment plan. She recommends adding probiotics to an [anti-inflammatory meal plan](https://www.autoimmuneinstitute.org/articles/culinary-medicine-autoimmunity-and-healthful-eating "Culinary Medicine: Autoimmunity and Healthy Eating"), noting that “probiotics help to reduce inflammation, support gut microbial balance, reduce leaky gut, strengthen the small intestinal lining, and they’re also effective for managing Helicobacter pylori infections (an underlying factor for those with autoimmune gastritis).” As with any intervention, consult a healthcare provider before taking supplements, such as [probiotics](https://www.autoimmuneinstitute.org/articles/probiotics-prebiotics-and-autoimmune-disease "Probiotics, Prebiotics, and Autoimmune Disease"). ## What’s on the Horizon for Autoimmune Gastritis? While our understanding of and treatment for this complex disease is improving, there remains much to learn. Researchers are studying new therapies to reduce stomach inflammation, prevent the development of, and reduce the progression of atrophy in autoimmune gastritis. Research is also exploring how to reduce the occurrence of and identify associated stomach cancer earlier ([1](https://link.springer.com/article/10.1007/s11938-023-00406-4)). ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/04/GAI-Logo-Image-811x1024.png) ### About the Author ![Tracy Asamoah bio headshot freelance writer for GAI](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/11/DSC05784-scaled.jpg) Tracy is a writer, child and adolescent psychiatrist, and leadership coach. Her journey into the world of autoimmune diseases began when she experienced sudden onset symptoms of multiple sclerosis early in her medical career. This personal experience, combined with her intense curiosity, has informed her work and writing in the field. As a writer, Tracy has contributed to various books and written articles related to mental health. She’s also written on various medical topics regularly contributing to publications such as GoodRx, Psychology Today, and Psychotherapy.net Tracy Asamoah, MD Freelance Writer for GAI ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** About Autoimmune Disease, Living Well with Autoimmune Disease --- ### [Misdiagnosed and Undiagnosed: Expert Insights on the Autoimmune Diagnosis Process](https://www.autoimmuneinstitute.org/articles/misdiagnosed-undiagnosed-expert-insights-on-the-autoimmune-diagnosis-process) **Published:** October 22, 2026 **Author:** Carolyn Serraino **Excerpt:** Diagnosing autoimmune diseases is often a complex and challenging process because autoimmune diseases vary widely. Identifying patterns and clusters of symptoms can help, but autoimmunity often relates to many factors including stress, deficiencies, toxic exposures, gut and immune dysfunction. As such, autoimmunity has a tendency to go undiagnosed — or misdiagnosed. Here, the Global Autoimmune Institute speaks with Dr. Francisco Contreras, Johannah Ruddy, M.Ed, and Dr. Henri Roca about the process of diagnosing autoimmune disease. **Content:** *Updated October 2026* Receiving an autoimmune disease diagnosis can be a long and frustrating process. Symptoms may develop gradually, fluctuate over time, or resemble those of other medical conditions. Even when someone experiences persistent symptoms, blood tests and other diagnostic evaluations may not provide immediate answers. With more than [140 autoimmune diseases and conditions identified by the National Institutes of Health (NIH)](https://orwh.od.nih.gov/in-the-spotlight/nih-unveils-inaugural-nih-wide-strategic-plan-for-autoimmune-disease-research), many of which affect multiple organs and body systems, identifying the underlying condition can be particularly challenging. Some individuals experience years of unexplained symptoms, multiple specialist appointments, or an initial misdiagnosis before receiving an accurate diagnosis. #### Why are autoimmune diseases sometimes so difficult to identify, and what can individuals do when symptoms persist without a clear explanation? The Global Autoimmune Institute spoke with Francisco Contreras, MD, Johannah Ruddy, M.Ed., and Henri Roca, MD, about common diagnostic barriers, the importance of patient-centered care, and strategies for navigating the diagnostic process. ### Why Are Autoimmune Diseases Sometimes Misdiagnosed or Overlooked? Autoimmune diseases can cause a wide range of symptoms, including fatigue, joint pain, muscle weakness, digestive problems, cognitive difficulties, and [inflammation](https://www.autoimmuneinstitute.org/articles/inflammation-a-driving-force-of-autoimmune-disease). Many of these symptoms are not unique to autoimmune disease, making it [difficult to distinguish one condition from another](https://www.autoimmuneinstitute.org/articles/autoimmune-or-not-the-diseases-that-blur-the-lines). Symptoms may also appear intermittently, particularly in diseases characterized by periods of increased activity, known as [flare-ups](https://www.autoimmuneinstitute.org/articles/outbursts-in-autoimmunity-disease-flare-ups), followed by periods of improvement. “This overlap can lead to misinterpretation or misdiagnosis,” says Contreras, director and president at Oasis of Hope Medical Institute. Contreras notes that some healthcare professionals may have limited awareness or experience with certain autoimmune conditions and may not be able to identify specific symptoms. “This lack of familiarity can hinder the recognition,” he says, which is particularly true for “conditions where clinical evaluation plays a significant role.” ### Can You Have an Autoimmune Disease With Normal Blood Tests? Blood tests are important tools in evaluating suspected autoimmune disease, but no single test can reliably diagnose or rule out every autoimmune condition. #### Common tests for autoimmunity include: - **Antinuclear antibody (ANA) testing:** Detects antibodies that may be associated with certain systemic autoimmune diseases, including lupus. A positive result does not necessarily indicate autoimmune disease, and a negative result does not exclude every autoimmune condition. - **Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP):** Measure markers of inflammation. Elevated results can occur for many reasons and are not specific to autoimmune disease. Normal results do not necessarily exclude it. - **Disease-specific antibody testing:** May help identify particular autoimmune conditions when interpreted alongside symptoms and other clinical findings. Depending on the suspected disease, physicians may also use imaging, biopsies, physical examinations, and other specialized tests. Henri Roca, MD, a family medicine physician at Palm Health in Missouri, explains that frustration often occurs when test results come back normal or only slightly elevated, even though someone may be feeling unwell. Importantly, autoimmune disease diagnosis generally requires consideration of the complete clinical picture, rather than relying on one laboratory result. ### What Are the Biggest Barriers to an Accurate Diagnosis? Beyond overlapping symptoms and inconclusive testing, [communication](https://www.autoimmuneinstitute.org/articles/effective-communication-strategies-for-patients-with-autoimmune-diseases) between healthcare professionals and individuals seeking care can influence the diagnostic experience. Roca emphasizes the importance of listening to individuals who report persistent symptoms, even when a definitive diagnosis has not yet been established. “Sometimes, people wait a long time while they are smoldering and feeling poorly – and they have to wait even longer until they get sufficiently ill to earn a diagnosis,” Roca says. His observations highlight the difficulties that can arise when symptoms precede clearly identifiable clinical or laboratory findings. Roca also urges greater attention to symptoms and potential health concerns earlier in the process. “Early on in the process, a lot of folks will recognize that something is creating inflammation or producing a tendency toward autoimmunity, but they’ll wait until it’s flaring to act,” he says. Research into [pre-autoimmunity](https://www.autoimmuneinstitute.org/articles/examining-pre-autoimmunity-can-autoimmune-disease-be-prevented) suggests that certain immune changes, including the development of autoantibodies, can occur before the clinical onset of some autoimmune diseases. However, these changes are not always detectable, do not necessarily lead to disease, and are not yet routinely used to predict most autoimmune conditions. Identifying early immune changes and determining their clinical significance remain active areas of research. ### What Can You Do if You Suspect an Autoimmune Disease but Remain Undiagnosed? When symptoms persist without a clear explanation, taking an active role in the diagnostic process can help improve communication and guide further evaluation. **Document symptoms and changes over time.** Keeping a record of symptoms, their frequency, severity, and potential triggers may help healthcare professionals identify patterns that are difficult to capture during a single appointment. **Ask what test results mean.** Understanding what a test can and cannot rule out may help clarify whether additional evaluation is appropriate. **Discuss specialist referrals.** Depending on the symptoms involved, evaluation by a rheumatologist, gastroenterologist, neurologist, endocrinologist, or another specialist may be helpful. **Consider a second opinion.** When symptoms remain unexplained or treatment is ineffective, another healthcare professional may offer a different perspective. #### “A fresh perspective may lead to alternative interpretations or diagnostic approaches,” Contreras says. **Build a supportive healthcare team.** Johannah Ruddy, M.Ed., co-author of *Gut Feelings: Doctors and Patient-Centered Care*, emphasizes the importance of working with people who take health concerns seriously. “It’s always best to surround yourself with people who have your best interests at heart and are supportive of you,” she says. For individuals who receive an autoimmune disease diagnosis, preparing for periods of increased disease activity is another important part of care. Flare-ups can happen unexpectedly and interfere with everyday life. “To manage such situations, it is important to work with your healthcare team to create a plan,” Ruddy says. ### The Importance of Continued Evaluation and Patient-Centered Care An inconclusive evaluation does not necessarily mean symptoms are insignificant, but it also does not establish that autoimmune disease is the underlying cause. Accurate diagnosis requires careful consideration of medical history, symptoms, examination findings, and appropriate testing, sometimes over multiple visits. #### “Inflammation and autoimmune diseases are an ongoing process,” Roca says. Although disease progression and activity vary considerably across autoimmune conditions, continued evaluation can be important when symptoms persist or change over time. For individuals navigating diagnostic uncertainty, maintaining communication with healthcare professionals, seeking appropriate follow-up, and understanding when further evaluation may be warranted are important steps toward receiving effective care. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/GAI-Logo-Image-e1707845715517.png) *Originally published April 2024* ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** Autoimmune Care & Caregiver Support, Diagnosis & Treatment --- ### [CAR T-Cell Therapy For Autoimmune Disease: What We Know Now](https://www.autoimmuneinstitute.org/articles/car-t-cell-therapy-for-autoimmune-disease) **Published:** November 17, 2023 **Author:** Carolyn Serraino **Content:** > *****Originally published November 17, 2023 \| Updated September 29, 2026***** ### What CAR T-Cell Therapy Means for the Future of Autoimmune Disease Treatment Chimeric antigen receptor (CAR) T-cell therapy, a form of cellular [immunotherapy](https://www.autoimmuneinstitute.org/articles/immunotherapy-for-those-with-autoimmune-disease) first developed to treat certain blood cancers, is now being investigated as a potential treatment for severe autoimmune diseases. Much of the research has focused on using CAR T cells to deeply deplete B cells, including abnormal B-cell populations that contribute to [autoantibody](https://www.autoimmuneinstitute.org/articles/decoding-the-role-of-autoantibodies-in-autoimmunity) production and autoimmune disease. The goal is ambitious: rather than continuously suppressing the immune system with [medication](https://www.autoimmuneinstitute.org/articles/biologics-for-autoimmune-disease-what-you-should-know), researchers are investigating whether a one-time treatment could effectively “reset” parts of the immune system and produce long-lasting remission. Early studies in people with severe, treatment-resistant [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/), [systemic sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/scleroderma/) (scleroderma), inflammatory [myositis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/polymyositis/), and other autoimmune diseases have reported substantial improvements, in some cases lasting after B cells returned and immunosuppressive medications were discontinued. Research has since expanded to additional diseases and new approaches designed to make CAR T-cell therapy more effective, accessible, and potentially safer. #### However, CAR T-cell therapy remains experimental for autoimmune disease. Important questions remain about who may benefit, how long responses last, and how to reduce the risks and complexity of treatment. [Serious adverse events reported in several clinical trials in 2026](https://www.autoimmuneinstitute.org/research_updates/car-t-cell-trials-safety-events/) have also underscored the need to better understand the safety of these powerful therapies as studies expand to larger numbers of people. **You may be wondering,** **[What is CAR T-Cell Therapy?](#anchor1)** **[How Could CAR T-Cell Therapy Treat Autoimmune Disease?](#anchor2) [Can CAR T-Cell Therapy “Reset” the Immune System?](#anchor3) [What Has More Recent CAR T-Cell Research Shown?](#anchor4) [How Is CAR T-Cell Therapy Evolving?](#anchor5) [What Are the Risks of CAR T-Cell Therapy?](#anchor6) [What Could CAR T-Cell Therapy Mean for the Future of Autoimmune Disease Treatment?](#anchor7)** ### What Is CAR T-Cell Therapy? CAR T-cell therapy uses genetically modified T cells, a type of immune cell, to recognize and attack cells carrying a specific target. **The process generally involves several steps:** 1. **Collection of T cells**: T cells are extracted from the patient’s blood through a process called leukapheresis. 2. **Genetic modification**: In the laboratory, these T cells are genetically engineered to express a synthetic receptor called a chimeric antigen receptor (CAR). This receptor is designed to recognize specific proteins on the surface of target cells. 3. **Expansion**: The modified T cells are then multiplied to create a large number of CAR-T cells. 4. **Preconditioning:** With many CAR T-cell therapies, a short course of chemotherapy called lymphodepletion is given before the CAR T cells are infused. This reduces existing immune cells and creates an environment that helps the engineered cells expand. 5. **Infusion and targeting:** The CAR T cells are infused back into the bloodstream, where they can recognize cells carrying their target, become activated, and destroy them. Unlike a conventional medication, CAR T cells are living immune cells. Once infused, they can expand within the body and continue functioning after the initial treatment. CAR T-cell therapies are already approved by the U.S. Food and Drug Administration (FDA) for several blood cancers, but no CAR T-cell therapy is currently FDA-approved to treat autoimmune disease. ### How Could CAR T-Cell Therapy Treat Autoimmune Disease? Most autoimmune CAR T-cell research has focused on **B cells**, immune cells that normally help protect the body from infection by producing antibodies and performing other immune functions. In several autoimmune diseases, abnormal B cells contribute to disease by producing autoantibodies, activating other immune cells, and sustaining inflammation. Treatments that reduce B cells are already used for some autoimmune diseases. Many experimental autoimmune CAR T-cell therapies target **CD19**, a protein expressed across much of the B-cell lineage. Once engineered to recognize CD19, CAR T cells can seek out and destroy CD19-positive B cells. Researchers are interested in whether CAR T cells can produce a deeper form of B-cell depletion than existing therapies. Disease-associated B cells do not exist only in the bloodstream. Some can persist in tissues, lymph nodes, and other areas that may be more difficult for conventional therapies to reach. This possibility is also being investigated in [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/) (MS). Researchers at Yale School of Medicine are studying whether CD19-targeted CAR T cells can reach disease-associated B cells beyond the bloodstream, including within the central nervous system. The goal is not simply to suppress immune activity temporarily. Researchers hope that removing a broad population of B cells involved in autoimmunity may allow a healthier B-cell population to emerge as the immune system rebuilds. ### Can CAR T-Cell Therapy “Reset” the Immune System? The idea of an immune “reset” is one of the most intriguing aspects of CAR T-cell therapy for autoimmune disease. After CD19 CAR T-cell treatment, B cells can eventually return. But early studies suggest that the returning B-cell population may differ from the one present before treatment. A landmark study published in *The New England Journal of Medicine* in 2024 followed 15 people with severe autoimmune disease who received CD19 CAR T-cell therapy: eight with systemic lupus erythematosus (SLE), three with idiopathic inflammatory myositis, and four with systemic sclerosis. All eight participants with lupus achieved remission according to established criteria. All three participants with inflammatory myositis achieved a major clinical response, while all four with systemic sclerosis experienced decreased disease activity. All 15 were able to discontinue immunosuppressive therapy during the reported follow-up period, which ranged from four to 29 months. B cells eventually returned, but clinical improvement persisted in many participants. Researchers observed the reappearance of predominantly naïve B cells rather than simply the return of the previous B-cell population. These findings helped support the idea that CAR T-cell therapy might interrupt an established autoimmune response and allow parts of the immune system to rebuild differently. However, “immune reset” remains a working concept rather than a guarantee. Researchers still need longer follow-up and larger studies to determine how often remission persists, why some people may relapse, and whether the rebuilt immune system remains different over many years. ### What Has More Recent CAR T-Cell Research Shown? Since the earliest case reports, CAR T-cell research in autoimmune disease has begun moving into larger and more structured clinical trials. Published in *Nature Medicine* in January 2026, the Phase 1/2a CASTLE trial evaluated CD19 CAR T-cell therapy in people with treatment-resistant SLE, systemic sclerosis, and idiopathic inflammatory myopathies. The basket-trial design allowed researchers to study the same treatment across multiple B-cell-mediated autoimmune diseases, reflecting the possibility that different autoimmune conditions may share immune mechanisms that can be targeted by the same cellular therapy. #### **Industry-sponsored programs are also expanding.** Cabaletta Bio is studying its investigational CD19 CAR T-cell therapy, resecabtagene autoleucel (rese-cel), across several autoimmune diseases. At the 2026 European Alliance of Associations for Rheumatology (EULAR) Congress, the company reported interim results from 52 evaluable participants with lupus, myositis, or systemic sclerosis. Among participants with [dermatomyositis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/dermatomyositis/), five of six achieved a moderate-to-major improvement response at 16 weeks while off immunomodulatory treatment, and those responses were maintained through the latest reported follow-up, extending as long as 1.5 years. Improvements were also reported among participants with systemic sclerosis. These are interim company-reported findings from ongoing studies rather than results from completed randomized trials. Clinical research has expanded beyond rheumatic diseases as well. CAR T-cell approaches are now being investigated in neurological and antibody-mediated autoimmune diseases, including MS, [myasthenia gravis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/myasthenia-gravis/), and [pemphigus vulgaris](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/pemphigus-vulgaris/). ### How Is CAR T-Cell Therapy Evolving? Traditional CAR T-cell therapy is [highly personalized](https://www.autoimmuneinstitute.org/articles/personalized-medicine-for-autoimmune-diseases). A person’s own T cells must be collected, genetically modified, expanded, tested, and returned to that individual. Researchers are now investigating ways to make this process more effective and accessible. One approach is to target more than one immune cell population. CD19 CAR T cells target B cells, but some long-lived plasma cells that produce autoantibodies may lack CD19. In a 2025 Phase 1 trial involving 15 people with treatment-resistant lupus, researchers combined CAR T cells targeting CD19 with CAR T cells targeting **B-cell maturation antigen (BCMA)**, which is expressed by plasma cells. Twelve of the 15 participants met both low-disease-activity and remission criteria by 12 weeks. Researchers also observed elimination of autoreactive cell populations and reconstitution of predominantly naïve B cells. Another strategy involves allogeneic, or donor-derived, cell therapy. Instead of creating a new treatment from each person’s own cells, researchers are investigating engineered donor cells that could potentially be prepared in advance. A small Phase 1 study published in 2025 evaluated one such approach in five people with severe, treatment-resistant lupus and [lupus nephritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/lupus-nephritis/). #### **Researchers are even investigating whether CAR T cells can be created inside the body.** In 2025, researchers reported an early in vivo approach that used lipid nanoparticles to deliver genetic instructions to T cells inside people with treatment-resistant lupus. The treatment generated CD19 CAR T cells without first removing and engineering the cells in a laboratory. Researchers reported B-cell depletion and reduced disease activity in this small early study. These approaches remain experimental, but they illustrate how rapidly CAR T-cell technology is evolving beyond the original model developed for [cancer](https://www.autoimmuneinstitute.org/gai-library/#immune-spectrum). #### **Another Approach: T-Cell Engagers** CAR T-cell therapy is not the only strategy researchers are using to harness T cells against disease-associated B cells. Clinical trials are also investigating **T-cell engagers (TCEs)**, including bispecific antibodies designed to bind a target on B cells and CD3 on T cells at the same time. This brings the two cells together and directs the person’s existing T cells to attack the targeted B cells. Unlike traditional CAR T-cell therapy, T-cell engagers do not require T cells to be removed from the body, genetically engineered, expanded in a laboratory, and reinfused. Researchers are now studying T-cell engagers in autoimmune diseases including lupus, [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/), [systemic sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/scleroderma/), [Sjögren disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sjogren-syndrome/), and inflammatory myopathies. Whether these treatments can achieve the same depth and durability of B-cell depletion being investigated with CAR T-cell therapy remains an important question. ### What Are the Risks of CAR T-Cell Therapy? CAR T-cell therapy can produce powerful immune effects, which also creates important risks. One of the best-known complications is **cytokine release syndrome (CRS)**, an inflammatory response caused by rapid immune activation. Symptoms can include fever, fatigue, low blood pressure, difficulty breathing, and, in severe cases, organ dysfunction. Another potential complication is **immune effector cell-associated neurotoxicity syndrome (ICANS)**, which can cause confusion and other neurological symptoms. CAR T-cell treatment and the lymphodepleting chemotherapy often given beforehand can also temporarily reduce normal immune cells and blood counts, increasing vulnerability to infection and other complications. The early autoimmune disease studies initially produced encouraging safety results. In the 15-person 2024 case series, CRS was mostly mild, with one case of grade 2 CRS. One participant experienced grade 1 ICANS. #### **However, [serious safety concerns](https://www.autoimmuneinstitute.org/research_updates/car-t-cell-trials-safety-events/) emerged as autoimmune CAR T-cell trials expanded.** In August 2026, ⁠Novartis paused eight clinical trials of its investigational CAR T-cell therapy rapcabtagene autoleucel (rap-cel) in autoimmune and neurological diseases after three participants died following a severe immune reaction. The affected research program included diseases such as lupus, rheumatoid arthritis, [vasculitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-vasculitis/), MS, and myasthenia gravis. Novartis reported that it was investigating the events with independent safety boards and health authorities. ⁠Bristol Myers Squibb also voluntarily paused studies of its investigational CD19 CAR T-cell therapy zola-cel while reviewing safety data after participants experienced inflammatory reactions that the company described as temporary and reversible. These developments do not erase the encouraging results reported in other CAR T-cell programs, but they reinforce why larger trials and careful long-term monitoring are essential before the overall benefits and risks of CAR T-cell therapy for autoimmune disease can be understood. #### **Safety is not the only obstacle.** Traditional CAR T-cell therapy requires specialized facilities and a complex manufacturing process. The time required to collect and engineer cells can also make treatment difficult to scale. Most autoimmune CAR T-cell protocols have additionally required lymphodepleting chemotherapy before infusion. Researchers are investigating whether this step can be reduced or eliminated. In 2026, Cabaletta Bio began reporting early results from participants receiving rese-cel without traditional preconditioning, although this approach remains in early clinical testing. Cost is another important question. Existing commercial CAR T-cell therapies for cancer are expensive and require substantial healthcare resources. Because there is currently no approved CAR T-cell treatment for autoimmune disease, however, there is no established price for autoimmune CAR T-cell therapy. Researchers will ultimately need to determine not only whether CAR T-cell therapies can produce lasting remission, but whether they can be delivered safely and practically to a broader population. ### What Could CAR T-Cell Therapy Mean for the Future of Autoimmune Disease Treatment? CAR T-cell therapy represents a fundamentally different way of thinking about autoimmune disease treatment. Many existing treatments are designed to control inflammation or suppress parts of the immune response over time. CAR T-cell therapy raises the possibility that, for some people with severe autoimmune disease, a short course of treatment could instead eliminate disease-associated immune cells deeply enough to produce prolonged remission without continuous immunosuppression. Early clinical results provide evidence that this may be possible in at least some people. At the same time, the number of people treated remains relatively small, follow-up is limited compared with the lifelong course of many autoimmune diseases, and recent serious safety events demonstrate how much remains to be understood. Researchers are now trying to determine which autoimmune diseases are most responsive to CAR T-cell therapy, which immune cells should be targeted, which people are most likely to benefit, how durable responses are, and whether newer approaches can make treatment safer and more accessible. #### **For now, CAR T-cell therapy remains an experimental treatment for autoimmune disease.** But research has advanced considerably from the first lupus case reports. What began as an unexpected extension of a cancer treatment has become a rapidly developing area of autoimmune disease research, one that is testing whether the immune system can be not only suppressed, but potentially rebuilt in a healthier state. ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** Diagnosis & Treatment --- ### [Effective Communication Strategies for Those with Autoimmune Disease](https://www.autoimmuneinstitute.org/articles/effective-communication-strategies-for-patients-with-autoimmune-diseases) **Published:** January 10, 2024 **Author:** Carolyn Serraino **Content:** ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Gut-Feelings-Book-3-1-671x1024.jpg) For patients with autoimmune disease, management means understanding a wide range of symptoms, unpredictable disease courses, and any impacts on quality of life. #### But how can patients better communicate with their providers? The Global Autoimmune Institute expounds on key tips elucidated by Johannah Ruddy, M.Ed., a doctoral candidate at Campbell University and co-author of [*Gut Feelings: Doctors and Patient-Centered Care. How Knowledge, Commitment to Care and Empathy Improve Patient’s Lives*](https://romefoundation.clickfunnels.com/optin1682609315121) to help patients establish a strong relationship with their provider and diminish stigma. ### 1. Make A List Of Noticeable Symptoms And Other Relevant Information ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Symptom-Checklist.png) *GAI has a Printable Daily Symptom Checklist in our free* ***[Autoimmune & Chronic Illness Toolkit](https://www.autoimmuneinstitute.org/autoimmune-chronic-illness-toolkit/)****!* When patients provide a clear and organized account of their symptoms, it allows a physician to gather relevant information efficiently and make a more accurate diagnosis. Noting the location, intensity, and duration of pain over time also helps the patient to become more aware of their own condition. “Many patients find it helpful to bring a written list of questions, medications, doses, a brief diary when symptoms are at their worst, and even a trusted friend or family member as support,” says Ruddy. If you are seeing a specialist, do not necessarily leave out symptoms that seem unrelated, e.g., skin rashes, while you’re at the gastroenterologist for abdominal pain. **There may be connections that do not seem apparent at first.** Explain each symptom or pain by answering the questions below. Then, make a summary of a few sentences and practice at home. **Describe the symptom.** *Example: Sharp, throbbing pain that feels deep.* **Where do you experience this?** *Example: In my lower abdomen, on the right side.* **How long have you had this symptom?** *Examples: 1 month or 3 years.* **How often does it happen? Is it associated with a particular activity?** *Examples:* *It happens every morning when I wake up.* *It’s constant.* *It comes and goes throughout the day, depending on how active I am or what position I’m in.* *It happens in bursts – the symptom appears for a few weeks, and then I’m symptom-free for a week.* **What makes it worse?** *Examples: Eating or vigorous activity.* **What makes it better?** *Examples: Taking a hot shower or using a heating pad.* **How does it affect your life?** *Examples: I am unable to participate in physical activities like jogging or picking up my kids. On days when the symptom is especially debilitating, I cannot get out of bed.* #### More Helpful Information To Bring With You Before you go to the doctor’s office, it’s helpful to **collect relevant records** of lab work, imaging, prescriptions, and doctor’s notes from previous visits. Also, make sure you have a list of any serious health conditions (including autoimmune diseases) that run in your family. You can also **make a list of all medications, supplements, and herbs** you are currently taking and details about them. Check out **Section 5 of the toolkit “Symptom & Medication Tracking”** for templates and what to include on your list. **Collect names and numbers of any previous or current doctors and practitioners.** This is especially helpful when requesting medical records or when you’d like to work with multiple providers simultaneously. **Write a brief synopsis of your health journey** by pulling information from your journal, symptom checklist, medical records, and medication and supplement list. All of this information can be distilled and added to a health timeline. Once you have a clearer picture and have identified patterns and significant issues or events from your timeline, you can summarize them. This abbreviated version is what you will present to your doctor. For more guidance, head to our How to Tell Your Chronic Illness Story page. ### 2. Research, But Keep An Open Mind Learning about your condition – even if you have no information other than your symptoms – can help you hit the ground running. Educating yourself (which is different from self-diagnosing) can spark questions about diagnosis, treatment, prognosis, lifestyle factors, and other topics to discuss with your doctor. Generally, a physician’s knowledge, experience, and training are important to finding the right answers and making the right connections. However, conducting research can help a patient grasp the basics, making it easier to communicate effectively and comprehend medical explanations. It can also provide a sense of control and alleviate some anxiety by giving patients a proactive role in managing their health. Ruddy notes that [autoimmune conditions are complex](https://www.autoimmuneinstitute.org/articles/untangling-a-complex-web-how-to-categorize-autoimmune-disease), chronic, and involve multiple factors. “There is no magic cure, and each patient responds differently to the current management options available,” she says. > **Knowledge evolves over time. Having an open mind allows a patient to consider different perspectives and be receptive to new options.** #### Quality Sources For Researching Symptoms, Conditions, And Treatments - [Mayo Clinic](https://www.mayoclinic.org/) - [Johns Hopkins Medicine](https://www.hopkinsmedicine.org/) - [MedlinePlus](https://medlineplus.gov/) - [National Center for Complementary and Integrative Health](https://www.nccih.nih.gov/) - [National Organization for Rare Disorders](https://rarediseases.org/for-patients-and-families/information-resources/patient-and-caregiver-resource-center/) If you are aware you have a certain autoimmune or related condition, look through the **[Autoimmune Organizations](https://www.autoimmuneinstitute.org/autoimmune-organizations/)** list to help you in your research. [**Johns Hopkins** ](https://www.hopkinsmedicine.org/health/conditions-and-diseases)is also a top-notch source for information about autoimmune diseases. As not all diseases are explicitly listed under “Conditions and Diseases” on the Johns Hopkins website, you may need to use their search bar to find what you need. ### 3. Embrace Collaboration Through patient-centered care, patients can avoid uncomfortable interactions with healthcare providers, and a more supportive and collaborative environment can be created. > **As someone with an autoimmune disease herself, Ruddy urges her patients to see their relationship with their doctor as a partnership.** “This entails being transparent and honest with one another, collaborating to achieve desired outcomes, and working together on testing and treatments,” Ruddy says. “It takes time to build this kind of relationship, but it can lead to better clinical outcomes, patient satisfaction, and physician well-being.” **Define your healthcare goals.** Are you focused on finding a diagnosis? Do you want to get a particular issue or symptom under control? What is more important to you? Be upfront about the severity of your symptoms, how they affect your quality of life, and what you want to change. **Start with realistic expectations.** It is not possible for one person to know everything, be able to diagnose every illness, or hold all the answers when it comes to treatment. Aim for the middle ground between blind trust and bold skepticism when talking with your doctor, and leave room for multiple perspectives. Keep trying, stay clear and focused, and refer to your notes for reinforcement if you start feeling off-course. **Practice healthy skepticism.** When searching for care, you might scroll through online reviews, get intel from friends and peers, and read about local doctors in magazines. Remember that all of this information about who is the best and who is the worst is subjective, so take it with a grain of salt. One person’s experience will not necessarily be your own – even with the same doctor. **Know that you deserve to be heard.** Go in with an open mind but also a willingness to speak up for yourself. Ask questions, get clarifications, and if you notice a problem in communication, say something. Our toolkit has a section on **Advocating for Yourself**; see page 20 for tips! **Remember that it’s a partnership.** You hold a special knowledge about your body, and your doctor has extensive education and training in medicine. In this new patient-physician relationship, your story and your doctor’s expertise are valuable in different ways. You describe your experience, set goals, and make the final decision about your health while your doctor serves as an educator and guide. Keep in mind that gaining trust and building a collaborative relationship will take time. ### 4. Keep Asking Questions And Sharing Information Generally, patients may not think of all the questions they have immediately, and additional information is likely to become available to both a patient and a provider over time. As it does, a patient should continue asking questions. It helps to go through your notes from the research you’ve done to come up with questions. Are there certain tests you’re curious about? Therapies you would like to discuss? Unanswered questions or concerns collecting dust in the back of your mind? Write them down in order of priority and bring them to your appointment. In doing so, patients will have a better opportunity to have a more detailed conversation, discover additional treatment options, and become more adequately able to process information. > **Ruddy says she has come across patients who feel uncomfortable and embarrassed when discussing their illnesses and symptoms, including their pain.** “This could be because of their cultural or generational background, where they regard their doctor as an esteemed authority figure and find it difficult to ask questions or be truthful about how their illness affects their life,” she says, “I tell patients that their provider needs to hear everything, even things they may consider embarrassing, to get a clear picture of what testing might be warranted to lead to a diagnosis or treatment and to understand the true impact of the condition on their life.” ### 5. Don’t Accept Explanations Such As “It’s Stress” Or “Psychological” Don’t underestimate the emotional toll that autoimmune diseases can have on a patient’s well-being. Patients should expect healthcare providers to approach situations with empathy and understanding, integrating mental health support into a treatment plan when needed. Some medical conditions, such as autoimmune disorders, can also present with symptoms similar to those attributed to stress. Proper evaluation is necessary to identify conditions and provide appropriate treatment. “When we look at illness through the lens of the traditional biomedical model, we cannot assess the impact of symptoms on the whole person,” says Ruddy. “We are blind to other issues that might be contributing to generating symptoms, such as genetics, previous life experiences such as infection, trauma, and other factors. This sets the stage for us to dismiss symptoms and dismiss the patient without any answers or help. > **“Stigma highly impacts patients’ behaviors, attitudes, and overall clinical outcomes.”** #### Advocating For Yourself Self-advocacy means knowing your rights, abilities, and needs and communicating them to others. This is an important skill to develop – whether or not the doctors you encounter are compassionate or attentive, dismissive or unresponsive, and whether or not they wholeheartedly support you or treat you unfairly. Self-advocacy is about finding and using your voice in order to get your needs across and make decisions about your life. When you advocate for yourself, you may experience stronger and more positive relationships with your doctors and practitioners, along with a sense of ownership over your healthcare journey. It takes practice to build your skills, and the better you become at expressing yourself, the more your self-confidence will grow. > **In an ideal situation, you will be working with your doctor in an environment of mutual respect and effective communication.** You and your doctor will build and maintain trust over time and share in the decision-making process. Your doctor will be knowledgeable about the conditions and symptoms you present and will serve as an educator and guide. When unsure about something, they will dig deeper or point you to another specialist or avenue. Your doctor will believe you when you tell them something is wrong, and they will be invested in diagnosing and treating your condition. In a good patient-doctor relationship, you may feel: - Valued - Heard - Acknowledged - Respected - Motivated - Empowered **Despite the need for patient-centered, compassionate care, you may encounter situations in which this need is not fulfilled.** When you have a complex, lesser-known, or invisible condition, routine tests may come back “normal.” Without hardcore “proof” that something is wrong or that a disease is present, a doctor may suggest you return when your symptoms progress. Or they may flat-out dismiss your symptoms and tell you that “it’s just stress.” Even if the relationship starts off well, there may also be a point where your doctor hits a roadblock or their level of expertise is insufficient. In a problematic patient-doctor relationship, you may feel: - Overwhelmed - Stressed - Frustrated - Belittled - Dismissed - Judged Try to notice in the moment – your body may even give you physical signs like sweaty palms, rapid heartbeat, tensing muscles, or a new breath pattern. First of all, remind yourself that you are not imagining your symptoms and that you need and deserve quality care. Give yourself the authority to ask questions and learn about your rights as a patient. It is your body and your life! If it feels ok, communicate your concerns with your doctor. They may not realize the effect their language or demeanor is having on you until you voice your concerns. If your doctor is receptive, you will be able to work together to improve communication. ***Remember:*** *there are times when moving on to a new provider is the right decision, and there are times when using your voice to self-advocate will help turn the tide.* ### 6. Redefine The Narrative In Ruddy’s view, most patients have felt stigma to some degree or another. “We are learning to understand why one patient chooses to believe the stigma and fall prey to the maladaptive behaviors around it, or another chooses to fight against it and redefine the narrative,” she says. “The latter approach is more adaptive as the patient can then appropriately find a healthcare provider, friends, and others who will provide empathy, validation, and support.” #### How To Advocate For Yourself **Ask questions!** Whether you are wondering if you should be tested in certain ways or if there are alternative diagnosis or treatment options for your condition, have a thorough discussion with your doctor. Ask all the questions you need to and make sure that you are satisfied with the response. Here are a few examples: “What are the risks of running this test?” “Do you think I should have this test?” “Can you explain why or why not?” “Is there another way to find answers?” “Could this symptom be connected to something else?” “What other possible conditions could I have?” “Why do you think I’m experiencing these symptoms? What do you think could be triggering them?” “Would you please explain about functional reference ranges?” (*In blood testing, functional ranges help determine the risk for disease while pathological ranges are diagnostic of disease.)* “Can we search for other underlying issues (such as nutritional deficiencies, microbiome imbalance/gut dysbiosis, infections, etc.) that can be further tested for and addressed now?” “What are my treatment options for this condition?” “Do you have advice on ways I can manage my symptoms on a daily basis?” “Do you have suggestions on preventive measures I can take to keep my symptoms from worsening?” “Have you seen other patients with similar symptoms?” “Is there another practitioner you recommend who may be able to help?” ### 7. Be Kind, It’s Hard To Feel Ill And Harder Still To Seek Help **Believe yourself!** You have the unique experience of spending every hour of every day living in your body and managing your health. Do not let anyone – doctor, friend, or family member – make you doubt what you are experiencing. It’s crucial to approach healthcare with self-compassion. Being kind to oneself during medical consultations can reduce the anxiety and stress associated with seeking help. > **“I encourage patients to ‘ditch the shame’ they may feel about their condition,” says Ruddy.** “It can be hard when we are feeling our worst, highly symptomatic and looking for answers, but looking completely healthy on the outside. Stigma and shame tend to ride together with these conditions for patients.” Cultivating a positive mindset can also help a patient to become better equipped to understand what it means to live and cope with a disease. ### A Note On Mental Health It is not easy [living with chronic illness](https://www.autoimmuneinstitute.org/gai-library/#living-with-chronic-illness) and dealing with [debilitating symptoms](https://www.autoimmuneinstitute.org/articles/outbursts-in-autoimmunity-disease-flare-ups "Outbursts in Autoimmunity: Disease Flare-ups") that impact [every aspect of your life](https://www.autoimmuneinstitute.org/articles/finding-purpose-and-fulfillment-with-autoimmune-and-chronic-disease "Finding Purpose & Fulfillment with Autoimmune and Chronic Disease"). On top of that, [navigating the medical care system](https://www.autoimmuneinstitute.org/articles/navigating-health-insurance-for-autoimmune-disease-patients-expert-tips-and-resources "Navigating Health Insurance with Autoimmune Disease") is no walk in the park. You may experience frustration, anger, fear, distress, or [hopelessness](https://www.autoimmuneinstitute.org/articles/chronic-illness-when-you-feel-like-giving-up "Chronic Illness: When You Feel Like Giving Up"), or simply feel overwhelmed. **[Everyone needs support](https://www.autoimmuneinstitute.org/articles/managing-mental-health-with-an-autoimmune-disease "Managing Mental Health with an Autoimmune Disease")**. Oftentimes, you can get support from a licensed counselor, who will help you cope with the emotional burden of chronic illness. Search for someone [who has experience working with individuals who live with chronic health conditions](https://www.autoimmuneinstitute.org/articles/when-youve-lost-trust-in-doctors "When You’ve Lost Trust in Doctors…"). ### Helpful Resources [Autoimmune & Chronic Illness Toolkit](https://www.autoimmuneinstitute.org/resources/autoimmune-chronic-illness-toolkit-download/) <https://romedross.video/GutFeelingsWebsite><https://romedross.video/patient-story><https://romedross.video/doctors-and-patient-centered-care> ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** Autoimmune Care & Caregiver Support, Diagnosis & Treatment --- ### [Environmental Toxins and Autoimmune Disease](https://www.autoimmuneinstitute.org/articles/environmental-triggers-autoimmune-disease) **Published:** August 24, 2026 **Author:** Carolyn Serraino **Excerpt:** Environmental toxins are part of everyday life, but not all exposures carry the same risk. Learn how pollutants, household chemicals, and other toxins may affect immune health, who may be more vulnerable, and practical ways to reduce exposure. **Content:** A hidden cause of autoimmune disease might be dripping from your kitchen faucet. Although genes play a role in autoimmunity, researchers are learning that environmental factors play a significant role in triggering autoimmune diseases in some people (1). The recent [Safe Drinking Water Act](https://www.epa.gov/sdwa) highlights the urgency of addressing environmental toxins in our environment. ## What are Environmental Toxins? Environmental chemicals are everywhere – air, water, food, and even household products like plastics and cleaners (2). These chemicals can be toxic and have been linked with illnesses such as autoimmune diseases. Here are some common culprits: - **PFAS (polyfluoroalkyl substances), a.k.a. “forever chemicals”:** These toxins, which resist heat, oil, and water, are found in clothing, furniture, and non-stick cookware (3). - **Toxic solvents:** Chemicals such as residential and commercial pest control products, paint, lacquer, glue, and industrial soap may contain environmental toxins (4). - **Heavy metals**: Such as mercury, lead, cadmium, and arsenic can be found in our food, water, dental fillings, cosmetics, and air (4). - **Pollution:** Environmental pollutants can enter our bodies through food, water, air, soil, flame retardants, and breast milk (4). - **Endocrine (hormone) disrupters:** Items such as plastic products, flame retardants, food, and the coating of paper plates can contain toxins that disrupt our body’s hormones (4). Dr. Kara Wada, a board-certified allergist in Columbus, OH, observed the growing threat of our environment to our health saying, “My practice increasingly reflects the ‘physiologic hangover’ caused by our rapidly changing modern lifestyle. I see patients with complex, multi-system conditions that don’t fit neatly into classic disease categories.” Recognizing the increasing complexity of the illnesses she treats, Dr. Wada notes, “Many patients have an overlap of allergic, autoimmune, and other chronic inflammatory conditions.” In her practice, she focuses on helping her patients understand and manage the additive effect of environmental exposures. ## How Do Environmental Toxins Impact Autoimmunity? Scientists are still trying to determine the link between environmental factors and autoimmune disease. Here are some potential mechanisms (4): - **Oxidative Stress:** Toxins may deplete antioxidants, which protect cells, leaving our cells vulnerable to inflammation and potentially triggering autoimmunity (5). - **Toxic chemical interactions:** Particles can bind to molecules in the body, altering their structure and function and possibly triggering autoimmunity. - **Genetic modification**:  Environmental chemicals can modify gene expression, potentially leading to immune dysfunction and autoimmunity. - **Normal immune disruption** Environmental factors can directly trigger abnormal immune responses. - **Endocrine disruption:** Some chemicals can bind to endocrine receptors, altering immunological pathways involved with autoimmune reactivity. - **Gut microbiome imbalance** Toxins may disrupt the gut’s healthy bacteria, making the stomach and intestinal lining more permeable to toxins. Dr. Alejandra Carrasco, a board-certified physician specializing in functional and integrative medicine in Austin, TX, highlights the interplay between genetics and the environment noting, “The interaction between environmental toxins and genetic predisposition plays a critical role in autoimmune diseases. While genetics set the stage for potential autoimmune responses, environmental toxins can act as triggers. For instance, individuals with specific genetic markers may be more vulnerable to the effects of certain toxins, leading to an increased risk of developing an autoimmune condition.” Dr. Wada compares the link between our genetics and the environment to the game Jenga. “Picture your genes as a game of Jenga. Our exposures to environmental toxins, stressors, trauma, and illnesses each remove a block or two, moving us closer to that tower collapsing. Someone may inherit a genetic susceptibility to an autoimmune disease, but without significant environmental insults, the disease might never manifest. This highlights the importance of reducing those insults where possible.” ## Are Some Autoimmune Diseases More Vulnerable to Environmental Toxins? Environmental toxins may trigger certain autoimmune diseases more readily. For example, researchers in China found that residents moving from rural into urban settings may be at greater risk of developing [Hashimoto’s thyroiditis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/hashimotos-thyroiditis/) (6). Pollutants, infections, stress, lifestyle, and socioeconomics may alter gene expression, triggering autoimmunity. In her practice, Dr. Carrasco sees the link between environmental exposures and certain autoimmune diseases, “Toxic exposures may lead to increased systemic inflammation and alter immune system responses, potentially initiating autoimmunity in susceptible individuals. I have seen this play out most often in multiple sclerosis and rheumatoid arthritis.” Several autoimmune diseases may have greater vulnerability to environmental toxins (7): - [Systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/) - [Multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/) - [Rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/) - [Systemic sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/scleroderma/ "Scleroderma (systemic sclerosis)") - Inflammatory bowel disease ([Crohn’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crohns-disease/ "Crohn’s disease") and [ulcerative colitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ulcerative-colitis/)) Dr. Wada stresses the importance of protecting our “barrier zones” suggesting, “While many autoimmune conditions are likely influenced by the environment, diseases linked to barrier dysfunction seem especially vulnerable.” Our skin, lungs and gut are our body’s barriers. Dr. Wada states, “We’re surrounded by threats that can disrupt our barriers and promote inflammation.” Environmental toxins can also impact disease progression. Dr. Carrasco says, “The severity and onset can be influenced by exposure to specific toxins, such as heavy metals, pollutants, and certain chemicals.” ## Who’s At Risk of Environmental Toxins Triggering Autoimmunity? While pinpointing individual risk is complex, certain groups may be more susceptible: **Occupationally exposed individuals**: Research has demonstrated that women are at greater risk for developing autoimmunity (8). Additionally, many occupations traditionally occupied by women, such as nail care technicians and cleaners, might increase their exposure to toxins, further increasing their risk (9). Research has shown that women working in occupations that expose them to high levels of skin care products are more likely to develop systemic lupus erythematosus (SLE) (10). On the other hand, men working in mines and other dust-producing fields, such as construction work and sandblasting, are also more likely to develop SLE (10). **Children:** Through their daily exploration, children may encounter more environmental toxins. They are also at increased risk of the effects of exposure to environmental toxins based on their smaller size (and proportionately larger dose of ingested toxins), their closer proximity to the ground, dirt, and indoor dust, and their tendency to explore their environments orally (11). Wada suggests, “These individuals may start with a lower threshold or set point, have greater exposure burden and/or may be less able to detoxify effectively.” ## How Can You Protect Yourself from Environmental Toxins? It starts with knowledge. Dr. Carrasco recommends “Being informed and educated about potential sources of toxins in food, products, and the environment.” The first step in protecting yourself from the negative impact of environmental toxins is awareness. The Environmental Working Group (12) offers some tips for reducing your exposure to environmental toxins: - **Use filtered water:** Our water supply may contain toxic substances. Water filters can remove some of the harmful substances. - **Ditch plastic bottles:** Products made from plastic may contain various environmental toxins. Consider using metal or glass bottles instead. - **Vacuum with a HEPA filter:** Many items in our homes, such as carpets or shower curtains, can leach out toxic chemicals. A vacuum with a HEPA (High-Efficiency Particulate Air) filter can help eliminate some of these toxins. - **Wash your hands:** Regular handwashing removes germs and can help remove harmful chemicals you’ve come in contact with. - **Remove shoes indoors:** Pesticides, construction dust, and microorganisms can all get tracked indoors on your shoes. Taking your shoes off can reduce the tracking of toxins around your house. Healthcare providers frequently recommend exercise as essential to preventing and managing illness. Dr. Carrasco offers another benefit of moving your body, “Sweat on a regular basis. Sweating can help eliminate various toxins from the body, including heavy metals, such as lead and mercury, as well as certain chemicals and environmental pollutants.” While battling environmental toxins can seem daunting, Dr. Wada offers, “The most important message is progress, not perfection. Small, sustainable changes make a difference, and prioritizing barrier support is key.” ## What’s Ahead for Environmental Toxins? Researchers are continuously working to identify and understand the impact of environmental toxins on our health. This knowledge will hopefully lead to reducing or eliminating these chemicals from our environment and empowering us to make informed choices to protect ourselves. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/GAI-Logo-Image-e1707845715517.png) #### About the Author ![Tracy Asamoah bio headshot freelance writer for GAI](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/11/DSC05784-scaled.jpg) Tracy is a writer, child and adolescent psychiatrist, and leadership coach. Her journey into the world of autoimmune diseases began when she experienced sudden onset symptoms of multiple sclerosis early in her medical career. This personal experience, combined with her intense curiosity, has informed her work and writing in the field. As a writer, Tracy has contributed to various books and written articles related to mental health. She’s also written on various medical topics regularly contributing to publications such as GoodRx, Psychology Today, and Psychotherapy.net Tracy Asamoah, MD Freelance Writer for GAI ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** Living Well with Autoimmune Disease --- ### [Chemical Exposure and Autoimmune Disease: What the Research Shows](https://www.autoimmuneinstitute.org/articles/chemical-exposure-autoimmune-disease) **Published:** August 24, 2026 **Author:** Carolyn Serraino **Excerpt:** Which chemicals are linked to autoimmune disease? Experts explain what research shows about PFAS, pesticides, heavy metals, TCE, silica, and why proving causation is so difficult. **Content:** Autoimmune diseases have long been thought to occur due to an interaction between our [genetic predispositions and environmental exposures](https://www.autoimmuneinstitute.org/articles/beyond-genes-and-smoking-5-more-triggers-that-heighten-autoimmune-disease-risk/). While many studies have examined the connections between specific chemicals and particular diseases and there are chemicals that are highly concerning, for some chemicals, media coverage may draw [conclusions beyond what the data shows](https://healthjournalism.org/blog/2024/11/how-to-cover-environmental-exposure-studies/) (1). In contrast to absolute statements like “x chemical causes y disease” or “x chemical found in \[insert household substance\],” the impacts of chemical exposure on our health is more nuanced. For example: - There are chemicals that are absolutely harmful to our health - The level of exposure matters - Some chemicals might not have biological effects - Many studies identify associations between a chemical exposure and health outcomes, but it’s very difficult to say for certain that a particular chemical causes a disease To dive into this topic in more detail, we talked to two experts who are actively researching the impacts of environmental exposures: [Sarah Blossom](https://hsc.unm.edu/directory/blossom-sarah-j.html), Associate Dean of Research in the College of Pharmacy and Professor in the Department of Pharmaceutical Sciences at the University of New Mexico, and [Melissa Furlong](https://publichealth.arizona.edu/directory/melissa-furlong), Assistant Professor in the Mel and Enid Zuckerman College of Public Health at the University of Arizona. ### Why Is the Link Between Chemical Exposure and Autoimmune Diseases Hard to Prove? We should first understand that it’s difficult to prove that a certain chemical causes a certain autoimmune disease and this difficulty is reflected on two levels: (1) scientific research on these connections, and (2) individuals looking to understand whether their past exposure triggered autoimmunity. **Research studies:** As mentioned above, research studies often begin by looking at associations between a chemical exposure and diseases, but this doesn’t necessarily mean a chemical causes disease. These studies often show associations based on population data, but might not necessarily look at what exactly happens in the body to trigger autoimmune diseases. To dig deeper into the mechanism behind how chemicals are linked to disease, researchers then turn towards cell models or animal models. Still, Blossom says it can still be difficult to extrapolate what they see in an animal model to a human, which makes it difficult to prove causation. In addition, there are so many variables between individual research studies. For example, some studies might be looking at different concentrations of exposures where at one concentration, the chemical can suppress the immune response, but at other concentrations, it could enhance the immune response. Other points of uncertainty could include whether the study looked at male or female populations, if the exposure occurred during development or as an adult, dietary differences, and a number of other variables. Blossom thinks that in the future mathematical modeling or computational models might help scientists handle these variables and help parse out important associations. **Investigating past exposures:** In determining the connection between an individual’s exposure and disease state, Blossom says that it’s hard to definitively extrapolate a link because “there are so many other things that we’re exposed to and there are genetic predisposing factors as well.” It becomes difficult to tease apart the contributions of our various exposures and genetics. For instance, [superfund sites](https://www.autoimmuneinstitute.org/research_updates/toxic-exposure-and-autoimmune-disease-superfund-sites/) – locations highly contaminated with hazardous chemicals – are associated with an increased risk of autoimmune diseases. However, not everyone near those sites develops an autoimmune disease indicating how variability in our genetics and other exposures may come into play. ### What Chemicals Have Been Associated With Autoimmune Diseases? There are over [80,000 chemicals registered in the US](https://www.epa.gov/sciencematters/science-matters-articles-related-safer-chemicals-research), but this fact alone is not necessarily a cause for alarm (2). “Not all chemicals are terrible for you or have a biological impact,” said Furlong. Furthermore, there is a difference between higher levels of chronic exposures (for example, associated with the workplace) versus exposures that are at lower levels in the general population. Scientists are still gathering evidence on many of these connections but as of now, there have been linkages between the following chemical exposures and autoimmune diseases. #### Metals Exposure to [mercury and lead](https://www.sciencedirect.com/science/article/pii/S1568997223002434) have been linked to autoimmune diseases affecting the central nervous system (3) and [exposure to mercury](https://www.autoimmuneinstitute.org/research_updates/the-role-of-exposomes-toxic-chemicals-food-and-pathogens-in-the-pathophysiology-of-ads/) can trigger local and systemic inflammation and cause dysregulation of autoimmune responses. “There have been some strong linkages between arsenic, cadmium, and different metals (such as heavy metals and other metalloids) that are in the environment with autoimmune disease,” said Blossom. Research finds that [heavy metals may exacerbate conditions](https://onlinelibrary.wiley.com/doi/10.1002/9781119858430.ch19) such as systemic lupus erythematosus, rheumatoid arthritis, and multiple sclerosis (4). #### Pesticides [Pesticides](https://www.autoimmuneinstitute.org/articles/pesticide-use-the-gut-microbiome/) and [herbicides](https://www.autoimmuneinstitute.org/articles/agent-orange-and-beyond-how-military-toxins-can-trigger-autoimmune-diseases/) have been associated with many autoimmune diseases, including Crohn’s disease, autoimmune hepatitis, and rheumatoid arthritis. #### Trichloroethylene Trichloroethylene (TCE) is an industrial solvent used to remove grease from metal parts. Blossom, who studies the effect of TCE on the immune system, says that most people are either exposed through the workplace or when TCE has been improperly disposed of and ends up contaminating water. TCE exposure can lead to inflammation. Studies have found that [chronic TCE exposure](https://pmc.ncbi.nlm.nih.gov/articles/PMC9650993/) has been linked to lupus, systemic sclerosis, and autoimmune hepatitis (5). #### Crystalline silica Crystalline silica, which is released during mining, rock drilling, and construction work, has been associated with various autoimmune diseases. A meta-analysis found that the relative risk of [rheumatoid arthritis](https://www.sciencedirect.com/science/article/pii/S2093791119308741) and [scleroderma](https://link.springer.com/article/10.1007/s00420-009-0505-7) increased in individuals with silica exposure compared to unexposed individuals (6,7). #### PFAS Per- and polyfluoroalkyl substances (PFAS) are a group of over [15,000 synthetic chemicals](https://www.niehs.nih.gov/health/topics/agents/pfc) that have been used for their ability to repel oil and water. Furlong’s work found that [PFAS exposure is associated with altered genetic expression](https://www.autoimmuneinstitute.org/research_updates/firefighter-study-links-pfas-to-immune-dysfunction/), with disruptions to pathways involved in the balance of the immune system (8). Other studies have shown that PFAS has an [immunosuppressive effect](https://doi.org/10.1016/j.envint.2023.107734), dampening immune responses to vaccination (9), but scientists know less about the effects of PFAS on immune hyperactivation, although there has been some evidence [linking PFAS to allergies and asthma](https://pmc.ncbi.nlm.nih.gov/articles/PMC8529509/) (10). ### How Can Chemical Exposures Interact With the Immune System? Chemical exposures can affect the immune system through a number of mechanisms. Furlong studies how environmental contaminants are linked to health outcomes and a focus of her work has been on how these exposures affect the [epigenome](https://www.autoimmuneinstitute.org/articles/the-role-of-epigenetics-in-autoimmune-disease/). Scientists are also investigating other proposed mechanisms of chemical-induced autoimmunity, such as (11): Tissue damage Cell death Inflammation Mucosal damage Immune dysregulation Autoantibody generation ### How Can I Reduce My Exposure to Chemicals? With the increasing amount of research into the [exposome](https://www.autoimmuneinstitute.org/research_updates/the-role-of-exposomes-toxic-chemicals-food-and-pathogens-in-the-pathophysiology-of-ads/), or an individual’s lifetime exposure to external and internal factors, it’s clear that there are highly concerning chemicals while other exposures aren’t as alarming. To minimize exposure, Furlong says, “do what you can to adopt healthy habits and reduce your exposure.” But she also cautioned that being overly anxious about your exposures might be worse than the effects of low-level exposure to many of these chemicals. Below are some practical actions you can take. **For those with occupational exposure**, there are several steps you can take as an individual or on the organization level to [reduce exposure](https://www.osha.gov/chemical-hazards/controlling-exposure) (12). This could include: - Substituting problematic chemicals with safer alternatives - Physical changes in the work environment to reduce exposure - Wearing personal protective equipment - Adjusting work schedules or assignments to minimize repeated overexposures **For the average person without occupational exposure**, there are still measures you can take to reduce exposure, including: - Being aware of your environment and contaminants in the area using sites like the [EPA’s superfund site map](https://www.epa.gov/superfund/search-superfund-sites-where-you-live) (13). - Using and maintaining a water filtration system. This is particularly useful if you use well water and have contaminants in the area. In contrast to municipal water supplies that are routinely tested, well water is not. One caveat here is that most risk assessments and tests are done using “maximum contaminant levels” (MCL) of chemicals that could cause cancer or reproductive harm, while levels below the MCL could still impact the body. - Using bait traps and sealing your home, instead of spraying pesticides and herbicides - Use cookware without PFAS chemicals and avoid plastic packaging. #### “These are small steps that taken together can be meaningful,” said Blossom.  ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/GAI-Logo-Image-e1707845715517.png) #### About the Author ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/10/Jennifer-Tsang-Bio-Headshot-e1753113113430.jpg) A microbiologist turned freelance science writer who works with life science companies, nonprofits, and academic institutions on anything from news stories, explainer articles, and content marketing. She shares the wonderful world of microbes on her blog [The Microbial Menagerie](https://microbialmenagerie.com/). Jennifer Tsang, PhD Freelance Writer for GAI ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** Living Well with Autoimmune Disease --- ### [Trauma and Autoimmune Disease: What the Research Shows](https://www.autoimmuneinstitute.org/articles/trauma-and-autoimmune-disease) **Published:** August 24, 2026 **Author:** Carolyn Serraino **Excerpt:** Research suggests trauma and PTSD may affect inflammation, immune function, and autoimmune disease risk. Here’s what scientists know about the connection. **Content:** According to the World Health Organization, about 70% of people worldwide will experience some trauma in their lifetime (1). Research increasingly suggests a connection between traumatic events and the development or worsening of autoimmune disorders. In this article, we’ll explore what trauma is, how it affects the body, and what it may mean for people living with autoimmune conditions. ## What Is Trauma? Trauma refers to experiences that overwhelm a person’s ability to cope, leaving lasting physical and/or psychological effects. Trauma is typically classified into three categories (2): - **Acute trauma:** a single distressing event (e.g., a car accident) - **Chronic trauma:** repeated, ongoing exposure to traumatic event (e.g., bullying) - **Complex trauma:** multiple, long-term events, often beginning in childhood (e.g., growing up in a warzone) Further examples of trauma include: - Natural disasters - Bullying or community violence - Intimate partner violence - Medical trauma - Race-based trauma - Serious physical injury - Wartime conflict Trauma can affect individuals or entire communities. While physical trauma (such as an injury) can have lasting consequences, this article focuses on psychological trauma, which can occur at any age and often leaves a lifelong imprint. Trauma increases the risk of developing psychological challenges such as depression, anxiety, cognitive impairment, and PTSD (post-traumatic stress disorder), as well as physical health problems like heart disease (3). PTSD is a chronic psychological disorder caused by trauma that often can have a significant impact on people’s daily lives. Not only does PTSD affect an individual’s emotional state, but it can also disrupt their relationships and how they function at work. PTSD can affect physical health too, with studies showing a link between PTSD and autoimmune disorders. People with PTSD experience four types of symptoms (4): - Re-experiencing the event (flashbacks or nightmares) - Avoidance of reminders - More negative thoughts and feelings than prior to the event - Heightened vigilance or feeling “on edge” ## How Trauma Affects the Body Growing evidence shows that trauma can disrupt our body’s normal physical and psychological functioning. **Dr. Winfrey**, a psychiatrist and Medical Director at [New Image Wellness](https://app.qwoted.com/companies/new-image-wellness) explains, #### “Trauma doesn’t just affect the mind or body in isolation, it destabilizes the entire network of regulatory systems that normally protect health.” These systems include the stress response system, immune function, hormone regulation, and even cellular health. This association doesn’t mean trauma causes autoimmune disease, but it does point to a possible connection. ### Stress Response and the HPA Axis The hypothalamic-pituitary-adrenal (HPA) axis regulates the body’s response to stress. Short-term stress can be protective, helping us avoid a fast-moving car or perform effectively under pressure. In these moments, stress hormones such as cortisol, epinephrine, and norepinephrine prepare the body for rapid action and recovery (5). However, repeated or chronic trauma can disrupt this system, keeping stress hormones elevated. Over time, this dysregulation can harm multiple body systems (cardiovascular, respiratory, gastrointestinal) and contribute to both psychological and physical illness (5). Dr. Winfrey explains, “When someone experiences trauma, whether it’s a psychological trauma, such as abuse, neglect, or violence, or a physical trauma, such as an accident or injury, the experience doesn’t just stay in \[the\] memory. It is processed through the limbic system, the brain’s emotional center, and through the autonomic nervous system, which governs the body’s stress responses.” These systems are linked to the HPA axis, the central hub of the body’s stress response. ### Immune System Dysfunction and Inflammation Under normal circumstances, the immune system promotes healing after injury or infection, but trauma can impair this process. The effects of prolonged release of stress-related substances include (5): - Weakened defenses against infection - Delayed wound healing - Worsened inflammation #### Chronic traumatic [stress](https://www.autoimmuneinstitute.org/articles/stress-autoimmune-disease-navigating-the-complex-relationship) promotes ongoing [inflammation](https://www.autoimmuneinstitute.org/articles/inflammation-a-driving-force-of-autoimmune-disease), which is a known driver of autoimmune disease. This effect may explain why trauma can both trigger new autoimmune conditions and worsen preexisting ones. ### Changes in Gene Expression [Epigenetics](https://www.autoimmuneinstitute.org/articles/the-role-of-epigenetics-in-autoimmune-disease) is the study of how the environment influences gene activity without altering the underlying DNA itself. Factors such as [diet](https://www.autoimmuneinstitute.org/gai-library/#ad-food), [infections](https://www.autoimmuneinstitute.org/research_updates/infections-and-pathogens-as-triggers-of-autoimmune-disease/), and [pollution](https://www.autoimmuneinstitute.org/articles/beyond-genes-and-smoking-5-more-triggers-that-heighten-autoimmune-disease-risk) can “switch” specific genes on or off. Stress and trauma function in a similar way, altering gene expression in ways that change how immune cells behave. Such changes may contribute to autoimmune disease (6). ## Trauma and Autoimmune Disease While trauma can trigger autoimmunity potentially impacting any autoimmune disorder, a few disorders have been the focus of research studies. These disorders include (3): - [Systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/) (SLE) - Inflammatory bowel disease ([Crohn’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crohns-disease/) and [ulcerative colitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ulcerative-colitis/)) - [Rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/) (RA) - [Multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/) (MS) - [Autoimmune thyroiditis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/hashimotos-thyroiditis/) (7) While trauma may play a role in the development or worsening or autoimmune disorders there are often other contributors. **Dr. Amy Offutt**, Board President of the International Lyme and Associated Diseases Society and Medical Director and Co-Owner of Heart *&* Soul Integrative Health, emphasizes, “There are multiple factors to consider such as the severity and chronicity of the stressor, phase of life during the trauma, presence of traumatic brain injury or repetitive head injuries, genetics, preexisting illnesses, age at exposure, number and intensity of infections, integrity of the blood-brain-barrier, co-exposures, sleep quality, chronic pain, substance use, social circumstances, access to comprehensive and integrative healthcare, and others.” These factors may also shape how people experience and manage autoimmune symptoms. ## What This Means If You Have Experienced Trauma If you live with an autoimmune disorder and have a history of trauma, it’s important to consider how these experiences may affect your health and to seek care that addresses your unique healthcare needs. Early recognition and better interventions for trauma and PTSD may reduce the risk or severity of autoimmune disorders. Additionally, treatments targeting the immune system may reduce PTSD symptoms (8). ### Trauma-Informed Care If you’ve experienced trauma and are concerned about its impact on your health, it’s vital that you share your concerns with your health care provider. Many healthcare providers understand or are trained in trauma-informed care. Trauma-informed care recognizes the widespread impact of trauma and integrates that understanding into medical practice (8). Dr. Offutt explains, “Trauma-informed care (TIC) integrates an understanding of trauma’s prevalence and its biological, psychological, and social impacts into every aspect of clinical practice.” He notes that traditional medicine tends to be more “siloed”. Dr. Winfrey explains that healthcare providers trained in trauma-informed care are better equipped to treat patients without furthering their trauma. Benefits of trauma-informed care include (9): - Better patient engagement - Improved adherence to treatment - Enhanced outcomes - Greater provider well-being Dr. Winfrey notes the importance of seeing patients as whole people, suggesting, #### “Patients are sometimes labeled with fixed personality traits or static psychiatric categories. Trauma-informed care, on the other hand, shifts the lens: it sees people as dynamic, shaped by life experiences, and still capable of growth and repair.” A trauma-informed approach views patients not as fixed labels or diagnoses, but as whole people with capacity for growth and healing. Depending on your needs, your care team may include a primary care provider, specialists (e.g., rheumatologists), mental health professionals, and other healthcare professionals working together. ### Mental Health Support and Self-Care Strategies If past trauma continues to affect your well-being, consider seeking help from a counselor or therapist. Trauma-focused therapies such as trauma-focused cognitive behavioral therapy (CBT), Eye Movement Desensitization and Reprocessing (EMDR), long-term exposure (4) and somatic experiencing (10) help address trauma by working with both the mind and body. In some cases, psychiatric support or medication may also be helpful. #### Self-care is a powerful part of recovery and resilience. Here are some evidence-based practices you can try (1): - Maintain daily routines as much as possible - Talk to trusted people when you feel ready - Limit alcohol and drug use - Exercise regularly, even short walks - Prioritize healthy sleep habits - Eat a nourishing diet - Practice stress management techniques (e.g., breathing exercises, muscle relaxation) ## Key Takeaway Many people experience trauma and its long-term effects on the body, including the immune system. Ongoing research is still uncovering the exact connections between trauma and autoimmune disease. For example, increasing evidence suggests a link between trauma and disruption in the balance of [gut microbes](https://www.autoimmuneinstitute.org/gai-library/#microbiome) (11). Gut microbes play a key role in the body’s immune response. Research is also exploring new indications for existing therapies, such as using anti-inflammatory medications to target inflammation seen in both PTSD and autoimmune disorders (8). As we continue to learn more about how trauma impacts the body, trauma-informed care and supportive strategies can help you manage both your physical and emotional health. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/GAI-Logo-Image-e1707845715517.png) #### About the Author ![Tracy Asamoah bio headshot freelance writer for GAI](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/11/DSC05784-scaled.jpg) Tracy is a writer, child and adolescent psychiatrist, and leadership coach. Her journey into the world of autoimmune diseases began when she experienced sudden onset symptoms of multiple sclerosis early in her medical career. This personal experience, combined with her intense curiosity, has informed her work and writing in the field. As a writer, Tracy has contributed to various books and written articles related to mental health. She’s also written on various medical topics regularly contributing to publications such as GoodRx, Psychology Today, and Psychotherapy.net Tracy Asamoah, MD Freelance Writer for GAI ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** Living Well with Autoimmune Disease --- ### [Outbursts in Autoimmunity: Disease Flare-ups](https://www.autoimmuneinstitute.org/articles/outbursts-in-autoimmunity-disease-flare-ups) **Published:** April 11, 2023 **Author:** Carolyn Serraino **Content:** Autoimmune disease flare-ups can be unpredictable and disruptive, causing symptoms to suddenly appear or worsen and interfering with daily life. But what causes a flare-up, what is happening in the body when one occurs, and what can you do when symptoms intensify? This article explores what researchers know about autoimmune disease flare-ups, including common triggers, the immune processes involved, how flares can differ across autoimmune diseases, and strategies for managing them. ### What Are Autoimmune Disease Flare-Ups? Also known as bouts, relapses, or episodes, autoimmune disease flare-ups occur when patients show a dramatic worsening of disease signs and symptoms or when they develop new ones. These manifestations occur in one or more organs of the body, are usually more severe than symptoms regularly observed in autoimmunity, and often interfere with daily activities. > Distinguishing between a flare-up and a regular symptom may be difficult. ### Triggers, Body Responses, and Symptoms Flare-ups are markers of autoimmune disease activity, meaning that the signs or symptoms can usually be observed or measured in an organ or organ system. **Factors that spur autoimmune disease flare-ups include stress, diet, drugs, pregnancy, changes in microbial populations, and seasonality** ([1](https://pubmed.ncbi.nlm.nih.gov/36341463/), [2](https://pubmed.ncbi.nlm.nih.gov/28624334/)). During a flare-up in autoimmune diseases, such as arthritis or lupus, a person’s immune system attacks the body, leading to signs and symptoms. More specifically, these **bouts are triggered by [autoantibodies](https://www.autoimmuneinstitute.org/articles/decoding-the-role-of-autoantibodies-in-autoimmunity "Decoding the Role of Autoantibodies in Autoimmunity"), specialized cells known as B and T cells, and cellular pathways that involve substances called cytokines which cause inflammation in different tissues and organs** ([3](https://pubmed.ncbi.nlm.nih.gov/34706228/), [4](https://pubmed.ncbi.nlm.nih.gov/30874345/), [5](https://pubmed.ncbi.nlm.nih.gov/33631651/)). Common flare-up symptoms include depression, exhaustion, unusual rashes, poor sleep, fever, and increased pain. However, different autoimmune diseases feature specific bouts that often depend on the body sites they affect. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2023/04/shutterstock_689195335-1-1024x969.jpg) ### Systemic Lupus Erythematosus (SLE) Flare-Ups During [lupus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus (SLE)") flare-ups, people may either experience a return of regular symptoms or develop new ones. Triggers include emotional stress, surgical procedures, injury, and pregnancy ([6](https://www.lupus.org/resources/what-is-a-flare)). The episodes are caused by autoantibodies that attack healthy tissue, leading to tissue inflammation and damage ([5](https://pubmed.ncbi.nlm.nih.gov/30874345/)). Fever, joint pain, increased fatigue, and rashes are common symptoms, and gastrointestinal complications may also occur. [Nephritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/lupus-nephritis/), caused by inflammation of the kidneys, is one of the most severe flare-ups of SLE, with up to 20% of patients with SLE nephritis developing end-stage renal disease ([7](https://pubmed.ncbi.nlm.nih.gov/35932197/)). Pregnant women with SLE and a history of kidney disease are at risk for flare-ups that may lead to pre-eclampsia, preterm birth, and fetal death ([8](https://pubmed.ncbi.nlm.nih.gov/35210867/)). High-intensity immunosuppressive therapy followed by longer courses of less intensive therapy is often prescribed to control disease activity of life-threatening lupus flares and prevent relapses ([9](https://pubmed.ncbi.nlm.nih.gov/33051219/)). However, drug administration should be closely monitored during pregnancy and lactation. **Some SLE flare-ups may occur without clinical manifestations, so patients should be regularly screened by a physician for signs and symptoms.** ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/shutterstock_760983952-1-1024x1024.jpg) ### Multiple Sclerosis (MS) Flare-Ups Relapsing-remitting [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/) (RRMS) is a type of MS marked by flare-ups caused by stress, infections, medical procedures, older age, and heat exposure. The flare-ups can be mild to severe, depending on which areas of the central nervous system are affected ([10](https://www.healthline.com/health/multiple-sclerosis/exacerbation-ms-attack)). Symptoms include limb weakness, blurred vision, slurred speech, numbness, bladder issues, and memory and concentration problems. **One way to distinguish between RRMS flare-ups and regular symptoms is to look at their duration and pattern** ([10](https://www.healthline.com/health/multiple-sclerosis/exacerbation-ms-attack), [11](https://pubmed.ncbi.nlm.nih.gov/26718593/)). A symptom is considered a flare-up when it has lasted for at least 24 hours, though they typically last longer (sometimes for weeks or even months at a time). Flare-ups usually occur at least 30 days after an earlier bout ([10](https://www.healthline.com/health/multiple-sclerosis/exacerbation-ms-attack)). Although flare-ups may clear on their own, medications such as corticosteroids and immunosuppressants are needed in more severe cases. Physical therapy may be recommended to regain strength. Minocycline, a tetracycline antibiotic, has shown promise for treating RRMS ([12](https://pubmed.ncbi.nlm.nih.gov/31721547/)). ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Screen-Shot-2023-10-24-at-9.07.46-PM-1024x728.jpg) ### Other Autoimmune Disease Flare-Ups **Autoimmune disease flare-ups can also affect the liver and skin.** [Psoriasis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/psoriasis/) features skin flare-ups that alternate with periods of remission. Common triggers include medications, stress, cold weather, alcohol intake, and trauma to the skin ([13](https://pubmed.ncbi.nlm.nih.gov/33206132/),[ 14](https://pubmed.ncbi.nlm.nih.gov/29729012/)). When a person’s mild lesions become painful and inflamed, a flare-up is probably occurring. In addition to topical, oral, and light therapies, mindfulness and meditation were recently found to be useful in managing psoriasis episodes ([15](https://pubmed.ncbi.nlm.nih.gov/36103011/)). A more rare disorder, [autoimmune hepatitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-hepatitis/), is characterized by the infiltration of T cells in the liver and a high risk of relapses ([16](https://pubmed.ncbi.nlm.nih.gov/33315790/)). The disease classically affects women of reproductive age and is known to cause especially serious and unpredictable liver flare-ups in [pregnancy](https://www.autoimmuneinstitute.org/articles/pregnancy-with-an-autoimmune-disease "Pregnancy with an Autoimmune Disease"), leading to pre-term birth and interfering with proper fetal growth ([17](https://pubmed.ncbi.nlm.nih.gov/32376296/)). Multidisciplinary surveillance and close evaluation of pregnant women with autoimmune hepatitis flare-ups has led to better outcomes ([17](https://pubmed.ncbi.nlm.nih.gov/32376296/)). ### Living Well With Flare-Ups Recognizing flare-ups in autoimmune disease can be difficult and take trial and error, but it is essential for managing any condition. Patients should consult their primary care physician or specialists when experiencing changes in regular autoimmune symptoms, especially if daily activities are affected. Exercising, eating well, resting, practicing mindfulness, and eliminating flare-up triggers will complement any therapy, but major lifestyle changes or switches in treatment should be discussed with a healthcare provider. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/04/GAI-Logo-Image-811x1024.png) ### About the Author **Damiana Chiavolini, MS, PhD** is a freelance writer who specializes in medical and life science topics. As a trained researcher, she authored journal articles in the areas of infection and immunity and wrote booklets and book chapters about different diseases. As a professional communicator, she writes feature articles for magazines and other publications and produces content for higher education platforms. Damiana is also an experienced academic editor, microbiology educator, writing coach, and fragrance blogger. She is a contributing member of the American Medical Writers Association and the current president of the association’s Southwest chapter. ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** About Autoimmune Disease, Living Well with Autoimmune Disease --- ### [Culinary Medicine: Autoimmunity and Healthy Eating](https://www.autoimmuneinstitute.org/articles/culinary-medicine-autoimmunity-and-healthful-eating) **Published:** August 16, 2023 **Author:** Carolyn Serraino **Content:** You may already know that eating a balanced diet supports a healthy lifestyle. If you have an autoimmune disease, you may also know that eating well and eliminating unhealthy foods, in addition to other beneficial habits (such as managing stress and sleeping well), may reduce the risk of developing unwanted signs and symptoms. Examples of foods and food components to cut down for a healthier life include processed and fried foods, sugar-sweetened foods and drinks, and refined carbohydrates. However, identifying the foods that can specifically initiate your [flare-ups](https://www.autoimmuneinstitute.org/articles/outbursts-in-autoimmunity-disease-flare-ups "Outbursts in Autoimmunity: Disease Flare-ups") may help you heal and feel better as you manage your autoimmune condition. Read more about the diets you can consider following to minimize triggers, and talk to your healthcare provider about which one may work best for you. ### Anti-Inflammatory Diets Inflammation is a process that helps the body recognize and fight foreign invaders such as microbes. Once the invaders are eliminated, inflammation resolves, and the body tissue heals ([1](https://pubmed.ncbi.nlm.nih.gov/34447777/)). Sometimes the invasion comes from specific components (for example, food dyes), so, if you regularly eat certain foods, inflammation may persist and lead to chronic illnesses ([1](https://pubmed.ncbi.nlm.nih.gov/34447777/),[ 2](https://www.health.harvard.edu/staying-healthy/foods-that-fight-inflammation)). The signs and symptoms observed in people with autoimmune diseases (fatigue, pain, headaches, and sleep problems) may, among other factors, be triggered by foods that cause inflammation ([1](https://pubmed.ncbi.nlm.nih.gov/34447777/),[ 2](https://www.health.harvard.edu/staying-healthy/foods-that-fight-inflammation)) and other responses that, in turn, damage the intestinal tract and breach other organs ([3](https://pubmed.ncbi.nlm.nih.gov/31917265/)). The anti-inflammatory diet recommends eliminating foods that may initiate inflammation in favor of healthier ones that help repair the digestive system and other organs and tissues ([2](https://www.health.harvard.edu/staying-healthy/foods-that-fight-inflammation)). ##### Foods to avoid in anti-inflammatory diets: - Red and processed meats - Refined sugars - Fried foods - Margarine or shortening - Dairy - Alcohol - Soda ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/anti-inflammatory-diets-foods-to-avoid-and-include.png) ##### In contrast, eating foods recommended as part of a Mediterranean diet plan may help fight inflammation and help heal the body ([**4**](https://pubmed.ncbi.nlm.nih.gov/27552476/)**):** - Fruits - Vegetables - Healthy proteins (fish or beans) - Eggs - Whole grains - Legumes - Nuts and seeds - Healthy oils (extra virgin olive oil) Anti-inflammatory food plans also include vegetarian, vegan, and ketogenic diets and foods rich in omega-3 fatty acids and fiber ([5](https://pubmed.ncbi.nlm.nih.gov/34959772/)). The lack of direct scientific evidence on the link between nutrition and autoimmunity has greatly influenced dietary advice for some autoimmune diseases. A few studies showed reduced joint pain and swelling, and improved inflammation in people with [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/) (RA) who followed anti-inflammatory diets ([5](https://pubmed.ncbi.nlm.nih.gov/34959772/),[ 6](https://pubmed.ncbi.nlm.nih.gov/32055820/),[ 7](https://pubmed.ncbi.nlm.nih.gov/37426179/)), but other investigators indicated that evidence is still needed to establish a stronger relationship between anti-inflammatory foods and RA ([8](https://pubmed.ncbi.nlm.nih.gov/32320014/)). Anti-inflammatory diets may also help patients with other autoimmune diseases. Examples include some improvement in the signs and symptoms of [Hashimoto’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/hashimotos-thyroiditis/) ([9](https://pubmed.ncbi.nlm.nih.gov/32588591/)) and reduced flare-ups of inflammatory bowel disease (IBD), which includes [Crohn’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crohns-disease/) and [ulcerative colitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ulcerative-colitis/) ([10](https://pubmed.ncbi.nlm.nih.gov/33806061/)). ### The Autoimmune Protocol (AIP) Diet The Autoimmune Protocol (AIP) is a type of anti-inflammatory diet that was specifically designed to remove foods that may cause inflammation and, thus, lead to flare-ups in people with autoimmune diseases. The AIP diet is stricter than other anti-inflammatory diet plans because the list of foods considered to be inflammatory is longer. Therefore, some of the items allowed in the Mediterranean and anti-inflammatory diets (see list below) should be eliminated here ([11](https://www.healthline.com/nutrition/aip-diet-autoimmune-protocol-diet)). ##### Additional foods to avoid in the AIP diet: - Nightshade vegetables (tomatoes, peppers, eggplants, potatoes) - Spices derived from nightshade vegetables (such as paprika) - Eggs - Legumes - Grains - Nuts and seed - Oils - Coffee ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/AIP-foods-to-avoid-and-include.png) ##### Foods to eat in the AIP diet ([**11**](https://www.healthline.com/nutrition/aip-diet-autoimmune-protocol-diet)**,**[ **12**](https://health.clevelandclinic.org/aip-diet-autoimmune-protocol-diet/)**):** - Vegetables (except for nightshade vegetables and algae) - Fruit - Fish - Minimally processed meats (wild game, poultry, and organ meat) - Meat and bone broths - Non-dairy fermented foods (pickles, sauerkraut) - Vinegar (free of sugars) - Maple syrup and honey - Tea (green, black) #### The AIP is an [elimination diet](https://www.autoimmuneinstitute.org/articles/elimination-diets-what-you-need-to-know "Elimination Diets: What You Need to Know") and includes three distinct phases. In the **elimination phase**, foods thought to cause inflammation are removed in favor of nutrient-dense foods (see lists above). As disease manifestations improve, a person will enter the **reintroduction phase,** where foods are brought back one by one, and signs or symptoms are observed before the next item is added back ([11](https://www.healthline.com/nutrition/aip-diet-autoimmune-protocol-diet),[ 12](https://health.clevelandclinic.org/aip-diet-autoimmune-protocol-diet/)). Foods such as dairy products may be reintroduced in a certain order, starting from the ones with a lower concentration of lactose ([11](https://www.healthline.com/nutrition/aip-diet-autoimmune-protocol-diet)). The **maintenance phase** focuses on long-term personalized plans to safeguard a person’s health. Diet diversity and flexibility are encouraged but foods that continue to trigger inflammation should be eliminated. New foods should not be reintroduced in people who have an infection, sleeping problems, or any other new stressor that may increase inflammation levels because this may interfere with results interpretation ([11](https://www.healthline.com/nutrition/aip-diet-autoimmune-protocol-diet)). Research studies have indicated that the AIP diet may relieve signs and symptoms of inflammation, especially in people with Hashimoto’s thyroiditis and IBD ([13](https://pubmed.ncbi.nlm.nih.gov/31275780/),[ 14](https://pubmed.ncbi.nlm.nih.gov/28858071/),[ 15](https://pubmed.ncbi.nlm.nih.gov/31832627/)), but the science behind the effectiveness of this diet in autoimmune disease is poorly understood. ### What Diet Is Best For You? Selecting the best diet for an autoimmune disease should be part of a well-thought-out personalized lifestyle plan that also includes proper exercise, sleep, and treatment. Talk to your doctor and dietitian to identify what foods you should eat and discuss the implications and solutions of highly restrictive diets in your daily routine, health condition, and social life. ### Can Vitamins And Other Supplements Help? Research on the beneficial effects that vitamins and other supplements may have on autoimmune disease is also limited. A 2022 clinical study reported that adults who took vitamin D and omega-3 fatty acids over the course of 5 years had lower risk of developing [RA](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/), [polymyalgia rheumatica](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/polymyalgia-rheumatica/), and [psoriasis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/psoriasis/) ([16](https://pubmed.ncbi.nlm.nih.gov/35082139/)). A Harvard Health Publishing article indicated the validity of the clinical study’s results, but also listed its limitations and highlighted that data should be confirmed by other researchers ([17](https://www.health.harvard.edu/blog/can-vitamin-d-supplements-prevent-autoimmune-disease-202203242712)). Always talk to your doctor before taking dietary supplements, keeping in mind that you will get vitamins, minerals, and other nutrients from wholesome foods and a diet that works for you. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/GAI-Logo-Image-e1707845715517.png) ### **About The Author** **Damiana Chiavolini, MS, PhD** is a freelance writer who specializes in medical and life science topics. As a trained researcher, she authored journal articles in the areas of infection and immunity and wrote booklets and book chapters about different diseases. As a professional communicator, she writes feature articles for magazines and other publications and produces content for higher education platforms. Damiana is also an experienced academic editor, microbiology educator, writing coach, and fragrance blogger. She is a contributing member of the American Medical Writers Association, the immediate past president of the association’s Southwest Chapter, and a professional member of the National Association of Science Writers. ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** Living Well with Autoimmune Disease --- ### [Managing Mental Health with an Autoimmune Disease](https://www.autoimmuneinstitute.org/articles/managing-mental-health-with-an-autoimmune-disease) **Published:** May 10, 2021 **Author:** Carolyn Serraino **Content:** Mental health: it’s a discussion that our modern world is slowly beginning to embrace. Although there are many factors that can impact a person’s emotional balance, the interplay between mental health and autoimmune disease is a topic that should not be dismissed. Mental health challenges are a common experience among people with autoimmune disease and other chronic illnesses. **In 2013, a group of Danish researchers concluded that participants of their study were 45% more likely to develop anxiety or depression if they had an autoimmune disease** ([**1**](https://www.health.harvard.edu/blog/infection-autoimmune-disease-linked-to-depression-201306176397))**. Additionally, Cleveland Clinic reports that** [**clinical depression occurs in 40% of people with multiple sclerosis**](https://my.clevelandclinic.org/health/articles/9288-chronic-illness-and-depression) ([**2**](https://my.clevelandclinic.org/health/articles/9288-chronic-illness-and-depression.))**.** From social and emotional burdens to physical challenges, many people with autoimmune disease experience significant disruption to their lives. The need for mental health support often goes hand-in-hand with the importance of managing disease symptoms, and yet many treatment protocols lack emphasis on mental health support. When it comes to managing mental health with autoimmune disease, there are no easy solutions. However, it is possible to find strength through building your support system and engaging in practices that help sustain your emotional well-being. There are also a number of ways that providers can center the mental health needs and challenges of autoimmune disease patients. ### The Emotional Tool of Chronic Illness Many patients agree that mental health is not discussed enough in the context of autoimmune disease treatment. The emotional and mental dimensions of illness tend to be deeply personal, and can often feel isolating. Struggles with unprocessed worry, grief, fear, or anger are not unusual to those with chronic illness. Additionally, many people find themselves feeling stigmatized or alienated by the circumstances of their illness. ##### **Other aspects of autoimmune disease that can impact mental health or trigger mood disorders such as anxiety or depression:** - Unrelenting fear and worry about disease fluctuations, flare-ups, or declining health. - Long-term inflammation and physical pain or discomfort. People living with chronic pain are four times more likely to experience depression or anxiety than those who are pain-free ([3](https://www.mhanational.org/chronic-pain-and-mental-health)). - Chemical and hormonal changes caused by certain autoimmune diseases. - Cognitive burnout that is caused by spending too much time doing research related to your disease. - Feeling worn down by doctor appointments that feel unproductive. When you have an invisible illness and your tests come back normal, it can be distressing because you might feel like you have to work harder to “prove” your symptoms to your doctor. ##### **What you can do:** - **Talk with people who validate your experiences.** This can be a trusted friend, loved one, healthcare provider, or mental health professional. If you have the ability and the desire to talk with a professional, it can be beneficial to work with a therapist that specializes in chronic illness. Psychology Today has an online tool to help [match you with a therapist](https://www.psychologytoday.com/us/therapists/chronic-illness) who meets your needs. - **Consider joining a support group.** Great support groups can offer a vibrant, judgement-free space to share support, build community, and connect with people who are going through similar experiences. Unsure how to find a support group? Check in with the [organizations](https://www.autoimmuneinstitute.org/autoimmune-organizations/) that support your disease. You might also consider joining The Global Autoimmune Institute’s [Autoimmune Aware Support Group](/join-our-support-group) community. The group meets monthly and our virtual sessions are open to all. - **Don’t try to do it all at once.** Create boundaries to steer clear of cognitive burn-out. Each time you sit down to research your condition, set a specific window of time that you won’t exceed. You might also enlist friends and loved ones by asking them to help research specific topics for you ([4](https://nationalceliac.org/wp-content/uploads/1609/82/12-17-All-Things-Celiac-Video.mp4)). - **Take a moment to remind yourself that mental health struggles are nothing to be ashamed of.** There is actually a great deal of courage and self-love in reaching out for help. Additionally, remind yourself that acceptance and healing are not linear. Be kind to yourself and remember that your bad days do not define you. - **Small, daily practices can be powerful tools for managing mental health.** Try to devote just a few moments of each day to pausing and taking a few deep breaths. Close your eyes, check in with your body, and notice any sensations or feelings that arise during these moments. Consider keeping a journal to jot down details or thoughts about your day, or to name a few [things that you are grateful for](https://www.autoimmuneinstitute.org/2024/02/21/what-is-gratitude/). ### Navigating the Social Challenges of Illness For many people, life changes significantly after developing an autoimmune disease or other chronic condition. The realities of coping with shifting disease symptoms, energy levels, and overall needs might leave you feeling like a burden to others. Additionally, many people see their social options diminished as a result of their changing health and energy levels, which can be difficult to adapt to. ##### **Other social challenges of autoimmune disease can include:** - Social isolation due to decreased mobility, low levels of energy, or frequent hospitalizations. - Avoiding others as a means to avoid being judged or having to explain your illness. - Anxiety around talking about your illness and explaining your accessibility needs or dietary restrictions. - Distancing yourself from others because you are tired of hearing hurtful comments or receiving unsolicited advice about your illness. ##### **What you can do:** - **Try your best not to isolate yourself.** Come up with a list of activities that feel safe and feasible for you. Ask your friends, family, and members of your household to help you come up with ideas. On your toughest illness days, remember that you don’t have to be physically present in order to enjoy human connection. Try using a video calling app to stay connected with loved ones. Even something as simple as watching a movie with a friend via Facetime or Skype can be enormously comforting. - **If you are struggling with feeling like a burden, try to talk openly with your friends and loved ones about it.** Having an honest conversation about your illness can be a huge relief. It can also encourage stronger communication and build deeper trust between you and your loved ones. - **When it comes to social situations, think ahead about how much information you feel comfortable sharing about your illness, dietary restrictions, accessibility needs, etc.** You might even try writing a short script explaining your illness. This can help you feel confident and direct when talking about your disease. ### Self-Advocacy in the Doctor’s Office When it comes to mental health, our society has a major problem with mishandling this serious and complex topic. Even though many advocates are working towards better mental health outcomes, stigma is still deeply internalized—even within the medical community. As such, **it is not uncommon for mental health issues to be overlooked or dismissed in the course of diagnosing or treating an autoimmune disease.** In some cases, signs of depression co-occurring with a chronic illness are missed by the treating physician. This relates to the fact that depression and conditions like autoimmune disease can share overlapping symptoms, such as fatigue, reduced concentration, and many others. Depression that is caused by a chronic illness is likely to exacerbate the symptoms of the disease, which can initiate a cycle of declining health and escalating flare-ups. There is also the issue that invisible symptoms, such as fatigue, [chronic pain](https://www.autoimmuneinstitute.org/articles/facts-about-chronic-pain "What Chronic Pain Really Means"), and [brain fog](https://www.autoimmuneinstitute.org/articles/understanding-brain-fog-in-autoimmune-disease "Understanding Brain Fog in Autoimmune Disease") are often undermined or completely [dismissed by healthcare professionals](https://www.autoimmuneinstitute.org/articles/when-youve-lost-trust-in-doctors "When You’ve Lost Trust in Doctors…"). **When a patient is constantly being told that they are exaggerating or fabricating their symptoms, they may become increasingly more reluctant to seek support and treatment.** This type of harm is often referred to as medical gaslighting. Medical gaslighting can cause a person to question their own reality, or to begin normalizing serious physical and mental health concerns. Some folks might begin to downplay their own physical and mental experiences as a reaction to medical gaslighting. It’s difficult to know exactly what percentage of chronic illness fighters experience medical gaslighting, but the damage is evident. A 1997 study found that 66% of myalgic encephalomyelitis patients felt that seeking a doctor’s care actually worsened their condition ([5](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6567989/#R43)). Such experiences are a result of many different factors, including long-held biases and misconceptions around gender, pain, illness, drug dependency, and more. Medical gaslighting leads to significant treatment disparities. While these outcomes exist across all demographics, they are especially harmful to women and people of color ([6](https://www.northwell.edu/katz-institute-for-womens-health/articles/gaslighting-in-womens-health), [7](https://www.aamc.org/news-insights/how-we-fail-black-patients-pain)). ##### **What you can do:** - **Trust your gut feelings during interactions with a doctor.** Is this doctor listening and responding meaningfully to your concerns? Do they interrupt or talk over you? Do they reduce your experiences to anxiety or hypochondria? Do they appear knowledgeable about invisible disease symptoms like brain fog, chronic pain, fatigue, etc? Don’t be afraid to speak up if you are feeling dismissed or invalidated by your doctor. You are an expert when it comes to what you are experiencing in your own body and mind, so your voice should always be valued by your doctors. - **Stand firm and remember that you are in control.** As a patient, you have the power to do [several things](https://www.autoimmuneinstitute.org/2024/02/21/when-youve-lost-trust-in-doctors/) that can influence your healthcare experiences and outcomes. You have the ability to request a second opinion, ask to be referred to a specialist, or look elsewhere for a new doctor who is better at addressing your health needs. You can also educate yourself about available therapies, diagnostic testing, and various approaches to health. Stay curious and don’t be afraid to ask questions. You deserve to be listened to. These efforts may be stressful and tiring, but self-advocacy can have significant benefits when you’re not getting the care you need. - **Collaborative, multidisciplinary care.** Multidisciplinary care involves working with a variety of specialists to implement care for different aspects or symptoms of your illness. Academic centers, such as university hospitals, are set up to diagnose and treat more complex conditions, as medical professionals consult with each other and use their combined knowledge. Multidisciplinary care can include specialist doctors, nutritionists, psychologists, and many more. If you are not already working with multiple providers, talk to your primary care physician about what types of specialists might compliment your treatment. - **Remember that the process of diagnosing and treating an autoimmune disease takes time.** Every person’s experience with autoimmune disease is unique. As such, it is likely that your diagnosis and treatment journey will feel more like a marathon rather than a sprint. Try your best to let go of expectations about how long it “should” take to receive a diagnosis. Likewise, you might have to cycle through time and trials before finding a treatment protocol that works best for you. Do your best not to be discouraged by this process. If you feel like you have [hit a wall with your health journey](https://www.autoimmuneinstitute.org/2024/02/21/chronic-illness-when-you-feel-like-giving-up/), communicate your feelings to your healthcare providers. **It’s important to remember that chronic illness treatment and managing mental health can involve many different pathways.** If something isn’t working for you, it’s not an indication of failure. There is no playbook on how to cope with chronic illness, but there is a lot of value in small breakthroughs. Leaning into your support systems, communicating with your healthcare providers, and treating yourself with kindness are all signs of your incredible ability to keep moving forward. One of our sources for this post was Sarah Ballou, PhD for The National Celiac Association. This fantastic discussion was recorded in a recent webinar, “[All Things Celiac](https://nationalceliac.org/wp-content/uploads/1609/82/12-17-All-Things-Celiac-Video.mp4)”. Visit [The National Celiac Association](https://nationalceliac.org/wp-content/uploads/1609/82/12-17-All-Things-Celiac-Video.mp4) on the web to view the entire video! ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** Living Well with Autoimmune Disease --- ### [Autoimmune vs Autoinflammatory Disease](https://www.autoimmuneinstitute.org/articles/autoimmune-vs-autoinflammatory-disease) **Published:** January 11, 2022 **Author:** Carolyn Serraino **Excerpt:** Autoimmune disease and autoinflammatory disease are two categories of illnesses that occur when the immune system mistakenly damages healthy cells. Although these inflammatory disorders share many commonalities, there are key features that make them unique. **Content:** # A Comparative Look Countless scientific studies have been conducted in the name of immunology, the study of human immunity. Scientists look to the immune system for a better understanding of asthma, allergies, cancer, metabolic diseases, and many other health conditions. Likewise, researchers are seeking to understand how and why the immune system malfunctions in some individuals. Abnormal activation of the immune system can point to many different diseases that cause chronic inflammation, tissue destruction, and more. **Autoimmune disease (AD)** and **autoinflammatory disease** **(AIF)** are two categories of illnesses that occur when the immune system mistakenly damages healthy cells. Although these inflammatory disorders share many commonalities, there are key features that make them unique. #### The immune system is where it all begins In order to describe the differences between autoimmune disease and autoinflammatory disease, it’s necessary to understand a few key facts about immunological function. The human immune system is a complex network of components that work to neutralize infections and protect the body from disease. Within the immune system are two lines of defense: innate immunity and adaptive immunity ([1](https://aacijournal.biomedcentral.com/articles/10.1186/1710-1492-7-S1-S1#citeas)). The **innate immune system** includes defensive barriers such as the skin and mucous membranes, as well as an army of chemicals and cells that target disease-causing pathogens ([2](https://www.ncbi.nlm.nih.gov/books/NBK279396/),[3](https://opentextbc.ca/biology/)). When provoked, the innate immune system releases an onslaught of these defensive properties. Some innate cells also secrete **cytokines**, which are proteins that deliver signals between immune cells. Additionally, cytokines play an important role in regulating fever and inflammation during an immune response ([4](https://www.frontiersin.org/articles/10.3389/fimmu.2014.00491/full))**.** Innate immunity can mobilize quickly, usually within minutes to hours of encountering a threat. Activity from an innate immune response summons the body’s second line of protection, known as the **adaptive immune system** ([5](https://www.ncbi.nlm.nih.gov/books/NBK459471/)). > When provoked, the innate immune system releases an onslaught of these defensive properties. Both innate and adaptive immunity can be activated by **antigens**, which are molecular structures that exist on the surface of human and pathogen cells ([6](https://jamanetwork.com/journals/jama/fullarticle/2279715)). However, innate immunity can only identify the presence of foreign antigens. Adaptive immunity recognizes specific foreign antigens and also builds specialized defenses against them. T cells and B cells are key players in the adaptive immune response ([7](https://www.cdc.gov/flu/about/professionals/antigenic.htm)). Together, these cells “memorize” the antigens of infectious agents, allowing the immune system to build a swift and targeted defense against repeat infections ([8](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2923430/)). Adaptive immune cells are hard-wired to ignore host cell antigens. Known as **self-tolerance**, this mechanism prevents the immune system from attacking healthy human tissues ([9](https://www.niaid.nih.gov/research/immune-tolerance)). ### What is Autoinflammatory Disease (AIF)? Most distinctly, autoinflammatory diseases only involve the innate immune system. AIFs occur when innate immune cells are activated without an infection or injury being present. This mishap kickstarts the release of cytokines and other immune responses, causing fever and inflammation. Recurring episodes of high fever are the primary symptom of AIF ([10](https://www.wehi.edu.au/research-diseases/immune-health-and-infection/autoinflammatory-diseases)). Similar to some autoimmune diseases, autoinflammatory symptoms can be widespread, affecting the joints, gastrointestinal tract, skin, eyes, and internal organs. Autoinflammatory diseases are caused by mutations in the genes that control and regulate innate immune cells ([11](https://www.immunology.org/public-information/bitesized-immunology/immune-dysfunction/autoinflammation)). Some AIFs, including Familial Mediterranean Fever (FMF) and TNF receptor–associated periodic syndrome (TRAPS), are known as monogenic because they are caused by a singular known genetic defect ([12](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4489412/),[13](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2996236/)). Because these diseases originate in the genes, they can run in families ([10](https://www.wehi.edu.au/research-diseases/immune-health-and-infection/autoinflammatory-diseases)). Autoinflammatory syndromes are very rare. Presently, there is no known gender prevalence ([14](https://ijponline.biomedcentral.com/articles/10.1186/1824-7288-36-57)). Unlike autoimmune disease, the majority of AIFs develop during childhood. Due to the rarity of these diseases and their close appearance to other illnesses, diagnosis is often delayed ([15](https://link.springer.com/article/10.1007%2Fs00247-019-04536-9)). Several AIFs are known for their higher frequencies within certain ethnicities. As such, age of onset and familial history, in addition to clinical observations, can be helpful in diagnosing these rare conditions. In some cases, testing for gene mutations is used to confirm a diagnosis of AIF ([12](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4489412/),[16](https://www.sciencedirect.com/science/article/pii/B9780702068966000600),). ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/04/Inflammatory-Spectrum-GAI-1024x531.png)**([17](https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.0030297), [18](https://rmdopen.bmj.com/content/1/1/e000097))** ### What is Autoimmune Disease (AD)? While problems with innate immunity cause autoinflammatory diseases, autoimmune disease originates in the adaptive immune system. AD occurs when adaptive immune cells lose their ability to maintain self-tolerance of human cells. As a result, the immune system begins attacking healthy tissues as though they were infectious agents. Some ADs are organ-specific, whereas others can affect multiple parts of the body. Like autoinflammatory syndromes, recurrent fever, and chronic inflammation can be attributed to autoimmune disease. However, many possible symptoms are unique to AD, including hair loss, dry mouth, temperature sensitivity, muscle weakness, reproductive issues, and more. > Researchers believe that a variety of conditions including environment, hormones, injury, infection, and genes could all play a role in initiating autoimmunity. AD is thought to be triggered by a combination of [multiple factors](https://www.autoimmuneinstitute.org/risk-factors/ "Risk Factors") not limited to genetics. Although the exact causes remain unknown, researchers believe that a variety of conditions, including environment, hormones, injury, infection, and genes, could all play a role in initiating autoimmunity. Numerous investigations demonstrate multifactorial causes of AD, including a Johns Hopkins [study](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4489412/) on patients who developed Scleroderma at the same time that their immune system was fighting cancer cells ([19](https://www.hopkinsrheumatology.org/2017/01/systematic-autoantigen-analysis-identifies-a-distinct-subtype-of-scleroderma-with-coincident-cancer/)). Another example is psoriasis, an autoimmune skin condition that often appears within a short time after a strep throat infection ([20](https://www.hopkinsmedicine.org/health/wellness-and-prevention/autoimmune-disease-why-is-my-immune-system-attacking-itself)). In contrast with autoinflammatory disease, autoimmune conditions are quite common. Current data estimates that ADs affect at least 14 million people in the U.S. alone. There are [80-100](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/ "A-Z Disease List") known autoimmune and autoimmune-related conditions, including [Hashimoto’s thyroiditis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/hashimotos-thyroiditis/ "Hashimoto’s Thyroiditis/autoimmune thyroiditis"), [Type 1 diabetes](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/diabetes-type-1/ "Diabetes, Type 1 (T1D)"), [Sjögren’s](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sjogrens-syndrome/ "Sjögren’s Syndrome"), and [celiac disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/celiac-disease/ "Celiac disease"). Gender prevalence in AD is well documented. In fact, around 80% of those diagnosed are women. While ADs can affect anyone at any age, the majority tend to appear during adulthood ([21](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7292717/)). One challenging aspect of diagnosing AD is that symptoms can vary widely—even among individuals with the same disease. Neither AD nor AIF has a standard presentation. This is just one reason why diagnosing these conditions can be a lengthy and complicated process. It also underscores the need for further scientific investigations and efforts to promote awareness. ### In Conclusion Although it is helpful to differentiate inflammatory disorders based on their involvement with innate or adaptive immunity, some conditions have combined features of autoimmune and autoinflammatory disease. As such, many researchers note that AIF and AD, rather than being two distinct groups, could actually be part of a spectrum of inflammatory disorders ([22](https://ejim.springeropen.com/articles/10.1186/s43162-021-00040-5), [23](https://spondylitis.org/spondylitis-plus/spondyloarthritis-autoimmune-or-autoinflammatory/)). Diseases that involve both types of immunity include [ankylosing spondylitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ankylosing-spondylitis/ "Ankylosing Spondylitis"), [psoriatic arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/psoriatic-arthritis/ "Psoriatic Arthritis"), [Behcet’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/behcets/ "Behçet’s disease"), [Crohn’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crohns-disease/ "Crohn’s disease"), and more ([24](https://www.nature.com/articles/s41584-021-00625-y)). Autoinflammatory and [autoimmune conditions belong to a complex group of diseases](https://www.autoimmuneinstitute.org/articles/untangling-a-complex-web-how-to-categorize-autoimmune-disease) characterized by immune system dysregulation. While scientists continue to search for answers involving the mechanisms of these diseases, it is clear that immune-related illnesses are becoming more prevalent in Western nations. Adding to the enormous importance of studying these conditions, chronic inflammation is linked to numerous other health concerns, including heart disease, cancer, stroke, and more ([25](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5669448/)). In order to improve strategies for diagnosis, treatment, and patient support, it is key that researchers continue their commitment to improving knowledge about inflammatory disorders. ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** About Autoimmune Disease --- ### [When You’ve Lost Trust in Doctors…](https://www.autoimmuneinstitute.org/articles/when-youve-lost-trust-in-doctors) **Published:** May 30, 2020 **Author:** Carolyn Serraino **Content:** #### Have you been told “*it’s just stress*”? Or diagnosed as a hypochondriac? Has it taken *years* to find a diagnosis? Maybe you’re still searching for one. The exhaustion is real! It’s a long road to figure out what’s wrong and how to address it, without getting derailed by judgment and misdiagnoses. The experience of managing chronic conditions can be as agonizing as the symptoms themselves. #### So who do we trust—the medical system we feel has let us down, or ourselves? ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/When-Youve-Lost-Trust-in-Doctors-Spectrum-of-Reliance-Image-no-title-1.png) At the beginning, when we’re new to the world of chronic health issues, we tend to cling to the medical system, confident that the doctors and specialists will have all the answers. It may take years before we realize that they’re only part of the equation. When the lightbulb goes off, we might slingshot towards the other end of the spectrum and overlook the value in maintaining and building relationships with medical professionals. ## Why We Rely On Doctors Through rigorous schooling, residency, and work experience, they gain—in short—an understanding of how the human body works and what happens when systems don’t function properly. Naturally, we look to our doctors for answers. We watch them fix broken bones and heal wounds, perform life-saving surgeries, and administer medications to improve quality of life. From a young age, we view them as the one source of knowledge when it comes to the body. **However, we tend to see their status and medical school education as a stand-in for our own personal wisdom.** This also means we may overlook the value in other fields of medicine. ## Why We Rely On Ourselves The doctors we’re supposed to trust have let us down one too many times. We’ve grown bitter, disillusioned. We therefore lack the motivation to return and be subjected to more misdiagnoses, judgment, and rejection. Instead, we attempt to carve our own paths. Through online research and talking with peers, we can discover fields of medicine and therapies not typically accepted or promoted within our modern (or Western) medical system. We may be introduced to functional, integrative and naturopathic medicine, which are particularly well-known within the chronic illness community. We may learn that pharmaceuticals aren’t always the answer. We may uncover the power of nutrition, meditation, essential oils, and supplements, and incorporate some of these into our lives. These bits of knowledge that seem to have been “hidden” from us can further calcify our decision to go rogue. **However, we soon learn that functional medicine and other whole body approaches are not usually covered by insurance.** The cost is too high for many, and we can easily fall into a space of self-reliance that is less than healthy. ## The Middle Ground **One person alone cannot build the path to better health.** It takes a collaborative effort. Knowing this doesn’t make it any easier though. A rolling sea of worries can easily shake your resolve when you so much as *think* about making an appointment. *Will they shame me for not going to the doctor for years? Will they order invasive tests? Will they actually listen to me?* **Walking into a doctor’s office again can feel like ripping open old scars into fresh, streaming wounds.** You might want to slip your armor back on, and march in there with a fiery list of rebuttals to the comments you expect to hear. It’s not a cakewalk. And you might have to deal with “it’s just stress” “here’s a prescription” “your labs are normal” all over again. But by expecting the same results every time you walk into an office, you’re only perpetuating that pattern. Remind yourself that this is a new journey, with new doctors and new possibilities, and that *you* are also different. **Let the past medical-related traumas give you only their wisdom, not their lurking presence.** #### With perseverance and an open mind, you *can* find a happy medium. On your search, look for professionals whose communication styles work for your needs, who listen and acknowledge the value you bring to the table, who are open to exploring “alternative” or “complementary” approaches, and who are able to collaborate with your other practitioners. **Are you currently on the Autoimmune Protocol (AIP)?** Or another [elimination/healing diet](https://www.autoimmuneinstitute.org/articles/elimination-diets-what-you-need-to-know "Elimination Diets: What You Need to Know")? [Autoimmune Wellness](https://autoimmunewellness.com/) has an incredibly encouraging, detailed guide to [combining AIP with conventional healthcare](https://autoimmunewellness.com/combining-aip-with-conventional-healthcare-the-definitive-guide/). ## What To Keep In Mind - **The medical landscape is constantly changing.** New research is exploring disease in relation to topics like the microbiome, diet and lifestyle, and meditation, thus expanding our understanding of the human body and what causes these conditions. It is possible that the doctor you saw last year may now be taking a whole new approach to chronic illness. - **Educating yourself is vital.** By doing your own research, you’ll be able to explore different treatments and side effects, ask questions about the mechanisms behind your condition, and request certain tests. As a result, you’ll better understand your doctor’s approach and be more equipped to work as a team. - **Be open to shopping around.** It may take time to find the right doctors; try to avoid betting all your chips in one place. - **Shift your expectations.** If you expect to leave the first appointment with answers, you may leave feeling disappointed instead. Nothing this complex is going to be seamless. - **They may not understand your needs right off-the-bat.** Describe what kind of relationship you’d like to have with your doctor, the approach you’ve been taking towards your health, how you like things explained, etc. - **It’s a two-way street.** Advocate for yourself, while remaining open to what they have to say. - **Speak up** when something doesn’t feel right. - **Pay attention to how you feel around a new doctor.** Supported, relaxed, and motivated? On-edge, rushed, and unheard? If your styles don’t match, it may be time to move on. - ***You* have the control here.** If you’re unhappy, you always have the option of looking elsewhere. It’s another copay and it can be disappointing and frustrating, but it’s well worth it. Remember that there are wonderful doctors out there—it’s just about finding the right person or team for you - **You are a participant in the process of change.** Each time you interact with a practitioner, you become one more patient with autoimmune disease or an undiagnosed pattern of symptoms. One more patient who has had a hard time finding proper care. One more patient who has found hope in holistic approaches. While you search for answers, keep advocating for yourself. The more you educate yourself and speak up, the more the medical landscape is compelled to adjust. ### How To Be Prepared Before you even step foot inside a doctor’s office, there are a few things you can do to start the process and ease yourself into this new undertaking. 1. **Collect all relevant paper records** of lab tests, images, prescriptions, and doctor’s notes from previous visits 2. **Make a list of all medications** you’ve taken, and any reactions you’ve had 3. **Write a brief synopsis of your chronic illness journey**, including when and how it began, major symptoms, significant treatments, and any diagnoses you’ve received. 4. **Get recommendations first!** If you’re in touch with your local autoimmune disease or chronic illness community, ask around to see what doctors they work with and like. This can save you time and stress, especially when you’re just starting out. 5. **Come with questions**. Go through any notes from research you’ve done overtime. Are there certain tests you want to request? Therapies you’d like to know more about? Unanswered questions or concerns collecting dust in the back of your mind? 6. **Know how much your insurance covers.** Which specialists and kinds of care does it cover? What about lab work? Diagnostic imaging scans (ultrasound, MRI, X-ray, etc.)? Medications? 7. **Understand your limits.** If you’re also working with a functional doctor and are trying to get functional labs done through your PCP, they might not be able (or willing) to order them. If they are, make sure you know exactly what tests to request, find out how much insurance will cover, and remember to request paper copies. It’s only natural to be exhausted from the diagnosis/treatment hunt. By all means, take a break if you can. Letting everything sink in could very well give you a fresh perspective and a renewal of energy and determination. But try to avoid letting that break turn into years and years of figuring it out on your own, without the guidance of professionals. **Think of the relationship with your doctors as a detective team working together to investigate your health issues.** Each person has wildly different skills, but both are vital in order to solve the case and work towards a better outcome. ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** Autoimmune Care & Caregiver Support --- ### [Chronic Illness: When You Feel Like Giving Up](https://www.autoimmuneinstitute.org/articles/chronic-illness-when-you-feel-like-giving-up) **Published:** February 22, 2025 **Author:** Carolyn Serraino **Excerpt:** When your chronic illness has put you through the wringer in terms of doctor and hospital visits, lab tests, imaging, medications, and other treatments, it’s only natural to feel defeated. **Content:** ### Coping With Chronic Illness When your chronic illness has put you through the wringer in terms of doctor and hospital visits, lab tests, imaging, medications, and other treatments, it’s only natural to feel defeated. All of us have been there at some point—when you almost want to throw your hands in the air and let the quicksand pull you under. I’ve been there, and spent years attempting to manage the symptoms on my own while getting sicker and sicker. I was grieving for the health I used to have, unsure of what to do. > WHEN YOU START CHALLENGING WHAT YOU KNOW, NEW WORLDS WILL OPEN UP. It’s an odd mental space to be in—hoping you’ll suddenly get better while either pretending nothing is wrong or deciding your life is over and you’ll die young. Just remember that: **You don’t know everything.** No matter what challenges you’ve experienced in your illness, there is always something out there—a community, a practitioner, a therapy—that has not been tapped into yet. How you perceive your situation is a direct result of what you know. When you start challenging what you know and asking why and how at every intersection, new worlds will open up. **You are not alone.** Whether you’re running the diagnosis marathon or trying to juggle a complex set of symptoms, there is a community of others out there whose situations parallel yours. We all feel alone, but we can experience this loneliness in isolation or unity; it’s a matter of accessing those connections. **You can *accept* your current situation without *giving up*.** Accepting is allowing yourself to be where you are, even if that place is dark: *This is how I feel, and I’m dealing with it the best I can*. When you’re not craving the life you used to have or resigning yourself to a future of pain and discomfort, you’ll be better able to take small steps forward. ### **5 Things To Do When you Feel Like Giving Up** #### **1. Find joy.** It can seem impossible to remember what it’s like to *feel* *good*. And besides the pain and other debilitating issues, you’re under constant pressure by the world around you (and yourself) to get better. The stress of being sick in and of itself is enough to keep you down. But you *can* move your mind into a more positive space. Weaving these practices into your daily life can regenerate a sense of hope and peace. - **Resurface a happy memory.** Maybe it’s playing outside as a child, falling in love for the first time, or traveling abroad. Get comfortable, close your eyes, and replay every detail of the scene in your mind. There’s no time limit, nothing to do. Just breathe and bring yourself back to those moments, recalling how light or energized you felt. You could also describe it in a journal or recount the story to someone. - **Do something creative and tactile.** Paint or freehand draw, do a puzzle, play an instrument, make a bracelet – anything that keeps you engaged, calm, and present. - **Keep a gratitude jar.** Write down one good thing that happened or one thing you’re grateful for each day. - **Find a meditation practice that works for you.** Cultivating a calm mind and peace from within can help you navigate situations that feel hopeless. [**Insight Timer**](https://insighttimer.com/) is a great app full of diverse, guided meditations for both beginner and experienced meditators. - **Engage in acts of kindness.** Step out of your own shoes for just a moment. This could mean sending your friend a thoughtful card, helping someone with a new project, answering questions on a health forum, or calling an older relative to reminisce. It can be empowering and a learning opportunity. Showing up for someone else does not mean taking on their emotions or their problems—it is holding space for them, in order to ease suffering or cultivate a little joy. Gifting kindness to another is, in effect, showing kindness to yourself. #### **2. Keep a symptom journal.** This powerful tool can help you recognize patterns in your health. When you have a flare, or any kind of reaction or fluctuation in your health, write it down and answer these questions: **How** do you feel? **When** did it start? **Where** were you? **What** were you doing? Maybe you just had dinner at a restaurant. Or you were in a building where harsh chemicals were being used. Or you recently got in a bad fight with your mom. You know yourself the best, and will be able to gauge what to include. As in other areas of life, there is a delicate balance to keep in mind. Logging every symptom in real time could turn from helpful to hyper-vigilant. Record the food reactions, the nausea, the joint pain, the moments of brain fog, but without judging them as good or bad, and without fixating on them. You’re simply observing how you feel and what’s happening in your body in order to take an active role in your own healing. #### **3. Partner up.** Go to social media sites and search for autoimmune disease groups. Instead of only interacting with the entire group’s page, try reaching out to someone privately and connecting one-on-one. Look for patients with similar conditions who may live in different areas of the country or the world, and who can offer a fresh perspective. Set up weekly check-ins to share experiences and suggestions. Where to start: - **Facebook** – online and local support groups - **Meetup** – join a group to attend events and connect with others in person - [**Healing Well**](https://www.healingwell.com/) – forum to share, ask questions, and get support - **Instagram** – follow the hashtags #autoimmunedisease #autoimmune #autoimmunehealing #autoimmuneawareness #chronicillness #chronicillnessawareness #### **4. Share your story.** You will get answers in the most unexpected places. Connect with people you meet in person, post in social media, or ask questions in forums. An acquaintance from work or the person next to you at a coffee shop could have a similar experience, and be able to offer some new ideas. Countless people are walking around *looking* healthy when they’re actually chronically ill, or when they’ve dealt with challenging medical situations in the past. If you don’t engage with them, you’ll never know. Sharing even a piece of your story can be tough, and sometimes you won’t feel comfortable doing it. Allow yourself some grace, but don’t forget to give yourself a sense of agency and recognize the power of your voice. Share your story with the Global Autoimmune Institute. We have prompts to help get you started that are also great for journaling on your own. We’re collecting personal stories to put up on our website and social media, bolstering the conversation on autoimmune disease and chronic illness. #### **5. Alter the inner dialogue.** The way you talk to *yourself* has a profound effect on the way you interpret and react to tough situations. Positive self-talk can help you cultivate and sustain a sense of control over your emotions and beliefs about yourself. Recognize when you use phrases like “I can’t” or “I have to”. Also notice when you call yourself names or respond to a situation with, “Why did I do that?” Instead, try, “That happened. It’s in the past. Next time I’ll try something different.” Practice showing love to yourself by reversing the negative to the positive, and by changing the words you use in response to challenging situations. P.S. It’s ok to feel angry, frustrated, and disappointed – we have all been there! The point is not to suppress negative emotions, but to promote more positive beliefs about yourself by simply observing and then reframing. For instance, we have a tendency to say things like “I am angry” instead of “I feel angry”. The first one promotes a sense of permanency, as if anger is a part of who we are. The second one is more accurate, because what we feel is ever-changing, and the anger present in that moment will soon dissolve as if it had never existed. ### Healing Through Community If you welcome any of these practices into your life, remember to be kind to yourself and also reach out to others. An accountability partner could be the push you need to start a symptom journal, or the friendly reminder to practice positive self-talk. It is natural to be so consumed with managing your illness that you forget there are others out there willing to offer guidance, a new perspective, or even just a listening ear. The micro-communities we build in our own corners of the world are slowly trickling into a thriving movement of autoimmune disease patients, researchers, and doctors. When we share with others, we are joining in a subtle but collaborative effort to heal the world of chronic conditions and to prevent disease in the future. ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** Living Well with Autoimmune Disease --- ### [Debunking Herd Immunity: A Review of We Want Them Infected](https://www.autoimmuneinstitute.org/articles/debunking-herd-immunity-a-review-of-we-want-them-infected) **Published:** December 16, 2024 **Author:** Carolyn Serraino **Excerpt:** A critical look at the Great Barrington Declaration, exposing the risks of herd immunity strategies and the spread of harmful COVID-19 misinformation. **Content:** The unprecedented advocacy for herd immunity as part of the COVID-19 policy has been both controversial and dangerous. This review delves into the flawed assumptions and real-world consequences of the Great Barrington Declaration, which advocated for achieving herd immunity through natural infection. By exploring the misinformation surrounding this approach, we uncover its risks to public health and the far-reaching impact of such misguided strategies. ## About the Author: Jonathan Howard, MD Dr. Howard is an Associate Professor of Neurology and Psychiatry at NYU Grossman School of Medicine and Director of the Neurology Service at Belleview Hospital in New York City. In addition to the book, *[We Want Them Infected](https://redhawkpublications.com/We-Want-Them-Infected-p547021769)*, he is the author of several clinical textbooks in neurology. He hosts the podcast, “[We Want Them Infected](https://podcasts.apple.com/us/podcast/we-want-them-infected-podcast/id1716215618),” which covers a range of disinformation in the health field. He worked throughout the COVID-19 pandemic at Bellevue Hospital, where he observed firsthand the devastating effects of the pandemic. ## An Overview of *We Want Them Infected* *We Want Them Infected* discusses the flaws and damaging effects of the policy promoted by the authors of the Great Barrington Declaration and others of allowing [SARS-CoV-2](https://www.autoimmuneinstitute.org/gai-library/#covid) to spread through the so-called “healthy” population. This would bring about “herd immunity” and thereby bring the pandemic to a relatively rapid end with minimal social and economic disruption. ## The Great Barrington Declaration: Background [![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/12/Untitled-design-37.png)](https://upload.wikimedia.org/wikipedia/commons/0/02/Great_Barrington_Declaration.pdf) Great Barrington, Massachusetts, is the home of the American Institute for Economic Research (AIER), a libertarian think tank. AIER sponsored a gathering of public health academics at the Institute that met in October 2020. The result of that conference was the issuance of the [Great Barrington Declaration](https://upload.wikimedia.org/wikipedia/commons/0/02/Great_Barrington_Declaration.pdf), a proposed plan for the management of the COVID-19 pandemic, advocating for discarding COVID-19 control measures such as lockdowns, school closings, masks and social distancing (so-called non-pharmaceutical interventions). Instead, it advocated allowing the development of so-called herd immunity through natural infection with SARS-CoV-2. This document was signed by Sunetra Gupta (Oxford), Jay Bhattacharya (Stanford), and Martin Kuldorff (Harvard). The declaration is short and omits any detailed recommendations. > ### **It does not include any scientific analysis or modeling and was not peer-reviewed.** > The three signatories are foremost among the many advocates of this approach, which Dr. Jonathan Howard critiques in his book *We Want Them Infected*. Howard persuasively argues that it is unscientific, impracticable, and dangerous. ## Herd Immunity: Theory vs. SARS-CoV-2 The theory behind herd immunity is that an infection by a novel virus will rapidly spread through a population, all of whom would be susceptible to infection. After a certain percentage of the population recovers and has acquired immunity to the virus, the spread of infection will halt due to the absence of sufficient susceptible individuals to continue the propagation of the infection. Because of the risk of unacceptable morbidity and mortality through this process, the Great Barrington Declaration made three assumptions that, if true, would avoid such outcomes for COVID-19: 1\) Infection by SARS-CoV-2 of non-elderly people without underlying medical conditions has a negligible risk of death or serious disease; 2\) infection by SARS-CoV-2 provides strong and long-lasting immunity from re-infection; 3\) elderly and other vulnerable populations can be effectively isolated from the remainder of the population until herd immunity is achieved through natural infection. Most public health experts and epidemiologists disagreed with the Great Barrington Declaration. **Dr. Howard notes that there is no precedent in history for advocating for the uncontrolled spread of an infectious disease to control an epidemic.** > None of the declaration’s three assumptions proved to be correct. Although the healthy non-elderly did have a much lower risk for serious disease and death than others, it was not negligible, and it led to thousands of deaths in that population. Secondly, infection by SARS-CoV-2 did not produce sufficient immunity to prevent reinfection, especially with the viral variants that later appeared, such as Delta and Omicron. And finally, it proved impossible to effectively segregate the various populations of the vulnerable to prevent the spread of infection to them. ## The Impact of Proselytizing for Herd Immunity Although never fully implemented, the GBD influenced many jurisdictions (such as Florida) to dispense with many non-pharmaceutical interventions and to recommend against boosters or vaccinations in some age groups. In addition, the high level of exposure that the advocates of this policy enjoyed (particularly on Fox News) convinced many people not to vaccinate or employ protective measures. Fortunately, most of the country chose to adhere to recommendations for avoiding exposure and a large percentage of the American populace was vaccinated (the GBD authors wanted their plan implemented even before vaccines were available). **To date, approximately 1.2 million Americans have died from COVID-19, with millions more hospitalized and a large but growing number suffering from complications of COVID-19 infections, including Long COVID.** These numbers would be much higher if the recommendations of the Great Barrington Declaration had been widely implemented. ## Misleading Narratives and Public Figures Dr. Howard is frustrated, as is the reader, by the casual disregard for the suffering caused by COVID-19 on the part of COVID-19 minimizers. Only one of the three declaration authors is a physician, and it is unclear whether he ever cared for patients after completing medical school. The same is true for many of the other physicians purveying COVID-19 vaccine misinformation. For example, Dr. Marty Makary, a well-respected professor of surgery at Johns Hopkins, has minimized the seriousness of COVID-19 infections, especially in children. As Dr. Howard observes: > “Dr. Marty Makary has a history of understating pediatric COVID hospitalizations when communicating with the public. In an article for the Wall Street Journal titled “Should You Vaccinate Your 5-Year-Old?” he reported that only 562 children ages 5-11 had been hospitalized with COVID-19. This number came from [COVID-NET](https://www.cdc.gov/covid/php/covid-net/index.html), a CDC surveillance system that covers approximately 10% of the U.S. population. In fact, the CDC reported that over 8,300 children ages 5-11 had been hospitalized with COVID-19, and this was just before the Omicron wave caused pediatric hospitalizations to spike to their highest levels.” Another academic physician with commendable credentials, Dr. Vinay Prasad, minimizes childhood COVID risk as well. For example, he noted that fewer children die of COVID-19 than from drowning, bicycle accidents, or cardiovascular disease, which he says we accept as a matter of course. Dr. Howard: “The CDC’s [COVID data tracker](https://covid.cdc.gov/covid-data-tracker/#datatracker-home) added 1,000 deaths to its grim tally in the year before that article was published, which is about the same as the number of children who drown annually and larger than the number of children who die from cardiovascular disease.” He goes on to point out that we do not regard the death of children from drowning or accidents as “a matter of course,” and nobody has suggested ending the American Academy of Pediatrics initiative to reduce the number of childhood drowning deaths because of their small numbers. Dr. Howard singles out for particularly harsh criticism statements by many of these individuals that are completely divorced from the reality of clinical care or public health. For example, the signers of the GBD gave no serious thought to the logistical complexities of “protecting the vulnerable.” Suggestions for protecting this diverse group of nursing home residents, the elderly living at home, individuals with pre-existing conditions, and vulnerable people living in multigenerational homes included such thoughtless suggestions as minimizing nursing home staff turnover, putting the elderly up in hotel rooms and feeding the vulnerable sheltering at home through door dash deliveries. Worse were their criticisms of the heroic people providing clinical care to patients, which were not only ignorant but insulting, such as suggesting that death certificates were filled out incorrectly, that critical care doctors were causing death by intubating people inappropriately, and suggesting that doctors were over-diagnosing COVID to benefit financially. ## COVID-19 Misinformation and Vaccine Disinformation Because there is an increasingly close association between the COVID-19 contrarians and the anti-vaccination movement, Dr. Howard devotes portions of his book covering vaccine disinformation in general. These groups share many of the same disinformation tactics, such as misrepresenting study results, trashing the methodology of studies supporting vaccine safety while lauding small, poorly done studies that support their own viewpoint, and outright lying. For more detailed information on the anti-vaccine movement, read Dr. Paul Offit’s “[Deadly Choices. How the Anti-Vaccine Movement Threatens All of US](https://www.hachettebookgroup.com/titles/paul-a-offit-md/deadly-choices/9780465023561/?lens=basic-books)” and Dr. Peter Hotez’s “[The Deadly Rise of Anti-Science](https://www.press.jhu.edu/books/title/33293/deadly-rise-anti-science?srsltid=AfmBOoorWzcg7Xjv2FLR6pAJe3VlXD6iyMM3g5U0Mu-Z4uKmOMOHuXPY).” ## Final Thoughts I read this book and wrote the review in the aftermath of the 2024 presidential elections. It is disconcerting and even frightening to watch many of the individuals exposed in Dr. Howard’s book being nominated for important health posts in the incoming administration. I hope dedicated opponents of untruth like Dr. Howard are up for the challenge. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/04/GAI-Logo-Image-811x1024.png) ### About the Author ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/12/IMG_0197-scaled-e1734378743432.jpeg) Uniquely valuable to GAI because of his in-depth knowledge of basic science, Bruce has experience in grant writing and reviewing, an early career in academic medicine in cancer research, and practice of pathology, as Chairman of Pathology and Laboratory Medical Director of the Inova Fair Oaks Hospital in Fairfax, Va. for over 21 years of his 23 years in the Inova Health system. Bruce Werness, MD Chief Scientific Advisor for GAI ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** Living Well with Autoimmune Disease --- ### [Comparing the World's Leading COVID-19 Vaccines](https://www.autoimmuneinstitute.org/articles/comparing-the-worlds-leading-covid-19-vaccines) **Published:** August 26, 2022 **Author:** Carolyn Serraino **Content:** ## Charting the research and development of authorized COVID-19 vaccines The following information is accurate to the best of our knowledge through August 2022. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/SpacerShield.jpg) Over 100 vaccines have been created to combat SARS-CoV-2. This chart details the development process of leading vaccines that have been authorized for emergency use or received approval from government health agencies, and are being widely distributed. As of the chart’s publication date, the use of the following vaccines has been authorized by the World Health Organization (WHO), excluding the Sputnik vaccine. ![Loader](https://www.autoimmuneinstitute.org/wp-content/plugins/embed-any-document/images/loading.svg) Loading… ![EAD Logo](https://www.autoimmuneinstitute.org/wp-content/plugins/embed-any-document/images/EAD-logo.svg) Taking too long? ![Reload](https://www.autoimmuneinstitute.org/wp-content/plugins/embed-any-document/images/reload.svg) Reload document \| [ ![Open](https://www.autoimmuneinstitute.org/wp-content/plugins/embed-any-document/images/open.svg) Open in new tab ](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Vaccine-Chart-for-August-26-2022-Sheet1.pdf) *The information on this page is for educational purposes only and should not be taken as medical advice. Please reference resources by the CDC, WHO, and public health authorities to stay informed, and seek professional medical advice for best practices pertaining to your medical plan.* ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** COVID-19 and Long Covid --- ### [COVID-19 and Autoimmune Disease](https://www.autoimmuneinstitute.org/articles/covid-19-autoimmune-disease) **Published:** October 24, 2020 **Author:** Carolyn Serraino **Content:** ### What is COVID-19 (AKA Coronavirus)? The World Health Organization (WHO) describes COVID-19 as an infectious disease caused by the most recently discovered coronavirus, a family of viruses known to cause respiratory infections in humans. This new virus and disease were unknown until the recent outbreak in Wuhan, China in December 2019 ([1](https://www.who.int/emergencies/diseases/novel-coronavirus-2019/question-and-answers-hub)). As of late October 2020, over [42 million cases](https://coronavirus.jhu.edu/map.html) have been reported throughout the world. This steadily growing number does not take into full account the potentially high number of asymptomatic individuals and carriers. ### What Are The Symptoms? The most common symptoms are fever, dry cough, flu-like aches, sore throat, fatigue, chest pain, shortness of breath, loss sense of taste and smell, and can range from mild to severe. **Most known cases have been mild to moderate and not life-threatening.** Infected persons fall into one or more of the following categories based on severity of symptoms: asymptomatic, mild, moderate, severe, and critical. Further details on asymptomatic and mild cases can be found [here](https://patient.info/news-and-features/coronavirus-what-are-asymptomatic-and-mild-covid-19). Learn more about what coronavirus symptoms can look like on a day by day basis in the video below: **If you have an autoimmune disease, some of your** [**autoimmune symptoms may mimic those of COVID-19**](https://creakyjoints.org/living-with-arthritis/coronavirus/managing-symptoms/coronavirus-symptoms-different-with-autoimmune-conditions-chronic-illness/)**.** You may be wondering how to tell them apart. The data is still limited, and there’s no hard and fast rule about which symptoms—like shortness of breath, fever, and fatigue—would signal the virus and which would belong to an autoimmune flare-up. However, below are a few promising thoughts from rheumatologists—thanks to the [Global Healthy Living Foundation](https://www.ghlf.org/) and [Creaky Joints](https://creakyjoints.org/living-with-arthritis/coronavirus/managing-symptoms/coronavirus-symptoms-different-with-autoimmune-conditions-chronic-illness/): - rheumatic conditions (SLE, RA, scleroderma) do not seem to experience increased rates of infection or severe complications - if you experience a coronavirus-like symptom (like fever), be aware of other symptoms that may indicate patterns consistent with a flare-up - notice if your dry cough, fever, fatigue, etc. is typical for your condition, or if it feels like something new **Experiencing unusual symptoms that may be consistent with COVID-19?** Call your healthcare provider. They may instruct you to visit a drive-up testing site. The CDC offers [information about testing here](https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/testing.html). You may also call your area’s hotline number (may vary by state, province, region, etc.) for any concerns or questions about what to do in your particular situation. In the case of emergency warning signs such as difficulty breathing, persistent chest pressure or pain, confusion, or bluish lips or face, get medical attention immediately. ### What To Do If You’ve Been Exposed According to the CDC, an exposure means spending at least 15 minutes of time in close proximity (within six feet) of someone with a confirmed or suspected case of COVID-19 ([34](https://www.cdc.gov/coronavirus/2019-ncov/php/public-health-recommendations.html)). **Scientists are discovering that the less time you’re exposed to the virus, the more likely it is to remain in the nose and throat**, instead of continuing into the lungs where the disease becomes serious ([35](https://www.nature.com/articles/d41586-020-01315-7)). The respiratory tract, including the nose and throat, contains a clean-sweeping army of cilia and mucus to brush out potential pathogens before they have a chance to dig deeper into the body. With a lower viral exposure or load, the body is better able to use this system and manage the threat. [**If you’ve been exposed**](https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/quarantine.html) **to someone with COVID-19**, you should self-monitor symptoms, take your temperature, stay away from people who are high-risk, and self-quarantine until 14 days after your last exposure. Minimizing or eliminating contact with others for 14 days (incubation period for the virus is 2-14 days) will ensure that you have not been infected and will not infect others. **The CDC has an informative page about** [**when to quarantine**](https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/quarantine.html) **in various situations.** Although you’ve been exposed, the people you’ve been in physical contact with do not need to be in quarantine. If there is a lot of community spread in your area, however, your local public health officials may advise otherwise ([2](https://www.msnbc.com/msnbc/watch/what-constitutes-a-compromised-immune-system-80564805732)). **If you test positive for SARS-CoV-2** **and are asymptomatic or have mild symptoms**, you may only need to self-isolate for 10 days. The CDC revealed new guidelines in July, stating that “for most persons with COVID-19 illness, isolation and precautions can generally be discontinued 10 days after symptom onset and resolution of fever for at least 24 hours.” For asymptomatic individuals, [10 days after your first positive test](https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/end-home-isolation.html). ### The Facts About COVID-19 Coronavirus data is limited, and prevalence statistics are difficult to clearly define. Mortality, hospitalization, and other rates are constantly being reevaluated due to testing, diagnoses, population age and density, under- and over-reported cases, and strong indications that asymptomatic carriers and mild, undocumented occurrences account for more of the total COVID-19 cases than previously thought ([24,](https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30243-7/fulltext) [25](https://www.wsj.com/articles/the-bearer-of-good-coronavirus-news-11587746176), [26](https://www.bloomberg.com/news/articles/2020-04-23/new-york-finds-virus-marker-in-13-9-suggesting-wide-spread), [27](https://science.sciencemag.org/content/368/6490/489)). However, testing is imperfect and no one study or estimation will give us the all answers—there is still much to learn. For a clearer picture of what the pandemic looks like in your particular country or region, stay informed through your local public health department. - **80% of known cases have been mild to moderate** (according to WHO report in China), and don’t require hospitalization ([4](https://www.npr.org/sections/goatsandsoda/2020/03/13/814691018/coronavirus-symptoms-defining-mild-moderate-and-severe)) ([10](https://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf)) - **High risk of severity in elderly persons and people with chronic health conditions** and altered immune systems; roughly 90% of hospitalized cases are those with underlying conditions, including those over age 65 ([21](https://www.cdc.gov/mmwr/volumes/69/wr/mm6915e3.htm)) - **Healthy individuals may also contract severe cases.** In a Georgia report, 1 in 4 hospitalized cases had no risk factors for COVID-19 ([29](https://www.cdc.gov/mmwr/volumes/69/wr/mm6918e1.htm)). Despite this, the number of healthy individuals with severe cases generally seems to be small. The reasons for this are largely unknown; researchers are searching for explanations through genetics, pollution, immune system response, and exposure to varied viral loads ([18](https://www.cnn.com/2020/04/05/health/young-people-dying-coronavirus-sanjay-gupta/index.html), [19](https://www.sciencemag.org/news/2020/03/how-sick-will-coronavirus-make-you-answer-may-be-your-genes), [20](https://projects.iq.harvard.edu/files/covid-pm/files/pm_and_covid_mortality.pdf)). - **Severe cases may be associated with** [**hyperactive immune responses**](https://www.wsj.com/articles/haywire-immune-response-eyed-in-coronavirus-deaths-treatment-11586430001), in both healthy and chronically ill individuals. A preexisting but possibly undetected issue with the immune system may enable the virus to move from the nose and throat, and into the lungs, resulting in a severe case of COVID-19. Some people may not be able to make the antibodies responsible for barring the virus entry into a cell, which is how it multiplies ([35](https://www.nature.com/articles/d41586-020-01315-7)). - **12% of known U.S. cases have been hospitalized**, with 20% aged 20-44, 35% aged 45-64, and 45% aged 65 and up (as of March 16th) ([11](https://www.cdc.gov/mmwr/volumes/69/wr/mm6912e2.htm)) - **35-40% of U.S. cases may be** **asymptomatic**, preliminary findings from the CDC suggest ([32](https://www.cdc.gov/coronavirus/2019-ncov/hcp/planning-scenarios.html), [36](https://www.cdc.gov/coronavirus/2019-ncov/hcp/planning-scenarios.html)). Asymptomatic individuals can provoke rapid spread of the virus, as many cases are unknown and undocumented ([12](https://science.sciencemag.org/content/early/2020/03/24/science.abb3221), [13](https://www.newscientist.com/article/2238473-you-could-be-spreading-the-coronavirus-without-realising-youve-got-it/)) - **COVID-19 disproportionately affects people of color** in cases with known race and ethnicity, as roughly 33% of persons have been Hispanic, 22% black, and 1.3% American Indian/Alaska Native ([37](https://www.cdc.gov/mmwr/volumes/69/wr/mm6924e2.htm)) - **.66% fatality rate at minimum**, which increases with age; this analysis of Chinese cases attempts to include mild or asymptomatic cases (from March 30th) ([24](https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30243-7/fulltext)). These numbers are not easy to determine and there is a wide range of estimates, including a 5.6% case-fatality rate in the U.S. reported by Johns Hopkins ([30](https://coronavirus.jhu.edu/data/mortality)) and a 1.3% rate in the U.S. from a Health Affairs study ([31](https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2020.00455?utm_campaign=covid19fasttrack&utm_medium=press&utm_content=basu&utm_source=mediaadvisory&)). - **Fatality rates may not include undetected and asymptomatic cases**, and differ greatly by country, region, state, etc. For example, in New York, the number of cases was found to be 10 times higher than data indicated, meaning fatality rate may be around .5% ([26](https://www.bloomberg.com/news/articles/2020-04-23/new-york-finds-virus-marker-in-13-9-suggesting-wide-spread)) - [**Spreads mainly through droplets**](https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/about-face-coverings.html) **from coughing, sneezing, shouting, or singing.** Droplets can travel about six feet. - **New research reveals coronavirus can spread through the air.** Aerosol transmission of infectious virus is possible from over 15 feet away. The paper has not yet been peer reviewed and experts are still learning how the virus spreads ([38](https://www.medrxiv.org/content/10.1101/2020.08.03.20167395v1)) - **Low risk of virus spreading via surfaces or** **objects** ([33](https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/how-covid-spreads.html)) - **Coronavirus has a reproductive number (R0) of about 2-3**, meaning that on average, one infected person infects between 2 to 3 new people ([22](https://academic.oup.com/jtm/article/27/2/taaa021/5735319)). In comparison, measles has a reproductive number of 12-18 ([23](https://www.healthline.com/health-news/50-percent-of-people-with-covid19-not-aware-have-virus#How-transmission-works)). However, this does not take into account dispersion patterns and the circumstances involved in cases of transmission - **Coronavirus may spread in clusters.** New information on transmission reveals that 10-20% of infected people may be responsible for 80-90% of virus transmission. The measure of dispersion, otherwise known as *k*, is one variable that has been out of focus. It is now thought that the coronavirus is an over-dispersed pathogen—one infected person may be the cause of many infections simultaneously, while another may cause none. This knowledge may drive changes in the way we approach the pandemic ([39](https://www.theatlantic.com/health/archive/2020/09/k-overlooked-variable-driving-pandemic/616548/)) - **Not seasonal like the flu**, as warmer temperatures seem to have no effect on the virus - **No one has immunity** (unlike the flu), and there is no vaccine. A vaccine is under development, but could take years - **Trials are currently ongoing for drugs** to treat people with the virus ([5](https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-guidance-management-patients.html#clinical-management-treatment%3C)). Current research on COVID-19 could have the unexpected benefit of discovering treatments for other related conditions or adding to medical knowledge for future research endeavors - **Children may have a similar risk as adults, but milder symptoms**. Higher risk children may be those with underlying health issues, as well as toddlers and babies ([14](https://www.medrxiv.org/content/10.1101/2020.03.03.20028423v2), [15](https://pediatrics.aappublications.org/content/pediatrics/early/2020/03/16/peds.2020-0834.full.pdf), [28](https://thespinoff.co.nz/society/23-04-2020/siouxsie-wiles-what-we-know-about-children-and-covid-19/?fbclid=IwAR12lstjlI_gnFBv9NrV8yeqswJZF--ofPAVwgJ2Jb1PhKZ_iKUH0l6WL7Y)) - **Pregnant women have generally had mild to moderate cases** and seem to be at no higher risk than the general population, based on a WHO report in China. There is also no evidence that the virus can be passed to their children ([7](https://www.sciencealert.com/reassuring-covid-19-guidelines-suggest-pregnant-women-are-no-more-at-risk-than-anyone-else), [10](https://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf)). However, there is still not enough known about the virus to paint a clear picture of the risk for pregnant women ([16](https://www.who.int/news-room/q-a-detail/q-a-on-covid-19-pregnancy-childbirth-and-breastfeeding)) If you’re also concerned about the rapid spread of misinformation, check out [WHO’s list of coronavirus Mythbusters](https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/myth-busters). ### What Does It Mean To Be “High-Risk”? **The phrase “high risk” most often refers to individuals who are more likely to develop severe symptoms or illness when infected.** High-risk individuals include those over age 65, and anyone with altered or compromised immune systems or underlying health conditions such as HIV, diabetes, obesity, heavy smokers, cancer, lung and heart disease, asthma, and other respiratory conditions. The high-risk category may also include many autoimmune diseases or chronic inflammatory conditions (as any infection can cause severe flares), and especially individuals treated with immunosuppressants like corticosteroids, or chemotherapy. *Tip: scroll down to the Resources section for links to detailed articles on autoimmune disease and COVID-19* #### [**CDC High-Risk List**](https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fneed-extra-precautions%2Fgroups-at-higher-risk.html) **Primary Group** (at increased risk) - Cancer - Chronic kidney disease - COPD (chronic obstructive pulmonary disease) - Heart conditions (coronary artery disease, cardiomyopathy) - Immunocompromised state from organ transplant - Obesity - Sickle cell disease - Smoking - Type 2 diabetes **Secondary Group** (may be at increased risk) - Moderate to severe asthma - Cerebrovascular disease - Cystic fibrosis - Hypertension - Immunocompromised state from blood or bone marrow transplant, HIV, immunodeficiencies, use of corticosteroids or other immunosuppressants - Neurological conditions, such as dementia - Liver disease - Overweight - Pregnancy - Pulmonary fibrosis - Thalassemia - Type 1 diabetes - Children with congenitial heart disease or neurologic, genetic, or metabolic conditions **Many people with autoimmune disease are likely to be high-risk, but some may not be.** Certain autoimmune conditions may also be more susceptible to contracting the virus or developing severe symptoms than others. As we are still learning about this virus, there is simply not enough information out there to know for sure. Physician-researchers at The Benaroya Institute emphasize that while there is still no clear connection between autoimmunity and the development of COVID-19, there are a[ few things people with autoimmune disease should know during this time](https://www.benaroyaresearch.org/blog/post/covid-19-coronavirus-11-things-people-autoimmune-disease-should-know#), including the risks of stopping or continuing medications like steroids and what it means to have a compromised immune system. **At the end of the day, your personal risk depends on your unique situation**, any medications you’re taking, if your disease is under control, and if you have multiple conditions. It is a determination to be made by both you and your doctor. Whether you think you may be high-risk or not, physical distancing (more commonly known as [social distancing](https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/social-distancing.html)) and heeding the advice of doctors and public health officials are absolutely critical. These efforts help to prevent high-risk individuals from becoming infected and from experiencing serious symptoms in a further effort to stem the flood of new cases in hospitals. ### COVID-19 Prevention - Stay home when possible, avoiding non-essential travel - Focus on your personal health by [eating nutrient-dense whole foods and staying hydrated](http://www.emro.who.int/nutrition/nutrition-infocus/nutrition-advice-for-adults-during-the-covid-19-outbreak.html). This helps optimize immune system function and that of other body systems, which may prevent the virus from triggering severe complications - Wash hands often with soap and water for at least 20 seconds. If unavailable, use hand sanitizer with at least 60% alcohol - Sneeze or cough into your elbow - Disinfect frequently touched surfaces and objects daily with [EPA-approved cleaners](https://www.epa.gov/pesticide-registration/list-n-disinfectants-use-against-sars-cov-2)—effective yet [milder options](https://www.nbcnews.com/better/lifestyle/many-common-household-cleaning-products-can-kill-coronavirus-if-you-ncna1160271) include 70% isopropyl alcohol solutions, hydrogen peroxide, and even plain soap and water - Choose drive-through, delivery, or pick-up options instead of sit-down restaurants - Limit close contact with others (leaving 6 feet of space) - Do not visit nursing homes or long-term care facilities - Take care of the emotional health of household members, especially children - If you’ve been in contact with an infected person, remain under quarantine for up to 14 days if you’ve been in contact with an infected person - If you’re sick, self-isolate in your home or a room in your home if you live with others #### **Especially for high-risk individuals:** - Stock up on supplies like groceries, medical supplies, and other household items in case you need to stay at home for an extended period of time - Take advantage of special early hours that many grocery stores are setting aside for the elderly or high-risk individuals - Contact your healthcare provider to ask about obtaining extra necessary medications - Avoid touching high-touch surfaces in public places, and wash hands if you do - Avoid crowds, particularly in poorly ventilated spaces - If the virus is spreading in your area, consider getting food brought to your house by friends, family, social networks, nonprofit programs, or food delivery services The above information was gathered from the CDC’s [Guide to Protecting Your Home](https://www.cdc.gov/coronavirus/2019-ncov/prepare/get-your-household-ready-for-COVID-19.html) the CDC’s steps to [Prevent Getting Sick](https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/prevention.html). #### **A Note on Face Masks** The CDC urges the use of [cloth face covers](https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/about-face-coverings.html) when in public settings, regardless if you’re symptomatic or not. The [WHO](https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/when-and-how-to-use-masks) suggests reducing your risk by using masks in conjunction with proper and frequent hand cleaning and physical distancing. Face masks are critical barriers for those who are [sick with COVID-19](https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/steps-when-sick.html), their caregivers, and healthcare workers. At the start of the pandemic, as many places were dealing with mask shortages, the CDC advised against the purchase of surgical masks or N-95 respirators for the general public. This helped save them for use in hospitals, where the risk of infection is especially high ([3](https://www.yalemedicine.org/stories/2019-novel-coronavirus/)). As an alternative, order a mask online from various retailers or at the grocery store, or use a homemade mask, bandana, or cloth from an old t-shirt to cover your nose and mouth. The efficacy of homemade face coverings is an ongoing conversation, as they are not comparable to N-95 respirators or surgical masks. The general consensus is that something is better than nothing, but wearing a thin, loose piece of cloth is not be sufficient – the material and fit matter. [The CDC’s face covering recommendation](https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/how-to-make-cloth-face-covering.html) is a thick, double layer of cotton that fits tightly around the face. **While they are not a surefire way of completely filtering the air or preventing tiny droplets from escaping, cloth face covers do help to protect against fluids** from coughing, sneezing, and speaking, and are another vital tool in slowing the spread of the virus. This is especially important in poorly ventilated, indoor spaces where physical distancing is more difficult, as well as in areas where there is strong community spread of the virus. [Watch Facebook Video](https://www.facebook.com/712416890/videos/10156892600751891/) ### Why The Precautions? Cancelling events, closing businesses, washing hands often and disinfecting surfaces, staying home, and wearing a mask will slow down the rate of the epidemic. Physical (or social) distancing is an especially vital tool epidemiologists employ to control outbreaks like COVID-19. This practice minimizes the risk of spreading the infection to immunocompromised individuals and of overwhelming the healthcare system. If proper measures aren’t taken, hospitals can be bombarded with a swarm of new patients all at once, *in addition* to their current caseload. This means slower, lower quality care for individuals with the virus, as well as those with other serious conditions like autoimmune disease and cancer. We’re encouraged to practice physical distancing not only to flatten the curve, but also to stop the spread. The graphic below explains how our attitudes and actions can help or hurt this situation. ### Panic Vs. Precaution **Our fears about this unprecedented situation are 100% valid; however, they drive us to overreact** in the hope of maintaining control—overbuying groceries, supplements, and supplies, obsessively sanitizing, holding our breath around others, letting our thoughts be consumed by coronavirus “what if’s”… It’s natural to feel this way, but it’s important to recognize when we’re tumbling into a panic. **Elevated stress, anxiety, and fear can keep our bodies in “fight or flight” mode.** Research studies have repeatedly demonstrated the effects this state of being can have on our bodies—including our immune systems. The impacts of stress are especially important to all individuals with chronic conditions like autoimmune disease. A healthy stress response is one of many components (including sleep, nutrition, nature, social interaction, and emotional support) essential to controlling symptoms and keeping conditions stable. **There is a lot of uncertainty and that’s ok.** We can’t do anything about that. What we *can* do is keep our gaze on the next small step ahead, follow the basic recommendations from public health officials, practice self-care, and simply stay informed. Head over to Psychology Today for some[ helpful tips on managing COVID-19 anxieties](https://www.psychologytoday.com/us/blog/erasing-stigma/202003/controlling-coronavirus-anxiety). You can also call the Helpline from the National Alliance on Mental Illness (NAMI) at (800) 950-6264, or check out [their comprehensive guide](https://www.nami.org/getattachment/About-NAMI/NAMI-News/2020/NAMI-Updates-on-the-Coronavirus/COVID-19-Updated-Guide-1.pdf) to navigate concerns like coronavirus anxiety, quarantine and isolation, and loved ones with mental illness. *Note: consult your psychologist about any mental health concerns.* ### The Bottom Line **The coronavirus pandemic is affecting the health and well-being of high-risk individuals, while simultaneously creating financial and logistical difficulties** for families, hourly wage employees, and small businesses, among many challenged populations—not to mention potential economic crises and famine in developing countries all over the world. **During this time, it’s important to stay calm and connected to your support community**, help each other, do your part in slowing the rate of infection, and know that we will move on from this crisis. ### COVID-19 Self-Care Tips - **Monitor your local situation, but take breaks** from reading, thinking, and talking about the coronavirus situation - **Connect with loved ones** through video calls, audio texts, social media challenges, online games, and sending packages and letters - **Spend time outside** in nature, in low-trafficked areas (depending on local guidelines) - **Incorporate movement into your day** – such as stretching, dancing, yoga, tai chi, or online workout classes - **Prioritize nutrient-dense foods** - **Stay well-hydrated** - **Get 7-9 hours of sleep** per night #### **Practice mindfulness and stress-reduction** **by:** - Making a list of things you *can* control - Diffusing[ calming essential oil blends](https://www.aromaweb.com/recipes/diffuser-blends-relaxation.asp) - Tactile activities like puzzles, knitting, painting - Reading - Journaling - [Reframing negative thoughts](https://confidentcounselors.com/2018/03/19/reframe-negative-thoughts/) - Writing down or repeating a mantra - Deep breathing - Meditating with these[ simple tips from yoga instructors](https://www.washingtonian.com/2020/03/16/7-meditation-tips-to-help-combat-covid-19-anxiety/) #### **Help others** **by:** - Delivering food to neighbors with weakened immune systems - Supporting small businesses and hourly workers in your community - Donating to organizations like[ Feed America](https://www.feedingamerica.org/about-us/press-room/feeding-america-establishes-covid-19-response-fund-help-food-banks-during), who are supporting low-income hourly wage earners and their families, especially while schools are closed - Connecting with nonprofits, including those on [Food Tank’s list of 31 organizations](https://foodtank.com/news/2020/03/support-these-31-organizations-helping-restaurants-workers-and-farmers-survive-covid-19/) who are helping restaurants, workers and farmers survive the outbreak ### Resources #### **Primary Sources** 1. [World Health Organization](https://www.who.int/emergencies/diseases/novel-coronavirus-2019) (WHO) 2. [Centers for Disease Control](https://www.cdc.gov/coronavirus/2019-ncov/index.html) (CDC) 3. [National Institutes of Health](https://www.nih.gov/health-information/coronavirus) (NIH) #### **COVID-19 Resource Hubs** 1. [American Medical Association](https://www.ama-assn.org/delivering-care/public-health/covid-19-2019-novel-coronavirus-resource-center-physicians) (AMA) 2. [Creaky Joints](https://creakyjoints.org/category/living-with-arthritis/coronavirus/) 3. [Global Healthy Living Foundation](https://www.ghlf.org/) (GHLF) 4. [John’s Hopkins Coronavirus Resource Center](https://coronavirus.jhu.edu/) 5. [Mayo Clinic’s News Network](https://newsnetwork.mayoclinic.org/category/covid-19/) 6. [National Organization for Rare Disorders](https://rarediseases.org/covid-19/) (NORD) 7. [The Institute for Functional Medicine](https://info.ifm.org/covid-19?utm_source=Mark%27s+Picks&utm_campaign=374a17d4e6-EMAIL_CAMPAIGN_2018_03_29_COPY_01&utm_medium=email&utm_term=0_3eb7466668-374a17d4e6-124413301&mc_cid=374a17d4e6&mc_eid=756c28b2af) (IFM) 8. [Patient.info](https://patient.info/coronavirus-covid-19) #### **Autoimmune Disease and Holistic Health** 1. [COVID-19 and Autoimmune Disease](https://autoimmunewellness.com/covid-19-and-autoimmune-disease/) – Autoimmune Wellness resident medical advisor and functional practitioner, Dr. Rob Abbott, explains what COVID-19 is, the risks, and how to respond 2. [COVID-19: An Integrative MD’s Common Sense Approach](https://avivaromm.com/category/covid-19/) – series of articles on naturally and safely preventing and treating the virus. Included is a page on the virus and autoimmune disease 3. [Natural, Science-Backed Approaches to COVID-19](https://www.thepaleomom.com/natural-approaches-to-cold-flu-season/) – by Dr. Sarah Ballantyne, The Paleo Mom 4. [Living with Immunosuppression During the Coronavirus Outbreak](https://www.npr.org/2020/03/13/815546888/living-with-immunosuppression-during-the-coronavirus-outbreak) – personal account of Kevin Brennan, who has an autoimmune disease 5. [Creaky Joints: Living with Arthritis](https://creakyjoints.org/category/living-with-arthritis/coronavirus/) – articles on COVID-19 topics (medications, using telehealth, managing pain and symptoms, caring for mental health and physical well-being during stressful times) for people with chronic and autoimmune rheumatic diseases and co-existing conditions #### **Mental Health** 1. [Coronavirus Anxiety: Key Advice for Chronic Illness Patients from Health Psychologists](https://creakyjoints.org/living-with-arthritis/coronavirus-anxiety-with-chronic-illness/?utm_source=GHLF+COVID-19+Support+Program&utm_campaign=7ec2760f96-auto_welcome-2&utm_medium=email&utm_term=0_e0b05b1451-7ec2760f96-233043777) 2. [Comprehensive guide](https://www.nami.org/getattachment/About-NAMI/NAMI-News/2020/NAMI-Updates-on-the-Coronavirus/COVID-19-Updated-Guide-1.pdf) from the National Alliance on Mental Illness (NAMI) on navigating the current situation 3. [Managing Life at Home During the COVID-19 Outbreak](https://www.yalemedicine.org/stories/life-at-home-covid-19-outbreak/) from Yale Medicine 4. [How to take charge of fear](https://www.psychologytoday.com/us/blog/erasing-stigma/202003/controlling-coronavirus-anxiety) during the outbreak 5. [Tips on coping with coronavirus anxiety](https://www.businessinsider.com/how-to-cope-with-coronavirus-covid-19-anxiety-psychologist-2020-2) from psychologists 6. [A Zen Master’s Tips for Staying Sane in Challenging Times](https://plumvillage.org/articles/a-zen-masters-tips-for-staying-sane-in-challenging-times/) from Plum Village monks and Thich Naht Hanh’s teachings on the art of living each day well 7. [Mindfulness exercises, techniques, and activities](https://positivepsychology.com/mindfulness-exercises-techniques-activities/) 8. [Simple meditation tips](https://www.washingtonian.com/2020/03/16/7-meditation-tips-to-help-combat-covid-19-anxiety/) from yoga instructors 9. [Reframing negative thoughts](https://confidentcounselors.com/2018/03/19/reframe-negative-thoughts/) 10. [Calming essential oil blends](https://www.aromaweb.com/recipes/diffuser-blends-relaxation.asp) #### **Miscellaneous** 1. [The Do’s & Don’t of Social Distancing](https://www.theatlantic.com/family/archive/2020/03/coronavirus-what-does-social-distancing-mean/607927/) – explanation of exactly what it means through real-life scenarios and responses by public health experts 2. [EPA-approved disinfectants](https://www.epa.gov/pesticide-registration/list-n-disinfectants-use-against-sars-cov-2) for protecting against coronavirus 3. [Common household cleaning products that kill coronavirus](https://www.nbcnews.com/better/lifestyle/many-common-household-cleaning-products-can-kill-coronavirus-if-you-ncna1160271) if you use them properly 4. [Resources for Parents](https://riseandshine.childrensnational.org/coronavirus/?_ga=2.95669274.748327386.1585163593-1361554683.1583183852) from Children’s National – how to talk to your kids about coronavirus, tips for homeschooling, gluten-free cleaning products, and more 5. [A Medical Review of COVID-19 Testing Options](https://autoimmunewellness.com/covid-19-testing/) – Autoimmune Wellness Medical Director Dr. Rob Abbott provides empowering, honest info about the challenges of testing #### **Info on COVID-19 from specific autoimmune disease organizations:** 1. [Beyond Celiac](https://www.beyondceliac.org/coronavirus/) 2. [Celiac Disease Foundation](https://celiac.org/about-the-foundation/featured-news/2020/03/celiac-disease-and-coronavirus-covid-19/) 3. [Crohn’s & Colitis Foundation](https://www.crohnscolitisfoundation.org/what-ibd-patients-should-know-about-2019-novel-coronavirus-covid-19) 4. [JDRF](https://www.jdrf.org/coronavirus/) (Juvenile / Type I Diabetes) 5. [Lupus Foundation of America](https://www.lupus.org/resources/coronavirus-and-lupus) 6. [Lupus Research Alliance](https://www.lupusresearch.org/covid-19-frequently-asked-questions/) 7. [Multiple Sclerosis Foundation](https://msfocus.org/About-Us/MSF-News-Articles/1251) 8. [Multiple Sclerosis Society UK](https://www.mssociety.org.uk/about-ms/treatments-and-therapies/disease-modifying-therapies/covid-19-coronavirus-and-ms) 9. [National MS Society](https://www.nationalmssociety.org/What-you-need-to-know-about-Coronavirus-(COVID-19)) 10. [Myasthenia Gravis Foundation of America](https://myasthenia.org/Portals/0/Coronavirus%20-%20General%20Information%20and%20Management.pdf) 11. [National Rheumatoid Arthritis Society](https://www.nras.org.uk/news/coronavirus-what-we-know-so-far) 12. [Scleroderma Foundation](https://www.scleroderma.org/site/SPageServer?pagename=patients_COVID19_MSAB&AddInterest=1281#.XnFWcqhKhdo) 13. [Sjogren’s Syndrome Foundation](https://www.sjogrens.org/news/2020/coronaviruscovid-19-precautions-for-sjogrens-patients) **Other:** [American Autoimmune Related Diseases Association](https://www.aarda.org/aarda-covid-19/) \|[ Asthma & Allergy Foundation of America](https://community.aafa.org/blog/coronavirus-2019-ncov-flu-what-people-with-asthma-need-to-know) \| [Autoimmune Wellness](https://autoimmunewellness.com/covid-19-and-autoimmune-disease/) \| [Creaky Joints](https://creakyjoints.org/coronavirus/) \| [Global Healthy Living Foundation](https://www.ghlf.org/) ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** COVID-19 and Long Covid --- ### [Understanding Late-Onset Autoimmunity](https://www.autoimmuneinstitute.org/articles/understanding-late-onset-autoimmunity) **Published:** December 19, 2025 **Author:** Carolyn Serraino **Excerpt:** While autoimmune disease is often associated with young or middle-aged adults, it can emerge for the first time later in life. Evidence suggests that diagnoses among older adults are increasing, raising new questions about how immune aging, hormonal changes, and environmental exposures shape disease risk. **Content:** ### How Autoimmunity Changes Over Time Autoimmune disease doesn’t follow a single path; it evolves. This series explores how immune activity shifts across the lifespan, from the earliest signs of [emerging autoimmunity](https://www.autoimmuneinstitute.org/articles/the-stages-of-autoimmunity/), to the rise of [late-onset disease in older adults](https://www.autoimmuneinstitute.org/articles/understanding-late-onset-autoimmunity/), to the ways [aging reshapes and weakens immune balance](https://www.autoimmuneinstitute.org/articles/aging-and-autoimmune-disease/). While autoimmune disease is often associated with young or middle-aged adults, it can emerge for the first time later in life. Evidence suggests that diagnoses among older adults are increasing, raising new questions about how immune aging, hormonal changes, and environmental exposures shape disease risk. To better understand why autoimmunity appears in later decades, **Frederick Miller, MD, PhD**, former head of the Environmental Autoimmunity Group at the National Institute of Environmental Health Sciences, and **Andrea George, MD**, an endocrinologist at Hill Country Endocrinology in Austin, Texas, share their perspectives on the factors driving this growing trend. ## Why Are More Autoimmune Diseases Being Diagnosed Later in Life? > *“It is a complex interplay of differences in exposures, hormones, and epigenetic effects that build up over decades and impact different immune compartments.”* > > – Frederick Miller, MD, PhD Research studies reveal a rise in certain autoimmune diseases [(1)](https://pubmed.ncbi.nlm.nih.gov/37156255/). A study in the journal *Arthritis & Rheumatology* highlights this trend, finding that anti-nuclear antibodies (ANA) increased in certain groups of people between 1988 and 2012 [(2)](https://pubmed.ncbi.nlm.nih.gov/32266792/)[.](https://pubmed.ncbi.nlm.nih.gov/37156255/) The presence of ANA can be a sign of an autoimmune disease such as [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/), [scleroderma](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/scleroderma/), and [Sjögren’s syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sjogrens-syndrome/). #### The study also found that people over 50 were among the groups with the most significant increase in ANA.  Our rapidly changing environment increasingly strains our immune systems, requiring constant adaptation. These changes, in addition to some lifestyle changes, may have a cumulative effect over time. Specific factors have been linked to the rise of autoimmune diseases, and older people might be particularly vulnerable to them [(3)](https://www.sciencedirect.com/science/article/abs/pii/S0952791522001133) : - **Diet:** Poor-quality diets high in processed foods and additives may be harmful. - **Environmental toxins:** Exposure to potentially harmful chemicals in household products is increasing. - **Air pollution:** Vehicle and factory exhaust reduce air quality. - **Infections:** Some infections can trigger autoimmune responses. - **Lifestyle challenges:** Sleep deprivation and chronic stress can negatively impact health. - **Climate change:** Climate shifts may be linked to new pathogens and food-borne illnesses. Dr. George also noted an even greater increase in certain autoimmune diseases since the beginning of the [COVID-19 pandemic](https://www.autoimmuneinstitute.org/gai-library/#covid). > *“Post COVID, we have seen a significant increase of autoimmune disease, including latent autoimmune diabetes in adults in patients with no prior history or family history of autoimmune disease.”* > > – Andrea George, MD ## Why Does Autoimmunity Increase With Age? ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/11/shutterstock_2661601041-scaled-e1765990263553-1016x1024.jpg) As we age, our immune system undergoes age-related changes, immunosenescence, leading to increased autoimmunity [(4)](https://www.ncbi.nlm.nih.gov/books/NBK576418/#:~:text=Autoimmunity%20refers%20to%20an%20aberration,factors%20all%20playing%20a%20role.). Our bodies begin to make more autoantibodies that can lead to autoimmune diseases. At the same time, our aging immune systems weaken, making us less able to fight off disease. A weakened immune system combined with increased autoimmune triggers makes older people a unique target for the development of late-onset autoimmune disease. ### Autoimmune Diseases More Commonly Diagnosed Later in Life - [ Systemic lupus erythematosus (SLE) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/) - [ Rheumatoid arthritis (RA) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/) - [ Sjögren’s syndrome ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sjogrens-syndrome/) - [ Giant cell arteritis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/giant-cell-arteritis-temporal-arteritis-hortons-disease/) ## How Do Autoimmune Symptoms Present in Older Adults? Older people can present with vague or atypical symptoms of autoimmune diseases. For example, older people with SLE might present with weight loss, muscle pain, and cognitive, behavioral, or mood deterioration [(5)](https://www.uptodate.com/contents/immune-function-in-older-adults). Dr. Miller cautions, “Some believe that older people do not develop new autoimmune diseases, so they are sometimes not adequately screened or assessed for these when they develop new syndromes. Also, since late-onset autoimmune diseases can present atypically, they can be misdiagnosed more frequently as other conditions.” Healthcare providers should consider late-onset autoimmune disease when older people present with new or unusual complaints. With respect to latent autoimmune diabetes in adults (LADA), Dr. George says, “The main challenges are due to the lack of awareness and education on accurately diagnosing LADA. It has always been taught, even in medical school, that a patient with diabetes diagnosed at a young age is consistent with autoimmune diabetes ([Type 1](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/type-1-diabetes-insulin-dependent-diabetes/ "Type 1 diabetes / insulin-dependent diabetes")) and a patient diagnosed at an older age most likely has Type 2″. ## Why Are Women at Higher Risk for Autoimmune Disease? Women are disproportionately affected by autoimmune diseases, with factors such as genetics, hormonal changes, and social/environmental influences contributing to this disparity. A recent review suggests that social (such as environmental exposures, access to healthcare, and dietary) and cultural factors (gender differences) are also possible culprits [(6)](https://www.frontiersin.org/articles/10.3389/fragi.2023.1272118/full). Women are at particular risk for developing an autoimmune disease at times of increased stress, such as pregnancy, or during a significant hormonal change [(7)](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7292717/). In addition to other age-related factors, menopause related hormonal changes might be an additional risk factor for late-onset autoimmune diseases. ## Can You Develop More Than One Autoimmune Disease? People with one autoimmune disease are more likely to develop other autoimmune diseases. When someone has three or more autoimmune diseases, it is called [multiple autoimmune syndrome](https://www.autoimmuneinstitute.org/articles/about-autoimmune/comorbidities-multiple-autoimmune-syndrome/) (MAS). According to Dr. Miller, “Given the shared genetic and environmental risk factors for many autoimmune diseases, it is common for people with one autoimmune disorder to develop others, and this increases over time as more environmental exposures and infections accumulate.” Older adults, who’ve likely had more environmental exposures and are more susceptible to infection, might be at risk for developing MAS. Certain autoimmune diseases are more likely than others to present with another autoimmune disease. For example, systemic lupus erythematosus may coexist with Sjögren’s syndrome [(8)](https://pubmed.ncbi.nlm.nih.gov/30774485/) and rheumatoid arthritis with [autoimmune thyroiditis](https://www.autoimmuneinstitute.org/autoimmune-resources/hashimotos-thyroiditis/). ## Managing Late-Onset Autoimmune Disease Although late-onset autoimmune diseases can be challenging to spot, they can be well-managed once diagnosed. Additionally, symptoms are generally milder than those seen in younger people [(9)](https://pubmed.ncbi.nlm.nih.gov/28768257/). Living with an autoimmune disease can significantly impact [quality of life](https://www.autoimmuneinstitute.org/articles/chronic-illness-when-you-feel-like-giving-up "Chronic Illness: When You Feel Like Giving Up"). They can also bring [considerable costs](https://www.autoimmuneinstitute.org/articles/navigating-health-insurance-for-autoimmune-disease-patients-expert-tips-and-resources "Navigating Health Insurance with Autoimmune Disease") to the healthcare system across the lifespan. Early diagnosis and treatment can help slow progression and minimize these diseases’ impact on your life. If you are experiencing symptoms that you can’t explain, see a healthcare provider for help. ## What’s Next for Late-Onset Autoimmune Disease Research? More research on late-onset autoimmune diseases is needed. Currently, most research focuses on younger adults. Dr. Miller notes, “There is a lack of systematic databases and registries for autoimmune diseases to understand how late-onset autoimmune disease presents and its natural history.” He points to “the general lack of mechanistic and therapeutic studies of late-onset autoimmune disease.” Treatment approaches for younger adults can guide diagnosis and treatment until more research is available. As research grows, so will our understanding of the treatment options for these diseases. ![This image has an empty alt attribute; its file name is GAI-Logo-Image-811x1024.png](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/04/GAI-Logo-Image-811x1024.png) ### About the Author ![Tracy Asamoah bio headshot freelance writer for GAI](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/11/DSC05784-scaled.jpg) Tracy is a writer, child and adolescent psychiatrist, and leadership coach. Her journey into the world of autoimmune diseases began when she experienced sudden onset symptoms of multiple sclerosis early in her medical career. This personal experience, combined with her intense curiosity, has informed her work and writing in the field. As a writer, Tracy has contributed to various books and written articles related to mental health. She’s also written on various medical topics regularly contributing to publications such as GoodRx, Psychology Today, and Psychotherapy.net Tracy Asamoah, MD Freelance Writer for GAI ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** About Autoimmune Disease --- ### [COVID-19 & Autoimmune Disease: What We Know Now](https://www.autoimmuneinstitute.org/articles/covid-19-autoimmune-disease-what-we-know-now) **Published:** October 24, 2020 **Author:** Carolyn Serraino **Excerpt:** While the world at large is still getting a handle on exactly how the coronavirus spreads, what causes COVID-19, and why it affects some people with autoimmune disease, what we know now is still a far cry from what we knew at the start. **Content:** While the world at large is still getting a handle on exactly how the coronavirus spreads, what causes COVID-19, and why it affects some people with autoimmune disease, what we know now is still a far cry from what we knew at the start. **As the number of studies on autoimmune disease and the coronavirus increase, we are beginning to see the associations between the two** and better understand why certain conditions are high risk. There are instances in which having an autoimmune disease increases vulnerability to COVID-19 complications, and other cases in which having a coronavirus infection may trigger autoimmune or other serious conditions. What also holds true, is the distinctive way in which this virus impacts individuals—healthy or chronically ill, young or old. Like a fingerprint is unique to each person, your personal risk is unlike anyone else’s. ### The High Risk List The term “high risk” may be used to denote infection risk or complication risk. There is concern over the susceptibility to infection, as individuals with compromised immune systems are generally the first in line for pathogenic attacks. However, the most widely investigated topic—and the one explored in this article—is the risk of serious complications once infected by the virus. The U.S. Centers for Disease Control and Prevention (CDC) released an updated [list of high risk conditions](https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fneed-extra-precautions%2Fgroups-at-higher-risk.html) (individuals who are at increased risk of serious illness from COVID-19). The CDC’s list defines a primary group including cancer, chronic kidney disease, COPD, immunocompromised from organ transplant, obesity, serious heart conditions, smoking, sickle cell disease, and type 2 diabetes, and a secondary group that may signal an increased risk for COVID-19 complications, including asthma, cystic fibrosis, suppressed immune system, neurological conditions, liver disease, pulmonary fibrosis and type 1 diabetes. For the full list, visit the [CDC’s website](https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html)*.* The CDC includes heart, lung, liver, and nervous system diseases on the high risk list. While there is limited data on the specific conditions affected in these categories, it is worthwhile to note the autoimmune or [autoimmune-related](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/ "A-Z Disease List") instances of them. Some of the heart, lung, liver, and nervous system autoimmune diseases indicating a potentially increased risk (including systemic conditions) are: [Autoimmune myocarditis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-myocarditis/ "Autoimmune myocarditis") [Dressler’s syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/dresslers-syndrome/ "Dressler’s syndrome") Subacute bacterial endocarditis Cardiac sarcoidosis [Idiopathic pulmonary fibrosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/fibrosing-alveolitis/ "Fibrosing alveolitis/Idiopathic pulmonary fibrosis (IPF)")[Autoimmune hepatitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-hepatitis/ "Autoimmune Hepatitis")[Multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/ "Multiple Sclerosis")[Guillain-Barre syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/guillain-barre-syndrome/ "Guillain-Barrè Syndrome")[Myasthenia gravis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/myasthenia-gravis/ "Myasthenia Gravis")[Lupus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic Lupus Erythematosus") [Rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid Arthritis")[Scleroderma](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/scleroderma/ "Scleroderma") [Sjogren’s](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/sjogrens-syndrome/ "Sjogren'S Syndrome") Individuals on immunosuppressive medications such as corticosteroids are also at higher risk for severe COVID-19 complications. However, keeping conditions in check and avoiding debilitating flare-ups may greatly outweigh the potential risks of a suppressed immune system. ### Why Are Non-Respiratory Diseases High Risk? We know that COVID-19 impacts the airways; therefore, COPD and other serious respiratory illnesses appear to present a clear pathway to disaster. Individuals with these conditions need to be particularly vigilant. But how could other conditions also [turn a coronavirus infection into a life threatening event?](https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/coronavirus-and-covid19-who-is-at-higher-risk) #### **Organ systems depend on each other.** Heart disease (like autoimmune myocarditis), for instance, presents itself as a likely factor for increased risk because normal operation of the heart is affected by other bodily functions. According to Dr. Maragakis, Senior Director of Infection Prevention at Johns Hopkins, the airways and lungs “work together with the heart to drive oxygen to the body’s tissues. When the lungs are overtaxed due to illness, the heart has to work harder” ([4](https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/coronavirus-and-covid19-who-is-at-higher-risk)). This is a telling example of the vital connections between the different organ systems in our bodies. #### **The immune system’s response is the primary culprit.** We are learning that the source of the mayhem might not be the virus itself, but rather the immune system’s response to it. Severe COVID-19 cases may be associated with [hyperactive immune responses](https://www.wsj.com/articles/haywire-immune-response-eyed-in-coronavirus-deaths-treatment-11586430001) in both chronically ill and healthy individuals. If you have an autoimmune disease, the immune system is already impaired – this may signal cause for concern. ### “I Have An Autoimmune Disease. Am I High Risk?” It remains unclear if having autoimmune disease automatically puts you at high risk for severe complications. However, many sources point to no—unless you are also on immunosuppressive medication, are over 60 years old, or have one of the listed high risk conditions (like heart disease or obesity) *in addition* to autoimmune disease ([5](https://rheum-covid.org/epidemiology-and-outcomes-of-novel-coronavirus-2019-in-patients-with-immune-mediated-inflammatory-diseases)). Many people with autoimmune disease and COVID-19 are asymptomatic or have mild to moderate symptoms and recover, some experience flare-ups or lingering effects, and others are hospitalized. Apart from type 1 diabetes, most autoimmune diseases are not yet considered high risk by the CDC. #### **1. We do not have enough data** Studying autoimmune diseases in general is a daunting task, as there is still much unknown about these conditions and their etiology, or causes. Therefore, untangling a relevant relationship between [autoimmune disease and COVID-19](https://www.autoimmuneinstitute.org/covid19/) is a tall order. #### **2. From the data we do have, there are mixed outcomes** One review laid out the complicated forces at play in certain autoimmune diseases, demonstrating the need for further study and precaution. In systemic lupus erythematosus (SLE), the overexpression of a [protein called ACE2](https://theconversation.com/what-is-the-ace2-receptor-how-is-it-connected-to-coronavirus-and-why-might-it-be-key-to-treating-covid-19-the-experts-explain-136928) may be involved in severe COVID-19 cases. Researchers investigating the [correlation between COVID-19 and rheumatic disease](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7194066/) explain that ACE2 is a “functional receptor for the viral spike \[of\] glycoprotein, that allows the entry of SARS-CoV-2 into cells.” In some lupus patients, this phenomenon may correlate with increased susceptibility ([6](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7194066/)). Other studies—the recent [“SARS-CoV-2 infection among patients with systemic autoimmune diseases”](https://pubmed.ncbi.nlm.nih.gov/32376395/) conducted in Italy, a case series from New York reporting on [“Covid-19 in Immune-Mediated Inflammatory Diseases”](https://www.nejm.org/doi/full/10.1056/NEJMc2009567?query=featured_home), and the [“Epidemiology and Outcomes of Novel Coronavirus 2019 in Patients with Immune-Mediated Inflammatory Diseases”](https://rheum-covid.org/epidemiology-and-outcomes-of-novel-coronavirus-2019-in-patients-with-immune-mediated-inflammatory-diseases/) from the Global Rheumatology Alliance—found no higher risk of COVID-19 complications associated with autoimmune disease. A review and meta-analysis on the [association between severe COVID-19 and autoimmune disease](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7264926/) “showed that autoimmune disease was slightly associated with increased risk of severity and mortality of COVID-19” ([7](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7264926/)). They do clarify that the statistical difference was not significant, but that these findings do not quell the threat and more research is needed. #### **3. The impact of autoimmune disease and the behavior of the immune system are different in different people** While those living with autoimmune disease do experience altered immune system function, the ability to fight off pathogens is not necessarily weakened; rather the response is misguided. Some people are more vulnerable to harmful bacteria and viruses because their bodies are busy attacking their own tissues – or they are living with suppressed immune systems. For others, hyper-vigilant immune systems may prevent them from getting sick often. A body that overreacts to benign substances, like foods or harsh chemicals, may actually continue putting up a good fight when it comes to the real enemies: pathogenic microbes like the coronavirus ([8](https://www.newscientist.com/article/2099313-autoimmune-diseases-may-be-side-effect-of-a-strong-immune-system/), [9](https://cellsciencesystems.com/education/research/inflammatory-symptoms-immune-system-and-food-intolerance-one-cause-many-symptoms/)). It depends on the individual. **It is possible for symptoms of COVID-19 to linger in people with chronic illnesses**, despite a lack of severe symptoms and hospitalization. Both the CDC and a survey conducted by the Indiana University School of Medicine found that chronically ill patients who contracted the virus experienced a particularly long road to recovery, with lingering symptoms like fatigue and cough, as well as skin and neurological problems ([10](https://creakyjoints.org/living-with-arthritis/coronavirus/managing-symptoms/chronic-illness-higher-risk-long-lasting-covid-19/?utm_source=GHLF+COVID-19+Support+Program&utm_campaign=e8a692eb43-real-time_email-26&utm_medium=email&utm_term=0_e0b05b1451-e8a692eb43-233043777), [11](https://dig.abclocal.go.com/wls/documents/2020/072720-wls-covid-symptom-study-doc.pdf)). To read more about lingering symptoms, scroll down to the section: “Long COVID” **Have you been feeling anxious and fatigued lately?** Or experiencing more autoimmune flare-ups? Even if you’re not at high risk for serious COVID-19 complications, having a chronic illness means that stress is often a symptom trigger. And the pandemic, in and of itself, can feel like an endless symphony of worry, isolation, life changes, and other stressors. You’re not alone. After surveying arthritis patients, [Creaky Joints reports that 42% of patients are experiencing an increase in fatigue](https://creakyjoints.org/living-with-arthritis/coronavirus/emotional-wellness/inflammatory-arthritis-fatigue-mental-health-issues-coronavirus-pandemic/?utm_source=GHLF+COVID-19+Support+Program&utm_campaign=e8a692eb43-real-time_email-26&utm_medium=email&utm_term=0_e0b05b1451-e8a692eb43-233043777) during the pandemic. ### Autoimmune Symptom Confusion It is not uncommon that some of your[ autoimmune symptoms mimic those of COVID-19](https://creakyjoints.org/living-with-arthritis/coronavirus/managing-symptoms/coronavirus-symptoms-different-with-autoimmune-conditions-chronic-illness/). You may be wondering how to tell them apart. One telltale sign you might have coronavirus is the loss of taste and smell, which is not a common autoimmune symptom. However, the data is still limited and there’s no hard-and-fast rule about which symptoms—like shortness of breath, fever, or fatigue—would signal presence of the virus and which would belong to an autoimmune flare-up. Below are a few thoughts from rheumatologists—thanks to the[ Global Healthy Living Foundation](https://www.ghlf.org/) and[ Creaky Joints](https://creakyjoints.org/living-with-arthritis/coronavirus/managing-symptoms/coronavirus-symptoms-different-with-autoimmune-conditions-chronic-illness/): 1. Rheumatic conditions (lupus, rheumatoid arthritis, scleroderma) do not seem to experience increased rates of infection or severe complications 2. If you experience a coronavirus-like symptom (like fever), be aware of other symptoms that may indicate patterns consistent with a flare-up 3. Notice if your dry cough, fever, fatigue, etc. is typical for your condition, or if it feels like something new ### Why Are Healthy People Affected? **A seemingly healthy individual may, in fact, be living with undetected issues in the body.** A preexisting—and possibly genetic—issue with the immune system may enable the virus to move from the nose and throat, and into the lungs ([12](https://www.nature.com/articles/d41586-020-01315-7), [13](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7289100/)). Unable to produce the antibodies responsible for barring the virus entry into certain cells, which is how coronavirus multiplies, the body is thrown into submission and develops complications like pneumonia and acute respiratory distress syndrome (ARDS) ([12](https://www.nature.com/articles/d41586-020-01315-7)). **Other undetected issues with the immune system, in conjunction with a COVID-19 infection, can give rise to events known as cytokine storms.** The ensuing events can land otherwise healthy people in the hospital. Cytokine storm is a general descriptor for any number of “hyperactive immune response\[s\] characterized by the release of interferons, interleukins, tumor-necrosis factors, chemokines, and several other mediators,” explain researchers in their JAMA article, [“Is a ‘Cytokine Storm’ Relevant to COVID-19?”](https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2767939) Sky-high numbers of these molecules (generally lumped together under the umbrella term of cytokines) are released and can wreak havoc on the body. The intensity of these hyperactive responses does not mean that the immune system is particularly good at fighting off the coronavirus. Rather, the off switch just doesn’t work. A bloated army of proinflammatory cytokines will remain on high alert and ready to fire well after the threat is over. Consequently, the immune system becomes chronically on-edge, which triggers actions against the body’s own cells. Herein lies the potentially deadly outcome, as it can eventually lead to multiple organ damage. The use of the term “cytokine storm” to describe the pathophysiology of severe COVID-19 complications is still debated. However, the theory has taken hold throughout the public and the scientific community. It brings a modicum of attention to immune-mediated events like autoimmunity, as we also see the cytokine storm phenomena in some autoimmune diseases, such as lupus and rheumatoid arthritis ([14](https://www.uab.edu/reporter/know-more/publications/item/8909-here-s-a-playbook-for-stopping-deadly-cytokine-storm-syndrome)). **Thankfully, severe complications in healthy individuals continue to be rare, and researchers are testing various drugs to dampen hyperactive immune responses.** Biologics used for many autoimmune diseases and affecting specific cytokine receptors and are currently being trialed as potential treatments for COVID-19 ([15](https://www.the-scientist.com/news-opinion/could-curbing-runaway-immune-responses-treat-covid-19--67450)). ### Can COVID-19 Trigger Autoimmune Disease or Illness? The body’s immune response to the virus is the center of the story here, as well. Some healthy individuals have experienced COVID-19 complications that do not result in immediate lung disease or death, but in the triggering and potential development of autoimmune conditions. In a [University College of London Hospital’s study](https://www.ucl.ac.uk/news/covid-neurology) of 43 patients previously infected with the coronavirus, eight acquired Guillain-Barre syndrome and nine acute disseminated encephalomyelitis (ADEM), both autoimmune diseases. The researchers suggest that this outcome was the result of the body’s immune response, rather than the virus itself. Other studies have identified an overproduction of multiple autoantibodies in some COVID-19 patients. According to researchers investigating [“The Correlation Between SARS-CoV-2 Infection and Rheumatic Disease”](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7194066/), such an event “is an important marker of autoimmune tolerance deficiency,” and may therefore signal a future of autoimmunity for those patients. **It is possible for COVID-19 to trigger the development of autoimmune disease or other post-infection fallout.** After all, other pathogens—Epstein-Barr virus (EBV), Parvovirus B19, Rubella virus—have been implicated in the development of autoimmune diseases ([13](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7289100/)). Nevertheless, the numbers are small, and further research is needed to understand the true impact and substantiate this theory. ### Long C**OVID** **Another possibility is long COVID—an extension of symptoms beyond the absence of infection.** The [National Institute for Health and Care Excellence](https://www.nice.org.uk/guidance/gid-ng10179/documents/final-scope) defines it as “signs and symptoms that develop during or following an infection consistent with COVID-19, continuing for more than 12 weeks and are not explained by an alternative diagnosis. It usually presents with clusters of symptoms, often overlapping, which can fluctuate and change over time and can affect any system in the body.” Symptoms many people with the condition can also experience are pain, fatigue, high temperature, and mental health conditions ([17](https://www.nice.org.uk/guidance/gid-ng10179/documents/final-scope)). In individuals with long COVID, coronavirus tests often come back negative. As a result, healthcare providers must lean more on patients’ personal experiences and symptoms, rather than evidence by way of test results. This different way of approaching health concerns could mean better care for people with chronic illness and autoimmune disease in the long-run. Other terms used to describe long COVID, like post-COVID syndrome and chronic COVID-19, actually “risk delegitimizing suffering…and that will make it harder for people to access care,” the authors of Nature editorial state ([16](https://www.nature.com/articles/d41586-020-02796-2)). Long COVID is coming into the spotlight as more and more researchers and doctors search for answers. If you or a loved one is experiencing long COVID, groups like [LongCovidSOS](https://www.longcovidsos.org/) are providing support and information. ### The Autoimmune COVID-19 Research Project One way we’re understanding more about the effects of COVID-19 on autoimmune disease is through patient-centered initiatives like the [Autoimmune COVID-19 Project](https://autoimmunecovid.org/), developed by the Global Healthy Living Foundation and Creaky Joints. The authors of this longitudinal study are using online surveys to gather a broad spectrum of perspectives from individuals with autoimmune disease. Information requested includes symptoms, experiences with testing, telehealth, concerns about immunosuppressive therapy, and preferred sources of information about the virus. Analyzing this data will produce a better understanding of the impact COVID-19 is having on quality of life. In this type of initiative, the experience of the patient is highly valued. Harnessing the expertise of researchers plus the power of patient voices will add a unique kind of knowledge to the conversation surrounding infectious disease today, as well as for future pandemics. **If you have been diagnosed with an autoimmune or related condition like rheumatoid arthritis, inflammatory bowel disease, multiple sclerosis, or vasculitis, you may** [**participate in this study**](https://autoimmunecovid.org/) to help researchers gain more insight into the relationship between COVID-19 and autoimmune disease. Our knowledge of autoimmune and the coronavirus is only going to increase, especially as the world gains a greater interest in the experiences and perspectives of the patients themselves. ### Reducing Risk **Just as nutrition and lifestyle factors can have profound impacts on our chronic conditions, so can they affect the way our bodies react when faced with COVID-19.** The forms of prevention we’re almost too familiar with—hand washing, face masks, social distancing, testing, contact tracing—are not our only tools. The seemingly benign factors of nutrition and lifestyle are powerful enough to steer us towards either health or disease. Practices such as proper nutrition and hydration contribute to optimal immune system function and that of other body systems, which helps prevent the virus from triggering severe complications. If we are able to make more healthful choices, then we can take some power back from the virus. It is important to keep in mind, however, that many people are living without access to fresh foods, support, financial stability, comfortable housing, and resources to manage their autoimmune diseases, let alone incorporate diet and lifestyle changes. This is one reason why all the other methods we’re using to combat the coronavirus (yes, like face masks!) are equally important. **As always, risk should be assessed on a case-by-case basis.** Outcomes depend on whether or not your disease is under control, you have multiple conditions, you’re taking medications, you experience racial inequities, you have access to quality care and resources, and a host of other factors with which we aren’t yet familiar. #### **Prevention Tips** - **Focus on your personal health by**[ **eating nutrient-dense whole foods and staying hydrated**](http://www.emro.who.int/nutrition/nutrition-infocus/nutrition-advice-for-adults-during-the-covid-19-outbreak.html) - **Get adequate rest** by practicing good sleep hygiene - **Move your body daily** through stretching, walking, yoga, swimming, dancing or any exercise that feels safe and enjoyable - **Keep chronic stress at bay**, as elevated stress, anxiety, and fear can keep our bodies in “fight or flight” mode. Research studies have repeatedly demonstrated the effects this state of being can have on our bodies – including our immune systems. The impacts of stress are especially important to all individuals with chronic conditions like autoimmune disease. - **Stay attuned to your mental health by following** [**psychologists’ advice for chronic illness patients**](https://creakyjoints.org/living-with-arthritis/coronavirus-anxiety-with-chronic-illness/?utm_source=GHLF+COVID-19+Support+Program&utm_campaign=7ec2760f96-auto_welcome-2&utm_medium=email&utm_term=0_e0b05b1451-7ec2760f96-233043777)**, practicing** [**mindfulness techniques**](https://positivepsychology.com/mindfulness-exercises-techniques-activities/)**,** [**reframing negative thoughts**](https://confidentcounselors.com/2018/03/19/reframe-negative-thoughts/)**, and reaching out to loved ones and others within the chronic illness community** #### **Autoimmune Disease and Holistic Health Information** - [COVID-19 and Autoimmune Disease](https://autoimmunewellness.com/covid-19-and-autoimmune-disease/) – Autoimmune Wellness resident medical advisor and functional practitioner, Dr. Rob Abbott, explains what COVID-19 is, the risks, and how to respond - [COVID-19 and Autoimmune Disease Risk: It Depends on the Condition](https://avivaromm.com/covid-19-autoimmune-disease/) and [COVID-19 Prevention: Commonsense to Natural Remedies](https://avivaromm.com/covid-19-natural-prevention/) – common sense approaches to the virus by Aviva Romm, an integrative MD - [Natural, Science-Backed Approaches to COVID-19](https://www.thepaleomom.com/natural-approaches-to-cold-flu-season/) – Dr. Sarah Ballantyne, The Paleo Mom - [Living with Immunosuppression During the Coronavirus Outbreak](https://www.thepaleomom.com/natural-approaches-to-cold-flu-season/) – personal account Kevin Brennan, who has an autoimmune disease #### **COVID-19 Resources from Organizations:** - [Beyond Celiac](https://www.beyondceliac.org/coronavirus/) - [Celiac Disease Foundation](https://celiac.org/about-the-foundation/featured-news/2020/03/celiac-disease-and-coronavirus-covid-19/) - [Creaky Joints](https://creakyjoints.org/coronavirus/) (arthritis and rheumatic disease) - [Crohn’s & Colitis Foundation](https://www.crohnscolitisfoundation.org/what-ibd-patients-should-know-about-2019-novel-coronavirus-covid-19) - [Global Healthy Living Foundation](https://www.ghlf.org/) - [JDRF](https://www.jdrf.org/coronavirus/) (juvenile / type I diabetes) - [Lupus Foundation of America](https://www.lupus.org/resources/coronavirus-and-lupus) - [Lupus Research Alliance](https://www.lupusresearch.org/covid-19-frequently-asked-questions/) - [Multiple Sclerosis Foundation](https://msfocus.org/About-Us/MSF-News-Articles/1251) - [National MS Society](https://www.nationalmssociety.org/What-you-need-to-know-about-Coronavirus-(COVID-19)) - [Myasthenia Gravis Foundation of America](https://myasthenia.org/Portals/0/Coronavirus%20-%20General%20Information%20and%20Management.pdf) - [National Rheumatoid Arthritis Society](https://nras.org.uk/information-support/information/coronavirus-and-ra/) - [Scleroderma Foundation](https://www.scleroderma.org/site/SPageServer?pagename=patients_COVID19_MSAB&AddInterest=1281#.XnFWcqhKhdo) - [Sjogren’s Syndrome Foundation](https://www.sjogrens.org/news/2020/coronaviruscovid-19-precautions-for-sjogrens-patients) ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** COVID-19 and Long Covid --- ### [Is Long COVID an Autoimmune Disease? Is SARS-CoV-2 an Autoimmune Virus?](https://www.autoimmuneinstitute.org/articles/is-long-covid-an-autoimmune-disease-is-sars-cov-2-an-autoimmune-virus) **Published:** March 27, 2021 **Author:** Carolyn Serraino **Content:** ## The Overlap Between COVID-19 and Autoimmunity A lack of diagnosing and misdiagnosing makes it nearly impossible to calculate a true estimate for how many people live with an autoimmune disease (AD). As AD cases continue to be on the rise, there is an even more apparent need to promote research and awareness on behalf of this sizable population ([1](https://www.nih.gov/news-events/news-releases/autoimmunity-may-be-rising-united-states)). The recent influx of scientific evidence around COVID-19 is showing a more direct correlation between the two. As the similarities between the symptoms and mechanisms of long-term SARS-CoV-2 infection (or long covid) and autoimmune disease became more apparent, researchers started calling the COVID-19-causing virus the “[autoimmune virus](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7598743/pdf/main.pdf).” This article breaks down some of the groundbreaking research corroborating this discovery into the following categories: - Presence of autoantibodies - Hyperferritinemia and cytokine storms - Molecular mimicry - HLA gene polymorphism ### Autoantibodies Activating Autoimmunity The current understanding surrounding [autoantibodies](https://www.autoimmuneinstitute.org/articles/decoding-the-role-of-autoantibodies-in-autoimmunity "Decoding the Role of Autoantibodies in Autoimmunity") is that they play a role in activating the immune response and induce cellular damage and inflammation ([2](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4497746/)). However, these findings have not been studied in all autoimmune diseases. The pathogenicity (ability to be disease-causing) of autoantibodies in mouse models with a lupus-like disease is the most thoroughly studied as of now ([3](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5786947/)). ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/COVID-SARS-CoV-2_Carolyn-article-infographics.png) *Comparing the presence of autoantibodies in autoimmune disease and COVID-19 infection.* S*ources for graphic: (*[*4,*](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC209428/pdf/JCI0114452.pdf)[*5*](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7080116/pdf/134_2020_Article_5991.pdf)*)* ### Hyperferritinemia & Cytokine Storms Hyperferritinemia is when there are unusually large amounts of ferritin in the blood. Ferritin is a protein that’s primary function appears to be the storage of iron and the concentrating of cellular iron to protect cells from its toxic effects ([6](https://www.sciencedirect.com/science/article/pii/B9780128096338040498)). It has recently emerged as an important molecule in the immune system response and, when present at normal levels, helps to coordinate the battle against hyper-inflammation. At higher levels, hyperferritinemia has been shown to lead to disease states by “mechanisms of inflammation, infection, injury, and repair” ([7](https://www.ima.org.il/FilesUploadPublic/IMAJ/0/42/21055.pdf)). The production of ferritin is regulated by cytokines. Cytokines respond to infection in part by expressing ferritin genes and when cytokines are being overproduced by macrophages (“**cytokine storm**“) it has been shown to enhance the inflammatory process and trigger an unusually large amount of ferritin in the blood ([8](https://bmcmedicine.biomedcentral.com/articles/10.1186/1741-7015-11-185)). It is suspected that the active ferritin production by macrophages and cytokines following COVID-19 infection might promote the production of several pro-inflammatory and anti-inflammatory cytokines ([9](https://pubmed.ncbi.nlm.nih.gov/32579952/)). ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/COVID-SARS-CoV-2_Carolyn-article-infographics-1.png) *Comparing hyperferritinemia and cytokine storms in autoimmune disease and COVID-19 infection.* *Sources for graphic: (*[*5*](https://pubmed.ncbi.nlm.nih.gov/32125452/)*,* [*7*](https://www.ima.org.il/FilesUploadPublic/IMAJ/0/42/21055.pdf)*,* [*10,* ](https://pubmed.ncbi.nlm.nih.gov/11354563/)[*11*](https://pubmed.ncbi.nlm.nih.gov/14626629/)*,* [*12*](https://pubmed.ncbi.nlm.nih.gov/33236582/)*,* [*13*](https://pubmed.ncbi.nlm.nih.gov/32120038/)*,* [*14*](https://pubmed.ncbi.nlm.nih.gov/32563547/)*,* [*15*](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7308649/)*,* [*16*](https://pubmed.ncbi.nlm.nih.gov/33610751/)*)* ### Malicious Molecular Mimicry Molecular mimicry has been drawing extra attention lately, as it is thought to be a possible mechanism of the autoimmune phenomena in COVID-19. Studies have shown that there is a homology (state of having the same or similar relation, relative position, or structure) of primary sequence between humans and components of SARS-CoV-2 ([17](https://link.springer.com/article/10.1007%2Fs12026-020-09152-6)). This is interesting in that the same structural similarity is not found in mammals unaffected by the virus, indicating that the virus is specifically adapting to imitate human biology. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/COVID-SARS-CoV-2_Carolyn-article-infographics-2.png) *Comparing molecular mimicry in autoimmune disease and COVID-19 infection.* *Sources for graphic: (*[*18*](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3266166/) *,* [*19*](https://pubmed.ncbi.nlm.nih.gov/17426366/) *,*[ *20*](https://www.karger.com/Article/FullText/502889) *,* [*21*](https://www.nature.com/articles/cmi2017151)*)* ### Polymorphism Predicting Pathogenicity It should come as no surprise that **there are significant genetic sequence variations when comparing individuals’ DNA.** These differences in the DNA sequence are called polymorphisms when they occur in ≥1% of the population. These polymorphisms can present silently (meaning they have not been found to alter the function or expression of a gene) or visibly. Polymorphisms can occur in any region of the genome, but the genes coding for the major histocompatibility complex (MHC), which in turn code the human leukocyte antigens (HLA) genes, have been found to contain the most polymorphic genes. This is relevant for the study of autoimmunity because these MHC molecules are involved in the immune system and interact with T-cells. ([22](https://www.sciencedirect.com/topics/biochemistry-genetics-and-molecular-biology/gene-polymorphism)) **What do these polymorphisms have to do with COVID-19?** Well, one of the biggest questions remaining is why some people have severe and potentially life-threatening responses to SARS-CoV-2 infection while others experience little to none. Another aspect of that question is why some individuals are developing autoimmune disease-related issues long after they’ve tested negative for COVID-19 and others are not. These differences have been found between individual patients as well as different populations. This discovery has led to the hypothesis that the differences in HLA genes might be influencing this variation through gene polymorphisms that involve one of two or more variants of a particular DNA sequence. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/COVID-SARS-CoV-2_Carolyn-article-infographics-3.png) *Comparing HLA gene polymorphism in autoimmune disease and COVID-19 infection.* *Sources for graphic: (*[*23*](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2628004/) *,* [*24* ](https://onlinelibrary.wiley.com/doi/full/10.1111/tan.14047?casa_token=eMLi8srLJW8AAAAA%3AHNKW9h5eryTOYrCZyW8D-_78rKuUjYjCz621P9dXTlNYWBQw3nCUZkuusdDRUJ8aPo1tiyIOgVKoLH_C)*,* [*25*](https://onlinelibrary.wiley.com/doi/full/10.1002/iid3.358) *,* [*26*](https://www.sciencedirect.com/science/article/abs/pii/S0210569120302667)*)* ### Further Associations Between Covid-19 and Autoimmunity The loss of smell has been a prevalent symptom experienced with COVID-19 infection. Olfactory dysfunction has been linked to several autoimmune diseases as well, including [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/ "Multiple sclerosis"), [lupus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus (SLE)"), and [myasthenia gravis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/myasthenia-gravis/ "Myasthenia gravis") ([28](https://pubmed.ncbi.nlm.nih.gov/29557516/)). While experts are not surprised by this connection, more research is required to bolster associations such as this one. The development of autoimmune diseases secondary to COVID-19 infection ([29](https://pubmed.ncbi.nlm.nih.gov/33015814/)–[35](https://pubmed.ncbi.nlm.nih.gov/32312628/)), bystander immunity activation ([14](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7308649/)), and neutrophil extracellular traps (NET) activation and release ([36](https://www.mdpi.com/1422-0067/22/2/559/pdf)), are some examples of more associations that, with stronger data and research, would show more robust connection to shed light on both autoimmune disease and COVID-19. ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** COVID-19 and Long Covid --- ### [Environmental and Lifestyle Risk Factors for Autoimmune Disease](https://www.autoimmuneinstitute.org/articles/beyond-genes-and-smoking-5-more-triggers-that-heighten-autoimmune-disease-risk) **Published:** February 26, 2024 **Author:** Carolyn Serraino **Excerpt:** Learn more about how pathogen influences, dysbiosis, dietary impacts, environmental triggers, and stress connections increase your risk of developing an autoimmune disease. **Content:** Genetics, smoking, and existing health conditions are only some of the factors that can influence a person’s susceptibility to autoimmune disease. These and other broad risk factors are discussed in our companion article, *[7 Risk Factors for Autoimmune Disease](https://www.autoimmuneinstitute.org/7-ad-risk-factors/ "7 Risk Factors for Autoimmune Disease")*. Environmental and lifestyle factors also play an important role in shaping immune function. Exposure to pathogens, changes in the gut microbiome, dietary patterns, environmental chemicals, and psychological stress have all been associated with autoimmune disease through complex biological mechanisms that researchers are continuing to investigate. Although these factors are discussed individually, they rarely act in isolation. Diet can influence the gut microbiome, environmental exposures may alter immune responses, and stress can affect both inflammation and microbial balance. Together, these interconnected influences help shape immune function and may contribute to autoimmune disease risk in genetically susceptible individuals. ## Pathogens as Autoimmune Triggers Infections are known to trigger autoimmunity. Pathogens, defined as microorganisms that cause an infection, may lead to autoimmune disease or activate flare-ups in people who already have an autoimmune disease. Examples are viruses like [SARS-CoV-2](https://www.autoimmuneinstitute.org/2021/03/27/is-long-covid-an-autoimmune-disease-is-sars-cov-2-an-autoimmune-virus/) and Epstein-Barr, and bacteria like *Streptococcus*, which have been [previously discussed](https://www.autoimmuneinstitute.org/risk-factors/). Other viral infections can activate immune responses that produce cross-reactive antibodies, which, in turn, may trigger an autoimmune disease. The influenza virus and HPV have been associated with multiple sclerosis, while coxsackie viruses have been associated with type 1 diabetes ([1](https://pubmed.ncbi.nlm.nih.gov/35736648/)). In a similar manner, bacterial pathogens have been linked to [reactive arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/reactive-arthritis/ "Reactive arthritis"), thyroid autoimmunity, [rheumatic fever](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatic-fever/ "Rheumatic fever"), and [lupus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus (SLE)") ([1](https://pubmed.ncbi.nlm.nih.gov/35736648/),[ 2](https://pubmed.ncbi.nlm.nih.gov/31781110/)). [Fungal infections](https://www.autoimmuneinstitute.org/articles/infection-and-immunity-turning-the-lens-on-microbes/) may be involved in autoimmune diseases, too. Candidiasis, caused by the *Candida* yeast, has been associated with an increased risk of developing multiple sclerosis ([3](https://pubmed.ncbi.nlm.nih.gov/20556470/),[ 4](https://pubmed.ncbi.nlm.nih.gov/23322279/)). However, despite the reported data, the causative link between the two is still unclear. A disorder known as autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED) brings together candidiasis and autoimmune disease by making people susceptible to chronic cutaneous infections by *Candida,* [type 1 diabetes](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/type-1-diabetes-insulin-dependent-diabetes/ "Type 1 diabetes (T1D)"), [vitiligo](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/vitiligo/ "Vitiligo"), and hypothyroidism ([5](https://pubmed.ncbi.nlm.nih.gov/37495514/)). Nevertheless, APECED is a complex condition with multiple clinical manifestations that merits further research ([6](https://pubmed.ncbi.nlm.nih.gov/2348835/)). ## Gut Dysbiosis and SIBO Pathogens are not the only microorganisms that trigger autoimmune disease. Dysbiosis, an imbalance in a person’s innate microbiome, may promote the loss of beneficial microorganisms and the growth of harmful ones in the human body, causing inflammation and other processes that lead to autoimmune disease ([7](https://pubmed.ncbi.nlm.nih.gov/35366249/),[ 8](https://pubmed.ncbi.nlm.nih.gov/29920643/)). Dysbiosis may occur in organs and tissues such as the intestinal tract, oral cavity, and skin, and has been associated with [lupus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus (SLE)"), [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/), [Sjogren disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sjogrens-syndrome/), and [systemic sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/scleroderma/ "Scleroderma (systemic sclerosis)") ([8](https://pubmed.ncbi.nlm.nih.gov/29920643/)). The excessive growth of bacterial populations in the gastrointestinal system may lead to a disorder called small intestinal bacterial overgrowth (SIBO). People with SIBO may show clinical signs such as abdominal pain and chronic diarrhea ([9](https://pubmed.ncbi.nlm.nih.gov/36615748/)). SIBO may influence or be linked to multiple conditions and disorders, including autoimmune diseases such as systemic sclerosis, [Hashimoto’s thyroiditis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/hashimotos-thyroiditis/), and [Graves’ disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/graves-disease/) ([9](https://pubmed.ncbi.nlm.nih.gov/36615748/),[ 10](https://pubmed.ncbi.nlm.nih.gov/36079838/)). However, additional studies are needed to unveil the complexity of SIBO and its relationship with the gastrointestinal tract and the immune system. ## Diet and Immune Health The mechanisms that regulate dysbiosis, SIBO, and gastrointestinal health are closely related to [nutrition](https://www.autoimmuneinstitute.org/gai-library/#microbiome). As an example, the combination of these factors was reported to affect thyroid autoimmunity ([10](https://pubmed.ncbi.nlm.nih.gov/36079838/)). Processed meats, refined sugars, dairy products, and even food colorings and preservatives increase the risk of intestinal inflammation and tissue damage that can lead to autoimmune diseases. Molecular mimicry, a process through which food items are mistakenly attacked as self-antigens, may be the main mechanism involved in triggering autoimmunity ([7](https://pubmed.ncbi.nlm.nih.gov/35366249/)). Hashimoto’s disease and inflammatory bowel disease are examples of autoimmune diseases that may be affected by diet and, therefore, can benefit from a healthy diet. The complex relationship between diet, gut health, and genetic susceptibility and their mechanistic effects on the immune system are still poorly understood. ## Environmental Exposures A person’s exposure to environmental factors alone may not be enough to cause autoimmunity, but their interactions with [genetics](https://www.autoimmuneinstitute.org/articles/how-sex-genetics-influence-autoimmunity "How Sex & Genetics Influence Autoimmunity"), health conditions, and other internal and external influences can lead to autoimmunity. Toxins, air pollutants, and certain chemicals have been described as autoimmunity triggers. Examples include the possible association of mercury, pesticides, and trichloroethylene (a chemical used as a cleaner for metal) with lupus and type 1 diabetes ([11](https://pubmed.ncbi.nlm.nih.gov/27666813/),[ 12](https://pubmed.ncbi.nlm.nih.gov/27497885/),[ 13](https://pubmed.ncbi.nlm.nih.gov/33949935/)), and the effects of silica (an additive in food and cosmetic items) on rheumatoid arthritis, systemic sclerosis, and, again, lupus ([14](https://pubmed.ncbi.nlm.nih.gov/27014276/)). Much of the evidence in this area comes from research conducted in laboratory animal models, such as the pristane-induced lupus model ([15](https://pubmed.ncbi.nlm.nih.gov/16177126/),[ 16](https://pubmed.ncbi.nlm.nih.gov/19699150/)); therefore, the causative relationship between environmental factors and autoimmune diseases in humans remains poorly understood. ## Stress, Trauma, and Immune Dysregulation  [Psychological](https://www.autoimmuneinstitute.org/articles/managing-mental-health-with-an-autoimmune-disease "Managing Mental Health with an Autoimmune Disease") and traumatic [stress](https://www.autoimmuneinstitute.org/articles/stress-autoimmune-disease-navigating-the-complex-relationship "Stress & Autoimmune Disease: Navigating the Complex Relationship") can contribute to the dysregulation of the immune system and impair the function of several immune factors, including cytokines, substances released by immune cells that affect other cells and cause inflammation ([17](https://pubmed.ncbi.nlm.nih.gov/18190880/)). A study published in the *Journal of the American Medical Association* found an association between post-traumatic stress disorder (PTSD) and autoimmune disease ([18](https://pubmed.ncbi.nlm.nih.gov/29922828/)). Characterized by psychological, behavioral, and physical signs and symptoms, PTSD is observed in some people who have gone through a traumatic event. As explained in a review paper published in *Nature*, PTSD may coexist with autoimmune diseases such as rheumatoid arthritis, multiple sclerosis, and psoriasis, affecting the immune system and triggering inflammation ([19](https://pubmed.ncbi.nlm.nih.gov/35927237/)). Nevertheless, the mechanisms behind the relationship between stress-related disorders and autoimmune disease remain unclear. ## Reduce Your Risk Although knowing about risk factors is an essential requirement for living a healthy life, exposure to any of the triggers discussed here does not necessarily mean you will develop an autoimmune disease. Talk to your doctor about ways to minimize infection, avoid exposure to potentially harmful chemicals, eat a balanced diet, and manage stress. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/04/GAI-Logo-Image-811x1024.png) #### About the Author **Damiana Chiavolini, MS, PhD** is a freelance writer who specializes in medical and life science topics. As a trained researcher, she authored journal articles in the areas of infection and immunity and wrote booklets and book chapters about different diseases. As a professional communicator, she writes feature articles for magazines and other publications and produces content for higher education platforms. Damiana is also an experienced academic editor, microbiology educator, writing coach, and fragrance blogger. She is a contributing member of the American Medical Writers Association and the immediate past-president of the association’s Southwest Chapter. ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** About Autoimmune Disease --- ### [The Promise of Artificial Intelligence (AI) in Autoimmune Disease Healthcare](https://www.autoimmuneinstitute.org/articles/the-promise-of-ai-in-autoimmune-disease-from-early-detection-to-personalized-care) **Published:** August 1, 2024 **Author:** Carolyn Serraino **Excerpt:** GAI consults experts to discuss how AI appears to be a transformative tool in the realm of medical research and care, but potential ethical consequences remain. **Content:** GAI consulted with two experts, **Harvey Castro, MD**, an emergency medicine physician and AI in healthcare expert and **Michelle Mello JD, PhD**, professor of law and health policy at Stanford University School of Medicine to discuss how artificial intelligence (AI) has emerged as a groundbreaking frontier in healthcare, offering revolutionary innovations alongside significant challenges. In the realm of autoimmune disease research and patient care, AI appears to be a powerful and transformative tool. ## What is AI? AI encompasses an area of digital technology involved with how machines learn and use what they’ve learned to imitate human behavior. Behaviors can range from carrying out basic tasks to analyzing vast amounts of information to solve problems. One type of AI, machine learning (ML), is particularly exciting in healthcare. ML focuses on recognizing patterns in data sets and using what is “learned” to better understand the body and disease. ## How Is AI Transforming Healthcare? Through ML, AI is already being applied in the growing field of precision medicine. Precision medicine uses specific patient characteristics and health information to design treatments most likely to help that individual. Precision medicine has a growing presence in cancer treatment, where AI is enabling earlier diagnosis, new drug discovery, and innovation for more targeted approaches to research and care ([1](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6616181/)). Dr. Castro sees the opportunities for AI in diagnosis, treatment planning, and communication. #### “AI algorithms, especially deep learning-based ones, can analyze medical images with high accuracy. For instance, AI systems detect early signs of diseases like cancer from radiographic images, often more precisely than human radiologists.” Dr. Castro also sees the potential for AI in engaging and educating patients through tools such as AI-powered chatbots and virtual assistants. These tools are available 24/7 to meet a variety of healthcare-related needs. AI can also support healthcare providers. Dr. Mello sees the potential for AI in supporting better-informed decision-making for healthcare providers. She believes that AI has the potential to overcome some of the human sources of bias that might lead physicians to different kinds of conclusions. She also notes that AI’s benefits might include “Helping us better risk stratify patients so that the resources can be targeted to the ones that are most likely to benefit, whether that’s additional screening or your supervision during hospitalization or post-discharge check-ins.” ## How Is AI Being Used in Autoimmune Disease Research and Care? **AI is rapidly evolving in various areas of research and patient care ([2](https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2022.966329/full))** ## DNA/RNA Sequencing Using genetic information to better understand disease mechanisms and find potential treatment targets. ## Data Set Analysis Analyzing large amounts of research and patient data to inform research and patient care. ## Digital Pathology Finding abnormalities in tissue samples that are undetectable by humans. ## Digital Radiology Detecting abnormalities in radiological studies that the human eye misses. ## Medical Device Technology Developing devices to help prevent and manage illnesses ([3](https://www.mckinsey.com/industries/social-sector/our-insights/public-healths-inflection-point-with-generative-ai)). Autoimmune diseases form a heterogeneous group of disorders. AI is helping researchers and healthcare providers decipher this complexity by finding the multiple target inflammatory pathways that trigger autoimmune diseases. This will help healthcare providers better understand diagnoses, disease progression, and treatment ([4](https://www.tandfonline.com/doi/abs/10.1080/1744666X.2022.2012452)). Variability is found between people affected by the same autoimmune disease and across different types of autoimmune diseases. Many autoimmune diseases share similar generalized symptoms, such as fatigue and cognitive changes, complicating understanding and treatment. AI can help identify the unique features of each autoimmune disease and design more appropriate therapies. #### Dr. Mello sees an exciting role of AI in improving care for people with autoimmune diseases, noting the role of AI in reducing care fragmentation. She reflects, “I think that those patients are often being cared for by many different physicians. For patients like that, who find themselves having to tell their story over and over again to the next \[physician\], it would be really wonderful if some outcome of this would be \[to\] make care simpler for the patient and for physicians who are functioning as part of a care team.” ## Current and Potential Applications of AI in Autoimmune Disease #### Early Detection of an Autoimmune Disease Autoimmune diseases are typically diagnosed in adulthood. By analyzing large amounts of patient information, AI has the potential to enable earlier diagnosis and treatment by detecting subtle differences in patient data. This may allow for disease detection before the onset of symptoms. AI has been studied for early diagnosis of [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/) (MS) and [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/) (SLE) ([5](https://www.nature.com/articles/s41746-020-0229-3)). Dr. Castro says that radiology, oncology, and cardiology are all on the leading edge of embracing AI for early disease detection, noting that “Oncology leverages AI for early detection of cancers, treatment personalization, and monitoring patient progress.” Similar uses for AI are being explored in autoimmune diseases. #### Predicting the Risk of Developing an Autoimmune Disease AI can identify risk factors in individuals before the onset of an autoimmune disease. These factors can help identify people at risk for developing autoimmune diseases, such as [inflammatory bowel disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crohns-disease/) (IBD), [SLE](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic Lupus Erythematosus"), [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/) (RA), and [type 1 ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/diabetes-type-1/)[diabetes](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/diabetes-type-1/) (T1D) ([5](https://www.nature.com/articles/s41746-020-0229-3)). #### Improving the Accurate Diagnosis of Autoimmune Disease AI can distinguish between those who have a specific autoimmune disease and those who do not or who have a different autoimmune disease. For example, ML has been used to differentiate people with [celiac disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/celiac-disease/ "Celiac disease") from those with irritable bowel syndrome ([6](https://pubmed.ncbi.nlm.nih.gov/25330367/)). #### Identifying Subtypes of Autoimmune Disease AI can classify subtypes of autoimmune diseases based on features such as disease severity or specific symptoms. This has been shown in diseases like RA, IBD, and MS ([5](https://www.nature.com/articles/s41746-020-0229-3)). #### Understanding the Progression of Autoimmune Disease AI can clarify disease severity and treatment responses, as seen in studies on RA and IBD, improving the management of these conditions ([5](https://www.nature.com/articles/s41746-020-0229-3)). #### Enhancing the Monitoring and Management of Autoimmune Disease AI models for [SLE](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic Lupus Erythematosus"), [Sjogren’s](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sjogren-syndrome/)[ syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sjogren-syndrome/), and [RA](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid Arthritis") have confirmed the complexity of these diseases, aiding in more targeted treatment design ([7](https://www.cell.com/trends/pharmacological-sciences/fulltext/S0165-6147(23)00088-3)). Healthcare providers have used AI tools to improve glucose monitoring in T1D, enhancing disease management ([5](https://www.nature.com/articles/s41746-020-0229-3)). ## What Are the Ethical Considerations in AI Healthcare Applications? While AI offers significant advancements in medical research and care, there are ethical issues, such as patient data collection and transparent clinical decision-making, to consider. Dr. Mello notes, “My biggest concern is just the speed with which it’s happening, which has very good reasons behind it. I understand the exuberance. There’s a lot that this development can improve about healthcare, but it hasn’t left a great deal of time for healthcare organizations to closely evaluate the tools that they’re thinking about implementing.” She notes that there aren’t regulatory requirements to guide the implementation of AI in healthcare settings, and many healthcare organizations aren’t vetting or monitoring AI apps themselves. Ethical considerations include (1): ## AI Errors Like humans, AI can make errors. Minimizing errors and ensuring accountability and transparency when they occur is crucial. ## Patient Protection All patient-related information must be protected, and privacy standards in research and care must be kept high. ## Transparency AI sometimes interprets data and solves problems in ways that humans do not fully understand, complicating patient communication around diagnosis and treatment recommendations. ## Algorithmic Bias AI learns from human-created algorithms, which can carry biases that impact research and patient care outcomes.What Are the Ethical Considerations in AI Healthcare Applications? AI holds tremendous potential for transforming autoimmune disease research and patient care. By augmenting human knowledge and surpassing human capabilities, AI can help deliver optimal care. However, this progress must address the ethical challenges of fully integrating AI into healthcare. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/04/GAI-Logo-Image-811x1024.png) #### About the Author **Tracy Asamoah, MD**, is a writer, child and adolescent psychiatrist, and leadership coach based in Austin, Texas. She completed her medical education at the University of California, San Francisco, and her general psychiatry residency and child and adolescent fellowship at the David Geffen UCLA School of Medicine. Tracy has served on the faculty of the University of New Mexico School of Medicine and the Texas A&M School of Medicine. Tracy’s journey into the world of autoimmune diseases began when she experienced sudden onset symptoms of multiple sclerosis early in her medical career. This personal experience, combined with her intense curiosity, has informed her work and writing in the field. As a writer, Tracy has contributed to various books and written articles related to mental health. She’s also written on various medical topics regularly contributing to publications such as GoodRx, Psychology Today, and Psychotherapy.net. ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** Diagnosis & Treatment --- ### [GLP-1 Receptor Agonists and Autoimmune Diseases](https://www.autoimmuneinstitute.org/articles/glp-1-receptor-agonists-and-autoimmune-diseases) **Published:** June 18, 2026 **Author:** Carolyn Serraino **Excerpt:** If you have an autoimmune disease, should you be concerned about GLP-1 medications? Here's what experts and current research say so far. **Content:** ## What’s the Connection and How Do They Affect Each Other? Since the first GLP-1 receptor agonist was [approved in 2005](https://my.clevelandclinic.org/health/treatments/13901-glp-1-agonists), there has been an incredible demand for this type 2 diabetes and obesity drug. A [Kaiser Family Foundation poll](https://www.kff.org/public-opinion/poll-1-in-8-adults-say-they-are-currently-taking-a-glp-1-drug-for-weight-loss-diabetes-or-another-condition-even-as-half-say-the-drugs-are-difficult-to-afford/) published in 2025 found that approximately 12% of adults in the US are currently taking a GLP-1 drug. Many people who are taking GLP-1s have other diseases or conditions beyond type 2 diabetes and obesity. Researchers are beginning to see effects of these drugs on cardiovascular disorders, arthritis, sleep apnea, and kidney and liver conditions (1). This is also the case for autoimmune diseases, but so far, the evidence has been mixed. **In this article, we take a look at**: - How GLP-1s impact autoimmune diseases - Direct and indirect effects of GLP-1s on autoimmune diseases - What to consider before starting a GLP-1 agonist ## How Do GLP-1 Drugs Work? GLP-1 stands for glucagon-like peptide-1. It is a hormone naturally produced in the gut in response to food intake (2). GLP-1 binds to the GLP-1 receptor, which then triggers insulin release, blocks glucagon secretion, slows stomach emptying, and increases satiety. GLP-1 drugs are sometimes referred to as “GLP-1 receptor agonists,” meaning that they mimic the GLP-1 hormone produced in the body and bind GLP-1 receptors. Colloquially, the terms GLP-1, GLP-1 agonists, and GLP-1 receptor agonists are used interchangeably to refer to the medication. However, in scientific contexts, these terms have different meanings. ## Long-Term Health Effects of GLP-1 Agonists Common side effects of GLP-1s are gastrointestinal symptoms such as nausea, vomiting, diarrhea, and constipation. These side effects are considered short-term, and because GLP-1 drugs are relatively new, there’s less data on long-term effects. One concern about GLP-1 has been the loss of muscle mass. However, a recent study found that although muscle mass is lost, it is not disproportionate to fat loss (3). It’s also possible that rapid weight loss and decreased nutritional intake can reduce bone density and increase fracture risk, but we still need more studies in this area (4). Additional resources about the effects of GLP-1s on muscle loss and bone density can be found here: - Cleveland Clinic: [Taking GLP-1s? Make Sure You Exercise](https://health.clevelandclinic.org/exercise-for-glp-1-use) - Mass General: [Preserving Lean Body Mass in Patients Taking GLP-1 for Weight Loss](https://advances.massgeneral.org/endocrinology/article.aspx?id=1601) - Mayo Clinic: [GLP-1 Medications and Muscle Loss: What to Know About Nutrition and Supplements](https://store.mayoclinic.com/education/glp-1-medications-and-muscle-loss-what-to-know-about-nutrition-and-supplements/) - Mayo Clinic: [Pros and cons of GLP-1 agonists for weight loss](https://communityhealth.mayoclinic.org/featured-stories/weight-loss-drugs) ## What’s the Evidence? How GLP-1s Impact Autoimmune Diseases Some immune cells contain receptors for GLP-1, and most studies so far show that GLP-1 drugs have an anti-inflammation effect (5,6,7). GLP-1 signaling reduces inflammatory responses in immune cells and decreases production of some inflammatory molecules, says Tue Wenzel Kragstrup, MD, PhD, Associate Professor, Department of Biomedicine, Aarhus University. Studies have found that GLP-1 receptor signaling can regulate maintenance of regulatory T cells and change the inflammatory state of macrophages (7,8). Another study points to a role in the brain when it comes to reducing inflammation. This study found that GLP-1 drugs reduced inflammation only when receptors that bind GLP-1 in the brain weren’t blocked (9). However, these studies might not directly translate into tangible outcomes for patients. “Most of these findings come from laboratory and animal studies,” says Kragstrup. “We still need more data from human studies to understand how relevant these mechanisms are in patients.” These types of studies are becoming more prevalent. One of these human studies included a clinical study in patients with type 2 diabetes and psoriasis that found that the GLP-1 drug, liraglutide, provided symptom relief but also reduced levels of pro-inflammatory cytokines in the body (10). A systematic review, however, found differing results among 33 publications, with 20 of them focused on inflammatory bowel disease and 13 on other immune-mediated inflammatory disorders (IMIDs) (11). **This study found**: - Out of 3 studies about new-onset IBD/IMID among people who use GLP-1s, two of them showed a lower incidence of these autoimmune conditions - Some studies found that hospitalizations, IBD complications, surgery, and mortality were reduced in those also taking GLP-1s However, another study, which looked at ~800,000 patients with type 2 diabetes, found that the use of GLP-1 drugs (as opposed to DPP-4is, another drug used to treat type 2 diabetes) was associated with a higher incidence of certain autoimmune diseases (12). More recently, another large real-world study comparing GLP-1 receptor agonists with other diabetes medications found a more nuanced pattern (13). Compared with DPP-4 inhibitors, GLP-1 receptor agonists were associated with higher rates of some autoimmune diseases, including [psoriasis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/psoriasis/ "Psoriasis"), [psoriatic arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/psoriatic-arthritis/ "Psoriatic arthritis"), and [autoimmune thyroiditis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/hashimotos-thyroiditis/ "Hashimoto’s thyroiditis (autoimmune thyroiditis)"), but lower rates of [dermatomyositis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/dermatomyositis/ "Dermatomyositis") and [bullous pemphigoid](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/bullous-pemphigoid/ "Bullous pemphigoid"). However, no significant differences in autoimmune disease risk were observed when GLP-1 receptor agonists were compared with SGLT2 inhibitors. Together, these findings reinforce that the relationship between GLP-1 medications and autoimmune disease remains complex and that additional prospective studies are needed. So what are the reasons that GLP-1s seem to help in some cases and not others? “Autoimmune diseases are not all the same,” says [Angela Mazza](https://drangelamazza.com/), DO, an internal medicine physician, integrative endocrinologist, and founder/medical director of Metabolic Center for Wellness. #### “A medication could theoretically reduce inflammation in one context while having a different association in another.” Another reason for these differences lies in the study design, such as whether they were done in humans or animals and what kind of data the researchers are using to make these associations. Kragstrup adds, “Many of the studies showing anti-inflammatory effects are experimental studies, while some of the signals about increased risk come from observational studies in large patient populations. These types of studies answer different questions and have different limitations.” Mazza adds, “The immune system is highly complex, so we should be cautious about saying GLP-1 drugs treat autoimmune disease directly.” ## Why Is It Hard to Distinguish Between Direct and Indirect Effects of GLP-1s on Autoimmune Diseases? Mazza says that right now, the best evidence we have about the impact of GLP-1s on autoimmune disease is “indirect.” This is because obesity, insulin resistance, and chronic inflammation can worsen immune dysregulation, she explains. Kragstrup adds that weight loss on its own can reduce inflammation, improve joint pain, and improve overall health. Therefore, it can be hard to tell whether any effects on other diseases such as autoimmune diseases are a direct effect of the drugs or an indirect effect due to weight loss. For future research, Kragstrup and Mazza both emphasized the importance of teasing apart the indirect effects of weight loss on autoimmune diseases from the direct effects of GLP-1s on the disease. ## GLP-1 Found in the Joints: Headways Into Rheumatoid Arthritis Studies For [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid arthritis"), things become even more interesting. Kragstrup’s research team recently found that GLP-1 can be detected in joint fluid (14). These levels mirrored the levels of GLP-1 in the blood. Since this study is a preliminary one, Kragstrup notes that there are several steps until it can actually be used to treat rheumatoid arthritis and other joint conditions. “First, we need to understand whether GLP-1–based drugs reach the joints in sufficient amounts when given as treatment. Second, we need to identify which cells in the joint can respond to GLP-1,” he says, noting that clinical trials that show improvements to disease activity or joint damage are also key. Kragstrup is interested in how injection of GLP-1 drugs into the joint could tease out the direct effects on the joints versus the more indirect effects of weight loss on the joints. “If the drug is injected directly into the joint, patients may have little or no systemic exposure and therefore little or no weight loss,” he says. ## I Have an Autoimmune Disease. What Should I Consider Before Starting a GLP-1? As with any medication, start by talking with your doctor about the pros and cons of how the drug will affect any current conditions. For autoimmune diseases, this could mean keeping a closer eye on your symptoms. “The main difference compared with someone without autoimmune disease is that we want to be more intentional about monitoring,” says Mazza. For example, patients with [Crohn’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crohns-disease/ "Crohn’s disease") or IBD may need closer monitoring, and for patients with [autoimmune thyroid disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/hashimotos-thyroiditis/ "Hashimoto’s thyroiditis (autoimmune thyroiditis)"), Mazza recommends thinking about the bigger metabolic picture. “If weight loss is significant, thyroid hormone requirements may also change,” she explains. Still, as things currently stand, GLP-1s are only approved for type 2 diabetes and weight management. “While there is growing research interest, we do not yet have strong evidence that they directly treat conditions like rheumatoid arthritis,” says Kragstrup. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/GAI-Logo-Image-e1707845715517.png) **Disclaimer** This article is intended for educational purposes only and is not a substitute for professional medical advice. Although researchers are actively studying the relationship between GLP-1 receptor agonists and autoimmune diseases, these medications are not currently approved to treat autoimmune conditions. Findings discussed in this article should not be interpreted as recommendations for treatment. Always consult your healthcare provider before making decisions about medications, treatment plans, or management of an autoimmune disease. #### About the Author ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/10/Jennifer-Tsang-Bio-Headshot-e1753113113430.jpg) A microbiologist turned freelance science writer who works with life science companies, nonprofits, and academic institutions on anything from news stories, explainer articles, and content marketing. She shares the wonderful world of microbes on her blog [The Microbial Menagerie](https://microbialmenagerie.com/). Jennifer Tsang, PhD Freelance Writer for GAI ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** Diagnosis & Treatment --- ### [Examining Pre-Autoimmunity: Can Autoimmune Disease Be Prevented?](https://www.autoimmuneinstitute.org/articles/examining-pre-autoimmunity-can-autoimmune-disease-be-prevented) **Published:** December 22, 2023 **Author:** Carolyn Serraino **Excerpt:** The period between the onset of asymptomatic autoimmunity and the development of symptomatic disease is referred to as “pre-clinical” autoimmunity, as the appearance of autoantibodies precedes most autoimmune diseases. While there is currently no way to prevent someone from developing an autoimmune disease, there are promising advancements in scientific discovery. **Content:** ## What is “Pre-Clinical” Autoimmune Disease? **The period between the onset of asymptomatic autoimmunity and the development of symptomatic disease is referred to as “pre-clinical” autoimmunity, as the appearance of autoantibodies precedes most autoimmune diseases.** Most people with autoimmune disease only develop symptoms after abnormal immune reactions begin ([1](https://www.sciencedirect.com/science/article/abs/pii/S0009898114002733?via%3Dihub)). Pre-autoimmunity has been observed in several autoimmune diseases, including [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid arthritis"), [systemic lupus erythematosus (SLE)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus (SLE)"), [Sjögren disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sjogren-syndrome/ "Sjögren disease (SjD)"), [primary biliary cholangitis (PBC)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/primary-biliary-cirrhosis/), inflammatory bowel disease ([](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crohns-disease/ "Crohn’s disease")[Crohn’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crohns-disease/) and [](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ulcerative-colitis/ "Ulcerative Colitis")[ulcerative colitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ulcerative-colitis/)), and [](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/ "Multiple Sclerosis")[multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/) ([2](https://www.sciencedirect.com/science/article/abs/pii/S0009898114002733?via%3Dihub)). ## Can Autoimmune Disease Be Prevented? Autoimmunity occurs when the immune system attacks its host. Autoimmune diseases are largely thought to result from immune dysregulation, and while there is currently no way to prevent someone from developing an autoimmune disease, there are promising advances in scientific research. Recently, “scientists identified a new type of human T cell that quells assaults on healthy tissues” ([3](https://www.science.org/content/article/new-class-killer-t-cells-may-prevent-autoimmune-diseases)). T cells (specifically those distinguished by the surface protein CD8), previously known for killing infected or cancerous cells, were found to kill other T cells that orchestrate autoimmune reactions in mice. The existence of CD8 T cells in humans is now confirmed. Separately, a team at Johns Hopkins is looking for solutions at the cellular level by using a protein that activates and increases the number of special, regulatory T cells that can stop autoimmune disease development. “The molecule, which fuses the interleukin-2 cytokine and the anti-cytokine antibody F5111, promoted T cell activation and expansion and protected non-obese diabetic mice against autoimmune disease development to a statistically significant degree,” an article from Johns Hopkins [explained](https://hub.jhu.edu/2022/10/21/researchers-design-protein-to-prevent-autoimmune-disorders/). Researchers at the Walter and Eliza Hall Institute also identified an enzyme that appears to prevent autoimmune diseases. An enzyme in the thymus, KAT7, was found to be necessary to activate thousands of genes needed for “training” immune T cells not to attack healthy tissue. The [research](https://www.sciencedaily.com/releases/2022/01/220131185859.htm) “paves the way for potential treatments to target KAT7, which could modify the training of immune T cells as needed.” ## Can Pre-Autoimmunity Be Detected? The average autoimmune disease diagnosis takes four years from the onset of symptoms. #### Diagnosing autoimmune diseases can be difficult because there is no one specific autoimmune disease test. Many autoimmune diseases also exhibit symptoms that are common to other conditions, such as muscle aches and a low-grade fever ([4](https://medlineplus.gov/autoimmunediseases.html)). To diagnose an autoimmune disease, a patient must have specific symptoms combined with specific blood markers and, in some cases, even a tissue biopsy ([5](https://www.hopkinsmedicine.org/health/wellness-and-prevention/what-are-common-symptoms-of-autoimmune-disease)). The following tests may help: ## C-Reactive Protein (CRP) Test A CRP test measures the level of CRP, a protein made by the liver. Higher levels of CRP in the bloodstream indicate inflammation in the body and may indicate an autoimmune disease. Chronic infections, certain autoimmune disorders, and other diseases can cause harmful chronic inflammation ([6](https://medlineplus.gov/lab-tests/c-reactive-protein-crp-test/)). ## Erythrocyte Sedimentation Rate (ESR) Test ESR is a blood test that measures the rate at which erythrocytes (red blood cells) settle at the bottom of a test tube containing a blood sample. Red blood cells that settle relatively quickly may indicate inflammation in the body, which may be a sign of a chronic disease, an immune disorder, or other medical condition ([7](https://medlineplus.gov/lab-tests/erythrocyte-sedimentation-rate-esr/)). ## Antinuclear Antibody (ANA) Test An ANA test looks for antinuclear antibodies in your blood. Your immune system uses antibodies to fight foreign substances such as viruses and bacteria. An antinuclear antibody attacks your own healthy cells instead. A large number of antinuclear antibodies in your blood may indicate an autoimmune disorder, including [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/), [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/), [Addison’s Disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-addisons-disease/) and [Autoimmune Hepatitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-hepatitis/) ([8](https://medlineplus.gov/lab-tests/ana-antinuclear-antibody-test/)). ## What Can Studying Pre-Autoimmunity Tell Us about Disease Outcomes? Understanding pre-autoimmunity and the development of autoimmunity may offer key insight into the progression of autoimmune diseases. Immunological and metabolic pathways are one of the most hopeful ways to find specific and early interventions at the individual patient level, and there is currently a plethora of research focused on pre-clinical autoimmunity across a number of conditions ([9](https://www.frontiersin.org/research-topics/18412/understanding-the-concept-of-pre-clinical-autoimmunity)). **One [research team](https://www.autoimmuneinstitute.org/about-us/whatwedo/research/) at Boston Children’s Hospital, funded by The Global AutoImmune Institute, uses blood samples to simultaneously test for multiple autoantibodies associated with many different autoimmune conditions using autoantigen microarray panels**. Utilizing this technology, the team will investigate whether there are identifiable autoantibody signatures that can distinguish individuals who have only one autoimmune condition from those who have multiple. The hope is to discover biomarkers that can be used to identify individuals who are at risk of [polyautoimmunity](https://www.autoimmuneinstitute.org/articles/living-with-multiple-autoimmune-conditions "Living with Multiple Autoimmune Conditions") prior to its development. The team will then use these findings to develop a standardized approach to screen and care for patients with multiple autoimmune conditions. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/04/GAI-Logo-Image-811x1024.png) ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** Diagnosis & Treatment --- ### [Stay Cool: How to Manage Autoimmune Flare-ups in Hot Temperatures](https://www.autoimmuneinstitute.org/articles/stay-cool-how-to-manage-autoimmune-flare-ups-in-hot-temperatures) **Published:** May 19, 2023 **Author:** Carolyn Serraino **Excerpt:** Heat and humidity can worsen symptoms for some people with autoimmune diseases. Learn why this happens, how to reduce the risk of heat-related flare-ups, and what research suggests about the effects of a warming climate on autoimmune health. **Content:** With temperatures rising, many people with autoimmune diseases are concerned that heat will trigger flare-ups. While warmer conditions and sunlight can provide relief for some people, heat and humidity can worsen signs and symptoms and lead to uncomfortable outbursts in others. This article will discuss some of the diseases aggravated by high temperatures, why certain manifestations may occur more during the summer, and how people can avoid or manage flare-ups. Some of global warming’s effects on autoimmunity will also be discussed. ### **Warm Temperature’s Effects On Autoimmunity** The relationship between heat and autoimmunity is poorly understood and supported by studies that often rely on self-reported signs and symptoms. Nevertheless, some autoimmune diseases clearly worsen with heat. **High temperatures, ultraviolet (UV) light, and humidity can trigger autoimmune flare-ups by inducing inflammation and affecting an already impaired immune system** ([1](https://www.providence.org/news/uf/624302840)). However, some diseases will flare up more than others. Also, people with the same autoimmune illness may have different signs and symptoms in the warmer months. Many heat-related flare-ups are transient and disappear once relief is sought, but this also varies from person-to-person. For example, many people with multiple sclerosis may have temporary blurred vision, fatigue, dizziness, weakness, numbness and tingling in the extremities, and even cognitive problems ([2](https://www.nationalmssociety.org/Living-Well-With-MS/Diet-Exercise-Healthy-Behaviors/Heat-Temperature-Sensitivity),[ 3](https://pubmed.ncbi.nlm.nih.gov/21352533/),[ 4](https://pubmed.ncbi.nlm.nih.gov/20671034/)). These issues occur because heat slows down impulse transmission in areas affected by demyelinating plaques, such as the brain and spinal cord ([2](https://www.nationalmssociety.org/Living-Well-With-MS/Diet-Exercise-Healthy-Behaviors/Heat-Temperature-Sensitivity),[ 3](https://pubmed.ncbi.nlm.nih.gov/21352533/)). ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Hot-Weather-effects-on-the-body-1.png) Research studies on the link between systemic lupus erythematosus and different weather conditions have revealed that warmer temperatures are associated with flare-ups that depend on what system or organ the disease attacks ([5](https://acrabstracts.org/abstract/environmental-and-atmospheric-factors-in-systemic-lupus-erythematosus-a-regression-analysis/),[ 6](https://pubmed.ncbi.nlm.nih.gov/32017464/)). Some of the observed signs include increased fatigue, joint pain, rashes, and blood-related flare-ups, such as changes in cell counts and antibody levels ([5](https://acrabstracts.org/abstract/environmental-and-atmospheric-factors-in-systemic-lupus-erythematosus-a-regression-analysis/),[ 6](https://pubmed.ncbi.nlm.nih.gov/32017464/)). The Lupus Foundation of America indicates that people with lupus are more sensitive to sunlight because the damaged cells are not cleared as promptly by an impaired immune system. This reduced clearance triggers immune reactions that lead to flare-ups ([7](https://www.lupus.org/resources/uv-exposure-what-you-need-to-know)). While warm weather and sunlight can often improve skin autoimmune disorders such as psoriasis, factors such as sunburn, injuries, and insect bites while spending time outside may trigger flare-ups that may cause plaques to become inflamed and painful ([8](https://www.psoriasis.org/advance/taking-care-of-your-skin-in-summer/),[ 9](https://www.aad.org/public/diseases/psoriasis/triggers/flares)). People living with different forms of arthritis may also be more susceptible to flare-ups in warmer times of the year. In the heat, joint pain and swelling may become more intense for some patients with psoriatic arthritis and rheumatoid arthritis ([8](https://www.psoriasis.org/advance/taking-care-of-your-skin-in-summer/),[ 10](https://pubmed.ncbi.nlm.nih.gov/24597710/)). ### **Living Well During The Warmer Months** If you suffer from an autoimmune disease, you can still enjoy your summer by preparing for both outdoor and indoor activities and checking in with your doctor about prevention strategies. Weather fluctuations often trigger flare-ups, so minimizing any sudden temperature changes helps reduce the risk of signs and symptoms. Wear lightweight, loose clothing such as vests, pants, and dresses ([2](https://www.nationalmssociety.org/Living-Well-With-MS/Diet-Exercise-Healthy-Behaviors/Heat-Temperature-Sensitivity)). Also, wear light scarves to protect sensitive areas such as the neck ([2](https://www.nationalmssociety.org/Living-Well-With-MS/Diet-Exercise-Healthy-Behaviors/Heat-Temperature-Sensitivity)). Choose breathable fabrics such as linen or cotton, and consider long sleeves and pants in lighter colors that absorb less heat. Wear hats and sunglasses and limit sun exposure to the morning or later afternoon hours ([2](https://www.nationalmssociety.org/Living-Well-With-MS/Diet-Exercise-Healthy-Behaviors/Heat-Temperature-Sensitivity),[ 8](https://www.psoriasis.org/advance/taking-care-of-your-skin-in-summer/)). Enjoy outdoor swimming but take care to protect your skin from sunburn. Mineral-based sunblock options (with zinc or titanium) are best because they form a physical barrier, do not contain potentially irritating chemicals, and are typically fragrance-free ([8](https://www.psoriasis.org/advance/taking-care-of-your-skin-in-summer/)). Wear protective clothing and apply insect repellent if you plan outdoor activities, such as hiking, to reduce the risk of injury and bites ([9](https://www.aad.org/public/diseases/psoriasis/triggers/flares)). When the heat and humidity are excessive, spend time in air-conditioned environments. Ask your doctor about an air-conditioning equipment prescription as you may be able to deduct the cost when filing taxes ([11](https://budgeting.thenest.com/can-deduct-air-conditioning-medically-necessary-24071.html)). However, **be mindful of colder environments and time spent in air-conditioned spaces because the [cold](https://www.autoimmuneinstitute.org/2023/01/31/how-do-cold-temperatures-affect-autoimmune-disease/) and sudden temperature fluctuations may have undesired effects too.** In addition, air-conditioning units dry out the air, so keeping your skin moisturized is essential. Drink cool beverages and popsicles to stay cool ([2](https://www.nationalmssociety.org/Living-Well-With-MS/Diet-Exercise-Healthy-Behaviors/Heat-Temperature-Sensitivity)). Exercise outdoors early in the morning or later in the evening and keep indoor environments cool and ventilated. The National Multiple Sclerosis Society recommends cooling down strategies before and after exercising ([2](https://www.nationalmssociety.org/Living-Well-With-MS/Diet-Exercise-Healthy-Behaviors/Heat-Temperature-Sensitivity)). For example, getting into a bathtub filled with lukewarm water and gradually adding cooler water over the course of about 30 minutes helps regulate body temperature ([2](https://www.nationalmssociety.org/Living-Well-With-MS/Diet-Exercise-Healthy-Behaviors/Heat-Temperature-Sensitivity)). Dipping the lower limbs in cool water also helps before physical activity ([4](https://pubmed.ncbi.nlm.nih.gov/20671034/)). Avoid places such as saunas and hot tubs and consider using cooling methods such as ice packs and other regional devices ([4](https://pubmed.ncbi.nlm.nih.gov/20671034/)). The American Academy for Dermatology suggests taking fewer baths and showers and washing with cool or lukewarm to prevent painful flare-ups for autoimmune diseases that affect the skin ([12](https://www.aad.org/public/diseases/psoriasis/skin-care/baths-showers)). Fragrance-free moisturizers help protect sensitive skin after washing ([12](https://www.aad.org/public/diseases/psoriasis/skin-care/baths-showers)). **Make an appointment with your doctor and discuss how to manage your specific autoimmune disease in higher temperatures, what precautions to take in different environments, or how to prepare for any upcoming vacation in hot climate destinations.** ### **Autoimmune Disease In A Warming World** Research studies have revealed that the world’s warming climate may affect human health and worsen conditions such as allergies and autoimmunity ([13](https://pubmed.ncbi.nlm.nih.gov/36847605/),[ 14](https://pubmed.ncbi.nlm.nih.gov/35599301/)). Along with elevated air pollution and pollen levels, high temperatures and humidity may alter the microbial populations that live on different organs and systems in our bodies ([14](https://pubmed.ncbi.nlm.nih.gov/35599301/)). **For example, the microorganisms of the skin, collectively known as the cutaneous microbiome, function as a barrier against illness and injury. When factors such as heat disrupt that barrier, the skin’s health may change and, thus, worsen diseases such as psoriasis** ([13](https://pubmed.ncbi.nlm.nih.gov/36847605/)). Also, warming conditions allow some emerging infectious diseases that may trigger autoimmunity to spread more easily because of increasing insect populations, including ticks. For example, rheumatoid arthritis can be triggered by Lyme disease ([15](https://pubmed.ncbi.nlm.nih.gov/29183642/)). > More research is needed to study the connection between climate change, higher temperatures, and autoimmunity. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/04/GAI-Logo-Image-811x1024.png) ### About the Author **Damiana Chiavolini, MS, PhD** is a freelance writer who specializes in medical and life science topics. As a trained researcher, she authored journal articles in the areas of infection and immunity and wrote booklets and book chapters about different diseases. As a professional communicator, she writes feature articles for magazines and other publications and produces content for higher education platforms. Damiana is also an experienced academic editor, microbiology educator, writing coach, and fragrance blogger. She is a contributing member of the American Medical Writers Association and the current president of the association’s Southwest chapter. ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** Living Well with Autoimmune Disease --- ### [The Vital Role of Caregivers in Autoimmune Disease](https://www.autoimmuneinstitute.org/articles/the-vital-role-of-caregivers-in-autoimmune-disease) **Published:** August 6, 2025 **Author:** Carolyn Serraino **Content:** Autoimmune disorders impact millions of Americans, with over 80 currently known [disorders](https://www.autoimmuneinstitute.org/resources/autoimmune-diseases-list/ "A-Z Disease List"). Informal caregivers play an essential role in supporting many adults living with these disorders. If you’re helping a loved one manage their health, your role is vital, and as the number of autoimmune diagnoses grows, understanding what you do and how to support you matters more than ever. ##### Most caregivers aren’t paid professionals; they’re often people who step up out of love and concern, such as spouses, children, siblings, or close friends. While caregiving can be deeply meaningful, it also comes with emotional, physical, and financial challenges. In fact, the [2022 National Strategy to Support Family Caregivers](https://acl.gov/sites/default/files/RAISE_SGRG/NatlStrategyToSupportFamilyCaregivers-2.pdf) (1) highlights the strain caregiving can create with a call to better understand how to support those in these roles. ## What Shapes the Caregiving Experience? ##### Every caregiver’s situation is unique, and several factors can shape the experience: - Your relationship with your loved one - Whether you live together or in different areas - Your employment status - Your background in healthcare (if any) - Cultural values and expectations - The age of your loved one and how independent they are - The complexity of their condition Caregiving can be filled with love and purpose, but also emotionally and physically draining. As Dr. Gerda Maissel, physician and founder of *My MD Advisor,* a patient advocacy service, puts it, “**Caregivers often experience a tremendous feeling of meaning, making a difference or \[a\] sense of expressing love to a treasured loved one. The flip side is that caregivers often experience tremendous stress, and they have higher rates of depression, anxiety, hypertension, diabetes, and pain**.” In this article, we’ll explore how caregivers support patients in managing their health and navigating the healthcare system, and how caregiving affects them. ## How Caregivers Support Health Management Dr. Maissel emphasizes that caregiving begins with truly listening to what your loved one needs and wants. From offering encouragement to health insurance hurdles, you may be involved in many aspects of their care. Autoimmune disorders can be complex, often affecting multiple parts of the body and causing significant disruption in a person’s daily life. You can play a role in your loved one’s life by helping them recognize the impact of their disease and how to best manage it. ##### The [Global Autoimmune Institute’s](https://www.autoimmuneinstitute.org/autoimmune-chronic-illness-toolkit/ "Autoimmune & Chronic Illness Toolkit") [toolkit](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/04/Autoimmune-Chronic-Illness-Toolkit.pdf) for people living with autoimmune disorders highlights areas where caregivers might offer support: - **Learn About the Condition:** Understanding your loved one’s autoimmune disorder can help you prepare for symptoms, flare-ups, and treatment options. - **Support Treatment Routines:** Help them stay on track with medications, appointments, and lifestyle changes. - **Offer Emotional Support:** Be a safe space for them to talk, vent, and process what they’re going through. - **Promote Healthy Habits:** Encourage rest, movement, nutrition, and stress relief. - **Watch for Flare-Ups:** Help them track symptoms and adjust daily routines when needed. Don’t forget the importance of balance. Elizabeth Miller, caregiving expert, coach, and founder of Happy Healthy Caregiver, LLC, learned first-hand about the complexity of being an adult caregiver caring for her mother. She shares, “**Sometimes caregivers feel their role is all about managing the care, however, it’s important to seek fun and honor the original relationship. For example, my mom and I used to play board games, go out for ice cream, reminisce over family photos and videos, color, and talk about the books we were reading**.” ### Helping Navigate a Complex Healthcare System The healthcare system can be overwhelming, especially with multiple appointments, specialists, and confusing insurance plans. You can help ease this burden by stepping in as a guide and advocate. **Where you can make a difference:** - **Helping schedule appointments:** Keep track of visits and treatments to ensure continuity of care. - **Helping with paperwork:** Assist with insurance claims, financial aid, and medication approvals. - **Speaking up at appointments:** Help prepare questions and ensure your loved one’s concerns are heard. - **Finding resources:** Explore reliable information, support groups, and potential clinical trials. ## How Caregiving Affects Caregivers There’s no doubt that caregiving can be rewarding; it often deepens bonds and builds resilience. But it can also take a toll, especially when caregiving needs are intense or long-term. You may find yourself juggling multiple roles, managing complex health needs, and feeling mentally or physically worn out. ##### Things that can contribute to caregiver strain include: - Long-term care responsibilities - High levels of patient dependence - Disease complexity - Constant multitasking - Emotional or behavioral challenges ### Taking Care of Yourself **Taking care of yourself is essential.** Ms. Miller recommends scheduling time for yourself just like you would for your loved one’s medical appointments. She also encourages finding a support community, building a personal care team, and recognizing when it’s time to ask for help. *“**I think the one piece of advice that works across all situations is to occasionally step away. That may mean allowing someone else to swap out with you, even if that means hiring someone. By stepping away, whether for 30 minutes or a day, you get a chance to recharge and gain perspective**.”* – Dr. Maissel Caregivers often lose time for social connection, which can lead to loneliness. But it doesn’t have to be that way. “Social isolation and relationship challenges are common as caregivers prioritize their loved ones over personal connections,” says Ms. Miller, ”however, caregiving can also build resilience, deepen relationships, and inspire advocacy when caregivers find support and infuse self-care.” Dr. Maissel suggests looking into organizations that offer support, such as health systems, state offices for the aging, disease-specific groups, hospices, and private-sector coaches. The AARP also offers extensive caregiving resources. #### **Strategies for Caregiver Wellness:** - **Know the Signs of Burnout:** Look for emotional exhaustion, irritability, or changes in sleep and mood. - **Set Healthy Boundaries:** Know your limits and ask for help from friends, family, or respite services. Getting help from family, friends, professional respite care services, and peer support programs have been found to reduce stress and improve caregiver well-being and overall quality of life (2). - **Care for Your Mind:** Therapy, mindfulness, and peer support groups can help process emotions. - **Care for Your Body:** Don’t neglect your own health! Nutrition, movement, rest, and doctor visits matter. - **Stay Connected to Joy:** Make time for hobbies, friends, and the parts of your identity that exist outside of caregiving. ### Empower the Patient Self-management, a patient’s daily activities to manage symptoms, treatments, lifestyle changes, and illness’s psychosocial, cultural, and spiritual consequences, can empower you and your loved one (3). ##### Self-management strategies might include (4): Learning about their condition Communicating with their care team Managing daily routines Navigating emotional ups and downs Exploring supportive resources Caring for a loved one with an autoimmune disorder can bring both the beauty and the challenges. #### Remember, support for caregivers exists because you deserve care, too. We encourage you to check out the **[Global Autoimmune Institute’s Autoimmune & Chronic Illness Toolkit](https://www.autoimmuneinstitute.org/autoimmune-chronic-illness-toolkit/ "Autoimmune & Chronic Illness Toolkit")** to find tools, checklists, and support for your caregiving journey. ![This image has an empty alt attribute; its file name is GAI-Logo-Image-811x1024.png](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/04/GAI-Logo-Image-811x1024.png) ### About the Author ![Tracy Asamoah bio headshot freelance writer for GAI](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/11/DSC05784-scaled.jpg) Tracy is a writer, child and adolescent psychiatrist, and leadership coach. Her journey into the world of autoimmune diseases began when she experienced sudden onset symptoms of multiple sclerosis early in her medical career. This personal experience, combined with her intense curiosity, has informed her work and writing in the field. As a writer, Tracy has contributed to various books and written articles related to mental health. She’s also written on various medical topics regularly contributing to publications such as GoodRx, Psychology Today, and Psychotherapy.net Tracy Asamoah, MD Freelance Writer for GAI ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** Autoimmune Care & Caregiver Support --- ### [Navigating Immunosuppression and Infection Risk](https://www.autoimmuneinstitute.org/articles/navigating-immunosuppression-and-infection-risk) **Published:** July 16, 2026 **Author:** Carolyn Serraino **Content:** Modern immunosuppressive therapies have transformed the treatment of autoimmune diseases, allowing many people to live healthier, more active lives. At the same time, these medications can increase susceptibility to certain infections, making prevention and early recognition especially important. #### As seasonal viruses, emerging infections, and vaccine-preventable disease outbreaks continue, many people taking immunosuppressive medications are left wondering how to protect themselves from infection while keeping their autoimmune disease under control. Rosemary Ainley developed [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid arthritis") in 2007 and started treating it with methotrexate, a medication designed to reduce swelling and inflammation. By 2008, methotrexate wasn’t enough on its own, and she needed a second-line treatment as well. She applied to participate in a clinical trial for a biologic drug. During the screening process, she had a routine chest X-ray. To her surprise, the X-ray showed a lump in her lung about the size of a thumb nail. She didn’t have any respiratory symptoms, and tests were inconclusive for cancer. After three long months, she had the lump removed, and doctors found out it was cryptococcosis, a fungal infection caused by breathing in cryptococcus fungal spores. “\[These spores are\] in the air all around us and everybody breathes \[them\] in and out all the time,” she says. For most people, cryptococcus doesn’t cause problems. So what was different in Ainley’s case? ### What Are Opportunistic Infections? Because Ainley was taking methotrexate, her immune system was suppressed, meaning that her body couldn’t fight off infections as well. The fungus may have been in her system for years, but it became active after she started methotrexate. These types of infections that occur in people with weakened immune systems are called opportunistic infections. For example, people who take [biologics to treat an autoimmune disease](https://www.autoimmuneinstitute.org/articles/biologics-for-autoimmune-disease-what-you-should-know/), those with HIV/AIDS, those undergoing cancer treatment, or those who are immunosuppressed due to organ transplants are at higher risk of these infections. Common opportunistic infections can be caused by fungi, bacteria, viruses, and parasites. In addition to opportunistic infections, those who are immunocompromised can have more serious complications from other infections like the flu or COVID-19. ### How Do I Know My Risk for Opportunistic Infections When I’m Treating My Autoimmune Disease? Not all immunosuppressive therapies for autoimmune diseases carry the same level of infection risk. “A short course of steroids is not really going to increase your risk as much as long-term immunologic drugs,” says Joshua Hill, an associate professor at Fred Hutch Cancer Center and the University of Washington School of Medicine. However, he cautions that sometimes a short steroid course can balloon into a longer course if someone doesn’t respond initially. This can increase the risk of infection and calls for a preventative antibiotic, he adds. However, it’s hard to determine risk. “There’s a lot of heterogeneity in immunocompromised patient populations,” Hill says. This risk depends on the underlying disease and type of therapy. Even in the same individual patient, the degree they are immunocompromised can change over time. #### “We don’t have a great test that we can do that says ‘you are this \[level of\] immunocompromised and as a result, this is what your risk profile looks like,'” he explains. While it is possible to measure counts of different types of immune cells, Hill says that these numbers “aren’t that predictive.” ### I’m Immunocompromised. How Should I Navigate Life and Medical Decisions While Avoiding Opportunistic Infections? Since her diagnosis nearly 20 years ago, Ainley has navigated many medical decisions while treating rheumatoid arthritis and other autoimmune conditions that she subsequently developed. She had a bout of pneumonia and bronchitis while waiting for back surgery. She needed to go off her immunosuppressant medications and delay her surgery to allow her immune system to recover. Soon after, she had to go off her immunosuppressants again before her surgery due to the high risk of infection from the procedure. Overall, she was off her immunosuppressants for about five out of seven months. Her rheumatoid arthritis and ankylosing spondylitis, which she developed in 2017, were “pretty well controlled” before then, but since she got back on the drugs after surgery, she noticed “they never worked one hundred percent since.” #### Ainley calls the decision to go off medication a “tricky balance” and only does this for major or persistent infections or for surgeries. For more routine medical appointments, Ainley makes it known right away that she is immunocompromised. “That means they are more alert and start to take my infection risk seriously,” she says. She brings a list of all medications and conditions when she goes to a new doctor. Ainley takes other precautions daily. To minimize the risk of opportunistic infections, she prefers to wear a mask when she is at the doctor’s or when she sings in her choir, avoids meeting people who are sick, gets all recommended vaccinations, and is aware of how her body is feeling and of possible signs of infection. She has found counseling helpful and manages two [support groups](https://www.autoimmuneinstitute.org/autoimmune-disease-chronic-illness-related-support-groups/ "support groups") for arthritis. “I believe connecting with other people with similar conditions who ‘get’ what you’re going through is very important for mental health,” she explains. ### What New Research Can Help People Who Are Immunocompromised Reduce Infection Risk? While there are day-to-day precautions to help manage opportunistic infection risks on an individual level, researchers around the world are devising new ways to better treat or understand opportunistic infections and to prevent common infections from becoming serious. #### Monoclonal Antibodies: An Alternative to Vaccines? One of these methods are monoclonal antibodies (mAbs) that can be used when vaccine responses are muted in people who are immunocompromised. Hill notes that this dampened response to vaccines is a problem because immunocompromised patients are already vulnerable, and vaccines cannot protect them well if they can’t mount a strong immune response. There have been studies on timing vaccinations around biologic infusions, but results have been mixed. For example, the [2022 American College of Rheumatology guidelines](https://pmc.ncbi.nlm.nih.gov/articles/PMC10291822/) recommend waiting two weeks after influenza vaccination before restarting methotrexate if possible and that vaccines other than influenza should be administered at least six months after a rituximab dose (1). Yet [another study](https://pubmed.ncbi.nlm.nih.gov/26595551/) in IBD patients found that giving an inactivated influenza vaccine resulted in a similar response regardless of whether it was given at the time of infliximab infusion or in between (2). This is where mAbs can help. Instead of asking the body to generate its own antibodies, mAbs given to a patient can act as natural antibodies against infectious agents they target. mAbs can stick around in the body for the length of a flu season, for example, so giving someone mAbs against flu at the start of flu season would protect them. “There’s a lot of research happening in this space and a lot of drug development happening to make monoclonal antibodies for some of the common respiratory viruses that can be severe in patients with autoimmune and other conditions,” said Hill. He mentioned that a cocktail of antibodies, for example against flu, RSV, and COVID, that’s given before the respiratory virus season begins could be helpful. #### Engineering B Cells to Make Antibodies Another approach would be giving patients engineered B cells that are designed to make antibodies against a specific group of pathogens. This is a new area of research with studies in preclinical phases. For example, one study found that when introduced in immunodeficient mice, engineered B cells could [protect against RSV infection](https://pmc.ncbi.nlm.nih.gov/articles/PMC6913193/) (3). #### Expanding Clinical Trial Inclusion Clinical trials have often focused on healthy populations as participants because they minimize any confounding variables. Yet, this doesn’t represent the real world where [6.6% of people in the US are immunocompromised](https://jamanetwork.com/journals/jama/fullarticle/2815274) (4). When clinical trials only focus on healthy populations, it makes it difficult to know how the drug or treatment would work in immunocompromised populations. Hill cites the COVID-19 pandemic as a prime example of this. “In the first year, almost all of the trials excluded higher-risk individuals for those vaccine studies, but those are the patients that are at the highest risk for bad outcomes,” he says. “The consequence of that is that we don’t know how to give vaccines \[against COVID\] to patients with suppressed immune systems.” Studies of how people who are immunocompromised respond to therapies can help inform dosing amount or interval. “That work just isn’t done very much and that’s a key limitation. We’re just stuck doing the same thing for our immunocompromised patients as we do for everyone else and that’s really not sufficient,” he says. Hill is trying to change that by building a clinical trial network, [ImmunOptimize Network](https://www.fredhutch.org/en/research/divisions/vaccine-infectious-disease-division/research/infectious-disease-sciences/immunoptimize-network.html), which would test therapies targeting infections in people who are immunocompromised on a larger scale. #### Targeted Therapies Instead of Widespread Immunosuppression Rather than addressing how to protect from opportunistic infections, another strategy focuses on eliminating the need for widespread immunosuppression. [Nanotechnology-based therapies](https://www.autoimmuneinstitute.org/articles/nanotechnology-breakthroughs-in-autoimmune-disease-treatment/) could help bring immunosuppressive drugs to the sites where they’re needed most as opposed to widespread delivery to the body. While work in this area is still new, it is a promising avenue to reduce the risk of opportunistic infections caused by other types of therapies. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/GAI-Logo-Image-e1707845715517.png) #### About the Author ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/10/Jennifer-Tsang-Bio-Headshot-e1753113113430.jpg) A microbiologist turned freelance science writer who works with life science companies, nonprofits, and academic institutions on anything from news stories, explainer articles, and content marketing. She shares the wonderful world of microbes on her blog [The Microbial Menagerie](https://microbialmenagerie.com/). Jennifer Tsang, PhD Freelance Writer for GAI ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** Living Well with Autoimmune Disease --- ### [How to Support Someone with Autoimmune or Chronic Disease](https://www.autoimmuneinstitute.org/articles/how-to-support-someone-with-autoimmune-or-chronic-disease) **Published:** July 16, 2026 **Author:** Carolyn Serraino **Content:** Many people want to support a parent, sibling, friend, partner, colleague, or neighbor living with an autoimmune or chronic disease but are often unsure how to help, what to say, or how to respond to their health needs. They may worry about saying the wrong thing, asking too many questions, becoming a burden, or respecting a loved one’s request for space. An important aspect of this discussion is that caregivers often come from a place of authentic care and awareness, so what they truly need are strategies to approach and interact with a loved one or person they assist. To explore this sensitive topic, we talked with two experts: [Brenda Snow,](https://brendasnow.com/) author, patient advocate, and founder of Snow Companies living with multiple sclerosis (MS), and [Sipora Weissman](https://siporaweissman.com/), licensed clinical social worker living with a chronic illness. ### Why Can Supporting Someone with Autoimmune or Chronic Disease Be Challenging? Supporting someone properly can be challenging because autoimmune and chronic diseases are diverse and invisible to others. People may not always talk about pain, fatigue, or other hidden symptoms they experience daily. They may also feel uncomfortable discussing changes that affect their mental wellbeing or openly sharing concerns about the future. “This invisibility often creates misunderstanding. People may look healthy on the outside while struggling profoundly on the inside, leading others to underestimate their needs or question their experience,” says Snow. #### “Discussing a diagnosis can also be difficult because individuals may fear stigma, being treated differently, or becoming defined by their illness rather than by who they are.” The other challenge is supporting people as they manage their disease through phases and changes. “Treatment journeys are rarely straightforward. They can involve trial and error, side effects, periods of stability, and unexpected setbacks,” adds Snow. #### Weissman mentions that many of her clients do not want to dwell on or explain their health struggles. “Because many people with chronic illness want to be social, it can be a challenge navigating telling friends and family about the accommodations they need. This is often especially true for people in their 20s and 30s.” **Snow and Weissman state that useful support includes:** Listening actively Believing a person about their symptoms and experiences Recognizing that invisible symptoms are still very real Being flexible and compassionate Communicating honestly and openly Refraining from giving unsolicited advice about supplements, diets, doctors, or treatments that will “fix them” ### How Can I Respect Boundaries and Avoid Creating Pressure? Respecting boundaries while maintaining meaningful connection is a crucial aspect of helping people living with autoimmune and chronic conditions. Snow highlights that being supportive also entails acknowledging that a person may be undergoing an identity crisis, so the perception and the reality of who they are sometimes shifts. “They may have gone from being a mother to being a ‘mother who is sick.’ That was my experience when I was diagnosed with [MS](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/ "Multiple sclerosis") while raising my young daughter.” Snow adds that family and friends may at some point cross a boundary, especially early in the disease process, so it’s important for a person with a chronic disease to advocate for themselves. #### “Saying ‘I know you mean well but that’s not helpful’ is a great way to safeguard your relationships,” says Snow. **The experts share additional pointers for offering concrete support:** - **Think about who your loved one was before their diagnosis** and connect with them on that level. Consider that they may have limitations, so involve them in activities that will not lead to exertion. - **Make the person feel needed** and don’t start every interaction by asking how they feel. Tell them about an experience, send them a lighthearted reel, or lean into them for advice, so your relationship doesn’t feel one-sided. - **Include a person in gatherings and events**. An invitation alone can mean a lot, even if they may be unable to attend. - **Be understanding if the person cancels plans**. Symptoms can shift quickly, and many people will not know how they will feel until the last minute. If they are unable to attend, be mindful not to make them feel guilty. ### What Do People with Autoimmune or Chronic Disease Find Most Helpful? **People living with autoimmune disease typically need** - Flexibility from employers and caregivers - Practical assistance during flares - Access to knowledgeable healthcare teams - Connection with others who share similar experiences They appreciate being supported by caregivers without judgment through a journey that may be difficult and unpredictable. Snow advises reading and learning about specific diseases. #### “Patients value when people educate themselves about the disease rather than expecting the person living with it to constantly explain or justify their condition,” she says. Weissman agrees about the importance of researching symptoms. “It could be helpful to do a little research on what your loved one is experiencing.” Snow cautions caregivers about what may be unhelpful, including putting pressure to “push through” symptoms and making remarks that minimize or compare experiences. **“Comments such as *But you look great*, *Everyone gets tired*, or *Have you tried this supplement*? may be well-intentioned but can make people feel dismissed or misunderstood.”** ### Related Article Knowing what *not* to say can be just as important as knowing how to offer support. Learn which common phrases may unintentionally minimize someone’s experience and explore more supportive alternatives. [ What Not to Say to Someone with a Chronic Illness → ](https://www.autoimmuneinstitute.org/articles/what-not-to-say-to-someone-with-a-chronic-illness/) ### What Can I Say to Someone with Autoimmune or Chronic Disease? What to say to someone with autoimmune or chronic disease greatly depends on the person and how they navigate their specific illness. Some want to openly talk about their illness, while others do not. **Both experts share tips that typically help, regardless of how a person is navigating a condition:** - **“I’m here to help you through this journey.”** This approach allows someone to know you’re there for them. - **“Are you okay with me asking about your health?”** This shows that you’re open but also respectful of their boundaries. - **“I’m bringing you dinner Tuesday and Friday. Do you prefer chicken, salmon, or vegetables?”** Saying what you plan to do (and providing flexible options) allows them to accept your offer without feeling dependent or indebted. ### How Can I Support Someone While Managing My Own Health Challenges? Keeping a balance between [supporting a loved one and taking care of oneself](https://www.autoimmuneinstitute.org/articles/the-vital-role-of-caregivers-in-autoimmune-disease "The Vital Role of Caregivers in Autoimmune Disease") is crucial, according to the experts. “Be open with your friends and family members about what you can realistically offer while managing your own health,” says Snow, who also points out that we should never assume that sharing our own health challenges is a burden to someone with a chronic illness. “Relationships are strengthened through mutual support and vulnerability,” she stresses.  **“A simple text or a phone call can be very meaningful to a person with chronic illness who is having a hard day and can’t leave the house,” adds Weissman.** ### The Role of Community and Support for People with Autoimmune or Chronic Disease A few words should be spent about the role that community, peers, and online support play in helping those living with chronic conditions. Reviews of multiple research studies revealed the potential of empowerment interventions such as self-managed education and health coaching, alongside digital technology to help people take greater control of their health and build meaningful relationships with others ([1](https://pubmed.ncbi.nlm.nih.gov/37626346/), [2](https://pubmed.ncbi.nlm.nih.gov/37799504/), [3](https://pubmed.ncbi.nlm.nih.gov/37067874/)). However, more research is needed to draw clear conclusions. As someone living with a chronic condition, Weissman suggests approaching online forums and support groups thoughtfully. “My recommendation is to find a group that doesn’t revolve around complaining but instead focuses on support, connection, and living life as fully as possible despite health challenges.” ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/GAI-Logo-Image-e1707845715517.png) #### About the Author ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/07/Chiavolini-Damiana-scaled.jpg) A freelance writer who specializes in medical and life science topics. As a trained researcher, she authored journal articles in the areas of infection and immunity and wrote booklets and book chapters about different diseases. As a professional communicator, she writes feature articles for magazines and other publications and develops content for higher education platforms. Damiana is also an experienced academic editor, microbiology educator, writing coach, and fragrance blogger. She is a contributing member of the American Medical Writers Association and a past-president of the association’s Southwest Chapter. Damiana Chiavolini, PhD Freelance Writer for GAI ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** Autoimmune Care & Caregiver Support --- ### [A Guide to Interpreting Clinical Trial Stories](https://www.autoimmuneinstitute.org/articles/a-guide-to-interpreting-clinical-trial-stories) **Published:** June 8, 2026 **Author:** Carolyn Serraino **Excerpt:** How to evaluate pre-clinical research, clinical trial phases, study results, and key questions to ask with expert insights from Monica Wang and Sylvia Baedorf Kassis. **Content:** ## Going Beyond the Headline Breakthrough. Revolutionary. Transformative. These catchy buzzwords are just a few examples of how scientific research is often described in the headlines. While scientific progress has created life-saving medicines for many different conditions, most research progresses incrementally, stemming from small gains in knowledge over long time frames to reach these big tangible outcomes. The path typically occurs like this: understanding the biology behind disease first in cells or animals, identifying and studying drug candidates in these models to find the most promising ones, and evaluating them in a series of [human clinical trials](https://www.autoimmuneinstitute.org/articles/the-importance-of-clinical-trials-for-autoimmunity/) before drugs get approved. #### Research in all of these stages is reported in the media, but with the wealth of coverage, it can be hard to decipher what this coverage means for you and the actual benefit to patients. To dive into the world of clinical trials and how to better understand reporting on them, we talked to two experts in the field: [Monica Wang](https://www.bu.edu/sph/profile/monica-l-wang/), Associate Professor of Community Health Sciences at Boston University School of Health, and [Sylvia Baedorf Kassis](https://mrctcenter.org/about-the-mrct-center/meet-the-mrct-center-team/sylvia-baedorf-kassis/), a Program DIrector at the Multi-Regional Clinical Trials Center of Brigham and Women’s Hospital and Harvard. This article will provide concrete tools from these experts on how to best interpret what you read about clinical trials. ## Preclinical vs. Clinical Trial. What Can We Take Away from Preclinical Studies? Studies in cells and animal models precede clinical trials. These types of studies are called preclinical studies. While these studies do not give us outcomes like “this drug will work for this condition in humans,” they lay the foundation for these interventional studies. To recognize whether a study is preclinical or not in a news story or announcement, look for words like: *in vitro*, in animal models, in cell lines, or in mice. The limitation of these types of studies, however, is that they’re not done in people. “Cells and animal models cannot capture the full biological, social, and behavioral complexity of humans,” says Wang. “These studies are best understood as early signals of scientific potential, not as evidence that a treatment will improve real-world outcomes in the near term.” Still, preclinical studies can be considered “breakthroughs,” says Baedorf Kassis. “They’re a breakthrough on the scientific level.” These types of studies help further our understanding of a disease mechanism, how something works, or moves research forwards with new methodologies, but they aren’t necessarily going to have tangible impacts for patients quite yet. “When research is done, it’s done with valid reasons and with the real purpose and the real spirit of it being that researchers are trying to understand what could help patients,” says Baedorf Kassis “Press releases and news stories could play more of a role in communicating the connection between research and the promise of medical advances that could one day offer therapeutic benefit.” ## Stages of a Clinical Trial: What it Can Show and What it Means Promising drug candidates or interventions from preclinical studies can then move towards clinical studies, which are [divided into different phases](https://www.nih.gov/health-information/nih-clinical-research-trials-you/basics). The more a drug progresses through the phases, the closer it gets to market to treat a disease or condition. - **Phase 1:** Phase 1 is geared towards safety and dosing and is done in a small group of participants (ex: 20-80). It answers the questions: is the intervention tested safe? What is the appropriate dosing? These studies use a small number of participants. - **Phase 2:** Phase 2 trials are done in a larger group of people (ex: 100-300) with the target condition and are used to further determine safety and to initially determine effectiveness of the intervention. - **Phase 3:** Phase 3 trials are large scale trials in more diverse groups (ex: 1,000+) with the target condition to test drug efficacy using a comparator (ex: current standard treatment or placebo group). This is the last phase prior to submitting to the FDA for approval. - **Phase 4:** For already approved drugs, Phase 4 trials are done after a drug is on the market to continue to learn about the drug in the real world. ## Questions to Ask to Help Understand Clinical Trial News So when coming across a clinical trial result, what are some of the things to look out for? Baedorf Kassis and Wang share their top tips and questions to ask yourself when reading about a clinical trial result: - **What was the study population that was enrolled?** To understand the population, consider the sample size and representation. “Sample size matters because small studies are more vulnerable to chance findings,” says Wang. “Representation is also important, since results are more informative when study participants reflect the populations most affected by the condition.” - **What was the condition being treated?** Drugs don’t get approved for broad categories of conditions such as “cancer” or “autoimmune diseases” as a whole. They get approved for subsets like a specific type of cancer or a specific type of autoimmune disease. Drugs approved for one autoimmune condition might not be approved for another autoimmune condition because they have different disease mechanisms and require their own set of clinical trial data. - **What was the actual purpose of the study?** The purpose of the study is what the study was designed to find out. For example, the study could be aimed at understanding safety, efficacy, or side effects. - **What was the intervention being compared against?** To understand how well an intervention could work, it needs to be compared to a control group, for example, a placebo group that did receive the intervention or the current best treatment. “Results are strongest when a new intervention is compared with standard care rather than no treatment,” says Wang. - **What phase was the study in?** Knowing the phase of study helps you understand how close the intervention is to a potential approval. Different phases also have different goals, as highlighted above. - **What were the endpoints and the results?** [Endpoints](https://www.cancer.gov/publications/dictionaries/cancer-terms/def/endpoint) are targeted outcomes that are set before the trial begins and can be statistically analyzed. Endpoints can range from anything like disease-free survival to symptom improvement. Studies often have a primary and secondary endpoint, where primary endpoints are the most important outcomes and secondary endpoints provide additional information on the treatment. - **Are these findings preliminary or has it been replicated in other studies?** Results that have been replicated elsewhere will give more confidence to the result of a particular study. > > **“Looking beyond the headline to understand who was studied, how large the effects were, and how the findings fit within the broader body of research can help place claims in proper context,” says Wang.** There are a lot of terms and concepts to consider, especially when it comes to understanding the way trials are run or controlled for bias. For more information on clinical trials and the terminology associated with them, we have listed a few resources to help you get started: - [What Are Clinical Trials and Studies?](https://www.nia.nih.gov/health/clinical-trials-and-studies/what-are-clinical-trials-and-studies) - [Clinical Research Glossary](https://mrctcenter.org/glossary/) - [How to Read a Study Record](https://clinicaltrials.gov/study-basics/how-to-read-study-record) - [How Clinical Trials Work: A Beginner’s Guide](https://ccrps.org/clinical-research-blog/how-clinical-trials-work) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/GAI-Logo-Image-e1707845715517.png) #### About the Author ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/10/Jennifer-Tsang-Bio-Headshot-e1753113113430.jpg) A microbiologist turned freelance science writer who works with life science companies, nonprofits, and academic institutions on anything from news stories, explainer articles, and content marketing. She shares the wonderful world of microbes on her blog [The Microbial Menagerie](https://microbialmenagerie.com/). Jennifer Tsang, PhD Freelance Writer for GAI ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** About Autoimmune Disease --- ### [Autoimmunity and the Eyes: A Spotlight on Uveitis](https://www.autoimmuneinstitute.org/articles/autoimmunity-and-the-eyes-a-spotlight-on-uveitis) **Published:** September 16, 2022 **Author:** Carolyn Serraino **Excerpt:** Uveitis presents as inflammation inside the part of your eye called the uvea and can also affect other parts of the eye. Uveitis can involve one or both eyes and can cause pain and redness in your eye(s), as well as vision loss. **Content:** The familiar quote: “The eyes are the window to your soul” (attributed to William Shakespeare) makes us think about sight as greater than the familiar 20/20 vision chart. Healthy eyes are essential to our well-being. Many with autoimmune conditions are challenged with secondary conditions or co-morbidities that accompany a primary condition. These conditions often contribute to significant health problems. Among the more rare and more serious conditions is uveitis, with approximately 30,000 new cases annually ([1](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5904090/)). ### **What Is Uveitis?** [Uveitis](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/uveitis/) presents as inflammation inside the part of your eye called the uvea and can also affect other parts of the eye. Uveitis can involve one or both eyes and can cause pain and redness in your eye(s), as well as vision loss. The condition sometimes resolves quickly, sometimes returns, and sometimes becomes chronic or long-term. ### **What Is The Uvea?** The uvea is the middle layer of the eye between the sclera (white part of the eye) and the retina (the light-sensitive layer at the back of the eye) and has three parts: - Iris (colored part of the eye) - Ciliary body (part of the eye that helps the lens focus) - Choroid (part of the eye that connects the retina to the sclera) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Screen-Shot-2023-10-24-at-8.17.47-PM-1.png) ### **What Are The Symptoms Of Uveitis?** Uveitis symptoms usually start suddenly and include: - Blurry vision - Floaters (small dark spots or squiggly lines that float across your vision) - Eye pain - Red eyes - Sensitivity to light See your eye doctor right away if you notice any of these symptoms because uveitis can cause vision loss if left untreated! ### **What Causes Uveitis?** The usual causes of uveitis are infection, injury, or an autoimmune or inflammatory disease; although, many times the cause is unidentified. If the cause is autoimmune, your body attacks healthy eye tissue. We do know that the condition more frequently affects individuals between 20 and 60 years old, cigarette smokers, and individuals with diseases that compromise the immune system. Sometimes uveitis is caused by autoimmune diseases or immunodeficiency diseases such as: - [Ankylosing spondylitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ankylosing-spondylitis/) - [Behcet’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/behcets/) - [Lupus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/) - [Multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/) - [Psoriasis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/psoriasis/) - [Rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/) - [Sarcoidosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sarcoidosis/) - [Ulcerative colitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ulcerative-colitis/) - Vogt-Koyanagi-Harada (VKH) disease - AIDS ### **How Can Your Eye Doctor or Ophthalmologist Diagnose Uveitis?** Fortunately, diagnosing uveitis is simple and painless. Your ophthalmologist will perform a dilated eye exam to confirm a diagnosis of uveitis. ### **How Is Uveitis Treated?** Steroid medication is the usual first-line treatment for uveitis and can reduce inflammation in your eye, ease symptoms, and prevent vision loss. Most commonly, steroids are administered by prescription eye drops. However, other steroids may be used in the form of pills, injections near or in the eye, or eye implants that release steroids. Steroids can have side effects and can increase your risk for cataracts and glaucoma. If you take steroids for uveitis, regular eye exams are important to monitor your progress and to check for signs of any problems. Your treatment plan will be determined by the affected part of your eye and any other health conditions. For example, your doctor may also prescribe some medications that control or quiet the immune response for longer-term prevention and management. ### **What Research Is Ongoing For Uveitis?** The National Eye Institute at the National Institutes of Health (a part of the United States government under the Department of Health and Human Services) conducts and funds many studies on uveitis including on causes and treatment. Cutting-edge research is being conducted through the [Laboratory of Immunology](https://www.nei.nih.gov/research/research-labs-and-branches/laboratory-immunology). > [Get the latest news on NEI-supported uveitis research](https://www.nei.nih.gov/about/news-and-events/news?topic=58&initiatives=All&research=All&source=All&created=All&language=All) ### **Eye Health** We all now work (and play) on computers, many of us for long hours! To reduce eye strain, The [Prevention of Blindness Society of Metropolitan Washington recommends](https://www.youreyes.org/) children and adults take regular breaks using the **20-20-20 rule**: **Every 20 minutes, shift your eyes away from the screen to look at an object at least 20 feet away for at least 20 seconds.** Everyone needs regular eye exams! The Bard was onto something important! Healthy eyes may reveal our soul, but they also are critical to a healthy body. Often, an eye condition is the initial warning to larger health issues. Take a minute to review The American Academy of Ophthalmology guidelines on eye screening: <https://www.aao.org/eye-health/tips-prevention/eye-exams-101> ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/GAI-Logo-Image-e1707845715517.png) ##### **About The Author** **Dorothy Weinstein**, M.A., has a long tenure working in health policy in Washington, D.C., and is a published author in health care delivery, biomedical research, technology, innovation, and environmental causes. She has been employed at Georgetown University: Institute of Health Policy Analysis, Association of American Medical Colleges, American Diabetes Association, The Endocrine Society, American College of Cardiology, and The National Health Council. Her expertise includes conducting large-scale research initiatives, developing advocacy programs, crafting legislation, lobbying on the local, state, and national levels, and directing government relations departments at leading nonprofit health organizations. ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** About Autoimmune Disease --- ### [PANDAS, PANS, and Autoimmunity](https://www.autoimmuneinstitute.org/articles/pandas-pans-and-autoimmunity) **Published:** October 27, 2025 **Author:** Carolyn Serraino **Excerpt:** When infection sparks autoimmunity, the brain can change. Learn how PANDAS and PANS trigger sudden behavioral shifts in children. **Content:** ### The Neuroimmune Connection Autoimmune activity doesn’t stop at the blood–brain barrier. Once seen as separate worlds, the brain and immune system are proving inseparable. This series explores how autoimmune and inflammatory processes influence [infection-triggered behavior changes](https://www.autoimmuneinstitute.org/articles/pandas-pans-and-autoimmunity), [brain fog](https://www.autoimmuneinstitute.org/articles/understanding-brain-fog-in-autoimmune-disease), and [neurodegeneration](https://www.autoimmuneinstitute.org/articles/autoimmune-aspects-of-neurodegenerative-diseases). Understanding these connections could open new paths toward healing and prevention. ## Autoimmune Neuropsychiatric Disorders in Children For many families, the sudden onset of severe neuropsychiatric symptoms in a child can be alarming and deeply confusing. When those symptoms appear after an infection, it raises even more questions. [**Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections (PANDAS)** and **Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS)**](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/pans-pandas/ "Pediatric acute-onset neuropsychiatric syndrome (PANS, PANDAS)") are diagnoses that attempt to explain this mysterious connection. While still not fully understood, increasing awareness and research are helping families and clinicians make sense of these complex conditions. To better understand both the science and the lived reality of these complex disorders, this article features expert insights from **Dr. Amy Offutt**, an integrative medicine physician and President of the Board of Directors for the International Lyme and Associated Diseases Society, and **Julie Cox**, LCSW, a child and family therapist who specializes in supporting families affected by PANDAS/PANS. ## Origin & Background of PANDAS/PANS PANDAS was first described in a group of 50 children who developed obsessive-compulsive disorder (OCD) and tics following a strep throat infection caused by group A beta-hemolytic streptococcus (GABHS) (1). Over time, clinicians noticed similar symptom patterns in children without confirmed strep infections. This led to the broader classification of Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS)—a diagnosis that includes a sudden onset of similar symptoms, with or without an identified microbial trigger. #### Diagnosing PANDAS/PANS has been controversial given the complex clinical presentation and challenges of establishing the cause (2). Dr. Offutt is well-acquainted with the complexities surrounding PANDAS and PANS. She affirms the growing body of evidence pointing to an autoimmune process at work in individuals with PANS, explaining, “We know this is an autoimmune disease because of the presence of abnormal antibodies found in so many of these patients.” Dr. Offutt highlights that elevated antibody levels, such as those triggered by post-streptococcal infections and other pathogens, often appear in routine laboratory tests. Dr. Offutt points out that many families remain unaware of PANS/PANDAS, often enduring prolonged struggles before finding answers. #### One of the most significant barriers to care is the reluctance, or outright denial, by some healthcare providers to recognize the condition’s existence. Misconceptions that families are simply seeking medical explanations for behavioral issues can further delay appropriate treatment. Dr. Offutt also warns that researchers may carry similar biases if they aren’t adequately educated about PANS. #### In short **PANS** is an umbrella term used to describe cases of sudden-onset neuropsychiatric symptoms triggered by a potential range of infections, environmental factors, or unknown causes. **PANDAS** is considered a subset of PANS, limited to cases triggered by group A beta-hemolytic streptococcus (GABHS). ## How does PANDAS/PANS Affect the Brain and Body? PANDAS/PANS is suspected to be an autoimmune-related condition, where the body’s immune response to an infection or other trigger may mistakenly affect certain areas of the brain. #### These regions, including the basal ganglia, play key roles in behavior, emotion, and movement. One leading theory suggests that this immune response could produce anti-neuronal antibodies that cross-react with brain tissue, potentially contributing to the symptoms seen in affected individuals (3). **PANDAS/PANS diagnosis includes the sudden onset of OCD or severe food restriction and at least two of the following symptoms** (4): - Severe anxiety, often with panic attacks - Mood swings, depression, and emotional lability - Irritability, aggression, and severe behavior problems - Behavioral (developmental) regression - A sudden drop in school performance - Motor or sensory abnormalities (e.g., tics, hypersensitivity) - Sleep disturbances, bedwetting, or increased urinary frequency ## How is PANDAS/PANS Diagnosed? Diagnosing PANDAS/PANS can be difficult. Many of the symptoms also appear in more common psychiatric and developmental conditions such as OCD, Tourette’s syndrome, ADHD, bipolar disorder, and eating disorders. Other autoimmune conditions, including [autoimmune encephalitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/acute-disseminated-encephalomyelitis/) and [Sydenham’s chorea](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sydenhams-chorea/) (also linked to strep infections), may look similar as well. #### How PANDAS/PANS Is Evaluated Because of the overlap with other conditions, diagnosis often involves ruling out alternative explanations. A typical evaluation may include: - A detailed patient and family history - Physical and psychiatric evaluation - Blood tests, and in some cases, brain imaging - Identification of possible infectious or environmental triggers Julie Cox understands the difficulties families face in accessing knowledgeable healthcare providers. Securing appropriate medical care often becomes the family’s most urgent need. In her work, Cox starts by offering parents validation, support, and a sense of hope, she shares“My next step is to work with the parents and provide validation, support, and hope that there is a way through the challenging path of having a child or teen with PANDAS or PANS,” she shares. For many families, finding clinicians who truly understand these conditions can feel like another obstacle in an already difficult journey. Given the complexity of diagnosis, the American Academy of Pediatrics (AAP) (5) recommends a team-based, family-centered approach to care, ideally anchored by the child’s primary care provider. #### Collaborative Teams for PANDAS/PANS may include specialists in: - Psychiatry - Psychology - Neurology - Rheumatology - Developmental-behavioral pediatrics - Occupational and physical therapy ## What Causes PANDAS/PANS? While the exact cause remains unclear, research supports the role of molecular mimicry, when foreign infectious or chemical agents trigger the formation of autoantibodies in genetically or immunologically vulnerable individuals. It’s suspected that these autoantibodies cross the blood-brain barrier and target neurons, particularly in brain regions responsible for mood, behavior, and motor control (3). **Potential risk factors:** - Family history of autoimmune diseases - Family history of psychiatric disorders - Pre-existing neurodevelopmental conditions Animal studies have further supported the autoimmune hypothesis, showing that behavioral changes can occur in mice exposed to these antibodies, and that symptoms often improve with immunosuppressive therapy (3). ## How is PANDAS/PANS Treated? There are currently no standardized treatment protocols for PANDAS/PANS, but care often falls into three main categories (5): - **Psychiatric and behavioral therapies** Cognitive-behavioral therapy and medications can help manage OCD, anxiety, depression, or tics. - **Antimicrobial treatments** Antibiotics may be used to treat infections such as GABHS. - **Immunomodulatory therapies** Using immune-modulating therapies is controversial because of limited research supporting their benefit. However, some healthcare providers recommend them in more severe cases. It’s important to address patients’ and their families’ physical and mental health concerns. Typically, medical issues are stabilized before starting therapy. Therapy can help children and teens develop techniques to better manage the thoughts, feelings, and behaviors associated with PANDAS/PANS. In addition to managing symptoms, therapy can help families cope with the disruptions that PANDAS/PANS can bring to some families. When working with families, Ms. Cox notes, “I teach parents self-regulation skills and DBT skills to help them through the ups and downs of medical treatment and the challenges that \[the\] PANDAS \[or\] PANS child or teen may experience such as OCD symptoms, angry outbursts, executive functioning difficulties, anxiety, and depression.” ## PANDAS/PANS Research and Hope for the Future Children and teens with PANDAS/PANS and their families are leading advocates for more research to help healthcare providers better understand PANDAS/PANS. Dr. Offutt notes, “I see this field evolving because of families who are advocating more and more for their children and adult children who are long-suffering with this condition. It happens often enough that more and more people will have heard of it, and the medical community will have to learn more about it and be able to help these patients and their families.” There is still much to learn about PANS and PANDAS. Questions remain around causes, diagnosis, and long-term outcomes. However, researchers are actively working to develop diagnostic tools, clarify mechanisms, and identify more effective treatments. As awareness grows, so does hope for earlier diagnosis, more targeted therapies, and better support for families navigating these difficulties. Families facing PANDAS/PANS can feel isolated and overwhelmed. However, growing recognition from the medical and scientific community is shifting the landscape. We move closer to understanding and healing this complex autoimmune-neuropsychiatric connection with continued research, advocacy, and clinical collaboration. ![This image has an empty alt attribute; its file name is GAI-Logo-Image-811x1024.png](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/04/GAI-Logo-Image-811x1024.png) ### About the Author ![Tracy Asamoah bio headshot freelance writer for GAI](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/11/DSC05784-scaled.jpg) Tracy is a writer, child and adolescent psychiatrist, and leadership coach. Her journey into the world of autoimmune diseases began when she experienced sudden onset symptoms of multiple sclerosis early in her medical career. This personal experience, combined with her intense curiosity, has informed her work and writing in the field. As a writer, Tracy has contributed to various books and written articles related to mental health. She’s also written on various medical topics regularly contributing to publications such as GoodRx, Psychology Today, and Psychotherapy.net Tracy Asamoah, MD Freelance Writer for GAI ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** About Autoimmune Disease --- ### [Personalized Medicine for Autoimmune Diseases](https://www.autoimmuneinstitute.org/articles/personalized-medicine-for-autoimmune-diseases) **Published:** September 25, 2025 **Author:** Carolyn Serraino **Excerpt:** Experts like Dr. Georg Schett highlight how personalized medicine and CAR T-cell therapy could transform autoimmune treatment and long-term remission. **Content:** ### New Frontiers in Autoimmune Treatment Finding effective treatments for autoimmune diseases is often a trial-and-error process, but the field is rapidly evolving. This series examines five areas driving innovation: **personalized medicine**, [immunotherapy](https://www.autoimmuneinstitute.org/articles/immunotherapy-for-those-with-autoimmune-disease/), [precision medicine](https://www.autoimmuneinstitute.org/articles/tailoring-autoimmune-treatment-with-precision-medicine/), [nanotechnology](https://www.autoimmuneinstitute.org/articles/nanotechnology-breakthroughs-in-autoimmune-disease-treatment/), and [stem cell therapy](https://www.autoimmuneinstitute.org/articles/stem-cell-therapy-for-autoimmune-disease/). Together, these advances show how science is reshaping the future of autoimmune treatment. If you have an autoimmune disease, chances are you might have to try several treatments before finding one that works. That could mean several months of unsuccessful treatments before landing on one that works. ##### “The current challenges in autoimmune disease treatment is that not all patients respond to the current available treatments,” says [Dr. Georg Schett](https://www.fau.eu/person/prof-dr-georg-schett/), Vice President Research at Friedrich-Alexander University of Erlangen-Nuremberg. “There is a fraction of patients who do not achieve remission of disease and they are at risk for developing organ damage.” With advances in genomics and other molecular tests that are paving the way for personalized medicine, it’s becoming possible to avoid scenarios such as this. ## What is Personalized Medicine? As the name suggests, personalized medicine tailors therapies to each individual patient. This is often done based on a person’s genetic profile, lifestyle, and environment. In contrast to a “one-size-fits-all” approach, personalized medicines could help improve drug effectiveness while reducing side effects. It is also known as precision medicine. **Examples of personalized medicine include**: - Using a person’s genetic profile to identify best treatment: - Using cytokine profiles to determine biologic drug choice - Identifying disease-specific autoantibodies to guide therapies - [CAR-T cell therapy](https://www.autoimmuneinstitute.org/articles/car-t-cell-therapy-for-autoimmune-disease/) that modifies a person’s own T cells to target and deplete B cells involved in autoimmunity Currently, personalized medicine is used in treating cancer, where a person’s tumor is removed and sequenced to identify the mutations that the patient has. Based on these mutations, doctors can determine the best treatments for individuals with [those particular mutations](https://www.nature.com/articles/s41571-023-00830-6) (1). Building upon this work, personalized medicine has the potential to make tremendous impacts in treating autoimmunity. ## Why Personalized Medicine Matters in Autoimmune Disease One of the reasons that autoimmune diseases are well-suited for personalized medicine is because “autoimmune diseases can be very heterogeneous,” says J. Michelle Kahlenberg, Professor of Rheumatology at the University of Michigan. “Patients can have different types of manifestations, and they can also have different reasons for having those manifestations based on their genetics and exposures.” While heterogeneity exists in many autoimmune diseases, a great example of heterogeneity is [lupus](https://www.jacionline.org/article/S0091-6749(21)01762-0/fulltext), which can affect different organs and present with different symptoms in different people (2). “It’s really the poster child for heterogeneity,” says Kahlenberg.  “It’s been hard to find treatments that are blockbusters for lupus.” Due to this heterogeneity, it becomes challenging to identify the most effective treatment. Currently, treatment is a trial-and-error approach dictated by insurance guidelines, often based on cost. Personalized medicine “gives us evidence to take to the insurance company and say, ‘you really need to cover this treatment because this is what’s driving this person’s disease’ as opposed to them using a blanket approach, which is ‘you have to try X, Y, and Z on everybody before we’ll even think about any of these other types of therapies,’” Kahlenberg explains. ## Understanding Disease Subtypes and Biomarkers Before personalized medicine approaches can make it into the clinic for treatments, scientists must first understand the [different subtypes](https://www.mdpi.com/2077-0383/8/8/1244) within a specific disease using data from genome and [RNA sequencing](https://insight.jci.org/articles/view/139558), blood samples, and/or [biopsies](https://pubmed.ncbi.nlm.nih.gov/34868043/) from affected sites (3, 4, 5). Kahlenberg heads such a project at the University of Michigan to [study autoimmune skin diseases](https://aidhi.umich.edu/permipa) . The goal of this project is identify biological underpinnings behind the symptoms patients are experiencing so that this information can be used to develop and implement more targeted therapies tailored to individuals. Research such as these can help researchers develop point-of-care testing that could enable quick diagnosis and inform treatment options. Kahlenberg gives an example: If we knew a particular cell type was critical for a response to Drug X and we had a way to quickly test for that cell type, we could implement therapy faster without trying other drugs and failing them. ## Personalized CAR T-Cell Therapy: A New Frontier Another form of personalized medicine is [CAR T-cell therapy](https://www.autoimmuneinstitute.org/articles/car-t-cell-therapy-for-autoimmune-disease/). “Disease \[resistant to conventional treatment\] or severe disease with organ involvement is a critical indication point for CAR T-cell therapy,” Schett says. While CAR-T is known for its use in treating cancer, Schett has been a pioneer of this approach for [treating autoimmune diseases](https://www.nejm.org/doi/full/10.1056/NEJMoa2308917) (6). This approach uses T cells extracted from the patient’s blood and modifies them to target antigens of interest (ex: surface proteins on B cells, including autoreactive B cells). After infusing these cells into the patient, [B cells are eliminated](https://ard.bmj.com/content/83/11/1409) and after about 100 days, the B cell population comes back without the autoimmune-associated B cells (7). The beauty of CAR T-cell therapy is that it contrasts with the majority of autoimmune disease treatments that aren’t curative and require patients to stay on the therapies indefinitely. “The big challenge in the future is really how to do curative approaches, which allows the patients to stop immunosuppressive drugs,” says Schett. CAR T-cell therapy has potential to solve this challenge. “It’s a single infusion stopping the disease, and you don’t need additional immunosuppressive treatment for a long time,” he adds. His current studies have found that remission lasts at least four years, but it’s possible that remission can be lifelong. “For the patient, this is a huge step forward.” While this approach is very individualized and can be very expensive and intensive to prepare, Schett is hopeful about the possibility of an off-the-shelf CAR T-cell therapy using T cells from donors. It can be more scalable and cost effective, he says. Because these types of therapies are so new, it’s unclear whether they can achieve sustained drug-free remission that has been seen from CAR T-cell therapy using the patient’s own T cells. ## The Future of Personalized Medicine in Autoimmune Care With advances in sequencing, cell profiling, AI, and CAR T-cell therapy, personalized medicine is advancing at a fast pace. One day in the future, we may be able to better predict how a person will respond to specific treatments so that we can deliver more effective treatments more quickly to patients. “Research is important. It has to be a priority to invest in these things if this is what patients want to be available 10 years from now,” says Kahlenberg. “If we don’t have the funding to do \[this type of work\], we’re going to be in the same situation where we are now where we’re using a lot of steroids to bridge people when we don’t have better therapies to give them.” ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/04/GAI-Logo-Image-811x1024.png) #### About the Author ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/10/Jennifer-Tsang-Bio-Headshot-e1753113113430.jpg) A microbiologist turned freelance science writer who works with life science companies, nonprofits, and academic institutions on anything from news stories, explainer articles, and content marketing. She shares the wonderful world of microbes on her blog The Microbial Menagerie. Jennifer Tsang, PhD Freelance Writer for GAI ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** Diagnosis & Treatment --- ### [Navigating Autoimmune Care With Limited Resources](https://www.autoimmuneinstitute.org/articles/navigating-autoimmune-care-with-limited-resources) **Published:** February 5, 2026 **Author:** Carolyn Serraino **Excerpt:** Navigating the healthcare system can be challenging for almost everyone. Finding the right providers, getting timely appointments, and accessing appropriate treatments often feel overwhelming. For people living with autoimmune and other chronic conditions, these challenges can be even greater. **Content:** ### When Autoimmune Disease Meets Real Life Autoimmune disease rarely unfolds under ideal conditions. Many people must balance managing symptoms with work, financial strain, fluctuating energy, and barriers to healthcare. This series explores practical aspects of living with autoimmune disease with expert insights. [ Navigating Autoimmune Care With Limited Resources ](https://www.autoimmuneinstitute.org/articles/navigating-autoimmune-care-with-limited-resources) examines healthcare barriers and strategies for accessing care. [ Exercise and Autoimmune Disease: Evidence-Based, Low-Impact Approaches ](https://www.autoimmuneinstitute.org/articles/exercise-and-autoimmune-disease-evidence-based-low-impact-approaches) highlights sustainable movement that supports immune health. [ Finding Purpose and Fulfillment with Autoimmune and Chronic Disease ](https://www.autoimmuneinstitute.org/articles/finding-purpose-and-fulfillment-with-autoimmune-and-chronic-disease) explores how people rebuild identity and pursue meaningful goals while living with chronic illness. Navigating the healthcare system can be challenging for almost everyone. Finding the right providers, getting timely appointments, and accessing appropriate treatments often feel overwhelming. For people living with autoimmune and other chronic conditions, these challenges can be even greater. Some individuals, such as those in low-income or rural communities and people of color, face additional obstacles because of limited access to healthcare, financial resources, or community support. These barriers, often referred to as healthcare inequities, play a powerful role in shaping overall health and long-term outcomes (1). **Zachary Schultz**, PhD, senior lecturer at Auburn University, highlights a core problem within the U.S. healthcare system, saying, “From a historical and public-health perspective, the central challenge is that chronic illness management assumes stability, stable housing, stable employment, stable insurance, while under-resourced communities often experience the opposite. The U.S. healthcare system was largely built to respond to acute crises rather than to sustain long-term care, and that structural mismatch is especially punishing for people with chronic or autoimmune conditions.” Like people who have chronic health conditions, people with autoimmune disorders can face unique healthcare challenges. Diagnosis and treatment can be complex, often involving multiple specialists, tests, and interventions. #### Care can be a financial and time burden. Some people with autoimmune disorders live in environments or are part of groups that can directly impact health outcomes. Certain factors can affect access to care and quality of care, leading to poorer health outcomes. For people with autoimmune disorders, diagnosis and treatment are often complex. Care may involve multiple specialists, repeated testing, long-term medications, and lifestyle adjustments. Managing all of this can place a heavy burden on time, finances, and emotional well-being. In addition, where someone lives, works, and accesses care, and the systems they must navigate, can significantly influence health outcomes. ## How Social Factors Shape Health Many health challenges are shaped by social determinants of health (SDH), nonmedical factors that influence how healthy someone can be. These include (2): - Poverty - Unsafe or unhealthy living environments - Poor quality or unaffordable housing - Food insecurity (lack of access to enough nutritious food) - Lack of access to quality education or jobs that pay a livable wage When these factors are present, individuals are more likely to experience healthcare disparities that lead to adverse health outcomes closely linked to social, economic, and/or environmental disadvantages (3). Patient care advocate **Hilary Hodges** observes these effects firsthand. She emphasizes the importance of taking preventative steps, saying, “Not taking medication or getting proper care results in a wide array of preventable outcomes, including worsening illness, developing comorbidities, and an increase in hospitalizations.” In this article, we’ll explore the challenges that people with autoimmune disorders in under-resourced communities face and practical strategies for navigating care when resources are limited. ## Unique Challenges Faced in Under-Resourced Communities Managing an autoimmune condition is difficult under the best of circumstances. Healthcare disparities can add several layers of complexity. ### Delayed Diagnosis Limited healthcare availability and poor symptom recognition can delay getting a diagnosis. Certain populations, such as women of color, are more likely to experience provider bias, leading to prolonged suffering and delayed treatment (4). ### Difficulties Accessing Care People facing healthcare inequities often experience long wait times and limited availability of providers, especially specialists such as rheumatologists or neurologists. Rural communities are particularly affected. Hodges points to a recent analysis, “I just read in a Commonwealth Fund Analysis report from 2025 that 45% of rural counties have five or fewer primary care physicians and that their average case load is 2,881 patients. Doctors simply don’t have the capacity to provide patients with chronic conditions consistent care and check-ins throughout the year.” ### Gaps in Health Information Access to reliable, understandable, and culturally relevant health information is unequal across communities, making it harder for patients to understand their conditions or treatment options. ### Financial Strain The cost of medications, lab tests, special diets, transportation, and missed workdays can disrupt care. Even insured individuals may struggle with out-of-pocket expenses. ### Systemic Barriers A lack of nearby healthcare facilities, limited culturally responsive care, transportation challenges, and structural bias within healthcare systems all contribute to poorer outcomes. Schulz emphasizes, “Historically, marginalized populations are more likely to enter care later in the course of illness, often only after symptoms have become severe or disabling. For chronic and autoimmune conditions, delays are not neutral events; they shape the entire trajectory of disease and daily life. Missed or disrupted care becomes cumulative harm over time, affecting not only physical health but also economic security, mental well-being, and the ability to plan for the future.” ## Navigating Care with Limited Resources Efforts, such as the [CDC’s REACH program](https://www.cdc.gov/reach/php/reach-2023-2028/index.html), are just beginning to address healthcare inequities. The REACH program’s goal is to make healthy eating and active living more accessible and affordable to priority populations. While systemic change is essential, individuals still need tools to navigate today’s healthcare landscape. Social support, collaborative care, technology, and informed self-advocacy can help ease the burden. ### Becoming a Self-Advocate Learning about your condition and becoming an active participant in your healthcare are essential. While larger system-wide changes are needed in healthcare, specific tools and strategies can empower individuals to have their needs met. Helpful strategies include: - Learning how to advocate for yourself during medical visits. The Myaware self-advocacy [resource page](https://www.myaware.org/self-advocacy-in-healthcare) offers helpful tips. - Joining research registries or patient councils to amplify underrepresented voices. - Educating family and community members to build a network of support Hodges emphasizes the importance of self-advocacy, noting, “On average, it takes 4.6 years from the onset of symptoms of an autoimmune condition to getting a correct diagnosis. If you continue to have symptoms and don’t feel like you are getting the right care, keep gently but firmly showing up to your doctor and getting second or third or fourth opinions until you get the care you need.” ### Building a Healthcare Team Autoimmune care often involves multiple providers. When possible, aim for a coordinated team that communicates effectively. Consider these steps: - **Identify local healthcare resources,** such as community clinics or federally qualified health centers - **Use your insurance directory** to find in-network primary and specialty providers - **Choose a ‘team captain’**, often your primary care provider, to help coordinate care - **Simplify, when possible,** by using providers within the same healthcare system - **Seek allies** such as patient advocates or healthcare navigators Flexible and collaborative care matters. Schulz notes, “From a public-health perspective, honesty and flexibility are essential. Patients benefit when providers acknowledge real-world constraints rather than presenting unattainable ideals. Historically, trust and adherence improve when care plans are negotiated within the realities of cost, access, and availability. This is not about lowering standards of care. It is about aligning care with lived conditions shaped by policy, economics, and inequality.” ### Making the Most of Primary Care  Your primary care provider can be the central hub of your care. To optimize visits: - Keep an up-to-date medication list - Use patient portals to communicate between visits - Write down your top three concerns before appointments - Take notes or bring a trusted support person - Request visit summaries and clear next steps ### Building Strong Support Networks Living with an autoimmune condition can be physically and emotionally demanding. Support from both people who understand your diagnosis and those who support you as a whole person is essential. Sources of support can include: - Trusted friends and family - In-person or online support groups - Community organizations, clubs, or faith-based groups ### Optimizing Lifestyle Choices Lifestyle choices are an essential component of your healthcare journey. Prioritizing balanced nutrition, quality sleep, and regular movement can make a difference. Stress contributes to our vulnerability to illness and to how conditions progress. Try free or low-cost stress-management strategies such as mindfulness or gratitude practices and time outdoors. ### Seeking Low-cost Tools and Resources   Several tools can help reduce barriers to care: - **[Telehealth services](http://Telehealth.HHS.gov "Telehealth services")** can minimize travel time and costs (libraries or community clinics may offer internet access if needed) - **Medication assistance programs** through manufacturers or insurers - **Prescription discount tools** and price comparison services - **Generic medications**, when appropriate Hodges advocates innovative approaches to accessing care, noting, “Telehealth appointments for check-ins, this is particularly useful for patients in rural areas, who lack reliable transportation, or who are largely homebound due to their condition.” ### Finding Community and Online Support Systems  Beyond family and friends, community-based resources can provide practical assistance such as education, transportation, or care coordination. These may include: - Faith-based programs offering rides or peer support - Nonprofits providing condition-specific [resources](https://www.autoimmuneinstitute.org/autoimmune-disease-chronic-illness-related-support-groups/) - Peer mentors, community health workers, or patient navigators As Hodges recommends, exploring online resources, “Foundations and online support groups on platforms like PatientsLikeMe are terrific free resources. For patients with rare diseases, the [EveryLife Foundation](https://everylifefoundation.org/). For patients with autoimmune conditions, the Autoimmune Association. “ Alongside supportive family and friends, community-based and online resources are essential to building an accessible, affordable support network. ### Finding Emotional and Mental Health Support People with autoimmune disorders experiencing the additional [challenges](https://www.autoimmuneinstitute.org/articles/chronic-illness-when-you-feel-like-giving-up/) of living with limited resources are at higher risk of having chronic stress, depression, or anxiety. Support is available often at low or no cost: - Free mental health hotlines and low-cost teletherapy programs - Online or in-person autoimmune support groups - Culturally responsive mental health services If you or someone you care about is experiencing a mental health crisis, immediate help is available through the [988 Lifeline](https://988lifeline.org/), a free, confidential resource. ## You’re Not Alone Schulz reminds us, “Chronic conditions require predictability, stable coverage, consistent access to medications, and fewer bureaucratic interruptions. Historically, systems that prioritize continuity produce better outcomes and lower long-term costs. Treating access as provisional or conditional undermines both health and trust, particularly for people managing lifelong conditions.” Living with an autoimmune condition, especially while navigating healthcare inequities, requires resilience, creativity, and strength. Small steps, supportive communities, and shared knowledge can make the journey more manageable. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/GAI-Logo-Image-e1707845715517.png) #### About the Author ![Tracy Asamoah bio headshot freelance writer for GAI](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/11/DSC05784-scaled.jpg) Tracy is a writer, child and adolescent psychiatrist, and leadership coach. Her journey into the world of autoimmune diseases began when she experienced sudden onset symptoms of multiple sclerosis early in her medical career. This personal experience, combined with her intense curiosity, has informed her work and writing in the field. As a writer, Tracy has contributed to various books and written articles related to mental health. She’s also written on various medical topics regularly contributing to publications such as GoodRx, Psychology Today, and Psychotherapy.net Tracy Asamoah, MD Freelance Writer for GAI ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** Autoimmune Care & Caregiver Support, Diagnosis & Treatment --- ### [The Immune Spectrum: From Autoimmunity to Cancer](https://www.autoimmuneinstitute.org/articles/the-immune-spectrum-from-autoimmunity-to-cancer) **Published:** April 13, 2026 **Author:** Carolyn Serraino **Excerpt:** How are autoimmune disease and cancer connected? Learn how immune balance, inflammation, and immune dysfunction shape disease across the immune spectrum. **Content:** ### The Immune Spectrum: Autoimmunity and Cancer Autoimmune disease and cancer are often treated as unrelated conditions, yet both arise from shifts in immune balance. This series begins by exploring the immune system as a continuum in [ The Immune Spectrum: From Autoimmunity to Cancer ](https://www.autoimmuneinstitute.org/articles/the-immune-spectrum-from-autoimmunity-to-cancer), then examines how treating one condition can influence risk for the other in [ The Immune Balancing Act: Cancer and Autoimmunity ](https://www.autoimmuneinstitute.org/articles/the-immune-balancing-act-cancer-and-autoimmunity). The final article, [ Restoring Immune Tolerance in Autoimmune Disease ](https://www.autoimmuneinstitute.org/articles/restoring-immune-tolerance-in-autoimmune-disease), looks ahead to emerging therapies designed to retrain the immune system without broadly weakening immune defense. Our immune system evolved to protect us from invaders like bacteria, viruses, and other microorganisms that could get us sick. In responding to potential threats, our immune system must perform several tasks: (a) recognize whether something is dangerous or just part of our own body (b) defend our body against the invading organism by initiating an immune response (c) shut off the immune response when it’s no longer needed ## The Immune System as a Continuum “The immune system is incredibly complicated,” says [Arabella Young](https://uofuhealth.utah.edu/huntsman/labs/young), an Assistant Professor at the University of Utah and the University of Utah Huntsman Cancer Institute. > **“There are so many different cell types that can contribute to different pathogenesis at different disease sites. We really do think of it as a spectrum because there are different players that come in at different times.”** If you think of the immune system as a continuum, on one end is an underactive immune system, and at the other end is an overactive immune system. [Davide Mangani](https://www.linkedin.com/in/davide-mangani-50377765/?originalSubdomain=ch), a Principal Investigator studying cancer and immunity at the Institute for Research in Biomedicine, says that in the middle of this continuum is a “balanced” immune system. In this case, the immune system responds only to infectious organisms without attacking our own cells. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/02/GAI-The-immune-spectrum.jpg) Below, we tease apart the continuum, outlining several diseases and conditions that lie beyond immune balance: #### **Overactive Immune System:** - **Autoimmunity:** Autoimmunity sits at the most overreactive end of the immune system spectrum, where the immune system attacks the body’s own tissues. It isn’t necessarily that the immune system functions “excessively,” but rather its inability to distinguish self from non-self is the [reason for its overactivity](https://pmc.ncbi.nlm.nih.gov/articles/PMC10584158/) (1). There are [over 100 autoimmune diseases](https://www.autoimmuneinstitute.org/understanding-autoimmune-disease/). - **Chronic inflammation:** [Inflammation](https://www.autoimmuneinstitute.org/articles/inflammation-a-driving-force-of-autoimmune-disease/) is a normal part of the immune response when responding to infectious organisms. The problem arises when the inflammation doesn’t stop. - **Allergies:** [Allergies](https://www.autoimmuneinstitute.org/articles/allergies-and-autoimmunity "Allergies and Autoimmunity") is an improper immune response to a harmless environmental substance, such as tree pollen or grass. While allergies are a result of an overreactive immune system, they generally aren’t as severe of a response. However, a life-threatening allergy can result in anaphylaxis. #### **Underactive Immune System:** - **Immunodeficiency:** Immunodeficiency is a result of an underactive immune system. In immunodeficiency, the immune system is not able to mount a robust immune response against pathogens. Immunodeficiencies can result from infections (ex: HIV), medications (ex: immunosuppressants), aging, and other factors. - **Cancer:** Cancer results from the failure of the immune system to recognize and eliminate harmful cells, allowing them to grow unchecked. “Cancer cells, even though they are aberrant cells, are still the cells of the individual,” says Mangani. This, along with other mechanisms to evade immune detection, makes it difficult to eliminate them. “Over time, if cancer cells can persist, they’ll start to modify and evolve to avoid the immune system,” says Young. “Eventually, these cancers will be able to escape the immune system altogether.” ## How Do Conditions Like Allergies and Chronic Inflammation Contribute to Autoimmunity? The immune dysfunction that’s common between [allergies and autoimmunity](https://www.autoimmuneinstitute.org/articles/allergies-and-autoimmunity/) is that the immune system reacts inappropriately to harmless substances. Allergies and autoimmunity share a subset of immune cells that are dysfunctional, although there are cell types unique to each disease. Studies have found that those with allergies have an [increased risk](https://onlinelibrary.wiley.com/doi/10.1111/1756-185X.13928) of developing an autoimmune disease but research is still ongoing to assess the causality and directionality of these relationships (2). [Chronic inflammation](https://www.autoimmuneinstitute.org/articles/inflammation-a-driving-force-of-autoimmune-disease/) leads to long-term stimulation of the innate immune system and can contribute to the development of autoimmune diseases as well. Chronic inflammation and autoimmunity can feed back into each other where autoimmune responses can intensify inflammation and chronic inflammation can stimulate autoimmune processes. For example, the chronic activation cells of the innate immune system can cause T cells to become [self-reactive](https://www.sciencedirect.com/science/article/pii/S2319417020300986#bib45) (3). ## How Does Autoimmunity Contribute to Cancer Risk? While autoimmunity and cancer sit at opposite ends of the continuum, scientific evidence finds that autoimmunity can contribute to cancer risk. This is partly because autoimmunity is characterized by bouts of inflammation. Chronic inflammation can progressively damage tissue, meaning that new cells are continually being produced to replace the damaged ones. At the same time, the proinflammatory environment during chronic inflammation promotes DNA damage. Ongoing cellular regeneration in this environment gives more opportunities for mutations to arise, [increasing the risk of cancer](https://pmc.ncbi.nlm.nih.gov/articles/PMC6831096/) (4). Other changes as a result of autoimmunity, including [epigenetic changes](https://www.autoimmuneinstitute.org/articles/the-role-of-epigenetics-in-autoimmune-disease/), also [increase the risk of cancer](https://www.frontiersin.org/journals/cell-and-developmental-biology/articles/10.3389/fcell.2021.664305/full) (5). > **“There are a number of different examples that autoimmune disease can lead to risk of different cancer types,” says Young.** For example, studies have found connections between the following autoimmune diseases and cancer: - [Autoimmune gastritis](https://pmc.ncbi.nlm.nih.gov/articles/PMC5855599/) and gastric adenocarcinoma (6) - [Crohn’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crohns-disease/ "Crohn’s disease"), [ulcerative colitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ulcerative-colitis/ "Ulcerative colitis") and colorectal cancer (7) - [Rheumatoid arthritis](https://pmc.ncbi.nlm.nih.gov/articles/PMC4536786/) and lung cancer (8) - [Systemic lupus erythematosus](https://pmc.ncbi.nlm.nih.gov/articles/PMC9115099/) and lymphoma (9) Autoimmune diseases are often managed with [immunosuppressive treatments](https://www.autoimmuneinstitute.org/the-spectrum-of-autoimmune-disease-treatments/), which can themselves reduce the immune response and increase risk of developing certain cancers. ## Changing Perspectives on the Role of the Immune System Despite their shared pathways rooted in immunology, Mangani says that historically, cancer research and autoimmunity research have developed independently from one another. But things are now changing, where cancer researchers are bringing in the immunological aspects of cancer. > **“We are starting to see that there is a merger between immunologist and cancer immunologist,” he adds. “We are really trying to understand how the spectrum of the immune system can be leveraged to treat cancer.”** Because dysfunction along the immune spectrum involves shared immune cell types and pathways, it’s important to think of diseases like autoimmune diseases as part of the continuum of immune function. Treating autoimmune diseases can increase risk of cancer while treating cancer can increase the risk of autoimmune effects. In a future article, we’ll share more about the immune cells and cytokines behind these shifts and how treating autoimmunity or cancer can cause other changes along the immune spectrum. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/04/GAI-Logo-Image-1.png) #### About the Author ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/10/Jennifer-Tsang-Bio-Headshot-e1753113113430.jpg) A microbiologist turned freelance science writer who works with life science companies, nonprofits, and academic institutions on anything from news stories, explainer articles, and content marketing. She shares the wonderful world of microbes on her blog The Microbial Menagerie. Jennifer Tsang, PhD Freelance Writer for GAI ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** About Autoimmune Disease --- ### [Living with Multiple Autoimmune Conditions](https://www.autoimmuneinstitute.org/articles/living-with-multiple-autoimmune-conditions) **Published:** June 8, 2026 **Author:** Carolyn Serraino **Excerpt:** Learn how to manage multiple autoimmune diseases with expert insights on polyautoimmunity, symptom tracking, specialist coordination, medication management, and daily life strategies. **Content:** ## Staying Organized, Supported, and Hopeful Having two or more autoimmune conditions, known as polyautoimmunity (PolyA) or three or more, referred to as [multiple autoimmune syndrome (MAS),](https://www.autoimmuneinstitute.org/articles/comorbidities-in-autoimmune-disease-multiple-autoimmune-syndrome/) is becoming more widely recognized. A growing body of research shows that certain conditions, such as [Graves’ Disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/graves-disease/) and [type 1 diabetes](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/type-1-diabetes-insulin-dependent-diabetes/), often occur together ([1](https://onlinelibrary.wiley.com/doi/full/10.1111/cen.14304)). **Living with multiple autoimmune conditions brings unique challenges, including ([2](https://journals.sagepub.com/doi/abs/10.1177/0193945914549058)):** - [Limited financial resources](https://www.autoimmuneinstitute.org/articles/navigating-autoimmune-care-with-limited-resources "Navigating Autoimmune Care With Limited Resources") - Logistical challenges such as transportation - [Physical limitations](https://www.autoimmuneinstitute.org/articles/exercise-and-autoimmune-disease-evidence-based-low-impact-approaches-3 "Exercise and Autoimmune Disease: Evidence-Based, Low-Impact Approaches") - Lifestyle disruptions - [Emotional strain](https://www.autoimmuneinstitute.org/articles/managing-mental-health-with-an-autoimmune-disease "Managing Mental Health with an Autoimmune Disease") - [Limited family and social support](https://www.autoimmuneinstitute.org/articles/chronic-illness-when-you-feel-like-giving-up "Chronic Illness: When You Feel Like Giving Up") - [Managing multiple conditions](https://www.autoimmuneinstitute.org/articles/comorbidities-in-autoimmune-disease-multiple-autoimmune-syndrome "Comorbidities in Autoimmune Disease & Multiple Autoimmune Syndrome") and [medications](https://www.autoimmuneinstitute.org/articles/biologics-for-autoimmune-disease-what-you-should-know "Biologics for Autoimmune Disease: What You Should Know") - [Communicating across different healthcare providers](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Effective-Communication-for-Patients.jpg "Effective Communication for Patients") In addition to individual challenges, a complex healthcare system creates further barriers to accessing care. Dr. Peter Kowey, cardiologist and Professor of Medicine and Clinical Pharmacology at Thomas Jefferson University, has witnessed the barriers patients with complicated, chronic illnesses face. In his book, *[Failure to Treat: How a Broken Healthcare System Puts Patients and Practitioners at Risk](https://heliotropebooks.com/books/failure-to-treat-how-a-broken-healthcare-system-puts-patients-and-practitioners-at-risk/),* Dr. Kowey shares the lived experiences of patients navigating a “broken” healthcare system. He says, “Physicians are highly frustrated with the state of medical care in the United States. Our healthcare system, unfortunately, is broken. There have been a lot of pressures on the medical profession—insurance companies, pharmaceutical companies, legislation—and it’s made it hard for us to take care of patients the way we would like to and the way they should be treated.” Dr. Kowey understands the difficulty of living with conditions that often have no cure. He shares, “The frustration, I think, that many of those patients have is the inability to access the system when they really need it, and a lot of that is because doctors and nurses and healthcare professionals are a bit overwhelmed with the number of patients that they have to see.” A patient-centered approach that focuses on the whole person, rather than treating each disease in isolation, can lead to a better quality of life ([3](https://link.springer.com/article/10.1007/s40271-023-00645-8)). This article explores practical strategies for staying organized, managing care, and maintaining balance while living with PolyA or MAS. ## Tools for Managing Your Health ### Symptom Tracking Autoimmune symptoms can be unpredictable and confusing. When several conditions overlap, patterns can become even more challenging to recognize, for both patients and their healthcare providers. Staying organized can help you spot trends, share accurate information, and make confident health decisions. Try using an app (such as Wave Health) or a notebook to track the progression of your condition. > **You can track:** - Type of symptom - When it occurred and how long it lasted - Possible triggers (i.e., food, stress) Over time, recognizing your symptom patterns can help guide your conversations with healthcare providers. ### Medication Tracking For some, managing multiple autoimmune conditions means taking medications numerous times per day. Coordinating the timing and doses of medications can be challenging. An organized system supports taking medications consistently and safely: - Apps (such as Medisafe) or reminders on digital devices support consistency - Daily pill boxes can provide visible reminders - Safely storing medicines in one place, seen every day, helps build routine ### Appointment and provider tracking Simplify keeping up with your appointments and healthcare providers by storing information in a centralized location. You can keep appointments in a digital or traditional calendar. Include each provider’s name, specialties, and contact information. ### Create an action plan  Create a plan for what to do if you do experience a symptom flare. - Identify which symptoms you can manage on your own - Decide when to contact your healthcare provider. - List your emergency contact information. Share this plan with your healthcare provider and a supportive friend or family member. ### Using Digital Tools Wisely When choosing digital apps or websites to help you organize your medical information, there are some important factors to keep in mind. Most importantly, technology should be easy to access and use. Dr. Sarah Matt, surgeon, health technology strategist, and author of the book*, [The Borderless Healthcare Revolution](https://drsarahmatt.com/book.html)*, notes, “Empowering patients with complex, chronic autoimmune conditions requires tools that go beyond simple convenience. We need technology that helps manage uncertainty, reduces burdens, and facilitates proactive care.” **Look for apps that:** - Clearly explain how they protect your privacy and data - Transparently disclose how they share user information - Avoid offering “diagnoses” based solely on user input - Are affiliated with reputable hospitals, universities, or government programs **Helpful features when choosing a health app or website:** - Customizable symptom lists - Medication reminders and dose logging - Ability to share or export data to healthcare providers - Research-based or endorsed by a hospital or medical organization ### Coordinating Multiple Specialists Managing multiple autoimmune conditions often means juggling several healthcare providers. Dr. Matt says, “’ Medical silo fatigue’ is incredibly real. Patients with multiple autoimmune conditions often feel like messengers, carrying information between specialists who don’t communicate. It’s exhausting and dangerous. Technology can help, but only if we stop building more silos.” Dr. Kowey describes the challenges of care communication and care coordination when individuals lack a primary care provider overseeing their care plan. He notes, “Everybody who looks at a patient from a consultant’s vantage point has a different way of looking at the disease. Patients frequently will get mixed messages from consultants. They’ll get diverse opinions about how things should \[be\] handled and the priorities for care and for procedures.” #### A team-based, coordinated approach helps reduce conflicting advice and medical errors while improving overall care. #### **What you can do:** - **Create a healthcare hub:** Store all vital health information (medication lists, test results, imaging, provider contact information) in one place, such as a binder or digital file. - **Medication List:** [Keep a current list](https://www.autoimmuneinstitute.org/autoimmune-chronic-illness-toolkit/ "Autoimmune & Chronic Illness Toolkit") of all medications that can be shared with healthcare providers. - **Use patient portals:** Share updates, ask questions, schedule appointments, and check on lab or test results. - **Pre-visit prep:** Before each visit, write down your [top three concerns to share with your healthcare provider](https://www.autoimmuneinstitute.org/articles/effective-communication-strategies-for-patients-with-autoimmune-diseases "Effective Communication Strategies for Those with Autoimmune Disease"). - **During medical visits:** Take notes or consider inviting [a trusted family member or friend](https://www.autoimmuneinstitute.org/category/autoimmune-care-and-support/ "Autoimmune Care & Caregiver Support") to attend the appointment to take notes for you. Request a summary of the visit, including any treatment changes or recommendations. - **Identify the “team captain”:** Identify one person, usually your primary care provider, to oversee your overall care plan. #### **What [providers](https://www.autoimmuneinstitute.org/effective-communication-strategies/) can do ([3](https://link.springer.com/article/10.1007/s40271-023-00645-8)):** - **Stay informed:** Healthcare providers should stay up-to-date on your condition. - **Help with goal setting:** Your healthcare provider can work with you to set priorities and create tools to support self-management. - **Support a healthy lifestyle:** Healthcare providers can suggest lifestyle changes that support disease control. - **Ensure reasonable availability:** Schedule regular follow-up appointments. - **Offer wrap-around services:** If available, nurse care managers or case coordinators can help organize appointments, manage follow-ups, and provide education and support. Dr. Matt notes that platforms such as user-friendly electronic health records, patient portals accessible across specialties, and integrated [telehealth](https://www.autoimmuneinstitute.org/articles/navigating-healthcare-through-the-practical-lens-of-telehealth "Navigating Healthcare Through the Practical Lens of Telehealth") can be powerful tools when used well. The best technology is easy to use and integrated across all of an individual’s systems of care. ### Daily Life Strategies Living with multiple autoimmune conditions can make daily life feel unpredictable, but small, consistent actions can help you feel more in control. #### Healthy diet A [balanced diet](https://www.autoimmuneinstitute.org/gai-library/#ad-food) rich in fruits, vegetables, healthy proteins, legumes, nuts, and whole grains may reduce inflammation and support overall health and well-being. Try limiting sugars and processed foods. #### Stress Management [Stress](https://www.autoimmuneinstitute.org/articles/stress-autoimmune-disease-navigating-the-complex-relationship "Stress & Autoimmune Disease: Navigating the Complex Relationship") can worsen symptoms in autoimmune conditions. Try mindfulness practices, such as deep breathing or a [gratitude](https://www.autoimmuneinstitute.org/articles/what-is-gratitude/) practice, to help lessen the impact of stress. If you’re concerned about your emotional well-being, seek out a mental health specialist. #### Environmental Factors  Minimize [exposure to potential pathogens](https://www.autoimmuneinstitute.org/articles/beyond-genes-and-smoking-5-more-triggers-that-heighten-autoimmune-disease-risk "Beyond Genes and Smoking: 5 More Triggers That Heighten Autoimmune Disease Risk"), such as infections, allergens, or environmental toxins that can trigger or worsen autoimmune conditions. #### Social Support Build a [network of supportive family, friends, and caregivers](https://www.autoimmuneinstitute.org/articles/the-vital-role-of-caregivers-in-autoimmune-disease "The Vital Role of Caregivers in Autoimmune Disease") who can help with daily tasks, attend appointments with you, and offer encouragement. Hilary Hodge, patient advocate and host of the [“*All Things Adrenal*” podcast](https://www.nadf.us/podcast), describes how finding understanding communities helped her after being diagnosed with [Addison’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-addisons-disease/). She says, “I had to learn much of how to manage my disease from support groups and foundations dedicated to the condition, like the [National Adrenal Disease Foundation (NADF)](https://www.nadf.us/) in the U.S. It was through those networks that I learned about the different medical IDs I needed \[like\] a bracelet, how to screen for potential complications, and, crucially, how to navigate the process of becoming a parent in terms of how the disease might affect my [fertility](https://www.autoimmuneinstitute.org/articles/how-autoimmune-disease-affects-fertility "How Autoimmune Disease Affects Fertility"), [pregnancy](https://www.autoimmuneinstitute.org/research_updates/autoimmune-diseases-and-pregnancy-a-complex-relationship/ "Autoimmune Disease and Pregnancy"), [childbirth, breastfeeding](https://www.autoimmuneinstitute.org/articles/why-autoimmunity-emerges-postpartum-and-how-to-recognize-it "Why Autoimmunity Emerges Postpartum and How to Recognize It") and so on.” #### Sleep and Rest  Fatigue is a common symptom of many autoimmune disorders. Regular, adequate sleep supports overall well-being ([4](https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2019.01827/full)). Listen to your body’s cues, rest when needed, and ask for help when necessary. Talk to your health provider if you’re having trouble falling or staying asleep. ## Looking Ahead The future of supporting individuals living with multiple autoimmune conditions will be a collaborative effort, both individual and group. Both Dr. Kowey and Dr. Matt emphasize that before actual impact can be achieved, it’s essential to repair a broken healthcare system. > Dr. Kowey says, “Real change in healthcare requires more than just implementing new technology; technology deployed within a broken system often amplifies existing problems rather than solving them. Therefore, fundamental adjustments to the system itself are necessary, and healthcare leaders must be the driving force behind this transformation.” With improvements in the healthcare system, Dr. Matt is optimistic about potential future advances, sharing, “The future of monitoring autoimmune conditions involves multi-modal data integration, drawing information from various sources. Clinical-grade wearables can track physiological markers like heart rate variability, temperature, sleep patterns, and activity levels.” Individuals can use apps and wearable devices to track other indicators of progression, such as fatigue or pain. An integrated, patient-centered healthcare system creates an environment in which this information is optimally used. Living with multiple autoimmune disorders can be challenging, but having the right tools can help you live with more control and hope for a full life. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/GAI-Logo-Image-e1707845715517.png) #### About the Author ![Tracy Asamoah bio headshot freelance writer for GAI](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/11/DSC05784-scaled.jpg) Tracy is a writer, child and adolescent psychiatrist, and leadership coach. Her journey into the world of autoimmune diseases began when she experienced sudden onset symptoms of multiple sclerosis early in her medical career. This personal experience, combined with her intense curiosity, has informed her work and writing in the field. As a writer, Tracy has contributed to various books and written articles related to mental health. She’s also written on various medical topics regularly contributing to publications such as GoodRx, Psychology Today, and Psychotherapy.net Tracy Asamoah, MD Freelance Writer for GAI ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** Living Well with Autoimmune Disease --- ### [Autoimmune or Not? The Diseases That Blur the Lines](https://www.autoimmuneinstitute.org/articles/autoimmune-or-not-the-diseases-that-blur-the-lines) **Published:** June 5, 2026 **Author:** Carolyn Serraino **Excerpt:** Many diseases affect the immune system without being classified as autoimmune. Experts explain why conditions like fibromyalgia, endometriosis, POTS, and Lyme disease remain difficult to categorize. **Content:** Certain conditions that affect the immune system may share features with autoimmune diseases, but they are not formally recognized as such. Distinguishing between immune-mediated disease and autoimmune disease is a challenging endeavor for many reasons, including difficulties in diagnosis and classification, overlapping signs and symptoms, and uncertainties in treatment options. To navigate the complexity of classifying immune-related conditions, we spoke to two experts: **Victoria Shanmugam**, MBBS, FRCP, FACR, CCD, director of the [Office of Autoimmune Disease Research](https://orwh.od.nih.gov/OADR-ORWH) in the Office of Research on Women’s Health at The National Institutes of Health (NIH), and **Kara Wada**, MD, founder of the Immune Confident Institute in Columbus, OH. ## What Defines an Autoimmune Disease? **According to revised postulates ([1](https://pubmed.ncbi.nlm.nih.gov/36865538/)), criteria that define autoimmune disease include**: - The presence of autoantibodies and autoreactive T cells - Evidence that visible clinical features can be reproduced by transferring autoantibodies or T cells - An ability to replicate a given disease in laboratory animal models While these criteria still generally apply, the boundaries between autoimmune, immune-related, and chronic inflammatory disease are not always clearly established ([1](https://pubmed.ncbi.nlm.nih.gov/36865538/)). Criteria also vary by specific conditions and are regularly updated by medical organizations as scientific understanding continues to evolve. ## Why Do Some Diseases Stay “In Between”? Immune-related diseases and comorbidities occupy intersecting positions, affected by both innate and adaptive immune responses that are not always connected to autoimmunity. This overlap contributes to the overall challenge of assigning specific diseases to distinct groups, with some studies highlighting conditions that exist as a [spectrum](https://www.autoimmuneinstitute.org/articles/the-immune-spectrum-from-autoimmunity-to-cancer "The Immune Spectrum: From Autoimmunity to Cancer") rather than as set [categories](https://www.autoimmuneinstitute.org/articles/untangling-a-complex-web-how-to-categorize-autoimmune-disease/) ([2](https://pubmed.ncbi.nlm.nih.gov/39372419/), [3](https://pubmed.ncbi.nlm.nih.gov/34341562/)). Some conditions can even coexist with autoimmunity, blurring existing classification parameters and further complicating the clinical picture ([4](https://pubmed.ncbi.nlm.nih.gov/39828017/)). **Important reasons why some diseases are not considered autoimmune include:** - No single identifiable autoantigen - No consistent biomarkers - Diverse symptoms - Overlap with neurological, hormonal, or metabolic systems - Historical bias in research (especially for women’s health) Experts indicate that several gaps need to be closed in terms of classification to improve diagnosis, treatment, and quality of life of people who are affected, including autoantibody testing for various autoimmune diseases ([5](https://pubmed.ncbi.nlm.nih.gov/37150488/)). “The ‘black and white’ world of lab data doesn’t always account for the gray areas of immune involvement. While classic autoimmunity requires a ‘smoking gun’ of specific autoantibodies or autoreactive T cells, many conditions live in a space defined by chronic inflammation, hormonal shifts, and/or nervous system dysregulation,” says [Wada](http://www.drkarawada.com). #### “We see patients with ‘non-specific’ symptoms that are very real, but they lack a neat diagnostic box.” [Shanmugam](https://orwh.od.nih.gov/oadr-directors-bio) is one of the leaders of the [NIH-Wide Strategic Plan for Autoimmune Disease Research](https://orwh.od.nih.gov/OADR-ORWH/Strategic-Planning-for-ADR), a framework that promotes research guidance, leverages modern technologies, and builds infrastructure to improve diagnosis and treatment for people with autoimmune disease. “Included within these priorities is an objective to expand autoimmune disease research focused on co-occurring and comorbid conditions, such as endometriosis and fibromyalgia, which commonly co-occur with autoimmune diseases but for which the pathogenesis and mechanisms are currently unclear,” says Shanmugam. ## “Suspected” or “Debated” Autoimmune Conditions > “These aren’t necessarily ‘lesser’ conditions; they just challenge our current definitions and frameworks,” says Wada. Diseases considered “suspected” or “debated” affect the immune system in various and specific ways but are not considered autoimmune diseases. The diseases below affect multiple body systems, organs, and tissues, from the skin to the endometrial tissue to the central nervous system, and are listed along with their key features. [**Atopic dermatitis**](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/eczema/ "Eczema (atopic dermatitis)"), an immune-mediated disease - Epidermis barrier disruption - Immune reactions typical of allergy - Chronic inflammation [**Endometriosis**](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/endometriosis/ "Endometriosis"), a chronic inflammatory disease with [immune dysfunction](https://www.autoimmuneinstitute.org/research_updates/is-there-a-connection-between-endometriosis-and-autoimmune-diseases/ "Is There a Connection Between Endometriosis and Autoimmune Disease?") - Hormone-driven inflammatory disease - Lack of consistent autoantibodies - Chronic inflammation and pain [**Fibromyalgia**](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/fibromyalgia/ "Fibromyalgia"), a neurological condition with emerging immune evidence - Neuroimmune disorder - Musculoskeletal [pain](https://www.autoimmuneinstitute.org/research_updates/new-research-illuminates-connection-between-fibromyalgia-antibodies-and-pain/ "New Research Illuminates Connection Between Fibromyalgia Antibodies And Pain") - Combination of genetic, environmental, and neurological triggers [**Lyme disease**](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/lyme-disease/ "Lyme disease"), an infectious disease that is not autoimmune at onset - Infection caused by *Borrelia burgdorferi* bacteria - Bacteria transmitted by tick bites - Long-term symptoms after treatment (post-treatment Lyme disease syndrome) “Lyme is the ultimate *provocateur*,” says Wada. “It can trigger a post-treatment syndrome that mimics autoimmune patterns so closely it blurs the lines of where the infection ends and the immune-mediated disease begins.” [**Postural Orthostatic Tachycardia Syndrome**](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/postural-orthostatic-tachycardia-syndrome/ "Postural orthostatic tachycardia syndrome (POTS)") **(POTS)**, an autonomic disorder with autoimmune signals - Dysregulation of blood flow and heart rate - Autonomic nervous system dysfunction - Multiple forms (neuropathic, hyperadrenergic, hypovolemic) **Schizophrenia** has also been explored as a possible immune-mediated or autoimmune-associated condition, after autoantibodies and inflammation were linked to disease pathogenesis ([6](https://pubmed.ncbi.nlm.nih.gov/40693926/)). This, however, remains an area of ongoing research and debate. ## How Does Disease Classification Affect Research and Clinical Care for Suspected Diseases? As “[multi-omics](https://www.autoimmuneinstitute.org/articles/the-promise-of-ai-in-autoimmune-disease-from-early-detection-to-personalized-care "The Promise of Artificial Intelligence in Autoimmune Disease Healthcare")” and [precision medicine](https://www.autoimmuneinstitute.org/articles/tailoring-autoimmune-treatment-with-precision-medicine/) research advances, identifying disease has shifted from symptom-based to mechanism-based, leading to classification systems being periodically revised ([7](https://pubmed.ncbi.nlm.nih.gov/35076341/)) and improving our understanding of disease pathogenesis ([8](https://pmc.ncbi.nlm.nih.gov/articles/PMC7051208/)). “Many conditions we currently group under one diagnosis are likely made up of biologically distinct subtypes,” says Shanmugam. “Advances in genomics, proteomics, and other molecular tools are helping us define those subgroups more precisely, which should support more personalized treatment decisions.” #### Classification affects multiple aspects of healthcare and research in immune-mediated disease, including insurance coverage, funding, and access to clinical trials. “As our understanding of genetics and the microbiome evolves, we hope to see ‘suspected’ conditions shift into ‘accepted’ autoimmune and/or autoinflammatory categories,” says Wada. “An official label shouldn’t be the only way to get validated care, but in our current system, it is often the key that unlocks the door.” The [EXACT-Plan Network](https://orwh.od.nih.gov/in-the-spotlight/all-articles/meet-2023-exact-plan-award-recipients) is a collaborative initiative that funds research on environmental exposures and how they shape autoimmune disease risk, onset, and outcomes. “Its goal is to build a system-level view of how factors such as chemicals, infections, diet, and other exposures disrupt cells, tissues, and organs across multiple autoimmune diseases,” says Shanmugam. “The EXACT Network is helping move the field beyond studying autoimmune diseases one at a time and toward a more integrated understanding of how environmental factors may trigger and shape disease across the autoimmune spectrum and across the lifespan.” ## Why Do Disease Classification Labels Matter? > Classification directly affects disease management, but without clear biomarkers, people who may have an autoimmune or immune-mediated disease may not receive a clear diagnosis or answers for years. “We’re practicing in an era of incredible diagnostic technology, yet we’re still humbled by the lack of specific biomarkers for many complex conditions,” discusses Wada. “Because symptoms so often overlap with other syndromes, the path to a name is rarely a straight line. This leads to the ‘diagnostic odyssey’, a frustrating cycle of delayed recognition and misdiagnosis that many of these patients know all too well.” In terms of treatment, research has focused on new biologic agents and engineered cellular therapies to assess whether they can restore immune balance. “We are seeing continued progress in targeted therapies. Rather than relying solely on broad immunosuppression, investigators are now developing treatments aimed at specific immune pathways, with the goal of improving efficacy while reducing toxicity,” says Shanmugam. In terms of research, controlled clinical trials are essential to explore experimental therapies and new tools to effectively monitor disease activity and treatment response. ## How can Clinicians, Researchers, and Patients Work Through Uncertainty? Diagnosis and treatment paths are not always straightforward, but clinicians, researchers, and people with autoimmune and immune-related diseases can take practical steps to make informed decisions amid incomplete information and uncertainty. Wada mentions strongly [validating a patient’s experience](https://www.autoimmuneinstitute.org/effective-communication-strategies/) even when lab results are inconclusive or unclear. > **“We have to broaden our definition of ‘do no harm.’ Sometimes, withholding a low-risk intervention just because a patient hasn’t checked every single diagnostic box can be the greater harm.”** She tells her patients to focus on functional outcomes rather than disease labels. “Keep the logs, see the specialists, but don’t let the pursuit of a lab-labeled disease overshadow your quality of life.” Getting helpful answers can take time, so it’s important to communicate with people affected by these diseases and ensure they understand the importance of medical and scientific research. > “Research is rarely a straight line. If we start with what matters to patients, then we are going to be answering important questions,” says Shanmugam. “Through partnership, every study, even negative ones, can add to a knowledge base that moves the whole field forward.” Partnerships and collaborations are essential to improving our understanding of disease development, even in growing research areas. The area of *exposomics* measures what (and how) people are exposed to over a lifetime, including [diet](https://www.autoimmuneinstitute.org/gai-library/#ad-food), [environmental factors](https://www.autoimmuneinstitute.org/articles/autoimmunity-on-the-rise), and [stress](https://www.autoimmuneinstitute.org/articles/stress-autoimmune-disease-navigating-the-complex-relationship), and could help us understand the mechanisms underlying immune disease induction ([9](https://pubmed.ncbi.nlm.nih.gov/38992882/)). Community engagement is also key to supporting people with complex immune diseases. NIH’s Office of Autoimmune Disease Research hosts a quarterly [forum](https://orwh.od.nih.gov/events/updates-on-oadr-orwh) where community members can hear research updates and share their thoughts and experiences. > ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/GAI-Logo-Image-e1707845715517.png) #### About the Author ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/07/Chiavolini-Damiana-scaled.jpg) A freelance writer who specializes in medical and life science topics. As a trained researcher, she authored journal articles in the areas of infection and immunity and wrote booklets and book chapters about different diseases. As a professional communicator, she writes feature articles for magazines and other publications and develops content for higher education platforms. Damiana is also an experienced academic editor, microbiology educator, writing coach, and fragrance blogger. She is a contributing member of the American Medical Writers Association and a past-president of the association’s Southwest Chapter. Damiana Chiavolini, PhD Freelance Writer for GAI ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** About Autoimmune Disease --- ### [Finding Purpose & Fulfillment with Autoimmune and Chronic Disease](https://www.autoimmuneinstitute.org/articles/finding-purpose-and-fulfillment-with-autoimmune-and-chronic-disease) **Published:** February 5, 2026 **Author:** Carolyn Serraino **Excerpt:** People with autoimmune diseases or other severe chronic illnesses learn how to manage their condition but also strive to find purpose, stability, and a way forward. Pursuing these goals while living with a chronic condition involves discovering personal and professional opportunities that fit a new lifestyle but also reclaiming agency, dignity, and the sense of being helpful to others.  **Content:** ### When Autoimmune Disease Meets Real Life Autoimmune disease rarely unfolds under ideal conditions. Many people must balance managing symptoms with work, financial strain, fluctuating energy, and barriers to healthcare. This series explores practical aspects of living with autoimmune disease with expert insights. [ Navigating Autoimmune Care With Limited Resources ](https://www.autoimmuneinstitute.org/articles/navigating-autoimmune-care-with-limited-resources) examines healthcare barriers and strategies for accessing care. [ Exercise and Autoimmune Disease: Evidence-Based, Low-Impact Approaches ](https://www.autoimmuneinstitute.org/articles/exercise-and-autoimmune-disease-evidence-based-low-impact-approaches) highlights sustainable movement that supports immune health. [ Finding Purpose and Fulfillment with Autoimmune and Chronic Disease ](https://www.autoimmuneinstitute.org/articles/finding-purpose-and-fulfillment-with-autoimmune-and-chronic-disease) explores how people rebuild identity and pursue meaningful goals while living with chronic illness. ## Leading a Purposeful Life  People with autoimmune diseases or other severe chronic illnesses learn how to manage their condition but also strive to find purpose, stability, and a way forward. Pursuing these goals while living with a chronic condition involves discovering personal and professional opportunities that fit a new lifestyle but also reclaiming agency, dignity, and the sense of being helpful to others. To learn more about finding purpose and fulfillment in everyday life, building resilience, and pursuing opportunities to turn one’s lived experience into ways of helping and engaging others, we spoke with **Kara Wada**, MD, founder of the Immune Confident Institute in Columbus, OH, and **Brenda Snow**, [multiple sclerosis (MS)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/) patient, advocate, and founder of Snow Companies. ## The Transition Point: Moving From *Coping* to Asking *What’s next?*  When living with or recovering from an autoimmune disease or chronic illness, people reach a turning point where [coping](https://www.autoimmuneinstitute.org/articles/chronic-illness-when-you-feel-like-giving-up/) alone may no longer be enough. Living fully is about transitioning from accepting a chronic condition to feeling hopeful, all the way to building resilience and feeling empowered to pursue opportunities that will be important to oneself and others. Evidence indicates that people who find meaning or purpose in the adversity that comes with a chronic illness, such as cancer, diabetes, and inflammatory bowel disease, have greater psychological well-being than those who have not yet found meaning ([1](https://pubmed.ncbi.nlm.nih.gov/41140532/), [2](https://pubmed.ncbi.nlm.nih.gov/41661854/)). Healthcare professionals play an essential role in helping people manage their chronic illness in their everyday life ([3](https://pubmed.ncbi.nlm.nih.gov/38886987/)). However, both professionals and advocates can also guide people to pursue professional opportunities, volunteer positions, or personal goals, while still handling symptoms. > Reaching these milestones can take time and patience. “Depending on one’s symptom burden, redefining identity and achievement is crucial. Not uncommonly, traditional career paths or full-time work may not be realistic in the short or long term,” says [Wada](https://www.drkarawada.com/about-dr-kara).  “When I was first diagnosed with MS, making my daughter toast in the morning was an incredible accomplishment that fueled me. Later, when I was building a disrupting healthcare agency, my ambition shifted. Both held the same weight of significance in my journey,” says [Snow](https://brendasnow.com/). ## Redefining Independence, Achievement, and Fulfillment While traditional career paths or full-time work may not be instantly feasible, Wada suggests redefining self-sufficiency as a crucial first step. “I encourage patients to think in terms of *functional independence*: the ability to manage day-to-day life in ways that feel meaningful, even if support is required for certain tasks,” says Wada. “Realistic self-sufficiency balances autonomy with health. Acknowledging that asking for help isn’t failure is very often not easy, but a strategy that can help sustain participation in work or hobbies.” > As someone who lives with MS, Snow underlines the importance of filling the days to find meaning, while maintaining flexibility. “Early in my diagnosis, I had a job that required me to work long hours in front of a computer. It became physically challenging because of the impact my MS had on my vision. So, I made adjustments but continued to work because it fulfilled me,” says Snow. ## Can I Work Again With Chronic Illness and Autoimmune Disease? > Pacing, managing energy, building a routine, and setting up systems that reduce fully relying on others are all essential components of building independence and intentionally exploring flexible work, creative outlets, or volunteering opportunities that respect health boundaries. Wada takes an active role in advising her patients to pursue goals and opportunities.  “Often this means reframing success from ‘doing everything independently’ to achieving milestones that matter to them. Flexible work, creative projects, volunteering, or advocacy roles are all areas where folks can explore goals that match their energy, capabilities, and health priorities,” she mentions. “We discuss pacing, energy management, and practical strategies to build routines and systems that minimize stress on their bodies while still allowing them to contribute.” Snow’s work centers on offering validation and strategies to people who want to rebuild their lives.  “I’ve spoken with many patients who thought that they had to leave their ambition behind after getting their diagnosis. Quite the contrary – it’s more of a reason to keep fighting,” she says. ## How do I Know if I am Pushing Too Hard? > Exploring opportunities and being actively involved in projects and initiatives are essential aspects of people’s well-being, but drive and ambition should be balanced with rest and energy conservation. Wada emphasizes warning signs of someone pushing too hard: - Persistent fatigue that doesn’t improve with rest - Flare-ups of autoimmune symptoms - Disrupted sleep - Increased anxiety or depression “When these \[signs\] occur, it’s a signal to scale back commitments, possibly adjust expectations, and strengthen support systems,” cautions Wada. “By aligning personal goals with health realities and formal pathways, individuals with chronic illness can contribute meaningfully, maintain independence, and find purpose while honoring their body’s limits,” she adds. Snow emphasizes that adjusting goals and decisions along with setting boundaries are crucial to keeping energy levels up. “Especially as women, we have a hard time saying ‘no’, so I remind people that ‘no’ isn’t a dirty word. It’s better to turn something down and reserve gas in your tank than to deplete yourself,” she advises. ## How Can I Help Others Through My Own Experience? The experience of a person with autoimmune disease or other chronic illnesses can become a resource to help others responsibly. > “Experiences with chronic illness are valuable in healthcare and advocacy, providing insight, empathy, and guidance that formal training alone can’t offer,” says Wada. “Lived experience can be recognized through peer support roles, mentoring, advocacy groups, coaching, or part-time caregiving positions.” Pathways to formalize these roles include: - Peer support through mentorship programs and certifications - State programs for disability advocacy, health coaching, or patient navigation - Programs that offer training and structured volunteer opportunities Snow points out that healthcare and life sciences systems need to be more aware of patient needs. “Life sciences have done an incredible job of introducing life-changing therapeutics to patients, but they haven’t always done a great job of understanding that patients are much more than their disease,” says Snow. “Through my work, I’ve been able to educate the healthcare/life sciences spaces by bringing to life the lived experiences of patients.” Another way to support others is by sharing your personal experience. Patient stories help raise awareness, build community, and give others navigating similar challenges a sense that they are not alone. GAI invites individuals to [share their experiences](https://www.autoimmuneinstitute.org/autoimmune-stories/ "Autoimmune Stories") through its **[How to Share Your Story](https://www.autoimmuneinstitute.org/share-your-story/ "Share your Story")** page, helping amplify patient voices and perspectives. ### Professional Associations and Organizations for Work Accommodations, Patient-Engagement, and Resources ## Support and Mentorship Programs [GAI Autoimmune Disease and Chronic Illness-Related Support Groups](https://www.autoimmuneinstitute.org/autoimmune-disease-chronic-illness-related-support-groups/) [GAI Support Resources](https://www.autoimmuneinstitute.org/04-find-resources/) [The Autoimmune Hepatitis Association (AIHA) Mentorship Program](https://aihep.org/mentorship-program/) [National Scleroderma Foundation Peer Mentor Program](https://scleroderma.org/peer-mentor-program) [Self-Management Resource Center ](https://selfmanagementresource.com/) ## State Self-Management Programs [Kansas Department of Health & Environment](https://www.kdhe.ks.gov/2346/Chronic-Disease-Self-Management-Programs) [Mississippi State Department of Health](https://msdh.ms.gov/page/43%2C9266%2C91%2C474.html) [Pennsylvania Aging & Community Services](https://www.pa.gov/services/aging/register-for-a-chronic-disease-self-management-program) [Oregon Health Authority](https://www.oregon.gov/oha/ph/preventionwellness/selfmanagement/pages/index.aspx) ## Training, Coaching, and Ambassador Opportunities [Chronic Care Policy Alliance](https://chroniccarealliance.org/our-work/) [Functional Medicine Coaching Academy Inc.](https://functionalmedicinecoaching.org/) [International Associations of Wellness Professionals](https://iawpwellnesscoach.com/wellness-coaching/) [National Board for Health & Wellness Coaching (NBHWC)](https://nbhwc.org/) [Snow Companies Ambassador Program](https://snow-companies.com/patient-ambassadors/) ## Job Accommodations [General](https://www.iwh.on.ca/news/iwh-launches-tool-to-help-workers-with-chronic-conditions-find-job-tailored-accommodations) [Lupus Foundation of America](https://www.lupus.org/resources/what-you-need-to-know-about-workplace-accommodations) [Crohn’s & Colitis Foundation](https://www.crohnscolitisfoundation.org/patientsandcaregivers/managing-the-cost-of-ibd/employee-and-employer-resources) ### Building Resilience Where Resources Are Limited Programs, resources, and opportunities regularly help people find purpose and meaning, but research has also focused on strengthening the resilience of people with chronic illnesses living in low-resource communities ([4](https://pubmed.ncbi.nlm.nih.gov/39005946/)). Through personal resilience and measures that encourage keeping occupied and connecting with others who may provide support, people can better adapt to ongoing adversity caused by ongoing illnesses. Investigators created a preliminary model of resilience that could help guide future research and support strategies aimed at improving quality of life and health outcomes in settings with limited resources ([4](https://pubmed.ncbi.nlm.nih.gov/39005946/)). ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/GAI-Logo-Image-e1707845715517.png) #### About the Author ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/07/Chiavolini-Damiana-scaled.jpg) A freelance writer who specializes in medical and life science topics. As a trained researcher, she authored journal articles in the areas of infection and immunity and wrote booklets and book chapters about different diseases. As a professional communicator, she writes feature articles for magazines and other publications and develops content for higher education platforms. Damiana is also an experienced academic editor, microbiology educator, writing coach, and fragrance blogger. She is a contributing member of the American Medical Writers Association and a past-president of the association’s Southwest Chapter. Damiana Chiavolini, PhD Freelance Writer for GAI ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** Living Well with Autoimmune Disease --- ### [Experts Discuss the Complex Path to an Autoimmune Diagnosis](https://www.autoimmuneinstitute.org/articles/experts-discuss-the-complex-path-to-an-autoimmune-diagnosis) **Published:** March 21, 2024 **Author:** Carolyn Serraino **Excerpt:** Unlock the mystery of autoimmune diagnosis with insights from medical experts. Learn about diverse timelines, proactive patient advocacy, and holistic approaches to unraveling the mysteries of chronic conditions. **Content:** Pinpointing the cause of symptoms is a key issue faced by those with or without an autoimmune diagnosis. Autoimmune disease manifests in various ways, affecting different organs and systems within the body. As such, many individuals undergo a prolonged period of inconclusive investigations without treatment. Here, The Global Autoimmune Institute speaks with Francisco Contreras, MD; Johannah Ruddy, M.Ed; and Henri Roca, MD, about autoimmune onset and diagnosis. ## **What is the typical length from autoimmunity onset to diagnosis?** Since symptoms can manifest in a variety of ways, the timeline for receiving an autoimmune diagnosis from the onset of symptoms can vary widely. For example, autoimmune disease often presents with non-specific symptoms, such as fatigue, joint pain, or gastrointestinal issues, which are characteristic of many disorders. “On average, the diagnostic process may take several months to years,” says Contreras, director and president at Oasis of Hope Medical Institute. > “Early consultation with a specialist, thorough communication of symptoms, and expedited testing can sometimes lead to a more prompt diagnosis.” He recommends scheduling an appointment with someone such as a rheumatologist or immunologist, in addition to a general practitioner or a physician dedicated to functional medicine. “They possess the expertise to navigate the complexities of these diseases and can conduct a thorough evaluation,” he says. Different autoimmune diseases present the possibility of truncated or extended timelines, too. For example, [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/ "Multiple Sclerosis") may worsen over time, while Crohn’s disease may have pronounced flares. > > “It’s important to recognize the uniqueness of each case. Our goal is to extinguish the proverbial fire; you can’t just suppress symptoms within a set time frame.” > > > > Francisco Contreras, MD Likewise, Roca, a family medicine physician at Palm Health, says that a timeline alone is not the only factor that should be considered. ## **How should an individual proceed without an autoimmune disease diagnosis?** Navigating the healthcare system, obtaining referrals, and coordinating appointments can be overwhelming. > In the absence of a diagnosis, patients should continue to communicate their concerns. Ruddy, co-author of ¨*[Gut Feelings: Doctors and Patient-Centered Care](https://romefoundation.clickfunnels.com/optin1682609315121)*,¨ notes that it is critical for patients to advocate for themselves and consistently convey symptoms to healthcare providers. “I recommend keeping a detailed health record, asking for a patient advocate within the hospital system if needed, and utilizing online tools or apps to manage appointments and information,” she says. Roca says this is often the stage when frustrations occur. Patients with test results that are only slightly elevated and non-diagnostic are told that they’re fine, even though they still may be feeling ill. ¨If any tests come back even slightly abnormal, though we may not be able to give a definitive diagnosis within the framework of conventional medicine, we´ll work with patients to figure out how we can help,¨ he says. ## **What should you convey to a provider?** While it may be frustrating not to have a specific diagnosis, Roca urges patients to consider the entirety of their mental and physical health, well-being, and medical history. He notes the importance of factors such as lifestyle, dietary habits, and occupational exposures, in addition to genetics. ¨For us, a patient’s history is very important because with it, we can create a hypothesis for the individual and say which biological functions are not working as well as we’d like, both mental and physical, without distinction,¨ he says. > For example, [autoimmunity in the gut can manifest in the head](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7767453/). ¨There is no diagnosis that exists outside the complexity of the human being,¨ Roca says. ## Can diagnostic tests change over time? Repeat testing is a good way to approach autoimmune diagnoses because diseases can manifest over time. > A patient should advocate for comprehensive testing. “Periodic reevaluation can provide a more dynamic understanding of your health and may capture changes that were not initially apparent. Even if initial tests appear normal, some autoimmune diseases may not present with clear markers,” Contreras says. However, Roca says that one key is to avoid thinking only in terms of ¨treatment¨ and ¨diagnosis.¨ ¨When it comes to autoimmunity, the diagnosis is not the only endpoint, even though that’s how many are trained to think,¨ he says. In his view, it is important for a physician to address the underlying factors and symptoms contributing to an autoimmune condition, even before a patient has a formal diagnosis. ## How should you address the stress that often accompanies the diagnostic process? According to Ruddy, it’s important to acknowledge and address emotions by seeking support from friends, family, or support groups. > > Living with a chronic illness can be emotionally challenging. She also believes therapy can be particularly helpful. “If needed,” she says, “consider therapy with a professional who specializes in chronic illness to address the emotional aspects of the illness journey.” ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/04/GAI-Logo-Image-811x1024.png) ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** Autoimmune Care & Caregiver Support, Diagnosis & Treatment --- ### [What Chronic Pain Really Means](https://www.autoimmuneinstitute.org/articles/facts-about-chronic-pain) **Published:** September 22, 2021 **Author:** Carolyn Serraino **Excerpt:** Chronic pain is common, yet often misunderstood. Unlike temporary pain, it can persist for months or years, affecting daily life, mental health, and overall well-being. Because it cannot always be seen or measured, many people experience their pain being dismissed or overlooked. **Content:** September is Pain Awareness Month. Although chronic pain is a common medical concern, it is often poorly understood and misrepresented through the public lens. This month is an empowering time to promote education, help dispel myths, or discuss your personal pain story. In honor of the occasion, we’ve compiled a list of enlightening facts about chronic pain. ### **A global public health concern** **Chronic pain is different from everyday aches and pains.** Pain that comes on suddenly and lasts anywhere from a few minutes to several weeks is known as acute pain. Acute pain typically has an identifiable cause, such as inflammation, injury, or surgery. On the other hand, pain is considered chronic when it is ongoing, lasting longer than six months. Chronic pain can result from an underlying issue or it may have no discernible cause at all ([1](https://southernpainclinic.com/blog/the-difference-between-the-types-of-pain-acute-vs-chronic/),[2](https://www.hopkinsmedicine.org/health/conditions-and-diseases/chronic-pain)). **Chronic pain is common.** Global data indicates that around 1 in 10 adults are diagnosed with chronic pain each year ([3](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3201926/)). In the U.S. alone, it is estimated that about 50 million adults are living with this condition ([4](https://www.cdc.gov/nchs/products/databriefs/db390.htm)). Children also experience chronic pain at a surprisingly high rate, with studies indicating that between one-quarter and one-third of the world’s youth are affected by it ([5](https://www.who.int/news/item/01-02-2021-who-issues-new-guidelines-on-the-management-of-chronic-pain-in-children)). Common types of chronic pain include back pain, headache, neuropathy (nerve pain), and arthritis ([6](https://abcnews.go.com/Health/PainOverview/story?id=4034145)). **Chronic pain can be disabling.** The [Americans with Disabilities Act](https://www.ada.gov/cguide.htm) defines disability as “a physical or mental impairment that substantially limits one or more major life activities” ([7](https://www.ada.gov/cguide.htm)). Impairment from chronic pain looks different for everyone. Many chronic pain sufferers rely on the use of medications, therapies, and mobility aids to help with daily management. Some others experience pain that is completely debilitating. Recurrent pain is not always immobilizing, and pain levels often fluctuate. Still, most people with painful autoimmune and chronic conditions like [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/), [multiple sclerosis](https://www.autoimmuneinstitute.org/medical_institutions/multiple-sclerosis/), [ankylosing spondylitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ankylosing-spondylitis/), and [ME/CFS](https://www.autoimmuneinstitute.org/covid_timeline/covid_news_and_autoimmune_disease/me-cfs/) experience some degree of pain at all times. One study estimated that 7.4% of American adults are living with pain that frequently limits their life and work activities ([4](https://www.cdc.gov/nchs/products/databriefs/db390.htm)). **Certain populations experience higher rates of chronic pain.** Studies have shown that chronic pain rates are highest among women ([8](https://www.iasp-pain.org/advocacy/global-year/pain-in-women/),[9](https://health.clevelandclinic.org/women-are-more-likely-to-have-chronic-pain-heres-why/)). According to a recent U.S. survey, people living near or below the poverty line experienced higher incidences of ongoing pain. The same study found that chronic pain rates are elevated in rural populations ([4](https://www.cdc.gov/nchs/products/databriefs/db390.htm)). > Because there is no way to objectively measure it, many patients have experienced their pain being questioned, dismissed, or downplayed. **Chronic pain significantly raises the risk for mental health concerns.** Up to 85% of chronic pain sufferers also experience depression ([10](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5494581/)). One study determined that patients with a history of chronic migraine were five times more likely to have a depressive episode for the first time. Despite these concerns, people with chronic pain and depression tend to use fewer mental health resources ([11](https://www.health.harvard.edu/mind-and-mood/depression-and-pain)). Left untreated, pain and depression can become a recipe for deteriorating physical and emotional health. It is essential to address [mental health](https://www.autoimmuneinstitute.org/2024/02/21/managing-mental-health-with-an-autoimmune-disease/) concerns in tandem with chronic pain treatment. **The needs of chronic pain patients are often underserved.** The high cost of inadequate or delayed pain treatment is well-documented in research. Because there is no way to visualize or objectively measure it, many patients have experienced their pain being questioned, dismissed, or downplayed by healthcare professionals. This issue, often called medical gaslighting, can have traumatic effects on patients. It also drives disparities in health and treatment outcomes. Due to stigmas around gender, race, mental health, substance use, and more, certain groups suffer the biggest gaps in pain treatment ([12](https://equityhealthj.biomedcentral.com/articles/10.1186/s12939-021-01394-6),[13](https://www.iasp-pain.org/resources/fact-sheets/disparities-in-back-pain/)). For example, an analysis of 20 years of research from the U.S. showed that Black patients with pain were 22% less likely to receive pain medication from their doctors ([14](https://www.washingtonpost.com/health/is-bias-keeping-female-minority-patients-from-getting-proper-care-for-their-pain/2019/07/26/9d1b3a78-a810-11e9-9214-246e594de5d5_story.html)). The issue of medical gaslighting is complex and systemic, and there are no simple solutions. However, maintaining [clear and direct communication with your physician ](https://www.calstate.edu/csu-system/news/Pages/Talking-to-your-doctor-about-pain.aspx)can be a powerful asset in your treatment journey ([15](https://www.calstate.edu/csu-system/news/Pages/Talking-to-your-doctor-about-pain.aspx)). **Chronic pain is costly.** According to estimates, expenditures for healthcare and lost productivity related to chronic pain cost about $560 to $635 billion per year in the U.S ([16](https://journalofethics.ama-assn.org/article/addressing-obstacles-evidence-informed-pain-care/2020-08)). It is impossible to measure the enormous personal, emotional, and social burdens of living with chronic pain. **Chronic pain is a complex condition requiring personal and comprehensive care.** As such, many experts advocate for a multidisciplinary approach to address the cognitive, emotional, behavioral, and social effects of chronic pain. A thorough treatment routine may focus on: - Proper pain assessment. - Management of acute pain as a preventative measure against chronic pain. - Addressing pain-related insomnia, distress, or disability. - Simplifying medication regimens and managing possible problems or side effects of drugs. - Increasing productivity and health status. - Development of coping skills and other stress-reduction techniques. - Utilizing mind-body medicine and holistic treatment modalities ([17](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3396080/),[18](https://www.calstate.edu/csu-system/news/Pages/Talking-to-your-doctor-about-pain.aspx),[19](https://www.iasp-pain.org/resources/fact-sheets/pain-in-children-management/)). ### **Living with chronic pain** Despite the many challenges that come with a chronic pain diagnosis, it is important to remember that this condition is treatable. With excellent management, support, and a committed team of healthcare providers, chronic pain patients can still live a full and vibrant life. We created a [free and comprehensive resource](https://www.autoimmuneinstitute.org/autoimmune-chronic-illness-toolkit/) for anyone experiencing pain and other chronic health issues. The toolkit includes tips to help manage chronic pain, explore treatment options, and find support as you continue to move forward. ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** Living Well with Autoimmune Disease --- ### [Finding Balance in Uncertain Times](https://www.autoimmuneinstitute.org/articles/finding-balance-in-uncertain-times) **Published:** April 10, 2020 **Author:** Carolyn Serraino **Excerpt:** Uncertainty has a way of quietly shaping everyday life, especially when you’re navigating chronic illness. Questions about symptoms, treatments, access to care, and what comes next can create a constant undercurrent of stress that’s difficult to ignore. **Content:** *This article was originally written during the COVID-19 pandemic, a time of widespread uncertainty and disruption. While the context has shifted, many of the emotional and practical challenges discussed remain relevant for those navigating chronic illness today.* As the coronavirus continues to grip our communities, it’s hard to say what the enduring emotional toll could look like. COVID-19 has already opened the door for a number of unwelcome guests – anxiety, fear, uncertainty—and it’s hard to know how to cope. These emotions may be weaving around a spectrum of potential scenarios, such as hospital visits, death from the virus, symptom flare-ups from stress or illness, and limited access to critical medications and medical care. Some may already be experiencing fallout from the situation, in the form of isolation, mental health crises, loss of financial stability, abusive homes, and other challenges. It is a difficult time for many reasons. ### Uncertainty As The New Normal The uncertainty can easily pull you into a head-spinning dance between feeling like the virus itself is a grave situation and wondering if we’re approaching it the right way. *Are we too strict? Not strict enough? Should we have acted sooner? How long will this go on? What effects will social distancing have long-term?* Or maybe your feet are planted firmly in the fear of catching the virus or having complications. If you’re still working in public, you’re constantly coming into contact with other people. But even if you’re at home, **a mere trip to the grocery store may mean your risk increases and, reasonably so, anxieties about the virus can bubble to the surface.** While attempting to physically keep six feet of distance between yourself and others, the tendency may also be to distance socially by looking down, not smiling, tensing up, and leaning away. This natural shift in body language and decrease in human interaction only tightens the firm grip of fear. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Finding-balance-anxiety-crowd-article-image.png) In hospitals, the strain for resources and equipment to properly care for the sick is affecting quality of care for those with and without COVID-19. **The thought of needing urgent or routine hospital care to address your chronic disease may make you feel anxious, helpless, or scared.** While the coronavirus seems to be more serious in high-risk individuals, small numbers of healthy people have also contracted severe cases. There is much about this virus that we do not know yet. Researchers are still searching for explanations through genetics, pollution, immune system response, and exposure to varied viral loads. **It can make you feel like a ticking time bomb, even if the chances of an unfavorable outcome are small.** What makes it even more unnerving is the constant barrage of statistics, building up the suspense like a thriller film. *When is it coming for me?* The situation is real and precautions are necessary; however, to be alerted every time a new COVID-19 headline appears can do more harm than good. The intense amount of coverage can be suffocating and unhealthy. ### Effects Of Imbalanced Responses The looming possibilities of severe illness and death fuel our daily anxiety levels. **This prolonged activation of the stress-response system (known as “fight or flight” mode) can have harmful effects on the body, including the immune system.** It can also result in mental health concerns. Many people have been drawn towards impulsive reactions or fear-based decisions, which have adverse effects on certain high-risk populations like the autoimmune disease community. People with [lupus](https://www.autoimmuneinstitute.org/medical_institutions/lupus-clinic/), [Sjogren’s](https://www.autoimmuneinstitute.org/medical_institutions/sjogrens-syndrome-clinic/), RA, and a few other related diseases have felt the effects of heightened coronavirus anxieties. A drug many of them take every day to keep symptoms under control and prevent their health conditions from worsening, called Hydroxychloroquine, was being considered as a potential treatment for COVID-19. As a result, the drug was being stockpiled and its access restricted. It is not a proven treatment for the virus, yet the rush to find a cure promptly put lives in peril. Many individuals, especially those with chronic illnesses, are also being denied routine procedures and treatments because of the focus on coronavirus. **Fear-based responses to the virus can be just as concerning as the virus itself.** ### Shifting Our Focus All concerns and emotions are valid. Every day we wake up to infections spreading and a medical industry that still has more questions than answers. **What can help, is focusing on what we *do* know.** We know that many people with COVID-19 are admitted to hospitals and then subsequently able to return home. Even if you’re high-risk, falling ill does not mean it will be severe; [you can catch COVID-19 and be ok](https://creakyjoints.org/symptoms/survive-coronavirus-rheumatoid-arthritis-health-care-worker/). For every tragic story out there, there are many more that fill us with hope. We are also continuing to understand and fine-tune precautions that actively reduce the risk of exposure, as well as help manage the current tensions and anxieties. This includes handwashing, wearing face cloths in public, physical distancing, disinfecting surfaces, staying home, having a plan if you fall ill, taking breaks from the news, connecting with your support system, and focusing on adequate sleep, nutrition, and hydration. Through it all, we are constantly reminded that everyone has different concerns and is living through this time in their own, unique ways. ### Addressing Uncertainty Another way to shift our focus is to work on accepting what we can’t control and recognize what we can. Instead of watching the clock or waiting for clarity, we can more smoothly navigate the pandemic by accepting the uncertainties. **We don’t have control over everything; it’s not ideal, but it’s ok.** Life will never be without uncertainties in some form or another. It’s what we do in response to them that determines our perception and ultimately shapes our experience. This goes for anxiety, fear, frustration, or other emotions you’re feeling. It’s ok to have those feelings and to accept where you’re at, even if it’s not where you want to be. The situation is constantly shifting and changing, as are your emotions. **The only certainty we have is that everything is temporary.** ### Using Chronic Illness As A Tool **In chronic illness land, we live under a rain cloud of potential pain or symptom flare-ups every single day.** The pandemic is another layer on top of all of that, and one more thing that’s out of our control. One more thing threatening our lives. We have the choice to respond in one of two ways. We can see COVID-19 as yet another issue that’s piled upon the mile-high stack we’re already trying to contend with in our everyday lives. We can recognize the poor state our bodies may be in and conclude that if the virus attacks it, it won’t be good. Or we can look at COVID-19 square in the face and say, **“I’ve overcome challenges and stresses greater than you, so I can handle you, too.”** It doesn’t matter if we think that’s true or not—only that we say it, write it, repeat it. Remember that so far, your track record for getting through bad days is 100%. Focus on the kind of person you are, rather than the state your body is in. Celebrate how skilled you’ve become at dealing with what your body throws at you, what life throws at you. Isolation? *Been there done that.* The unknown? [*That’s my everyday.*](https://creakyjoints.org/living-with-arthritis/coronavirus-anxiety-with-chronic-illness/?utm_source=GHLF+COVID-19+Support+Program&utm_campaign=7ec2760f96-auto_welcome-2&utm_medium=email&utm_term=0_e0b05b1451-7ec2760f96-233043777) Use your past and present health challenges as tools to help you get through this one. Because whether you like it or not, while you’re waiting for the pandemic to end, your life is happening. **You may not be able to control the outcome, but you have the power in your own mind to change the way you see it—to change the way you live through it.** ### 6 Ways To Find Balance The fear, anxiety, frustration, overwhelm, confusion—all of it is real and valid. Give yourself space to feel, while recognizing that there are actions you can take to relieve the burden of these emotions. #### **1. Be kind to yourself.** What would you say to a friend who’s feeling scared, anxious, frustrated, or overwhelmed? Remind yourself to have compassion as you would for a friend, and use that same language internally. ##### **1.5 Be kind to others.** The only thing you can control is yourself. Strangers, partners, friends, parents, and siblings are experiencing and responding to the pandemic in different ways. You may see them doing or not doing things you don’t agree with, and become upset. Those accompanying emotions will not inspire change in others. But they *will* change *you—*and increase your level of stress. Being kind does not mean you agree. It does not mean you are letting go of your beliefs. By noticing your feelings but compassionately letting others be, you are easing anxiety within yourself. Try to keep the focus on what *you* are doing to feel safe, calm, and content. #### **2. Talk to your healthcare practitioners.** What is your risk level of catching the virus, or of developing severe symptoms? What kind of precautions should you take for your specific condition? #### **3. Write out the potential scenarios and what your plan is for each one.** How you respond is what you *can* control. Having a plan in place can help calm your mind, knowing that the future is a little less unknown. For example: If you get sick with moderate symptoms and stay home in isolation, record what you’ll do for medical care, food, emergencies, medication, etc. If you become severely ill, write down the first steps you’ll take, who to contact, which hospital go to, and what to bring with. #### **4. Envision best case scenarios.** Beyond what you *can* control (which is how you respond), try to let the rest go by shifting your mindset. Close your eyes and let your thoughts cycle through each worst case scenario you’re concerned about. What is the root of those fears? Take a look at the emotions coming up for you, and accept their presence. Now try to think about the opposite—the best case scenarios. *What if I get sick and it’s mild? What if I don’t get sick?* *What if this ends soon? What if I get through this and I’m ok? What if something good comes from this?* The point is not to have a false sense of hope, but to give your mind a more positive outlook to attach to. Either scenario has a chance of materializing. In your mind, you get to choose which one to give power to. #### **5. Talk, talk, and talk some more.** Express your feelings to people you trust, who will respond with compassion. Learn what others with chronic illness are doing to stay positive. Reach out to your chronic illness community via Facebook, Meetup, local support groups, or through specific disease organizations. Follow hashtags on Instagram like #highriskcovid19 #spooniesupport #butyoudontlooksick #chronicillnesslife #autoimmunewarrior #copewithanxiety #selflove #### **6. Limit exposure to the news.** The more you watch or read, the deeper you are pulled into a fearful state of mind. You might start to feel like you *need* to know how many new cases there are or what’s happening every second—just like you may feel the need to check social media multiple times a day. It can be addictive. **To stay informed, reach out to your support system.** Ask a trusted friend or relative to be in charge of alerting you to any new recommendations by public health officials in your area. **Otherwise, set firm boundaries with yourself.** For example: you may decide to read updates on what’s happening in your local area for 30-60 minutes each day, but avoid any coronavirus news in the morning or before you go to bed. Learn more about dealing with fear and anxiety during the pandemic in [Coronavirus Anxiety: Key Advice for Chronic Illness Patients from Health Psychologists](https://creakyjoints.org/living-with-arthritis/coronavirus-anxiety-with-chronic-illness/?utm_source=GHLF+COVID-19+Support+Program&utm_campaign=7ec2760f96-auto_welcome-2&utm_medium=email&utm_term=0_e0b05b1451-7ec2760f96-233043777). *Note: Always contact your healthcare provider or therapist with any mental health concerns.* ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** COVID-19 and Long Covid --- ### [Pesticide Use & the Gut Microbiome](https://www.autoimmuneinstitute.org/articles/pesticide-use-the-gut-microbiome) **Published:** July 21, 2023 **Author:** Carolyn Serraino **Excerpt:** The gut microbiome is shaped by more than diet. See how pesticides and other environmental exposures may alter microbial balance and contribute to autoimmune disease risk. **Content:** ### **What is the Gut Microbiome?** The gut microbiome refers to the microbes of the gut — the bacteria, fungi and viruses. There are up to 100 trillion microbes in the human intestine ([1](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8196593)) — and bacteria species are the main component. > **The genes encoded by bacteria within the human gastrointestinal tract actually outnumber human genes by more than 100 times (**[**2**](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4566439/)**)!** Bacteria species – which are taxonomically classified by genus, family, order, and phyla – can play a variety of roles. While every gut microbiome is different due to an individual’s exercise and diet habits – among other factors – a healthy microbiota composition enables metabolic and immune functions to perform optimally. **An imbalance of gut microbiota, on the other hand, [has been linked to](https://www.autoimmuneinstitute.org/2021/08/26/the-relationship-between-autoimmune-disease-and-the-gut-microbiome/) intestinal diseases like irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD).** ### **How Do Pesticides Impact the Gut Microbiome?** ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/jpg-1024x823.jpg) Pesticides have become a key part of agricultural production because their use can lead to greater crop yields. But pesticides intended to control weeds and pests can ultimately reach the soil, water, air, and food, negatively affecting humans. The gut microbiome metabolizes chemicals, but pesticides can impair its activity and composition. The gastrointestinal tract — which is a barrier against pathogenic microorganisms and toxins — is a key site for exposure. “Many factors influence the gut microbiome, including diet, such as ultra-processed food, as well as medications, illness, environmental chemicals such as pesticides, and hormones,” said [Karen Costenbader](https://connects.catalyst.harvard.edu/Profiles/display/Person/68138), a physician specializing in rheumatology at Brigham and Women’s Hospital. **Costenbader and others have determined that in addition to added chemicals in one’s diet, pesticides are another exposure that** [**research**](https://acrabstracts.org/abstract/association-of-ultra-processed-food-intake-with-risk-of-systemic-lupus-erythematosus-in-women/) **shows may increase the risk of developing an autoimmune disease.** However, it is still not completely clear how pesticides interact with the microbiome and what effects the interaction has on human health. ### **Which Autoimmune Diseases are Specifically Impacted by Pesticides?** Pesticides and insecticides have been found to influence [autoimmune hepatitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-hepatitis/) (AIH), systemic sclerosis (SSc), [inflammatory bowel disease](https://www.autoimmuneinstitute.org/medical_institutions/inflammatory-bowel-disease-center/) (which includes [Crohn’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crohns-disease/) and [ulcerative colitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ulcerative-colitis/)), [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/) (SLE), and [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/) (RA), ([3](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9143500/)) among other ADs. [Multiple Sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/) (MS), [Crohn’s Disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crohns-disease/) and [thyroid diseases](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/hashimotos-thyroiditis/) have also been associated with pesticide exposure. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Screen-Shot-2023-10-25-at-9.23.39-AM-1024x822.jpg) *Vojdani, A.; Vojdani, E. The Role of Exposomes in the Pathophysiology of Autoimmune Diseases I: Toxic Chemicals and Food. Pathophysiology 2021, 28, 513-543.* [*https://doi.org/10.3390/pathophysiology28040034*](https://doi.org/10.3390/pathophysiology28040034) A multitude of studies have examined the role that environmental factors play in the pathogenesis of autoimmune diseases. In patients with SLE, for example, exposure to pesticides in rural areas resulted in more than 3.5 times more oxidative DNA damage compared to exposure among those living in a city ([4](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6970196/)). Researchers have also found an association between insecticide use and RA and SLE among groups of post-menopausal women and farmers — with more exposure associated with a higher risk of developing disease. Lupus may have origins in abnormal lymphocyte functions. > **“It is plausible to think that pesticides could damage genes that are important to lymphocyte function”** said Costenbader. But research can be complicated because the research available is often based on data using small population sizes. It’s also difficult to isolate one agricultural exposure or to look specifically at a single pesticide as the cause of an autoimmune disease. “It can be challenging to rule out biases and prove causality in observational settings,” said Christine Parks, a staff scientist at the National Institute of Environmental Health Sciences. “There’s a lot of work to be done.” ### **Which Pesticides Are the Major Culprits?** Pesticides include a wide variety of chemicals such as herbicides, insecticides, and fumigants that are used in the home and in farming. Some, like DDT, are no longer in use but may still be circulating in people’s blood systems. Others are easy to purchase and less acutely toxic. “You have herbicides to treat the weeds, and then insecticides, and then among each one of those, you have dozens of different types of chemicals and products that are used,” said Parks. Although pesticide use is associated with autoimmune diseases, the role of specific pesticides in the development of systemic autoimmunity is not entirely established. Certain organochlorine insecticides are associated with an increased risk for ADs ([5](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6637299/)). Exposure to chlordecone, an organochlorine that was previously used widely to control rust mites, wireworms, crickets, and other bugs, for example, has been noted to accelerate the appearance of SLE. Crystalline silica has also been linked with an increased incidence of systemic autoimmune diseases, such as SLE, rheumatoid arthritis, and scleroderma. Chemicals kill insects by impacting their nervous system. ### **How would an herbicide promote the development of an autoimmune disease?** “A pesticide that disturbs the immune response may help it go off balance in the context of another exposure which reveals an autoantigen. And the cycle develops into a clinically apparent disease,” explained Parks. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Screen-Shot-2023-10-25-at-9.24.34-AM-1024x675.jpg) ### **How Can You Improve Your Gut Microbiome?** There’s wide interest in the relationship between autoimmune diseases and composition of the microbiome. While much remains unknown, every person has a distinct gut microbiome, and diet plays a key role. Some methods of improving the microbiome may include: - Vegetarian diets may be beneficial for establishing a diverse and stable microbiome. Plant-based diets can also “promote effective intestinal immune responses, maintain intestinal barrier function, and protect against pathogens ([6](https://www.sciencedirect.com/science/article/pii/S2213453021000963)).” - Artificial sweeteners such as saccharin, sucralose, and stevia may adversely change the composition of the gut microbiota. When possible, use substitutes such as honey ([7](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6363527/)). - Foods containing prebiotics promote good bacteria, including garlic, onions, leeks, asparagus, artichokes, dandelion greens, bananas, seaweed, and beans ([8](https://www.hsph.harvard.edu/nutritionsource/microbiome/#diet-microbiota)). - A high-fiber diet affects the type and amount of microbiota in the intestines. That’s because short-chain fatty acids (SCFA) are released as a result of fermentation that occurs when dietary fiber is broken down, resulting in better microbial diversity. High-fiber foods include whole grains like wheat, oats, and barley ([9](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8153313/)). - Probiotic foods may further improve the microbiome because they contain beneficial, live microbiota. Some recommend fermented foods like kefir, yogurt with live active cultures, pickled vegetables, tempeh, kombucha tea, kimchi, miso, and sauerkraut ([8](https://www.hsph.harvard.edu/nutritionsource/microbiome/#diet-microbiota)). - Polyphenols, or secondary metabolites of plants, may increase beneficial bacteria in the gut microbiota. Polyphenols are present in fruit, vegetables, and plant-derived foods such as cocoa, chocolate, tea, coffee, and wine ([10](https://www.frontiersin.org/articles/10.3389/fnut.2019.00188/full)). ### **Elimination/Exclusion Diets For Autoimmune Disease** #### **Autoimmune Protocol (AIP)** - An extension of the Paleolithic diet, the AIP involves the elimination of foods that may act as antigens, stimulate mucosal inflammation, and/or trigger dysbiosis within the gastrointestinal tract ([11](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7147823/)) ([12](https://academic.oup.com/ibdjournal/article/23/11/2054/4791635)). #### **Specific Carbohydrate Diet (SCD)** - The SCD is commonly used in the treatment of inflammatory bowel disease (IBD) by patients, and anecdotal evidence suggests it may be an effective for treatment of Crohn’s disease (CD) or ulcerative colitis (UC). The SCD is thought to be effective due to the increased bacterial diversity of the microbiome ([13](https://journals.lww.com/ajg/fulltext/2013/10001/the_bacterial_microbiome_of_ibd_patients_on_the.1828.aspx)). #### **Low FODMAP Diet** - A low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) diet is frequently used to manage symptoms of irritable bowel syndrome (IBS). However, a recent study showed that while “a low FODMAP diet consistently led to lower abundance of Bifidobacteria, there were no clear effects on diversity of the microbiome or abundances of other specific taxa” ([14](https://academic.oup.com/ajcn/article/116/4/943/6612725)). #### **Mediterranean Diet** - The Mediterranean diet may modulate gastrointestinal microbiota and reduce metabolic endotoxemia (the presence of too many lipopolysaccharides in the blood, which are toxins that reside on the outer membrane of bacteria that would otherwise not be allowed into our bloodstream) ([15](https://academic.oup.com/advances/article/9/3/193/4996113#116686991)) ([16](https://pubmed.ncbi.nlm.nih.gov/32066625/)). ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** Living Well with Autoimmune Disease --- ### [The Relationship Between Autoimmune Disease and the Gut Microbiome](https://www.autoimmuneinstitute.org/articles/the-relationship-between-autoimmune-disease-and-the-gut-microbiome) **Published:** August 26, 2021 **Author:** Carolyn Serraino **Excerpt:** Could the gut microbiome influence autoimmune disease? See how microbial imbalances may affect immune function, inflammation, and disease development. **Content:** **The Mysterious Microbiome** As researchers continue to look for environmental factors that cause autoimmune disease, many are turning the lens towards the human body itself, and to vast [networks of microbial communities](https://www.autoimmuneinstitute.org/2024/02/21/what-is-the-microbiome-and-why-is-it-important/) that dwell in and on it. **Humans are host to an array of microscopic life.** At several trillion strong, microbial communities consisting of bacteria, fungi, protozoa, and viruses occupy numerous parts of the body. Their genetic material is collectively known as the microbiome. **These microbes may be up to two times more prevalent than human cells**, and each person’s microbiome could weigh as much as 5 pounds ([1](https://www.nature.com/articles/nature.2016.19136), [2](https://depts.washington.edu/ceeh/downloads/FF_Microbiome.pdf)). Microbial colonies support human health in a variety of ways. **The gut microbiota is involved in nutrient digestion, vitamin synthesis, and several other metabolic processes.** It also influences the development and maintenance of the immune system ([2](https://depts.washington.edu/ceeh/downloads/FF_Microbiome.pdf)). > Some studies suggest that imbalances in the microbiome may be an activator for disease—including autoimmune conditions. **Alterations in the microbiome, broadly referred to as dysbiosis, can result from a variety of factors, including diet, toxins, pathogens, and more.** Pathogens that attack the intestines are the most influential in promoting microbial dysbiosis. In animal studies, researchers have observed that foodborne viral pathogens can alter the composition of the microbiome, trigger inflammation, and contribute to the development of autoimmunity ([3](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6854958/)). ### **Autoimmune Disease and the Gut** Researchers have yet to determine which specific microbiota are directly involved in the regulation of inflammatory mechanisms. However, many believe that **bacteria found in the mucus layer of the intestines may hold the key to understanding more about how the microbiome relates to health and disease.** While further investigation is needed, many researchers suspect that autoimmune diseases, as well as some other chronic conditions, could have their origins in the gut microbiome ([2](https://depts.washington.edu/ceeh/downloads/FF_Microbiome.pdf), [3)](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6854958/). Scientists are currently studying the relationship between gut microbe health and the following autoimmune diseases: - **[Lupus](https://www.autoimmuneinstitute.org/medical_institutions/lupus-center/)**: The microbiomes of patients with systemic lupus erythematosus (SLE) have shown significantly decreased microbial diversity, as well as an increase in a specific species, *Ruminococcus gnavus*. These trends also correlated with the severity of disease activity ([4](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4315779/)). - **Inflammatory bowel disease** ([Crohn’s disease and Ulcerative Colitis](https://www.autoimmuneinstitute.org/medical_institutions/crohns-colitis-program/)): There is an apparent link between Crohn’s disease flare-ups and transient blooms of *Ruminococcus gnavus. R. gnavus* is a typical part of the microbiome, but it produces harmful amounts of inflammatory polysaccharides when present in abnormally high numbers ([5](https://www.the-rheumatologist.org/article/to-understand-lupus-study-the-gut/2/)). - **[Type one diabetes](https://www.autoimmuneinstitute.org/covid_timeline/type-1-diabetes-patients-become-eligible-for-covid-19-vaccine-in-12-states/)**: Increased permeability of the gut epithelial barrier, known as “leaky gut”, has been observed in T1D patients and is thought to be a primary feature of the disease ([6](https://www.pnas.org/content/116/26/12672)). Research suggests that dysbiosis “may influence the pathogenesis of T1D by affecting immune homeostasis and/or gut permeability” ([7](https://www.frontiersin.org/articles/10.3389/fendo.2020.00125/full)). - **[Multiple sclerosis](https://www.autoimmuneinstitute.org/medical_institutions/multiple-sclerosis/)**: In studies, MS patients exhibit dysbiosis, specifically in the absence or over-prevalence of several genus and species of microbes. Among these, certain species have been implicated in an increased expression of genes that are involved in both innate and adaptive immunity ([7](https://www.frontiersin.org/articles/10.3389/fendo.2020.00125/full)). - **[Rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/)**: Compared to the microbiomes of healthy controls, studies indicate that several bacteria taxa are abundant in RA patients, while some others are depleted ([8](https://www.nature.com/articles/ncomms12015)). Certain bacteria that are significantly enriched in the microbiomes of RA patients have been shown to induce intestinal inflammation that leads to severe arthritis in animal models ([9](https://www.oarsijournal.com/article/S1063-4584(17)30533-2/fulltext#relatedArticles)). ### **Conclusion** Data strongly suggests that there is some degree of interplay between autoimmune disease and gut microbiome health. However, more research is necessary to determine whether abnormalities in the gut microbiome are a cause of autoimmune disease, an effect, or both ([6](https://www.pnas.org/content/116/26/12672), [7](https://www.frontiersin.org/articles/10.3389/fendo.2020.00125/full)). As scientists continue to investigate this complex relationship, many are hopeful that studies of the microbiome could one day give way to improvements in diagnostics and therapies- and possibly even in the prevention of some autoimmune diseases. **For more about the microbiome, check out our previous article, [What Is the Microbiome?](https://www.autoimmuneinstitute.org/2024/02/21/what-is-the-microbiome-and-why-is-it-important/)** ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** Living Well with Autoimmune Disease --- ### [Elimination Diets: What You Need to Know](https://www.autoimmuneinstitute.org/articles/elimination-diets-what-you-need-to-know) **Published:** January 13, 2022 **Author:** Carolyn Serraino **Excerpt:** Elimination diets are often used to manage symptoms in autoimmune disease and chronic illness. Learn how they work, their potential benefits, and when they may not be the right approach. **Content:** With food sensitivities and intolerances impacting 15-20% of the population ([1](https://pubmed.ncbi.nlm.nih.gov/25471897/)), many people—especially in the autoimmune disease and chronic illness communities—are turning to food to uncover issues and feel better. When used mindfully and appropriately, elimination diets can be powerful healing tools; however, there are some precautions to take. Read on for the [risks and benefits](#anchor1), as well as [five common diets](#anchor2). ### **WHAT ARE ELIMINATION DIETS?** **Elimination diets are tools to identify [food sensitivities and intolerances](https://www.autoimmuneinstitute.org/articles/food-sensitivity-intolerance-or-allergy-whats-the-difference "Food Sensitivity, Intolerance, or Allergy: What’s the Difference?"), as well as to reduce symptoms like brain fog, joint pain, rashes, anxiety, bloating, and fatigue.** These diets, a.k.a. exclusion or healing diets, involve temporarily excluding foods that may be problematic and trigger symptoms. This is called the elimination phase of the protocol, which can last anywhere from two to six weeks on average. Next, foods are challenged one by one to see how the body reacts. If a food does not trigger symptoms, it may be reintroduced back into the diet. Depending on the body’s reactions as well as the specific protocol being followed, certain foods may remain out of the diet for a long period of time. Foods that are not currently tolerated can sometimes be incorporated back into the diet after the body has had an opportunity to heal. > **In elimination diets, the foods most commonly excluded are dairy, gluten, sugar, nightshades, soy, alcohol, and processed foods.** Elimination diets are becoming more popular as doctors are using them to identify and treat patients. Studies have shown that elimination diets can reduce symptoms in individuals with irritable bowel syndrome ([2](https://pubmed.ncbi.nlm.nih.gov/15361495)), eosinophilic esophagitis ([3](https://pubmed.ncbi.nlm.nih.gov/25845555/), [4](https://pubmed.ncbi.nlm.nih.gov/23689524/), [5](https://pubmed.ncbi.nlm.nih.gov/16279563/)), eczema ([6](https://pubmed.ncbi.nlm.nih.gov/27904183/), [7](https://pubmed.ncbi.nlm.nih.gov/2359866/)), and autoimmune diseases like Crohn’s disease and ulcerative colitis ([8](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5647120/)), as well as Hashimoto’s thyroiditis ([9](https://www.cureus.com/articles/18455-efficacy-of-the-autoimmune-protocol-diet-as-part-of-a-multi-disciplinary-supported-lifestyle-intervention-for-hashimotos-thyroiditis?utm_medium=email&utm_source=transaction)). ##### **People use elimination diets when they:** - Want to feel better and are looking for more natural approaches - Cannot tell which (or if) foods are triggering their symptoms - Are stuck in their health journeys and do not know what to do next - Feel they have exhausted all options and their doctors are unable to help - Have particularly stubborn health issues that have not improved after addressing known root causes ### **HOW DO THEY WORK?** **There are many types of elimination diets out there. The protocol you use will depend on your symptoms and health condition.** Each elimination diet has its own instructions regarding “yes” and “no” foods, what to challenge first and how, and when to reintroduce. However, they all follow a similar method: eliminate, challenge, and reintroduce. Use a journal to keep track of the way you feel throughout each phase, especially while eating challenging foods. ##### **Eliminate** **Avoid eating foods on the “no” list for a short period, typically three to six weeks.** Pay attention to labels, as well as extracts or derivatives of your “no” foods. If you happen to eat an excluded food, you may need to rewind and start the protocol from the beginning. Notice whether your symptoms have improved, stayed the same, or worsened, and keep in touch with your practitioner about how you’re feeling. If symptoms have not improved, you may need to remain in the elimination phase for a longer amount of time. ##### **Challenge** **Try eating your excluded foods one at a time, noticing any reactions.** Write down the date, time, symptoms, and amount of food. Use singular foods, like fresh corn kernels, rather than products with the food mixed in, like cornbread. You may choose to separately challenge different varieties or preparations of the same food, such as almonds and almond milk. Wait three to seven days between food challenges and start with a small amount of food, increasing the amount daily. The exact methods will vary depending on the protocol and the practitioner who is guiding you. ##### **Reintroduce** **You may reintroduce foods as you challenge them, or wait until all foods have been tested** before you include any of them back in your diet. Continue paying attention to how you feel. You may find that your body tolerates eggs, for example, but only one or two per week. This can shift over time. Work with your practitioner to develop a personalized eating plan. *→ Check out* [*The Elimination Diet*](https://www.fammed.wisc.edu/files/webfm-uploads/documents/outreach/im/handout_elimination_diet_patient.pdf)*, an in-depth resource from the University of Wisconsin-Madison School of Medicine and Public Health* ### **5 COMMON ELIMINATION DIETS** - **Low-FODMAP**: remove or limit foods high in FODMAPs (fermentable oligo-, di-, and monosaccharides and polyols), “a group of sugars that are not completely digested or absorbed in our intestines” ([10](https://www.monashfodmap.com/about-fodmap-and-ibs/)). Often used to treat IBS or SIBO. Resources: [Monash University (and FODMAP Diet App)](https://www.monashfodmap.com/about-fodmap-and-ibs/) - **Autoimmune Protocol (AIP)**: remove potentially inflammatory and immune-stimulating foods while increasing nutrient-dense foods to manage and treat autoimmune diseases. AIP emphasizes other lifestyle factors in addition to diet. Resources: [Autoimmune Wellness](https://autoimmunewellness.com/what-is-aip-the-definitive-guide/), [Dr. Sarah Ballantyne](https://www.thepaleomom.com/start-here/the-autoimmune-protocol/) - **Gut and Psychology/Physiology Syndrome (GAPS)**: remove foods that are difficult to digest, while incorporating nutritious whole foods in order to treat neurological and psychological conditions. Resources: [GAPSdiet.com](https://www.gapsdiet.com/), [Gut and Psychology Syndrome](https://www.amazon.com/Psychology-Syndrome-D-D-D-H-D-Schizophrenia/dp/0954852028) (book) - **Specific Carbohydrate Diet (SCD)**: remove grains as well as foods containing sugars called di- and polysaccharides, while adding nutritious whole foods to help balance the gut microbiome. Often used to treat ulcerative colitis, Crohn’s disease, and IBS. Resources: [Medical News Today](https://www.medicalnewstoday.com/articles/scd-diet), [Breaking the Vicious Cycle: Intestinal Health Through Diet](https://www.amazon.com/Breaking-Vicious-Cycle-Intestinal-Through/dp/0969276818) (book) - **Whole30**: remove potentially inflammatory and problematic foods such as grains, sugar, alcohol, and dairy. Resources: [Whole 30 Program](https://whole30.com/do-the-whole30/) Apart from the above well-known protocols, there are countless other options and ways to complete an elimination diet. Many doctors, dieticians, medical clinics, and health educators design their own plans that they use with patients or promote online. You may also focus on one food or or food group, such as dairy. Note that eating plans like the ketogenic and paleo diets are not commonly used as elimination diets, but can be. With the endless options available, it is especially helpful to work with a professional who understands your unique needs. ### **POTENTIAL BENEFITS & RISKS OF ELIMINATION DIETS** ##### **Benefits** - Reduce and manage symptoms (2-9) - Discover food triggers - Decrease inflammation ([8](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5647120/)) - Learn how to listen to your body - Take control of your health - Create a personalized eating plan ##### **Risks** - Rely too heavily on the diet to feel better - Remain in the elimination phase too long - Unintentionally decrease diversity and nutrients - Ignore other underlying issues and root causes - Develop disordered eating patterns ### **WHAT TO CONSIDER BEFORE STARTING** **1.** Is this the right time to take on a food-focused lifestyle change? **2.** Is an elimination diet the best way to address your health concerns? **3.** Do you have a personal or family history of eating disorders? **4.** What kind of medical and personal support do you have available? **5.** Have you been able to investigate and address underlying issues with your healthcare providers, such vitamin and mineral deficiencies? **6.** How much time and energy will you need to complete the protocol? ### **THE BOTTOM LINE** Elimination diets temporarily remove foods that tend to be inflammatory, immune-stimulating, or difficult to digest. After a period of time, foods are challenged in order to detect sensitivities and intolerances. When used as short-term nutritional tools, they can improve quality of life and be an invaluable part of the healing journey for people with autoimmune disease, IBS, and other health conditions. However, elimination diets may not be the best approach for everyone—particularly for those with a history of eating disorders or disordered eating. Know yourself, talk with your healthcare team, and follow the path that feels right for you. ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** Living Well with Autoimmune Disease --- ### [What is Processed Food?](https://www.autoimmuneinstitute.org/articles/what-is-processed-food) **Published:** September 21, 2019 **Author:** Carolyn Serraino **Excerpt:** Processed foods can influence nutrition, gut health, and immune function. This article explains what processing means and how to make more informed choices in the context of overall health. **Content:** The phrase “processed food” has been getting a lot of attention, as we’re increasingly encouraged to avoid them. They are found in the form of microwave dinners, candy bars, chips, and soda, but canned beans, yogurt, olive oil, and frozen vegetables are also examples of processed foods. They can be complete meals, snacks, or time-saving ingredients we use to cook our own meals. **To process a food means to alter it from its natural state.** Even cutting up a pineapple and cooking rice are examples of processing that we do at home. On a larger scale, when we say “processed foods” we are referring to ready-to-eat, packaged products that have been manipulated through processes like pasteurization or heat, or by adding natural or synthetic ingredients for flavor, color, texture, or preservation. **Many types of processing can also strip foods of their vitamins and minerals**, which is why manufacturers will often add them back in, fortifying packaged foods with iron, magnesium, B vitamins, vitamin D, and other nutrients. **As a rule of thumb, the more ingredients you see on the label, the further that food is from its natural state.** **More often than not, a product with a laundry list of ingredients will:** - lack many of the original nutrients - be highly caloric - contain an alarming amount of sodium and sugar - include additives and other ingredients that can be harmful to your health Studies have demonstrated a link between processed foods and diabetes, obesity, and heart disease. We are also coming to understand that these foods may disrupt the balance between good and bad bacteria in the gut microbiome, which can impact everything from mood to autoimmune disease. Using packaged foods once in awhile can help us manage our busy lives, but choosing whole and minimally processed foods is always optimal. Here are a few tips to minimize the role of processed foods in your diet: - **At the grocery store, stick to the perimeter** where the fresh produce is—if you don’t see those enticing, colorful packages of cookies and crackers, you won’t be tempted to buy them. - **Plan ahead! Prep meals for the week** so that you are not caught off guard without time to cook and end up reaching for a frozen meal. - **Do not keep snacks at home.** You can’t eat what you don’t have. - **Visit your local farmer’s market.** Make food an adventure. You will be able to find beautiful, in-season produce that will never reach the grocery store shelves and talk with your farmers about how their fruits and veggies are grown. Farmer’s market produce is also brought straight from the farm—a fresher and more nutrient-dense option than grocery store produce. All that being said, many people lack the access and resources needed to incorporate whole foods into their diets on a daily basis. Food security and affordability are ongoing issues that many organizations (such as the [Food Tank](https://foodtank.com/news/category/food-security/)) are working to address through food policy change, food stamp incentive programs, school garden programs, urban farming and community gardens, food waste recovery and redistribution, and more. ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** Living Well with Autoimmune Disease --- ### [Restoring Immune Tolerance in Autoimmune Disease](https://www.autoimmuneinstitute.org/articles/restoring-immune-tolerance-in-autoimmune-disease) **Published:** April 13, 2026 **Author:** Carolyn Serraino **Excerpt:** Immune tolerance prevents the body from attacking itself. Learn how it breaks down in autoimmune disease and how new therapies aim to restore it. **Content:** ### The Immune Spectrum: Autoimmunity and Cancer Autoimmune disease and cancer are often treated as unrelated conditions, yet both arise from shifts in immune balance. This series begins by exploring the immune system as a continuum in [ The Immune Spectrum: From Autoimmunity to Cancer ](https://www.autoimmuneinstitute.org/articles/the-immune-spectrum-from-autoimmunity-to-cancer), then examines how treating one condition can influence risk for the other in [ The Immune Balancing Act: Cancer and Autoimmunity ](https://www.autoimmuneinstitute.org/articles/the-immune-balancing-act-cancer-and-autoimmunity). The final article, [ Restoring Immune Tolerance in Autoimmune Disease ](https://www.autoimmuneinstitute.org/articles/restoring-immune-tolerance-in-autoimmune-disease), looks ahead to emerging therapies designed to retrain the immune system without broadly weakening immune defense. Our immune system exists to help our bodies fight and destroy infectious agents like viruses or bacteria. The challenge is making sure that the immune system only targets these invading pathogens, without attacking our own bodies and tolerating harmless substances like the food and pollen we encounter. > “By default, the immune system will attack everything, and we have to teach it what not to attack,” says [Adrian Liston](https://www.listonlab.uk/), Professor of Pathology at the University of Cambridge. Understanding how this immune tolerance mechanism works can help scientists develop therapies for autoimmune diseases that help our immune system be tolerant to harmless substances without widespread immune suppression. ## What Is Immune Tolerance & How Does It Work? [Immune tolerance](https://www.niaid.nih.gov/research/immune-tolerance) is the idea that the immune system does not respond to parts of our own body and therefore, won’t attack our own cells, tissues, and organs (1). Generally, this tolerance is divided into two types: central tolerance and peripheral tolerance. #### Central Immune Tolerance and the Role of the Thymus Central tolerance is primarily built during early development (ex: prenatal and neonatal stages) when T cells develop in the thymus and B cells develop in the bone marrow. These cells generate receptors that will bind molecules called antigens to cause an immune response. Because the receptors are generated at random, a subset of these receptors recognize antigens produced from our own bodies (self-antigens). Central tolerance eliminates the T and B cells that react to these self-antigens. While the bulk of central tolerance develops in early development, the [thymus does produce new T cells throughout life](https://pmc.ncbi.nlm.nih.gov/articles/PMC7583557/) (2). However, [Ann Griffith](https://www.annvgriffithlab.org/), Associate Professor at University of Texas at San Antonio, says that the number of new T cells produced declines with age as the tissue atrophies. “Each wave of newly developing T cells in the thymus continues to require the selection processes that promote tolerance,” she says. However, she notes that there is evidence that the selection process is impaired with aging, which is partially why there is an [increased risk for T cell autoimmunity with age](https://www.autoimmuneinstitute.org/articles/age-ethnicity-and-unexpected-connections-in-autoimmune-risk-factors/). Thymic peptides, which are short amino acid fragments naturally derived from the thymus, have roles in central tolerance and have an [anti-inflammatory potential](https://pmc.ncbi.nlm.nih.gov/articles/PMC7104151/) (3). Examples of these include thymosin alpha-1, which has been found to promote an anti-inflammatory status in blood samples from [multiple sclerosis patients](https://pubmed.ncbi.nlm.nih.gov/28273784/) (4). However, there is currently limited evidence on the use of thymic peptides in autoimmune disease contexts and the evidence so far has been preliminary using [animal models](https://pmc.ncbi.nlm.nih.gov/articles/PMC11231030/) or [small scale trials](https://pubmed.ncbi.nlm.nih.gov/6751241/) and have [yielded mixed results](https://pubmed.ncbi.nlm.nih.gov/6384507/) (5, 6, 7). #### Peripheral Immune Tolerance: Protecting the Body Beyond the Thymus Because central tolerance isn’t perfect, the body needs a way to promote immune tolerance beyond the thymus and bone marrow once T and B cells enter the lymph nodes and tissues. This peripheral tolerance prevents the self-reactive cells that have escaped central tolerance from attacking our own body. [Peripheral tolerance](https://pmc.ncbi.nlm.nih.gov/articles/PMC3367546/) keeps these self-reactive immune cells at bay either by suppressing their activity, deleting these cells, or keeping them in an inactive state (8). Liston points out another important function for peripheral tolerance: preventing the immune system from reacting to harmless, but foreign, substances like food or pollen. “Central tolerance does not work on that extended self,” he said. “It only works on a very narrow definition of our genome-encoded self.” When failures in “teaching” immune tolerance happens, this can lead to conditions like allergies, if the immune system recognizes food or pollen as dangerous, or autoimmune diseases,if the immune system attacks our own body. ## Therapies That Aim to Restore Immune Tolerance An ideal in treating autoimmune diseases is to address the root cause of disease, rather than widespread immune suppression. > “Immune suppression is not the answer in the field of immune tolerance because immune suppression is not going into the root of the problem,” says [Eva Martínez-Cáceres](https://www.linkedin.com/in/eva-mart%C3%ADnez-c%C3%A1ceres-50871113/?originalSubdomain=es), Professor of Immunology at Universitat Autònoma de Barcelona. Re-teaching the immune system to become tolerant to harmless antigens like those from our own bodies is one way to address this. While immune tolerance begins in the thymus and bone marrow, it’s hard to target the thymus therapeutically. Griffith says that “its location near the heart, and the fact that the blood vessels in some critical anatomical areas of the thymus have relatively low permeability to circulating factors both make it difficult to selectively and efficiently deliver therapeutics.” This is why many of the therapies to re-educate the immune system focuses on the peripheral immune system. #### Low-Dose IL-2 Therapy and Regulatory T Cells Low dose IL-2 therapy’s goal is to boost the regulatory T cells in the immune system. Liston calls these cells the “brakes on the immune system.” These regulatory T cells are a type of immune cell that helps the body maintain tolerance to self-antigens and suppress the growth of the more pro-inflammatory T cells. “You don’t want to have too few regulatory T cells because you’re going to react against everything,” he adds. “You don’t want to have too many regulatory T cells, otherwise you’ll react against nothing.” One way to control this is with IL-2, which acts as a “food source” for [regulatory T cells](https://pubmed.ncbi.nlm.nih.gov/37882232/) (9). While Liston says that low dose IL-2 is “pretty safe,” there have been a limited range of conditions where the therapy has been tested on a large scale. One problem is because IL-2 therapy is already on the market. “It’s not commercially viable for any company to run very large trials to show that it definitively works, \[for example\], in lupus,” says Liston. “If it gets approved for lupus because the company that runs the trial pays for the cost, then any manufacturer is able to support that because the drug is off patent.” Instead, where the field is headed now is making second generation IL-2 products that have been modified for specific purposes. Liston’s team is working on developing IL-2 therapies that [target just one part of the body](https://www.nature.com/articles/s41590-022-01208-z) (10). He adds, “We’d like to only provide extra IL-2 in the brain so that we can just treat neuroinflammatory diseases without shutting down immune responses in the rest of the body.” #### Tolerogenic Dendritic Cell Therapy Another type of therapy, tolerogenic dendritic cells, attempts to reinstate tolerance specifically towards self-antigens. This therapy is based on the fact that dendritic cells normally display antigens to T cells. The outcome of this interaction depends on the environment it occurs in. Within an inflammatory setting, these T cells become activated while in a steady state or anti-inflammatory environment, the dendritic cells either lead to the deletion of pro-inflammatory T cells or the generation of regulatory T cells that suppress the immune response. Martínez-Cáceres says that tolerogenic dendritic cells can be [generated in the lab](https://www.cell.com/trends/immunology/fulltext/S1471-4906(20)30259-3) by taking monocytes (a precursor to dendritic cells) from patients, differentiating them in the lab, adding a tolerogenic environment, and loading them with the target antigen before they are introduced back into the patient (11). The challenge here is that it’s difficult to identify the self-antigen that should be introduced. “In most autoimmune diseases, we don’t know the antigens that are causing the disease,” says Martínez-Cáceres. She added that [epitope spreading](https://www.sciencedirect.com/science/chapter/edited-volume/abs/pii/B9780444632692000039), a process where damaged tissues reveal different self-antigens, makes it even more challenging to pinpoint specific self-antigens to generate tolerogenic dendritic cells (12). Beyond epitope spreading, there are additional challenges for tolerogenic dendritic cells to work effectively. First, this therapy would require multiple doses (similar to allergy shots), but it’s not known how long a patient would have to continue therapy for. Martínez-Cáceres says this could take years, with treatment every one to two months, for example. There are multiple tolerogenic dendritic cell therapies [in clinical trials](https://www.cell.com/trends/immunology/fulltext/S1471-4906(20)30259-3) (11). #### Stem Cell Therapies for Autoimmune Disease A specific type of stem cells called mesenchymal stromal cells (MSCs) have an immunosuppressive and regenerative feature that make them useful in treating autoimmune disease. They can migrate to damaged tissues and regulate inflammation, promoting immune tolerance. For more information on stem cells and how they can help treat autoimmune diseases, [see this article here](https://www.autoimmuneinstitute.org/articles/stem-cell-therapy-for-autoimmune-disease/). ## The Future of Immune Tolerance Research Being able to apply principles of immune tolerance to therapies that target autoimmune diseases requires first understanding how immune tolerance works and then translating these findings into therapies that give patients tangible, beneficial outcomes. Liston thinks that scientists currently have a “very good understanding” of how immune tolerance works, but it’s more difficult to restore it clinically. For Martínez-Cáceres, she noted that “the challenge in autoimmunity is that you want to induce tolerance to the antigens that are self, but you want to keep the immune competence of the immune system towards dangerous illnesses.” ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/GAI-Logo-Image-e1707845715517.png) #### About the Author ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/10/Jennifer-Tsang-Bio-Headshot-e1753113113430.jpg) A microbiologist turned freelance science writer who works with life science companies, nonprofits, and academic institutions on anything from news stories, explainer articles, and content marketing. She shares the wonderful world of microbes on her blog The Microbial Menagerie. Jennifer Tsang, PhD Freelance Writer for GAI ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** About Autoimmune Disease, Diagnosis & Treatment --- ### [The Immune Balancing Act: Cancer and Autoimmunity](https://www.autoimmuneinstitute.org/articles/the-immune-balancing-act-cancer-and-autoimmunity) **Published:** April 13, 2026 **Author:** Carolyn Serraino **Excerpt:** Cancer and autoimmune disease sit at opposite ends of the immune spectrum. Yet treating one condition can sometimes increase the risk of the other. This article explores the shared immune pathways behind both diseases and the delicate balance clinicians must navigate when making treatment decisions. **Content:** ### The Immune Spectrum: Autoimmunity and Cancer Autoimmune disease and cancer are often treated as unrelated conditions, yet both arise from shifts in immune balance. This series begins by exploring the immune system as a continuum in [ The Immune Spectrum: From Autoimmunity to Cancer ](https://www.autoimmuneinstitute.org/articles/the-immune-spectrum-from-autoimmunity-to-cancer), then examines how treating one condition can influence risk for the other in [ The Immune Balancing Act: Cancer and Autoimmunity ](https://www.autoimmuneinstitute.org/articles/the-immune-balancing-act-cancer-and-autoimmunity). The final article, [ Restoring Immune Tolerance in Autoimmune Disease ](https://www.autoimmuneinstitute.org/articles/restoring-immune-tolerance-in-autoimmune-disease), looks ahead to emerging therapies designed to retrain the immune system without broadly weakening immune defense. The immune system exists [as a spectrum of immune responses](https://www.autoimmuneinstitute.org/articles/the-immune-spectrum-from-autoimmunity-to-cancer) from an overactive immune system to an underreactive one. While cancer and autoimmunity sit at opposite ends of the spectrum, treating autoimmunity can increase cancer risk and treating cancer can increase autoimmune disease risk. These diseases and their treatment effects are so intertwined because the same pathways and cells in the immune system are implicated in both disease states. ## Immune Cell Dysfunction in Autoimmunity and Cancer These cells in common include T cells and B cells, where their dysfunction leads to disease. The action of these cells is governed by a complex network of signals that regulate their activation and tolerance to our own cells. **T cells:** T cells are the immune cells that attack and kill cells infected with viruses or bacteria. However, during autoimmunity, T cells attack our own cells. In cancer, T cells get “fooled” by the cancer cells because they resemble normal cells. “They are still cells of the individual,” says [Davide Mangani](https://www.linkedin.com/in/davide-mangani-50377765/?originalSubdomain=ch), a Principal Investigator studying cancer and immunity at the Institute for Research in Biomedicine, so it makes it difficult for the immune system to distinguish them from non-cancerous cells. **B cells:** B cells typically produce antibodies that target viruses and bacteria, which help mark them for destruction. However, in autoimmunity, B cells produce autoantibodies, which are antibodies against our own cells. B cells normally have the ability to present antigens to T cells to activate them so it’s possible that they can present tumor antigen to T cells to instruct them to attack tumor cells. > **“In cancer, this activity is something that we would like to see, whereas in autoimmunity, it’s something that we like to block,” says Mangani.** However, in cancer, a type of B cell called regulatory B cells dampens the immune response and secrete factors to inhibit T cells from attacking tumors. ## How Do Cancer Treatments Trigger Autoimmune Effects? In cancer, tumor cells have found ways to evade the host immune system by increasing our body’s tolerance to them. They do this by interfering with immune checkpoints, which normally govern when an immune response should be turned off. Cancer drugs, like immune checkpoint inhibitors, counteract this by blocking these checkpoints so that the immune system can better recognize and destroy tumor cells. Current immune checkpoints being targeted in cancer therapeutics include those that block [CTLA-4](https://doi.org/10.1097/COC.0000000000000239) (cytotoxic T-lymphocyte-associated antigen 4), PD-1 (programmed death 1), and [LAG-3](https://doi.org/10.3389/fimmu.2020.615317) (lymphocyte activation gene 3) (1, 2). > **“The new therapies for cancer try to lower the activation threshold of a T cell. Now these cells are able to attack the tumor cells,” says Mangani. “But, what we also see by lowering this threshold is that you can increase the chance that some T cells start recognizing normal cells.”** This phenomenon is known as **immune-related adverse events (irAEs)**. These irAEs are rare but can affect nearly every organ. While some irAEs are more limited, some are more systemic and dangerous, resulting in widespread inflammation or arthritis that become really debilitating, says Mangani. “If they’re too strong, you need to stop the therapy,” he adds. However, irAEs are hard to predict. “What’s really difficult about that is that we currently don’t have strategies to identify who might be at risk for these immune-related adverse events and where they’re going to occur,” says [Arabella Young](https://uofuhealth.utah.edu/huntsman/labs/young), an Assistant Professor in the Department of Pathology and Huntsman Cancer Institute at the University of Utah. In the future, if we can understand why some people respond to immune checkpoint inhibitors alongside patient risk for irAEs, Young thinks that personalized treatments can be tailored to maximize a treatment’s effectiveness against cancer while minimizing irAEs. #### Treating cancer while minimizing autoimmune reactions is a balancing act. Evidence finds that: - Patients who developed [irAEs](https://pmc.ncbi.nlm.nih.gov/articles/PMC6858629/) had [better treatment outcomes](https://pubmed.ncbi.nlm.nih.gov/38629295/) than those who did not (3, 4). - [Corticosteroids](https://pubmed.ncbi.nlm.nih.gov/34226279/), which can be used to treat irAEs, can lower the antitumor immune response during immune checkpoint inhibitor treatment if used too early (5). > **“That balance of risk versus benefit is not one that’s very easy for clinicians to delineate at the moment,” says Young.** ## Autoimmune Therapies Increase Cancer Risk While immunosuppressive therapies have greatly improved the quality of life for people with autoimmune diseases, immunosuppressants and [biologics](https://www.autoimmuneinstitute.org/articles/biologics-for-autoimmune-disease-what-you-should-know/) can increase cancer risk by weakening immune surveillance. This can make the body less able to find and destroy cancer cells or fight off viral infections like human papillomavirus or Epstein-Barr virus that increase the [risk of developing cancer](https://bmjoncology.bmj.com/content/2/1/e000127) (6). The general recommendation for those on immunosuppressive therapy has been to monitor for cancer development by routine and early screening. > **However, the link between the immunosuppressive effects of these drugs and cancer is unclear, as having an immune-related disease itself [increases the risk of cancer](https://doi.org/10.1093/cei/uxaf013) (6, 7).** For example, a [study](https://bmjoncology.bmj.com/content/2/1/e000127) in patients with ocular inflammatory disease found no links between overall or site-specific cancer and the use of multiple immunosuppressive drugs (6). Another [study](https://bmjoncology.bmj.com/content/2/1/e000037) found that short-term use of immunosuppressive drugs was not linked to cancer (8). Yet, other studies find the opposite. Treatment with [TNF inhibitors](https://pmc.ncbi.nlm.nih.gov/articles/PMC8568666/) is linked to an elevated risk for skin cancer and lymphomas (9), so patients on these drugs should look out for unusual changes in the skin. However, the risk of most other cancers wasn’t elevated with TNF inhibitor treatment (9). Treatment with [methotrexate](https://www.nature.com/articles/s41416-023-02172-7) was linked to an elevated risk for basal cell carcinoma and squamous cell carcinoma (10). However, the study also acknowledges the possibility of surveillance bias – those on methotrexate are more likely to undergo skin examinations compared to those who aren’t. ## A Balancing Act The connectedness between autoimmunity and cancer highlights how the immune system can be swayed towards overactivity or underactivity. “It’s a balancing act,” said Young. With continued research, it’s possible that scientists will understand more about keeping undesirable immune responses in check when treating autoimmunity or cancer. Personalized treatment can also help avoid adverse outcomes by tailoring treatment to the individual. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/GAI-Logo-Image-e1707845715517.png) #### About the Author ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/10/Jennifer-Tsang-Bio-Headshot-e1753113113430.jpg) A microbiologist turned freelance science writer who works with life science companies, nonprofits, and academic institutions on anything from news stories, explainer articles, and content marketing. She shares the wonderful world of microbes on her blog The Microbial Menagerie. Jennifer Tsang, PhD Freelance Writer for GAI ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** About Autoimmune Disease --- ### [Navigating Healthcare Through the Practical Lens of Telehealth](https://www.autoimmuneinstitute.org/articles/navigating-healthcare-through-the-practical-lens-of-telehealth) **Published:** September 17, 2020 **Author:** Carolyn Serraino **Content:** ### What Is Telehealth? **Telehealth refers to the strategy of providing virtual healthcare.** This includes any technologies and services that physicians use to conduct appointments remotely. Another feature of telehealth is the use of communications between hospitals and clinics to bring collaborative expertise into emergency procedures. As early as the 1970s, telehealth was used to assist remote, underserved Native communities in the Southwest. In the 1980’s, telehealth made its way to the final frontier by providing care to the astronauts aboard Space Station Freedom. Since those formative days, telehealth hasn’t exactly exploded in popularity—that is, until the emergence of COVID-19 ([1](https://www.newyorker.com/magazine/2020/06/29/the-promise-and-the-peril-of-virtual-health-care)). ### A New Normal We often hear people reference a “new normal” when they talk about the latest innovations and guidelines for keeping our communities safe during the coronavirus pandemic. Many questions remain about the respiratory disease that has infected millions worldwide. What we do know is that many people with chronic illnesses are also in the category of “high risk,” meaning that they are more susceptible to contracting and developing a serious case of COVID-19. **To compound this problem, people with chronic illnesses are likely to require frequent medical appointments to help manage their diseases.** People with chronic conditions are often faced with the impossible choice of risking contact with the virus by continuing their treatment plan, or putting off vital care in order to mitigate that risk. This is where telehealth has the potential to transform patient experiences—and not just for the chronically ill. If healthcare providers can serve patients from afar, it means that **less people will come into contact with the virus by way of clinic and hospital visits.** ### Addressing Disparities There is also potential for telehealth to help tackle some of the racial and socioeconomic disparities that exist in healthcare today. Disparities that lead to delayed or denied access to care include—but are not limited to—**access to transportation, translation services, travel expenses associated with specialist visits, and insurance.** According to a Journal of Community Health article titled [“Traveling Towards Disease: Transportation Barriers to Health Care Access”](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4265215/#idm140456248186320title), research indicates that “such delays in care may lead to a lack of appropriate medical treatment, chronic disease exacerbations or unmet healthcare needs, which can accumulate and worsen health outcomes.” In light of these challenges, chronic conditions can become worse and overall health can suffer. Both circumstances increase susceptibility to severe COVID-19 complications. ### Telehealth In Practice Dr. Benny Kerzner, a pediatric gastroenterologist at Children’s National Medical Center, is successfully utilizing telehealth to treat young people with celiac disease. He refers to telehealth as a silver lining in healthcare during the pandemic. As a high-risk individual, his work in telehealth has allowed him to continue patient care routines uninterrupted. **Dr. Kerzner notes that telehealth has eliminated many of the factors that turn his patients into no-shows.** In fact, his no-show rate has dropped from 20% to about 1%-2%. According to Dr. Kerzner, the factoring out of potential transportation barriers, as well as eliminating the burden of long and expensive travel, are among the factors that have influenced this trend. These outcomes are consistent with what researchers have observed. Studies indicate that transportation barriers can have tremendous consequences for treatment outcomes in chronically ill patients, and that these barriers are disproportionately experienced across certain populations, including ethnic minority groups ([2](https://www.news-medical.net/health/Disparities-in-Access-to-Health-Care.aspx), [3](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4265215/#idm140456248186320title)). Dr. Kerzner’s cases suggest that telehealth may prove to be a viable approach to eliminating certain transportation issues that limit access to care, including inadequate transportation, unforeseen issues with public transportation, and time and expense of travel. ### Additional Benefits The keystone of Dr. Kerzner’ telehealth work is the Multidisciplinary Celiac Disease Clinic at Children’s National Medical Center in Washington, D.C. The Clinic provides an integrative approach to celiac disease treatment, where each patient is seen by a gastroenterologist, nutritionist, education staff, psychologist, neurologist, and neuropsychologist. **Telehealth has allowed Dr. Kerzner and his team to streamline this model of care.** The entire team can convene in a virtual meeting room before and after an appointment to discuss the patient’s case and coordinate follow-up care. Telehealth also allows the team to efficiently mobilize other types of patient support, such as translation services. **The ease of virtual care means that translators can be more readily available, which can ensure less delays in care.** Translators are also more likely to improve delivery of healthcare services, thus improving overall health outcomes. Like many, Dr. Kerzner believes that there is tremendous need to address disparities in access to healthcare. Translation services help illustrate the size of that need, as studies estimate that about 14% of the US population—and as many as 36% of the population of some US states—do not speak English as a primary language ([4](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1495243/)). ### Limitations In spite of its enormous benefits, Dr. Kurzner points out that telehealth is not without limitations. **One of the most limiting factors in telehealth success is access to technology and broadband services.** Without a concrete way for providers to identify and address that need, households who lack access to these necessities could very well be excluded from telehealth programs. One possible approach to expanding telehealth services might be to identify nearby clinics that could facilitate specialist telehealth exams using their own equipment. Issues involving access are complex and multi-layered. Dr. Kerzner believes that solving such issues will ultimately require advancements within legislation, as well as within the health insurance companies. Still, he remains hopeful that telehealth can and will close some of the gaps that limit access to sustained, quality care. ### What Does The Future Hold? **When asked what he sees for the future of telehealth, Dr. Kerzner replies that he believes telehealth *is* the future of healthcare.** With an enthusiastic smile, he says, “We’re just at the beginning. I’d love to come back in 50 years’ time and check this out, because I think it’s going to be amazing.” Check out our entire [interview with Dr. Benny Kerzner to learn more about telehealth](https://www.autoimmuneinstitute.org/autoimmune-chats-expert-talks/), its applications, and possible limitations. ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** Autoimmune Care & Caregiver Support, COVID-19 and Long Covid, Diagnosis & Treatment --- ### [The Chronic Search for Relief in the Medical System](https://www.autoimmuneinstitute.org/articles/the-chronic-search-for-relief-in-the-medical-system) **Published:** October 21, 2020 **Author:** Carolyn Serraino **Content:** ## A book review of “Ask Me About My Uterus: A Quest to Make Doctors Believe in Women’s Pain” by Abby Norman **Physicians dismiss women’s pain more than men’s. Period.** This unfortunate truth is displayed in full color detail throughout [Abby Norman’s book, *Ask Me About My Uterus*](https://www.abbynormanwriter.com/book). Raw, bold, and unflinchingly honest, her memoir flashes back to a traumatic childhood while taking us through the relentless pain and endometriosis diagnosis that derailed her life. With her sharp wit and a knack for research, she uncovers the dark underbelly of the fraught relationship between women’s health and the male-dominated medical establishment through the telling of her own complicated tale. ### Overview Many of us living with chronic illness can relate to the shock of pain that zapped through Abby’s body on an otherwise uneventful morning—that moment when life as we know it comes to a screeching halt. The stabbing coursed through her abdomen, as though “on the receiving end of an unseen assailant’s invisible knife.” **She tried to manage it, put her mind over matter; but the pain viciously stole her attention.** Barely able to sleep, it terrorized her for nearly a week before she finally relented and went to the hospital (despite the bills that would later pile up). Both the 1-10 pain scale, which she heavily condemns in the book, as well as the physicians who used it did not begin to acknowledge the level of agony she was in. Only once she saw a specialist did a laparoscopic surgery uncover a gnarly ovarian cyst as well as endometriosis. Endometriosis is a chronic condition that often coexists with autoimmune diseases. When endometrial-like tissue mistakenly attaches to organs, tissues, and nerves outside the uterus, it causes inflammation, scarring, and excruciating pain. One year prior to the onset of her illness, Abby had started a new chapter at Sarah Lawrence College in New York, far away from the sting of recent family trauma that left her homeless and sleeping in her car. The school was her home, her safe haven away from a fight-or-flight existence. She was dead-set on returning to student life as soon as possible. **The lack of support or information given about her diagnosis fueled the hope that the surgery had “fixed” whatever was wrong.** But the constant, agonizing pain greedily revealed its chronic nature and she was forced to drop out of school entirely. > Even armed with a diagnosis, healthcare visits often left her ears ringing with pronouncements of “it’s just stress” and “it’s all in your head.” As those of us with invisible illnesses can heartily echo, Abby had “never wanted to be right, only to be well.” **Self-doubt, shame, and guilt crowded around her and relief was nowhere to be found – from the pain, nor the belittling.** Abby aptly broadens the scope of her own story by weaving in historical narratives on the treatment of women in the medical system from the 1600s to the 1900s. She explains why gender bias and this dismissive behavior are so pervasive even today, as they are deeply rooted in our cultural beliefs about women. > Wading through the shifty undercurrent of medical sexism, Abby had no choice but to put on her inspector badge and go to work. She poured over medical texts and studies, acquiring serious respect for science as well as a brilliant education in her diagnosis. Her perseverance and ability to assert herself led to an important discovery about her condition. **As endometriosis affects every aspect of life, Abby slowly—but surely—learned to accept her situation.** Time spent nose-deep in research and at doctor’s offices never ceased, however, as her health took on new complexities overtime. Undoubtedly she’s tired, yet to this day she persists. Abby is a strong example of the value of lived experience and the power of self-advocacy and research. ### A Quest For Alternatives **Abby’s story, like many others, is long and complicated, saturated with the ever-burning question: *why did this happen to me?*** As a person who has experienced chronic illness myself, including unexplained severe abdominal pain, nausea, and brain fog, I can relate to the distress of constantly searching for answers, dealing with disbelief, and managing pain, all while trying to live a satisfying life. I found myself silently cheering as she very articulately slammed physicians who provided poor treatment and an even poorer attitude. Abby’s stories highlighted the same medical system limitations and downright failures that I have experienced. At the onset of my symptoms, I was thrown into a chaotic sea of blood tests, exams, imaging, and surgical procedures. > Doctors tossed antibiotics and other drugs at me left and right to see what stuck. I sat silent while too many specialists either rolled their eyes and scoffed, or shrugged their shoulders because they didn’t know what to do. I felt trapped. Luckily, a determined friend of mine was well-versed in **holistic approaches to health, where the aim is to treat the whole person—including physical as well as emotional, social, and spiritual wellbeing.** I had no clue at the time, but many people with chronic illness benefit from a harmonious mélange of both holistic and conventional interventions like biologics, surgical procedures, diet change, herbal medicine, acupuncture, supplements, and more. When I first visited an integrative medicine doctor, she sat me down for a full 90 minutes, digging into my health condition without even a whisper of “you’re young you’ll be fine” or “it’s just stress.” Even before the functional labs revealed some major issues, there was simply no denying that I had a physical illness. My faith in medicine had been restored—and redirected. **Many of the women I connect with have parallel stories to mine.** Their health suddenly plummets and they struggle through our modern Western medical system with little to no success. Then they become research maniacs, find more holistic forms of care, and are able to manage their conditions or slowly improve. I read Abby’s story through the lens of these experiences, wondering whether she would be given the choice to pursue another avenue and find the care she deserved, too. Abby mentions naturopathy and supplements once, fleetingly. Near the end of the book she states that she’s on a helpful and “fairly uninteresting, low inflammation type diet.” I was hungry for more. How did she get to that point, and what person or research led her to use food in this way? I was rooting for Abby to explore outside conventional (a.k.a. Western or modern) medicine, acknowledge that other options exist, and pass this on to her readers. The book is structured in a manner that extends beyond a typical memoir. With her narrative forays into the stories of other women who have experienced the same letdowns as well as histories of how women have been treated in medicine, the book acts as an educational piece on women’s health. **The story as a whole serves as an anthem for patients, but it is limited.** For all her grievances with our current system (to which many of us can relate!), somehow her feet stayed firmly planted within it. While this was a barrier for me as a reader, it highlights the many valid reasons why holistic medicine may not end up in someone’s health journey: > Managing an illness can be just as financially draining as emotionally, even *with* decent insurance. - Integrative, functional, naturopathic, and Eastern medicine do not come cheap, as they fall outside the scope of conventional care. - Even if cost is not the biggest barrier, access can be another as availability and quality of holistic practitioners depend heavily on location and resources. - Many forms of holistic medicine lack the data our Western world looks for and are not seen as evidence-based or legitimate (by insurance companies, physicians, and the general public). - Holistic and personalized medicine tend to follow “slow healing” approaches and vary dramatically in their methods, therapies, and applications. Efficacy of these approaches also depends upon the practitioner’s experience as well as the patient’s circumstances While socioeconomic position plays a monumental role in access, there are ways to incorporate holistic medical care and therapies on a tight budget. Reaching out to a local community of patients with autoimmune disease or chronic conditions can illuminate new pathways. And there are organizations like [Chronic Wellness Collective](https://www.chronicwellnesscollective.org/), which offer affordable support, education, and programs in whole body wellness for people with chronic illnesses—a valuable companion to conventional or other medical treatment. For me, the kinds of patient-centered care that look for root causes (namely, functional medicine and naturopathic medicine) and treat the whole person were the only spaces where doctors wholeheartedly believed in both my pain and my insights. > Holistic medicine was my own antidote to the age-old struggle: the “quest to make doctors believe in women’s pain.” Seven years into my journey, I still work every single day to maintain and slowly—very slowly—improve my health. **Abby’s bold, well-researched, and relatable memoir is a must-read for anyone with chronic illness *or* a license to practice medicine.** She vividly describes the plight of the patient within the constraints of modern medicine in a way that speaks to both physicians and the people they treat. [*Ask Me About My Uterus*](https://www.abbynormanwriter.com/book) brings awareness to the limitations of our current system, while encouraging women to never give up. Empowering messages from people within the community keep the rest of us (including me!) moving forward. We’ve got this. ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** Autoimmune Care & Caregiver Support, Diagnosis & Treatment --- ### [Explained: Holistic vs Modern Western Medicine](https://www.autoimmuneinstitute.org/articles/explained-holistic-vs-modern-western-medicine) **Published:** January 28, 2021 **Author:** Carolyn Serraino **Content:** When it comes to holistic medicine and approaches to health, confusion abounds. The word “holistic” is scattered across the internet, business storefronts, and packaging, but similar to the terms “natural” or “grass-fed,” its true meaning still eludes us. Consider this your guide to understanding the differences and cutting through the confusion between the modern Western approach and holistic medicine. ### Modern Western **Modern Western medicine, a.k.a. allopathic, conventional, mainstream, or bio-medicine, uses a research- and organ systems-based approach to diagnose and treat various specific medical conditions, often using pharmaceutical drugs, radiation, and surgery.** In the modern Western system of medicine, it is common for patients to be referred to specialists—immunologists, neurologists, endocrinologists, gastroenterologists—whose expert knowledge of specific organs and body systems allows them to target treatment in those areas. #### **Healthcare professionals include:** - Medical doctors and specialists (MD) - Osteopathic doctors (DO) - Nurse practitioners - Physician’s assistants #### **Modern Western medicine excels in:** - Acute and emergency care - Diagnosing disease and postponing progression - Symptom relief - Diagnostic tools and testing - Pharmaceuticals and drug interactions - Surgical procedures - Clinical trials ### Holistic **Holistic medicine, which may also be referred to as traditional, alternative, complementary, or Eastern medicine, recognizes health as a combination of mind, body, and spirit. Holistic medicine focuses on** **bio-individual nutrition and lifestyle interventions, mental health support, social relationships, and environmental health in the prevention and treatment of health conditions.** This approach tends to fall outside the paradigm of modern Western healthcare, as it involves whole body support and slow healing, with an emphasis on natural therapies. Holistic doctors and practitioners may use herbs, supplements, homeopathic medicine, acupuncture, manual medicine, neural retraining, biofeedback, and other traditional and modern therapies *in addition to* pharmaceuticals and surgery to treat their patients. The term “holistic” casts a wide net—health philosophies and approaches to healing vary depending on the field or system of medicine, as well as the individual’s education and personal experiences. #### **Healthcare professionals include:** - Naturopathic doctors (ND) - Functional medicine doctors and practitioners - Integrative medicine doctors and practitioners - Osteopathic doctors (DO) - Medical doctors (MD), nurses, nurse practitioners, physician’s assistants and other professionals trained in functional or integrative medicine - Other practitioners fluent in systems of medicine such as Ayurveda or Traditional Chinese Medicine (TCM) There are many crossover healthcare professionals. One of the most well-known is osteopathic doctors (DO), who receive equivalent education to MDs but are trained in a more “whole body” approach. They use hands-on manipulation of the musculoskeletal system, among other therapies, to treat patients. Other holistic professionals may have first completed modern Western medical school and been subsequently educated in various forms of holistic medicine or holistic therapies. They may not practice within the modern Western medical model due to its constraints; in that case, their services are not typically covered by insurance. #### **Holistic medicine excels in:** - Preventive care and slow healing. - Undiagnosable or complex chronic conditions. - Symptom relief. - Identifying root cause. - Functional lab testing and ranges. - Supplements, herbs, homeopathy, food as medicine. - Assistance in implementing lifestyle change. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Toolkit-full-front-page-image-791x1024.png) **Learn more about holistic and modern Western medicine by downloading your FREE copy of [The Autoimmune & Chronic Illness Toolkit](https://www.autoimmuneinstitute.org/autoimmune-chronic-illness-toolkit/)**. ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** Autoimmune Care & Caregiver Support, Diagnosis & Treatment --- ### [Autoimmune Disease Specialist Spotlight](https://www.autoimmuneinstitute.org/articles/autoimmune-disease-specialist-spotlight) **Published:** February 24, 2023 **Author:** Carolyn Serraino **Content:** ## How to find the right doctor to treat your specific autoimmune condition and how insurance factors in Finding a specialist to treat your autoimmune symptoms can be crucial to receiving an accurate diagnosis and developing a comprehensive treatment plan. How can you find the right doctor to treat your autoimmune disease (AD), and how does insurance factor into specialist appointments? ### **How does someone with a suspected autoimmune disease know which type of doctor to see?** It can be difficult for patients with a suspected autoimmune disease to know which type of doctor to see. A primary care physician or a general practitioner can evaluate symptoms, perform exams and refer a patient to a specialist for further evaluation. But autoimmune diseases can affect multiple organs and systems, so the type of specialist depends on specific symptoms and the [organs affected](https://www.autoimmuneinstitute.org/articles/body-regions-commonly-affected-by-autoimmunity "Body Regions Commonly Affected by Autoimmunity"). If symptoms suggest an autoimmune disease that primarily affects the joints, such as [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/), a primary care physician may refer a patient to a rheumatologist. If symptoms suggest an autoimmune disease that primarily affects the skin, such as lupus or scleroderma, a primary care physician may refer the patient to a dermatologist. It may be necessary to see more than one specialist to get an accurate diagnosis and comprehensive [treatment plan](https://www.autoimmuneinstitute.org/the-spectrum-of-autoimmune-disease-treatments/). Below are some specialists who treat autoimmune diseases. ### **Rheumatologists** ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/rheum-1.png) **A rheumatologist treats arthritis and other inflammatory diseases that can affect the muscles, bones, joints, ligaments, and tendons.** In “systemic autoimmune diseases,” a person’s immune system attacks their body and can cause deformities. Autoimmune conditions include: [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/), [ankylosing spondylitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ankylosing-spondylitis/), [antiphospholipid syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/antiphospholipid-syndrome/), [juvenile idiopathic arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/juvenile-idiopathic-arthritis-stills/), [lupus](https://www.autoimmuneinstitute.org/medical_institutions/lupus-clinic/), [polymyositis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/polymyositis/), [psoriatic arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/psoriatic-arthritis/), [Raynaud’s syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/raynauds-syndrome/), [Scleroderma](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/scleroderma/), [Sjӧgren’s syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sjogrens-syndrome/), [Still’s disease](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/stills-disease/), and [vasculitis](https://www.autoimmuneinstitute.org/medical_institutions/vasculitis-center/). A rheumatologist completes three to four years of medical or osteopathic education followed by three years of residency training in either internal medicine or pediatrics. In order to focus on musculoskeletal and autoimmune conditions, a rheumatologist must commit to specialty training for another two to three years. Rheumatologists must pass an exam to be board-certified, and many remain committed to furthering their education by participating in a voluntary program coordinated by the American Board of Medical Specialties called Maintenance of Certification. Those with a genetic history of autoimmune or rheumatic disease or symptoms, including inexplicable, recurring, or worsening joint pain and swelling, should see a rheumatologist. An early diagnosis can often prevent permanent damage to joints and organs. ### **Dermatologists** **Dermatologists diagnose and treat skin, hair, and nail diseases**. Autoimmune conditions of the skin include [alopecia areata](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/alopecia-areata/), [Behçet’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/behcets/), [dermatomyositis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/dermatomyositis/), [linear IgA disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/linear-igadisease/), [pemphigus](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/pemphigus/), [pemphigoid](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/pemphigoid-gestationis/), [psoriasis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/psoriasis/), [scleroderma](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/scleroderma/), and [vitiligo](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/vitiligo/). Dermatologists must earn a bachelor’s degree and complete four years of medical school, a year-long internship in medicine, and three years of a residency in which they accumulate 12,000 to 16,000 hours of treating patients. A dermatologist becomes board certified after passing an exam administered by the American Board of Dermatology, the American Osteopathic Board of Dermatology, and the Royal College of Physicians and Surgeons of Canada. According to the clinical program in dermatology at the University of Pennsylvania, [more than 80 types of known autoimmune disorders](/a-z-disease-list) affect organs and tissues. In an autoimmune disorder of the skin, the body’s immune system mistakenly destroys healthy body tissue. Symptoms include rashes and hardening or tightening of the skin. ### **Gastroenterologists** ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/gastro-1.png) **Gastroenterologists treat diseases of the gastrointestinal tract and liver**. Those include autoimmune conditions such as [autoimmune gastritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-gastritis/), autoimmune gastrointestinal dysmotility, [autoimmune hepatitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-hepatitis/), [autoimmune pancreatitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-pancreatitis/), [Celiac disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/celiac-disease/), [Crohn’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crohns-disease/), [primary biliary cholangitis/cirrhosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/primary-biliary-cirrhosis/), and [Ulcerative Colitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ulcerative-colitis/). Various symptoms may indicate an autoimmune condition affecting the digestive system, including abdominal pain, diarrhea, constipation, weight loss, and fatigue. To diagnose a condition, a gastroenterologist may perform a variety of diagnostic procedures, such as endoscopies, which use a small camera to see inside the digestive tract. A gastroenterologist may also perform a stool analysis, blood tests, or other laboratory tests. Treatment may include immunosuppressive medications to control symptoms and prevent further damage to the digestive system. Gastroenterologists may also recommend dietary changes, such as a gluten-free diet for Celiac disease, to help manage the condition. Gastroenterologists must complete four years of medical school and a three-year internal medicine residency to become eligible to further specialize in gastroenterology through a two-to-three year fellowship. Groups that oversee advanced training include the American Board of Internal Medicine, the American College of Gastroenterology, the American Gastroenterological Association, and the American Society for Gastrointestinal Endoscopy. ### **Immunologists** **Immunologists, also known as allergists, specialize in studying the immune system, including how it works, fights off infections and diseases, and how it can go wrong in autoimmune conditions**. Immunologists can treat and manage allergies, asthma, and immunologic disorders, including primary immunodeficiency disorders. When the immune system produces antibodies against certain substances or foods that cause allergies, symptoms may include nasal congestion, watery eyes, shortness of breath, and low blood pressure. To become an immunologist, one must complete medical school, three years of internal medicine or pediatrics training, and then at least two years of study in an allergy/immunology training program. Immunologists must also pass the American Board of Internal Medicine (ABIM) or the American Board of Pediatrics (ABP) exam. Rheumatologists and immunologists often work together on autoimmune conditions because of their different areas of expertise. Rheumatologists are specialists in the diagnosis and treatment of musculoskeletal and autoimmune conditions, while immunologists may study the genetic factors that contribute to certain autoimmune conditions, as well as the environmental triggers that can cause the immune system to attack healthy cells. ### **Neurologists** ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/neuro-1.png) **Neurologists specialize in nervous system disorders, including the brain, spinal cord, nerves, and muscles**. Neurologists focus on the diagnosis and treatment of neurological conditions such as Alzheimer’s disease, epilepsy, Parkinson’s disease, [Multiple Sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/) (MS), migraine headaches, and stroke. Autoimmunity is the cause of a range of neurologic disorders. Some autoimmune conditions, such as MS, can significantly impact the nervous system. For example, a neurologist may also be consulted in cases of lupus to evaluate and treat neurological symptoms such as seizures, headaches, or nerve damage. Autoimmune conditions treated by neurologists include [acute disseminated encephalomyelitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/acute-disseminated-encephalomyelitis/), [autoimmune encephalitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-encephalitis/), [chronic inflammatory demyelinating polyneuropathy](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/chronic-inflammatory-demyelinating-polyneuropathy/), [Guillain-Barré syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/guillain-barre-syndrome/), [Multiple Sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/), [Myasthenia Gravis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/myasthenia-gravis/), and [neuromyelitis optica](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/neuromyelitis-optica/). Standard neurologic tests used to complete evaluations include computed tomography (CT) or computer-assisted tomography (CAT) scans; magnetic resonance imaging (MRI); electroencephalography (EEG); nerve conduction studies and electromyography (NCS/EMG) and lumbar puncture (LP) for cerebral spinal fluid analysis. To become a neurologist in the United States, one must receive a pre-medical education at a college or university, attend four years of medical school, complete a one-year internship in internal medicine or medicine/surgery, and have at least three years of specialty training in an accredited neurology residency program. ### **Endocrinologists** **An endocrinologist specializes in disorders of the endocrine system, which includes the glands that produce hormones**. Hormones are chemical messengers that play a key role in regulating many of the body’s functions, such as metabolism, growth and development, and the body’s response to stress. Endocrinologists have expertise in diagnosing and treating a wide range of endocrine disorders, including diabetes, thyroid disease, osteoporosis, and disorders of the pituitary and adrenal glands. They also have expertise in diagnosing and managing certain autoimmune diseases that can affect the endocrine system, such as [autoimmune Addison’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-addisons-disease/), [autoimmune hypophysitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-hypophysitis/), [Graves disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/graves-disease/), [Hashimoto’s thyroiditis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/hashimotos-thyroiditis/), [testicular autoimmunity](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/testicular-autoimmunity/), [Type 1 Diabetes](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/diabetes-type-1/), and [Schmidt (polyendocrine) syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/schmidt-syndrome/). Some disorders involve the endocrine system, even though they do not originate there. An endocrinologist works closely with other specialists, such as a rheumatologist, neurologist, or dermatologist, to provide comprehensive care. Understanding processes that may be disrupted in endocrine disorders requires knowledge of pathophysiology and biochemistry. After medical school and internal medicine residency training, a two or three-year fellowship in the field of endocrinology must be undertaken for a physician to become an endocrinologist. An endocrinologist must also be board-certified. ### **Which Autoimmune Diseases Are Typically Covered By Insurance?** Insurance coverage for autoimmune diseases can vary depending on the specific type of disease, the insurance plan, the type of treatment required, and the state someone lives in. In the United States, most insurance plans, including those offered by employers, as well as Medicaid and Medicare, cover the diagnosis and treatment of autoimmune diseases. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/ADs-commonly-covered-by-insurance-for-AD-Specialists-article.png) However, coverage may vary. Some insurance plans may require pre-authorization or may have limits on the number of visits to a specialist or the number of medications that are covered. Immunological diseases can also be challenging to navigate because there may not necessarily be a finite treatment that guarantees patients will recover. Andrea Zlatkus, executive director at the [National Organization of Rheumatology Management](https://normgroup.org/), notes a $7,500 out-of-pocket fee for biologics related to autoimmune diseases, which may not always be fully covered. “We always tell patients to look at possibly having Medicare and a secondary insurer because you won’t have to pay the $7,500 out-of-pocket fee,” she says. Even with a secondary insurer, many chronic immune patients may still have to pay up to $2,000 a year, which can become extremely expensive over time. Zlatkus also says the more information you can give ahead of time can be useful, and she notes it’s often easier to help someone with no insurance than someone who is underinsured. Check with your insurance provider to understand your specific plan and also be aware of the out-of-pocket expenses, deductibles, and coinsurance. Additionally, it’s a good idea to be familiar with the terms and conditions of the insurance policy, including exclusions and restrictions. ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** Autoimmune Care & Caregiver Support, Diagnosis & Treatment --- ### [Autoimmune Terminology To Know For Your Next Doctor’s Appointment](https://www.autoimmuneinstitute.org/articles/autoimmune-terminology-to-know-for-your-next-doctors-appointment) **Published:** December 12, 2023 **Author:** Carolyn Serraino **Content:** While having guidance and support from your doctor is essential, taking control of your own health is important for planning and making informed decisions about your autoimmune disease. Being on board with the terms used to describe autoimmunity and specific diseases during your doctor’s appointments can help you receive the care you need as you ask questions to recognize signs and symptoms, understand the reasons behind testing, and navigate treatment options. ### General Medical Terms Understanding the meaning of basic terms can greatly boost your confidence as you discuss your autoimmune disease, potential complications, and best management strategies with your doctor. ## Disease, condition: A disease is a change from a state of health that causes harm to a body system or organ. You may also hear your healthcare provider call it morbidity (1). Autoimmune diseases are attacks from a person’s own immune system that weaken different parts of the body and affect their function (2, 3). The term condition is broader and refers to any state of a person that may require medical care. Conditions include diseases, but also injuries, psychological disorders, and even pregnancy. Condition is also used as a standard term by hospitals or clinics to refer to a patient’s status, such as stable, fair, or critical (4). You may sometimes hear the terms disease and condition being used interchangeably, but paying attention to context is key. ## Comorbidity: A comorbidity is the presence of two or more diseases in a person at the same time. In the realm of autoimmunity, polyautoimmunity is the coexistence of two autoimmune diseases, such as rheumatoid arthritis and autoimmune thyroiditis. Multiple autoimmune syndrome (MAS) is the coexistence of three or more autoimmune diseases (5). ## Symptom, sign, syndrome: A symptom is a subjective feature that can be experienced only by the affected person. Examples of symptoms in autoimmunity are joint pain, dizziness, and fatigue (1). A sign is an objective characteristic or physical finding that can be observed and measured by others, with autoimmune examples being swelling, rash, and fever (1). A syndrome is the collection of signs and symptoms that characterize a certain disease (1). In autoimmunity, an example of a syndrome is MAS, earlier defined as the presence of three or more autoimmune diseases at once. ## Trigger: A trigger is a factor that initiates the signs and symptoms of an autoimmune disease. “Trigger” and “cause” do not mean the same thing. While a cause creates the opportunity for a disease to develop, a trigger is the spark that activates it. Therefore, if an autoimmune disease is caused by a person’s autoantibodies or genes, triggers like food, pollution, or stress have the potential to activate the signs and symptoms of that disease. Different people may be sensitive to different triggers. ## Infection, inflammation: Autoimmune disease can often alter the cells of the immune system in a way that makes people more susceptible to infection, defined as the invasion of a body system or organ by microorganisms like viruses or bacteria. Although infection does not always cause disease (1), certain infections may be triggers of autoimmune disease signs and symptoms. Inflammation is a general response to tissue damage caused by infection but also by chemicals, heat, injury, or the immune system itself. While short-lived inflammation may be a beneficial process, long-lasting (chronic) inflammation can activate an autoimmune disease (1). For example, autoantibodies and T cells are known to be players in the inflammation process that leads to diseases like psoriasis. ## Flare-ups: In autoimmunity, flare-ups occur when signs and symptoms get dramatically worse in one or more organs of the body, often interfering with regular activities. Examples of severe flare-ups include nephritis in systemic lupus erythematosus, blurred vision and slurred speech in multiple sclerosis, and painful plaques in psoriasis. Your healthcare provider may refer to flare-ups also as flares, bouts, outbursts, or episodes. ### Autoimmune Disease Specific Terms Taking the time to become familiar with the terminology that is more specific to autoimmunity can help you understand more about disease features, diagnostic testing, available treatments, and experimental therapies. ## Immune dysregulation: Immune dysregulation collectively refers to the abnormal changes that cause an imbalance of the immune system, leading to the development of autoimmune disease (6). ## Antibodies, antigens, autoantibodies, autoantigens, antigen-presenting cells: Antibodies are specialized proteins that defend your body. They recognize antigens, defined as substances that cause the body to generate an immune response. Examples of antigens are external factors like microbes and chemicals. Autoantibodies are antibodies that recognize antigens inherently present in the body of patients who have an autoimmune disease. These antigens are called autoantigens or self-antigens (6). Antigen-presenting cells (APCs) are immune cells that allow lymphocytes to recognize the pathogen and organize an immune response. APCs consume and break down pathogens, and then express antigens on their cell’s surface to allow other immune cells to recognize the foreign invader (7). ## Cytokine, Cytokine Storm: Cytokines are small proteins released by the body involved in cell communication; there are proinflammatory and anti-inflammatory cytokines (8). A cytokine storm refers to a severe immune response in which dangerously high levels of proinflammatory cytokines are released by the body, which can seriously harm a patient. This condition may be triggered by autoimmune diseases or pathogens, such as the SARS-CoV-2 virus (9). ## Lymphocytes: Lymphocytes are white blood cells that are highly involved in autoimmunity. They include B and T cells. B lymphocytes, or B cells, are white blood cells that produce antibodies to fight specific pathogens (10). T lymphocytes, or T cells, are white blood cells in the body’s adaptive immune response. One major type of T cells are CD8+ T cells, also called cytotoxic T cells, which can kill infected cells. Then, CD4+ helper cells can recognize antigens of foreign substances and then release cytokines to cause B cells to differentiate into antibody-producing plasma cells (11). ## IgE, IgG, IgM: IgE, or immunoglobulin E, is an antibody often produced when the body has an allergic reaction (12). IgG, immunoglobulin G, is the most common class of antibodies, and they make up 75% of the antibodies found in the blood serum (13). IgM, or immunoglobulin M, is the first antibody produced by the body in response to infection and enhances the body’s ability to remove dead cells (14). ### **Autoimmune Disease Testing:** After a physical exam, your healthcare provider will order additional tests to diagnose your disease depending on your signs and symptoms. Terms to keep in mind include autoantibody tests, antinuclear antibody (ANA), complete blood count (CBC), C-reactive protein (CRP), enzyme-linked immunosorbent assay (ELISA), and erythrocyte sedimentation rate (ESR) ([7](https://medlineplus.gov/ency/article/000816.htm)). Take note of these terms and abbreviations and ask for more details about the ones your doctor recommends. Always ask questions about what they mean and how they work. ### Some Common Autoimmune Disease Tests Include: ## Antinuclear antibody (ANA) test ANA tests determine the level of antinuclear antibodies in your blood; these antibodies attack the nuclei of healthy cells. ANA tests help diagnose autoimmune diseases such as lupus, rheumatoid arthritis, or scleroderma (15). ## C-Reactive Protein (CRP) test C-Reactive protein (CRP) tests measure the level of C-reactive protein in the blood. CRP levels in healthy individuals are generally low. The liver releases CRP into the blood in response to inflammation, so CRP tests can help monitor inflammation and to determine its cause. Inflammation may be due to bacterial or fungal infections or autoimmune diseases, like lupus and rheumatoid arthritis (16). ## ELISA assay ELISA assays are immunological assays used to test for the presence of different antibodies, antigens, proteins, or hormones in a sample. These assays can identify specific cytokines and test for pregnancy and HIV, among many other conditions (17). ## Erythrocyte sedimentation rate (ESR) test An erythrocyte sedimentation rate (ESR) test is a test for how quickly red blood cells, or erythrocytes, settle in a test tube with blood. Inflammation is a common symptom of autoimmune diseases, which causes red blood cells to settle faster than normal. An ESR test does not diagnose one disease but provides an indication that there is increased inflammation in the body, so it’s often used in combination with more specific tests (18). ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/SpacerShield.jpg) ### **ABOUT THE AUTHOR** **Damiana Chiavolini, MS, PhD** is a freelance writer who specializes in medical and life science topics. As a trained researcher, she authored journal articles in the areas of infection and immunity and wrote booklets and book chapters about different diseases. As a professional communicator, she writes feature articles for magazines and other publications and produces content for higher education platforms. Damiana is also an experienced academic editor, microbiology educator, writing coach, and fragrance blogger. She is a contributing member of the American Medical Writers Association and the immediate past-president of the association’s Southwest Chapter. ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** Autoimmune Care & Caregiver Support, Diagnosis & Treatment --- ### [Navigating Health Insurance with Autoimmune Disease](https://www.autoimmuneinstitute.org/articles/navigating-health-insurance-for-autoimmune-disease-patients-expert-tips-and-resources) **Published:** October 23, 2024 **Author:** Carolyn Serraino **Excerpt:** With insights on how to best navigate health insurance from two experts in the field, GAI delves into the complicated process of dealing with health insurance with an autoimmune disease. **Content:** ### Expert Tips and Resources Dealing with health insurance can be a frustrating experience. Lost paperwork. Phone tag with your doctor’s office and the insurance company. The lack of transparency in what insurance will or will not cover. Issues with health insurance can be even more complicated if you have an autoimmune disease and you see multiple specialists or if you are considering a new drug. [Diagnosing autoimmune diseases](https://www.autoimmuneinstitute.org/articles/misdiagnosed-undiagnosed-expert-insights-on-the-autoimmune-diagnosis-process/) can be [expensive and takes a lot of time](https://www.npr.org/sections/health-shots/2023/11/18/1213946352/autoimmune-disease-patients-hit-hurdles-in-diagnosis-costs-and-care). And often, you might have to try different types of medication before finding one that works. In today’s article, we bring you insights on how to best navigate health insurance from two experts in the field: [Ashley Holden](https://www.lupus.org/leadership/ashley-holden-med-ches), Health Education Manager, Access and Advocacy at the Lupus Foundation of America, and [Scott Glovsky](https://scottglovsky.com/insurance-bad-faith/health-claim-denial/autoimmune-disorders/), a health insurance denial attorney based in California. ## What Autoimmune Diseases are Typically Covered by Insurance?  Most plans in the United States cover the [diagnosis and treatment of autoimmune diseases](https://www.autoimmuneinstitute.org/articles/autoimmune-disease-specialist-spotlight/). However, there are differences from plan to plan in what exactly they cover. Doctors and insurance companies use medical billing codes that tell the health insurance companies what service was provided ([CPT codes](https://www.ama-assn.org/practice-management/cpt/cpt-overview-and-code-approval)) and indicate the patient’s diagnosis ([ICD-10 codes](https://www.cms.gov/medicare/coding-billing/icd-10-codes)). “The health insurance company determines what is billable based on the medical coding and then the health insurance plan outlines at what level that service is covered at,” says Holden. ## What Types of Doctors/Specialists are Typically Covered by Insurance? Before seeing any doctor, it’s important to consider whether they’re in-network or out-of-network. “The network is a group of doctors and healthcare providers, including specialties, that the insurance company has built based on a contract where they both agree to the insurer’s negotiated prices,” says Holden. “Providers not in a network are called out-of-network providers. Depending on the health insurance plan, out-of-network services cost more and/or may not be covered by the insurer.” To get coverage for a specialist visit, you may need to see your primary care physician for a referral to an [autoimmune disease specialist](https://www.autoimmuneinstitute.org/articles/autoimmune-disease-specialist-spotlight/) such as a rheumatologist or a gastroenterologist. “Typically Health Maintenance Organization (HMO) plans require referrals. Preferred Provider Organization (PPO) plans generally do not require referral,” says Holden. Other [holistic health practitioners](https://www.autoimmuneinstitute.org/articles/explained-holistic-vs-modern-western-medicine/), such as acupuncturists and aromatherapists, may or may not be covered by insurance. ## What are Common Difficulties Experienced by Those with Autoimmune Disease When Dealing with Insurance? A [KFF poll in 2023](https://www.kff.org/private-insurance/poll-finding/kff-survey-of-consumer-experiences-with-health-insurance/) found that 58% of insured adults had issues with their health insurance in the last year. Only half of these cases were adequately resolved. Below are some common problems people face when using their insurance policy. **High costs, despite insurance coverage:** “Even if someone has health insurance, many still face difficulties affording their care,” says Holden. “This is especially true for someone with an autoimmune disease who may see multiple specialists.” Newer drugs – including biologics – that treat autoimmune diseases come with a high price tag that, even when covered by insurance, can result in a hefty expense for the patient. However, there are ways to cover the costs of health care beyond insurance, which are discussed below. **Network coverage:** Depending on where you live and the type of doctor you need to see, it can be difficult to find a doctor in your area that’s accepting new patients, in your network, and has upcoming availability without having you to wait months. This may be especially true for specialists. **Claim denials:** Issues with payment are a common problem people face when it comes to insurance companies. The KFF poll found that 27% of insured adults paid more than they expected after insurance and 18% found out their insurance did not cover costs that they thought should be covered. Other reasons health insurance companies deny coverage can be found [here](https://www.verywellhealth.com/why-your-health-insurance-wont-pay-for-your-health-care-1738481). ## So your Insurance Company Denies Coverage. What Can You Do? “With a denial, never take no for an answer,” Glovsky says. “You have to be extremely proactive to deal with it.”  Having a friend or family member help deal with insurance denials can be helpful, Glovsky adds. If needed, healthcare advocates or lawyers can help determine the best strategies to appeal the denial. > The first step is to get the denial letter from the insurance company and see why your claim was denied. “The main reason that new medications get denied is because the insurance companies claim they’re experimental or investigational,” says Glovsky. Treatment for autoimmune diseases can include newer biologics on the market. Because biologics are often more complex to administer to patients and are a newer class of drugs, they are generally much more expensive and are often denied by insurance companies. If the denial occurred because the insurance company deems the drug “experimental” or “investigational,” you’d need your doctor to send a letter to the insurer. “It’s crucial to have the treating physicians write good letters as to why they’re not experimental or investigational, to quote the medical literature that show that they’re effective, safe, and FDA approved, and explain what they expect to happen to the patient if they don’t approve it,” says Glovsky. ## If Health Insurance Doesn’t Cover a Specific Medication, What Financial Resources Might Be Available? [Patient assistance programs (PAPs)](https://www.goodrx.com/healthcare-access/patient-advocacy/what-are-patient-assistance-programs) offered by drug manufacturers can provide discounted or free prescriptions for those without health insurance or are underinsured. To be eligible for PAPs, you must meet specific requirements such as showing that your insurance doesn’t cover the drug or meet specific income requirements. Another type of assistance comes in the form of [manufacturer copay cards](https://www.goodrx.com/drugs/savings/what-are-manufacturer-copay-cards), which allow you to save on out-of-pocket costs. These copay cards require the patient to have private insurance rather than government health insurance. **Below, you can find a list of programs and resources that can help cover or lower out-of-pocket costs for medications:** [Co-Pay Relief](https://copays.org/): Financial assistance for eligible patients [Cost Plus Drugs](https://costplusdrugs.com/): Online pharmacy with generics at lower cost [Financial Assistance Resources](https://www.lupus.org/resources/financial-assistance): A curated list of resources by the Lupus Foundation of America [GoodRx](https://www.goodrx.com/): App to help users find lower prices and discounts for prescription drugs [NowPatient](https://nowpatient.com/): Telehealth and online pharmacy providing free access to healthcare tools and drug coupons [Patient Access Network Foundation](https://www.panfoundation.org/): Assistance with out-of-pocket costs [RxAssist](https://www.rxassist.org/): Directory of Patient Assistance Programs ## What Factors Should I Consider When Choosing a Health Insurance Plan? When choosing a new health insurance plan, some things to consider are the premium cost, the deductible, maximum out-of-pocket, and copays. “It’s important to have an insurance plan that covers primary care visits, specialist appointments, diagnostics tests and screenings, medications, and hospital visits – and that the plan has affordable copays or coinsurance for these services,” says Holden. Another thing to consider, especially if you plan to stick with your current doctors, is whether your doctors are in-network in the plan you’re considering. If you would like to switch doctors, make sure that the new doctor is covered by your new policy. Lastly, since autoimmune disease treatments can be expensive, it’s important to check whether the plan will cover the medications you need. “Do your research ahead of time before you buy your insurance to see who’s going to cover the medications that you need,” Glovsky adds. [**Download the free Autoimmune & Chronic Illness Toolkit**](https://www.autoimmuneinstitute.org/autoimmune-chronic-illness-toolkit/) ## Additional Resources - [Patient Advocate Foundation](https://www.patientadvocate.org/): Patient advocacy for those with chronic, life threatening, and debilitating illnesses. - [Health Insurance Guide for People with Lupus](https://www.lupus.org/resources/health-insurance-guide-for-people-with-lupus): PDF guide covering the basics of health insurance, how to choose insurance policies, how to pay for health care, and advocating for yourself. [A National Report Card for Health Insurance Plans that Cover Medications for Autoimmune Diseases](https://www.msms.org/DesktopModules/EasyDNNNews/DocumentDownload.ashx?portalid=0&moduleid=6982&articleid=1310&documentid=13): Report examining medication coverage from different plans for patients with autoimmune diseases. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/10/image-1.png) *GAI does not endorse the views and opinions expressed in the listed resources; they are simply a sample of the resources available on managing life with autoimmune disease and other chronic illnesses.* #### About the Author ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/10/Jennifer-Tsang-Bio-Headshot-e1729699053652.jpg) A microbiologist turned freelance science writer who works with life science companies, nonprofits, and academic institutions on anything from news stories, explainer articles, and content marketing. She shares the wonderful world of microbes on her blog The Microbial Menagerie. Jennifer Tsang, PhD Freelance Writer for GAI ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** Autoimmune Care & Caregiver Support, Diagnosis & Treatment --- ### [Food Sensitivity, Intolerance, or Allergy: What’s the Difference?](https://www.autoimmuneinstitute.org/articles/food-sensitivity-intolerance-or-allergy-whats-the-difference) **Published:** July 3, 2020 **Author:** Carolyn Serraino **Content:** **Does your autoimmune disease come with a side of food reactions that cause symptom flare-ups?** You may be part of the [15-20%](https://pubmed.ncbi.nlm.nih.gov/25471897/) of people who experience food sensitivities and intolerances. The pain and discomfort can be invisible, and are often misdiagnosed or dismissed despite their severity. These buzzwords can also cause a great deal of confusion. People with food sensitivities, intolerances, and even allergies and celiac disease can exhibit similar symptoms; however each condition works in a different way. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Allergy-Intolerance-Sensitivity-graphic.png) ### **A**llergy Although they are often confused with sensitivities and intolerances, allergies are fairly easy to differentiate. **Allergies are specific IgE-mediated immune responses to substances.** An allergic reaction produces IgE antibodies, which attack the offending substance (like pet dander, pollen, bee venom, or peanuts). This triggers a release of histamine, causing immediate, severe, and often life-threatening reactions. The symptoms are usually experienced in the airways or on the skin in the form of anaphylaxis or hives. In the event of exposure to an allergen, treatment must include a swift injection of epinephrine (widely known as an EpiPen) or as a second wave of defense, administration of an antihistamine. About 35% of Americans have reported a food allergy, but it is likely that a portion of these cases are in fact non-immune-mediated food intolerances. While research is limited and most food allergy data relies of self-reported information, actual prevalence may be up to 10%, especially in Western countries. ### Sensitivity V.s. Intolerance & The Microbiome While conducting your own online research, you may notice that intolerances are sometimes called sensitivities and vice versa. The words “intolerance” or “food hypersensitivity” may also be used as an umbrella term for various non-allergic reactions to food, as is evident in some scientific studies. For the purpose of clarity, however, we will refer to the [European Society of Neurogastroenterology and Motility (ESNM)](https://www.esnm.eu/) for information on the subject. ESNM is a nonprofit society uniting medical professionals all over the world. Their [Gut Microbiota for Health](https://www.gutmicrobiotaforhealth.com/) section focuses on sharing knowledge and promoting debate regarding the microbiome. **The** [**infographic**](https://www.gutmicrobiotaforhealth.com/food-sensitivity-vs-food-intolerance/) **below explains the differences between a sensitivity and an intolerance, and their relationship to the [gut microbiota](https://www.autoimmuneinstitute.org/2024/02/21/what-is-the-microbiome-and-why-is-it-important/).** ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/GMFH-FOODSENSITIVITY-20180919-1024x818.png) ### Intolerance [**The ESNM Gut Microbiota for Health**](https://www.gutmicrobiotaforhealth.com/food-sensitivity-vs-food-intolerance/) **defines an intolerance as an abnormal, non-immune mediated, functional response to a food.** This could result from an enzyme deficiency, malabsorption, or other issues. Individuals with food intolerance are unable to properly process certain foods in the digestive tract—think lactose in cow’s milk or histamine in fermented foods. Intolerances trigger symptoms such as abdominal pain, bloating, gas, nausea, and diarrhea. In the case of milk, intolerant individuals do not produce any or enough lactase to fully break down the lactose (milk sugars) and enable absorption by the body. The dosage tends to have an effect on the severity of the reaction, which also varies depending on the individual. Lactose intolerance is common after infancy, and affects roughly 65% of the world’s population. It is extremely prevalent in African Americans, Hispanics, and Asians. People with histamine intolerance may lack the enzyme called diamine oxidase (a.k.a. DAO), that is primarily responsible for breaking down ingested histamine and preventing build-up and absorption by the bloodstream. As histamine intolerance is less studied and often misdiagnosed, the true prevalence is unknown, however it is estimated that it affects roughly 1% of the population. #### **Common food intolerances:** - Lactose (dairy products) - Histamine (fermented foods, alcohol, shellfish, smoked meats, legumes, chocolate, certain fruits and vegetables) - [FODMAPs](https://www.monashfodmap.com/) (Fermentable Oligosaccharides, Disaccharides, Monosaccharides, And Polyls, including fructose, lactose, mannitol, sorbitol, GOS, and fructan) - Caffeine (coffee, chocolate) **Lactose and histamine intolerances are functional and primarily involve the digestive system.** Other adverse food reactions—like sensitivities—may involve the immune system, but in a different way than allergies. ### Sensitivity Food sensitivities are still a debated issue, as this term is not an official medical diagnosis and the scientific world has not yet come to a consensus on its precise meaning. The [ESNM Gut Microbiota for Health section](https://www.gutmicrobiotaforhealth.com/food-sensitivity-vs-food-intolerance/) offers some clarity, reporting that **sensitivities result from an inappropriate activation of the immune system upon exposure to a particular food.** This is an IgG-mediated immune response, as opposed to the IgE-mediated response involved in allergic reactions or an autoimmune response as in celiac disease. Some sensitivities, like wheat or gluten, may be associated with autoimmune markers, however the mechanisms remain largely unknown. Food sensitivities can cause a wide range of painful or uncomfortable reactions that may be felt immediately, or even days later. Potential symptoms include abdominal pain, anxiety, bloating, brain fog, diarrhea, fatigue, headaches, heartburn, joint pain, nausea, and rashes, which closely mirror many autoimmune disease symptoms. **Most food sensitivities are self-reported and many are discovered through elimination diets, as testing is full of controversy.** Most experts agree that IgG testing is inaccurate and not a viable method for identifying trigger foods, as high antibody levels may actually indicate tolerance to a particular food rather than intolerance. **A contributing factor in food sensitivities seems to be increased intestinal permeability, otherwise known as leaky gut.** This condition is often seen in people with autoimmune disease, including celiac. When the intestinal lining becomes too permeable, unwelcome molecules can cross the gut barrier and enter the bloodstream. The immune system sees these molecules—even partially digested food proteins or gut microbes—as foreign bodies and therefore prepares to attack them. **This imbalanced immune response may also involve the gut microbiome.** Researchers suspect that “a disruption in an individual’s gut microbiota may lead to a change in how the immune system recognizes and reacts to certain foods”. Eating trigger foods can result in inflammation and further disruptions in the gut microbiota. Thus, it is no surprise that many people with autoimmune disease—who so often exhibit intestinal impermeability, chronic inflammation, and compromised gut health—may experience food sensitivities. #### **Common food sensitivities:\*** - Gluten (wheat, barely, rye) a.k.a. Non-Celiac Gluten Sensitivity (NCGS) or Non-Celiac Wheat Sensitivity (NCWS) - Casein (dairy products) - Eggs - Corn - Soy - Yeast - Citrus - Nightshades (tomatoes, eggplants, peppers, goji berries) - Legumes (peanuts, lentils, chickpeas, beans) - Nuts (walnuts, cashews, hazelnuts, almonds) - Food additives (sulfites, artificial colors, preservatives) \*NOTE: depending on the individual, adverse reactions to foods on this list may not result from IgG-mediated immune responses, as research on food sensitivities is very limited. In addition, not enough about NCGS/NCWS is known to determine whether it is immune-mediated or not. ### Celiac Disease Unlike allergies, intolerances, and senstivities, celiac disease is a lifelong, genetic autoimmune disorder in which the body mistakenly attacks itself. When a person with celiac disease ingests gluten (a protein found in wheat, barley, and rye) the immune system reacts by mounting an attack against the body’s own healthy cells, damaging the villi lining the small intestine. If this continues overtime, many celiacs experience the effects of malabsorption as the villi are unable to send nutrients into the bloodstream. There are [over 200 symptoms of celiac disease](https://celiac.org/about-celiac-disease/symptoms-of-celiac-disease/). The most widely experienced include fatigue, cognitive problems like brain fog, neurological problems like severe headaches, and digestive issues such as bloating, diarrhea, constipation, gas, abdominal pain, and nausea and vomiting. Many people with celiac disease experience kaleidoscope of symptoms, including anxiety, depression, mouth ulcers, skin rashes, joint pain, numbness and tingling, that result in misdiagnoses and a challenging path to relief. Celiac disease can be life-threatening if left untreated, and include intestinal, neurological, and cognitive damage and the development of additional autoimmune conditions. Currently, around 1.4% of the global population lives with celiac disease. ### Treatments Treatments for food sensitivities and intolerances may involve: - correcting imbalances, deficiencies, and gut health issues - incorporating new lifestyle practices - taking prescribed supplements and probiotics - working with a dietitian to: - pinpoint trigger foods and address inflammation through a healing protocol or elimination diet (like AIP, GAPS, low FODMAP, or SCD) - properly reintroduce foods - adjust eating habits > Remember to always discuss your symptoms and concerns with your practitioners, and avoid self-diagnosing. ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** Living Well with Autoimmune Disease --- ### [Immunotherapy for Those with Autoimmune Disease](https://www.autoimmuneinstitute.org/articles/immunotherapy-for-those-with-autoimmune-disease) **Published:** September 24, 2025 **Author:** Carolyn Serraino **Excerpt:** Immunotherapy is changing autoimmune treatment by using targeted drugs and cellular therapies to reduce flare-ups and damage. **Content:** ### New Frontiers in Autoimmune Treatment Finding effective treatments for autoimmune diseases is often a trial-and-error process, but the field is rapidly evolving. This series examines five areas driving innovation: **immunotherapy**, [stem cell therapy](https://www.autoimmuneinstitute.org/articles/stem-cell-therapy-for-autoimmune-disease/), [precision medicine](https://www.autoimmuneinstitute.org/articles/tailoring-autoimmune-treatment-with-precision-medicine/), [nanotechnology](https://www.autoimmuneinstitute.org/articles/nanotechnology-breakthroughs-in-autoimmune-disease-treatment/), and [personalized medicine](https://www.autoimmuneinstitute.org/articles/personalized-medicine-for-autoimmune-diseases). Together, these advances show how science is reshaping the future of autoimmune treatment. Medicines and treatments for people with autoimmune diseases have vastly advanced over the past decades. However, one of the main challenges is finding therapies that effectively prevent disease progression and [flare-ups](https://www.autoimmuneinstitute.org/articles/outbursts-in-autoimmunity-disease-flare-ups/). Immunotherapy includes a collection of medical approaches that work by exploiting the immune system’s properties and activities to treat and manage various diseases. ## What is Immunotherapy? Immunotherapy strategies work by modifying, stimulating, or slowing down the body’s immune system using antibodies, vaccines, or other substances. Many of these substances are produced from living organisms and are called biological therapies, or, more commonly, *[biologics](https://www.autoimmuneinstitute.org/articles/biologics-for-autoimmune-disease-what-you-should-know "Biologics for Autoimmune Disease: What You Should Know")*. Immunotherapy has transformed the field of cancer, but can also be used to treat other groups of diseases: - Neurological Diseases - Allergies - Infectious Diseases - Organ Transplantation - Autoimmune Diseases ## What Types of Immunotherapy Are Used in Autoimmune Diseases? In diseases such as cancer, immunotherapy treatments typically activate the immune system and its pathways to destroy malignant cells. In autoimmunity, immunotherapy treatments restrain or block immune factors and pathways and stop the immune system from attacking and harming the body. There are various types of immunotherapies, including: ## B-cell-depletion therapies B-cell depletion therapies have been used to successfully treat autoimmune disorders by destroying the B cells involved in disease progression ([1](https://pubmed.ncbi.nlm.nih.gov/33324003/)). Examples include monoclonal antibodies, laboratory-made antibodies that target and deplete the activity of B cells by disabling specific molecules on their surface. Monoclonal antibodies can also inhibit the activity of proteins such as cytokines. For example, tumor necrosis factor (TNF) alpha inhibitors help to curb inflammation, a process that can trigger autoimmunity. ## Immunomodulators As the term suggests, immunomodulators are drugs that modulate the immune system’s intense activities. In other words, these drugs stop the immune system from overreacting and harming the body by turning the levels of specific proteins and molecules up or down. Examples include traditional immunosuppressants, such as methotrexate and corticosteroids ([2](https://pubmed.ncbi.nlm.nih.gov/21044435/),[ 3](https://pubmed.ncbi.nlm.nih.gov/31971601/)). ## CAR T-cell therapy Chimeric antigen receptor[ (CAR) T-cell therapy](https://www.autoimmuneinstitute.org/articles/car-t-cell-therapy-for-autoimmune-disease/) is an emerging, personalized immunotherapy approach that involves genetically modifying a patient’s T-cells in a laboratory so they can kill other cells or block specific activities that induce autoimmune reactions ([4](https://pubmed.ncbi.nlm.nih.gov/37748491/)). ## Tolerization therapy Tolerization involves inducing “tolerance” to specific antigens that help the immune system to recognize its own healthy cells, tissues, and organs as familiar and, thus, prevent it from attacking and damaging them ([5](https://pubmed.ncbi.nlm.nih.gov/29588069/)). ## Which Immunotherapy Approaches Work Best for Autoimmune Diseases? The most suitable immunotherapeutic approaches should be selected after thoroughly assessing each autoimmune disease case and a patient’s overall health. When used in the right situation, immunotherapy can clear even the most severe flare-ups and radically improve patients’ lives. The American College of Rheumatology offers essential information for health professionals on biologics and other drugs for people with rheumatic diseases. For example, the monoclonal antibody, adalimumab (Humira®), blocks the activity of TNF-alpha and treats [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid arthritis"), [psoriatic arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/psoriatic-arthritis/ "Psoriatic arthritis"), and [ankylosing spondylitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ankylosing-spondylitis/ "Ankylosing spondylitis") in adults, and [juvenile idiopathic arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/juvenile-idiopathic-arthritis-stills/ "Juvenile idiopathic arthritis / adult-onset Still’s disease") in children. The monoclonal antibody, certolizumab (Cimzia®), also a TNF alpha blocker, helps to treat [Crohn’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crohns-disease/ "Crohn’s disease") ([6](https://rheumatology.org/medication-guides)). In 2022, the monoclonal humanized antibody teplizumab (Tzield®) was approved by the Food and Drug Administration (FDA) to treat advanced type 1 diabetes in children aged eight and above, as well as adults. Teplizumab is safe and effective and can be infused for 12 days, with no requirement for long-term administration ([7](https://pubmed.ncbi.nlm.nih.gov/33658358/),[8](https://pubmed.ncbi.nlm.nih.gov/37861217/)) David Hafler, MD, a human immunologist and an expert in diseases of the nervous system disorders at Yale School of Medicine, routinely uses immunotherapy in patients with [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/ "Multiple sclerosis") (MS). “In the 1970s, there were no helpful therapies for MS, but now we can successfully treat the disease with immunotherapy. Yet, many people don’t know this,” says Hafler. Hafler discusses that B-cell depletion is a useful option for MS. “B-cell depletion drugs have a 98% success rate in slowing down the disease process,” he says. “And although it’ll take us 20 to 30 years to know whether the treatment can stop the progressive form of the disease, B-cell depletion continues to improve people’s lives, especially when we start treating early,” he adds. Immunotherapy treatments work well for other autoimmune diseases, too. “Interleukin (IL) -17 inhibitors are incredibly effective for [psoriasis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/psoriasis/ "Psoriasis"),” he says. Cameron Coury, MD, a board-certified dermatologist in Richardson, TX, who regularly treats patients with psoriasis, also highlights the benefits of IL-17 inhibitors. “IL-17 inhibitors affect the immune system in a narrow way, re-balancing the arm of the immune system that is overactive, but leaving the remainder relatively untouched,” says Coury. “These medications are especially effective for psoriasis and can work quickly to clear even some of the most severe disease cases,” she adds. CAR T-cell therapy stands out as a promising personalized treatment approach for autoimmune rheumatic diseases, including [lupus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus"), [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid arthritis"),[ Sjögren’s syndrome](https://www.autoimmuneinstitute.org/diseases_list/sjogrens-syndrome/), and [ankylosing spondylitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ankylosing-spondylitis/ "Ankylosing spondylitis"). “Research on CAR T-cell therapy for patients with lupus has been encouraging, but this disease is especially complex, so we’ll have to wait for more results,” adds Hafler. ## What Are the Side Effects of Immunotherapy for Autoimmune Diseases? Because of its ability to suppress the immune system, immunotherapy can cause adverse effects that vary depending on the disease. Patients who are prescribed immunotherapy drugs should be carefully monitored because infection is one of the potential complications ([9](https://www.nature.com/articles/s41551-019-0394-3)). Hafler indicates that the benefits of B-cell depletion therapy for MS outweigh the risk of undesired effects. “In young patients, we see a slight increase in infection rates, including urinary tract infections. However, over years of treatment this is relatively benign,” he says. Coury mentions that IL-17 inhibitors also cause fewer adverse effects because they target the immune system in a focused way. “Many of my patients are very happy on medications that inhibit IL-17. They work quickly to clear inflammation in patients with psoriasis and joint inflammation/arthritis – both skin and joints improve quickly when using IL-17 inhibitors,” Coury says. “And these medications are also very tolerable with minimal side effects in most patients,” she adds. ## How Can People Learn More About Immunotherapy for Autoimmune Diseases? Patients who’d like to consider immunotherapy should talk to their doctor or immune disease specialist about options for their specific autoimmune disease or[ comorbidities](https://www.autoimmuneinstitute.org/articles/comorbidities-in-autoimmune-disease-multiple-autoimmune-syndrome/). Benefits, drawbacks, and adverse effects should be discussed and carefully considered depending on disease type and a person’s clinical history and health. Researchers and health providers are also committed to finding the best ways to use precision medicine and other personalized approaches to identify the most suitable immunotherapy drugs for patients. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/04/GAI-Logo-Image-811x1024.png) ### About the Author ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/07/Chiavolini-Damiana-scaled.jpg) A freelance writer who specializes in medical and life science topics. As a trained researcher, she authored journal articles in the areas of infection and immunity and wrote booklets and book chapters about different diseases. As a professional communicator, she writes feature articles for magazines and other publications and develops content for higher education platforms. Damiana is also an experienced academic editor, microbiology educator, writing coach, and fragrance blogger. She is a contributing member of the American Medical Writers Association and a past-president of the association’s Southwest Chapter. Damiana Chiavolini, MS, PhD Freelance Writer for GAI ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** Diagnosis & Treatment --- ### [Tailoring Autoimmune Treatment with Precision Medicine](https://www.autoimmuneinstitute.org/articles/tailoring-autoimmune-treatment-with-precision-medicine) **Published:** September 25, 2025 **Author:** Carolyn Serraino **Excerpt:** From lupus to IBD, precision medicine uses genetics and biomarkers to personalize autoimmune treatment and advance beyond trial-and-error care. **Content:** ### New Frontiers in Autoimmune Treatment Finding effective treatments for autoimmune diseases is often a trial-and-error process, but the field is rapidly evolving. This series examines five areas driving innovation: **precision medicine**, [immunotherapy](https://www.autoimmuneinstitute.org/articles/immunotherapy-for-those-with-autoimmune-disease/), [stem cell therapy](https://www.autoimmuneinstitute.org/articles/stem-cell-therapy-for-autoimmune-disease/), [nanotechnology](https://www.autoimmuneinstitute.org/articles/nanotechnology-breakthroughs-in-autoimmune-disease-treatment/), and [personalized medicine](https://www.autoimmuneinstitute.org/articles/personalized-medicine-for-autoimmune-diseases). Together, these advances show how science is reshaping the future of autoimmune treatment. Precision medicine is a new medical approach designed to tailor disease treatment to people. Not everyone responds to therapy or prevention in the same manner, so medical care should be adapted to patients’ unique characteristics and needs. The aim is to move away from traditional “one-size-fits-all” approaches and shift toward methods that consider individual responses to treatment. Developing precision medicine may improve patient care in all areas of medicine, but the approach may especially benefit diseases with intricate underlying biologic and genetic features. ## How Can Precision Medicine Improve Autoimmune Treatment? Autoimmune diseases are extremely diverse and may fit both chronic and rare disease categories. Their diagnosis or classification is unpredictable; signs and symptoms can be misleading, and responses to medications may vary from person to person. > “I hope the one-size-fits-all approach will be limited to the first half, if not the first quarter of the 21st century”, says Sarah Ennis, PhD, Professor of Genomics at the University of Southampton in the UK. ##### “By knowing patients’ genetic information, we can match a specific mutation or molecular problem to a drug that targets that problem.” **Benefits of precision medicine for autoimmune diseases include**: - Using people’s genetic or cellular information to design targeted therapies - Using targeted therapies to treat diseases precisely and minimize toxic side effects - Reducing trial-and-error drug prescription - Predicting what treatment will work best for patients with rare diseases - Selecting ideal therapy administration times - Increasing patient adherence to prescribed medication - Improving overall clinical outcomes ## What Factors Influence Precision Medicine in Autoimmunity? [Lupus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus") expert Marta Alarcón Riquelme, MD, PhD, Professor and Scientific Director at the new Pfizer-University of Granada-Junta de Andalucía Centre for Genomics and Oncological Research (GENYO) in Spain, notes that research can be quite a challenge due to the intricate nature of deciphering the relationship between various factors involved in autoimmunity. “Genetic studies have allowed us to move forward because precision medicine technology has advanced so much,” says Alarcón Riquelme. “But studying the role of environmental factors, diet, and infection is difficult and time-consuming. And studying lupus triggers is especially challenging because of its multisystemic and unpredictable nature.” ## What Tools and Technologies Make Precision Medicine Possible? The area of precision medicine relies on “omics” (for example, genomics and proteomics), technologies that are integrated with other tools, including population genetics, to help identify molecular information about people’s genes or cells. Learning this information will enable the design of interventions that precisely and efficiently act against autoimmunity, replacing trial-and-error approaches that may be ineffective and cause adverse effects. Ennis specializes in whole-exome sequencing to identify rare mutations in the genes of patients with inflammatory bowel disease (IBD), which includes [Crohn’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crohns-disease/ "Crohn’s disease") and [ulcerative colitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ulcerative-colitis/ "Ulcerative colitis"). ([1](https://pubmed.ncbi.nlm.nih.gov/32195365/),[2](https://pubmed.ncbi.nlm.nih.gov/37205778/)). > “The diseases we label as [psoriasis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/psoriasis/ "Psoriasis"), arthritis, or IBD are ‘mixed bags’ of complex disease that may be triggered by the interaction between genetics and environmental factors. However, some rare autoimmune conditions are driven by one gene that may be masquerading as a complex disease,” explains Ennis. “Some patients are diagnosed with either ulcerative colitis or Crohn’s disease, but their condition may be caused by an underlying malfunction in a single gene. For example, identifying a rare genetic mutation called XIAP led to a young boy’s complete recovery after receiving a stem cell transplant. If doctors had observed the boy’s signs and symptoms alone, they may have diagnosed him with severe, early-onset Crohn’s disease and prescribed medications that may not have been effective.” ## What Are the Challenges of Applying Precision Medicine to Autoimmune Disease? Dr. Alarcón Riquelme discussed the challenges of using precision medicine in autoimmune disease, especially for lupus ([3](https://pubmed.ncbi.nlm.nih.gov/34003926/)). “Because some autoimmune diseases are especially insidious, identifying them can take a long time,” says Alarcón Riquelme. “And for lupus, we have classification criteria that rely on markers, such as antinuclear antibodies, which are also observed in asymptomatic individuals. Therefore, it is important to predict who among these individuals will eventually develop lupus. One approach is to closely monitor people who tested positive for specific markers and catch early signs of disease, so we can act quickly.” ##### Although genetic testing is one of the promising tools of precision medicine, Alarcón Riquelme believes that its usefulness greatly depends on the disease. “Through genetic testing, we may identify lupus risk variants in research settings, but we cannot always guarantee that the findings can be applied to real-world situations,” says Alarcón Riquelme. “Also, patients may want to learn about their personal risk of developing the disease, but should consider whether they are prepared to live with that knowledge, particularly when treatment options are limited,” she adds. “For lupus, knowing the family history and following patients to anticipate severe outcomes are still essential.” Ennis emphasizes the importance of genomic studies but also highlights the challenges of data analysis. “Our genomic studies generate enormous sets of data with millions of genetic variants. So, we are always trying to find ways to collapse the data and select the most important signals, which isn’t easy,” she says. “We have the various ‘omics’, but we also need to better integrate them with one another and develop methodologies that will help us spot patterns in data.” ## What Ethical Concerns Come With Precision Medicine Research? Ethical considerations in conducting precision medicine research for autoimmune diseases include: - Genetic testing privacy - Data security - Identity protection - Healthy control testing “Genetic data holds sensitive information, including ethnicity and disease susceptibility, so it needs to be handled carefully,” explains Ennis. “We have secure systems in place, but scientists are not especially good at explaining these concepts, so we need to have more conversations.” Ennis mentions that because people with rare diseases are fewer in number, their distinct phenotypes, the set of observable features of an individual, might make them more recognizable. ##### “We need to protect one’s identity when we share results,” Ennis adds, “but patients with rare diseases have long been underserved and need hope and answers. So, we need to find ways to balance innovation and ethics.” Additionally, studies involving healthy individuals are challenging to conduct. “In our IBD studies, we have observed that healthy people with rare disease variants may have other mutations that ‘rescue’ that variant. While this is promising, ethics committees may not easily allow samples to be collected from healthy people because the tests are too invasive,” says Ennis. ## How Can Precision Medicine Shape the Future of Autoimmune Care? Both experts highlight that progress in precision medicine requires the work of multidisciplinary teams to solve complex problems and overcome disparities. “Patients with autoimmune diseases can have multiple complications and, sometimes, overlapping illnesses, so they are often followed by various specialists,” says Alarcón Riquelme. “Communication across specialties is essential to manage both autoimmune diseases and comorbidities. And more collaborations should be established between hospitals and universities across countries.” “We need new methodologies to analyze large sets of genomic data, so we are actively recruiting experts in machine learning who sit at the interface of computer science and healthcare data applications,” adds Ennis. “We also need mathematicians, biologists, clinicians, and ethicists.” Alarcón Riquelme also mentions barriers to access. “We need to work toward addressing health disparities related to race and socio-economic status.” ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/04/GAI-Logo-Image-811x1024.png) ### About the Author ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/07/Chiavolini-Damiana-scaled.jpg) A freelance writer who specializes in medical and life science topics. As a trained researcher, she authored journal articles in the areas of infection and immunity and wrote booklets and book chapters about different diseases. As a professional communicator, she writes feature articles for magazines and other publications and develops content for higher education platforms. Damiana is also an experienced academic editor, microbiology educator, writing coach, and fragrance blogger. She is a contributing member of the American Medical Writers Association and a past-president of the association’s Southwest Chapter. Damiana Chiavolini, MS, PhD Freelance Writer for GAI ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** Diagnosis & Treatment --- ### [Why Autoimmunity Emerges Postpartum and How to Recognize It](https://www.autoimmuneinstitute.org/articles/why-autoimmunity-emerges-postpartum-and-how-to-recognize-it) **Published:** August 15, 2025 **Author:** Carolyn Serraino **Excerpt:** Why autoimmune disease can emerge after childbirth, common postpartum autoimmune symptoms, and treatment considerations while breastfeeding. **Content:** ### Pregnancy and Autoimmune Disease: From Conception to Postpartum Pregnancy can pose unique challenges for people living with autoimmune disease. This series explores how immune changes throughout [conception](https://www.autoimmuneinstitute.org/articles/how-autoimmune-disease-affects-fertility), [pregnancy](https://www.autoimmuneinstitute.org/articles/pregnancy-with-an-autoimmune-disease), and [the postpartum period](https://www.autoimmuneinstitute.org/articles/why-autoimmunity-emerges-postpartum-and-how-to-recognize-it) influence fertility, disease activity, treatment decisions, and maternal and infant health. #### The postpartum period brings dramatic shifts in immune function, hormone levels, and overall health, all of which can influence autoimmune activity. When Gillian was pregnant with her second child, she started experiencing wrist pain towards the end of her pregnancy. Two weeks after giving birth, she had a hard time straightening out her hands, it was difficult to hold her baby to breastfeed, and she couldn’t snap together cloth diapers. She tried Tylenol and ibuprofen but it didn’t help. “The pain was progressing elsewhere,” she said. By week four, she recalled that the pain reached her feet and ankles. “I could no longer walk down the stairs normally,” she said. > ##### “Deep down, I knew something was wrong, but I was really scared to admit it.” ## Why Autoimmune Diseases Flare After Childbirth Gillian’s symptoms ended up being signs of [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid arthritis"). The postpartum period can be a common time when symptoms of autoimmunity – either flares of existing disease or new disease – emerge. ##### Research finds that the risk of developing an autoimmune disease is [highest in the first 3 years postpartum](https://academic.oup.com/ije/article/53/5/dyae115/7742811?login=false) and that pregnancy complications increase this risk (1). During pregnancy, the immune system is relatively suppressed. “This is basically nature’s way of preventing the mother from rejecting the fetus as something foreign,” said [Elizabeth Pearce](https://www.bmc.org/about-us/directory/doctor/elizabeth-n-pearce-md), Professor of Medicine at Boston University Chobanian & Avedisian School of Medicine and an endocrinologist at Boston Medical Center. After the baby is delivered, the immune system gradually returns to its baseline state over the following weeks. “That is a time where we frequently see autoimmune disease \[come back\].” [Kecia Gaither](http://keciagaither.com), Associate Professor of Clinical Obstetrics and Gynecology at Weill Cornell Medicine and Director of Perinatal Services at NYC Health + Hospitals/Lincoln, notes the role of the rapid decrease in estrogen and progesterone as well as shifts in cortisol and prolactin levels. “The interplay between hormones and immune function in the postpartum period is a key reason why the postpartum period is particularly vulnerable for autoimmune complications,” she added. “There are certain autoimmune diseases that are recognized for their increased risk of onset or flare in the postpartum window, especially within the first year after childbirth.” ##### Conditions like [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/ "Multiple sclerosis"), [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus"), [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid arthritis"), and [Crohn’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crohns-disease/ "Crohn’s disease") often have higher risk of flares postpartum. ## Postpartum Thyroiditis [Postpartum thyroiditis](https://www.ncbi.nlm.nih.gov/books/NBK557646/) is an autoimmune disease where the thyroid becomes inflamed within one year of delivery (2). Postpartum thyroiditis can present as either thyroid hormones being too high or too low. “The immune system attacks the thyroid and causes some inflammation of the thyroid glands,” said Pearce. “This causes the hormone that’s stored in the gland to leak out into circulation, so the thyroid hormone levels transiently become too high. After a few weeks, the thyroid gland runs out of that pre-formed hormone and since the gland is not functioning properly, thyroid hormone levels may become too low.” ##### In most patients, thyroid function will normalize after several months. “Postpartum thyroiditis is quite common,” says Pearce. It occurs in [8% of pregnancies](https://pmc.ncbi.nlm.nih.gov/articles/PMC4989649/) (3). However, she explains that many women don’t have symptoms and it usually resolves spontaneously. Those with symptoms of thyroid excess can be treated with a beta-blocker medication. Pearce mentions that those with symptoms of too little thyroid hormone can be treated with thyroid hormone replacement, but oftentimes, it’s a short-term treatment as most women recover normal thyroid function in a few months. ## Postpartum Autoimmune Symptoms to Watch For In the throes of sleepless nights, hormonal changes, and adjusting to life with a new baby, it can be difficult to know whether symptoms experienced during postpartum are abnormal. This is exactly what Gillian found. When she first started having wrist symptoms, she first thought it was carpal tunnel. She explained, “a lot of the odd symptoms I was experiencing… I chalked it up to pregnancy.” But things got worse and she suspected something was wrong. “There are a lot of symptoms that are normal to the postpartum period,” said Pearce. “Weight loss, sleeplessness, and heightened anxiety are all pretty common and may be a normal part of the postpartum experience.” However, she noted that joint pain, weight gain, constipation, severe palpitations, and tremors would be red flags for something abnormal. Gaither also notes other symptoms to watch out for including: - Joint stiffness, swelling, and weakness - Skin rashes, lesions - Bloody stool or diarrhea - Fevers - Unusual fatigue - Mood changes - Decline in milk production ##### Another important point is that these symptoms can overlap with other non-autoimmune disorders. But it’s not super straightforward. For example, fatigue can be a sign of normal postpartum life, postpartum depression, or an autoimmune disease. “It’s important for women to be alert to changes in their body, and if things really don’t seem like they are right, to reach out to a care provider and, and to seek testing and evaluation,” Pearce said. When Gillian went to the doctor, they ordered blood tests. “All the blood work that they ran was negative,” she said. “The only thing that was abnormal was my rheumatoid factor.” [Rheumatoid factors](https://my.clevelandclinic.org/health/diagnostics/rheumatoid-factor) are antibodies that target a person’s own body and are used to help diagnose autoimmune diseases, such as rheumatoid arthritis (4). With Gillian’s new rheumatoid arthritis diagnosis, the next step was to decide on the treatment option. ## Breastfeeding Safely with Autoimmune Disease Gillian’s first treatment was a course of steroids to help calm her symptoms first. “Within 12 hours, I started feeling symptom relief,” she said. She also found ways to make breastfeeding more manageable in the meantime while adjusting to her new medication. She ended up using a wrist brace during feedings and changed breastfeeding positions to keep weight off of her wrist and hands. Since steroids are intended for short-term use, Gillian needed to find a more long-term option. For rheumatoid arthritis, this option was commonly [methotrexate](https://www.ncbi.nlm.nih.gov/books/NBK582834/), but this medication is toxic and can make its way into breast milk (5). While this level is [low in breastmilk](https://www.liebertpub.com/doi/10.1089/bfm.2018.0078), the drug label recommends not using methotrexate while breastfeeding (6). Methotrexate isn’t the only autoimmune therapy that should be avoided during breastfeeding. Others include cyclophosphamide and mycophenolate mofetil. “It’s best to discuss medication safety with providers as not all therapies are compatible,” says Gaither. For Gillian, she and her doctor eventually settled on the [biologic](https://www.autoimmuneinstitute.org/articles/biologics-for-autoimmune-disease-what-you-should-know/) Enbrel for longer-term treatment. While she started noticing improvements within a week, “I remember thinking it took quite a while before I was a little bit more like myself,” she recalled. Since her diagnosis, Gillian has been on Enbrel for almost four years and gave birth to her third child. Her experience this time went much smoother under the care of a high-risk OBGYN and having her symptoms under control with a plan in place in case her symptoms flared. **Her advice to new mothers navigating the postpartum period with an autoimmune condition:** ##### “Give yourself grace, and lean into the help. It’s okay to have bad days, and it’s okay to let other people see your vulnerability.”  ### Additional Resources - [LactMed](https://www.ncbi.nlm.nih.gov/books/NBK501922/): Database of medications and their effects on breastmilk and possible adverse effects to the infant - [Postpartum Support International](https://postpartum.net/): Support and resources for those with postpartum depression - [Find a Lactation Consultant Directory](https://portal.ilca.org/i4a/memberDirectory/index.cfm?directory_id=19&pageID=4356): Directory of lactation consultants from the International Lactation Consultant Association - [American Thyroid Association](https://www.thyroid.org/): Up-to-date information and resources for thyroid patients and medical professionals - [Autoimmune Disease and Chronic Illness-Related Support Groups](https://www.autoimmuneinstitute.org/autoimmune-disease-chronic-illness-related-support-groups/): List of support groups by organization curated by the Global Autoimmune Institute ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/10/image-1.png) *GAI does not endorse every view and opinion expressed in the listed resources; they are simply a sample of the resources available on managing life with autoimmune disease and other chronic illnesses.* ### Related Reading: Autoimmunity & Pregnancy - [Pregnancy with an Autoimmune Disease](https://www.autoimmuneinstitute.org/articles/pregnancy-with-an-autoimmune-disease/) - [How Autoimmune Disease Affects Fertility](https://www.autoimmuneinstitute.org/articles/how-autoimmune-disease-affects-fertility/) - [Veterans With Lupus and RA Have Higher Pregnancy Risks](https://www.autoimmuneinstitute.org/research_updates/veterans-with-lupus-and-ra-have-higher-pregnancy-risks/) - [Is it Safe to Take a Biologic During Pregnancy?](https://www.autoimmuneinstitute.org/research_updates/is-it-safe-to-take-a-biologic-during-pregnancy/) - [Updated Guidance: Autoimmune Drug Safety in Pregnancy and Breastfeeding](https://www.autoimmuneinstitute.org/research_updates/updated-guidance-autoimmune-drug-safety-in-pregnancy-and-breastfeeding/) ### About The Author ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/10/Jennifer-Tsang-Bio-Headshot-e1753113113430.jpg) A microbiologist turned freelance science writer who works with life science companies, nonprofits, and academic institutions on anything from news stories, explainer articles, and content marketing. She shares the wonderful world of microbes on her blog The Microbial Menagerie. Jennifer Tsang, PhD Freelance Writer for GAI ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** About Autoimmune Disease, Living Well with Autoimmune Disease --- ### [How Autoimmune Disease Affects Fertility](https://www.autoimmuneinstitute.org/articles/how-autoimmune-disease-affects-fertility) **Published:** August 15, 2025 **Author:** Carolyn Serraino **Excerpt:** Infertility is more common in autoimmune disease. Discover how inflammation, hormones, and medications affect fertility and what treatments may help. **Content:** ### Pregnancy and Autoimmune Disease: From Conception to Postpartum Pregnancy can pose unique challenges for people living with autoimmune disease. This series explores how immune changes throughout [conception](https://www.autoimmuneinstitute.org/articles/how-autoimmune-disease-affects-fertility), [pregnancy](https://www.autoimmuneinstitute.org/articles/pregnancy-with-an-autoimmune-disease), and [the postpartum period](https://www.autoimmuneinstitute.org/articles/why-autoimmunity-emerges-postpartum-and-how-to-recognize-it) influence fertility, disease activity, treatment decisions, and maternal and infant health. Autoimmune diseases occur when the immune system mistakenly attacks the body’s own healthy cells and tissues, leading to chronic inflammation and organ damage. This immune overactivity can affect fertility in several ways. Chronic inflammation may lower sperm and egg counts, trigger early menopause, or create an inhospitable environment for pregnancy. Autoimmunity can also interfere with the hormones needed for reproduction, cause blood clots in the placenta, or increase the risk of miscarriage and stillbirth. ##### “If a patient has an autoimmune disease and has been trying for longer than six months, both partners need to be evaluated,” said Dr. Cuoghi Edens, a rheumatologist and assistant professor of internal medicine and pediatrics at the University of Chicago Medicine. ## What Is Infertility? Infertility is defined as the inability to conceive after one year of regular, unprotected sex if under age 35. It affects up to 15% of couples worldwide, with male and female factors contributing about equally. According to Dr. Edens, infertility is often multifactorial: > “There are specific issues that affect males and females separately in regard to their ability to procreate, such as problems with the sperm or egg, anatomy of their reproductive organs, or hormonal issues,” she said. “For example, a male may have a low sperm count, but his partner could have blocked fallopian tubes or endometriosis.” This is in addition to any other diagnoses they may have or medications that could affect their fertility. Infertility can manifest in many ways, including difficulty with conception, implantation, and pregnancy maintenance, as well as recurrent miscarriages and stillbirths. Social and cultural factors also play a role, including access to healthcare, stigma, and societal pressure around childbearing. ## Autoimmune Diseases Linked to Infertility Autoimmune diseases can cause infertility in both males and females. As a rheumatologist, Dr. Edens sees firsthand that women with [systemic lupus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus"), [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid arthritis"), [juvenile arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/juvenile-idiopathic-arthritis-stills/ "Juvenile idiopathic arthritis / adult-onset Still’s disease"), [psoriatic arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/psoriatic-arthritis/ "Psoriatic arthritis"), [Sjögren disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sjogren-syndrome/ "Sjögren disease (SjD)"), [mixed connective tissue disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/mixed-connective-tissue-disease/ "Mixed connective tissue disease"), and other rheumatic diseases can have a hard time becoming pregnant or staying pregnant. Males with these diagnoses can also struggle to father a child, although less often. #### Systemic Lupus Erythematosus (SLE) SLE affects the immune system and can cause infertility in women by prematurely decreasing the number of eggs.  Treatment for SLE can cause damage to the ovaries that leads to ovarian failure. Some women also have clotting issues with SLE, which increases the risk of miscarriages and stillbirths.  In men, SLE can cause erectile dysfunction or inflammation that damages the testicles and reduces sperm count. #### Rheumatoid Arthritis (RA) Women with RA have been found to have a higher risk of infertility compared to the general population, which may be due to hormonal imbalances, ovulatory dysfunction, or the fact that women with RA may delay becoming pregnant due to their diagnosis or its medications.  The main medication used to treat RA, Methotrexate, is not safe for pregnancy. In men, RA can cause inflammation that damages the testicles and reduces sperm count. #### Antiphospholipid Syndrome (APS) [APS](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/antiphospholipid-syndrome/ "Antiphospholipid syndrome") is an autoimmune disease associated with recurrent miscarriages, stillbirths, and other pregnancy complications, which can ultimately lead to infertility. This is caused due to its impact on blood clotting. Specifically, the abnormal blood clots can affect the blood flow to the uterus, disrupting the normal development of the embryo or impairing the implantation of the fertilized egg. Adequate blood flow is crucial for a healthy pregnancy, as it ensures that the developing fetus receives the necessary nutrients and oxygen. #### Autoimmune Thyroid Disease (AITD) / Hashimoto’s Thyroiditis [AITD](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/hashimotos-thyroiditis/ "Hashimoto’s thyroiditis / autoimmune thyroiditis") is a common condition that can affect fertility in women by disrupting their hormonal balance. Insufficient levels of thyroid hormones, as seen in Hashimoto’s disease, can disrupt the menstrual cycle and ovulation. #### Inflammatory Bowel Disease (IBD) [Crohn’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crohns-disease/ "Crohn’s disease") and [ulcerative colitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ulcerative-colitis/ "Ulcerative colitis") can potentially impact fertility in several ways. Malnutrition due to the body’s poor absorption of nutrients from food may affect the body’s ability to support a healthy pregnancy. The corticosteroids and immunosuppressants used to manage the disease can have side effects that may interfere with fertility by affecting hormonal balance or have direct effects on reproductive organs. Other factors, such as chronic inflammation in the abdominal area, and surgical interventions, may also affect the function of the reproductive organs. #### Celiac Disease [Celiac disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/celiac-disease/ "Celiac disease") damages the lining of the small intestine, reducing the absorption of nutrients from food, including essential vitamins and minerals. Proper nutrition is crucial for reproductive health, and deficiencies caused by malabsorption can affect fertility. Hormonal imbalances also may interfere with the menstrual cycle, ovulation, and overall reproductive function. Chronic inflammation in the small intestine, a characteristic of celiac disease, can extend to other parts of the body, potentially affecting the reproductive system. #### Type 1 Diabetes [Type 1 diabetes](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/type-1-diabetes-insulin-dependent-diabetes/ "Type 1 diabetes / insulin-dependent diabetes") affects insulin levels and can lead to hormonal imbalances, disrupting the normal menstrual cycle and ovulation in women, and affecting sperm production in men. Diabetes can also damage blood vessels and reduce blood flow throughout the body, including those in the reproductive organs, which can impact their function and fertility. Diabetes can cause damage to nerves, potentially leading to difficulties in achieving or maintaining an erection in men and affecting sexual function in women. High blood sugar levels may also affect the quality of eggs, potentially making it more challenging to conceive. Women with diabetes may face a higher risk of complications during pregnancy, such as gestational diabetes and preeclampsia. ## How Does Autoimmune Disease Interfere with Fertility? ##### “Our body is smart, so if it is inflamed or stressed, it knows that it is not a good time for pregnancy,” says Dr. Edens. The ways autoimmunity contributes to infertility are not fully understood, but several broad mechanisms across different autoimmune conditions are known: - **Chronic inflammation** lowers egg and sperm reserves - **Immune stress signals** that suppress fertility during disease flares - **Premature ovarian insufficiency (POI) and early menopause** in women, possibly from long-term inflammation - **Hormonal disruption** that interferes with ovulation or sperm production ## How Do Medications for Autoimmune Disease Affect Fertility? In addition to the immune system itself, some autoimmune disease treatments can affect fertility. - **Cyclophosphamide** – a chemotherapy agent used for severe rheumatic diseases; can cause permanent ovarian damage. - **Methotrexate** – commonly prescribed for rheumatoid arthritis; unsafe in pregnancy and requires discontinuation before conception. - **NSAIDs** – may temporarily impair ovulation or sperm production; effects are usually reversible after stopping. - **Sulfasalazine** – can lower sperm counts; recovery may take up to three months after discontinuation. - **Steroids (e.g., prednisone)** – may disrupt hormone signals that regulate ovulation and sperm formation. Because of these effects, patients planning for pregnancy are often advised to review their medications carefully with their rheumatologist and reproductive specialist. ## What Fertility Treatments Are Available for Those with Autoimmune Disease? Yes, assisted reproductive technologies (ART) and other treatments can help, including: - **Intrauterine Insemination (IUI):** Sperm placed directly into the uterus using a tube called a catheter. - **In Vitro Fertilization (IVF):** Egg fertilized outside the body, embryo implanted into the uterus. - **Intracytoplasmic Sperm Injection (ICSI):** A single sperm injected directly into an egg during IVF. Often used when there are male factor infertility issues, such as low sperm count, poor sperm motility, or abnormal sperm shape. - **Third-Party ART:** Use of donor sperm, eggs, embryos, or gestational surrogacy. Often used when one or both partners have fertility issues that prevent natural conception, or when there is a high risk of passing on a genetic disorder to a child. Persons with autoimmune diseases may also consider surrogacy if they have health conditions or take medications that are not compatible with pregnancy. Other medical interventions for infertility include medication to stimulate ovulation, surgery to correct structural issues, and hormone therapy to balance hormone levels. According to Dr. Edens, many patients who are infertile can benefit from an evaluation of why they are infertile and fertility treatments, and recommends this be done sooner than later, especially if over 35. However, it’s important to remember that the success rate for things like IVF and IUIs is still low and decreases as women age due to egg quality. ### Related Reading: Autoimmunity & Pregnancy - [Pregnancy with an Autoimmune Disease](https://www.autoimmuneinstitute.org/articles/pregnancy-with-an-autoimmune-disease/) - [Why Autoimmunity Emerges Postpartum and How to Recognize It](https://www.autoimmuneinstitute.org/articles/why-autoimmunity-emerges-postpartum-and-how-to-recognize-it/) - [Veterans With Lupus and RA Have Higher Pregnancy Risks](https://www.autoimmuneinstitute.org/research_updates/veterans-with-lupus-and-ra-have-higher-pregnancy-risks/) - [Is it Safe to Take a Biologic During Pregnancy?](https://www.autoimmuneinstitute.org/research_updates/is-it-safe-to-take-a-biologic-during-pregnancy/) - [Updated Guidance: Autoimmune Drug Safety in Pregnancy and Breastfeeding](https://www.autoimmuneinstitute.org/research_updates/updated-guidance-autoimmune-drug-safety-in-pregnancy-and-breastfeeding/) ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** About Autoimmune Disease, Living Well with Autoimmune Disease --- ### [Pregnancy with an Autoimmune Disease](https://www.autoimmuneinstitute.org/articles/pregnancy-with-an-autoimmune-disease) **Published:** August 15, 2025 **Author:** Carolyn Serraino **Excerpt:** How autoimmune disease affects pregnancy, from flare risks to medication safety, fertility, and long-term health, plus expert guidance on managing care. **Content:** ### Pregnancy and Autoimmune Disease: From Conception to Postpartum Pregnancy can pose unique challenges for people living with autoimmune disease. This series explores how immune changes throughout [conception](https://www.autoimmuneinstitute.org/articles/how-autoimmune-disease-affects-fertility), [pregnancy](https://www.autoimmuneinstitute.org/articles/pregnancy-with-an-autoimmune-disease), and [the postpartum period](https://www.autoimmuneinstitute.org/articles/why-autoimmunity-emerges-postpartum-and-how-to-recognize-it) influence fertility, disease activity, treatment decisions, and maternal and infant health. #### The relationship between pregnancy and autoimmune disease is complex, inconsistent, and influenced by many factors. Certain autoimmune diseases may worsen during pregnancy, resulting in complications in both the mother and the fetus and even causing problems during and after childbirth. Other autoimmune diseases may improve during pregnancy and pose no harm ([1](https://pubmed.ncbi.nlm.nih.gov/27651750/),[2](https://pubmed.ncbi.nlm.nih.gov/34874264/)). Also, because many autoimmune diseases begin to manifest in women of childbearing age, identifying pregnancy as a major trigger in initial disease development may be difficult ([2](https://pubmed.ncbi.nlm.nih.gov/34874264/)). ## Can Pregnancy Trigger Autoimmune Disease Flare-Ups? Yes. Pregnancy can sometimes trigger flare-ups of autoimmune diseases, though the risk and severity depend on the condition and the individual. The development of signs, symptoms, and flare-ups of autoimmune diseases during pregnancy is unpredictable. It varies from person to person and depends on the specific type of disease. Some flare-ups can be severe, such as nephritis, which is more frequently observed in women with systemic lupus erythematosus and a history of kidney disease ([3](https://pubmed.ncbi.nlm.nih.gov/35210867/)). The reasons behind the diverse effects of pregnancy on autoimmunity and autoimmune disease remain uncertain but could be connected to the intricate immunologic changes that take place in the body during pregnancy. These changes may affect both mother and fetus ([2](https://pubmed.ncbi.nlm.nih.gov/34874264/)). ## Are Biologics and Other Autoimmune Medications Safe During Pregnancy? Some biologics and autoimmune medications can be safe in pregnancy, while others pose risks to the fetus and should be discontinued under medical guidance. Discontinuing medications that may be harmful to the developing fetus may trigger flare-ups of autoimmune diseases such as [lupus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus"), [ulcerative colitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ulcerative-colitis/ "Ulcerative colitis"), and [psoriasis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/psoriasis/ "Psoriasis") ([4](https://pubmed.ncbi.nlm.nih.gov/35249153/),[5](https://www.hmpgloballearningnetwork.com/site/autoimmune/conference-coverage/managing-imids-during-and-after-pregnancy)). Therefore, health providers should carefully assess the use or interruption of any treatment during pregnancy. In the realm of autoimmune diseases, biologics are therapeutic interventions that modify parts of the immune system and improve the well-being of patients. [Biologics](https://www.autoimmuneinstitute.org/articles/biologics-for-autoimmune-disease-what-you-should-know "Biologics for Autoimmune Disease: What You Should Know") include a range of treatments, including immunomodulatory drugs, proteins, and monoclonal antibodies. In a 2022 study, researchers assessed the effects of biologics on pregnant women with immune-mediated inflammatory disease ([4](https://pubmed.ncbi.nlm.nih.gov/35249153/)). The study aimed to compare disease outcomes between pregnant women who continued to receive biologics and those who stopped taking them. Women who continued to use biologics were at higher risk of severe infection and in greater need of glucocorticoid medication than women who discontinued biologic treatment. Flare-ups were still consistently observed in some of the women who discontinued biologic treatment ([4](https://pubmed.ncbi.nlm.nih.gov/35249153/)). Certain biologics, such as methotrexate and thalidomide, should be discontinued during pregnancy because of the risk they pose to a growing fetus. Others, such as certain corticosteroids, ozanimod, and upadacitinib, may also be interrupted because of limited experience with their use. However, anti-inflammatory agents and aspirin may be safely used during both pregnancy and breastfeeding. The choice of biologics, such as mesalamine, can also vary depending on what other agents they are combined with ([5](https://www.hmpgloballearningnetwork.com/site/autoimmune/conference-coverage/managing-imids-during-and-after-pregnancy)). ## How Do Autoimmune Diseases Affect Fertility and Pregnancy? Autoimmune diseases may affect fertility in multiple ways. [Lupus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus"), [thyroiditis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/hashimotos-thyroiditis/ "Hashimoto’s thyroiditis / autoimmune thyroiditis"), and [celiac disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/celiac-disease/ "Celiac disease") may cause infertility, the complete inability to become pregnant. Others, such as [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid arthritis"), probably contribute more to subfertility, defined as a difficulty or delay in becoming pregnant ([6](https://pubmed.ncbi.nlm.nih.gov/31837981/)). Other autoimmune diseases may not interfere with fertility as much. Uma Mahadevan, MD, an expert in pregnancy and irritable bowel syndrome (IBD) at the University of California, San Francisco, recently highlighted the misconception that patients with IBD may have to deal with fertility problems. She added that infertility rates observed in patients with IBD are similar to infertility rates in other women ([5](https://www.hmpgloballearningnetwork.com/site/autoimmune/conference-coverage/managing-imids-during-and-after-pregnancy)). In addition to potential fertility problems, pregnant women with autoimmune diseases may also be at higher risk of complications, such as recurrent pregnancy loss ([7](https://pubmed.ncbi.nlm.nih.gov/33672505/)). Because of the complex and unpredictable nature of these mechanisms, pregnant patients who have an autoimmune disease should receive guidance from collaborating specialists in clinics and institutions that offer personalized care. This support will help them make informed decisions, ensuring the well-being of both mothers and newborns. ([2](https://pubmed.ncbi.nlm.nih.gov/34874264/),[5](https://www.hmpgloballearningnetwork.com/site/autoimmune/conference-coverage/managing-imids-during-and-after-pregnancy)). ## Are There Long-Term Health Effects of Having an Autoimmune Disease During Pregnancy? Having an autoimmune disease during pregnancy may also be linked to several long-term effects and complications. Blood clots, preeclampsia, placental problems, restricted fetal growth, premature birth, and even disease later in a child’s life, including cardiovascular, metabolic, and even mental disorders, have been reported for diseases such as lupus, antiphospholipid syndrome, type 1 diabetes, and rheumatoid arthritis ([2](https://pubmed.ncbi.nlm.nih.gov/34874264/),[8](https://www.merckmanuals.com/home/women-s-health-issues/pregnancy-complicated-by-disease/autoimmune-disorders-during-pregnancy),[9](https://pubmed.ncbi.nlm.nih.gov/35426923/)). A 2024 study revealed a potential two-way association between autoimmune diseases, such as multiple sclerosis, and depression in women during the perinatal period. The depression was not attributed to pre-existing mental conditions, leading researchers to propose that shared biologic mechanisms may be involved in autoimmune diseases’ association with perinatal depression ([10](https://pubmed.ncbi.nlm.nih.gov/38191927/)). ## How Should Autoimmune Disease Be Managed During Pregnancy? Pregnant women with autoimmune diseases require close monitoring and care provided by collaborating specialists. Healthcare providers should consistently offer comprehensive care and support throughout pregnancy, with every woman having access to personalized care that extends beyond childbirth to ensure the health of both mother and child. Effective strategies for managing autoimmune diseases include maintaining safe and stable medication courses, fostering open communication among various specialists, offering counseling services during pregnancy and breastfeeding, and monitoring for possible mental disorders from childhood to adulthood ([2](https://pubmed.ncbi.nlm.nih.gov/34874264/),[9](https://pubmed.ncbi.nlm.nih.gov/35426923/),[11](https://pubmed.ncbi.nlm.nih.gov/31542218/)). If you are pregnant or plan to start a family, talk to your doctor about any worries you may have and discuss the best ways to manage your autoimmune condition. **Read On:** [ Why Autoimmunity Emerges Postpartum and How to Recognize It ](https://www.autoimmuneinstitute.org/articles/why-autoimmunity-emerges-postpartum-and-how-to-recognize-it/) Autoimmune diseases may flare or first appear after childbirth. Learn the early warning signs and treatment considerations while breastfeeding. [ How Autoimmune Disease Affects Fertility ](https://www.autoimmuneinstitute.org/articles/how-autoimmune-disease-affects-fertility/) Autoimmune conditions can interfere with fertility through inflammation, hormonal disruption, and certain treatments. Learn the causes, risks, and treatment options. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/GAI-Logo-Image-e1707845715517.png) ### Related Reading: Autoimmunity & Pregnancy - [Veterans With Lupus and RA Have Higher Pregnancy Risks](https://www.autoimmuneinstitute.org/research_updates/veterans-with-lupus-and-ra-have-higher-pregnancy-risks/) - [Is it Safe to Take a Biologic During Pregnancy?](https://www.autoimmuneinstitute.org/research_updates/is-it-safe-to-take-a-biologic-during-pregnancy/) - [Updated Guidance: Autoimmune Drug Safety in Pregnancy and Breastfeeding](https://www.autoimmuneinstitute.org/research_updates/updated-guidance-autoimmune-drug-safety-in-pregnancy-and-breastfeeding/) ### About The Author ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/07/Chiavolini-Damiana-scaled.jpg) A freelance writer who specializes in medical and life science topics. As a trained researcher, she authored journal articles in the areas of infection and immunity and wrote booklets and book chapters about different diseases. As a professional communicator, she writes feature articles for magazines and other publications and develops content for higher education platforms. Damiana is also an experienced academic editor, microbiology educator, writing coach, and fragrance blogger. She is a contributing member of the American Medical Writers Association and a past-president of the association’s Southwest Chapter. Damiana Chiavolini, MS, PhD Freelance Writer for GAI ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** About Autoimmune Disease, Living Well with Autoimmune Disease --- ### [Aging and Autoimmune Disease](https://www.autoimmuneinstitute.org/articles/aging-and-autoimmune-disease) **Published:** December 19, 2025 **Author:** Carolyn Serraino **Excerpt:** What happens to the immune system during aging that could lead to an increase in autoimmune disease risk? To take a deeper look, we spoke with two experts on aging and autoimmunity: Paul Robbins, co-director of the Masonic Institute on the Biology of Aging and Metabolism at the University of Minnesota, and Niharika Duggal, assistant professor at the Institute of Inflammation and Ageing at the University of Birmingham. **Content:** ### How Autoimmunity Changes Over Time Autoimmune disease doesn’t follow a single path; it evolves. This series explores how immune activity shifts across the lifespan, from the earliest signs of [emerging autoimmunity](https://www.autoimmuneinstitute.org/articles/the-stages-of-autoimmunity/), to the rise of [late-onset disease in older adults](https://www.autoimmuneinstitute.org/articles/understanding-late-onset-autoimmunity/), to the ways [aging reshapes and weakens immune balance](https://www.autoimmuneinstitute.org/articles/aging-and-autoimmune-disease/). **What happens to the immune system during aging that could lead to an increase in autoimmune disease risk?** To take a deeper look, we spoke with two experts on aging and autoimmunity: **Paul Robbins**, co-director of the Masonic Institute on the Biology of Aging and Metabolism at the University of Minnesota, and **Niharika Duggal**, assistant professor at the Institute of Inflammation and Ageing at the University of Birmingham. #### In 1969, the pathologist Roy Walford introduced the autoimmune theory of aging. In this [theory](https://link.springer.com/referenceworkentry/10.1007/978-0-387-33754-8_46), he proposed that with age, the immune system becomes dysfunctional, autoimmune diseases increase, and our bodies don’t respond to infections as well (1). It is not surprising that for many autoimmune diseases, age is considered a risk factor. A study published in 2023 looked at the [incidence of 19 autoimmune diseases](https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00457-9/fulltext) from 22 million people in the United Kingdom (2). They found that for several autoimmune diseases, including [Graves’ disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/graves-disease/), [Hashimoto’s thyroiditis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/hashimotos-thyroiditis/), pernicious anaemia, and [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/), incidence increased with age. Trends for other diseases weren’t as clear, with some diseases, like inflammatory bowel disease, having multiple peaks in incidence rates across ages. ## What Does Aging Do To the Immune System? #### Cellular Senescence Aging also affects other cell types through a process known as cellular senescence, in which cells stop dividing but don’t die off.  “**Our lab believes that DNA damage, or genomic instability with age, is one of the key drivers of senescence**,” says [Robbins](https://robbins.umn.edu/dr-paul-robbins-phd). Once cells become senescent, they undergo several changes, including the secretion of a mixture of pro-inflammatory molecules that leads to an [inflammatory response](https://www.jci.org/articles/view/95148) (3). This inflammation prompts the innate immune system to clear these cells. When we’re young, the immune system clears these senescent cells more easily. As we age, our immune system can’t clear them as well. This leads to a state of chronic, low-grade inflammation. #### Immunosenescence: Immune System Remodeling and Dysfunction Immunosenescence refers to the age-related remodeling of the immune system. It begins with [subtle changes in our 20s and accelerates around age 50](https://www.gsk.com/en-gb/behind-the-science-magazine/age-related-decline-immunity-infectious-disease/). Despite similarities in their names, immunosenescence is quite different from cellular senescence. “Overall, what we’re seeing is a decline in the ability of the immune system to fight off pathogens,” says [Duggal](https://www.birmingham.ac.uk/staff/profiles/inflammation-ageing/duggal-niharika). “On the other hand, we’re also seeing that the immune system is in this persistent activated state due to chronic exposure to pathogens across life course. This persistent activation could be inducing a state of cellular senescence and making these cells more proinflammatory in nature.” During immunosenescence, not all cells are affected the same way. “Depending on which cells we look at, things look different,” says Duggal. For example, neutrophils, which have roles in autoimmunity and in clearing bacterial infections, don’t decline in terms of numbers but decline in terms of function. For T cells, there’s a remodeling in the different subsets of T cells. “We see an expansion of circulating pro-inflammatory senescent T cells, for example,” Duggal adds. In addition, as we age, the thymus also shrinks and produces fewer naive T cells. All in all, these changes in the immune system as we age lead to immune dysfunction. #### Inflammaging: Chronic Low Levels of Inflammation Inflammaging is the chronic, low levels of systemic inflammation that’s associated with aging. This inflammation is partly caused by an [increase in the innate immune response](https://www.cell.com/cell-reports/fulltext/S2211-1247(22)00806-3?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS2211124722008063%3Fshowall%3Dtrue) leading to the secretion of pro-inflammatory substances (4) and senescent cells themselves secrete pro-inflammatory molecules. This chronic inflammation, while at a low level, damages healthy tissues over time, leading to an increased risk of diseases including [heart disease](https://pmc.ncbi.nlm.nih.gov/articles/PMC8946971/), [Alzheimer’s disease](https://pmc.ncbi.nlm.nih.gov/articles/PMC9496782/) and [Parkinson’s disease](https://pubmed.ncbi.nlm.nih.gov/29080843/) (5, 6, 7). ## Connections Between Autoimmunity and Neurodegenerative Diseases We normally think of diseases such as Alzheimer’s disease and Parkinson’s disease as [neurodegenerative diseases](https://www.autoimmuneinstitute.org/articles/autoimmune-aspects-of-neurodegenerative-diseases "Autoimmune Aspects of Neurodegenerative Diseases"), but these diseases may actually have characteristics of autoimmune diseases. Much of the research in this area is relatively recent. In 2014, David Sulzer’s group from Columbia University published their finding that neuronal death seen in Parkinson’s occurs because our immune system [mistakenly targets neurons as non-self](https://www.nature.com/articles/ncomms4633) (8). Other work finds that a type of T cells called Th17 lymphocytes [attack dopamine cells](https://www.cell.com/cell-stem-cell/fulltext/S1934-5909(18)30297-2?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS1934590918302972%3Fshowall%3Dtrue) in Parkinson’s patients but not in people without Parkinson’s (9). There’s also some evidence of autoimmune aspects of Alzheimer’s disease. The idea comes from the fact that in response to a pathogen, amyloid beta is released and launches a cascade of immune responses. But because of [electrophysiological similarities](https://pubmed.ncbi.nlm.nih.gov/36165334/) between bacteria and neurons, they can mistakenly attack neurons (10). [Other studies](https://www.alzheimers.org.uk/Care-and-cure-magazine/dementia-and-autoimmune-disease) find that those admitted to a hospital for autoimmune diseases are more likely to be admitted to a hospital later in life. As of now, neither of these diseases are primarily known as autoimmune diseases, but the connections between these diseases and autoimmunity are becoming more apparent. ## How Can I Keep My Immune System Healthy Through Aging? #### Lifestyle Changes We’ve probably all heard about the health benefits that reducing stress, eating well, sleeping well, and being active have on our bodies. But what’s the evidence for these benefits, and can these habits help keep our immune system functioning well? Duggal’s lab studies these connections and finds that many lifestyle factors contribute to the rate of immune aging. She explains that there is evidence that physical activity and healthy eating positively influence immune aging, while chronic stress has a negative impact on the immune aging trajectory. One study from her lab finds a [link between physical activity and reduced immunosenescence](https://onlinelibrary.wiley.com/doi/10.1111/acel.12750) in the body (11). Another study finds that the [Mediterranean diet](https://www.autoimmuneinstitute.org/articles/culinary-medicine-autoimmunity-and-healthful-eating "Culinary Medicine: Autoimmunity and Healthy Eating") is[ associated with a lower immunological age](https://academic.oup.com/ib/article/doi/10.1093/intbio/zyae010/7685005?login=false) (12). #### Senolytic Drugs to Clear Senescent Cells A growing area of age-related drug development is senolytics. These drugs target and clear senescent cells from the body. Recent efforts looking at senolytics have found that they [decrease the severity of autoimmune encephalomyelitis in preclinical models](https://jneuroinflammation.biomedcentral.com/articles/10.1186/s12974-024-03278-2) (13). “If we can make senolytic drugs better and more effective, I think that’s going to have tremendous potential,” says Robbins. Senolytic compounds are often found in plant-based foods. “They actually can reduce your senescent cell burden if you take enough of it,” says Robbins. “Whether you get enough in fruits and vegetables is still a question, but I think you probably can. That will reduce your senescent cell burden, either of your immune cells or other cells, at least a little, which then indirectly improves your immune system.” However, it’s unclear how helpful senolytics can be. Robbins says that many of the supplements that are meant to boost immune health have been shown to work in preclinical models, but not in humans. And if you don’t have a lot of senescent cells in your body, senolytic drugs won’t help you that much. Regardless, there’s no easy fix to boost immune health – you can’t just take supplements and ignore your diet or exercise. “Our usual take-home message is that there’s not one simple solution. It’s a more holistic approach,” says Duggal. ## Future Research in Aging and Autoimmunity There are still a lot of unknowns when it comes to aging and the immune system (even aging researchers [can’t agree on what aging exactly is or when it starts](https://academic.oup.com/pnasnexus/article/3/12/pgae499/7913315) (13). Recent efforts from the NIH-funded [SenNet consortium](https://sennetconsortium.org/) include [mapping where cells go senescent](https://sennetconsortium.org/) across multiple tissue types in the body. “What we’re realizing is that senescence is far more complicated than we thought,” says Robbins. “Through SenNet, we’ll have the opportunity to start to look at this in different disease contexts, both in mice and in humans.” While the aging process is already a complicated area of study, considering autoimmune diseases in the context of aging adds another level of complexity. It’s another reminder of the interconnectedness that the seemingly disparate systems and diseases within the human body are actually quite connected. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/GAI-Logo-Image-e1707845715517.png) ### About the Author ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/10/Jennifer-Tsang-Bio-Headshot-e1753113113430.jpg) A microbiologist turned freelance science writer who works with life science companies, nonprofits, and academic institutions on anything from news stories, explainer articles, and content marketing. She shares the wonderful world of microbes on her blog The Microbial Menagerie. Jennifer Tsang, PhD Freelance Writer for GAI ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** About Autoimmune Disease --- ### [Understanding Brain Fog in Autoimmune Disease](https://www.autoimmuneinstitute.org/articles/understanding-brain-fog-in-autoimmune-disease) **Published:** October 27, 2025 **Author:** Carolyn Serraino **Excerpt:** Fatigue, forgetfulness, and mental haze can all point to one culprit: immune dysfunction disrupting the brain’s clarity and focus. **Content:** ### The Neuroimmune Connection Autoimmune activity doesn’t stop at the blood–brain barrier. Once seen as separate worlds, the brain and immune system are proving inseparable. This series explores how autoimmune and inflammatory processes influence [brain fog](https://www.autoimmuneinstitute.org/articles/understanding-brain-fog-in-autoimmune-disease), [neurodegeneration](https://www.autoimmuneinstitute.org/articles/autoimmune-aspects-of-neurodegenerative-diseases), and [infection-triggered behavior changes](https://www.autoimmuneinstitute.org/articles/pandas-pans-and-autoimmunity). Understanding these connections could open new paths toward healing and prevention. Cognitive changes are increasingly recognized as part of the body’s immune response. Research into neuroimmune interactions has shown that inflammation can alter how the brain processes information, affecting focus, memory, and mood. In autoimmune diseases, where the immune system mistakenly targets the body’s own tissues, these effects can be especially pronounced, sometimes appearing long before structural brain changes are detectable. **Julius Birnbaum**, MD, MHS, Associate Professor of Rheumatology at the University of Pittsburgh Medical Center, and **Elizabeth Yarnell**, ND, MS, CNS, a traditional naturopath specializing in multiple sclerosis and autoimmunity, provide insight into how immune signaling, inflammation, and lifestyle factors may contribute to this experience commonly described as brain fog. ## What Is Brain Fog? Brain fog refers to changes in cognitive function that can make everyday thinking and memory tasks more difficult. It has recently gained increased recognition when identified in people with long-COVID (1). While not formally classified as a medical diagnosis, brain fog involves a collection of symptoms that can significantly disrupt daily life, affecting work, relationships, and overall well-being. In some cases, it can become severe enough to make it difficult for individuals to continue working. Brain fog is a common complaint among people with autoimmune disorders (2). It can develop suddenly or gradually and may not always correlate with the severity of the underlying disease. #### Common Symptoms of Brain Fog: - Disorientation or feeling mentally “lost” or confused. - Difficulty sustaining attention and concentration, making it difficult to focus on tasks. - Impaired judgment and problem-solving leading to challenges with decision-making and logical thinking. - Memory issues such as forgetting names, dates, or details more frequently. - Language difficulties, such as struggling to find the right words in conversation. Dr. Birnbaum notes that cognitive issues in autoimmune conditions, often described as cognitive slowing, can differ from those seen in non-autoimmune neurodegenerative conditions. [Alzheimer’s disease](https://www.autoimmuneinstitute.org/research_updates/is-alzheimers-disease-an-autoimmune-disease/ "Is Alzheimer’s Disease an Autoimmune Disease?"), for example, typically affects the outer cortex, the outer layer of the brain, and these individuals often experience difficulties with reading, calculation, and understanding or expressing language. Dr. Birnbaum notes, “In most autoimmune diseases, there is less impairment of these cognitive domains; and therefore, fewer problems with reading, calculation, understanding, or expressing language.” Brain fog can make routine tasks seem challenging. Yarnell says, “Brain fog may make it harder to follow the characters in a movie, or to remember many plot lines in a television series when episodes are only released weekly. You may find yourself rewatching earlier episodes before viewing the latest in order to be reminded of who is who and what is going on.” ## What Causes Brain Fog? Research into the potential multiple underlying causes of brain fog is ongoing. Some autoimmune disorders, like [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/ "Multiple sclerosis"), directly affect the central nervous system, leading to cognitive symptoms. However, brain fog also occurs in autoimmune conditions that do not directly impact the brain. One explanation involves the blood-brain barrier, a network of cells and blood vessels that regulates what substances can enter the brain. When this barrier becomes compromised, inflammatory molecules and autoantibodies can infiltrate the brain, triggering inflammation and potentially damaging neural tissue (3). **Additional factors not directly caused by autoimmune activity may also contribute to brain fog, including:** - Lack of [sleep](https://www.autoimmuneinstitute.org/research_updates/sleeps-important-role-in-ms-care/ "Sleep’s Important Role in MS Care") - [Hormonal changes](https://www.autoimmuneinstitute.org/research_updates/the-role-of-hormones-and-sex-chromosomes-in-autoimmune-disease/ "The Role of Hormones and Sex Chromosomes in Autoimmune Disease") (such as perimenopause/menopause) - [Certain medications](https://www.autoimmuneinstitute.org/articles/biologics-for-autoimmune-disease-what-you-should-know "Biologics for Autoimmune Disease: What You Should Know") and illicit substances (4) Systemic inflammation seen in autoimmune disorders can go undetected in the brain. Yarnell suggests considering inflammatory effects on the brain when other signs and symptoms of systemic inflammation are present. She notes, “We can’t see that our brain is inflamed when we look in the mirror, but we might notice that our rings are tight or we feel stiffer when rising, or our pants are tighter today than they were yesterday, or we feel weepy or irrational.” ## Which Autoimmune Diseases are Associated with Brain Fog? Brain fog is associated with both central nervous system-related autoimmune disorders, such as [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/ "Multiple sclerosis") and [autoimmune encephalitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/acute-disseminated-encephalomyelitis/ "Autoimmune encephalitis / acute disseminated encephalomyelitis (ADEM)") (5), and non-central nervous system-associated disorders, including (3): - [Rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid arthritis") - [Systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus") - [Type 1 diabetes](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/type-1-diabetes-insulin-dependent-diabetes/ "Type 1 diabetes / insulin-dependent diabetes") - Inflammatory bowel disease ([Crohn’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crohns-disease/ "Crohn’s disease") and [ulcerative colitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ulcerative-colitis/ "Ulcerative colitis")) - [Antiphospholipid syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/antiphospholipid-syndrome/ "Antiphospholipid syndrome") - [Celiac disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/celiac-disease/ "Celiac disease") ## How Is Brain Fog Diagnosed? There is no single test to diagnose brain fog. Instead, doctors rely on a patient’s medical history, symptom descriptions, and physical exams. Some individuals may also benefit from: - Cognitive assessments can be self-administered or performed by a healthcare provider to measure cognitive function. - Occupational therapy evaluations assess how cognitive difficulties impact daily tasks, particularly in work settings (6). - Imaging studies such as MRI or PET scans can sometimes reveal structural damage or inflammation. Even if imaging or cognitive tests appear normal, individuals may still experience brain fog. Many available assessments are not sensitive enough to detect subtle cognitive dysfunction. ## How Is Brain Fog Treated? Managing brain fog typically involves a multi-faceted approach, including treating the underlying autoimmune disorder, addressing contributing factors, and adopting lifestyle modifications to support cognitive function. ### Treating the Underlying Condition In some cases, brain fog improves when the autoimmune disease is well-managed. For example, people with hypothyroidism often report cognitive improvements after starting thyroid medication (7). Addressing the primary autoimmune disorder is an essential first step in managing brain fog. Dr. Birnbaum emphasizes the importance of paying attention to the causes of cognitive symptoms not directly related to autoimmune disorders. He says, “This can include poor sleep, depression, and a pain syndrome called fibromyalgia that causes widespread pain. Optimizing sleep, managing depression, and treating fibromyalgia can greatly improve cognitive impairment.” ### Addressing Other Contributing Factors Certain risk factors make people with autoimmune diseases more susceptible to cognitive difficulties. Addressing these can help lessen brain fog symptoms. Key factors include: - [Chronic stress](https://www.autoimmuneinstitute.org/articles/stress-autoimmune-disease-navigating-the-complex-relationship "Stress & Autoimmune Disease: Navigating the Complex Relationship") - [Aging-related cognitive changes](https://www.autoimmuneinstitute.org/articles/age-ethnicity-and-unexpected-connections-in-autoimmune-risk-factors "Age, Ethnicity, and Unexpected Connections in Autoimmune Risk Factors") - Poor physical health - Hormonal fluctuations (e.g., menopause) - Sleep disturbances - Emotional health issues (such as [anxiety or depression](https://www.autoimmuneinstitute.org/articles/managing-mental-health-with-an-autoimmune-disease "Managing Mental Health with an Autoimmune Disease")) - [Medications](https://www.autoimmuneinstitute.org/articles/biologics-for-autoimmune-disease-what-you-should-know "Biologics for Autoimmune Disease: What You Should Know") and substance use (7) Lifestyle adjustments to improve sleep, reduce stress, and maintain a [balanced diet](https://www.autoimmuneinstitute.org/research_updates/how-diet-impacts-autoimmunity/ "How Diet Impacts Autoimmunity") can significantly enhance cognitive function. ### Occupational Therapy Occupational therapists can help individuals develop strategies to manage cognitive challenges in daily life. Interventions may include: - **Cognitive rehabilitation**: Exercises and strategies to improve memory and problem-solving skills - **Energy management techniques**: Learning how to pace activities to avoid mental exhaustion - **Workplace adaptations**: Adjustments to reduce cognitive strain in professional settings (6) Occupational therapy can be crucial to treatment, equipping individuals with practical tools to navigate daily life more effectively. Yarnell explains that reducing one’s exposure to inflammatory triggers is essential to reducing the pain and discomfort of autoimmune disorders. She notes lifestyle adjustments can have a significant impact on health and well-being. Yarnell suggests: - Eating an [anti-inflammatory diet](https://www.autoimmuneinstitute.org/articles/culinary-medicine-autoimmunity-and-healthful-eating "Culinary Medicine: Autoimmunity and Healthy Eating") of more whole foods than [processed foods](https://www.autoimmuneinstitute.org/articles/what-is-processed-food "What is Processed Food?") - Avoidance of synthetic additives and preservatives - Eliminating chemicals and chemical scents from living environments Addressing brain fog centers around addressing those modifiable factors that are part of everyday life. ## Final Thoughts Brain fog is a real and often disruptive symptom of autoimmune diseases. While there is no one-size-fits-all solution, understanding the potential causes and adopting strategies to manage cognitive function can make a significant difference. If you or a loved one is experiencing brain fog, working with a healthcare provider to identify possible contributors and develop a personalized management plan is key. ![This image has an empty alt attribute; its file name is GAI-Logo-Image-811x1024.png](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/04/GAI-Logo-Image-811x1024.png) ### About the Author ![Tracy Asamoah bio headshot freelance writer for GAI](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/11/DSC05784-scaled.jpg) Tracy is a writer, child and adolescent psychiatrist, and leadership coach. Her journey into the world of autoimmune diseases began when she experienced sudden onset symptoms of multiple sclerosis early in her medical career. This personal experience, combined with her intense curiosity, has informed her work and writing in the field. As a writer, Tracy has contributed to various books and written articles related to mental health. She’s also written on various medical topics regularly contributing to publications such as GoodRx, Psychology Today, and Psychotherapy.net Tracy Asamoah, MD Freelance Writer for GAI ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** About Autoimmune Disease --- ### [Autoimmune Aspects of Neurodegenerative Diseases](https://www.autoimmuneinstitute.org/articles/autoimmune-aspects-of-neurodegenerative-diseases) **Published:** October 27, 2025 **Author:** Carolyn Serraino **Excerpt:** Can neurodegenerative diseases have autoimmune origins? New research suggests immune dysfunction plays a key role in Alzheimer’s, Parkinson’s, and MS. **Content:** ### The Neuroimmune Connection Autoimmune activity doesn’t stop at the blood–brain barrier. Once seen as separate worlds, the brain and immune system are proving inseparable. This series explores how autoimmune and inflammatory processes influence [neurodegeneration](https://www.autoimmuneinstitute.org/articles/autoimmune-aspects-of-neurodegenerative-diseases), [brain fog](https://www.autoimmuneinstitute.org/articles/understanding-brain-fog-in-autoimmune-disease), and [infection-triggered behavior changes](https://www.autoimmuneinstitute.org/articles/pandas-pans-and-autoimmunity). Understanding these connections could open new paths toward healing and prevention. Alzheimer’s disease and Parkinson’s disease have generally been thought of as neurodegenerative diseases, meaning those that damage and destroy parts of the brain. However, evidence now suggests that immune system dysfunction plays a role in these conditions, giving them autoimmune characteristics as well. [Multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/ "Multiple sclerosis") (MS), already established as a neurodegenerative autoimmune disease, offers a contrast to the emerging immune-related findings in Parkinson’s and Alzheimer’s disease. Experts in the field of neurodegeneration and neuroinflammation, **Alessandro Sette**, a [professor and director](https://www.lji.org/labs/sette-lab/) of the Center for Autoimmunity and Inflammation at [La Jolla Institute for Immunology](https://www.autoimmuneinstitute.org/gai-and-la-jolla-institute-for-immunology/ "GAI and La Jolla Institute for Immunology"), **Esther Melamed**, M.D., Ph.D., a [neurologist and assistant professor](https://dellmed.utexas.edu/directory/esther-melamed) at the Dell Medical School at The University of Texas at Austin, and **Dr. Donald Weaver** of the [Krembil Research Institute](https://www.weaverlab.ca/) discuss how the recognition of these diseases as autoimmune can change how they’re diagnosed and treated in the future. ### What Evidence Links Neurodegenerative Disease to Autoimmunity? #### Multiple Sclerosis: The Established Neurodegenerative Autoimmune Disease MS involves an autoimmune attack on myelin, the insulating sheath surrounding nerve cells in the brain and spinal cord. When myelin is compromised, it is more difficult for neurons to communicate with one another, which can lead to nearly any neurological symptom. In 2024, a research study involving over 10 million individuals found that nearly 10% of MS cases have distinct sets of [autoantibodies years before symptoms](https://www.nature.com/articles/s41591-024-02938-3) appear (1). These [autoantibodies](https://www.autoimmuneinstitute.org/articles/decoding-the-role-of-autoantibodies-in-autoimmunity "Decoding the Role of Autoantibodies in Autoimmunity") target a shared molecular pattern found in both human and viral proteins, including those from [Epstein-Barr Virus](https://pubmed.ncbi.nlm.nih.gov/35025605/), a virus [linked to MS](https://www.autoimmuneinstitute.org/research_updates/the-puzzling-link-between-ebv-and-ms/ "The Puzzling Link Between EBV and MS") in 2022 (2). ###### It’s possible that in the future, a blood test could help identify multiple sclerosis risk before any symptoms appear. “The hope is when people start getting treated early on for their neuroinflammatory MS condition that it would slow down neurodegeneration and hopefully prevent it,” says Melamed. #### Parkinson’s Disease: When T Cells Attack Neurons In Parkinson’s disease, brain cells that produce dopamine die off, giving rise to motor and non-motor symptoms, including tremors, rigidity, and balance issues. The symptoms in Parkinson’s develop gradually. “Initially, we don’t really have the symptoms that we all associate with Parkinson’s, such as cognitive and motor symptoms,” says Sette. ###### “There’s a process of destruction that goes unnoticed.”  Sette first found evidence of the autoimmune aspects of this disease in 2017 when he and collaborators at Columbia University discovered that T cells recognize alpha-synuclein peptides, which aggregate in Parkinson’s disease, and [initiate an autoimmune attack on neurons](https://www.nature.com/articles/nature22815) (3). The following year, work from another group found that T cells from people with Parkinson’s disease [attack dopamine-producing neurons](https://www.cell.com/cell-stem-cell/fulltext/S1934-5909(18)30297-2?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS1934590918302972%3Fshowall%3Dtrue) (4). On the other hand, T cells from people without Parkinson’s did not. While Sette has found that T cells target alpha-synuclein in Parkinson’s disease, not all patients have T cells against it. Therefore, his team searched for other T cell targets in the disease. In 2024, they found another target: a protein called [PINK1 ](https://www.jci.org/articles/view/180478)(5). PINK1 helps the brain regulate mitochondria, which provide energy for the cell. When T cells attack cells that express PINK1, it leads to inflammation and neuronal death. Despite these molecular clues, Sette says it’s not clear whether autoimmune reactivity is the culprit behind the disease or if there’s another cause of damage responsible for the initial inflammation. #### Alzheimer’s Disease: Is It an Innate Autoimmune Disorder? Research into the [autoimmune aspects of Alzheimer’s disease](https://www.autoimmuneinstitute.org/research_updates/is-alzheimers-disease-an-autoimmune-disease/ "Is Alzheimer’s Disease an Autoimmune Disease?") is still limited compared to multiple sclerosis and Parkinson’s disease, but some key insights are beginning to emerge. ###### One of the main features of Alzheimer’s is the buildup of amyloid beta, a protein that, in high numbers, clumps together and forms plaques around brain cells. While the normal function of amyloid beta is unclear, it appears to play a role in protecting the brain from invading microbes by triggering an innate immune response, the body’s first line of defense. According to Dr. Weaver, where problems arise is when amyloid beta’s antimicrobial properties result in a “[misdirected attack upon ‘self’ neurons](https://alz-journals.onlinelibrary.wiley.com/doi/10.1002/alz.12789)” (6). Weaver suggests the misdirected attack may result from electrophysiological similarities between neurons and bacteria. ### Blood-Based Biomarkers May Predict Autoimmune Risk In 2018, scientists realized that patients with [ulcerative colitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ulcerative-colitis/) and other autoimmune disorders had a [lower risk of developing Parkinson’s disease](https://onlinelibrary.wiley.com/doi/10.1002/acn3.580) (7). A commonality that the researchers found among these patients were the immunosuppressive drugs used to treat these diseases and the researchers suggest that these drugs could lower risk of Parkinson’s disease. But does it make sense to treat people preemptively with immunosuppressants – which can be expensive and have side effects – to avoid developing Parkinson’s disease? That depends on the patient’s risk. Sette explains, “if you could have a test that says, ‘aha, you are at high risk of being on a pathway of progression towards Parkinson,’ then I think it would be justified to intervene to shut down this festering inflammation.” A person’s blood could give clues into future autoimmune diseases. For multiple sclerosis, signs of disease could be found in the blood [years before MS onset](https://www.nature.com/articles/s41591-024-02938-3) (8). The same can be seen in Parkinson’s disease. Sette and colleagues found that [alpha-synuclein reactive T cells](https://www.nature.com/articles/s41467-020-15626-w) could be found in the blood of Parkinson’s patients years before a Parkinson’s diagnosis (9). “It becomes a question of if we can develop biomarkers of neuroinflammation which potentially may contribute to or worsen neurodegeneration and if we can come up with the right people to screen from early on,” says Melamed. “Perhaps they have family history or perhaps they have other autoimmune conditions. We might be able to slow down or stop this process that’s starting before it shows up.” ### Genetic Connections Between Autoimmunity and Neurodegeneration HLA, or human leukocyte antigen, is a molecule that’s expressed on the surface of certain immune cells that help the immune system determine self from non-self. Mutations in HLA genes have been connected with various autoimmune diseases. ###### “HLA certainly is the biggest risk factor for autoimmune conditions and neurodegenerative conditions and some of that is thought to be driven by microglial dysfunction,” says Melamed. Microglia help clear damaged proteins or aggregated proteins in the brain and the HLA molecule on these cells help them recognize what to target. Aside from HLA, Melamed notes that hundreds of other genes have been identified that affect both autoimmunity and neurodegeneration such as those involved in blood brain barrier integrity, mitochondrial genes, and immune regulatory genes. One study from 2017 found [17 genes in common between Parkinson’s and other autoimmune diseases](https://pmc.ncbi.nlm.nih.gov/articles/PMC5710535/) including multiple sclerosis, [Crohn’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crohns-disease/ "Crohn’s disease"), and [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid arthritis"), among others (10). In the last decades, advances in genomic and proteomic technologies have allowed scientists to more quickly and more cheaply identify trends in the genes and protein associated with disease among a large patient population. ###### This allows scientists to look at and analyze multiple biomarkers of disease at once. Genomics and proteomics are most used in the research setting but it’s possible that in the future, these technologies could be put into play in personalized medicine, where a person’s genetic profile could be used to make medical decisions. ### Managing Modifiable Risk Factors for Brain and Immune Health While a person’s genes are inherited, many other [external lifestyle factors](https://www.autoimmuneinstitute.org/7-ad-risk-factors/) impact the progression of autoimmune diseases. Melamed, who studies how genetics, diet, and gut microbiome influences multiple sclerosis says, “\[lifestyle\] is the one factor that it’s in our control.” She notes that vitamin deficiency and poor sleep has been linked to a higher risk of both autoimmune diseases and neurodegenerative diseases. Melamed says, “the best thing we can do for ourselves… is to make sure that we get enough sleep, avoid smoking and [heavy alcohol use](https://pmc.ncbi.nlm.nih.gov/articles/PMC8259720/), manage stress, prioritize exercise, and keep a [healthy diet](https://sites.utexas.edu/melamed-lab/2023/07/07/start-trusting-your-gut-the-bodys-second-brain/).” ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/GAI-Logo-Image-e1707845715517.png) #### About the Author ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/10/Jennifer-Tsang-Bio-Headshot-e1753113113430.jpg) A microbiologist turned freelance science writer who works with life science companies, nonprofits, and academic institutions on anything from news stories, explainer articles, and content marketing. She shares the wonderful world of microbes on her blog The Microbial Menagerie. Jennifer Tsang, PhD Freelance Writer for GAI ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** About Autoimmune Disease --- ### [The Importance of Clinical Trials for Autoimmunity](https://www.autoimmuneinstitute.org/articles/the-importance-of-clinical-trials-for-autoimmunity) **Published:** June 3, 2022 **Author:** Carolyn Serraino **Content:** ## Key highlights from GAI’s presentation at the Autoimmune Warrior Conference, hosted by Aila Health GAI’s Executive Director, Sandy Boek Werness speaks during Aila Health’s Autoimmune Warrior Conference: [LEARN MORE ABOUT AILA HEALTH HERE](https://www.ailahealth.com/) ### **What is the importance of clinical trials in Autoimmune Disease?** **Clinical research is vital, especially in autoimmune disease,** as studies directly impact medical practice, particularly diagnosis and treatment. Doctors do their best to investigate and learn about the variety of illnesses encountered by their patients, but with the great variability in autoimmune diseases, there are some details that only patients themselves can know about their individual experiences. The best way to begin connecting the dots and help patients better navigate their illness is for patients and clinicians to work together. One major avenue to facilitate this collaboration for improved health outcomes is with clinical research studies, which is why so many of those with autoimmune diseases look to published clinical research studies for guidance. > Clinical research gives us answers, eliminates some red herrings, gives us clues about what to look for, and what kinds of connections can be made. ### **How does GAI contribute to clinical research in Autoimmune Disease?** Clinical research can be patient and family-driven, funded and supported by academic institutions, hospitals, and the US government, or by nonprofits with the desire to improve diagnosis and treatment. For example, Global Autoimmune Institute funded and helped propel Children’s National Hospital in Washington, D.C. to establish a [multidisciplinary clinic for Celiac Disease](https://childrensnational.org/departments/celiac-disease-program/celiac-disease-clinic). This program also runs an ongoing clinical research study to determine how many pediatric patients with Celiac disease experience comorbidities, such as neurological disorders. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Screen-Shot-2023-10-24-at-7.53.25-PM-1024x546.jpg) This Clinic has brought to light symptoms that have not been openly discussed or previously affiliated with autoimmune disease, such as memory and mood disturbances. **The multidisciplinary nature of the clinic has allowed the medical teams to explore under-researched and misunderstood – but debilitating – symptoms such as chronic fatigue and brain fog.** They are also able to provide psychosocial support for the children in their day-to-day lives, lifestyle, and medical education for the children and their families, as well as an ongoing support group. > Multidisciplinary clinics are the gold standard in treating all autoimmune disease, and the world is taking notice. ### **What is mainly being studied in Autoimmune Disease clinical Trials?** **Better identification and classification of autoimmune disease**, including the recognition of the many symptoms that can arise, and which autoimmune diseases are likely to be found with each other, will allow for better diagnosis. In addition to **finding the most effective tools for managing autoimmune disease**, we still need to study details regarding **root causes**. Why do some people develop autoimmune disease and others do not, even when exposed to the same factors or are in the same family? What are the specific **genetic differences** and can knowing these help us learn the best treatment options or possibly even cures? It has been established that most autoimmune diseases are triggered by a combination of environmental and genetic factors, though more information is desperately needed in this field. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Screen-Shot-2023-10-24-at-7.55.03-PM-1024x946.jpg) *Photo credit: Ermann, J., Fathman, C. Autoimmune diseases: genes, bugs and failed regulation. Nat Immunol 2, 759–761 (2001).* [*https://doi.org/10.1038/ni0901-759*](https://www.nature.com/articles/ni0901-759) Right now, most research looking at **environmental triggers of autoimmune disease** involves the study of viral and bacterial infections, such as Epstein Barr Virus, Coxsackievirus, Herpesvirus, and now SARS-CoV-2 viruses. Pinpointing specific causes will help not only with the prevention of autoimmune disease in the future, but will also help to provide answers and validate the experience of those with autoimmune disease – some of which spring up seemingly out of nowhere, interrupting their previously healthy state. Clinical research is especially important in the U.S., where our patient data is not accessible or centralized, meaning **we don’t have a consolidated database to compile essential information about people and their illnesses**. This leaves the burden of spreading crucial information on published information channels such as scientific and medical journals. Doctors and scientists learn from each other at conferences, on online forums, and in other settings, but translating their shared experiences and hypotheses to real data that can be trusted and used to make progress is done primarily through clinical research studies. ### **How do you find published studies that relate to what you have or are experiencing?** The best source for searching relevant articles is [PubMed](https://pubmed.ncbi.nlm.nih.gov/), the free NIH government website which is accessible to everyone. Simply enter your search terms and read the first part of the article, which summarizes the subject (called the Abstract), to learn what was done and the results they found. Other important journals to look at are [Nature](https://www.nature.com/), [Science](https://www.science.org/), the [Journal of the American Medical Association](https://jamanetwork.com/), the [New England Journal of Medicine](https://www.nejm.org/), the [Lancet](https://www.thelancet.com/), and the [Journal of Autoimmunity](https://www.sciencedirect.com/journal/journal-of-autoimmunity). ### **How do clinical research studies work?** Doctors or scientists (often researchers are practicing doctors who also do research) have an idea they want to test, so they write a plan (called a protocol), which is then reviewed by other doctors and/or scientists (called peer review) to make sure it makes sense and is worth doing based on what we already know relating to the idea. A team is formed and gets funding, the plan is approved by an ethics committee, and hospitals agree to help by recruiting patients who want to participate and who fit the study’s eligibility criteria. Important rules of scientific inquiry and patient privacy are followed. ### **Should I join a clinical trial? How can I find one?** It is a very personal decision. It is possible that whatever is being tested may help you, and if not, you are certainly helping others. Autoimmune disease can run in families, so the results may help your children, relatives, friends, and the overall community. It can also be a good way to focus on yourself and what you are experiencing, which can feel inspiring, empowering, and validating. The best way to find a clinical trial that is specifically related to your situation is to talk to your specialist(s) to see if they know of any clinical studies being done that correspond with your diagnoses, symptoms, or other factors. You can also browse the [NIH website](https://www.niaid.nih.gov/clinical-trials/find-a-clinical-trial?f%5B0%5D=disease%3A74). ### **What does participation involve?** That depends as clinical trials vary depending on what it is they are trying to accomplish. You may need to give saliva or blood or other biosamples to be tested, at regular intervals. You may need to take medicine(s), and record and report how you feel. You may need to be given certain tests such as an MRI, or EEG. You may decide to enroll in an observational study and record certain aspects of what you eat, or your activity level, and how you feel, in order to determine how certain lifestyle variables affect your health. ### **What us being done to further Autoimmune Disease research?** Congress is recognizing that the NIH needs a strategic research plan and coordination across institutes and centers to optimize collaboration in autoimmune disease and has called for the creation of an Office of Autoimmune Disease/Autoimmunity Research in the Office of the Director of the NIH. This is a very big and necessary change as autoimmune disease research had previously been under the National Allergy and Infectious Disease division. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/NIH-Research-Consensus-Study-Report-1024x683.jpg) *Read the National Academies of Sciences, Engineering, and Medicine’s report on Enhancing NIH Research on Autoimmune Disease* [*here*](https://nap.nationalacademies.org/catalog/26554/enhancing-nih-research-on-autoimmune-disease)*!* ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** About Autoimmune Disease, Diagnosis & Treatment --- ### [Body Regions Commonly Affected by Autoimmunity](https://www.autoimmuneinstitute.org/articles/body-regions-commonly-affected-by-autoimmunity) **Published:** January 3, 2023 **Author:** Carolyn Serraino **Content:** Autoimmune diseases can affect almost any part of your body and can be classified into systemic or organ-specific diseases based on their location. “The key thing is that you can actually test for an autoimmune reaction by looking at serologies in the blood,” said Gabriella Safdieh, an integrative medicine physician. “There are various serologies that are consistent with different forms of autoimmune diseases.” Serology is the scientific study of serum (blood component) and other body fluids. The term usually refers to the diagnostic identification of antibodies in the serum. In systemic autoimmune diseases, such as [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/), autoantigens are found in cells throughout the body, resulting in a variety of damaged organs and tissues. Organ-specific autoimmune diseases affect particular targets in the body, such as the thyroid gland in those with [Graves’ Disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/graves-disease/). “When someone has one autoimmune disease, they are at increased risk for development of another autoimmune disease,” Safdieh said. A single patient may experience various types of autoimmune diseases at the same time as a result of autoantibodies that attack corresponding autoantigens. Some body regions commonly affected by autoimmune diseases are outlined below: ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/stomach-300x300-1.png) ### **Stomach** ##### **Related antibodies: anti-parietal cell antibodies (APCA)** **[Autoimmune gastritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-gastritis/)** (AIG) is more common in females than in males and is generally asymptomatic until the disease has advanced ([1](https://www.mdpi.com/1422-0067/19/2/377)). As a result, it is frequently underdiagnosed. AIG is more prevalent in patients affected by other autoimmune diseases, especially [autoimmune thyroid diseases](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/hashimotos-thyroiditis/) (AITD) and [Type 1 diabetes](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/diabetes-type-1/). Parietal cells make and release a substance that the body needs to absorb vitamin B12. But antibodies were found to inhibit the activity of H+, K+-adenosine triphosphatase ([2](https://pubmed.ncbi.nlm.nih.gov/26918709/)). Patients with chronic iron deficiency should be evaluated for the presence of autoimmune gastritis ([3](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5065578/)). ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/thyroid.png) ### **Thyroid** ##### **Related antibodies: anti-thyroid peroxidase (TPO)** Autoimmune thyroid diseases (AITD) are the most prevalent organ-specific autoimmune diseases, affecting 2 to 5% of the population ([4](https://www.ncbi.nlm.nih.gov/books/NBK459466/)). Frequently, AITD are accompanied by the presence of antithyroid antibodies, including anti-thyroid peroxidase (TPO), which are found in 90–95% of AITD patients ([5](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8203296/)). TPO is key for adequate function of the thyroid gland as it helps produce thyroid hormones which regulate growth, brain development, and metabolism ([6](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4044302/)). Autoimmune thyroid diseases include [Hashimoto’s Thyroiditis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/hashimotos-thyroiditis/) and [Graves’ Disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/graves-disease/), among others. **Hashimoto’s thyroiditis** is the most common cause of hypothyroidism in developed countries ([7](https://www.ncbi.nlm.nih.gov/books/NBK459262/)). The pathology of the disease involves the formation of antithyroid antibodies that attack the thyroid tissue. Under attack, the thyroid is unable to make enough thyroid hormones (hypothyroidism). Over time, the thyroid enlarges. **Graves’ disease (GD)** is an autoimmune disease that primarily affects the thyroid gland. In patients suffering from Graves, autoantibodies to the thyroid-stimulating hormone receptor (TSHR) induce excessive thyroid hormone secretion ([8](https://pubmed.ncbi.nlm.nih.gov/32616746/)). Body functions accelerate as a result. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/brain.png) ### **Brain** ##### **Related antibodies: brain-reactive antibodies, including synapsin antigens** Approximately 2–3% of the general population has brain-reactive antibodies which penetrate brain tissue and can cause damage to the brain ([9](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4401150/)). Autoimmune diseases that affect the brain include Vasculitis and [Multiple Sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/): **Vasculitis:** Inflammation of the blood vessel wall ([10](https://www.ninds.nih.gov/vasculitis-and-nervous-system-fact-sheet)). In dire cases, such inflammation can result in aneurysms or hemorrhage. There is no known cause. **Multiple Sclerosis:** A chronic disease affecting the brain and spinal cord, which comprise the central nervous system. MS often leads to severe physical or cognitive incapacitation ([11](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5241505/)). ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/adrenals.png) ### **Adrenals** ##### **Related antibodies: 21-hydroxylase antigens** In some autoimmune diseases, the immune system attacks adrenal glands, which leads to primary adrenal insufficiency, or [autoimmune Addison’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-addisons-disease/) (AAD). Autoimmune adrenalitis, or AAD, is rare, but it is the most prevalent cause of primary adrenal insufficiency in the developed world ([12](https://pubmed.ncbi.nlm.nih.gov/24424183/)). The cause is complex and not completely understood. Adrenal glands are located at the top of the kidneys and produce a variety of hormones including: – **Cortisol**: A stress hormone involved in the response to physical and/or emotional stress. Cortisol is related to blood pressure, anti-inflammatory action, and the metabolism of protein, carbohydrates, and adipose ([13](https://www.sciencedirect.com/topics/biochemistry-genetics-and-molecular-biology/cortisol)). – **Aldosterone**: A steroid hormone that plays an important role in sodium and fluid reabsorption, as well as regulating blood pressure and volume ([14](https://www.sciencedirect.com/topics/biochemistry-genetics-and-molecular-biology/aldosterone)). **Autoimmune Addison’s disease** occurs when the immune system attacks 21-hydroxylase, which is important for hormone production in the outer layers of the adrenal glands, known as the adrenal cortex. A shortage of adrenal hormones (adrenal insufficiency) results in hypoglycemia, hyponatremia, hypotension, muscle cramps, skin hyperpigmentation, and other features of Autoimmune Addison’s disease. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/gut.png) ### **G**ut ##### **Related antibodies: tropomyosin antigens** One autoimmune disease which occurs in the gut is [Ulcerative Colitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ulcerative-colitis/) (UC). UC is a form of chronic inflammatory bowel disease (IBD) that impacts mucosa in the colon. In patients with UC, antibodies target the protein tropomyosin ([15](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1905040/)). UC is not caused by any specific pathogen. Rather, a combination of genetics, environmental factors, and altered immune responses to dietary macromolecules, colonic bacteria, and cellular proteins are related. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/joints.png) ### **Joints** ##### **Related antibodies: arthritic peptide antigens, including rheumatoid factor (RF) and anti-citrullinated protein antibodies (ACPA)** [Rheumatoid Arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/) (RA) principally affects synovial joints, particularly the hands, feet, and knees. Around 0.5 to 1% of the world population is affected ([16](https://www.sciencedirect.com/science/article/pii/S0896841119308194)). Symptoms include pain, joint swelling, and stiffness, in addition to cartilage and bone degradation. Blood vessels, kidneys, the heart, lungs, and the liver can also be affected ([16](https://www.sciencedirect.com/science/article/pii/S0896841119308194)). The exact cause of RA is unknown, although researchers believe it’s caused by a combination of genetics, hormones, and environmental factors. When antibodies attack the tissues lining joints, synovial cells divide and contribute to inflammation, which can ultimately contribute to cartilage and bone destruction. RA patients can be divided into two subsets: **Autoantibody positive:** 60%-80% of people with RA are seropositive, meaning blood possesses antibodies that can attack your body and inflame your joints. Several antibody systems have been identified in RA, including rheumatoid factor (RF) and anti-citrullinated protein antibodies (ACPA). **Autoantibody negative:** Seronegative RA means autoantibodies are not present. It can be diagnosed with a particular set of symptoms. ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** About Autoimmune Disease --- ### [What Does Organic Really Mean?](https://www.autoimmuneinstitute.org/articles/what-does-organic-really-mean-part-one) **Published:** August 15, 2023 **Author:** Carolyn Serraino **Content:** **The word “organic” is everywhere.** It’s stamped on our bell peppers and peaches at the grocery store, it makes appearances in snack commercials, and it shows up in recipes requesting “juice from one organic lemon.” Even businesses like airlines and gas stations are stocking up on the surging trend. **We’ve heard that organic produce is higher in nutrients, reduces our exposure to toxic pesticides, and that it’s better for the environment than conventional produce.** Those of us with chronic illnesses (like autoimmune disease) are encouraged by friends, practitioners, and a cacophony of internet voices to eat organic fruits and veggies. We are inundated with all this information and many of us are still left scratching our heads. While checking our apples for brown spots and trying desperately to avoid the candy aisle, we can’t help but wonder, *what does organic* ***really*** *mean*? ### Terminology For the purposes of this article, we will primarily discuss farms that are “certified organic” by the USDA. When the term “organic” is used, it means “certified organic,” unless otherwise specified. “Big organic” signifies large-scale operations—ones supplying grocery stores like Whole Foods with a high volume of produce. Conventional agriculture is similar in scale, but relies on synthetic pesticides, fertilizers, and monoculture crops, and benefits from government subsidies. To pare down such a complicated topic, we will describe what organic really means according to the United States Department of Agriculture National Organic Program. Organic certifications like Canadian Organic Standards (COS) in Canada, the Société Générale de Surveillance (SGS) in the EU, and others in Asia and Oceania, have their own unique standards that can vary greatly from those of the USDA. There are also third-party certifiers of everything from organic and humanely-raised, to gluten-free and Kosher. ### History Of Organics In The U.S. The organic movement began in the early twentieth century as a way to eliminate problems created by modern agriculture like soil erosion, decrease in biodiversity, deteriorating food quality, and pesticide accumulation ([1](https://kerrcenter.com/wp-content/uploads/2014/08/organic-philosophy-report.pdf)). **In the wake of World War I and the onset of the Great Depression, farmers were searching for ways to secure higher yields and profits.** The use of mechanized farming techniques saw a sharp rise as tractors plowed acres and acres of fertile grasslands, breaking up the soil into a fine powder to plant wheat and other monocrops. Years of this practice, while immediately benefitting the farmers, stripped the soil of moisture and nutrients, and removed native grasses—top soil that had protected the land from erosion for millennia. When the first drought hit in 1931 and the plain winds kicked up speed, large swathes of arid American soil consumed the sky, corrupting air quality and reducing visibility for hundreds of miles. Throughout the Southern Plains—the epicenter of this disaster—crops failed and hundreds perished as the delicate ecosystem was thrown off-balance. **Deemed, the “Dust Bowl,” these alarming impacts of large-scale farming forced the government to review the country’s land management practices**, instilling new conservation policies. One such measure was the initiation of the Soil Conversation Service (now known as the National Resources Conservation Service or NRCS), an educational organization focused on teaching farmers about soil conservation ([2](http://latebloomamerica.org/thedustbowldemandedsustainableagriculture/), [3](https://www.nrcs.usda.gov/wps/portal/nrcs/detail/national/about/history/?cid=nrcs143_021392)). Around the same time, **Jerome Rodale (a.k.a. the grandfather of organics), began to spread the idea that soil health and human health are intertwined.** He emphasized to the public, through his *Organic Farming and Gardening* magazine, that farming with compost and without the use of pesticides and synthetic fertilizers was the key to living healthier ([4](https://www.researchgate.net/publication/231845985_A_history_of_organic_farming_Transitions_from_Sir_Albert_Howard's_War_in_the_Soil_to_USDA_National_Organic_Program)). By focusing on the health of the soil instead of the crop and its yield, organic methods of farming promised to develop sustainable systems for the long-term health of both the environment and the population. By the 1940s, organic farming, which had until then only been popular in Europe, slowly gained ground in the US. Since techniques like crop rotation and composting inherently challenged the philosophy of mainstream farming (now known as conventional farming), it took time to earn acceptance in the greater agricultural community. However, starting with the federal government’s 1972 ban on the toxic insecticide DDT ([5](https://blogs.uoregon.edu/nbrownw14gateway/timeline-2/)), and Oregon’s adoption of its own organic regulations, other states followed suit and the movement drummed up support from consumers across the country. **The demand for organic food continued on an upward trend through the last decade of the 21st century**, when Congress passed the Organic Food Production Act and the seeds of the USDA National Organic Program (NOP) began to sprout ([5](https://blogs.uoregon.edu/nbrownw14gateway/timeline-2/)). ### Overview Of What “Organic” Means Since 2002, our understanding of the word “organic” has been shaped by the USDA’s NOP, when national standards for organic food production came into effect. The USDA defines organic produce as crops grown in certain conditions, adhering to a strict set of standards laid out by the NOP. Organic farmers must take care to avoid contamination from conventional crops, and keep detailed records of their growing practices in preparation for a yearly inspection ([7](https://www.ams.usda.gov/sites/default/files/media/GuideForOrganicCropProducers.pdf)). Certified organic fruits and vegetables are meant to be produced with only naturally-derived substances, without the use of genetically-modified organisms (GMOs), synthetic pesticides or fertilizers, growth hormones, or antibiotics. Instead, **organic farms use alternative methods, like crop rotation and providing habitats for insect predators, in order to mitigate pest problems, nourish the soil, and reduce erosion.** That little green and white USDA Organic seal, however, does not describe to what extent the standards are followed. Chemical inputs, like pesticides, are considered a last line of defense. Especially regarding the 25 synthetic chemicals allowed in organics (versus 900 in conventional), farmers are encouraged by the NOP to use them only if they’ve exhausted other methods, and only in very limited amounts ([8](https://www.ecowatch.com/pesticides-organic-farming-2292594453.html)). One of the most commonly known synthetic fungicides used in organic farming, copper sulfate, is harmful to farm workers and consumers at certain volumes, and is therefore regulated ([9](https://geneticliteracyproject.org/2018/11/16/organic-fungicide-copper-sulfate-poses-dangers-to-humans-animals-insects-how-does-it-compare-to-conventional-pesticides/)). As the NOP cannot monitor their every move, **organic farmers may choose to use synthetics earlier on in a pest outbreak, or they may decide to never head down that road at all.** While there are limits on the amount of synthetic pesticides used, the same cannot be said for organic ones, like diatomaceous earth and neem oil. Since many of these naturally-derived substances have lower toxicity levels, there is no limit for the amount of residue allowed on food ([10](https://www.safefruitsandveggies.com/organic-regulations/)). To be clear, a large volume of organic chemicals is not necessarily better than a small amount of synthetic chemicals. Plus, certain synthetic chemicals, like chlorine and sulfurous acid, are frequently used in pre- and post-harvest preparation of grocery store organics ([11](https://www.ecfr.gov/cgi-bin/text-idx?c=ecfr&SID=9874504b6f1025eb0e6b67cadf9d3b40&rgn=div6&view=text&node=7:3.1.1.9.32.7&idno=7#se7.3.205_1601)). An apple is not an apple is not an apple. **The amount and types of chemicals used on our fruits and vegetables can vary wildly depending on the particular farm, even if they all display the green and white seal.** Thus, it is up to us—the consumers—to be aware of these limitations. Some farms fulfill the minimum requirements, acknowledging the financial benefit of growing organic. Others go above and beyond what the certification demands and are focused on creating a sustainable system. Many more, however, fall somewhere in between. **If you want to understand what organic really means for you personally, it can come in handy to talk to your farmers**—via email, phone, social media, online articles, or in-person at the farmer’s market. Getting to know their philosophies on pesticides and the agricultural practices used on their land will give you a glimpse into what’s behind that ubiquitous USDA Organic label. ### Is Organic Really Better? A lot goes into bearing the USDA’s seal of approval. Not only does this certification affect the processes farmers have to use, but also the prices consumers have to pay. It garners the question of whether or not buying organic produce is worth the cost from both an environmental and a human health perspective. In terms of whether “organic” means better for the environment or our health, we will mainly focus on big organic vs conventional agriculture, since these are the choices most of us face when grocery shopping for ourselves and our families. ### The Environment There are three main tenets of big (and small) organic farms, which set them apart from conventional ones: 1. To build soil through composting rather than synthetic fertilizer; 2. To avoid the use of synthetic pesticides; 3. To avoid genetically-modified organisms (GMOs) ([12](https://geneticliteracyproject.org/2017/10/20/big-ag-big-organic-much-big-matter-comes-sustainability/)) There is much room for interpretation, here. The difference in how these principles are followed means that **big organic farms can generate an environmental impact not unlike that of conventional farms.** Big organic farms are large-scale operations, and are thus more likely to use similar practices to their conventional counterparts like planting one plant variety at a time and relying more heavily on the use of chemical inputs to fix problems. There are no effective organic herbicides to control weeds, but organic fungicides and pesticides, which are less toxic, are also less effective ([13](https://geneticliteracyproject.org/2018/05/21/do-organic-farmers-really-use-more-pesticides-than-conventional-farmers-not-even-close/)). This can lead farmers to spray a greater volume onto their crops. As in conventional farming, these chemicals leach into the surrounding environment, and can put soil health on the back burner, potentially affecting the nutrient content of their produce ([14](https://www.sciencedaily.com/releases/2010/06/100622175510.htm)) Organic farms also require more space to produce a yield equivalent to that of conventional farms. Thus, if farmers aren’t pulling out all the stops when it comes to carbon sequestration (trapping the element in the soil rather than letting it escape into the atmosphere), the amount of carbon released can be quite worrying ([15](https://www.sciencedaily.com/releases/2018/12/181213101308.htm)). While big organic farming can have a negative effect on the environment, not all of these operations are doing the bare minimum as described above. **Organics are under pressure from the NOP to employ more environmentally-friendly techniques in the name of conservation, biodiversity, and soil health**—a focus that does not see as much support in conventional agriculture. Plus, organic pesticides (with a few exceptions) take less time to break down than synthetic ones ([16](https://blogs.scientificamerican.com/guest-blog/myths-busted-clearing-up-the-misunderstandings-about-organic-farming/), [17](http://npic.orst.edu/factsheets/half-life.html)). If we put the impact of carbon emissions aside, even large-scale organic farming demonstrates less environmental harm than conventional. **Organic systems are not without flaw, but they do lead to better soil, more diverse ecosystems, and a lower risk of environmental contamination and toxic chemical exposure than most conventional ones.** ### Is Organic Produce More Nutrient-Dense? We may never have a black-and-white answer to this question. As of 2010, a comprehensive analysis of a number of studies showed that there are no nutritional differences between organic and conventional produce that you find in a typical grocery store ([18](https://www.ncbi.nlm.nih.gov/pubmed/20463045)). Nutritional studies can be finnicky, however, and do not tell the whole story. Nutrient levels vary depending on the farmer, the season, and even the seed used ([19](https://bionutrient.org/site/bionutrient-rich-food/bionutrient-rich-food-health)). More often than not, exactly ***how* the produce is farmed (what chemicals were used) and *who* is eating it (their genetics and environment) are two other factors not taken into account when examining nutritional differences in produce.** We also have to consider who is funding the study in question, and their specific interests. Another point of consideration is soil fertility, which is the diverse population of microorganisms, organic matter, nutrients, and minerals that creates the optimal environment for plants grow. According to the UN, intensive farming practices, deforestation, and climate change have degraded a third of the world’s soil health ([20](https://www.scientificamerican.com/article/only-60-years-of-farming-left-if-soil-degradation-continues/)). This is a problem, since **healthy, fertile soil feeds healthy plants, and higher quality plants means an increase in bioavailable (or easily absorbed) nutrients for us humans** ([21](https://www.scientificamerican.com/article/soil-depletion-and-nutrition-loss/)). Since organic farming is more focused on soil health, the connection can be made that **plants grown in a rich, thriving medium may offer more nutrients than those grown in depleted soils.** Note that at farmer’s markets, some smaller farms promote being “sustainable,” “regenerative,” “biodynamic,” or “pesticide-free.” These producers take it up a notch when it comes to soil health, and may or may not possess a USDA Organic certification (due to cost, need, resources, or other factors). So again, the best information will come from talking to your farmers and doing your own research about the farms you purchase from. ### Are Organics Less Harmful? When we consume fruits and vegetables, **we are not just consuming the nutrients that are in the food, but also the residual chemicals that went into farming it**, from the time the seed was planted, to the time it was plopped in the produce aisle of the grocery store. We, the eaters, are largely unaware of the chemicals used, the doses we’re consuming, and which of those substances bioaccumulate (pile up in our systems faster than our bodies can expel them). **The USDA Pesticide Data Program (PDP) has found synthetic pesticide residue on 21% of washed, organic U.S. produce and on a higher percentage of conventional produce** ([22](https://www.forbes.com/sites/stevensavage/2016/02/08/inconvenient-truth-there-are-pesticide-residues-on-organics/#d467f3683b92)). The fruit and vegetable samples were taken from distribution centers “close to the time and point of consumption, reflecting what is typically available to the consumer throughout the year” ([23](https://www.ams.usda.gov/sites/default/files/media/2014%20PDP%20Annual%20Summary.pdf)). In other words, they tested produce from larger scale operations, produce fit to be sold in your neighborhood grocery store. There is less data on organic pesticide residues, however. Various forms of pesticides are used in all stages of food production. Even regarding organic produce, Consumer Reports “Pesticide Report” states that “on some fruits and vegetables, one third to one half of the residues are from pesticides that were not applied in the fields or orchards but in storage” ([24](https://article.images.consumerreports.org/prod/content/dam/cro/news_articles/health/CR_FSASC_FromCroptoTablePesticides_Mar2015.pdf)) to kill insects or extend shelf life. Acceptable post-harvest chemicals include those 25 synthetic chemicals permitted on the field ([25](https://www.ams.usda.gov/sites/default/files/media/NOP%205023%20Post%20Harvest%20Hdlg%20Rev01.pdf)). Thus, **even if USDA certified organic produce escapes pesticide use on the farm, it may be treated post-harvest.** Now to make this topic even more complex, there is the issue of cross-contamination. **Some big organic farms use land parallel to their own conventional ones, which leaves room for pesticide drift in the air and water.** Just like neighboring operations and shared facilities, processers or distributers also play a role in chemical application, which risks accidental contamination. This unfortunate but completely natural kind of event is impossible to stop. Research has borne the bitter truth that just because produce is labeled “certified organic” it does not necessarily mean that it has been spared from exposure to synthetic pesticides. With that knowledge the question then becomes, how much of a concern *are* those pesticides? **In the US, chemicals are given the presumption of innocence, and accepted as safe until they’ve been proven otherwise.** The worrying part about this, is that there is not quite enough data out there. The EPA’s 2018 Annual Cancer Report classifies a chemical as either *likely* or *not likely* to be carcinogenic to humans. Definitive answers are hard to come by, and is more concerning considering that synthetic pesticides, some of which are carcinogenic or endocrine disruptors, have been found on 21% of organic produce. Even some organic pesticides, like the aforementioned copper sulfate, can also pose health risks. Guidelines from the Environmental Protection Agency (EPA) allow certain “tolerance levels” of these chemicals, measured in parts per million (ppm). For instance, apples may contain up to .5 ppm of an insecticide called diazinon, declared as safe in that amount. However, there are numerous other chemicals, like acephate, imazalil, and kresoxim-methyl, that are classified as “likely to be carcinogenic in humans” ([26](http://npic.orst.edu/chemicals_evaluated.pdf)) but have no established tolerance levels. **Tolerance levels are often based on what is healthy for an average male adult; this is not the same as what’s safe for a child, a pregnant woman, or an individual with autoimmune disease or other chronic health condition.** Despite this fact, many pesticides are allowed in food production and can be found on produce tested in the 2014 USDA Pesticide Data Program ([23](https://www.ams.usda.gov/sites/default/files/media/2014%20PDP%20Annual%20Summary.pdf)). To complicate things further, **there are countless pesticides allowed in the growing of our food (especially conventional), that do not have sufficient data to condemn them as health risks.** Research is ongoing but also lacking, as studies investigating chemical toxicity in agriculture are complicated, costly, and time consuming to carry out. The sheer number of variables involved in this area of research means we still don’t have a clear picture of the health impacts. A few topics demanding further investigation are: 1\. The synergistic effects of multiple chemicals 2\. The long-term cumulative effect of chemicals that remain in the body 3\. The effects on individuals with chronic health issues like autoimmune disease. **Organic agriculture is a broad spectrum, ranging from big organic operations to small regenerative farms.** By buying organic, you may avoid a higher volume of pesticides, and also encounter less toxic ones (like apple cider vinegar, baking soda, rosemary, etc), thus minimizing health risks. As the broken record states, however, the best way to get a clear picture of how your organic fruits and veggies are grown (and to decide if you should shell out more cash for organics in the first place) is to gather intel about the farms that produced them. ### Organics & Chronic Health Conditions The way your body reacts to chemical inputs on produce may be different than that of a typical research subject (typically a healthy male). Depending on your state of health, you may be more or less susceptible to environmental triggers. This is of special importance to anyone living with a chronic health condition as chemical intolerance is a growing concern in autoimmune disease and related issues. **Chemical intolerance means that symptoms flare up or are triggered by low-level chemical exposure** (e.g. residues on food, cleaning products, fragrance in detergent, etc.). It develops overtime as health issues persist, and even appears as other conditions begin to heal. Then there is the more severe version, which can have serious consequences on quality of life: Multiple Chemical Sensitivity (MCS). Chemical intolerance and MCS are largely unknown in the medical world, although the level of knowledge is slowly shifting. A lack of diagnostic tools and acceptance of this condition leads practitioners and loved ones to dismiss and doubt sufferers of chemical intolerance and MCS ([27](https://www.ncbi.nlm.nih.gov/pubmed/26088215)). Thus, many are self-diagnosed and forced to manage this condition on their own. ### The Bottom Line Eating organic or conventional is a personal choice, heavily influenced by resources, location, lifestyle, and health concerns. Organics are better for the soil and surrounding environment, and are potentially better for your health. Still, there is no definitive answer, since the produce you encounter at your local store may differ greatly from produce sold in a different part of the country. Ultimately, the best thing you can do is make informed decisions based on what’s best for you and your family. #### **Environment** Organic systems are not without flaw, but they do lead to better soil, more diverse ecosystems, and a lower risk of environmental contamination and toxic chemical exposure than most conventional ones. #### **Nutrients** Plants grown in a rich, thriving medium offer more nutrients than those grown in depleted soils soaked with chemical inputs. Small farms labeled sustainable, regenerative, biodynamic, or pesticide-free use fewer pesticides and exhibit healthier soil. Even regarding big organic farms, the USDA Organic label generally indicates lower pesticide use. This could mean more nutrient density; however, the most recent studies show no evidence of this. #### **Safety** Organic grocery store produce may contain synthetic pesticides due to large-scale farming practices, processing requirements, and farm and storage contamination. Research on the safety of synthetic pesticides is lacking, as chemicals are deemed safe until proven otherwise. Organic pesticides are considered less toxic; they are also only used as a last resort, especially on smaller farms. Again, buying sustainable, regenerative, biodynamic, or pesticide-free produce at your local farmer’s market is your best bet if avoiding all varieties of chemical inputs. #### **Do your own research** The USDA Organic label does not spell out the types of chemicals and amounts used, nor how committed the farms are to pesticide-free practices and why. Get to know the farms you purchase from by talking with the owners or workers, asking friends and neighbors, and scouring the internet for articles and videos. The more you know, the more power you have in contributing to safe, healthy practices in the growing of your food. ### Related Reading Curious about how diet and toxins affect autoimmune disease? Part two looks at red meat, dairy, food chemicals, and what foods may lower risk. [ Read: How Food Can Influence Autoimmune Disease ](https://www.autoimmuneinstitute.org/articles/what-does-organic-really-mean-part-two/) ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** Living Well with Autoimmune Disease --- ### [How Food Can Influence Autoimmune Disease](https://www.autoimmuneinstitute.org/articles/what-does-organic-really-mean-part-two) **Published:** August 16, 2023 **Author:** Carolyn Serraino **Excerpt:** While diet alone cannot guarantee the prevention of autoimmune diseases, certain foods and dietary patterns are believed to support a healthy immune system and reduce the risk of autoimmune conditions. **Content:** ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/D9cNJE2UEAApren-701x1024.jpeg) [In part one, we explored what the “organic” label really means](https://www.autoimmuneinstitute.org/articles/what-does-organic-really-mean-part-one) Autoimmunity is significantly impacted by [genetic](https://www.autoimmuneinstitute.org/2023/03/24/how-sex-genetics-influence-autoimmunity/) and [environmental](https://www.autoimmuneinstitute.org/2022/08/24/autoimmunity-on-the-rise/) factors, with the latter encompassing pathogens, food, and toxic chemicals. But… **[What Are the Mechanisms at Play When it Comes to Food and Autoimmune Disorders?](#anchor1)** **[How Does Organic or Non-Organic Food Contribute to Autoimmune Disorders?](#anchor2)** **[What Effects Do Red Meat and Dairy Have on the Body and the Immune System?](#anchor3)** **[What Foods are Recommended to Lessen Autoimmune Risk?](#anchor4)** To answer these questions, The Global Autoimmune Institute consulted Dr. Aristo Vojdani, author of “[*Food Associated Autoimmunities: When Food Breaks Your Immune System*](https://www.amazon.com/Food-Associated-Autoimmunities-Breaks-Immune-Autoimmunity/dp/0578499770).” ### **What Are The Mechanisms At Play When It Comes To Food And Autoimmune Disorders?** In the context of autoimmune diseases, molecular mimicry refers to a phenomenon where certain foreign substances or pathogens have structural similarities to components of the body’s own tissues. When it comes to food, Vojdani explains that certain components of food and human tissue share homology. When certain components of food and human tissue share homology, it means that they have similarities in their molecular structures or sequences. This resemblance can lead to confusion in the immune system. Therefore, when a food component is not properly digested and absorbed in the gastrointestinal tract, it can trigger an immune response in some individuals. This immune response may involve the production of antibodies against the undigested food component. The antibody against that component may then cross react with human tissue and turn against it, initiating an autoimmune disease. ### **How Does Organic Or Non-Organic Food Contribute To Autoimmune Disorders?** It doesn’t matter whether food is organic or non-organic, because amino acid sequences are the same regardless, in this regard, says Vojdani. However, if chemicals are added to a food, the calculus may change. Food additives, preservatives, pesticides, herbicides, and more may manage to interact with proteins and even modify a proteins’ structure. Such chemical interactions can lead to the formation of new compounds, some of which may be toxic or allergenic. In sum, says Vojdani, that means that the body may react more strongly against food that contains more toxic chemicals than food that does not contain toxic chemicals. It should be noted that organic food is not completely free of toxic chemicals either. “Even organic foods contain significant amounts of chemicals,” says Vojdani. But [organic food does have less toxic chemicals than non-organic food](https://pubmed.ncbi.nlm.nih.gov/24968103/). In sum, minimizing the possibility for chemicals to bind to the proteins and peptides of food minimizes the possibility of food antigens crossing gut barriers and entering the blood, allowing antibodies to attack tissues. Vojdani notes that when it comes to organic food, there is a common refrain that people are wasting their money because some may find that both types of foods have similar amounts of nutrients — or that organic food even has less nutrients. However, organic foods do have less toxic chemicals, which are a big contributor to autoimmune diseases. ### **What Effects Do Read Meat And Dairy Have On The Body And Immune System?** Diet has been closely tied to both alleviating and exacerbating autoimmunity. A [well-known study](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7388395/) by Gershteyn and Ferreira from the University of California San Francisco published in 2019 matched epitopes between 77 autoimmune diseases and 14 species of animals and plants used for food. An epitope is the part of an antigen molecule to which an antibody attaches itself. The authors did this because diet was already being proposed by some as a risk factor for some autoimmune diseases. Gershteyn and Ferreira’s own epitope matching between the autoimmune diseases and the foods found that red meat (cow, sheep, goat, pig) had the highest matching index, poultry and fish (chicken, turkey, duck. tilapia, salmon) had an intermediate index, and cereals (rice, quinoa, soybean, rye and wheat) had a low index. The standout hit was pig or pork, with generally about 10-15 times the number of matching epitopes as the other species. The higher the number of matches, the greater possibility of autoimmune problems arising, with pork apparently the food to watch out for. For Vojdani, that’s mostly because meat has more proteins that are identical to human tissue when compared to foods like vegetables. Pork, for example, has the highest homology with the human body, with pigs frequently used as [animal models for medical research](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8623580/) due to their biological similarity with humans. Likewise, there are many studies which have examined the impact of dairy. Vojdani notes that the consumption of cows’ milk products, for example, has been associated with an increased risk of autoimmunity. It has also [been proposed as a contributor](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4104257/) to the development of [type 1 diabetes](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/diabetes-type-1/) and [Multiple Sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/). ### **What Foods Are Recommended To Lessen Autoimmune Risk?** While diet alone cannot guarantee the prevention of autoimmune diseases, certain foods and dietary patterns are believed to support a healthy immune system and reduce the risk of autoimmune conditions. “Without any reservations, I recommend dairy free and gluten free diets for individuals with a history of neuro-autoimmune disorders,” Vojdani says. In the case of gluten, some individuals with autoimmune thyroid conditions, such as [Hashimoto’s thyroiditis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/hashimotos-thyroiditis/) or [Graves’ disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/graves-disease/), may exhibit cross-reactivity between gluten antibodies and proteins in the thyroid gland. As such, Vojdani recommends starting the day with fruits, vegetables, coconut or almond milk, and fiber or flaxseed. He also recommends diets that are low in salt and have no artificial sweeteners. ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** Living Well with Autoimmune Disease --- ### [Exercise and Autoimmune Disease: Evidence-Based, Low-Impact Approaches](https://www.autoimmuneinstitute.org/articles/exercise-and-autoimmune-disease-evidence-based-low-impact-approaches-3) **Published:** February 5, 2026 **Author:** Carolyn Serraino **Excerpt:** An expert-informed, evidence-based overview of low-impact exercise approaches for people with autoimmune disease. **Content:** ### When Autoimmune Disease Meets Real Life Autoimmune disease rarely unfolds under ideal conditions. Many people must balance managing symptoms with work, financial strain, fluctuating energy, and barriers to healthcare. This series explores practical aspects of living with autoimmune disease with expert insights. [ Navigating Autoimmune Care With Limited Resources ](https://www.autoimmuneinstitute.org/articles/navigating-autoimmune-care-with-limited-resources) examines healthcare barriers and strategies for accessing care. [ Exercise and Autoimmune Disease: Evidence-Based, Low-Impact Approaches ](https://www.autoimmuneinstitute.org/articles/exercise-and-autoimmune-disease-evidence-based-low-impact-approaches) highlights sustainable movement that supports immune health. [ Finding Purpose and Fulfillment with Autoimmune and Chronic Disease ](https://www.autoimmuneinstitute.org/articles/finding-purpose-and-fulfillment-with-autoimmune-and-chronic-disease) explores how people rebuild identity and pursue meaningful goals while living with chronic illness. ## Physical Activity Without Overdoing It Physical activity (any movement of the body generated by the skeletal muscle) and exercise (any organized and regular physical activity) are an important part of a person’s well-being. They can take various forms and levels of intensity, with the American Heart Association (AHA) recommending at least 150 minutes of moderate activity each week ([1](https://www.heart.org/en/healthy-living/fitness/fitness-basics/aha-recs-for-physical-activity-infographic)). AHA recommendations are general guidelines for adults, but exercise can benefit everyone, including people with chronic illnesses. To better understand how people with autoimmune diseases may benefit from low-impact training, we spoke with three experts: **Kara Wada**, MD, founder of the Immune Confident Institute in Columbus, OH; **Caryn McAllister**, PT, DPT, founder of High Quality Home Therapy in Stamford, CT; **Michela Bressan**, OD, practicing osteopath and physical exercise specialist in Ferrara, Italy. ### How Can Low-Impact Movement Help People With Autoimmune and Inflammatory Diseases? Low-impact movement is especially helpful for those with an autoimmune disease because it helps strengthen the heart and keep energy levels up without stressing the joints and other parts of the body. Low-impact activities include: - Walking - Swimming - Rowing - Cycling - Yoga - Pilates - Machine workouts, such as elliptical trainers or vertical climbers ### How Does Movement Regulate the Immune System? Moving the body through physical activity or exercise has many favorable effects on various organs and systems, including the nervous and immune systems ([2](https://pubmed.ncbi.nlm.nih.gov/39097997/), [3](https://pubmed.ncbi.nlm.nih.gov/29108826/)). #### Regular physical activity activates immune factors and pathways that reduce or eliminate [inflammation](https://www.autoimmuneinstitute.org/articles/inflammation-a-driving-force-of-autoimmune-disease "Inflammation: A Driving Force of Autoimmune Disease") (a major response in chronic disease and autoimmunity). “Physical activity influences both the innate and adaptive immune system through multiple biological pathways. When muscles contract during movement, they release chemical messengers called myokines, which can stimulate anti-inflammatory pathways (e.g., increased IL-10) while lowering pro-inflammatory signaling like IL-1β,” says [Wada](https://www.drkarawada.com/), an expert in Sjögren’s disease. Exercise also appears to promote the activity of regulatory T cells, which play an important role in preventing autoimmunity ([4](https://pubmed.ncbi.nlm.nih.gov/39303372/)). The way physical activity and exercise regulate a person’s immune system also boost other parts of the body, helping to improve overall well-being. “Movement regulates the immune system by decreasing inflammation, moving fluids around in the body (lymph, blood, urine, feces), decreasing [stress](https://www.autoimmuneinstitute.org/articles/stress-autoimmune-disease-navigating-the-complex-relationship "Stress & Autoimmune Disease: Navigating the Complex Relationship") and activation of stress hormones, promoting sleep, and more” says [McAllister](https://www.hqhtherapy.com/provider/caryn-b-mc-allister-pt-dpt-ceo). ### What Are the Benefits of Physical Activity and Exercise in People With Autoimmune Diseases? Research suggests that physical activity and exercise are safe in most autoimmune diseases ([3](https://pubmed.ncbi.nlm.nih.gov/29108826/)). However, identifying what type of movement will be both safe and beneficial for an individual person is crucial. “When I work with clients who have autoimmune diseases, I generally focus more on physical activity rather than physical exercise,” says McAllister. “I want people to shoot for consistent regular pain free movement because sometimes that alone can be quite challenging.” People with [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid arthritis") who were physically active showed improved cardiovascular disease profiles and joint flexibility. People with [type 1 diabetes](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/type-1-diabetes-insulin-dependent-diabetes/ "Type 1 diabetes / insulin-dependent diabetes") who exercised regularly had decreased risk of both cardiovascular disease and autonomic neuropathy. Thanks to physical activity, those with [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/ "Multiple sclerosis") showed improvements in mobility, fatigue, mood, and cognitive abilities ([3](https://pubmed.ncbi.nlm.nih.gov/29108826/)). A small clinical study on [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus") indicated that women enrolled in supervised aerobic exercise routines showed improvements in heart and lung function and fatigue levels ([5](https://pubmed.ncbi.nlm.nih.gov/36220328/)). The benefits of exercise for symptom improvement and quality of life were reported in a systematic review and meta-analysis on [Sjögren disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sjogren-syndrome/ "Sjögren disease (SjD)") ([6](https://pubmed.ncbi.nlm.nih.gov/40062666/)). “In Sjögren’s disease, resistance-focused programs have shown meaningful improvements in fatigue, pain, aerobic capacity and quality of life in clinical studies,” says Wada. ### Can Exercise Be Matched With People, Conditions, and Symptoms? Experts highlight that the type of physical activity should be selected based on a person’s autoimmune conditions, personal preferences, and symptoms. #### “Since immune diseases don’t discriminate, I find that my clients vary in age, diagnosis, stage of life, and cultural representation,” says McAllister. “The best exercise / physical activity for any individual is the one they want to do, so it’s important that a physical therapist custom-tailor specific activities for each patient based on needs, goals, and symptom provocation.” Experts agree on the importance of low-impact movements for the treatment of symptomatic disease. Many people with an autoimmune disease have joint pain and stiffness, so they tend to tolerate activities that enhance joint mobility better than those that place heavy mechanical strain on the joints, such as jogging or jumping. “Low-impact activities are especially beneficial for patients with inflammatory or autoimmune diseases because they do not involve jumping and do not excessively raise the heart rate,” says Bressan. Organized, regular physical activity and training were shown to improve cardiovascular problems in people with rheumatoid arthritis and inflammation in multiple autoimmune diseases (rheumatoid arthritis, multiple sclerosis, lupus, and type 1 diabetes) ([7](https://pubmed.ncbi.nlm.nih.gov/37907642/), [8](https://pubmed.ncbi.nlm.nih.gov/38341137/)). Wada suggests swimming, water aerobics, gentle cycling, walking, and combination training. “In conditions where fatigue is a major barrier, evidence supports combining low-intensity cardiovascular work with light resistance exercises to help improve aerobic capacity and reduce fatigue.” ### How Can People With an Autoimmune Disease Exercise During a Flare-Up? “Typically, low-impact activities help best during flare-ups. These can include gentle walking, swimming, walking in water to decrease the effects of gravity on joints, restorative yoga, beginner Pilates, and biking. I’ve had some clients enjoy tai chi and qigong too – these seem to help with decreasing stress, promoting balance and centeredness as well as gentle strengthening,” mentions McAllister. #### “During disease flare-ups, reducing intensity and focusing on gentle mobility and circulation can help maintain function without adding stress,” says Wada. “Simple range-of-motion stretches, short walks, or similar low-intensity activities are often easier to tolerate, and warm water environments can be soothing when pain is heightened.” Experts also note that people with an autoimmune disease may not be able to exercise or move at all because of [flare-ups](https://www.autoimmuneinstitute.org/articles/outbursts-in-autoimmunity-disease-flare-ups/) such as pain, fatigue, and malaise. In these situations, McAllister recommends something gentle and calm, such as breathing exercises. ### What Are Some of the Precautions of Exercising With an Autoimmune Disease? Even exercise that is meant to be beneficial can lead to adverse effects. Some of the common effects observed in people with autoimmune disease include: - Post-exertional malaise (PEM) ([9](https://pubmed.ncbi.nlm.nih.gov/40778181/)) - Joint stress ([8](https://pubmed.ncbi.nlm.nih.gov/38341137/)) - Overtraining responses ([10](https://pubmed.ncbi.nlm.nih.gov/40264836/)) “A ‘pacing-first’ approach prioritizes experience and response over performance and helps avoid ‘boom-and-bust’ cycles that can worsen symptoms. For people who experience PEM, tailored, graded movement with adequate rest is especially important. A one-size-fits-all workout plan doesn’t work for this group,” says Wada. #### To avoid excessive fatigue and malaise, Bressan suggests choosing activities during a preferred time of day, which will vary for every person. “If in the morning you feel more ‘slowed down’, exercise in the second part of the day; if in the afternoon/evening you feel more tired, make sure to train in the morning,” says Bressan.**“**Choose ‘scalable’ exercises that include a softer version you can adopt on the toughest days.” She adds that recovering between sessions is just as important as the training itself, so for example, people should avoid training two days in a row. ### Understanding What Training Routines May Work Best Research will continue to inform best low-impact activities and exercise routines to optimize benefits and reduce adverse effects ([11](https://pubmed.ncbi.nlm.nih.gov/40631512/), [12](https://pubmed.ncbi.nlm.nih.gov/41430002/)). However, responses differ for every person and autoimmune disease, so it is essential to develop an appropriate movement or training plan with the help of a trusted care team. “Information is educational and not medical, so before starting or changing any exercise routine, people should discuss their plans with their own healthcare team to ensure safety, especially if they have chronic autoimmune or complex medical conditions,” says Wada. “Structured programming, whether through a physical therapist, exercise physiologist or a supportive group class, helps people build sustainable routines that are safer and more enjoyable. Programs that allow flexibility within a supportive framework can reduce anxiety about movement, provide accountability, and help participants learn their own thresholds and patterns,” concludes Wada. ### Professional Organizations and Physical Activity Information ## Arthritis Foundation Offers Your Exercise Solution (YES), a resource developed by physical therapists that helps create physical activity routines based on specific needs and abilities of people with [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/). [Learn More](https://www.arthritis.org/health-wellness/healthy-living/physical-activity/getting-started/your-exercise-solution) ## Lupus Foundation of America  Provides a low-impact exercise routine for people with [lupus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/) to protect the joints, reduce fatigue, and boost energy. [Learn More](https://www.lupus.org/resources/a-low-impact-exercise-routine-for-lupus) ## Multiple Sclerosis Association of America Features video series on movement, energy conservation, and other wellness topics for people with [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/). [Learn More](https://mymsaa.org/videos/ms-health-and-wellness-video-series/) ## Crohn’s and Colitis Foundation Provides information on physical activity and helpful tips on exercise for people with inflammatory bowel disease ([Crohn’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crohns-disease/) and [ulcerative colitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ulcerative-colitis/)). [Learn More](https://www.crohnscolitisfoundation.org/patientsandcaregivers/campus-connection/navigating-college/exercise) ## Sjögren’s Foundation Offers essential tips for living with [Sjögren’s](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sjogren-syndrome/), including a specific exercise pointer. [Learn More](https://sjogrens.org/living-with-sjogrens/survival-tips) ##### **Always discuss physical activities and exercises with your physician, physical therapist, or other health provider.** ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/GAI-Logo-Image-e1707845715517.png) #### About the Author ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/07/Chiavolini-Damiana-scaled.jpg) A freelance writer who specializes in medical and life science topics. As a trained researcher, she authored journal articles in the areas of infection and immunity and wrote booklets and book chapters about different diseases. As a professional communicator, she writes feature articles for magazines and other publications and develops content for higher education platforms. Damiana is also an experienced academic editor, microbiology educator, writing coach, and fragrance blogger. She is a contributing member of the American Medical Writers Association and a past-president of the association’s Southwest Chapter. Damiana Chiavolini, MS, PhD Freelance Writer for GAI ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** Living Well with Autoimmune Disease --- ### [The Stages of Autoimmunity](https://www.autoimmuneinstitute.org/articles/the-stages-of-autoimmunity) **Published:** December 19, 2025 **Author:** Carolyn Serraino **Excerpt:** Autoimmune disease can take years to develop, moving from silent immune misfires to full clinical symptoms. Researchers are discovering that before a diagnosis is ever made, the immune system may already be producing autoantibodies and mounting inflammatory responses against the body’s own tissues. Understanding these early “stages” of disease could facilitate prevention and earlier intervention. To explore what happens as autoimmunity takes shape, this article features insight from Jane Buckner, MD, President of the Benaroya Research Institute at Virginia Mason Franciscan Health, and Michael Rosenblum, MD, PhD, Professor of Dermatology at the University of California, San Francisco, both of whom study the immune mechanisms that drive disease onset and regulation. **Content:** ### How Autoimmunity Changes Over Time Autoimmune disease doesn’t follow a single path; it evolves. This series explores how immune activity shifts across the lifespan, from the earliest signs of [emerging autoimmunity](https://www.autoimmuneinstitute.org/articles/the-stages-of-autoimmunity/), to the rise of [late-onset disease in older adults](https://www.autoimmuneinstitute.org/articles/understanding-late-onset-autoimmunity/), to the ways [aging reshapes and weakens immune balance](https://www.autoimmuneinstitute.org/articles/aging-and-autoimmune-disease/). Autoimmune disease can take years to develop, moving from silent immune misfires to full clinical symptoms. Researchers are discovering that before a diagnosis is ever made, the immune system may already be producing autoantibodies and mounting inflammatory responses against the body’s own tissues. Understanding these early “stages” of disease could facilitate prevention and earlier intervention. To explore what happens as autoimmunity takes shape, this article features insight from **Jane Buckner, MD**, President of the Benaroya Research Institute at Virginia Mason Franciscan Health, and **Michael Rosenblum, MD, PhD**, Professor of Dermatology at the University of California, San Francisco, both of whom study the immune mechanisms that drive disease onset and regulation. ## What Factors Predispose You to Autoimmunity? Before an autoimmune disease develops, genetic and environmental factors must converge to set the stage for disease progression. “Some people are born with a genetic risk for autoimmune disease. That doesn’t mean you’re going to get an autoimmune disease, but it does mean you might be predisposed to it,” says [Dr. Buckner](https://www.benaroyaresearch.org/our-research/labs-research/lab/buckner-lab). These [genetic factors](https://www.autoimmuneinstitute.org/articles/about-autoimmune/how-genetics-influence-autoimmunity/) include mutations in genes that affect immune regulation, and autoimmune diseases often involve multiple mutations simultaneously. Some examples of genetic mutations involved in autoimmunity include: - **HLA (human leukocyte antigen) region:** The HLA region is a risk factor for many autoimmune diseases. This was the first genetic link to autoimmune disease found ([1](https://doi.org/10.1016/j.jaut.2015.08.015)). HLA is involved in presenting antigens to immune cells. - **PTPN22:** PTPN22 encodes an enzyme involved in multiple signaling pathways and has been linked to numerous autoimmune diseases ([2](https://pubmed.ncbi.nlm.nih.gov/33866147/)). - **FOXP3:** FOXP3 is required for the development and function of regulatory T cells which help in self-tolerance ([3](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5793224/)). An autoimmune disease called immunodysregulation polyendocrinopathy enteropathy X-linked (IPEX) is caused by a FOXP3 mutation ([4](https://doi.org/10.1155%2F2007%2F89017)). What drives genetic disposition towards autoimmunity is a myriad of [environmental factors](https://www.autoimmuneinstitute.org/articles/about-autoimmune/more-risk-factors-for-autoimmune-disease/#environmental-factors). #### Environmental factors involved in autoimmunity include: [Stress](https://www.autoimmuneinstitute.org/articles/stress-autoimmune-disease-navigating-the-complex-relationship "Stress & Autoimmune Disease: Navigating the Complex Relationship") [Viral infection](https://www.autoimmuneinstitute.org/covid_timeline/long-covid-follows-a-pattern-of-post-viral-illness/) [Chemical or toxin exposure](https://www.autoimmuneinstitute.org/research_updates/toxic-exposure-and-autoimmune-disease-superfund-sites/) [UV radiation](https://www.autoimmuneinstitute.org/articles/stay-cool-how-to-manage-autoimmune-flare-ups-in-hot-temperatures) [Microbiome](https://www.autoimmuneinstitute.org/articles/pesticide-use-the-gut-microbiome "Pesticide Use & the Gut Microbiome") ## Preclinical Autoimmunity: Autoimmunity Without Symptoms With the specific combination of genetic predisposition and environmental exposure in place, autoimmunity can progress into what’s known as autoreactivity. At this stage the immune system responds to a self protein and generates autoantibodies against our own tissues, but there aren’t any outward symptoms. This stage is called [preclinical autoimmunity](https://www.autoimmuneinstitute.org/examining-pre-autoimmunity-can-autoimmune-disease-be-prevented/) or silent autoimmunity. “Some people never progress beyond that stage,” says Buckner. Why some people develop autoimmune diseases and others do not is another area of exploration for many scientists who study autoimmunity. “We have all of these mechanisms in our body that try to regulate and control inflammation,” says [Dr. Rosenblum](https://profiles.ucsf.edu/michael.rosenblum). “Many people, including myself, believe that it’s really a defect in the ability to control inflammation that results in autoimmune diseases.” While there have been many mechanisms proposed to explain how autoimmunity progresses, scientists have honed in on the imbalance between effector T cells, which promote inflammation, and regulatory T cells, which control inflammation, as one of the driving forces behind autoimmune disease progression. “Regulatory T cells actually wander around the body. They can be triggered to suppress inflammation,” says Buckner, who studies the role of these cells in autoimmunity. “If you don’t have them, you actually get all sorts of autoimmune diseases.” ## Clinical Signs of Autoimmunity  As autoreactivity progresses, it leads to more and more [inflammation](https://www.autoimmuneinstitute.org/articles/about-autoimmune/inflammation-a-driving-force-of-autoimmune-disease/) and tissue damage and you begin to see [symptoms of autoimmune disease](https://www.autoimmuneinstitute.org/articles/about-autoimmune/symptomlist/). Left unchecked, autoimmunity can be seen as a self-perpetuating feedback loop where self-antigens can’t be eliminated, tissue damage activates further immune responses, which leads to more inflammation and tissue damage, and subsequently more immune activation (5). Autoimmune diseases can cycle through [flare-ups](https://www.autoimmuneinstitute.org/articles/living-well/autoimmune-disease-flare-ups/) where symptoms worsen and remissions where symptoms wane or disappear completely for a period of time. “Flares may be driven by environmental exposures that could change that balance of your immune system in such a way to allow the autoimmunity to become more aggressive,” says Buckner. Remissions can be achieved by many mechanisms such as immunosuppressive medications. ## How do you Control Autoimmunity? Can it be Reversed? The key to keeping autoimmune disease in check is reducing inflammation by limiting effector T cell response and increasing regulatory T cell response. This can be done by boosting immune regulation and/or by targeting the specific factors driving inflammation, says Rosenblum, who studies the regulation of immune responses and autoimmune skin diseases. Many autoimmune diseases cannot be completely cured but treatments that modulate the immune response have been helpful in managing symptoms of disease. Rosenblum is hopeful about advancements in cell depletion therapy ([6](https://doi.org/10.1038/s41573-020-00092-2)). “Cell depletion therapy is one of the only places where we’ve actually really been able to achieve cure for autoimmune diseases,” says Rosenblum. Activities like diet and exercise can have impacts in mild forms of autoimmune disease, but for more severe forms of disease, lifestyle changes aren’t enough to tame autoimmunity. However, some autoimmune diseases, like celiac disease, IBD, or Crohn’s disease, can benefit from dietary changes. ## Does Autoimmune Disease Severity Change Over Time?  For the most part, the severity of symptoms associated with autoimmune disease remains the same throughout life. Rosenblum says that in most cases, mild forms of disease will stay mild and severe forms of disease will stay severe. “Some people actually start out relatively mild and then they develop fulminant and severe disease that is way farther on the disease spectrum in which they started,” says Rosenblum. “That’s usually rare.” ## Examples of Autoimmune Disease Progression **Type 1 diabetes**: Preclinical autoimmunity is characterized by the presence of diabetes-related autoantibodies ([7](https://doi.org/10.1159/000053305)). This stage can last years. There are no symptoms of disease, but there can be evidence that beta cells aren’t producing enough insulin. When autoimmunity manifests with clinical symptoms, treatment involves insulin injection. **Rheumatoid arthritis**: Risk factors for rheumatoid arthritis include variation in the HLA allele and smoking ([8](https://doi.org/10.1016/j.jaut.2019.102392)). Rheumatoid arthritis autoantibodies can be detected for years before disease onset. Disease affects the joints, usually in the hands, feet, and knees, and is characterized by immune cell infiltration into the joints. **Systemic Lupus Erythematosus (SLE)**: Before any noticeable symptoms of SLE, the immune system is already changing and is characterized by the presence of autoantibodies, cytokines, and antigen-antibody complexes ([9](https://doi.org/10.3389%2Ffimmu.2022.890522)). Some patients progress to clinical symptoms, including fatigue, rashes, fever, and joint pain, while others do not. ## Understanding the Autoimmunity Continuum to Inform Treatments Research into how autoimmunity presents itself both on the molecular level and on the clinical level can help scientists understand more about disease progression and inform treatments. Buckner says that understanding the transition between preclinical autoimmunity to symptomatic autoimmune disease is key. “If we can pick out those people who have autoreactivity but don’t have the illness yet – that’s where we could intervene to keep them from ever getting it,” says Buckner. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/GAI-Logo-Image-e1707845715517.png) ### About the Author ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/10/Jennifer-Tsang-Bio-Headshot-e1753113113430.jpg) A microbiologist turned freelance science writer who works with life science companies, nonprofits, and academic institutions on anything from news stories, explainer articles, and content marketing. She shares the wonderful world of microbes on her blog The Microbial Menagerie. Jennifer Tsang, PhD Freelance Writer for GAI ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** About Autoimmune Disease --- ### [What Not to Say to Someone with a Chronic Illness](https://www.autoimmuneinstitute.org/articles/what-not-to-say-to-someone-with-a-chronic-illness) **Published:** March 5, 2020 **Author:** Carolyn Serraino **Content:** If you know someone—a friend, parent, sibling, patient, coworker—with a chronic or invisible illness like autoimmune disease, you may be unsure of how to talk to them, and how to respond appropriately in regards to their health. It can be tricky, especially since good intentions are often drowned out by poor word choice. You may want to reflect on where your comments are coming from—confusion, lack of knowledge on the subject, difficulty empathizing, etc. Or maybe your friend or family member’s situation is triggering and you’re speaking from a place of trauma. The important thing, however, is that you care and are self-aware enough to examine your own language and learn better ways to respond. Below are examples of comments chronically ill people often hear, followed by “translations” meant to demonstrate how the words are actually heard, and suggestions of what to say instead. ### **8 Things Not To Say To Someone With A Chronic Illness** #### **1. “You’re probably just stressed”** ##### *Translation: “You brought this on yourself”* This kind of statement plays the blame game. It implies that the person let this happen because they got too stressed, and that they are in fact the root cause of their condition. It lacks empathy and disregards any other factors involved. Yes, stress can trigger or exacerbate issues, but it never acts alone. To assume so is to dismiss the person and devalue the knowledge they have of their own body. ##### Instead: “That has to be frustrating” “I hope you find out what’s wrong” “How can I best support you?” #### **2. “You should do yoga”** ##### *Translation: “You’re probably just stressed”* \*see above Disguised as advice, telling someone to try yoga or other similar suggestions implies one or all of the following: - Your friend or family member never thought of trying yoga before - You have the answer to their problems - Your experience with yoga will be their experience - They just need to destress and they’ll feel better ##### Instead: “What are some things that help you feel better?” #### **3. “It could be worse”** ##### *Translation: “Suck it up” “Your experience isn’t valid”* You could make this case in pretty much any situation. For example, you find out that your significant other is cheating on you and a friend responds with, “It could be worse. It’s not that big of a deal, at least he wasn’t abusive.” Can you imagine the guilt, shame, and embarrassment you would feel? “It could be worse” is a comment aimed at providing comfort, while in fact devaluing personal experience. It rejects a person’s right to feel angry, frustrated, sad, disappointed, hopeless, or any other number of emotions that come with navigating a chronic illness on a daily basis. ##### Instead: Simply listen and be there for them. If you don’t know what to say, be honest and tell them that. #### **4. “Just don’t eat gluten, you’ll be fine”** ##### *Translation: “It’s not that hard”* This is an oversimplification of a very complex situation. People with celiac disease (and those with suspected gluten sensitivity) often hear this from their doctors, or even from others who do not quite understand what going gluten-free truly means. Changing their lifestyle includes a number of factors, such as social pressures to eat wheat and “fit in”, extreme sensitivity even to crumbs in a toaster or flour dust in the air, relearning how and what to cook, triggering ingredients hidden in familiar foods, anxiety when going out to eat, recovering from a gluten reaction, and the list goes on. Plus, for many people with celiac disease or gluten sensitivity, just taking care of the gluten is not enough to eliminate symptoms. There are often more pieces to the puzzle. ##### Instead: ask about their health journey, how they found a diagnosis, what their greatest challenges are (or will be) when living gluten-free, etc. > *To understand what challenges a person with celiac disease may be facing, check out the* [*Getting Started Guide*](https://childrensnational.org/departments/celiac-disease-program/resources-for-families) *and other resources from the Celiac Program at Children’s National Medical Center.* #### **5. “You should do \_\_\_\_\_, it worked for me”** ##### *Translation: “You obviously haven’t tried the right things”* Similar to “you should do yoga”, this is a false friend. The intention may be to help, but it misses the mark. It is wonderful to hear how a therapy or practice has helped you feel better. But at the moment it’s not about your journey, it’s about theirs. Unless the person you’re addressing specifically asks for advice, comments like this can be less than helpful. They assume that the person has not heard of the practice before, that they aren’t doing everything they can to improve their health, and that they will have the same experience as you did. ##### Instead: “What are some things that have helped you feel better before?” “Is there anything new you’ve been wanting to try?” “Let me know if there’s anything I can do to help.” #### **6. “I think you should talk to someone”** ##### *Translation: “I don’t believe you” “It’s all in your head”* Therapy can be an invaluable tool for anyone, including people living with chronic health conditions. But this comment is dismissive and lacking in empathy, implying that what the person is dealing with is purely psychosomatic. People with unexplained symptoms are often told (even by their doctors) that they’re not actually sick, which prolongs diagnosis and sows distrust in the medical system, as well as harboring shame, confusion, and isolation. The comment “I think you should talk to someone” pairs well with “You’re probably just stressed” or “You should do yoga.” ##### Instead: “That has to be frustrating” “I hope you find out what’s wrong” “How can I best support you?” #### **7. “Are you sure you can’t eat that?”** ##### *Translation: “I don’t trust you.”* If someone tells you they cannot have cheese, for example, and your response is “are you sure?” that signals a problem. Think about the root of why you’re asking that. Maybe you don’t understand their food restrictions or you’re uncomfortable in some way. It could even mean that there are personal feelings of insecurity bubbling beneath the surface. It may be tough to watch your friend or family member dig into a big salad while you chow down on pizza, or eat their own “special” cookies instead of your famous homemade treats. You may view their refusal to eat “normal” or “unhealthy” food as an attack on your own eating habits. In reality, what they eat has nothing to do with you – it is not a judgement of your choices, nor a rejection of your hard work and talent in the kitchen. If they tell you no, it means no. Keep in mind that there is much you do not know about their health situation. Trust that they know what’s best for them and their body. ##### Instead: Say nothing, or “I’m happy you’re here!” “I’d love to know more about your diet if you feel like sharing” #### **8. “But you don’t look sick”** ##### *Translation: “You’re faking it” “I don’t believe you” “You’re a hypochondriac” “There’s nothing wrong with you”* If you notice yourself even thinking this in response to, say, a coworker leaving early because of their autoimmune disease, take a step back. Try to think about times when you haven’t felt well and no one could tell. Should you have to prove to everyone around you that you have a headache in order to make it true, to validate the pain you’re feeling? What we see on the outside never tells the full story. ##### Instead: “Let me know if you need anything” or “I’d like to better understand what you’re going through. I’m here to listen if you’d ever like to share” ### The Bottom Line Much of the time, what people are looking for when they talk about a challenge in their health journey is compassion. Not pity, not solutions, not unsolicited advice, and especially not judgement—just a listening ear, maybe a hug, or an “I believe you” or “I’m here for you.” If they want your opinion or suggestions, they’ll ask! To better understand your friends or family members who have chronic illnesses, check out personal [Autoimmune Stories](https://www.autoimmuneinstitute.org/category/autoimmune-stories/) describing what it’s like to live with these conditions on a daily basis. Another great way to get a clearer picture of what it’s like to have a lifelong health condition, is encouraging your friends and family members to share their experiences. This helps to raise awareness, by adding more voices into the greater conversation around autoimmune disease. They can express themselves on social media or by using journal prompts and submitting their [stories to the Global Autoimmune Institute](https://www.autoimmuneinstitute.org/share-your-story/). ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** Autoimmune Care & Caregiver Support --- ### [Understanding Long COVID](https://www.autoimmuneinstitute.org/articles/understanding-long-covid) **Published:** December 19, 2020 **Author:** Carolyn Serraino **Excerpt:** Long-term effects from COVID-19 fall into several categories, making it difficult to identify when the normal recovery period ends and long COVID begins. **Content:** > For up to date information and more answers, visit our [Long Covid FAQ page](https://www.autoimmuneinstitute.org/long-covid-faq/) ### **W**hat is “Long Covid”? Although there is no firm agreement in the medical world, long COVID develops when COVID-19 patients find that their symptoms persist after the normal period of recovery. These patients may also experience new and puzzling symptoms after they are confirmed COVID negative. **You may have long COVID or be a “long hauler” if you had confirmed or suspected COVID-19, and you have not fully recovered or returned to your previous state of health—for weeks or months after the infection itself has gone.** Other terms used are post-COVID-19 syndrome and chronic COVID-19; however, they “risk delegitimizing suffering… and that will make it harder for people to access care,” the authors of a *Nature* editorial state ([1](https://www.nature.com/articles/d41586-020-02796-2)). In fact, among the difficulties long COVID patients face is credibility. Patients may feel dismissed by their health care practitioner if they still have lingering unexplainable symptoms post-recovery. With still developing knowledge of COVID-19’s long-term ramifications, both patients are feeling their way forward. The varying lengths of time that patients experience lingering symptoms are debated. A King’s College Study states that long COVID is the presence of continued symptoms for over one month ([2](https://www.kcl.ac.uk/news/study-identifies-those-most-risk-long-covid)), while entities in the United Kingdom, such as The National Institute for Health & Care Excellence (NICE), have determined the time period to be more than three months ([4](https://www.pharmaceutical-journal.com/news-and-analysis/features/i-could-barely-function-the-devastating-effects-of-long-covid/20208498.article)). Any of the above estimates is in stark contrast with the fact that a typical coronavirus infection resolves after two weeks. ### Four Categories of Long-Term Effects Long-term effects from COVID-19 fall into several categories, making it difficult to identify when the normal recovery period ends and long COVID begins. 1. Post-intensive care syndrome ([4](https://www.pharmaceutical-journal.com/news-and-analysis/features/i-could-barely-function-the-devastating-effects-of-long-covid/20208498.article), [5](https://medicalxpress.com/news/2020-09-long-term-effects-covid-cope.html)) 2. Organ damage (including heart, lung, brain, and kidneys) from COVID-19-related pneumonia, lung inflammation, and other complications ([4](https://www.pharmaceutical-journal.com/news-and-analysis/features/i-could-barely-function-the-devastating-effects-of-long-covid/20208498.article), [5](https://medicalxpress.com/news/2020-09-long-term-effects-covid-cope.html), [6](https://www.health.harvard.edu/blog/the-tragedy-of-the-post-covid-long-haulers-2020101521173), [7](https://www.weforum.org/agenda/2020/11/lung-damage-covid-dead-long-covid-study), [8](https://www.weforum.org/agenda/2020/11/lung-damage-covid-dead-long-covid-study)) 3. Ongoing symptomatic COVID-19, which the U.K.’s NICE defines as continued symptoms for 4 to 12 weeks ([4](https://www.pharmaceutical-journal.com/news-and-analysis/features/i-could-barely-function-the-devastating-effects-of-long-covid/20208498.article)) 4. **Post-COVID-19 syndrome, post-infectious fatigue syndrome, or post-viral syndrome – generally known as long COVID** You may see the term “long COVID” as referring to all or some of these effects; however, it has become more synonymous with the mysterious lingering symptoms—ones unrelated to organ damage—experienced by both severely and mildly ill patients alike. ### Common Long Covid Symptoms A person experiencing long COVID has persistent symptoms despite a negative coronavirus test after the normal recovery period from COVID-19. Symptoms can come and go, change over time, and affect any system in the body ([4](https://www.pharmaceutical-journal.com/news-and-analysis/features/i-could-barely-function-the-devastating-effects-of-long-covid/20208498.article)). For many, despite fatigue, brain fog, shortness of breath, and other debilitating symptoms, routine lab work will show zero red flags. This makes the search for answers frustrating and confusing for both doctor and patient. According to patient studies ([6](https://www.health.harvard.edu/blog/the-tragedy-of-the-post-covid-long-haulers-2020101521173), [8](https://www.weforum.org/agenda/2020/11/lung-damage-covid-dead-long-covid-study)), the most common symptoms reported include: - Extreme fatigue - Body aches - Shortness of breath - Difficulty concentrating (brain fog) - Trouble sleeping - Headaches The CDC includes joint pain and chest pain on their list, as well as other reported symptoms like depression, muscle pain, intermittent fever, and rapid heartbeat ([9](https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects.html)). ### Post-Exertional Malaise & ME/CFS **One other common occurrence in people with long COVID is post-exertional malaise (PEM)**, “where even mild physical exertion can cause a severe symptom flare-up for days,” says Dr. Putrino at the Mount Sinai Hospital in New York ([7](https://mecfsresearchreview.me/2020/09/17/understanding-long-covid-a-shortcut-to-solving-me-cfs/?fbclid=IwAR19XkkBsmJ4DrlmBwkLZq58Y3svjebsjhjNcAgLWrWIDpgDAFR3WiVKRDw)). The Solve ME/CFS Initiative notes that exertion in PEM also means cognitive or emotional, not just physical symptoms ([10](https://solvecfs.org/management-and-treatment-of-me-cfs/)). Around 90% of Dr. Putrino’s long COVID patients are living with PEM. PEM is also a distinctive feature of myalgic encephalomyelitis or chronic fatigue syndrome (ME/CFS). Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases (NIAID) at the National Institutes of Health (NIH) stated that long COVID symptoms are “strikingly similar” to those of ME/CFS ([11](https://www.theguardian.com/world/2020/nov/19/long-covid-overlap-emerges-with-me-including-debate-over-treatment)), indicating that some cases of long COVID may actually be ME/CFS itself. The mounting information available on ME/CFS and PEM is coming in handy regarding long COVID patients, as the discussion surrounding treatment is an equally delicate matter. **One suggested treatment for both conditions has been graded exercise therapy (GET); however, it is becoming well-known that this therapy can be dangerous for many patients experiencing PEM.** Despite its seemingly gentle approach by incrementally increasing activity overtime, “GET can repeatedly push a patient to the point where the PEM response is triggered, resulting in an overall (possibly permanent) worsening of symptoms” ([10](https://solvecfs.org/management-and-treatment-of-me-cfs/)) according to the Solve ME/CFS Initiative. Patient advocate groups like the [ME Action Network](https://www.meaction.net/2020/07/11/graded-exercise-therapy-not-recommended-for-post-covid-fatigue-say-nice/) and the [Solve ME/CFS Initiative](https://solvecfs.org/management-and-treatment-of-me-cfs/) firmly state that it can be extremely damaging for ME/CFS patients and warn against its usage. The Centers for Disease Control and Prevention (CDC) has removed GET from its list of recommended treatments ([21](https://www.meaction.net/2020/07/11/graded-exercise-therapy-not-recommended-for-post-covid-fatigue-say-nice/)), and the National Institute for Health and Care Excellence (NICE) in the UK is reviewing the evidence for this therapy in response to mounting concerns. NICE also states that the clinical guidelines on GET “…only apply to people with a diagnosis of ME/CFS as part of specialist care…” and that the guidelines “…should be part of an individualised, person-centred programme of care, with GET only recommended for people with mild to moderate symptoms…” ([22](https://www.nice.org.uk/guidance/gid-ng10091/documents/statement)). **PEM has different triggers and outcomes for each person, thus requiring a high level of awareness and personalized strategies.** This is why it is crucial for doctors to assess needs on an individual basis and for patients to learn about the treatments and recommendations provided to them. For individuals with PEM, it is widely agreed that a safe way to reduce potential symptoms, flare-ups, or “crashes” is pacing. As the Solve ME/CFS Initiative explains, this means adopting specific strategies that help you “remain as active as your limited energy allows while taking proactive steps to avoid reaching your personal overexertion point and triggering the PEM response” ([10](https://solvecfs.org/management-and-treatment-of-me-cfs/)). It is all about listening to your body and getting to know its boundaries, and using that information to make decisions about daily activities. **As an accompaniment to the strategy of pacing, doctors and researchers from the Stanford ME/CFS Initiative have created an in-depth** [**PEM Avoidance Toolkit**](https://solvecfs.org/wp-content/uploads/2019/01/PEM-Avoidance-Toolkit.pdf)with tracking sheets and detailed information on causes, barriers, and strategies to help people manage their conditions on a daily basis. ### Long Covid & Autoimmune Disease The fact that ME/CFS can be triggered by an infection like coronavirus is not necessarily a new phenomenon. Pathogens like the Parvovirus B19, Rubella virus, and Epstein-Barr virus (EBV) have been implicated in the development of autoimmune diseases ([13](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7289100/))as well as post-infectious or post-viral disease syndromes linked to Lyme disease, mononucleosis, and the West Nile virus (WNV) ([3](https://www.theguardian.com/commentisfree/2020/aug/19/we-know-too-little-about-covid-19-long-haulers-we-need-a-comprehensive-study)). Glandular fever, which usually stems from an EBV infection, seems to trigger ME/CFS in some people. Other conditions that may develop post-COVID are [Guillain Barré syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/guillain-barre-syndrome/), [acute disseminated encephalomyelitis (ADEM)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/acute-disseminated-encephalomyelitis/), [systemic lupus erythematosus (SLE)](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/systemic-lupus-erythematosus-sle/), and other autoimmune diseases and inflammatory illnesses ([13](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7556280/#:~:text=The%20development%20of%20autoimmune%20conditions,individuals%20with%20predisposing%20conditions%20of)). One preliminary [investigation studying autoreactivity and COVID-19](https://www.medrxiv.org/content/10.1101/2020.10.21.20216192v2) found a link between severe SARS CoV-2 infection and “the presence of autoantibodies against multiple targets,” indicating that an antiviral immune response in the case of COVID-19 prompts the production of autoreactive antibodies. Many features of this response are “reminiscent of SLE pathogenic autoreactivity” ([14](https://www.medrxiv.org/content/10.1101/2020.10.21.20216192v2)).Although there is quite clearly a link, neither the precise etiology nor the prevalence of these coronavirus-related autoimmune diseases is widely known. ### How Many People Experience Symptoms And For How Long? A [King’s College Study](https://www.medrxiv.org/content/10.1101/2020.10.19.20214494v1) from October 2020 analyzed data from 4,182 users of the [COVID Symptom Study](https://covid.joinzoe.com/us-2) app. The article is not yet peer-reviewed, but nonetheless offers significant insight into what sufferers of long COVID experience. According to researchers, “one in 20 people with COVID-19 are likely to suffer symptoms for 8 weeks or more” ([2](https://www.kcl.ac.uk/news/study-identifies-those-most-risk-long-covid)). They also learned that around 10% of people have lingering symptoms after 3 weeks and 5% are unwell for months post-COVID ([6, ](https://www.health.harvard.edu/blog/the-tragedy-of-the-post-covid-long-haulers-2020101521173)[15](https://www.weforum.org/agenda/2020/10/covid-coronavirus-symptoms-health?utm_source=facebook&utm_medium=social_scheduler&utm_term=COVID-19&utm_content=31%2F10%2F2020%2013%3A00&fbclid=IwAR2ApJEUsIaREJBZeOr_yngfNa-hAoQeb5fc3J_u6RUZP4htXyRLhVSZhkg)**)**. A CDC study reported that **35% of symptomatic COVID-19 patients still were not back to their original state of health 2-3 weeks after their positive tests.** Additionally, one in five respondents were aged 18-34 and did not have underlying health conditions ([16](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7392393/)). ### Who Is At-Risk For Long Covid? Anyone can develop long COVID, no matter the age or if their case of COVID-19 is mild or not, though there are factors that put someone at higher risk. Risk factors include: - Severe COVID-19 cases ([6](https://www.health.harvard.edu/blog/the-tragedy-of-the-post-covid-long-haulers-2020101521173)) - Adults over 50 ([6](https://www.health.harvard.edu/blog/the-tragedy-of-the-post-covid-long-haulers-2020101521173)) - \*Female sex ([18](https://www.medrxiv.org/content/10.1101/2020.10.19.20214494v1)) - Individuals with 2 or 3 chronic conditions ([6](https://www.health.harvard.edu/blog/the-tragedy-of-the-post-covid-long-haulers-2020101521173)) \**Another connection between long COVID and autoimmune disease is that women are at greater risk to develop these conditions with women 50% more likely to suffer from long COVID than men,” according to a COVID Symptom Study app analysis by King’s College* ([18](https://www.medrxiv.org/content/10.1101/2020.10.19.20214494v1)). *While the reason is still being explored, experts like Professor Tim Spector (one of the researchers leading the COVID Symptom Study App analysis at King’s College), speculates that it may have something to do with gender differences in immune response (*[*19*](https://www.theguardian.com/world/2020/oct/21/women-aged-50-60-at-greatest-risk-of-long-covid-experts-suggest)*).* ### Why Are Patient-Reported Experiences Important? Patient-led research and analyses of patient-reported experiences are increasingly common in the age of coronavirus. Of course, bench science remains essential, but this new strain of coronavirus has brought research to a frenzied level as the world tries to stop its devastation. Therefore, patient-led research can provide clues about early warning signs of long COVID as well as how symptoms vary and fluctuate depending on a variety of factors, including age and underlying condition. Medical professionals and public health officials can use this information to explore early treatment options and ensure people are getting the care they need. Data collection and aggregation are vitally important to the discovery of treatments for long COVID. The effort to gather information is essential for ongoing research to find out how to treat, mitigate, or even cure long COVID. Since medical research is dealing with a newly emergent disease, very little data exists. All research entities need to compile as much data as possible. **In an ideal world, a global consortium of data would benefit scientific discovery not only on COVID-19 but also on long COVID.** If you or a loved one have long COVID, consider getting involved by reporting symptoms and other information about your experience through any one of these sources: - [COVID Symptom Study App](https://covid.joinzoe.com/us-2) - [You + M.E. Registry](https://solvecfs.org/you-me-registry/) - [Patient-Led Research for COVID-19](https://patientresearchcovid19.com/) ### Supporting Long Haulers If you or a loved one is experiencing long COVID, Survivor Corps offers a helpful list of [Post-COVID Care Centers (PCCC)](https://www.survivorcorps.com/pccc) across the U.S., as well as in Canada and India. These centers focus on multidisciplinary and comprehensive care. In the U.K., there are [multidisciplinary clinics opening in various regions throughout England](https://www.england.nhs.uk/2020/12/long-covid-patients-to-get-help-at-more-than-60-clinics/), funded by NHS England. Also offered is an online rehab service called [Your COVID Recovery](https://www.nhsinform.scot/long-term-effects-of-covid-19-long-covid/about-long-covid/your-recovery/), with resources for managing symptoms as well as an on-demand service providing consultations with medical professionals. For added support and information, connect with fellow long haulers through these groups: - [LongCovidSOS](https://www.longcovidsos.org/) - [Survivor Corps](https://www.survivorcorps.com/) - [Body Politic COVID-19 Support Group](https://www.wearebodypolitic.com/resources/#4) - [Long Haul COVID Fighters – Round 2](https://www.facebook.com/groups/650553172199572/) - [Long Covid Support](https://www.longcovid.org/) ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** COVID-19 and Long Covid --- ### [Vaccines, COVID-19, & Autoimmune Disease: New Developments](https://www.autoimmuneinstitute.org/articles/vaccines-covid-19-autoimmune-disease-new-developments) **Published:** March 12, 2021 **Author:** Carolyn Serraino **Content:** > For up-to-date information and more answers, check out our **[COVID Vaccine & Autoimmune Disease FAQ](https://www.autoimmuneinstitute.org/2024/02/21/vaccines-covid-19-autoimmune-disease-new-developments/)** Since the start of the pandemic, researchers and health officials alike have wondered about the impact of SARS-CoV-2 on autoimmune disease. - Are people with autoimmune disease more susceptible to severe COVID symptoms? - What are the vaccine recommendations, and are people with autoimmune disease more vulnerable to adverse reactions? - Do vaccines have a lower efficacy rate for those taking immunosuppressants? Now, more than a year since the first case of COVID-19 in the United States, scientific research developments and hospital data have revealed answers to these salient questions. ### Are People With Autoimmune Disease More Susceptible To Sever Covid Symptoms? The results of a retrospective cohort study recently published by New York-Presbyterian Hospital/Columbia University Irving Medical Center show this not to be the case. Conducted in the spring of 2020, this was one of the most extensive inpatient studies evaluating the impact of COVID-19 on autoimmune disease patients. The results, which were peer-reviewed and published in February 2021, showed that ICU admission and outcomes were similar between patients with and without autoimmune disease. **While autoimmune disease patients were more likely to have at least one comorbidity, take immunosuppressants, and/or have had an organ transplant, “there were no significant differences in ICU admission, intubation, or death”** ([1](https://www.jrheum.org/content/jrheum/48/3/454.full.pdf)). “Although some studies have suggested a higher risk of respiratory failure in patients with autoimmune disease, most have not observed an increase in overall mortality” ([1](https://www.jrheum.org/content/jrheum/48/3/454.full.pdf)). This can be seen as encouraging news for the autoimmune disease community. Across the board, hospital data reveals that, in general, autoimmune disease patients are not at a higher risk than the general population ([2](https://www.nejm.org/doi/full/10.1056/NEJMc2009567)). This discovery, however, does not negate the fact that certain autoimmune diseases and comorbidities may still be considered high risk. The myriad factors at play—including population groups, sex, and coexisting conditions—merit continued investigation. ### Getting Vaccinated When You Have An Autoimmune Disease Given the speed at which vaccines have been authorized for emergency use, raw data from clinical trials on COVID vaccines and autoimmune disease is lacking. This has left health and industry experts with the complicated task of guiding their communities on getting the vaccine and abating concerns about its safety. The CDC updated their[ vaccination recommendations](https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/underlying-conditions.html) on March 5, 2021, stating autoimmune disease patients may receive the vaccine. > “People with autoimmune conditions may receive a COVID-19 vaccine. However, they should be aware that no data are currently available on the safety of COVID-19 vaccines for people with autoimmune conditions.” To view specific vaccine recommendations from autoimmune organizations, scroll to the bottom of this page! Each organization makes their consensus clear: people with autoimmune diseases are highly encouraged to speak with their healthcare teams regarding the vaccine. **What could be a reason for allergic reactions or adverse effects to the COVID-19 vaccine?** Contrary to what you may initially think, it would not come from the [vaccine’s active ingredients](https://www.cdc.gov/vaccines/covid-19/info-by-product/clinical-considerations.html#Appendix-C). In the Moderna and Pfizer vaccines, this means the mRNA encoding the viral spike (S) glycoprotein of SARS-CoV-2; in the Johnson & Johnson (J&J) vaccine, the active ingredient is theAd26 vector encoding a SARS-CoV-2 S (S) spike protein. While available data around autoimmune disease and the COVID-19 vaccine is still scarce, previous[ studies with autoimmune rheumatic disease patients](https://www.nature.com/articles/nrrheum.2014.206) underscore the importance of vaccinations in general. **The materials that may trigger adverse reactions in certain individuals are known as lipid nanoparticles.** These are used as a carrier mechanism to deliver the viral encoding, and can be found in scores of vaccines. However, this is the first time lipids are being used in a licensed, FDA-approved mRNA vaccine. Research published in the [New England Journal of Medicine ](https://www.nejm.org/doi/full/10.1056/NEJMra2035343)expounds on the possibility of a hyperimmune response to these lipids, leading to an adverse reaction in some recipients of the Pfizer and Moderna vaccines ([3](https://www.nejm.org/doi/full/10.1056/NEJMra2035343), [4](https://www.sciencemag.org/news/2020/12/suspicions-grow-nanoparticles-pfizer-s-covid-19-vaccine-trigger-rare-allergic-reactions)). The J&J vaccine has reported less adverse reactions. Experts are unsure as to exactly why this is ([5](https://www.nytimes.com/2021/02/28/us/jj-vaccine-pfizer-moderna-differences.html)). If you are living with [contraindication](https://www.cdc.gov/vaccines/pubs/pinkbook/genrec.html#contraindications)—a health condition that increases the likelihood of an adverse reaction after receiving a vaccine—talk to your doctor about the best course of action. The only contraindications to the COVID-19 vaccine listed by the Centers for Disease Control and Prevention (CDC) are for patients who have experienced a history of “severe allergic reaction (e.g. anaphylaxis) after a previous dose or component of the vaccine, \[or\] immediate allergic reaction of any severity after a previous dose or known (diagnosed) allergy to a component of the vaccine.” Check out the CDC’s [Appendix C: Ingredients Included in the COVID-19 Vaccine](https://www.cdc.gov/vaccines/covid-19/info-by-product/clinical-considerations.html#Appendix-C) for a break-down of the ingredients in each US-approved vaccine. **The CDC website also explains the characteristics of** [**adverse reactions and vaccine side effects**](https://www.cdc.gov/vaccines/covid-19/info-by-product/clinical-considerations.html#Appendix-D) **for each vaccine.** ### Vaccines and Immunosuppressive Therapies **Generally, individuals taking immunosuppressive drugs—such as corticosteroids, hydroxychloroquine, or biologics—are only included in studies after a vaccine receives FDA approval.** If included before Phase 4 surveillance studies, they can skew the vaccine’s efficacy rates. This begs the question: are vaccines less effective if you’re taking immunosuppressants for your autoimmune disease? You may be wondering if your chance for creating a robust immune response after vaccination might be compromised by how you care for your health. Although experts recommend that the autoimmune disease community get vaccinated (see above), the question of efficacy rate is worth exploration ([6](https://link.springer.com/content/pdf/10.1007/s40123-021-00338-1.pdf)). **What does “efficacy” mean in the context of vaccines?** The New York Times wrote an informative piece breaking down [efficacy numbers](https://www.nytimes.com/interactive/2021/03/03/science/vaccine-efficacy-coronavirus.html) and implications of each US-approved vaccine. In short, 100% efficacy means that 100% of the risk for a COVID-19 infection is eliminated by the vaccine. Conversely, 0% means that those who’ve taken the vaccine are at the same risk as those who have not been vaccinated (or received the placebo during clinical trials). For the J&J vaccine, there is an 85% efficacy rate against severe cases and death as of 28 days after vaccination ([7](https://www.jnj.com/johnson-johnson-covid-19-vaccine-authorized-by-u-s-fda-for-emergency-usefirst-single-shot-vaccine-in-fight-against-global-pandemic)). Of the variants tested during clinical trials (besides the B.1.351 variant in which the efficacy was 64%), that means there is 85% less risk of developing a severe case of COVID-19 compared to those who did not receive the vaccine. When taking a look at the J&J vaccine’s ability to reduce the risk of contracting COVID-19 in the first place, the efficacy rate is 66%. While the data is still being evaluated, Dr. Fauci has stated a broad strokes recommendation that **those who are immunocompromised and actively receiving immunotherapies should, in fact, get vaccinated against COVID-19.** During the 62nd annual American Society of Hematology meeting in December 2020, Dr. Fauci reminded virtual attendees that those on immunosuppressant agents may not have as robust of an immune response to the vaccine since their immune system is compromised. That being said, **Dr. Fauci is clear that “some degree of immunity is better than no degree of immunity”** ([8](https://www.ajmc.com/view/taking-immunosuppressants-fauci-says-get-the-covid-19-vaccine)). It is critical to speak with your healthcare provider regarding specific medications when considering getting the COVID-19 vaccine. Recommendations for which medications should be paused or continued are in flux, and your provider will have the most accurate information specific to you and your health plan. New data and scientific research is being published regularly, speaking volumes toward the attention COVID-19 has brought to studying autoimmunity. These most recent developments, addressed by US health authorities like the CDC, create a solid starting point for autoimmune disease and immunocompromised patients to navigate their health. In regards to COVID long-haulers, we are working on a thorough round-up dedicated to understanding new developments around long COVID and autoimmunity. Until then, check out [our initial insights on long COVID](https://www.autoimmuneinstitute.org/2024/02/21/understanding-long-covid/). ##### **The following autoimmune disease organizations have released statements with vaccine recommendations for their specific communities:** - [American Behcet’s Disease Association](https://www.behcets.com/covid-19-and-behcets-disease-3/) - [American Thyroid Association](https://www.thyroid.org/covid-19/coronavirus-frequently-asked-questions/) - [The Aplastic Anemia and MDS International Foundation (AAMDS)](https://www.aamds.org/education/covid-19) - [Arthritis Foundation](https://www.arthritis.org/health-wellness/about-arthritis/related-conditions/other-diseases/acr-covid-19-vaccine-clinical-guidance) - [Beyond Celiac](https://www.beyondceliac.org/celiac-news/statement-covid-vaccine/) - [Crohn’s and Colitis Foundation](https://www.crohnscolitisfoundation.org/coronavirus/vaccine-position-statement) - [The Ehlers-Danlos Society](https://www.ehlers-danlos.com/covid-19-vaccines/) - [Global Healthy Living Foundation](https://www.ghlf.org/coronavirus-patient-support/) - [International Pemphigus & Pemphigoid Foundation](https://www.pemphigus.org/information-for-pemphigus-and-pemphigoid-patients-related-to-coronavirus-disease-covid-19/) - [Juvenile Diabetes Research Foundation (JDRF)](https://www.jdrf.org/blog/2021/01/22/answering-your-questions-about-the-covid-19-vaccines/) - [American Liver Foundation](https://liverfoundation.org/alf-february-2021-covid-vaccine-statement-and-update/) - [Lupus Research Alliance](https://www.lupusresearch.org/update-from-lras-president-on-covid-19-vaccines-in-lupus/) - [Lyme Disease Org](https://www.lymedisease.org/covid19-vaccine-mylymedata/) - [Myasthenia Gravis Foundation of America](https://myasthenia.org/MG-Community/COVID-19-Resource-Center) - [Narcolepsy Network](https://narcolepsynetwork.org/update-on-covid-19-vaccine/) - [National Alopecia Areata Foundation](https://www.naaf.org/covid19-vaccines) - [National MS Society](https://www.nationalmssociety.org/coronavirus-covid-19-information/multiple-sclerosis-and-coronavirus/covid-19-vaccine-guidance) - [National Psoriasis Foundation](https://www.psoriasis.org/guidance-statements-covid-19-vaccines/) - [Raynaud’s Association](https://www.raynauds.org/2021/02/08/raynauds-and-the-coronavirus-vaccine/) - [Scleroderma Foundation](https://www.scleroderma.org/site/SPageServer?pagename=patients_COVID19_MSAB_Vaccines&AddInterest=1281#.YEe_uWRKhKM) - [Sjogren’s Foundation](https://www.sjogrens.org/news/2021/sjogrens-and-covid-19-vaccination-statement) - [Solve ME/CFS Initiative (Solve M.E.)](https://solvecfs.org/the-me-cfs-community-and-covid-19/) - [Spondylitis Association of America](https://spondylitis.org/research-new/covid-19-vaccines-and-spondyloarthritis-what-you-should-know/) - [Vasculitis Foundation](https://www.vasculitisfoundation.org/coronavirus-covid-19/covid-19-webinar-february-27-2021/) - [Vestibular Disorder Association (VeDA)](https://vestibular.org/covid-19-vaccination/) ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** COVID-19 and Long Covid --- ### [COVID Vaccine: Side Effects in Women & the Purpose of Two Doses](https://www.autoimmuneinstitute.org/articles/covid-vaccine-side-effects-in-women-the-purpose-of-two-doses) **Published:** April 1, 2021 **Author:** Carolyn Serraino **Content:** Retrospective hospital analyses and cohort studies have shown that people with autoimmune disease are not more susceptible to *severe* COVID-19 symptoms. Moreover, health experts now offer concrete [recommendations for autoimmune disease patients](https://www.autoimmuneinstitute.org/2024/02/21/vaccines-covid-19-autoimmune-disease-new-developments/) about the COVID-19 vaccine. What do we understand about vaccine side effects in the general population, and how does it parallel outcomes for autoimmune disease (AD)? Moreover, how do the two doses of both the Moderna and Pfizer vaccine fully protect people against severe COVID-19 infection while also mitigating the spread of variants? **According to news reports and clinical observations, women may be more susceptible to experiencing side effects from the new COVID-19 vaccines than men**. Last month, the Centers for Disease Control and Prevention (CDC) published a report [monitoring the 13.7 million doses](https://www.cdc.gov/mmwr/volumes/70/wr/mm7008e3.htm) of the Pfizer-BioNTech and Moderna vaccines distributed between December 14, 2020 and January 13, 2021. Around 60% of people who received the vaccine were women, and 79% of side effects were reported by women. Headaches, dizziness, and fatigue were the most common side effects experienced. ### Women Experience Covid-19 side effects more often than men Health experts are unable to discern precisely why women account for the majority of those experiencing side effects. While social factors may be at play—e.g. a greater willingness to get vaccinated, as well as an increased likelihood of reporting side effects – there are also biological reasons that can substantiate this occurrence. Myriad factors underscore the prevalence of women experiencing vaccine side effects in general. This prevalence parallels the rate of autoimmune disease in women. While the *overall* prevalence of autoimmune disease is far from being known, it has been consistently established in the scientific literature that around **78% of people experiencing autoimmune disease are women** ([1](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3328995/pdf/04-0367.pdf))**.** Autoimmune diseases are characterized by the activation of T cells or the presence of B cells (autoantibodies), often in response to a viral infection ([2](https://linkinghub.elsevier.com/retrieve/pii/S0896841120301281)). In response to the vaccine and autoimmune diseases, the immune system creates a robust response. When someone receives the vaccine, the immune system produces antibodies, and a noticeable physiological reaction indicates an appropriate and healthy immune response. According to the CDC, “side effects are normal signs that your body is building protection” ([3](https://www.cdc.gov/coronavirus/2019-ncov/vaccines/expect/after.html)). That being said, almost [50% of patients don’t experience side effects](https://health.clevelandclinic.org/if-you-dont-get-sick-after-your-covid-19-vaccination-does-it-mean-your-immune-system-isnt-working/). Experts are unsure as to why some people experience side effects, and others don’t. **As far as we know, the severity of side effects (or lack thereof) does not impact the vaccine’s efficacy.** The production of estrogen—a hormone involved in regulating the immune system—is one determining factor responsible for higher rates of side effects and encouraging the production of T-cells. **T-cells play a role in both innate and adaptive immunity, and studies have shown that a higher number of T-cells are activated during the adaptive immune response in women versus men** ([4](https://www.nature.com/articles/nri.2016.90)). These T-cells increase the immune response, which can also lead to increased efficacy of the vaccine. The heightened immune activation dampens the virus’ severity; in fact, **women typically have a lower viral load (number of viral particles in the body) than men because their bodies can generate a more robust immune response**. This same biological response plays a role in the predisposition women have towards developing diseases from an overactive immune system, a.k.a. autoimmune disease ([5](https://www.nature.com/articles/s41586-020-2700-3)). Additionally, research has shown that **women generally need a lower vaccine dose to elicit an immune response** ([6](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4120666/)). This may be partially due to the fact that immune-related genes are found within the X chromosome (of which women have two copies, whereas men have one). X chromosomes hold more genetic information and create more genetic mutations than Y chromosomes, leading to the potential development of autoimmune diseases. **Because vaccine doses are the same across the board, women may be receiving a higher amount than necessary to elicit an immune response and gain protection against COVID-19.** Women, in general, have more immunity than men—whether towards a virus, a vaccine, or their own body. Regardless, the CDC encourages women to receive the COVID-19 vaccine amidst concerns of possible side effects, as the majority are short-lived and mild in nature. The CDC recommends that patients stay away from ibuprofen, aspirin, or acetaminophen directly before their vaccination appointment, as it may damper the body’s immune response, thereby impacting the vaccine’s efficacy ([7](https://www.cdc.gov/coronavirus/2019-ncov/vaccines/expect.html)). It is possible to have an allergic reaction within 4 hours of getting vaccinated. This can include hives, swelling, and wheezing. Even though these reactions may not require emergency care, the CDC recommends that you *do not get a second shot* of that mRNA vaccine ([8](https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/allergic-reaction.html)). The Johnson & Johnson vaccine only requires one dose. General fatigue, pain, redness and swelling around the injection site, headache, chills, low-grade fever, and nausea are some of the common side effects. For updates on [possible side effects to the COVID-19 vaccine](https://www.cdc.gov/coronavirus/2019-ncov/vaccines/expect/after.html), check out this page by the CDC. ### The purpose behind two doses It has been noted that patients more commonly experience side effects after receiving their second dose of the COVID-19 vaccine. This may be due to the fact that **the body creates two separate immune responses after each dose.** After being inoculated with the COVID-19 vaccine for the first time, the body recognizes the outside invaders and is prompted to create a first-line response. Instead of fighting to kill the invader, it slows down the rate of infection. This is innate immunity. While your body isn’t actually being infected with COVID but rather, an incomplete copy of its genetic material, the body still fights as if it’s in contact with a live virus. After the body’s innate response, it begins the production of T cells and B cells to fight against infection. The production of antibodies spurs the body to react at the tissue level, offering more protection against the virus. **While the body is creating antibodies from the first COVID-19 vaccine dose, the second dose “supercharges” the antibody response since the body has actively been building immunity** ([9](https://health.clevelandclinic.org/if-you-dont-get-sick-after-your-covid-19-vaccination-does-it-mean-your-immune-system-isnt-working/)). It takes around two weeks after the second shot of Moderna or Pfizer’s vaccine for a complete immune response that provides protection against COVID-19. This is the five to six week mark after the first dose. While one dose of the Pfizer vaccine reduces a person’s risk of getting COVID-19 by around 50%—and 80% for Moderna’s—this increases to around 95% after the second dose. The CDC recommends that the [Pfizer vaccines](https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines/Pfizer-BioNTech.html) be spread 21 days apart, whereas for the [Moderna vaccine](https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines/Moderna.html), 28 days. That being said, there is some wiggle room ([10](https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/getting-the-covid-19-vaccine-what-to-expect)). It takes around four weeks for full immunity against COVID-19 after getting Johnson & Johnson’s vaccine ([11](https://www.nejm.org/doi/full/10.1056/NEJMoa2034201)). Johnson and Johnson reported that T-cell response was detected in clinical trial participants 15 days post-inoculation. By day 29, 90% of participants had coronavirus-neutralizing antibodies in their blood, regardless of age ([11](https://www.nejm.org/doi/full/10.1056/NEJMoa2034201)). ### Mitigating the spread of variants While questions have surfaced regarding the need for two doses, experts continue to agree that a second dose of the Pfizer or Moderna vaccine is necessary to suppress the emergence of COVID-19 variants ([12](https://www.scientificamerican.com/article/is-it-safe-to-delay-a-second-covid-vaccine-dose/)). As more people become vaccinated and create antibodies to ward off the novel coronavirus, the virus will mutate to evade those defenses. By only getting partially vaccinated (receiving one dose), the body is left with holes in its defenses to fully protect itself from COVID variants ([12](https://www.scientificamerican.com/article/is-it-safe-to-delay-a-second-covid-vaccine-dose/)). Variants tend to spread faster and are more transmissible as people have lower immunity to fight against them. This is one reason why experts have shown mounting concerns around mutations such as the B.1.1.7 variant. The CDC updates their website regularly with real-time [numbers on COVID-19 cases caused by variants across the US](https://www.cdc.gov/coronavirus/2019-ncov/transmission/variant-cases.html). If one dose of the vaccine creates partial immunity, the body could become defenseless against antibody-resistant variants of the virus. Providing the body with full protection will limit the number of variants to grow and spread. Read more about recent developments on [COVID-19 and vaccine recommendations in the context of autoimmune disease](https://www.autoimmuneinstitute.org/vaccines-covid-19-autoimmune-disease-developments/) by reading our latest featured article. You can also check out our timeline for [up-to date information regarding COVID-19](https://www.autoimmuneinstitute.org/covid-19-news-and-research-updates/). If you’ve received the COVID-19 vaccine and have experienced an allergic reaction(s) or side effects, report them to the CDC using their [V-Safe After Vaccination Health-Checker app](https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/vsafe.html). *To the best of our knowledge, this article is accurate as of the date specified. Because the COVID-19 pandemic is rapidly evolving, as is the scientific community’s understanding of this virus, information and insights are constantly updating. Please read resources provided by the CDC, WHO, and public health authorities to stay informed, and seek professional medical advice for best practice pertaining to your medical plan.* ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** COVID-19 and Long Covid --- ### [4 Myths about Autoimmune Disease](https://www.autoimmuneinstitute.org/articles/4-myths-about-autoimmune-disease) **Published:** September 1, 2021 **Author:** Carolyn Serraino **Content:** Brush up on your knowledge as we thoughtfully address four myths about autoimmune disease, including: - **[There is a cure for autoimmune disease](#anchor1)** - **[One treatment should work for everyone](#anchor2)** - **[If my family member has an autoimmune disease, I will get that same disease](#anchor3)** - **[Autoimmune disease is caused by stress](#anchor4)** ### **Myth #1: There is a cure for Autoimmune Disease** [Autoimmune diseases](/a-z-disease-list) occur when the immune system mistakenly attacks the body’s own healthy cells, tissues, and organs. While the causes are not fully known, these [diseases are likely triggered by complex](https://www.autoimmuneinstitute.org/articles/untangling-a-complex-web-how-to-categorize-autoimmune-disease) environmental and genetic factors. While there is no true consensus on exactly what the word “cure” means, it is generally understood that when a disease is cured, it does not exist anymore. This means that there is no risk of it coming back, no more symptoms, and no need for treatment. As far as autoimmune disease goes, **there is no particular remedy—conventional or otherwise—that can fully and permanently stop a disease from taking place, or cure it.** This may be the case for other related chronic illnesses as well. > “Some individuals are able to heal over time and move toward a new state of health” **It *is* possible, however, to manage conditions and improve quality of life** by controlling the immune response, calming inflammation, and addressing other underlying issues. Through a combination of medical interventions, supplements, dietary and lifestyle changes, and other therapies, some individuals are even able to heal over time and move toward a new state of health. Healing may mean permanently adopting certain lifestyle changes and continuing therapies that improve immune system function, repair damage, and eliminate symptoms. **This state of stable health (which may still involve symptom [flare-ups](https://www.autoimmuneinstitute.org/2023/04/11/outbursts-in-autoimmunity-disease-flare-ups/) from time to time) is known by many as remission—**when symptoms are reduced almost or entirely to zero. Be aware that all of these terms (cure, heal, treat, remission) remain a source of debate within medical and patient communities. It may be helpful to decide for yourself what these words mean in your life. And keep in mind that **although there is no known cure, it is possible to live a full and vibrant life with autoimmune disease.** ### **Myth #2: One treatment should work for everyone** **Treatment for autoimmune disease is typically focused on managing or minimizing symptoms and disease activity on an ongoing basis.** There is no one-size-fits-all treatment! This goes for related or undiagnosed chronic illnesses, as well. Each approach depends on your unique circumstances—your symptoms, overall state of health, and environment, as well as what works best for your way of life. ##### Common medical [treatments for autoimmune disease](https://www.autoimmuneinstitute.org/the-spectrum-of-autoimmune-disease-treatments/) are: - immunosuppressant drugs - non-steroidal anti-inflammatories - other conventional medications - surgery - physical therapy **[Holistic forms of medicine](https://www.autoimmuneinstitute.org/2021/01/28/explained-holistic-vs-modern-western-medicine/) take a slow healing and whole body approach to chronic conditions**, sometimes in conjunction with pharmaceutical interventions and supplements. Holistic approaches often focus on: - improving sleep quality - spending time in nature - practicing mindfulness - exercising daily - addressing mental health - eating a whole-food, nutrient-rich diet - other therapies and practices The right approach for one person will not necessarily be right for someone else. A treatment protocol is meant to be personalized and comprehensive, and may often involve different types of practitioners and care. **While searching for answers and treatments, you may need to adjust the expectations you have about your health.** Both you and your healthcare providers will likely hit roadblocks, but know that there are countless options and perspectives out there. Give yourself a break when you need one, but [don’t give up!](https://www.autoimmuneinstitute.org/2020/02/03/chronic-illness-when-you-feel-like-giving-up/) ### **Myth #3: If my family member has an Autoimmune Disease, I will get that same disease** **There is evidence that having autoimmune disease in the family puts a person at higher [risk for developing a condition](https://www.autoimmuneinstitute.org/risk-factors/), though not necessarily the same one.** With certain diseases in particular, such as lupus and multiple sclerosis, the [risk of developing the same disease as a family member may be elevated](https://www.autoimmuneinstitute.org/2023/03/24/how-sex-genetics-influence-autoimmunity/). Nevertheless, if someone is at higher risk it does not mean they’re destined to get sick. The way a particular gene is expressed can be altered via the epigenome, a layer of chemical tags that sits on top of our DNA. **When environmental components—such as toxic chemicals, diet, or infections—interact with the epigenome, they may activate or deactivate parts of the genome through complex chemical reactions, thus triggering disease.** As [environment and lifestyle](https://www.autoimmuneinstitute.org/2022/08/24/autoimmunity-on-the-rise/) play a role in the epigenetic equation, you may want to talk with your healthcare provider or a genetic counselor about preventative steps you can take. Due to epigenetics as well as various reasons researchers are still working to untangle, not everyone who is predisposed will develop autoimmune disease. ### **Myth #4: Autoimmune Disease is caused by stress** While chronic stress can play a role in triggering autoimmune and other conditions, stress is not the singular cause. Given that doctors are dismissing symptoms and misdiagnosing diseases, when they pronounce “it’s just stress” it wrongly puts the blame on the patient. Many mysterious and often invisible sets of symptoms (i.e. autoimmune and related conditions) are blamed on psychological distress alone, which results in delayed diagnoses and deep frustration with the medical system. **There are myriad factors—environmental, immunological, hormonal, genetic—that trigger, perpetuate, and exacerbate disease.** There are also many faces of stress (including physical and psychological), as well as the stressors that induce it. These stressors may be perceived as positive or negative, and may induce positive or negative responses. For instance, a “negative” stressor in one person’s life will provide improved coping skills and personal growth in the long-term, but for another person it will have the opposite effect. A traumatic life event or a serious viral infection can trigger a new health condition or an autoimmune flare-up. ##### Examples of “negative” stressors: - managing a chronic illness - abusive relationship - environmental toxins - processed foods - infections - injuries Events perceived as more positive can also be considered stressors. They might provide much needed energy and stimulation, or they might bring about less desired effects. ##### Examples of “positive” stressors: - pregnancy and childbirth - work and school deadlines - social interactions - planning an event - preparing for a competition As there are many kinds of stressors and personal responses to them, the impact of these events is not always clear. The question of whether stress can be labeled as “good” or “bad” is a complex one. **Yet what is becoming clearer is the distinction between daily or short-term stress and chronic stress.** Our sympathetic nervous system—one key player in the stress response—will activate the “fight or flight” mode during periods of stress to increase energy and alertness. When it does not switch off or is not interrupted by periods of “rest and digest,” however, this completely normal and healthy reaction can evolve into chronic stress. > “If you encounter disbelief and blame from your doctor, do not hesitate to seek out someone new” With a dysfunctional stress response, typical life stressors can affect you in different ways than someone who has a healthy stress response. **In a chronic state, studies have shown that stress has damaging effects on many areas of the body—including the immune system.** Lifestyle interventions and reducing factors contributing to chronic stress can help manage health conditions and prevent flare-ups. Talk to your healthcare providers about what role chronic stress may be playing and how to address it. While it is empowering to know that you do have some control, it is important to remember that it is not your fault you’re sick. **When doctors point the finger directly at stress, they are palpably disregarding the various other factors involved.** They are also undermining the fact that being chronically ill in and of itself causes stress, as well as conditions like anxiety and depression. If you encounter disbelief and blame from your doctor, do not hesitate to seek out someone new. There are compassionate healthcare professionals out there. > ***Also read: [The Chronic Search for Relief in the Medical System](https://www.autoimmuneinstitute.org/2020/10/21/the-chronic-search-for-relief-in-the-medical-system/)*** ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** About Autoimmune Disease --- ### [Patient-Powered Surveys Help Generate New Data About Long Covid](https://www.autoimmuneinstitute.org/articles/patient-powered-surveys-help-generate-new-data-about-long-covid) **Published:** May 5, 2022 **Author:** Carolyn Serraino **Content:** ## A look at Long Covid surveys Nearly three years into the pandemic, the long-term impacts of COVID-19 continue to unfold in real time. Now, communities and medical experts are grappling with an alarming reality: COVID-19 can trigger serious and long-lasting health complications in a significant number of people. The increasingly prevalent illness that follows COVID-19 goes by several names, including **Long Covid**, long-haul COVID, chronic COVID, post-acute COVID-19, and post-acute sequelae of COVID-19 (PASC) ([1](https://www.yalemedicine.org/conditions/long-covid-post-acute-sequelae-of-sars-cov-2-infection-pasc)). Much remains unknown about Long Covid, but many experts propose that studies called Long Covid Surveys are vital to understanding and addressing this emerging health crisis. Although outcomes for COVID-19 have varied widely, the initial illness, or acute phase, is typically around ten days ([2](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8056514/)). However, some patients – even those who initially developed mild symptoms – do not fully recover or begin to suffer new symptoms for weeks or months following an acute COVID-19 infection. People who experience this ongoing illness are often referred to as long-haulers. The true size of this burden is difficult to estimate at this time, but preliminary studies suggest that Long Covid affects around 30% of those who contract COVID-19 ([3](https://www.cedars-sinai.org/newsroom/covid-19-can-trigger-self-attacking-antibodies/),[4](https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2776560),[5](https://www.reuters.com/business/healthcare-pharmaceuticals/almost-third-people-report-lingering-symptom-6-12-months-after-covid-19-study-2022-03-04/)). ### **LONG COVID, AUTOIMMUNITY, AND VIRAL TRIGGERS** It’s important to note that Long Covid currently lacks a distinct and universal definition. According to some experts, Long Covid broadly refers to an array of signs and symptoms that persist for at least 12 weeks following an acute COVID-19 infection ([6](https://www.who.int/news-room/questions-and-answers/item/coronavirus-disease-(covid-19)-post-covid-19-condition)). Long Covid symptoms can be fluctuating, relapsing, or ongoing. The most common long-haul symptoms include exhaustion, shortness of breath, chest tightness, muscle aches, headache, poor concentration, memory problems, changes in taste and smell, and more ([7](https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects/index.html),[8](https://www.sciencedirect.com/science/article/pii/S2666776221000995)). Many long-haulers experience a systemic illness that causes problems throughout the entire body ([9](https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0264331),[10](https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(21)00299-6/fulltext)). Long-term pulmonary and cardiovascular complications have also been reported, most frequently in individuals who were hospitalized due to COVID-19 ([11](https://www.nature.com/articles/s41598-021-95565-8)). It is unclear how or why Long Covid occurs. However, some researchers are turning to features of autoimmune disease for clues. A handful of ongoing studies are investigating whether autoantibodies, proteins that attack healthy human cells in autoimmune disease patients, could be an underlying cause of Long Covid. Some researchers posit that COVID-19 could cause proteins called fibrin to form microclots in the blood of some patients. As these microclots circulate, they may entrap other proteins, triggering the production of destructive autoantibodies ([12](https://portlandpress.com/biochemj/article/479/4/537/230829/A-central-role-for-amyloid-fibrin-microclots-in)). Furthermore, limited research is casting a light on the similarities between Long Covid and [myalgic encephalomyelitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/me-cfs/) ([ME/CFS](https://solvecfs.org/)), a chronic neuroimmune disease characterized by debilitating fatigue that inhibits daily activities ([13](https://www.mayoclinicproceedings.org/article/S0025-6196(21)00513-9/fulltext)). The exact causes of ME/CFS remain unknown. However, viruses such as Epstein-Barr and enterovirus have long been implicated as triggers. In studies, Long Covid and ME/CFS have been shown to share key clinical features, including fatigue, decreased ability to complete daily activities, and worsening of symptoms after physical or mental effort (commonly known as post-exertional malaise) ([14](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8145228/)). Although the exact association between these diseases is still unknown, many experts and advocates believe that data collected in Long Covid studies could be enormously valuable for understanding, diagnosing, and managing other immune system disorders- including autoimmune diseases and ME/CFS. ### **THE RACE TO ADDRESS LONG COVID** Despite advancements in treating and preventing acute COVID-19, research into Long Covid continues to lag behind. Many experts have warned that the pandemic could cause a significant uptick in disability, noting that Long Covid symptoms can cause serious impairments that prevent people from working and performing other day-to-day activities. Incoming data is beginning to shed light on the disabling effects of Long Covid. In a 2020 study, German researchers found that 11% of non-hospitalized COVID-19 patients still had symptoms that prevented them from fully returning to work and daily activities seven months after contracting the disease ([8](https://www.sciencedirect.com/science/article/pii/S2666776221000995)). Additionally, the [Patient-Led Research Collaborative for Long Covid ](https://cdn.who.int/media/docs/default-source/health-care-readiness---post-covid-19-condition/long-covid_-who-presentation-hannah.pdf?sfvrsn=dcd75c2c_5)reported that 67.5% of the Long Covid patients they surveyed required reduced work hours or could not work at all due to their illness. The burden of Long Covid is not exclusive to disability. With no approved treatments yet available, many long-haulers turn to self-management, which can include a variety of pricey and unproven approaches, supplements, or medications. For some, the economic distress of self-management could be too much to bear. A recent report from the Lancet proposed that expenses related to Long Covid self-management could generate greater inequalities in affordability and access to care ([15](https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)02798-7/fulltext)). As patients struggle to find adequate resources and treatment, there is an intensifying need for research that emphasizes the economic, social, and medical impacts of Long Covid. ### **LONG COVID SURVEYS** The swarm of uncertainty around Long Covid has left no shortage of questions for researchers. Yet, even as data begins to roll in, there remains an urgent need for standardized approaches to studying the disease ([16](https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-021-02222-y)). As such, many researchers and advocacy groups are turning to questionnaires designed to gather data through patient self-reporting- known as Long Covid surveys- to help fill in these gaps. Experts are hopeful that Long Covid surveys can help further our understanding of the disease. Some key applications of Long Covid surveys include: - Developing, shaping, and optimizing treatments ([17](https://www.sciencedaily.com/releases/2021/10/211013114112.htm)). - Identifying causes and risk factors ([18](https://jamanetwork.com/journals/jamapediatrics/fullarticle/2782612?resultClick=1)). - Prevention of Long Covid. - Understanding physical, mental, and economic impacts on long-haulers ([19](https://www.fredhutch.org/en/news/center-news/2022/01/long-covid-research.html)). - Understanding the impacts of the disease across different racial and ethnic groups ([18](https://jamanetwork.com/journals/jamapediatrics/fullarticle/2782612?resultClick=1)). - Assessing the effects of COVID-19 and Long Covid on patients with various pre-existing conditions. #### **Finding and participating in a Long Covid Survey** Long Covid surveys are not just for those currently experiencing symptoms. Like other types of research, Long Covid surveys utilize healthy control groups. Even if you have never developed ongoing symptoms or have since recovered from Long Covid, you are encouraged to participate. Long Covid surveys are also designed to validate patients who became sick but could not confirm their COVID-19 diagnosis due to lack of availability or access to testing. Therefore, if you suspect that you had COVID-19, your experiences are equally valuable in a Long Covid survey. Some Long Covid surveys consist of a one-off questionnaire, whereas others are more comprehensive. For longer studies, you may be prompted to answer survey questions over a period of time or work with your doctor to provide biological samples for research. The following studies are actively gathering information on COVID-19 and Long Covid in the United States: - [You + ME Covid-19 Study](https://youandmecovid.com/home) - [RECOVER](https://recovercovid.org/) - [Johns Hopkins Long Covid Study](https://covid-long.com/) - [Allergy and Asthma Network Covid-19 Study](https://www.entnet.org/covid-19-anosmia-reporting-tool/https://allergyasthmanetwork.org/research/covid-19-registry/) - [MotherToBaby Covid-19 Study](https://mothertobaby.org/ongoing-study/coronavirus-covid-19/) - [Covid INSPIRE Study](https://www.yalemedicine.org/clinical-trials/inspire-covid-19-study-1) - [The Patient-led Research Collaborative](https://patientresearchcovid19.com/) - [Serrimune Covid-19 Study](https://serimmune.com/covid19study/) - [The HERO registry](https://heroesresearch.org/) (must be a healthcare worker to participate in this survey) Additionally, online communities like [Body Politic](https://www.wearebodypolitic.com/) and [The Long Hauler Advocacy Project](https://www.longhauler-advocacy.org/get-connected) are dedicated to building awareness and solutions around Long Covid. Thousands of long-haulers find connection and support through patient-led support groups and networks. Resources and insights regularly circulate through these spaces, so they’re a great place to discover new Long Covid studies as they arise. Many organizations and medical institutions have created their own registries to capture Long Covid data. While most of these registries are only for use by healthcare professionals, some offer insights into their ongoing work. The [American Heart Association,](https://www.heart.org/en/professional/quality-improvement/covid-19-cvd-registry) [The Covid-19 and Cancer Consortium](https://ccc19.org/), the [American Academy of Pediatrics](https://www.pedscovid19registry.com/), and the [Type 1 Diabetes Exchange](https://t1dexchange.org/covid19/) are a few examples of institutions hosting ongoing COVID-19-related studies. Patient experiences are one of the most important factors shaping our understanding of Long Covid. As research continues, there is hope that Long Covid surveys will shed light on the causes and impacts of the disease while amplifying the most valuable voices of all: those impacted by Long Covid. ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** COVID-19 and Long Covid --- ### [Global Perspectives on Long Covid](https://www.autoimmuneinstitute.org/articles/global-perspectives-on-long-covid) **Published:** June 1, 2022 **Author:** Carolyn Serraino **Content:** ## Insights from South Africa, Pakistan, the U.S., and the U.K. Innovative research programs around the world confront a health crisis in the wake of the Covid-19 pandemic. **Some 43 percent of people infected with Covid-19 develop Long Covid, which means at least 200 million people have had or currently have the condition, according to the most recent meta-analysis.** And that estimate may be conservative. At the higher end, up to 87 percent of people who come down with Covid-19 experience at least one long-term symptom consistent with Long Covid ([1](https://academic.oup.com/jid/advance-article/doi/10.1093/infdis/jiac136/6569364)). Scientists, healthcare providers, and policymakers around the globe are honing in on Long Covid to figure out the mechanisms that cause it, how to treat patients with persistent and sometimes disabling symptoms, and how to manage the sheer magnitude of the crisis. ### **What is long COVID?** Long Covid has gone by many names, including Post-Acute Sequelae of Covid-19 (PASC), Post-Acute Covid-19 Syndrome (PACS), Chronic Covid-19 Syndrome (CCS), and Long Haul Covid-19. In October 2021, the World Health Organization defined it this way: “the condition that occurs in individuals with a history of probably or confirmed SARS-CoV-2 infection, usually 3 months from the onset of Covid-19, with symptoms that last for at least 2 months and cannot be explained by an alternative diagnosis”([1](https://academic.oup.com/jid/advance-article/doi/10.1093/infdis/jiac136/6569364)). Some of the most commonly reported symptoms are fatigue, memory problems, shortness of breath, sleep issues, and joint pain ([1](https://academic.oup.com/jid/advance-article/doi/10.1093/infdis/jiac136/6569364)). ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Screen-Shot-2023-10-24-at-7.44.55-PM.png)SARS-CoV-2 virus particles. Photo Credit: NAID In order to determine what percentage of COVID-19 patients have gone on to develop Long COVID, a recent meta-analysis looked at nearly 4,500 papers and 50 studies comprising almost 1.7 million patients in 16 countries. **In addition to the global prevalence of 43 percent, researchers noted a regional frequency of 51 percent, 44 percent, and 31 percent for Asia, Europe, and the US, respectively** ([1](https://academic.oup.com/jid/advance-article/doi/10.1093/infdis/jiac136/6569364)). Importantly, some regions—including Africa, Central America, Oceania, and the Caribbean—and some populations—especially children—were missing from the literature and point to a critical gap in understanding how Long Covid affects people around the world ([1](https://academic.oup.com/jid/advance-article/doi/10.1093/infdis/jiac136/6569364)). ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Screen-Shot-2023-10-24-at-7.47.27-PM-1024x674.png) ### **SOUTH AFRICA:** #### **Microclots may cause Long Covid** Understanding what causes Long Covid may be key to figuring out how to treat it. There are a few ideas out there, and one of the most compelling comes from the lab of [Resia Pretorius](https://twitter.com/resiapretorius) of South Africa’s Stellenbosch University. > When scanned, the lungs of Covid-19 patients reveal opaque spots that look like ground glass and persist well beyond the acute infection in follow up scans. Pretorius’ team thinks these may be tiny clumps of a protein called fibrin ([2](https://portlandpress.com/biochemj/article/479/4/537/230829/A-central-role-for-amyloid-fibrin-microclots-in), [3](https://cardiab.biomedcentral.com/articles/10.1186/s12933-021-01359-7)). Normally, blood travels through vessels and capillaries to supply oxygen to body tissues, but these micro-clots of fibrin clog the tiniest capillaries, blocking the flow of blood like a clump of hair clogs a pipe. This could explain a wide range of Long Covid symptoms, because tissues become damaged when their cells are starved of oxygen ([2](https://portlandpress.com/biochemj/article/479/4/537/230829/A-central-role-for-amyloid-fibrin-microclots-in), [3](https://cardiab.biomedcentral.com/articles/10.1186/s12933-021-01359-7)). In addition to respiratory symptoms like shortness of breath, the effects of oxygen deprivation include non-respiratory features like [postural tachycardia syndrome (PoTS)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/postural-orthostatic-tachycardia-syndrome/), kidney dysfunction, and muscle pain ([2](https://portlandpress.com/biochemj/article/479/4/537/230829/A-central-role-for-amyloid-fibrin-microclots-in)). These microclots are amyloid—meaning abnormally folded—and similar amyloid clotting has been associated with inflammatory diseases like Alzheimer’s, Parkinson’s, type 2 diabetes, and [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/) ([2](https://portlandpress.com/biochemj/article/479/4/537/230829/A-central-role-for-amyloid-fibrin-microclots-in)). Plus, blood vessels are lined with a layer of endothelial cells that moves it through the system. This endothelial layer also acts as a gateway that connects the cardiovascular and immune systems, so it’s critical for maintaining blood flow and regulating inflammation. Microclots may kill individual endothelial cells—and breaches in that gateway dysregulates its functions ([2](https://portlandpress.com/biochemj/article/479/4/537/230829/A-central-role-for-amyloid-fibrin-microclots-in), [3](https://cardiab.biomedcentral.com/articles/10.1186/s12933-021-01359-7)). Digging deeper, Pretorius’ team notes that some patients with Long Covid make autoantibodies—blood proteins that recognize substances from the body as foreign and target them for destruction—including one to an abnormal form of fibrin. **It’s plausible that autoantibodies could play a role in Long Covid like they do in other chronic inflammatory diseases** ([2](https://portlandpress.com/biochemj/article/479/4/537/230829/A-central-role-for-amyloid-fibrin-microclots-in), [3](https://cardiab.biomedcentral.com/articles/10.1186/s12933-021-01359-7)). Right now, Pretorius’ team is developing a lab test to diagnose microclots in Long Covid patients. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Screen-Shot-2023-10-24-at-7.47.56-PM.png) ### **PAKISTAN:** #### **Cracking open neurological features of Long Covid** Fibrin microclots could also play a role in one of the most troubling aspects of Long Covid: neurological features like brain fog, dysautonomia, and problems with taste and smell. Remember the layer of endothelial cells that line blood vessels? Those cells also separate the circulating blood from the central nervous system. This is the bulk of what’s meant by the “blood brain barrier” as these cells serve as sentries, regulating what can move into and out of the brain ([4](https://www.nature.com/articles/s41582-021-00593-7), [5](https://pubs.acs.org/doi/10.1021/acschemneuro.2c00164)). That’s part of what [Abdul Mannan Baig](https://twitter.com/AMannanBaig) explores in his lab at Aga Khan University in Pakistan. It’s been clear since 2020 that COVID-19 is neuroinvasive—meaning it can get past that cellular barrier and into the brain—and perhaps even preferentially targets the nervous system ([4](https://www.nature.com/articles/s41582-021-00593-7), [5](https://pubs.acs.org/doi/10.1021/acschemneuro.2c00164)). Baig hopes to tease out how much of this neuro-invasion comes from breaching the blood brain barrier via microclots, oxygen starvation, and autoantibodies versus other mechanisms like a direct passage from the nasal cavity to the brain or direct injury to brain cells ([4](https://www.nature.com/articles/s41582-021-00593-7), [5](https://pubs.acs.org/doi/10.1021/acschemneuro.2c00164)). ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Screen-Shot-2023-10-24-at-7.48.10-PM.png) ### **UNITED KINGDOM:** #### **Largest clinical trial of Long Covid** The UK leads on this point, thanks to a series of government-funded studies and the ease with which researchers can access information through the nationalized patient data system ([6](https://pharmaceutical-journal.com/article/feature/opening-the-black-box-the-researchers-trying-to-find-treatments-for-long-covid)). There are at least 13 ongoing trials, including one focused on children and young people ([CLoCK](https://www.hra.nhs.uk/planning-and-improving-research/application-summaries/research-summaries/children-young-people-with-long-covid-clock-study-covid-19-uph/)), one targeting mechanisms like micro-clots and autoantibodies ([REACT-LC](https://www.imperial.ac.uk/medicine/research-and-impact/groups/react-study/studies/react-long-covid/)), and a few exploring interventions, such as repurposing anticoagulants to deal with micro-clots and antihistamines for inflammation ([HEAL-COVID](https://heal-covid.net/), [STIMULATE-ICP](https://www.stimulate-icp.org/)) ([6](https://pharmaceutical-journal.com/article/feature/opening-the-black-box-the-researchers-trying-to-find-treatments-for-long-covid)). The [STIMULATE-ICP study](https://www.stimulate-icp.org/), led by [Amitava Banerjee](https://twitter.com/amibanerjee1) of University College London and [Melissa Heightman](https://twitter.com/melheightman) of University College London Hospitals NHS Foundation Trust, is the largest trial for Long Covid so far. It includes more than 60 researchers, clinicians, and partners across more than 30 organizations and is actively recruiting 4,500 participants. The study will explore multi-organ scans to aid diagnosis and investigate repurposed drugs to address microclots and inflammation—but that’s not all ([6](https://pharmaceutical-journal.com/article/feature/opening-the-black-box-the-researchers-trying-to-find-treatments-for-long-covid)). The trial also proposes an innovative remote rehabilitation program to address inequities in accessing the more than 80 Long Covid clinics that operate in the UK ([7](https://pharmaceutical-journal.com/article/feature/opening-the-black-box-the-researchers-trying-to-find-treatments-for-long-covid)). Remote rehabilitation includes digital dashboards for clinicians connected to mobile apps for patients, as well as specific measures to investigate barriers to tech uptake ([7](https://pharmaceutical-journal.com/article/feature/opening-the-black-box-the-researchers-trying-to-find-treatments-for-long-covid)). Perhaps most interesting, STIMULATE-ICP features a community advisory board of people with Long Covid. This will ensure a patient-centered focus and help address misconceptions about Long Covid as the team works toward clear, scalable recommendations that could serve as a model around the world ([8](https://www.openaccessgovernment.org/stimulate-long-covid-study/132075/)). ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Screen-Shot-2023-10-24-at-7.48.24-PM.png) ### **UNITED STATES:** #### **Global grassroots efforts to address Long Covid** In an [April 5, 2022 factsheet](https://www.whitehouse.gov/briefing-room/statements-releases/2022/04/05/fact-sheet-the-biden-administration-accelerates-whole-of-government-effort-to-prevent-detect-and-treat-long-covid/), US president Joe Biden directed Health and Human Services to coordinate a national, interagency response to Long Covid. This includes developing a national research plan that builds on the NIH [RECOVER](https://recovercovid.org/) program, which began funding US researchers in 2021, and ramping up enrollment in the CDC-funded [INSPIRE](https://www.covidinspire.org/) study, which is recruiting Long Covid patients right now ([9](https://www.whitehouse.gov/briefing-room/statements-releases/2022/04/05/fact-sheet-the-biden-administration-accelerates-whole-of-government-effort-to-prevent-detect-and-treat-long-covid/)). > One of the challenges facing the US response to Long Covid is the decentralized healthcare system, which makes it more difficult to access patient data compared with the UK trials. This may drive grassroots action to address Long Covid in the US, including identifying symptoms and management strategies and advocating for policies and research programs that prioritize the lived experience of people with Long Covid. A fascinating aspect of long Covid is that this is the first time the clinical description of a health condition began on social media ([10](https://linkinghub.elsevier.com/retrieve/pii/S0277953620306456)). Starting in 2020, people with persistent symptoms after COVID-19 came together through outlets like the [Long Covid Support Group](https://www.facebook.com/groups/longcovid) on Facebook and [Body Politic Covid-19 Support Group](https://www.wearebodypolitic.com/covid-19) on Instagram, which launched May 2 and May 26, respectively—just over a month after the first official US case of COVID-19 ([10](https://linkinghub.elsevier.com/retrieve/pii/S0277953620306456)). This global, patient-led movement includes researchers and clinicians who have Long Covid and strengthen the grassroots push for research and evidence-based treatment ([11](https://blogs.bmj.com/bmj/2020/05/05/paul-garner-people-who-have-a-more-protracted-illness-need-help-to-understand-and-cope-with-the-constantly-shifting-bizarre-symptoms/)). One of the most notable grassroots efforts is the [Patient-Led Research Collaborative](https://patientresearchcovid19.com/) (PLRC), which published the first all-patient survey of persistent symptoms back in May 2020. They’re working with the [Council of Medical Specialties Societies](https://cmss.org/) to secure funding through the [Patient-Centered Outcomes Research Institute](https://www.pcori.org/), a US non-profit linked to the Affordable Care Act, to develop a patient-led model for Long Covid research ([12](https://patientresearchcovid19.com/research/report-1/)). On April 22, PLRC announced $3 million in funding from the direct giving fund [Balvi](http://www.balvi.io/), which will support patient-directed grants to outside researchers as well as the collaborative’s own research program. One of the clear lessons of the COVID-19 pandemic is global interconnectedness. As Long Covid numbers continue to climb, insights gleaned from research programs around the world will drive diagnosis and treatment. ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** COVID-19 and Long Covid --- ### [Is Long Covid a New Autoimmune Disease?](https://www.autoimmuneinstitute.org/articles/is-long-covid-a-new-autoimmune-disease) **Published:** June 16, 2022 **Author:** Carolyn Serraino **Content:** ## A pathologist weighs in on the latest research involving the link between autoimmunity and Long Covid The more we learn about Long COVID—one of the terms for the health problems that appear or worsen in some people [weeks](https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects/index.html) to [months](https://www.who.int/publications/i/item/WHO-2019-nCoV-Post_COVID-19_condition-Clinical_case_definition-2021.1) after acute SARS-CoV-2 infection—the more confusing the picture becomes. The disease can cause a dizzying array of more than [200](https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(21)00299-6/fulltext) possible symptoms and can follow even [mild](https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2784918) or [asymptomatic](https://www.nature.com/articles/s41598-021-92045-x) infections ([1](https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(21)00299-6/fulltext),[2](https://www.nature.com/articles/s41598-021-92045-x)). Presently, there are no standard therapies or medications to treat Long COVID symptoms. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/49949741686_55048a019d_o.jpg) *Model of the SARS-CoV-2 virus. Photo:* [*NIH*](https://www.flickr.com/photos/nihgov/49949741686/in/album-72157713108522106/) **One of the most troubling mysteries about Long COVID, also known as long-haul COVID or post-COVID syndrome, is what occurs in the bodies of patients to drive this persistent and often distressing condition.** One theory is that Long COVID could be an autoimmune disease (AD). To illustrate this possibility, studies have noted shared symptoms between Long COVID and suspected ADs like chronic fatigue syndrome (ME/CFS) and fibromyalgia- including persistent fatigue, widespread muscle pain, memory difficulties, and mood disorders ([3](https://pubmed.ncbi.nlm.nih.gov/33401106/),[4](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8848724/)). If the autoimmune theory pans out-and that is still a big *if*– SARS-CoV-2 would join a long list of viruses that are strongly implicated in the development of AD based on the fact that the infection coincides with disease onset and the appearance of autoantibodies, autoreactive T cells, and other features of autoimmune disease. Other probable viral triggers of chronic illness include [Epstein-Barr virus](https://www.jci.org/articles/view/154886) (EBV), which is thought to be a trigger for lupus in certain individuals, and [influenza](https://pubmed.ncbi.nlm.nih.gov/31430946/), which has been linked to the development of type 1 diabetes ([5](https://www.jci.org/articles/view/154886),[6](https://pubmed.ncbi.nlm.nih.gov/31430946/)). > “It is certainly possible that SARS-CoV-2 infection could induce autoimmune problems” says Dr. Eline Luning Prak, a professor of pathology and laboratory medicine at the Hospital of the University of Pennsylvania. But the path to being able to categorize Long COVID as a bona fide AD is a long one. “We will probably never know that completely—and there will probably be different ways of generating something that is long COVID,” with autoimmunity being involved in only some patients, Luning Prak says. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/52129878815_cdb27e1b0d_o-1024x870.jpg) *SARS-CoV-2 infection. Photo:* [*NIH*](https://www.flickr.com/photos/nihgov/52129878815/) Much of the research exploring the autoimmune properties of Long COVID has revolved around autoantibodies, which have been detected in a large proportion (about [half](https://www.nature.com/articles/s41467-021-25509-3) in some studies) of patients who are severely ill with acute COVID-19 ([7](https://www.nature.com/articles/s41467-021-25509-3)). **A hallmark of many autoimmune diseases, autoantibodies wreak havoc by recognizing and interfering with the body’s own proteins, DNA, and other molecules, known altogether as self-antigens.** Studies have now documented a laundry list of different autoantibodies that are present during acute COVID-19 infection. One study [found](https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0257016) autoantibodies against ACE2 among a small group of patients hospitalized with COVID, as well as a group that had recovered from infection. ACE2, which the SARS-CoV-2 virus uses to gain entry into cells, is an important player in controlling inflammation ([8](https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0257016)). Autoantibodies that inhibit ACE2 may contribute to persistent inflammation, which is a central feature of many ADs and is [thought](https://www.nature.com/articles/s41590-021-01104-y) to be involved in Long COVID. Evidence of a link between autoantibodies and Long COVID symptoms is also building. Among the most incriminating are autoantibodies that bind to cell surface proteins called G-protein coupled receptors (GPCRs) and [may](https://www.sciencedirect.com/science/article/pii/S0889159115300209?via%3Dihub) block the messages these proteins convey to cells to control immune and other functions. Various GPCR antibodies are thought to contribute to ADs including [ME/CFS](https://www.sciencedirect.com/science/article/abs/pii/S1521661619306680?via%3Dihub), [rheumatoid arthritis](https://pubmed.ncbi.nlm.nih.gov/35182777/), and [Sjogren’s syndrome](https://pubmed.ncbi.nlm.nih.gov/35182777/). Last spring, a small [study](https://pubmed.ncbi.nlm.nih.gov/33880442/) of individuals experiencing Long COVID symptoms—particularly neurological (fatigue, etc) and cardiovascular (elevated heart rate, etc)—found that all had GPCR autoantibodies ([9](https://www.sciencedirect.com/science/article/pii/S2589909021000204)). ### **Making the case for autoantibodies** In order to definitively link Long COVID to autoantibody activity, several criteria still need to be met, Dr. Luning Prak says. For one, “it would be really nice to know if patients had the autoantibodies all along or if the virus-induced them,” she notes. If SARS-CoV-2 infection does indeed spur the production of new autoantibodies, it could happen through several possible mechanisms. For example, the infection may provoke such a strong immune response—an “all hands on deck” response, as Dr. Luning Prak describes —that the immune system begins to turn on itself. Another possible factor is molecular mimicry, in which components of the virus resemble human proteins, causing the immune system to mistakenly attack the body’s own healthy tissues and organs. A recent [study](https://www.nature.com/articles/s41467-021-25509-3) by Dr. Luning Prak and her colleagues found that, in a small group of patients hospitalized with COVID-19, autoantibody levels rose as infection progressed. These findings suggest that SARS-CoV-2 could stimulate autoantibody production. Additionally, a Yale study reported that autoantibody production began ramping up at the same time as antiviral antibodies ([10](https://www.nature.com/articles/s41586-021-03631-y)). It is also possible that SARS-CoV-2 infection unearths a pre-existing autoimmune disease or predisposition in some patients. A recent [study](https://www.sciencedirect.com/science/article/pii/S0092867422000721) of patients hospitalized with COVID-19 found that some had autoantibodies prior to infection, including types that have been associated with lupus ([11](https://www.sciencedirect.com/science/article/pii/S0092867422000721)). > Another question that should be fleshed out, Dr. Luning Prak notes, is whether autoantibodies that are present around the time of acute infection persist in patients with Long COVID. In 2021, a small study of Long COVID patients found that 44% had high levels of antinuclear antibodies (ANAs), a group of autoantibodies associated with lupus and other autoimmune diseases. These autoantibodies remained present for as long as 12 months after SARS-CoV-2 infection ([12](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8394862/)). The group was also more likely to have neurocognitive problems, such as difficulty concentrating, than those with low ANA levels. Even though Dr. Luning Prak’s team found a diverse array of autoantibodies among patients in their study, each patient produced autoantibodies that target only a small number of self-antigens during acute infection. As such, it seems that COVID-19 could randomly trigger a loss of immune tolerance to a small set of self-antigens that results in the immune system attacking specific tissues and organs, just like in many ADs. **If it can be demonstrated that certain autoantibodies are associated with specific symptoms of long COVID, “that would help strengthen the case” that there is an underlying autoimmune cause, Dr. Luning Prak says.** In the context of acute COVID-19, there is evidence of autoantibodies targeting a range of self-antigens in the lungs, central nervous system, and other organs that have been implicated in Long COVID disease. ### **Broadening the search for immune drivers** Many autoimmune diseases are the result of a [complex interplay](https://www.nature.com/articles/ni.3731) of immune responses that involve the production of destructive autoantibodies, as well as autoreactive T-cells, which recognize self molecules called peptides— and innate immune cells, which are thought to harbor sensing molecules that can turn on self-antigens. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/40071652562_1ec41d5f6c_o-1024x1022.jpg) *T- and B- cells, like the ones pictured here, are involved in the production of harmful autoantibodies in patients with autoimmune disease. Photo:* [*NIH*](https://www.flickr.com/photos/niams_nih/40071652562/in/photolist-29c2Bh7-243ZGeq-23eWvbp-2nbmCQt-6XTgiq-82we1q-2n5qpU5-i3kum7-VCxP-2mGf4Yv-2n45UdM-7FfwR1-APciT6-2hZ9aMN-82GjZx-2njF29d-2myoCzD-82Gk3P-9kQzeM-82H5c3-VCvQ-VCvp-2n6heEE-VCwd-7Wd6iy-2mGJNnM-2kws29r-VCxf-VCwE-2nd2wR7-PVjRBT-7WdaPL-2n7iEn2-MUdcJJ-2iJbfvY-Rps5Xm-nNCyU4-2kDAouE-2c9BLtK-2jK8v9Q-JDGJis-2mFHrk1-2n6bLCH-2mmwDVT-2mMEEWR-2n2xkrj-2mTQyDr) Although measuring T-cell and innate immune responses is more technically challenging than detecting autoantibodies, emerging research aims to understand their role in acute COVID-19 infection and Long COVID. Over the last year, researchers at the Institute for Systems Biology in Seattle, Washington endeavored to profile the immune systems of Long COVID patients 2 to 3 months following acute infections ranging from mild to severe. In the small study, researchers found an expanded population of cytotoxic T-cells at 2 to 3 months compared with the acute phase of infection, specifically in a small subset of patients (9%) who were experiencing gastrointestinal symptoms ([11](https://www.sciencedirect.com/science/article/pii/S0092867422000721)). Cytotoxic T-cells are [increasingly](https://www.frontiersin.org/articles/10.3389/fimmu.2019.00856/full) recognized as playing a role in autoimmune diseases ([13](https://www.frontiersin.org/articles/10.3389/fimmu.2019.00856/full)). A recent study by researchers in Australia followed people for 8 months after mild or moderate SARS-CoV-2 infection and found evidence for widespread “[immunological dysfunction](https://www.nature.com/articles/s41590-021-01113-x)”—disruptions in B and T-cell and innate immune responses—among individuals who continued to have Long COVID symptoms ([14](https://www.nature.com/articles/s41590-021-01113-x)). Compared with a small group of people who had recovered from infection, those experiencing Long COVID had higher levels of a set of immune-signaling molecules that altogether suggested ongoing inflammation. The study also found ongoing activation of cytotoxic T cells and certain classes of innate immune cells. ### **Parsing the possibilities** Despite the growing evidence that Long COVID may be a type of autoimmune disease—and some [experts are already ](https://www.rheumatologyadvisor.com/home/news/exploring-the-link-between-covid-19-and-autoimmunity-can-help-patients-with-long-haul-covid/)calling it an “autoimmune-related disorder”— a case can be made for other causes. Leading the pack of alternative explanations is that proteins or RNA from the SARS-CoV-2 virus may remain in tissue, or the virus itself may actually continue to [replicate](https://www.frontiersin.org/articles/10.3389/fmicb.2021.698169/full) in some individuals, driving chronic inflammation. In support of this theory is the fact that viral proteins and/or RNA have been [found](https://www.science.org/doi/10.1126/science.abm8108) in a range of tissue types, including respiratory, cardiac, renal, brain, and muscle, months after COVID-19 infection ([16](https://www.science.org/doi/10.1126/science.abm8108)). Another potential cause of Long COVID is that the body could be responding to [unresolved](https://www.science.org/doi/10.1126/science.abm8108) tissue damage. This explanation is more feasible for people who had severe infections, particularly those who were in the ICU and likely lost muscle mass. **Unearthing the causes of Long COVID is far more than an academic exercise because it could pave the way for developing treatments.** Last year, doctors gave a 59-year-old man an experimental drug for his glaucoma that blocks GPCR autoantibodies ([17](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8637609/)). The patient also suffered from Long COVID and had autoantibodies against GPCRs. In addition to improvements in his glaucoma, the man recovered from fatigue, brain fog, and loss of taste for at least four weeks. Experts hope that breakthroughs like these will give way to improvements in research, diagnosis, and treatment for Long COVID. “There are a lot of nice therapies that we can use to target people’s B-cells \[if a subset of people with Long COVID can be shown to have B-cell disorders\],” Dr. Luning Prak says. “Maybe that can put them into remission from Long COVID and maybe they never have it again.” ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** COVID-19 and Long Covid --- ### [Autoimmunity on the Rise](https://www.autoimmuneinstitute.org/articles/autoimmunity-on-the-rise) **Published:** August 24, 2022 **Author:** Carolyn Serraino **Content:** With autoimmune biomarkers (substances in the body that can be measured in order to help determine the intensity of a disease or other physiological state) increasing in prevalence, some researchers are looking at the association between autoimmunity and environmental factors like microplastics to explain this trend. The best guess that current research literature has is that an estimated 4 percent of the world’s population has at least one autoimmune disease. In the United States, that number may be closer to 8 percent ([1](https://www.nature.com/articles/d41586-021-01836-9))—and those rates aren’t static. Experts say they’ve been increasing for decades ([2](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3114837/),[3](https://pubmed.ncbi.nlm.nih.gov/32266792/),[4](https://pathology.jhu.edu/autoimmune/development)). A 2020 study in *Arthritis Rheumatology* found a steady rise over time in the frequency of antinuclear antibodies (ANA), proteins that occur in autoimmune diseases like [lupus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/lupus-nephritis/), [scleroderma](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/scleroderma/), and [Sjögren’s](https://www.autoimmuneinstitute.org/medical_institutions/sjogrens-syndrome-clinic/) ([3](https://pubmed.ncbi.nlm.nih.gov/32266792/)). These findings further suggest that autoimmune diseases are becoming more prevalent. Now, researchers are zeroing in on environmental factors in an effort to explain why. ### **What Are Antinuclear Antibodies (ANA)?** In the human body, specialized white blood cells make antibodies that defend against pathogens. These are adaptable proteins with highly variable regions, meaning that once the immune system recognizes a specific bacteria or virus as foreign to the body, it can crank out custom antibodies that target those microorganisms. The antibodies neutralize the pathogen and recruit other proteins and cells to help fight the infection. This collective response is inflammation. Usually, this system works like a charm—but for reasons that are still unclear, the immune system sometimes turns its pathogen-busting attention toward the body’s own proteins by making ANA. > These autoantibodies initiate an inflammatory response that damages the body’s own healthy cells and can lead to the development of an autoimmune disease. Many people have some ANA circulating in their bloodstream and may never go on to develop an autoimmune disease. The immune system usually has regulatory mechanisms to keep autoantibodies in check ([4](https://pathology.jhu.edu/autoimmune/development)). Those mechanisms may not function correctly for people with autoimmune diseases. ANA remains the primary clinical indicator of immune dysfunction for people with autoimmune diseases—and can show up in blood tests years before diagnosis ([4](https://pathology.jhu.edu/autoimmune/development)). ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/ANA-testing.png) ### **ANA On The Rise** To learn more about the increase in autoimmune disease over time, researchers turned to the US National Health and Nutrition Examination Survey, which has continuously collected information from questionnaires and physical exams since 1999 and releases data to the public every two years ([3](https://pubmed.ncbi.nlm.nih.gov/32266792/)). The researchers used a method called immunofluorescence on preserved blood serum samples from 14,211 people stored over a 25-year period. Samples were organized into three separate time periods and tested for ANA. The technique, which stains antibodies in the serum so they glow under a microscope, revealed a marked increase in ANA over time—especially in the most recent cohort (Figure 1) ([3](https://pubmed.ncbi.nlm.nih.gov/32266792/)). ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Dinse-study.png) *Figure 1: Results from Dinse study (2020).* The increase in autoimmune markers was steepest for adolescents aged 12 to 19 years; in fact, their ANA rate almost tripled by the end of the study ([3](https://pubmed.ncbi.nlm.nih.gov/32266792/)). The researchers also noted significant increases for men, adults over 50, and non-Hispanic white people. These broad findings correlate with previous work that shows an uptick in [multiple sclerosis (MS)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/), [systemic lupus erythematosus (SLE)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/), and [diabetes](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/diabetes-type-1/), to name a few ([5](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7720355/#:~:text=The%20estimated%20number%20of%20people,%2C%2035.95%5D%20per%20100%2C000%20people),[6](https://pubmed.ncbi.nlm.nih.gov/29987494/),[7](https://jamanetwork.com/journals/jama/fullarticle/2783420?guestAccessKey=86b21242-9016-4399-9615-10f2d00d259c&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=082421)). The researchers dug into the sociological data that accompanied each of those serum samples and reported that the **increases in ANA could not be explained by trends in things like body size, smoking history, or alcohol use** ([3](https://pubmed.ncbi.nlm.nih.gov/32266792/)). ### **Why Is ANA Increasing?** So, what could be at the root of this increase in ANA and autoimmune conditions? While it’s true that autoimmune diseases have a genetic component, experts say genetics are insufficient to explain the rise in ANA and autoimmunity ([4](https://pathology.jhu.edu/autoimmune/development)). Over the years, [environmental exposures](https://www.autoimmuneinstitute.org/research_updates/the-role-of-exposomes-toxic-chemicals-food-and-pathogens-in-the-pathophysiology-of-ads/)—including pollutants, medications, dietary components, viral infections, and stress—have been linked to autoimmunity ([4](https://pathology.jhu.edu/autoimmune/development)). > In fact, scientists say environmental factors may be responsible for up to 70 percent of autoimmune diseases ([8](https://www.frontiersin.org/articles/10.3389/fimmu.2019.03094/full)) Some of those associations involve obvious toxins like pesticides, mercury, solvents, and crystalline silicates. The latter—minerals found in stone, sand, and soil that become respirable dust during construction activities—have been associated with [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/), [SLE](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/), [autoimmune hepatitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-hepatitis/), [systemic sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/), and [scleroderma](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/scleroderma/) for many years ([2](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3114837/)). When these aerosolized compounds make their way into the lungs, immune cells mount an inflammatory response and may eventually cause the body to lose tolerance to its own cells and generate autoantibodies ([2](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3114837/)). Environmental exposure can also dysregulate the [microbiome](https://www.autoimmuneinstitute.org/2024/02/21/what-is-the-microbiome-and-why-is-it-important/). These beneficial bacteria live in the gut, helping digest food and supporting the immune system. When the balance of microbes in the gut community is thrown off—by inflammation, hormonal triggers, oxidative stress, or other mechanisms—the result is even more inflammation, autoimmunity, and the development of conditions like [SLE](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/), [MS](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/), [RA](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/), [IBD](https://www.autoimmuneinstitute.org/medical_institutions/inflammatory-bowel-disease-center/), [diabetes](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/diabetes-type-1/), and [ulcerative colitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ulcerative-colitis/) ([8](https://www.frontiersin.org/articles/10.3389/fimmu.2019.03094/full)). ### **Emerging Environmental Factors** When it comes to environmental exposure, there’s one pressing area of emerging science: microplastic. These are plastic particles, smaller than about 5 millimeters, that permeate the world around us: they’re mixed into the soil, churning around in our oceans and waterways, and even float in the air ([9](https://particleandfibretoxicology.biomedcentral.com/articles/10.1186/s12989-020-00387-7)). **Researchers say adults take in approximately 883 particles of microplastic every day—which works out to more than 322,000 particles per year** ([10](https://pubs.acs.org/doi/10.1021/acs.est.0c07384#:~:text=This%20intake%20can%20irreversibly%20accumulate,age%2070%20in%20the%20body)). And the study that reported this number includes a caveat that microplastic embedded in fruits, vegetables, and packaged meat products isn’t included in the calculation ([10](https://pubs.acs.org/doi/10.1021/acs.est.0c07384#:~:text=This%20intake%20can%20irreversibly%20accumulate,age%2070%20in%20the%20body)). **Other scientists tasked with estimating the amount of plastic in human waste report that the average person excretes 90,000 particles of microplastic every year** ([9](https://particleandfibretoxicology.biomedcentral.com/articles/10.1186/s12989-020-00387-7)). > The discrepancy between those two figures—microplastic in versus microplastic out—is noteworthy. Here’s what experts know so far about the fate of ingested and inhaled microplastic. Ingested plastic bits larger than 150 microns—about the size of three grains of powdered sugar—stick to the mucus layer of the intestines where they encounter epithelial cells, the major protective barrier between the outside world and the interior of the body ([9](https://particleandfibretoxicology.biomedcentral.com/articles/10.1186/s12989-020-00387-7)). This may trigger local immune responses, including inflammation. The smallest plastic fragments—less than 150 microns—can cross the epithelial layer and enter circulating blood, eventually winding up in the liver, heart, lungs, or brain ([9](https://particleandfibretoxicology.biomedcentral.com/articles/10.1186/s12989-020-00387-7)). ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Microplastics.png) But eating plastic isn’t the only route of exposure. Microplastic bits float in the air, and people breathe in as many as 130 particles every day ([9](https://particleandfibretoxicology.biomedcentral.com/articles/10.1186/s12989-020-00387-7)). Once inhaled, these particles can travel from the lungs to the gut and then out to the tissues just like ingested particles ([9](https://particleandfibretoxicology.biomedcentral.com/articles/10.1186/s12989-020-00387-7)). The smallest bits can pass directly through the lungs’ epithelial layer to reach the circulating blood ([9](https://particleandfibretoxicology.biomedcentral.com/articles/10.1186/s12989-020-00387-7)). Or they might just embed in the lungs. Researchers found microplastic deep in human lungs for the first time just this year ([11](https://www.sciencedirect.com/science/article/pii/S0048969722020009?via%3Dihub)). And that’s only microplastic. The smallest plastic particles are called nanoplastics, which clock in at less than 0.1 micron—about 1/3 the size of a single tobacco particle in cigarette smoke. These plastic particles are so small that they’re difficult to analyze, so most environmental data don’t include them ([9](https://particleandfibretoxicology.biomedcentral.com/articles/10.1186/s12989-020-00387-7)). Our ever-increasing exposure to those microplastics through ingestion or inhalation seems to cause similar issues as other environmental exposures: oxidative stress, inflammation, and a dysregulated microbiome with the potential to trigger immune, inflammatory, or metabolic disorders ([9](https://particleandfibretoxicology.biomedcentral.com/articles/10.1186/s12989-020-00387-7)). Sometimes the effects of microplastic go unnoticed until an infection tests the immune system. One animal study found that microplastic-fed mice who didn’t show obvious signs of microbiome or gut changes developed prolonged arthritis after exposure to a virus—a phenomenon the authors called “systemic immunopathological consequences” ([12](https://pubmed.ncbi.nlm.nih.gov/34890673/)). That’s worrisome in the context of an ongoing viral pandemic. Viral infection is already a known environmental factor that can lead to ANA, and COVID-19 has been shown to produce new-onset autoantibodies that are considered a hallmark symptom of Long Covid ([4](https://pathology.jhu.edu/autoimmune/development),[13](https://pubmed.ncbi.nlm.nih.gov/35296346/)). ### **More Work** Needed The past few years have seen an explosion in research around microplastic. Ten years ago, a PubMed search for “microplastic” generated just 35 studies. Today, that same search yields 6,642 hits. That’s great news when it comes to unraveling any role this environmental exposure could play in the increase in autoimmune disease. The authors of the recent ANA study say more research is required in order to get a handle on rising autoimmunity rates ([3](https://pubmed.ncbi.nlm.nih.gov/32266792/)). They recommend establishing a national registry for autoimmune diseases to make it easier to monitor changes in prevalence over time, pinpoint places with exceptional upticks in prevalence, and help understand the underlying causes and rising rates of autoimmunity ([14](https://www.nih.gov/news-events/news-releases/autoimmunity-may-be-rising-united-states)). ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** About Autoimmune Disease --- ### [Inflammation: A Driving Force of Autoimmune Disease](https://www.autoimmuneinstitute.org/articles/inflammation-a-driving-force-of-autoimmune-disease) **Published:** September 16, 2022 **Author:** Carolyn Serraino **Excerpt:** An abnormal inflammatory response is involved in the majority of acute and chronic conditions, with strong evidence linking chronic inflammation to the pathogenesis of autoimmune disease (1,2,3). **Content:** An abnormal inflammatory response is involved in the[ majority](https://www.frontiersin.org/articles/10.3389/fmed.2018.00316/full) of acute and chronic conditions, with strong [evidence](https://www.nature.com/articles/s41573-020-0082-8%20) linking chronic inflammation to the pathogenesis of autoimmune disease ([1](https://www.frontiersin.org/articles/10.3389/fmed.2018.00316/full),[2](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6421792/),[3](https://www.nature.com/articles/s41573-020-0082-8)). This includes [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/), [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/), [ulcerative colitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ulcerative-colitis/), [Crohn’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crohns-disease/), [psoriasis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/psoriasis/), and [idiopathic pulmonary fibrosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/fibrosing-alveolitis/). > Major questions remain as to exactly how the immune cells and molecules that promote inflammation contribute to the pathogenesis of autoimmune diseases ([2](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6421792/)). While many treatments for these diseases rely on decreasing inflammation, they[ do not work](https://immunenetwork.org/pdf/10.4110/in.2022.22.e9) for all patients and can have[ serious side effects](https://immunenetwork.org/pdf/10.4110/in.2022.22.e9), such as increasing the risk of infection ([4](https://immunenetwork.org/pdf/10.4110/in.2022.22.e9)). Could a more precise understanding of the inflammatory mechanisms behind the broad range of autoimmune conditions pave the way for better therapies? ### **History Of Inflammation and Autoimmune Disease** Around[ 150](https://mstrust.org.uk/a-z/history-ms) years ago, research on multiple sclerosis cast doubt on the reputation of inflammation. The inflammatory response had[ long been viewed](https://www.ncbi.nlm.nih.gov/books/NBK53379/) as an important component of the body’s defense against infection and a healing mechanism for damaged tissue ([5](https://www.ncbi.nlm.nih.gov/books/NBK53379/)). But when a French neurologist[ reported](https://mstrust.org.uk/a-z/history-ms) the presence of inflammation in areas of multiple sclerosis lesions in the central nervous system, the evidence suggested it might actually cause harm. This idea was reinforced in the 1980s when a team of British scientists found a[ slew](https://www.jci.org/articles/view/71860) of inflammation-inducing molecules called cytokines in the joints of patients[ suffering](https://laskerfoundation.org/marc-feldmann-teaming-up/) from [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/) ([6](https://www.jci.org/articles/view/71860)). > **The group went on to make a convincing case that inflammation was a driver, not a bystander, of disease.** They showed that antibodies that blocked one type of cytokines – TNF alpha – dampened other cytokine levels in the joint tissues growing in the lab, and provided patients in clinical trials with almost immediate symptom relief. The work led to the development of infliximab (Remicade) as a[ targeted](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8901705/)[ therapy](https://www.accessdata.fda.gov/drugsatfda_docs/label/2011/103772s5281lbl.pdf) for [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/), as well as [ulcerative colitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ulcerative-colitis/), [psoriasis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/psoriasis/), and other autoimmune diseases. ### **The Good And Bad Sides of Inflammation** Considering its relationship with autoimmune disease – and so many other diseases – inflammation can seem like the bad guy. However, inflammation held a good reputation for many millennia, dating back to[ ancient](https://www.ncbi.nlm.nih.gov/books/NBK53379/) Egypt and Greece ([5](https://www.ncbi.nlm.nih.gov/books/NBK53379/)). Acute inflammation protects the body and helps it[ recover](https://www.nature.com/articles/s41591-019-0675-0) from bacterial and viral infections, as well as toxins and physical injury ([7](https://www.nature.com/articles/s41591-019-0675-0)).[ Innate](https://www.nature.com/articles/s41591-019-0675-0) immune cells, which are the body’s first line of defense, rush to the area of injury ([7](https://www.nature.com/articles/s41591-019-0675-0)). During this delivery process, blood vessels[ dilate](https://www.britannica.com/science/inflammation) and leak—resulting in [redness](https://www.britannica.com/science/inflammation),[ heat](https://www.lhsc.on.ca/critical-care-trauma-centre/critical-care-trauma-centre-287),[ swelling](https://www.webmd.com/heart-disease/heart-failure/edema-overview), and[ pain](https://www.britannica.com/science/inflammation) commonly associated with inflammation. This cascade is triggered by an interaction between innate immune cells and the insulting agent. Bacteria and viruses have distinct proteins, nucleic acids, and other[ molecules](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2668232/) on their surface called pathogen-associated molecular patterns ([PAMPs](https://www.nature.com/articles/s41591-019-0675-0)) that are recognized by receptors on the surface of[ innate immune cells, including neutrophils](https://rupress.org/jcb/article/219/7/e202004003/151857/The-cell-biology-of-inflammation-From-common) and macrophages ([8](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2668232/),[7](https://www.nature.com/articles/s41591-019-0675-0),[9](https://rupress.org/jcb/article/219/7/e202004003/151857/The-cell-biology-of-inflammation-From-common)). If there is physical or chemical damage to tissues, cells release damage-associated molecular patterns ([DAMPs](https://www.nature.com/articles/s41591-019-0675-0)) that immune cell receptors can also bind to ([7](https://www.nature.com/articles/s41591-019-0675-0)). Innate immune cells then spring into action, producing inflammatory[ cytokines](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2668232/) and other molecules that[ recruit](https://pubmed.ncbi.nlm.nih.gov/28722720/) more immune cells that have a range of functions, including [killing](https://www.sciencedirect.com/science/article/pii/S0092867410000231) and [clearing](https://www.thermofisher.com/us/en/home/life-science/cell-analysis/cell-analysis-learning-center/immunology-at-work/proinflammatory-cytokines-overview.html) diseased cells from the area ([8](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2668232/),[10](https://pubmed.ncbi.nlm.nih.gov/28722720/),[11](https://www.sciencedirect.com/science/article/pii/S0092867410000231)).[ Cytokines](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2919277/) can also pass through the blood-brain barrier and cause so-called[ sickness behavior](https://www.nature.com/articles/s41591-019-0675-0) – including sadness, fatigue, and reduced appetite – which also aids the body to heal by conserving energy ([12](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2919277/),[7](https://www.nature.com/articles/s41591-019-0675-0)). > Problems arise when inflammation lingers for more than a few days or weeks. Some of the same processes that jumpstart acute inflammation – such as the interplay between DAMPs and innate immune cells – can also incite chronic inflammation. In this case, cells release[ DAMPs](https://www.nature.com/articles/s41591-019-0675-0) because of ongoing changes or[ stress](https://www.nature.com/articles/s41591-019-0675-0), which can be the result of chronic infections, obesity, poor diet, exposure to toxins, and the aging process ([7](https://www.nature.com/articles/s41591-019-0675-0)). Moreover, adaptive immune cells such as T cells often arrive at the area of injury at[ higher levels](https://rupress.org/jcb/article/219/7/e202004003/151857/The-cell-biology-of-inflammation-From-common) during chronic inflammation than during an acute response ([9](https://rupress.org/jcb/article/219/7/e202004003/151857/The-cell-biology-of-inflammation-From-common)). While these cells contribute to the development of immune memory, they also[ release](https://www.frontiersin.org/articles/10.3389/fimmu.2018.00339/full) inflammatory cytokines that communicate with innate immune cells and provoke further inflammation ([13](https://www.frontiersin.org/articles/10.3389/fimmu.2018.00339/full)). ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Inflammation-A-Driving-Force-of-Autoimmune-Disease-graphics-1024x683.jpg) **For inflammation to become chronic, it not only has to be present in the body but also has to**[ **fail**](https://www.frontiersin.org/articles/10.3389/fimmu.2021.658840/full#B4) **to stop producing these inflammatory cytokines (**[**14**](https://www.frontiersin.org/articles/10.3389/fimmu.2021.658840/full#B4)**).** There is a highly coordinated series of[ checks](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2517296/) that limit the strength and duration of the acute inflammatory response ([15](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2517296/)). As cytokines flood an area of injury,[ cells](https://www.ncbi.nlm.nih.gov/books/NBK556083/) in the vicinity release[ lipoxin](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2517296/), a molecule that puts the[ brakes](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6093916/) on this[ flood ](https://www.ahajournals.org/doi/10.1161/circresaha.116.307308)([16](https://www.ncbi.nlm.nih.gov/books/NBK556083/#_NBK556083_pubdet_),[15](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2517296/),[17](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6093916/),[18](https://www.ahajournals.org/doi/10.1161/circresaha.116.307308)). [Later](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7088989/), innate immune cells produce a molecule called protectin that helps[ speed](https://www.tandfonline.com/doi/pdf/10.2217/clp.13.31) the resolution of the inflammatory response ([19](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7088989/),[20](https://www.tandfonline.com/doi/pdf/10.2217/clp.13.31)). However, the de-escalation of inflammation can go awry in a variety of[ ways](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6093916/), such as genetic factors that lead to an exaggerated immune response or prolonged exposure to the inflammatory trigger ([17](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6093916/)). ### **How Inflammation Spurs Autoimmunity** Research over the last decade has [pointed](https://immunenetwork.org/pdf/10.4110/in.2022.22.e9) to the innate immune system as playing a key role in the creation and progression of autoimmune disease ([4](https://immunenetwork.org/pdf/10.4110/in.2022.22.e9)). While T and B lymphocytes have long been blamed, there is growing [evidence ](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6476281/)that innate immune cells are the force behind damage to adaptive immune cells ([21](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6476281/)). Taking a look at [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/), we see that [neutrophils](https://www.sciencedirect.com/science/article/pii/S2319417020300986#bib45) swarm affected joints and damage the surrounding tissue ([22](https://www.sciencedirect.com/science/article/pii/S2319417020300986#bib45)). These innate immune cells also produce molecules that spur B cells to produce autoantibodies, a key component in the destructive nature of many autoimmune diseases. As part of the acute immune response, [dendritic cells](https://www.sciencedirect.com/science/article/pii/S2319417020300986#bib45) follow neutrophils to the affected joints, orchestrating a T-cell response ([22](https://www.sciencedirect.com/science/article/pii/S2319417020300986#bib45)). These dendritic cells direct T-cells to either promote further inflammation and become autoreactive, or toward a state of tolerance in which adaptive immune cells do not react to self-antigen. When joints are inflamed, dendritic cells follow the first path by pushing T-cells toward autoreactivity and greater inflammation. **However, major** [**questions**](https://www.sciencedirect.com/science/article/pii/S2319417020300986#bib45) **remain as to the exact factors, likely genetic and environment, underlying the abnormal innate immune response in rheumatoid arthritis (**[**22**](https://www.sciencedirect.com/science/article/pii/S2319417020300986#bib45))**.** The pathology of other [autoimmune diseases experience the same level of complexity](https://www.autoimmuneinstitute.org/articles/untangling-a-complex-web-how-to-categorize-autoimmune-disease). In [psoriasis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/psoriasis/), the[ involvement](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6676248/) of T-cells has long been clear, as well as the role that dendritic cells play to steer them toward an inflammatory state ([23](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6676248/)). The [interface](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6676248/) between autoreactive T-cells – which are thought to recognize self-antigens in the skin – and autoantibodies, contributes to the progression of psoriasis ([23](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6676248/)). In the past, adaptive immune cells – namely autoantibodies and autoreactive T-cells – were thought to play a solo role in the development of [systemic lupus erythematosus (SLE)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/). Over the last decade, research [studies](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6476281/) have pinpointed how disruptions in the normal function of [macrophages](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6476281/) in SLE can delay the clearance of self-antigens (autoantibody targets) from tissue, which in turn could promote the production of autoantibodies and T-cell malfunction ([21](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6476281/)). ### **Next Generation Therapies** The advent of [infliximab and similar drugs](https://immunenetwork.org/pdf/10.4110/in.2022.22.e9) that target TNF alpha cytokines was a game changer for treating autoimmune disease ([4](https://immunenetwork.org/pdf/10.4110/in.2022.22.e9)). That being said, there is a[ subset](https://immunenetwork.org/pdf/10.4110/in.2022.22.e9) of patients with [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/), [psoriasis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/psoriasis/), [Crohn’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crohns-disease/), and other conditions that do not respond to TNF inhibitors ([4](https://immunenetwork.org/pdf/10.4110/in.2022.22.e9)). A growing[ number](https://immunenetwork.org/pdf/10.4110/in.2022.22.e9) of therapies that inhibit other inflammatory cytokines have been developed to effectively combat the effects of [psoriasis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/psoriasis/); others are being tested with autoimmune diseases such as [SLE](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/) and [Crohn’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crohns-disease/) ([4](https://immunenetwork.org/pdf/10.4110/in.2022.22.e9)). Understanding the role of adaptive immune cells in autoimmune conditions has given way to several treatments based on inhibiting B or T cells. [Rituximab](https://immunenetwork.org/pdf/10.4110/in.2022.22.e9), an antibody that depletes B cells, is a success story for relapsing multiple sclerosis ([4](https://immunenetwork.org/pdf/10.4110/in.2022.22.e9)). Similarly, [abatacept](https://immunenetwork.org/pdf/10.4110/in.2022.22.e9), a T cell inhibitor, is approved to treat [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/) and [juvenile idiopathic arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/juvenile-idiopathic-arthritis-stills/) ([4](https://immunenetwork.org/pdf/10.4110/in.2022.22.e9)). **The growing recognition of the role of innate immune cells in autoimmune disease has paved the way for new treatments.** In the case of rheumatoid arthritis,[ drugs](https://www.sciencedirect.com/science/article/pii/S2319417020300986#bib45) that block neutrophil products and dendritic cells showed the potential to repair tissue damage and reduce symptoms in mouse studies ([22](https://www.sciencedirect.com/science/article/pii/S2319417020300986#bib45)). Likewise, mouse studies suggest that depleting harmful dendritic cells, or modifying the function of these cells, could have therapeutic benefits for SLE. An upside of the long, entangled list of immune cell players and molecules that are involved in inflammation and autoimmunity is that there are[ ample](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6476281/) targets to explore for new therapies ([21](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6476281/)). ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** About Autoimmune Disease --- ### [Probiotics, Prebiotics, and Autoimmune Disease](https://www.autoimmuneinstitute.org/articles/probiotics-prebiotics-and-autoimmune-disease) **Published:** October 6, 2022 **Author:** Carolyn Serraino **Excerpt:** The idea of probiotics and prebiotics as part of a wellness routine has recently increased in popularity. The internet and social media platforms share a plethora of claims on the benefits of their consumption; however, many claims require a discerning eye in regard to scientific evidence. **Content:** ### **What are Prebiotics and Probiotics?** The idea of probiotics and prebiotics as part of a wellness routine has recently increased in popularity. The internet and social media platforms share a plethora of claims on the benefits of their consumption; however, many claims require a discerning eye in regard to scientific evidence. In fact, a study published in the [Frontiers in Medicine](https://www.frontiersin.org/articles/10.3389/fmed.2019.00296/full) analyzed 150 Google-populated web pages for the keyword search term “probiotics,” and concluded that only 35% cited scientific literature. Probiotics have [a long history](https://pubmed.ncbi.nlm.nih.gov/25922406/); even people in ancient times consumed fermented milk for its health benefits. The WHO defines probiotics as “live microorganisms which, when administered in adequate amounts, confer a health benefit to the host.” On the other hand, prebiotics are compounds in food whose function is to help with the growth and activity of the gut microbiota. **Influence of the gut microbiome on immunity** ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Shutterstock_2171802895-1-1-1024x917.jpg) The state of our [gut microbiome](https://www.autoimmuneinstitute.org/2024/02/21/what-is-the-microbiome-and-why-is-it-important/) (the community of microorganisms living in our digestive tracts) plays a large role in influencing the state of our immune system ([1](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4095778/),[2](https://www.sciencedirect.com/science/article/pii/S1931312808003053)). There are also differences in the microbiome composition of those living with autoimmunity. > Is it possible for probiotics and prebiotics to alter the microbiome’s composition to benefit those living with autoimmunity? Dietary supplementation with prebiotics and probiotics has been documented to exhibit a therapeutic effect. Beneficial microbes in our intestines can inhibit pathogenic microbes, modify intestinal permeability, as well as impede or boost an immune response. Microbes can also ferment prebiotics – such as fiber – and produce molecules that have anti-inflammatory properties or can inhibit pathogen growth ([3](https://pubmed.ncbi.nlm.nih.gov/32698454/)). While scientists have gained insight into many molecular pathways involved in these processes, they are still working to define strains that exhibit the most therapeutic potential. ### **Role of Probiotics and Prebiotics on Autoimmune Diseases** The therapeutic value of probiotics and prebiotics have been studied in several autoimmune diseases, with varying results. ##### **Rheumatoid Arthritis ([RA](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/))** While some earlier studies have shown [no significant improvement](https://pubmed.ncbi.nlm.nih.gov/14626627/) in disease activity from probiotic treatment in RA patients, [others suggest](https://pubmed.ncbi.nlm.nih.gov/24673738/) the beneficial effect of probiotic supplementation in patients consuming either *Lactobacillus casei* – a mix of three bacteria, *Lactobacillus acidophilus*, *Lactobacillus casei*, and [*Bifidobacterium bifidum*](https://pubmed.ncbi.nlm.nih.gov/27135916/) or [*Bacillus coagulans*](https://pubmed.ncbi.nlm.nih.gov/20067641/) *GBI-30, 6086* – alongside anti-arthritic medications. In another [study](https://pubmed.ncbi.nlm.nih.gov/28914373/), researchers performed a meta-analysis of studies investigating the influence of microbiota treatment in RA patients. The authors found that some disease markers were lower in patients taking probiotics compared to the placebo group. However, the difference in disease activity scores was not significant between the two groups. Another researcher investigated the effect of prebiotics in patients with RA. The authors used high-fiber supplementation and [observed improvement](https://www.mdpi.com/2072-6643/11/10/2392) in disease markers after one month of the treatment. ##### **Inflammatory Bowel Disease: Ulcerative Colitis ([UC](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ulcerative-colitis/)) And Crohn’s Disease ([CD](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crohns-disease/))** Research on those with Ulcerative colitis shows promise in using probiotics as a treatment option. While there are studies that [show no beneficial effect](https://pubmed.ncbi.nlm.nih.gov/24972748/) of *Escherichia coli Nissle 1917* on patients with active UC, *E. coli Nissle* was shown to [be effective](https://gut.bmj.com/content/53/11/1617) in maintaining remission at the same level as the gold standard treatment (mesalazine) in another study. Multiple studies reinforce the positive effects of probiotics on patients with UC. In one study, researchers found that VSL#3 (an eight-strain probiotic including *lactobacilli*, *bifidobacilli*, and *Streptococcus thermophilus*) significantly increased remission and positively impacted patients with UC ([4](https://pubmed.ncbi.nlm.nih.gov/24280877/),[5](https://pubmed.ncbi.nlm.nih.gov/28653751/),[6](https://pubmed.ncbi.nlm.nih.gov/28294322/)). This effect was not observed in Crohn’s disease. Patients living with Ulcerative colitis were also given oligofructose-enriched inulin as a prebiotic, which [significantly reduced colitis](https://www.tandfonline.com/doi/full/10.1080/19490976.2018.1526583) when taken in high doses. In the study, this led to an increased production of colonic butyrate, a bacterial product with anti-inflammatory properties and decreasing fecal inflammatory marker calprotectin \[[7](https://onlinelibrary.wiley.com/doi/10.1111/j.1365-2036.2007.03288.x)\]. Similarly, Ulcerative colitis patients taking Germinated Barley Foodstuff combined with routine pharmaceutical medication [showed a significant reduction](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4122037/) in inflammation markers, abdominal pain, and cramping. ##### **Multiple Sclerosis ([MS](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/))** There is [evidence from both rodent and human studies](https://pubmed.ncbi.nlm.nih.gov/22031325/) suggesting that intestinal microbiota play an important role in MS. A [study using MS mouse models](https://pubmed.ncbi.nlm.nih.gov/30899262/) showed that introducing probiotics allowed for the modulation of immune responses resulting in decreased disease severity. [Research](https://pubmed.ncbi.nlm.nih.gov/18974295/) has also supported that altering the gut microbiome can suppress the development of MS by modifying immune system components. Additionally, a [clinical trial](https://pubmed.ncbi.nlm.nih.gov/27669638/) in patients with MS showed a positive impact on symptoms and quality of life in MS patients who were regularly taking probiotic capsules. ##### **Systemic Lupus Erythematosus ([SLE](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/))** In one experiment, the immune system markers of rodents with SLE given *Lactobacillus paracasei* or *Lactobacillus reuteri* were [observed to have notable improvements](https://pubmed.ncbi.nlm.nih.gov/28901888/). While the mice model showed promising results, further studies are necessary to define whether this kind of treatment will be successful in patients with SLE. ### **Important Points to Consider** Probiotics and prebiotics are common buzzwords in the media, oftentimes with unverified claims promoting health. While generally regarded as safe, there are several points to remember when considering probiotics and prebiotics: - Probiotics and prebiotics are umbrella terms for many microorganisms and compounds. Findings from scientific studies are relevant only to the specific microorganisms or compounds that are studied and do not mean all probiotics and prebiotics can produce the same effect. - Many of the claims, correlations, and information presented on the internet regarding probiotics and prebiotics, especially in regard to symptom management, are not supported by scientific evidence. - Probiotics and prebiotics are sold as supplements and often [do not undergo the rigorous tests or studies](https://www.sciencedirect.com/science/article/pii/S1542356518300843) that are required for medications. - Probiotics are considered safe for the general population. However, since people with autoimmune diseases are often on immunosuppressive medications, [some question](https://www.tandfonline.com/doi/full/10.1517/14740338.2014.872627?scroll=top&needAccess=true) whether it is safe to give those patients probiotics. - While evidence suggests using certain probiotics or prebiotics in treating diseases, research often includes small group sizes. More extensive clinical trials are needed to gain more robust data. - A consensus has not been made on the use of probiotics and prebiotics by the scientific or medical community at large. So far, there has not been an FDA-approved therapy that uses probiotics and guidelines on the use of probiotics and prebiotics have not been published by recognized medical institutions or professional societies. Science seems to be scratching the surface of which probiotics and prebiotics can potentially help patients with autoimmune diseases and which supplements can harm or exacerbate autoimmune disease symptoms. Before probiotics or prebiotics are used as a treatment, it is essential to take safety measures and select optimal strains and protocols, by consulting a medical professional. ### **About the Author** **Anna Drangowska-Way**, PhD attended the University of Wrocław in Poland, where she obtained a Bachelor’s and Master’s in Biotechnology, followed by a PhD in Biology from the University of Virginia. During her doctoral studies, she joined the Genetics Society of America’s Early Career Scientist Leadership Program and is a member of the Communication and Outreach Subcommittee. Currently, she works with ASAPbio as a Communications Assistant and is a Freelance Science Writer. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/SpacerShield.jpg) ***NOTE:*** *The information in this article is for educational purposes only and should not be taken as medical advice. Please seek professional medical counsel for best practices in addressing your health plan.* ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** Living Well with Autoimmune Disease --- ### [Comorbidities in Autoimmune Disease & Multiple Autoimmune Syndrome](https://www.autoimmuneinstitute.org/articles/comorbidities-in-autoimmune-disease-multiple-autoimmune-syndrome) **Published:** December 29, 2022 **Author:** Carolyn Serraino **Content:** The co-occurrence of more than two autoimmune diseases within the same person is known but only partly understood. > The combination of two autoimmune diseases is called polyautoimmunity with common examples being [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/) with [Sjögren’s syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sjogren-syndrome/ "Sjögren’s syndrome") and [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/) with [autoimmune thyroiditis](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/autoimmune-thyroiditis/) ([1](https://pubmed.ncbi.nlm.nih.gov/30774485/),[ 2](https://pubmed.ncbi.nlm.nih.gov/30646250/)). The combination of three or more autoimmune diseases is called multiple autoimmune syndrome (MAS) and was described for the first time in 1988 ([3](https://pubmed.ncbi.nlm.nih.gov/3059902/)). In MAS, one of the conditions typically affects the skin, with [vitiligo](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/vitiligo/) and [psoriasis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/psoriasis/) as common examples ([4](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3150011/)). The coexistence of five autoimmune diseases is rarely observed ([4](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3150011/)). ### **MAS Classification, Diagnosis , And Prevalence** ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Multiple-Autoimmune-Syndrome-MAS.png) MAS is categorized into three groups, each corresponding to specific diseases that tend to occur with one another: - Type 1 MAS includes [myasthenia gravis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/myasthenia-gravis/), thymoma, [polymyositis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/polymyositis/), and [giant cell myocarditis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/giant-cell-myocarditis/ "Giant cell myocarditis") - Type 2 MAS includes [Sjögren’s syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sjogren-syndrome/ "Sjögren’s syndrome"), [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/), [primary biliary cirrhosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/primary-biliary-cirrhosis/), [scleroderma](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/scleroderma/), and [autoimmune thyroid disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/hashimotos-thyroiditis/). - Type 3 MAS includes autoimmune thyroid disease, myasthenia gravis and/or thymoma, Sjögren’s syndrome, [pernicious anemia](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/pernicious-anemia/ "Pernicious anemia"), idiopathic thrombopenic purpura, [Addison’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-addisons-disease/), [type 1 diabetes mellitus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/diabetes-type-1/ "Type 1 diabetes / insulin-dependent diabetes"), [vitiligo](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/vitiligo/), [autoimmune hemolytic anemia](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-hemolytic-anemia/), [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/), and [dermatitis herpetiformis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/dermatitis-herpetiformis/) ([4](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3150011/)). Usually associated with thyroiditis, vitiligo is often the first skin disease to be observed in patients with MAS. Bullous pemphigoid also affects the skin and may occur with psoriasis and primary biliary cirrhosis though the frequency of the association with both conditions is still unclear. As mentioned earlier, Sjögren’s syndrome frequently coexists with systemic lupus erythematosus, but an association with rheumatoid arthritis has also been reported. Sjögren’s syndrome has also appeared to increase the risk of lymphoma ([4](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3150011/)). Other diseases seen in different combinations are [autoimmune hemolytic anemia](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-hemolytic-anemia/ "Autoimmune hemolytic anemia"), [alopecia areata](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/alopecia-areata/), [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/), [ulcerative colitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ulcerative-colitis/), and scleroderma. A more recent study reported more comorbidity patterns, with disease groups including systemic lupus erythematosus, rheumatoid arthritis, [dermatomyositis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/dermatomyositis/), and Sjögren’s syndrome ([5](https://pubmed.ncbi.nlm.nih.gov/32801041/)). Chronic active hepatitis and primary biliary cirrhosis were also seen, which may be attributed to the presence of antinuclear antibodies in some patients with these liver diseases ([5](https://pubmed.ncbi.nlm.nih.gov/32801041/)). Other comorbid groups included neurological diseases (multiple sclerosis, myasthenia gravis) and gastrointestinal diseases (ulcerative colitis, [Crohn’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crohns-disease/)). Both disease groups appeared to be associated with intestinal malabsorption and pernicious anemia ([5](https://pubmed.ncbi.nlm.nih.gov/32801041/)). **Despite the evidence of specific autoimmune diseases clustering together, the clinical presentation of MAS in patients is often complex and intricate.** Disease clusters are challenging to diagnose because a person might be visiting multiple specialists who will recognize different conditions. Therefore, visual characterization in research helps healthcare providers to identify MAS more readily ([5](https://pubmed.ncbi.nlm.nih.gov/32801041/),[ 6](https://my.clevelandclinic.org/health/diseases/21624-autoimmune-diseases#diagnosis-and-tests)). Autoimmune diseases have been observed to coexist both in individual people and within families ([7](https://pubmed.ncbi.nlm.nih.gov/16477262/)). Women may be more likely to have MAS because they are more frequently affected by single autoimmune diseases overall ([6](https://my.clevelandclinic.org/health/diseases/21624-autoimmune-diseases#diagnosis-and-tests)). Indeed, some studies were conducted in female populations only ([7](https://pubmed.ncbi.nlm.nih.gov/16477262/),[ 8](https://pubmed.ncbi.nlm.nih.gov/31110493/)). **Also, because research seems to focus more on diseases within certain specialties, broader studies are needed to better understand MAS prevalence, distribution, and predisposition** ([5](https://pubmed.ncbi.nlm.nih.gov/32801041/),[ 8](https://pubmed.ncbi.nlm.nih.gov/31110493/)). > About 25 percent of patients with an autoimmune disease are at risk of developing an additional autoimmune disease. ### **MAS Causes and Triggers** The mechanisms that lead to MAS are still largely unknown ([4](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3150011/)). Like single autoimmune diseases, MAS may be induced by multiple environmental triggers in genetically predisposed people. The triggers that appear to play a role in the development of MAS are both externalandinternal and include infectious, immunologic, and even psychological factors ([4](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3150011/)). **Autoantibodies** are hallmarks of autoimmune diseases and have been detected in people infected with microorganisms such as the Epstein-Barr virus ([9](https://newsinhealth.nih.gov/2022/06/understanding-autoimmune-diseases)). More recently, severe acute respiratory syndrome-associated coronavirus 2 (SARS-CoV-2), the causative agent of Coronavirus disease (COVID-19), has been [connected to the development of autoimmunity](https://www.autoimmuneinstitute.org/articles/is-long-covid-a-new-autoimmune-disease "Is Long Covid a New Autoimmune Disease?") ([9](https://newsinhealth.nih.gov/2022/06/understanding-autoimmune-diseases),[ 10](https://pubmed.ncbi.nlm.nih.gov/33610751/),[ 11](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9046575/),[ 12](https://pubmed.ncbi.nlm.nih.gov/33332890/)). Understanding more about the relationship between COVID-19 and autoimmune diseases, such as [Guillain-Barré syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/guillain-barre-syndrome/) and Kawasaki disease, will provide helpful information on multiple disease associations, leading to better management strategies ([10](https://pubmed.ncbi.nlm.nih.gov/33610751/)). ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Screen-Shot-2023-10-24-at-8.28.45-PM-1024x238.png) *Cardenas-Roldan J, Rojas-Villarraga A, Anaya JM. How do autoimmune diseases cluster in families? A systematic review and meta-analysis. BMC medicine. 2013;11:73.* [Image Copyright](https://www.ncbi.nlm.nih.gov/pmc/about/copyright/) © 2013 Cárdenas-Roldán et al; licensee BioMed Central Ltd. Genetic studies have identified **[susceptibility genes](https://www.autoimmuneinstitute.org/articles/how-sex-genetics-influence-autoimmunity "How Sex & Genetics Influence Autoimmunity")** shared by several autoimmune diseases ([13](https://www.ncbi.nlm.nih.gov/books/NBK459433/),[ 14](https://pubmed.ncbi.nlm.nih.gov/35749015/)). A meta-analysis conducted for ten autoimmune diseases with onset in childhood, including type 1 diabetes, celiac disease, juvenile idiopathic arthritis, and ulcerative colitis, revealed that 19 of the identified gene sites were shared by at least three autoimmune diseases ([15](https://pubmed.ncbi.nlm.nih.gov/26301688/)). Recent evidence has connected autoimmunity to the **[exposome](https://www.autoimmuneinstitute.org/research_updates/the-role-of-exposomes-toxic-chemicals-food-and-pathogens-in-the-pathophysiology-of-ads/ "The Role of Exposomes (Toxic Chemicals, Food, and Pathogens) in the Pathophysiology of ADs")**, defined as a person’s lifetime exposure to external ([stress](https://www.autoimmuneinstitute.org/articles/stress-autoimmune-disease-navigating-the-complex-relationship "Stress & Autoimmune Disease: Navigating the Complex Relationship"), [food](https://www.autoimmuneinstitute.org/articles/food-sensitivity-intolerance-or-allergy-whats-the-difference "Food Sensitivity, Intolerance, or Allergy: What’s the Difference?"), [infections](https://www.autoimmuneinstitute.org/research_updates/sciencetalks-recap-viral-triggers-of-autoimmune-disease/ "ScienceTALKS Recap: Viral Triggers of Autoimmune Disease")) and internal ([inflammation](https://www.autoimmuneinstitute.org/articles/inflammation-a-driving-force-of-autoimmune-disease "Inflammation: A Driving Force of Autoimmune Disease"), gut [microbiota](https://www.autoimmuneinstitute.org/research_updates/how-gut-microbes-evolve-to-escape-the-intestines-and-trigger-chronic-infection/ "How Gut Microbes Evolve to Escape the Intestines and Trigger Chronic Infection")) factors in the pathophysiology of autoimmune disease ([16](https://pubmed.ncbi.nlm.nih.gov/35366249/),[ 17](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9231084/)). Although these studies do not address [MAS](https://www.autoimmuneinstitute.org/articles/comorbidities-in-autoimmune-disease-multiple-autoimmune-syndrome "Comorbidities in Autoimmune Disease & Multiple Autoimmune Syndrome") as a disease entity, the authors mentioned that factors such as **[microbiome disruption](https://www.autoimmuneinstitute.org/articles/the-relationship-between-autoimmune-disease-and-the-gut-microbiome "The Relationship Between Autoimmune Disease and the Gut Microbiome")** could lead to multiple autoimmune disorders ([17](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9231084/)). ### **MAS Life Expectancy and Management** The life expectancy of patients with MAS is an ongoing mystery because of the complexity of managing concurrent disorders. Mortality also depends on how autoimmune diseases with different fatalities combine. Although there is no cure for autoimmune disease, symptoms can often be carefully managed ([9](https://newsinhealth.nih.gov/2022/06/understanding-autoimmune-diseases)). Current therapies are increasing life expectancy for individual conditions, but because treating patients for one disorder may predispose them to others, managing two or more concurrent conditions may prove to be complicated. Also, treatments such as immunosuppressants cause significant side effects, including multiple infections ([18](https://pubmed.ncbi.nlm.nih.gov/27726779/)). Increased mortality is observed for [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/) and vasculitis; thus, having more than one of these conditions may lower life expectancy ([19](https://pubmed.ncbi.nlm.nih.gov/23836941/),[ 20](https://pubmed.ncbi.nlm.nih.gov/28468793/)). More recently, systemic autoimmune diseases ([sarcoidosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sarcoidosis/) and [amyloidosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/amyloidosis/ "Amyloidosis") in addition to [lupus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus"), [Sjögren’s syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sjogrens-syndrome/), and vasculitis) have been associated with comorbidities (cardiovascular disease, cancer), leading to high mortality ([21](https://pubmed.ncbi.nlm.nih.gov/32944773/)). ### **Better Clinical Coordination and More Research Needed** A deeper understanding of the clinical picture of MAS and improvements in communication across multiple medical specialties will help providers diagnose and manage patients more successfully. Also, more research is needed to unveil causes and triggers, including the role of SARS-CoV- 2 in autoimmunity, and to understand comorbidity patterns better. ### **About The Author** **Damiana Chiavolini, MS, PhD** is a freelance writer who specializes in medical and life science topics. As a trained researcher, she authored journal articles in the areas of infection and immunity and wrote booklets and book chapters about different diseases. As a professional communicator, she writes feature articles for magazines and other publications and produces content for higher education platforms. Damiana is also an experienced academic editor, microbiology educator, writing coach, and fragrance blogger. She is a contributing member of the American Medical Writers Association and the current president of the association’s Southwest chapter. ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** About Autoimmune Disease --- ### [How do Cold Temperatures Affect Autoimmune Disease?](https://www.autoimmuneinstitute.org/articles/how-do-cold-temperatures-affect-autoimmune-disease) **Published:** January 31, 2023 **Author:** Carolyn Serraino **Content:** During the fall and winter months, cold temperatures can exacerbate many disease symptoms. Sensitivity to temperature fluctuations is a problem common to many autoimmune conditions, with the cold activating flare-ups of diseases such as [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/), [arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/), and [psoriasis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/psoriasis/). This is especially true when temperature changes are extreme. Although scientists have described cold weather as a trigger for autoimmune diseases, the mechanisms behind it are not fully understood, and research on this topic is less extensive than other areas of autoimmunity. Nevertheless, this article will discuss what is known about cold weather’s ability to trigger flare-ups, what can be done to minimize exposure, as well as insights into seasonal affective disorder and its effect on people with autoimmune diseases. This article will also cover recent research on the potential benefits of cold temperatures for some conditions. ### **Autoimmune Diseases Commonly Affected By Cold Weather And Why It Happens** The reasons why some conditions are more susceptible to the cold than others are unknown, but cold temperature’s effects on blood vessels appear to play a role in how flare-ups are triggered. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Cold-Weather-effects-on-the-body-1.png) With [lupus](https://www.autoimmuneinstitute.org/medical_institutions/lupus-nephritis-clinic/), cold temperatures activate painful flare-ups as blood vessels constrict to minimize heat loss. As this happens, pressure increases in different parts of the body, thereby reducing blood flow to the extremities. Because these body parts receive less oxygen, tissue is damaged, causing pain in areas such as the fingers and toes. Blood flow in lupus patients may already be impaired by a condition known as [Raynaud’s Phenomenon](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/raynauds-syndrome/), during which the body’s response to cold or stress causes abnormal spasms in the blood vessels ([1](https://lupus.net/living/cold-weather)). Drops in temperature can also trigger headaches and fatigue in those with lupus ([2](https://lupuscorner.com/seasonal-affective-disorder-changing-seasons-and-lupus/)). A connection between weather changes and arthritis has also been established. A study published in 2015 suggested that weather conditions and changes may affect joint pain in older adults with osteoarthritis ([3](https://pubmed.ncbi.nlm.nih.gov/24597710/)). People living with [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/) have reported that cold weather worsens their symptoms while sunny, warmer weather conditions improve them ([4](https://pubmed.ncbi.nlm.nih.gov/25342437/)). The activity of genes that promote inflammation associated with joint pain was also higher in the winter months in some people with rheumatoid arthritis and other conditions ([5](https://pubmed.ncbi.nlm.nih.gov/25965853/)). A more recent study indicated that women with arthritis were more susceptible to extreme cold weather and at higher risk of being hospitalized due to pain ([6](https://pubmed.ncbi.nlm.nih.gov/34718869/)). Autoimmune skin disorders like [psoriasis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/psoriasis/) are significantly affected during the colder seasons because of reduced sunlight and humidity, as well as drier air conditions indoors. In the late winter months, reduced vitamin D levels are also known to be associated with disease activity and severe bouts of psoriasis, lupus, [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/), [diabetes mellitus type 1](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/diabetes-type-1/), and rheumatoid arthritis ([7](https://pubmed.ncbi.nlm.nih.gov/28624334/), [8](https://pubmed.ncbi.nlm.nih.gov/23323190/), [9](https://pubmed.ncbi.nlm.nih.gov/31323357/)). ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/raynauds.png) ### **What Can You Do About Weather Changes Triggering Autoimmune Flares?** The best way to prevent and minimize autoimmune flare-ups is to prepare for cold weather. The most straightforward way is to stay as warm as possible by layering clothes, placing warmers in pockets and shoes to keep the hands and feet from getting too cold, eating frequent small meals or snacks, and staying indoors as much as possible on days of extreme cold. Most importantly, patients who are prone to flare-ups that cause severe pain and inflammation should consult their healthcare providers for advice on additional protective measures, resources on specific autoimmune conditions, as well as considerations about living in places with warmer climates. The relationship between climate change and health is currently being studied. Although research is still in the early stages, the effects of climate events on autoimmunity are a growing concern. Recent studies have reported that the loss of biodiversity, the increase in air pollution and viral infections, and extreme weather conditions may lead to more cases of autoimmune conditions like [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/), [celiac disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/celiac-disease/), and [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/) ([10](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7369820/), [11](https://pubmed.ncbi.nlm.nih.gov/35292563/), [12](https://pubmed.ncbi.nlm.nih.gov/31430946/)). ### **Seasonal Affective Disorders And Autoimmune Disease** Environmental factors such as infections, low vitamin D levels, UV light, and melatonin vary with each season and greatly influence the severity of autoimmune disease symptoms. The effects can be both physical and psychological. Seasonal affective disorder is commonly observed in the colder months when days get shorter and daylight is reduced, often presenting with signs of depression, mood swings, and changes in sleep patterns and appetite. Emotional stress can make people with certain autoimmune diseases more susceptible to flares. When the symptoms of seasonal affective disorder are severe, light therapy may be recommended. However, because UV light can worsen symptoms of diseases such as lupus, patients should consult a physician to consider the possible side effects ([13](https://www.lupus.org/resources/is-light-therapy-for-seasonal-affective-disorder-safe)). ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/light-therapy.jpg) ### Can Cold Temperatures Be Beneficial? A study published in *Cell Metabolism* in 2021 reported that low temperatures might help improve autoimmune conditions such as [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/) ([14](https://pubmed.ncbi.nlm.nih.gov/34687652/)). Mice affected by this disease that were exposed to cold temperatures increased their metabolic rate to maintain body heat. Investigators speculated that exposing the body to the cold takes away the resources the immune system would typically use to attack healthy tissue. Indeed, after exposure to the cold, disease symptoms in the mice’s central nervous system appeared to be less severe. Although these results are promising, the mechanisms behind these processes and the broad implications in certain autoimmune diseases are still unknown ([14](https://pubmed.ncbi.nlm.nih.gov/34687652/)). ### **About The Author** **Damiana Chiavolini, MS, PhD** is a freelance writer who specializes in medical and life science topics. As a trained researcher, she authored journal articles in the areas of infection and immunity and wrote booklets and book chapters about different diseases. As a professional communicator, she writes feature articles for magazines and other publications and produces content for higher education platforms. Damiana is also an experienced academic editor, microbiology educator, writing coach, and fragrance blogger. She is a contributing member of the American Medical Writers Association and the current president of the association’s Southwest chapter. ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** Living Well with Autoimmune Disease --- ### [How Sex & Genetics Influence Autoimmunity](https://www.autoimmuneinstitute.org/articles/how-sex-genetics-influence-autoimmunity) **Published:** March 24, 2023 **Author:** Carolyn Serraino **Content:** > **“There are very few conditions besides autoimmunity which have such remarkable differences in sex bias”** says Veena Taneja of the Mayo Clinic, who is currently working with [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/)-associated bacteria in mouse models to define sex-specific responses and mechanisms. The reasons for such disparities are not fully understood, but Taneja says [genetics](https://www.science.org/doi/10.1126/science.adg2992), epigenetics, hormones, environmental exposures, diet, and lifestyle may all play a role. “It is a complex story,” she says. Autoimmunity affects both males and females, but the mechanisms that drive the process may differ between the sexes. Overall, autoimmune diseases are more prevalent in females than males, with females comprising 80% of autoimmune disease patients ([1](https://pubmed.ncbi.nlm.nih.gov/19356902/)). However, males tend to have a higher risk of developing certain autoimmune diseases such as [Ankylosing Spondylitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ankylosing-spondylitis/) and [Type 1 Diabetes](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/diabetes-type-1/) ([2](https://pubmed.ncbi.nlm.nih.gov/12114267/)). ### **Sex Hormones** One of the key differences between males and females in the development of autoimmunity is the role of sex hormones. **“Sex hormones affect immune cell function because immune cells have estrogen receptors,” says Taneja.** ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2023/03/Estrogen.png) **Estrogen** has been shown to trigger the immune response in females, which may increase the risk of autoimmune diseases. On the other hand, **testosterone** has been shown to have immunosuppressive effects, which may help protect males from developing autoimmune diseases. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2023/03/Testosterone.png) However, the relationship between sex hormones and autoimmunity is complex, and some studies have suggested that testosterone may actually contribute to the development of certain autoimmune diseases in males, such as Rheumatoid Arthritis ([2](https://pubmed.ncbi.nlm.nih.gov/12114267/)). ### **Genetic Factors** Many autoimmune diseases have a strong genetic component, with certain genes predisposing individuals to developing a condition. Such genes may influence immune system function, regulating the production of antibodies and cytokines and the activation of immune cells ([3](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2992886/)). Research has identified several genes that are associated with autoimmune diseases, including the **human leukocyte antigen (HLA) genes**, which play a critical role in the immune response. One study published in the journal *Frontiers in Immunology* found that certain HLA gene variants were associated with a higher risk of developing autoimmune diseases in both males and females, but the specific variants varied depending on the disease and the sex of the individual ([4](https://pubmed.ncbi.nlm.nih.gov/24793874/)). > **Studies have also found sex-specific genetic effects on autoimmune disease susceptibility.** ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/X-Chromosome.png) For example, the X chromosome harbors many genes known to regulate and be involved in the immune response. Females have two copies of the X chromosome, while males have only one. This difference may contribute to the sex bias in autoimmune diseases. “Increased expression of certain genes can regulate **innate and adaptive immunity**,” Taneja says. **For example, genetic studies have identified multiple genes associated with [Systemic Lupus Erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/) (SLE), many of which are located on the X chromosome**. SLE is a chronic autoimmune disease that primarily affects females, with a female-to-male ratio of approximately 9:1 ([5](https://pubmed.ncbi.nlm.nih.gov/17307106/)). However, not all people with susceptible genes develop autoimmunity. Taneja says that is where the possibility of other factors arises. “It could be sex-specific, but still different for each person,” she says. ### **Environmental Exposures** Environmental exposures may contribute to the development of autoimmunity and may differ between men and females. For example, viral infections have been implicated in the development of autoimmune diseases since some viruses can trigger the production of autoantibodies and activate the immune system. An article published in the journal *Trends in Immunology* proposed that infection with the Epstein-Barr Virus (EBV) may contribute to the development of [Multiple Sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/) and [SLE](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/) by infecting autoreactive B lymphocytes and triggering the production of autoantibodies ([6](https://pubmed.ncbi.nlm.nih.gov/14596882/)). **The researchers found that males who had been infected with EBV had a higher risk of developing MS than females who had been infected with the same virus.** ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/shutterstock_797211184-scaled-1-1024x799.jpg) Regardless of sex, toxins and chemicals have also been associated with autoimmune diseases ([7](https://pubmed.ncbi.nlm.nih.gov/35123967/)), as well as diets and smoking. “\[Males\] and \[females\] have different lifestyles and dietary needs,” Taneja says. She notes **the [microbiome](https://www.autoimmuneinstitute.org/2024/02/21/what-is-the-microbiome-and-why-is-it-important/) may also be a “black box” because the gut has the maximum number of antibody-producing B cells, which females have more of.** ### **Males & Females: What Are The Differences In Autoimmune Flare-Ups?** When it comes to occurrence and severity, females tend to experience more frequent and severe flare-ups compared to males. The effects of female hormones on the immune system may play a role, as **females experience hormonal changes throughout their lifetime, such as during menstruation, pregnancy, and menopause, which can affect their immune system and worsen flare-ups**. Estrogen during pregnancy, for example, suppresses the immune response ([8](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3376705/)). On the other hand, certain autoimmune diseases such as [Ankylosing Spondylitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ankylosing-spondylitis/) and [Type 1 Diabetes](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/diabetes-type-1/) may also have different patterns of flare-ups and symptoms in males compared to females. For example, a study by Veena Taneja and other authors published in the *Journal of Rheumatology* found that **males with Ankylosing Spondylitis had more severe spinal inflammation and less peripheral joint involvement compared to females with the same condition** ([9](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8867405/)). Environmental factors, such as exposure to certain toxins or infectious agents, may also contribute to the occurrence and severity of autoimmune flare-ups. ([10](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4159850/)) ### **Males & Females: What Are The Differences In Autoimmunity Symptoms and Diagnosis?** Autoimmune diseases can affect individuals of any sex, age, or race, and can range from mild to severe, chronic conditions. However, research has shown that there are differences in autoimmune disease symptoms and diagnosis between males and females, which can impact management and treatment. ##### Symptoms Autoimmune diseases can be accompanied by a variety of symptoms. For example, [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/) (SLE) is a chronic autoimmune disease that can affect multiple organs and tissues in the body. Females with SLE are more likely to experience symptoms such as skin rashes, joint pain, and fatigue, while males are more likely to have issues with their kidneys ([11](https://pubmed.ncbi.nlm.nih.gov/32029091/)). Females are also three times more likely than males to develop [Rheumatoid Arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/) (RA), which affects joints and connective tissues. Females with RA are more likely to present with symmetrical joint pain, while males are more likely to present with asymmetrical joint pain ([12](https://pubmed.ncbi.nlm.nih.gov/26545825/)). ##### Diagnosis Autoimmune diseases can be challenging to diagnose due to the variability of symptoms and the lack of a single diagnostic test. There may also be differences in how autoimmune diseases are diagnosed between males and females. For example, a study of patients with SLE found that males were more likely than females to receive a delayed diagnosis due to the atypical presentation of symptoms ([13](https://pubmed.ncbi.nlm.nih.gov/23641038/)), which can result in delayed treatment and increased disease severity. Males with RA may be less likely to receive a timely diagnosis for similar reasons ([12](https://pubmed.ncbi.nlm.nih.gov/26545825/)). ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Genetics-article-1.png) Genetic testing can be used to identify genetic risk factors for autoimmune diseases and to guide treatment decisions. However, research has shown that genetic testing may also be underutilized in males with autoimmune diseases. ([12](https://pubmed.ncbi.nlm.nih.gov/26545825/)) ### **Males & Females: What Are The Differences In Autoimmune Disease Management and Treatment?** While there are some differences in the occurrence and severity of autoimmune diseases between males and females, treatment approaches and medications are typically prescribed based on an individual’s disease activity, symptoms, and overall health status, rather than their sex. **However, some studies have suggested that females may respond differently to certain medications used to treat autoimmune diseases.** In the opinion of Veena Taneja of the Mayo Clinic: “It is time treatments are thought of in terms of \[the\] sex of the patient because there is some literature that suggests that some treatments may be much more effective.” For example, a study published in the journal *Arthritis & Rheumatology* found that females with RA had a higher risk of developing liver toxicity when taking methotrexate, a commonly used immunosuppressive medication, compared to men with the same condition ([14](https://pubmed.ncbi.nlm.nih.gov/36597979/)). Another study published in the journal *Clinical Rheumatology* found that females with SLE had a higher risk of developing serious infections when taking high-dose corticosteroids compared to males with the same condition ([11](https://pubmed.ncbi.nlm.nih.gov/32029091/))*.* According to Taneja, comprehensive work on the aspects of sex bias is still needed. She says that > **“A model where there is sex bias of disease that can explore all possibilities, will provide a comprehensive view of the problem, and expedite the solution.”** ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** About Autoimmune Disease --- ### [Nanotechnology Breakthroughs in Autoimmune Disease Treatment](https://www.autoimmuneinstitute.org/articles/nanotechnology-breakthroughs-in-autoimmune-disease-treatment) **Published:** September 23, 2025 **Author:** Carolyn Serraino **Excerpt:** Could nanoparticles transform autoimmune care? Scientists are testing ways to deliver drugs with precision, restore immune tolerance, and improve early diagnosis. **Content:** ### New Frontiers in Autoimmune Treatment Finding effective treatments for autoimmune diseases is often a trial-and-error process, but the field is rapidly evolving. This series examines five areas driving innovation: **nanotechnology**, [immunotherapy](https://www.autoimmuneinstitute.org/articles/immunotherapy-for-those-with-autoimmune-disease/), [precision medicine](https://www.autoimmuneinstitute.org/articles/tailoring-autoimmune-treatment-with-precision-medicine/), [stem cell therapy](https://www.autoimmuneinstitute.org/articles/stem-cell-therapy-for-autoimmune-disease/), and [personalized medicine](https://www.autoimmuneinstitute.org/articles/personalized-medicine-for-autoimmune-diseases). Together, these advances show how science is reshaping the future of autoimmune treatment. Lipid nanoparticles (LNPs) gained widespread recognition during the COVID-19 pandemic for their role in delivering mRNA vaccines. These tiny fat-based particles helped trigger a strong immune response, which is precisely what you want in a vaccine. #### Scientists are now using nanotechnology for the opposite purpose: to calm the immune system in individuals with autoimmune diseases. “The use of nanotechnology in autoimmunity is still in its very infancy. There’s incredible opportunity here,” says Michael Mitchell, Associate Professor of Bioengineering at the University of Pennsylvania. This article highlights how nanotechnology addresses current challenges in treating autoimmune diseases, how nanotechnology is used in diagnosing autoimmune disease, and the anticipated advancements in nanotechnology for autoimmune disease treatment. ## What are the Current Challenges in Autoimmune Disease Treatment? “The biggest challenge with current autoimmune disease therapies is that most of them induce systemic immune suppression,” says Ajay Thatte, a PhD candidate and NSF fellow at the University of Pennsylvania. “That systemic immune suppression is good in terms of reducing symptoms of autoimmune disorders, but can lead to other disorders popping up,” he continues. Finding a treatment option that doesn’t cause widespread immune suppression would help alleviate some of the side effects of current treatment options, such as increased susceptibility to infections or cancer ([1](https://www.sciencedirect.com/science/article/pii/S0092867420302695)). #### Other challenges in current therapies for autoimmune disease include: - Life-long compliance - High cost - Frequent dosing as the drugs are cleared from the body - Only aimed at reducing inflammation and not the cause of autoimmunity ## What is Nanotechnology? By definition, nanotechnology is the manipulation of particles typically with at least one dimension that’s less than 100 nanometers in length ([2](https://www.cdc.gov/niosh/topics/nanotech/default.html)). Because nanoparticles are so tiny (about 1,000 times smaller than the width of a human hair), they can sneak into specific tissues or cells, making them ideal for delivering medicine precisely where it’s needed. Innovations in nanotechnology can help improve drug delivery systems (ex: nanoparticles that are engineered to bring drugs to specific parts of the body), monitoring health conditions (ex: measuring glucose levels with biosensors), and diagnostics (ex: nanoparticles with molecules that recognize specific disease biomarkers, or nanoparticles used with imaging techniques like MRI, CT scans) ([3](https://www.sciencedirect.com/science/article/pii/S2414644723000337?via%3Dihub)). #### Different types of nanotechnology include: - **Lipid nanoparticles:** encapsulate a therapeutic for delivery to specific cells - **Gold nanoparticles:** bind therapeutic agents and enable controlled release of therapeutics at target sites ([4](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8470500/)) - **Carbon nanotubes:** suppresses autoimmune responses by inhibiting the development of Th17 cells, which activate inflammation ([5](https://onlinelibrary.wiley.com/doi/full/10.1111/cns.12121)) - **Iron oxide nanoparticles:** used as a contrast agent for MRI to detect inflammation ## How can Nanotechnology Improve Targeted Delivery of Immunosuppressants and Reduce Side Effects? “If you had approaches that could selectively yet comprehensively blunt the autoimmune attack without compromising normal immunity, then you would be able to treat the disease much more effectively than current drugs do,” says [Pere Santamaria](https://profiles.ucalgary.ca/pere-santamaria), Professor at the Cumming School of Medicine at the University of Calgary, Founder and CSO of Parvus Therapeutics, and Group Leader at Institut D’Investigacions Biomédiques August Pi i Sunyer. One way nanotechnology can circumvent the widespread immunosuppression of currently available treatments and their associated side effects is through targeted delivery, where nanoparticles encapsulate immunosuppressive drugs and deliver them to the sites affected by disease. This methodology is what Santamaria considers the “first generation of NP-based compounds used to treat autoimmunity” ([6](https://www.sciencedirect.com/science/article/pii/S0169409X2100291X#b0115)).  “There are a lot of ways to modify nanoparticles in terms of where they’re going,” says Thatte. #### Targeting nanoparticles to specific locations can be achieved by: - **Chemical targeting:** changing the composition of the nanoparticle shell to dictate what cell types the nanoparticle can target - **Molecular targeting:** attaching a molecule (ex: antibody, peptide, sugar) to the surface of the nanoparticle that interacts with specific receptors on certain cells - **Modulating delivery routes:** different delivery routes, such as intravenous, intraperitoneal, or intramuscular, can help target specific organs (ex: pancreas, which is not as accessible through IV delivery) #### Using nanotechnology for targeted delivery has been tested in animal studies, including: - Liposome delivery of prednisolone phosphate in a rat model of arthritis ([7](https://pubmed.ncbi.nlm.nih.gov/12847701/)) - Targeting of inflamed tissues with hyaluronic acid-based NPs used to target inflamed tissue and deliver methotrexate, an antirheumatic drug, to the joints of mice ([8](https://pubs.rsc.org/en/content/articlelanding/2014/cc/c4cc02595d)) - Liposome delivery of methylprednisolone hemisuccinate in a mouse model of [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus") ([9](https://journals.sagepub.com/doi/10.1177/0961203316636468)) ## How can Nanotechnology Restore Immune Tolerance? As an alternative to delivering immunosuppressive drugs in a targeted manner, nanotechnology can also be utilized to help the immune system tolerate the body’s tissues by depleting harmful T or B cells, or by enhancing the number or function of regulatory T cells ([10](https://www.nature.com/articles/s41587-019-0015-4)). “Where nanotechnology can be the most effective is in developing tolerogenic therapies,” says Thatte. One approach to this, which is the basis of Santamaria’s company, is to use nanoparticles called [Navacims](https://parvustx.com/our-science/). Navacims consist of disease-specific peptides complexed with proteins called major histocompatibility complexes (MHCs). These molecules bind to a specific type of autoreactive T cell and cause them to proliferate and reprogram into regulatory T cells that can dampen autoimmune attacks. “The beauty of this approach is that it can be extended to many autoimmune diseases,” says Santamaria. Thatte and Mitchell are taking a different approach. They’re using LNPs to introduce mRNA into T cells to create immunosuppressive cells that can then suppress the proliferation of pro-inflammatory T cells ([11](https://mitchell-lab.seas.upenn.edu/wp-content/uploads/2023/10/thatte-et-al-2023-mrna-lipid-nanoparticles-for-ex-vivo-engineering-of-immunosuppressive-t-cells-for-autoimmunity.pdf)). #### Other examples of how nanotechnology has been used to promote immune tolerance include:  - Liposomes encapsulating autoantigens to promote self-tolerance in [type 1 diabetes](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/type-1-diabetes-insulin-dependent-diabetes/ "Type 1 diabetes / insulin-dependent diabetes"), [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/ "Multiple sclerosis"), [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid arthritis"), and [myasthenia gravis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/myasthenia-gravis/ "Myasthenia gravis") in experimental models ([12](https://www.sciencedirect.com/science/article/pii/S1549963422001216?via%3Dihub)) - Using nanoparticles to deliver peptides to dendritic cells for the deletion of autoreactive T cells in type 1 diabetes ([13](https://www.pnas.org/doi/full/10.1073/pnas.0802644105)) ## What Role does Nanotechnology Have in Imaging and Diagnosing Autoimmune Disease? Because of nanotechnology’s ability to target specific organs and cells, this technology can be used to diagnose autoimmune disease by identifying disease-specific features either as biosensors or contrast agents during imaging. #### Nanotechnology-based Biosensors: Identifying Biomarkers Current methods for diagnosing autoimmune disease include identifying specific biomarkers associated with the disease and assessing nonspecific indicators such as markers of inflammation ([14](https://www.sciencedirect.com/science/article/pii/S174801322200322X)). In addition to the unmet need for diagnostics for certain autoimmune diseases, nanotechnology-based biosensors can aid in efforts to make diagnosis faster, more convenient, and less invasive. For example, a nanomaterial-based sensor that analyzes volatile organic compounds in the breath has [undergone clinical trials for the diagnosis of MS](https://classic.clinicaltrials.gov/ct2/show/NCT04074629) and is reported to be 90% accurate ([15](https://pubs.acs.org/doi/10.1021/acschemneuro.7b00181)). #### Nanotechnology-based Contrast Agents: Better Imaging Imaging technologies can reveal signs of early autoimmune disease, which is often asymptomatic but already involves changes in the cells that line the blood vessels and lymphatic system. MRI can detect signals of early inflammation, including vascular permeability and immune cell infiltration. Imaging technologies, such as MRIs and CT scans, require a contrast agent to help visualize structures and fluids in the body. For MRIs, this means using gadolinium-based contrast agents, which have short half-lives, low specificity, and may come with adverse effects. Nanoparticles, such as those made from iron oxide, can help overcome these limitations. Several nanotechnology-based contrast agents have entered clinical trials, for example, for the [diagnosis of type 1 diabetes](https://classic.clinicaltrials.gov/ct2/show/NCT02511028) and [multiple sclerosis](https://clinicaltrials.gov/study/NCT01973517) (MS). Magnetic nanoparticles have been used to visualize islet inflammation, allowing for the differentiation between individuals with type 1A diabetes and non-diabetic individuals at the onset of the disease ([16](https://www.jci.org/articles/view/44339)). For MS, nanoparticles can bind specific immune cells, help monitor their distribution, and detect their infiltration into the central nervous system. For diagnosing rheumatoid arthritis, nanoparticles containing folic acid can bind folate receptors that are overabundant in activated macrophages ([17](https://www.cell.com/heliyon/pdf/S2405-8440(23)07069-X.pdf)). ## The Future of Nanotechnology in Autoimmune Disease Treatments Currently, there are no nanotechnology-based medicines available to treat autoimmune diseases; however, several are undergoing clinical trials. Many components that go into nanotechnology-based therapies for autoimmune diseases are FDA-approved. “While dexamethasone is FDA approved, nanotechnologies utilizing dexamethasone have not been approved,” says Thatte. ##### “The components that could be used in these technologies are approved individually, but nobody has put them together.” “Therapeutics that are getting closer to the clinic now are targeted LNP therapies that could selectively deliver to different immune cell types, such as T cells, are going to have a transformative impact,” says Mitchell. The use of nanotechnology for targeted delivery can provide clinicians and drug developers with access to cell types and tissues that were previously unavailable. “Once you are able to better access new cell types of interest, that could give rise to several new classes of therapeutics. It’s a really exciting time for the field,” says Mitchell. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/04/GAI-Logo-Image-811x1024.png) #### About the Author ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/10/Jennifer-Tsang-Bio-Headshot-e1753113113430.jpg) A microbiologist turned freelance science writer who works with life science companies, nonprofits, and academic institutions on anything from news stories, explainer articles, and content marketing. She shares the wonderful world of microbes on her blog The Microbial Menagerie. Jennifer Tsang, PhD Freelance Writer for GAI ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** Diagnosis & Treatment --- ### [Stem Cell Therapy for Autoimmune Disease](https://www.autoimmuneinstitute.org/articles/stem-cell-therapy-for-autoimmune-disease) **Published:** September 22, 2025 **Author:** Carolyn Serraino **Excerpt:** Stem cell therapy is showing promise for autoimmune disease treatment, with trials exploring immune reset, tissue repair, and reduced inflammation. **Content:** ### New Frontiers in Autoimmune Treatment Finding effective treatments for autoimmune diseases is often a trial-and-error process, but the field is rapidly evolving. This series examines five areas driving innovation: **stem cell therapy**, [immunotherapy](https://www.autoimmuneinstitute.org/articles/immunotherapy-for-those-with-autoimmune-disease/), [precision medicine](https://www.autoimmuneinstitute.org/articles/tailoring-autoimmune-treatment-with-precision-medicine/), [nanotechnology](https://www.autoimmuneinstitute.org/articles/nanotechnology-breakthroughs-in-autoimmune-disease-treatment/), and [personalized medicine](https://www.autoimmuneinstitute.org/articles/personalized-medicine-for-autoimmune-diseases). Together, these advances show how science is reshaping the future of autoimmune treatment. Stem cells have the unique ability to turn into any cell type when given specific stimuli. Recently, they have become a promising avenue for autoimmune disease treatment. “They are like a blank slate,” says Juan Domínguez-Bendala, Director of Stem Cell & Pancreatic Regeneration at the Diabetes Research Institute, University of Miami Miller School of Medicine. > “They are waiting for instructions to become one thing or another, and it’s up to us to tell them what path to take.” ### What are the Different Types of Stem Cells? Stem cells fall into different categories based on their source and what type of cell they can become: - **Embryonic stem cells**, derived from early-stage embryos, can become any cell type. - **Adult stem cells** are found in different tissues in the body. They can give rise to different cell types but are much more limited in what they can become. For example, hematopoietic stem cells (HSCs) are found in the bone marrow and can become different types of blood cells and immune cells. Adult stem cells are meant to regenerate damaged tissues and cells. - **Induced pluripotent stem cells** are differentiated cells that are genetically programmed back to embryonic stem cells so that they can be later differentiated into any cell type. ### Where has Stem Cell Therapy Shown Promise in Treating Autoimmune Disease? > “In general, for cell therapy in autoimmune diseases, there are two approaches,” says Saad Kenderian, Professor of Medicine, Immunology, and Oncology at Mayo Clinic. “Either you kill the cells that cause autoimmune diseases or you use suppressive cells and engineer them to go to the site of the inflammation.” #### Hematopoietic stem cell transplantation (HSCT) “resets” the immune system The idea behind stem cell transplantation is that the technique removes a patient’s self-reactive immune system and replaces it with a self-tolerant immune system. This process either uses hematopoietic stem cells from a donor (allogenic) or from the patient (autologous). The patient undergoes chemotherapy to delete the immune system. The stem cells are placed into the patient where they travel to the bone marrow, where they create new blood cells and regenerate a new, self-tolerant immune system. In contrast to allogeneic stem cell transplantation, autologous stem cell transplants require extracting a patient’s stem cells from the bone marrow using medication and collecting them from the blood ([1](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6334059/)). Autologous transplants do not have the incompatibility issue that donor stem cells may have. This technique is most often used to treat cancers like lymphomas and myeloma, but has applications in treating autoimmune diseases. As of 2020, about 3,000 patients with autoimmune diseases have been treated with HSCT ([2](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7187990/)). According to the American Society for Blood and Marrow Transplantation, HSCT should be the “standard of care, clinical evidence available” for multiple sclerosis (MS) patients with treatment-refractory relapsing MS ([3](https://doi.org/10.1016/j.bbmt.2019.02.014)). But there are many risks associated with HSCTs since it removes your existing immune system and there’s the potential for your body to reject the transplanted cells. “You don’t do a bone marrow transplant unless your life depends on it,” says Domínguez-Bendala. #### Dampening inflammation and promoting immune tolerance One type of stem cell, the mesenchymal stromal cells (MSCs), have a unique characteristic: they’re immunosuppressive and regenerative. Mesenchymal stromal cells (MSC) can be isolated from many tissue types in the body. In the body, they migrate to damaged tissues and can inhibit the growth and function of T cells and regulate expression of inflammatory molecules ([4](https://stemcellres.biomedcentral.com/articles/10.1186/s13287-022-02782-7)). “MSCs have been quite safe,” says Kenderian. “They have been widely used in the treatment of autoimmune diseases, but their activity has been kind of modest. You see some activity in some patients and no activity in others.” A recent study from Kenderian’s team reported the engineering of MSCs with chimeric antigen receptors (the technology used in [CAR-T therapy](https://www.autoimmuneinstitute.org/articles/car-t-cell-therapy-for-autoimmune-disease/)) ([5](https://www.nature.com/articles/s41551-024-01195-6)). “We could engineer the receptor in a way to get it to \[target\] different autoimmune diseases,” says Kenderian. He found that these cells were site specific and induced immunosuppression at the desired location. “We’re looking forward to translating this into a phase one clinical trial, and also see this as a platform that can be modified to make MSCs more suppressive in different diseases,” says Kenderian. “I think it’s a platform that can be engineered and adapted to develop designer therapy for a specific disease.” #### Applications for type 1 diabetes [Type 1 diabetes](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/diabetes-type-1/) has been long treated by giving the body insulin. In recent years, scientists have attempted to replenish insulin-producing cells, or islets, that have been destroyed by autoimmune attacks. Transplanting islet cells from donors has been difficult because organ donations are limited, which is why the field has turned to stem cells. When stem cells are transformed into a type of islet cell called beta cells, they offer a supply of insulin when placed into the body. However, the challenge then becomes keeping the patient’s immune system from attacking these cells. Many strategies to shield these cells from the immune system have reached clinical trials ([6](https://www.sciencedirect.com/science/article/pii/S0021979722022718)). “When you think about a cure for type one diabetes, it entails two things. One of them is to replenish cells that have been lost. The other is to correct autoimmunity, which is what caused the disease in the first place,” says Domínguez-Bendala. “Ultimately, if you can have your own body reheal your pancreas, and regrow your own cells, as opposed to having to transplant them, I think it will be much more holistic and the way to a cure,” says Domínguez-Bendala. ### What are the Potential Risks and Side Effects Associated with Stem Cell Treatments? **(1) Reduced ability to fight infections:** Many of the potential infection risks associated with bone marrow transplantation occur in the time between deleting self-reacting immune cells and the formation of a new immune system. Infections, that would otherwise be minor illnesses, could become life-threatening as the body doesn’t have a way to fight them off. **(2) Low blood counts:** For bone marrow transplants, low blood counts occur before the stem cells migrate to the bone marrow where they make new blood cells. There can be an increased bleeding risk as platelets (which affect clotting) are low after stem cell transplant. **(3) Tumor formation:** “The very reason that makes stem cells appealing, which is the fact that they proliferate all the time so you can get unlimited numbers of them, is also a reason for concern,” says Domínguez-Bendala. Because stem cells live so long and divide rapidly, they have the potential to acquire mutations that lead them to form tumors. Scientists, like Domínguez-Bendala, are working on mechanisms to prevent uncontrolled growth from stem cells ([7](https://www.sciencedirect.com/science/article/pii/S2213671119300141)). **(4) Graft versus host disease:** For transplanted stem cells that did not originate from the patient, it’s possible that the body recognizes donated stem cells as foreign and attacks them. ### Stem Cell Tourism Risks While stem cells have great potential in treating a variety of diseases, many experts have warned about the risks of [stem cell tourism](https://www.nytimes.com/2016/06/23/health/a-cautionary-tale-of-stem-cell-tourism.html), where individuals seeking treatment travel to countries with looser regulations for unproven stem cell therapies ([8](https://pubmed.ncbi.nlm.nih.gov/34415026/)). These types of treatments are often characterized by: - Lack of scientific evidence to support the treatment - Claims solely based on patient testimonials - High cost of treatment with hidden costs - Unclear documentation of cell source and treatment protocol Learn more in the resources below: [The International Society for Stem Cell Research Guide to Stem Cell Treatments](https://www.isscr.org/treatment-guide) [Safeguarding patients against stem cell tourism](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3338049/) ### Ongoing Clinical Trials Investigating Stem Cell Therapy for Autoimmune Disease > **The following clinical trials are now recruiting or will be recruiting *(\*as of publication date September 25, 2025)*:** ## Lupus - [Treatment of Lupus Nephritis With Allogeneic Mesenchymal Stem Cells (MSV\_LE)](https://clinicaltrials.gov/study/NCT03673748) - [Mesenchymal Stem Cell Transfusion for the Treatment of Refractory Lupus Nephritis (LN)](https://clinicaltrials.gov/study/NCT06485648) ## Multiple Sclerosis - [Autologous Hematopoietic Stem Cell Transplantation for Refractory Multiple Sclerosis](https://clinicaltrials.gov/study/NCT06228781) - [Best Available Therapy Versus Autologous Hematopoetic Stem Cell Transplant for Multiple Sclerosis (BEAT-MS) (BEAT-MS)](https://clinicaltrials.gov/study/NCT04047628?cond=Autoimmune%20Diseases&intr=Stem%20Cell&aggFilters=status:not%20rec&page=2&rank=18) - [Evaluate the Safety and Efficacy of Allogeneic Umbilical Cord Mesenchymal Stem Cells in Patients With Multiple Sclerosis (UMSC01)](https://clinicaltrials.gov/study/NCT05532943) - [Observational Study in Multiple Sclerosis Patients Treated With Autologous Hematopoietic Stem Cell Transplantation (OMST)](https://clinicaltrials.gov/study/NCT04674280) ## Rheumatoid Arthritis [Autologous Adipose-derived Stem Cells (AdMSCs) for Rheumatoid Arthritis](https://clinicaltrials.gov/study/NCT04170426) ## Systemic Lupus Erythematosus - - [Exploring the Efficacy and Safety of CS20AT04 (Allogenic Bone Marrow-Derived Stem Cell) in Systemic Lupus Erythematosus Patients](https://clinicaltrials.gov/study/NCT04835883) - [Treatment of Systemic Lupus Erythematosus With Human Umbilical Cord Mesenchymal Stem Cells](https://clinicaltrials.gov/study/NCT07041801) - - [Exploring the Efficacy and Safety of CS20AT04 (Allogenic Bone Marrow-Derived Stem Cell) in Systemic Lupus Erythematosus Patients](https://clinicaltrials.gov/study/NCT04835883) - [Treatment of Systemic Lupus Erythematosus With Human Umbilical Cord Mesenchymal Stem Cells](https://clinicaltrials.gov/study/NCT07041801) ## Type 1 Diabetes [Cellular Therapy for Type 1 Diabetes Using Mesenchymal Stem Cells](https://clinicaltrials.gov/study/NCT04061746) ## Other - - [Autologous Stem Cell Transplant (ASCT) for Autoimmune Diseases](https://clinicaltrials.gov/study/NCT05029336) - - [Autoimmune Disease Treatment With Mesenchymal Stem Cells (MSCs) and CAR-T Cells](https://clinicaltrials.gov/study/NCT06435897) - - [Autologous Stem Cell Transplant (ASCT) for Autoimmune Diseases](https://clinicaltrials.gov/study/NCT05029336) ##### **See all ongoing and not-yet-recruiting clinical trials using stem cells to treat autoimmune diseases [here](https://clinicaltrials.gov/search?cond=Autoimmune%20Diseases&intr=Stem%20Cell&aggFilters=status:not%20rec&page=2&rank=18&limit=10).** ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/04/GAI-Logo-Image-811x1024.png) #### About the Author ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/10/Jennifer-Tsang-Bio-Headshot-e1753113113430.jpg) A microbiologist turned freelance science writer who works with life science companies, nonprofits, and academic institutions on anything from news stories, explainer articles, and content marketing. She shares the wonderful world of microbes on her blog The Microbial Menagerie. Jennifer Tsang, PhD Freelance Writer for GAI ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** Diagnosis & Treatment --- ### [Decoding the Role of Autoantibodies in Autoimmunity](https://www.autoimmuneinstitute.org/articles/decoding-the-role-of-autoantibodies-in-autoimmunity) **Published:** June 20, 2025 **Author:** Carolyn Serraino **Content:** Your immune system makes antibodies against foreign invaders like viruses and bacteria. Sometimes, your body makes autoantibodies, proteins that mistakenly attack your body’s tissue, leading to autoimmunity. ## What are Autoantibodies? Under normal conditions, antibodies protect us by recognizing and attacking harmful substances. However, autoantibodies mistakenly identify the body’s tissues as threats. Faulty [autoantibodies](https://www.autoimmuneinstitute.org/articles/body-regions-commonly-affected-by-autoimmunity/) can target specific body regions, leading to various autoimmune disorders including: - [Autoimmune gastritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-gastritis/): Anti-parietal cell antibodies target stomach tissue. - [Autoimmune thyroid diseases:](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/hashimotos-thyroiditis/) Anti-thyroid peroxidase attacks the thyroid gland - [Multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/): Brain-reactive antibodies in the brain damage the nervous system. - [Addison’s disease:](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-addisons-disease/) 21-hydroxylase antigens impair adrenal function. - [Ulcerative colitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ulcerative-colitis/): Autoantibodies destroy the gut protein, protein tropomyosin. - [Rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/): Arthritic peptide antigens, including rheumatoid factor and anti-citrullinated protein antibodies, are associated with joint damage. ## Are Autoantibodies Always Harmful? Not always. Many healthy people are born with natural autoantibodies that are part of a normally functioning immune system ([1](https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2023.1147871/full "1")). Autoantibodies may help the immune system by “cleaning up” dead cells after infection or injury ([1](https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2023.1147871/full "1")). This housekeeping might prevent the emergence of disease-causing autoantibodies. Even when autoantibodies contribute to disease, their presence can still be clinically useful for doctors. In these cases, autoantibodies don’t benefit the patient directly, but they help guide medical care by: ([2](https://www.cdc.gov/mmwr/volumes/72/wr/mm7205e3.htm?s_mm7205e3_w "2")): - **Detecting disease early** by serving as important warning signs for conditions like lupus ([3](https://medlineplus.gov/immunesystemanddisorders.html "3")). - **Clarifying diagnoses** because their presence or absence can help distinguish between different types of the same disease, such as certain forms of lupus ([4](https://www.aaaai.org/conditions-treatments/related-conditions/immunosuppressive "4")). - **Tracking disease progression** since specific autoantibodies can show whether a condition is getting worse or better over time ([3](https://medlineplus.gov/immunesystemanddisorders.html "3")). - **Predicting treatment outcomes** by helping doctors choose therapies that are more likely to work for each patient. ## What Triggers Autoantibodies? While the exact cause of autoantibodies is unclear, several culprits have been suggested. Emergency medicine physician and integrative medicine specialist Dr. Ruby Rose describes the impact of the “total toxic burden.” She notes that the combination of environmental factors, genetics, lifestyle behaviors, and one’s internal environment contributes to autoimmunity. ##### Research has also shown that both internal factors, such as cellular abnormalities in cancer, and external factors, including toxins, may trigger the production of autoantibodies that drive autoimmune responses. Dr. Rose suggests, “What you put in your body affects what you get out of it,” she explains. A nutrient-rich diet, regular exercise, and stress management are essential for minimizing risks. Focusing on the factors within your control is vital to reducing your risk of developing autoimmunity. ## Can you Prevent the Development of Harmful Autoantibodies? There’s no guaranteed way to prevent autoantibodies, but allergy immunology physician and lifestyle medicine specialist Dr. Kara Wada suggests some healthy habits that can reduce your risk: #### ***Diet*** - Focus on whole foods like vegetables, whole grains, and lean protein. - Consider an elimination diet to identify potential food triggers such as gluten and dairy. - Limit processed foods, sugar, and unhealthy fats. #### ***Stress Management:*** - Practice relaxation techniques like meditation, deep breathing, and yoga. - Aim for seven to nine hours of quality sleep per night. #### ***Other Lifestyle Factors:*** - Engage in regular, moderate physical activity. - Minimize exposure to chemicals and pollutants, including cigarette smoke and alcohol. - Ensure adequate levels of vitamin D to support immune health. ## Can you Get Rid of Autoantibodies? Autoantibodies are typically only discovered when they cause symptoms. Therefore, therapies generally target the underlying disease or condition. #### Treatment approaches can include: - **Immunosuppressive drugs** – to reduce harmful immune activity. - **Anti-inflammatory medications** – to control symptoms. - **Lifestyle adjustments** – to support overall health and reduce inflammation. Autoantibody levels may fluctuate over time, indicating disease progression or successful treatment. Dr. Wada notes, “While not always directly targeted by treatments, monitoring autoantibody levels can help assess the effectiveness of therapies in some conditions.” Dr. Rose highlights the importance of lifestyle practices in managing autoimmunity and autoimmune conditions. She notes, “Chronic stress, lack of movement, and reduced autonomic nervous system resilience, never intentionally quieting the mind or relaxing the body, leads to further inflammation and damage.” ## What’s Next in Autoantibody Research? Research in autoimmunity is growing, bringing hope to people with autoimmune diseases. #### Current research includes: - Studies investigating how to better connect autoantibody detection with clinical disease. - New technologies that allow for precise measurement of autoantibodies to track disease progression. - Exploration of stem cell therapy to suppress autoimmunity. Advances in autoantibody research are paving the way for earlier diagnosis, personalized treatment, and better disease management in the future. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/04/GAI-Logo-Image-811x1024.png) ### Related Reading - [COVID-19 and Autoimmunity: The Role of Autoantibodies](https://www.autoimmuneinstitute.org/covid_timeline/covid-19-and-autoimmunity-the-role-of-autoantibodies/) - [Autoantibodies Linked to Long COVID Neurological Symptoms](https://www.autoimmuneinstitute.org/covid_timeline/autoantibodies-linked-to-long-covid-neurological-symptoms/) - [Autoantibodies & Long COVID](https://www.autoimmuneinstitute.org/covid_timeline/autoantibodies-long-covid/) - [The Relationship Between Blood Glucose and Autoantibodies](https://www.autoimmuneinstitute.org/research_updates/the-relationship-between-blood-glucose-and-autoantibodies/) - [COVID-19 Severity and Autoantibody Production](https://www.autoimmuneinstitute.org/covid_timeline/covid-19-severity-and-autoantibody-production/) - [The Repertoire of Autoantibodies in Celiac Disease: Any New One?](https://www.autoimmuneinstitute.org/research_updates/the-repertoire-of-autoantibodies-in-celiac-disease/) - [Spermatogenesis-related Autoantibodies in Patients with Acute and Long COVID-19](https://www.autoimmuneinstitute.org/covid_timeline/spermatogenesis-related-autoantibodies-in-patients-with-acute-and-long-covid-19/) - [Antiphospholipid Autoantibodies May Lead to Blood Clots After COVID-19 Infection](https://www.autoimmuneinstitute.org/covid_timeline/antiphospholipid-autoantibodies-may-lead-to-blood-clots-after-covid-19-infection/) ### About the Author ![Tracy Asamoah bio headshot freelance writer for GAI](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/11/DSC05784-scaled.jpg) Tracy is a writer, child and adolescent psychiatrist, and leadership coach. Her journey into the world of autoimmune diseases began when she experienced sudden onset symptoms of multiple sclerosis early in her medical career. This personal experience, combined with her intense curiosity, has informed her work and writing in the field. As a writer, Tracy has contributed to various books and written articles related to mental health. She’s also written on various medical topics regularly contributing to publications such as GoodRx, Psychology Today, and Psychotherapy.net Tracy Asamoah, MD Freelance Writer for GAI ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** About Autoimmune Disease, Diagnosis & Treatment --- ### [Vitiligo: What We Know and What We Don’t Know](https://www.autoimmuneinstitute.org/articles/vitiligo-what-we-know-and-what-we-dont-know) **Published:** May 1, 2025 **Author:** Carolyn Serraino **Content:** [Vitiligo](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/vitiligo/) is an autoimmune disease characterized by a loss of pigment (color) in the skin, resulting in lighter spots or patches that may gradually expand. While it commonly affects a person’s face, hands, arms, feet, and legs, vitiligo patches can also appear anywhere else in the body. ## **How Does Vitiligo Develop?** [Cameron Coury, MD](https://dermspecialist-tx.com/cameron-coury-md/), a dermatologist at Dermatologist Specialists in Richardson, TX, mentions that vitiligo often begins on areas of the face. “Vitiligo can start as one small light patch, or as several patches around eyes, nose, or mouth,” she says. Vitiligo arises when melanocytes, the cells that produce melanin, die and no longer produce melanin, the substance that gives the skin, hair, and eyes their typical color. [Hannah Kopelman, MD](https://drkopelman.com/), a dermatologist at Kopelman Aesthetic Surgery, mentions the role of the immune system in killing these cells. “While we know that this occurs due to the immune system attacking melanocytes—the cells responsible for producing skin pigment—there’s still much we don’t fully understand about why this happens in the first place,“ she explains. The causes of vitiligo are unknown, but a family history may increase a person’s risk of developing the condition. Other risk factors include severe sunburn, chemical burns, and injury ([1](https://www.aad.org/public/diseases/a-z/vitiligo-overview)). “We also see vitiligo in areas of trauma – so the back of the hands, feet, and knees are also common spots,” notes Dr. Coury. ## **What are the Clinical Manifestations of Vitiligo?** The way vitiligo presents itself can differ from one person to another. “The clinical manifestations vary widely, not just in terms of the extent of skin involvement but also in the way it progresses,” Dr. Kopeland says. “Some patients experience a rapid spread, while others may have long periods where the condition remains stable,” she adds. Additional signs and symptoms may include itchiness in the discolored skin areas, eye and hair color changes, and even hearing loss. ### There are Different Types of Vitiligo: **Localized**: Skin spots or patches are scattered in limited areas of the body, such as the hands and face. **Generalized**: Spots or patches appear throughout multiple areas of the body. **Segmental**: Spots and patches appear on one side of the body. This type is unique because it typically affects only one side of the body, without crossing the midline on either the front or back. **Non-segmental**: Spots and patches are on both sides of the body, such as both hands or both feet. **Mucosal**: Patches of pigment appear on mucosal surfaces, including the mouth, nose, or genitals. **Universal**: In this widespread form of vitiligo, people lose most of their skin’s pigment. **Trichrome**: Rare form with lesions that usually have three different shades: white, intermediate, and normal. **Confetti**: Tiny spots appear in clusters. ## **What Populations Does Vitiligo Affect?** The contrast between skin shade and the patches that lose pigment is typically greater in people with darker skin types, yet people of any race, ethnicity, or skin color can develop vitiligo. Many of the people who develop vitiligo start showing signs in childhood or by age 20 ([2](https://pubmed.ncbi.nlm.nih.gov/21839315/)). Dr. Coury confirms that although the disease is common in children, the timing of its onset varies. “I frequently see vitiligo in children, but I have had some adult patients with new-onset vitiligo as well,” she notes. ## **How is Vitiligo Currently Treated?** **Can it be Reversed or Prevented?** Dr. Coury and Dr. Kopelman both discuss that while there is no cure for vitiligo, people can explore various treatments to help manage the spots and patches. “Current treatments focus on managing symptoms and improving cosmetic appearance,” mentions Dr. Kopelman. “Options include topical corticosteroids, calcineurin inhibitors, and light therapy, such as narrowband UVB. More recent research is exploring the role of JAK inhibitors, which show promise in repigmenting the skin by interrupting the immune response that leads to depigmentation,” she adds. A recent review highlighted Janus kinase inhibitors (JAK) as groundbreaking options for vitiligo treatment, with benefits noted when combined with light therapy ([3](https://pubmed.ncbi.nlm.nih.gov/38610078/)). “Procedures such as laser treatments or even transplanting cells from areas of the body that have normal pigmentation can be offered in dermatology centers that have a special focus on treating vitiligo as soon as spots appear,” says Dr. Coury. Because the skin has lost its pigment, the lighter patches are especially susceptible to sunburn. Therefore, people with vitiligo should stay in the shade or shield the skin from sunlight using sunscreen and wearing hats and other protective clothing items. Makeup and self-tanners can also help mask the lighter spots or patches that appear on the face. Treatments have been summarized in multiple review articles and guidelines, including practical recommendations for health care providers that were released in 2021 and published in The British Journal of Dermatology in 2022 ([4](https://pubmed.ncbi.nlm.nih.gov/34160061/)). There are no preventive measures against vitiligo, but people should visit a dermatologist’s office when lighter spots or discolored areas appear. “Because vitiligo is an autoimmune problem, there is not much a person can do to prevent the condition,” explains Dr. Coury. ## **What is Known and Unknown about** V**itiligo?** Like many other autoimmune diseases, uncovering the causes and biological processes behind the development of vitiligo has been difficult. People who have moles with halos around them, people with melanoma, and people who are receiving immunotherapy for melanoma appear to be more at risk of developing vitiligo ([5](https://www.aad.org/public/diseases/a-z/vitiligo-causes)). However, the reasons behind these connections are unknown. The link between vitiligo and melanoma has been discussed for decades because both normal and abnormal cancer cells express similar[ antigens](https://www.autoimmuneinstitute.org/articles/autoimmune-terminology-to-know-for-your-next-doctors-appointment/) ([6](https://pubmed.ncbi.nlm.nih.gov/31731645/)). Research has shown that patients who are receiving immunotherapy for melanoma and develop vitiligo may have a better chance of surviving ([6](https://pubmed.ncbi.nlm.nih.gov/31731645/)). “Ongoing research is key to uncovering more about the underlying mechanisms of vitiligo and developing more effective treatments. The field is evolving, and I’m optimistic about the potential for new therapies that may offer better outcomes for those living with vitiligo,” says Dr. Kopelman. ## **How does Vitiligo affect People’s Psychological Health?** Because of its direct influence on appearance, vitiligo can affect a person’s self-esteem, leading to feelings of self-consciousness and frustration. A literature review highlighted relationships between vitiligo and anxiety, depression, sleep disturbances, and adjustment disorders ([7](https://pubmed.ncbi.nlm.nih.gov/34554406/)). “The psychological impact of vitiligo can’t be understated,” says Dr. Kopelman. “For many, it can lead to significant emotional distress, affecting self-esteem and quality of life. It’s crucial to approach treatment with empathy, considering both the physical and mental aspects of the condition,” she adds. Dr. Coury stresses the importance of seeking support from specialized groups. “Support for people with vitiligo is also available through national research organizations”, she says. Interdisciplinary treatment approaches that take medical, psychological, and social factors into consideration are essential for improving disease burden and patients’ quality of life ([7](https://pubmed.ncbi.nlm.nih.gov/34554406/),[ 8](https://pubmed.ncbi.nlm.nih.gov/37624845/)). ![Monwabisi's photo](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/image-1-scaled-e1707931969274-750x1024.jpg) #### [**Read Monwabisi’s Story: Growing up with Vitiligo, Growing into Self-Acceptance** ](https://www.autoimmuneinstitute.org/autoimmune_stories/monwabisis-story-growing-up-with-vitiligo-growing-into-self-acceptance/ "Monwabisi’s Story: Growing up with Vitiligo, Growing into Self-Acceptance") His experience sheds light on the challenges he faces, along with the resilience and strength he’s developed along the way. ## **What Can Those with Vitiligo Ask Their Doctor?** Every vitiligo situation is distinct, with different people displaying varying patch sizes and numbers across their bodies. People who have been diagnosed with vitiligo should seek out a dermatologist specialized in managing skin pigmentation disorders. This will ensure that they receive tailored care depending on their vitiligo type, individual needs, and other medical conditions, which is especially important when treating children ([9](https://www.aad.org/public/diseases/a-z/vitiligo-treatment)). Dr. Coury emphasizes that sharing concerns with a dermatologist is a crucial first step. “Patients should be direct about how vitiligo affects their life. They should ask for several different types of treatment and discuss their pros/cons in detail,” says Dr. Coury.  “Sometimes, I even suggest body makeup that is also used to cover birthmarks and tattoos,” she adds. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/04/GAI-Logo-Image-811x1024.png) #### About The Author ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/07/Chiavolini-Damiana-scaled.jpg) A freelance writer who specializes in medical and life science topics. As a trained researcher, she authored journal articles in the areas of infection and immunity and wrote booklets and book chapters about different diseases. As a professional communicator, she writes feature articles for magazines and other publications and develops content for higher education platforms. Damiana is also an experienced academic editor, microbiology educator, writing coach, and fragrance blogger. She is a contributing member of the American Medical Writers Association and a past-president of the association’s Southwest Chapter. Damiana Chiavolini, MS, PhD Freelance Writer for GAI ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** About Autoimmune Disease --- ### [What is the Microbiome and Why is it Important?](https://www.autoimmuneinstitute.org/articles/what-is-the-microbiome-and-why-is-it-important) **Published:** May 20, 2025 **Author:** Carolyn Serraino **Excerpt:** Many chronic illnesses, including obesity, type 2 diabetes, and inflammatory bowel disease, appear to be affected by the microbiome. The relationship between autoimmunity and the microbiome is still being studied intensely, but these conditions are likely associated with an imbalance in the gut microbiome. Although strong evidence is still emerging, studies suggest that autoimmune patients exhibit reduced microbial diversity. **Content:** **Our bodies are teeming with single-celled organisms called microbes, which include bacteria,** archaea, fungi, viruses, and others. In fact, the number of microscopic inhabitants is roughly equivalent to the number of our own human cells. There are distinct, diverse microbial communities – or microbiomes – found in various parts of the body, including the skin, mouth, lungs, and the gastrointestinal tract, commonly referred to as the gut. ## The Microbiome and Autoimmune Disease Just as we provide these microorganisms with a warm, comfortable environment and plenty to eat, their presence plays a critical role in our health. The microbiome helps us digest food and extract nutrients, carry out metabolic processes, and work in tandem with the immune system to protect the body against infectious agents. When this delicate ecosystem becomes imbalanced, the effects can be serious, influencing digestion, metabolism, and immune regulation. #### **Many chronic illnesses, including obesity, type 2 diabetes, and inflammatory bowel disease, appear to be affected by the microbiome.** The [relationship between autoimmunity and the microbiome](https://www.autoimmuneinstitute.org/2021/08/26/the-relationship-between-autoimmune-disease-and-the-gut-microbiome/ "The Relationship Between Autoimmune Disease and the Gut Microbiome") is still being studied intensely, but these conditions are likely associated with an imbalance in the gut microbiome. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2019/06/shutterstock_2154325179-1024x768.jpg) **Although strong evidence is still emerging, studies suggest that autoimmune patients exhibit reduced microbial diversity**. In [Crohn’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crohns-disease/ "Crohn’s disease"), for example, one study found that the beneficial bacteria *Faecalibacterium prausnitzii*, normally present in healthy individuals, were missing in those with Crohn’s. Similar findings have been reported in [ulcerative colitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ulcerative-colitis/ "Ulcerative colitis"). While these studies don’t prove a direct cause-and-effect relationship, they highlight an important area for further investigation. ### Research on the Human Microbiome To better understand the microbiome, scientists are characterizing the composition and function of these microbial communities. A major effort, the **[Human Microbiome Project (HMP)](https://www.bcm.edu/departments/molecular-virology-and-microbiology/research/human-microbiome-project)** led by the NIH, has gathered extensive data on microbes in the gastrointestinal tract, nasal passages, oral cavities, skin, and urogenital tract. This work, along with similar research, continues to reveal the significant influence of the microbiome on disease, immunity, and overall human health. ### Microbiome Facts - Our gut microbiome **interacts with the microbiomes of our organs**, including the brain - The functions and interactions of the microbiome **differ according to the species** and strains of bacteria, fungi, and viruses, their quantity, their proximity to each other, and even their location in the gut - Our microbiomes **change in reaction to the food we eat**, the time of day, and any medications we take – most importantly antibiotics - It is believed that being born via **cesarean section** **adversely affects our microbiomes**, as they start developing at birth (and most likely even in utero) - **When our microbiomes are unhealthy, we are vulnerable** to allergies, infectious and autoimmune diseases, as well as neurological damage, which can cause anxiety, depression, anxiety, OCD, and movement and cognitive disorders ### Trending Topics In Research - Effect of **[antibiotics](https://www.autoimmuneinstitute.org/research_updates/can-diet-repair-gut-damage-from-antibiotics/ "Can Diet Repair Gut Damage from Antibiotics?")** on the microbiome - Impact of **[cesarean section birth](https://www.autoimmuneinstitute.org/research_updates/study-finds-cesarean-section-linked-to-crohns-disease-later-in-life/ "Study Finds Cesarean Section Linked to Crohn’s Disease Later in Life")** on the microbiome and disease development - Use of **[probiotics](https://www.autoimmuneinstitute.org/articles/probiotics-prebiotics-and-autoimmune-disease "Probiotics, Prebiotics, and Autoimmune Disease")** to improve digestive conditions - Influence of the microbiome on **[gastrointestinal disorders](https://www.autoimmuneinstitute.org/articles/living-with-autoimmune-gastritis-what-you-need-to-know "Living with Autoimmune Gastritis: What You Need to Know ")** such as IBS (irritable bowel syndrome), IBD (inflammatory bowel disease), Crohn’s, and ulcerative colitis - Role of the **[environment](https://www.autoimmuneinstitute.org/research_updates/experts-report-environmental-contributors-to-autoimmune-disease/ "Experts Report Environmental Contributors to Autoimmune Disease")** on the microbiome’s composition ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** Living Well with Autoimmune Disease --- ### [A Guide for Immunocompromised Individuals in a Post-Pandemic World](https://www.autoimmuneinstitute.org/articles/a-guide-for-immunocompromised-individuals-in-a-post-pandemic-world) **Published:** March 4, 2025 **Author:** Carolyn Serraino **Excerpt:** Even as the world moves on from the pandemic, immunocompromised individuals continue to face heightened health risks. With fewer people wearing masks, navigating daily life safely can be challenging. This guide explores the science behind immune function, the impact of mask-wearing, legal protections, and practical strategies for advocating for personal health. Whether seeking protection in healthcare settings, workplaces, or social interactions, immunocompromised individuals can find support and solutions to maintain both physical and mental well-being in an increasingly unmasked world. **Content:** # Navigating Mask-Wearing Even before the COVID pandemic spotlighted the vulnerability of immunocompromised people to infection, people with compromised immune systems were challenged with staying healthy in an infectious microorganism-filled world. The pandemic, however, brought these struggles into sharper focus. ## Understanding the Risks for Immunocompromised Individuals Immunocompromised people are at greater risk of contracting infections and having severe disease than people with normally functioning immune systems ([1](https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2023.1147871/full)). Vaccines, like the COVID-19 vaccine, are critical factors in decreasing the prevalence and severity of contagious diseases in the general population. People who are immunocompromised can have a weaker response and, therefore, less protection against infections ([2](https://www.cdc.gov/mmwr/volumes/72/wr/mm7205e3.htm?s_mm7205e3_w)). More than four years after the start of the COVID pandemic, few people wear masks in private or public settings. However, immunocompromised people are still at high risk of serious illness from COVID and other contagious diseases. New York-based therapist and chronic illness expert Jodi Taub, LCSW, PLLC, notes that in addition to the risk of infection, immunocompromised people deal with the emotional and mental impact related to the stigma of masking. ## The Polarization of Mask-Wearing Unlike other medical devices, wearing a respirator or a mask has become a polarizing topic that can distract from the intent of these devices. Dr. Judy Stone, an infectious disease physician and author in Maryland, says, “A huge problem we’re all facing is the incredible denial that COVID is an ongoing problem. This comes from the government declaring that ‘the pandemic is over’ and continual downplaying of the magnitude of the ongoing pandemic.” Dr. Stone notes that some people may lash out when seeing someone in a mask reminds them of the ongoing risks. It is essential to understand the challenges immunocompromised individuals face and how they can best navigate living in an unmasked, post-pandemic world. ## How Does the Immune System Work? Before we can understand the risks of infection to people with compromised immune systems, it’s helpful to know how the immune system works. The immune system fights foreign substances, such as bacteria, allergens, or toxins, that can cause problems in our bodies. Our immune systems are made up of a complex network of organs, tissues, and cells ([3](https://medlineplus.gov/immunesystemanddisorders.html)). These body parts work together to identify invaders and produce antibodies to attack foreign substances entering the body. ## How Can the Immune System Malfunction? In some people, the immune system does not function as it should. It can be dysfunctional, meaning it fails to respond adequately to invaders or overactive, attacking the body’s tissues. ### Dysfunctional immune system People with dysfunctional immune systems, such as immunocompromised people, may mount a weak response or no response at all to foreign substances in the body. These people are at greater risk of getting an infection or having an infection become serious or even life-threatening. Immunocompromised people, a heterogeneous group of youth and adults, include people with immunodeficiency disorders and transplant patients. Certain medications, like those taken by people with [autoimmune diseases](https://www.autoimmuneinstitute.org/understanding-autoimmune-disease/) such as [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/), [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/), and [ulcerative colitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ulcerative-colitis/), cause a type of immunocompromise referred to as immunosuppression. ### Overactive immune system Some people’s immune systems are activated when they don’t need to be. In people with autoimmune diseases, the immune system mistakenly identifies its own tissue as foreign, damaging it. People who experience allergies have immune systems that mount a large response to harmless foreign invaders. Some people can be both immunocompromised and have an overactive immune system. For example, many people with autoimmune diseases, such as systemic lupus erythematosus and rheumatoid arthritis, take immunosuppressive medications to treat their disease ([4](https://www.aaaai.org/conditions-treatments/related-conditions/immunosuppressive)). ## What Precautions Should You Take if You’re Immunocompromised?  If you’re immunocompromised, there are steps you, and people in close contact with you, can take. According to Dr. Stone, basic measures, such as improving ventilation by opening windows and masking in enclosed or crowded spaces, remain important for protecting medically vulnerable individuals from infection. While vaccines may not offer complete protection in immunocompromised people, they can still provide some defense against infection and serious illness. For people with moderate to severe immunocompromise, the CDC recommends the following precautions to protect against infections ([2](https://www.cdc.gov/mmwr/volumes/72/wr/mm7205e3.htm?s_mm7205e3_w)): - Get an updated COVID-19 vaccine - Improve ventilation and spend time outdoors when possible - Learn testing and treatment options before getting exposed or sick - Get tested if you’ve been exposed or have symptoms - Wash your hands often - Wear a well-fitting respirator or mask and maintain distance in crowded spaces ## The Impact of Mask-Wearing on Relationships As mask-wearing becomes less common, immunocompromised individuals often find themselves vulnerable. Deciding which protective measures to take is a personal choice, but many ask those close to them—such as family, friends, classmates, coworkers, caregivers, and healthcare providers—to wear masks in their presence. Requesting someone to wear a mask can feel uncomfortable, but clear communication helps. Explain your health condition and how wearing a mask can help protect you. Most people are more cooperative when the request is framed as a polite ask rather than a demand. However, cooperation varies. Dr. Stone describes difficulties that arise when some healthcare professionals refuse to wear masks upon request by an immunocompromised person. Conflict can also arise in the workplace, school, and public settings. The obstacles immunocompromised people encounter when advocating for their physical health can negatively impact their mental health and well-being. Ms. Taub highlights the unwanted attention that masking has brought some immunocompromised people. She observes, “\[Before\], their illness was invisible, and now with masking, a lot of people who are immunocompromised have had to face being visible and what that means to them.” ## Are there Legal Protections for Mask-Wearing Requests? The answer isn’t clear. The Americans with Disabilities Act of 1990 (ADA) protects the rights of people with disabilities, including those with chronic illnesses, such as immunocompromised individuals ([5](https://www.ada.gov/law-and-regs/ada/)). The ADA protects individuals with disabilities from being denied access to services because of limitations related to their disability. For many immunocompromised people, requesting that people they’re in close contact with, such as healthcare providers, wear masks enables them to safely and fully access healthcare and other services. However, as Dr. Stones discussed in a recent [article](https://www.forbes.com/sites/judystone/2024/02/13/hospitals-deny-immunocompromised-patients-ada-requests-for-masks/), some healthcare institutions and providers disagree that masking falls under the ADA and refuse to require it. This opposition has led some patients to forgo medical care, fearing for their health. Healthcare advocates are working to clarify the ADA’s provisions to protect immunocompromised individuals better. ## How does Mask-Wearing affect Mental Health? Immunocompromised individuals constantly weigh the risks of spending time in enclosed or public spaces. Balancing the desire to stay physically healthy and maintain mental well-being can make these decisions challenging. Relationships with loved ones, access to essential services, and the ability to move freely through the world all play a role in overall well-being. [Mental health challenges](https://www.autoimmuneinstitute.org/articles/managing-mental-health-with-an-autoimmune-disease/) are common among those with chronic illnesses like immunodeficiencies or autoimmune disorders. These individuals may face: - Anxiety - Depression - Isolation/loneliness - Lack of medical care - Work-related difficulties ## How can People who are Immunocompromised Manage Masking-Related Challenges? Navigating the world when you are immunocompromised can be challenging, but there are ways to make it a little easier. Surrounding yourself with supportive and informed people is important. It’s also helpful to find spaces and communities that are sensitive and responsive to the needs of immunocompromised people. Here are some other ways to get help: - Seek support from friends and family. - Utilize adapted healthcare settings such as [telehealth](https://www.autoimmuneinstitute.org/articles/navigating-healthcare-through-the-practical-lens-of-telehealth/). - You can join disease-specific support groups either in person or online through platforms such as [myHealthteam](https://myhealthteam.com/), [PatientsLikeMe](https://www.patientslikeme.com/), [The Mighty](https://themighty.com/), [Immune Deficiency Foundation](https://primaryimmune.org/living-primary-immunodeficiency/get-support), or condition-specific Facebook groups. - See a counselor/therapist for support and help with coping strategies. - Find service providers that offer empathetic, adaptive care when possible. - Contact a patient advocate group, such as the [Disability Rights Education & Defense Fund (DREDF)](https://dredf.org/) or the [National Patient Advocate Foundation (NPAF)](https://www.npaf.org/), to protect your legal rights. Being immunocompromised can make navigating a world that is not adapted to your unique needs challenging. However, finding support and developing a plan can make the challenges a little more manageable. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/04/GAI-Logo-Image-811x1024.png) ### About the Author ![Tracy Asamoah bio headshot freelance writer for GAI](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/11/DSC05784-scaled.jpg) Tracy is a writer, child and adolescent psychiatrist, and leadership coach. Her journey into the world of autoimmune diseases began when she experienced sudden onset symptoms of multiple sclerosis early in her medical career. This personal experience, combined with her intense curiosity, has informed her work and writing in the field. As a writer, Tracy has contributed to various books and written articles related to mental health. She’s also written on various medical topics regularly contributing to publications such as GoodRx, Psychology Today, and Psychotherapy.net Tracy Asamoah, MD Freelance Writer for GAI ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** Autoimmune Care & Caregiver Support, COVID-19 and Long Covid, Living Well with Autoimmune Disease --- ### [Innovative Diagnostic Techniques for Detecting Autoimmune Diseases](https://www.autoimmuneinstitute.org/articles/innovative-diagnostic-techniques-for-detecting-autoimmune-diseases) **Published:** July 11, 2025 **Author:** Carolyn Serraino **Content:** Autoimmune disease is a complex group of diseases, where symptoms can vary, wax and wane, and overlap with those of other conditions. This often means the [time to diagnosis](https://www.autoimmuneinstitute.org/articles/experts-discuss-the-complex-path-to-an-autoimmune-diagnosis/) can take several months to years. Current tests available for autoimmune disease testing include antinuclear antibody (ANA) testing, C-reactive protein tests, ELISAs, and erythrocyte sedimentation rate tests. More information about these tests can be found [here](https://www.autoimmuneinstitute.org/articles/autoimmune-terminology-to-know-for-your-next-doctors-appointment/). ## Why is Autoimmune Disease Challenging to Diagnose? [David Pisetsky](https://medicine.duke.edu/profile/david-stephen-pisetsky), Professor of Medicine at Duke University School of Medicine, cites three common challenges when it comes to diagnosing autoimmune diseases: non-specific symptoms, uncertainty in screening tests, and a clinical situation known as [pre-clinical immunity](https://www.autoimmuneinstitute.org/articles/examining-pre-autoimmunity-can-autoimmune-disease-be-prevented/). “Patients can sense there’s something wrong and go to physicians. They don’t have localized signs and symptoms, and there’s uncertainty. It’s not unusual that people can go for a while before they get a diagnosis,” says Pisetsky. Even within the same autoimmune disease, there can be a lot of variation in symptoms. #### While there are blood tests to detect antibodies associated with autoimmune diseases, some of these screening tests, such as the ANA test, can be what Pisetsky describes as “problematic” since up to 20% of healthy individuals will have a positive result. “It becomes very unclear whether the patient has the disease, whether the patient may get the disease, or whether this is just an unknown phenomenon of uncertain significance,” he says. “It’s both a laboratory issue and a health system issue of how do you diagnose diseases earlier, especially when the symptomatology is more vague,” adds Pisetsky. ## How are New Biomarkers Discovered and Validated? There are many types of biomarkers, or measurable biological indicators, of disease. Biomarkers such as blood glucose level or high blood pressure are easily measured and can help pinpoint a disease diagnosis. But not all biomarkers are straightforward, and often doctors need to evaluate several biomarkers to make a confident diagnosis. #### “For autoimmune cerebral ataxia, there are upwards of 30 biomarkers at this point,” says [Andrew McKeon](https://www.mayo.edu/research/faculty/mckeon-andrew-m-b-b-ch-m-d/bio-00027993), a Professor of Neurology and Professor of Laboratory Medicine at Mayo Clinic who works on identifying antibody biomarkers associated with autoimmune neurological diseases. Genomic and proteomic techniques can help pinpoint specific changes in genetic sequences or protein levels associated with disease. McKeon notes that with the increasing number of biomarkers discovered for particular diseases, it’s possible to offer more sensitive testing. “Because the field is evolving so rapidly and there’s so many biomarkers, we’re really in a space that’s a little bit more like the field of diagnostic genetics where there’s a profile or a panel of targets that’s been designed by a laboratorian and offered as a clinical test,” he says. When a biomarker is discovered, its route towards clinical utility involves several steps. McKeon describes the process. “Once we’ve screened and detected an antibody of interest, we do three or four additional confirmatory techniques to show \[that the antibody is truly a biomarker\],” he says. “But in order for it to enter clinical practice, that’s a whole different ball game.” To be used clinically, a potential biomarker must be evaluated alongside the type of test used to detect it. The first step here involves determining which is the best test to use to detect the biomarker in the clinic. Once that’s established, more formal validation studies can include testing a large number of patients and healthy individuals without disease to make sure that the test is accurate, precise, sensitive, and selective. Lastly, the test must be approved by a regulatory agency. ## What Imaging Techniques are Used to Diagnose Autoimmune Diseases? For autoimmune diseases, imaging techniques are particularly helpful to detect early signs of disease before symptoms show up. The types of imaging used for autoimmune disease diagnostics includes: - **Magnetic resonance imaging (MRI)** uses magnetic fields and radio waves to visualize organs, tissues, and blood vessels. It can help detect early inflammation. Innovations in nanotechnology-based contrast agents (vs. traditional gadolinium-based contrast agents) can help overcome the adverse effects and low specificity of traditional gadolinium-based contrast agents. - **Positron Emission Tomography (PET)** uses radioactive tracers to visualize metabolic activity in tissues and can detect tissue inflammation and immune cell activity. For example, a recent study used total body PET to assess the distribution of T cells in the body by using radiolabeled antibodies that specifically bind T cells ([1](https://www.science.org/doi/full/10.1126/sciadv.adh7968?af=R)). While this study was done for COVID-19, this application can be applied to autoimmune diseases as well. - **Computed tomography (CT)** uses x-rays to image cross-sections of the body. It’s helpful for understanding the structural changes in tissues and organs and can help guide biopsy procedures. - **Ultrasound** uses high frequency sound waves to examine joint inflammation and blood flow in inflamed tissues. Acoustically active microbubble contrast agents can give better ultrasound imaging and better quantify inflammation ([2](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3617300/)). - **Single-photon emission computed tomography (SPECT)** creates 3D images and uses radiolabeled peptides, proteins, or antibodies to track specific biomarkers of disease at sites of inflammation ([3](https://journals.sagepub.com/doi/10.2310/7290.2011.00045)). ## How can Wearable Devices Monitor Autoimmune Conditions? Wearable devices that track our physical activity, heart rate, and sleep can have great impacts in monitoring the current state and progression of autoimmune diseases. Since autoimmune disease symptoms can ebb and flow, wearables can help a patient understand what is considered normal for them. “Wearable devices can give an indication of whether you need to book an appointment because something is not going right,” says [Linda Li](https://www.arthritisresearch.ca/linda-li/), a senior scientist at Arthritis Research Canada and Professor at the University of British Columbia. She adds that augmenting data from wearable devices with [symptom tracking](https://www.autoimmuneinstitute.org/autoimmune-chronic-illness-toolkit/ "Autoimmune & Chronic Illness Toolkit") makes it even more powerful. #### One pilot study found that patterns in physical activity could predict rheumatoid arthritis flares over 95% of the time ([4](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7506912/)). While wearables can be great tools, it’s also important to use them in moderation. “There is a balance between being obsessed about tracking versus tracking information sufficiently, so that you can get useful information and see the trends of your health,” says Li. “Behavioral scientists are investigating what is the optimum engagement with these wearable devices.” Aside from the fitness and activity trackers that are popular on the market, several biotech companies are developing new ways to monitor autoimmune disease, including monitoring sleep disturbances and wrist movements associated with scratching in [atopic dermatitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/eczema/ "Eczema / atopic dermatitis") ([5](https://www.pfizer.com/news/articles/capturing-itch-using-digital-wearable-devices-help-patients-atopic-dermatitis)), and measuring involuntary body motions to assess balance and neurophysiological impairment associated with [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/ "Multiple sclerosis") ([6](https://www.mdpi.com/1424-8220/21/21/7417)). ## Can Artificial Intelligence Help With Diagnosing Autoimmune Diseases? With the ability to produce increasingly large amounts of data, scientists are turning to [artificial intelligence](https://www.autoimmuneinstitute.org/articles/the-promise-of-ai-in-autoimmune-disease-from-early-detection-to-personalized-care/) to help transform this vast amount of data into actionable results. “If we’re able to collect more data over time and make sense out of it, we may actually be able to set more precise parameters for people tracking their symptoms and disease activity to determine whether it’s a flare or not,” says Li. **By identifying patterns in data, AI can help scientists and clinicians:** - Predict autoimmune disease risk based on genetic and [epigenetic](https://www.autoimmuneinstitute.org/articles/the-role-of-epigenetics-in-autoimmune-disease "The Role of Epigenetics in Autoimmune Disease") data ([7](https://www.nature.com/articles/s41467-024-48143-1)) - Diagnose autoimmune disease with AI-assisted ultrasound ([8](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10315148/)) - Identify patients who would benefit from autoimmune testing based on their electronic medical records ([9](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10130143/)) #### “These big data approaches offer the opportunity to better characterize the immune profile of people with autoimmune disease, so that these approaches have a lot of promise. The challenge is reducing the information in these tests into a format that’s more easily utilizable and easily interpreted,” says Pisetsky. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/04/GAI-Logo-Image-811x1024.png) ### About the Author ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/10/Jennifer-Tsang-Bio-Headshot-e1753113113430.jpg) A microbiologist turned freelance science writer who works with life science companies, nonprofits, and academic institutions on anything from news stories, explainer articles, and content marketing. She shares the wonderful world of microbes on her blog The Microbial Menagerie. Jennifer Tsang, PhD Freelance Writer for GAI ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** Diagnosis & Treatment --- ### [Is Your Oral Microbiome Fueling Autoimmune Disease?](https://www.autoimmuneinstitute.org/articles/is-your-oral-microbiome-fueling-autoimmune-disease) **Published:** June 2, 2025 **Author:** Carolyn Serraino **Content:** Trillions of microorganisms colonize our bodies. These microorganisms, collectively known as the [microbiome](https://www.autoimmuneinstitute.org/articles/living-well/what-is-the-microbiome/), help us out in many ways, from protecting us from invading bacteria to digesting our food. However, the microbiome can sometimes get out of balance, which has been correlated with a variety of diseases, including autoimmune diseases. In this article, we examine the oral microbiome, oral dysbiosis, and their connections to autoimmunity. ## What is the Oral Microbiome? The oral microbiome is the community of microorganisms in the mouth that colonize our saliva, teeth, gums, cheeks, tongue, hard and soft palates, and tonsils. We acquire our oral microbiomes beginning at birth, and our encounters further shape the microbiome throughout life. With approximately 700 species identified ([1](https://doi.org/10.1128/jb.00542-10)) as part of the oral microbiome, it is one of the most diverse and abundant microbial communities in the human body, second to the gut microbiome. #### **The microbes in our oral cavity have many roles ([2](https://doi.org/10.4103/jomfp.jomfp_304_18)), including:** - Maintaining homeostasis in the mouth - Preventing invading microorganisms from colonizing - Maintaining the balance between pro-inflammatory and anti-inflammatory processes - Developing allergic responses - Disease development ## What is Oral Dysbiosis? Ideally, the oral microbiome and the immune system work together. When the balance of microbes gets disrupted, our microbiome becomes “dysbiotic” or out of balance. This dysbiosis causes issues in our mouths (ex: periodontitis) and has impacts on diseases beyond the oral cavity ([3](https://doi.org/10.1186/s12967-023-03995-x)). #### Some common oral bacteria involved in oral disease include: - *Porphyromonas gingivalis*: Associated with gum disease (periodontitis) - *Streptococcus mutans*: Associated with dental cavities - *Fusobacterium nucleatum*: Associated with periodontitis ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/05/Pink-and-white-Quote-Instagram-Post-1024x1024.png) “Once the oral microbiome becomes dysbiotic, they trigger the immune system to attack them,” says Jan Potempa, professor in the Department of Oral Immunology and Infectious Diseases at the University of Louisville. “Many diseases actually can be linked to periodontitis.” Scientists have found connections between oral dysbiosis and immune disorders, cardiovascular disease, diabetes, and respiratory diseases. ##### Common causes of oral dysbiosis include: Poor oral hygiene Smoking Taking antibiotics Infections Diet ## How is Oral Dysbiosis and Autoimmunity Connected? “There was this very interesting observation 120 years ago where physicians at the time made the connection between the presence of bad oral hygiene and the presence of severe arthritis,” says Maximilian Konig, Assistant Professor of Medicine in the Division of Rheumatology and Director of the Cellular Therapy Program (Autoimmunity) in the Department of Medicine at the Johns Hopkins University School of Medicine. We now understand more about the connection between oral health and rheumatoid arthritis, but it’s often hard to tease apart what came first: oral dysbiosis or autoimmune disease. Most of the studies on the microbiome to date have been descriptive: what microbes are there and what are they associated with? “In patients who have autoimmune disease, we see changes in the microbiome and we associate that with dysbiosis. It’s still very hard to know what is the cause and what is the effect,” says Konig, who studies the role of the oral microbiome in rheumatoid arthritis.  For example, chronic inflammation affects how microbes colonize mucosal surfaces. Conversely, immunosuppressants, used to treat autoimmune diseases, impact how the immune system responds to pathogens. Potempa, who studies the enzymes of periodontal bacteria, describes this conundrum in terms of our behavior. Do we see poor oral hygiene because joint problems arising from rheumatoid arthritis make it difficult to brush our teeth? Or does poor oral hygiene itself cause rheumatoid arthritis? To better understand the connections between oral microbes and autoimmunity, Konig and Potempa both think that we need to dig deeper into the mechanisms behind these associations. ## How Oral Dysbiosis Impacts the Gut and Autoimmunity While the manifestation of autoimmune disease is multifaceted and involves multiple mechanisms, these studies highlight how microbes in our mouths have such widespread impact ([2](https://doi.org/10.1186/s12967-023-03995-x)). These include: #### **Microbial translocation** Microbial translocation occurs when microbes travel from the mouth, through the bloodstream, and to other organs. This can occur from invasive oral treatment, ulcers, and periodontitis, for example. - ***S. mutans and colitis*** When *S. mutans* enters the bloodstream, it can increase the severity of [colitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ulcerative-colitis/) by increasing the secretion of the [cytokine](https://www.autoimmuneinstitute.org/articles/diagnosis-and-treatment/autoimmune-terminology/) interferon-gamma ([4](https://doi.org/10.1111/odi.12125)). Abnormal interferon-gamma levels are linked to the development and severity of autoimmune diseases ([5](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3934799/)). - ***Klebsiella and Inflammatory Bowel Disease*** When *Klebsiella* strains from the oral microbiota colonize the gut, they activate T helper 1 immune cells and cause severe gut inflammation ([6](https://doi.org/10.1126/science.aan4526)). - ***P. gingivalis and gut dysbiosis** P. gingivalis,* when found in the gut, alters gene expression of tight junction proteins in the gut and increases gut permeability ([7](https://doi.org/10.1038/srep04828)). #### **Autoantigen overproduction** Autoantigens are specific substances (ex: proteins, DNA) in our bodies that trigger an immune response against our own bodies. Normally, self-antigens don’t trigger an immune response. - ***P. gingivalis and rheumatoid arthritis*** *P*. *gingivalis* is involved in a process called protein citrullination, which triggers our bodies to produce autoantibodies against citrullinated proteins. “You can detect these autoantibodies 10 years before the first clinical symptoms of rheumatoid arthritis,” says Potempa. #### **Molecular mimicry** Molecular mimicry is based on commonalities between amino acid sequences of foreign proteins (ex: bacteria) and our own proteins. If the immune system recognizes one of these regions in a foreign protein, it could launch an immune response against a similar protein from our bodies. However, there are many instances where small portions within proteins have similarity between species. “It’s very hard to disprove or prove because molecular mimicry exists everywhere,” says Konig. - ***Group A streptococci and rheumatic heart disease*** The M protein from Group A streptococcus, which causes strep throat, has similarities to the cardiac myosin, leading scientists to hypothesize a connection between these microbes and chronic [rheumatic heart disease](https://www.who.int/news-room/fact-sheets/detail/rheumatic-heart-disease) ([8](https://doi.org/10.1080/08916930500484674)). - ***Bacillus cereus and Sjögren’s syndrome*** The self-autoantigen, Ro 60kDa, is detected in [Sjögren’s syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sjogrens-syndrome/) and has high similarity to proteins within *B. cereus* ([3](https://doi.org/10.1186/s12967-023-03995-x)). #### **Increased cytokine production** Cytokines are proteins that help immune cells communicate with each other. There are both pro-inflammatory and anti-inflammatory cytokines and the increased production of specific cytokines has been linked to the development of autoimmune diseases. Here’s how the oral microbiome can be involved: - ***P. gingivalis and rheumatoid arthritis** P*. *gingivalis* promotes the production of rheumatoid arthritis-related cytokines ([9](https://doi.org/10.1186/ar4376)). - ***F. nucleatum and IBD** F. nucleatum* is enriched in the gut of IBD patients and promotes the expression of several proinflammatory cytokines ([10](https://doi.org/10.1111/1751-2980.12909)). ## How to Take Care of Your Oral Microbiome Potempa describes autoimmunity as a coming together of three factors: genetics, environment, and oral hygiene. While we can’t control our genetics, we can make a difference in our environment and oral hygiene in efforts to prevent autoimmune diseases from getting worse or arising in the first place. ##### Some ways to improve our oral health include: Brushing and flossing daily Getting regular dental checkups Preventing dry mouth which can increase risk of cavities Avoiding smoking Eating a healthy diet Beyond at-home care, scientists have been exploring the idea of vaccinating against oral pathogens. “If we can get vaccinated and eliminate *Porphyromonas gingivalis* from our oral cavity, we might decrease the chances of developing autoimmune disease like rheumatoid arthritis,” says Potempa. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/04/GAI-Logo-Image-1.png) #### About the Author ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/10/Jennifer-Tsang-Bio-Headshot-e1729699053652.jpg) A microbiologist turned freelance science writer who works with life science companies, nonprofits, and academic institutions on anything from news stories, explainer articles, and content marketing. She shares the wonderful world of microbes on her blog The Microbial Menagerie. Jennifer Tsang, PhD Freelance Writer for GAI ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** Living Well with Autoimmune Disease --- ### [Agent Orange and Beyond: How Military Toxins Can Trigger Autoimmune Diseases](https://www.autoimmuneinstitute.org/articles/agent-orange-and-beyond-how-military-toxins-can-trigger-autoimmune-diseases) **Published:** October 16, 2023 **Author:** Carolyn Serraino **Content:** In the annals of military history, many battles were not only fought on foreign soil but within the bodies of the service-men and -women themselves. This invisible warfare was instigated by the exposure to various toxins, often used as weapons or as unintended byproducts of military operations. ![Mary Stout, former National President of Vietnam Veterans of America, was honored at the White House in 2023. Photograph Courtesy of the Department of Veterans Affairs.](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Mary-Stout-who-served-two-terms-as-National-President-of-Vietnam-Veterans-of-America.jpeg)*Mary Stout, former National President of Vietnam Veterans of America, was honored at the White House in 2023.* *Photograph Courtesy of the Department of Veterans Affairs.* With insights from Mary Stout, who served two terms as National President of Vietnam Veterans of America and fought strenuously for years to get veterans the justice they deserve over the course of four decades, this article will delve into the history and chemical nature of military toxins and beyond. The connections between these toxins and the development of autoimmune diseases, supported by the latest scientific evidence, are discussed. A notorious example of a military toxin is Agent Orange, [an herbicide and defoliant chemical](https://www.hillandponton.com/agent-orange-presumptive-list-of-conditions/) widely used during the Vietnam War. However, the story does not stop there. From the Gulf War Syndrome to the burn pits in Iraq and Afghanistan, our military personnel have faced a spectrum of toxic threats. One of the less spoken of and more insidious health effects of these exposures is the increased risk of autoimmune diseases. [Rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/), [lupus](https://www.autoimmuneinstitute.org/medical_institutions/lupus-center/), and [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/) are just a few examples of the numerous known autoimmune diseases that develop after repeat exposure to Agent Orange. ### **Understanding Agent Orange** One of the most infamous toxins in military history is Agent Orange. Named after the orange stripe on the barrels it was stored in, this herbicide was employed extensively during the Vietnam War with long-lasting health effects that continue to be [a subject of research and concern](https://www.publichealth.va.gov/exposures/agentorange/basics.asp#:~:text=The%20two%20active%20ingredients%20in,unwanted%20byproduct%20of%20herbicide%20production). #### **The History of Agent Orange** Agent Orange was one of the so-called “Rainbow Herbicides,” a group of chemicals used by the U.S. military [to defoliate the dense jungles of Vietnam](https://www.britannica.com/science/Agent-Orange). From 1961 to 1971, approximately 20 million gallons of these herbicides were sprayed, with Agent Orange constituting a large majority. The intent was to remove the lush forest cover that provided a tactical advantage to the Viet Cong and North Vietnamese troops and to destroy the crops that fed the enemy forces. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Aerial-herbicide-spray-missions-in-Southern-Vietnam-1965-1971-768x991-1.jpg)*Map showing locations of U.S. Army aerial herbicide spray missions in South Vietnam taking place from 1965 to 1971. By* [*U.S. Army*](http://theorangestripe.org/agent-orange-spray-map-large.html)*,* [*Public Domain*](https://commons.wikimedia.org/w/index.php?curid=11426235) However, the impact extended far beyond the war’s tactical aspects. **Mary Stout stated that “the herbicides in Agent Orange were not the problem. It was dioxin, a byproduct of the manufacturing process, that was believed to cause illness in veterans.”** Exposure to these byproducts has led to severe health consequences for many veterans, local Vietnamese people, and [subsequent generations](https://www.publichealth.va.gov/exposures/agentorange/birth-defects/index.asp). #### **The Chemical Composition of Agent Orange** Agent Orange is a 50/50 mixture of two chemicals: 2,4-D (2,4-dichlorophenoxyacetic acid) and 2,4,5-T (2,4,5-trichlorophenoxyacetic acid). However, the production process of Agent Orange often led to the creation of an impurity – TCDD (Tetrachlorodibenzo-p-dioxin),[ one of the most toxic dioxin compounds known to man](https://www.publichealth.va.gov/exposures/agentorange/basics.asp#:~:text=The%20two%20active%20ingredients%20in,unwanted%20byproduct%20of%20herbicide%20production). Mary explains that in order to make Agent Orange, “chemicals were heated together. The higher the temperature, the faster the process. But that also results in a higher concentration of dioxin. The military needed lots of Agent Orange, and fast, so manufacturers used the highest possible temperatures in the production.” **TCDD is an incredibly potent toxin. It is not easily broken down in the environment and can accumulate**[ **in the fat tissues of animals and humans**](https://www.who.int/news-room/fact-sheets/detail/dioxins-and-their-effects-on-human-health)**, leading to a variety of potential health issues.** #### **The Health Implications of Agent Orange** The health effects of Agent Orange are both immediate and long-term, many of which are still being studied and understood. Direct exposure can cause skin disorders like [chloracne and may lead to several types of cancers, including lung, larynx, and prostate cancer, as well as multiple myeloma](https://www.publichealth.va.gov/exposures/agentorange/conditions/index.asp). Research indicates that this may be due to the toxin’s ability to interfere with immune function. Although further studies are necessary to fully understand these mechanisms, the pattern of immune-related illnesses in populations exposed to Agent Orange is significant and cannot be overlooked. This includes not only veterans who served in Vietnam, but also those exposed elsewhere. [![](https://www.publichealth.va.gov/images/agentorange/korea-dmz-herbicides-210px.jpg)](https://www.publichealth.va.gov/exposures/agentorange/locations/korea.asp)*Defoliated Korean DMZ, 1968. US Army* #### **Agent Orange Exposure Along the Korean DMZ** While Agent Orange is most commonly associated with the Vietnam War, it was also used along the Korean Demilitarized Zone (DMZ) between 1967 and 1971. In recognition of this, the [Department of Veterans Affairs](https://www.publichealth.va.gov/exposures/agentorange/locations/korea.asp) has granted presumptive exposure status to veterans who served in specific units along the DMZ during this time and may qualify for disability compensation related to a [defined list of diseases](https://www.publichealth.va.gov/exposures/agentorange/conditions/index.asp). However, many illnesses affecting Korean DMZ veterans remain absent from the VA’s list of presumptive conditions. [Rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid arthritis"), for example—a painful and debilitating autoimmune disease that can require expensive treatments—is not recognized, even in cases where Agent Orange exposure has already been acknowledged. This gap persists despite emerging research suggesting a [link between dioxin exposure and increased risk for autoimmune disease](https://pubmed.ncbi.nlm.nih.gov/24137524/), leaving many veterans without the care and validation they deserve. ### **The Fight To Get Justice For Exposed Veterans** #### **Why weren’t studies conducted immediately to determine the health implications of Agent Orange byproducts?** Mary revealed that both the New Jersey Agent Orange Commission, Massachusetts Agent Orange Commission, and other state commissions were working on ways to detect the presence of dioxin in veterans but that “the VA \[Department of Veterans Affairs\] was dragging its feet on a study mandated by H.R.1961, which had become law in 1963. There was little support from other veterans service organizations. **Members of Congress wanted definitive proof that dioxin was the causative agent in any illness**.” Angie Auletta, an epidemiologist with the Environmental Protection Agency, explained to Mary how difficult it is to find that “silver bullet” correlation between chemicals and illnesses that Congress was demanding because you can’t test chemicals on people. “What scientists look for is an increased risk of illnesses in exposed communities,” continues Mary. “There were already scientists looking at dioxin exposure, but VA discredited every study by questioning the methodology, the sample size, or anything else they could find to throw into doubt the scientific work. At the same time, however, they couldn’t work out a protocol for the legislatively mandated study. **Eventually, the VA transferred the study to the Centers for Disease Control, which also never did the study**.” #### **What was the process like to get veterans proper compensation?** Mary elucidated her rigorous battle plan for getting justice, “we would propose legislation to have an independent scientific body review all dioxin-related studies and inform VA of their findings on a regular basis. Along with this, we needed to have VA rescind its regulation that only chloracne was related to Agent Orange exposure. NVLSP \[the National Veterans Legal Services Project\] accomplished that by bringing the [*Nehmer* class-action suit](https://www.nvlsp.org/what-we-do/class-actions/nehmer-agent-orange-lawsuit), which they won in 1986. We also needed to have a presumption that anyone who served in Vietnam had been exposed to Agent Orange.” “Then we started our work with members of the VVA \[Vietnam Veterans of America\] Board to get their approval and with members of Congress to get legislation written and introduced. Rep. Tom Daschle and his staff took the lead in writing the legislation for the House of Representatives and John Kerry took on the task in the Senate. **We felt the most important part of the legislation was the establishment of an independent scientific group to look at all the studies**. It could not be the VA or any other government agency. Sen. Kerry convinced us that we had to ask for the most credible group, which was the National Academy of Sciences. He argued that it was the only group Congress would recognize as fully credible. We reluctantly agreed.” “It took four years of work with the VVA Agent Orange Committee, the VVA Board, members of Congress, VVA Legislative Coordinators, State Councils, and Chapters to finally have a change to get the legislation before the House Veterans’ Affairs Committee. During that time, there were numerous hearings in both the House and Senate Veterans’ Affairs Committees. **We tried to get the committees to allow testimony from scientists working in the field, but those requests were most often denied**.” Mary stated that the press was very keen to talk to the first woman elected to head a veterans service organization, so she took advantage of this to raise awareness of Agent Orange and the issues facing Vietnam veterans, doing many interviews for radio, TV, and print media. All of this effort is merely a fraction of her extensive work to get compensation for those exposed to Agent Orange. ### **More Notable Military Toxins** While Agent Orange may be one of the most infamous military toxins, it is far from being the only one that has affected the health of service-men and -women. From the mysterious Gulf War Syndrome to the toxic burn pits in Iraq and Afghanistan, exposure to harmful substances continues to have long-lasting effects on our military personnel. #### **Gulf War Syndrome and Its Causes** During and after the Gulf War in the early 1990s, many veterans began reporting a complex array of symptoms that didn’t fit into any known diagnosis, including fatigue, headaches, joint pain, indigestion, insomnia, dizziness, respiratory disorders, and memory problems. This condition is now referred to as Gulf War Syndrome or Gulf War Illness, and it is believed to affect as many as one in four of [the 697,000 U.S. veterans who served in the Gulf War](https://www.publichealth.va.gov/exposures/gulfwar/medically-unexplained-illness.asp). The exact cause of Gulf War Syndrome remains unclear, but several military-related toxins are suspected to play a role. These include exposure to pesticides, nerve gas, certain vaccines, and the widespread use of pyridostigmine bromide pills given to troops as a protective measure against nerve gas. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/shutterstock_1229492416-768x576-1.jpg)*Afghanistan – Circa 2006:* *A burn pit at a US base.* [*Photograph* ](https://www.shutterstock.com/g/SamAndSonImaging)*[Credit](https://www.shutterstock.com/image-photo/afghanistan-circa-2006-burn-pit-us-1229492416).* #### **Burn Pits in the Iraq and Afghanistan Wars** During the more recent wars in Iraq and Afghanistan, a standard method of waste disposal was the use of open-air burn pits. These pits were used to dispose of a variety of waste materials, including plastics, medical waste, and even ammunition. **The combustion process released a cocktail of pollutants, many of which are known to have** [**potential health risks**](https://pubmed.ncbi.nlm.nih.gov/33058561/)**.** The long-term health effects of [exposure to burn pit emissions](https://www.publichealth.va.gov/exposures/burnpits/index.asp) are still under study, but there is mounting evidence that they can contribute to a variety of respiratory diseases, cancers, and [autoimmune disorders](https://doi.org/10.1097/JOM.0b013e3182529799). #### **Other Military-Related Toxins** In addition to the examples above, military personnel have been exposed to a range of other potentially harmful substances throughout history. These include asbestos used in military vehicles and buildings, lead and other heavy metals, and depleted uranium used in armor-piercing ammunition. ### **The Connection Between Toxins And Autoimmune Diseases** Exposure to certain toxins can contribute to the development of autoimmune diseases by causing changes in the immune system. Toxins can trigger inflammation, damage DNA, alter the gut microbiome, and cause epigenetic changes—all of which can lead to a misdirected immune response. In the context of military toxins, [studies have shown](https://www.govinfo.gov/content/pkg/CHRG-115hhrg35728/html/CHRG-115hhrg35728.htm) that veterans exposed to Agent Orange, Gulf War toxins, and burn pit emissions have an increased risk of autoimmune diseases. The exact mechanisms are still under study, but it is clear that these toxins can have profound and lasting effects on the immune system. #### **Specific Autoimmune Diseases Linked to Military Toxins** Studies have suggested links between exposure to military toxins and several specific autoimmune diseases. For instance, there is strong evidence associating Agent Orange exposure with [an increased risk of developing diabetes mellitus type 2](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9920643/#:~:text=Agent%20Orange%20exposures%20are%20associated,of%20the%20PNS%20and%20CNS.). Similarly, Gulf War veterans have been found to have higher rates of [systemic lupus erythematosus](http://brain.umn.edu/2021-02-25__Lupus_Anticoagulant_in_Gulf_War_Illness_and_Autoimmune_Disorders__A_Common_Pathway_Toward_Autoimmunity.html) and [rheumatoid arthritis](https://doi.org/10.1001/archinte.158.4.367). Research on veterans of the Iraq and Afghanistan wars exposed to burn pit emissions also shows a worrying increase in autoimmune disorders, [including rheumatoid arthritis and lupus](https://apps.dtic.mil/sti/pdfs/ADA563160.pdf). The exact causative relationships and underlying mechanisms between these toxins and specific autoimmune diseases are areas of active research. By understanding these links better, we can develop more effective strategies to prevent and treat these conditions in our veterans and active service members. ### **Coping And Moving Forward** Bearing the invisible scars of their service, many veterans are left to deal with the impact of exposure to military toxins long after their active duty ends. From rheumatoid arthritis to systemic lupus erythematosus, these autoimmune diseases pose ongoing health challenges. However, with the appropriate treatment, support from advocacy groups, and the promise of ongoing research, there is hope for improved outcomes and quality of life. #### **Treatment Options for Autoimmune Diseases** Treatment of autoimmune diseases typically focuses on managing symptoms, reducing immune system overactivity, and maintaining the body’s ability to fight disease. This can involve a combination of medications, physical therapy, and lifestyle changes. Immunosuppressive drugs, pain management, physiotherapy, and even surgical intervention may be used depending on the specific disease and the individual’s condition. Although there is currently no cure for most autoimmune diseases, ongoing research holds the promise of new and improved treatments. Advances in areas like immunotherapy and personalized medicine could lead to more effective and targeted treatment strategies. #### **Disability Compensation** The Department of Veteran Affairs (VA) provides disability compensation for service-connected Infectious Diseases and Immune Disorders, a policy also observed by the Department of Defense (DoD) if the conditions render a service member unfit for duty. For Reservists, eligibility hinges on the disease or disorder stemming from a Line of Duty injury. The VA’s Schedule for Rating Disabilities (VASRD) provides various rating options tailored to the main symptoms of each condition. ##### **The VASRD offers ratings for the following autoimmune diseases, infectious diseases, and immune disorders:** Systemic Lupus Erythematosus Chronic Fatigue Syndrome Bacterial Infectious Diseases Parasitic Infectious Diseases Viral Infectious Diseases When it comes to calculating disability ratings for multiple conditions, the VA adheres to the “Pyramiding Principle,” which allows only one rating for overlapping symptoms. However, if the conditions have distinctly separate symptoms, each can be rated individually. If the symptoms are inseparable, the VA will amalgamate them to form a single rating under the code that best captures the predominant disability. For a detailed list of how specific Infectious Diseases and Immune Disorders are rated, [you can visit the VASRD’s official page here](https://www.benefits.va.gov/WARMS/bookc.asp#h). #### **Advocacy and Legal Actions** Several advocacy groups work tirelessly to support veterans affected by military toxins. These organizations provide resources, help raise awareness, and lobby for policy changes to better recognize and address the health effects of military toxins. Notable examples include the [Vietnam Veterans of America](https://vva.org/), [the National Gulf War Resource Center](http://ngwrc.net/), and [Burn Pits 360](https://burnpits360.org/). In addition, there have been several critical legal actions related to military toxins and autoimmune diseases. For example, in 1991, the U.S. Congress passed the [Agent Orange Act](https://www.congress.gov/bill/102nd-congress/house-bill/556), acknowledging that certain diseases, including some autoimmune diseases, are presumptively connected to Agent Orange exposure. **The Importance of Continued Research and Support** ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/shutterstock_322020428-768x512-1.jpg)*Roses left at the Vietnam Veterans Memorial in Washington, DC.* While significant progress has been made, much remains to be done to fully understand the complex relationships between military toxins and autoimmune diseases. Continued research is essential to unravel these links and develop effective preventive strategies and treatments. Equally important is the ongoing support for our veterans and active service members—those who bear the brunt of these health issues. It’s crucial that we continue to advocate for their health rights, provide them with the resources they need, and recognize their unique health challenges. In closing, the true toll of military toxins is a burden borne not only on the battlefields abroad but also within the bodies of our service members. By shedding light on this critical issue, we aim to inspire more comprehensive research, improved medical treatments, and stronger advocacy for those affected. ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** About Autoimmune Disease --- ### [Untangling a Complex Web: How to Categorize Autoimmune Disease](https://www.autoimmuneinstitute.org/articles/untangling-a-complex-web-how-to-categorize-autoimmune-disease) **Published:** July 1, 2024 **Author:** Carolyn Serraino **Excerpt:** Advancements in autoimmunity reveal more about immune system malfunctions and disease triggers though diagnosis and classification remains complex. **Content:** The field of autoimmunity has greatly advanced over the last decades. We know more about the mechanisms behind immune system malfunctions, triggers of flare-ups, and ways to manage autoimmune disease signs and symptoms. Despite the continuous progress, autoimmune diseases are a heterogeneous and complex group of diseases that aren’t always easy to detect and categorize. Identifying an autoimmune disease is difficult because no single test can diagnose it. Also, many [autoimmune diseases share similar signs and symptoms,](https://www.autoimmuneinstitute.org/covid_timeline/covid-19-symptoms-treatments-in-autoimmune-disease-patients/) which further complicates their identification. Therefore, the areas of diagnosis and classification need further research. Grouping [autoimmune diseases according to well-defined criteria would help advance](https://www.autoimmuneinstitute.org/research_updates/unlocking-advances-in-womens-health-key-insights-from-the-autoimmune-disease-symposium/) these areas and, in turn, guide disease monitoring and treatment to improve people’s health and quality of life. Before discussing the challenges surrounding categorization, a few key terms should be defined. Also, sorting and categorizing autoimmune diseases can be difficult because of the overlap with other disease groups. The Autoimmune Registry defines an autoimmune condition either as a disease, syndrome, or comorbidity that develops when the immune system mistakes its own molecules and cells for harmful intruders ([1](https://www.autoimmuneregistry.org/disease-classification)). However, disease, syndrome, or comorbidity [terms should not be used interchangeably](https://www.autoimmuneinstitute.org/articles/autoimmune-terminology-to-know-for-your-next-doctors-appointment "Autoimmune Terminology To Know For Your Next Doctor’s Appointment") (see table below). The existence of overlapping syndromes and disease subtypes complicates things further (see table below). Syndromes, comorbidities, overlapping syndromes, and subtypes aren’t always connected to autoimmunity and, thus, contribute to the overall challenge of assigning specific diseases to distinct categories. ## Autoimmune disease Change from a state of health that causes harm to a person’s organ or system after the immune system attacks healthy cells ## Autoimmune syndrome Collection of signs and symptoms that characterize an autoimmune disease ## Autoimmune comorbidity Presence of two or more autoimmune diseases in a person at the same time OR A distinct medical condition that co-occurs with an autoimmune disease (eg, endometriosis) ## Overlap syndrome Presence of two or more autoimmune diseases or autoimmune symptoms for an extended period ## Subtype A condition or complication of a disease that may appear in some people but not in others ## **How to Categorize Autoimmune Disease** ### *Anatomical criteria* In clinical settings, autoimmune diseases are usually categorized depending on whether they affect either one or multiple organs. In **organ-specific** **autoimmune diseases**, a person’s immune system attacks a single system, organ, or tissue. Examples include Graves’ disease in the thyroid gland, autoimmune hepatitis in the liver, and vitiligo in the skin. More autoimmune diseases grouped by organ or tissue are indicated in the figure below. **Systemic** **autoimmune diseases** affect and damage multiple tissues and organs of the body and include systemic lupus erythematosus, rheumatoid arthritis, Sjogren’s syndrome, and dermatomyositis ([1](https://www.autoimmuneregistry.org/disease-classification),[ 2](https://pathology.jhu.edu/autoimmune/classification/),[ 3](https://pubmed.ncbi.nlm.nih.gov/26212387/)). The classification of organ-specific and systemic autoimmune diseases can be supported by detecting and describing the histopathologic features of the affected tissues ([3](https://pubmed.ncbi.nlm.nih.gov/26212387/)). ### *Immunologic criteria* ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/06/Categorizing-ADs-by-anatomy-graphic-1.jpg) Classification according to the location of the autoimmune attack is straightforward and clinically useful, but the drawback is that chronic inflammatory diseases may also be categorized as autoimmune even if they are not characterized by the B and T cells responses (adaptive immunity) typically observed in autoimmune diseases. Therefore, scientists and researchers have proposed categorizing autoimmune diseases according to their unique immunologic profiles ([4](https://pubmed.ncbi.nlm.nih.gov/11484692/),[ 5](https://pubmed.ncbi.nlm.nih.gov/37165096/)). For example, autoantibodies are invaluable markers for classifying, diagnosing, and identifying disease activity ([5](https://pubmed.ncbi.nlm.nih.gov/37165096/),[6](https://pubmed.ncbi.nlm.nih.gov/37150488/)). But one drawback is that autoantibodies’ connection to tissue damage tends to be more evident for organ-specific autoimmune diseases than for systemic autoimmune diseases ([5](https://pubmed.ncbi.nlm.nih.gov/37165096/)). Analyzing aberrant (abnormal) T and B cells may be another approach to classification, which would involve closely looking at autoantigens and cellular immunity profiles ([5](https://pubmed.ncbi.nlm.nih.gov/37165096/)). ### *Other approaches* Additional practices that help classifying and diagnosing autoimmune disease include laboratory and imaging techniques as well as proteomics, genomics, and metabolomic approaches that may assist in detecting autoantibodies, B and T cells, cytokines, organ-specific proteins, and molecular profiles ([3](https://pubmed.ncbi.nlm.nih.gov/26212387/),[7](https://pubmed.ncbi.nlm.nih.gov/22647780/)). An alternative suggestion for categorizing autoimmune diseases may be to include them under the more heterogeneous group of “non-infectious inflammatory diseases”. This means they would be considered as part of a larger group of conditions that have self-directed inflammation in common but trigger different kinds of immune responses. Therefore, the type of diseases could be categorized according to their ability to stimulate either[ innate (**autoinflammatory diseases**) or adaptive immunity (**autoimmune disease**](https://www.autoimmuneinstitute.org/articles/about-autoimmune/autoimmune-vs-autoinflammatory/)) ([8](https://pubmed.ncbi.nlm.nih.gov/23838615/),[9](https://pubmed.ncbi.nlm.nih.gov/16942393/)). This proposed classification method, however, would not solve the problem of using non-specific terms such as “inflammatory disease”, which may continue to cause overall confusion ([5](https://pubmed.ncbi.nlm.nih.gov/37165096/)). In a recent study, investigators used a process called “data mining” to sort through co-citations in the search engine, PubMed, and classify multiple autoimmune disease and comorbidities according to gender, age, prevalence, and body system ([10](https://pubmed.ncbi.nlm.nih.gov/35893435/)). Processes that allow scientists to analyze complex databases hold promise in categorizing this complex group of diseases and other associated conditions, but additional research is needed to explain why certain conditions are observed more in some groups than others ([10](https://pubmed.ncbi.nlm.nih.gov/35893435/)). Finding new and improved classification methods will guide disease diagnosis and monitoring, helping health care workers to better treat patients with an autoimmune disease. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/04/GAI-Logo-Image-811x1024.png) #### About The Author ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/07/Chiavolini-Damiana-scaled.jpg) A freelance writer who specializes in medical and life science topics. As a trained researcher, she authored journal articles in the areas of infection and immunity and wrote booklets and book chapters about different diseases. As a professional communicator, she writes feature articles for magazines and other publications and develops content for higher education platforms. Damiana is also an experienced academic editor, microbiology educator, writing coach, and fragrance blogger. She is a contributing member of the American Medical Writers Association and a past-president of the association’s Southwest Chapter. Damiana Chiavolini, MS, PhD Freelance Writer for GAI ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** About Autoimmune Disease --- ### [Biologics for Autoimmune Disease: What You Should Know](https://www.autoimmuneinstitute.org/articles/biologics-for-autoimmune-disease-what-you-should-know) **Published:** April 8, 2025 **Author:** Carolyn Serraino **Excerpt:** How biologics work to treat autoimmune diseases, their benefits, risks, costs, and what to expect if your doctor prescribes one. **Content:** Many of the drugs we take are known as small molecule drugs. These drugs, such as over-the-counter pain relievers, antibiotics, or other prescriptions, are chemically synthesized. They’re convenient and oftentimes exist as pills stored at room temperature. Biologics, in contrast, are drugs that are produced from biological sources like cells. As a newer class of drugs, biologics have many benefits over small molecule drugs but also bring many logistical changes. In this article, we describe how biologics are used to treat autoimmune diseases and discuss the practical details of taking a biologic. ## What are Biologics? Biologics used to treat autoimmune disease come in the form of antibodies, proteins designed to bind specific components (ex: molecules, proteins) in our body to modulate their activity. “**In the case of conditions like rheumatoid arthritis or psoriatic arthritis, a biologic can be used as an antibody against certain molecules that cause inflammation, thereby reducing the inflammation that causes symptoms in these diseases**,” says [Jason E. Liebowitz](https://doctors.columbia.edu/us/ny/new-york/jason-e-liebowitz-md-161-fort-washington-avenue), Rheumatologist and Assistant Professor of Medicine at Columbia University Irving Medical Center. Beyond this, biologics can have other mechanisms of action. For example, other biologics bind components on the surface of a specific cell type to inhibit them. ## How do Biologics Work to Treat Autoimmune Disease? The first biologic drug used to treat autoimmune disease was approved by the FDA in 1998 ([1](https://pmc.ncbi.nlm.nih.gov/articles/PMC6679695/)). This drug, infliximab (Remicade), was initially approved to treat Crohn’s disease but has since then been approved to treat other autoimmune conditions like rheumatoid arthritis, ankylosing spondylitis, and plaque psoriasis ([2](https://pmc.ncbi.nlm.nih.gov/articles/PMC6679695/)). Since then, the number of biologic drugs used to treat autoimmune diseases has continued to grow. [Ashish S. Patel](https://phoenixchildrens.org/find-a-doctor/ashish-s-patel-md), Physician-in-Chief; Division Chief, Gastroenterology at Phoenix Children’s, adds, “now what you’re starting to see is \[biologics\] expand into more antibodies that target different pathways of inflammation.” Liebowitz says, “there are many new agents coming onto the market all the time, particularly for conditions like psoriasis and psoriatic arthritis.” Many biologics used to treat autoimmune diseases exist in the form of monoclonal antibodies that bind to components of the immune system to prevent them from being self-reactive. These can include: ## TNFɑ blockers - TNFɑ inhibitors are antibodies that bind TNFɑ (tumor necrosis factor). Those with autoimmune diseases can have excessive TNFɑ which can lead to inflammation. When inhibitors bind to TNFɑ, they block their activity ([3](https://pmc.ncbi.nlm.nih.gov/articles/PMC7962638)). - Ex: adalimumab (Humira), etanercept (Embrel), infliximab (Remicade) ## B cell inhibitors - B cell inhibitors are monoclonal antibodies that target specific proteins on the B cell’s surface. Once binding, these antibodies trigger the body to remove the B cell. This method is also known as B cell depletion therapy ([4](https://pmc.ncbi.nlm.nih.gov/articles/PMC7737718/)). Because B cells contribute to autoantibody production, the idea is that by targeting B cells, the self reactivity is removed as well. Another method of inhibiting B cells involves blocking proteins that bind and stimulate B cells. - - Ex: belimumab (Benlysta), rituximab (Rituxan) ## Interleukin inhibitors - Interleukins are molecules that can either suppress or prompt inflammation. Different interleukin inhibitor drugs target different interleukin molecules ([5](https://immunenetwork.org/DOIx.php?id=10.4110/in.2022.22.e9)). - - Ex: risankizumab (Skyrizi), ustekinumab (Stelara) Biologics were once prescribed after other options, such as steroids or other immunosuppressive drugs, have been exhausted. This was especially true when biologics were first starting to come on the market. “What we learned is that \[this\] often delays the best therapy for the patient,” says Patel. “**Now, we’ve shifted our minds to look at the patient \[individually\] and understand the complexity of their disease, and then decide if the biologic is the right therapy for them**,” Patel adds that in the pediatric IBD space, biologics are often the first line of therapy. ## My Doctor Prescribed me a Biologic. What Should I Know? ### Administration routes Unlike the majority of small molecule drugs, biologics are delivered either through an IV or through an injection. This is for many reasons. Monoclonal antibodies can be broken down by enzymes and the low pH in the gastrointestinal tract so oral administration doesn’t work. Moreover, due to their large size, biologics cannot pass through the gastrointestinal tract to the bloodstream. How often the biologic needs to be administered depends on the specific biologic and condition. For example, it can be every week or every other month. ### Side effects “As a class, some of the common side effects that doctors must be wary of are increased risk of infection and potential for site reaction for injectable biologics or infusion reactions for infusible biologics,” explains Liebowitz. - **Increased infection risk:** Because biologics suppress a part of the immune system, they can leave patients more susceptible to infections in general. This could either be new respiratory tract infections, serious infections (ex: high risk of complications, life-threatening infections), opportunistic infections, or reactivation of latent infections that have previously become inactive in the body ([6](https://journals.asm.org/doi/10.1128/cmr.00035-19)). - **Site reaction:** A site reaction is a localized reaction at the site of injection ([7](https://pmc.ncbi.nlm.nih.gov/articles/PMC10486173/)). This can include redness, pain, itching, and swelling. - **Infusion reaction:** Infusion reactions, in cases where the biologic was delivered through an IV, produce systemic symptoms. These can include fever, chills, nausea, dizziness, and shortness of breath. ### Cost Biologics are expensive, with costs ranging from $10,000 to as much as $500,000 per year ([8](https://pubmed.ncbi.nlm.nih.gov/30446980/)). They’re costly for many reasons. They’re complex drugs to develop, manufacture, and store, they require specialized administration routes, and they’re in high demand with few competitors. “Although insurance will often cover a portion of the cost, most patients qualify for and will need a [patient assistance program](https://www.autoimmuneinstitute.org/articles/navigating-health-insurance-for-autoimmune-disease-patients-expert-tips-and-resources/) to help with cost through the company making the medication,” says Liebowitz. Another way to bring down the high costs of biologics is with biosimilars, drugs that are very close in structure to the biologic ([9](https://www.cancer.org/cancer/managing-cancer/treatment-types/biosimilar-drugs/what-are-biosimilars.html)). Biosimilars are generally 10-30% less costly than the reference biologic. However, with only dozens of biosimilars approved and 12-year exclusivity periods for the referenced biologic, it can be some time before they can drive down the price of biologics ([10](https://www.fda.gov/drugs/biosimilars/background-information-list-licensed-biological-products-reference-product-exclusivity-and)). “I am excited to see if biosimilars can reduce costs to patients and overall healthcare costs for the country,” says Liebowitz. ### Cancer risk Early studies point to the connection between the use of biologics and a small increase in the risk of developing lymphoma ([11](https://www.gastrojournal.org/article/S0016-5085(99)70294-5/fulltext)). However, more recent studies make this association unclear. For example, a study of 15,000 patients with rheumatoid arthritis found that using TNFɑ inhibitors did not influence the risk of developing lymphomas ([12](https://ard.bmj.com/content/76/3/497)). Nevertheless, it’s important to weigh the risks of taking a biologic versus the risks of disease progression. For cases of inflammatory bowel disease, Patel explains that “the disease itself increases your risk of colon cancer if you don’t treat the disease effectively.” ## Future Outlook for Biologics With more and more biologics becoming available it can be difficult for doctors to find the best option for patients. “The biggest opportunity is that we now have many treatment options for most patients,” says Liebowitz. “The biggest challenge is knowing which biologic to select for each patient. We are still largely needing to rely on clinical experience and trial and error.” Not all therapeutics work for all patients so it could take months before finding one that is ideal for a particular patient. Patel hopes that one day, he is able to go beyond trial and error in finding the best therapies for his patients. “What I would love to see is when I diagnose a new patient with Crohn’s disease, if I can have a way to determine what’s the best biologic for that patient at this time, and not have to necessarily put some of these patients through \[multiple drugs to find the right one\],” he says. More research into specific biomarkers or disease subtypes could help clinicians determine which biologic – or other drugs – is going to work for a particular patient. When it comes to treating autoimmune diseases, Patel says, “the future is personalizing therapy.” ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/01/image.png) #### About the Author ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/10/Jennifer-Tsang-Bio-Headshot-e1729699053652.jpg) A microbiologist turned freelance science writer who works with life science companies, nonprofits, and academic institutions on anything from news stories, explainer articles, and content marketing. She shares the wonderful world of microbes on her blog The Microbial Menagerie. Jennifer Tsang, PhD Freelance Writer for GAI ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** Diagnosis & Treatment --- ### [Gut-Skin Connection: How Your Microbiome Impacts Autoimmune Skin Diseases](https://www.autoimmuneinstitute.org/articles/gut-skin-connection-how-your-microbiome-impacts-autoimmune-skin-diseases) **Published:** February 4, 2025 **Author:** Carolyn Serraino **Excerpt:** The gut and the skin are more alike than you might think. Learn more the complexities of the gut-skin axis and how it influences autoimmune diseases. **Content:** The gut and the skin are the two biggest surfaces of the human body. Each of them measures about 25-30 square meters and is home to billions of microbes, known as the [microbiome](https://www.autoimmuneinstitute.org/articles/what-is-the-microbiome-and-why-is-it-important/https://www.autoimmuneinstitute.org/articles/what-is-the-microbiome-and-why-is-it-important/). They’re both places that shield us from the external environment. Because of their roles in immunity, they’re also sites where autoimmunity tends to occur ([1](https://www.jidonline.org/article/S0022-202X(21)02612-9/fulltext)). While seemingly separate entities, the gut and the skin influence each other in many ways. ## The Gut-Skin Axis, Explained The communication between the gut microbiome and the skin is known as the gut-skin axis. “It’s an emerging field, but we know that the microbes in our gut can influence immune function in the skin, as well as other cell types,” says Martin Kriegel, Chair of Rheumatology and Clinical Immunology at the University of Münster. This relationship between gut microbes and the skin is a bi-directional relationship. For example, people with inflammatory bowel disease may also have inflammatory skin disease ([2](https://pubmed.ncbi.nlm.nih.gov/27793451/)). Other studies have found that skin damage leads to changes in the gut microbiome ([3](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11001995)). “**Stress from the outside leads to stress on the inside. Stress from the inside leads to stress from the outside**,” notes Chris Callewaert, a microbiologist and bioengineer at Ghent University, as he describes the gut-skin axis. ## How can the Gut Microbiome affect Skin Health? Kriegel notes that one way that gut microbes impact the skin is through the metabolites they produce. When secreted into the bloodstream, these metabolites can have far reaching effects ([4](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7916842/)). “**Many organs outside of the gut can be influenced by gut microbes via metabolites**,” says Kriegel. Aside from the impacts of metabolites they secrete, could microbes from the gut actually travel to the skin? “Whether microbes from the gut can reach the skin is controversial and unknown, but one potential mechanism which we’ve been working on is bacteria leaving the gut, and reaching lymph nodes, liver, and spleen,” says Kriegel, who has found evidence of this movement in animal models ([5](https://www.science.org/doi/10.1126/science.aar7201)) and is studying the effects of gut microbe translocation on the immune response ([6](https://doi.org/10.1101/2023.06.29.546430)). Gut and skin microbiomes are [altered in many skin autoimmune diseases](https://www.autoimmuneinstitute.org/articles/the-relationship-between-autoimmune-disease-and-the-gut-microbiome/). However, it’s difficult to know whether microbial changes are the cause of a skin disease or a consequence of the disease. - **[Alopecia](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/alopecia-areata/):** Research finds that changes in the scalp, hair follicle, and gut microbiomes are associated with alopecia ([7](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10617895/)). - **[Atopic dermatitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/eczema/):** People with atopic dermatitis are more likely to be colonized by bacterium *Staphylococcus aureus* than those without atopic dermatitis ([8](https://pubmed.ncbi.nlm.nih.gov/26994362/)). People with atopic dermatitis also have decreased microbial diversity on the skin, which can allow *S*. *aureus* to grow ([9](https://pubmed.ncbi.nlm.nih.gov/29233606/)). Atopic dermatitis flares have also been associated with reduced *Streptococcus*, *Corynebacterium*, and *Propionibacterium* bacteria, likely due to antibacterial compounds produced by *S*. *aureus* ([10](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3337431/)). - **[Psoriasis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/psoriasis/):** People with psoriasis have changes in their gut and skin microbiomes. There’s evidence that  *Propionibacterium*, *Staphylococcus*, *Corynebacterium*, and *Streptococcus* are the main bacteria involved in psoriasis ([11](https://onlinelibrary.wiley.com/doi/full/10.1111/jocd.14273)). People with psoriasis are more likely to develop intestinal immune diseases ([4](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7916842/)). - **[Systemic Lupus Erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/):** A study that compared the gut microbiome in people with SLE found that *Bacteroides thetaiotaomicron* was more abundant in those with SLE ([12](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6781142/)). The balance of bacteria that have roles in intestinal homeostasis is also altered in SLE ([13](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4196225/)). - **[Vitiligo](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/vitiligo/):** A study that compared sites affected by vitiligo versus unaffected skin found that the microbial diversity was reduced in sites affected by vitiligo. Different types of bacteria also dominated in sites affected by vitiligo ([14](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4725359/)). ## Support a Healthy Gut Microbiome through Diet and Probiotics One of the primary ways to support a healthy gut microbiome is to focus on diet. “You are what you eat,” says Callewaert. “Our gut microbiome is shaped by what we eat for the large part. We need a lot of fiber.” He notes that the standard Western diet, which contains high levels of sugar and fats, is not ideal for our gut microbiome. Research shows that a high-fat diet increased skin inflammation in psoriasis mouse models ([15](https://www.cell.com/cell-reports/pdfExtended/S2211-1247(23)00724-6)). Another study found that the high-fiber Mediterranean diet correlated with lower psoriasis severity ([16](https://translational-medicine.biomedcentral.com/articles/10.1186/s12967-014-0372-1#Sec6)). Other sources recommend fermented foods to decrease inflammation and improve microbial diversity in the gut ([17](https://www.cell.com/cell/fulltext/S0092-8674(21)00754-6)). Probiotics are another popular way to promote a healthy gut microbiome, but it is hard to know whether probiotic bacteria actually make it into the intestines in high enough doses. “For some people, probiotics help, and for other people, it doesn’t help,” says Callewaert. ## Can Healing the Gut Microbiome Reduce Autoimmune Skin Disease Flares? While it’s possible that taking measures to heal the gut microbiome can help manage autoimmune skin diseases, it’s complicated. “There’s a strong link between diet, gut microbiome and autoinflammatory diseases,” says Callewaert. “But there are so many factors, like lifestyle and stress, that play a role in the gut. It’s difficult to control them all.“ “I strongly believe that by managing your gut, you can also manage autoinflammatory disease or reduce it for large parts,” says Callewaert. ## Potential Future Microbiome-based Treatments for Autoimmune Skin Diseases Many biotech companies are beginning to work on topical probiotics that can be applied directly to the skin. “It’s less studied compared to oral probiotics. But it definitely has a future,” says Kriegel. “We need to better figure out how probiotics stick to the skin and remain there.” “It’s still the early days. Hopefully some new preventative measures and therapies will come out in the coming years that aren’t just medication to suppress the immune system,” says Callewaert. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/01/image.png) #### About the Author ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/10/Jennifer-Tsang-Bio-Headshot-e1729699053652.jpg) A microbiologist turned freelance science writer who works with life science companies, nonprofits, and academic institutions on anything from news stories, explainer articles, and content marketing. She shares the wonderful world of microbes on her blog The Microbial Menagerie. Jennifer Tsang, PhD Freelance Writer for GAI ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** Living Well with Autoimmune Disease --- ### [CRISPR/Cas9 Gene Editing: Revolutionizing Autoimmune Disease Treatment](https://www.autoimmuneinstitute.org/articles/crispr-cas9-gene-editing-revolutionizing-autoimmune-disease-treatment) **Published:** January 3, 2025 **Author:** Carolyn Serraino **Excerpt:** Discover how CRISPR/Cas9 technology is revolutionizing the treatment of autoimmune diseases like Rheumatoid Arthritis, Type 1 Diabetes, and Multiple Sclerosis through targeted gene editing and precise DNA repair mechanisms. **Content:** > > CRISPR gene editing offers new hope for patients with autoimmune diseases, providing targeted and precise genetic modifications that traditional treatments cannot achieve. ## **How Does CRISPR Technology Work?** Clustered regularly interspaced palindromic repeats (CRISPR)/CRISPR-associated protein 9 (Cas9) is a groundbreaking gene-editing tool revolutionizing the treatment of various autoimmune diseases by altering DNA sequences and modifying genes. > **CRISPR works like this: it uses a guide RNA (gRNA) to lead a protein called Cas9 to a specific spot in the DNA. Cas9 acts like a pair of molecular scissors, cutting the DNA at that spot. ([1](https://ep.bmj.com/content/101/4/213.short),[2](https://doi.org/10.1002/iub.2296))** > Once the DNA is cut, the cell tries to repair it using two different methods: non-homologous end joining (NHEJ) or homology-directed repair (HDR). ([3](https://doi.org/10.1016/j.jbiotec.2020.05.008)) ## **What Are the DNA Repair Mechanisms Activated by CRISPR/Cas9?** ### **Non-homologous end joining (NHEJ):** - The broken DNA ends are quickly joined together (through ligation). This process is not very precise and can often result in changes to the DNA, such as mutations, deletions, or insertions. These changes can sometimes disable the gene, effectively turning it off. Because this method is less accurate, it can sometimes add random, ‘nonsensical’ genetic material.” ([4](https://doi.org/10.3892/ijmm.2020.4609)) - Often used for creating gene knockouts by introducing small insertions or deletions that disrupt the gene’s function. This is useful for studying gene function or creating model organisms. - Works in all cell types and throughout the cell cycle, including non-dividing cells. ### **Homology-directed repair (HDR):** - Uses a matching piece of DNA as a guide (a homologous DNA template) to fix the break accurately. This method allows scientists to make precise changes, like fixing a broken gene or adding a new one, and can even reactivate a gene that was turned off. ([3](https://doi.org/10.1016/j.jbiotec.2020.05.008)) - More effective in dividing cells and during the S and G2 phases of the cell cycle when a homologous template is available. [![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/12/Gene-Editing-Mechanisms-in-Autoimmune-Disease-GAI-1.jpg)](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/12/Gene-Editing-Mechanisms-in-Autoimmune-Disease-GAI-1.jpg) ## **What Is the History of CRISPR Technology?** CRISPR technology is both powerful and easy to use. It all started in 1987 when researchers noticed a repetitive DNA sequence in a bacterium called *Escherichia coli*. This discovery suggested that bacteria could remember and target specific viral DNA sequences. Since then, many studies have advanced gene editing significantly. ## **How Does CRISPR Modify Genes Associated with Autoimmune Disorders?** Many autoimmune diseases, including [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid Arthritis"), [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic Lupus Erythematosus"), [type 1 diabetes mellitus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/diabetes-type-1/ "Diabetes, Type 1 (T1D)"), and [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/ "Multiple Sclerosis"), have a strong genetic component. As a result, gene therapy has promising applications. Autoimmune diseases are often treated with immunosuppressive drugs meant to control an immune response. But CRISPR/Cas9 offers a targeted approach to modify specific genes implicated in autoimmune disorders. In addition to being a treatment option for infectious diseases and cancers, researchers have begun examining the technology to learn about the mechanisms of pathogenesis and possible treatments for ADs. ([6](https://doi.org/10.1093/pcmedi/pbab014), [2](https://doi.org/10.1002/iub.2296)) ## **What Are the Potential Applications of CRISPR in Autoimmune Disease Treatment?** The following section provides a summary of two recent studies which reviewed advances related to CRISPR/Cas9 in infection and autoimmunity. Those studies are: “Genome Editing Using CRISPR-Cas9 and Autoimmune Diseases: A Comprehensive Review” ([7](https://www.mdpi.com/1422-0067/23/3/1337)) and “CRISPR/Cas9 gene editing: A new therapeutic approach in the treatment of infection and autoimmunity.” ([2](https://doi.org/10.1002/iub.2296)) For more information on autoimmune disease treatments, visit our [Autoimmune Disease Treatments page](https://www.autoimmuneinstitute.org/the-spectrum-of-autoimmune-disease-treatments/). ### **How Can CRISPR/Cas9 Help in Treating Rheumatoid Arthritis (RA)**? In [RA](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid Arthritis"), the immune system attacks the joints, causing inflammation. According to Min Ho Lee et al., the MYC, FOXO1 gene, SNP rs6927172, TNFAIP3, OLIG3 gene, and miR-155 may all be relevant for CRISPR/Cas9 treatment. ([7](https://www.mdpi.com/1422-0067/23/3/1337)): ## MYC and FOXO1 These genes have been found to be possible causal factors of RA. ## SNP rs6927172 An intergenic SNP on chromosome 6q23 region is associated with RA. ## TNFAIP3 and OLIG3 Using CRISPR/Cas9, these genes showed decreased expressivity in a specific genomic region. ## miR-155 Turning off this microRNA reduces the production of pro-inflammatory cytokines, playing an important role in RA. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/07/RA-1.png) ### **What Are the CRISPR/Cas9 Applications in Inflammatory Bowel Disease (IBD)?** IBD includes Crohn’s disease and ulcerative colitis, which involve chronic inflammation of the digestive tract. ([8](https://doi.org/10.1002/jcp.27173)) According to [Min Ho Lee et al](https://doi.org/10.3390/ijms23031337)., JAK2, TL1A, SGK2, PTPN2, c-MYC, HDAC7, and IFN- γ genes and miR-125a may all be candidates for CRISPR-Cas9 technology: ## rs1887428 rs1887428 in the promoter region of the Janus kinase 2 \[*JAK2*\] gene, as well as SGK2, were found to potentially impact the course of IBD. ## MYC Elevated expression levels were observed in Crohn’s disease patients. ## IFNγ IFNγ has been found to play a key role in colon inflammation ## TL1A and MLCK Flare-ups of these genes are noted in IBD ([10](https://academic.oup.com/ecco-jcc/article/11/suppl_1/S109/2961007)) ## HDAC7 Reduced function of this gene, Histone deacetylase 7 (HDAC7) helps maintain the intestinal barrier in IBD patients ([10](https://academic.oup.com/ecco-jcc/article/11/suppl_1/S109/2961007)) ## miR-125a This microRNA protects against intestinal inflammation, with knockout mice showing more severe colitis ([11](https://www.sciencedirect.com/science/article/pii/S0896841119300678?casa_token=1WkQCNN0K8wAAAAA:P_Aec6Z5tTEo-MRxROBoDWjAV8ypcMwYqyqCv2ZUbCrrcNMFB1nurGasZLWi9dwDh-FgDixN5Ew)) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/07/IBD.png) ### **How Does CRISPR/Cas9 Target Genes in Systemic Lupus Erythematosus (SLE)?** The A20 DUB and CXorf21 gene have both been suggested as appropriate candidates for CRISPR-Cas9 treatment. ## A20 DUB Interrupting this gene increases susceptibility to SLE ([12](https://ard.bmj.com/content/78/10/1363.abstract)) ## CXorf21 Sexually dimorphic expression of this gene may increase the risk of SLE ([13](https://doi.org/10.3389/fimmu.2019.02160 "13")) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/07/SLE.png) ### **Can CRISPR/Cas9 Be Used to Treat Multiple Sclerosis (MS)?** According to the review by Min Ho Lee et al., the IR7R gene, the RNA helicase DEAD box polypeptide 39B, the IL2RA gene, and the TNFRSF1A gene may all be appropriate candidates for CRISPR-Cas9 treatment. ## IL-2RA variants of the IL-2RA gene increase the risk of MS ([14](https://doi.org/10.1371/journal.pgen.1000322)) ## TNFRSF1A rs1800693 SNP in the TNFRSF1A gene is associated with MS as the causal variant ([15](https://www.nature.com/articles/nature11307)) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/07/MS.png) ### **What Is the Role of CRISPR/Cas9 in Treating Type 1 Diabetes?** In Type 1 Diabetes Mellitus (T1DM), the body’s immune system attacks pancreatic B cells, causing the body to produce insufficient insulin. The AID/RAD51, and SNP rs10914542 of LCK gene have been suggested as appropriate candidates for CRISPR-Cas9 treatment. ## AID/RAD51 found to be a potential target for treatment of T1DM patients ([16](https://journals.aai.org/jimmunol/article/198/11/4255/106029)) ## LCK SNP rs10914542 of the LCK gene was significantly associated with the susceptibility of T1DM ([17](https://doi.org/10.1038/s41390-019-0436-2)) ## dCas9-VP160 a CRISPR/Cas9 system fused with transcriptional activators (dCas9-VP160) has been found to activate the transcription of the insulin gene in T1DM patient’s derived fibroblasts ([18](https://doi.org/10.1038/gt.2016.28)) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/07/T1D-1.png) ### **How Can CRISPR/Cas9 Technology Help in Celiac Disease (CD)?** Celiac Disease is an autoimmune disorder which causes damage to the small intestine as a result of inflammatory reactions induced by gluten.  The **α- or γ-gliadin genes** (gluten encoding genes) have been suggested as candidates for CRISPR-Cas9 treatment. > In one study, CRISPR-Cas9 was shown to successfully edit α- or γ-gliadins and make gluten-free or low-gluten wheat. ([19](https://doi.org/10.1111/pbi.12837)) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/07/Celiac.png) ## **What Are the Limitations of CRISPR in Autoimmune Disease Treatment?** CRISPR/Cas9 technology is a promising method for understanding and treating autoimmune diseases. CRISPR also exhibits higher efficiency and fewer off-target effects than other gene editing tools such as ZFNs and TALENS. ([4](https://doi.org/10.3892/ijmm.2020.4609)) However, CRISPR-Cas systems are frequently unreliable in editing primary cells and certain tissues, and in patient’s bodies. One major limitation is effectively directing Cas9 to the desired sequence. Developing more effective editing techniques is crucial for advancing human gene therapy applications. ([4](https://doi.org/10.3892/ijmm.2020.4609), [6](https://doi.org/10.1093/pcmedi/pbab014)) ## **What Are the Promising Preclinical Studies on CRISPR/Cas9 for Autoimmune Diseases?** According to [Çerçi](https://journals.scholarsportal.info/search?q=Bar%C4%B1%C5%9F%20%C3%87er%C3%A7i&search_in=AUTHOR&sub=) et al, there have been advances which have successfully resulted in “increased survival of model animals and tolerable safety.“ ([20](https://doi.org/10.1016/j.lfs.2022.121204)) That team has listed some research that is close to the clinical phase [here](https://www.sciencedirect.com/science/article/abs/pii/S0024320522009043?casa_token=meXA-SbWG6cAAAAA:IQE8qTyIR8Kb-IKvWHvdcLpnNOR-w1fLypqqhOC1L05zsmq-Cm_R8XI7C0W5hxG4MaqFHrITAw#t0015). Promising advancements related to CRISPR/Cas9 gene editing have been made in the last four decades. While much remains to be accomplished, CRISPR/Cas9 technology provides a way to manipulate the genome and marks a significant advance for diseases and illnesses of many kinds. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/04/GAI-Logo-Image-811x1024.png) ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** Diagnosis & Treatment --- ### [Allergies and Autoimmunity](https://www.autoimmuneinstitute.org/articles/allergies-and-autoimmunity) **Published:** June 23, 2023 **Author:** Carolyn Serraino **Content:** Allergies and autoimmune diseases are both conditions that result from an inappropriate immune response. > “In the case of autoimmunity, it is an inappropriate response to a self-antigen, while in the case of allergy it is an inappropriate response to a harmless environmental antigen, such as grass pollen or cat dander” said Steven F. Ziegler, the director of the Immunology Program at the Benaroya Research Institute at the University of Washington. ### **The Connection Between Autoimmune Disease And Allergies** One similarity in the pathways of development between allergies and autoimmune diseases is the involvement of immune cells in the immune response. ([1](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2923430/)) With allergies, the immune system reacts to harmless substances or allergens, which leads to the activation of immune cells. ([2](https://www.hopkinsmedicine.org/health/conditions-and-diseases/allergies-and-the-immune-system)) Similarly, in [autoimmune diseases](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/ "A-Z Disease List"), immune cells may recognize self-tissues as foreign and mount an immune response, resulting in tissue damage and [inflammation](https://www.autoimmuneinstitute.org/articles/inflammation-a-driving-force-of-autoimmune-disease "Inflammation: A Driving Force of Autoimmune Disease"). You can read more about the specific [body regions commonly affected by autoimmunity](https://www.autoimmuneinstitute.org/articles/body-regions-commonly-affected-by-autoimmunity "Body Regions Commonly Affected by Autoimmunity") in our other article. Environmental factors such as allergens, medications, and toxins can trigger or exacerbate allergic reactions, while infections, stress, and exposure to certain environmental toxins have been implicated in triggering or exacerbating autoimmune diseases. ([3](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5097114/)) [Genetic factors](https://www.autoimmuneinstitute.org/articles/how-sex-genetics-influence-autoimmunity "How Sex & Genetics Influence Autoimmunity") also play a role in the development of both allergies and autoimmune diseases. Certain genes are associated with an increased risk of developing allergies or autoimmune diseases, and genetic factors can influence immune cell function, cytokine production, and other immune responses. > “As we learn more about the immune responses in autoimmunity and allergy, we are discovering that in some cases variants of the same gene are involved in both. This suggests a connection between these immune-mediated diseases” said Ziegler. “As is often the case in immunology, the more we learn about one type of immune-mediated disease, the more we find commonalities with others.” ### **Immune Cells Involved in Autoimmune Disease Vs Allergies** While allergies and autoimmune diseases share some similarities, including the involvement of immune cells and genetic factors, they diverge at certain points. One key area of interest between autoimmune diseases and allergies is the type of immune cells involved. ([4](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4687447/)) According to Ziegler, there is an overlap between the cell types involved in autoimmunity and allergy in that both have pathogenic CD4 T-cells (self-reactive in the former, allergen-reactive in the latter) as well as B cells. Additional cell types are unique to each disease, such as (e.g., mast cells in allergy). Immune cells can drive inflammation and tissue damage in the target organs. ### **Is There A Correlative Component Between Allergies And Autoimmune Disease?** Some studies have shown that individuals with allergies may have an increased risk of developing autoimmune disease and vice versa. This suggests that there may be some shared genetic or environmental factors that contribute to the development of both conditions. For example, a [study](https://onlinelibrary.wiley.com/doi/10.1111/1756-185X.13928) published in the journal *International Review of Rheumatic Diseases* found that patients with [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/) (SLE), an autoimmune disease, had a higher prevalence of allergic rhinitis compared to healthy controls. Another [study](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8467008/) published in *Allergy, Asthma and Clinical Immunology* found that patients with [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/), also an autoimmune disease, had a higher prevalence of [atopic dermatitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/eczema/), a type of skin allergy. That being said, the relation is not direct. “The frequency of allergy in the general population is quite high (about 20% of Americans), while the frequency of autoimmune disease is (between 5 and 7%),” said Ziegler. “Thus, the likelihood that some individuals with allergies will also develop autoimmune disease is relatively high.” ### **Can Allergies Trigger Autoimmunity And/Or Autoimmune Flare-Ups?** While there are anecdotal reports of responses to some allergens also causing autoimmunity, such an effect of allergic responses is not generally seen, according to Ziegler. Overall, the relationship between allergies and autoimmunity is complex and often varies depending on the individual, the specific allergen or autoimmune disease, and other factors. Not all individuals with allergies will develop autoimmune diseases, and not all autoimmune diseases are triggered or exacerbated by allergies. Understanding the association between allergies and autoimmune diseases could have important implications for diagnosing, managing, and treating immune-mediated disorders. It is important to find specialists who can collaborate on care when possible in order to fine-tune a treatment plan. ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** Living Well with Autoimmune Disease --- ### [Infection and Immunity: Turning the Lens on Microbes](https://www.autoimmuneinstitute.org/articles/infection-and-immunity-turning-the-lens-on-microbes) **Published:** October 26, 2023 **Author:** Carolyn Serraino **Content:** Infections can influence the development and progression of autoimmune diseases. In order to understand the intricate relationship between infections and autoimmune diseases, it is crucial to take microbial influence on autoimmunity into perspective. Infection – the invasion of a body system or organ by microbes – has been known as a key player in autoimmune disease development. Most autoimmune diseases or [flare-ups](https://www.autoimmuneinstitute.org/2023/04/11/outbursts-in-autoimmunity-disease-flare-ups/) have been associated with at least one infection, and a single infection can trigger multiple autoimmune diseases or flare-ups. People with an autoimmune disease are also at higher risk of infection, even while receiving treatment for that disease ([1](https://www.ncbi.nlm.nih.gov/books/NBK459437/)). Infection activates multiple components of the immune system, leading to immune dysregulation – a set of abnormal changes that disrupt the immune system ([2](https://www.sciencedirect.com/science/article/abs/pii/B9780444632692000404)). Although immune dysregulation may be induced without infection, microbes initiate autoimmunity in many susceptible people ([2](https://www.sciencedirect.com/science/article/abs/pii/B9780444632692000404), [3](https://pubmed.ncbi.nlm.nih.gov/31422877/)). Infection can also trigger signs, symptoms, and flare-ups and move more quickly in those who already have an autoimmune disease. ### Understanding Infection’s Influence on Autoimmunity Infection induces autoimmunity by activating autoantibodies and cells through different mechanisms. The following terms are helpful to know: ## Autoantibodies Antibodies that recognize antigens inherently present in the body of patients who have an autoimmune disease. These antigens are called [autoantigens or self-antigens.](https://pathology.jhu.edu/autoimmune/glossary-of-autoimmunity-terms) ## Molecular mimicry During infection, the similarities between the molecules that are part of microbes (i.e., bacteria and parasites) and the molecules from the immune system (self-peptides) trigger B and T cells, leading to autoimmunity. ([1](https://www.ncbi.nlm.nih.gov/books/NBK459437/),[ 2](https://www.sciencedirect.com/science/article/abs/pii/B9780444632692000404),[ 3](https://pubmed.ncbi.nlm.nih.gov/31422877/)). ## Epitope spreading, constant activation Persistent infection constantly stimulates the immune system and, thus, releases self-peptides, causing the tissue damage typical of autoimmune disease. ## Bystander activation Infection triggers a “cascade” of immune events in people with immune diseases like multiple sclerosis, leading to inflammation and swelling in different organs. ## Superantigens These microbial parts potently activate large numbers of T cells, which can dramatically change the immune system. These factors have been associated with the signs, symptoms, and flare-ups of [psoriasis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/psoriasis/). ## Clearance deficiency When the processes that recognize and fight microbes (e.g., phagocytosis) are deeply altered, the immune system cannot effectively fight off infection. This commonly occurs in people with lupus. ## Complement system This cascade-like process helps antibodies and immune cells attack and clear microbes from the body. Excessive activation and defects of the complement system may lead to the development of disorders like lupus and vasculitis ([4](https://pubmed.ncbi.nlm.nih.gov/31192812/)). ### Turning The Lens On Bacteria, Parasites, And Fungi Microbial infections influence the course of autoimmune disease in combination with other factors, such as the inner characteristics of a population or an individual person ([1](https://www.ncbi.nlm.nih.gov/books/NBK459437/),[ 5](https://pubmed.ncbi.nlm.nih.gov/19076824/)). A person’s microbiota consists of microbial communities that live in different body systems. Non-pathogenic (harmless) microorganisms like bacteria, protozoa, and fungi often cohabit in harmony in different body organs and promote human health in multiple ways. However, changes and imbalances in these microbial communities can turn “peaceful” microorganisms into opportunistic microbes, turning them into pathogens (capable of causing disease). Microbes that trigger autoimmunity are not always part of the body’s microbiota but can access organs and systems from the outside. Fundamentally, they invade the body and activate disease as foreign agents. Although investigators have studied the relationship between viruses and autoimmune disorders like [lupus](https://www.autoimmuneinstitute.org/medical_institutions/lupus-clinic/), [Sjögren’s syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sjogrens-syndrome/), [celiac disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/celiac-disease/), and [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/) ([6](https://pubmed.ncbi.nlm.nih.gov/31430946/)), the focus here will be on bacteria, parasites, and fungi. Research studies using genetic tools such as [infectomics](https://pubmed.ncbi.nlm.nih.gov/11957108/) (the study of structural and functional genomics and proteomics of microbial infections) and [autoinfectomics](https://pubmed.ncbi.nlm.nih.gov/25801879/) (the study of infectious-induced autoimmunity) will help us understand the relationship between these microbes and autoimmunity and explain why some people are more susceptible and why others may develop [more than one autoimmune disease](https://www.autoimmuneinstitute.org/2022/12/29/comorbidities-in-autoimmune-disease-multiple-autoimmune-syndrome/) ([7](https://pubmed.ncbi.nlm.nih.gov/25801879/)). #### Bacteria Infections caused by bacteria may trigger immune responses that either initiate or aggravate autoimmune diseases ([3](https://pubmed.ncbi.nlm.nih.gov/31422877/)). For example, gastroenteritis caused by *Salmonella* and genital infections caused by *Chlamydia* may trigger [reactive arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/reactive-arthritis/), which affects the joints and eyes and can last for several years ([3](https://pubmed.ncbi.nlm.nih.gov/31422877/)). Signs and symptoms of autoimmune arthritis may also be observed in people with untreated [Lyme disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/lyme-disease/), tuberculosis, and urinary tract infections ([1](https://www.ncbi.nlm.nih.gov/books/NBK459437/),[ 3](https://pubmed.ncbi.nlm.nih.gov/31422877/),[ 8](https://pubmed.ncbi.nlm.nih.gov/34226730/),[ 9](https://pubmed.ncbi.nlm.nih.gov/35430551/)). The stomach pathogen *Helicobacter pylori*, the enteric pathogen *Escherichia coli,* and the respiratory pathogen *Streptococcus pneumoniae* have all been associated with [lupus](https://www.autoimmuneinstitute.org/medical_institutions/lupus-clinic/) ([1](https://www.ncbi.nlm.nih.gov/books/NBK459437/),[ 10](https://pubmed.ncbi.nlm.nih.gov/31781110/)). Streptococci may also be involved in [psoriasis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/psoriasis/) development. *Acinetobacter* *and Pseudomonas aeruginosa,* were found to trigger autoantibodies against a myelin-specific protein and, thus, may play a role in [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/) development ([1](https://www.ncbi.nlm.nih.gov/books/NBK459437/)). Some bacteria form thin layers that stick to body surfaces, known as biofilms, which increase a microbe’s ability to cause disease. Biofilms carry structures that resemble the host’s, activating autoimmune responses ([3](https://pubmed.ncbi.nlm.nih.gov/31422877/)). #### Parasites Research studies have suggested that chronic infections caused by parasites like protozoa and worms may be linked to autoimmunity ([2](https://www.sciencedirect.com/science/article/abs/pii/B9780444632692000404)). Examples of protozoa (microbial parasites made of one cell) include *Plasmodium,* which causes malaria, and *Leishmania*, responsible for leishmaniasis. Autoantibodies and [autoimmune anemia](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-hemolytic-anemia/) have been detected in patients with malaria, but the connection with autoimmunity is poorly understood ([11](https://pubmed.ncbi.nlm.nih.gov/31864893/)). Cases of visceral leishmaniasis were associated with [lupus](https://www.autoimmuneinstitute.org/medical_institutions/lupus-center/), [autoimmune hepatitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-hepatitis/), and [primary biliary cirrhosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/primary-biliary-cirrhosis/) ([2](https://www.sciencedirect.com/science/article/abs/pii/B9780444632692000404)). The production of autoantibodies has also been observed with parasitic worm infections caused by fluke flatworms and roundworms ([2](https://www.sciencedirect.com/science/article/abs/pii/B9780444632692000404)). Parasitic worms are also being studied for use in autoimmunity therapy, but their role in autoimmune disease and health is still unclear ([12](https://pubmed.ncbi.nlm.nih.gov/28432858/),[ 13](https://pubmed.ncbi.nlm.nih.gov/16965287/)). #### Fungi Exposure to molds (fungi) and the toxins they produce (mycotoxins) is known to influence human microbiota and immunity and lead to the development of different diseases. Molds are known to trigger respiratory conditions such as asthma, and mycotoxins may have long-term effects such as cancer ([14](https://pubmed.ncbi.nlm.nih.gov/34830149/),[ 15](https://www.who.int/news-room/fact-sheets/detail/mycotoxins)). Although the involvement of molds and mycotoxins is well established in allergy, their role in autoimmunity is still being investigated. They were found to be linked to [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/) and [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/) in people with pre-existing immune dysregulation ([14](https://pubmed.ncbi.nlm.nih.gov/34830149/),[ 16](https://pubmed.ncbi.nlm.nih.gov/20214953/)). Evidence of the *Candida* yeast (also a fungus) was found in patients with multiple sclerosis, but the mechanisms behind this relationship are not fully understood ([17](https://pubmed.ncbi.nlm.nih.gov/20556470/),[ 18](https://pubmed.ncbi.nlm.nih.gov/23322279/)). ### Minimizing The Risks Of Infection If you have an autoimmune disease, take action to minimize the risks of infection. Practice good hand hygiene and avoid contact with people who are sick. Regularly check food for signs of mold and buy dry items such as rice and nuts as often as possible. Store and refrigerate food properly to eliminate the risk of both bacterial and fungal contamination. Always talk to your doctor about your concerns before taking any additional steps. ### **About The Author** **Damiana Chiavolini, MS, PhD** is a freelance writer who specializes in medical and life science topics. As a trained researcher, she authored journal articles in the areas of infection and immunity and wrote booklets and book chapters about different diseases. As a professional communicator, she writes feature articles for magazines and other publications and produces content for higher education platforms. Damiana is also an experienced academic editor, microbiology educator, writing coach, and fragrance blogger. She is a contributing member of the American Medical Writers Association and the immediate past-president of the association’s Southwest Chapter. ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** Living Well with Autoimmune Disease --- ### [What Is Gratitude?](https://www.autoimmuneinstitute.org/articles/what-is-gratitude) **Published:** November 13, 2023 **Author:** Carolyn Serraino **Content:** It’s been on the shortlist for buzzword of the year for quite some time, conjuring up images of peaceful, cross-legged yogis and hands pressed together in prayer. But how many of us know what it truly means and why it can lead to improvements in our mental and physical health? **Gratitude may be thought of as an emotion, a behavior, an attitude, or even a virtue.** While it is often represented as a simple “thank you” when receiving a gift or other kindness, gratitude goes much deeper. It is an active and profound appreciation for someone (including yourself) or something, that can have long-lasting positive and scientifically-measurable effects. This experience can elicit pleasurable feelings and positive emotions. > “I would maintain that thanks are the highest form of thought, and that gratitude is happiness doubled by wonder.” -G.K. CHESTERTON In *[The Science of Subjective Well-Being](https://www.autoimmuneinstitute.org/books-we-love/)*, Michael Eid and Randy Larsen explain that “at the cornerstone of gratitude is the notion of undeserved merit. The grateful person recognizes that he or she did nothing to deserve the gift or benefit; it was freely bestowed.” > **In gratitude, we acknowledge the goodness in life, whether we have a hand in it or not.** ### **The effects on our mind and body** Practicing gratitude produces both immediate and long-term effects. Even a few minutes of focusing on our own positive qualities, the kindness of others, or the beauty of the natural world can **enhance dopamine and serotonin**, some of the “feel-good” neurotransmitters that regulate mood and other bodily functions. > **A daily practice can even change neural structures in the brain and promote long-lasting feelings of happiness, reduce stress, and improve sleep (**[**1**](https://positivepsychology.com/neuroscience-of-gratitude/)**).** The benefits don’t stop there. Research has shown that gratitude can **decrease stress hormones like cortisol** and produce a “shift in autonomic balance toward increased parasympathetic activity,” otherwise known as the “rest and digest” state ([2](http://perpus.univpancasila.ac.id/repository/EBUPT190074.pdf)). Being in a state of chronic stress state can put a strain on your immune system and make you more susceptible to a [leaky gut](https://www.autoimmuneinstitute.org/2021/08/26/the-relationship-between-autoimmune-disease-and-the-gut-microbiome/ "The Relationship Between Autoimmune Disease and the Gut Microbiome") and/or chronic infections. For individuals experiencing anxiety, sensitivities, and other health issues who may be operating in a chronic “fight or flight” mode, sending the body into a relaxed state can positively impact health and aid in the healing process. A [study](https://pubmed.ncbi.nlm.nih.gov/26203459/) conducted by the Chopra Foundation in collaboration with the University of San Diego and the University of Sterling, Scotland, found that engaging in a regular gratitude practice was associated with **better mood, better sleep, less fatigue, and less inflammation** in the study participants who were asymptomatic heart failure patients. [Inflammation can cause autoimmune disease flare-ups and even directly trigger an autoimmune disease](https://www.autoimmuneinstitute.org/2022/09/16/inflammation-a-driving-force-of-autoimmune-disease/ "Inflammation: A Driving Force of Autoimmune Disease"), so reducing overall inflammation can help you slow down the progression of your autoimmune disease. People who consistently cultivate feelings of appreciation may also develop more optimism over time, better preparing them to navigate life’s challenges, such as autoimmune disease and chronic illnesses or the [COVID-19 pandemic](https://www.autoimmuneinstitute.org/2024/02/21/finding-balance-in-uncertain-times/). > Through gratitude, we are reminded that there is more to our lives than the suffering we endure. ### **Practicing gratitude** When you are managing a chronic health condition with a body that’s in pain or severely fatigued, it is not easy to think about the good things. That is ok! Let yourself feel frustration, anger, and sadness, and know that they can be experienced alongside an appreciation for the good in your life. Keep a daily gratitude journal, or simply jot down a few things you’re grateful for when you have a minute or two. Start with simple things, like the feeling of sunshine on your face or hugs from your kids, or think about a close friend or family member. Let go of expectations and focus on the act itself, rather than what you hope to gain from doing it. > Think not only of *what* you’re grateful for in your life, but ***why*** #### **Ways to practice gratitude:** - list 3 to 5 things you’re grateful for each morning or night - write yourself love notes or mantras to keep in visible places - send warm, sincere messages of appreciation to friends and family - create new family traditions or games to instill gratitude - follow guided meditations (such as loving-kindness) in apps like [Insight Timer](https://insighttimer.com/), [Headspace](https://www.headspace.com/headspace-meditation-app), [Calm](https://www.calm.com/), or [Happify](https://www.happify.com/) You may even set up a gratitude nook with candles, calming photos, items from nature like stones or leaves, and a peaceful music playlist. This can be a space to write in your gratitude journal, share quiet moments with your partner or family, or simply sit and let the calm wash over you. Practice gratitude in a way that feels good for you—your mind and body will thank you for it! ***Get your FREE gratitude journal worksheet in our [Autoimmune & Chronic Illness Toolkit](https://www.autoimmuneinstitute.org/autoimmune-chronic-illness-toolkit/)*** ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Gratitude-Journal-page.png) ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** Living Well with Autoimmune Disease --- ### [Breaking the Silence: Navigating Stigma and Shared Challenges in Long Covid and Autoimmune Disease](https://www.autoimmuneinstitute.org/articles/breaking-the-silence-navigating-stigma-and-shared-challenges-in-long-covid-and-autoimmune-disease) **Published:** January 19, 2024 **Author:** Carolyn Serraino **Excerpt:** “The hope is that the floodgates will open and that other people with invisible illnesses will be able to come to the table and talk about their invisible symptoms and be welcomed and embraced,” says James C. Jackson, Director of Long-Term Outcomes at the ICU Recovery Center at Vanderbilt University. **Content:** Individuals with Long Covid may experience debilitating symptoms – as well as associated stigmas. But in important respects, Long Covid has also contributed to a conversation about the de-stigmatization of chronic illnesses, including autoimmune disease. > “The hope is that the floodgates will open and that other people with invisible illnesses will be able to come to the table and talk about their invisible symptoms and be welcomed and embraced,” says James C. Jackson, Director of Long-Term Outcomes at the ICU Recovery Center at Vanderbilt University. Here, The Global Autoimmune Institute looks at some of the progress. ### **Parallel Symptoms Between Long Covid and Autoimmune Diseases** Long Covid can present over 200 symptoms, which cause issues throughout the body, including the nervous, cardiovascular, gastrointestinal, pulmonary, and immune systems. Symptoms include fatigue, muscle pain, joint aches, brain fog, headaches, dizziness, depression, anxiety, sleep problems, breathing difficulties, and loss of smell. Other research suggests that the “depletion of certain anti-inflammatory gut bacteria“ as a result of COVID-19 may lead to lingering inflammation or that some individuals may develop a leaky gut, which allows gut microbes to enter the bloodstream, leading to chronic inflammation. Those who report Long Covid symptoms may also experience immunologic dysfunction marked by alterations in immune cells and proteins. ([1](https://hms.harvard.edu/news/most-important-question-about-long-covid)) Symptoms of autoimmune diseases may include fatigue, joint pain and stiffness, muscle aches, skin problems, breathing difficulties, depression, anxiety, and fever. Imbalances in the microbiome may also be an activator for autoimmune conditions, with gut microbe health and autoimmune disease found to be closely related. For Dr. Melanie Sloan of the Department of Public Health and Primary Care at The University of Cambridge, fatigue is one of the most life-changing symptoms experienced by both patients with systemic autoimmune diseases and Long Covid. “It permeates – and often destroys – almost every aspect of people’s lives, from being unable to work, to socialize, to carry out all those roles and activities that give our lives meaning and pleasure,” she said. “I’ve interviewed many patients who have told me that they would happily lose decades of their lifespans in exchange for just a few years of having no fatigue since many have no quality of life at all.” ### **Stigmatization of Long Covid and Autoimmune Disease**  According to one study published in the journal [PLOS One](https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0277317), 95% of those suffering from Long Covid experienced stigma related to their condition. Roughly 61% of respondents said they were careful about who to talk about their illness to, and 34% said they had “sometimes“ regretted telling people that they had Long Covid. Individuals suffering from autoimmune diseases, such as [lupus](https://www.autoimmuneinstitute.org/medical_institutions/lupus-center/), [inflammatory bowel disease](https://www.autoimmuneinstitute.org/medical_institutions/inflammatory-bowel-disease-center/) (Crohn’s disease and ulcerative colitis), and [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/), have described similar sentiments. Up to 79% of individuals with a diagnosis of multiple sclerosis were found to have experienced some degree of stigma in the workplace, according to a [study](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9367867/) in the International Journal of Environmental Research and Public Health. In a separate study by Dr. Sloan and colleagues, it was found that **almost 50% of lupus patients experienced suicidal thoughts**, with interviews revealing that fatigue frequently made lives unbearable and or made people feel “worthless” and excluded. ([2](https://doi.org/10.1093/rheumatology/kead369)) > Those suffering from all types of chronic illness often share concerns that non-visible symptoms may be dismissed or scrutinized by doctors, employers, family, and friends. “We have found many similarities between Long Covid and autoimmune diseases such as lupus, not just in the shared persistent debilitating symptoms such as severe fatigue and cognitive dysfunction, but also in the frequently reported patient experiences of feeling these symptoms are not taken seriously by some clinicians and society,” Dr. Sloan said. “These symptoms often can’t be seen and can’t be tested for with blood tests and brain scans.” Symptoms may also shift or prove ambiguous, diagnoses may change, and accurate causes and treatment plans can be difficult to pinpoint. Medical practitioners, in turn, may have a limited understanding of what is actually occurring and how to provide care. “What you’re left with to make the diagnosis is the patient’s account and often we’ve found that unfortunately symptoms have to be seen to be believed and have to be personally experienced to be truly understood,” Dr. Sloan said. ### **Advances Related to Long Covid and Potential Impacts on Autoimmunity**  [![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/screenshot_2024-01-19_at_1.36.24_pm.png)](https://www.covid.gov/sites/default/files/documents/National-Research-Action-Plan-on-Long-COVID-08012022.pdf) The pandemic has led to extraordinary developments in funding, research, and knowledge for Long Covid. In 2023, the Department of Health and Human Services [announced](https://www.hhs.gov/about/news/2023/07/31/hhs-announces-formation-office-long-covid-research-practice-launch-long-covid-clinical-trials-through-recover-initiative.html) the formation of the Office of Long Covid Research and Practice, as well as Long Covid clinical trials through the National Institutes of Health (NIH). The trials are part of a $1.15 billion nationwide research program aimed at improving the lives of Long Covid patients. In addition, many researchers are exclusively dedicated to understanding the effects of Long Covid at a large network of more than 300 newly established clinics, such as the Center for Post-COVID Care at Mount Sinai in New York City. Other measures include support programs, such as [one](https://www.vanderbilthealth.com/service/adult-post-covid-clinic) at Vanderbilt University, which is actively helping patients cope with Long Covid. There is also ongoing work to illuminate the relationship between autoimmune disorders and COVID-19 directly, including therapies aimed at preventing overactive immune systems from [causing](https://www.nih.gov/news-events/news-releases/clinical-trial-test-immune-modulation-strategy-hospitalized-covid-19-patients-begins) severe symptoms. Among the disorders linked to COVID-19 are [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/), [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/), and [vasculitis](https://www.autoimmuneinstitute.org/medical_institutions/vasculitis-program/), as well as [inflammatory bowel disease](https://www.autoimmuneinstitute.org/medical_institutions/inflammatory-bowel-disease-center/) and [type 1 diabetes](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/diabetes-type-1/). In addition, research has shown that the risk of autoimmune and inflammatory diseases is significantly higher in individuals who have had COVID-19. One [study](https://www.nature.com/articles/s41584-023-00964-y), for example, identified a 42.6% higher likelihood of acquiring an autoimmune condition up to 15 months after an infection from Covid-19. Likewise, people with pre-existing autoimmune disease have been found to be at greater risk of having more severe COVID-19. ### **Going Forward**  James C. Jackson, who is also the author of “[Clearing the Fog: From Surviving to Thriving with Long Covid](https://www.amazon.com/Clearing-Fog-Surviving-Thriving-Practical/dp/0316530093#:~:text=Fog%2C%20neuropsychologist%20Dr.-,James%20C.,when%20to%20seek%20professional%20evaluations),” believes that divorcing Long Covid from other chronic conditions is a grave mistake, and he notes that chronic patients with so-called “invisible conditions” have had an impact on the course of Long Covid, too. “While those illnesses are not the same as Long Covid, they have taught us about how people thrive, about acceptance, about the role of mental health, about the impact of families, and about PTSD in the context of medical conditions,” he said. “We know a lot because we’ve observed many similar issues in patients with multiple sclerosis and lupus. And that understanding is highly relevant to engaging people with Long Covid.” Going forward, he hopes that any stigma related to chronic illness is increasingly replaced by a movement to be kind and thoughtful – and that patients are able to regain their trust in disclosing their conditions and symptoms to family, friends, and providers. ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** About Autoimmune Disease, COVID-19 and Long Covid --- ### [The Global Landscape of Autoimmune Disease](https://www.autoimmuneinstitute.org/articles/the-global-landscape-of-autoimmune-disease) **Published:** February 20, 2024 **Author:** Carolyn Serraino **Excerpt:** The exact percentage of the world’s population affected by autoimmune diseases is not well documented. Worldwide inequities and gaps in access to healthcare and data mean that the diagnosis and treatment of autoimmune diseases can differ significantly, which is a prime reason that much remains unknown. A broader lack of awareness around the burden of autoimmune disease is also a contributing factor. **Content:** # Bridging Gaps in Diagnosis, Treatment, and Awareness Autoimmunity has traditionally been associated with developed Western countries, with some studies showing a higher incidence rate in industrial regions such as Northern Europe and North America. According to one study, autoimmune diseases cumulatively affect 5 to 10% of the industrial world population ([1](https://www.sciencedirect.com/science/article/abs/pii/S0896841109001589)) ([2](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2783422/)). Other studies have shown that the prevalence of autoimmune disease in developing countries is lower ([3](https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(05)62867-X/fulltext)) but on the rise ([4](https://pubmed.ncbi.nlm.nih.gov/31854165/)). That being said, the exact percentage of the world’s population affected by autoimmune diseases is not well documented. The prevalence of autoimmune diseases can vary greatly between countries and regions, and the general discrepancy between developing and developed has been a subject of research and debate among scientists and healthcare professionals. Sandro Vento, Dean of the Faculty of Medicine at the University of Puthisastra, who has studied [autoimmune hepatitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-hepatitis/ "Autoimmune Hepatitis"), says it is virtually impossible to know what percentage of people or how many are affected by autoimmune diseases. “The number of studies is extremely small,” he says. “With so few reports and so few studies, researchers must rely on a small number of studies to extrapolate and estimate the prevalence rate.” One [study](https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(68)90595-3/fulltext) published in 1968 in *The Lancet*, for example, noted that in a Nigerian hospital, there were few autoimmune diseases. Vento has one response: “I’m not convinced.” ### **Autoimmune Disease in the Industrialized World vs Developing Countries** Many studies have explained a higher prevalence of autoimmune diseases in developed countries to be the impact of [environmental factors](https://www.autoimmuneinstitute.org/2022/08/24/autoimmunity-on-the-rise/ "Autoimmunity on the Rise"), such as pollution and [diet](https://www.autoimmuneinstitute.org/2023/08/16/culinary-medicine-autoimmunity-and-healthful-eating/ "Culinary Medicine: Autoimmunity and Healthful Eating"). Exposure to certain chemicals, toxins, and pollutants in the environment has also been found to increase the risk of developing autoimmune diseases. Determinants include diminished ultraviolet radiation exposure, a Western or affluence-related lifestyle, infection exposure, nutritional factors, and disease-specific precipitants like iodine exposure ([1](https://www.sciencedirect.com/science/article/abs/pii/S0896841109001589)). Additionally, the Western diet, which is high in processed foods, saturated fats, and sugar, has been linked to the development of autoimmune diseases. According to one study, commonly used industrial food additives, such as glucose, salt, emulsifiers, organic solvents, gluten, microbial transglutaminase, and nanoparticles, all increase intestinal permeability and the subsequent activation of the autoimmune cascade ([5](https://www.sciencedirect.com/science/article/pii/S1568997215000245)). Genetic factors are another underlying issue which have been found to predispose an individual to an autoimmune condition. Among patients with [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic Lupus Erythematosus") (SLE), for example, certain ethnic groups have been found to be more vulnerable than others, and the prevalence and mortality of the disease vary widely between geographic regions ([6](https://www.nature.com/articles/s41584-021-00668-1)). The epidemiology of [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/ "Multiple Sclerosis") (MS) also demonstrates the role of ethno-genetic factors. According to one study, MS is significantly more prevalent in Whites compared to Blacks and Asians. Some ethnic populations also seem disease-resistant, such as Northern Norwegians, Australian Aboriginals, New Zealand Maoris, natives of the Southern part of the former Soviet Union, and North and South American Indians ([1](https://www.sciencedirect.com/science/article/abs/pii/S0896841109001589)). ### **Geographic Differences in Diagnostics & Treatment for Autoimmune Disease** Worldwide inequities and gaps in access to healthcare and data mean that the diagnosis and treatment of autoimmune diseases can differ significantly ([7](https://www.sciencedirect.com/science/article/abs/pii/S1568997220300860.)), which is a prime reason that much remains unknown. “There is a huge lack of knowledge in many developing countries, and this makes diagnosis really difficult. It also explains why the number of cases and the overall prevalence of autoimmune diseases are likely to be understated,” says Vento. In developed countries, healthcare systems have advanced diagnostic tools and technology, which often allows for early detection and diagnosis. This includes access to laboratory tests, imaging studies, and specialized clinics for autoimmune disorders. Additionally, healthcare professionals in developed countries may have more training and experience with autoimmune diseases, which can lead to a more accurate diagnosis and management. Immunosuppressant drugs, biologics, and other targeted therapies can also help to reduce inflammation and slow the progression of diseases. In contrast, healthcare systems in developing countries may have limited access to similar tools and technology. In some countries, it can be difficult for people with autoimmune diseases to receive a proper diagnosis due to a lack of funding, a lack of trained healthcare professionals, and the limited availability of diagnostic tests ([1](https://www.sciencedirect.com/science/article/abs/pii/S0896841109001589)). “In a huge number of developing countries, there aren’t many rheumatologists or specialized doctors, so the diagnosis is likely to be much less than the real number of patients with these diseases,” says Vento. A broader lack of awareness around the burden of autoimmune disease is also a contributing factor. Since there are so many autoimmune diseases, and each individual disease is largely considered to be rare with the exception of [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid Arthritis"), they’re not top of mind. In addition to diagnosis delays, patients and medical providers are often unaware of what autoimmune disease involves. Non-specific symptoms can also make them difficult to diagnose. In many developing countries, treatments may be more limited and less effective, or they may focus on symptom management, such as pain relief and non-steroidal anti-inflammatory drugs (NSAIDs), which can lead autoimmune diseases to progress unchecked. “There may be more cases, but we cannot be sure, because even though Western countries also have problems in diagnosing autoimmune diseases, laboratories, and facilities are much more developed, and there are huge numbers of doctors and specialists,” Vento says. “It’s easier to make a diagnosis and receive patients in developed Western countries, but it’s much more difficult for a patient to present themselves to hospitals in developing countries where the doctor makes the right diagnosis.” ### **What can be done?** There are several additional strategies that can be implemented to combat autoimmune diseases: **Increasing awareness and education:** Raising awareness about autoimmune diseases and their symptoms more broadly can help patients and medical providers seek early diagnosis and treatment, which can improve outcomes and reduce disease severity. **Improving access to healthcare:** In developing countries, access to healthcare is often limited, which can make it difficult for people with autoimmune diseases to receive proper diagnosis and treatment. Improving access to drugs, diagnostic tools, and treatments can help reduce the burden of autoimmune diseases. **Developing new treatments:** Discovering more effective treatments is key to better management of autoimmune diseases. This can include therapies that target specific immune cells involved in the disease, as well as new drugs that have fewer side effects than current options. **Addressing environmental factors:** Identifying and addressing environmental factors that contribute to the development of autoimmune diseases, such as exposure to toxins and pollutants, can help reduce the risk of conditions in both developed and developing countries. **Filling gaps in data collection:** Gaining epidemiologic, demographic, and clinical data is essential to having a better understanding of diseases and improving patient outcomes. **Promoting healthy lifestyles:** Encouraging healthy lifestyle choices, such as regular exercise, healthy eating, and stress management, can help reduce the risk of autoimmune diseases. **Advancing research:** By understanding the underlying causes of autoimmune diseases, scientists can develop new treatments and prevention strategies that can help reduce the burden of conditions worldwide. According to Vento, developing countries often rely on guidance from the World Health Organization to determine health policy. Historically, the WHO has focused on infectious diseases, such as HIV and tuberculosis. While it’s recently begun to pay closer attention to non-communicable diseases, it still hasn’t issued guidance on autoimmune disease. “It is important to raise awareness, particularly with governments in developing countries, in addition to increasing coordination with the WHO,” says Vento. “If the WHO could more clearly establish the prevalence of autoimmune diseases in developing countries, it could push governments to do something more.” ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** About Autoimmune Disease --- ### [The Importance of Autoimmune Disease Research](https://www.autoimmuneinstitute.org/articles/bridging-hope-and-science-the-importance-of-autoimmune-disease-research) **Published:** March 6, 2024 **Author:** Carolyn Serraino **Excerpt:** What triggers autoimmunity? What drives its manifestations? Why do some succumb while others remain unscathed? And could restoring immune tolerance hold the key to salvation? **Content:** An estimated 23.5 million Americans are affected by autoimmune diseases. Well-known autoimmune diseases include [Hashimoto’s Thyroiditis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/hashimotos-thyroiditis/), [Graves’ Disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/graves-disease/), [Multiple Sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/), and [Rheumatoid Arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/). The causes of many autoimmune diseases remain unknown, and there is no cure or [single treatment](https://www.nih.gov/research-training/accelerating-medicines-partnership-amp/autoimmune-immune-mediated-diseases) for every person or autoimmune disease. ## **What are the goals of Autoimmune Disease research?** Some of the latest studies focus on common mechanisms related to the causes and factors of autoimmune diseases. According to a congressionally-mandated 2022 report by The National Academies of Sciences, Engineering, and Medicine ([1](https://nap.nationalacademies.org/catalog/26554/enhancing-nih-research-on-autoimmune-disease)), areas of autoimmune disease cure research opportunity include the following: **Genetics**: Identifying mechanisms underlying genotype–phenotype associations can help researchers better understand the role of genes in autoimmune diseases. **Environmental exposure**: Understanding exposures associated with diseases, in addition to the permutations of genes and environmental exposures that lead to autoimmune diseases may enable researchers to better target treatment **Biomarkers**: Traditional and novel biomarkers may enable disease prediction, ultimately delaying or preventing disease before clinical disease develops or modifying disease outcomes. **Sex**: Understanding the role that sex chromosomes, sex hormones, and the effects of environmental exposures on sex hormones have on the occurrence and pathogenesis of autoimmune disease. **Autoimmune disease complications**: Examining the patterns of complications may inform the understanding of pathophysiology and mechanistic pathways as well as approaches to patient care. **Mechanistic pathways as therapeutic targets**: Identifying additional proinflammatory signaling pathways and their cytokines may inform drug development. **Animal models of disease**: Developing improved animal models of disease can continue to define common genetic and environmentally induced mechanisms. ## **What are big questions that have yet to be answered?**  While research has made strides, understanding the pathogenesis of autoimmune disease and the events that provoke autoimmunity have been a major challenge. One [article](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4335798/) looked at some of the biggest questions that remain to be solved when it comes to the pathogenic mechanisms of autoimmune disorders. According to the researchers, those questions are: How is autoimmunity triggered? What components of the immune response drive the clinical manifestations of disease? What determines whether a genetically predisposed individual will develop an autoimmune disease? And is restoring immune tolerance the secret to finding cures for autoimmune disease? ([2](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4335798/)) ## **Approximately how much money is spent on AD research?**  The National Institute of Health (NIH), a key source of funding for auto-immune research, dedicates resources to areas including pre-clinical, clinical, biomedical, health services, behavioral and social research. Current support for autoimmune disease funding by the NIH was estimated to be around $1 billion [in 2022](https://report.nih.gov/funding/categorical-spending#/). As a percentage of overall NIH obligations, spending on autoimmune diseases has remained at 2.6 percent between 2013 and 2020. ([1](https://nap.nationalacademies.org/catalog/26554/enhancing-nih-research-on-autoimmune-disease "1")) ## **What are clinical studies?**  NIH [defines a clinical trial](https://grants.nih.gov/policy/clinical-trials/definition.htm) as a research study in which one or more human subjects are assigned to one or more “interventions.” The effects of those interventions on health and behavior are then studied. In many studies, neither the patient nor the doctor know what, if any, treatment is being received. According to the National Academies of Sciences, Engineering, and Medicine, from 2008 to 2020, there has been a greater percentage of clinical trials for autoimmune diseases including Type 1 diabetes, systemic lupus erythematosus, IBD, and rheumatoid arthritis, with a much smaller percentage seen for other autoimmune diseases. Inflammatory disorders of the brain, for example, are some of the most under-researched areas in neuroimmunology. “Some ongoing efforts are some of the first clinical trials seeking to understand which mitigation is actually best for these conditions,” said Elena Grebenciucova, an assistant professor of neurology at Northwestern University’s Feinberg School of Medicine. ## **What is the benefit of patient participation?** Clinical trials are a key way researchers determine how to reduce the effects of autoimmune diseases. Trials often show whether treatment is safe and effective and what side effects or complications may look like. To find out how you can participate, go to the NIH website. [Find a Clinical Trial](https://www.niaid.nih.gov/clinical-trials/find-a-clinical-trial) ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** About Autoimmune Disease --- ### [Age, Ethnicity, and Unexpected Connections in Autoimmune Risk Factors](https://www.autoimmuneinstitute.org/articles/age-ethnicity-and-unexpected-connections-in-autoimmune-risk-factors) **Published:** May 31, 2024 **Author:** Carolyn Serraino **Excerpt:** In the first two parts of this article series, we discussed factors that may lead to the development of autoimmune diseases or the occurrence of flare-ups of existing ones. We highlighted genetic susceptibility, gender and sex, lifestyle habits, medications, microbial imbalances, and stress, among other triggers. Our review continues with three additional risk factor categories, including age, ethnicity, and diseases that are not related to autoimmune diseases. **Content:** In the first two parts of this article series, we discussed factors that may lead to the development of autoimmune diseases or the occurrence of flare-ups of existing ones. We highlighted [genetic susceptibility, gender and sex](https://www.autoimmuneinstitute.org/7-ad-risk-factors/ "7 Risk Factors for Autoimmune Disease"), [lifestyle habits, medications, microbial imbalances, and stress](https://www.autoimmuneinstitute.org/articles/beyond-genes-and-smoking-5-more-triggers-that-heighten-autoimmune-disease-risk "Beyond Genes and Smoking: 5 More Triggers That Heighten Autoimmune Disease Risk"), among other triggers. Our review continues with three additional risk factor categories, including age, ethnicity, and diseases that are not related to autoimmune diseases. ### **1.** **Age** Autoimmune diseases may develop in childhood, adulthood, or later stages of life. Disease progression can vary depending on the age at which it first appears, a concept defined as *age at onset* ([1](https://pubmed.ncbi.nlm.nih.gov/22195277/)). For example, early age at onset can affect the severity of diseases, such lupus and type 1 diabetes, but may not be as important for rheumatoid arthritis and multiple sclerosis ([1](https://pubmed.ncbi.nlm.nih.gov/22195277/)). Diseases that affect younger people include [juvenile idiopathic arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/juvenile-idiopathic-arthritis-stills/), [juvenile dermatomyositis](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/juvenile-dermatomyositis/), [type 1 diabetes](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/diabetes-type-1/), and [scleroderma](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/scleroderma/) ([2](https://www.childrenshospital.org/conditions/autoimmune-diseases),[ 3](https://www.sciencedirect.com/science/article/abs/pii/S0140673607603638)). Alopecia areata and lupus can also manifest in childhood ([4](https://pubmed.ncbi.nlm.nih.gov/24383154/),[ 5](https://pubmed.ncbi.nlm.nih.gov/22451604/)), while [Raynaud’s syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/raynauds-syndrome/) is an example of an autoimmune disease that begins between 15 and 30 years old ([6](https://pubmed.ncbi.nlm.nih.gov/27311222/)). [Multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/) typically develops within the age range of 20 to 40 ([7](https://link.springer.com/article/10.1007/s100720070027),[ 8](https://pubmed.ncbi.nlm.nih.gov/15727228/)), while various forms of autoimmune arthritis (such as rheumatoid and psoriatic) can manifest at any age but were reported to peak between 30 and 55 years old ([1](https://pubmed.ncbi.nlm.nih.gov/22195277/),[ 9](https://pubmed.ncbi.nlm.nih.gov/19874432/)). [Sjögren’s syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sjogrens-syndrome/) and [Hashimoto’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/hashimotos-thyroiditis/) are more commonly found in middle-aged people ([10](https://pubmed.ncbi.nlm.nih.gov/15158743/),[ 11](https://pubmed.ncbi.nlm.nih.gov/31485975/)), while atherosclerosis and bullous pemphigoid were reported to develop in older individuals, including those aged 90 and older ([12](https://pubmed.ncbi.nlm.nih.gov/22773427/),[ 13](https://pubmed.ncbi.nlm.nih.gov/10426901/)). Despite the presence of autoantibodies that trigger autoimmunity, older people seem to be less susceptible to developing autoimmune diseases than children and middle-aged adults ([1](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3238350/)). This could be attributed to the presence of specialized immune cells (regulatory T cells) that play a role in preventing the development of disease signs and symptoms ([14](https://pubmed.ncbi.nlm.nih.gov/23556986/)). ### **2.** **Race, ethnicity, and geographic location** Autoimmune diseases affect people from all races, ethnicities, and geographic regions. Although certain autoimmune diseases appear to be more prevalent in specific populations, their diverse nature poses challenges in conducting extensive studies ([15](https://pubmed.ncbi.nlm.nih.gov/26223182/),[ 16](https://pubmed.ncbi.nlm.nih.gov/31733367/)). Over the years, lupus, as well as nephritis associated with lupus, sarcoidosis, and systemic sclerosis, have been reported to be prevalent in African Americans (17, 18, 19). In contrast, [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/), [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/), and [celiac disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/celiac-disease/) have been reported to be prevalent in people of Caucasian origin ([20](https://pubmed.ncbi.nlm.nih.gov/32946613/),[ 21](https://pubmed.ncbi.nlm.nih.gov/29551598/)). A study highlighted an increase in multiple sclerosis occurrence in African American populations ([22](https://pubmed.ncbi.nlm.nih.gov/31965878/)). The same study highlighted that multiple sclerosis is less common in Hispanic and Asian populations than in Caucasians of European descent ([22](https://pubmed.ncbi.nlm.nih.gov/31965878/)). In another study, researchers examined the occurrence of autoimmune diseases in different populations according to sex, race, and geographical area. Researchers specifically observed that the rates of lupus, multiple sclerosis, and rheumatoid arthritis varied in African American communities living in different regions of the US ([16](https://pubmed.ncbi.nlm.nih.gov/31733367/)). [Autoimmune hepatitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-hepatitis/) is known to affect people of all racial and ethnic backgrounds. However, a retrospective study reported it to be prevalent in Latino, Black, and Asian/Pacific Island communities living in underserved and vulnerable communities of San Francisco ([23](https://pubmed.ncbi.nlm.nih.gov/29890851/)). Systemic sclerosis has a high prevalence in Native Americans because of genetic predisposition caused by DNA variants. However, the development of the disease in these populations may also be connected to other genes and environmental factors ([24](https://pubmed.ncbi.nlm.nih.gov/8702445/)). Research has aimed to uncover how the connections between ethnic diversity, genetic susceptibility, and environmental factors influence autoimmunity in different populations. Despite the research advances, the underlying causes for the increased prevalence of autoimmune diseases in specific ethnic groups or geographic regions are still unknown. Scientists are actively engaged in investigating how social factors contribute to the severity and outcomes of diseases such as lupus ([25](https://pubmed.ncbi.nlm.nih.gov/34468428/)). The goal is to investigate the factors contributing to racial disparities in autoimmune diseases and improve the well-being of patients and their families by enhancing the accuracy of diagnosis and improving treatment options. ### **3.** **Illnesses and conditions (other than autoimmune diseases)** Certain illnesses and conditions can increase the likelihood of developing an autoimmune disease. Examples of these conditions are high blood pressure, high cholesterol, and high CRP levels (CRP is an inflammation marker that has been associated with cardiovascular disease, heart attack, and stroke). These factors have been identified as possible risks for developing autoimmune diseases, such as [arteriosclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/arteriosclerosis/) and [psoriasis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/psoriasis/) ([26](https://pubmed.ncbi.nlm.nih.gov/7843763/),[ 27](https://pubmed.ncbi.nlm.nih.gov/16624260/),[ 28](https://pubmed.ncbi.nlm.nih.gov/25870469/)). [Bullous pemphigoid](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/bullous-pemphigoid/) has various triggers and risk factors, including neurologic diseases such as Parkinson’s disease, Alzheimer’s disease, epilepsy, and stroke. Nevertheless, the mechanisms behind these complex relationships are poorly understood and should be studied further ([29](https://pubmed.ncbi.nlm.nih.gov/33050407/)). Our understanding of cancer’s role as a risk factor for the development of autoimmune diseases is still poor. Specifically, the association of bullous pemphigoid and different cancer types (kidney, laryngeal, blood) has been controversial ([29](https://pubmed.ncbi.nlm.nih.gov/33050407/)). Another example is the relationship between [vitiligo](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/vitiligo/) and melanoma, which remains unclear ([30](https://ard.bmj.com/content/78/Suppl_2/1633.1),[ 31](https://pubmed.ncbi.nlm.nih.gov/31731645/)). ### **Reduce your risk** If you have an autoimmune disease, talk to your doctor about ways to minimize flare-ups, effectively manage existing diseases and conditions, maintain a balanced diet, and adopt a healthy lifestyle. Remember that autoimmunity is a multifaceted condition triggered by tightly connected factors. However, belonging to a specific group or ethnic background and having the mentioned illnesses or conditions does not imply the development of an autoimmune disease. #### About the Author **Damiana Chiavolini, MS, PhD** is a freelance writer who specializes in medical and life science topics. As a trained researcher, she authored journal articles in the areas of infection and immunity and wrote booklets and book chapters about different diseases. As a professional communicator, she writes feature articles for magazines and other publications and produces content for higher education platforms. Damiana is also an experienced academic editor, microbiology educator, writing coach, and fragrance blogger. She is a contributing member of the American Medical Writers Association and the immediate past-president of the association’s Southwest Chapter. ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** About Autoimmune Disease --- ### [Stress & Autoimmune Disease: Navigating the Complex Relationship](https://www.autoimmuneinstitute.org/articles/stress-autoimmune-disease-navigating-the-complex-relationship) **Published:** June 3, 2024 **Author:** Carolyn Serraino **Excerpt:** Stress is a powerful and often underestimated force that can significantly impact our overall health, particularly when it comes to autoimmune diseases. While stress can sometimes act as a motivator, chronic and intense stress can lead to a cascade of negative health effects, particularly by disrupting the immune system's delicate balance. **Content:** Stress is a powerful and often underestimated force that can significantly impact our overall health, particularly when it comes to autoimmune diseases. While stress can sometimes act as a motivator, chronic and intense stress can lead to a cascade of negative health effects, particularly by disrupting the immune system’s delicate balance. This article explores the intricate relationship between stress and autoimmune diseases, examining how negative stressors can trigger and exacerbate these conditions. We delve into the physiological mechanisms of stress, its various manifestations, and its profound impact on specific autoimmune diseases, shedding light on the importance of managing stress for those affected by these chronic conditions. ### **What is Stress?**  Stress can be defined as a threat to homoeostasis, whether the threat is real or psychological ([1](https://www.frontiersin.org/articles/10.3389/fimmu.2020.01823/full)). But stress is not necessarily negative. An actress who is feeling stress before a production may feel energized to take to the stage. When a situation exceeds an individual’s ability to cope, however, negative stressors can occur. During a “fight or flight” response, for example, an individual can experience a quickened pulse, faster breathing, and increased blood pressure ([2](https://www.health.harvard.edu/blog/autoimmune-disease-and-stress-is-there-a-link-2018071114230)). “Our brains perceive events in our lives as stressful or not, and when they’re perceived as stressful, that results in the activation of certain areas of the brain, which includes the activation of pathways that release the so-called stress hormones norepinephrine, epinephrine and cortisol,” said Dr. Michelle Dossett, who has studied mind-body health. “These stress hormones have effects on all the organs and tissues of our bodies and can impact intestinal functions, cardiovascular functions and the immune system.” Responses to stressors vary, and an individual may generate a greater response depending on a situation’s intensity, controllability, and predictability. Persistent stress stemming from worry over issues including finances, health and relationships can also have long term negative effects ([2](https://www.health.harvard.edu/blog/autoimmune-disease-and-stress-is-there-a-link-2018071114230)). ### **Is Stress a Factor in the Development of Autoimmunity?** Stress may both trigger and exacerbate autoimmune disease. Up to 80% of patients have reported uncommon emotional stress before the onset of disease ([3](https://link.springer.com/chapter/10.1007/978-3-030-16996-1_6)). Researchers describe a sort of feedback loop: Stress not only causes disease, but disease causes significant stress in patients. In one study, researchers looked at more than 100,000 people with stress-related disorders. Compared to 126,000 of their siblings and another million without stress-related disorders, it found that those individuals were more likely to be diagnosed with an autoimmune disease or develop multiple autoimmune diseases ([4](https://jamanetwork.com/journals/jama/fullarticle/2685155)). However, an autoimmune condition may have already been present before the stress-related disorder was diagnosed or there may have been other explanations for the higher rate of autoimmune disease ([2](https://www.health.harvard.edu/blog/autoimmune-disease-and-stress-is-there-a-link-2018071114230)). ### **Which Autoimmune Diseases Have Been Associated with Stress?** Stress has been associated with rheumatoid arthritis, systemic lupus erythematosus, inflammatory bowel disease, multiple sclerosis, Graves’ disease and other autoimmune conditions. #### **Rheumatoid Arthritis and Stress** [Rheumatoid Arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid Arthritis") (RA) is an autoimmune disease that causes pain, swelling, stiffness and tenderness in the joints. It occurs when the immune system [destroys the synovial membrane](https://www.nccih.nih.gov/health/rheumatoid-arthritis-in-depth) in diarthodial joints. The symptoms of RA can prove stressing, but stress can make [tolerating the disease](https://www.niams.nih.gov/health-topics/rheumatoid-arthritis/basics/diagnosis-treatment-and-steps-to-take) more difficult and worsen the pain. #### **Stress and Multiple Sclerosis** [Multiple Sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/ "Multiple Sclerosis") (MS) is an autoimmune disease that affects the brain and spinal cord. It damages the myelin sheath, which surrounds and protects nerve cells. MS has been shown to be aggravated by exposure to stress. In [a study, around 80%](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3115807/) of patients with MS reported an unusual amount of stress **before** the onset of the disease. #### **Stress and Inflammatory Bowel Disease** Inflammatory bowel disease (IBDs), including [Crohn’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crohns-disease/ "Crohn’s disease") (CD) and [ulcerative colitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ulcerative-colitis/ "Ulcerative Colitis") (UC), is an intestinal inflammatory disease. Stress [has been found](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6821654/) to aggravate the disease and have an impact on the frequency of symptomatic flares. #### **Stress and Systemic Lupus Erythematosus** [Systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic Lupus Erythematosus") (SLE) is an autoimmune disease that can affect many parts of the body, including the skin, joints, heart, lungs, kidneys, circulating blood cells, and brain (5). Stress has been found to increase the incidence of SLE and [exacerbate symptoms](https://www.frontiersin.org/articles/10.3389/fimmu.2020.01823/full), including physical pain and sleep disturbances. #### **Stress and Graves’ Disease** [Graves’ disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/graves-disease/ "Graves’ disease") is an autoimmune disease that can cause [hyperthyroidism](https://www.niddk.nih.gov/health-information/endocrine-diseases/graves-disease) or an overactive thyroid. [Several studies](https://eje.bioscientifica.com/downloadpdf/journals/eje/168/1/R13.pdf) have found that stress hormones have an impact on the pathophysiology of Graves’ disease. #### **Stress and Type 1 Diabetes**  In [Type 1 diabetes](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/diabetes-type-1/ "Diabetes, Type 1 (T1D)"), the pancreas makes an insufficient amount of [insulin](https://www.cdc.gov/diabetes/basics/what-is-type-1-diabetes.html). Stress may cause blood sugar levels to rise and become more difficult to control, meaning patients may need to take higher insulin doses. #### **Stress and Psoriasis** [Psoriasis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/psoriasis/ "Psoriasis") is a [chronic inflammatory disease](https://www.niams.nih.gov/health-topics/psoriasis) in which the immune system becomes overactive, causing skin cells to multiply too quickly. A classic symptom is scaly patches of skin, usually on the scalp, elbows, or knees, although other parts of the body can also be affected. An [estimated 2%](https://www.sciencedirect.com/science/article/abs/pii/S1568997218301770) of the general population is affected. Stress, which can make itching worse, has been found to be a common trigger for a psoriasis [flare](https://www.psoriasis.org/life-with-psoriasis/). ### **What are the Different Types of Stress?**  Individuals vary in their ability to cope with stressful events ([5](https://www.niams.nih.gov/health-topics/lupus)). “What I find stressful and what you find stressful may be different,” said Dr. Michelle Dossett, who has studied mind-body health. > “Different things are stressful to different people.” Some stressors are common to all humans, such as having a spouse die or losing a job. But there are other physical, psychological and environmental sources of stress as well. Air pollution from sources including vehicle exhaust and forest fires, for example, can have detrimental effects on health and play a major role in various autoimmune diseases. Pollution includes solid, liquid and gas components such as: carbon monoxide, nitrogen dioxide, ozone, and sulfur dioxide ([5](https://www.niams.nih.gov/health-topics/lupus)). Stress can occur at any age — from early life stages to adulthood. ### **Is Stress a Trigger for Autoimmune Disease Flares?**  Symptoms of autoimmune diseases may ebb and flow ([6](https://www.womenshealth.gov/a-z-topics/autoimmune-diseases)), but during a flare, they may be sudden and severe. Stress is a common trigger. > “I can’t tell you how many patients I’ve seen who’ve had a major stressor and started to develop symptoms or had a flare of an ongoing condition,” > > said Dr. Michelle Dossett. A stressful event doesn’t mean someone will experience a flare. But sustained stress increases the risk. Becoming aware of what triggers symptoms can help alleviate flares or prevent them from becoming worse. Psychological and cognitive behavioral therapy aimed to reduce stress levels has also been shown to be effective in influencing better outcomes for many autoimmune diseases ([7](https://www.sciencedirect.com/science/article/abs/pii/S1568997218301770)). Dr. Dossett also studies yoga and breathing techniques which help to reset the body to a more normal homeostatic regulation. “It’s well-documented that the regular practice of meditation impacts the expression of genes involved in the production of inflammatory cytokines,” she said. “Meditating for 20 minutes a day creates changes that we can see in an MRI scan.” Data is still slim. “There haven’t been a lot of randomized, controlled trials of mind-body interventions in people with autoimmune conditions to show it reverses the disease course,” she said. But some studies have shown mind-body interventions which have improved quality of life and given patients additional options for improving their health. ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** Living Well with Autoimmune Disease --- ### [Understanding Autoimmune Disease in Children](https://www.autoimmuneinstitute.org/articles/understanding-autoimmune-disease-in-children) **Published:** September 3, 2024 **Author:** Carolyn Serraino **Excerpt:** Autoimmune diseases can affect people of all ages. While they are more common in adults during their reproductive years (20-40), some autoimmune diseases can appear in childhood. Early diagnosis and treatment are crucial for improving the lives of children and teens living with these conditions. **Content:** Autoimmune diseases can affect people of all ages. While they are more common in adults during their reproductive years (20-40), some autoimmune diseases can appear in childhood. Early diagnosis and treatment are crucial for improving the lives of children and teens living with these conditions. ## What Causes Autoimmune Diseases in Children? The specific causes of autoimmune diseases in children are unclear, but [genetics](https://www.autoimmuneinstitute.org/articles/how-sex-genetics-influence-autoimmunity "How Sex & Genetics Influence Autoimmunity") and [environmental](https://www.autoimmuneinstitute.org/articles/autoimmunity-on-the-rise "Autoimmunity on the Rise") factors likely play a role ([1](https://newsinhealth.nih.gov/2022/06/understanding-autoimmune-diseases)). Dr. Robyn Tiger, radiologist and certified Lifestyle Medicine physician, says, “Stress has a dual role in impairing immune system function.” She notes that stress increases the production of certain pro-inflammatory hormones, which can worsen autoimmune diseases such as [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid Arthritis") and [systemic lupus erythematous](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic Lupus Erythematosus"). ## What Are the Key Differences Between Autoimmune Diseases in Children and Adults? Children and teens are not little adults. Autoimmune disease may look quite different in youth than in their adult counterparts. > Youth may experience many of the generalized symptoms associated with autoimmune disorders as part of normal immune maturation. Dr. Chinwe Efuribe, a pediatrician and owner of Centered Youth Clinic and Consulting in Austin, TX, notes, “Because of normal expectations that young people will experience frequent immune responses as their systems mature, early identification of autoimmune conditions may be more challenging during this period compared to during adulthood.” Dr. Efuribe, acknowledges the challenges in recognizing autoimmune diseases in youth, saying, “Symptoms can be non-specific, attributed to isolated inflammatory responses or develop gradually with no early symptoms to identify. For example, fatigue, joint pain, and swelling are most associated with injuries or transient inflammatory conditions \[like\] infections in young people and do not always warrant initial blood testing.” Additionally, youth with certain autoimmune diseases, like [celiac disease](https://www.autoimmuneinstitute.org/diseases_list/celiac-disease/) ([2](https://pubmed.ncbi.nlm.nih.gov/37299501/)), [juvenile idiopathic arthritis](https://www.autoimmuneinstitute.org/diseases_list/juvenile-idiopathic-arthritis-stills/) ([3](https://pubmed.ncbi.nlm.nih.gov/32503658/)), and [type 1 diabetes](https://www.autoimmuneinstitute.org/diseases_list/diabetes-type-1/) ([4](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7424019/#:~:text=It%20has%20been%20reported%20recently,4:1%20(10).)), are more likely to develop other autoimmune diseases. ## What Are the Most Common Autoimmune Diseases in Children and Teens? While autoimmune diseases are uncommon in youth, some are seen more frequently than others. Recognizing how these diseases may present differently in youth can help improve diagnosis and management. #### [**Celiac disease**](https://www.autoimmuneinstitute.org/diseases_list/celiac-disease/) **(CD)** Triggered by consuming gluten, CD in children can cause various symptoms, including diarrhea, constipation, weight loss, delayed growth, iron deficiency anemia, and abdominal pain. Younger children often present with vague, unexplained symptoms such as chronic diarrhea, poor appetite, abdominal distension, and abdominal pain ([5](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8290992/)). #### [**Systemic lupus erythematosus**](https://www.autoimmuneinstitute.org/diseases_list/systemic-lupus-erythematosus/) **(SLE)**  SLE is a rare disease in children (only 10% of cases) that affects multiple organs. Compared to adults, children with SLE are more likely to have kidney, blood, and brain involvement ([6](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5964827/)). #### [**Juvenile idiopathic arthritis**](https://www.autoimmuneinstitute.org/diseases_list/juvenile-idiopathic-arthritis-stills/) **(JIA)** JIA encompasses various conditions causing inflammation in joints, eyes, skin, and internal organs. Symptoms appear before age 16 and last for at least six weeks. Pain, eye problems, and rashes are potential symptoms ([7](https://pubmed.ncbi.nlm.nih.gov/34425842/)). #### [**Type 1 diabetes mellitus**](https://www.autoimmuneinstitute.org/diseases_list/diabetes-type-1/) **(T1D)** T1D typically first appears in childhood. It affects the pancreas, causing low insulin and high blood sugar. Children with T1D often experience excessive thirst, urination, and weight loss. Diabetic ketoacidosis, a serious complication of high blood sugar, can be the first presentation in about a third of children ([8](https://pubmed.ncbi.nlm.nih.gov/29916386/)). ## What Should You Do If You Suspect Your Child Has an Autoimmune Disease? Having an autoimmune disease in childhood comes with unique challenges. Dr. Efuribe recognizes the diagnostic dilemma: “Compared to adults, children and teens may experience non-specific symptoms without notifying their caregivers/parents, so identifying onset or duration of symptoms may be difficult to pinpoint during history-taking.” If you’re concerned that your child or teen might be experiencing symptoms suggestive of an autoimmune disorder, take them to see a healthcare provider. Autoimmune diseases diagnosed in childhood can show worse outcomes both because of the duration of the disease and long-term treatment. Families have an important role in helping youth manage their disease. > Dr. Efuribe also stresses the importance of supporting older children and teens’ self-advocacy. She advises that families and youth track concerning symptoms. She says, “Families and youth can use calendars, diary, or notes section in a phone app to document symptoms by when they occur, how frequently they occur, what body parts are involved, and any associated factors that alleviate or aggravate the symptoms. ### Additional Tips to Consider for Managing Autoimmune Diseases in Children **Education**: Families can help a youth living with an autoimmune disease understand their condition. Explaining what’s happening to their bodies can help ease anxiety. They can also learn to recognize symptoms, actively engage in treatment, and make informed decisions about their care. **Medical care:** Autoimmune diseases are complex and can be even more challenging to diagnose, understand, and manage in youth. These diseases are often missed in young people and can require the involvement of various specialties, such as endocrinologists, rheumatologists, or neurologists. Families must also consider the potential side effects of long-term treatments with medications such as corticosteroids. Families can be advocates for their children and teens, helping them get the most appropriate care. **Lifestyle**: The choices we make can play a significant role in preventing and managing autoimmune diseases. Dr. Tiger stresses the importance of the basics, such as choosing healthful foods, getting nourishing sleep, and moving your body. She also emphasizes the importance of having a supportive network of family and friends. In addition to helping with loneliness, she notes, “Social connection increases the binding hormone, oxytocin, which decreases stress and anxiety and enhances immune system function.” ## What’s on the Horizon for Understanding and Treating Autoimmune Disease in Children and Teens? Research is ongoing to improve the early detection of autoimmune diseases in children. Early diagnosis allows prompt treatment, potentially slowing disease progression and improving long-term outcomes. Additionally, the development of more targeted therapies holds promise for better management in the future. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/09/image.png) ##### About the Author **Tracy Asamoah, MD**, is a writer, child and adolescent psychiatrist, and leadership coach based in Austin, Texas. She completed her medical education at the University of California, San Francisco, and her general psychiatry residency and child and adolescent fellowship at the David Geffen UCLA School of Medicine. Tracy has served on the faculty of the University of New Mexico School of Medicine and the Texas A&M School of Medicine. Tracy’s journey into the world of autoimmune diseases began when she experienced sudden onset symptoms of multiple sclerosis early in her medical career. This personal experience, combined with her intense curiosity, has informed her work and writing in the field. As a writer, Tracy has contributed to various books and written articles related to mental health. She’s also written on various medical topics regularly contributing to publications such as GoodRx, Psychology Today, and Psychotherapy.net ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** Diagnosis & Treatment --- ### [The Role of Epigenetics in Autoimmune Disease](https://www.autoimmuneinstitute.org/articles/the-role-of-epigenetics-in-autoimmune-disease) **Published:** November 22, 2024 **Author:** Carolyn Serraino **Excerpt:** How DNA modifications impact gene expression, immune regulation, and future therapies. **Content:** DNA is made of a string of molecules designated by the letters, A’s, G’s, T’s, and C’s. The order of these molecules determines the sequence of your genes, the proteins they encode, and the functions these proteins carry out. But ultimately, it’s not just your DNA sequence that determines what goes on in your cells. Enter epigenetics. ## What is Epigenetics? While the genes in your body govern what proteins are made, the gene sequence itself doesn’t determine *when* the proteins are made. **Epigenetics, or modifications to the DNA that don’t directly alter its sequences, governs when specific genes are turned on or off**. Christopher Lessard, a Professor at Oklahoma Medical Research Foundation and Adjunct Associate Professor at the University of Oklahoma Health Sciences Center, compares epigenetics to the brakes and accelerator of a car. > “It makes it so that things don’t spontaneously go when they’re not supposed to and they stay stopped if they’re supposed to.” “**Even though the DNA is the same, the layers of epigenetic marks make gene expression happen differently, and that’s what’s changing the functionality of cells**,” says Montserrat Anguera, Associate Professor at the University of Pennsylvania School of Veterinary Medicine. ### What Types of Epigenetic Modifications Are There? ## DNA methylation DNA methylation is a type of epigenetic mark that is added to specific sequences within the DNA sequence ([1](https://www.nature.com/articles/npp2012112)). Methylation results in changes in gene expression, but whether it activates or inhibits a gene depends on where methylation occurs and the specific gene involved. Methylation is a natural process carried out by specific enzymes in the cell beginning during embryonic development. ## Histone modifications In the cell, DNA is wound around spool-like proteins called histones. These structures then assemble into a highly organized fiber called chromatin. Because DNA strands are so long, histones protect them from being tangled and damaged. Histones also have a role in regulating whether a gene is turned on or off. ## Non-coding RNAs A plethora of non-coding RNA, or RNAs that do not code for proteins, regulate expression of genes. “There are a lot more non-coding RNAs than there are protein-coding RNAs,” says Lessard. These non-coding RNAs regulate whether proteins are made or not and modulate chromatin remodeling, DNA methylation, or histone modification ([2](https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2020.598817/full)). ## How do Environmental Factors and Lifestyle Impact Epigenetic Modifications? In 2010, researchers from Bellvitge Biomedical Research Institute (IDIBELL) published a paper that describes lupus cases in identical twins. In most cases where one twin developed lupus, the other twin did not ([3](https://genome.cshlp.org/content/20/2/170.full.pdf)). > When they looked at pairs of twins where only one twin developed lupus, they found widespread changes in DNA methylation patterns in a number of genes. Because the twins are genetically identical, a possible culprit to the discordance is the impact of environmental and lifestyle factors on the epigenome. #### **Many studies have found that the epigenome can change from exposure to:** - Air pollution - Smoking - Radiation - Metals such as arsenic, lead, and mercury - Specific nutrients from food - Stress ## How do Epigenetic Modifications Impact Autoimmunity? Because epigenetic modifications impact gene expression, modifications affecting the expression of immune-related genes, such as those involved in immune regulation or self-tolerance, can contribute to the susceptibility or progression of autoimmunity. Scientists have found connections between epigenetic marks and a variety of autoimmune diseases. The contributions of epigenetics in autoimmune disease are complex and can involve global changes in epigenetic marks (ex: decrease in epigenetic marks throughout the genome in a certain cell type), epigenetic changes at specific sites on DNA, or a combination of both. ### Epigenome changes in autoimmune diseases ## Lupus Several studies have found abnormal non-coding RNA expression in T cells in lupus ([4](https://www.sciencedirect.com/science/article/pii/S1521661618301189#bb0235)). Interferon-related genes are also widely demethylated in neutrophils, a type of white blood cell ([5](https://www.sciencedirect.com/science/article/pii/S0896841115000050?via%3Dihub)). Abnormal demethylation patterns in CD4+ T cells may also explain why T cells are over-reactive in systemic lupus erythematosus ([6](https://pubmed.ncbi.nlm.nih.gov/21436623/)). ## Rheumatoid arthritis Global hypomethylation can be seen in the T cells in the context of rheumatoid arthritis ([7](https://onlinelibrary.wiley.com/doi/10.1002/art.1780331109)). ## Sjögren’s disease Overexpression of a long non-coding RNA normally found to influence the expression of interferon and the adaptive immune response can be seen in Sjögren’s disease ([8](https://rmdopen.bmj.com/content/8/2/e002672.long)). Its overexpression may lead to dysregulated T cell inflammatory pathways. ## Systemic sclerosis Scientists have found abnormal DNA methylation globally and in specific genes in CD4+ T cells in systemic sclerosis ([4](https://www.sciencedirect.com/science/article/pii/S1521661618301189#bb0235)). Aside from links of epigenetic alterations to specific autoimmune diseases, epigenetics may explain why autoimmune diseases affect women at far greater rates than in men. Normally, epigenetic modifications silence the genes on one of the two X chromosomes in women. A long non-coding RNA, called [Xist](https://www.autoimmuneinstitute.org/research_updates/why-are-females-more-likely-to-develop-autoimmune-disease-than-males/ "Why Are Females More Likely to Develop Autoimmune Disease Than Males?"), normally coats the inactive X chromosome. The X chromosome has a high density of immune-related genes, which is why improper inactivation impacts rates of autoimmunity. “If you look at T cells and B cells from patients with autoimmune disease, in lupus specifically, we see that Xist is not localized properly around the inactive X chromosome,” says Anguera, who studies the contribution of X-chromosome inactivation in female-biased autoimmunity. ## Epigenetic Biomarkers for the Detection of Autoimmune Disease As several studies have found differences in the epigenetic landscape in autoimmune disease, is it possible for altered epigenetic marks to be used as biomarkers for disease? Currently, there aren’t any clinical tests targeted towards the epigenome, says Anguera. Lessard adds that “gene involvement is more likely to be used sooner for diagnosis than epigenetic changes.” But in the future, it might be possible that epigenetics can be used as biomarkers clinically. As an example, methylation of a region of DNA called the IFI44L promoter is being explored as a biomarker for SLE diagnosis ([9](https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC4955646&blobtype=pdf)). In an [article discussing epigenetic markers in various autoimmune diseases](https://pubmed.ncbi.nlm.nih.gov/29574040/), Haijing Wu and colleagues from Hunan Key Laboratory of Medical Epigenomics wrote “genetic biomarkers might predict the future manifestations, while epigenetic and protein biomarkers might reflect disease activity and drug response” ([4](https://pubmed.ncbi.nlm.nih.gov/29574040/)). > In other words, our DNA can give us indications that an autoimmune disease might develop, while epigenetic and protein biomarkers reveal what’s actively going on in our bodies. ## The Future of Epigenetics-Based Therapies to Treat Autoimmune Disease Currently, epigenetics based therapies are at the beginning stages of development. “There are a number of epigenetic targeted inhibitors that have been developed that have efficacy in cancer. There’s some work suggesting that targeting these same complexes might be effective in the context of lupus,” says Anguera. An example of a cancer therapeutic being repurposed for autoimmune diseases is IOX1, which is being studied as a cancer therapy. Preclinical studies have found that IOX1, which impacts DNA methylation, can be used to treat inflammation of the eye ([1](https://www.thelancet.com/journals/ebiom/article/PIIS2352-3964(22)00515-1/fulltext)[0](https://www.thelancet.com/journals/ebiom/article/PIIS2352-3964(22)00515-1/fulltext)). Anguera also points out that other DNA methylation inhibitors could be effective to treat lupus. However, “it’s a bit more challenging in autoimmunity,” says Lessard. “In situations of cancer, you’re targeting some sort of lesion where drug delivery is a little bit more obvious.” For autoimmunity however, these drugs could cause widespread immune suppression, which could interfere with our ability to fend off infections. “We have to balance the unnecessary level of infection with the efficaciousness of the drug,” says Lessard. For the field as a whole, epigenetics has benefited from recent technological developments like CRISPR, which gives scientists the ability to easily edit cells and organoids derived from pluripotent stem cells, says Lessard. “I think those things coupled together are really going to enable us to figure out what’s the target genes, and then we can really start thinking about how the epigenetic changes are really impacting gene expression in a cell type and context-specific manner,” says Lessard. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/04/GAI-Logo-Image-811x1024.png) #### About the Author ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/10/Jennifer-Tsang-Bio-Headshot-e1729699053652.jpg) A microbiologist turned freelance science writer who works with life science companies, nonprofits, and academic institutions on anything from news stories, explainer articles, and content marketing. She shares the wonderful world of microbes on her blog The Microbial Menagerie. Jennifer Tsang, PhD Freelance Writer for GAI ![author avatar](https://secure.gravatar.com/avatar/c1b0d4d8fcd53b21d24c857cf4df779f19499650bb97b211d0037a9f2185d8cf?s=300&d=mm&r=g) Carolyn Serraino [See Full Bio](https://www.autoimmuneinstitute.org/author/carolynserraino/) **Categories:** About Autoimmune Disease --- ## Pages ### [Homepage](https://www.autoimmuneinstitute.org/) **Published:** February 23, 2024 **Author:** Carolyn Serraino **Excerpt:** The Global Autoimmune Institute is empowering solutions in the diagnosis and treatment of autoimmune disease through research, education, and validation. **Content:** Your browser does not support the video tag. ##### LEAD DAY 2026 HIGHLIGHTS ## What’s Next in Autoimmune Research Experts explored how AI, multi-omics, and new approaches to measuring immune health could help researchers better understand autoimmune and other complex chronic diseases. See highlights from the event, watch the scientific panel, and access the new resource guide. [See More](https://www.autoimmuneinstitute.org/research_updates/lead-day-2026-highlights/) ![-desc](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/07/How-to-Support-Someone-with-Autoimmune-Disease-1.jpg) ##### Guidance for Family, Friends, and Caregivers ### How to Support Someone with Autoimmune Disease When someone you love is living with a complex health condition, your support matters. Learn practical ways to communicate, respect boundaries, and help them feel seen, heard, and supported. [Learn More](https://www.autoimmuneinstitute.org/articles/how-to-support-someone-with-autoimmune-or-chronic-disease) ![is it an autoimmune disease-desc](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/07/Autoimmune-or-not-homepage.jpg) ##### The Diseases That Blur the Lines # Autoimmune or Not? 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Covid-19 Antibodies - Covid-19 Vaccines September 8, 2026 [ Paul Offit on Vaccine Trust, Policy, and Public Communication Dr. Paul Offit reflects on vaccine trust, lessons from the COVID-19 pandemic, and why clear,… ](https://www.autoimmuneinstitute.org/covid_timeline/paul-offit-vaccine-trust-public-communication/) August 20, 2026 [ Vaccine Responses Vary Even Among Immunosuppressed Individuals Many studies have looked at how our immune system responds to a vaccine by measuring… ](https://www.autoimmuneinstitute.org/covid_timeline/vaccine-responses-vary-even-among-immunosuppressed-individuals/) - Autoimmune Diseases & Covid-19 - Covid-19 Antibodies August 13, 2026 [ Study Identifies Molecular Pathways Involved in COVID-19-Related Heart Damage Researchers identified changes in gene regulation associated with inflammation, fibrosis, and heart muscle damage following… ](https://www.autoimmuneinstitute.org/covid_timeline/covid-19-heart-damage-molecular-pathways/) - Covid-19 Infections - Covid-19 Research Studies August 5, 2026 [ COVID-19 May Reactivate Dormant Viruses, Study Finds A large study of people hospitalized with COVID-19 found that the infection was frequently accompanied… ](https://www.autoimmuneinstitute.org/covid_timeline/covid-19-may-reactivate-dormant-viruses-study-finds/) - Covid-19 Antibodies - Covid-19 Infections July 21, 2026 [ Resources for Interpreting Long COVID Clinical Trials As Long COVID clinical trials continue to report new findings, understanding how to interpret those… ](https://www.autoimmuneinstitute.org/covid_timeline/resources-for-interpreting-long-covid-clinical-trials/) - Covid-19 Clinical Trials - Long COVID July 16, 2026 [ RECOVER-TLC July 2026 Update: Long COVID Clinical Trial Progress The NIH hosted a community webinar on July 16, 2026, to provide updates on the… ](https://www.autoimmuneinstitute.org/covid_timeline/recover-tlc-july-2026-update-long-covid-clinical-trial-progress/) - Covid-19 Clinical Trials - Covid-19 Research Studies July 13, 2026 [ COVID-19 and Autoimmune Disease: Current Evidence A new review published in the Korean Journal of Internal Medicine synthesizes evidence from epidemiologic studies, immunology… ](https://www.autoimmuneinstitute.org/covid_timeline/covid-19-and-autoimmune-disease-current-evidence/) - Autoimmune Diseases & Covid-19 - Celiac disease & Covid-19 July 1, 2026 [ The Future of Wastewater Surveillance and Immune Research During the COVID-19 pandemic, wastewater surveillance transformed how scientists tracked the spread of disease, providing… ](https://www.autoimmuneinstitute.org/covid_timeline/the-future-of-wastewater-surveillance-and-immune-research/) - Autoimmune Diseases & Covid-19 - Covid-19 Antibodies June 8, 2026 [ New NIH-Funded Trial Tests Different Approaches to Long COVID Fatigue A new NIH-funded clinical trial will test whether rehabilitation and pacing strategies should be tailored… ](https://www.autoimmuneinstitute.org/covid_timeline/new-nih-funded-trial-tests-different-approaches-to-long-covid-fatigue/) - Covid-19 Research Studies - Long COVID [ COVID-19 and AD Research & News ](https://www.autoimmuneinstitute.org/covid-timeline/) ![United States map with pins](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/04/Mask-group-1.webp) ## Find Medical Institutions That Treat Autoimmune Disease A comprehensive list of medical institutions across the United States specializing in diagnosing and treating various autoimmune diseases in an easy-to-use keyword and location search format. 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Confirm GAI as a trusted autoimmune disease news source to make it easier to find our latest resources and updates. [ ![Add Global Autoimmune Institute as a preferred source on Google](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/08/google_preferred_source_badge_light_en@2x.png) ](https://www.google.com/preferences/source?q=https://www.autoimmuneinstitute.org) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/GAI-Logo-Image-e1707845715517.png) ### Autoimmunity: Risk & Triggers ### Autoimmunity: Risk & Triggers A closer look at the factors that may influence autoimmune disease development, from genetics and early immune changes to inflammation and the exposome, including environmental and chemical exposures, stress, and trauma. ![Industrial facility beside polluted water with discarded chemical containers, representing environmental chemical exposure and autoimmune disease risk.](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/08/Chemical-Exposure-and-Autoimmune-Disease-1024x576.jpg) Chemical Exposure and Autoimmune Disease: What the Research Shows Which chemicals are linked to autoimmune disease? Experts explain what research shows about PFAS, pesticides, heavy metals, TCE, silica, and why proving causation is so difficult. Living Well with Autoimmune Disease [Read Post Chemical Exposure and Autoimmune Disease: What the Research Shows](https://www.autoimmuneinstitute.org/articles/chemical-exposure-autoimmune-disease) ![Illustration of a person surrounded by reaching shadow-like hands, representing trauma, chronic stress, and their potential effects on health and autoimmune disease.](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/08/trauma-autoimmune-disease-stress-response-1024x576.jpg) Trauma and Autoimmune Disease: What the Research Shows Research suggests trauma and PTSD may affect inflammation, immune function, and autoimmune disease risk. Here’s what scientists know about the connection. Living Well with Autoimmune Disease [Read Post Trauma and Autoimmune Disease: What the Research Shows](https://www.autoimmuneinstitute.org/articles/trauma-and-autoimmune-disease) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2023/03/Genetic-Factors-2-1024x576.png) How Sex & Genetics Influence Autoimmunity “There are very few conditions besides autoimmunity which have such remarkable differences in sex bias” says Veena Taneja of the Mayo Clinic, who is currently working with rheumatoid arthritis-associated bacteria in mouse models to define sex-specific responses and mechanisms. The reasons for such disparities are not fully understood, but Taneja says genetics, epigenetics, hormones, environmental exposures, diet, and lifestyle may all play a role. “It is a complex story,” she says. Autoimmunity affects both males and females, but the mechanisms that drive the process may differ between the sexes. Overall, autoimmune diseases are more prevalent in females than males, with females \[…\] About Autoimmune Disease [Read Post How Sex & Genetics Influence Autoimmunity](https://www.autoimmuneinstitute.org/articles/how-sex-genetics-influence-autoimmunity) ![Conceptual medical illustration of a human silhouette showing the effects of environmental and lifestyle factors on autoimmune disease risk, including airborne pathogens, lung exposure, stress-related brain activity, and gut microbiome dysbiosis.](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/08/environmental-toxins-autoimmune-disease-2-1024x576.jpg) Environmental Toxins and Autoimmune Disease Environmental toxins are part of everyday life, but not all exposures carry the same risk. Learn how pollutants, household chemicals, and other toxins may affect immune health, who may be more vulnerable, and practical ways to reduce exposure. Living Well with Autoimmune Disease [Read Post Environmental Toxins and Autoimmune Disease](https://www.autoimmuneinstitute.org/articles/environmental-triggers-autoimmune-disease) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/05/Age-Ethnicity-and-Unexpected-Connections-in-Autoimmune-Risk-Factors-1024x576.png) Age, Ethnicity, and Unexpected Connections in Autoimmune Risk Factors In the first two parts of this article series, we discussed factors that may lead to the development of autoimmune diseases or the occurrence of flare-ups of existing ones. We highlighted genetic susceptibility, gender and sex, lifestyle habits, medications, microbial imbalances, and stress, among other triggers. Our review continues with three additional risk factor categories, including age, ethnicity, and diseases that are not related to autoimmune diseases. About Autoimmune Disease [Read Post Age, Ethnicity, and Unexpected Connections in Autoimmune Risk Factors](https://www.autoimmuneinstitute.org/articles/age-ethnicity-and-unexpected-connections-in-autoimmune-risk-factors) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/04/EXAMINING-PRE-AUTOIMMUNITY-CAN-AUTOIMMUNE-DISEASE-BE-PREVENTED-1024x576.png) Examining Pre-Autoimmunity: Can Autoimmune Disease Be Prevented? The period between the onset of asymptomatic autoimmunity and the development of symptomatic disease is referred to as “pre-clinical” autoimmunity, as the appearance of autoantibodies precedes most autoimmune diseases. While there is currently no way to prevent someone from developing an autoimmune disease, there are promising advancements in scientific discovery. Diagnosis & Treatment [Read Post Examining Pre-Autoimmunity: Can Autoimmune Disease Be Prevented?](https://www.autoimmuneinstitute.org/articles/examining-pre-autoimmunity-can-autoimmune-disease-be-prevented) ![Conceptual medical illustration of a human silhouette showing the effects of environmental and lifestyle factors on autoimmune disease risk, including airborne pathogens, lung exposure, stress-related brain activity, and gut microbiome dysbiosis.](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Environmental-and-Lifestyle-Risk-Factors-for-Autoimmune-Disease-1024x576.jpg) Environmental and Lifestyle Risk Factors for Autoimmune Disease Learn more about how pathogen influences, dysbiosis, dietary impacts, environmental triggers, and stress connections increase your risk of developing an autoimmune disease. About Autoimmune Disease [Read Post Environmental and Lifestyle Risk Factors for Autoimmune Disease](https://www.autoimmuneinstitute.org/articles/beyond-genes-and-smoking-5-more-triggers-that-heighten-autoimmune-disease-risk) ![Conceptual medical illustration of a human silhouette containing DNA, chromosomes, immune cells, inflamed adipose tissue, pathogens, smoke, and molecular structures representing seven major risk factors for autoimmune disease.](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/07/7-risk-factors-for-autoimmune-disease-1024x576.jpg) 7 Risk Factors for Autoimmune Disease While researchers are still digging for answers on exactly what causes over 80 autoimmune diseases, there are certain risk factors that are believed to impact immune tolerance and may lead to the development of autoimmune conditions. [Read Post 7 Risk Factors for Autoimmune Disease](https://www.autoimmuneinstitute.org/7-ad-risk-factors/) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Inflammation-A-Driving-Force-of-Autoimmune-Disease-1-1024x576.jpg) Inflammation: A Driving Force of Autoimmune Disease An abnormal inflammatory response is involved in the majority of acute and chronic conditions, with strong evidence linking chronic inflammation to the pathogenesis of autoimmune disease (1,2,3). About Autoimmune Disease [Read Post Inflammation: A Driving Force of Autoimmune Disease](https://www.autoimmuneinstitute.org/articles/inflammation-a-driving-force-of-autoimmune-disease) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Stress-Autoimmune-Disease-Navigating-the-Complex-Relationship-1024x576.jpg) Stress & Autoimmune Disease: Navigating the Complex Relationship Stress is a powerful and often underestimated force that can significantly impact our overall health, particularly when it comes to autoimmune diseases. While stress can sometimes act as a motivator, chronic and intense stress can lead to a cascade of negative health effects, particularly by disrupting the immune system’s delicate balance. Living Well with Autoimmune Disease [Read Post Stress & Autoimmune Disease: Navigating the Complex Relationship](https://www.autoimmuneinstitute.org/articles/stress-autoimmune-disease-navigating-the-complex-relationship) ### Autoimmune Disease Spotlight ### Autoimmune Disease Spotlight In-depth looks at individual autoimmune diseases and conditions, bringing together current research, clinical understanding, and practical information about how they develop, are diagnosed, and affect the body. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/04/Vitiligo-What-We-Know-and-What-We-Dont-Know-1-e1746714296437-1024x576.png) Vitiligo: What We Know and What We Don’t Know Vitiligo is an autoimmune disease characterized by a loss of pigment (color) in the skin, resulting in lighter spots or patches that may gradually expand. While it commonly affects a person’s face, hands, arms, feet, and legs, vitiligo patches can also appear anywhere else in the body.   How Does Vitiligo Develop? Cameron Coury, MD, a dermatologist at Dermatologist Specialists in Richardson, TX, mentions that vitiligo often begins on areas of the face. “Vitiligo can start as one small light patch, or as several patches around eyes, nose, or mouth,” she says. Vitiligo arises when melanocytes, the cells that produce melanin, die \[…\] About Autoimmune Disease [Read Post Vitiligo: What We Know and What We Don’t Know](https://www.autoimmuneinstitute.org/articles/vitiligo-what-we-know-and-what-we-dont-know) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Autoimmunity-The-Eyes-1024x576.png) Autoimmunity and the Eyes: A Spotlight on Uveitis Uveitis presents as inflammation inside the part of your eye called the uvea and can also affect other parts of the eye. Uveitis can involve one or both eyes and can cause pain and redness in your eye(s), as well as vision loss. About Autoimmune Disease [Read Post Autoimmunity and the Eyes: A Spotlight on Uveitis](https://www.autoimmuneinstitute.org/articles/autoimmunity-and-the-eyes-a-spotlight-on-uveitis) ![Illustration of autoimmune gastritis showing chronic inflammation and damage to the stomach lining with a magnified view of the gastric mucosa.](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/12/autoimmune-gastritis-stomach-lining-inflammation-1-1024x576.jpg) Living with Autoimmune Gastritis: What You Need to Know  Struggling with autoimmune gastritis? Discover symptoms, triggers, and expert tips to manage this complex condition and reclaim your health and energy. About Autoimmune Disease [Read Post Living with Autoimmune Gastritis: What You Need to Know ](https://www.autoimmuneinstitute.org/articles/living-with-autoimmune-gastritis-what-you-need-to-know) ### Caregiving and Autoimmune Disease ### Caregiving and Autoimmune Disease Supporting someone with autoimmune or chronic disease can involve navigating unpredictable symptoms, changing needs, and difficult conversations. This series offers practical guidance for caregivers, family members, and friends on communicating with compassion, providing meaningful support, and caring for their own well-being along the way. ![Supportive hands holding one another, representing compassion and emotional support for people living with autoimmune or chronic disease.](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/07/supporting-someone-with-autoimmune-or-chronic-disease-1024x576.jpg) How to Support Someone with Autoimmune or Chronic Disease Many people want to support a parent, sibling, friend, partner, colleague, or neighbor living with an autoimmune or chronic disease but are often unsure how to help, what to say, or how to respond to their health needs. They may worry about saying the wrong thing, asking too many questions, becoming a burden, or respecting a loved one’s request for space. An important aspect of this discussion is that caregivers often come from a place of authentic care and awareness, so what they truly need are strategies to approach and interact with a loved one or person they assist. To explore \[…\] Autoimmune Care & Caregiver Support [Read Post How to Support Someone with Autoimmune or Chronic Disease](https://www.autoimmuneinstitute.org/articles/how-to-support-someone-with-autoimmune-or-chronic-disease) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2020/03/shutterstock_2274180457-1024x576.jpg) What Not to Say to Someone with a Chronic Illness If you know someone—a friend, parent, sibling, patient, coworker—with a chronic or invisible illness like autoimmune disease, you may be unsure of how to talk to them, and how to respond appropriately in regards to their health. It can be tricky, especially since good intentions are often drowned out by poor word choice. You may want to reflect on where your comments are coming from—confusion, lack of knowledge on the subject, difficulty empathizing, etc. Or maybe your friend or family member’s situation is triggering and you’re speaking from a place of trauma. The important thing, however, is that you care and \[…\] Autoimmune Care & Caregiver Support [Read Post What Not to Say to Someone with a Chronic Illness](https://www.autoimmuneinstitute.org/articles/what-not-to-say-to-someone-with-a-chronic-illness) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/08/Caregivers-1024x576.png) The Vital Role of Caregivers in Autoimmune Disease Autoimmune disorders impact millions of Americans, with over 80 currently known disorders. Informal caregivers play an essential role in supporting many adults living with these disorders. If you’re helping a loved one manage their health, your role is vital, and as the number of autoimmune diagnoses grows, understanding what you do and how to support you matters more than ever. Most caregivers aren’t paid professionals; they’re often people who step up out of love and concern, such as spouses, children, siblings, or close friends. While caregiving can be deeply meaningful, it also comes with emotional, physical, and financial challenges. In fact, \[…\] Autoimmune Care & Caregiver Support [Read Post The Vital Role of Caregivers in Autoimmune Disease](https://www.autoimmuneinstitute.org/articles/the-vital-role-of-caregivers-in-autoimmune-disease) ### Living with Chronic Illness ### Living with Chronic Illness Chronic illness affects every part of daily life. This series looks at the realities of living with autoimmune disease, from managing symptoms and flare-ups to navigating relationships, mental health, and uncertainty. ![Illustration of a person with lungs surrounded by viruses, bacteria, and fungi representing infection risk in people with autoimmune diseases receiving immunosuppressive therapy.](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/07/navigating-immunosuppression-infection-risk-autoimmune-disease-1024x576.jpg) Navigating Immunosuppression and Infection Risk Modern immunosuppressive therapies have transformed the treatment of autoimmune diseases, allowing many people to live healthier, more active lives. At the same time, these medications can increase susceptibility to certain infections, making prevention and early recognition especially important. As seasonal viruses, emerging infections, and vaccine-preventable disease outbreaks continue, many people taking immunosuppressive medications are left wondering how to protect themselves from infection while keeping their autoimmune disease under control. Rosemary Ainley developed rheumatoid arthritis in 2007 and started treating it with methotrexate, a medication designed to reduce swelling and inflammation. By 2008, methotrexate wasn’t enough on its own, and she needed \[…\] Living Well with Autoimmune Disease [Read Post Navigating Immunosuppression and Infection Risk](https://www.autoimmuneinstitute.org/articles/navigating-immunosuppression-and-infection-risk) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/06/living-with-multiple-ADs-4-1024x576.jpg) Living with Multiple Autoimmune Conditions Learn how to manage multiple autoimmune diseases with expert insights on polyautoimmunity, symptom tracking, specialist coordination, medication management, and daily life strategies. Living Well with Autoimmune Disease [Read Post Living with Multiple Autoimmune Conditions](https://www.autoimmuneinstitute.org/articles/living-with-multiple-autoimmune-conditions) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/01/Navigating-Mask-Wearing-e1749652601982-1024x576.png) A Guide for Immunocompromised Individuals in a Post-Pandemic World Even as the world moves on from the pandemic, immunocompromised individuals continue to face heightened health risks. With fewer people wearing masks, navigating daily life safely can be challenging. This guide explores the science behind immune function, the impact of mask-wearing, legal protections, and practical strategies for advocating for personal health. Whether seeking protection in healthcare settings, workplaces, or social interactions, immunocompromised individuals can find support and solutions to maintain both physical and mental well-being in an increasingly unmasked world. Autoimmune Care & Caregiver Support [Read Post A Guide for Immunocompromised Individuals in a Post-Pandemic World](https://www.autoimmuneinstitute.org/articles/a-guide-for-immunocompromised-individuals-in-a-post-pandemic-world) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Managing-Mental-Health-1024x576.jpg) Managing Mental Health with an Autoimmune Disease Mental health: it’s a discussion that our modern world is slowly beginning to embrace. Although there are many factors that can impact a person’s emotional balance, the interplay between mental health and autoimmune disease is a topic that should not be dismissed. Mental health challenges are a common experience among people with autoimmune disease and other chronic illnesses. In 2013, a group of Danish researchers concluded that participants of their study were 45% more likely to develop anxiety or depression if they had an autoimmune disease (1). Additionally, Cleveland Clinic reports that clinical depression occurs in 40% of people with multiple \[…\] Living Well with Autoimmune Disease [Read Post Managing Mental Health with an Autoimmune Disease](https://www.autoimmuneinstitute.org/articles/managing-mental-health-with-an-autoimmune-disease) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/When-Youve-Lost-Trust-in-Doctors-1024x576.jpg) When You’ve Lost Trust in Doctors… Have you been told “it’s just stress”? Or diagnosed as a hypochondriac? Has it taken years to find a diagnosis? Maybe you’re still searching for one. The exhaustion is real! It’s a long road to figure out what’s wrong and how to address it, without getting derailed by judgment and misdiagnoses. The experience of managing chronic conditions can be as agonizing as the symptoms themselves. So who do we trust—the medical system we feel has let us down, or ourselves? At the beginning, when we’re new to the world of chronic health issues, we tend to cling to the medical system, \[…\] Autoimmune Care & Caregiver Support [Read Post When You’ve Lost Trust in Doctors…](https://www.autoimmuneinstitute.org/articles/when-youve-lost-trust-in-doctors) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Outbursts-in-Autoimmunity-Disease-Flare-ups-1024x576.png) Outbursts in Autoimmunity: Disease Flare-ups Autoimmune disease flare-ups can be unpredictable and disruptive, causing symptoms to suddenly appear or worsen and interfering with daily life. But what causes a flare-up, what is happening in the body when one occurs, and what can you do when symptoms intensify? This article explores what researchers know about autoimmune disease flare-ups, including common triggers, the immune processes involved, how flares can differ across autoimmune diseases, and strategies for managing them. What Are Autoimmune Disease Flare-Ups? Also known as bouts, relapses, or episodes, autoimmune disease flare-ups occur when patients show a dramatic worsening of disease signs and symptoms or when they \[…\] About Autoimmune Disease [Read Post Outbursts in Autoimmunity: Disease Flare-ups](https://www.autoimmuneinstitute.org/articles/outbursts-in-autoimmunity-disease-flare-ups) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Finding-Balance-1024x576.jpg) Finding Balance in Uncertain Times Uncertainty has a way of quietly shaping everyday life, especially when you’re navigating chronic illness. Questions about symptoms, treatments, access to care, and what comes next can create a constant undercurrent of stress that’s difficult to ignore. COVID-19 and Long Covid [Read Post Finding Balance in Uncertain Times](https://www.autoimmuneinstitute.org/articles/finding-balance-in-uncertain-times) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Chronic-Pain-1024x576.jpg) What Chronic Pain Really Means Chronic pain is common, yet often misunderstood. Unlike temporary pain, it can persist for months or years, affecting daily life, mental health, and overall well-being. Because it cannot always be seen or measured, many people experience their pain being dismissed or overlooked. Living Well with Autoimmune Disease [Read Post What Chronic Pain Really Means](https://www.autoimmuneinstitute.org/articles/facts-about-chronic-pain) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Comorbidities-MAS-1-1024x576.jpg) Comorbidities in Autoimmune Disease & Multiple Autoimmune Syndrome The co-occurrence of more than two autoimmune diseases within the same person is known but only partly understood. The combination of two autoimmune diseases is called polyautoimmunity with common examples being systemic lupus erythematosus with Sjögren’s syndrome and rheumatoid arthritis with autoimmune thyroiditis (1, 2). The combination of three or more autoimmune diseases is called multiple autoimmune syndrome (MAS) and was described for the first time in 1988 (3). In MAS, one of the conditions typically affects the skin, with vitiligo and psoriasis as common examples (4). The coexistence of five autoimmune diseases is rarely observed (4). MAS Classification, Diagnosis , \[…\] About Autoimmune Disease [Read Post Comorbidities in Autoimmune Disease & Multiple Autoimmune Syndrome](https://www.autoimmuneinstitute.org/articles/comorbidities-in-autoimmune-disease-multiple-autoimmune-syndrome) ![GLP-1 Receptor Agonists and Autoimmune Diseases](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/06/GLP-1-Receptor-Agonists-and-Autoimmune-Diseases-1-1024x576.jpg) GLP-1 Receptor Agonists and Autoimmune Diseases If you have an autoimmune disease, should you be concerned about GLP-1 medications? Here’s what experts and current research say so far. Diagnosis & Treatment [Read Post GLP-1 Receptor Agonists and Autoimmune Diseases](https://www.autoimmuneinstitute.org/articles/glp-1-receptor-agonists-and-autoimmune-diseases) ![Mental,Health,Disorder,Concept.,Exhausted,Depressed,Female,Touching,Forehead.,Stressed](https://www.autoimmuneinstitute.org/wp-content/uploads/2020/02/shutterstock_1936385779-1024x559.jpg) Chronic Illness: When You Feel Like Giving Up When your chronic illness has put you through the wringer in terms of doctor and hospital visits, lab tests, imaging, medications, and other treatments, it’s only natural to feel defeated. Living Well with Autoimmune Disease [Read Post Chronic Illness: When You Feel Like Giving Up](https://www.autoimmuneinstitute.org/articles/chronic-illness-when-you-feel-like-giving-up) ### The Immune Spectrum: Autoimmunity and Cancer ### The Immune Spectrum: Autoimmunity and Cancer Autoimmunity and cancer are often viewed as separate conditions, but both arise from disruptions in immune balance. This series examines the immune system as a continuum, the trade-offs involved in treating each condition, and the growing focus on therapies that restore immune tolerance at the root of disease. ![Flying blue 3d antibodies interacting with red viruses. Immune defense, immunotherapy, disease prevention, vaccination, pathogen neutralization, molecular biology concept. Low poly wireframe.](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/02/The-Immune-Spectrum-From-Autoimmunity-to-Cancer-1024x576.jpg) The Immune Spectrum: From Autoimmunity to Cancer How are autoimmune disease and cancer connected? Learn how immune balance, inflammation, and immune dysfunction shape disease across the immune spectrum. About Autoimmune Disease [Read Post The Immune Spectrum: From Autoimmunity to Cancer](https://www.autoimmuneinstitute.org/articles/the-immune-spectrum-from-autoimmunity-to-cancer) ![Lymphocytes and biological immune system, 3d rendering. 3D illustration.](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/02/AD-and-cancer-1024x576.jpg) The Immune Balancing Act: Cancer and Autoimmunity Cancer and autoimmune disease sit at opposite ends of the immune spectrum. Yet treating one condition can sometimes increase the risk of the other. This article explores the shared immune pathways behind both diseases and the delicate balance clinicians must navigate when making treatment decisions. About Autoimmune Disease [Read Post The Immune Balancing Act: Cancer and Autoimmunity](https://www.autoimmuneinstitute.org/articles/the-immune-balancing-act-cancer-and-autoimmunity) ![Immune Nodes and Vessels in Lymphatic System 3d illustration](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/02/Restoring-Immune-Tolerance-1024x576.jpg) Restoring Immune Tolerance in Autoimmune Disease Immune tolerance prevents the body from attacking itself. Learn how it breaks down in autoimmune disease and how new therapies aim to restore it. About Autoimmune Disease [Read Post Restoring Immune Tolerance in Autoimmune Disease](https://www.autoimmuneinstitute.org/articles/restoring-immune-tolerance-in-autoimmune-disease) ### When Autoimmune Disease Meets Real Life ### When Autoimmune Disease Meets Real Life Autoimmune disease rarely unfolds under ideal conditions. Many people must balance managing symptoms with work, financial strain, fluctuating energy, and barriers to healthcare. This series examines practical aspects of managing autoimmune disease with expert insights. It discusses healthcare barriers and strategies to access care, emphasizes sustainable movement to support immune health, and looks into how individuals rebuild their identity and pursue meaningful goals while living with chronic illness. ![Physician billing statement marked ‘past due’ beside a stethoscope and a one-hundred-dollar bill, illustrating the financial strain of medical care.](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/01/healthcare-with-limited-resources-1024x576.jpg) Navigating Autoimmune Care With Limited Resources Navigating the healthcare system can be challenging for almost everyone. Finding the right providers, getting timely appointments, and accessing appropriate treatments often feel overwhelming. For people living with autoimmune and other chronic conditions, these challenges can be even greater. Autoimmune Care & Caregiver Support [Read Post Navigating Autoimmune Care With Limited Resources](https://www.autoimmuneinstitute.org/articles/navigating-autoimmune-care-with-limited-resources) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/01/Exercise-and-Autoimmune-Disease-1024x576.jpg) Exercise and Autoimmune Disease: Evidence-Based, Low-Impact Approaches An expert-informed, evidence-based overview of low-impact exercise approaches for people with autoimmune disease. Living Well with Autoimmune Disease [Read Post Exercise and Autoimmune Disease: Evidence-Based, Low-Impact Approaches](https://www.autoimmuneinstitute.org/articles/exercise-and-autoimmune-disease-evidence-based-low-impact-approaches-3) ![silhouette of a woman in front of a sunset peering into the distance](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/03/Finding-Purpose-with-Autoimmune-Disease-and-Chronic-Illness-GAI-1024x576.jpg) Finding Purpose & Fulfillment with Autoimmune and Chronic Disease People with autoimmune diseases or other severe chronic illnesses learn how to manage their condition but also strive to find purpose, stability, and a way forward. Pursuing these goals while living with a chronic condition involves discovering personal and professional opportunities that fit a new lifestyle but also reclaiming agency, dignity, and the sense of being helpful to others.  Living Well with Autoimmune Disease [Read Post Finding Purpose & Fulfillment with Autoimmune and Chronic Disease](https://www.autoimmuneinstitute.org/articles/finding-purpose-and-fulfillment-with-autoimmune-and-chronic-disease) ### How Autoimmunity Changes Over Time ### How Autoimmunity Changes Over Time Autoimmune disease doesn’t follow a single path; it evolves. This series explores how immune activity shifts across the lifespan, from the earliest signs of emerging autoimmunity, to the rise of late-onset disease in older adults, to the ways aging reshapes and weakens immune balance. Together, these pieces highlight how changes in the immune system over time shape the onset, expression, and progression of autoimmune disease. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/11/The-Stages-of-Autoimmunity-1024x576.jpg) The Stages of Autoimmunity Autoimmune disease can take years to develop, moving from silent immune misfires to full clinical symptoms. Researchers are discovering that before a diagnosis is ever made, the immune system may already be producing autoantibodies and mounting inflammatory responses against the body’s own tissues. Understanding these early “stages” of disease could facilitate prevention and earlier intervention. To explore what happens as autoimmunity takes shape, this article features insight from Jane Buckner, MD, President of the Benaroya Research Institute at Virginia Mason Franciscan Health, and Michael Rosenblum, MD, PhD, Professor of Dermatology at the University of California, San Francisco, both of whom study the immune mechanisms that drive disease onset and regulation. About Autoimmune Disease [Read Post The Stages of Autoimmunity](https://www.autoimmuneinstitute.org/articles/the-stages-of-autoimmunity) ![Two people walking side by side on a tree-lined path, suggesting healthy aging and daily activity.](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/11/Understanding-Late-Onset-Autoimmunity-1024x576.jpg) Understanding Late-Onset Autoimmunity While autoimmune disease is often associated with young or middle-aged adults, it can emerge for the first time later in life. Evidence suggests that diagnoses among older adults are increasing, raising new questions about how immune aging, hormonal changes, and environmental exposures shape disease risk. About Autoimmune Disease [Read Post Understanding Late-Onset Autoimmunity](https://www.autoimmuneinstitute.org/articles/understanding-late-onset-autoimmunity) ![Close-up of an older person's hands, with a healthcare provider gently supporting them, symbolizing care and human connection in aging with autoimmune disease.](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/11/Aging-and-Autoimmune-Disease-1024x576.jpg) Aging and Autoimmune Disease What happens to the immune system during aging that could lead to an increase in autoimmune disease risk? To take a deeper look, we spoke with two experts on aging and autoimmunity: Paul Robbins, co-director of the Masonic Institute on the Biology of Aging and Metabolism at the University of Minnesota, and Niharika Duggal, assistant professor at the Institute of Inflammation and Ageing at the University of Birmingham. About Autoimmune Disease [Read Post Aging and Autoimmune Disease](https://www.autoimmuneinstitute.org/articles/aging-and-autoimmune-disease) ### The Neuroimmune Connection ### The Neuroimmune Connection Autoimmune activity doesn’t stop at the blood–brain barrier. Once seen as separate worlds, the brain and immune system are proving inseparable. This series explores how autoimmune and inflammatory processes influence neurodegeneration, brain fog, and infection-triggered behavior changes. Understanding these connections could open new paths toward healing and prevention. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/10/GAI-Autoimmune-Aspects-of-Neurodegenerative-Diseases-Global-Autoimmune-Institute-1024x576.jpg) Autoimmune Aspects of Neurodegenerative Diseases Can neurodegenerative diseases have autoimmune origins? New research suggests immune dysfunction plays a key role in Alzheimer’s, Parkinson’s, and MS. About Autoimmune Disease [Read Post Autoimmune Aspects of Neurodegenerative Diseases](https://www.autoimmuneinstitute.org/articles/autoimmune-aspects-of-neurodegenerative-diseases) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/10/Understanding-Brain-Fog-in-Autoimmune-Disease-2-1024x576.jpg) Understanding Brain Fog in Autoimmune Disease Fatigue, forgetfulness, and mental haze can all point to one culprit: immune dysfunction disrupting the brain’s clarity and focus. About Autoimmune Disease [Read Post Understanding Brain Fog in Autoimmune Disease](https://www.autoimmuneinstitute.org/articles/understanding-brain-fog-in-autoimmune-disease) ![Stock Photo ID: 2262066589 Doctor woman and kid boy patient at home. The pediatrician using tablet computer while filling up medical records, close up. Medicine, healthcare concepts.](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/10/PANDAS-PANS-1024x576.jpg) PANDAS, PANS, and Autoimmunity When infection sparks autoimmunity, the brain can change. Learn how PANDAS and PANS trigger sudden behavioral shifts in children. About Autoimmune Disease [Read Post PANDAS, PANS, and Autoimmunity](https://www.autoimmuneinstitute.org/articles/pandas-pans-and-autoimmunity) ### New Frontiers in Autoimmune Treatment ### New Frontiers in Autoimmune Treatment Finding effective treatments for autoimmune diseases is often a trial-and-error process, but the field is rapidly evolving. This series highlights emerging approaches such as immunotherapy, gene editing, and other advances in precision and personalized medicine that are reshaping autoimmune care. ![Physician And Patient Examine A Holographic Dna Model. AI-Powered Genomic Analysis Highlights Mutation Hotspots And Therapeutic Targets In Real-Time, Precision Medicine And Targeted Gene Therapies.](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/09/shutterstock_2577081413-1024x540.jpg) Personalized Medicine for Autoimmune Diseases Experts like Dr. Georg Schett highlight how personalized medicine and CAR T-cell therapy could transform autoimmune treatment and long-term remission. Diagnosis & Treatment [Read Post Personalized Medicine for Autoimmune Diseases](https://www.autoimmuneinstitute.org/articles/personalized-medicine-for-autoimmune-diseases) ![Nanotechnology Genetic engineering and the use of nanorobots to destroy microbes. Medical concept, future medicine technology. 3D illustration, 3D rendering](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/09/nanotechnology-for-autoimmune-disease-GAI-1024x576.png) Nanotechnology Breakthroughs in Autoimmune Disease Treatment Could nanoparticles transform autoimmune care? Scientists are testing ways to deliver drugs with precision, restore immune tolerance, and improve early diagnosis. Diagnosis & Treatment [Read Post Nanotechnology Breakthroughs in Autoimmune Disease Treatment](https://www.autoimmuneinstitute.org/articles/nanotechnology-breakthroughs-in-autoimmune-disease-treatment) ![Creative image of embryonic stem cells, cellular therapy. 3d illustration](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/09/stem-cell-therapy-for-autoimmune-disease-1024x576.png) Stem Cell Therapy for Autoimmune Disease Stem cell therapy is showing promise for autoimmune disease treatment, with trials exploring immune reset, tissue repair, and reduced inflammation. Diagnosis & Treatment [Read Post Stem Cell Therapy for Autoimmune Disease](https://www.autoimmuneinstitute.org/articles/stem-cell-therapy-for-autoimmune-disease) ![Personal genomics, personalized healthcare and wellness concept. Genetic testing and analyzing an individual's genetic makeup to provide customized healthcare and wellness solutions.](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/09/shutterstock_2504009949-1024x564.jpg) Tailoring Autoimmune Treatment with Precision Medicine From lupus to IBD, precision medicine uses genetics and biomarkers to personalize autoimmune treatment and advance beyond trial-and-error care. Diagnosis & Treatment [Read Post Tailoring Autoimmune Treatment with Precision Medicine](https://www.autoimmuneinstitute.org/articles/tailoring-autoimmune-treatment-with-precision-medicine) ![immunotherapy research concept with cells and DNA background](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/09/shutterstock_578121100-1024x683.jpg) Immunotherapy for Those with Autoimmune Disease Immunotherapy is changing autoimmune treatment by using targeted drugs and cellular therapies to reduce flare-ups and damage. Diagnosis & Treatment [Read Post Immunotherapy for Those with Autoimmune Disease](https://www.autoimmuneinstitute.org/articles/immunotherapy-for-those-with-autoimmune-disease) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/07/NEWBase-Graphic-for-CRISPR-1024x567.jpg) CRISPR/Cas9 Gene Editing: Revolutionizing Autoimmune Disease Treatment Discover how CRISPR/Cas9 technology is revolutionizing the treatment of autoimmune diseases like Rheumatoid Arthritis, Type 1 Diabetes, and Multiple Sclerosis through targeted gene editing and precise DNA repair mechanisms. Diagnosis & Treatment [Read Post CRISPR/Cas9 Gene Editing: Revolutionizing Autoimmune Disease Treatment](https://www.autoimmuneinstitute.org/articles/crispr-cas9-gene-editing-revolutionizing-autoimmune-disease-treatment) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/CAR-T-CELL-THERAPY-4-1024x576.jpg) CAR T-Cell Therapy For Autoimmune Disease: What We Know Now Originally published November 17, 2023 \| Updated September 29, 2026 What CAR T-Cell Therapy Means for the Future of Autoimmune Disease Treatment Chimeric antigen receptor (CAR) T-cell therapy, a form of cellular immunotherapy first developed to treat certain blood cancers, is now being investigated as a potential treatment for severe autoimmune diseases. Much of the research has focused on using CAR T cells to deeply deplete B cells, including abnormal B-cell populations that contribute to autoantibody production and autoimmune disease. The goal is ambitious: rather than continuously suppressing the immune system with medication, researchers are investigating whether a one-time treatment could \[…\] Diagnosis & Treatment [Read Post CAR T-Cell Therapy For Autoimmune Disease: What We Know Now](https://www.autoimmuneinstitute.org/articles/car-t-cell-therapy-for-autoimmune-disease) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/03/cenetered-Biologics-for-ADs-1024x576.png) Biologics for Autoimmune Disease: What You Should Know How biologics work to treat autoimmune diseases, their benefits, risks, costs, and what to expect if your doctor prescribes one. Diagnosis & Treatment [Read Post Biologics for Autoimmune Disease: What You Should Know](https://www.autoimmuneinstitute.org/articles/biologics-for-autoimmune-disease-what-you-should-know) ### Navigating Autoimmune Healthcare ### Navigating Autoimmune Healthcare Navigating autoimmune healthcare can be complex, confusing, and often overwhelming. This series brings together expert-informed guidance on accessing care, communicating effectively with providers, understanding insurance and treatment options, and staying informed as healthcare continues to evolve. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/06/A-Guide-to-Interpreting-Clinical-Trial-Stories-1024x576.jpg) A Guide to Interpreting Clinical Trial Stories How to evaluate pre-clinical research, clinical trial phases, study results, and key questions to ask with expert insights from Monica Wang and Sylvia Baedorf Kassis. About Autoimmune Disease [Read Post A Guide to Interpreting Clinical Trial Stories](https://www.autoimmuneinstitute.org/articles/a-guide-to-interpreting-clinical-trial-stories) ![Navigating Health Insurance with Autoimmune Disease](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/10/Navigating-Health-Insurance-with-Autoimmune-Disease-1024x576.png) Navigating Health Insurance with Autoimmune Disease With insights on how to best navigate health insurance from two experts in the field, GAI delves into the complicated process of dealing with health insurance with an autoimmune disease. Autoimmune Care & Caregiver Support [Read Post Navigating Health Insurance with Autoimmune Disease](https://www.autoimmuneinstitute.org/articles/navigating-health-insurance-for-autoimmune-disease-patients-expert-tips-and-resources) ![Physician billing statement marked ‘past due’ beside a stethoscope and a one-hundred-dollar bill, illustrating the financial strain of medical care.](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/01/healthcare-with-limited-resources-1024x576.jpg) Navigating Autoimmune Care With Limited Resources Navigating the healthcare system can be challenging for almost everyone. Finding the right providers, getting timely appointments, and accessing appropriate treatments often feel overwhelming. For people living with autoimmune and other chronic conditions, these challenges can be even greater. Autoimmune Care & Caregiver Support [Read Post Navigating Autoimmune Care With Limited Resources](https://www.autoimmuneinstitute.org/articles/navigating-autoimmune-care-with-limited-resources) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Telehealth-1024x576.jpg) Navigating Healthcare Through the Practical Lens of Telehealth What Is Telehealth? Telehealth refers to the strategy of providing virtual healthcare. This includes any technologies and services that physicians use to conduct appointments remotely. Another feature of telehealth is the use of communications between hospitals and clinics to bring collaborative expertise into emergency procedures. As early as the 1970s, telehealth was used to assist remote, underserved Native communities in the Southwest. In the 1980’s, telehealth made its way to the final frontier by providing care to the astronauts aboard Space Station Freedom. Since those formative days, telehealth hasn’t exactly exploded in popularity—that is, until the emergence of COVID-19 (1). A \[…\] Autoimmune Care & Caregiver Support [Read Post Navigating Healthcare Through the Practical Lens of Telehealth](https://www.autoimmuneinstitute.org/articles/navigating-healthcare-through-the-practical-lens-of-telehealth) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/terminology-1024x576.jpg) Autoimmune Terminology To Know For Your Next Doctor’s Appointment While having guidance and support from your doctor is essential, taking control of your own health is important for planning and making informed decisions about your autoimmune disease. Being on board with the terms used to describe autoimmunity and specific diseases during your doctor’s appointments can help you receive the care you need as you ask questions to recognize signs and symptoms, understand the reasons behind testing, and navigate treatment options. Autoimmune Disease Testing: After a physical exam, your healthcare provider will order additional tests to diagnose your disease depending on your signs and symptoms. Terms to keep in mind include \[…\] Autoimmune Care & Caregiver Support [Read Post Autoimmune Terminology To Know For Your Next Doctor’s Appointment](https://www.autoimmuneinstitute.org/articles/autoimmune-terminology-to-know-for-your-next-doctors-appointment) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Effective-Communication-for-Patients-1-1024x576.jpg) Effective Communication Strategies for Those with Autoimmune Disease For patients with autoimmune disease, management means understanding a wide range of symptoms, unpredictable disease courses, and any impacts on quality of life. But how can patients better communicate with their providers? The Global Autoimmune Institute expounds on key tips elucidated by Johannah Ruddy, M.Ed., a doctoral candidate at Campbell University and co-author of Gut Feelings: Doctors and Patient-Centered Care. How Knowledge, Commitment to Care and Empathy Improve Patient’s Lives to help patients establish a strong relationship with their provider and diminish stigma. 1. Make A List Of Noticeable Symptoms And Other Relevant Information GAI has a Printable Daily Symptom Checklist \[…\] Autoimmune Care & Caregiver Support [Read Post Effective Communication Strategies for Those with Autoimmune Disease](https://www.autoimmuneinstitute.org/articles/effective-communication-strategies-for-patients-with-autoimmune-diseases) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/AD-Specialists-1-1024x576.png) Autoimmune Disease Specialist Spotlight How to find the right doctor to treat your specific autoimmune condition and how insurance factors in Finding a specialist to treat your autoimmune symptoms can be crucial to receiving an accurate diagnosis and developing a comprehensive treatment plan. How can you find the right doctor to treat your autoimmune disease (AD), and how does insurance factor into specialist appointments? How does someone with a suspected autoimmune disease know which type of doctor to see? It can be difficult for patients with a suspected autoimmune disease to know which type of doctor to see. A primary care physician or a general \[…\] Autoimmune Care & Caregiver Support [Read Post Autoimmune Disease Specialist Spotlight](https://www.autoimmuneinstitute.org/articles/autoimmune-disease-specialist-spotlight) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/07/AI-and-ADs-1024x576.png) The Promise of Artificial Intelligence (AI) in Autoimmune Disease Healthcare GAI consults experts to discuss how AI appears to be a transformative tool in the realm of medical research and care, but potential ethical consequences remain. Diagnosis & Treatment [Read Post The Promise of Artificial Intelligence (AI) in Autoimmune Disease Healthcare](https://www.autoimmuneinstitute.org/articles/the-promise-of-ai-in-autoimmune-disease-from-early-detection-to-personalized-care) ![Autoimmune Disease Treatments Global Autoimmune Institute](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Spectrum-of-AD-treatments-1024x576.png) The Spectrum of Autoimmune Disease Treatments With multiple autoimmune disease treatment options available, learning about and deciding which treatment route to follow can be an overwhelming task. This article provides a high-level view of the most common treatment options, ranging from pharmaceutical agents requiring a doctor’s prescription to at-home treatments. [Read Post The Spectrum of Autoimmune Disease Treatments](https://www.autoimmuneinstitute.org/the-spectrum-of-autoimmune-disease-treatments/) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Holistic-vs-Modern-Western-Medicine-1024x576.jpg) Explained: Holistic vs Modern Western Medicine When it comes to holistic medicine and approaches to health, confusion abounds. The word “holistic” is scattered across the internet, business storefronts, and packaging, but similar to the terms “natural” or “grass-fed,” its true meaning still eludes us. Consider this your guide to understanding the differences and cutting through the confusion between the modern Western approach and holistic medicine. Modern Western Modern Western medicine, a.k.a. allopathic, conventional, mainstream, or bio-medicine, uses a research- and organ systems-based approach to diagnose and treat various specific medical conditions, often using pharmaceutical drugs, radiation, and surgery. In the modern Western system of medicine, it is \[…\] Autoimmune Care & Caregiver Support [Read Post Explained: Holistic vs Modern Western Medicine](https://www.autoimmuneinstitute.org/articles/explained-holistic-vs-modern-western-medicine) ### Understanding Autoimmunity ### Understanding Autoimmunity Core concepts and key insights into autoimmune disease, including how it is defined, categorized, and shaped by immune system function, environmental factors, and differences across populations. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/06/Autoimmune-or-Not-2-1024x576.jpg) Autoimmune or Not? The Diseases That Blur the Lines Many diseases affect the immune system without being classified as autoimmune. Experts explain why conditions like fibromyalgia, endometriosis, POTS, and Lyme disease remain difficult to categorize. About Autoimmune Disease [Read Post Autoimmune or Not? The Diseases That Blur the Lines](https://www.autoimmuneinstitute.org/articles/autoimmune-or-not-the-diseases-that-blur-the-lines) ![Basics of Autoimmune Disease Global Autoimmune Institute](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/AD-Basics-1024x576.png) Autoimmune Disease Basics A clear guide to autoimmune disease, including how it develops, common conditions, risk factors, and how diagnosis and testing work. [Read Post Autoimmune Disease Basics](https://www.autoimmuneinstitute.org/understanding-autoimmune-disease/) ![Autoantibodies bond to receptor (achr) blocking the acetylcholine transmitters in Myasthenia gravis (MG) - 3d illustration isometric view](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/09/autoantibodies-1-1024x576.png) Decoding the Role of Autoantibodies in Autoimmunity Your immune system makes antibodies against foreign invaders like viruses and bacteria. Sometimes, your body makes autoantibodies, proteins that mistakenly attack your body’s tissue, leading to autoimmunity.  What are Autoantibodies? Under normal conditions, antibodies protect us by recognizing and attacking harmful substances. However, autoantibodies mistakenly identify the body’s tissues as threats.  Faulty autoantibodies can target specific body regions, leading to various autoimmune disorders including: Are Autoantibodies Always Harmful? Not always. Many healthy people are born with natural autoantibodies that are part of a normally functioning immune system (1). Autoantibodies may help the immune system by “cleaning up” dead cells after infection \[…\] About Autoimmune Disease [Read Post Decoding the Role of Autoantibodies in Autoimmunity](https://www.autoimmuneinstitute.org/articles/decoding-the-role-of-autoantibodies-in-autoimmunity) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Body-Regions-1024x576.png) Body Regions Commonly Affected by Autoimmunity Autoimmune diseases can affect almost any part of your body and can be classified into systemic or organ-specific diseases based on their location. “The key thing is that you can actually test for an autoimmune reaction by looking at serologies in the blood,” said Gabriella Safdieh, an integrative medicine physician. “There are various serologies that are consistent with different forms of autoimmune diseases.” Serology is the scientific study of serum (blood component) and other body fluids. The term usually refers to the diagnostic identification of antibodies in the serum. In systemic autoimmune diseases, such as rheumatoid arthritis, autoantigens are found in \[…\] About Autoimmune Disease [Read Post Body Regions Commonly Affected by Autoimmunity](https://www.autoimmuneinstitute.org/articles/body-regions-commonly-affected-by-autoimmunity) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2022/01/Autoimmune-vs-Autoinflammatory-Disease-2-1024x576.png) Autoimmune vs Autoinflammatory Disease Autoimmune disease and autoinflammatory disease are two categories of illnesses that occur when the immune system mistakenly damages healthy cells. Although these inflammatory disorders share many commonalities, there are key features that make them unique. About Autoimmune Disease [Read Post Autoimmune vs Autoinflammatory Disease](https://www.autoimmuneinstitute.org/articles/autoimmune-vs-autoinflammatory-disease) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/09/ADs-in-Children-1024x576.png) Understanding Autoimmune Disease in Children Autoimmune diseases can affect people of all ages. While they are more common in adults during their reproductive years (20-40), some autoimmune diseases can appear in childhood. Early diagnosis and treatment are crucial for improving the lives of children and teens living with these conditions. Diagnosis & Treatment [Read Post Understanding Autoimmune Disease in Children](https://www.autoimmuneinstitute.org/articles/understanding-autoimmune-disease-in-children) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/4-Myths-1-1024x576.png) 4 Myths about Autoimmune Disease Brush up on your knowledge as we thoughtfully address four myths about autoimmune disease, including: Myth #1: There is a cure for Autoimmune Disease Autoimmune diseases occur when the immune system mistakenly attacks the body’s own healthy cells, tissues, and organs. While the causes are not fully known, these diseases are likely triggered by complex environmental and genetic factors. While there is no true consensus on exactly what the word “cure” means, it is generally understood that when a disease is cured, it does not exist anymore. This means that there is no risk of it coming back, no more symptoms, \[…\] About Autoimmune Disease [Read Post 4 Myths about Autoimmune Disease](https://www.autoimmuneinstitute.org/articles/4-myths-about-autoimmune-disease) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/06/How-to-Categorize-Autoimmune-Disease-1024x576.png) Untangling a Complex Web: How to Categorize Autoimmune Disease Advancements in autoimmunity reveal more about immune system malfunctions and disease triggers though diagnosis and classification remains complex. About Autoimmune Disease [Read Post Untangling a Complex Web: How to Categorize Autoimmune Disease](https://www.autoimmuneinstitute.org/articles/untangling-a-complex-web-how-to-categorize-autoimmune-disease) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/12/Epigenetics-1024x576.png) The Role of Epigenetics in Autoimmune Disease How DNA modifications impact gene expression, immune regulation, and future therapies. About Autoimmune Disease [Read Post The Role of Epigenetics in Autoimmune Disease](https://www.autoimmuneinstitute.org/articles/the-role-of-epigenetics-in-autoimmune-disease) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Infection-and-Immunity-Turning-the-Lens-on-Microbes-1024x576.jpg) Infection and Immunity: Turning the Lens on Microbes Infections can influence the development and progression of autoimmune diseases. In order to understand the intricate relationship between infections and autoimmune diseases, it is crucial to take microbial influence on autoimmunity into perspective. Infection – the invasion of a body system or organ by microbes – has been known as a key player in autoimmune disease development. Most autoimmune diseases or flare-ups have been associated with at least one infection, and a single infection can trigger multiple autoimmune diseases or flare-ups. People with an autoimmune disease are also at higher risk of infection, even while receiving treatment for that disease (1). \[…\] Living Well with Autoimmune Disease [Read Post Infection and Immunity: Turning the Lens on Microbes](https://www.autoimmuneinstitute.org/articles/infection-and-immunity-turning-the-lens-on-microbes) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Autoimmunity-on-the-rise-1-1024x576.jpg) Autoimmunity on the Rise With autoimmune biomarkers (substances in the body that can be measured in order to help determine the intensity of a disease or other physiological state) increasing in prevalence, some researchers are looking at the association between autoimmunity and environmental factors like microplastics to explain this trend. The best guess that current research literature has is that an estimated 4 percent of the world’s population has at least one autoimmune disease. In the United States, that number may be closer to 8 percent (1)—and those rates aren’t static. Experts say they’ve been increasing for decades (2,3,4). A 2020 study in Arthritis Rheumatology \[…\] About Autoimmune Disease [Read Post Autoimmunity on the Rise](https://www.autoimmuneinstitute.org/articles/autoimmunity-on-the-rise) ### Pregnancy and Autoimmune Disease ### Pregnancy and Autoimmune Disease Pregnancy can pose unique challenges for people living with autoimmune disease. This series explores how immune changes throughout conception, pregnancy, and the postpartum period influence fertility, disease activity, treatment decisions, and maternal and infant health. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/08/preg-article-1-1024x576.png) Pregnancy with an Autoimmune Disease How autoimmune disease affects pregnancy, from flare risks to medication safety, fertility, and long-term health, plus expert guidance on managing care. About Autoimmune Disease [Read Post Pregnancy with an Autoimmune Disease](https://www.autoimmuneinstitute.org/articles/pregnancy-with-an-autoimmune-disease) ![A woman lying on a bed holding a negative pregnancy test, symbolizing infertility challenges related to autoimmune disease.](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/09/Infertility-and-ADs-2-1024x576.png) How Autoimmune Disease Affects Fertility Infertility is more common in autoimmune disease. Discover how inflammation, hormones, and medications affect fertility and what treatments may help. About Autoimmune Disease [Read Post How Autoimmune Disease Affects Fertility](https://www.autoimmuneinstitute.org/articles/how-autoimmune-disease-affects-fertility) ![Why Autoimmunity Emerges Postpartum and How to Recognize It](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/08/New-Website-Banners-articles-2-1024x576.png) Why Autoimmunity Emerges Postpartum and How to Recognize It Why autoimmune disease can emerge after childbirth, common postpartum autoimmune symptoms, and treatment considerations while breastfeeding. About Autoimmune Disease [Read Post Why Autoimmunity Emerges Postpartum and How to Recognize It](https://www.autoimmuneinstitute.org/articles/why-autoimmunity-emerges-postpartum-and-how-to-recognize-it) ### COVID-19, Long Covid, and Autoimmune Disease ### COVID-19, Long Covid & Autoimmune Disease As the long-term impact of COVID-19 continues to unfold, this series examines how it intersects with autoimmune disease, from shared symptoms and stigma to vaccine responses, patient-led research, and global perspectives on Long Covid. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Is-Long-Covid-a-New-Autoimmune-Disease-3-1024x576.jpg) Is Long Covid a New Autoimmune Disease? A pathologist weighs in on the latest research involving the link between autoimmunity and Long Covid The more we learn about Long COVID—one of the terms for the health problems that appear or worsen in some people weeks to months after acute SARS-CoV-2 infection—the more confusing the picture becomes. The disease can cause a dizzying array of more than 200 possible symptoms and can follow even mild or asymptomatic infections (1,2). Presently, there are no standard therapies or medications to treat Long COVID symptoms. Model of the SARS-CoV-2 virus. Photo: NIH One of the most troubling mysteries about Long COVID, also \[…\] COVID-19 and Long Covid [Read Post Is Long Covid a New Autoimmune Disease?](https://www.autoimmuneinstitute.org/articles/is-long-covid-a-new-autoimmune-disease) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/stigma-4-1024x576.jpg) Breaking the Silence: Navigating Stigma and Shared Challenges in Long Covid and Autoimmune Disease “The hope is that the floodgates will open and that other people with invisible illnesses will be able to come to the table and talk about their invisible symptoms and be welcomed and embraced,” says James C. Jackson, Director of Long-Term Outcomes at the ICU Recovery Center at Vanderbilt University. About Autoimmune Disease [Read Post Breaking the Silence: Navigating Stigma and Shared Challenges in Long Covid and Autoimmune Disease](https://www.autoimmuneinstitute.org/articles/breaking-the-silence-navigating-stigma-and-shared-challenges-in-long-covid-and-autoimmune-disease) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Vaccine-Comparison-Chart-1024x576.jpg) Comparing the World’s Leading COVID-19 Vaccines Charting the research and development of authorized COVID-19 vaccines The following information is accurate to the best of our knowledge through August 2022. Over 100 vaccines have been created to combat SARS-CoV-2. This chart details the development process of leading vaccines that have been authorized for emergency use or received approval from government health agencies, and are being widely distributed. As of the chart’s publication date, the use of the following vaccines has been authorized by the World Health Organization (WHO), excluding the Sputnik vaccine. The information on this page is for educational purposes only and should not be taken as \[…\] COVID-19 and Long Covid [Read Post Comparing the World’s Leading COVID-19 Vaccines](https://www.autoimmuneinstitute.org/articles/comparing-the-worlds-leading-covid-19-vaccines) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Global-Perspectives-Long-Covid-1024x576.jpg) Global Perspectives on Long Covid Insights from South Africa, Pakistan, the U.S., and the U.K. Innovative research programs around the world confront a health crisis in the wake of the Covid-19 pandemic. Some 43 percent of people infected with Covid-19 develop Long Covid, which means at least 200 million people have had or currently have the condition, according to the most recent meta-analysis. And that estimate may be conservative. At the higher end, up to 87 percent of people who come down with Covid-19 experience at least one long-term symptom consistent with Long Covid (1). Scientists, healthcare providers, and policymakers around the globe are honing in \[…\] COVID-19 and Long Covid [Read Post Global Perspectives on Long Covid](https://www.autoimmuneinstitute.org/articles/global-perspectives-on-long-covid) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Long-Covid-Surveys-1024x576.png) Patient-Powered Surveys Help Generate New Data About Long Covid A look at Long Covid surveys Nearly three years into the pandemic, the long-term impacts of COVID-19 continue to unfold in real time. Now, communities and medical experts are grappling with an alarming reality: COVID-19 can trigger serious and long-lasting health complications in a significant number of people. The increasingly prevalent illness that follows COVID-19 goes by several names, including Long Covid, long-haul COVID, chronic COVID, post-acute COVID-19, and post-acute sequelae of COVID-19 (PASC) (1). Much remains unknown about Long Covid, but many experts propose that studies called Long Covid Surveys are vital to understanding and addressing this emerging health crisis. \[…\] COVID-19 and Long Covid [Read Post Patient-Powered Surveys Help Generate New Data About Long Covid](https://www.autoimmuneinstitute.org/articles/patient-powered-surveys-help-generate-new-data-about-long-covid) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/COVID-Vaccine-Side-Effects-in-Women-the-Purpose-of-Two-Doses-1-1024x576.jpg) COVID Vaccine: Side Effects in Women & the Purpose of Two Doses Retrospective hospital analyses and cohort studies have shown that people with autoimmune disease are not more susceptible to severe COVID-19 symptoms. Moreover, health experts now offer concrete recommendations for autoimmune disease patients about the COVID-19 vaccine. What do we understand about vaccine side effects in the general population, and how does it parallel outcomes for autoimmune disease (AD)? Moreover, how do the two doses of both the Moderna and Pfizer vaccine fully protect people against severe COVID-19 infection while also mitigating the spread of variants? According to news reports and clinical observations, women may be more susceptible to experiencing side effects \[…\] COVID-19 and Long Covid [Read Post COVID Vaccine: Side Effects in Women & the Purpose of Two Doses](https://www.autoimmuneinstitute.org/articles/covid-vaccine-side-effects-in-women-the-purpose-of-two-doses) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/VACCINES-COVID-19-AUTOIMMUNE-DISEASE-NEW-DEVELOPMENTS-1024x576.jpg) Vaccines, COVID-19, & Autoimmune Disease: New Developments For up-to-date information and more answers, check out our COVID Vaccine & Autoimmune Disease FAQ Since the start of the pandemic, researchers and health officials alike have wondered about the impact of SARS-CoV-2 on autoimmune disease. Now, more than a year since the first case of COVID-19 in the United States, scientific research developments and hospital data have revealed answers to these salient questions. Are People With Autoimmune Disease More Susceptible To Sever Covid Symptoms? The results of a retrospective cohort study recently published by New York-Presbyterian Hospital/Columbia University Irving Medical Center show this not to be the case. Conducted in \[…\] COVID-19 and Long Covid [Read Post Vaccines, COVID-19, & Autoimmune Disease: New Developments](https://www.autoimmuneinstitute.org/articles/vaccines-covid-19-autoimmune-disease-new-developments) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2020/12/shutterstock_2163033541-1-1024x517.jpg) Understanding Long COVID Long-term effects from COVID-19 fall into several categories, making it difficult to identify when the normal recovery period ends and long COVID begins. COVID-19 and Long Covid [Read Post Understanding Long COVID](https://www.autoimmuneinstitute.org/articles/understanding-long-covid) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/What-We-Know-Now-1024x576.jpg) COVID-19 & Autoimmune Disease: What We Know Now While the world at large is still getting a handle on exactly how the coronavirus spreads, what causes COVID-19, and why it affects some people with autoimmune disease, what we know now is still a far cry from what we knew at the start. COVID-19 and Long Covid [Read Post COVID-19 & Autoimmune Disease: What We Know Now](https://www.autoimmuneinstitute.org/articles/covid-19-autoimmune-disease-what-we-know-now) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Covid-AD-1024x576.jpg) COVID-19 and Autoimmune Disease What is COVID-19 (AKA Coronavirus)? The World Health Organization (WHO) describes COVID-19 as an infectious disease caused by the most recently discovered coronavirus, a family of viruses known to cause respiratory infections in humans. This new virus and disease were unknown until the recent outbreak in Wuhan, China in December 2019 (1). As of late October 2020, over 42 million cases have been reported throughout the world. This steadily growing number does not take into full account the potentially high number of asymptomatic individuals and carriers. What Are The Symptoms? The most common symptoms are fever, dry cough, flu-like aches, sore \[…\] COVID-19 and Long Covid [Read Post COVID-19 and Autoimmune Disease](https://www.autoimmuneinstitute.org/articles/covid-19-autoimmune-disease) ### Food, Immunity, and Autoimmune Disease ### Food, Immunity, and Autoimmune Disease Food plays a complex role in immune health. This series breaks down how different types of foods and dietary patterns may influence autoimmune disease, while clarifying common sources of confusion like food sensitivities, processed foods, and elimination diets. ![Vegetable farmer arranging freshly picked produce into a crate on an organic farm](https://www.autoimmuneinstitute.org/wp-content/uploads/2020/02/shutterstock_2127480059-1024x683.jpg) How Food Can Influence Autoimmune Disease While diet alone cannot guarantee the prevention of autoimmune diseases, certain foods and dietary patterns are believed to support a healthy immune system and reduce the risk of autoimmune conditions. Living Well with Autoimmune Disease [Read Post How Food Can Influence Autoimmune Disease](https://www.autoimmuneinstitute.org/articles/what-does-organic-really-mean-part-two) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Culinary-Medicine-1-1024x576.jpg) Culinary Medicine: Autoimmunity and Healthy Eating You may already know that eating a balanced diet supports a healthy lifestyle. If you have an autoimmune disease, you may also know that eating well and eliminating unhealthy foods, in addition to other beneficial habits (such as managing stress and sleeping well), may reduce the risk of developing unwanted signs and symptoms. Examples of foods and food components to cut down for a healthier life include processed and fried foods, sugar-sweetened foods and drinks, and refined carbohydrates. However, identifying the foods that can specifically initiate your flare-ups may help you heal and feel better as you manage your autoimmune condition. \[…\] Living Well with Autoimmune Disease [Read Post Culinary Medicine: Autoimmunity and Healthy Eating](https://www.autoimmuneinstitute.org/articles/culinary-medicine-autoimmunity-and-healthful-eating) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Food-Sensitivity-Intolerance-or-Allergy-1024x576.jpg) Food Sensitivity, Intolerance, or Allergy: What’s the Difference? Does your autoimmune disease come with a side of food reactions that cause symptom flare-ups? You may be part of the 15-20% of people who experience food sensitivities and intolerances. The pain and discomfort can be invisible, and are often misdiagnosed or dismissed despite their severity. These buzzwords can also cause a great deal of confusion. People with food sensitivities, intolerances, and even allergies and celiac disease can exhibit similar symptoms; however each condition works in a different way. Allergy Although they are often confused with sensitivities and intolerances, allergies are fairly easy to differentiate. Allergies are specific IgE-mediated immune responses \[…\] Living Well with Autoimmune Disease [Read Post Food Sensitivity, Intolerance, or Allergy: What’s the Difference?](https://www.autoimmuneinstitute.org/articles/food-sensitivity-intolerance-or-allergy-whats-the-difference) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Processed-Food-1024x576.jpg) What is Processed Food? Processed foods can influence nutrition, gut health, and immune function. This article explains what processing means and how to make more informed choices in the context of overall health. Living Well with Autoimmune Disease [Read Post What is Processed Food?](https://www.autoimmuneinstitute.org/articles/what-is-processed-food) ![Vegetable farmer arranging freshly picked produce into a crate on an organic farm](https://www.autoimmuneinstitute.org/wp-content/uploads/2020/02/shutterstock_2127480059-1024x683.jpg) What Does Organic Really Mean? The word “organic” is everywhere. It’s stamped on our bell peppers and peaches at the grocery store, it makes appearances in snack commercials, and it shows up in recipes requesting “juice from one organic lemon.” Even businesses like airlines and gas stations are stocking up on the surging trend. We’ve heard that organic produce is higher in nutrients, reduces our exposure to toxic pesticides, and that it’s better for the environment than conventional produce. Those of us with chronic illnesses (like autoimmune disease) are encouraged by friends, practitioners, and a cacophony of internet voices to eat organic fruits and veggies. We \[…\] Living Well with Autoimmune Disease [Read Post What Does Organic Really Mean?](https://www.autoimmuneinstitute.org/articles/what-does-organic-really-mean-part-one) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Elimination-Diets-1024x576.jpg) Elimination Diets: What You Need to Know Elimination diets are often used to manage symptoms in autoimmune disease and chronic illness. Learn how they work, their potential benefits, and when they may not be the right approach. Living Well with Autoimmune Disease [Read Post Elimination Diets: What You Need to Know](https://www.autoimmuneinstitute.org/articles/elimination-diets-what-you-need-to-know) ### Diagnosing Autoimmune Disease ### Diagnosing Autoimmune Disease Getting an autoimmune diagnosis is rarely straightforward. These articles explore misdiagnosis, evolving diagnostic tools, and the challenges patients face along the way. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/07/Innovative-Diagnostic-1024x576.png) Innovative Diagnostic Techniques for Detecting Autoimmune Diseases Autoimmune disease is a complex group of diseases, where symptoms can vary, wax and wane, and overlap with those of other conditions. This often means the time to diagnosis can take several months to years. Current tests available for autoimmune disease testing include antinuclear antibody (ANA) testing, C-reactive protein tests, ELISAs, and erythrocyte sedimentation rate tests. More information about these tests can be found here. Why is Autoimmune Disease Challenging to Diagnose? David Pisetsky, Professor of Medicine at Duke University School of Medicine, cites three common challenges when it comes to diagnosing autoimmune diseases: non-specific symptoms, uncertainty in screening tests, and \[…\] Diagnosis & Treatment [Read Post Innovative Diagnostic Techniques for Detecting Autoimmune Diseases](https://www.autoimmuneinstitute.org/articles/innovative-diagnostic-techniques-for-detecting-autoimmune-diseases) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/diagnosing-AD-1024x576.png) Misdiagnosed and Undiagnosed: Expert Insights on the Autoimmune Diagnosis Process Diagnosing autoimmune diseases is often a complex and challenging process because autoimmune diseases vary widely. Identifying patterns and clusters of symptoms can help, but autoimmunity often relates to many factors including stress, deficiencies, toxic exposures, gut and immune dysfunction. As such, autoimmunity has a tendency to go undiagnosed — or misdiagnosed. Here, the Global Autoimmune Institute speaks with Dr. Francisco Contreras, Johannah Ruddy, M.Ed, and Dr. Henri Roca about the process of diagnosing autoimmune disease. Autoimmune Care & Caregiver Support [Read Post Misdiagnosed and Undiagnosed: Expert Insights on the Autoimmune Diagnosis Process](https://www.autoimmuneinstitute.org/articles/misdiagnosed-undiagnosed-expert-insights-on-the-autoimmune-diagnosis-process) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/04/diagnosing-AD-2-1024x576.webp) Experts Discuss the Complex Path to an Autoimmune Diagnosis Unlock the mystery of autoimmune diagnosis with insights from medical experts. Learn about diverse timelines, proactive patient advocacy, and holistic approaches to unraveling the mysteries of chronic conditions. Autoimmune Care & Caregiver Support [Read Post Experts Discuss the Complex Path to an Autoimmune Diagnosis](https://www.autoimmuneinstitute.org/articles/experts-discuss-the-complex-path-to-an-autoimmune-diagnosis) ![Which Doctors Treat Autoimmune Disease Global Autoimmune Institute](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Which-doctors-treat-1024x576.jpg) Doctors who Diagnose & Treat Autoimmune Disease Many people are still experiencing delayed autoimmune disease diagnosis or misdiagnosis. Seeking out doctors with greater awareness of these chronic, immune-mediated conditions can help speed up the process. [Read Post Doctors who Diagnose & Treat Autoimmune Disease](https://www.autoimmuneinstitute.org/doctors-who-diagnose-treat/) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/terminology-1024x576.jpg) Autoimmune Terminology To Know For Your Next Doctor’s Appointment While having guidance and support from your doctor is essential, taking control of your own health is important for planning and making informed decisions about your autoimmune disease. Being on board with the terms used to describe autoimmunity and specific diseases during your doctor’s appointments can help you receive the care you need as you ask questions to recognize signs and symptoms, understand the reasons behind testing, and navigate treatment options. Autoimmune Disease Testing: After a physical exam, your healthcare provider will order additional tests to diagnose your disease depending on your signs and symptoms. Terms to keep in mind include \[…\] Autoimmune Care & Caregiver Support [Read Post Autoimmune Terminology To Know For Your Next Doctor’s Appointment](https://www.autoimmuneinstitute.org/articles/autoimmune-terminology-to-know-for-your-next-doctors-appointment) ### Microbiome and Autoimmune Disease ### Microbiome and Autoimmune Disease We’ve learned a lot about the microbiome in recent years, from its role in digestion to its influence on immune function. This series explores how microbial communities in the gut, mouth, and skin may shape inflammation and play a role in autoimmune disease. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2019/06/shutterstock_2481364381-1024x576.jpg) What is the Microbiome and Why is it Important? Many chronic illnesses, including obesity, type 2 diabetes, and inflammatory bowel disease, appear to be affected by the microbiome. The relationship between autoimmunity and the microbiome is still being studied intensely, but these conditions are likely associated with an imbalance in the gut microbiome. Although strong evidence is still emerging, studies suggest that autoimmune patients exhibit reduced microbial diversity. Living Well with Autoimmune Disease [Read Post What is the Microbiome and Why is it Important?](https://www.autoimmuneinstitute.org/articles/what-is-the-microbiome-and-why-is-it-important) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Autoimmune-disease-and-the-Gut-Microbiome-1024x576.jpg) The Relationship Between Autoimmune Disease and the Gut Microbiome Could the gut microbiome influence autoimmune disease? See how microbial imbalances may affect immune function, inflammation, and disease development. Living Well with Autoimmune Disease [Read Post The Relationship Between Autoimmune Disease and the Gut Microbiome](https://www.autoimmuneinstitute.org/articles/the-relationship-between-autoimmune-disease-and-the-gut-microbiome) ![Gut-Skin Connection: How Your Microbiome Impacts Autoimmune Skin Diseases Global Autoimmune Institute](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/01/Gut-Skin-Connection-1024x576.png) Gut-Skin Connection: How Your Microbiome Impacts Autoimmune Skin Diseases The gut and the skin are more alike than you might think. Learn more the complexities of the gut-skin axis and how it influences autoimmune diseases. Living Well with Autoimmune Disease [Read Post Gut-Skin Connection: How Your Microbiome Impacts Autoimmune Skin Diseases](https://www.autoimmuneinstitute.org/articles/gut-skin-connection-how-your-microbiome-impacts-autoimmune-skin-diseases) ![oral microbiome and autoimmune disease](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/05/oral-microbiome-2-1024x576.png) Is Your Oral Microbiome Fueling Autoimmune Disease? Trillions of microorganisms colonize our bodies. These microorganisms, collectively known as the microbiome, help us out in many ways, from protecting us from invading bacteria to digesting our food. However, the microbiome can sometimes get out of balance, which has been correlated with a variety of diseases, including autoimmune diseases.  In this article, we examine the oral microbiome, oral dysbiosis, and their connections to autoimmunity. What is the Oral Microbiome? The oral microbiome is the community of microorganisms in the mouth that colonize our saliva, teeth, gums, cheeks, tongue, hard and soft palates, and tonsils. We acquire our oral microbiomes beginning at \[…\] Living Well with Autoimmune Disease [Read Post Is Your Oral Microbiome Fueling Autoimmune Disease?](https://www.autoimmuneinstitute.org/articles/is-your-oral-microbiome-fueling-autoimmune-disease) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Pesticides-1-1024x576.jpg) Pesticide Use & the Gut Microbiome The gut microbiome is shaped by more than diet. See how pesticides and other environmental exposures may alter microbial balance and contribute to autoimmune disease risk. Living Well with Autoimmune Disease [Read Post Pesticide Use & the Gut Microbiome](https://www.autoimmuneinstitute.org/articles/pesticide-use-the-gut-microbiome) --- ### [A-Z Disease List](https://www.autoimmuneinstitute.org/resources/autoimmune-diseases-list/) **Published:** February 26, 2024 **Author:** Carolyn Serraino **Excerpt:** This A-Z list and basic information about each recognized autoimmune disease were compiled and written by our dedicated research team at the Global Autoimmune Institute. The list provides a starting point in learning about autoimmune diseases and immune-mediated conditions, with links to other sources that we believe to be accurate and informative. This section will be updated periodically. **Content:** ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/banner-photo-1.jpg) # A-Z Autoimmune Disease List This A-Z list and basic information about each recognized or suspected autoimmune disease were compiled and written by our dedicated research team at the Global Autoimmune Institute. The list provides a starting point in learning about confirmed and suspected autoimmune diseases, with links to other sources that we believe to be accurate and informative. This section is continuously updated. ![](https://www.autoimmuneinstitute.org/wp-content/themes/elevation-framework/src/assets/images/layer-list.svg) Search: Clear filters A B C D E F G H I J K L M N O P Q R S T U V W X Y Z [Acquired hemophilia ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/acquired-hemophilia/) [Acromegaly ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/acromegaly/) [Acute disseminated encephalomyelitis (ADEM) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/acute-disseminated-encephalomyelitis/) [Acute hemorrhagic leukoencephalitis (AHLE, Hurst’s disease) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/hursts-disease/) [Addison’s disease ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-addisons-disease/) [Adult-onset Still’s disease ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/adult-onset-stills-disease/) [Agammaglobulinemia ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/agammaglobulinemia/) [Alopecia areata ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/alopecia-areata/) [Amyloidosis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/amyloidosis/) [Ankylosing spondylitis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ankylosing-spondylitis/) [Anti-NMDAR encephalitis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/anti-nmda-receptor-encephalitis/) [Antiphospholipid syndrome ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/antiphospholipid-syndrome/) [Aplastic anemia ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/aplastic-anemia/) [Arteriosclerosis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/arteriosclerosis/) [Autoimmune angioedema ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-angioedema/) [Autoimmune autonomic disorders (autoimmune dysautonomia) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-autonomic-disorders-autoimmune-dysautonomia/) [Autoimmune autonomic ganglionopathy (AAG) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-autonomic-ganglionopathy/) [Autoimmune encephalitis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-encephalitis/) [Autoimmune gastritis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-gastritis/) [Autoimmune hemolytic anemia ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-hemolytic-anemia/) [Autoimmune hepatitis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-hepatitis/) [Autoimmune hyperlipidemia ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-hyperlipidemia/) [Autoimmune hypophysitis (lymphocytic hypophysitis) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-hypophysitis/) [Autoimmune inner ear disease ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-inner-ear-disease/) [Autoimmune interstitial lung disease ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-interstitial-lung-disease/) [Autoimmune lymphoproliferative syndrome ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-lymphoproliferative-syndrome/) [Autoimmune myelofibrosis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-myelofibrosis/) [Autoimmune myocarditis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-myocarditis/) [Autoimmune neutropenia ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-neutropenia/) [Autoimmune oophoritis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-oophoritis/) [Autoimmune orchitis (testicular autoimmunity) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/testicular-autoimmunity/) [Autoimmune pancreatitis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-pancreatitis/) [Autoimmune polyglandular syndrome ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-polyglandular-syndromes/) [Autoimmune retinopathy ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-retinopathy/) [Autoimmune sudden sensorineural hearing loss ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-sudden-sensorineural-hearing-loss/) [Autoimmune urticaria (chronic spontaneous urticaria) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/chronic-urticaria/) [Autoimmune uveitis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-uveitis/) [Autoimmune vasculitis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-vasculitis/) [Balo disease (concentric sclerosis) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/balo-disease/) [Behçet’s disease ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/behcets/) [Birdshot chorioretinopathy ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/birdshot-chorioretinopathy/) [Bullous pemphigoid ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/bullous-pemphigoid/) [Castleman disease ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/castleman-disease/) [Celiac disease ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/celiac-disease/) [Chagas disease ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/chagas-disease/) [Chronic inflammatory demyelinating polyneuropathy (CIDP) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/chronic-inflammatory-demyelinating-polyneuropathy/) [Chronic recurrent multifocal osteomyelitis ](https://www.autoimmuneinstitute.org/?post_type=diseases_list&p=33722) [Churg-Strauss syndrome (eosinophilic granulomatosis with polyangiitis, EGPA) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/churg-strauss-syndrome/) [Cogan’s syndrome ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/cogan-syndrome/) [Cold agglutinin disease ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/cold-agglutinin-disease/) [Complex regional pain syndrome (CRPS) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/complex-regional-pain-syndrome-crps/) [Congenital heart block ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/congenital-heart-block/) [CREST syndrome (limited cutaneous systemic sclerosis) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crest-syndrome/) [Crohn’s disease ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crohns-disease/) [Cronkhite-Canada syndrome ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/cronkhite-canada-syndrome/) [Cryptogenic organizing pneumonia ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/cryptogenic-organizing-pneumonia/) [Custom Articles Block Test ](https://www.autoimmuneinstitute.org/?post_type=diseases_list&p=22460) [Dermatitis herpetiformis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/dermatitis-herpetiformis/) [Dermatomyositis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/dermatomyositis/) [Discoid lupus ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/discoid-lupus/) [Dressler’s syndrome (postmyocardial infarction syndrome) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/dresslers-syndrome/) [Eczema (atopic dermatitis) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/eczema/) [Endometriosis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/endometriosis/) [Eosinophilic esophagitis (eosinophilic gastroenteritis) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/eosinophilic-esophagitis/) [Eosinophilic fasciitis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/eosinophilic-fasciitis/) [Erythema nodosum ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/erythema-nodosum/) [Essential mixed cryoglobulinemia ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/essential-mixed-cryoglobulinemia/) [Evans syndrome ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/evans-syndrome/) [Fibromyalgia ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/fibromyalgia/) [Fibrosing alveolitis (idiopathic pulmonary fibrosis) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/fibrosing-alveolitis/) [Giant cell arteritis (temporal arteritis, Horton’s disease) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/giant-cell-arteritis-temporal-arteritis-hortons-disease/) [Giant cell myocarditis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/giant-cell-myocarditis/) [Glomerulonephritis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/glomerulonephritis/) [Goodpasture’s syndrome (anti-GBM disease) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/goodpastures-syndrome/) [Granulomatosis with polyangiitis (GPA, Wegener’s granulomatosis) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/wegeners/) [Graves’ disease ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/graves-disease/) [Guillain-Barré syndrome (GBS) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/guillain-barre-syndrome/) [Hashimoto’s thyroiditis (autoimmune thyroiditis) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/hashimotos-thyroiditis/) [Henoch-Schonlein purpura ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/henoch-schonlein-purpura/) [Hidradenitis suppurativa ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/hidradenitis-suppurativa/) [Hypogammaglobulinemia ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/hypogammaglobulinemia/) [IgA nephropathy (Berger’s disease) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/iga-nephropathy/) [IgG4-related sclerosing disease ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/igg4-related-sclerosing-disease/) [Immune thrombocytopenia (autoimmune thrombocytopenic purpura) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/immune-thrombocytopenia/) [Immune-mediated necrotizing myopathy ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/immune-mediated-necrotizing-myopathy/) [Inclusion body myositis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/inclusion-body-myositis/) [Interstitial cystitis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/interstitial-cystitis/) [Juvenile idiopathic arthritis (JIA) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/juvenile-idiopathic-arthritis-stills/) [Juvenile myositis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/juvenile-myositis/) [Kawasaki disease ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/kawasaki-disease/) [Lambert-Eaton myasthenic syndrome ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/lambert-eaton-myasthenic-syndrome/) [Leukocytoclastic vasculitis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/leukocytoclastic-vasculitis/) [Lichen planus ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/lichen-planus/) [Lichen sclerosus ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/lichen-sclerosus/) [Ligneous conjunctivitis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ligneous-conjunctivitis/) [Linear IgA disease ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/linear-igadisease/) [Lupus nephritis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/lupus-nephritis/) [Lyme disease ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/lyme-disease/) [Ménière’s disease ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/menierers-disease/) [Microscopic colitis (lymphocytic colitis and collagenous colitis) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/microscopic-colitis/) [Microscopic polyangiitis (MPA) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/microscopic-polyangiitis-anca-associated-vasculitis/) [Mixed connective tissue disease ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/mixed-connective-tissue-disease/) [Mooren’s ulcer ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/moorens-ulcer/) [Mucous membrane pemphigoid (MMP) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/mucous-membrane-pemphigoid/) [Multifocal motor neuropathy ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multifocal-motor-neuropathy/) [Multiple sclerosis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/) [Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/me-cfs/) [Myasthenia gravis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/myasthenia-gravis/) [Myelin oligodendrocyte glycoprotein antibody disease (MOGAD) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/myelin-oligodendrocyte-glycoprotein-antibody-disease-mogad/) [Myositis/polymyositis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/polymyositis/) [Narcolepsy ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/narcolepsy/) [Neonatal lupus ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/neonatal-lupus/) [Neuromyelitis optica (NMO, Devic’s disease) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/neuromyelitis-optica/) [Opsoclonus-myoclonus syndrome ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/opsoclonus-myoclonus-syndrome/) [Optic neuritis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/optic-neuritis/) [Palindromic rheumatism ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/palindromic-rheumatism/) [Palmoplantar pustulosis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/palmoplantar-pustulosis/) [Paraneoplastic cerebellar degeneration ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/paraneoplastic-cerebellar-degeneration/) [Paraneoplastic pemphigus ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/paraneoplastic-pemphigus/) [Paroxysmal nocturnal hemoglobinuria ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/paroxysmal-nocturnal-hemoglobinuria/) [Parry-Romberg syndrome (progressive hemifacial atrophy) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/parry-romberg-syndrome/) [Pars planitis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/pars-planitis/) [Parsonage-Turner syndrome (brachial neuritis) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/parsonage-turner-syndrome/) [Pediatric acute-onset neuropsychiatric syndrome (PANS, PANDAS) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/pans-pandas/) [Pemphigoid gestationis (herpes gestationis) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/pemphigoid-gestationis/) [Pemphigus foliaceus ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/pemphigus-foliaceus/) [Pemphigus vulgaris ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/pemphigus-vulgaris/) [Pernicious anemia ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/pernicious-anemia/) [Pityriasis lichenoides et varioliformis acuta (PLEVA, Mucha-Habermann disease) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/pityriasis-lichenoides-et-varioliformis-acuta-pleva/) [POEMS syndrome ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/poems-syndrome/) [Polyarteritis nodosa ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/polyarteritis-nodosa/) [Polymyalgia rheumatica ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/polymyalgia-rheumatica/) [Postural orthostatic tachycardia syndrome (POTS) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/postural-orthostatic-tachycardia-syndrome/) [Primary biliary cholangitis (PBC) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/primary-biliary-cirrhosis/) [Primary sclerosing cholangitis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/primary-sclerosing-cholangitis/) [Progesterone dermatitis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-progesterone-dermatitis/) [Psoriasis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/psoriasis/) [Psoriatic arthritis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/psoriatic-arthritis/) [Pulmonary alveolar proteinosis ](https://www.autoimmuneinstitute.org/?post_type=diseases_list&p=33723) [Pure red cell aplasia ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/pure-red-cell-aplasia/) [Pyoderma gangrenosum ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/pyoderma-gangrenosum/) [Raynaud’s ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/raynauds-syndrome/) [Reactive arthritis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/reactive-arthritis/) [Relapsing polychondritis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/relapsing-polychondritis/) [Retroperitoneal fibrosis ](https://www.autoimmuneinstitute.org/?post_type=diseases_list&p=33728) [Rheumatic fever ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatic-fever/) [Rheumatoid arthritis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/) [Sarcoidosis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sarcoidosis/) [Schmidt syndrome ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/schmidt-syndrome/) [Scleritis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/scleritis/) [Scleroderma (systemic sclerosis) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/scleroderma/) [Sjögren disease (SjD) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sjogren-syndrome/) [Small fiber sensory neuropathy ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/small-fiber-sensory-neuropathy/) [Stiff person syndrome ](https://www.autoimmuneinstitute.org/?post_type=diseases_list&p=33732) [Susac’s syndrome ](https://www.autoimmuneinstitute.org/?post_type=diseases_list&p=33735) [Sydenham’s chorea ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sydenhams-chorea/) [Sympathetic ophthalmia ](https://www.autoimmuneinstitute.org/?post_type=diseases_list&p=33740) [Systemic lupus erythematosus (SLE) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/) [Takayasu arteritis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/takayasu-arteritis/) [Thyroid eye disease (Graves’ ophthalmopathy, thyroid-associated orbitopathy) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/thyroid-eye-disease-graves-ophthalmopathy-thyroid-associated-orbitopathy/) [Tolosa-Hunt syndrome ](https://www.autoimmuneinstitute.org/?post_type=diseases_list&p=33744) [Transverse myelitis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/transverse-myelitis/) [Type 1 diabetes (T1D) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/type-1-diabetes-insulin-dependent-diabetes/) [Ulcerative colitis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ulcerative-colitis/) [Undifferentiated connective tissue disease ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/undifferentiated-connective-tissue-disease/) [Vitiligo ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/vitiligo/) [Vogt-Koyanagi-Harada disease ](https://www.autoimmuneinstitute.org/?post_type=diseases_list&p=33747) ## Posts navigation ### Helpful Resources, Institutions & More [ ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/facybox-img1_hover.png) Doctors & Specialists Autoimmune diseases are becoming more well-known, yet many people are still experiencing delayed diagnosis or misdiagnosis. As finding answers can take years, seeking out doctors who have a greater awareness of these chronic, immune-mediated conditions can help speed up the process. More about AD Doctors & Specialists Read more about Doctors & Specialists ](https://www.autoimmuneinstitute.org/doctors-who-diagnose-treat/) [ ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/facybox-img1_hover-1.png) Medical Institutions Directory A comprehensive list of medical institutions across the United States specializing in the diagnosis and treatment of autoimmune diseases in an easy-to-use keyword and location search format. Find Medical Institutions Near You Read more about Medical Institutions Directory ](https://www.autoimmuneinstitute.org/medical-institutions/) [ ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/pexels-pixabay-2156-3-1.png) Autoimmune Organizations Explore our growing list of national and international organizations. From groups that focus on whole-body approaches to autoimmune health and healing to alphabetically listed disease organizations. This list provides in-depth information and support on daily living, advocacy, research, science, healthcare, and more. Browse Autoimmune Organizations Read more about Autoimmune Organizations ](https://www.autoimmuneinstitute.org/autoimmune-organizations/) ## Want to see more from the Global Autoimmune Institute? Confirm GAI as a trusted autoimmune disease news source to make it easier to find our latest resources and updates. 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Scroll down for concise and clear updates on clinical trials, innovations, and new findings in autoimmune research, including COVID-19 and long COVID. #### Recently Published - [Misdiagnosed and Undiagnosed: Expert Insights on the Autoimmune Diagnosis Process](https://www.autoimmuneinstitute.org/articles/misdiagnosed-undiagnosed-expert-insights-on-the-autoimmune-diagnosis-process) - [Environmental Toxins and Autoimmune Disease](https://www.autoimmuneinstitute.org/articles/environmental-triggers-autoimmune-disease) - [Trauma and Autoimmune Disease: What the Research Shows](https://www.autoimmuneinstitute.org/articles/trauma-and-autoimmune-disease) - [Chemical Exposure and Autoimmune Disease: What the Research Shows](https://www.autoimmuneinstitute.org/articles/chemical-exposure-autoimmune-disease) - [How to Support Someone with Autoimmune or Chronic Disease](https://www.autoimmuneinstitute.org/articles/how-to-support-someone-with-autoimmune-or-chronic-disease) - [Navigating Immunosuppression and Infection Risk](https://www.autoimmuneinstitute.org/articles/navigating-immunosuppression-and-infection-risk) - [GLP-1 Receptor Agonists and Autoimmune Diseases](https://www.autoimmuneinstitute.org/articles/glp-1-receptor-agonists-and-autoimmune-diseases) - [A Guide to Interpreting Clinical Trial Stories](https://www.autoimmuneinstitute.org/articles/a-guide-to-interpreting-clinical-trial-stories) - [Living with Multiple Autoimmune Conditions](https://www.autoimmuneinstitute.org/articles/living-with-multiple-autoimmune-conditions) [See all articles](https://www.autoimmuneinstitute.org/our-articles/) ### Understanding Autoimmune Disease Explore GAI’s collection of article series, each offering original, expert-informed insights that translate complex autoimmune disease research, care, and lived experience into clear, trustworthy information. ## Browse by Topic [The Immune Spectrum: Autoimmunity and Cancer](https://www.autoimmuneinstitute.org/gai-library/#immune-spectrum) [When Autoimmune Disease Meets Real Life](https://www.autoimmuneinstitute.org/gai-library/#real-life) [How Autoimmunity Changes Over Time](https://www.autoimmuneinstitute.org/gai-library/#disease-progression) [Living with Chronic Illness](https://www.autoimmuneinstitute.org/gai-library/#living-with-chronic-illness) [The Neuroimmune Connection](https://www.autoimmuneinstitute.org/gai-library/#neuroimmune) [New Frontiers in Autoimmune Treatment](https://www.autoimmuneinstitute.org/gai-library/#new-frontiers) [Navigating Autoimmune Healthcare](https://www.autoimmuneinstitute.org/gai-library/#healthcare) [Understanding Autoimmunity](https://www.autoimmuneinstitute.org/gai-library/#autoimmunity) [Pregnancy and Autoimmune Disease](https://www.autoimmuneinstitute.org/gai-library/#pregnancy) [COVID-19, Long Covid, and Autoimmune Disease](https://www.autoimmuneinstitute.org/gai-library/#covid) [Food, Immunity, and Autoimmune Disease](https://www.autoimmuneinstitute.org/gai-library/#ad-food) [Autoimmune Disease Risk Factors](https://www.autoimmuneinstitute.org/gai-library/#risk-factors) [Diagnosing Autoimmune Disease](https://www.autoimmuneinstitute.org/gai-library/#diagnosis) [Microbiome and Autoimmune Disease](https://www.autoimmuneinstitute.org/gai-library/#microbiome) --- ### [Our Articles](https://www.autoimmuneinstitute.org/our-articles/) **Published:** February 23, 2024 **Author:** Carolyn Serraino **Excerpt:** An assortment of informative and easy-to-understand articles about autoimmune disease! **Content:** ## Our Articles [addtoany] Search Categories\* Category About Autoimmune Disease Autoimmune Care & Caregiver Support COVID-19 and Long Covid Diagnosis & Treatment Living Well with Autoimmune Disease Search Clear all filters Displaying Results For: ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/diagnosing-AD.png) October 22, 2026 by Carolyn Serraino Misdiagnosed and Undiagnosed: Expert Insights on the Autoimmune Diagnosis Process Diagnosing autoimmune diseases is often a complex and challenging process because autoimmune diseases vary widely. Identifying patterns and clusters of… - [Autoimmune Care & Caregiver Support](https://www.autoimmuneinstitute.org/category/autoimmune-care-and-support/) - [Diagnosis & Treatment](https://www.autoimmuneinstitute.org/category/diagnosis-treatment/) [Read Post](https://www.autoimmuneinstitute.org/articles/misdiagnosed-undiagnosed-expert-insights-on-the-autoimmune-diagnosis-process) ![Conceptual medical illustration of a human silhouette showing the effects of environmental and lifestyle factors on autoimmune disease risk, including airborne pathogens, lung exposure, stress-related brain activity, and gut microbiome dysbiosis.](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/08/environmental-toxins-autoimmune-disease-2.jpg) August 24, 2026 by Carolyn Serraino Environmental Toxins and Autoimmune Disease Environmental toxins are part of everyday life, but not all exposures carry the same risk. Learn how pollutants, household… - [Living Well with Autoimmune Disease](https://www.autoimmuneinstitute.org/category/living-well-understanding-the-body/) [Read Post](https://www.autoimmuneinstitute.org/articles/environmental-triggers-autoimmune-disease) ![Illustration of a person surrounded by reaching shadow-like hands, representing trauma, chronic stress, and their potential effects on health and autoimmune disease.](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/08/trauma-autoimmune-disease-stress-response.jpg) August 24, 2026 by Carolyn Serraino Trauma and Autoimmune Disease: What the Research Shows Research suggests trauma and PTSD may affect inflammation, immune function, and autoimmune disease risk. Here’s what scientists know about… - [Living Well with Autoimmune Disease](https://www.autoimmuneinstitute.org/category/living-well-understanding-the-body/) [Read Post](https://www.autoimmuneinstitute.org/articles/trauma-and-autoimmune-disease) ![Industrial facility beside polluted water with discarded chemical containers, representing environmental chemical exposure and autoimmune disease risk.](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/08/Chemical-Exposure-and-Autoimmune-Disease.jpg) August 24, 2026 by Carolyn Serraino Chemical Exposure and Autoimmune Disease: What the Research Shows Which chemicals are linked to autoimmune disease? Experts explain what research shows about PFAS, pesticides, heavy metals, TCE, silica,… - [Living Well with Autoimmune Disease](https://www.autoimmuneinstitute.org/category/living-well-understanding-the-body/) [Read Post](https://www.autoimmuneinstitute.org/articles/chemical-exposure-autoimmune-disease) ![Supportive hands holding one another, representing compassion and emotional support for people living with autoimmune or chronic disease.](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/07/supporting-someone-with-autoimmune-or-chronic-disease.jpg) July 16, 2026 by Carolyn Serraino How to Support Someone with Autoimmune or Chronic Disease Many people want to support a parent, sibling, friend, partner, colleague, or neighbor living with an autoimmune or chronic… - [Autoimmune Care & Caregiver Support](https://www.autoimmuneinstitute.org/category/autoimmune-care-and-support/) [Read Post](https://www.autoimmuneinstitute.org/articles/how-to-support-someone-with-autoimmune-or-chronic-disease) ![Illustration of a person with lungs surrounded by viruses, bacteria, and fungi representing infection risk in people with autoimmune diseases receiving immunosuppressive therapy.](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/07/navigating-immunosuppression-infection-risk-autoimmune-disease.jpg) July 16, 2026 by Carolyn Serraino Navigating Immunosuppression and Infection Risk Modern immunosuppressive therapies have transformed the treatment of autoimmune diseases, allowing many people to live healthier, more active lives…. - [Living Well with Autoimmune Disease](https://www.autoimmuneinstitute.org/category/living-well-understanding-the-body/) [Read Post](https://www.autoimmuneinstitute.org/articles/navigating-immunosuppression-and-infection-risk) ![GLP-1 Receptor Agonists and Autoimmune Diseases](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/06/GLP-1-Receptor-Agonists-and-Autoimmune-Diseases-1.jpg) June 18, 2026 by Carolyn Serraino GLP-1 Receptor Agonists and Autoimmune Diseases If you have an autoimmune disease, should you be concerned about GLP-1 medications? Here’s what experts and current research… - [Diagnosis & Treatment](https://www.autoimmuneinstitute.org/category/diagnosis-treatment/) [Read Post](https://www.autoimmuneinstitute.org/articles/glp-1-receptor-agonists-and-autoimmune-diseases) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/06/A-Guide-to-Interpreting-Clinical-Trial-Stories.jpg) June 8, 2026 by Carolyn Serraino A Guide to Interpreting Clinical Trial Stories How to evaluate pre-clinical research, clinical trial phases, study results, and key questions to ask with expert insights from… - [About Autoimmune Disease](https://www.autoimmuneinstitute.org/category/about-autoimmune-disease/) [Read Post](https://www.autoimmuneinstitute.org/articles/a-guide-to-interpreting-clinical-trial-stories) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/06/living-with-multiple-ADs-4.jpg) June 8, 2026 by Carolyn Serraino Living with Multiple Autoimmune Conditions Learn how to manage multiple autoimmune diseases with expert insights on polyautoimmunity, symptom tracking, specialist coordination, medication management, and… - [Living Well with Autoimmune Disease](https://www.autoimmuneinstitute.org/category/living-well-understanding-the-body/) [Read Post](https://www.autoimmuneinstitute.org/articles/living-with-multiple-autoimmune-conditions) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/06/Autoimmune-or-Not-2.jpg) June 5, 2026 by Carolyn Serraino Autoimmune or Not? The Diseases That Blur the Lines Many diseases affect the immune system without being classified as autoimmune. Experts explain why conditions like fibromyalgia, endometriosis, POTS,… - [About Autoimmune Disease](https://www.autoimmuneinstitute.org/category/about-autoimmune-disease/) [Read Post](https://www.autoimmuneinstitute.org/articles/autoimmune-or-not-the-diseases-that-blur-the-lines) ![Immune Nodes and Vessels in Lymphatic System 3d illustration](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/02/Restoring-Immune-Tolerance.jpg) April 13, 2026 by Carolyn Serraino Restoring Immune Tolerance in Autoimmune Disease Immune tolerance prevents the body from attacking itself. Learn how it breaks down in autoimmune disease and how new… - [About Autoimmune Disease](https://www.autoimmuneinstitute.org/category/about-autoimmune-disease/) - [Diagnosis & Treatment](https://www.autoimmuneinstitute.org/category/diagnosis-treatment/) [Read Post](https://www.autoimmuneinstitute.org/articles/restoring-immune-tolerance-in-autoimmune-disease) ![Lymphocytes and biological immune system, 3d rendering. 3D illustration.](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/02/AD-and-cancer.jpg) April 13, 2026 by Carolyn Serraino The Immune Balancing Act: Cancer and Autoimmunity Cancer and autoimmune disease sit at opposite ends of the immune spectrum. Yet treating one condition can sometimes increase… - [About Autoimmune Disease](https://www.autoimmuneinstitute.org/category/about-autoimmune-disease/) [Read Post](https://www.autoimmuneinstitute.org/articles/the-immune-balancing-act-cancer-and-autoimmunity) ![Flying blue 3d antibodies interacting with red viruses. Immune defense, immunotherapy, disease prevention, vaccination, pathogen neutralization, molecular biology concept. Low poly wireframe.](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/02/The-Immune-Spectrum-From-Autoimmunity-to-Cancer.jpg) April 13, 2026 by Carolyn Serraino The Immune Spectrum: From Autoimmunity to Cancer How are autoimmune disease and cancer connected? Learn how immune balance, inflammation, and immune dysfunction shape disease across the… - [About Autoimmune Disease](https://www.autoimmuneinstitute.org/category/about-autoimmune-disease/) [Read Post](https://www.autoimmuneinstitute.org/articles/the-immune-spectrum-from-autoimmunity-to-cancer) ![silhouette of a woman in front of a sunset peering into the distance](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/03/Finding-Purpose-with-Autoimmune-Disease-and-Chronic-Illness-GAI.jpg) February 5, 2026 by Carolyn Serraino Finding Purpose & Fulfillment with Autoimmune and Chronic Disease People with autoimmune diseases or other severe chronic illnesses learn how to manage their condition but also strive to… - [Living Well with Autoimmune Disease](https://www.autoimmuneinstitute.org/category/living-well-understanding-the-body/) [Read Post](https://www.autoimmuneinstitute.org/articles/finding-purpose-and-fulfillment-with-autoimmune-and-chronic-disease) ## Posts navigation 1[2](https://www.autoimmuneinstitute.org/wp-admin/admin-ajax.php/page/2/?action=as_async_request_queue_runner&nonce=03efbfba2b)[3](https://www.autoimmuneinstitute.org/wp-admin/admin-ajax.php/page/3/?action=as_async_request_queue_runner&nonce=03efbfba2b)…[8](https://www.autoimmuneinstitute.org/wp-admin/admin-ajax.php/page/8/?action=as_async_request_queue_runner&nonce=03efbfba2b)[Next »](https://www.autoimmuneinstitute.org/wp-admin/admin-ajax.php/page/2/?action=as_async_request_queue_runner&nonce=03efbfba2b) --- ### [Autoimmune Disease Research News & Updates](https://www.autoimmuneinstitute.org/ad-news-research-updates/) **Published:** February 23, 2024 **Author:** Carolyn Serraino **Excerpt:** Stay updated with informative and easy-to-understand summaries of the most critical research breakthroughs in autoimmune disease. Search our interactive news timeline for information on the science behind autoimmunity and developments in the diagnosis and treatment of autoimmune disease dating back to 2019! **Content:** ## Autoimmune Disease Research News and Updates Stay updated with informative and easy-to-understand summaries of the most critical research breakthroughs in autoimmune disease. Search our interactive news timeline for information on the science behind autoimmunity and developments in the diagnosis and treatment of autoimmune disease. Search Displaying Results For: Clear all filters Apply Filters Autoimmune Diseases Autoimmune Brain Inflammation Celiac Disease Eye Disease IBD (Crohn’s and UC) Lupus ME/CFS Multiple Sclerosis Neurological Disorders Psoriasis Rheumatoid Arthritis Sjögren disease Thyroid Disease Type 1 Diabetes Autoimmune Stories Case Studies Clinical Trials Diagnostic Testing Events GAI-Funded Genetics Microbiome Policy & Health Decisions OADR (NIH Office of Autoimmune Disease Research) Research Studies Resources Risk Factors Therapies Apply Filters Oct 22, 2026 GLP-1 Drugs and the Immune System: New Research on Autoimmune Disease As GLP-1 medications become increasingly common, researchers are looking beyond their effects on blood sugar and weight to better understand how they influence the immune system. While previous studies suggest these medications may reduce inflammation, their effects on autoimmune disease remain uncertain. On October 21, 2026, the La Jolla Institute for Immunology (LJI) announced a new study led by Professor Alessandro Sette, Dr.Biol.Sci., investigating whether GLP-1 medications alter adaptive immunity, the part of the immune system responsible for recognizing specific threats and developing immune memory. Researchers will collect blood samples before individuals begin GLP-1 treatment and throughout the following months, examining whether the medications \[…\] - Research Studies - Therapies [Read Post](https://www.autoimmuneinstitute.org/research_updates/glp-1-drugs-and-the-immune-system-new-research-on-autoimmune-disease/) Oct 21, 2026 Applegate’s MS Misdiagnosis Highlights Challenges of Diagnosing Multiple Sclerosis After five years of living with an MS diagnosis, Christina Applegate is searching for answers again. Her experience highlights why multiple sclerosis can be difficult to diagnose and the emotional impact of diagnostic uncertainty. - Autoimmune Stories - Diagnostic Testing - Multiple Sclerosis [Read Post](https://www.autoimmuneinstitute.org/research_updates/christina-applegate-ms-misdiagnosis/) Oct 05, 2026 Celiac Disease Halloween Resources & Gluten-Free Candy List Halloween traditions centered around candy can be difficult to navigate for children who need to avoid certain foods for medical reasons. For children with celiac disease, an autoimmune disease triggered by gluten, trick-or-treating can mean navigating unfamiliar food labels, shared treat bowls, and the possibility of gluten exposure. The Celiac Disease Foundation (CDF) is highlighting two resources for 2026 that offer practical ways to make Halloween safer and more inclusive: the Teal Pumpkin Project, which provides an alternative for children with a range of dietary restrictions, and an updated Gluten-Free Halloween Candy List for families managing celiac disease. The Teal Pumpkin \[…\] - Celiac Disease - Events - Resources [Read Post](https://www.autoimmuneinstitute.org/research_updates/celiac-disease-halloween-resources-gluten-free-candy-list/) Oct 01, 2026 Lupus Gene Variant May Strengthen Antiviral Immunity New research finds that a genetic variant in the IRF7 gene that increases risk of systemic lupus erythematosus (lupus) also makes us more resilient to viruses. The researchers found that this variant has persisted in human populations for millennia. Around 70% of the human population carry this variant. This variant increases the amount of interferon-ɑ produced by immune cells called monocytes and in cells that line the respiratory tract. In mouse models, the researchers of this study modified the mice’s IRF7 gene so that it matches the variant associated with lupus. After stimulating an autoimmune-like disease in these mice, the researchers \[…\] - Lupus - Research Studies - Risk Factors [Read Post](https://www.autoimmuneinstitute.org/research_updates/lupus-gene-variant-may-strengthen-antiviral-immunity/) Sep 25, 2026 NIH “From Mechanisms To Medicine” Workshop Highlights Researchers studying autoimmune disease, chronic pain, post-infectious illness, dysautonomia, and other complex chronic conditions are increasingly encountering the same challenge: the biology does not always fit neatly within the boundaries of individual diagnoses or medical specialties. That was a central theme of the National Institutes of Health (NIH) workshop “From Mechanisms to Medicine: Rethinking the Discovery-to-Care Continuum in Multi-System Disorders,” held September 23–24, 2026, at the Neuroscience Center in North Bethesda, Maryland. - Events - Research Studies [Read Post](https://www.autoimmuneinstitute.org/research_updates/nih-from-mechanisms-to-medicine-workshop/) Sep 23, 2026 Celiac Disease Experts To Address Common Myths In Upcoming Webinar September 30: Celiac disease experts will address common myths and misconceptions about celiac disease and the gluten-free diet during a webinar hosted by the National Celiac Association and Harvard Medical School’s Celiac Education and Research Program. - Celiac Disease - Events - Resources [Read Post](https://www.autoimmuneinstitute.org/research_updates/celiac-disease-myths-webinar/) Sep 18, 2026 LEAD Day 2026 Highlights Multi-Omics In Autoimmune Research On September 15, 2026, the Global Autoimmune Institute and La Jolla Institute for Immunology held the second annual Lectures, Empowerment, and Awareness for Autoimmune Disease (LEAD) Day at the Scripps Seaside Forum in La Jolla, California. The event brought together scientists, clinicians, advocates, and members of the broader community to discuss emerging approaches to understanding autoimmune disease and other complex chronic conditions. - Events - GAI Funded [Read Post](https://www.autoimmuneinstitute.org/research_updates/lead-day-2026-highlights/) Sep 15, 2026 Eric Topol on Immune Aging and the Future of Disease Prevention At LEAD Day 2026, physician-scientist Eric Topol examined why some people remain healthy well into old age and how advances in immunology, biological aging clocks, and artificial intelligence could help identify disease risks earlier. His keynote highlighted emerging research connecting immune aging, chronic inflammation, and neurodegenerative disease. - Events - GAI Funded - Risk Factors [Read Post](https://www.autoimmuneinstitute.org/research_updates/lead-day-2026-topol-award-lecture/) ## Posts navigation 1[2](https://www.autoimmuneinstitute.org/wp-admin/admin-ajax.php/page/2/?action=as_async_request_queue_runner&nonce=03efbfba2b)[3](https://www.autoimmuneinstitute.org/wp-admin/admin-ajax.php/page/3/?action=as_async_request_queue_runner&nonce=03efbfba2b)…[46](https://www.autoimmuneinstitute.org/wp-admin/admin-ajax.php/page/46/?action=as_async_request_queue_runner&nonce=03efbfba2b)[Next »](https://www.autoimmuneinstitute.org/wp-admin/admin-ajax.php/page/2/?action=as_async_request_queue_runner&nonce=03efbfba2b) --- ### [Current Research Grants & Projects](https://www.autoimmuneinstitute.org/current-research-grants-projects/) **Published:** February 23, 2024 **Author:** Carolyn Serraino **Excerpt:** GAI is increasing knowledge and progress in autoimmune disease by funding important scientific investigations. We are a moving force in propelling collaboration and awareness in science and medicine. Information on some ADs is much less available than others – we are on our way to help change that. **Content:** ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/banner-home-_photo-1.jpg) # Get to know the Research we Fund ![](https://www.autoimmuneinstitute.org/wp-content/themes/elevation-framework/src/assets/images/layer-purple-top.png) ##### GAI is increasing knowledge and progress in autoimmune disease by funding important scientific investigations. We are a moving force in propelling collaboration and awareness in science and medicine. Information on some ADs is much less available than others – we are on our way to help change that. ![](https://www.autoimmuneinstitute.org/wp-content/themes/elevation-framework/src/assets/images/layer-purple-bottom.png) - Johns Hopkins - Children’s National Hospital - La Jolla Institute for Immunology ### Čiháková Research Laboratory AT JOHNS HOPKINS UNIVERSITY Principal Investigator: Principal Investigator: Daniela Čiháková, MD ### Long Covid (PASC) Study ##### Background Information: Acute SARS-CoV-2 infection (COVID-19) is associated with both high cardiovascular morbidity and mortality. After an acute infection, some patients fail to fully recover and suffer for an extended period of time. Commonly referred to as “Long Covid,” this phenomenon is technically called Post-Acute Sequelae of SARS-CoV-2 (PASC). PASC is characterized by a high prevalence of persistent cardiac symptoms (such as chest pain, shortness of breath, arrhythmias, and decreased cardiac function). Remarkably, more than 25% of patients hospitalized with COVID-19 are found to have myocardial injury. However, the extent to which immune responses—such as myeloid cells, lymphocytes, and cytokines—may contribute to cardiovascular involvement in acute COVID-19 and in PASC is unknown. The duration of cardiovascular morbidity in PASC patients is also unknown. The immune profile of patients with cardiovascular PASC is understudied. To date, there have been no long-term studies investigating systemic markers in patients with PASC. Consequently, there is a need to understand the determinants of cardiovascular sequelae along the acute COVID-19 to PASC disease spectrum with attention to the immune profile. ##### Research Aims: Daniela Čiháková, M.D., Ph.D., has assembled a [team of cardiologists, virologists, and experts in animal modeling at Johns Hopkins](https://labs.pathology.jhu.edu/cihakova/) to collaborate with her on this project. The team will examine sera and immune cells from the blood of patients that were seen at the Johns Hopkins’ Long Covid clinic. These samples will be compared to healthy controls and samples from patients who tested positive for Covid in the past but completely recovered. The samples will undergo immunological, clinical, and imaging assessments. ### Cancer Therapy Induced Autoimmune Myocarditis Study ##### Background Information: Myocarditis is an inflammatory disease of the heart muscle cells, and myocarditis is most often caused by a viral infection. Giant cell myocarditis and eosinophilic myocarditis are rare but particularly severe types of myocarditis. About 30% of myocarditis survivors develop dilated cardiomyopathy (an enlargement and weakening of the heart muscle), one of the most common reasons for heart transplantation in all ages. Immune checkpoint inhibitors (ICI) have transformed the treatment of a wide spectrum of cancers. These therapies target molecules called “programmed cell death protein 1” (PD-1) and its ligand (PD-L1) (anti-PD-1/PD-L1 therapy). However, this new cancer therapy can lead to immune-related adverse events when autoimmune inflammation affects various organs. Immune-related adverse events are typically not life-threatening and manageable. However, autoimmune myocarditis has emerged as a rare but fatal complication of ICI therapies. Mortality for this ICI-associated myocarditis is high—50% of affected patients died. ##### **Research Aims:** Dr. Čiháková’s team will investigate the protective mechanism of the PD-1/PD-L1 interaction in the myocardium (the cardiac source of PD-L1 that protects the heart from myocarditis), the ability of the PD-1/PD-L1 pathway to prevent myocarditis progression to dilated cardiomyopathy, and the therapeutic potential of forced PD-L1 overexpression in myocarditis/dilated cardiomyopathy treatment. #### **GAI-Funded Publications** - Daoud, A., Kalinoski, H., Talor, M. V., Welsh, R. A., Jo, W., Jaime, C. M., Kolim, B., Mahto, N., Kveton, M., Weislová, I., Melenovský, V., Fabián, O., Kiemen, A. L., & Čiháková, D. (2025). [**Whole-heart 3D reconstruction of mouse CVB3 myocarditis reveals spatial and transcriptomic heterogeneity of immune foci**](https://doi.org/10.1093/cvr/cvaf209). *Cardiovascular research*, *121*(17), 2777–2790. https://doi.org/10.1093/cvr/cvaf209 - [Read Summary](https://www.autoimmuneinstitute.org/research_updates/whole-heart-3d-analysis-redefines-myocarditis/) - Campos Ramos, Gustavo, Daniela Čiháková, Christoph Maack, and Sumanth D. Prabhu. “[**Interface Between Cardioimmunology, Myocardial Health, and Disease: A Compendium**](https://www.ahajournals.org/doi/full/10.1161/CIRCRESAHA.124.324871).” *Circulation Research* 134, no. 12 (2024): 1661-1662. - [Read Summary](https://www.autoimmuneinstitute.org/research_updates/the-immune-systems-role-in-heart-disease/) - Čiháková, Daniela. “[**T Cells and Macrophages Drive Pathogenesis of Immune Checkpoint Inhibitor Myocarditis**](https://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.123.067189).” *Circulation* 149.1 (2024): 67-69. - [Read Summary](https://www.autoimmuneinstitute.org/research_updates/understanding-immune-checkpoint-inhibitor-myocarditis-risks/) - Jo, Wonyoung, Taejoon Won, Abdel Daoud, and Daniela Čiháková. “[**Immune checkpoint inhibitors associated cardiovascular immune-related adverse events**](https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2024.1340373/full).” *Frontiers in immunology* 15 (2024): 1340373. - [Read Summary](https://www.autoimmuneinstitute.org/research_updates/cardiovascular-immune-related-adverse-effects-from-immune-checkpoint-inhibitors-used-to-treat-cancer/) - Kalinoski, et al;“[**Injury-induced myosin-specific tissue-resident memory T cells drive immune checkpoint inhibitor myocarditis**](https://pubmed.ncbi.nlm.nih.gov/39378095/).” *PNAS* (2024) - [Read Summary](https://www.autoimmuneinstitute.org/research_updates/prior-heart-disease-increases-risk-of-ici-associated-myocarditis/) - Won, Taejoon, Evelyn J. Song, Hannah M. Kalinoski, Javid J. Moslehi, and Daniela Čiháková. “[**Autoimmune myocarditis, old dogs and new tricks**](https://www.ahajournals.org/doi/full/10.1161/CIRCRESAHA.124.323816).” *Circulation Research* 134, no. 12 (2024): 1767-1790. - [Read Summary](https://www.autoimmuneinstitute.org/research_updates/untangling-the-mechanisms-behind-autoimmune-myocarditis/) - Won, Taejoon, Hannah M. Kalinoski, Megan K. Wood, David M. Hughes, Camille M. Jaime, Paul Delgado, Monica V. Talor, Ninaad Lasrado, Jay Reddy, and Daniela Čiháková. “[**Cardiac myosin-specific autoimmune T cells contribute to immune-checkpoint-inhibitor-associated myocarditis**](https://www.cell.com/cell-reports/fulltext/S2211-1247(22)01480-2).” *Cell reports* 41, no. 6 (2022). <https://doi.org/10.1016/j.celrep.2022.111611> - [Read Summary](https://www.autoimmuneinstitute.org/research_updates/new-mouse-model-unveils-autoimmune-t-cell-involvement-in-checkpoint-inhibitor-induced-myocarditis/) - Daoud, Abdel, Diego A. Lema, Taejoon Won, and Daniela Čiháková. “[**Integrative single-cell analysis of cardiac and pulmonary sarcoidosis using publicly available cardiac and bronchoalveolar lavage fluid sequencing datasets**](https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2023.1227818/full).” *Frontiers in Cardiovascular Medicine* 10 (2023): 1227818. - [Read Summary](https://www.autoimmuneinstitute.org/research_updates/understanding-cardiac-sarcoidosis-on-a-cellular-level/) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/10/Dr-Cihakova-300x284-1.jpg) ### A Brighter Future for Children with Neuroimmunological Conditions AT THE NEUROSCIENCE AND BEHAVIORAL MEDICINE CENTER OF CHILDREN’S NATIONAL HOSPITAL Principal Investigator: Elizabeth Wells, MD ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2022/02/Copy-of-Co-Branding-Logos-Childrens-and-GAI-163-×-163-px.png) **Background Information:** Pediatric neuroimmunological conditions are a group of neurologic disorders predominantly characterized by inflammatory responses in the central nervous system and are autoimmune in nature. In children with these autoimmune conditions, the body’s natural defense system attacks its own healthy cells. Neuroimmunological conditions specifically target the brain and nervous system. Many of these complete conditions are idiopathic and arise spontaneously, leaving previously healthy children with a lifetime of illness and challenges. Neuroimmunological conditions can affect a child’s ability to eat, walk, talk, think, see or move normally. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/03/blog-box1-img.jpg) #### Children’s National Hospital Children’s National Hospital is home to one of the few comprehensive pediatric neuroimmunology programs in the country and some of the nation’s leading Neuroimmunology experts. Their specialists have expertise in caring for children with a wide range of neuroimmunological conditions, including [autoimmune encephalitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-encephalitis/), [neuromyelitis optica spectrum disorder](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/neuromyelitis-optica/) (NMO or NMOSD), [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/) (MS), [myelin oligodendrocyte glycoprotein antibody disease](https://www.autoimmuneinstitute.org/covid_timeline/safety-of-covid-19-vaccination-in-those-with-ms-nmosd-and-mogad/) (MOG or MOGAD), [acute disseminated encephalomyelitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/acute-disseminated-encephalomyelitis/) (ADEM), opsoclonus-myoclonus-ataxia syndrome (OMAS), primary CNS vasculitis, transverse myelitis, acute flaccid myelitis (AFM), new-onset refractory status epilepticus (NORSE), and febrile infection-related epilepsy syndrome (FIRES). #### Research Aims: To develop and implement new investigative studies and clinical trials for children with neuroimmunological conditions. More specifically: 1. Identify shared immune dysregulatory pathways in patients with immune-neurologic conditions 2. Discover potential genetic causes of clinically characterized but genetically uncharacterized neuro-inflammatory diseases 3. Characterize the clinical disease manifestations to generate a comprehensive assessment of neurological and non-neurological disease indicators, and 4. Collect longitudinal functional outcomes, including neurologic status, functional status, neurocognitive outcomes, and quality of life. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/03/blog-box1-img-1.jpg) Principal Investigator: Dr. Elizabeth Wells, M.D. ### Advancing Autoimmune Understanding WITH THE LA JOLLA INSTITUTE FOR IMMUNOLOGY (LJI) Principal Investigator: Dr. Sam Myers      This GAI-LJI collaboration seeks to leverage LJI’s expertise in immunology through the **Center for Autoimmunity and Inflammation** to unravel the mysteries of autoimmune disease and develop novel treatments.      In 2024, GAI launched a new research partnership with LJI, including the creation of the **Global Autoimmune Institute Assistant Professorship.** [Seminars](https://www.autoimmuneinstitute.org/research_updates/walter-and-jean-boek-seminar-series-at-lji/) such as *Life Without Disease* and *Live from the Lab,* a short film, an autoimmune disease resource guide, *Immune Matters* magazine features, and [LEAD Day](https://www.autoimmuneinstitute.org/lead-day/) were also supported through this collaboration.      In 2025, this support expanded to a **five-year, $1 million commitment**, deepening our investment in long-term autoimmune research. #### **Learn more about our strategic partnership with LJI [here](https://www.autoimmuneinstitute.org/gai-and-la-jolla-institute-for-immunology/).** ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/02/Sam-Headshot-scaled-e1740409000915-1261x1080.jpg) ### **Dr. Sam Myers** Dr. Myers investigates how immune cells process information and how signaling errors can lead to autoimmune disease. His lab uses advanced mass spectrometry and proteomics to study these molecular decisions. In 2024, GAI helped fund the purchase of the **Astral mass spectrometry platform**, enhancing his lab’s ability to track the signals that drive immune dysfunction. His work also explores how immune pathways intersect with brain health, offering insights into symptoms like brain fog and sensory sensitivity. [**Learn More**](https://www.autoimmuneinstitute.org/research_updates/myers-gai-autoimmune-research/) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/past-grants_background-photo.jpg) ## Past Grants & Projects Funding studies on autoimmune disease is central to GAI’s mission. We are proud to have had a part in its advancement, from groundbreaking research that helped answer what causes lupus to develop to establishing clinics for multidisciplinary care. We continue to support researchers at the highest-ranking academic and medical institutions across the US. [Learn More](https://www.autoimmuneinstitute.org/past-grants-collaborations/) --- ### [Past Grants & Collaborations](https://www.autoimmuneinstitute.org/past-grants-collaborations/) **Published:** February 16, 2024 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Discover the history of grants and collaborations at the Global Autoimmune Institute and learn about our contributions to autoimmune disease. **Content:** ### Boston Children’s Hospital **Principal Investigators: Jocelyn Silvester, MD, Ph.D. and Denis Chang, MD, MS** With support from GAI, researchers at Boston Children’s Hospital investigated whether patterns of autoantibodies could help distinguish individuals with a single autoimmune disease from those with multiple autoimmune diseases, known as polyautoimmunity. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2021/09/boston-childrens_orig.png) #### Characterizing the Autoantibody and Genetic Profiles of Patients with Multiple Autoimmune Conditions The research team used autoantigen microarray technology to simultaneously measure antibodies against a broad range of autoantigens, with the goal of identifying autoantibody signatures associated with polyautoimmunity. ##### **Research Aims** The project sought to identify biomarkers that could improve understanding of why some individuals develop multiple autoimmune diseases and potentially help identify those at increased risk of polyautoimmunity. Ultimately, this research could contribute to improved approaches for screening and caring for people with multiple autoimmune conditions. ##### **Research Outcomes** This research resulted in the 2026 publication, **“[Autoantibody signatures in children with celiac disease, juvenile idiopathic arthritis, and polyautoimmunity](https://pubmed.ncbi.nlm.nih.gov/41695077/).”** The study analyzed autoantibodies against 120 autoantigens in 114 children with celiac disease, juvenile idiopathic arthritis, or both conditions. Researchers identified distinct autoantibody patterns associated with polyautoimmunity, providing new insight into immune profiles that may distinguish children with more than one autoimmune disease. These findings support continued research into autoantibody signatures as potential biomarkers for understanding and identifying polyautoimmunity. [**Read Research Summary Here**](https://www.autoimmuneinstitute.org/research_updates/autoantibody-signatures-polyautoimmunity-children/) ## Children’s National Hospital Celiac Disease Program ### Children’s National Hospital Celiac Disease Program **Principal Investigators: Vanessa Weisbrod, Jocelyn Silvester, Catherine Raber, Joyana McMahon, Shayna Coburn and Benny Kerzner** The [Children’s National Celiac Disease Program](https://childrensnational.org/departments/celiac-disease-program) and the Global Autoimmune Institute worked in partnership from 2015 to 2021 to develop robust educational resources, including: ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Children22s-National-300x158-1.png) - [Digital resources](https://www.autoimmuneinstitute.org/helpful-apps/) including podcasts and an app streamline access to information and navigating new lifestyle choices. - [Web-based video education seminars](https://childrensnational.org/departments/celiac-disease-program/resources-for-families) to help families with this autoimmune disease cope with the chronic condition. - Building alliances with pediatric celiac disease programs across the United States to develop national recommendations for managing celiac disease at school and other learning environments. - A [research publication](https://www.tandfonline.com/doi/abs/10.1080/02739615.2023.2259291) that aimed to investigate whether attention and executive functioning were associated with dietary adherence in children with celiac disease. In addition, through the synthesis of our financial support and the passionate dedication of both the Celiac Group at Children’s National Hospital and GAI, CNH established the first-of-its-kind [multidisciplinary clinic for celiac disease](https://childrensnational.org/departments/celiac-disease-program/celiac-disease-clinic) patients. The clinic brings together several medical specialties, including gastroenterology, neurology, psychology, nutrition, and education. These specialties collaborate to thoroughly diagnose and treat coexisting autoimmune diseases and neurological and psychological disorders, as well as to teach the patients and their families about proper nutrition and the many important aspects of living a gluten-free life. ### Antibodies to an Epstein Barr Virus Protein that Cross-React with dsDNA Have Pathogenic Potential **Principal Investigator: Dr. Linda Spatz** *Photo: Linda Spatz, PhD, and colleagues in their lab, City University of New York (CUNY)* This scientific investigation of patients with systemic lupus erythematosus (SLE) patients focuses on whether the Epstein-Barr Virus (EBV) causes the production of human antibodies using molecular mimicry in SLE patients. This could suggest that EBV may be a cause of SLE. The long-term goal of the study is to design a treatment to block certain EBV antibodies that cause organ damage in SLE patients. You can find the research article, published in Molecular Immunology, [here](https://www.sciencedirect.com/science/article/abs/pii/S0161589021000213?via%3Dihub)! ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/ResearchContainerResearch-300x225-1.jpg) ### Exploring Effects of Cancer Immunotherapy Drugs on Autoimmune Manifestations **Principal Investigator: Dr. Paulina Chalan** *Photo from left to right; Patrizio Caturegli, M.D., M.P.H., Director of The Autoimmune Research Center, Johns Hopkins Medicine; Sandra J. Boek, Executive Director, GAI; Paulina Chalan, PhD, Walter and Jean Boek Autoimmune Research Fellow, Division of Immunology, Johns Hopkins Medicine.* Postdoctoral research at Johns Hopkins Medicine is exploring the development of autoimmune hypophysitis (primarily affecting the pituitary gland) following cancer immunotherapy. This study is significant and unique, in that it will track the development of this autoimmune disease from inception, in mouse models, in order to better understand the evolution of the disease. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/ResearchContainerJohnHopkins-2-300x225-1.jpg) ### Bibliography of Funded Works ## Peer Reviewed Publications Antibodies to an Epstein Barr Virus Protein That Cross-React With dsDNA Have Pathogenic Potential | Published in *Molecular Immunology* | [View →](https://pubmed.ncbi.nlm.nih.gov/33545624/) | |---|---| Preparation of Gluten-Free Foods Alongside Gluten-Containing Food May Not Always Be as Risky for Celiac Patients as Diet Guides Suggest | Published in *Gastroenterology* | [View →](https://pubmed.ncbi.nlm.nih.gov/31560900/) | |---|---| Psychological Needs and Services in a Pediatric Multidisciplinary Celiac Disease Clinic | Published in *Journal of Clinical Psychology in Medical Settings* | [View →](https://pubmed.ncbi.nlm.nih.gov/31673859/) | |---|---| Mental Health Disorders and Psychosocial Distress in Pediatric Celiac Disease | Published in *Journal of Pediatric Gastroenterology and Nutrition* | [View →](https://pubmed.ncbi.nlm.nih.gov/31880669/) | |---|---| A Quantitative Assessment of Gluten Cross-Contact in the School Environment for Children With Celiac Disease | Published in *Journal of Pediatric Gastroenterology and Nutrition* | [View →](https://pubmed.ncbi.nlm.nih.gov/31868785/) | |---|---| ## Conference Presentations NASPGHAN Annual Meeting Virtual | 2020 - Expert Consensus on Recommendations to Accommodate Children with Celiac Disease in Learning Environments (Poster) - Trisomy 21: Not All Duodenal Abnormalities Are Celiac Disease (Poster) - Comparison of Parental Gluten-Free Diet Knowledge Between “New” and “Established” Diagnoses in a Pediatric Multidisciplinary Celiac Disease Clinic (Poster) Society of Pediatric Psychology Annual Conference Virtual | 2020 - The Gluten-Free Diet Is a Double-Edged Sword for Children with Celiac Disease and Their Parents (Poster) NASPGHAN Annual Meeting Chicago, IL | 2019 - Time Point to Gluten Clearance After Initiation of a Gluten-Free Diet in Patients with Celiac Disease (Poster) - Celiac Kids Internet Diet Survey (CeliacKids): A Multicenter Consortium Using the Modified Delphi Method to Create a Gluten Exposure Assessment Tool (Poster) International Celiac Disease Symposium Paris, France | 2019 - A Real-Life Assessment of Gluten Cross-Contact in a Shared Kitchen Environment (Poster) - A Quantitative Analysis of Gluten Contamination in Everyday School Supplies and Concern for Children with Celiac Disease (Poster) - An Educational App to Support the Gluten-Free Diet in Patients with Celiac Disease (Poster) - Perceived Psychosocial Distress Improves in Youth and Their Parents After Diagnosis of Celiac Disease (Poster) - Psychological Needs and Services in a Multidisciplinary Celiac Disease Clinic (Poster) Digestive Disease Week San Diego, CA | 2019 - An Educational App to Support the Gluten-Free Diet in Patients with Celiac Disease (Poster) Society of Pediatric Psychology Annual Conference New Orleans, LA | 2019 - Psychological Needs and Services in a Multidisciplinary Celiac Disease Clinic (Poster) Research and Education Week, Children’s National Health System Washington, DC | 2019 - Psychological Needs and Services in a Multidisciplinary Celiac Disease Clinic (Poster) NASPGHAN Annual Meeting Hollywood, FL | 2018 - Assessment of Parental Gluten-Free Diet Knowledge in a Multidisciplinary Celiac Disease Clinic (Poster) - An Educational App to Support the Gluten-Free Diet in Patients with Celiac Disease (Poster) - Executive Functioning, Social-Emotional Ratings, and Cognitive Test Performance in Pediatric Celiac Disease (Poster) - Living Gluten-Free: Adherence and Psychosocial Considerations for Pediatric Celiac Disease (Invited Symposium Presentation) Child Neurology Society 47th Annual Meeting Chicago, IL | 2018 - Neurological and Psychological Vulnerabilities in Pediatric Celiac Disease (Poster) 126th Annual American Psychological Association Convention San Francisco, CA | 2018 - Psychological Comorbidities and Psychosocial Burden in Pediatric Celiac Disease (Poster) Children’s Research Institute’s 8th Annual Research and Education Week Washington, DC | 2018 - Psychological and Neurological Vulnerabilities in Pediatric Celiac Disease (Poster) International Conference on Communication in Healthcare Baltimore, MD | 2017 - Communication During and After Diagnosis of Pediatric Celiac Disease: Opportunities to Facilitate Successful Adherence and Recovery (Oral Research Presentation) International Celiac Disease Symposium Delhi, India | 2017 - Peer Mentorship Social Groups for Children with Celiac Disease (Poster) - A Digital App for Gluten-Free Diet Management in Patients with Celiac Disease (Poster) International Celiac Disease Symposium Prague, Czech Republic | 2015 - Increasing the Awareness and Treatment of the Psychological Needs of Children with Celiac Disease (Poster) - Increasing Access to Support Groups for Children and Adolescents with Celiac Disease (Poster) ## Other Initiatives Through its longstanding partnership with Children’s National Hospital, the Global Autoimmune Institute has provided substantial financial support for initiatives advancing celiac disease research, multidisciplinary care, education, and public awareness. Beyond research publications and conference presentations, this collaboration has supported educational tools and resources for children with celiac disease, their families, educators, and healthcare professionals. Educational Resources & Digital Tools Resources developed through the partnership include gluten-free diet guides, educational handbooks, school and grocery shopping resources, interactive apps and games, and instructional video series. Professional Training & Community Education Initiatives have also included web-based training for school health staff and nutrition providers, community education programs, and public awareness efforts. Children’s National maintains a collection of celiac disease educational materials, interactive tools, and videos. [View Celiac Disease Resources at Children’s National →](https://www.childrensnational.org/get-care/departments/celiac-disease-program/family-resources) --- ### [Lectures, Empowerment, and Awareness in Autoimmune Disease (LEAD) Day](https://www.autoimmuneinstitute.org/lead-day/) **Published:** February 1, 2025 **Author:** Carolyn Serraino **Excerpt:** LEAD Day, an annual autoimmune disease event hosted by the LJI and sponsored by the GAI, features a keynote lecture, scientific panel discussion, and presentation of the Walter and Jean Boek Leadership in Research Award. **Content:** ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/03/LEAD-Day-1-1024x576.png) ## What is LEAD Day? #### (Lectures, Empowerment, and Awareness in Autoimmune Disease) LEAD Day is an annual event hosted by [La Jolla Institute for Immunology](https://www.autoimmuneinstitute.org/gai-and-la-jolla-institute-for-immunology/ "GAI and La Jolla Institute for Immunology") (LJI) and sponsored by the Global Autoimmune Institute (GAI) that brings together leading scientists, healthcare professionals, advocates, and the autoimmune disease community. Through scientific lectures, community discussions, and public engagement, LEAD Day connects emerging autoimmune research with the people whose lives it aims to improve. ## Why was LEAD Day Created? Autoimmune disease research is advancing rapidly, but scientific discoveries often remain within research communities long before they reach the people living with these conditions. ##### LEAD Day was created to help close that gap. Building on months of scientific exchange through the [Walter and Jean Boek Seminar Series](https://www.autoimmuneinstitute.org/research_updates/walter-and-jean-boek-seminar-series-at-lji/ "Walter and Jean Boek Seminar Series at LJI"), LEAD Day extends those conversations beyond the research community by bringing scientists, clinicians, patients, caregivers, advocates, and the public together to explore emerging discoveries and what they may mean for the future of autoimmune disease prevention, diagnosis, and treatment. ## What Happens at LEAD Day? Each year’s program is unique, reflecting the latest developments in autoimmune disease research and emerging opportunities for community engagement. Attendees can expect a scientific panel discussion featuring experts in immunology and autoimmune disease research, the Walter and Jean Boek Leadership in Research Award Lecture, opportunities to engage directly with speakers during audience question-and-answer sessions, presentation of the annual research award, and a social reception that encourages continued conversation and collaboration. | **Date** | **Walter and Jean Boek Leadership in Research Awardee** | ****Walter and Jean Boek Leadership in Research** Lecture** | **Panel Discussion** | |---|---|---|---| | September 15, 2026 | Dr. Eric Topol | [Super Agers and the Immune System](https://www.autoimmuneinstitute.org/research_updates/lead-day-2026-topol-award-lecture/) | [AI and Multi-Omics: Building a New Era of Autoimmune and Chronic Disease Research](https://www.youtube.com/watch?v=wN52dpnnv5A) | | March 6, 2025 | Dr. Georg Schett | Control of autoimmune disease by deep B-cell depletion | [Beyond the Diagnosis: The Autoimmunity Research That’s Reshaping Lives](https://youtu.be/J5WfaiKmdxM "Beyond the Diagnosis: The Autoimmunity Research That's Reshaping Lives") | ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/07/TK8A0455-2-edited-scaled.jpeg) ### Walter and Jean Boek Leadership in Research Award and Lecture The Walter and Jean Boek Leadership in Research Award recognizes a distinguished scientist whose work has significantly advanced the understanding of autoimmune disease. The recipient delivers the Walter and Jean Boek Leadership in Research Award Lecture, sharing insights into their work and its potential to shape the future of autoimmune disease research and care. [ ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/09/Copy-of-LJI-IMG_2253-PhotobyMelissaJacobs-scaled.jpg) LEAD Day 2026 On September 15, 2026, the second annual LEAD Day honored Dr. Eric Topol and brought together leading researchers and the autoimmune disease community for discussions on AI, multi-omics, and the future of autoimmune and chronic disease research. Event Highlights Read more about LEAD Day 2026 ](https://www.autoimmuneinstitute.org/research_updates/lead-day-2026-highlights/) [ ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/07/LEAD-Day-2025-GAI-Dr-Georg-Schett.jpg) LEAD Day 2025 The inaugural LEAD Day honored Dr. Georg Schett and brought together leading researchers and the autoimmune disease community for a day of scientific presentations, community discussion, and the presentation of the first Walter and Jean Boek Leadership in Research Award. Event Highlights Read more about LEAD Day 2025 ](https://www.autoimmuneinstitute.org/lead-day-2025-highlights/) --- ### [Autoimmune Organizations](https://www.autoimmuneinstitute.org/autoimmune-organizations/) **Published:** February 13, 2024 **Author:** Carolyn Serraino **Excerpt:** Explore our comprehensive list of autoimmune disease organizations providing essential support, resources, and advocacy for patients and their families. Connect with trusted nonprofits dedicated to autoimmune health and wellness. **Content:** ## Autoimmune Organizations Explore our list of organizations offering support, education, resources, advocacy, and community for people affected by autoimmune disease and related conditions. This resource is updated regularly as organizations and available resources change. If you know of an organization that should be included, we welcome recommendations. ## Holistic Health [Autoimmune Families](https://www.autoimmunefamilies.com/) peer support and resources with a functional medicine approach [Autoimmune Wellness](https://autoimmunewellness.com/) Autoimmune Protocol (AIP) resources, recipes, articles, and community [Chronic Wellness Collective](https://www.chronicwellnesscollective.org/) educational program, community, and nurse coaching [Global Healthy Living Foundation](https://www.ghlf.org/) resources and support for chronic illness patients during the pandemic [The Institute for Functional Medicine](https://www.ifm.org/) information and “find a practitioner” tool [Overcoming Multiple Sclerosis](https://overcomingms.org/) evidence-based recovery program, resources, and support for MS ## Acquired Aplastic Anemia [The Aplastic Anemia and MDS International Foundation (AAMDS)](https://www.aamds.org/diseases/aplastic-anemia/causes) ## Addison's disease [National Adrenal Diseases Foundation (NADF)](https://www.nadf.us/) ## Alopecia Areata [National Alopecia Areata Foundation (NAAF)](https://www.naaf.org/) ## Ankylosing Spondylitis [Spondylitis Association of America (SAA)](https://spondylitis.org/about-spondylitis/types-of-spondylitis/ankylosing-spondylitis/) ## Autoimmune Dysautonomia [Dysautonomia International](http://www.dysautonomiainternational.org/page.php?ID=124) ## Autoimmune Encephalitis [Autoimmune Encephalitis Alliance (AEA)](https://aealliance.org/) ## Autoimmune Hemolytic Anemia Warm Autoimmune Hemolytic Anemia [wAIHA Warriors](https://www.waihawarriors.org/) ## Autoimmune Hepatitis [American Liver Foundation (ALF)](https://liverfoundation.org/for-patients/about-the-liver/diseases-of-the-liver/autoimmune-hepatitis/) ## Autoimmune Inner Ear Disease [Vestibular Disorder Association (VeDA)](https://vestibular.org/autoimmune-inner-ear-disease-aied) ## Autoimmune Myocarditis [Myocarditis Foundation](https://www.myocarditisfoundation.org/) ## Behcets Disease [American Behcet’s Disease Association (ABDA)](https://www.behcets.com/) ## Bullous Pemphigoid [International Pemphigus & Pemphigoid Foundation (IPPF)](http://www.pemphigus.org/) ## Celiac Disease [Beyond Celiac](https://www.beyondceliac.org/) [Celiac Disease Foundation (CDF)](https://celiac.org/) [Celiac Disease Program at Children’s National Hospital](https://childrensnational.org/departments/celiac-disease-program) [National Celiac Association](https://nationalceliac.org/) ## Crohn's Disease [Crohn’s and Colitis Foundation](https://www.crohnscolitisfoundation.org/) [IBD Partners](https://ccfa.med.unc.edu/home) ## Diabetes, Type 1 [Juvenile Diabetes Research Foundation (JDRF)](https://www.jdrf.org/) ## Eosinophilic esophagitis (eosinophilic gastroenteritis) [American Partnership for Eosinophilic Disorders (APFED)](https://apfed.org/) [American Gastroenterological Association (AGA)](https://gastro.org/) Disease Page ## Hashimoto's Thyroiditis [American Thyroid Association](https://www.thyroid.org/hashimotos-thyroiditis/) [National Academy of Hypothyroidism and Integrative Sciences (NAHIS)](https://www.nahypothyroidism.org/) ## Immune Thrombocytopenia [Platelet Disorder Support Association (PDSA)](https://www.pdsa.org/) ## Lupus [Lupus Foundation of America (LFA)](https://www.lupus.org/) [Lupus Research Alliance (LRA)](https://www.lupusresearch.org/) [Lupus UK](https://www.lupusuk.org.uk/) ## Menieres Disease [Vestibular Disorder Association (VeDA)](https://vestibular.org/menieres-disease) ## Multiple Sclerosis [MS Society (UK)](https://www.mssociety.org.uk/) [Multiple Sclerosis Foundation](https://msfocus.org/) [National Multiple Sclerosis Society (NMSS)](https://www.nationalmssociety.org/) [Overcoming Multiple Sclerosis (OMS)](https://overcomingms.org/) ## Myasthenia Gravis [Myasthenia Gravis Foundation of America (MGFA)](https://myasthenia.org/) ## Other [Advocacy and Awareness for Immune Disorders Association (AAIDA)](https://www.godoaaida.org/) [Autoimmune Association](https://www.autoimmune.org/) [National Organization for Rare Disorders (NORD)](https://rarediseases.org/) ## Pemphigus Vulgaris [International Pemphigus & Pemphigoid Foundation (IPPF)](http://www.pemphigus.org/) ## Primary Biliary Cholangitis [American Liver Foundation (ALF)](https://liverfoundation.org/) ## Psoriasis [National Psoriasis Foundation (NPF)](https://www.psoriasis.org/) ## Psoriatic Arthritis [Arthritis Foundation](https://www.arthritis.org/diseases/psoriatic-arthritis) [Creaky Joints](https://creakyjoints.org/) [Spondylitis Association of America (SAA)](https://spondylitis.org/) ## Relapsing Polychrondritis [Relapsing Polychondritis Foundation](https://polychondritis.org/) ## Rheumatoid Arthritis [Arthritis Foundation](https://www.arthritis.org/diseases/rheumatoid-arthritis) [Creaky Joints](https://creakyjoints.org/) [National Rheumatoid Arthritis Society, UK (NRAS)](https://www.nras.org.uk/) [Rheumatoid Arthritis Support Network](https://www.rheumatoidarthritis.org/) [Rheumatoid Patient Foundation (RPF)](http://rheum4us.org/) ## Scleroderma [Scleroderma Foundation](https://scleroderma.org/) ## Sjogren's Syndrome [Sjogren’s Foundation](https://www.sjogrens.org/) ## Ulcerative Colitis [Crohn’s and Colitis Foundation](https://www.crohnscolitisfoundation.org/) [IBD Partners](https://ccfa.med.unc.edu/home) ## Vitiligo [Vitiligo Support International (VSI)](https://vitiligosupport.org/) ### Related Conditions Many of the following conditions either coexist or are associated with autoimmune diseases. Others are suspected to be autoimmune in nature. Visit our [A-Z Disease List](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/) for more information. ## Chronic Fatigue Syndrome [Solve ME/CFS Initiative (Solve M.E.)](https://solvecfs.org/) ## Ehler's-Danlos [The Ehlers-Danlos Society](https://www.ehlers-danlos.com/) ## Endometriosis [Endometriosis Association](https://endometriosisassn.org/) ## Lyme [American Lyme Disease Foundation (ALDF)](https://www.aldf.com/#chronicLymeDisease) [LymeDisease.org](https://www.lymedisease.org/) ## Narcolepsy [Narcolepsy Network (NN)](https://narcolepsynetwork.org/) ## Reflex Sympathetic Dystrophy Syndrome [Reflex Sympathetic Dystrophy Syndrome Association (RSDSA)](https://rsds.org/) ## Raynaud's Phenomenon [Raynaud’s Association](https://www.raynauds.org/) ## Tinnitus [American Tinnitus Association (ATA)](https://www.ata.org/) ## Vasculitis [Vasculitis Foundation (VF)](https://www.vasculitisfoundation.org/) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/GAI-Logo-Image.png) *DISCLAIMER: The above lists do not indicate affiliation with any organization, nor do they signify or imply endorsement of any information provided on linked websites.* --- ### [Autoimmune Disease and Chronic Illness-Related Support Groups](https://www.autoimmuneinstitute.org/autoimmune-disease-chronic-illness-related-support-groups/) **Published:** April 10, 2024 **Author:** Elevation **Excerpt:** This is an evolving list of autoimmune disease and chronic illness-related support groups. If you feel that any are missing, please let us know! **Content:** #### Connect with others, share experiences, and join virtual or local communities for support. *This is an evolving list, if you feel that any are missing, please let us know!* ### Autoimmune disease and chronic illness-related support groups by organization: ## American Liver Foundation [Facebook group](https://www.facebook.com/groups/1881641552083412/) for those with Primary Biliary Cholangitis [Learn More](https://www.facebook.com/groups/1881641552083412/) ## Arthritis Foundation [Online support group](https://www.arthritis.org/about-live-yes!-connect-group) for those with arthritis, their families, and caregivers [Learn More](https://www.arthritis.org/about-live-yes!-connect-group) ## Autoimmune Encephalitis Alliance [Monthly regional support groups meeting](https://aealliance.org/all-events/) on zoom for those with autoimmune encephalitis and their family members [Learn More](https://aealliance.org/all-events/) ## Autoimmune Hepatitis Association Has [virtual support groups](https://aihep.org/support-groups/) regionally and for teens, caregivers of children with Autoimmune hepatitis, young adults, and newly diagnosed patients [Learn More](https://aihep.org/support-groups/) ## Body Politic Has [Facebook support groups](https://www.wearebodypolitic.com/covid-19) for those with Long Covid, and a group through the Bateman Horne Center that meets twice a month on Zoom and is open to those with Long Covid, ME/CFS, fibromyalgia, and dysautonomia as well as their family and caregivers [Learn More](https://www.wearebodypolitic.com/covid-19) ## Chronic Pain Anonymous [Support groups](https://chronicpainanonymous.org/) both in-person and online for those with chronic pain and chronic illness [Learn More](https://chronicpainanonymous.org/) ## Covid-19 Long hauler Advocacy Project Has [Facebook groups](https://www.longhauler-advocacy.org/support-us) for kids and families, BIPOC, teens, healthcare workers and researchers, first responders and military personnel, pregnant mothers, single parents and caregivers, and educators. Open to those with Long Covid or families/caregivers of those with Long Covid [Learn More](https://www.longhauler-advocacy.org/support-us) ## Crohn’s & Colitis Foundation Offers regional [support groups](https://www.crohnscolitisfoundation.org/find-a-support-group) in-person, virtual, and hybrid for those with Crohn’s or Colitis. Also offers peer support via app [Learn More](https://www.crohnscolitisfoundation.org/find-a-support-group) ## Dysautonomia International Has Facebook [support groups](https://www.dysautonomiainternational.org/page.php?ID=24) for those with dysautonomia (including POTS, and Long Covid) both regionally, and internationally as well as groups for teens, LGBTQIA+, BIPOC, men, parents, and spouses/significant others [Learn More](https://www.dysautonomiainternational.org/page.php?ID=24) ## International Pemphigus and Pemphigoid Foundation Virtual regional [support groups](https://www.pemphigus.org/support-groups/) for those with pemphigus or pemphigoid and their caregivers [Learn More](https://www.pemphigus.org/support-groups/) ## Juvenile Diabetes Research Foundation Offers a virtual monthly peer [support group](https://www.jdrf.org/virtual-events/) for those with type 1 diabetes and parents of children with Type 1 Diabetes [Learn More](https://www.jdrf.org/virtual-events/) ## Long Covid Kids Has an [online chatroom](https://www.longcovidkids.org/chat-box) for kids ( ages 8-17) with Long Covid [Learn More](https://www.longcovidkids.org/chat-box) ## Lupus Foundation of America Open to those affected by lupus. Similar to Facebook, [post and reply discussion board style](https://www.inspire.com/groups/lupusconnect/?utm_source=www.lupus.org) available 24/7 Offers [state support groups](https://www.lupus.org/resources/find-support-near-you) as well as groups specific to Asian community, hispanic/latino community, men, youth, caregivers, and black women. Meetings are held monthly online, in person or hybrid, depending on the group. Different groups are open to different people, but all are aimed at people with lupus or a family member with lupus. [Learn More](https://www.lupus.org/resources/find-support-near-you) ## Lupus UK Has [support groups](https://www.lupusuk.org.uk/join-lupus-uk/) for those with lupus in the UK (must join to find out, where, when, and how they meet) [Learn More](https://www.lupusuk.org.uk/join-lupus-uk/) ## Mayo Clinic [Discussion Board style support group](https://connect.mayoclinic.org/group/autoimmune-diseases/) with many threads open to anyone with an autoimmune disease [Learn More](https://connect.mayoclinic.org/group/autoimmune-diseases/) ## Mount Sinai [Support group](https://www.mountsinai.org/care/liver-diseases/services/autoimmune%20) for those with Primary Biliary Cirrhosis. Information on where and how often it meets is available by email [Learn More](https://www.mountsinai.org/care/liver-diseases/services/autoimmune%20) ## MS Society [Support Groups](https://www.mssociety.org.uk/care-and-support/emotional-support/ms-support-groups) for those with MS in the UK [Learn More](https://www.mssociety.org.uk/care-and-support/emotional-support/ms-support-groups) ## Multiple Sclerosis Foundation [Support groups](https://msfocus.org/Get-Help/Support-Groups.aspx) for those with MS around the US. Information about how often groups meet, and whether or not they are on zoom is available through email. [Learn More](https://msfocus.org/Get-Help/Support-Groups.aspx) ## Myasthenia Gravis Foundation of America Has a long list of [support groups](https://myasthenia.org/MG-Community/Find-MG-Support-Groups) around the country some on zoom, some in person, some meet once a month, some meet every other month [Learn More](https://myasthenia.org/MG-Community/Find-MG-Support-Groups) ## Myocarditis Foundation [Discussion board-style support group](https://www.inspire.com/groups/myocarditis-foundation/) for those with myocarditis, their families, friends, and caregivers [Learn More](https://www.inspire.com/groups/myocarditis-foundation/) ## Narcolepsy Network Online and in-person [support groups](https://narcolepsynetwork.org/resources/support-groups/) for people with narcolepsy, their family, and friends [Learn More](https://narcolepsynetwork.org/resources/support-groups/) ## National Adrenal Diseases Foundation Has state-level [support groups](https://www.nadf.us/support-groups) for those with adrenal diseases and Addison’s disease specifically, as well as groups for teens, caregivers and families, young adults, Spanish speakers, and pregnant women. You must email for information on how to join each group, how often they meet, and where. [Learn More](https://www.nadf.us/support-groups.html) ## National Alopecia Areata Foundation Has state and regional [support groups](https://www.naaf.org/support-contacts/?state=&support_type=childrens-group&language=) for those with alopecia areata, as well as groups specifically for children with alopecia areata and Spanish speakers. You must email to get information on how to join a group, how often they meet, and where They also have a [mentorship program](https://www.naaf.org/youth-mentor-program/) for kids and teens with alopecia areata [Learn More](https://www.naaf.org/support-contacts/?state=&support_type=childrens-group&language=) ## National Celiac Association Virtual monthly [support groups](https://nationalceliac.org/celiac-disease-support-groups/) for people with celiac disease [Learn More](https://nationalceliac.org/celiac-disease-support-groups/) ## National Multiple Sclerosis Society Local in-person and virtual [support groups](https://www.nationalmssociety.org/Resources-Support/Find-Support/Join-a-Local-Support-Group) for those with MS. Meetings occur once a month [Learn More](https://www.nationalmssociety.org/Resources-Support/Find-Support/Join-a-Local-Support-Group) ## National Rheumatoid Arthritis Society Local and online [support groups](https://nras.org.uk/information-support/connect-with-others/) for those with Rheumatoid Arthritis Living in the UK. Information on how often groups meet and where is available by email [Learn More](https://nras.org.uk/information-support/connect-with-others/) ## Orlando Health [Support group](https://www.orlandohealth.com/content-hub/autoimmune-support-group) for individuals and families affected by autoimmune diseases. In-person, monthly meetings (located in Orlando, Florida) [Learn More](https://www.orlandohealth.com/content-hub/autoimmune-support-group) ## Overcoming Multiple Sclerosis Local [support groups](https://overcomingms.org/circles) for people with MS [Learn More](https://overcomingms.org/circles) ## Platelet Disorder Support Association Offers [support groups](https://www.pdsa.org/support-groups.html) around the US and Canada for those with Platelet Disorders (such as Immune thrombocytopenic purpura) [Learn More](https://www.pdsa.org/support-groups.html) ## Reflex Sympathetic Dystrophy Syndrome Association Online and in-person [support groups](https://rsds.org/find-a-support-group-near-you/) for those with Complex Regional Pain Syndrome, or Reflex Sympathetic Dystrophy [Learn More](https://rsds.org/find-a-support-group-near-you/) ## Siegel Rare Neuroimmune Association Has several online and in-person [support groups](https://wearesrna.org/living-with-myelitis/resources/support-group-network/) around the world for those living with rare neuroimmune diseases. Online support groups meet monthly; to get information on how often in-person groups meet, you must email them. Open to those with neuroimmune diseases such as acute disseminated encephalomyelitis, acute flaccid myelitis, MOG antibody disease, neuromyelitis optica spectrum disorder, optic neuritis, or transverse myelitis ## Sjogren’s Foundation Has [support groups](https://sjogrens.org/living-with-sjogrens/support-groups-networks/us-support-groups) across the US and Canada as well as groups specifically for 20-30 yr olds, families with kids who have Sjogren’s, men, and spouses and partners of those with Sjogren’s. How and when meetings are held differs by group. Open to those with Sjogren’s [Learn More](https://sjogrens.org/living-with-sjogrens/support-groups-networks/us-support-groups) ## Spondylitis Association of America Several [support groups](https://spondylitis.org/resources-support/support-resources/support-groups/) for various regions (some on Zoom, some in person). Open to those with spondylitis, also a group for caregivers and a group for parents, meeting times, places, and frequencies available upon email [Learn More](https://spondylitis.org/resources-support/support-resources/support-groups/) ## The Center for Chronic Illness Offers several [support groups](https://www.thecenterforchronicillness.org/programs), including one for teens, one for Long Covid, one for postpartum mothers with chronic illness, one for African Americans, one for LGBTQIA+, one for Spanish speakers, and several for caregivers. Meetings are free and held virtually weekly, biweekly, or monthly depending on the group. Open to anyone with chronic illness or rare disease or caregivers [Learn More](https://www.thecenterforchronicillness.org/programs) ## The Ehlers-Danlos Society Online [support groups](https://www.ehlers-danlos.com/virtual-support/) that meet monthly and quarterly. Open to those with Ehlers-Danlos Syndrome or Hypermobility Spectrum Disorders [Learn More](https://www.ehlers-danlos.com/virtual-support/) ## The Myositis Association Has a variety of [support groups](https://www.myositis.org/patient-support/support-groups/find-support-group/) across the country. Meeting times and locations are available once you join a group; some meet in person, some via phone or Zoom. Open to those with myositis (any type), their families, and caregivers [Learn More](https://www.myositis.org/patient-support/support-groups/find-support-group/) ## US Pain Foundation Offers a variety of national, state/regional [support groups](https://painconnection.org/) through Zoom. All groups meet once a month, but the days and times vary. Open to those with chronic pain, no matter the cause [Learn More](https://painconnection.org/) ## Vasculitis Foundation Weekly and monthly Zoom [support groups](https://www.vasculitisfoundation.org/virtual-support-meetings/) aimed at those living with vasculitis (caregivers and family welcome), monthly virtual support group for parents of children with vasculitis, monthly virtual support group for caregivers and family members of those with vasculitis [Learn More](https://www.vasculitisfoundation.org/virtual-support-meetings/) ## Vestibular Disorder Association Offers a variety of Zoom and in-person [support groups](https://vestibular.org/support-groups/), some open to anyone with a vestibular disorder, others for a specific disease (ex: Ménière’s Disease) How often they meet varies by group [Learn More](https://vestibular.org/support-groups/) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/04/GAI-Logo-Image-811x1024.png) --- ### [Our Team](https://www.autoimmuneinstitute.org/our-team/) **Published:** February 16, 2024 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Meet the passionate team behind the Global Autoimmune Institute! **Content:** # Meet the GAI team! ### Sandra Boek Werness ##### EXECUTIVE DIRECTOR Sandy personally experienced a common story of delayed and misdiagnosis of autoimmune disease. It took over 7 years for her daughter to be diagnosed with [celiac disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/celiac-disease/), followed by another 11 years of continued excruciating pain, chronic fatigue, constantly recurring illnesses, and many other symptoms, until she was diagnosed with thyroid disease and POTS ([postural orthostatic tachycardia](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/postural-orthostatic-tachycardia-syndrome/)). In the meantime, Sandy’s concerns and her daughter’s suffering were dismissed, and neurological, gastroenterological, and many other symptoms were ignored. Sandy and her daughter were told the symptoms either did not exist or were “psychological” and even that Sandy was making her daughter ill. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/03/Bruce-Werness-bio-photo-2025-1713-x-1400-px.png) The challenges of ignorance and misconceptions that they faced serve as a driver for Sandy’s actions to bring about change so that autoimmune disease will be properly diagnosed and treated, and that patients and their families will be afforded the educational and psychosocial support they need. Sandy has worked full time most of her adult life; on Capitol Hill, in private law practice, and as Vice President of Northern Virginia Pathology, P.C. She is a graduate of Duke University and the law school of the College of William and Mary. In 2013 she embarked upon her leadership of an existing nonprofit organization to create the Global Autoimmune Institute, which addresses the many pressing needs of the autoimmune disease and chronic illness community; patients, families, physicians, and other health care providers, and the public at large. ### Liz Loftus ##### BOARD MEMBER Liz began her career in health care as a registered nurse, receiving a Bachelor’s of Science in Nursing from American University in Washington, DC, and working in intensive care step-down and emergency departments in the DC area. In 1986, she earned a Master’s of Public Health from Johns Hopkins University. Liz worked as a health policy analyst at the National Association of Children’s Hospitals in Alexandria, VA, and a drug reviewer for the Food and Drug Administration (FDA) in Rockville, MD. As a drug reviewer at the FDA, Liz conducted scientific reviews of investigative new drug studies and evaluated clinical trials to ensure compliance with the FDA’s Bioresearch Monitoring Compliance Program. ![Liz Loftus Global Autoimmune Institute GAI Board Member](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/09/2026-Liz-1.jpg) After raising three children, Liz pursued a lifelong interest in decorative arts. For several years prior to joining GAI, Liz worked as an interior designer as well as an adjunct professor in the Interior Design program at Northern Virginia Community College. She is honored to bring her varied professional experience to support GAI in its mission to promote research, education, and treatment for autoimmune diseases. ### Marcia V. Mayo ##### BOARD MEMBER An art historian and appraiser, Marcia V. Mayo was a curator with the U.S. Department of State’s Art in Embassies Program, creating thematic exhibitions of American art for the residences of U.S. ambassadors worldwide. Prior to her 27 years of government service, Marcia was the director of Sotheby’s Mid-Atlantic office, specializing in American fine and decorative arts and working with Sotheby’s Valuations, Trusts and Estates, and Museum Services departments. Now retired, she is the vice president of the Fund to Conserve U.S. Diplomatic Treasures Abroad board of directors. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/07/Marcia-Mayo.jpg) Marcia is a Trustee Emeritus of the National Trust for Historic Preservation (NTHP), co-chairing the 2008 NTHP National Conference and chairing the 2007 and 2008 NTHP/HGTV fundraising events. A former board member, she currently serves on the Collections Committee of Tudor Place Historic House and Garden in Georgetown, having chaired the 2016 bicentennial fundraising event. Previously, Marcia was a member of the Operating Committee of the Wadsworth-Sulgrave Historic Preservation Foundation, as well as the Preservation and Facilities committees of the Washington National Cathedral, where she is a member of the Dean’s Advisory Committee. Marcia has been a supporter of the Washington Winter Show for many decades and is a member of its Board of Advisors. Within the larger community, she served on the Board and Executive committees of Washington National Opera and the DC Jazz Festival and is a supporter of the Bishop Walker School. She holds the rank of Dame in the U.S. Priory of the Order of St. John and is a member of the Priory’s Finance Committee. Marcia has long been dedicated to leading and supporting important national and community organizations and initiatives, including in the health care field. In addition, Ms. Mayo is an active supporter of many other organizations, including helping to propel better diagnoses, treatment and support in “lesser known” illnesses. ### Lydia Chopivsky Benson ##### BOARD MEMBER Community stewardship is a defining element in Lydia’s career. She has lived and worked in the Capital Region for more than 35 years following undergraduate and graduate studies at Stanford University. She was the two-term past President of the All Hallows Guild of the Washington National Cathedral, which oversees the gardens and grounds of the Cathedral, and the three-time Chairwoman of the Washington National Cathedral’s annual Flower Mart. Prior board and leadership service includes the Board of Governors of the National Cathedral School, the Board of Directors of Adventure Theatre, the Board of Directors of the Petite Society of Washington, and the Board of Directors of the Palisades Village. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/01/Lydia.jpg) She has also chaired numerous community fundraising events, including the Faith, Hope, Love Gala benefiting the Johns Hopkins Pancreatic Cancer Research Center, the Palisades Village House Tour, and the above-mentioned Flower Mart. A proud first-generation Ukrainian-American, Lydia is deeply engaged with the Ukrainian community in the DMV. She maintains strong relationships with cultural organizations, Embassy leaders, and advocacy groups, and actively supports initiatives that promote Ukrainian heritage and raise awareness of issues affecting Ukraine and the Ukrainian diaspora. She is the past President of The Washington Group, an association of Ukrainian-American professionals, and the past President of the Ukrainian American Federation of Business and Professional Associations. Through sustained service across cultural, educational, artistic, and charitable institutions, Lydia exemplifies conscientious leadership, fiduciary responsibility, and a deep commitment to the vitality of the communities she serves. ### Mariana Doval, MD ##### BOARD MEMBER Mariana Doval, MD, FCAP, is a physician board certified in anatomic and clinical pathology, based in Boca Raton, Florida. Born and raised in Argentina, she earned her medical degree from the University of Buenos Aires in 1990. She trained in anatomic and clinical pathology at Washington Hospital Center in Washington, DC, now known as MedStar Washington Hospital Center, and at Mount Sinai Medical Center in Miami Beach, where she also undertook a surgical pathology fellowship. Dr. Doval has nearly three decades of professional experience in diagnostic pathology and hospital leadership. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/10/Mariana-bio-photo.jpg) She served as Medical Director of the Pathology Department at Palms West Hospital from 2015 to January 2025, following appointments as Chief Pathologist at Wellington Regional Medical Center and Medical Director of the Pathology Department at Columbia Hospital in West Palm Beach. She currently practices as a PRN staff pathologist and independent locum tenens pathologist. Her career also includes teaching medical students and residents, as well as research and publications addressing breast cancer, dermatologic disease, and experimental pathology. She is a Fellow of the College of American Pathologists. ### Bruce Werness, MD ##### CHIEF SCIENTIFIC ADVISOR Bruce is uniquely valuable to GAI because of his in-depth knowledge of basic science, experience in grant writing and reviewing, his early career in academic medicine in cancer research, and practice of pathology, as Chairman of Pathology and Laboratory Medical Director of the Inova Fair Oaks Hospital in Fairfax, Va. for over 21 years of his 23 years in the Inova Health system. Bruce’s passion for science and medicine is lifelong.  With his B.S. in Zoology from the University of Minnesota, he joined the Denver County Public Health Department during the era of emerging AIDS.  This inspired him to pursue a clinical and academic medicine career.  He received his M.D. from the University of Colorado as well as completing his residency in anatomic and clinical pathology there. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/03/Bruce-Werness-bio-photo-2025.png) He was then awarded a fellowship at the NIH to work in the Laboratory of Tumor Virus Biology under the renowned scientist Peter Howley, MD.  Bruce’s work in Dr. Howley’s lab was instrumental in determining the molecular basis of carcinogenesis by oncogenic human papillomaviruses.  After a stint in clinical pathology at the Washington Hospital Center in Washington, D.C. Bruce pursued an academic career at the Roswell Park Cancer Institute and the University of Cincinnati where he focused on ovarian cancer research. Bruce’s many interests include reading history, hiking, and enjoying time with his family.  He has a particular interest in immunology with a focus on Celiac Disease.  He and Sandy have a daughter with Celiac Disease diagnosed early in life, and he was recently diagnosed with Celiac Disease in 2023.  Bruce looks forward to continuing to contribute to the mission of the Global Autoimmune Institute in his capacity as Chief Scientific Advisor. ### Carolyn Serraino, MS ##### DIRECTOR OF RESEARCH & DIGITAL MEDIA Carolyn brings a background in biology, neuroscience, research, and scientific communication to her work at GAI. She specializes in translating complex medical and scientific information into clear, accurate, and engaging content for broad audiences, with a particular focus on autoimmune disease and emerging research. Her experience spans academic research, editorial development, digital media, science writing, and public education. She develops and edits evidence-based health content, creates digital resources, and collaborates with researchers, writers, and partner organizations. Becoming a mother to a son with complex chronic health needs has further strengthened her commitment to helping others navigate complicated medical information. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/09/2026-Carolyn-2.jpg) --- ### [GAI and La Jolla Institute for Immunology](https://www.autoimmuneinstitute.org/gai-and-la-jolla-institute-for-immunology/) **Published:** November 19, 2024 **Author:** Elevation **Content:** # GAI and La Jolla Institute for Immunology ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/12/DSC_4512-scaled-e1734552186457-1024x466.jpg) ### A Unified Mission Established in 2024, the partnership between the Global Autoimmune Institute (GAI) and [La Jolla Institute for Immunology (LJI)](https://www.lji.org/) has grown into a multifaceted collaboration advancing autoimmune disease research, scientific education, and public engagement. > #### To date, GAI has committed more than $1.8 million to support research, scientific infrastructure, educational initiatives, scientific events, and public resources through its partnership with LJI. LJI is one of the few organizations in the world solely dedicated to research on the immune system. Its Center for Autoimmunity and Inflammation enables LJI’s experts to uncover the causes and commonalities among different autoimmune diseases and to develop new treatments that teach the immune system to tolerate the body’s own cells. As a result, LJI researchers have wide-ranging expertise in the fundamental mechanisms of self-tolerance, as well as in many of the autoimmune diseases that result when self-tolerance breaks down. “ What began as a catalytic investment has evolved into a sustained commitment that is enabling deeper discovery, expanded collaboration, and a more continuous path from fundamental insight to translational impact. **Eileen Timken, MPA** Director of Advancement, La Jolla Institute for Immunology GAI/LJI 2025-2026 Impact Report > *This **2025–2026 Impact Report*** *prepared by the La Jolla Institute for Immunology reflects the growing impact of the GAI–LJI partnership. It highlights scientific advances, collaborative initiatives, and ongoing efforts to accelerate autoimmune disease research while supporting a more continuous path from discovery to real-world impact.* ### **Dr. Sam Myers** GAI proudly supports the work of LJI’s Dr. Sam Myers, the inaugural **Global Autoimmune Institute Assistant Professor**. Dr. Myers leads the [*Laboratory for Immunochemical Circuits*](https://www.lji.org/labs/myers-lab/), which focuses on how molecular modifications affect immune cell behavior, providing critical insights into autoimmune disease mechanisms. ##### **In 2025, GAI renewed its support for Dr. Myers with a five-year commitment to fund the GAI Assistant Professorship and ensure long-term continuity in his research.** ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/02/Photo-and-Text-Format-New-Website-Size-6.png) As the Global Autoimmune Institute Assistant Professor, Dr. Myers leads a research program focused on decoding the molecular signals that govern immune cell behavior—work that is redefining how autoimmune diseases are understood at their most fundamental level. With GAI’s support, his lab has been able to pursue high-risk, high-reward questions, expand its suite of cutting-edge technologies, recruit exceptional scientific talent, and build collaborative networks that extend across disciplines and institutions. This flexibility, which is especially rare for early-career faculty, has enabled discoveries that would not otherwise be possible. Excerpted from the 2025–2026 GAI/LJI Impact Report ![Dr. Sam Myers, GAI Executive Director Sandra Boek Werness, Dr. Bruce Werness, and GAI Board Member Liz Loftus](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/04/Copy-of-LJI-IMG_6192F-2025-1024x683.jpg)With GAI’s support, the Myers lab acquired the **Astral mass spectrometry platform** in fall 2024, bringing advanced proteomic capabilities to LJI and expanding the lab’s ability to investigate immune signaling and autoimmune disease mechanisms. **2025–2026 Update:** The [Myers lab](https://www.lji.org/labs/myers-lab/) has used these expanded proteomics capabilities to advance research on how immune cells interpret inflammatory signals, uncover new mechanisms that regulate immune activity, and develop innovative tools for studying signaling pathways. These efforts contributed to discoveries accepted for publication in *Nature* and *Proceedings of the National Academy of Sciences* and continue to inform new approaches for understanding autoimmune and inflammatory diseases. ### The Decision Makers *The Decision Makers* is a short documentary highlighting Dr. Sam Myers’ research journey, scientific leadership, and contributions to autoimmune disease research. Through interviews and behind-the-scenes footage, the film offers an inside look at the people, discoveries, and partnerships helping advance our understanding of immune-mediated disease while exploring the role philanthropy can play in accelerating scientific progress. [ ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/04/The-Decision-Makers-Dr.-Sam-Myers-x-Global-Autoimmune-Institute.png) ](https://www.youtube.com/watch?v=60Vg1ZVqkDA) #### **Autoimmune Disease Resource Guide** **A practical resource for understanding autoimmune disease** Developed by LJI and GAI, the Autoimmune Disease Resource Guide brings together clear, accessible information about autoimmune disease and the science behind it. The guide helps readers understand how the immune system works, what happens in autoimmune disease, how autoimmune conditions are diagnosed and treated, and how research is advancing our understanding of autoimmunity. It translates complex science into approachable explanations and visuals designed to support people living with autoimmune disease, families, healthcare professionals, and the broader community. [View the Guide](https://drive.google.com/file/d/1CREXAlHxFq314iTbXDyVtqGDUYJd7RZ4/view) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/09/GAI-resource-guide-preview.jpg) ### [Walter and Jean Boek Seminar Series](https://www.autoimmuneinstitute.org/research_updates/walter-and-jean-boek-seminar-series-at-lji/ "Walter and Jean Boek Seminar Series at LJI") GAI LJI Impact Report 2025 Walter and Jean Boek Seminar Series > This impact report prepared by LJI highlights the first year of the Walter and Jean Boek Seminar Series and the Walter and Jean Boek Leadership in Research Award Lecture. It reflects GAI’s support for scientific collaboration, thought leadership, and patient engagement through programs that bring together researchers, clinicians, advocates, and families while advancing dialogue around autoimmune disease research and innovation. > > To view upcoming seminars, access previously recorded presentations, and learn more about the series, visit: <https://www.lji.org/events/seminars/> ## LEAD Day ### (Lectures, Empowerment, and Awareness in Autoimmune Disease) [**LEAD Day**](https://www.autoimmuneinstitute.org/lead-day/) is an annual event hosted by LJI and GAI that brings together leading scientists, healthcare professionals, advocates, and the autoimmune disease community. Through scientific lectures, community discussions, and public engagement, LEAD Day connects emerging autoimmune research with the people whose lives it aims to improve. The inaugural LEAD Day was held on March 6, 2025, featuring the presentation of the first **Walter and Jean Boek Leadership in Research Award** to **Georg Schett, M.D.**, in recognition of his pioneering work in autoimmune disease, along with a panel discussion exploring advances reshaping autoimmune research. [**Read Event Highlights from LEAD Day 2025**](https://www.autoimmuneinstitute.org/lead-day-2025-highlights/). On **September 15, 2026**, GAI and LJI held the second annual LEAD Day at the Scripps Seaside Forum in La Jolla, California. The event featured **Eric Topol, M.D.**, as the 2026 Walter and Jean Boek Leadership in Research Award honoree and a scientific panel, **“AI and Multi-Omics: Building a New Era of Autoimmune and Chronic Disease Research,”** moderated by **Shane Crotty, Ph.D.**, with **Eric Topol, M.D.; Ferhat Ay, Ph.D.; and Sam Myers, Ph.D.** The discussion explored how artificial intelligence, genomics, proteomics, and other data-rich approaches are changing the study of the immune system. [**Read Event Highlights from LEAD Day 2026**](https://www.autoimmuneinstitute.org/research_updates/lead-day-2026-highlights/). [Learn More about LEAD Day](https://www.autoimmuneinstitute.org/lead-day/) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/03/TK8A0452-2-900x600.jpeg) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/03/TK8A0460-2-900x600.jpeg) ![Sandy Boek Werness presenting LEAD Day award to Dr. Schett](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/03/TK8A0487-900x600.jpeg) Sandra Boek Werness, Executive Director of the Global Autoimmune Institute presenting Dr. Georg Schett with the Walter and Jean Boek Leadership in Research Award ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/09/LEAD-Day-2026-Scientific-Panel-800x600.jpeg) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/09/Copy-of-Sandy-Presenting-Award-to-Eric-900x597.jpg) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/09/Copy-of-Shane-Eric-Sandy-Bruce-Erica-5-900x600.jpg) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/09/Copy-of-Topol-Lecture-Speech-and-Guests-900x600.jpg) ### **Live From the Lab** ### with LJI’s Dr. Sonia Sharma [*Full recap*](https://www.autoimmuneinstitute.org/research_updates/live-from-the-lab-the-autoimmune-framework/) On March 19, 2025, GAI and LJI held a virtual event offering a rare behind-the-scenes look into pioneering autoimmune research. In this session, viewers were introduced to the overlooked role of non-immune cells, such as those in the skin and blood vessels, as critical first responders in autoimmune and inflammatory responses. [ ![Live from the Lab with LJI's Dr. Sonia Sharma and GAI's Sandy Boek Werness](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/04/Screenshot-2025-04-24-at-4.37.41 PM.png) ](https://www.youtube.com/watch?v=_cPbfxKuRMs&t=4s) Dr. Sharma led attendees through an [eye-opening exploration](https://www.autoimmuneinstitute.org/research_updates/could-a-healthy-fat-help-calm-autoimmune-flares/ "Could a Healthy Fat Help Calm Autoimmune Flares?") of how early immune signaling by these cells can influence disease progression. Using cutting-edge techniques like genome-scale RNA interference, CRISPR/Cas9, and mass spectrometry metabolomics, Dr. Sharma revealed how this research is shaping the future of autoimmune disease understanding and treatment. Whether seeking personal insight or scientific enrichment, attendees walked away with a deeper appreciation for the hidden complexity of immune system triggers. A lively Q&A session followed, moderated by GAI Executive Director Sandy Boek Werness, J.D. GAI Stewardship Report Sep 2025 – sponsorship of LJI Life Without Disease seminar and Live from the Lab webinar > **Patient Engagement Programs Impact Report** > > This impact report prepared by LJI highlights GAI-sponsored public education and outreach initiatives, including the *Life Without Disease* lecture series and *Live from the Lab* webinar program. It reflects ongoing efforts to make complex immunology research more accessible while creating meaningful opportunities for patients, advocates, and the broader community to engage with the science shaping the future of autoimmune disease research. ## Life Without Disease Seminar > Held in La Jolla, CA on November 7, 2024 LJI’s *[Life Without Disease](https://www.lji.org/events/life-without-disease-seminar-series/)* seminar series connects Southern California with the frontlines of immune research, highlighting discoveries that could transform the future of human health. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/12/Untitled-design-38.png) Play Event Recording ##### videoTextBlockModalblock\_0142309b891462fd757558b80fa01a4cTitle × Your browser does not support the video tag. Close Popup ### Outsmarting Autoimmune Disease ##### If we want to control how immune cells behave, we first need to understand how they “think” and “make decisions.” In the fall of 2024, GAI helped bring together researchers through a seminar at La Jolla Institute for Immunology featuring Samuel Anthony Myers, Ph.D., the inaugural Global Autoimmune Institute Assistant Professor. Dr. Myers highlighted how his research combines mass spectrometry and proteomics to understand how immune cells make decisions, providing new insights into the mechanisms underlying autoimmune, inflammatory, and other diseases. ### Event Photographs ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/12/DSC_4311-750x600.jpg) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/12/DSC_4406-e1734554366867-640x600.jpg) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/12/DSC_4288-754x600.jpg) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/12/DSC_4471-844x600.jpg) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/12/DSC_4403-890x600.jpg) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/12/DSC_4365-769x600.jpg) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/12/DSC_4669-883x600.jpg) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/12/DSC_4642-878x600.jpg) **[More event photographs](https://zenfolio.page.link/LUWLG)** --- ### [Resources for Hope and Health](https://www.autoimmuneinstitute.org/resources-for-hope-health/) **Published:** February 23, 2024 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Our aim is to serve as a hub for practical and reliable information on autoimmune disease to help those affected in their daily lives, as well as their friends, family, and caregivers. Information overload can be overwhelming! Exploring the resources below is a good place to start. **Content:** ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/pexels-antoni-shkraba-7345471-4.jpg) # Find Resources for Hope and Health Our aim is to serve as a hub for practical and reliable information on autoimmune disease to help those affected in their daily lives, as well as their friends, family, and caregivers. Information overload can be overwhelming! Exploring the resources below is a good place to start. ![](https://www.autoimmuneinstitute.org/wp-content/themes/elevation-framework/src/assets/images/layer-ocean-top.png) ## Autoimmune Medical Institutions Directory ##### A comprehensive list of medical institutions across the United States specializing in diagnosing and treating various autoimmune diseases. [Find the help you need](https://www.autoimmuneinstitute.org/medical-institutions/) ![](https://www.autoimmuneinstitute.org/wp-content/themes/elevation-framework/src/assets/images/layer-ocean-bottom.png) ## GAI Resource Guides [![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/09/Toolkit-preview-1024x936.jpg)](https://www.autoimmuneinstitute.org/autoimmune-chronic-illness-toolkit/) **The Autoimmune & Chronic Illness Toolkit** A practical guide to navigating life with autoimmune and chronic illness, with information on healthcare, insurance, work and disability, mental health, relationships, caregiving, and more. [![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/09/GAI-resource-guide-preview-1024x936.png)](https://drive.google.com/file/d/1CREXAlHxFq314iTbXDyVtqGDUYJd7RZ4/view) **Navigating Autoimmune Disease Resource Guide** An introduction to autoimmune disease, including how autoimmunity develops, how diseases are diagnosed and treated, and how emerging research is advancing more personalized approaches to care. ### Practical Strategies for Living with Autoimmune Disease and Chronic Illness ![silhouette of a woman in front of a sunset peering into the distance](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/03/Finding-Purpose-with-Autoimmune-Disease-and-Chronic-Illness-GAI-1024x576.jpg) Finding Purpose & Fulfillment with Autoimmune and Chronic Disease People with autoimmune diseases or other severe chronic illnesses learn how to manage their condition but also strive to find purpose, stability, and a way forward. Pursuing these goals while living with a chronic condition involves discovering personal and professional opportunities that fit a new lifestyle but also reclaiming agency, dignity, and the sense of being helpful to others.  Living Well with Autoimmune Disease [Read Post Finding Purpose & Fulfillment with Autoimmune and Chronic Disease](https://www.autoimmuneinstitute.org/articles/finding-purpose-and-fulfillment-with-autoimmune-and-chronic-disease) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/01/Exercise-and-Autoimmune-Disease-1024x576.jpg) Exercise and Autoimmune Disease: Evidence-Based, Low-Impact Approaches An expert-informed, evidence-based overview of low-impact exercise approaches for people with autoimmune disease. Living Well with Autoimmune Disease [Read Post Exercise and Autoimmune Disease: Evidence-Based, Low-Impact Approaches](https://www.autoimmuneinstitute.org/articles/exercise-and-autoimmune-disease-evidence-based-low-impact-approaches-3) ![Physician billing statement marked ‘past due’ beside a stethoscope and a one-hundred-dollar bill, illustrating the financial strain of medical care.](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/01/healthcare-with-limited-resources-1024x576.jpg) Navigating Autoimmune Care With Limited Resources Navigating the healthcare system can be challenging for almost everyone. Finding the right providers, getting timely appointments, and accessing appropriate treatments often feel overwhelming. For people living with autoimmune and other chronic conditions, these challenges can be even greater. Autoimmune Care & Caregiver Support [Read Post Navigating Autoimmune Care With Limited Resources](https://www.autoimmuneinstitute.org/articles/navigating-autoimmune-care-with-limited-resources) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Managing-Mental-Health-1024x576.jpg) Managing Mental Health with an Autoimmune Disease Mental health: it’s a discussion that our modern world is slowly beginning to embrace. Although there are many factors that can impact a person’s emotional balance, the interplay between mental health and autoimmune disease is a topic that should not be dismissed. Mental health challenges are a common experience among people with autoimmune disease and other chronic illnesses. In 2013, a group of Danish researchers concluded that participants of their study were 45% more likely to develop anxiety or depression if they had an autoimmune disease (1). Additionally, Cleveland Clinic reports that clinical depression occurs in 40% of people with multiple \[…\] Living Well with Autoimmune Disease [Read Post Managing Mental Health with an Autoimmune Disease](https://www.autoimmuneinstitute.org/articles/managing-mental-health-with-an-autoimmune-disease) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Effective-Communication-for-Patients-1-1024x576.jpg) Effective Communication Strategies for Those with Autoimmune Disease For patients with autoimmune disease, management means understanding a wide range of symptoms, unpredictable disease courses, and any impacts on quality of life. But how can patients better communicate with their providers? The Global Autoimmune Institute expounds on key tips elucidated by Johannah Ruddy, M.Ed., a doctoral candidate at Campbell University and co-author of Gut Feelings: Doctors and Patient-Centered Care. How Knowledge, Commitment to Care and Empathy Improve Patient’s Lives to help patients establish a strong relationship with their provider and diminish stigma. 1. Make A List Of Noticeable Symptoms And Other Relevant Information GAI has a Printable Daily Symptom Checklist \[…\] Autoimmune Care & Caregiver Support [Read Post Effective Communication Strategies for Those with Autoimmune Disease](https://www.autoimmuneinstitute.org/articles/effective-communication-strategies-for-patients-with-autoimmune-diseases) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/01/Navigating-Mask-Wearing-e1749652601982-1024x576.png) A Guide for Immunocompromised Individuals in a Post-Pandemic World Even as the world moves on from the pandemic, immunocompromised individuals continue to face heightened health risks. With fewer people wearing masks, navigating daily life safely can be challenging. This guide explores the science behind immune function, the impact of mask-wearing, legal protections, and practical strategies for advocating for personal health. Whether seeking protection in healthcare settings, workplaces, or social interactions, immunocompromised individuals can find support and solutions to maintain both physical and mental well-being in an increasingly unmasked world. Autoimmune Care & Caregiver Support [Read Post A Guide for Immunocompromised Individuals in a Post-Pandemic World](https://www.autoimmuneinstitute.org/articles/a-guide-for-immunocompromised-individuals-in-a-post-pandemic-world) ![Mental,Health,Disorder,Concept.,Exhausted,Depressed,Female,Touching,Forehead.,Stressed](https://www.autoimmuneinstitute.org/wp-content/uploads/2020/02/shutterstock_1936385779-1024x559.jpg) Chronic Illness: When You Feel Like Giving Up When your chronic illness has put you through the wringer in terms of doctor and hospital visits, lab tests, imaging, medications, and other treatments, it’s only natural to feel defeated. Living Well with Autoimmune Disease [Read Post Chronic Illness: When You Feel Like Giving Up](https://www.autoimmuneinstitute.org/articles/chronic-illness-when-you-feel-like-giving-up) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/diagnosing-AD-1024x576.png) Misdiagnosed and Undiagnosed: Expert Insights on the Autoimmune Diagnosis Process Diagnosing autoimmune diseases is often a complex and challenging process because autoimmune diseases vary widely. Identifying patterns and clusters of symptoms can help, but autoimmunity often relates to many factors including stress, deficiencies, toxic exposures, gut and immune dysfunction. As such, autoimmunity has a tendency to go undiagnosed — or misdiagnosed. Here, the Global Autoimmune Institute speaks with Dr. Francisco Contreras, Johannah Ruddy, M.Ed, and Dr. Henri Roca about the process of diagnosing autoimmune disease. Autoimmune Care & Caregiver Support [Read Post Misdiagnosed and Undiagnosed: Expert Insights on the Autoimmune Diagnosis Process](https://www.autoimmuneinstitute.org/articles/misdiagnosed-undiagnosed-expert-insights-on-the-autoimmune-diagnosis-process) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/04/diagnosing-AD-2-1024x576.webp) Experts Discuss the Complex Path to an Autoimmune Diagnosis Unlock the mystery of autoimmune diagnosis with insights from medical experts. Learn about diverse timelines, proactive patient advocacy, and holistic approaches to unraveling the mysteries of chronic conditions. Autoimmune Care & Caregiver Support [Read Post Experts Discuss the Complex Path to an Autoimmune Diagnosis](https://www.autoimmuneinstitute.org/articles/experts-discuss-the-complex-path-to-an-autoimmune-diagnosis) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/terminology-1024x576.jpg) Autoimmune Terminology To Know For Your Next Doctor’s Appointment While having guidance and support from your doctor is essential, taking control of your own health is important for planning and making informed decisions about your autoimmune disease. Being on board with the terms used to describe autoimmunity and specific diseases during your doctor’s appointments can help you receive the care you need as you ask questions to recognize signs and symptoms, understand the reasons behind testing, and navigate treatment options. Autoimmune Disease Testing: After a physical exam, your healthcare provider will order additional tests to diagnose your disease depending on your signs and symptoms. Terms to keep in mind include \[…\] Autoimmune Care & Caregiver Support [Read Post Autoimmune Terminology To Know For Your Next Doctor’s Appointment](https://www.autoimmuneinstitute.org/articles/autoimmune-terminology-to-know-for-your-next-doctors-appointment) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Hot-Temp-1024x576.jpg) Stay Cool: How to Manage Autoimmune Flare-ups in Hot Temperatures Heat and humidity can worsen symptoms for some people with autoimmune diseases. Learn why this happens, how to reduce the risk of heat-related flare-ups, and what research suggests about the effects of a warming climate on autoimmune health. Living Well with Autoimmune Disease [Read Post Stay Cool: How to Manage Autoimmune Flare-ups in Hot Temperatures](https://www.autoimmuneinstitute.org/articles/stay-cool-how-to-manage-autoimmune-flare-ups-in-hot-temperatures) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Outbursts-in-Autoimmunity-Disease-Flare-ups-1024x576.png) Outbursts in Autoimmunity: Disease Flare-ups Autoimmune disease flare-ups can be unpredictable and disruptive, causing symptoms to suddenly appear or worsen and interfering with daily life. But what causes a flare-up, what is happening in the body when one occurs, and what can you do when symptoms intensify? This article explores what researchers know about autoimmune disease flare-ups, including common triggers, the immune processes involved, how flares can differ across autoimmune diseases, and strategies for managing them. What Are Autoimmune Disease Flare-Ups? Also known as bouts, relapses, or episodes, autoimmune disease flare-ups occur when patients show a dramatic worsening of disease signs and symptoms or when they \[…\] About Autoimmune Disease [Read Post Outbursts in Autoimmunity: Disease Flare-ups](https://www.autoimmuneinstitute.org/articles/outbursts-in-autoimmunity-disease-flare-ups) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Cold-Temperatures-1024x576.jpg) How do Cold Temperatures Affect Autoimmune Disease? During the fall and winter months, cold temperatures can exacerbate many disease symptoms. Sensitivity to temperature fluctuations is a problem common to many autoimmune conditions, with the cold activating flare-ups of diseases such as systemic lupus erythematosus, arthritis, and psoriasis. This is especially true when temperature changes are extreme. Although scientists have described cold weather as a trigger for autoimmune diseases, the mechanisms behind it are not fully understood, and research on this topic is less extensive than other areas of autoimmunity. Nevertheless, this article will discuss what is known about cold weather’s ability to trigger flare-ups, what can be done \[…\] Living Well with Autoimmune Disease [Read Post How do Cold Temperatures Affect Autoimmune Disease?](https://www.autoimmuneinstitute.org/articles/how-do-cold-temperatures-affect-autoimmune-disease) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/When-Youve-Lost-Trust-in-Doctors-1024x576.jpg) When You’ve Lost Trust in Doctors… Have you been told “it’s just stress”? Or diagnosed as a hypochondriac? Has it taken years to find a diagnosis? Maybe you’re still searching for one. The exhaustion is real! It’s a long road to figure out what’s wrong and how to address it, without getting derailed by judgment and misdiagnoses. The experience of managing chronic conditions can be as agonizing as the symptoms themselves. So who do we trust—the medical system we feel has let us down, or ourselves? At the beginning, when we’re new to the world of chronic health issues, we tend to cling to the medical system, \[…\] Autoimmune Care & Caregiver Support [Read Post When You’ve Lost Trust in Doctors…](https://www.autoimmuneinstitute.org/articles/when-youve-lost-trust-in-doctors) ## Want to see more from the Global Autoimmune Institute? Confirm GAI as a trusted autoimmune disease news source to make it easier to find our latest resources and updates. [ ![Add Global Autoimmune Institute as a preferred source on Google](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/08/google_preferred_source_badge_light_en@2x.png) ](https://www.google.com/preferences/source?q=https://www.autoimmuneinstitute.org) ## Diagnosis-Based and Patient-Focused Assistance Programs (Including prescription and other financial support) - [RxAssist](https://www.rxassist.org/patients) - Can help you learn about ways to use pharmaceutical company programs and other resources to help reduce your medication costs - [Healthwell Foundation](https://www.healthwellfoundation.org) (P: [800-675-8416](tel:800-675-8416)) - Provide financial assistance to adults and children to cover the cost of prescription drug coinsurance, copayments, deductibles, health insurance premiums and other selected out-of-pocket health care costs. - [211](https://www.211.org) (P: 211) - Whether it’s help paying your bills, finding resources for caregivers, or just needing someone to listen, 211 is only a call away. - [Patient Advocate Foundation](https://www.patientadvocate.org) (P: [800-532-5274](tel:800-532-5274); Co-pay relief program: [866-512-2861](tel:866-512-2861)) - Provides case management services and financial aid to Americans with chronic, life threatening and debilitating illnesses. - [GoodRx](https://www.goodrx.com/mobile) - A free mobile app and website that helps Americans save millions of dollars every month by finding them the lowest prescription prices in their neighborhood. - [Accessia Health](https://accessiahealth.org) (P: [800-366-7741](tel:800-366-7741)) - Offer financial assistance for health insurance premiums, medication copayments, travel, and other essential medical expenses to individuals of all ages with qualifying household income and diagnosed chronic medical conditions. - [National Organization for Rare Disorders](https://rarediseases.org/patient-assistance-programs/#section-1) (P: [617-249-7300](tel:617-249-7300)) - Provide patient assistance programs to help individuals living with rare diseases obtain medication, receive financial help with insurance premiums and co-pays, get diagnostic testing assistance, receive travel assistance for clinical trials or consultation with disease specialists, provide caregiver respite, offer support during emergencies, gain knowledge about rare diseases, and connect with other patient assistance programs. - [My Good Days](https://www.mygooddays.org) (P: [877-968-7233](tel:877-968-7233)) - Offer copay assistance, travel assistance, monthly medical insurance premium assistance, and diagnostic testing assistance. - [The Patient Access Network (PAN) Foundation](https://www.panfoundation.org) (P: [866-316-7263](tel:866-316-7263)) - Offer financial assistance to help people with serious illnesses afford their out-of-pocket treatment costs ## Help Lines - National Organization for Rare Disorders: [203-744-0100](tel:203-744-0100); Patient service: [800-999-6673](tel:800-999-6673) - National Heart, Lung, and Blood Institute (NHLBI), NIH, HHS: [301-592-8573](tel:301-592-8573) - National Institute of Allergy and Infectious Diseases (NIAID), NIH, HHS: [866-284-4107](tel:866-284-4107) - National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), NIH, HHS: [301-49504484](tel:301-49504484); Toll-Free: [877-226-4267](tel:877-226-4267) - National Institute of Neurological Disorders and Stroke (NINDS), NIH, HHS: [800-352-9424](tel:800-352-9424) - Office of Women’s Health: [1-800-994-9662](tel:1-800-994-9662) ### Our Recommendations [ ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Frame-59650.svg) ##### Autoimmune Disease Podcasts Top-notch podcasts on nutrition, finding community, mind-body medicine, and more. ](https://www.autoimmuneinstitute.org/ad-podcasts/) [ ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/04-icon-1.svg) ##### Books We Love Essential reading for understanding autoimmune disease and the body, chronic illness memoirs, practical guides, cookbooks, and children’s books, as well as other books of interest. ](https://www.autoimmuneinstitute.org/books-we-love/) [ ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Frame-59651.svg) ##### Helpful Apps A brief list of our favorite, simple, and practical mobile apps to help manage life with chronic illness. ](https://www.autoimmuneinstitute.org/helpful-apps/) [ ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Frame-59652.svg) ##### Autoimmune & Chronic Illness Toolkit Includes journal templates, resource lists, guidance for doctor appointments, tips on communication, and many more tools to support and empower you throughout your experience. ](https://www.autoimmuneinstitute.org/autoimmune-chronic-illness-toolkit/) [ ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/03/Icon-8.png) ##### Doctors who Diagnose & Treat Autoimmune Disease Medical specialists typically familiar with autoimmunity and the specific autoimmune diseases they often diagnose and treat. ](https://www.autoimmuneinstitute.org/doctors-who-diagnose-treat/) [ ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Frame-59654.svg) ##### Autoimmune Basics Learn more about autoimmune disease and how it is diagnosed. ](https://www.autoimmuneinstitute.org/understanding-autoimmune-disease/) ### My Autoimmune Story [See All Stories](https://www.autoimmuneinstitute.org/autoimmune-stories/) ![GAI Heather Blair](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/06/Heathers-AD-story-banner.jpg) Jun 15,26 · by Heather Blair ## [Heather’s Story: The Hurt and Healing](https://www.autoimmuneinstitute.org/autoimmune_stories/heathers-story-the-hurt-and-healing/) In her story, Heather shares her journey from years of unexplained symptoms and repeated surgeries to a diagnosis of hypermobile Ehlers-Danlos syndrome (hEDS), and the resilience, self-discovery, and hope she found along the way. While Ehlers-Danlos syndrome (EDS) is not classified as an autoimmune disease, many people living with EDS face challenges that will feel familiar to those in the autoimmune community, including chronic pain, diagnostic delays, complex symptoms, and the emotional toll of an often invisible condition. Diagnostic Delays ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/02/Melanies-AD-story-GAI.jpg) Mar 06,26 · by Melanie Cammarano ## [Melanie’s Story: Living With Type 1 Diabetes](https://www.autoimmuneinstitute.org/autoimmune_stories/melanies-story-living-with-type-1-diabetes/) Type 1 Diabetes ![Bárbara Barros Global Autoimmune Institute Autoimmune Story](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/01/Barbaras-AD-Story.jpg) Jan 27,26 · by Bárbara Barros ## [Bárbara’s Story: The Invisibility of Continuity](https://www.autoimmuneinstitute.org/autoimmune_stories/barbaras-story-the-invisibility-of-continuity/) Multiple Autoimmune DiseasesMultiple Sclerosis (MS)Undiagnosed ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/01/Gracies-AD-Story-e1769458604970.jpg) Jan 26,26 · by Gracie Rady-Ginther ## [Gracie’s Story: Reclaiming my Life](https://www.autoimmuneinstitute.org/autoimmune_stories/gracies-story-reclaiming-my-life/) POTS ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/08/Spring-Reyna-Fam-2.jpg) Aug 08,25 · by Erika Reyna ## [Erika’s Story: Still Me](https://www.autoimmuneinstitute.org/autoimmune_stories/erikas-story/) Lupus (SLE)Multiple Autoimmune DiseasesRheumatoid ArthritisSjogren’s Disease ## Find the Support You Need ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Group-59508.svg) ## Autoimmune Disease & Chronic Illness Related Support Groups Connect with others, share experiences, and join virtual or local communities for support. [Find the Group for You!](https://www.autoimmuneinstitute.org/autoimmune-disease-chronic-illness-related-support-groups/) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Frame-59531.svg) ## Resources for Healthcare Providers In an exclusive interview, Dr. Drossman and Johannah Ruddy, M.Ed., authors of the *Gut Feelings* series, discuss how healthcare providers can better communicate with patients when it comes to autoimmune diseases in order to improve patient satisfaction and overall healthcare experience. [Learn more in our article!](https://www.autoimmuneinstitute.org/effective-communication-strategies/) --- ### [Find Help](https://www.autoimmuneinstitute.org/find-help/) **Published:** February 20, 2024 **Author:** Elevation **Excerpt:** Resources for managing autoimmune disease, including symptom-tracking apps, financial assistance programs, and helplines for personalized support. **Content:** ![United States map with pins](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/04/Mask-group-1.webp) ### U.S. Medical Institutions That Treat Autoimmune Disease A comprehensive list of medical institutions across the United States specializing in diagnosing and treating various autoimmune diseases in an easy-to-use keyword and location search format. [Find the Help You Need](https://www.autoimmuneinstitute.org/medical-institutions/) [ ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/03-icon.svg) Support Groups Learn More Read more about Support Groups ](https://www.autoimmuneinstitute.org/autoimmune-disease-chronic-illness-related-support-groups/) [ ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/02-icon.svg) Autoimmune Organizations Learn More Read more about Autoimmune Organizations ](https://www.autoimmuneinstitute.org/autoimmune-organizations/) ## Diagnosis-Based and Patient-Focused Assistance Programs (Including prescription and other financial support) - [RxAssist](https://www.rxassist.org/patients) - Can help you learn about ways to use pharmaceutical company programs and other resources to help reduce your medication costs - [Healthwell Foundation](https://www.healthwellfoundation.org) (P: [800-675-8416](tel:800-675-8416)) - Provide financial assistance to adults and children to cover the cost of prescription drug coinsurance, copayments, deductibles, health insurance premiums and other selected out-of-pocket health care costs. - [211](https://www.211.org) (P: 211) - Whether it’s help paying your bills, finding resources for caregivers, or just needing someone to listen, 211 is only a call away. - [Patient Advocate Foundation](https://www.patientadvocate.org) (P: [800-532-5274](tel:800-532-5274); Co-pay relief program: [866-512-2861](tel:866-512-2861)) - Provides case management services and financial aid to Americans with chronic, life threatening and debilitating illnesses. - [GoodRx](https://www.goodrx.com/mobile) - A free mobile app and website that helps Americans save millions of dollars every month by finding them the lowest prescription prices in their neighborhood. - [Accessia Health](https://accessiahealth.org) (P: [800-366-7741](tel:800-366-7741)) - Offer financial assistance for health insurance premiums, medication copayments, travel, and other essential medical expenses to individuals of all ages with qualifying household income and diagnosed chronic medical conditions. - [National Organization for Rare Disorders](https://rarediseases.org/patient-assistance-programs/#section-1) (P: [617-249-7300](tel:617-249-7300)) - Provide patient assistance programs to help individuals living with rare diseases obtain medication, receive financial help with insurance premiums and co-pays, get diagnostic testing assistance, receive travel assistance for clinical trials or consultation with disease specialists, provide caregiver respite, offer support during emergencies, gain knowledge about rare diseases, and connect with other patient assistance programs. - [My Good Days](https://www.mygooddays.org) (P: [877-968-7233](tel:877-968-7233)) - Offer copay assistance, travel assistance, monthly medical insurance premium assistance, and diagnostic testing assistance. - [The Patient Access Network (PAN) Foundation](https://www.panfoundation.org) (P: [866-316-7263](tel:866-316-7263)) - Offer financial assistance to help people with serious illnesses afford their out-of-pocket treatment costs ## Help Lines - National Organization for Rare Disorders: [203-744-0100](tel:203-744-0100); Patient service: [800-999-6673](tel:800-999-6673) - National Heart, Lung, and Blood Institute (NHLBI), NIH, HHS: [301-592-8573](tel:301-592-8573) - National Institute of Allergy and Infectious Diseases (NIAID), NIH, HHS: [866-284-4107](tel:866-284-4107) - National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), NIH, HHS: [301-49504484](tel:301-49504484); Toll-Free: [877-226-4267](tel:877-226-4267) - National Institute of Neurological Disorders and Stroke (NINDS), NIH, HHS: [800-352-9424](tel:800-352-9424) - Office of Women’s Health: [1-800-994-9662](tel:1-800-994-9662) --- ### [Medical Institutions](https://www.autoimmuneinstitute.org/medical-institutions/) **Published:** February 23, 2024 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Explore our list of top medical institutions specializing in the treatment and research of autoimmune diseases. Find leading clinics, hospitals, and centers dedicated to autoimmune care and support. **Content:** # Find Medical Institutions Near You A comprehensive list of medical institutions across the United States specializing in diagnosing and treating various autoimmune diseases in an easy-to-use keyword and location search format. Search Apply Filters Autoimmune Disease Addison’s Disease Agammaglobulinemia Alopecia Areata Amyloidosis Ankylosing Spondylitis Anti-NMDA Receptor Encephalitis Antiphospholipid Syndrome Aplastic Anemia Arteriosclerosis / atherosclerosis Autoimmune Autonomic Ganglionopathy Autoimmune Cytopenia Autoimmune Encephalitis/Acute Disseminated Encephalomyelitis (ADEM) Autoimmune Enteropathy Autoimmune Hemolytic Anemia Autoimmune Hepatitis Autoimmune Inner Ear Disease Autoimmune Lymphoproliferative Syndrome Autoimmune Pancreatitis Autoimmune Polyglandular Syndrome Autonomic Neuropathy Behçet’s Disease Bullous Pemphigoid Celiac Disease Central Nervous System Vasculitis Chilblain Lupus Erythematosus Chronic Granulomatous Disease Chronic Inflammatory Demyelinating Polyneuropathy Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA) Cogan Syndrome Connective Tissue Disease Crohn’s Disease Cronkhite-Canada Syndrome Cryoglobulinemia Cryoglobulinemic Vasculitis Cutaneous Lupus Cutaneous Vasculitis Dermatitis Herpetiformis Dermatomyositis Discoid Lupus Dressler’s Syndrome Dysautonomia Ehlers-Danlos Syndrome Eosinophilic Esophagitis Eosinophilic Fasciitis Evans Syndrome Giant Cell Arteritis Glomerulonephritis Goodpasture Syndrome Graves’ Disease Guillain-Barre Syndrome Hashimoto’s Thyroiditis/Autoimmune Thyroiditis Hashimoto’s Encephalopathy Henoch–Schönlein Purpura Hyperthyroidism Iga Nephropathy/Berger’s Disease Igg4-Related Disease Immune Thrombocytopenia Purpura Juvenile Ankylosing Spondylitis Juvenile Arthritis Juvenile Dermatomyositis Juvenile Idiopathic Arthritis Juvenile Idiopathic Arthritis/Adult-Onset Still’s Disease Juvenile Lupus Juvenile Myositis Juvenile Polymyositis Juvenile Psoriatic Arthritis Juvenile Rheumatoid Arthritis Juvenile Scleroderma Kawasaki Disease Lambert-Eaton Myasthenic Syndrome Lichen Planus Linear IgA Bullous Dermatosis Lupus Nephritis Lyme Disease Ménière’s disease Microscopic Polyangiitis (MPA)/ANCA-Associated Vasculitis Mixed Connective Tissue Disease Multiple Sclerosis Myasthenia Gravis Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease (MOGAD) Myositis Necrobiosis Lipoidica Neuromyelitis Optica/Devic’s Disease Nonvasculitic Autoimmune Inflammatory Meningoencephalitis Oligoarticular Juvenile Arthritis Paraneoplastic Pemphigus Parsonage-Turner Syndrome Pemphigoid Pemphigus Plaque Psoriasis POEMS Syndrome Polyarteritis Nodosa Polyarticular Juvenile Arthritis Polymyalgia Rheumatica Polymyositis Postural Orthostatic Tachycardia Syndrome (POTS) Primary Adrenal Insufficiency Primary Biliary Cholangitis Primary Biliary Cirrhosis Primary Immunodeficiency Primary Immunodeficiency Disorders Primary Sclerosing Cholangitis Psoriasis Psoriatic Arthritis Pulmonary Alveolar Proteinosis Pyoderma Gangrenosum Raynaud Syndrome/Phenomenon Reactive Arthritis Relapsing Polychondritis Rheumatoid Arthritis Sarcoidosis Scleroderma Sclerosing Mesenteritis Sjögren Syndrome Spondyloarthritis Stiff Person Syndrome Sydenham’s Chorea Systemic Lupus Erythematosus Takayasu’s arteritis Temporal Arteritis Transverse Myelitis Type 1 Diabetes Ulcerative Colitis Undifferentiated Connective Tissue Disease Uveitis Various Autoimmune Diseases Vasculitis Vexas Syndrome Vitiligo Show more State California Colorado Delaware Maryland Massachusetts Minnesota New Jersey New York North Carolina Ohio Pennsylvania Washington DC Show more Apply Filters Displaying Results For: Clear all filters New Jersey Penn Medicine Becker ENT & Allergy Freehold Penn Medicine Address: [303 West Main Street Freehold,7728 ](https://www.google.com/maps?q=303+West+Main+StreetFreehold7728) [visit website](https://www.pennmedicine.org/practices/becker-ent-allergy-freehold?fadf=pennmedicine) - Ménière’s disease Pennsylvania Penn Medicine Becker ENT & Allergy Walnut Street Penn Medicine Address: [1608 Walnut Street Philadelphia,19103 ](https://www.google.com/maps?q=1608+Walnut+StreetPhiladelphia19103) [visit website](https://www.pennmedicine.org/practices/becker-ent-allergy-walnut-street?fadf=pennmedicine) - Ménière’s disease Pennsylvania Penn Medicine Becker ENT & Allergy South Street Penn Medicine Address: [1740 South Street Philadelphia,19146 ](https://www.google.com/maps?q=1740+South+StreetPhiladelphia19146) [visit website](https://www.pennmedicine.org/practices/becker-ent-allergy-south-street?fadf=pennmedicine) - Ménière’s disease New Jersey Penn Medicine Becker ENT & Allergy Mullica Hill Penn Medicine Address: [199 Mullica Hill Road Mullica Hill,8062 ](https://www.google.com/maps?q=199+Mullica+Hill+RoadMullica+Hill8062) [visit website](https://www.pennmedicine.org/practices/becker-ent-allergy-mullica-hill?fadf=pennmedicine) - Ménière’s disease New Jersey Penn Medicine Becker ENT & Allergy Mount Laurel Penn Medicine Address: [5000 Dearborn Circle Mount Laurel,8054 ](https://www.google.com/maps?q=5000+Dearborn+CircleMount+Laurel8054) [visit website](https://www.pennmedicine.org/practices/becker-ent-allergy-mount-laurel?fadf=pennmedicine) - Ménière’s disease ## Posts navigation 1[2](https://www.autoimmuneinstitute.org/wp-admin/admin-ajax.php/page/2/?action=as_async_request_queue_runner&nonce=03efbfba2b)[3](https://www.autoimmuneinstitute.org/wp-admin/admin-ajax.php/page/3/?action=as_async_request_queue_runner&nonce=03efbfba2b)…[117](https://www.autoimmuneinstitute.org/wp-admin/admin-ajax.php/page/117/?action=as_async_request_queue_runner&nonce=03efbfba2b)[Next »](https://www.autoimmuneinstitute.org/wp-admin/admin-ajax.php/page/2/?action=as_async_request_queue_runner&nonce=03efbfba2b) ## Want to see more from the Global Autoimmune Institute? Confirm GAI as a trusted autoimmune disease news source to make it easier to find our latest resources and updates. [ ![Add Global Autoimmune Institute as a preferred source on Google](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/08/google_preferred_source_badge_light_en@2x.png) ](https://www.google.com/preferences/source?q=https://www.autoimmuneinstitute.org) --- ### [Nature Outlook on Autoimmune Disease](https://www.autoimmuneinstitute.org/nature-outlook-on-autoimmune-disease/) **Published:** July 21, 2021 **Author:** Carolyn Serraino **Content:** # *Nature Outlook* issue on Autoimmune Disease ### In July 2021, GAI funded the *Nature Outlook on Autoimmune Disease*, a landmark collection published by *Nature*. [![Cover of the 2021 Nature Outlook on Autoimmune Disease, featuring a stylized figure with red lines radiating from the chest, symbolizing the immune system going rogue. The issue was produced with support from the Global Autoimmune Institute.](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/10/d41586-021-01833-y_19343074-1.jpg)](https://www.nature.com/collections/eccdbchgch) [![](https://www.autoimmuneinstitute.org/wp-content/uploads/2021/07/Nature-Feature-larger.png)](https://www.nature.com/collections/eccdbchgch) This special issue brought international attention to the latest research, clinical challenges, and patient perspectives in autoimmunity. By supporting this initiative, GAI ensured that autoimmune disease was featured on a global stage alongside other major health topics such as cancer, neuroscience, and infectious disease. ### Highlights from the Issue [Read our Sponsor Feature](https://www.nature.com/articles/d42473-021-00313-1) - **The rising burden of autoimmune disease**: An overview of how autoimmune conditions are increasing worldwide, why they remain challenging to diagnose, and the urgent need for coordinated research. - **Genetics and risk factors**: Articles explored genetic predispositions, environmental triggers, and how sex and hormones shape autoimmune risk. - **The microbiome’s role**: New insights into how gut microbes may influence immune system misfires, with potential implications for prevention and treatment. - **Advances in diagnostics**: Discussion of emerging biomarkers, imaging tools, and screening methods that could shorten the often years-long diagnostic journey. - **Therapies and clinical innovation**: From biologics to cell therapies, scientists described the most promising avenues for treatment and how they differ across diseases. - **Patient perspectives**: Essays highlighted the lived experience of people navigating fatigue, pain, stigma, and barriers to care, emphasizing the need for more holistic approaches. - **Global collaboration**: The Outlook highlighted the importance of international partnerships and cross-disciplinary science in advancing our understanding and treatment of autoimmune diseases. [Read the full collection](https://www.nature.com/collections/eccdbchgch) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/GAI-Logo-Image-e1707845715517.png) --- ### [Contact Us](https://www.autoimmuneinstitute.org/contact-us/) **Published:** February 16, 2024 **Author:** Elevation **Excerpt:** Thank you for your interest in the Global Autoimmune Institute as we continue to power critical research, educational programs, and community support in autoimmune disease. We look forward to hearing from you! **Content:** ## Contact Us Reach our team at [ info@autoimmuneinstitute.org ](mailto:info@autoimmuneinstitute.org) or by using the contact form below. [Subscribe to our newsletter](https://mailchi.mp/autoimmuneinstitute.org/newsletter) Δ Name(Required) First Last Email Address(Required) Message(Required) Submit Thank you for your interest in the Global Autoimmune Institute as we continue to power critical research, educational programs, and community support in autoimmune disease. ### We look forward to hearing from you! If you have an autoimmune or chronic condition, we’d love to hear your story. Check out our [ Autoimmune Stories ](https://www.autoimmuneinstitute.org/autoimmune-stories/) page for inspiration and [ Share Your Story ](https://www.autoimmuneinstitute.org/share-your-story/) page for prompts and the link to send your story in. ## Want to see more from the Global Autoimmune Institute? Confirm GAI as a trusted autoimmune disease news source to make it easier to find our latest resources and updates. [ ![Add Global Autoimmune Institute as a preferred source on Google](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/08/google_preferred_source_badge_light_en@2x.png) ](https://www.google.com/preferences/source?q=https://www.autoimmuneinstitute.org) --- ### [Who We Are & How We Help](https://www.autoimmuneinstitute.org/who-we-are-how-we-help/) **Published:** February 16, 2024 **Author:** agustin.fernandezb@elevationweb.org **Content:** ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/04/Untitled-design-31.png) ## Who We Are & How We Help #### The Global Autoimmune Institute empowers solutions in the prevention, diagnosis, treatment, and cure of autoimmune disease by funding scientific research and collaborations, and by providing science-based education and information to the autoimmune disease community. ![Global Autoimmune Institute logo showing a variety of people with autoimmune diseases](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/06/Untitled-design-32.png) ### Who We Are The Global Autoimmune Institute advances the prevention, diagnosis, treatment, and cure of autoimmune disease. We improve the health and quality of life of those impacted by autoimmunity by providing science and medicine-based information to our community, and by direct funding of interdisciplinary science and medicine. [Learn about our sponsorship of the Nature Outlook issue on Autoimmune Disease](https://www.autoimmuneinstitute.org/nature-outlook-on-autoimmune-disease/) ### What We Do We partner with leading research institutions to drive innovation in autoimmune disease science—from early immune signaling for prevention to new therapeutic breakthroughs for treatment. We equip patients and caregivers with clear, evidence-based information through digital tools, podcasts and webinars. To foster multidisciplinary collaboration and innovation, we integrate research, treatment and informational support to shape a future where autoimmune diseases are preventable, treatable, and curable. [More about our Work](https://www.autoimmuneinstitute.org/impact/) [ ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/04/Research-1.png) Research We are increasing knowledge and progress in autoimmune disease through the funding of scientific investigations and propelling collaboration and awareness in science and medicine. Information on some autoimmune diseases is much less available than others – we are on our way to help change that. Current Research Grants & Projects Read more about Research ](https://www.autoimmuneinstitute.org/current-research-grants-projects/) [ ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/04/Education-1.png) Education Our website offers well-researched and thoughtful articles on the science of disease and daily management of health conditions. You can also find our Medical Institutions Directory, Autoimmune & Chronic Illness Toolkit, lists of other autoimmune organizations, books, apps, podcasts, and more. Resources for Hope & Health Read more about Education ](https://www.autoimmuneinstitute.org/resources-for-hope-health/) [ ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/04/Awareness.png) Awareness We believe in the power of shared experiences. By highlighting real stories from those affected by autoimmune diseases, we foster awareness, reduce stigma, and create a supportive environment for all. Read Autoimmune Stories Read more about Awareness ](https://www.autoimmuneinstitute.org/autoimmune-stories/) [## Contact Us Reach our team at info@autoimmuneinstitute.org ](https://www.autoimmuneinstitute.org/contact-us/) ## Want to see more from the Global Autoimmune Institute? Confirm GAI as a trusted autoimmune disease news source to make it easier to find our latest resources and updates. [ ![Add Global Autoimmune Institute as a preferred source on Google](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/08/google_preferred_source_badge_light_en@2x.png) ](https://www.google.com/preferences/source?q=https://www.autoimmuneinstitute.org) The Global Autoimmune Institute is a 501(c)(3) organization. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/04/GAI-Logo-Image-811x1024.png) --- ### [09 - Autoimmune Disease News & Research Updates](https://www.autoimmuneinstitute.org/09-autoimmune-disease-news-research-updates/) **Published:** February 23, 2024 **Author:** agustin.fernandezb@elevationweb.org **Content:** # Autoimmune Disease News & Research Updates Stay updated with informative and easy-to-understand summaries of the most critical research breakthroughs in autoimmune disease. Search our interactive news timeline for information on the science behind autoimmunity and developments in the diagnosis and treatment of autoimmune disease dating back to 2019! Search Displaying Results For: Clear all filters Apply Filters Autoimmune Diseases Autoimmune Brain Inflammation Celiac Disease Eye Disease IBD (Crohn’s and UC) Lupus ME/CFS Multiple Sclerosis Neurological Disorders Psoriasis Rheumatoid Arthritis Sjögren disease Thyroid Disease Type 1 Diabetes Autoimmune Stories Case Studies Clinical Trials Diagnostic Testing Events GAI-Funded Genetics Microbiome Policy & Health Decisions OADR (NIH Office of Autoimmune Disease Research) Research Studies Resources Risk Factors Therapies Apply Filters Oct 22, 2026 GLP-1 Drugs and the Immune System: New Research on Autoimmune Disease As GLP-1 medications become increasingly common, researchers are looking beyond their effects on blood sugar and weight to better understand how they influence the immune system. While previous studies suggest these medications may reduce inflammation, their effects on autoimmune disease remain uncertain. On October 21, 2026, the La Jolla Institute for Immunology (LJI) announced a new study led by Professor Alessandro Sette, Dr.Biol.Sci., investigating whether GLP-1 medications alter adaptive immunity, the part of the immune system responsible for recognizing specific threats and developing immune memory. Researchers will collect blood samples before individuals begin GLP-1 treatment and throughout the following months, examining whether the medications \[…\] - Research Studies - Therapies [Read Post](https://www.autoimmuneinstitute.org/research_updates/glp-1-drugs-and-the-immune-system-new-research-on-autoimmune-disease/) Oct 21, 2026 Applegate’s MS Misdiagnosis Highlights Challenges of Diagnosing Multiple Sclerosis After five years of living with an MS diagnosis, Christina Applegate is searching for answers again. Her experience highlights why multiple sclerosis can be difficult to diagnose and the emotional impact of diagnostic uncertainty. - Autoimmune Stories - Diagnostic Testing - Multiple Sclerosis [Read Post](https://www.autoimmuneinstitute.org/research_updates/christina-applegate-ms-misdiagnosis/) Oct 05, 2026 Celiac Disease Halloween Resources & Gluten-Free Candy List Halloween traditions centered around candy can be difficult to navigate for children who need to avoid certain foods for medical reasons. For children with celiac disease, an autoimmune disease triggered by gluten, trick-or-treating can mean navigating unfamiliar food labels, shared treat bowls, and the possibility of gluten exposure. The Celiac Disease Foundation (CDF) is highlighting two resources for 2026 that offer practical ways to make Halloween safer and more inclusive: the Teal Pumpkin Project, which provides an alternative for children with a range of dietary restrictions, and an updated Gluten-Free Halloween Candy List for families managing celiac disease. The Teal Pumpkin \[…\] - Celiac Disease - Events - Resources [Read Post](https://www.autoimmuneinstitute.org/research_updates/celiac-disease-halloween-resources-gluten-free-candy-list/) Oct 01, 2026 Lupus Gene Variant May Strengthen Antiviral Immunity New research finds that a genetic variant in the IRF7 gene that increases risk of systemic lupus erythematosus (lupus) also makes us more resilient to viruses. The researchers found that this variant has persisted in human populations for millennia. Around 70% of the human population carry this variant. This variant increases the amount of interferon-ɑ produced by immune cells called monocytes and in cells that line the respiratory tract. In mouse models, the researchers of this study modified the mice’s IRF7 gene so that it matches the variant associated with lupus. After stimulating an autoimmune-like disease in these mice, the researchers \[…\] - Lupus - Research Studies - Risk Factors [Read Post](https://www.autoimmuneinstitute.org/research_updates/lupus-gene-variant-may-strengthen-antiviral-immunity/) Sep 25, 2026 NIH “From Mechanisms To Medicine” Workshop Highlights Researchers studying autoimmune disease, chronic pain, post-infectious illness, dysautonomia, and other complex chronic conditions are increasingly encountering the same challenge: the biology does not always fit neatly within the boundaries of individual diagnoses or medical specialties. That was a central theme of the National Institutes of Health (NIH) workshop “From Mechanisms to Medicine: Rethinking the Discovery-to-Care Continuum in Multi-System Disorders,” held September 23–24, 2026, at the Neuroscience Center in North Bethesda, Maryland. - Events - Research Studies [Read Post](https://www.autoimmuneinstitute.org/research_updates/nih-from-mechanisms-to-medicine-workshop/) Sep 23, 2026 Celiac Disease Experts To Address Common Myths In Upcoming Webinar September 30: Celiac disease experts will address common myths and misconceptions about celiac disease and the gluten-free diet during a webinar hosted by the National Celiac Association and Harvard Medical School’s Celiac Education and Research Program. - Celiac Disease - Events - Resources [Read Post](https://www.autoimmuneinstitute.org/research_updates/celiac-disease-myths-webinar/) Sep 18, 2026 LEAD Day 2026 Highlights Multi-Omics In Autoimmune Research On September 15, 2026, the Global Autoimmune Institute and La Jolla Institute for Immunology held the second annual Lectures, Empowerment, and Awareness for Autoimmune Disease (LEAD) Day at the Scripps Seaside Forum in La Jolla, California. The event brought together scientists, clinicians, advocates, and members of the broader community to discuss emerging approaches to understanding autoimmune disease and other complex chronic conditions. - Events - GAI Funded [Read Post](https://www.autoimmuneinstitute.org/research_updates/lead-day-2026-highlights/) Sep 15, 2026 Eric Topol on Immune Aging and the Future of Disease Prevention At LEAD Day 2026, physician-scientist Eric Topol examined why some people remain healthy well into old age and how advances in immunology, biological aging clocks, and artificial intelligence could help identify disease risks earlier. His keynote highlighted emerging research connecting immune aging, chronic inflammation, and neurodegenerative disease. - Events - GAI Funded - Risk Factors [Read Post](https://www.autoimmuneinstitute.org/research_updates/lead-day-2026-topol-award-lecture/) ## Posts navigation 1[2](https://www.autoimmuneinstitute.org/wp-admin/admin-ajax.php/page/2/?action=as_async_request_queue_runner&nonce=03efbfba2b)[3](https://www.autoimmuneinstitute.org/wp-admin/admin-ajax.php/page/3/?action=as_async_request_queue_runner&nonce=03efbfba2b)…[46](https://www.autoimmuneinstitute.org/wp-admin/admin-ajax.php/page/46/?action=as_async_request_queue_runner&nonce=03efbfba2b)[Next »](https://www.autoimmuneinstitute.org/wp-admin/admin-ajax.php/page/2/?action=as_async_request_queue_runner&nonce=03efbfba2b) ## Want to see more from the Global Autoimmune Institute? Confirm GAI as a trusted autoimmune disease news source to make it easier to find our latest resources and updates. [ ![Add Global Autoimmune Institute as a preferred source on Google](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/08/google_preferred_source_badge_light_en@2x.png) ](https://www.google.com/preferences/source?q=https://www.autoimmuneinstitute.org) --- ### [Doctors who Diagnose & Treat Autoimmune Disease](https://www.autoimmuneinstitute.org/doctors-who-diagnose-treat/) **Published:** February 13, 2024 **Author:** Elevation **Excerpt:** Many people are still experiencing delayed autoimmune disease diagnosis or misdiagnosis. Seeking out doctors with greater awareness of these chronic, immune-mediated conditions can help speed up the process. **Content:** > Autoimmune diseases are becoming more well-known, yet many people are still experiencing delayed diagnosis or misdiagnosis. As finding answers can take years, seeking out doctors who diagnose & treat autoimmune disease, with a greater and more specialized awareness of these chronic, immune-mediated conditions can help speed up the process. ## DOCTORS WHO DIAGNOSE AUTOIMMUNE DISEASE Medical specialists typically familiar with autoimmune disease (AD), and the specific ADs they often diagnose and treat: - **Dermatologists** – [alopecia areata](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/alopecia-areata/), [Behçet’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/behcets/), [dermatomyositis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/dermatomyositis/), [linear IgA disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/linear-igadisease/), [pemphigus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/pemphigus-vulgaris/), [pemphigoid](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/pemphigoid-gestationis/), [psoriasis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/psoriasis/), [scleroderma](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/scleroderma/), [vitiligo](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/vitiligo/) - **Endocrinologists** – [autoimmune Addison’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-addisons-disease/), [autoimmune hypophysitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-hypophysitis/), [Graves’ disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/graves-disease/), [Hashimoto’s thyroiditis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/hashimotos-thyroiditis/), [testicular autoimmunity](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/testicular-autoimmunity/), [type 1 diabetes](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/diabetes-type-1/), [Schmidt (polyendocrine) syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/schmidt-syndrome/) - **Gastroenterologists** – [autoimmune gastritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-gastritis/), autoimmune gastrointestinal dysmotility, [autoimmune hepatitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-hepatitis/), [autoimmune pancreatitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-pancreatitis/), [celiac disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/celiac-disease/), [Crohn’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crohns-disease/), [primary biliary cholangitis/cirrhosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/primary-biliary-cirrhosis/), [ulcerative colitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ulcerative-colitis/) - **Immunologists** – various immunological conditions and autoinflammatory syndromes - **Internists** – various chronic conditions - **Neurologists** – [acute disseminated encephalomyelitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/acute-disseminated-encephalomyelitis/), [autoimmune encephalitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-encephalitis/), [chronic inflammatory demyelinating polyneuropathy](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/chronic-inflammatory-demyelinating-polyneuropathy/), [Guillain-Barré syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/guillain-barre-syndrome/), [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/), [myasthenia gravis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/myasthenia-gravis/), [neuromyelitis optica](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/neuromyelitis-optica/) - **Rheumatologists** – [ankylosing spondylitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ankylosing-spondylitis/), [antiphospholipid syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/antiphospholipid-syndrome/), [juvenile idiopathic arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/juvenile-idiopathic-arthritis-stills/), [lupus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/), [psoriatic arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/psoriatic-arthritis/), [Raynaud’s syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/raynauds-syndrome/), [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/), [scleroderma](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/scleroderma/), [Sjӧgren’s syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sjogrens-syndrome/), [Still’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/juvenile-idiopathic-arthritis-stills/), [vasculitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/microscopic-polyangiitis-anca-associated-vasculitis/) [Holistic doctors](https://www.autoimmuneinstitute.org/2021/01/28/explained-holistic-vs-modern-western-medicine/) who often identify and treat patients with autoimmune disease or other chronic, hard-to-treat conditions: - **Functional medicine doctors** – Personalized, whole-body medicine with a focus on finding root causes of disease. Credentials: may be a doctor of medicine (MD) - **Integrative medicine doctors** – Whole body approaches for optimal health. Inclusive of all healing modalities, including modern Western medicine and holistic therapies. Credentials: may be a doctor of medicine (MD) - **Naturopathic doctors** – Holistic preventive care and self-healing, informed by a combination of traditional healing methods and current research. Credentials: doctor of naturopathic medicine (ND or NMD) - **Osteopaths –** Preventive and whole body care through hands-on manipulation of the musculoskeletal system. Credentials: doctor of osteopathy (DO) *For more information on specific autoimmune diseases, head to the* [*A-Z Autoimmune Disease List*](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/)*.* ### HOW TO FIND A DOCTOR - [U.S. Medical Institutions Directory](https://www.autoimmuneinstitute.org/medical-institutions/) – Browse the Global Autoimmune Institute’s curated collection of high-ranking institutions, clinics, and programs specializing in autoimmune diseases - [ExpertScape](https://www.expertscape.com/) – Search for the world’s top experts in various conditions and topics - [The Institute for Functional Medicine](https://www.ifm.org/find-a-practitioner/) – Find a certified functional medicine practitioner - [Academy of Integrative Health & Medicine](https://aihm.org/directory/) – Find an integrative medicine provider - [American Association of Naturopathic Physicians](https://naturopathic.org/search/custom.asp?id=5613) – Find a naturopathic doctor - [Open Path Healing Arts Collective](https://healingarts.org/) (nonprofit) – Access in-person and online holistic practitioners through a low-cost, sliding-scale system - Join a [local](https://www.meetup.com/topics/autoimmune-support-group/) or [online support group](https://www.autoimmuneinstitute.org/join-our-support-group/) to get recommendations from peers As everyone’s health journey is unique, do your research and find someone who is a good fit for *you*. Be open to hunting around, as well as getting a second or third opinion. Ideally, your provider will collaborate with you to find answers, manage your condition, and work towards healing. Remember: no matter how skilled or knowledgeable a doctor is, always educate yourself and be your own advocate. ##### For more resources on navigating your health journey, including how to prepare for appointments and communicate with doctors, download our free [**Autoimmune & Chronic Illness Toolkit**](https://www.autoimmuneinstitute.org/autoimmune-chronic-illness-toolkit/). --- ### [7 Risk Factors for Autoimmune Disease](https://www.autoimmuneinstitute.org/7-ad-risk-factors/) **Published:** February 13, 2024 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** While researchers are still digging for answers on exactly what causes over 80 autoimmune diseases, there are certain risk factors that are believed to impact immune tolerance and may lead to the development of autoimmune conditions. **Content:** # Risk Factors for Autoimmune Disease ![Conceptual medical illustration of a human silhouette containing DNA, chromosomes, immune cells, inflamed adipose tissue, pathogens, smoke, and molecular structures representing seven major risk factors for autoimmune disease.](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/07/7-risk-factors-for-autoimmune-disease-1024x576.jpg) While researchers are still digging for answers on exactly what causes [over 80 autoimmune diseases](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/), there are certain risk factors that are believed to impact immune tolerance and may lead to the development of autoimmune conditions. Keep in mind that while falling into one or more of these categories may increase your susceptibility, it does not mean you’re destined to develop a disorder. ## 1. Your Sex Overall, 78% of people affected by autoimmune disease are female ([1](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2527069/)). Regarding specific conditions, up to 95% of [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/) (SLE) and [Sjogren’s syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sjogrens-syndrome/) patients are female ([2](https://tidsskriftet.no/en/2017/06/kronikk/why-are-autoimmune-diseases-more-prevalent-women)). Other conditions like arthritis and [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/) (MS) occur in females around 60% more than in males ([2](https://tidsskriftet.no/en/2017/06/kronikk/why-are-autoimmune-diseases-more-prevalent-women)). Factors that [differ between sexes](https://www.autoimmuneinstitute.org/2023/03/24/how-sex-genetics-influence-autoimmunity/) like the additional X chromosome, certain hormonal changes, reproductive function, immune responses, effects of environmental agents, and organ vulnerability could all have a hand in the higher autoimmune disease prevalence in females. ## 2. Genetics Certain disorders, such as [lupus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/) and [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/), tend to run in families ([3](https://ghr.nlm.nih.gov/condition/systemic-lupus-erythematosus#inheritance), [4](https://ghr.nlm.nih.gov/condition/multiple-sclerosis#inheritance)). If you have relatives with autoimmune disease, then you are more likely to develop a condition yourself (though not necessarily the same one). Having a genetic predisposition towards autoimmunity means that your risk is higher due to an inherited genetic variation – one that may impact immune response ([5](https://www.genengnews.com/news/gene-mutation-study-sheds-light-on-autoimmune-disease-development/81250616/)). The way that particular gene is expressed can be altered via the epigenome – a layer of chemical tags that sits on top of your DNA ([6](https://learn.genetics.utah.edu/content/epigenetics/)). When environmental triggers – such as toxic chemicals, infections or other physical traumas, intestinal dysbiosis, or dietary factors ([7](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4290643/)) – interact with the epigenome, they have the ability to activate or deactivate parts of the genome through complex chemical reactions. Further study on the epigenome is needed, however the field of epigenetics highlights the critical role our lifestyle plays in either generating or preventing disease. ## 3. Having An Autoimmune Disease When you already exhibit one autoimmune disease, you’re at risk to develop more. An accumulation of three or more autoimmune conditions is called [Multiple Autoimmune Syndrome (MAS)](https://www.autoimmuneinstitute.org/2022/12/29/comorbidities-in-autoimmune-disease-multiple-autoimmune-syndrome/), which is seen in roughly 25% of patients ([11](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3150011/)). It is common for individuals with certain conditions like [celiac disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/celiac-disease/), [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/), [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/), [Hashimoto’s](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/hashimotos-thyroiditis/), or [Sjogren’s](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sjogrens-syndrome/) to exhibit MAS. The reason is unknown, but it is likely due to a combination of genetics and environmental factors. ## 4. Obesity Given that roughly 35% of the global population ([13](https://www.sciencedaily.com/releases/2014/11/141110110722.htm)) and 72% of adults in the U.S. are overweight or obese ([14](https://www.cdc.gov/nchs/fastats/obesity-overweight.htm)), it is critical that we recognize the relationship between obesity and other chronic conditions like autoimmune disease. Excess weight is associated with over ten autoimmune diseases and may be implicated in others ([13](https://www.sciencedaily.com/releases/2014/11/141110110722.htm)). It has been found to increase the risk of developing autoimmune conditions like rheumatoid and psoriatic arthritis ([15](https://rmdopen.bmj.com/content/1/1/e000012)). Fat – or adipose tissue – is involved in many physiological functions, including metabolism and immune system response. When adipose tissue accumulates and becomes dysfunctional, it can lead to increased or dysregulated secretion of compounds called adipokines ([16](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3518031/)). In this case, these bioactive substances tend to be pro-inflammatory and significantly alter immune system function. In other words, obesity sends the body into a chronic state of low-grade inflammation and can threaten an otherwise healthy immune response. Research in this area is ongoing, but we are discovering that these factors (and potentially others, like alteration of the gut microbiota and intestinal dysbiosis) can lead to organ damage, metabolic syndrome, and autoimmune conditions. ## 5. Smoking and Exposure to Toxic Agents It is widely known that smoking cigarettes is not a healthy practice and can lead to cancer. Now, researchers are discovering that smoking is a risk factor in more than just respiratory conditions. Smoking has been linked to rheumatoid arthritis, systemic lupus erythematosus, multiple sclerosis, and other autoimmune diseases ([22](https://www.ncbi.nlm.nih.gov/pubmed/17153844)). Why? When you burn tobacco, thousands of chemicals are produced – some of which are known to be toxic. Inhaling that smoke impacts the immune system through various complex interactions, including inflammatory responses, immune suppression, dysregulation of cytokines (signaling molecules involved in autoimmunity), and the development of autoantibodies ([23](https://www.nature.com/articles/ncprheum0655), [24](https://www.ncbi.nlm.nih.gov/pubmed/20042314?dopt=Citation), [25](https://www.sciencedirect.com/science/article/pii/B9780128143070000372)). Exposure to other toxins like air pollutants, crystalline silica, ultraviolet radiation, or organic solvents are also associated with the development of autoimmune diseases like multiple sclerosis ([26](https://www.sciencedirect.com/science/article/abs/pii/S1568997219300886), [27](https://www.ncbi.nlm.nih.gov/pubmed/22739348), [28](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3526640/)). Moreover, a genetic predisposition to autoimmunity further increases your risk. Many toxic agents have the ability to alter gene expression. In a nutshell, they can activate an otherwise repressed gene or deactivate an active one, leading to disease. ## 6. Certain Medications Many people take pharmaceuticals on a daily basis to decrease blood pressure, manage depression and anxiety, or balance cholesterol levels. And it’s common knowledge that these drugs have potential side effects. We’re discovering that in some cases, these side effects involve immune system function, and will trigger autoimmune reactions. Certain blood pressure medications, statins, and antibiotics can trigger drug-induced autoimmune conditions like [lupus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/) or [autoimmune hepatitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-hepatitis/) ([31](https://www.hopkinsmedicine.org/health/wellness-and-prevention/what-are-common-symptoms-of-autoimmune-disease), [32](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4009471/)). ## 7. Infections Early exposure to certain infections increases your susceptibility to autoimmune disease. The presence of Epstein Barr Virus (EBV), which tends to present as a mild illness in childhood and then turn dormant, is associated with [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/), [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/), and [Sjogren’s syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sjogrens-syndrome/) ([33](https://www.nih.gov/news-events/nih-research-matters/epstein-barr-virus-autoimmune-diseases), [34](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3766599/)). Another infectious microorganism – a bacteria called Group A Streptococcus – can trigger heart, joint, and brain-related autoimmune disease including acute rheumatic fever and rheumatic heart disease ([35](https://www.ncbi.nlm.nih.gov/pubmed/16225745), [36](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3993104/)). These viruses interact with your genetics through a variety of mechanisms. In short, they can turn on certain genes that impact the immune system’s ability to differentiate between self and non-self, triggering an autoimmune reaction. [SARS-CoV-2 virus is associated with autoimmune disease](https://www.autoimmuneinstitute.org/2021/03/27/is-long-covid-an-autoimmune-disease-is-sars-cov-2-an-autoimmune-virus/) in various ways, although researchers are still investigating the relationship. COVID-19 infection has been reported to trigger cases of Guillain-Barre syndrome, antiphospholipid syndrome, lupus, and other diseases ([41](https://www.sciencedirect.com/science/article/pii/S156899722030272X?via%3Dihub)). ### Decrease your risk In some cases, such as being born female, your inherent level of risk cannot be controlled. On the upside, there are a number of ways to avoid the accumulation of multiple risk factors and help prevent the onset of chronic illness or additional diseases, including: - Eating a nutrient-dense diet and limiting processed foods - Incorporating physical movement into your daily life - Keeping up with the latest information about your medications - Paying attention to environmental toxins and your exposure to them - Avoiding cigarettes Talk with your doctor about specific ways you can reduce your personal risk. #### SOURCES 1. Fairweather, D., Frisancho-Kiss, S., Rose, N. (2008). [Sex Differences in Autoimmune Disease from a Pathological Perspective](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2527069/). *The American Journal of Pathology*, 173(3), 600-609. 2. Ørstavik, K. H. [Why are autoimmune diseases more prevalent in women?](https://tidsskriftet.no/en/2017/06/kronikk/why-are-autoimmune-diseases-more-prevalent-women) 3. Ngo, S.T., Steyn F. J., McCombe P. A. (2014). [Gender Differences in Autoimmune Disease](https://www.sciencedirect.com/science/article/pii/S0091302214000466). *Frontiers in Neuroendocrinology*, 35(3), 347-369. 4. [Systemic Lupus Erythematosus.](https://ghr.nlm.nih.gov/condition/systemic-lupus-erythematosus#inheritance) (2019). *Genetics Home Reference, U.S. National Library Of Medicine*. 5. [Multiple Sclerosis](https://ghr.nlm.nih.gov/condition/multiple-sclerosis#inheritance). (2019). *Genetics Home Reference, U.S. National Library Of Medicine*. 6. [Gene Mutation Study Sheds Light on Autoimmune Disease Development](https://www.genengnews.com/news/gene-mutation-study-sheds-light-on-autoimmune-disease-development/81250616/). (2014). *Genetic Engineering and Biotechnology News*. 7. [Epigenetics](https://learn.genetics.utah.edu/content/epigenetics/). (n.d.). *Genetics Science Learning Center, University of Utah*. 8. Vojdani, A., Pollard M. K., Campbell A. W. (2014). [Environmental Triggers and Autoimmunity](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4290643/). *Autoimmune Diseases*. doi: 10.1155/2014/798029 9. Weinhold, B. (2006). [Epigenetics: The Science of Change](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1392256/). *Environmental Health Perspectives*, 114(3), A160-A167. doi: 10.1289/ehp.114-a160. 10. Ennis, C. (2014). [Epigenetics 101: A Beginner’s Guide to Explaining Everything](https://www.theguardian.com/science/occams-corner/2014/apr/25/epigenetics-beginners-guide-to-everything). *The Guardian*. 11. [Epigenomics Fact Sheet](https://www.genome.gov/about-genomics/fact-sheets/Epigenomics-Fact-Sheet). (2016). *National Human Genome Research Institute*. 12. Cojocar M., Cojocaru I. M., Silosi I. (2010). [Multiple Autoimmune Syndrome](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3150011/). *Maedica, Journal of Clinical Medicine*. 5(2), 132-134. 13. [Obesity Plays Major Role in Triggering Autoimmune Diseases](https://www.sciencedaily.com/releases/2014/11/141110110722.htm). (2014). *Tel Aviv University American Friends*. 14. [Obesity and Overweight](https://www.cdc.gov/nchs/fastats/obesity-overweight.htm). (2016). *National Center for Health Statistics, Centers for Disease Control and Prevention*. 15. Daïen C. I., Sellam J. (2015). [Obesity and inflammatory arthritis: impact on occurrence, disease characteristics and therapeutic response](https://rmdopen.bmj.com/content/1/1/e000012) *RMD Open*. doi: 10.1136/rmdopen-2014-000012 16. Ouchi, N., Parker, J. L., Lugus, J. J., & Walsh, K. (2011).[ Adipokines in inflammation and metabolic disease.](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3518031/) *Nature reviews. Immunology*, 11(2): 85–97. doi:10.1038/nri2921 17. Pragh G., Seres I., Harangi M., Fülöp P. (2014) [Dynamic interplay between metabolic syndrome and immunity](https://www.ncbi.nlm.nih.gov/pubmed/25039000). *Advances in Experimental Medicine and Biology*, 824: 171-90. doi: 10.1007/978-3-319-07320-0\_13 18. Versini M. Jeandel PY, Rosenthal E., Shoenfeld Y. (2014). [Obesity in autoimmune diseases: not a passive bystander](https://www.ncbi.nlm.nih.gov/pubmed/25092612). *Autoimmunity Reviews*, 9: 981-1000. doi: 10.1016/j.autrev.2014.07.001. 19. Gremese E., Tolusso B., Gigante M. R., & Ferraccioli G. (2014). [Obesity as a Risk and Severity Factor in Rheumatic Diseases (Autoimmune Chronic Inflammatory Diseases)](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4227519/). *Frontiers in immunology*, 5, 576. doi:10.3389/fimmu.2014.00576. 20. Wensveen F. M., Valentić S., Šestan M., Wensveen TT., Polić B. (2015). [Interactions between adipose tissue and the immune system in health and malnutrition](https://www.ncbi.nlm.nih.gov/pubmed/26603491). *Seminars in Immunology*, 5: 322-33. doi: 10.1016/j.smim.2015.10.006. 21. Lago F., Dieguez C., Gómez-Reino J., Gualillo O. (2007). [Adipokines as emerging mediators of immune response and inflammation](https://bioekuiliber.com/wp-content/uploads/2017/06/Adipokines-mediate-immune-response.pdf). *Nature Clinical Practice Rheumatology* 3(12). 22. Costenbader K. H., Karlson E. W. (2006). [Cigarette smoking and autoimmune disease: what can we learn from epidemiology?](https://www.ncbi.nlm.nih.gov/pubmed/17153844) *Lupus*, 15(11): 737-45. 23. Harel-Meir M., Sherer Y., Shoenfeld Y. (2007). [Tobacco smoking and autoimmune rheumatic diseases](https://www.nature.com/articles/ncprheum0655). *Nature Clinical Practice Rheumatology*, 3: 707-715. 24. Arnson Y., Shoenfeld Y., Amital H. (2010). [Effects of tobacco smoke on immunity, inflammation and autoimmunity.](https://www.ncbi.nlm.nih.gov/pubmed/20042314?dopt=Citation) *Journal of Autoimmunity*, 34(3): J258-65. doi: 10.1016/j.jaut.2009.12.003 25. Perricone C., Versini M., Ben-Ami D., Gertel S., Watad A;, Segel M. J., Ceccarelli F., Conti F., Cantarini L., Bogdanos D. P., Antonelli A., Amital H., Valesini G., Shoenfeld Y. (2019). [Smoke and Autoimmunity: The Fire Behind the Disease](https://www.sciencedirect.com/science/article/pii/B9780128143070000372). In *Mosaic of Autoimmunity*, Chapter 37: 383-415. Academic Press. 26. Zhao C., Xu Z., Wu G., Mao Y., Liu L., QIan-Wu, Dan y., Tao S., Zhang Q., Sam N. B., Fan Y., Zou Y., Ye D., Pan H. (2019). [Emerging role of air pollution in autoimmune diseases](https://www.sciencedirect.com/science/article/abs/pii/S1568997219300886). *Autoimmunity Reviews*, 18(6): 607-614. Elsevier. 27. Miller F. W., Alfredsson L., Costenbader K. H., Kamen D. L., Nelson L. M., Norris J. M., De Roos A. J. (2012). [Epidemiology of environmental exposures and human autoimmune diseases](https://www.ncbi.nlm.nih.gov/pubmed/22739348). *Journal of Autoimmunity*, 39(4): 259-71. doi: 10.1016/j.jaut.2012.05.002. 28. Barragán-Martínez, C., Speck-Hernández, C. A., Montoya-Ortiz, G., Mantilla, R. D., Anaya, J. M., & Rojas-Villarraga, A. [Organic Solvents as Risk Factor for Autoimmune Diseases: A Systematic Review and Meta-Analysis](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3526640/). *PLoS One*, 7(12): e51506. doi:10.1371/journal.pone.0051506. 29. Charlesworth J. C., Curran J. E., Johnson M. P., Göring H. H., Dyer T. D., Diego V. P., Blangero J. (2010). [Transcriptomic epidemiology of smoking: the effect of smoking on gene expression in lymphocytes](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2911391/). *BMC medical genomics*, *3*, 29. doi:10.1186/1755-8794-3-29. 30. Lee K. W. & Pausova Z. (2013). [Cigarette smoking and DNA methylation.](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3713237/) *Frontiers in genetics*, 4, 132. doi:10.3389/fgene.2013.00132 31. [What Are Common Symptoms of Autoimmune Disease?](https://www.hopkinsmedicine.org/health/wellness-and-prevention/what-are-common-symptoms-of-autoimmune-disease) *Johns Hopkins Medicine.* 32. Castiella A., Zapata E., Lucena I. M., Andrade R. J. (2014) [Drug-induced autoimmune liver disease: A diagnostic dilemma of an increasingly reported disease](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4009471/). *World Journal of Hepatology*, 6(4), 160–168. doi:10.4254/wjh.v6.i4.160 33. [Epstein-Barr virus and autoimmune diseases](https://www.nih.gov/news-events/nih-research-matters/epstein-barr-virus-autoimmune-diseases) (2014). *National Institutes of Health, Research Matters*. 34. Draborg, A. H., Duus, K., & Houen, G. (2013). [Epstein-Barr Virus in Systemic Autoimmune Diseases](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3766599/). *Clinical & developmental immunology*, 535738. doi:10.1155/2013/535738 35. Dale R. C. (2005). [Post-streptococcal autoimmune disorders of the central nervous system.](https://www.ncbi.nlm.nih.gov/pubmed/16225745) *Developmental Medicine and Child Neurology*, 47(11): 785-91. 36. Walker M. J., Barnett T. C., McArthur J. D., Cole J. N., Gillen C. M., Henningham A., Sriprakash K. S., Sanderson-Smith M. L., Nizet V. (2014). [Disease Manifestations and Pathogenic Mechanisms of Group A Streptococcus.](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3993104/) *Clinical microbiology reviews*, *27*(2), 264–301. doi:10.1128/CMR.00101-13. 37. Harley J. B., Chen X., Pujato M., Miller D., Maddox A., Forney C., Magnusen A. F., Lynch A., Chetal K., Yukawa M., Barski A., Salomonis N., Kaufman K. M., Kottyan L. C., Weirauch M.T. (2018). [Transcription factors operate across disease loci, with EBNA2 implicated in autoimmunity](https://www.nature.com/articles/s41588-018-0102-3). *Nature Genetics*. 50: 699-707. doi: 10.1038/s41588-018-0102-3. \[Epub ahead of print\]. PMID: 29662164. 38. Getts, D. R., Chastain, E. M., Terry, R. L., & Miller, S. D. (2013). [Virus infection, antiviral immunity, and autoimmunity](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3971377/). Immunological reviews, 255(1): 197–209. doi:10.1111/imr.12091. 39. Cusick M. F., Libbey J. E., & Fujinami R. S. (2012). [Molecular mimicry as a mechanism of autoimmune disease](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3266166/). *Clinical reviews in allergy & immunology*, 42(1), 102–111. doi:10.1007/s12016-011-8294-7. 40. Niklas, K., Arkadiusz N., Majewski, D., Puszczewicz, M. (2016). [Rheumatic diseases induced by drugs and environmental factors: the state-of-the-art – part one](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4967979/). *Reumatologica*, 54(3), 122–127. doi: 10.5114/reum.2016.61212 41. Halpert, G., Shoenfeld, Y. (December 2020). [SARS-CoV-2, the autoimmune virus.](https://www.sciencedirect.com/science/article/pii/S156899722030272X?via%3Dihub) *Autoimmunity Reviews,* 19(12). doi: 10.1016/j.autrev.2020.102695 --- ### [Our Story](https://www.autoimmuneinstitute.org/our-story/) **Published:** February 16, 2024 **Author:** agustin.fernandezb@elevationweb.org **Content:** ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2022/02/OUR-STORY-5-1024x341.png) ## THE HISTORY OF ## THE GLOBAL AUTOIMMUNE INSTITUTE **The Global Autoimmune Institute had its origins in the mid 1960’s as a research institute for public health, founded by Dr. Walter E. Boek** along with a Board of Directors drawn from distinguished community leaders. Their mission soon transformed, leading to the founding of a graduate school dedicated to the teaching of science, technology and sociology using an interdisciplinary approach. Dr. Boek previously had enjoyed a distinguished career in the public health field, serving as an assistant to the Commissioner of Health of New York State during the 1950’s. He expanded and administered what was considered at the time to be the most productive and influential social science research program in the world. His wife Dr. Jean K. Boek, ran a number of important public health research studies. Among her many discoveries were the demonstration for the first time of the association between cigarette smoking and heart disease, and that seatbelt use saved lives. Drs. Walter and Jean Boek co-authored the seminal book, *Society and Health*, and published numerous academic papers, both individually and together. **Their contributions were invaluable in developing our understanding of the importance of social issues in public health. This field became known as medical sociology.** Dr. Walter Boek would go on to work for the Health Information Foundation, seeking to develop effective communication among American physicians. In addition, both Drs. Boek served as full time and visiting professors at various colleges and universities. They will long be remembered for their warm and caring devotion to their students. **After Dr. Walter Boek’s death, the organization’s Board of Directors hired Sandra Boek Werness**, **the eldest daughter of Walter and Jean Boek**, as its new President and CEO, and now Executive Director. They knew that her leadership would bring the organization into a new era of growth and accomplishment. > Sandy was concerned with the widespread incidence of autoimmune diseases, as well as the failure to identify and diagnose them. Her prior work experience on Capitol Hill – years as a practicing attorney and then managing a medical practice – would benefit the organization in many important ways. Sandy left her ten-year-long position as Vice President of Northern Virginia Pathology, and began her new job. **In 2013, after extensive consideration, the Board concluded that a new mission was in order.** Sandy was particularly concerned with the widespread incidence of autoimmune disease, as well as the failure to identify and diagnose many of these conditions. **She had experienced common difficulties in advocating for one of her daughters, who was not well-served by the medical community.** The lack of understanding they encountered in schools and the community underscored a swelling information gap in healthcare and support for patients with chronic illness. **Autoimmune diseases and associated neurological disorders were seen by Sandy and the Board as representative of a serious public health problem.** A growing number of people in an often medically underserved population were continuing to be affected, requiring increased education, scientific research, and general public awareness. The Board therefore concluded that the resources of the organization would best be dedicated to improving the lives of those suffering from autoimmune diseases and neurological disorders. Due in large part to Sandy’s knowledge, drive, experience, and community ties, she was in a unique position to make a significant difference. The assets of the organization were marshaled, and The Global Autoimmune Institute was born. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/SpacerShield.jpg) --- ### [LEAD Day 2025 Highlights](https://www.autoimmuneinstitute.org/lead-day-2025-highlights/) **Published:** March 7, 2025 **Author:** Carolyn Serraino **Excerpt:** GAI was proud to support the inaugural LEAD Day at LJI on March 6, 2025, featuring Dr. Georg Schett, the Walter and Jean Boek Leadership in Research Award honoree. **Content:** ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/03/LEAD-Day-1-1024x576.png) #### 📅 **Thursday, March 6, 2025** 📍 **La Jolla Institute for Immunology (LJI)** **In recognition of Autoimmune Disease Awareness Month, GAI was proud to support the very first LEAD Day.** LEAD Day started as an idea—a way to dissolve the silos between research and real-world impact, to bring patients into the conversation, to make the progress on autoimmune disease something shared. This event brought together experts, researchers, and the autoimmune disease community to foster scientific progress, empower patients, and raise awareness. This inaugural event included the awarding of the very first Walter and Jean Boek Leadership in Research Award. ## **LEAD Day 2025 Highlights** ##### **LEAD Day** featured two key components: - A **scientific session** highlighting groundbreaking autoimmune research. - A **community-centered discussion** focused on patient perspectives, education, and engagement. ### **Walter and Jean Boek Leadership in Research Award** ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/03/LEAD-Day-Award.png) ##### This award recognizes a distinguished scientist whose research has significantly advanced our understanding of autoimmune diseases. This award is part of LJI’s **[Walter and Jean Boek Seminar Series](https://www.autoimmuneinstitute.org/research_updates/walter-and-jean-boek-seminar-series-at-lji/ "Walter and Jean Boek Seminar Series at LJI")**, which provides a platform for in-depth discussions on immunology throughout the academic year. ![Sandy Boek Werness presenting LEAD Day award to Dr. Schett](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/03/TK8A0487-1024x683.jpeg)*Sandra Boek Werness, Executive Director of the Global Autoimmune Institute, presented Dr. Georg Schett with the Walter and Jean Boek Leadership in Research Award during LEAD Day 2025.*![](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/03/Untitled-design-54.png) This prestigious lecture honored a researcher whose work has significantly advanced the understanding of autoimmune diseases. The inaugural recipient, **Dr. Georg Schett**, led groundbreaking studies exploring the potential for long-term cures without immunosuppressive drugs, reshaping the future of autoimmune disease treatment. Following the lecture, a dedicated reception provided scientists and clinicians an opportunity to connect and discuss advancements in immunology. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/03/1-1024x576.png)![](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/03/2-1024x576.png) #### **Community Panel Discussion** A lay-friendly discussion featured Dr. Schett and leading medical research experts, focusing on the real-world implications of autoimmune research and patient perspectives. ##### **You can watch the full discussion [here](https://youtu.be/J5WfaiKmdxM)!** [![](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/03/Dr.-Schetts-lay-friendly-panel-discussion-Beyond-the-Diagnosis-The-Autoimmunity-Research-Thats-Reshaping-Lives.jpg)](https://youtu.be/J5WfaiKmdxM) Attendees then gathered for a reception offering exclusively gluten-free refreshments, providing an opportunity to engage with researchers, advocates, and fellow community members. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/03/LJI-IMG_6636F-2025-1024x683.jpg)![](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/03/LJI-IMG_6205F-2025-1024x683.jpg) --- ## **Looking Ahead** The inaugural LEAD Day’s success highlights the importance of continued collaboration between researchers, clinicians, and the autoimmune disease community. GAI remains committed to supporting initiatives that advance autoimmune research and patient empowerment. For more information about GAI’s collaboration with LJI, visit <https://www.autoimmuneinstitute.org/gai-and-la-jolla-institute-for-immunology/> ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/04/GAI-Logo-Image-1.png) --- ### [Autoimmune Disease Competency Exam](https://www.autoimmuneinstitute.org/autoimmune-disease-competency-exam/) **Published:** February 24, 2026 **Author:** Carolyn Serraino **Content:** # Autoimmune Disease Competency Exam ###### **Understanding autoimmune disease, common myths & evidence-based science** This exam explores foundational concepts in autoimmune disease, including areas that are often misunderstood. Some questions may be more nuanced than they appear. Choose the version that best fits your time and learning goals: **5 Questions:** A quick introduction (2–3 minutes). **20 Questions:** A more comprehensive assessment (10–15 minutes). At the end, you’ll receive your score, a learning-stage designation, and detailed explanations with resources to continue learning. [5 questions ➜ ](https://www.autoimmuneinstitute.org/autoimmune-disease-competency-exam-5-questions/) [20 questions ➜ ](https://www.autoimmuneinstitute.org/autoimmune-disease-competency-exam-20-questions) [50 questions (coming soon)](https://www.autoimmuneinstitute.org/autoimmune-disease-competency-exam/#popmake-27584) This exam is for educational purposes only and is not medical advice. --- ### [Autoimmune Disease Competency Exam](https://www.autoimmuneinstitute.org/autoimmune-disease-competency-exam-20-questions/) **Published:** February 24, 2026 **Author:** Elevation **Content:** ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/GAI-Logo-Image-e1707845715517.png) ### Autoimmune Disease Competency Exam *20 questions · 10-15 minutes* Δ Step 1 of 20 5% Do all autoimmune diseases have the same cause? Yes, diet is the universal cause of all autoimmune disease Yes, they all arise from a single root cause No, they can be triggered by different genetic, environmental, hormonal, and immunological factors Yes, stress is the universal cause of all autoimmune disease Next If a family member has an autoimmune disease, will I get the same one? Yes, you will almost certainly inherit the same disease No, family history has no influence Yes, unless you avoid stress completely Family history raises risk, but not necessarily for the same disease Previous Next Are autoimmune diseases rare? Yes, because only one or two diseases qualify as autoimmune Yes, only a few thousand people worldwide are actually affected Yes, because they only count if you’re born with them or have an official diagnosis from a doctor No, they affect millions globally with more than 100 recognized conditions Previous Next Does a positive antinuclear antibody (ANA) test always mean you have an autoimmune disease? Yes, a positive ANA is definitive proof of autoimmune disease No, a positive ANA always means you have an infection No, ANA can be positive even in those without any disease Yes, but only if symptoms are severe Previous Next Does a negative antinuclear antibody (ANA) test always mean you don’t have an autoimmune disease? No, but a negative ANA only means the disease is inactive Yes, a negative ANA rules out autoimmunity No, some autoimmune diseases do not involve ANA positivity Yes, because ANA is the only test that matters Previous Next What percentage of healthy individuals may test positive for ANA? About 1–2% Around 10–30%, depending on the study and testing method More than 50% None — healthy people always test negative Previous Next Do all autoimmune diseases have the same symptoms? Yes, they all affect the digestive system No, symptoms vary between different diseases and from person to person within the same disease Yes, they all involve fatigue and joint pain Within the same disease, yes, but symptoms vary between different diseases Previous Next Is autoimmune disease caused by stress? Yes, stress is the only cause of autoimmune disease No, stress has no effect on the immune system Stress alone explains most autoimmune symptoms Stress can contribute, but many other factors are involved Previous Next Can you cure your autoimmune disease just by changing your diet? Yes, a gluten-free diet cures all autoimmune diseases No, diet has no impact on autoimmune disease Diet can help manage symptoms and control disease activity, but it is not a cure Yes, diet alone cures autoimmune disease Previous Next Who is more likely to develop an autoimmune disease? A 12-year-old boy A 30-year-old man A 30-year-old woman A 70-year-old woman Previous Next Can vaccines cause autoimmune disease? Yes, vaccines frequently trigger autoimmune disease No, vaccines have never been shown to interact with the immune system Overall, serious autoimmune events after vaccination are rare; a few specific associations exist, though infection generally carries a higher risk Only childhood vaccines are linked to autoimmune disease Previous Next Can autoimmune diseases go into remission? No, symptoms never improve Yes, if you find the right supplement Yes, symptoms can lessen or disappear for extended periods, though flares may return Only if stress is eliminated completely Previous Next Are autoimmune diseases always visible to others? Yes, they always cause rashes or visible skin changes No, many autoimmune diseases are “invisible illnesses” that may not show outward signs Yes, symptoms are always obvious Yes, because if you look fine, you can’t really have a chronic illness Previous Next Can lifestyle changes alone replace medical care for autoimmune disease? Yes, lifestyle changes cure all autoimmune diseases No, lifestyle has no role in managing autoimmune disease No, lifestyle can improve health and sometimes control symptoms, but medical care is often needed for safety and long-term outcomes Yes, but only exercise works Previous Next Do autoimmune flares only happen when someone makes a mistake in management? Yes, if patients fail to avoid stress Yes, flares are always caused by poor lifestyle choices No, flares can occur even with excellent management Yes, unless patients take supplements consistently Previous Next Do men and women experience autoimmune disease at the same rates? Yes, but only women after menopause Yes, men and women are equally affected No, autoimmune diseases only affect women No, women are more likely to develop autoimmune diseases overall Previous Next Are autoimmune diseases often misdiagnosed? No, blood tests always give a clear answer Yes, but only in rare cases with unusual symptoms No, they are usually diagnosed quickly and accurately Yes, because symptoms overlap with many other conditions and may come and go Previous Next Can you catch an autoimmune disease from someone else? No, autoimmune diseases are not contagious Yes, but only if you share food or drinks Yes, if you live with someone who has an autoimmune disease Yes, some autoimmune diseases are contagious through close contact Previous Next Does the gut microbiome influence autoimmune disease? Yes, research shows that changes in the gut microbiome may affect both the development and activity of autoimmune disease No, the bacteria in your gut do not interact with the immune system Yes, but only if someone already has food intolerances No, the microbiome only matters for digestive conditions like celiac or Crohn’s disease Previous Next Can autoimmune disease be completely cured? Yes, with the right medication, it can be cured permanently Yes, once symptoms disappear, the disease is gone for good No, autoimmune disease cannot be cured, but symptoms can often be managed Yes, alternative therapies and supplements cure all autoimmune diseases Previous Submit --- ### [Autoimmune Disease Competency Exam - 5 questions](https://www.autoimmuneinstitute.org/autoimmune-disease-competency-exam-5-questions/) **Published:** June 30, 2026 **Author:** Elevation **Content:** ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/GAI-Logo-Image-e1707845715517.png) ### Autoimmune Disease Competency Exam *Abbreviated version · 5 questions* Δ Step 1 of 5 20% Do all autoimmune diseases have the same cause? Yes, diet is the universal cause of all autoimmune disease Yes, stress is the universal cause of all autoimmune disease No, they can be triggered by different genetic, environmental, hormonal, and immunological factors Yes, they all arise from a single root cause Next If a family member has an autoimmune disease, will I get the same one? Yes, you will almost certainly inherit the same disease Family history raises risk, but not necessarily for the same disease Yes, unless you avoid stress completely No, family history has no influence Previous Next Does a negative antinuclear antibody (ANA) test always mean you don’t have an autoimmune disease? Yes, because ANA is the only test that matters Yes, a negative ANA rules out autoimmunity No, some autoimmune diseases do not involve ANA positivity No, but a negative ANA only means the disease is inactive Previous Next Test Field Second Choice Fourth Choice First Choice Third Choice Previous Next Test field 1 Second Choice Fourth Choice First Choice Third Choice Previous Submit --- ### [Our Impact](https://www.autoimmuneinstitute.org/impact/) **Published:** February 16, 2024 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Discover the significant impact of the Global Autoimmune Institute and learn about our achievements and ongoing efforts to improve the lives of those with autoimmune disease. **Content:** ## Making a Difference in Autoimmmune Disease ## Since 2015 ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Our-Work-Our-Impact.png) Play ##### videoTextBlockModalblock\_630e45df2a0c77e33a19746f24a03d8fTitle × Your browser does not support the video tag. Close Popup ### Introduction Since focusing its resources on the challenges of autoimmune diseases in 2015, the Global Autoimmune Institute has devoted leadership and financial support to an impressive array of initiatives and programs, several of which are groundbreaking in the medical community. An essential partner in much of our work has been the Children’s National Hospital (CNH) in Washington, DC. This partnership grew out of our Executive Director’s work as a member of the Advisory Board of the Celiac Group. Together, we shared a drive to achieve several goals, including: - to raise awareness in the medical community of many unrecognized symptoms. - to support and educate patients and their families living with celiac disease. - to improve diagnoses of co-existing autoimmune diseases and neurological disorders by promoting a multidisciplinary approach in medicine, and in particular in celiac disease, the one autoimmune disease with an identified cause. - to promote an added focus on celiac disease and commonalities with other autoimmune diseases in science. - to improve diagnosis and treatment of celiac disease. - to hear and validate the experiences of those on their journey to obtain accurate diagnoses and treatment of their autoimmune diseases. **As the Institute’s knowledge grew, it became clear that a broad scope of work was necessary to address the complex issues involved in autoimmune disease. This underpins our current focus on five key areas:** 1. Expanding and strengthening the community of those affected by a range of autoimmune disorders in addition to celiac disease. 2. Developing and disseminating reliable, informative, and in-depth educational resources, shared widely at no cost. 3. Funding and promoting scientific research to further unravel the mysteries confounding successful diagnosis and treatment. 4. Promoting multidisciplinary approaches to diagnosis and treatment of autoimmune diseases and disorders, including neurological. 5. Informing and engaging future leaders in the public health field to improve the future of diagnosis, treatment, community services, and support for autoimmune disease patients and their families. The Global Autoimmune Institute (GAI) believes that our leadership, work, and funding, had an outsized impact in causing changes in the field of celiac disease, and by extension, in autoimmune disease. We have been an essential part of the powerful new movement to improve the lives of those with autoimmune diseases including celiac disease. The way the community thinks about and understands symptoms treats patients, and researches connections to other autoimmune diseases are radically different from just six years ago. We are proud to share this summary of our work and a glimpse into GAI’s priorities for the next decade. ### Creating a Caring, Healing, Solution-Oriented Community As the past decade unfolded, due to improved access to information and ease of communication via the internet, it became increasingly clear that celiac disease and many other autoimmune diseases were largely unknown to many physicians. Misdiagnosis and lack of diagnosis was a critical problem, and reliable information on diagnosis, treatment, and coping with these diseases was largely unavailable. To make matters worse, patients and their families were reluctant to tell the whole story. They felt isolated, ashamed, discouraged, and desperate as they searched for help. One of GAI’s first priorities was to listen, connect, engage, and educate this community of patients, families, and physicians. ### Connecting Resources to Those who Benefit Most #### Gluten-Free Education Since 2014, the GAI and the Children’s National Celiac Disease Program have collaborated on a variety of educational initiatives designed to support people with celiac disease and their families. Together, the organizations developed in-person gluten-free cooking classes, educational programming for regional gluten-free community events, and annual educational programs featuring physicians, researchers, dietitians, and other experts. These efforts helped expand access to evidence-based information and practical resources for individuals navigating life with celiac disease. GAI and the Children’s National Celiac Disease Program also collaborated to develop a variety of educational resources, including more than 70 podcast episodes and the Gluten-Free Diet and Resource Center App. These resources were created to help individuals and families access trusted information, practical guidance, and support throughout their celiac disease journey. ![Global Autoimmune Institute and Children's National Celiac Disease Program](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Gluten-Free-Education.png) #### A Trusted Source of Information Since 2020, GAI has worked to make reliable, evidence-based information about autoimmune disease accessible to people around the world. Through our website, we translate complex scientific research into clear, understandable content while connecting our community with trusted resources and expert perspectives. Our site features original educational content developed by the GAI team and contributors, including research summaries, timeline updates, disease information pages, patient stories, expert insights, and practical resources designed to help individuals better understand autoimmune disease and chronic illness. Visitors can also explore recommended [books](https://www.autoimmuneinstitute.org/books-we-love/), [organizations](https://www.autoimmuneinstitute.org/autoimmune-organizations/), and other carefully selected [resources](https://www.autoimmuneinstitute.org/resources-for-hope-health/). As the central hub of our organization, the website is designed to be informative, accessible, and easy to navigate while maintaining a strong commitment to scientific accuracy. [Our Articles](https://www.autoimmuneinstitute.org/gai-library/) ### Children’s National Hospital & ### Global Autoimmune Institute ### 2021 Impact Report ### Funding a Multi-Disciplinary Approach to Diagnoses and Treatment It was clear to GAI and CNMC, along with many others in the celiac disease and autoimmune disease community, that co-occurring disorders were under-recognized and diagnosed. Not only are they unlikely to be accurately diagnosed, but many celiacs never recover and their additional illnesses, autoimmune conditions, and neurological disorders go undetected. In addition, patients who are diagnosed are not afforded critical support and necessary basic information in several areas necessary for their optimal health. First, they need to know if they have any other conditions, autoimmune diseases, and neurological disorders that exist in addition to their celiac disease that may not improve with diagnosis and adopting the necessary gluten-free diet. Second, they need guidance and education in managing their new gluten-free diet. Finally, they need emotional support to cope with their new challenges and to manage their past and present grief and anxiety. The best solution to this pressing need was to bring multiple specialists together to meet with the patients and their families, to develop a coordinated system of care. In addition, it was important to develop a clinical research project to gather valuable information in the furtherance of the scientific study of celiac disease. To achieve these goals, from 2017 through 2020 GAI granted CNMC $1.5 million to establish and operate a new Multidisciplinary Clinic for celiac disease patients. At this Clinic patients and their families are provided consultations with an experienced team including a Gastroenterologist, Neurologist, Dietician, Psychologist, and a celiac disease Educational Specialist. The model developed at the CNMC Multidisciplinary Clinic is now the gold standard, nationally and internationally, for celiac disease patients. The Clinic has also undertaken selected research experiments. A clinical study on the neurological disorder headaches was conducted. Patient bio-samples have been collected and preserved for future study and one scientific investigation of T-cell behavior was attempted; however, this was deemed unsuccessful and was discontinued without findings. On the advent of COVID-19, CNMC’s Celiac Clinic developed a comprehensive and well-received telemedicine operation. Originally contemplated and planned (pending changes in applicable laws and regulations) as a solution for underserved populations, such as those in rural areas in the far reaches of Maryland, the Clinic seamlessly adapted its coordinated system of care to the telemedicine format for all of its patients. This proved advantageous to the Clinic patients and their families, well beyond the importance of minimizing in-person contact due to the pandemic, and likely even improved the quality of care. ### Autoimmune Disease Research Funding [Additional funding for autoimmune disease research](https://www.autoimmuneinstitute.org/current-research-grants-projects/) was awarded to investigators at Johns Hopkins Medicine, Baltimore, MD, Washington University School of Medicine, St. Louis, MO, and the City University of New York. The GAI website contains more details on each of these important studies and investigations. Funding research will continue to be a priority for GAI. ### Looking Forward GAI is extremely proud of the progress and changes in which we have played a part in the autoimmune disease community at large. Millions of patients, each an individual on a unique journey, their families, and those who care about them, are in need of help and support. We will continue to increase our reach to assist more individuals, and help validate, encourage, care for and respond to their challenges and needs. Our team has been inspired by the enthusiastic response to and widespread interest in our rapid response communications during the COVID-19 pandemic via our website and our social media outreach. GAI has created a uniquely comprehensive resource allowing anyone seeking answers to access the science-based information that becomes available at a dizzying pace. Our team will continue to recognize and respond to the most urgent needs in our community, as quickly as possible. A nimble organization by design, we will continue to adapt our approaches to the constantly shifting ways in which people communicate and choose to receive information. During the past few years, GAI has seen great strides in the field of AD. Physician specialists are increasingly focusing on autoimmune disease and how it relates to the diseases they treat. Almost overnight many medical specialty conferences now include lectures, panel discussions, and workshops on how AD affects their patients. Much important scientific research is underway, bringing the scientific and medical communities closer to significant answers, making many important connections. Private industry is paying attention and university and industry collaboration continues to flourish. Two examples include laboratory testing companies that are investing in improved diagnostic tests for more autoimmune antibodies and pharmaceutical companies pursuing more effective deliverance of therapies at the molecular level. COVID-19 has galvanized the research world in gathering data to track the functioning of the immune system following infection by the virus, focusing in particular on the now common long term heightened immune response currently known as “long Covid” which may lead to more widespread autoimmune disease in the world’s population. GAI is in process of compiling a list of organizations with long Covid registries, to post and encourage participation. ### GAI’S ongoing and future projects include: - Sponsoring a special [Outlook Section on Autoimmune Disease, in *Nature*](https://www.nature.com/collections/eccdbchgch), a preeminent magazine for peer-reviewed scientific articles, published July 15, 2021, to promote awareness in the medical and scientific communities, as well as to the interested layman; - Identifying and funding clinical and basic scientific research in cutting edge aspects of autoimmune disease; - Developing additional educational events and materials independently and in partnership with institutions known for autoimmune disease expertise and leadership; - Expanding our efforts to reach the broadest audience, to ensure maximum inclusivity, and to help bridge and improve existing socio-economic disparities; - Collaborating with other organizations to develop consensus in important aspects of autoimmune disease; - Developing unique, downloadable tools to assist individuals in their search for diagnoses and solutions, and to better understand and manage their conditions; - Supporting and assisting other meritorious and dynamic organizations with related missions in autoimmune disease, and developing consensus, coordination, and efficiency with AD organizations and the AD community at large. ### In Conclusion Despite the many discoveries that have been made, and the growing awareness of physicians of the presence and nature of autoimmune diseases, as well as some of their possible interrelationships, many forms of autoimmune disease remain difficult to diagnose, and effective treatment is often unavailable. AD symptoms are usually idiopathic; each person experiences variations in the extent and nature of their symptoms. Co-existences are poorly understood, with relatively few studies of only the most common AD’s having been completed. Existing study designs are very limited, and AD is extremely complex. In addition, we have a cultural norm of symptom dismissal or attribution to psychological illness in the absence of a diagnosis that can be made by laboratory testing. This has caused a great deal of harm to the many who are genuinely ill, trying to find help, and striving to cope. Many of our best and brightest are devoting themselves to the field of AD, but it continues to grow in a piecemeal, fragmented manner because of its immense complexity and our limitations. New scientific knowledge is difficult to apply to the practice of medicine if it can be. In general, our dissemination of important information is not efficient. We are in a golden age of science, we have a physician community willing to learn, listen, and respond to the needs of their patients, and understanding of science is increasing in the general public. We at GAI will continue to confront the complex problems of AD and provide the best and most comprehensive information for those seeking answers and validation. As the needs of our community evolve, GAI will remain active and committed to expanding our resources and the information we provide, as well as increasing our outreach through social media, networking, and educational events and programs. GAI is hopeful that the aftermath of COVID-19 will bring to light more connections, within immunology and the community at large. These connections will create increased momentum in the discovery of the processes involved in autoimmune disease and validating and helping those who struggle to find the answers that will enable them to achieve better health. GAI will help propel the growth and delivery of expertise and education needed as we move forward into the future. ### Acknowledgements ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/04/With-deepest-appreciation-for-vision-wisdom-commitment-perseverance-and-generous-sharing-of-expertise-1.png) ### Bibliography of funded work ## Peer Reviewed Publications ###### Antibodies to an Epstein Barr Virus protein that cross-react with dsDNA have pathogenic potential - [Article published in *Molecular Immunology*](https://pubmed.ncbi.nlm.nih.gov/33545624/#:~:text=One%20mechanism%20by%20which%20EBV,these%20mAbs%20have%20pathogenic%20potential) ###### Preparation of Gluten-Free Foods Alongside Gluten-Containing Food May Not Always Be as Risky for Celiac Patients as Diet Guides Suggest - [Article published in *Gastroenterology*](https://pubmed.ncbi.nlm.nih.gov/31560900/) ###### Psychological Needs and Services in a Pediatric Multidisciplinary Celiac Disease Clinic - [Article published in *Journal of Clinical Psychology in Medical Settings*](https://pubmed.ncbi.nlm.nih.gov/31673859/) ###### Mental Health Disorders and Psychosocial Distress in Pediatric Celiac Disease - [Article published in *Journal of Pediatric Gastroenterology and Nutrition*](https://pubmed.ncbi.nlm.nih.gov/31880669/) ###### A Quantitative Assessment of Gluten Cross-contact in the School Environment for Children with Celiac Disease - [Article published in *Journal of Pediatric Gastroenterology and Nutrition*](https://pubmed.ncbi.nlm.nih.gov/31868785/) ## Conference Presentations ###### NASPGHAN Annual Meeting, Virtual (2020) - Expert Consensus on Recommendations to Accommodate Children with Celiac Disease in Learning Environments (poster) - Trisomy 21: Not All Duodenal Abnormalities are Celiac Disease (poster) - Comparison of Parental Gluten-Free Diet Knowledge Between “New” and “Established” Diagnoses in a Pediatric Multidisciplinary Celiac Disease Clinic (poster) ###### Society of Pediatric Psychology Annual Conference, Virtual (2020) - The Gluten-Free Diet is a Double-Edged Sword for Children with Celiac Disease and their Parents (poster) ###### NASPGHAN Annual Meeting, in Chicago, IL (2019) - Time Point to Gluten Clearance After Initiation of a Gluten-Free Diet in Patients with Celiac Disease (poster) - Celiac Kids Internet Diet Survey (CeliacKids): A Multicenter Consortium Using the modified Delphi Method to Create a Gluten Exposure Assessment Tool (poster) ###### International Celiac Disease Symposium, in Paris, France (2019) - A Real-Life Assessment of Gluten Cross-Contact in a Shared Kitchen Environment (poster) - A Quantitative Analysis of Gluten Contamination in Everyday School Supplies and Concern for Children with Celiac Disease (poster) - An Educational App to Support the Gluten-Free Diet in Patients with Celiac Disease (poster) - Perceived Psychosocial Distress Improves in Youth and their Parents after Diagnosis of Celiac Disease (poster) - Psychological Needs and Services in a Multidisciplinary Celiac Disease Clinic (poster) ###### Digestive Disease Week, in San Diego, CA (2019) - An Educational App to Support the Gluten-Free Diet in Patients with Celiac Disease (poster) ###### Society of Pediatric Psychology Annual Conference, in New Orleans, LA (2019) - Psychological Needs and Services in a Multidisciplinary Celiac Disease Clinic (poster) ###### Research and Education Week, Children’s National Health System, in Washington DC (2019) - Psychological Needs and Services in a Multidisciplinary Celiac Disease Clinic (poster) ###### NASPGHAN Annual Meeting, in Hollywood, FL (2018) - Assessment of Parental Gluten-Free Diet Knowledge in a Multidisciplinary Celiac Disease Clinic (poster) - An Educational App to Support the Gluten-Free Diet in Patients with Celiac Disease (poster) - Executive Functioning, Social-Emotional Ratings, and Cognitive Test Performance in Pediatric Celiac Disease (poster) - Living Gluten-Free: Adherence and Psychosocial Considerations for Pediatric Celiac Disease (invited symposium presentation) ###### Child Neurology Society 47th Annual Meeting, in Chicago, IL (2018) - Neurological and Psychological Vulnerabilities in Pediatric Celiac Disease (poster) ###### 126th Annual American Psychological Association Convention, in San Francisco, CA (2018) - Psychological Comorbidities and Psychosocial Burden in Pediatric Celiac Disease (poster) ###### Children’s Research Institute’s 8th Annual Research and Education Week, in Washington, DC (2018) - Psychological and Neurological Vulnerabilities in Pediatric Celiac Disease (poster) ###### International Conference on Communication in Healthcare, in Baltimore, MD (2017) - Communication During and After Diagnosis of Pediatric Celiac Disease: Opportunities to Facilitate Successful Adherence and Recovery (oral research presentation) ###### International Celiac Disease Symposium, in Delhi, India (2017) - Peer Mentorship Social Groups for Children with Celiac Disease (poster) - A Digital App for Gluten-Free Diet Management in Patients with Celiac Disease (poster) ###### International Celiac Disease Symposium, in Prague, CZ (2015) - Increasing the Awareness and Treatment of the Psychological Needs of Children with Celiac Disease (poster) - Increasing Access to Support Groups for Children and Adolescents with Celiac Disease (poster) ## Other Initiatives ###### [Gluten Free Diet App](https://childrensnational.org/departments/celiac-disease-program/resources-for-families/gluten-free-diet-app) ###### [Gluten-Free Grocery Store Game](https://childrensmedicaleducation.org/celiacmain/) ###### Brochures/Printouts/Guides - [Celiac Disease & Gluten-Free Diet Getting Started Handbook (PDF)](https://childrensnational.org/-/media/cnhs-site/files/resources/celiac-gluten-free-handbook2717.pdf?la=en&hash=06009D858B951AA7BE46BA236D16FC771DB23047) - [Gluten-Free Diet Guide: Safe and Unsafe Ingredients (PDF)](https://childrensnational.org/-/media/cnhs-site/files/resources/glutenfree-diet-guide_2016_final.pdf?la=en&hash=4315E31D4794C2B79ADF9622C49E04331442301F) - [Gluten-Free Flour Guide (PDF)](https://childrensnational.org/-/media/cnhs-site/files/resources/glutenfree-flour-guide_2016_final.pdf?la=en&hash=4A0CD03823652EEA991CDD33C58C65A0C53DC1DD) - [Gluten-Free Grocery Store Guide (PDF)](https://childrensnational.org/-/media/cnhs-site/files/resources/final_glutenfree-grocery-store-guide_cnmc-celiac-program.pdf?la=en&hash=F3587E22BB64BC6E42A8856CB1FD83A5368E146D) - [Preventing Cross-Contamination at Home (PDF)](https://childrensnational.org/-/media/cnhs-site/files/resources/preventing-cross-contamination_2016_final.pdf?la=en&hash=9F9D4753940B41B024073573B9300B1D443D41D7) - [School Cafeteria Tips (PDF)](https://childrensnational.org/-/media/cnhs-site/files/resources/school-cafeteria-tips_2016_final.pdf?la=en&hash=88EAD7336461AEB1191E29FA912CF6EC41995210) - [A Teenager’s Guide to Thriving with Celiac Disease (PDF)](https://childrensnational.org/-/media/cnhs-site/files/departments/gi/celiac-disease-teen-guide.pdf?la=en&hash=BAAF312944BCDFCEF7FFA6E4B0BD6E1262AD6B7E) ###### Web-based trainings - [Celiac Disease in Learning Environments: A Training for School-Based Health Staff Who Care for Children with Celiac Disease](https://www.autoimmuneinstitute.org/celiac-education/managing-celiac-in-schools/) - [Celiac Disease in Learning Environments: A Training for Nutrition Providers Who Care for Children with Celiac Disease](https://www.autoimmuneinstitute.org/celiac-education/managing-celiac-in-schools/) ###### [Celiac Disease Educational Video Series](https://www.youtube.com/playlist?list=PLpaHC44oF7Z9gIEEsLoXoEyIOeWx_ylFZ) ###### [Gluten-Free Cooking Video Series](https://www.youtube.com/playlist?list=PLpaHC44oF7Z_83g_B-JA3URZVu-rbSlbq) ###### [Community Education Classes/Events](https://www.eventbrite.com/o/celiac-disease-program-431830803) ###### [CNN’s Wolf Blitzer talks with Children’s About Celiac Disease](https://childrensnational.org/news-and-events/childrens-newsroom/2012/cnns-wolf-blitzer-talks-with-childrens-about-celiac-disease) --- ### [Autoimmune Disease Podcasts](https://www.autoimmuneinstitute.org/ad-podcasts/) **Published:** February 15, 2024 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** This curated list of podcasts covers a wide array of subjects, such as nutrition, finding community, mind-body medicine, rare diseases, and managing life with a chronic illness. **Content:** ###### This curated list of podcasts covers a wide array of subjects, such as nutrition, finding community, mind-body medicine, rare diseases, and managing life with a chronic illness. ## Autoimmune Adventures Information, tools, and community support to help people with autoimmune disease and chronic illness reclaim their health. [Learn More](https://www.stitcher.com/show/autoimmune-adventures) ## Autoimmune Wellness **Inspiring and practical conversations about nutrition, lifestyle, and using the Autoimmune Protocol (AIP) and both conventional and natural medicine to live a vibrant, healthy life with autoimmune disease.** [Learn More](https://autoimmunewellness.com/awp/) ## The Doctor’s Farmacy Expert interviews on health, wellness, food, and policy from Mark Hyman M.D., a functional medicine doctor. [Learn More](https://www.stitcher.com/show/the-doctors-farmacy-with-mark-hyman-md) ## Enabled in Academia Conversations with academics and students about how they thrive in academia with a disability. [Learn More](https://www.stitcher.com/show/enabled-in-academia) ## Love and Heal Podcast Explorations of mind-body medicine and compassionate healing by an AIP Nutritionist and the founder of The Crohn’s Foundation. [Learn More](https://www.stitcher.com/show/love-and-heal) ## NORDpod The voice of rare disease and the official podcast of the National Organization for Rare Disorders. [Learn More](https://www.stitcher.com/show/nordpod) ## Pheonix Helix: Autoimmune Health Personal stories of the autoimmune experience and expert interviews to maximize autoimmune health through nutrition and functional medicine. [Learn More](https://www.stitcher.com/show/phoenix-helix-reversing-autoimmune-disease-through-the-paleo) ## Raising Celiac A podcast from the Celiac Disease Program at Boston Children’s Hospital dedicated to raising the standard of education, awareness, and research on celiac disease and related autoimmune conditions. [Learn More](https://dme.childrenshospital.org/raisingceliac/) ## This Week in Virology TWiV is a weekly netcast about viruses – the kind that make you sick. Brought to you by four university professors and a science writer. [Learn More](http://microbe.tv/twiv/archive/) ## Uninvisible Pod Interviews with experts in varied healing modalities, survivors of invisible and chronic conditions, and their loved ones and advocates. [Learn More](https://www.stitcher.com/show/uninvisible-with-lauren-freedman) ## The Whole View Dr. Sarah Ballantyne (a.k.a. The Paleo Mom) busts myths and answers questions about nontoxic lifestyle, nutrient-dense diets, and parenting. [Learn More](https://www.stitcher.com/show/the-paleo-view) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/SpacerShield.jpg) The views and opinions expressed in the listed podcasts are those of the authors. GAI does not endorse the contents of the above podcasts; they are simply a sample of the resources available on managing life with autoimmune disease and other chronic illnesses. --- ### [Books We Love](https://www.autoimmuneinstitute.org/books-we-love/) **Published:** February 14, 2024 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Browse our library of books we love, which includes essential reading for understanding autoimmune disease (AD) and the body, chronic illness memoirs, practical guides, cookbooks, and children’s books, as well as other books of interest. **Content:** Browse our library of books we love, which includes essential reading for understanding autoimmune disease (AD) and the body, chronic illness memoirs, practical guides, cookbooks, and children’s books, as well as other books of interest. ## About Autoimmune Disease - [**“Autoimmune Diseases and Their Environmental Triggers”**](https://www.amazon.com/Autoimmune-Diseases-Environmental-Triggers-McFarland-dp-0786413220/dp/0786413220/ref=mt_other?_encoding=UTF8&me=&qid=1618506081) by Elaine A. Moore - [**“The Autoimmune Epidemic: Bodies Gone Haywire in a World Out of Balance–and the Cutting-Edge Science that Promises Hope”**](https://donnajacksonnakazawa.com/autoimmune-epidemic/) by Donna Jackson Nakazawa - [**“Celiac Disease: A Hidden Epidemic”** ](https://www.amazon.com/Celiac-Disease-Updated-4th-Epidemic/dp/0063034859/ref=sr_1_1?crid=1HBV46KEJDTZN&dchild=1&keywords=celiac+disease+a+hidden+epidemic&qid=1618506484&s=books&sprefix=celiac+disease+a+hidden+epid%2Caudible%2C229&sr=1-1)by Peter H.R. Green and Rory Jones - [**“Celiac Disease and Gluten: Multidisciplinary Challenges and Opportunities”**](https://www.amazon.com/Celiac-Disease-Gluten-Multidisciplinary-Opportunities-dp-0124202209/dp/0124202209/ref=mt_other?_encoding=UTF8&me=&qid=1618506749) by Peter Koehler, Herbert Wieser, and Katharina Konitzer - [**“An Elegant Defense: The Extraordinary New Science of the Immune System: A Tale in Four Lives”**](https://www.mattrichtel.com/an-elegant-defense) by Matt Richtel - [**“An Epidemic of Absence: A New Way of Understanding Allergies and Autoimmune Diseases”**](https://www.moisesvm.com/) by Moises Velasquez-Manoff - [**“The Invisible Kingdom: Reimagining Chronic Illness”**](https://meghanorourke.com/books) by Meghan O’Rourke ## Understanding the Body - [**“Childhood Disrupted: How Your Biography Becomes Your Biology, and How You Can Heal”**](https://donnajacksonnakazawa.com/childhood-disrupted/) by Donna Jackson Nakazawa - [**“The Circadian Code: Lose Weight, Supercharge Your Energy, and Transform Your Health from Morning to Midnight”**](https://www.penguinrandomhouse.com/books/592260/the-circadian-code-by-satchin-panda-phd/) by Satchin Panda - [**“Do You Believe in Magic? Vitamins, Supplements, and All Things Natural: A Look Behind the Curtain”**](https://www.paul-offit.com/recent-books) by Paul A. Offit - [**“Fast Carbs, Slow Carbs: The Simple Truth About Food, Weight, and Disease”**](https://www.amazon.com/Fast-Carbs-Slow-Simple-Disease-ebook/dp/B07W93KBDP/ref=sr_1_1?dchild=1&keywords=fast+carbs+slow+carbs&qid=1618506279&s=books&sr=1-1) by David A. Kessler - [**“Follow Your Gut: The Enormous Impact of Tiny Microbes”**](https://www.amazon.com/Follow-Your-Gut-Enormous-Microbes/dp/1476784744/ref=tmm_hrd_title_0?_encoding=UTF8&qid=&sr=) by Rob Knight - [**“The Good Gut: Taking Control of Your Weight, Your Mood, and Your Long-Term Health”**](https://sonnenburglab.stanford.edu/press.html) by Justin and Erica Sonnenburg - [**“Gut: The Inside Story of Our Body’s Most Underrated Organ”**](https://www.amazon.com/Gut-Inside-Story-Bodys-Under-Rated/dp/938528861X/ref=tmm_pap_swatch_0?_encoding=UTF8&qid=1586383680&sr=1-1) by Giulia Enders - [**“I Contain Multitudes: The Microbes Within Us and a Grander View of Life”** ](https://edyong.me/i-contain-multitudes)by Ed Yong - [**“In the Kingdom of the Sick: A Social History of Chronic Illness in America”**](https://www.amazon.com/Kingdom-Sick-History-Chronic-Illness/dp/1620406284) by Laurie Edwards - [**“Missing Microbes: How the Overuse of Antibiotics Is Fueling Our Modern Plagues”**](http://www.missingmicrobes.com/) by Martin Blaser - [**“The Psychobiotic Revolution: Mood, Food, and the New Science of the Gut-Brain Connection”**](http://psychobiotic-revolution.com/) by John F. Cryan, Ted Dinan, and Scott Anderson - [**“This Is Your Brain On Parasites: How Tiny Creatures Manipulate Our Behavior and Shape Society”**](https://www.kmcauliffe.com/books) by Kathleen McAuliffe ## Memoirs - [**“Ask Me About My Uterus: A Quest to Make Doctors Believe in Women’s Pain”**](https://www.amazon.com/Ask-Me-About-My-Uterus/dp/1568589417/ref=sr_1_1?dchild=1&keywords=Ask+Me+About+My+Uterus%3A+A+Quest+to+Make+Doctors+Believe+in+Women%27s+Pain&qid=1593992036&sr=8-1) by Abby Norman - [**“Brain on Fire: My Month of Madness”**](https://www.susannahcahalan.com/work-1#/the-great-pretender-1/) by Susannah Cahalan - [**“Brave New Medicine: A Doctor’s Unconventional Path to Healing Her Autoimmune Illness”**](https://cynthialimd.com/brave-new-medicine/) by Cynthia Li and Arlie Russel Hochschild - [**“The Lady’s Handbook for Her Mysterious Illness”**](https://www.sarahmarieramey.com/) by Sarah Ramey - [**“Pain Woman Takes Your Keys, and Other Essays from a Nervous System”** ](https://sonyahuber.com/books-2/pain-woman-takes-your-keys/)by Sonya Huber - [**“Shake, Rattle & Roll With It: Living and Laughing with Parkinson’s”**](https://www.amazon.com/gp/product/0997587180/ref=dbs_a_def_rwt_hsch_vapi_tpbk_p1_i0) by Vikki Claflin - [**“Waist-High in the World: A Life Among the Nondisabled”**](https://www.amazon.com/Waist-High-World-Life-Among-Nondisabled/dp/0807070874/ref=tmm_pap_swatch_0?_encoding=UTF8&qid=&sr=) by Nancy Mairs ## Practical Guides - [**“Living Well with Autoimmune Diseases: A Rheumatologist’s Guide to Taking Charge of Your Health”**](https://www.juliusbirnbaum.com/) by Julius Birnbaum, MD, MHS - [**“Gut Feelings: Doctors and Patient-Centered Care: How Knowledge, Commitment to Care and Empathy Improve Patient’s Lives”**](https://romefoundation.clickfunnels.com/optin1682609315121) by Douglas A. Drossman MD and Johannah Ruddy M.Ed. - [**“The Autoimmune Wellness Handbook: A DIY Guide to Living Well with Chronic Illness”**](https://autoimmunewellness.com/introducing-the-autoimmune-wellness-handbook/) by Mickey Trescott and Angie Alt - [**“The Complete Low-FODMAP Diet: A Revolutionary Plan for Managing IBS and Other Digestive Disorders”**](https://www.amazon.com/Complete-Low-FODMAP-Diet-Revolutionary-Digestive/dp/1615190805/ref=sr_1_1?dchild=1&keywords=The+Complete+Low-FODMAP+Diet+%28A+Revolutionary+Plan+for+Managing+IBD+and+Other+Digestive+Disorders%29&qid=1612579990&s=books&sr=1-1) by Dr. Sue Shepherd and Peter Gibson - [**“Finding a New Normal: Living Your Best Life with Chronic Illness”**](https://suzanjackson.homestead.com/Books.html) by Suzan Jackson - [**“Gut Feelings: Disorders of the Gut-Brain Interaction and the Patient-Doctor Relationship, A Guide for Patients and Doctors”**](https://romefoundation.clickfunnels.com/optin1600283572404) by Dr. Douglas Drossman and Johannah Ruddy - [**“Mayo Clinic: Guide to Self-Care”**](https://mcpress.mayoclinic.org/categories/healthy-lifestyle/mayo-clinic-guide-to-self-care-7th-edition.php) 7th Edition, by Dr. Cindy Kermott and Dr. Martha Millman - [**“The Patient’s Playbook: How to Save Your Life and the Lives of Those You Love”**](https://www.amazon.com/Patients-Playbook-Save-Lives-Those/dp/038535228X) by Leslie Michelson - [**“You Are Not Your Pain: Using Mindfulness to Relieve Pain, Reduce Stress, and Restore Well-Being—An Eight-Week Program”**](https://www.amazon.com/You-Are-Your-Pain-Well-Being/dp/125005267X/ref=tmm_pap_swatch_0?_encoding=UTF8&qid=&sr=) by Vidyamala Burch and Danny Penman - [**“You Don’t LOOK Sick! Living Well with Invisible Chronic Illness”**](https://www.joywrites.com/you-dont-look-sick) by Joy Selak and Dr. Overman ## Cookbooks - [**“My Gluten-Free Family Kitchen: 151 Fast, Fun, and Flavorful Recipes”**](https://www.amazon.com/My-Gluten-Free-Family-Kitchen-Flavorful/dp/1642932949) by Vanessa Weisbrod - [**“Gluten-Free on a Shoestring: 125 Easy Recipes for Eating Well on the Cheap”**](https://www.amazon.com/dp/073821986X/?tag=dotdashvwellf-20&ascsubtag=4773267%7Cnb6a0e14ab2844482a3852a8df79338d718) by Nicole Hunn - [**“Alternative Baker: Reinventing Dessert with Gluten-Free Grains and Flours”** ](https://www.amazon.com/dp/1624142036/?linkCode=ogi&tag=delish_auto-append-20&ascsubtag=%5Bartid|1782.g.25222809%5Bsrc|%5Bch|%5Blt|sale)by Alanna Taylor-Tobin - [**“A Good Food Day: Reboot Your Health with Food That Tastes Great”**](https://www.amazon.com/dp/0385344910/?linkCode=ogi&tag=delish_auto-append-20&ascsubtag=%5Bartid|1782.g.25222809%5Bsrc|%5Bch|%5Blt|sale) by Marco Canora - [**“The Nutrient Dense Kitchen: 125 Autoimmune Paleo Recipes for Deep Healing and Vibrant Health”**](https://www.amazon.com/Nutrient-Dense-Kitchen-Autoimmune-Recipes-Healing/dp/0692042024/ref=as_li_ss_tl?ie=UTF8&qid=1549849966&sr=8-1&keywords=mickey+trescott&linkCode=ll1&tag=autoipaleo-20) by Mickey Prescott - [**“The Healing Kitchen: 175+ Quick & Easy Paleo Recipes to Help You Thrive”**](https://www.amazon.com/gp/product/1628600942/ref=as_li_tl?ie=UTF8&camp=1789&creative=390957&creativeASIN=1628600942&linkCode=as2&tag=autoipaleo-20) by Alaena Haber and Sarah Ballantyne - [**“The Heal Your Gut Cookbook: Nutrient-Dense Recipes for Intestinal Health Using the GAPS Diet”**](https://www.amazon.com/Heal-Your-Gut-Cookbook-Nutrient-Dense/dp/1603585613) by Hilary Boynton and Mary Brackett - [**“Cooking for the Specific Carbohydrate Diet: Over 100 Easy, Healthy, and Delicious Recipes that are Sugar-Free, Gluten-Free, and Grain-Free”**](https://www.amazon.com/Cooking-Specific-Carbohydrate-Diet-Gluten-Free/dp/1612431747) by Erica Kerwien - [**“The Low-FODMAP Cookbook: 100 Delicious, Gut-Friendly Recipes for IBS and other Digestive Disorders”**](https://www.amazon.com/Low-FODMAP-Cookbook-Delicious-Gut-Friendly-Digestive/dp/1592337147) by Dianne Benjamin ## Children's Books - [**“Eating Gluten-Free with Emily: A Story for Children with Celiac Disease”**](https://www.amazon.com/Eating-Gluten-Free-Emily-Children-Disease/dp/1439212260/ref=sr_1_3?dchild=1&keywords=eating+gluten+free+with+emily&qid=1620933077&s=books&sr=1-3) by Bonnie J. Kruszka - [**“Some Days We…”**](https://www.amazon.com/Some-Days-We-Julie-Stamm/dp/0578650002) by Julie A. Stamm (parent with multiple sclerosis) - [**“Sometimes”**](https://www.amazon.com/Sometimes-Rebecca-Elliott/dp/0745962696) by Rebecca Elliot (sibling with a disability) - [**“Taking Arthritis to School (Special Kids in School)”** ](https://www.amazon.com/Taking-Arthritis-School-Special-Kids/dp/1891383213/ref=sr_1_1?dchild=1&keywords=taking+arthritis+to+school&qid=1620933149&s=books&sr=1-1)by Dee Dee L. Miller - [**“Why Does Mommy Hurt? Helping Children Cope with the Challenges of Having a Caregiver with Chronic Pain, Fibromyalgia, or Autoimmune Disease”**](https://www.amazon.com/Why-Does-Mommy-Hurt-Fibromyalgia/dp/1478732962/ref=sr_1_1?dchild=1&keywords=why+does+mommy+hurt&qid=1620933167&s=books&sr=1-1) by Elizabeth M. Christ ## Other Books of Interest - [**“Artificial Intelligence: A Guide for Thinking Humans”**](https://www.amazon.com/Artificial-Intelligence-Guide-Thinking-Humans-ebook/dp/B07MYWPQSK/ref=sr_1_3?dchild=1&keywords=artificial+intelligence+melanie&qid=1618506616&s=books&sr=1-3) by Melanie Mitchell - [**“Can’t. Just. Stop. An Investigation of Compulsions”**](http://www.sharonlbegley.com/books) by Sharon Begley - [**“The Doctor Who Fooled the World: Science, Deception, and the War on Vaccines”**](https://www.amazon.com/Doctor-Who-Fooled-World-Deception/dp/1421438003) by Brian Deer - [**“A Planet of Viruses”**](https://carlzimmer.com/books/a-planet-of-viruses/) by Carl Zimmer - [**“Unbroken Brain: A Revolutionary New Way of Understanding Addiction”**](https://maiasz.com/books/unbroken-brain/) by Maia Szalavitz - [**“Unthinkable: An Extraordinary Journey Through the World’s Strangest Brains”**](https://www.helenthomson.co.uk/) by Helen Thomson ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/SpacerShield.jpg) ###### The views and opinions expressed in the listed books are those of the authors. GAI does not endorse the contents of the above books; they are simply a sample of the resources available on managing life with autoimmune disease and other chronic illnesses. --- ### [Autoimmune Disease Basics](https://www.autoimmuneinstitute.org/understanding-autoimmune-disease/) **Published:** February 13, 2024 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** A clear guide to autoimmune disease, including how it develops, common conditions, risk factors, and how diagnosis and testing work. **Content:** ## What is Autoimmune Disease (AD)? Your immune system protects you by defending the body from disease and infection. When your immune system detects a threat (such as a toxin, bacteria, or virus), it mounts an immune response and produces antibodies and white blood cells to fight the invader. When you have an autoimmune disease, however, your immune system activates in an inappropriate or abnormal manner. Unable to distinguish between self and non-self proteins, a dysfunctional immune system mistakes the body’s own cells for harmful invaders. It produces cells and antibodies that target, attack, and damage healthy cells, tissues, and organs. This results in a wide spectrum of possible symptoms and severity. There are over [80-100 autoimmune diseases (AD),](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/) many of which have subtypes that are being discovered and distinguished. These include common diseases as well as those still considered to be rare. Certain AD’s are well known to be common, based on research studies, physician experience in-clinic, hospital and other data, and patient-reported information. Some autoimmune diseases are organ specific as they affect certain areas of the body, such as the heart, kidney, or skin, or cell-specific as in type 1 diabetes, the insulin-producing cells of the pancreas. Most are also systemic, meaning that damage results in different tissues of the body. Examples of systemic autoimmune diseases are [Sjögren’s syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sjogren-syndrome/), [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/) (Lupus), [Scleroderma](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/scleroderma/), [Rheumatoid Arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/), and [Celiac disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/celiac-disease/). ### What are the Most Common Autoimmune Diseases? There are over 80 autoimmune diseases (ADs) and counting, including many rare and also more common conditions. The consensus on which ADs are most common varies. It is likely based on patient-reported information, physician experience in-clinic, hospital data, and research studies. Based on current information, some of the most common autoimmune diseases include: - [Alopecia areata](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/alopecia-areata/) - [Celiac disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/celiac-disease/) - [Crohn’s disease (CD)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crohns-disease/) - [Grave’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/graves-disease/) - [Hashimoto’s thyroiditis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/hashimotos-thyroiditis/) - [Multiple sclerosis (MS)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/) - [Psoriasis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/psoriasis/) - [Psoriatic arthritis (PA)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/psoriatic-arthritis/) - [Raynaud’s syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/raynauds-syndrome/) - [Rheumatoid arthritis (RA)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/) - [Sjögren’s syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sjogrens-syndrome/) - [Systemic lupus erythematosus (SLE)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/) - [Type I diabetes (T1D)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/diabetes-type-1/) - [Ulcerative colitis (UC)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ulcerative-colitis/) - [Vitiligo](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/vitiligo/) Examples of common autoimmune-related or suspected conditions: - [Chagas disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/chagas-disease/) - [Chronic fatigue syndrome (ME/CFS)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/me-cfs/) - [Chronic urticaria (CU)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/chronic-urticaria/) - [Eczema](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/eczema/) - [Endometriosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/endometriosis/) - Fibromyalgia - [Interstitial cystitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/interstitial-cystitis/) - [Lyme disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/lyme-disease/) - [Postural orthostatic tachycardia syndrome (POTS)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/postural-orthostatic-tachycardia-syndrome/) - Restless leg syndrome (RLS) There are also many rare autoimmune diseases. In the United States, a rare disease means that it affects fewer than 200,000 people. In many cases, there exists such little information that the true prevalence is unknown. To learn about rare diseases, head to the [National Organization for Rare Disorders](https://rarediseases.org/for-patients-and-families/information-resources/rare-disease-information/). ### What Risk Factors Should I be Aware of? Certain [risk factors](https://www.autoimmuneinstitute.org/risk-factors/) are believed to impact immune tolerance and may lead to the development of autoimmune disease (AD): ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/06-icon.svg) Your Sex Hormonal differences and the presence of a second X chromosome are factors that may explain why up to 80% of people living with autoimmune disease are female. Males with an extra X chromosome are also more likely to develop AD. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/02-icon.svg) Genetics Certain inherited genetic variations, such as the HLA Q8 and HLA Q2 genes, may impact immune response and predispose you to the development of autoimmune disease. As environmental factors can activate or deactivate genes, not everyone who is predisposed to AD will develop an illness. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/03/Icon-8.png) Having an autoimmune disease The reason for this may involve genetic predisposition and environmental factors. Accumulation of three or more autoimmune conditions is called Multiple Autoimmune Syndrome (MAS), which is seen in roughly 25% of people with AD. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/03/Icon-19.png) Obesity An increased amount of adipose (or fat) tissue sends the body into a chronic state of low-grade inflammation and can significantly alter immune system function. Metabolic syndrome and insulin resistance are also strongly associated with obesity. ![an icon of a person wearing a face mask, representing the prevention of spreading disease](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/06-icon-4.svg) Smoking and exposure to toxic agents The inhalation of toxic chemicals in cigarettes and exposure to air pollutants, organic solvents, and other toxins are associated with the development of autoimmune diseases. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/03/Icon-5.png) Medications Blood pressure medications, cancer immunotherapy, antibiotics, and other pharmaceutical therapies may induce side effects that impact immune system function and leading to autoimmune disease. ![Immunity Icon](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/03/Icon-13.png) Infections Infectious microorganisms, such as Epstein Barr Virus (EBV), SARS-CoV-2, and Group A Streptococcus, can turn on certain genes and impact the immune system’s ability to differentiate between self and non-self, thus triggering an autoimmune reaction. Various other viruses and bacteria are associated with development of AD, but their significance is not yet understood. ### Which Doctors are Familiar with Autoimmune Disease? [**Rheumatologists**](https://www.autoimmuneinstitute.org/2023/02/24/autoimmune-disease-specialist-spotlight/) are trained to diagnose and treat autoimmune and inflammatory diseases that affect the musculoskeletal system, as well as systemic conditions. [Other doctors who diagnose and treat autoimmune disease and related conditions](https://www.autoimmuneinstitute.org/doctors-who-diagnose-treat/): - Dermatologists - Endocrinologists - Gastroenterologists - Immunologists - Internists - Neurologists - Functional medicine doctors - Integrative medicine doctors - Naturopathic doctors - Osteopaths You may choose to work with a combination of modern Western physicians and holistic practitioners to build your network of healthcare providers. It can be helpful to work with more than one expert in order to benefit from their additional knowledge, experience, and methods. They may offer fresh perspectives and be willing to communicate with each other, as the need arises, and coordinate your care. ### How is Autoimmune Disease Diagnosed? In your doctor’s initial assessment, they will take your history, examine you, discuss your symptoms and risk factors, and order initial tests to search for clues. If they find an indication of what may be wrong, they can follow that lead through further diagnostic testing and analysis. Testing is used in conjunction with your experiences and your doctor’s medical knowledge to investigate the underlying causes of your illness. Identifying complex, chronic conditions requires serious and compassionate detective work. The paths your doctor explores will depend on your particular symptoms, history, environment, and other details. Listed below are a few examples of factors clinicians may look at and tests they may run to find answers. Understanding what tests are out there can help you get an idea of what may be involved in diagnosis and ask further questions. #### Common autoimmune disease testing: ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Frame-59647.svg) Antinuclear antibodies (ANA) High amounts or certain patterns of autoantibodies; often the first test used when autoimmune disease is suspected. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Frame-59649.svg) Autoantibodies High levels of specific autoantibodies such as rheumatoid factor (RF), thyroid antibodies (TPO, TgAB, TSI), or antitransglutaminase antibodies can indicate conditions like rheumatoid arthritis, autoimmune thyroid conditions, and celiac disease. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Frame-59648.svg) Secretory IgA antibodies Selective IgA deficiency may occur in autoimmune diseases like rheumatoid arthritis, lupus, celiac disease, ulcerative colitis, and Crohn’s disease. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Frame-59647.svg) Thyroid function Complete panel may include TSH (or sensitive TSH), total T4, free T4, free T3, and reverse T3; can be used in diagnosing and monitoring Hashimoto’s thyroiditis, Grave’s disease, and other thyroid conditions. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Frame-59649.svg) Inflammation C-reactive protein (CRP) or erythrocyte sedimentation rate (ESR) tests detect inflammatory markers. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Frame-59648.svg) Organ function Endoscopies, colonoscopies, x-rays, ultrasounds, and other tests check for damage to the liver, kidneys, large intestine, thyroid, and other organs and tissues that may be indicative of certain diseases. ##### Other tests to understand the full picture of health and detect autoimmune or other conditions: - Complete blood count (CBC) - Comprehensive metabolic panel (CMP) - Nutritional anemia profile - Micronutrient deficiencies - Glucose regulation and metabolism - Organic acids test (OAT) - Hormone levels - Genetic testing - Comprehensive stool analysis *Note: Some of the listed tests are more routinely ordered by [functional medicine, integrative medicine, or naturopathic doctors](https://www.autoimmuneinstitute.org/2021/01/28/explained-holistic-vs-modern-western-medicine/).* #### SOURCES 1. Orbai, Ana-Maria. [Why is My Immune System Attacking Itself?](https://www.hopkinsmedicine.org/health/wellness-and-prevention/autoimmune-disease-why-is-my-immune-system-attacking-itself) *Johns Hopkins Medicine.* 2. InformedHealth.org. (April 23, 2020). [How Does the Immune System Work?](https://www.ncbi.nlm.nih.gov/books/NBK279364/) *Institute for Quality and Efficiency in Health Care.* 3. Newman, T. (January 11, 2018). [How the Immune System Works](https://www.medicalnewstoday.com/articles/320101#immunity). *Medical News Today*. 4. Free, M., Falk, R. [The Science Behind Autoimmune Disease.](https://www.med.unc.edu/medicine/news/chairs-corner/podcast/autoimmune-science/) *UNC School of Medicine.* 5. Fairweather, D., Frisancho-Kiss, S., Rose, N. (2008). [Sex Differences in Autoimmune Disease from a Pathological Perspective](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2527069/). *The American Journal of Pathology*, 173(3), 600-609. 6. Cojocar M., Cojocaru I. M., Silosi I. (2010). [Multiple Autoimmune Syndrome](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3150011/). *Maedica, Journal of Clinical Medicine*. 5(2), 132-134. 7. Desai, M., Brinton, R. (April 29, 2019). [Autoimmune Disease in Women: Endocrine Transition and Risk Across the Lifespan](https://www.frontiersin.org/articles/10.3389/fendo.2019.00265/full). *Frontiers in Endocrinology.* doi: https://doi.org/10.3389/fendo.2019.00265 8. [Obesity Plays Major Role in Triggering Autoimmune Diseases](https://www.sciencedaily.com/releases/2014/11/141110110722.htm). (2014). *Tel Aviv University American Friends*. 9. Costenbader K. H., Karlson E. W. (2006). [Cigarette smoking and autoimmune disease: what can we learn from epidemiology?](https://www.ncbi.nlm.nih.gov/pubmed/17153844) *Lupus*, 15(11): 737-45. 10. Zhao C., Xu Z., Wu G., Mao Y., Liu L., QIan-Wu, Dan y., Tao S., Zhang Q., Sam N. B., Fan Y., Zou Y., Ye D., Pan H. (2019). [Emerging role of air pollution in autoimmune diseases](https://www.sciencedirect.com/science/article/abs/pii/S1568997219300886). *Autoimmunity Reviews*, 18(6): 607-614. Elsevier. 11. Barragán-Martínez, C., Speck-Hernández, C. A., Montoya-Ortiz, G., Mantilla, R. D., Anaya, J. M., & Rojas-Villarraga, A. [Organic Solvents as Risk Factor for Autoimmune Diseases: A Systematic Review and Meta-Analysis](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3526640/). *PLoS One*, 7(12): e51506. doi:10.1371/journal.pone.0051506. 12. Niklas, K., Arkadiusz N., Majewski, D., Puszczewicz, M. (2016). [Rheumatic diseases induced by drugs and environmental factors: the state-of-the-art – part one](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4967979/). *Reumatologica*, 54(3), 122–127. doi: 10.5114/reum.2016.61212 13. Getts, D. R., Chastain, E. M., Terry, R. L., & Miller, S. D. (2013). [Virus infection, antiviral immunity, and autoimmunity](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3971377/). Immunological reviews, 255(1): 197–209. doi:10.1111/imr.12091. 14. Mayo Clinic. [Hashimoto’s disease.](https://www.mayoclinic.org/diseases-conditions/hashimotos-disease/diagnosis-treatment/drc-20351860) (February 11, 2020). *Mayo Clinic*. 15. Johns Hopkins Medicine. [Immunology Laboratory.](http://pathology.jhu.edu/department/Immunology/tests.cfm) Laboratory Tests. *Johns Hopkins Medicine: Pathology*. 16. Mayo Clinic. [Rheumatoid factor.](https://www.mayoclinic.org/tests-procedures/rheumatoid-factor/about/pac-20384800) (February 14, 2019). *Mayo Clinic*. 17. Mayo Clinic. [Selective IgA Deficiency](https://www.mayoclinic.org/diseases-conditions/selective-iga-deficiency/symptoms-causes/syc-20362236). (April 2, 2020). *Mayo Clinic*. 18. Quest Diagnostics. [Tests for Autoimmune Disease](https://www.questdiagnostics.com/dms/Documents/Other/Autoimmune-Arthritis/MI5462_FAQs-Tests-for-Autoimmune-Diseases.pdf). (2016). *Quest Diagnostics*. 19. Trescott, M., Alt, A. (November 1, 2016). “Inform.” *The Autoimmune Wellness Handbook* (pp. 16-20). Rodale Books; 1st edition. --- ### [04 - Find Resources](https://www.autoimmuneinstitute.org/04-find-resources/) **Published:** February 23, 2024 **Author:** agustin.fernandezb@elevationweb.org **Content:** ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/pexels-antoni-shkraba-7345471-4.jpg) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/03/banner-_photo-1-e1710416620316.jpg) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/03/banner-_photo-e1710416588611.jpg) # Find Resources for Hope Health Our aim is to serve as a hub for practical and reliable information on autoimmune disease to help those affected in their daily lives, as well as their friends, family, and caregivers. Information overload can be overwhelming! Exploring the resources below is a good place to start. ![](https://www.autoimmuneinstitute.org/wp-content/themes/elevation-framework/src/assets/images/layer-blue-top.png) ## Autoimmune Medical Institutions Directory ##### A comprehensive list of medical institutions across the United States specializing in diagnosing and treating various autoimmune diseases. Find the help you need ![](https://www.autoimmuneinstitute.org/wp-content/themes/elevation-framework/src/assets/images/layer-blue-bottom.png) ## Support Groups ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Group-59508.svg) ### Join our monthly virtual support group! Autoimmune Aware is our dynamic virtual support group initiative focused on creating an inclusive space for the autoimmune disease and chronic illness community to thrive, learn, connect & share. Learn More ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Frame-59531.svg) ### Discover other support groups! In case our support group isn’t a good fit for you, we’ve also compiled a list of autoimmune disease and chronic illness-related support groups! Check out the list ### My Autoimmune Story See All Stories ![GAI Heather Blair](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/06/Heathers-AD-story-banner.jpg) Jun 15,26 · by Heather Blair ## [Heather’s Story: The Hurt and Healing](https://www.autoimmuneinstitute.org/autoimmune_stories/heathers-story-the-hurt-and-healing/) In her story, Heather shares her journey from years of unexplained symptoms and repeated surgeries to a diagnosis of hypermobile Ehlers-Danlos syndrome (hEDS), and the resilience, self-discovery, and hope she found along the way. While Ehlers-Danlos syndrome (EDS) is not classified as an autoimmune disease, many people living with EDS face challenges that will feel familiar to those in the autoimmune community, including chronic pain, diagnostic delays, complex symptoms, and the emotional toll of an often invisible condition. Diagnostic Delays ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/02/Melanies-AD-story-GAI.jpg) Mar 06,26 · by Melanie Cammarano ## [Melanie’s Story: Living With Type 1 Diabetes](https://www.autoimmuneinstitute.org/autoimmune_stories/melanies-story-living-with-type-1-diabetes/) Type 1 Diabetes ![Bárbara Barros Global Autoimmune Institute Autoimmune Story](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/01/Barbaras-AD-Story.jpg) Jan 27,26 · by Bárbara Barros ## [Bárbara’s Story: The Invisibility of Continuity](https://www.autoimmuneinstitute.org/autoimmune_stories/barbaras-story-the-invisibility-of-continuity/) Multiple Autoimmune DiseasesMultiple Sclerosis (MS)Undiagnosed ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/01/Gracies-AD-Story-e1769458604970.jpg) Jan 26,26 · by Gracie Rady-Ginther ## [Gracie’s Story: Reclaiming my Life](https://www.autoimmuneinstitute.org/autoimmune_stories/gracies-story-reclaiming-my-life/) POTS ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/08/Spring-Reyna-Fam-2.jpg) Aug 08,25 · by Erika Reyna ## [Erika’s Story: Still Me](https://www.autoimmuneinstitute.org/autoimmune_stories/erikas-story/) Lupus (SLE)Multiple Autoimmune DiseasesRheumatoid ArthritisSjogren’s Disease ### Our Recommendations [ ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Frame-59650.svg) ##### Essential Podcasts Top-notch podcasts on nutrition, finding community, mind-body medicine, and more. ](#) [ ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/04-icon-1.svg) ##### Books We Love Essential reading for understanding autoimmune disease and the body, chronic illness memoirs, practical guides, cookbooks, and children’s books, as well as other books of interest. ](#) [ ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Frame-59651.svg) ##### Helpful Apps A brief list of our favorite, simple, and practical mobile apps to help manage life with chronic illness. ](#) [ ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Frame-59652.svg) ##### Autoimmune & Chronic Illness Toolkit Includes journal templates, resource lists, guidance for doctor appointments, tips on communication, and many more tools to support and empower you throughout your experience. ](#) [ ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Frame-59653.svg) ##### Common Symptoms Explore the many common autoimmune disease symptoms. ](#) [ ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Frame-59654.svg) ##### Autoimmune Basics Learn more about autoimmune disease and how it is diagnosed. ](#) ## Find Resources for Healthcare Providers In an exclusive interview, Dr. Douglas Drossman and Johannah Ruddy, M.Ed., authors of the Gut Feelings series, discuss how healthcare providers can better communicate with patients when it comes to autoimmune diseases in order to improve patient satisfaction and overall healthcare experience. [Learn More](https://www.autoimmuneinstitute.org/effective-communication-strategies/) --- ### [The Spectrum of Autoimmune Disease Treatments](https://www.autoimmuneinstitute.org/the-spectrum-of-autoimmune-disease-treatments/) **Published:** February 13, 2024 **Author:** Carolyn Serraino **Excerpt:** With multiple autoimmune disease treatment options available, learning about and deciding which treatment route to follow can be an overwhelming task. This article provides a high-level view of the most common treatment options, ranging from pharmaceutical agents requiring a doctor’s prescription to at-home treatments. **Content:** # The Spectrum of Autoimmune Disease Treatments With multiple autoimmune disease treatment options available, learning about and deciding which treatment route to follow can be an overwhelming task. This page provides a high-level overview of the most common treatment options, ranging from prescription pharmaceuticals to at-home treatments. ![Autoimmune Disease Treatments Global Autoimmune Institute](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Spectrum-of-AD-treatments-1024x576.png) u003ch3 style=u0022text-align: center;u0022u003ePharmaceutical Agentsu003c/h3u003ernDoctors commonly prescribe immunosuppressants to reduce immune system activity and disease u003ca href=u0022https://www.autoimmuneinstitute.org/symptoms-signs/u0022 target=u0022\_blanku0022 rel=u0022noopeneru0022u003esymptomsu003c/au003e. Some treatments act on the whole immune system while others are u003ca href=u0022https://www.autoimmuneinstitute.org/articles/tailoring-autoimmune-treatment-with-precision-medicineu0022 target=u0022\_blanku0022 rel=u0022noopeneru0022u003etargeted therapiesu003c/au003e.rnrnImmunosuppressants may be taken in a pill form at home or may require a trip to the doctor if they are injected or infused intravenously (IV). Steroids (corticosteroids) are one of the most commonly prescribed immunosuppressants. These medications have a broad, non-specific effect on your body by reducing the activity of your white blood cells (immune cells) \[u003ca href=u0022https://pubmed.ncbi.nlm.nih.gov/27022244/u0022 target=u0022\_blanku0022 rel=u0022noopener noreferreru0022 data-gc-link=u0022https://pubmed.ncbi.nlm.nih.gov/27022244/u0022u003e1u003c/au003e\].rnrnBiologic medications are a newer and rapidly evolving class of medications that provide targeted treatment for autoimmune diseases. This means they only interact with specific immune cells or immune-related proteins, called cytokines. For example, B cells are commonly targeted immune cells, and TNF (tumor necrosis factor) is a commonly targeted cytokine due to its role in promoting autoimmune disease. Generally, targeted therapies are better tolerated and provide better results for people living with an autoimmune disease \[u003ca href=u0022https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5506195/u0022 target=u0022\_blanku0022 rel=u0022noopener noreferreru0022 data-gc-link=u0022https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5506195/u0022u003e2u003c/au003e, u003ca href=u0022https://pubmed.ncbi.nlm.nih.gov/33324003/u0022 target=u0022\_blanku0022 rel=u0022noopener noreferreru0022 data-gc-link=u0022https://pubmed.ncbi.nlm.nih.gov/33324003/u0022u003e3u003c/au003e, u003ca href=u0022https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3616818/u0022 target=u0022\_blanku0022 rel=u0022noopener noreferreru0022 data-gc-link=u0022https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3616818/u0022u003e4u003c/au003e\].rnrnu0026nbsp;rnu003ch3 style=u0022text-align: center;u0022u003eComplementary And Alternative Medicineu003c/h3u003ernComplementary and alternative medicine, CAM, are medical practices that sit outside of standard medical care. Acupuncture, cupping, therapeutic touch (Reiki), and biofeedback are examples of CAM that have been observed to alleviate autoimmune disease symptoms \[u003ca href=u0022https://pubmed.ncbi.nlm.nih.gov/29635832/u0022 target=u0022\_blanku0022 rel=u0022noopener noreferreru0022 data-gc-link=u0022https://pubmed.ncbi.nlm.nih.gov/29635832/u0022u003e5u003c/au003e\]. ## Acupuncture Acupuncture is a popular alternative therapy that has been used for centuries. This therapy involves the insertion of tiny needles into your skin at strategic locations based on your symptoms. Although some people consider acupuncture lacking scientific rigor, a growing number of studies show that this alternative therapy is effective at relieving symptoms. Acupressure is the needle-free version of acupuncture, but the effectiveness of this method is less scientifically documented.rnrnStudies using animal models with autoimmune disease show that acupuncture can reduce the biological factors that are causing disease symptoms, such as pain and inflammation. For example, an animal model of u003ca href=u0022https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/u0022u003erheumatoid arthritisu003c/au003e showed that acupuncture reduced inflammation and pain in affected joints and also changed the levels of inflammatory cytokines, the immune molecules that cause inflammation \[u003ca href=u0022https://pubmed.ncbi.nlm.nih.gov/30001644/u0022 target=u0022\_blanku0022 rel=u0022noopener noreferreru0022 data-gc-link=u0022https://pubmed.ncbi.nlm.nih.gov/30001644/u0022u003e6u003c/au003e\]. Another study showed that acupuncture had anti-inflammatory and pain-reducing effects, possibly due to acupuncture stopping a type of immune cell called macrophages from turning into pro-inflammatory cells in inflamed joints \[u003ca href=u0022https://pubmed.ncbi.nlm.nih.gov/33727948/u0022 target=u0022\_blanku0022 rel=u0022noopener noreferreru0022 data-gc-link=u0022https://pubmed.ncbi.nlm.nih.gov/33727948/u0022u003e7u003c/au003e\].rnrnStudies on people living with autoimmune disease show that acupuncture is an effective alternative therapy for some people, but not everyone. How well acupuncture works seems to depend upon the disease symptom. For example, two studies reported minimal evidence for acupuncture relieving the fatigue that is associated with systemic lupus erythematosus \[u003ca href=u0022https://pubmed.ncbi.nlm.nih.gov/26238554/u0022 target=u0022\_blanku0022 rel=u0022noopener noreferreru0022 data-gc-link=u0022https://pubmed.ncbi.nlm.nih.gov/26238554/u0022u003e8u003c/au003e, u003ca href=u0022https://pubmed.ncbi.nlm.nih.gov/25328393/u0022 target=u0022\_blanku0022 rel=u0022noopener noreferreru0022 data-gc-link=u0022https://pubmed.ncbi.nlm.nih.gov/25328393/u0022u003e9u003c/au003e\]. Acupuncture appears to be more effective for people with multiple sclerosis as it can reduce spasticity \[u003ca href=u0022https://pubmed.ncbi.nlm.nih.gov/28410453/u0022 target=u0022\_blanku0022 rel=u0022noopener noreferreru0022 data-gc-link=u0022https://pubmed.ncbi.nlm.nih.gov/28410453/u0022u003e10u003c/au003e\]. Not all autoimmune diseases have been well studied in terms of acupuncture, but studies show that for most people, acupuncture is a safe alternative therapy. ## Cupping Cupping, also called Hijama, is an ancient holistic practice for the prevention and treatment of a variety of diseases \[u003ca href=u0022https://pubmed.ncbi.nlm.nih.gov/28494847/u0022 target=u0022\_blanku0022 rel=u0022noopener noreferreru0022 data-gc-link=u0022https://pubmed.ncbi.nlm.nih.gov/28494847/u0022u003e11u003c/au003e\]. This practice, which has both early Egyptian and Chinese origins, uses special cups placed along specific regions of your skin to create suction that stimulates the flow of energy and blood. Wet cupping is a variation where a person’s skin is lightly punctured and blood is drawn out by suction.rnrnA growing body of research shows that cupping may improve circulation while reducing inflammation and pain associated with a variety of ailments. Activation of the immune system, an increase in nitric oxide, and changes in biomechanical properties of the skin are some of the ways that cupping may reduce pain and alleviate disease symptoms \[u003ca href=u0022https://pubmed.ncbi.nlm.nih.gov/30963043/u0022 target=u0022\_blanku0022 rel=u0022noopener noreferreru0022 data-gc-link=u0022https://pubmed.ncbi.nlm.nih.gov/30963043/u0022u003e12u003c/au003e, u003ca href=u0022https://pubmed.ncbi.nlm.nih.gov/29436369/u0022 target=u0022\_blanku0022 rel=u0022noopener noreferreru0022 data-gc-link=u0022https://pubmed.ncbi.nlm.nih.gov/29436369/u0022u003e13u003c/au003e\].rnrnThe few studies that have directly investigated the effects of cupping in autoimmune diseases have produced conflicting results. While a recent trial showed that cupping therapy improved autoimmune activity and thyroid hormone profiles in 13 patients with u003ca href=u0022https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/hashimotos-thyroiditis/u0022u003eHashimoto’s diseaseu003c/au003e \[u003ca href=u0022https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9280564/u0022 target=u0022\_blanku0022 rel=u0022noopener noreferreru0022 data-gc-link=u0022https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9280564/u0022u003e14u003c/au003e\], a more broad literature review found that cupping increased rheumatic disease side effects, including joint pain \[u003ca href=u0022https://pubmed.ncbi.nlm.nih.gov/35128323/u0022 target=u0022\_blanku0022 rel=u0022noopener noreferreru0022 data-gc-link=u0022https://pubmed.ncbi.nlm.nih.gov/35128323/u0022u003e15u003c/au003e\]. A comprehensive analysis of the benefits of cupping across a variety of autoimmune diseases has not been performed. ## Reiki Reiki (therapeutic touch) is a non-invasive therapy described as an energy-healing technique that promotes relaxation and healing. Reiki is considered safe, but it is unclear if it can reduce symptoms of autoimmune disease. A 2015 literature review found that Reiki therapy may effectively reduce pain and anxiety \[u003ca href=u0022https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4147026/u0022 target=u0022\_blanku0022 rel=u0022noopener noreferreru0022 data-gc-link=u0022https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4147026/u0022u003e16u003c/au003e\], but this has not specifically been studied in people with autoimmune diseases. ## Biofeedback Biofeedback is a technique that focuses on partly controlling body functions that aren’t generally thought about, such as heart rate and breathing. Biofeedback training can vary depending on health challenges and goals. As technology advancements have been incorporated into medicine, patients have been able to improve their quality of life. For example, a 2019 rheumatology study of 20 patients showed that the combination of virtual reality and biofeedback successfully helped reduce pain and anxiety \[u003ca href=u0022https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6917304/u0022 target=u0022\_blanku0022 rel=u0022noopener noreferreru0022 data-gc-link=u0022https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6917304/u0022u003e17u003c/au003e\]. ## Hydrotherapy Hydrotherapy, also called aquatic therapy or spa therapy, is safe for most people. Although the long-term benefit of hydrotherapy is unknown, studies in people with u003ca href=u0022https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/u0022u003emultiple sclerosisu003c/au003e \[u003ca href=u0022https://pubmed.ncbi.nlm.nih.gov/28215060/u0022 target=u0022\_blanku0022 rel=u0022noopener noreferreru0022 data-gc-link=u0022https://pubmed.ncbi.nlm.nih.gov/28215060/u0022u003e18u003c/au003e\] and u003ca href=u0022https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/u0022u003erheumatoid arthritisu003c/au003e \[u003ca href=u0022https://pubmed.ncbi.nlm.nih.gov/22806987/u0022 target=u0022\_blanku0022 rel=u0022noopener noreferreru0022 data-gc-link=u0022https://pubmed.ncbi.nlm.nih.gov/22806987/u0022u003e19u003c/au003e\] show that aquatic therapy can improve quality of life by reducing pain and boosting mood in people living with these autoimmune diseases. ## Chelation Therapy Chelation therapy is a mainstream treatment for removing toxic levels of heavy metals such as mercury or lead in a person’s blood after overexposure. However, it is also an alternative, experimental therapy for people living with autoimmune disease. Past studies have found that some u003ca href=u0022https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/u0022u003emultiple sclerosisu003c/au003e patients have abnormal iron deposits in their brains, and chelation therapy was able to improve gait and balance \[u003ca href=u0022https://pubmed.ncbi.nlm.nih.gov/24397846/u0022 target=u0022\_blanku0022 rel=u0022noopener noreferreru0022 data-gc-link=u0022https://pubmed.ncbi.nlm.nih.gov/24397846/u0022u003e20u003c/au003e\]. Chelation therapy should only be used as a potential treatment for patients with autoimmune diseases that are linked to high levels of heavy metals; patients should be closely monitored during the chelation therapy process due to the risk of temporary side effects \[u003ca href=u0022https://pubmed.ncbi.nlm.nih.gov/24397846/u0022 target=u0022\_blanku0022 rel=u0022noopener noreferreru0022 data-gc-link=u0022https://pubmed.ncbi.nlm.nih.gov/24397846/u0022u003e20u003c/au003e\]. u003ch3u003eSelf-Care At Homeu003c/h3u003ernSelf-care techniques that can be routinely performed at home are beneficial for anyone with an autoimmune disease. Research shows that mind-body interventions such as yoga and meditation can improve the perception of pain, joint flexibility, muscle strength, and disease activity in those living with autoimmune disease \[u003ca href=u0022https://pubmed.ncbi.nlm.nih.gov/33048777/u0022 target=u0022\_blanku0022 rel=u0022noopener noreferreru0022 data-gc-link=u0022https://pubmed.ncbi.nlm.nih.gov/33048777/u0022u003e21u003c/au003e, u003ca href=u0022https://pubmed.ncbi.nlm.nih.gov/26270955/u0022 target=u0022\_blanku0022 rel=u0022noopener noreferreru0022 data-gc-link=u0022https://pubmed.ncbi.nlm.nih.gov/26270955/u0022u003e22u003c/au003e\]. Some researchers believe that mind-body interventions can also help overcome the psychosomatic component of disease \[u003ca href=u0022https://pubmed.ncbi.nlm.nih.gov/30714983/u0022 target=u0022\_blanku0022 rel=u0022noopener noreferreru0022 data-gc-link=u0022https://pubmed.ncbi.nlm.nih.gov/30714983/u0022u003e23u003c/au003e\].rnrnWhile self-care techniques are likely to improve quality of life, they have not been shown to improve autoimmune disease activity. A 2019 literature review analyzed 15 controlled studies of non-pharmacological interventions (education, relaxation exercises such as meditation, and performance exercises) with u003ca href=u0022https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/u0022u003elupusu003c/au003e patients. The review found that the interventions improved pain, fatigue, and quality of life. However, none of the studies, which ranged from 5 – 52 weeks, reported an improvement in disease activity \[u003ca href=u0022https://pubmed.ncbi.nlm.nih.gov/30961418/u0022 target=u0022\_blanku0022 rel=u0022noopener noreferreru0022 data-gc-link=u0022https://pubmed.ncbi.nlm.nih.gov/30961418/u0022u003e24u003c/au003e\]. u003ch3 style=u0022text-align: center;u0022u003eNutrition-Based Treatmentsu003c/h3u003ernMany people turn to nutrition-based treatments — homeopathy, herbal products, dietary supplements — as traditional herbal and nutritional approaches are being explored in the context of modern science \[u003ca href=u0022https://pubmed.ncbi.nlm.nih.gov/28758992/u0022 target=u0022\_blanku0022 rel=u0022noopener noreferreru0022 data-gc-link=u0022https://pubmed.ncbi.nlm.nih.gov/28758992/u0022u003e25u003c/au003e\]. While many supplements are being investigated, vitamin D and curcumin are two of the best-studied supplements in the context of autoimmune disease.rnrnCurcumin, a polyphenolic compound, helps regulate the cytokines that cause inflammatory signals in autoimmune diseases \[u003ca href=u0022https://pubmed.ncbi.nlm.nih.gov/17569223/u0022 target=u0022\_blanku0022 rel=u0022noopener noreferreru0022 data-gc-link=u0022https://pubmed.ncbi.nlm.nih.gov/17569223/u0022u003e26u003c/au003e\]. A systematic review of all studies about the efficacy of pure curcumin concluded that curcumin may have a variety of biological mechanisms. One of the human studies included in this review found that curcumin improved morning stiffness, joint stiffness, and walking time in people living with u003ca href=u0022https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/u0022u003erheumatoid arthritisu003c/au003e \[u003ca href=u0022https://pubmed.ncbi.nlm.nih.gov/33914984/u0022 target=u0022\_blanku0022 rel=u0022noopener noreferreru0022 data-gc-link=u0022https://pubmed.ncbi.nlm.nih.gov/33914984/u0022u003e27u003c/au003e\].rnrnThere is also strong evidence for the use of vitamin D to support proper immune system function. Vitamin D has a broad range of functions in immunity, including supporting gut health and immune cell functions. Low vitamin D levels are seen in people living with u003ca href=u0022https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/u0022u003emultiple sclerosisu003c/au003e or u003ca href=u0022https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/u0022u003esystemic lupus erythematosusu003c/au003e, and vitamin D levels may impact disease activity \[u003ca href=u0022https://pubmed.ncbi.nlm.nih.gov/31286174/u0022 target=u0022\_blanku0022 rel=u0022noopener noreferreru0022 data-gc-link=u0022https://pubmed.ncbi.nlm.nih.gov/31286174/u0022u003e28u003c/au003e\]. Supplemental vitamin D may help reduce relapses, or relapse severity, in people with multiple sclerosis since lower serum levels of vitamin D are seen in patients during relapse \[u003ca href=u0022https://pubmed.ncbi.nlm.nih.gov/28507011/u0022 target=u0022\_blanku0022 rel=u0022noopener noreferreru0022 data-gc-link=u0022https://pubmed.ncbi.nlm.nih.gov/28507011/u0022u003e29u003c/au003e\]. u003ch3 style=u0022text-align: center;u0022u003eTrial-and-Error of Treatmentu003c/h3u003ernThe goal of most autoimmune disease treatments and interventions is to reduce symptoms and improve quality of life. u003cstrongu003eUsing a combination of approaches is likely to get the best results and finding the best combination that works for you may be a trial-and-error process.u003c/strongu003e You can learn more about specific options by working with your physician and other medical specialists. As always, it’s important to speak with your doctor before starting a new treatment, to ensure it’s the right fit for you and complements your healthcare plan.rnrnu0026nbsp;rnrnu0026nbsp; ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/GAI-Logo-Image-e1707845715517.png) u003ch4u003eArticle Sources:u003c/h4u003ernu003colu003ern tu003cli data-gc-list-depth=u00221u0022 data-gc-list-style=u0022orderedu0022u003eKrasse M. et al. 2016. Efficacy and Safety of Modified-Release Prednisone in Patients with Rheumatoid Arthritis. Drug Design, Development and Therapy, 10, 1047-1058. u003ca href=u0022https://pubmed.ncbi.nlm.nih.gov/27022244/u0022 target=u0022\_blanku0022 rel=u0022noopener noreferreru0022 data-gc-link=u0022https://pubmed.ncbi.nlm.nih.gov/27022244/u0022u003ehttps://pubmed.ncbi.nlm.nih.gov/27022244/u003c/au003eu003c/liu003ern tu003cli data-gc-list-depth=u00221u0022 data-gc-list-style=u0022orderedu0022u003eLi P. et al. 2017. Drugs for Autoimmune Inflammatory Diseases: From Small Molecule Compounds to Anti-TNF Biologics. Frontiers in Pharmacology, 8, 460. u003ca href=u0022https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5506195/u0022 target=u0022\_blanku0022 rel=u0022noopener noreferreru0022 data-gc-link=u0022https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5506195/u0022u003ehttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5506195/u003c/au003eu003c/liu003ern tu003cli data-gc-list-depth=u00221u0022 data-gc-list-style=u0022orderedu0022u003eLee D.S.W. et al. 2021. B Cell Depletion Therapies in Autoimmune Disease: Advances and Mechanistic Insights. 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Advances in Nutrition, 8(3), 463-472. u003ca href=u0022https://pubmed.ncbi.nlm.nih.gov/28507011/u0022 target=u0022\_blanku0022 rel=u0022noopener noreferreru0022 data-gc-link=u0022https://pubmed.ncbi.nlm.nih.gov/28507011/u0022u003ehttps://pubmed.ncbi.nlm.nih.gov/28507011/u003c/au003eu003c/liu003ernu003c/olu003e --- ### [Privacy Policy](https://www.autoimmuneinstitute.org/privacy-policy/) **Published:** January 26, 2024 **Author:** Elevation **Excerpt:** GAI is committed to respecting your privacy and handling your information responsibly. This Privacy Policy explains how we collect, use, and protect information when you visit our website, submit forms or stories, or interact with our content online. **Content:** # **Privacy Policy** ## Who We Are The Global Autoimmune Institute (“GAI,” “we,” “us,” or “our”) is committed to respecting your privacy and handling your information responsibly. This Privacy Policy explains how we collect, use, store, and protect information when you visit our website or interact with us online. The Global Autoimmune Institute is a nonprofit organization dedicated to advancing education, research, and awareness related to autoimmune disease. Our website provides educational content, resources, and opportunities for individuals to share their stories and engage with our work. Our website address is: https://www.autoimmuneinstitute.org --- ## Cookies and Website Functionality Our website uses cookies to support basic functionality and improve user experience. You may disable cookies through your browser settings, though some site features may not function properly as a result. Our website may offer optional educational assessments. Individual responses are not linked to personal identifiers. No individual participant is identified. 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Right to Decline or Remove Submissions GAI reserves the right, at its sole discretion, to decline, remove, or discontinue publication of any Submission at any time. #### 8. Indemnification You agree to indemnify and hold harmless the Global Autoimmune Institute from any claims, damages, or liabilities arising from your Submission, including claims that the content infringes upon the rights of any third party. --- ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/GAI-Logo-Image-e1707845715517.png) --- ### [Share your Story](https://www.autoimmuneinstitute.org/share-your-story/) **Published:** February 14, 2024 **Author:** Elevation **Excerpt:** People may feel unseen and unheard both in their social lives and in the medical world. It is our hope for these stories to cushion the loneliness often felt by people with autoimmune disease, and to give caregivers and loved ones valuable insight into what they may be going through. Let your story be heard! **Content:** ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2020/05/How-to-Write-Story-Article-website-banner-1024x341.png) Share Your Autoimmune Story #### **Welcome to the Global Autoimmune Institute and our community**! We look forward to your Autoimmune Story submission! Personal stories are so inspiring and helpful. They bring us together and provide comfort and useful information to those who need it most. We appreciate your effort on behalf of others who, like you, are on this difficult journey. [**Find the submission form below**](#story-submission-form) ## How to Tell Your Chronic Illness Story **Through stories, we create connection and understanding**—**in relation to others, but also for ourselves.** Have you been thinking about telling your chronic illness or autoimmune story? Maybe you want to keep a private record of what it’s been like to live with health issues. Or maybe you want to share your experiences with friends and family. No matter the reason, remember that it can be as simple or as involved as you make it. Understanding why you’re writing, learning helpful tips and tricks, and identifying a starting point can help you shake off the overwhelm and take action. ### 7 reasons to tell your story ## 1. Feel a sense of relief and reduce stress levels. Your mind is most likely teeming with endless questions, worries, opinions, emotions, and information all the time—even if you don’t realize it. Think of Dumbledore tapping a wand to his head, and leading a trail of shimmering thoughts into a glowing, glass orb. Writing is a way to let things out and release the pressure. ## 2. Track your progress. You don’t have to record just one version of your story; your perspective will change overtime. Write periodic journal entries or recaps of your chronic illness journey to help your future self better understand what happened, and what has improved or worsened. ## 3. Connect with others in similar situations. The act of sharing your story may start a conversation. You can make new friends with people who relate to what you’re going through. ## 4. Practice communicating about your illness. It’s not easy to talk about these kinds of things, but the more you practice, the more confident and empowered you’ll feel. You’ll also be in a better position to educate those around you and raise awareness, if that is a path you’re looking to take. ## 5. Gain perspective and new insights. Writing down thoughts and memories can have the powerful effect of shifting the way we see things and bringing new ideas to light. You never know—it could trigger a “eureka!” moment. ## 6. Help others feel less isolated, alone, and hopeless. We all know there are too many people out there without adequate support. Reach out with your own personal story and be one more hug, one more smile, one more voice insisting, “You’re not alone.” ## 7. Raise awareness. Assumptions, social constructs, and other factors can get in the way of true understanding. Add your voice to the collection of insider stories circulating online. It helps friends, relatives, healthcare professionals—all the people around you—better understand what life with a condition like yours is *really* like. ### Writing tips! - **Celebrate what makes you, you.** You may *have* a disease, but you *are not* your disease. Your story does not need to solely be about illness, but about what makes you unique and how your qualities as a person have brought you to this point in your journey. - **Write as if you’re talking to a friend.** Use conversational language and let your personality come through. - **Keep your notes** from doctor visits, journal entries about symptoms, text messages, etc. Gather all your information in one place to better recall details of your story. - **Create a timeline.** Years of symptoms, medical visits, tests, research, protocols, therapies—and everything else in between—can easily become a jumbled, overwhelming mess in your head.To more easily write your story and piece together a clearer picture of your journey as a whole, grab a pen and paper. Mark time intervals along a line and jot down significant events that changed the trajectory of your illness (first symptoms, diagnoses, test results, surgeries, treatment plans, etc.). - **Let your present emotions fuel your writing.** You don’t have to be in any particular headspace to write your story. You may find just the right words during a bad day or good day, and taking out your pen or laptop no matter what you’re feeling can contribute to a more rounded picture of your experience. - **Use your senses.** Sound and smell are powerful ways to unearth memories. Listening to music from the time period you’re focused on, or smelling a lotion you used or food you frequently ate can unlock specific feelings you had at the time. - **Know who you’re writing for.** You may be writing primarily for yourself, but you also might have others in mind – a friend with autoimmune disease, someone with new symptoms who don’t know where to turn, a relative who is having trouble understanding what you’re going through. It can be helpful to have them in your head- however, remember that this doesn’t need to be for anyone else. - **Ask for input.** Friends or family members could have interesting insights and different perspectives on your experience. Call them up and ask questions about what they remember during different points in your journey. - **Don’t downplay your experience**. Give the gift of allowing yourself to be honest about what this is like for you. Many of us are used to sugar-coating how we feel in order to make the people around us more comfortable. This is your chance to tear down that wall. Be open about both the negative and the positive. - **Ignore that voice of judgment.** As you write, the only one who gets to see those words is you! You are the only reader, so don’t be worried about how you sound, about writing a “good story”, or about it being perfect. You (or a friend) can edit it later.What matters is that you’re honest. No matter what your goal is in writing this, focus on letting your authentic self come through. - **Let the creativity flow.** “Writing” your story doesn’t mean you have to write an essay. Note feelings or memories in bullet points, draw or paint scenes and images, write a poem or a play, create a meme, or record a video. - **Explain the lingo.** If you decide to share your story with others, be sure to briefly define terms or phrases that people outside the chronic illness or autoimmune disease community may not understand, like ANA testing, brain fog, SIBO, hypothyroid, LDN, etc. - **Use an emotional intelligence wheel.** This is a helpful tool to peel away surface emotions like anger and sadness and get to root emotions hiding underneath. Pinpointing what you felt from the very beginning to now – at all the various stages – helps your story resonate with readers, and emphasizes the roller coaster ride that is living with chronic illness. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/How-to-Write-Your-Story-Article-Feelings-Wheel-768x620-1.png)The Feeling Wheel, created by Dr. Gloria Willcox, was designed to aid people in learning to recognize and communicate about their feelings. Image from SimpleMost. ### Prompts: Keep it simple *Use this set of prompts to write a brief but colorful snapshot of your journey with chronic illness.* 1. Say something unique about yourself. It could be anything: hobbies, favorite places or foods, fun memories, your quirks/dreams/fears, etc. 2. When did you realize something was wrong? How did it make you feel? 3. Describe your diagnosis and/or symptoms. 4. Explain how your health condition has changed the way you live—what are the biggest challenges you experience? 5. What has living with an autoimmune disease or chronic illness taught you? 6. Give one piece of advice to someone who has recently been diagnosed or who’s experiencing health issues. 7. Name one thing you’d like people to know about living with a condition like yours. ### Prompts: Get inspired *Looking for more ideas? These questions can get the wheels turning when you want to share an in-depth look at your life, but you feel stuck. Writer’s block is no joke!* - What does a “typical” day look like for you? - Describe your very first symptoms, including how you felt, where you were, how you reacted, etc. - How has your perspective changed since you fell ill or were diagnosed? Do you see the world differently in some way? - What is the best or worst experience you’ve had with a doctor? - Living with chronic illness, it can often feel you have no control. What are some examples of things you’ve discovered are within your control? - Describe a few challenges you’ve overcome. What have they taught you? What have they taught those around you? - How has your illness impacted you financially? - Is there one symptom you’d say is “the worst”? - What does the word “support” mean to you? In what way have you been supported by others and vice versa? - Have your relationships with friends and family changed? How so? - Have you made diet and lifestyle changes? How have they impacted your symptoms, mental health, etc.? - What were your favorites hobbies or activities before? What are they now? - Has your career had to change? How so? - What 3 adjectives would you use to describe yourself before chronic illness? And now? - Have you hit “rock bottom” or a point where you felt completely hopeless? How did that transpire and how did you move forward? - What are the most vibrant memories from your journey that stick out in your mind? - How do you manage not just the symptoms, but the stress of being chronically ill? - How do you distract yourself from pain or discomfort? - What are your favorite ways to keep yourself in a calm state of mind? - What is one comment you wish people would stop making? #### [***GAI’s Autoimmune Stories***](https://www.autoimmuneinstitute.org/autoimmune-stories/) – *a moving collection of autoimmune disease & chronic illness experiences.* ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/01/Screenshot-2026-01-27-at-1.06.09-PM.png) “Illness did not end my artistic life. It forced a deep reconfiguration of my relationship with music, leadership, and creation. Excess was stripped away, urgency gave way to attention, and artistic practice became more concentrated, more intentional, and more human.” Bárbara Barros Bárbara’s Story: The Invisibility of Continuity ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/02/Gracie-2.jpg) “For seven months, my pleas for answers were met with dismissals: “It’s just anxiety.” Appointment after appointment blurred together. I fought, not just to be heard by doctors, but to find the person I once was.” Gracie Rady-Ginther Gracie’s Story: Reclaiming my Life ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/06/StoryphotosErika-Reyna_Page_1.jpg) “It took 7 years and a whole lot of persistence to finally get answers. And even when I did, the answers came with more layers: conflicting diagnoses, medication side effects, and constant uncertainty. But I kept showing up.” Erika Reyna Erika’s Story: Still Me ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/02/Anthony-3.jpg) “My complaints of discomfort fell on deaf ears. The doctors attributed the pain to my past surgeries while confronting me with skepticism as if I were a hypochondriac. Despite presenting extensive research I had meticulously collected on my symptoms, the doctors swiftly brushed aside any consideration of a possible Ankylosing Spondylitis diagnosis.” Anthony Simpson Anthony’s Story: Waging a War Within ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Savannah-3-e1770145534583.jpg) “In the beginning of my diagnosis, it shattered every kind of normalcy I had. I went half-blind and still am to this day. Being the independent woman that I am, battling this crippling disease was extremely humbling, and I had to finally accept help from others.” Savannah Wall Savannah’s Story: Finding My Inner Superwoman While Battling a Rare Disease ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Presha-2-IMG-20180510-WA0012.jpg) “Being diagnosed with an autoimmune disease at the prime of my life was definitely not something that I had factored in. I was a young woman with dreams of traveling the world and no ceiling on her ambitions.” Presha Kardile Presha’s Story: Being Okay With Not Being Okay ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/02/MONWABISI-1.jpg) “Support is essential, especially for a person who deals with invisible pain which might lead to depression and low self-esteem.” Monwabisi Mabude Monwabisi’s Story: Growing up with Vitiligo, Growing into Self-Acceptance ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2021/12/claire-AD-story-e1691005514765.png) “I am sure that my diagnoses were delayed due to the fact I am a young woman. My experiences have shown how biased the healthcare system is in how it treats men and women.” Claire Lapaz Claire’s Story: Gender Bias & the Long Road to Diagnosis ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2022/08/Rahels-AD-Story.png) “With an illness, you feel similar to Sisyphus: one day you have rolled the rock almost to the top, and the next day the boulder rolls over you and down towards the valley again.” Rahel Wildberger Rahel’s Story: MCTD, Raynaud’s, & Living with Gratitude ### Share your story Once you’ve written your autoimmune or chronic illness story, you can either keep it for yourself (which is 100% ok!) or share it with others. Add your voice to the chronic illness and autoimmune community on Instagram, [Facebook](https://www.facebook.com/AutoimmuneGAI/), [Twitter](https://twitter.com/AutoimmuneGAI), sites like [A Chronic Voice](https://www.achronicvoice.com/), [The Mighty](https://themighty.com/), [Medium](https://medium.com/), specific autoimmune disease organizations, and – of course – the Global Autoimmune Institute. If you’re sharing on social media, don’t forget the hashtags #spoonie #spoonielife #spooniesupport #chronicillness #chronicpain #invisibleillness #butyoudontlooksick #autoimmuneaware #autoimmunestories ## Submit your Autoimmune Story Δ ### Next Steps: Sync an Email Add-On To get the most out of your form, we suggest that you sync this form with an email add-on. To learn more about your email add-on options, visit the following page (https://www.gravityforms.com/the-8-best-email-plugins-for-wordpress-in-2020/). Important: Delete this tip before you publish the form. ### About You Your Name(Required) First Last Email Address(Required) Your Autoimmune Story(Required) Phone Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzechiaDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussian FederationRwandaSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTürkiyeTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Images(Required)Accepted file types: jpg, jpeg, png, gif. Please share three high-resolution photos of yourself. We would like one portrait-style photo and two that are expressive of who you are. They can portray you doing something you love, hanging out with family, or anything else that you would like to share about yourself. By submitting photographs to GAI, you consent to their use on our website as well as other platforms run by GAI. GAI will never sell your images to third parties, nor will we distribute said photographs to unassociated third parties. Please Note(Required) I accept By submitting your GAI Autoimmune Story you acknowledge that you are at least 18 years of age and that you have read and agree to the terms and conditions, including User Submission Release Agreement, which are found in the Privacy Policy. Submitting your story grants the Global Autoimmune Institute, its affiliates, and licensees permission to edit your story and to publish it online and on social media. Your personal information will not be shared or sold to third parties. You agree and affirm that the photos and content you submit to GAI do not contain AI generated material, and you release GAI from any liability relating to the publication of the material you submit to us. Submit --- ### [Autoimmune & Chronic Illness Toolkit](https://www.autoimmuneinstitute.org/autoimmune-chronic-illness-toolkit/) **Published:** February 14, 2024 **Author:** Elevation **Excerpt:** The Autoimmune & Chronic Illness Toolkit offers practical tools, guidance, and resources to help people navigate diagnosis, care, and daily life with chronic health conditions. **Content:** # Autoimmune & Chronic Illness Toolkit ## Find your hope in your health journey Whether you have a diagnosis or are still seeking answers about unexplained symptoms, dealing with chronic health issues can be an enormous challenge. It is hard to know where to start, or where to go when you feel stuck. **The** **Autoimmune & Chronic Illness Toolkit** is here to help! This guide includes journal templates, resource lists, guidance for doctor appointments, tips on communication, and many more tools to support and empower you throughout your experience. ![Autoimmune Disease and Chronic Illness Toolkit Global Autoimmune Institute](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Autoimmune-Chronic-Illness-Toolkit-Preview-Image-2-1.png) ## Get the Toolkit Δ Name(Required) First Last Email(Required) Get the Toolkit ## Explore healthcare options Finding the right doctor can be a process! Check out the various kinds of care available, prepare yourself for appointments, and learn how to practice self-advocacy. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/doctor-talking-with-patient-e1626223739708.png) ## Discover Autoimmune Myths Learn about the roles of stress, treatments, cures, and genetics in autoimmune disease. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/qa-bubbles.png) ## Connect with the community There are many avenues of support – from social media accounts to in-person and online groups to mental health practitioners. Find experts and friends who understand what it’s like to live with chronic illness. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/friends-e1626223761253.png) ## Track your health We created journal and medication tracking templates to keep tabs on your symptoms and flare-ups. You may notice patterns that can help you and your doctor in the diagnosis or treatment process. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/women-writing.png) ## Get Practical Communication Tips Check out example scenarios and language to use in challenging situations with family, friends, and doctor relationships. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/two-people-talking-e1626223781145.png) ## Understand the diagnosis process Prime yourself with an overview of commonly ordered tests and how practitioners diagnose autoimmune disease. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/woman-with-puzzle-piece.png) ## Know you’re not alone Read and listen to powerful stories, memoirs, and podcasts from the many people who live with chronic illness and autoimmune disease. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/people-e1626223803734.png) --- ### [Autoimmune Chats & Expert Talks](https://www.autoimmuneinstitute.org/autoimmune-chats-expert-talks/) **Published:** February 14, 2024 **Author:** agustin.fernandezb@elevationweb.org **Content:** ### The Global Autoimmune Institute facilitates conversations with leading experts and researchers to share insights, updates, and real-world perspectives on autoimmune disease. #### The Decision Makers In this short film, [Dr. Sam Myers](https://www.autoimmuneinstitute.org/current-research-grants-projects/) shares his work on immune cell decision-making and how GAI’s support has fueled his career and discoveries in autoimmune disease. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/04/The-Decision-Makers-Dr.-Sam-Myers-x-Global-Autoimmune-Institute.png) Play ##### videoTextBlockModalblock\_720f6dcf1c90431604f5d815562cd4e1Title × Your browser does not support the video tag. Close Popup #### Live from the Lab: The Autoimmune Framework In partnership with La Jolla Institute for Immunology ([LJI](https://www.autoimmuneinstitute.org/gai-and-la-jolla-institute-for-immunology/)), GAI funded this [*Live from the Lab*](https://www.autoimmuneinstitute.org/research_updates/live-from-the-lab-the-autoimmune-framework/) webinar to bring cutting-edge autoimmune research directly to the community. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/04/Screenshot-2025-04-24-at-4.37.41 PM.png) Play ##### videoTextBlockModalblock\_2c79c573be9b89aabd08de42df401b39Title × Your browser does not support the video tag. Close Popup #### Autoimmunity Research That’s Reshaping Lives At [**LEAD Day 2025**](https://www.autoimmuneinstitute.org/lead-day/), Dr. Georg Schett joined Dr. Sam Myers, Dr. Monica Guma, and Sandy Boek Werness for a lay-friendly panel discussion moderated by Dr. Erica Ollmann Saphire. This conversation explored the real-world implications of autoimmune research and highlighted patient perspectives. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/03/Dr.-Schetts-lay-friendly-panel-discussion-Beyond-the-Diagnosis-The-Autoimmunity-Research-Thats-Reshaping-Lives.jpg) Play ##### videoTextBlockModalblock\_66642c44af71008b7059d1bc8f56ecb6Title × Your browser does not support the video tag. Close Popup #### Outsmarting Autoimmune Disease GAI extends a virtual welcome to the Life Without Disease Event Series at the [La Jolla Institute for Immunology](https://www.autoimmuneinstitute.org/gai-and-la-jolla-institute-for-immunology/) (LJI). In this talk, [LJI Global Autoimmune Institute Assistant Professor](https://www.autoimmuneinstitute.org/current-research-grants-projects/) Sam Myers, Ph.D. explains how his lab uses mass spectrometry and proteomics to uncover how immune cells “think” and make decisions, and what goes wrong in autoimmune, inflammatory, and other diseases. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/10/GAI-Outsmarting-Autoimmune-Disease.png) Play ##### videoTextBlockModalblock\_c3ce8ddd2c5e329a298df04459e58a87Title × Your browser does not support the video tag. Close Popup #### The Importance of Clinical Trials for Autoimmunity GAI’s Executive Director, Sandy Boek Werness speaks during [Aila Health](https://www.ailahealth.com/)‘s Autoimmune Warrior Conference Check out highlights from the talk [here](https://www.autoimmuneinstitute.org/articles/the-importance-of-clinical-trials-for-autoimmunity)! ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/09/GAI-Aila.jpg) Play ##### videoTextBlockModalblock\_435a10b49aaec4d5bc7e890e02524bfcTitle × Your browser does not support the video tag. Close Popup #### Telehealth: A Silver Lining in Healthcare Dr. Benny Kerzner is a Pediatric Gastroenterologist and the Clinical Director of the Celiac Disease Clinic at Children’s National Hospital in Washington, D.C. One of the most practical applications of [Telehealth](https://www.autoimmuneinstitute.org/articles/navigating-healthcare-through-the-practical-lens-of-telehealth) is that it allows for a contact-free approach to healthcare – perfect for protecting patients and providers during the COVID-19 pandemic. But as Dr. Kerzner and many others believe, the benefits of Telehealth could go even further. Telehealth has the potential to improve access to healthcare, especially for disadvantaged patients. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/09/Screenshot-2024-09-04-at-11.34.16 AM.png) Play ##### videoTextBlockModalblock\_aa32a88444374214af60e2ce71dc8d51Title × Your browser does not support the video tag. Close Popup #### Inside Our Guts! A Look Inside the Small Intestine and Q&A with Your Favorite Docs! Go inside the Operating Room and learn about what happens during an endoscopy. What do villi look like? How do doctors know you have celiac? What do the slides look like that pathologists review? What happens to your gut as you stick to the gluten-free diet? What does the future of celiac diagnosis look like? ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/09/Inside-our-guts-webinar.jpg) Play ##### videoTextBlockModalblock\_e3daedecdc850738ad80c6fdd01f35c4Title × Your browser does not support the video tag. Close Popup #### Advocating on Capitol Hill and In Your Child’s School Every disease needs funding for research and a voice in Washington, D.C. Join Celiac Disease Foundation CEO Marilyn Geller for a session to learn how patients and families can become advocates for celiac disease in their hometowns and nationally. Then we’ll talk about advocating for your gluten-free diet needs at school. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/09/celiac-advocacy.webp) Play ##### videoTextBlockModalblock\_10aa33321a2c8efb3619cf8e112d6f58Title × Your browser does not support the video tag. Close Popup #### Creating a Cure for Celiac Disease Learn about the latest drug developments and the future of treatments for celiac disease. You’ll hear from Dr. Ciaran Kelly (Beth Israel Deaconess Medical Center), Dr. Dan Leffler (Takeda Pharmaceuticals), and Dr. Francisco Leon (Provention Bio) about multiple medications being tested as a treatment for celiac disease. Then, Dr. Jocelyn Silvester from Boston Children’s Hospital will discuss getting involved in clinical trials and how these medications may change the daily lives of celiac patients. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/09/cure-for-celiac.jpg) Play ##### videoTextBlockModalblock\_48604876a9ac9365dedf480062e4da1dTitle × Your browser does not support the video tag. Close Popup #### Contaminate This! Inside a Lab that Tests for Gluten Contamination Take a look inside a lab that tests food for gluten contamination and learn how much gluten it really takes to cross the 20ppm threshold. Luke Emerson and Thomas Grace from Bia Diagnostics in Vermont join us to demonstrate the food testing process from start to finish. This is a rare opportunity to see a real, live lab testing for gluten in food. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/09/Contaminate-this.webp) Play ##### videoTextBlockModalblock\_f96067a6dc29bf502a5dc8f8bff04cf2Title × Your browser does not support the video tag. Close Popup ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/SpacerShield.jpg) --- ### [Helpful Apps](https://www.autoimmuneinstitute.org/helpful-apps/) **Published:** February 15, 2024 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Explore our curated list of helpful apps designed to assist those with autoimmune diseases and chronic illnesses. Find tools for tracking health, managing medications, reducing stress, and connecting with support communities. **Content:** ###### This list includes a few of our favorite, simple, and practical apps to help manage many areas of life with autoimmune disease and other chronic illnesses. ## Gluten-Free Diet Digital Resource Center Safe and unsafe ingredient lists, shopping tips, recipes, nutrition education, and more. [Learn More](https://www.childrensnational.org/get-care/departments/celiac-disease-program/family-resources/gluten-free-diet-app) ## GoodRX Inexpensive prescription medications without the need for insurance. [Learn More](https://www.goodrx.com/) ## Happify Science-based mindfulness activities and games to boost resilience and reduce stress and anxiety. [Learn More](https://happify.com/) ## Healp Share experiences and connect with others who have similar medical conditions. [Learn More](https://healp.co/) ## Manage My Pain Simple pain tracker with graphs and charts to recognize patterns and figure out what makes your pain better or worse. [Learn More](https://managemypainapp.com/) ## MediSafe Medication reminder app to keep track of all medications, be alerted when it is time for a refill, and learn about drug interactions. [Learn More](https://www.medisafe.com/) ## Real Plans Meal planning tool to help navigate new eating habits or dietary protocols, including low FODMAP, AIP, paleo, dairy-free, or gluten-free. [Learn More](https://realplans.com/) ## Talkspace Therapist search tool for online counseling anytime, anywhere (accepts insurance). [Learn More](https://www.talkspace.com/) ## Aila Health Track symptoms, nutrition, digestion, mood, and more for personalized insights and support on your autoimmune journey. [Learn More](https://www.ailahealth.com/) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/SpacerShield.jpg) The views and opinions expressed in the listed apps are those of the authors. GAI does not endorse the contents of the above apps; they are simply a sample of the resources available on managing life with autoimmune disease and other chronic illnesses. --- ### [01 - Sample page](https://www.autoimmuneinstitute.org/01-sample-page/) **Published:** February 5, 2024 **Author:** agustin.fernandezb@elevationweb.org **Content:** Introduction. Maximum 50 words per paragraph. Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Vitae et leo duis ut diam. Pellentesque elit ullamcorper dignissim cras. Consequat nisl vel pretium lectus quam id leo in. Pellentesque elit ullamcorper dignissim cras. Consequat nisl vel pretium lectus quam id leo in. ## H2. Text-Only Block with CTA **Maximum 50 words per paragraph.** Lorem ipsum dolor sit amet, consectetur adipiscing elit. Pellentesque in aliquam lorem, in blandit mi. Duis non [**neque et neque vulputate aliquet**](https://www.google.com/) vitae nec libero. Donec pulvinar vulputate tempor. Praesent orci velit, viverra non pulvinar in, pretium sit amet felis. Donec cursus tortor dolor. Vestibulum viverra gravida felis, in varius. Lorem ipsum dolor sit amet, consectetur adipiscing elit. Pellentesque in aliquam lorem, in blandit mi. Duis non neque et neque vulputate aliquet vitae nec libero. Donec pulvinar vulputate tempor. Praesent orci velit, viverra non pulvinar in, pretium sit amet felis. Donec cursus tortor dolor. Vestibulum viverra gravida felis, in varius. read More ## H2. Text-Only Block. Large content Lorem ipsum dolor sit amet, consectetur adipiscing elit. Phasellus laoreet elit eu erat finibus, sit amet ultrices neque maximus. Quisque quis est eget erat vehicula auctor a at eros. Cras efficitur dolor vel rutrum finibus. Nulla pellentesque et diam non commodo. Phasellus sit amet condimentum mi. Morbi a est vel eros malesuada vestibulum. Nullam aliquam, justo nec venenatis tincidunt, tortor diam finibus quam, id bibendum ligula ante eu nunc. > “Nulla rhoncus tellus est, nec sodales nisl dictum et. Praesent eu turpis sit amet tellus imperdiet convallis. Morbi sapien sapien, aliquam sed elementum vitae, consequat non nunc. Aliquam congue consectetur leo. Morbi dapibus pharetra tempus. Maecenas at mauris pellentesque, elementum ligula non, sollicitudin est. Mauris sed risus et arcu varius sodales id eget orci. Cras venenatis imperdiet sem, ut lacinia lectus pretium ut. Morbi at neque dui. Mauris nec pellentesque erat.” Aenean ultricies neque eros, ac luctus turpis egestas eu. Vivamus varius libero sit amet dignissim vestibulum. Vivamus eget odio at erat fermentum ultrices sed nec purus. Quisque accumsan egestas volutpat. Proin ut leo ut sapien porttitor dignissim. Nulla pellentesque dui quis ante condimentum tincidunt. Sed quis vulputate nibh, eget mollis lectus. Duis metus nunc, auctor nec volutpat sit amet, interdum ut nibh. Phasellus ac eleifend urna. Quisque vulputate tempus nisl. Fusce quis mi ex. Donec in egestas augue. ## H2. Text-Only Block with CTA Lorem ipsum dolor sit amet, consectetur adipiscing elit. Phasellus laoreet elit eu erat finibus, sit amet ultrices neque maximus. Quisque quis est eget erat vehicula auctor a at eros. Cras efficitur dolor vel rutrum finibus. Highlight. Donec mattis erat vel tellus lobortis, a accumsan urna mollis. Phasellus mauris nisi, accumsan non accumsan ac, porta in magna. Curabitur varius augue sit amet sem vulputate, sagittis cursus lacus luctus. Sed viverra vulputate quam. Sed ac felis sit amet justo convallis interdum. Ut vel maximus lacus. Donec ac quam ultricies, aliquet est vitae, ultrices magna. Sed elit quam, tincidunt eu est id, blandit. Lorem ipsum dolor sit amet, consectetur adipiscing elit. Phasellus laoreet elit eu erat finibus, sit amet ultrices neque maximus. Quisque quis est eget erat vehicula auctor a at eros. Cras efficitur dolor vel rutrum finibus. ### H3. Text-Only Block with Simple CTA Highlight/ Strong. Maximum 50 words per paragraph. Lorem ipsum dolor sit amet, consectetur adipiscing elit. Pellentesque in aliquam lorem, in blandit mi. Duis non neque et neque vulputate aliquet vitae nec libero. Donec pulvinar vulputate tempor. Praesent orci velit, viverra non pulvinar in, pretium sit amet felis. Donec cursus tortor dolor. Vestibulum viverra gravida felis, in varius. Lorem ipsum dolor sit amet, consectetur adipiscing elit. Pellentesque in aliquam lorem, in blandit mi. Duis non neque et neque vulputate aliquet vitae nec libero. Donec pulvinar vulputate tempor. Praesent orci velit, viverra non pulvinar in, pretium sit amet felis. Donec cursus tortor dolor. Vestibulum viverra gravida felis, in varius. secondary black button ##### H5. List with links Maximum 50 words per paragraph. Lorem ipsum dolor sit amet, consectetur adipiscing elit. Pellentesque in aliquam lorem, in blandit mi. Duis non neque et neque vulputate aliquet vitae nec libero. Donec pulvinar vulputate tempor. Praesent orci velit, viverra non pulvinar in, pretium sit amet felis. Donec cursus tortor dolor. Vestibulum viverra gravida felis, in varius. - Lorem ipsum dolor sit amet, **consectetur adipiscing elit**. Pellentesque in aliquam lorem, in blandit mi. Duis non neque et neque vulputate aliquet vitae nec libero. Donec pulvinar vulputate tempor. Praesent orci velit, viverra non pulvinar in, pretium sit amet felis. Donec cursus tortor dolor. Vestibulum viverra gravida felis, in varius. - Lorem ipsum dolor sit amet, consectetur adipiscing elit. **Pellentesque in aliquam lorem, in blandit mi**. Duis non neque et neque. - Lorem ipsum dolor sit amet. secondary black button ##### H5. List with links Maximum 50 words per paragraph. Lorem ipsum dolor sit amet, consectetur adipiscing elit. Pellentesque in aliquam lorem, in blandit mi. Duis non neque et neque vulputate aliquet vitae nec libero. Donec pulvinar vulputate tempor. Praesent orci velit, viverra non pulvinar in, pretium sit amet felis. Donec cursus tortor dolor. Vestibulum viverra gravida felis, in varius. - - - - [Lorem ipsum dolor sit amet.](https://www.google.com/) - [Lorem ipsum dolor sit amet, consectetur adipiscing elit. **Pellentesque in aliquam lorem, in blandit mi**. Duis non neque et neque.](https://www.google.com/) - [Lorem ipsum dolor sit amet.](https://www.google.com/) ###### H6. Lists with Titles Maximum 50 words per paragraph. Lorem ipsum dolor sit amet, consectetur adipiscing elit. Pellentesque in aliquam lorem, in blandit mi. Duis non neque et neque vulputate aliquet vitae nec libero. Donec pulvinar vulputate tempor. Praesent orci velit, viverra non pulvinar in, pretium sit amet felis. Donec cursus tortor dolor. Vestibulum viverra gravida felis, in varius. - Lorem ipsum Lorem ipsum dolor sit amet, consectetur adipiscing elit. Pellentesque in aliquam lorem, in blandit mi. Duis non neque et neque vulputate aliquet vitae nec libero. Donec pulvinar vulputate tempor. Praesent orci velit, viverra non pulvinar in, pretium sit amet felis. Donec cursus tortor dolor. Vestibulum viverra gravida felis, in varius. - Lorem ipsum Lorem ipsum dolor sit amet, consectetur adipiscing elit. Pellentesque in aliquam lorem, in blandit mi. Duis non neque et neque. - Lorem ipsum Lorem ipsum dolor sit amet, consectetur adipiscing elit. Pellentesque in aliquam lorem, in blandit mi. Duis non neque et neque vulputate aliquet vitae nec libero. Donec pulvinar vulputate tempor. Praesent orci velit, viverra non pulvinar in, pretium sit amet felis. Donec cursus tortor dolor. Vestibulum viverra gravida felis, in varius. ##### H5. List with links Maximum 50 words per paragraph. Lorem ipsum dolor sit amet, consectetur adipiscing elit. Pellentesque in aliquam lorem, in blandit mi. Duis non neque et neque vulputate aliquet vitae nec libero. Donec pulvinar vulputate tempor. Praesent orci velit, viverra non pulvinar in, pretium sit amet felis. Donec cursus tortor dolor. Vestibulum viverra gravida felis, in varius. - Lorem ipsum dolor sit amet - Donec cursus tortor [dolor viverra gravida felis, in varius](https://elevationframework.mystagingwebsite.com/video-block/) - [Pellentesque in aliquam lorem](https://elevationframework.mystagingwebsite.com/testimonials-block/) - Lorem ipsum dolor sit amet, consectetur **adipiscing elit. Pellentesque** in aliquam lorem, in blandit mi. Duis non neque et neque - vulputate aliquet vitae nec libero. Donec pulvinar vulputate tempor. - **Praesent orci velit**, viverra non pulvinar in, pretium sit amet felis. *Donec cursus tortor dolor*. - Vestibulum viverra gravida felis, in varius. - aliquam lorem, in blandit mi. Duis non neque et ###### H6. Some Example of Title Donec mattis erat vel tellus lobortis, a accumsan urna mollis. Phasellus mauris nisi, accumsan non accumsan ac, porta in magna. Curabitur varius augue sit amet sem vulputate, sagittis cursus lacus luctus. Sed viverra vulputate quam. Sed ac felis sit amet justo convallis interdum. Ut vel maximus lacus. Donec ac quam ultricies, aliquet est vitae, ultrices magna. Sed elit quam, tincidunt eu est id, blandit. - Lorem ipsum dolor sit amet, **consectetur adipiscing elit.** Pellentesque in aliquam lorem, in blandit mi. Duis non neque et neque vulputate aliquet vitae nec libero. Donec pulvinar vulputate tempor. Praesent orci velit, viverra non pulvinar in, pretium sit amet felis. **Donec cursus tortor dolor.** - Lorem ipsum dolor sit amet, consectetur adipiscing elit. Pellentesque in aliquam lorem, in blandit mi. Duis non neque et neque. **Donec mattis erat vel tellus lobortis, a accumsan urna mollis. Phasellus mauris nisi, accumsan non accumsan ac, porta in magna. Curabitur varius augue sit amet sem vulputate, sagittis cursus lacus luctus. Sed viverra vulputate quam. Sed ac felis sit amet justo convallis interdum. Ut vel maximus lacus. Donec ac quam ultricies, aliquet est vitae, ultrices magna. Sed elit quam, tincidunt eu est id.** Donec mattis erat vel tellus lobortis, a accumsan urna mollis. Phasellus mauris nisi, accumsan non accumsan ac, porta in magna. Curabitur varius augue sit amet sem vulputate, sagittis cursus lacus luctus. Sed viverra vulputate quam. Sed ac felis sit amet justo convallis interdum. Ut vel maximus lacus. Donec ac quam ultricies, aliquet est vitae, ultrices magna. Sed elit quam, tincidunt eu est id. Primary White Button ##### H4. Some Example of Title, Text and Landscape Photo in Columns Maximum 50 words per paragraph. Lorem ipsum dolor sit amet, consectetur adipiscing elit. Pellentesque in aliquam lorem, in blandit mi. Duis non neque et neque vulputate aliquet vitae nec libero. Donec pulvinar vulputate tempor. Praesent orci velit, viverra non pulvinar in, pretium sit amet felis. Donec cursus tortor dolor. Vestibulum viverra gravida felis, in varius. [Donec cursus tortor dolor.](https://www.google.com/) Vestibulum viverra gravida felis, in varius. Lorem ipsum dolor sit amet, consectetur adipiscing elit. Pellentesque in aliquam lorem, in blandit mi. Duis non neque et neque vulputate aliquet vitae nec libero. [Donec pulvinar vulputate tempor.](https://www.google.com/) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/03/Mask-group.jpg) ##### H5. Some Example of Title, Text with Lists and Vertical Photo in Columns - Lorem ipsum dolor sit amet, consectetur adipiscing elit. Pellentesque in aliquam lorem, in blandit mi. Duis non neque et neque vulputate aliquet vitae nec libero. Donec pulvinar vulputate tempor. Praesent orci velit, viverra non pulvinar in, pretium sit amet felis. Donec cursus tortor dolor. ##### H5. Some Example of Title - Lorem ipsum dolor sit amet, consectetur adipiscing elit. Pellentesque in aliquam lorem, in blandit mi. Duis non neque et neque. - Lorem ipsum dolor sit amet, consectetur adipiscing elit. Pellentesque in aliquam lorem, in blandit mi. [Duis non neque et neque vulputate aliquet vitae nec libero](https://www.google.com/). Donec pulvinar vulputate tempor. Praesent orci velit, viverra non pulvinar in, pretium sit amet felis. Donec cursus tortor dolor. **Vestibulum viverra gravida felis, in varius**. - Lorem ipsum dolor sit amet, **consectetur adipiscing elit. Pellentesque in** aliquam lorem, in blandit mi. Duis non neque et neque. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/03/Mask-group.png) ## H2. Title lorem ipsum Description. Lorem ipsum dolor sit amet, [consectetur adipisc](http://gai.local/wp-admin)ing elit. Sed augue mattis massa ultrices. Scelerisque diam eu egestas erat gravida massa at nulla odio. Volutpat aliquam mattis aliquet aenean dictum facilisi porttitor pretium. Id velit lectus tortor, pharetra, maecenas turpis dignissim vel tincidunt. Vulputate amet eu curabitur lectus pellentesque. Secondary Black Button [ ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/pexels-michelangelo-buonarroti-8728385-1.png) H5. Box 1 Title Maximum 15 words per paragraph. Lorem ipsum dolor sit amet, consectetur adipi scing elit, sed do eiusmod tempor incidid… Secondary White Button Read more about H5. Box 1 Title ](#) [ ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/pexels-pixabay-2156-3.png) H5. Box 1 Title Maximum 15 words per paragraph. Lorem ipsum dolor sit amet, consectetur adipi scing elit, sed do eiusmod tempor incidid… Secondary White Button Read more about H5. Box 1 Title ](#) [ ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/pexels-polina-tankilevitch-3735726-2.png) H5. Box 1 Title Maximum 15 words per paragraph. Lorem ipsum dolor sit amet, consectetur adipi scing elit, sed do eiusmod tempor incidid… Secondary White Button Read more about H5. Box 1 Title ](#) ## H2. Title lorem ipsum Description. Lorem ipsum dolor sit amet, consectetur adipiscing elit. Sed augue mattis massa ultrices. Scelerisque diam eu egestas erat gravida massa at nulla odio. Volutpat aliquam mattis aliquet aenean dictum facilisi porttitor pretium. Id velit lectus tortor, pharetra, maecenas turpis dignissim vel tincidunt. Vulputate amet eu curabitur lectus pellentesque. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Frame-59647.svg) H6. Title Lorem Ipsum Phasellus mauris nisi, accumsan non accumsan ac, porta in magna. Curabitur varius augue sit porta in. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Frame-59648.svg) H6. Title Lorem Ipsum Orci varius natoque penatibus et magnis dis parturient montes, nascetur ridiculus. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Frame-59649.svg) H6. Title Lorem Ipsum Lorem ipsum dolor sit amet, consectetur adipiscing elit. Sed augue mattis massa ultrices. ### H3. Title lorem ipsum Description. Lorem ipsum dolor sit amet, consectetur adipiscing elit. Sed augue mattis massa ultrices. Scelerisque diam eu egestas erat gravida massa at nulla odio. Volutpat aliquam mattis aliquet aenean dictum facilisi porttitor pretium. Id velit lectus tortor, pharetra, maecenas turpis dignissim vel tincidunt. Vulputate amet eu curabitur lectus pellentesque. [ ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/03-icon.svg) Title lorem ipsum Donec mattis erat vel tellus lobortis, a accumsan urna mollis. Phasellus mauris nisi, accumsan non accumsan ac, porta in magna. Curabitur varius augue sit amet sem vulputate, sagittis cursus lacus luctus. Sed viverra vulputate quam. Sed ac felis sit amet justo convallis interdum. Ut vel maximus lacus. Donec ac quam ultricies, aliquet est vitae, ultrices magna. Sed elit quam, tincidunt eu est id, blandit venenatis mi. Secondary Black Button Read more about Title lorem ipsum ](#) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/02-icon.svg) Title lorem ipsum Donec mattis erat vel tellus lobortis, a accumsan urna mollis. Phasellus mauris nisi, accumsan non accumsan ac, porta in magna. Curabitur varius augue sit amet sem vulputate, sagittis cursus lacus luctus. Sed viverra vulputate quam. Sed ac felis sit amet justo convallis interdum. Ut vel maximus lacus. Donec ac quam ultricies, aliquet est vitae, ultrices magna. Sed elit quam, tincidunt eu est id, blandit venenatis mi. [ ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/04-icon.svg) Title lorem ipsum Donec mattis erat vel tellus lobortis, a accumsan urna mollis. Phasellus mauris nisi, accumsan non accumsan ac, porta in magna. Curabitur varius augue sit amet sem vulputate, sagittis cursus lacus luctus. Sed viverra vulputate quam. Sed ac felis sit amet justo convallis interdum. Ut vel maximus lacus. Donec ac quam ultricies, aliquet est vitae, ultrices magna. Sed elit quam, tincidunt eu est id, blandit venenatis mi. Secondary Black Button Read more about Title lorem ipsum ](#) [ ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/06-icon-1.svg) Title lorem ipsum Donec mattis erat vel tellus lobortis, a accumsan urna mollis. Phasellus mauris nisi, accumsan non accumsan ac, porta in magna. Curabitur varius augue sit amet sem vulputate, sagittis cursus lacus luctus. Sed viverra vulputate quam. Sed ac felis sit amet justo convallis interdum. Ut vel maximus lacus. Donec ac quam ultricies, aliquet est vitae, ultrices magna. Sed elit quam, tincidunt eu est id, blandit venenatis mi. Secondary Black Button Read more about Title lorem ipsum ](#) [ ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/05-icon.svg) Title lorem ipsum Donec mattis erat vel tellus lobortis, a accumsan urna mollis. Phasellus mauris nisi, accumsan non accumsan ac, porta in magna. Curabitur varius augue sit amet sem vulputate, sagittis cursus lacus luctus. Sed viverra vulputate quam. Sed ac felis sit amet justo convallis interdum. Ut vel maximus lacus. Donec ac quam ultricies, aliquet est vitae, ultrices magna. Sed elit quam, tincidunt eu est id, blandit venenatis mi. Secondary Black Button Read more about Title lorem ipsum ](#) [ ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/06-icon.svg) Title lorem ipsum Donec mattis erat vel tellus lobortis, a accumsan urna mollis. Phasellus mauris nisi, accumsan non accumsan ac, porta in magna. Curabitur varius augue sit amet sem vulputate, sagittis cursus lacus luctus. Sed viverra vulputate quam. Sed ac felis sit amet justo convallis interdum. Ut vel maximus lacus. Donec ac quam ultricies, aliquet est vitae, ultrices magna. Sed elit quam, tincidunt eu est id, blandit venenatis mi. Secondary Black Button Read more about Title lorem ipsum ](#) ### H3. Title lorem ipsum Subheading. Lorem ipsum dolor sit amet, consectetur adipiscing elit. Pellentesque in aliquam lorem, in blandit mi. Duis non neque et neque vulputate aliquet vitae nec libero. Donec pulvinar vulputate tempor. Praesent orci velit, viverra non pulvinar in, pretium sit amet felis. Donec cursus tortor dolor. donate ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/IMG_7022-1.jpg) #### H4. Title lorem ipsum. Pellentesque elit ullamcorper dignissim cras. Consequat nisl vel pretium lectus quam id leo in vitae. Rhoncus mattis rhoncus urna. Secondary White Button ## H2. Title lorem ipsum ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/03/carousel-img1.jpg) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/03/carousel-img2.jpg) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/03/carousel-img3.jpg) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/pexels-pixabay-2156-3-1.png) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/facybox-img1_hover-1.png) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/facybox-img1_hover.png) ### H3. Title lorem ipsum Description. Lorem ipsum dolor sit amet, consectetur adipiscing elit. Sed augue mattis massa ultrices. Scelerisque diam eu egestas erat gravida massa at nulla odio. Volutpat aliquam mattis aliquet aenean dictum facilisi porttitor pretium. Id velit lectus tortor, pharetra, maecenas turpis dignissim vel tincidunt. Vulputate amet eu curabitur lectus pellentesque. This is an important cta ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Important-icon-01.svg) 0 + Orci varius natoque penatibus et magnis dis parturient montes, nascetur ridiculus mus. Phasellus cursus. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Important-icon-02.svg) 0 + Orci varius natoque penatibus et magnis dis parturient montes, nascetur ridiculus mus. Phasellus cursus. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Important-icon-03.svg) 0 % Orci varius natoque penatibus et magnis dis parturient montes, nascetur ridiculus mus. Phasellus cursus. ## H3. Title lorem ipsum Maximum 50 words per paragraph. Lorem ipsum dolor sit amet, consectetur adipiscing elit. Pellentesque in aliquam lorem, in blandit mi. Duis non neque et neque vulputate aliquet vitae nec libero. Donec pulvinar vulputate tempor. Praesent orci velit, viverra non pulvinar in, pretium sit amet felis. Donec cursus tortor dolor. Vestibulum viverra gravida felis, in varius. Secondary Black Button ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/pexels-thisisengineering-3861457-1.jpg) Play ##### videoTextBlockModalblock\_f69c0afe4df491469231cf346ba59b96Title × Your browser does not support the video tag. Close Popup ## H3. Title lorem ipsum Lorem ipsum dolor sit amet, consectetur adipiscing elit. Sed augue mattis massa ultrices. Scelerisque diam eu egestas erat gravida massa at nulla odio. Volutpat aliquam mattis aliquet aenean dictum facilisi porttitor pretium. Id velit lectus tortor, pharetra, maecenas turpis dignissim vel tincidunt. ## H5. Lorem ipsum dolor sit amet, consectetur adipiscing elit? Lorem ipsum dolor sit amet, consectetur adipiscing elit. Pellentesque mauris, nulla aliquam lacus lectus habitant. Eu ullamcorper sed fames libero morbi velit euismod. Sem cursus commodo mollis aliquam aliquam varius. Amet ut mi nunc ut tellus bibendum morbi curabitur adipiscing. Nisl sed risus sit odio. Bibendum massa habitasse nulla fringilla sociis nec cursus et urna. Urna, vitae aliquet fringilla placerat. Porta duis turpis dignissim. Lorem ipsum dolor sit amet, consectetur adipiscing elit. Pellentesque mauris, nulla aliquam lacus lectus habitant. Eu ullamcorper sed fames libero morbi velit euismod. Sem cursus commodo mollis aliquam aliquam varius. Amet ut mi nunc ut tellus bibendum morbi curabitur adipiscing. Nisl sed risus sit odio. Bibendum massa habitasse nulla fringilla sociis nec cursus et urna. Urna, vitae aliquet fringilla placerat. Porta duis turpis dignissim. Secondary Black Button ## H5. Lorem ipsum dolor sit amet, consectetur adipiscing elit? Lorem ipsum dolor sit amet, consectetur adipiscing elit. Pellentesque mauris, nulla aliquam lacus lectus habitant. Eu ullamcorper sed fames libero morbi velit euismod. Sem cursus commodo mollis aliquam aliquam varius. Amet ut mi nunc ut tellus bibendum morbi curabitur adipiscing. Nisl sed risus sit odio. Bibendum massa habitasse nulla fringilla sociis nec cursus et urna. Urna, vitae aliquet fringilla placerat. Porta duis turpis dignissim. Lorem ipsum dolor sit amet, consectetur adipiscing elit. Pellentesque mauris, nulla aliquam lacus lectus habitant. Eu ullamcorper sed fames libero morbi velit euismod. Sem cursus commodo mollis aliquam aliquam varius. Amet ut mi nunc ut tellus bibendum morbi curabitur adipiscing. Nisl sed risus sit odio. Bibendum massa habitasse nulla fringilla sociis nec cursus et urna. Urna, vitae aliquet fringilla placerat. Porta duis turpis dignissim. Secondary Black Button ## H5. Lorem ipsum dolor sit amet, consectetur adipiscing elit? Lorem ipsum dolor sit amet, consectetur adipiscing elit. Pellentesque mauris, nulla aliquam lacus lectus habitant. Eu ullamcorper sed fames libero morbi velit euismod. Sem cursus commodo mollis aliquam aliquam varius. Amet ut mi nunc ut tellus bibendum morbi curabitur adipiscing. Nisl sed risus sit odio. Bibendum massa habitasse nulla fringilla sociis nec cursus et urna. Urna, vitae aliquet fringilla placerat. Porta duis turpis dignissim. Lorem ipsum dolor sit amet, consectetur adipiscing elit. Pellentesque mauris, nulla aliquam lacus lectus habitant. Eu ullamcorper sed fames libero morbi velit euismod. Sem cursus commodo mollis aliquam aliquam varius. Amet ut mi nunc ut tellus bibendum morbi curabitur adipiscing. Nisl sed risus sit odio. Bibendum massa habitasse nulla fringilla sociis nec cursus et urna. Urna, vitae aliquet fringilla placerat. Porta duis turpis dignissim. Secondary Black Button ## H5. Lorem ipsum dolor sit amet, consectetur adipiscing elit? Lorem ipsum dolor sit amet, consectetur adipiscing elit. Pellentesque mauris, nulla aliquam lacus lectus habitant. Eu ullamcorper sed fames libero morbi velit euismod. Sem cursus commodo mollis aliquam aliquam varius. Amet ut mi nunc ut tellus bibendum morbi curabitur adipiscing. Nisl sed risus sit odio. Bibendum massa habitasse nulla fringilla sociis nec cursus et urna. Urna, vitae aliquet fringilla placerat. Porta duis turpis dignissim. Lorem ipsum dolor sit amet, consectetur adipiscing elit. Pellentesque mauris, nulla aliquam lacus lectus habitant. Eu ullamcorper sed fames libero morbi velit euismod. Sem cursus commodo mollis aliquam aliquam varius. Amet ut mi nunc ut tellus bibendum morbi curabitur adipiscing. Nisl sed risus sit odio. Bibendum massa habitasse nulla fringilla sociis nec cursus et urna. Urna, vitae aliquet fringilla placerat. Porta duis turpis dignissim. Secondary Black Button ### H3. Title lorem ipsum Description. Lorem ipsum dolor sit amet, consectetur adipiscing elit. Sed augue mattis massa ultrices. Scelerisque diam eu egestas erat gravida massa at nulla odio. Volutpat aliquam mattis aliquet aenean dictum facilisi porttitor pretium. Id velit lectus tortor, pharetra. 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Title lorem ipsum --- ### [Long COVID: What People with Autoimmune Disease and Chronic Illness Need to Know](https://www.autoimmuneinstitute.org/long-covid-faq/) **Published:** February 15, 2024 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Explore our comprehensive FAQs on Long COVID, including symptoms, treatments, and management strategies. Get the latest information and support for those affected by Long COVID. **Content:** ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/03/New-Website-Banners-articles-1-1024x576.png) **Updated March 26, 2025:** This page was refreshed to reflect the most current Long COVID research and policy developments, including the expected closure of the federal Office of Long COVID Research and Practice, new clinical trial updates from the NIH’s RECOVER Initiative, and growing evidence linking Long COVID to immune dysfunction, viral persistence, and overlapping infection-associated chronic conditions like ME/CFS. While effective treatments remain elusive, major international trials are underway. We remain committed to helping patients understand this evolving condition and advocating for continued investment in Long COVID science. #### **What is Long COVID and why should people with autoimmune or chronic illness be concerned?** Long COVID, or post-acute sequelae of SARS-CoV-2 infection (PASC), is a complex condition where symptoms persist or emerge after a COVID-19 infection. People with autoimmune disease, chronic illness, or who are immunocompromised may face unique risks from COVID-19 itself and may experience more severe or prolonged symptoms if they develop Long COVID. --- #### **Are people with autoimmune diseases or weakened immune systems at higher risk for Long COVID?** Emerging research suggests that individuals with autoimmune disease or who are immunocompromised may have distinct vulnerabilities. Factors such as immune system dysregulation, severity of initial infection, and lower vaccine response may contribute to a higher risk of Long COVID in these populations, though the exact degree of risk is still under investigation. --- #### **Can Long COVID trigger autoimmune diseases or worsen existing ones?** Yes. Long COVID may unmask, trigger, or worsen autoimmune conditions. Some individuals develop new autoimmune diseases following COVID-19, while others experience flare-ups of preexisting autoimmune symptoms. This may be due to lingering immune activation, viral persistence, or reactivation of latent viruses. --- #### **What are the most common Long COVID symptoms?** While Long COVID symptoms vary widely, individuals with underlying conditions often report: - Increased fatigue and post-exertional malaise - Brain fog and memory issues - Muscle and joint pain - Shortness of breath and chest discomfort - Autonomic symptoms such as dizziness, palpitations, or POTS-like episodes - Gastrointestinal problems These symptoms may overlap with existing illness, making it difficult to distinguish Long COVID flares from baseline disease activity. --- #### **Is Long COVID considered an autoimmune disease?** Long COVID is not formally classified as an autoimmune disease. However, growing evidence suggests it may involve autoimmune-like processes in some patients, including the presence of autoantibodies and prolonged immune activation. It may also trigger autoimmune disease in people with genetic or environmental susceptibility. --- #### **Is there a diagnostic test for Long COVID?** The short answer is that, while promising research is underway, a definitive diagnostic test for Long COVID has not been established as of March 2025. Ongoing research is exploring potential biomarkers that could aid in diagnosis. For instance, a study reported by Medscape in November 2023 identified certain immune system proteins that, when elevated, might predict the presence of Long COVID with approximately 78.5% accuracy. Despite these advancements, such tests are still under investigation and are not yet part of standard diagnostic protocols. In clinical practice, healthcare providers may use various tests to assess and manage symptoms associated with Long COVID, such as blood tests, imaging studies, and pulmonary function tests. These are primarily employed to rule out other conditions and to guide treatment rather than to confirm a Long COVID diagnosis. #### **How is Long COVID diagnosed in someone with an existing chronic illness?** Diagnosis is clinical and based on a history of COVID-19 infection followed by new or worsening symptoms not explained by another condition. For individuals already living with autoimmune or chronic diseases, diagnosis may require tracking symptom changes and excluding other causes. --- #### **What treatments are available—and are they safe for people with immune system concerns?** There is no FDA-approved treatment specifically for Long COVID, but many people benefit from symptom-based care. Treatment strategies may include: - Energy conservation and pacing strategies (especially for fatigue and post-exertional malaise) - Physical or pulmonary rehabilitation - Cognitive rehabilitation for brain fog - Medications for specific symptoms (e.g., sleep, pain, heart rate) - Nutritional support and mental health care People who are immunocompromised or on immunosuppressive medications should discuss the risks and benefits of any new treatments with their healthcare providers. --- #### **What research is being done to better understand Long COVID in immunocompromised and chronically ill populations?** The NIH’s [RECOVER Initiative](https://trials.recovercovid.org/) is the largest U.S. research effort on Long COVID. The RECOVER clinical trials team is partnering with patient and community representatives, including through NIH CEAL, as well as the RECOVER National Community Engagement Group to reach communities of people who have historically been underrepresented in research. In addition, a track record for enrolling diverse participants is a key criterion for trial site selection. Each trial is designed to test multiple treatments at once, improving the speed at which potentially helpful interventions can be identified and advanced. ##### RECOVER includes clinical trials focused on symptoms common among people with chronic illness, such as: ###### **RECOVER-VITAL** Evaluates therapies targeting viral persistence, one potential root cause of Long COVID. Paxlovid (nirmatrelvir/ritonavir) is among the treatments under investigation. ###### **RECOVER-NEURO** Tests interventions for brain fog and neurocognitive dysfunction, a common and debilitating symptom. ###### **RECOVER-AUTONOMIC** Focuses on treatments for autonomic dysfunction, including conditions like postural orthostatic tachycardia syndrome (POTS). ###### **RECOVER-SLEEP** Addresses long-term sleep disturbances reported by many people with Long COVID. ###### **RECOVER-ENERGIZE** Investigates therapies for fatigue, exercise intolerance, and post-exertional malaise—symptoms that also overlap with ME/CFS. #### Is the NIH’s RECOVER Initiative at risk of being shut down? ​As of March 26, 2025, the closure of the federal Office of Long COVID Research and Practice does not appear to directly impact the National Institutes of Health’s (NIH) RECOVER Initiative. The RECOVER Initiative operates under the NIH’s purview and has received substantial funding allocations, including an additional $515 million in February 2024 and $147 million in reallocated funds in December 2024, to support its ongoing research efforts. However, it’s important to note that the broader reorganization within the Department of Health and Human Services (HHS) has led to significant funding withdrawals from various COVID-19-related programs. For instance, the Trump administration announced the rescinding of $11.4 billion in COVID-19-related funds from state and local health departments and other health organizations.  While the RECOVER Initiative has not been specifically mentioned in these funding retractions, the overall shift in federal priorities may influence future support for Long COVID research.​ Therefore, while the RECOVER Initiative remains operational and funded at this time, the evolving landscape of federal health priorities suggests that continued vigilance is necessary to ensure sustained support for Long COVID research initiatives. --- #### **What is happening with the federal Office of Long COVID Research and Practice?** The Office of Long COVID Research and Practice, launched by the U.S. Department of Health and Human Services in August 2023, was designed to coordinate a whole-of-government response to the long-term effects of COVID-19. However, as of early 2025, internal communications and independent reporting suggest the office is being phased out. While no formal announcement has been made, the office is expected to shut down as part of a broader reorganization, raising concerns about the loss of centralized leadership, research momentum, and federal commitment to Long COVID care and coordination. --- #### **Can vaccines help protect against Long COVID for immunocompromised or chronically ill individuals?** COVID-19 vaccines are associated with a reduced risk of developing Long COVID in many studies, but the degree of protection varies by individual and variant. For people who are immunocompromised or living with autoimmune disease, the immune response to vaccination may be less robust. Vaccination remains an important tool, especially when combined with early treatment and continued risk mitigation. --- #### **How can people with autoimmune or chronic illness tell the difference between Long COVID and a flare?** It can be challenging. People living with chronic illness may already experience symptoms such as fatigue, brain fog, or joint pain. Key indicators of Long COVID include the emergence of new symptoms, a notable shift in baseline function, or increased symptom severity following COVID-19. Keeping a symptom journal and working with healthcare providers can help clarify what’s new. --- #### **Where can I find support and information specific to Long COVID and chronic illness?** Many hospitals now offer multidisciplinary post-COVID care clinics. National and local support groups, condition-specific nonprofits, and online patient communities may provide education, advocacy, and peer support. Look for providers familiar with complex chronic illness and post-viral recovery. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/SpacerShield.jpg) *This content is accurate to the best of our knowledge, is for educational and informational purposes only, and is not intended as a substitute for advice from a qualified medical professional. Information shared on this page is not intended to serve as diagnosis, treatment, or prevention of disease. Seek professional medical advice regarding your medical condition or any symptoms you may be experiencing, and for best practices pertaining to your medical plan.* #### SOURCES 1. 1. Hhs. (n.d.). [**What is long covid**](https://www.covid.gov/longcovid/definitions). *COVID.gov.* 2. World Health Organization. (n.d.). [**Post COVID-19 condition**](https://www.who.int/teams/health-care-readiness/post-COVID-19-condition). *World Health Organization*. 3. Centers for Disease Control and Prevention. (2022, December 16). [**Post-covid conditions: Information for healthcare providers**](https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-care/post-covid-conditions.html#management). *Centers for Disease Control and Prevention.* 4. Snowden, J. (2023). [**What Long Covid looks like in children and young adults**](https://covid19.nih.gov/news-and-stories/what-long-covid-looks-like-children-young-adults). *National Institutes of Health.* 5. Thaweethai, T., et al (2023). [**Development of a definition of postacute sequelae of SARS-COV-2 infection**](https://doi.org/10.1001/jama.2023.8823). *JAMA*, 329(22), 1934. 6. Vojdani, A., Vojdani, E., Saidara, E., &; Maes, M. (2023). [**Persistent SARS-COV-2 infection, EBV, HHV-6 and other factors may contribute to inflammation and autoimmunity in long COVID**](https://doi.org/10.3390/v15020400). *Viruses*, 15(2), 400. 7. Kruger, A., et al. (2022). [**Proteomics of fibrin amyloid microclots in long COVID/post-acute sequelae of COVID-19 (PASC) shows many entrapped pro-inflammatory molecules that may also contribute to a failed fibrinolytic system**](https://doi.org/10.1186/s12933-022-01623-4). *Cardiovascular Diabetology*, 21(1). 8. Pretorius, E., et al. (2022). [**Prevalence of symptoms, comorbidities, fibrin amyloid microclots and platelet pathology in individuals with long COVID/post-acute sequelae of COVID-19 (PASC)**](https://doi.org/10.1186/s12933-022-01579-5). *Cardiovascular Diabetology*, 21(1). 9. Chen, T.-H., Chang, C.-J., &; Hung, P.-H. (2023). [**Possible pathogenesis and prevention of long COVID: SARS-COV-2-induced mitochondrial disorder**](https://doi.org/10.3390/ijms24098034). *International Journal of Molecular Sciences*, 24(9), 8034. 10. Rombauts, A., et . (2023). [**Impact of SARS-CoV-2 RNAemia and other risk factors on long-COVID: A prospective observational multicentre cohort study**](https://pubmed.ncbi.nlm.nih.gov/36403699/). *Journal of Infection*, 86(2), 154–225. 11. Tene, L., et al. (2023). [**Risk factors, health outcomes, healthcare services utilization, and direct medical costs of patients with long COVID**](https://pubmed.ncbi.nlm.nih.gov/36529373/). *International Journal of Infectious Diseases*, 128, 3–10. 12. Zheng, Y.-B., et al. (2023). [**Prevalence and risk factor for long COVID in children and adolescents: A meta-analysis and systematic review**](https://pubmed.ncbi.nlm.nih.gov/36931142/). *Journal of Infection and Public Health*, 16(5), 660–672. 13. Khullar, D., et al. (2023). [**Racial/Ethnic Disparities in Post-acute Sequelae of SARS-CoV-2 Infection in New York: an EHR-Based Cohort Study from the RECOVER Program**](https://doi.org/10.1007/s11606-022-07997-1). *Journal of general internal medicine*, 38(5), 1127–1136. 14. Guzman-Esquivel, J., et al. (2023). [**Clinical Characteristics in the Acute Phase of COVID-19 That Predict Long COVID: Tachycardia, Myalgias, Severity, and Use of Antibiotics as Main Risk Factors, While Education and Blood Group B Are Protective**](https://pubmed.ncbi.nlm.nih.gov/36673565/). *HEALTHCARE*, 11(2), 197. 15. Ceban, F., et al. (2023). [**COVID-19 vaccination for the prevention and treatment of long COVID: A systematic review and meta-analysis**](https://pubmed.ncbi.nlm.nih.gov/36990297/). *Brain Behavior and Immunity*, 111, 211–229. 16. Boglione, L., et al. (2022). [**Risk factors and incidence of long-COVID syndrome in hospitalized patients: does remdesivir have a protective effect?**](https://doi.org/10.1093/qjmed/hcab297) *QJM : monthly journal of the Association of Physicians*, 114(12), 865–871. 17. *U.S. Department of Veterans Affairs*. (2022, August 1). [**Whole Health System Approach to Long COVID**](https://www.publichealth.va.gov/n-coronavirus/docs/Whole-Health-System-Approach-to-Long-COVID_080122_FINAL.pdf). 18. Blitshteyn, S., et al. (2022). [**Multi-disciplinary collaborative consensus guidance statement on the assessment and treatment of autonomic dysfunction in patients with post-acute sequelae of SARS-CoV-2 infection (PASC)**](https://onlinelibrary.wiley.com/doi/10.1002/pmrj.12894). *PM&R*, *14*(10), 1270–1291. 19. Herrera, J. E., et al. (2021). [**Multidisciplinary collaborative consensus guidance statement on the assessment and treatment of fatigue in postacute sequelae of SARS‐CoV‐2 infection (PASC) patients**](https://doi.org/10.1002/pmrj.12684). *PM&R: Journal of Injury, Function & Rehabilitation*, 13(9), 1027–1043. 20. Maley, J. H., et al. (2022). [**Multi‐disciplinary collaborative consensus guidance statement on the assessment and treatment of breathing discomfort and respiratory sequelae in patients with post‐acute sequelae of SARS‐CoV‐2 infection (PASC)**](https://onlinelibrary.wiley.com/doi/10.1002/pmrj.12744). *PM&R*, 14(1), 77–95. 21. Fine, J. S., et al. (2022). [**Multi‐disciplinary collaborative consensus guidance statement on the assessment and treatment of cognitive symptoms in patients with post‐acute sequelae of SARS‐CoV‐2 infection (PASC)**](https://onlinelibrary.wiley.com/doi/10.1002/pmrj.12745). *PM&R*, 14(1), 96–111. 22. *Substance Abuse and Mental Health Service Administration*. (2023, June). [**Identification and Management of Mental Health Symptoms and Conditions Associated with Long COVID**](https://www.samhsa.gov/resource/ebp/identification-management-mental-health-symptoms-conditions-associated-long-covid). 23. Melamed, E., et al. (2023). [**Multidisciplinary collaborative consensus guidance statement on the assessment and treatment of neurologic sequelae in patients with post-acute sequelae of SARS-CoV-2 infection (PASC)**](https://doi.org/10.1002/pmrj.12976). *PM&R*. 24. Thompson, J. S., et al. (2023). [**Long-term high-dose immunoglobulin successfully treats long COVID patients with pulmonary, neurologic, and cardiologic symptoms**](https://doi.org/10.3389/fimmu.2022.1033651). *Frontiers in Immunology*, 13. 25. O’Kelly, B., et al. (2022). [**Safety and efficacy of low dose naltrexone in a long covid cohort; an interventional pre-post study**](https://doi.org/10.1016/j.bbih.2022.100485). *Brain, Behavior & Immunity – Health*, 24, 100485. 26. Bramante, C., et al. (2023). [**68 Metformin prevents the diagnosis of Long Covid in phase 3 trial of early treatment**](https://doi.org/10.1017/cts.2023.154). *Journal of Clinical and Translational Science*, 7, 18–19. 27. Chee, Y. J., et al. (2023). [**Clinical trials on the pharmacological treatment of long COVID: A systematic review**](https://pubmed.ncbi.nlm.nih.gov/36349400/). *Journal of Medical Virology*, 95(1). 28. Chang, R., et al. (2023). [**Risk of autoimmune diseases in patients with COVID-19: A retrospective cohort study**](https://doi.org/10.1016/j.eclinm.2022.101783). *eClinicalMedicine*, 56, 101783. 29. Fedorchenko, Y., & Zimba, O. (2023). [**Long COVID in autoimmune rheumatic diseases**](https://doi.org/10.1007/s00296-023-05319-0). *Rheumatology International: Clinical and Experimental Investigations*, 1–11. 30. [**The Long Haul of Long Covid**](https://www.nejm.org/doi/full/10.1056/NEJMp2309483). (2023). In *New England Journal of Medicine* (Vol. 389, Issue 15, p. e29). Massachusetts Medical Society. --- ### [Support Resources for Autoimmune Disease & Chronic Illness](https://www.autoimmuneinstitute.org/join-our-support-group/) **Published:** February 23, 2024 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Although our Autoimmune Aware group has ended, we continue to support the community through research, education, and resource sharing. **Content:** Since its inception, serving the autoimmune disease and chronic illness community has been the cornerstone of the Global Autoimmune Institute’s mission. We started Autoimmune Aware, our monthly support group, to engage the community and provide a safe place for each other to connect, share, and learn. As the support group has grown, we’ve realized that our small but mighty team does not have the resources to maintain it. We regret to inform you that the last meeting will be on August 24, 2024. We hope this list of support groups offered by other autoimmune disease organizations is helpful to you: <https://www.autoimmuneinstitute.org/autoimmune-disease-chronic-illness-related-support-groups/>. As always, we wish you the best on your health journey. We will continue to carry out our mission by funding research in autoimmunity and providing education, resources, and support via our website. Best, The team at GAI --- ### [Understanding COVID and Long COVID](https://www.autoimmuneinstitute.org/covid-long-covid/) **Published:** February 15, 2024 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Discover essential insights and explore the latest research, resources, and support for managing long-term effects and autoimmune complications. **Content:** [ ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/03/carousel-img1.jpg) COVID timeline Learn More Read more about COVID timeline ](https://www.autoimmuneinstitute.org/covid-timeline/) [ ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Global-Perspectives-Long-Covid.jpg) COVID & Long Covid articles Learn More Read more about COVID & Long Covid articles ](https://www.autoimmuneinstitute.org/our-articles?elevaTerm=covid-19-and-long-covid) [ ![Vaccine FAQ Autoimmune Disease Global Autoimmune Institute](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Vaccine-FAQ.jpg) COVID Vaccine FAQ Learn More Read more about COVID Vaccine FAQ ](https://www.autoimmuneinstitute.org/covid-vax-faq/) [ ![Long Covid FAQ Global Autoimmune Institute](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Long-Covid-FAQ-5.jpg) Long COVID FAQ Learn More Read more about Long COVID FAQ ](https://www.autoimmuneinstitute.org/long-covid-faq/) ![mask-home-b](https://www.autoimmuneinstitute.org/wp-content/themes/elevation-framework/src/assets/images/mask-home-b.svg) --- ### [Autoimmune Stories](https://www.autoimmuneinstitute.org/autoimmune-stories/) **Published:** March 22, 2024 **Author:** agustin.fernandezb@elevationweb.org **Content:** ## Autoimmune Stories [addtoany] Search Categories\* Category Ankylosing Spondylitis Autoimmune Hepatitis Berger’s disease & glomerulonephritis Caregiver’s Story Crohn’s Disease Devic’s disease/Neuromyelitis Optica Diagnostic Delays Food Sensitivities Guillain–Barré syndrome (GBS) Hashimoto’s Henoch-Schönlein purpura Lupus (SLE) Lyme Disease Misdiagnosis Mixed connective tissue disease (MCTD) Multiple Autoimmune Diseases Multiple Sclerosis (MS) Neuromyelitis Optica POTS Raynaud’s Rheumatoid Arthritis Sjogren’s Disease Type 1 Diabetes Ulcerative Colitis Undiagnosed Vitiligo Search Clear all filters Displaying Results For: ![GAI Heather Blair](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/06/Heathers-AD-story-banner.jpg) June 15, 2026 by Heather Blair Heather’s Story: The Hurt and Healing In her story, Heather shares her journey from years of unexplained symptoms and repeated surgeries to a diagnosis of… - Diagnostic Delays 15 June 2026 [Read Post](https://www.autoimmuneinstitute.org/autoimmune_stories/heathers-story-the-hurt-and-healing/) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/02/Melanies-AD-story-GAI.jpg) March 6, 2026 by Melanie Cammarano Melanie’s Story: Living With Type 1 Diabetes Melanie grew up watching her father manage Type 1 diabetes. 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This… - Multiple Autoimmune Diseases - Multiple Sclerosis (MS) - Undiagnosed 27 January 2026 [Read Post](https://www.autoimmuneinstitute.org/autoimmune_stories/barbaras-story-the-invisibility-of-continuity/) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/01/Gracies-AD-Story-e1769458604970.jpg) January 26, 2026 by Gracie Rady-Ginther Gracie’s Story: Reclaiming my Life Gracie reflects on how a once-active life was reshaped by POTS and how persistence, support, and patient advocacy helped… - POTS 26 January 2026 [Read Post](https://www.autoimmuneinstitute.org/autoimmune_stories/gracies-story-reclaiming-my-life/) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/08/Spring-Reyna-Fam-2.jpg) August 8, 2025 by Erika Reyna Erika’s Story: Still Me Mom of three. Six autoimmune diseases. Endless resilience. Erika’s story is one of strength, purpose, and powerful chronic illness… - Lupus (SLE) - Multiple Autoimmune Diseases - Rheumatoid Arthritis - Sjogren’s Disease 08 August 2025 [Read Post](https://www.autoimmuneinstitute.org/autoimmune_stories/erikas-story/) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Dillon-AD-story.png) February 22, 2024 by Dillon Horsley Dillon’s Story: My 12-Year Journey to a Lyme Disease Diagnosis After years of relentless fatigue, muscle weakness, and a slew of debilitating symptoms, a journey spanning numerous doctors, tests,… - Lyme Disease - Undiagnosed 22 February 2024 [Read Post](https://www.autoimmuneinstitute.org/autoimmune_stories/dillons-story-my-12-year-journey-to-a-lyme-disease-diagnosis/) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/01/Anthony-2.png) January 10, 2024 by Anthony Simpson Anthony’s Story: Waging a War Within Anthony describes the daily agony, numerous medical consultations, and misdiagnoses before finally receiving the diagnosis he suspected: ankylosing spondylitis…. - Ankylosing Spondylitis 10 January 2024 [Read Post](https://www.autoimmuneinstitute.org/autoimmune_stories/anthonys-story-waging-a-war-within/) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Zoe.jpg) August 29, 2023 by Zoe Zoe’s Story: Embracing Your New Normal Zoe’s story of managing ulcerative colitis and seizures highlights the importance of self-advocacy and support from family and institutions. - Ulcerative Colitis 29 August 2023 [Read Post](https://www.autoimmuneinstitute.org/autoimmune_stories/zoes-story-embracing-your-new-normal/) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Holly-2.jpg) May 11, 2023 by Holly Frances Holly’s Story: Courage Doesn’t Always Roar Holly’s journey with Guillain-Barré Syndrome (GBS) highlights resilience, recovery, and the power of quiet courage in overcoming life’s toughest… - Guillain–Barré syndrome (GBS) 11 May 2023 [Read Post](https://www.autoimmuneinstitute.org/autoimmune_stories/hollys-story-courage-doesnt-always-roar/) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Aashika.jpg) November 16, 2022 by Aashika Gangwal Aashika’s Story: Finding Hope and Gratitude In the Journey to Healing Aashika recounts the ups and downs of being suddenly diagnosed with Autoimmune Hepatitis – including the physical, mental, and… - Autoimmune Hepatitis 16 November 2022 [Read Post](https://www.autoimmuneinstitute.org/autoimmune_stories/aashikas-story-finding-hope-and-gratitude-in-the-journey-to-healing/) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Meshach.png) August 24, 2022 by Meshach Johnston Meshach’s Story: Believing in Yourself and Turning Burdens into Blessings For many with autoimmune disease, the biggest obstacle is just getting a diagnosis. A combination of the complexity of… - Misdiagnosis - Neuromyelitis Optica 24 August 2022 [Read Post](https://www.autoimmuneinstitute.org/autoimmune_stories/meshachs-story-believing-in-yourself-and-turning-burdens-into-blessings/) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Hannah.jpg) August 12, 2022 by Hannah Edwards Hannah’s Story: Celebrating Progress While Battling Crohn’s Disease When I first heard the words “you have Crohn’s disease” I thought my life was over and that I’d… - Crohn’s Disease 12 August 2022 [Read Post](https://www.autoimmuneinstitute.org/autoimmune_stories/hannahs-story-celebrating-progress-while-battling-crohns-disease/) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Ashley.jpg) August 4, 2022 by Ashley Spivey Ashley’s Story: Turning the Tables on Primary Raynaud’s Disease I was burning up on the inside of my body, but on the outside, I was so cold my… - Raynaud’s 04 August 2022 [Read Post](https://www.autoimmuneinstitute.org/autoimmune_stories/ashleys-story-turning-the-tables-on-primary-raynauds-disease/) ![Illustration of a young woman with red hair sitting in a circular window, looking out at a cityscape with skyscrapers and a sky with birds.](https://www.autoimmuneinstitute.org/wp-content/uploads/2022/07/Morgans-Update.png) July 25, 2022 by Morgan Schoepfer Morgan’s Update: Keeping Dreams in View While Having Multiple Illnesses When you have multiple chronic illnesses, a new diagnosis often brings new waves of frustration, fear, and grief. That’s… - Crohn’s Disease 25 July 2022 [Read Post](https://www.autoimmuneinstitute.org/autoimmune_stories/morgans-update-keeping-dreams-in-view-while-having-multiple-illnesses/) ## Posts navigation 1[2](https://www.autoimmuneinstitute.org/wp-admin/admin-ajax.php/page/2/?action=as_async_request_queue_runner&nonce=03efbfba2b)[Next »](https://www.autoimmuneinstitute.org/wp-admin/admin-ajax.php/page/2/?action=as_async_request_queue_runner&nonce=03efbfba2b) --- ### [Confirmation - Newsletter](https://www.autoimmuneinstitute.org/confirmation-newsletter/) **Published:** February 22, 2024 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Thank you for subscribing to our monthly newsletter. Stay updated with the latest content and events related to autoimmune disease **Content:** ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/05/newsletter-confirmation.png) ## Thank you for subscribing! ###### Your subscription to our list has been confirmed. ###### Thank you for subscribing to the Global Autoimmune Institute’s monthly newsletter! Stay informed with new content, research updates, and upcoming events focused on autoimmune disease. --- ### [Confirmation - Contact Form](https://www.autoimmuneinstitute.org/confirmation-contact-form/) **Published:** February 22, 2024 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Thank you for reaching out to the Global Autoimmune Institute! Your message is important to us and our team will respond as soon as possible. **Content:** ###### Thank you for reaching out to us! Your message has been sent. --- ### [Effective Communication Strategies for Healthcare Providers of those with Autoimmune Diseases](https://www.autoimmuneinstitute.org/effective-communication-strategies/) **Published:** August 9, 2023 **Author:** Elevation **Excerpt:** Effective communication between healthcare providers and patients is crucial for optimizing treatment outcomes, improving patient satisfaction, and enhancing overall healthcare experiences. Discover key communication strategies to help autoimmune patients improve interactions with healthcare providers, manage symptoms effectively, and enhance overall healthcare experiences. **Content:** Effective communication between healthcare providers and patients is crucial for optimizing treatment outcomes, improving patient satisfaction, and enhancing overall healthcare experiences. “Where there are issues around communication is where you have a disease without any structural abnormalities,” says Douglas Drossman, co-author of *[Gut Feelings: Doctors and Patient-Centered Care. How Knowledge, Commitment to Care and Empathy Improve Patient’s Lives](https://romefoundation.clickfunnels.com/optin1682609315121).* > **“IN MANY CASES, SYMPTOMS MAY BE SILENT.”** How can a provider better communicate with a patient, particularly when it comes to an autoimmune disease? **The Global Autoimmune Institute expounds on key tips set forth by Dr. Drossman & co-author Johannah Ruddy, M.Ed. to understand symptoms, needs, perceptions & concerns related to patient health.** ### 1. Get To Know The Symptoms – Everyone Is Different Understanding symptoms of autoimmune disease while acknowledging the uniqueness of each patient’s experience is key. Autoimmune diseases are diverse and encompass conditions as varied as [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/rheumatoid-arthritis/), [lupus](https://www.autoimmuneinstitute.org/autoimmune-resources/systemic-lupus-erythematosus/), [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/multiple-sclerosis/), and [celiac disease](https://www.autoimmuneinstitute.org/autoimmune-resources/celiac-disease/), among others. While some symptoms may overlap across different diseases, presentation and severity can vary significantly. > **IT’S CRUCIAL FOR PHYSICIANS TO BE WELL-VERSED IN CHARACTERISTIC SYMPTOMS, DIAGNOSTIC CRITERIA, AND THE POTENTIAL COURSE EACH AUTOIMMUNE DISEASE CAN TAKE.** According to Dr. Drossman, patients often leave issues unaddressed because they haven’t been given an opportunity to speak about them, or were not previously aware of what they were feeling. Physicians should use open-ended questions to gather detailed information about the patient’s symptoms, their impact on daily life, and any potential triggers or patterns. This approach can provide clues that may lead to a more accurate diagnosis or treatment plan. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/physicians.png) ### 2. Take Time To Listen When communicating with patients, the importance of active listening cannot be overstated. Patients with autoimmune diseases often have complex medical histories and may have multiple symptoms that can be difficult to untangle. There may also be atypical or rare presentations, as some patients may have subtle or less common symptoms. Taking the time to listen, pay attention to language and subtleties, and allow patients to express their concerns and experiences is important. As Dr. Drossman elucidates: “You want to listen actively, rather than jump in.” Additionally, some issues may have a psychosocial component that may not be causing disease, but could be exacerbated by it. > **REMOVING ANY STIGMA IS KEY.** “If patients have symptoms of depression and anxiety, providers can help them to fully understand what that means.” ### 3. Empathize, Don’t Sympathize, To Put A Patient At Ease Physicians should be empathetic and validate a patient’s experiences, even if symptoms are atypical or seemingly unrelated. Often, acknowledging a patient’s journey and frustrations can help build trust and strengthen a relationship. “It can be unhelpful and invalidating to tell a patient with an autoimmune condition that they should be grateful for not having a particular disease,” says Ruddy, M.Ed., who is also a doctoral candidate at Campbell University as well as a patient advocate. > **“OFFERING PATIENTS KNOWLEDGE ABOUT THEIR SYMPTOMS WITH EMPATHY PROVIDES VALIDATION AND BUILDS TRUST,” SHE SAYS.** ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/empathy.png) As one example, Ruddy recommends using a script like the one below: “These test results came back within the normal range which means you do not have XYZ causing your symptoms. I want to further investigate but, in the meantime, I empathize with how much these symptoms have impacted your life and how much you have been suffering. Based on your symptoms, we know that you meet the criteria for ABC condition, and that is encouraging because we can now collaborate on a plan to help you feel better.” ### 4. Be Patient, Answer Questions, And Give Sources Some patients may take more time to articulate their thoughts or may feel hesitant to share sensitive information. Patients may also be anxious, scared, or uncertain about their condition. As a physician, a compassionate and understanding demeanor can go a long way in making patients feel comfortable and heard. > **“VALIDATE WHAT PATIENTS ARE EXPERIENCING, RATHER THAN TELLING THEM WHAT THEY SHOULD DO,” SAYS DR. DROSSMAN. THOUGH A PHYSICIAN MAY NOT NECESSARILY AGREE, HE OR SHE IS STILL ACCEPTING THE PATIENT’S PERSPECTIVE AS LEGITIMATE.** For example, a validating statement for a patient who feels stigmatized by others who say their problem is due to stress would be: “I can see you are upset when people say this is due to stress when you know there are other factors.” Likewise, encouraging patients to ask questions about their condition, treatment options, or any other medical concerns can be helpful. Providing credible sources or reputable websites where patients can find additional information can go a long way toward empowering patients to feel informed and involved in their healthcare decisions. > **“IT IS CRUCIAL TO PROVIDE PATIENTS WITH SCIENTIFIC EDUCATION ABOUT THEIR CONDITION AND A RATIONALE FOR A FULLY INTEGRATED MANAGEMENT APPROACH THAT INCLUDES DIETARY, BEHAVIORAL, AND COMPLEMENTARY THERAPIES,” SAYS RUDDY.** She also says that patients want to be well-informed about their illness, and not just given a simple brochure with limited information. “Providing more information about the integrated care process that takes a fully biopsychosocial approach can help patients manage their treatment expectations and understand their role in the management process,” Ruddy says. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/education.png) ### 5. Encourage Follow-Up Visits; Set Realistic Goals Memory and thought are not linear. A patient’s experience is complex, and there are numerous challenges involved with retaining and processing medical information during a single visit. > **OVER TIME, PHYSICIANS CAN REINFORCE INFORMATION TO ENSURE THAT PATIENTS HAVE A CLEAR UNDERSTANDING OF THEIR CONDITION, TREATMENT PLAN, AND ANY NECESSARY LIFESTYLE CHANGES.** Likewise, scheduling follow-ups allows physicians to address emerging issues, potentially preventing further complications. Illnesses may take a long time to cure, or they may involve ongoing management. Dr. Drossman has suggested the following line: “I can understand how much you want these symptoms to go away, but they are longstanding, and as such we need to reset our expectations. If we could seek to reduce your symptoms by 30% over the next several months would that help?” ### 6. Help The Patient Take Responsibility Dr. Drossman believe a better understanding can come about by speaking with a patient and allowing them to set their goals and understand their agenda. For example, rather than asking a patient: “How is your pain doing?” Dr. Drossman has suggested asking: “How are you managing with your pain?” > **“CARE SHOULD BE COLLABORATIVE,” SAYS DR. DROSSMAN.** “You want the patient to own their illness and take responsibility because self-reliance has a much better outcome than a patient passively doing what the doctor says.” ### Helpful Resources <https://romedross.video/GutFeelingsWebsite> <https://romedross.video/patient-story> <https://romedross.video/doctors-and-patient-centered-care> --- ### [COVID-19 Vaccine & Autoimmune Disease FAQ](https://www.autoimmuneinstitute.org/covid-vax-faq/) **Published:** February 15, 2024 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Over the course of the pandemic, Global Autoimmune Institute has stayed abreast of research on the novel coronavirus and its impact on those living with autoimmune disease. **Content:** Over the course of the pandemic, Global Autoimmune Institute has stayed abreast of research on the novel coronavirus and its impact on those living with autoimmune disease. As public health measures around COVID-19 vaccines continue to evolve, we have received an influx of questions from the autoimmune disease community. While we are unable to provide medical advice or guidance about individual health plans, we would like to share answers to our most frequently asked questions! ## 1. I Have An Autoimmune Disease – Which Vaccine Should I Get? Speak with your doctor to determine which vaccine is right for you; they will have a broader understanding of which vaccine suits you and your medical profile. On January 31, 2022, the FDA approved Moderna’s COVID-19 vaccine. This is the second vaccine to gain full approval in the U.S. The Pfizer and BioNTech COVID-19 vaccine was approved by the FDA on August 23, 2021. The application for full FDA approval requires ample clinical data from trials demonstrating high safety and efficacy ratings. Read the difference between approval and emergency use authorization on the [FDA’s website](https://www.fda.gov/consumers/consumer-updates/understanding-regulatory-terminology-potential-preventions-and-treatments-covid-19). **Check out our vaccine comparison chart for details on scientific and research developments behind the world’s leading vaccines, from March 2020 – August 2022.** ## 2. I Have An Autoimmune Disease – Is It Safe For Me To Get The COVID Vaccine? From what the Global Autoimmune Institute has reviewed in the scientific literature in regards to COVID-19 vaccination and autoimmune disease, the evidence available at this point indicates that **the benefit of COVID-19 vaccination outweighs the risk of side-effects.** The [CDC](https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html) also states that “COVID-19 vaccines may be administered to most people with underlying medical conditions.” In regard to immunocompromised persons receiving a third vaccine dose, the [CDC](https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/immuno.html) has stated that “there is limited information about the risks of receiving an additional primary shot of mRNA COVID-19 vaccine.” The safety, efficacy, and benefits of a third primary dose in those with compromised immune systems is being evaluated on an ongoing basis. Reactions to a third primary dose are similar to reactions after the two-dose primary series, and are typically mild to moderate in nature. “As with the two-dose primary series, [serious side effects are rare](https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/safety-of-vaccines.html), but may occur.” The FDA has verified a list of rare adverse events, some of which can be found [here](https://www.autoimmuneinstitute.org/covid-news-and-autoimmune-disease/vaccine-adverse-events/). ## 3. I Have An Autoimmune Disease – Will The COVID-19 Vaccine Work For Me? The consensus has been that COVID-19 vaccine efficacy may be decreased for people who take immunosuppressant drugs, which includes many being treated for autoimmune disease. This was suspected by experts earlier in the pandemic but has been confirmed via clinical trials and real-world data including the following: - On May 2, 2021, researchers published the results of a retrospective study of 17 hospitals throughout Israel. The [study ](https://www.clinicalmicrobiologyandinfection.com/action/showPdf?pii=S1198-743X%2821%2900367-0)included **152 patients who tested positive for COVID-19 after being fully vaccinated with the Pfizer vaccine (breakthrough cases) and required hospitalization**. This study aimed to “characterize vaccinated patients with breakthrough COVID-19 requiring hospitalization and define the main risk factors associated with poor outcomes in this group.” **Notably, 40% of breakthrough cases included patients who were immunocompromised.** Data coming from Israel’s mass vaccination campaign parallel Phase 3 clinical trial data, supporting Pfizer vaccine’s 95% efficacy rate. That being said, **efficacy was shown to be lower in those with multiple comorbidities and the immunocompromised**. The most common causes of immunosuppression included chronic corticosteroid treatment, antimetabolite therapy, and anti-CD20 treatment (Rituximab, commonly used to treat rheumatoid arthritis, is an anti-CD20 biologic agent). - On August 6, 2021, a [study](https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(21)00222-8/fulltext) was published that analyzed the immune response following COVID-19 vaccination in patients with autoimmune disease, focusing specifically on the effects of different immunosuppressive drugs on antibody development. Researchers used serum samples from 289 patients without autoimmune disease, who served as the control group, and 632 patients with autoimmune disease (including rheumatoid arthritis, ankylosing spondylitis, systemic lupus erythematosus, and multiple sclerosis). Serum samples were collected from participants after their first or second dose of the COVID-19 vaccine (to include Johnson & Johnson, Pfizer, AstraZeneca, and Moderna). Seroconversion rates (speed of the body’s transition from viral infection to antibody presence in the body) and antibody titers were similar across autoimmune disease types and vaccine types included in the study, “suggesting that **treatment with immunosuppressive medication, rather than the underlying autoimmune disease, is the main factor that influences immunogenicity of vaccines**.” For those with autoimmune disease who take immune system-altering medications, the American College of Rheumatology released a [recommendation](https://www.rheumatology.org/Portals/0/Files/COVID-19-Vaccine-Clinical-Guidance-Rheumatic-Diseases-Summary.pdf) to delay taking such medications for one week after vaccination—under the direction of their doctor. Doing this may allow their immune systems to create a stronger antibody response and combat the drop in vaccine efficacy seen in those on immunosuppressants. ## 4. I Take Medications For My Autoimmune Disease – How Will They React With The COVID-19 Vaccine? The Washington University School of Medicine is conducting a study called COVaRiPAD ([COVID-19 Vaccine Responses in Patients with Autoimmune Disease](https://studysearch.wustl.edu/studies/357)). The team just[ published research](https://www.acpjournals.org/doi/10.7326/M21-1757) looking at the effect of immunosuppression on the efficacy of mRNA COVID-19 vaccines. They found that 88.7% of patients with chronic inflammatory conditions\* (CID), including rheumatoid arthritis (28.5%), Crohn’s disease (16.5%), spondyloarthritis (15%), ulcerative colitis (13.5%), systemic lupus erythematosus (11.3%), multiple sclerosis (6.8%), and Sjögrens syndrome (6%), produced detectable antibodies in response to the vaccine. Researchers found that immune responses varied depending on the medication being taken, which included glucocorticoids, antimetabolites, tumor necrosis factor inhibitors (TNFis), B-cell depleting therapy (BCDT), and Janus kinase inhibitors (JAKis). All CID participants continued use of their immunosuppressive medications during the study per their treating physician, except for 3 who held methotrexate (antimetabolite) within 1 week of immunization. Those taking BCDT (60%) and glucocorticoids (65%) had absent or numerically lower antibody levels after both vaccinations, while the other immunosuppressives did not generate much lower antibody levels when compared to those not taking the drugs. It should be noted that the antibody levels in CID participants were one-third of the levels seen in the healthy controls. The researchers highlighted the difficulty of determining whether the levels achieved by those on immune-suppressing drugs are high enough to protect them from severe COVID-19 given that a minimum level of antibodies required for protection against COVID-19 has yet to be established. Nonetheless, evidence supporting that vaccination does elicit a response in those with compromised immune systems is still encouraging for a population that has a high risk of serious illness. *\* Those with acquired or inherited immunocompromised conditions and those using systemic immunosuppression were excluded.* The primary recommendation from the [American College of Rheumatology](https://web.archive.org/web/20210731131218/https://www.rheumatology.org/Portals/0/Files/COVID-19-Vaccine-Clinical-Guidance-Rheumatic-Diseases-Summary.pdf) is to delay certain medications for one week after vaccination. These include: - Methotrexate - janus kinase (JAK) inhibitors – baricitinib (Olumiant), tofacitinib (Xeljanz), upadacitinib (Rinvoq) - Cyclophosphamide Longer delays are recommended for biologics – abatacept (Orencia), rituximab (Rituxan). It is recommended that you speak with your doctor about any medications you may be taking and how they may interact with the COVID-19 vaccine. ## 5. I Have An Autoimmune Disease – Am I At Risk Of Experiencing A Flare-Up From The Vaccine? There is a risk that flare-ups may occur. That being said, it has been observed that people living with autoimmune and inflammatory conditions are at higher risk of experiencing severe symptoms from a COVID-19 infection. Due to this concern, the [American College of Rheumatology ](https://www.rheumatology.org/About-Us/Newsroom/Press-Releases/ID/1138)has stated that “the benefit of COVID-19 vaccination outweighs any small, possible risks for new autoimmune reactions or disease flare after vaccination.” This [questionnaire study](https://www.thelancet.com/action/showPdf?pii=S2665-9913%2821%2900181-8) to come out of the Netherlands compiled the post-vaccination experience of 505 patients living with systemic autoimmune disease. Researchers compared the “tolerability of different COVID-19 vaccine types between patients with autoimmune diseases and healthy controls… \[and assessed\] the effect of COVID-19 vaccination on underlying disease activity. ” Severe adverse events occurred in 1% of patients. Moreover, *COVID-19 vaccinations were not observed to trigger AD flares.* One study from [Cedar’s Sinai Medical Center](https://journals.lww.com/ajg/Abstract/9000/Adverse_Events_Following_SARS_CoV_2_mRNA.98766.aspx) evaluated a longitudinal vaccine registry and reported that the Covid-19 vaccine was found to be safe for patients with immune-mediated inflammatory diseases, such as IBD. Adverse event frequency and type were similar to that of the general population. Moreover, authors have reassured IMID patients that the risk of adverse events is “likely not increased, and may be reduced, while on biologics.” A [research study](https://www.frontiersin.org/articles/10.3389/fonc.2022.855723/full) published in *Frontiers in Oncology* evaluated COVID-19 vaccine (Pfizer and Moderna) safety in 566 immunocompromised patients including those with hematological malignancies (131), solid tumors (191), immune-rheumatological diseases (86), and neurological disease (158) including multiple sclerosis and generalized myasthenia. Overall, the “incidence of severe adverse events after vaccine administration was generally low and <3%.” Prominent autoimmune disease organizations share a common consensus: that the benefits of the vaccine outweigh possible risks of experiencing new autoimmune reactions or flare-ups. Read more about about post-vaccination flares in specific autoimmune diseases here. Research on COVID-19 vaccine adverse events in autoimmune disease patients can be found here. ## 6. I Have An Autoimmune Disease, Was Vaccinated, And Have Experienced Side Effects – What Should I Do Now? Speak with your doctor. They will have your complete medical history as well as current medical profile, and will be able to guide you through side effects you may be experiencing. You can also submit your side effects to the [Vaccine Adverse Effects Reporting System](https://vaers.hhs.gov/) (VAERS). Scientists at the CDC and FDA monitor VAERS to decide which adverse events merit further investigation. There may be others experiencing similar side effects to you; submitting them to VAERS provides the best chance for the CDC and FDA to know and study side effects from the COVID-19 vaccine. This [review](https://pubmed.ncbi.nlm.nih.gov/36143376/) discusses the frequency, management, and outcome of reported neurological complications from COVID-19 vaccines over an 18 month period, some of which have been verified by the FDA and CDC. ## 7. Where Can I Find Clinical Trial Data On People With Autoimmune Diseases Getting The COVID-19 Vaccine? People living with autoimmune disease and those on immunosuppressive therapies were not included in initial clinical trials for the COVID-19 vaccine. This is due to the fact these population groups can skew efficacy data. That being said, the NIH is currently recruiting participants with autoimmune disease for a new clinical trial testing the [Immunological Response to COVID-19 Vaccine in Patients With Autoimmune and Inflammatory Diseases Treated With Immunosuppressants and/or Biologics](https://www.clinicaltrials.gov/ct2/show/NCT04870411?term=coronavirus+vaccine&cond=Autoimmune+Diseases&draw=2&rank=2). The National Institute of Arthritis and Musculoskeletal and Skin Diseases is also sponsoring an [observational study on how a COVID-19 infection impacts patients with systemic autoimmune disease](https://clinicaltrials.gov/ct2/show/study/NCT04690816?cond=Autoimmune+Diseases&draw=2&rank=2), particularly inflammation, the immune system and blood vessels. The study will also assess the response to potential antiviral treatments and vaccines for those living with autoimmune disease. Yale and the National Institute of Allergy and Infectious Diseases (NIAID) are collaborating to evaluate the [immune response to COVID-19 vaccination in immunodeficient patients](https://clinicaltrials.gov/ct2/show/NCT05286242?term=autoimmune+disease&cond=COVID-19&cntry=US&draw=3&rank=13), including those with autoimmune disease and undergoing treatment with anti-CD20 medications. ## 8. I Have An Autoimmune Disease And Had A COVID-19 Infection – Should I Still Get Both Doses Of The Vaccine? Speak with your doctor before getting the COVID-19 vaccine, as they may have recommendations regarding the timing and dosing of the COVID-19 vaccine that are specific to your medical profile. As of September 2022, the [CDC](https://www.cdc.gov/coronavirus/2019-ncov/vaccines/faq.html) states that those who have been previously infected with COVID-19 should get vaccinated and receive a booster dose, as the effectiveness of the COVID-19 vaccine wanes over time. This is especially true for those who are immunocompromised. ## 9. I Have An Autoimmune Disease -Should I Get A Booster Dose? The CDC recently adjusted their language around COVID-19 vaccines, and recommendations now include [staying up to date](https://www.cdc.gov/coronavirus/2019-ncov/vaccines/stay-up-to-date.html) with COVID-19 vaccines for adequate protection. That being said, there are separate recommendations for those who are immunocompromised. “For people who are immunocompromised, the third primary dose is the final dose of the primary series of an mRNA COVID-19 vaccine. Boosters are shots that enhance or restore protection against COVID-19, which may have decreased over time” ([5](https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/immuno.html)). Generally, living with an autoimmune disease does not necessarily mean you are immunocompromised. Oftentimes, certain medications and treatments may cause immunosuppression while reducing an autoimmune reaction. A consensus has not been made on the antibody threshold for adequate immunity against SARS-CoV-2. For this reason, it is recommended that you speak with your doctor about staying up to date with COVID-19 vaccines. This [page](https://www.cdc.gov/vaccines/covid-19/downloads/COVID-19-immunization-schedule-ages-6months-older.pdf) details the COVID-19 immunization schedule per the CDC (accurate as of September 9, 2022). On **April 19, 2023**, the [CDC](https://www.cdc.gov/media/releases/2023/s0419-covid-vaccines.html) issued a blanket recommendation that everyone ages 6 years and older receive an updated bivalent mRNA COVID-19 vaccine, regardless of whether they were fully vaccinated with the monovalent primary series. Regarding immunocompromised persons, new recommendations allow for an additional bivalent vaccine dose. “This allows more flexibility for healthcare providers to administer additional doses to immunocompromised patients as needed.” On **October 3, 2022**, the [FDA](https://www.fda.gov/drugs/drug-safety-and-availability/fda-releases-important-information-about-risk-covid-19-due-certain-variants-not-neutralized-evusheld) published updated information on Evusheld, citing data that shows a [1,000 fold decrease](https://www.fda.gov/media/154701/download?utm_campaign=wp_to_your_health&utm_medium=email&utm_source=newsletter&wpisrc=nl_tyh) in efficacy as a prophylaxis against the omicron subvariant. On **September 14, 2022**, the [CDC](https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/immuno.html) published their recommendation on the bivalent booster for those who are moderately to severely immunocompromised; they also cover eligibility for [Evusheld](https://www.autoimmuneinstitute.org/fda-updates-recommendation-around-astrazenecas-evusheld/). On **September 1, 2022**, the [CDC](https://www.cdc.gov/coronavirus/2019-ncov/vaccines/stay-up-to-date.html) updated their recommendation for those 18+ to receive a Pfizer or Moderna bivalent booster. The updated booster targets the most recent Omicron subvariants, as well as the original SARS-CoV-2 strain. On **March 29, 2022**, the [CDC](https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-authorizes-second-booster-dose-two-covid-19-vaccines-older-and) updated their recommendation to include a second booster dose for immunocompromised persons using the Pfizer or Moderna vaccine. On **January 7, 2022**, the [CDC](https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/immuno.html) updated their vaccine guidance for immunocompromised persons. It is now recommended that persons 12+ who are immunocompromised receive a booster dose. “If you are eligible for an additional primary shot, you should get this done before you get a booster shot.” On **December 16, 2021**, the CDC recommended against the use of a second J&J dose following a J&J primary dose. Thrombosis with thrombocytopenia has been verified by the FDA and CDC as a rare but possible adverse event after receiving the J&J vaccine; given their recommendation on boosters in light of the Omicron variant, the CDC’s official stance now recommends an mRNA vaccine booster after the initial J&J primary dose. That being said, those wanting to receive two doses of a J&J vaccine may do so; it is recommended that you speak with your doctor beforehand. On **November 29, 2021**, the CDC changed their recommendation on boosters in an effort to combat the Omicron variant. Adults “should” receive a booster, rather than “may” receive a booster 6 months after their Pfizer or Moderna primary series, or 2 months following their initial J&J vaccine. On **November 19, 2021,** the CDC expanded booster eligibility for everyone over 18 years of age. Those who received a Pfizer or Moderna vaccine *may* receive a booster dose 6 months after their primary series. Ahead of the CDC’s endorsement, an advisory committee to the CDC convened to discuss two new recommendations. Members voted 11-0 in favor of both recommendations: \#1 – A single COVID-19 vaccine booster dose is recommended for persons aged 18+ who received an mRNA COVID-19 vaccine primary series based on individual benefit and risk, at least 6 months after the primary series, under the FDA’s emergency use authorization. \#2 – A single COVID-19 vaccine booster dose is recommended for persons 50+ years who received an mRNA COVID-19 vaccine at least 6 months after the primary series under the FDA’s emergency use authorization. On **October 26, 2021**, the CDC updated their [guidelines](https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/immuno.html) on COVID-19 vaccines for those who are “moderately and severely” immunocompromised. Those who received an mRNA vaccine for their primary series and received an additional dose of an mRNA vaccine, **may** receive a fourth COVID-19 booster dose at 6+ months. This fourth dose may be administered using a Moderna, Pfizer or Johnson & Johnson (J&J) vaccine. “In such situations, people who are moderately and severely immunocompromised may receive a total of four COVID-19 vaccine doses.” If obtaining the Moderna vaccine for a third dose, one should receive a 50 microgram dose, followed by a fourth 50 microgram dose at 6+ months. Those who are immunocompromised and received the J&J vaccine for their primary series should get a second COVID-19 vaccine. If the J&J primary dose is followed by a Moderna booster, it should measure 50 micrograms. Those who received a J&J vaccine for their primary series followed by either a second dose of the J&J, Moderna or Pfizer vaccine should not obtain a third dose at this time. Speak with your doctor regarding the timing of a fourth dose, as they are “best positioned to determine the appropriate timing of vaccination.” On **October 21, 2021**, the CDC amended their [EUA](https://www.cdc.gov/media/releases/2021/p1021-covid-booster.html) to include a *booster* recommendation for the Moderna and Johnson & Johnson vaccines. The Moderna vaccine has been endorsed for use as a booster vaccine at least 6 months after the primary series in the following populations: - those 65+ years in age - those 18+ in long-term care settings - those 18+ who have certain underlying medical conditions - those 18+ who work or live in high-risk settings The Johnson & Johnson (J&J) vaccine has been recommended for persons 18+ years of age, 2 months after their primary dose. The CDC also endorsed a mix-and-match strategy for booster doses. Unlike the Moderna booster (which is a half dose at 50 micrograms), Pfizer and J&J booster doses will measure the same as the primary series. The ACIP, the advisory panel to the CDC, recommended that those who are immunocompromised and completing a primary series as well as an additional dose, should utilize vaccines from the same manufacturer. Those who are “moderately to severely” immunocompromised and received a J&J primary series, should receive a 50 microgram dose of the Moderna vaccine should they decide to mix-and-match between their first and second dose. Those who receive a third, 100 microgram dose of the Moderna vaccine due to their immunocompromised status, should not get a 4th booster shot from Pfizer or J&J at this time ([1](https://www.cdc.gov/vaccines/acip/meetings/downloads/slides-2021-10-20-21/12-COVID-Reddy-508.pdf)). On **September 24, 2021**, the CDC updated their [recommendations](https://www.cdc.gov/media/releases/2021/p0924-booster-recommendations-.html) for a *booster* dose of the Pfizer vaccine at least 6 months after a primary series for the following individuals: - people 65 years and older and residents in long-term care settings - people aged 50–64 years with [underlying medical ](https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html)conditions people aged 18–49 years with underlying medical conditions **may** receive a booster shot based on their individual benefits and risks, and - people aged 18-64 years who are at increased risk for COVID-19 exposure and transmission because of occupational or institutional setting **may** receive a booster shot based on their individual benefits and risks. On **August 12, 2021**, [**the FDA authorized the use of an additional dose**](https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-authorizes-additional-vaccine-dose-certain-immunocompromised) **of Pfizer-BioNTech and Moderna’s COVID-19 vaccines for those who are immunocompromised** and may not have developed sufficient antibodies after a full dose of the COVID-19 vaccine. These patients include those who have received solid organ transplants, as well as “those who are diagnosed with conditions that are considered to have an equivalent level of immunocompromise.” On **August 13, 2021**, the FDA authorized the use of a third dose of the [Moderna vaccine](https://news.modernatx.com/news/news-details/2021/Moderna-Announces-FDA-Authorization-of-Third-Dose-of-COVID-19-Vaccine-for-Immunocompromised-Individuals/default.aspx) as well, which measures 100 micrograms. This is the same dose as the first two of the primary series. The NIH is currently holding a clinical trial on [Booster Vaccine in Autoimmune Disease Non-Responders](https://clinicaltrials.gov/ct2/show/NCT05000216). This study will determine the antibody response of a booster dose in autoimmune disease patients who did not respond to an initial full dose of the COVID-19 vaccine. The trial includes participants living with one of five autoimmune diseases: rheumatoid arthritis, pemphigus, systemic lupus erythematosus, systemic sclerosis, or multiple sclerosis, and taking mycophenolate mofetil (MMF) or mycophenolic acid (MPA), methotrexate (MTX), or B cell-depleting drugs. These immunosuppressive therapies have been associated with low antibody production after the COVID-19 vaccine. ## 10. My Child Has An Autoimmune Disease – Should They Get Vaccinated? This [page](https://www.cdc.gov/vaccines/covid-19/downloads/COVID-19-immunization-schedule-ages-6months-older.pdf) details the COVID-19 immunization schedule for children starting at 6 months in age, including children who are immunocompromised. As of **June 16, 2023**, the [CDC](https://www.cdc.gov/mmwr/volumes/72/wr/mm7224a3.htm) recommends children 6 months-5 years receive a bivalent vaccine, with “optional additional bivalent booster doses for moderately or severely immunocompromised persons aged ≥6 months.” Children ≥6 months who are moderately or severely immunocompromised may receive ≥1 additional bivalent mRNA dose ≥2 months after their most recent bivalent mRNA dose. On **April 19 2023**, the [CDC](https://www.cdc.gov/media/releases/2023/s0419-covid-vaccines.html) updated guidelines for immunocompromised persons, including children 6 years and older. Their recommendation now allows for an *additional* bivalent vaccine dose on top of a primary bivalent mRNA COVID-19 dose; this is separate from a monovalent primary series. “This allows more flexibility for healthcare providers to administer additional doses to immunocompromised patients as needed… For young children, multiple doses continue to be recommended and will vary by age, vaccine, and which vaccines were previously received.” On **September 14, 2022**, the [CDC](https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/immuno.html) updated recommendations on a second booster for children ages 5-11 years, who received a Pfizer primary series. Children 12+ are also recommended to receive the Pfizer bivalent booster ([4](https://www.cdc.gov/coronavirus/2019-ncov/vaccines/stay-up-to-date.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fvaccines%2Fbooster-shot.html)). On **May 20, 2022**, the [CDC](https://www.cdc.gov/vaccines/covid-19/clinical-considerations/interim-considerations-us.html) updated their recommendation for children ages 5-11. Children within this age group should receive a third dose of the Pfizer vaccine at least 5 months after their second dose. On **February 22, 2022,** the [CDC](https://www.cdc.gov/vaccines/covid-19/clinical-considerations/covid-19-vaccines-us.html) updated their recommendation for time intervals between the first and second dose of the Moderna vaccine. Boys, especially those 12-39 years of age, are suggested to wait 8-weeks between their first and second dose. The CDC still recommends the original time interval of 4-weeks between Moderna doses for those who are moderately to severely immunocompromised. On **January 5, 2022,** the [CDC](https://www.cdc.gov/media/releases/2022/s0105-Booster-Shot.html) endorsed booster shots for children 12-17 years of age using the Pfizer vaccine, five months after the second dose of a primary series. This endorsement follows a 13-1 vote by the ACIP in favor of booster doses. On **January 3, 2022**, the [FDA](https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-takes-multiple-actions-expand-use-pfizer-biontech-covid-19-vaccine) authorized booster doses in children 12-15 years of age, five months after a primary series. Additionally, children 5-11 years of age with compromised immune systems may now receive a third dose of the Pfizer COVID-19 vaccine at least 28 days following a primary series. The clinical trials conducted for the COVID-19 vaccine included different cohorts with groups split by age, including 16-25, 12-15, 6-11, 2-5, and 6 months to 2 years. Pfizer-BioNTech was recently granted emergency use authorization in children ages 5-11 on October 29, 2021; vaccination in children 12+ was authorized on May 10, 2021. The FDA also granted EUA for a third dose of Pfizer’s vaccine in those 12+ “who have been determined to have certain kinds of immunocompromise” ([2](https://www.pfizer.com/news/press-release/press-release-detail/pfizer-and-biontech-receive-first-us-fda-emergency-use-0)). This third shot is considered part of the primary series, and is different from a “booster.” Pfizer’s clinical trials in children ages [5-11](https://www.pfizer.com/news/press-release/press-release-detail/pfizer-and-biontech-receive-first-us-fda-emergency-use-0) and [12-15](https://www.pfizer.com/news/press-release/press-release-detail/pfizer-biontech-announce-positive-topline-results-pivotal) did not include those with autoimmune disease; that being said, the vaccine demonstrated 91% and 100% efficacy, respectively, and robust antibody responses. In Pfizer’s clinical trial of 5-11 year olds, antibody responses were similar to those seen in 16-25 year olds, even though they received a low dose of the vaccine (two 10-microgram doses versus two 30-microgram doses for those 12+). The vaccine was also well-tolerated in both sets of age groups, with the most common adverse reactions being pain at the injection site, fatigue, headache, muscle pain, chills, and joint pain. Read more about the CDC’s recommendation on vaccination in 5-11 year old pediatric populations, [here](https://www.cdc.gov/vaccines/covid-19/planning/children.html#covid19-vax-recommendations). This [CDC resource page](https://www.cdc.gov/vaccines/acip/recs/grade/covid-19-pfizer-biontech-etr-12-15-years.html) discusses the benefits and potential risks of the vaccine in children 12-15 years of age, as well as recommendations, assessment, development, and evaluation of the Pfizer vaccine in children 12-15 years of age ([3](https://www.cdc.gov/vaccines/acip/recs/grade/covid-19-pfizer-biontech-vaccine-12-15-years.html)). Last year, [Creaky Joints](https://creakyjoints.org/living-with-arthritis/coronavirus/covid-19-vaccines/juvenile-arthritis-covid-19-vaccine/) released a statement regarding the COVID-19 vaccine in patients with juvenile arthritis, sharing that, “experts believe the Pfizer COVID-19 vaccine is safe for children who are immunocompromised or are taking a medication that affects the immune system.” This [review](https://www.frontiersin.org/articles/10.3389/fimmu.2021.711637/full) compiles the latest literature and recommendations on vaccination (generally) in children who are immunocompromised, including those with specific autoimmune diseases and being treated with immunosuppressive regimens. It is recommended that you speak with your child’s doctor regarding any medication they are taking for their autoimmune disease before getting the COVID-19 vaccine. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/SpacerShield.jpg) *The information shared on this page is accurate to the best of our knowledge. Please read resources provided by the CDC, WHO, and public health authorities to stay best informed, and seek professional medical advice for best practices pertaining to your medical plan.* --- ### [Accessibility Policy](https://www.autoimmuneinstitute.org/accessibility-policy/) **Published:** February 20, 2024 **Author:** Elevation **Excerpt:** Global Autoimmune Institute strives to ensure that its services are accessible to people with disabilities. Global Autoimmune Institute has invested a significant amount of resources to help ensure that its website is made easier to use and more accessible for people with disabilities, with the strong belief that every person has the right to live with dignity, equality, comfort and independence. **Content:** *Updated: April 2022.* ### General Global Autoimmune Institute strives to ensure that its services are accessible to people with disabilities. Global Autoimmune Institute has invested a significant amount of resources to help ensure that its website is made easier to use and more accessible for people with disabilities, with the strong belief that every person has the right to live with dignity, equality, comfort and independence. ### Accessibility on Autoimmuneinstitute.org Autoimmuneinstitute.org makes available the UserWay Website Accessibility Widget that is powered by a dedicated accessibility server. The software allows Autoimmuneinstitute.org to improve its compliance with the Web Content Accessibility Guidelines (WCAG 2.1). ### Enabling the Accessibility Menu The Autoimmuneinstitute.org accessibility menu can be enabled either by hitting the tab key when the page first loads or by clicking the accessibility menu icon that appears on the corner of the page. After triggering the accessibility menu, please wait a moment for the accessibility menu to load in its entirety. ### Disclaimer Global Autoimmune Institute continues its efforts to constantly improve the accessibility of its site and services in the belief that it is our collective moral obligation to allow seamless, accessible, and unhindered use also for those of us with disabilities. In an ongoing effort to continually improve and remediate accessibility issues, we also regularly scan Autoimmuneinstitute.org with UserWay’s [Accessibility Scanner ](https://userway.org/scanner)to identify and fix every possible accessibility barrier on our site. Despite our efforts to make all pages and content on Autoimmuneinstitute.org fully accessible, some content may not have yet been fully adapted to the strictest accessibility standards. This may be a result of not having found or identified the most appropriate technological solution. ### Here For You If you are experiencing difficulty with any content on Autoimmuneinstitute.org or require assistance with any part of our site, please contact us during normal business hours as detailed below and we will be happy to assist. ### Contact Us If you wish to report an accessibility issue, have any questions or need assistance, please contact the Global Autoimmune Institute at <info@autoimmuneinstitute.org> --- ### [COVID Timeline](https://www.autoimmuneinstitute.org/covid-timeline/) **Published:** February 23, 2024 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Want to know what’s going on in coronavirus news? Check out our ongoing timeline summarizing key COVID-19 scientific developments, especially as they pertain to autoimmune disease. **Content:** # COVID-19 News & Research Updates about Autoimmune Disease Want to know what’s going on in coronavirus news? Check out our ongoing timeline summarizing key COVID-19 scientific developments, especially as they pertain to autoimmune disease. Search Displaying Results For: Clear all filters Apply Filters Autoimmune Diseases & Covid-19 Celiac disease & Covid-19 GBS & Covid-19 IBD & Covid-19 Lupus & Covid-19 ME/CFS & Covid-19 MS & Covid-19 Myasthenia gravis & Covid-19 RA & Covid-19 Sjögren disease & Covid-19 T1D & Covid-19 Thyroid disease & Covid-19 Covid-19 & Long Covid Treatments Covid-19 Antibodies Covid-19 Boosters Covid-19 Clinical Trials Covid-19 Infections Covid-19 Policy Covid-19 Research Studies Covid-19 Vaccines Vaccine Adverse Events Vaccine Manufacturers Covid-19 Variants Long COVID Apply Filters Oct 06, 2026 Study Finds Stable Autoantibody Profiles 6 Months After COVID-19 Booster Researchers found stable autoantibody profiles six months after COVID-19 booster vaccination in 30 healthy adults, providing new insights into immune responses and autoimmune disease research. - Covid-19 Antibodies - Covid-19 Vaccines [Read Post](https://www.autoimmuneinstitute.org/covid_timeline/study-finds-stable-autoantibody-profiles-6-months-after-covid-19-booster/) Sep 08, 2026 Paul Offit on Vaccine Trust, Policy, and Public Communication Dr. Paul Offit reflects on vaccine trust, lessons from the COVID-19 pandemic, and why clear, credible communication will be essential to rebuilding confidence in vaccine policy. [Read Post](https://www.autoimmuneinstitute.org/covid_timeline/paul-offit-vaccine-trust-public-communication/) Aug 20, 2026 Vaccine Responses Vary Even Among Immunosuppressed Individuals Many studies have looked at how our immune system responds to a vaccine by measuring whether the immune system created antibodies against the vaccine. However, a new study finds that already circulating antibodies could hold clues into how well the immune system will respond to a future vaccine.  This study involved 2,445 healthy individuals and 1,644 immunosuppressed individuals. The researchers used blood samples from the participants to measure antibodies against almost 200 antigens including those from common infections and autoantigens associated with autoimmune diseases. They then compared the levels of these antibodies to how well the study participants responded to the \[…\] - Autoimmune Diseases & Covid-19 - Covid-19 Antibodies - Covid-19 Vaccines [Read Post](https://www.autoimmuneinstitute.org/covid_timeline/vaccine-responses-vary-even-among-immunosuppressed-individuals/) Aug 13, 2026 Study Identifies Molecular Pathways Involved in COVID-19-Related Heart Damage Researchers identified changes in gene regulation associated with inflammation, fibrosis, and heart muscle damage following SARS-CoV-2 infection, highlighting potential biomarkers and therapeutic targets for COVID-19-related cardiac complications. - Covid-19 Infections - Covid-19 Research Studies [Read Post](https://www.autoimmuneinstitute.org/covid_timeline/covid-19-heart-damage-molecular-pathways/) Aug 05, 2026 COVID-19 May Reactivate Dormant Viruses, Study Finds A large study of people hospitalized with COVID-19 found that the infection was frequently accompanied by reactivation of viruses that can remain dormant in the body for years. Conducted across 15 biomedical research institutions in the United States, the findings may help us better understand how severe infections disrupt the immune system and whether reactivated viruses contribute to complications of acute COVID-19 or long COVID. Researchers analyzed samples from 1,154 people hospitalized with COVID-19 at 20 U.S. hospitals, collecting more than 200,000 samples and generating more than 1 billion data points over the course of a year. Using RNA sequencing and \[…\] - Covid-19 Antibodies - Covid-19 Infections - Covid-19 Research Studies [Read Post](https://www.autoimmuneinstitute.org/covid_timeline/covid-19-may-reactivate-dormant-viruses-study-finds/) Jul 21, 2026 Resources for Interpreting Long COVID Clinical Trials As Long COVID clinical trials continue to report new findings, understanding how to interpret those results is just as important as keeping up with the latest research. Clinical trial headlines can sometimes overstate what a study actually shows, particularly when early-stage or preliminary findings are reported. Resources For readers looking to better understand clinical trial evidence, GAI’s article, “A Guide to Interpreting Clinical Trial Stories,” explains how treatments progress from preclinical research through Phase 4 clinical trials and offers practical questions to ask when evaluating research. Topics include understanding study populations, trial phases, endpoints, control groups, replication, and how to look beyond attention-grabbing headlines \[…\] - Covid-19 Clinical Trials - Long COVID [Read Post](https://www.autoimmuneinstitute.org/covid_timeline/resources-for-interpreting-long-covid-clinical-trials/) Jul 16, 2026 RECOVER-TLC July 2026 Update: Long COVID Clinical Trial Progress The NIH hosted a community webinar on July 16, 2026, to provide updates on the RECOVER-Treating Long COVID (RECOVER-TLC) initiative. NIH leaders emphasized that Long COVID research and treatment development remain priorities across NIAID and NIH before researchers reviewed four clinical trials underway or in development, discussed how biomarkers will be incorporated into the studies, explained the clinical trial development process, and answered questions from the Long COVID community. - Covid-19 Clinical Trials - Covid-19 Research Studies - Long COVID [Read Post](https://www.autoimmuneinstitute.org/covid_timeline/recover-tlc-july-2026-update-long-covid-clinical-trial-progress/) Jul 13, 2026 COVID-19 and Autoimmune Disease: Current Evidence A new review published in the Korean Journal of Internal Medicine synthesizes evidence from epidemiologic studies, immunology research, clinical registries, vaccine studies, and Long COVID investigations to examine how COVID-19 influences autoimmune disease and how autoimmune diseases, in turn, affect COVID-19 outcomes. - Autoimmune Diseases & Covid-19 - Celiac disease & Covid-19 - Covid-19 Infections - Covid-19 Research Studies - Covid-19 Vaccines - GBS & Covid-19 - IBD & Covid-19 - Long COVID - Lupus & Covid-19 - MS & Covid-19 - RA & Covid-19 - Sjögren disease & Covid-19 - T1D & Covid-19 [Read Post](https://www.autoimmuneinstitute.org/covid_timeline/covid-19-and-autoimmune-disease-current-evidence/) ## Posts navigation 1[2](https://www.autoimmuneinstitute.org/wp-admin/admin-ajax.php/page/2/?action=as_async_request_queue_runner&nonce=03efbfba2b)[3](https://www.autoimmuneinstitute.org/wp-admin/admin-ajax.php/page/3/?action=as_async_request_queue_runner&nonce=03efbfba2b)…[46](https://www.autoimmuneinstitute.org/wp-admin/admin-ajax.php/page/46/?action=as_async_request_queue_runner&nonce=03efbfba2b)[Next »](https://www.autoimmuneinstitute.org/wp-admin/admin-ajax.php/page/2/?action=as_async_request_queue_runner&nonce=03efbfba2b) --- ### [03 - Homepage](https://www.autoimmuneinstitute.org/03-homepage/) **Published:** February 23, 2024 **Author:** agustin.fernandezb@elevationweb.org **Content:** ### Global Autoimmune Institute Is Empowering Solutions In the diagnosis and treatment of autoimmune disease through research, education, and validation while supporting multidisciplinary approaches to wellness. Make a difference in the lives of those with autoimmune disease. make a donation ###### What You Need To Know ## COVID News & Research Updates Want to know what’s going on in coronavirus news? Check out our ongoing timeline summarizing key COVID-19 scientific developments, especially as they pertain to autoimmune disease. Read more Your browser does not support the video tag. ###### What You Need To Know ## COVID News & Research Updates Want to know what’s going on in coronavirus news? Check out our ongoing timeline summarizing key COVID-19 scientific developments, especially as they pertain to autoimmune disease. ![-desc](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/03/blog-box1-img-1.jpg) ###### What You Need To Know ## COVID News & Research Updates Want to know what’s going on in coronavirus news? Check out our ongoing timeline summarizing key COVID-19 scientific developments, especially as they pertain to autoimmune disease. ![](https://www.autoimmuneinstitute.org/wp-content/themes/elevation-framework/src/assets/images/mask-banner.svg) ![-desc](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/pexels-antoni-shkraba-7345471-2-1.jpg) ###### What You Need To Know ## COVID News & Research Updates Want to know what’s going on in coronavirus news? Check out our ongoing timeline summarizing key COVID-19 scientific developments, especially as they pertain to autoimmune disease. Read more Your browser does not support the video tag. Want to know what’s going on in coronavirus news? Check out our ongoing timeline summarizing key COVID-19 scientific developments, especially as they pertain to autoimmune disease. ![](https://www.autoimmuneinstitute.org/wp-content/themes/elevation-framework/src/assets/images/mask-banner.svg) ![-desc](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/pexels-antoni-shkraba-7345471-2-1.jpg) ###### What You Need To Know ## COVID News & Research Updates Want to know what’s going on in coronavirus news? Check out our ongoing timeline summarizing key COVID-19 scientific developments, especially as they pertain to autoimmune disease. Read more ![-desc](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/03/blog-box1-img-1.jpg) Want to know what’s going on in coronavirus news? Check out our ongoing timeline summarizing key COVID-19 scientific developments, especially as they pertain to autoimmune disease. ![](https://www.autoimmuneinstitute.org/wp-content/themes/elevation-framework/src/assets/images/mask-banner.svg) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Group-59391.jpg) ### Who We Are A nonprofit dedicated to improving the health and well-being of people with autoimmune disease. Too often, the ‘invisible’ yet debilitating aspects of life with autoimmune disease are unrecognized or misunderstood, which has driven GAI’s desire to not only help improve the health and wellbeing of people with an autoimmune disease, but also to raise awareness and promote open communication in the community and between patients and their physicians. Learn more about us in our featured Outlook section on autoimmune disease in Nature magazine ### What We Do A nonprofit dedicated to improving the health and well-being of people with autoimmune disease. Too often, the ‘invisible’ yet debilitating aspects of life with autoimmune disease are unrecognized or misunderstood, which has driven GAI’s desire to not only help improve the health and wellbeing of people with an autoimmune disease, but also to raise awareness and promote open communication in the community and between patients and their physicians. More about our Work ![mask-home-b](https://www.autoimmuneinstitute.org/wp-content/themes/elevation-framework/src/assets/images/mask-home-b.svg) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Mask-group.png) ## Find medical Institutions that treat ADs A comprehensive list of medical institutions across the United States specializing in diagnosing and treating various autoimmune diseases in an easy-to-use keyword and location search format. Find the Help You Need ### Resources for Hope & Health ![Global Autoimmune Institute Autoimmune Aware Support Group Logo](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Group-59259.svg) ##### Join our Online Support Group DATE: November 7th, 2PM EST Autoimmune Aware is a dynamic support group initiative focused on creating an inclusive space for the autoimmune disease and chronic illness community to thrive, learn, connect & share. [ More about our Support Group ](#) ![an icon showing a microphone and headphones, representing audio media](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Group-59545.svg) ##### Listen to the Raising Celiac podcast! Funded by GAI, this podcast covers the complexities of celiac disease and how it intertwines with so many other autoimmune diseases. With new episodes monthly featuring experts from across the United States, this podcast is a must-listen! [ More about the Podcast ](#) ![Smiling girl with headphones on computer](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Group-59268.png) --- ### [07 - A-Z Disease List Directory](https://www.autoimmuneinstitute.org/07-a-z-disease-list-directory/) **Published:** February 23, 2024 **Author:** agustin.fernandezb@elevationweb.org **Content:** ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/banner-photo-1.jpg) # A-Z Autoimmune Disease List This A-Z list and basic information about each recognized autoimmune disease were compiled and written by our dedicated research team at the Global Autoimmune Institute. The list provides a starting point in learning about autoimmune diseases and immune-mediated conditions, with links to other sources that we believe to be accurate and informative. This section will be updated periodically. ![](https://www.autoimmuneinstitute.org/wp-content/themes/elevation-framework/src/assets/images/layer-list.svg) Search: Clear filters **Legend:** \* indicates autoimmune-related diseases or diseases that are suspected to be autoimmune \| indicates a variant or subtype of the disease / indicates a synonym or alternate name for the same disease A B C D E F G H I J K L M N O P Q R S T U V W X Y Z [Acquired hemophilia ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/acquired-hemophilia/) [Acromegaly ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/acromegaly/) [Acute disseminated encephalomyelitis (ADEM) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/acute-disseminated-encephalomyelitis/) [Acute hemorrhagic leukoencephalitis (AHLE, Hurst’s disease) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/hursts-disease/) [Addison’s disease ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-addisons-disease/) [Adult-onset Still’s disease ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/adult-onset-stills-disease/) [Agammaglobulinemia ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/agammaglobulinemia/) [Alopecia areata ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/alopecia-areata/) [Amyloidosis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/amyloidosis/) [Ankylosing spondylitis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ankylosing-spondylitis/) [Anti-NMDAR encephalitis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/anti-nmda-receptor-encephalitis/) [Antiphospholipid syndrome ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/antiphospholipid-syndrome/) [Aplastic anemia ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/aplastic-anemia/) [Arteriosclerosis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/arteriosclerosis/) [Autoimmune angioedema ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-angioedema/) [Autoimmune autonomic disorders (autoimmune dysautonomia) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-autonomic-disorders-autoimmune-dysautonomia/) [Autoimmune autonomic ganglionopathy (AAG) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-autonomic-ganglionopathy/) [Autoimmune encephalitis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-encephalitis/) [Autoimmune gastritis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-gastritis/) [Autoimmune hemolytic anemia ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-hemolytic-anemia/) [Autoimmune hepatitis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-hepatitis/) [Autoimmune hyperlipidemia ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-hyperlipidemia/) [Autoimmune hypophysitis (lymphocytic hypophysitis) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-hypophysitis/) [Autoimmune inner ear disease ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-inner-ear-disease/) [Autoimmune interstitial lung disease ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-interstitial-lung-disease/) [Autoimmune lymphoproliferative syndrome ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-lymphoproliferative-syndrome/) [Autoimmune myelofibrosis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-myelofibrosis/) [Autoimmune myocarditis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-myocarditis/) [Autoimmune neutropenia ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-neutropenia/) [Autoimmune oophoritis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-oophoritis/) [Autoimmune orchitis (testicular autoimmunity) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/testicular-autoimmunity/) [Autoimmune pancreatitis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-pancreatitis/) [Autoimmune polyglandular syndrome ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-polyglandular-syndromes/) [Autoimmune retinopathy ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-retinopathy/) [Autoimmune sudden sensorineural hearing loss ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-sudden-sensorineural-hearing-loss/) [Autoimmune urticaria (chronic spontaneous urticaria) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/chronic-urticaria/) [Autoimmune uveitis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-uveitis/) [Autoimmune vasculitis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-vasculitis/) [Balo disease (concentric sclerosis) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/balo-disease/) [Behçet’s disease ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/behcets/) [Birdshot chorioretinopathy ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/birdshot-chorioretinopathy/) [Bullous pemphigoid ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/bullous-pemphigoid/) [Castleman disease ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/castleman-disease/) [Celiac disease ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/celiac-disease/) [Chagas disease ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/chagas-disease/) [Chronic inflammatory demyelinating polyneuropathy (CIDP) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/chronic-inflammatory-demyelinating-polyneuropathy/) [Chronic recurrent multifocal osteomyelitis ](https://www.autoimmuneinstitute.org/?post_type=diseases_list&p=33722) [Churg-Strauss syndrome (eosinophilic granulomatosis with polyangiitis, EGPA) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/churg-strauss-syndrome/) [Cogan’s syndrome ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/cogan-syndrome/) [Cold agglutinin disease ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/cold-agglutinin-disease/) [Complex regional pain syndrome (CRPS) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/complex-regional-pain-syndrome-crps/) [Congenital heart block ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/congenital-heart-block/) [CREST syndrome (limited cutaneous systemic sclerosis) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crest-syndrome/) [Crohn’s disease ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crohns-disease/) [Cronkhite-Canada syndrome ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/cronkhite-canada-syndrome/) [Cryptogenic organizing pneumonia ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/cryptogenic-organizing-pneumonia/) [Custom Articles Block Test ](https://www.autoimmuneinstitute.org/?post_type=diseases_list&p=22460) [Dermatitis herpetiformis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/dermatitis-herpetiformis/) [Dermatomyositis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/dermatomyositis/) [Discoid lupus ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/discoid-lupus/) [Dressler’s syndrome (postmyocardial infarction syndrome) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/dresslers-syndrome/) [Eczema (atopic dermatitis) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/eczema/) [Endometriosis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/endometriosis/) [Eosinophilic esophagitis (eosinophilic gastroenteritis) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/eosinophilic-esophagitis/) [Eosinophilic fasciitis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/eosinophilic-fasciitis/) [Erythema nodosum ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/erythema-nodosum/) [Essential mixed cryoglobulinemia ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/essential-mixed-cryoglobulinemia/) [Evans syndrome ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/evans-syndrome/) [Fibromyalgia ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/fibromyalgia/) [Fibrosing alveolitis (idiopathic pulmonary fibrosis) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/fibrosing-alveolitis/) [Giant cell arteritis (temporal arteritis, Horton’s disease) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/giant-cell-arteritis-temporal-arteritis-hortons-disease/) [Giant cell myocarditis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/giant-cell-myocarditis/) [Glomerulonephritis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/glomerulonephritis/) [Goodpasture’s syndrome (anti-GBM disease) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/goodpastures-syndrome/) [Granulomatosis with polyangiitis (GPA, Wegener’s granulomatosis) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/wegeners/) [Graves’ disease ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/graves-disease/) [Guillain-Barré syndrome (GBS) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/guillain-barre-syndrome/) [Hashimoto’s thyroiditis (autoimmune thyroiditis) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/hashimotos-thyroiditis/) [Henoch-Schonlein purpura ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/henoch-schonlein-purpura/) [Hidradenitis suppurativa ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/hidradenitis-suppurativa/) [Hypogammaglobulinemia ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/hypogammaglobulinemia/) [IgA nephropathy (Berger’s disease) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/iga-nephropathy/) [IgG4-related sclerosing disease ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/igg4-related-sclerosing-disease/) [Immune thrombocytopenia (autoimmune thrombocytopenic purpura) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/immune-thrombocytopenia/) [Immune-mediated necrotizing myopathy ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/immune-mediated-necrotizing-myopathy/) [Inclusion body myositis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/inclusion-body-myositis/) [Interstitial cystitis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/interstitial-cystitis/) [Juvenile idiopathic arthritis (JIA) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/juvenile-idiopathic-arthritis-stills/) [Juvenile myositis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/juvenile-myositis/) [Kawasaki disease ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/kawasaki-disease/) [Lambert-Eaton myasthenic syndrome ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/lambert-eaton-myasthenic-syndrome/) [Leukocytoclastic vasculitis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/leukocytoclastic-vasculitis/) [Lichen planus ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/lichen-planus/) [Lichen sclerosus ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/lichen-sclerosus/) [Ligneous conjunctivitis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ligneous-conjunctivitis/) [Linear IgA disease ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/linear-igadisease/) [Lupus nephritis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/lupus-nephritis/) [Lyme disease ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/lyme-disease/) [Ménière’s disease ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/menierers-disease/) [Microscopic colitis (lymphocytic colitis and collagenous colitis) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/microscopic-colitis/) [Microscopic polyangiitis (MPA) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/microscopic-polyangiitis-anca-associated-vasculitis/) [Mixed connective tissue disease ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/mixed-connective-tissue-disease/) [Mooren’s ulcer ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/moorens-ulcer/) [Mucous membrane pemphigoid (MMP) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/mucous-membrane-pemphigoid/) [Multifocal motor neuropathy ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multifocal-motor-neuropathy/) [Multiple sclerosis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/) [Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/me-cfs/) [Myasthenia gravis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/myasthenia-gravis/) [Myelin oligodendrocyte glycoprotein antibody disease (MOGAD) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/myelin-oligodendrocyte-glycoprotein-antibody-disease-mogad/) [Myositis/polymyositis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/polymyositis/) [Narcolepsy ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/narcolepsy/) [Neonatal lupus ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/neonatal-lupus/) [Neuromyelitis optica (NMO, Devic’s disease) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/neuromyelitis-optica/) [Opsoclonus-myoclonus syndrome ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/opsoclonus-myoclonus-syndrome/) [Optic neuritis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/optic-neuritis/) [Palindromic rheumatism ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/palindromic-rheumatism/) [Palmoplantar pustulosis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/palmoplantar-pustulosis/) [Paraneoplastic cerebellar degeneration ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/paraneoplastic-cerebellar-degeneration/) [Paraneoplastic pemphigus ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/paraneoplastic-pemphigus/) [Paroxysmal nocturnal hemoglobinuria ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/paroxysmal-nocturnal-hemoglobinuria/) [Parry-Romberg syndrome (progressive hemifacial atrophy) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/parry-romberg-syndrome/) [Pars planitis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/pars-planitis/) [Parsonage-Turner syndrome (brachial neuritis) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/parsonage-turner-syndrome/) [Pediatric acute-onset neuropsychiatric syndrome (PANS, PANDAS) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/pans-pandas/) [Pemphigoid gestationis (herpes gestationis) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/pemphigoid-gestationis/) [Pemphigus foliaceus ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/pemphigus-foliaceus/) [Pemphigus vulgaris ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/pemphigus-vulgaris/) [Pernicious anemia ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/pernicious-anemia/) [Pityriasis lichenoides et varioliformis acuta (PLEVA, Mucha-Habermann disease) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/pityriasis-lichenoides-et-varioliformis-acuta-pleva/) [POEMS syndrome ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/poems-syndrome/) [Polyarteritis nodosa ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/polyarteritis-nodosa/) [Polymyalgia rheumatica ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/polymyalgia-rheumatica/) [Postural orthostatic tachycardia syndrome (POTS) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/postural-orthostatic-tachycardia-syndrome/) [Primary biliary cholangitis (PBC) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/primary-biliary-cirrhosis/) [Primary sclerosing cholangitis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/primary-sclerosing-cholangitis/) [Progesterone dermatitis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-progesterone-dermatitis/) [Psoriasis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/psoriasis/) [Psoriatic arthritis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/psoriatic-arthritis/) [Pulmonary alveolar proteinosis ](https://www.autoimmuneinstitute.org/?post_type=diseases_list&p=33723) [Pure red cell aplasia ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/pure-red-cell-aplasia/) [Pyoderma gangrenosum ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/pyoderma-gangrenosum/) [Raynaud’s ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/raynauds-syndrome/) [Reactive arthritis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/reactive-arthritis/) [Relapsing polychondritis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/relapsing-polychondritis/) [Retroperitoneal fibrosis ](https://www.autoimmuneinstitute.org/?post_type=diseases_list&p=33728) [Rheumatic fever ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatic-fever/) [Rheumatoid arthritis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/) [Sarcoidosis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sarcoidosis/) [Schmidt syndrome ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/schmidt-syndrome/) [Scleritis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/scleritis/) [Scleroderma (systemic sclerosis) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/scleroderma/) [Sjögren disease (SjD) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sjogren-syndrome/) [Small fiber sensory neuropathy ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/small-fiber-sensory-neuropathy/) [Stiff person syndrome ](https://www.autoimmuneinstitute.org/?post_type=diseases_list&p=33732) [Susac’s syndrome ](https://www.autoimmuneinstitute.org/?post_type=diseases_list&p=33735) [Sydenham’s chorea ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sydenhams-chorea/) [Sympathetic ophthalmia ](https://www.autoimmuneinstitute.org/?post_type=diseases_list&p=33740) [Systemic lupus erythematosus (SLE) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/) [Takayasu arteritis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/takayasu-arteritis/) [Thyroid eye disease (Graves’ ophthalmopathy, thyroid-associated orbitopathy) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/thyroid-eye-disease-graves-ophthalmopathy-thyroid-associated-orbitopathy/) [Tolosa-Hunt syndrome ](https://www.autoimmuneinstitute.org/?post_type=diseases_list&p=33744) [Transverse myelitis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/transverse-myelitis/) [Type 1 diabetes (T1D) ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/type-1-diabetes-insulin-dependent-diabetes/) [Ulcerative colitis ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ulcerative-colitis/) [Undifferentiated connective tissue disease ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/undifferentiated-connective-tissue-disease/) [Vitiligo ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/vitiligo/) [Vogt-Koyanagi-Harada disease ](https://www.autoimmuneinstitute.org/?post_type=diseases_list&p=33747) ## Posts navigation ### Helpful Resources, Institutions & More [ ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/facybox-img1_hover.png) AD Doctors & Specialists Autoimmune diseases are becoming more well-known, yet many people are still experiencing delayed diagnosis or misdiagnosis. As finding answers can take years, seeking out doctors who have a greater awareness of these chronic, immune-mediated conditions can help speed up the process. More about AD Doctors & Specialists Read more about AD Doctors & Specialists ](#) [ ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/facybox-img1_hover-1.png) Medical Institutions Directory A comprehensive list of medical institutions across the United States specializing in the diagnosis and treatment of autoimmune diseases in an easy-to-use keyword and location search format. Find Medical Institutions Near You Read more about Medical Institutions Directory ](#) [ ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/pexels-pixabay-2156-3-1.png) Autoimmune Organizations Explore our growing list of national and international organizations. From groups that focus on whole-body approaches to autoimmune health and healing to alphabetically listed disease organizations. This list provides in-depth information and support on daily living, advocacy, research, science, healthcare, and more. Browse Autoimmune Organizations Read more about Autoimmune Organizations ](#) --- ### [06 - Current Research](https://www.autoimmuneinstitute.org/06-current-research/) **Published:** February 16, 2024 **Author:** Elevation **Content:** ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/banner-home-_photo-1.jpg) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/03/banner-home-_photo-1-1-e1710416901981.jpg) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/03/banner-home-_photo-1-2-e1710416926548.jpg) # Get to know the Research Grants & Projects we fund ![](https://www.autoimmuneinstitute.org/wp-content/themes/elevation-framework/src/assets/images/layer-purple-top.png) ##### GAI is increasing knowledge and progress in autoimmune disease by funding important scientific investigations. We are a moving force in propelling collaboration and awareness in science and medicine. Information on some ADs is much less available than others – we are on our way to help change that. ![](https://www.autoimmuneinstitute.org/wp-content/themes/elevation-framework/src/assets/images/layer-purple-bottom.png) - Children’s National Hospital - Johns Hopkins - Boston Children’s Hospital ### A Brighter Future for Children with Neuroimmunological Conditions AT THE NEUROSCIENCE AND BEHAVIORAL MEDICINE CENTER OF CHILDREN’S NATIONAL HOSPITAL Principal Investigator: Elizabeth Wells, MD **Background Information:** Pediatric neuroimmunological conditions are a group of neurologic disorders predominantly characterized by inflammatory responses in the central nervous system and are autoimmune in nature. In children with these autoimmune conditions, the body’s natural defense system attacks its own healthy cells. Neuroimmunological conditions specifically target the brain and nervous system. Many of these complete conditions are idiopathic and arise spontaneously, leaving previously healthy children with a lifetime of illness and challenges. Neuroimmunological conditions can affect a child’s ability to eat, walk, talk, think, see or move normally. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/03/blog-box1-img.jpg) #### Children’s National Hospital Children’s National Hospital is home to one of the few comprehensive pediatric neuroimmunology programs in the country and some of the nation’s leading Neuroimmunology experts. Their specialists have expertise in caring for children with a wide range of neuroimmunological conditions, including [autoimmune encephalitis, neuromyelitis optica spectrum disorder](#) (NMO or NMOSD), [multiple sclerosis](#) (MS), myelin oligodendrocyte glycoprotein antibody disease (MOG or MOGAD), [acute disseminated encephalomyelitis](#) (ADEM), opsoclonus-myoclonus-ataxia syndrome (OMAS), primary CNS vasculitis, transverse myelitis, acute flaccid myelitis (AFM), new-onset refractory status epilepticus (NORSE), and febrile infection-related epilepsy syndrome (FIRES). #### Research Aims: To develop and implement new investigative studies and clinical trials for children with neuroimmunological conditions. More specifically: 1. Identify shared immune dysregulatory pathways in patients with immune-neurologic conditions 2. Discover potential genetic causes of clinically characterized but genetically uncharacterized neuro-inflammatory diseases 3. Characterize the clinical disease manifestations to generate a comprehensive assessment of neurological and non-neurological disease indicators, and 4. Collect longitudinal functional outcomes, including neurologic status, functional status, neurocognitive outcomes, and quality of life. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/03/blog-box1-img-1.jpg) Principal Investigator: Dr. Elizabeth Wells, M.D. Background Information: Pediatric neuroimmunological conditions are a group of neurologic disorders predominantly characterized by inflammatory responses in the central nervous system and are autoimmune in nature. In children with these autoimmune conditions, the body’s natural defense system attacks its own healthy cells. Neuroimmunological conditions specifically target the brain and nervous system. Many of these complete conditions are idiopathic and arise spontaneously, leaving previously healthy children with a lifetime of illness and challenges. Neuroimmunological conditions can affect a child’s ability to eat, walk, talk, think, see or move normally. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/past-grants_background-photo.jpg) ## Find past Research Grants & Projects Funding studies on autoimmune disease is central to GAI’s mission. We are proud to have had a part in its advancement, from groundbreaking research that helped answer what causes lupus to develop to establishing clinics for multidisciplinary care. We continue to support researchers at the highest-ranking academic and medical institutions across the US. Past Grants & Projects --- ### [05 - Support group](https://www.autoimmuneinstitute.org/05-support-group/) **Published:** February 23, 2024 **Author:** agustin.fernandezb@elevationweb.org **Content:** ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/banner-home-_photo.jpg) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/03/banner-home-_photo-e1710416383792.jpg) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/03/banner-home-_photo-1-e1710416425552.jpg) ![](https://www.autoimmuneinstitute.org/wp-content/themes/elevation-framework/src/assets/images/layer-ocean-top.png) ## About the Support Group ##### Autoimmune Aware is a dynamic support group initiative focused on creating an inclusive space for the autoimmune disease and chronic illness community to thrive, learn, connect & share. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Group-59504.jpg) ### What to Expect **Monthly, virtual meetings** touch upon all aspects of life with chronic illness – symptom management, diagnosis, stress, social life and relationships, physical movement, nutrition – and include casual conversation and connection with others. **Our aim is to help each other live well and feel heard, while not letting disease define us**. We encourage members to come as they are, with an open mind and the willingness to nurture a positive atmosphere. **This group is community-focused**. Attendees are welcome to give suggestions and create leadership roles if desired. They may even choose to branch off and develop local groups in their own unique communities. Meetings are facilitated by fellow support group member Jessica Ulmer. **Meetings are typically held on the last Saturday of each month at 10 a.m. PST/1 p.m. EST. The schedule may differ some months due to holidays or the schedule of our moderator, but we do our best to have the dates for the upcoming three meetings posted. Last-minute cancellations may occur, so make sure you are subscribed to our support group text updates!** ### Upcoming Schedule Date Time ##### December 16 ##### 10AM PST/ 1PM EST ##### January 27 ##### 10AM PST/ 1PM EST ##### February 24 ##### 10AM PST/ 1PM EST #### Join today! Please RSVP for our upcoming meetings on [MeetUp](http://gai.local/) or [Facebook](http://gai.local/) ###### PLEASE NOTE: Autoimmune Aware Support Group meetings are not mediated by a trained professional. The meetings are facilitated and attended by peers in the autoimmune and chronic illness community solely to provide comfort and encouragement. GAI strongly recommends that all participants seek and obtain medical advice, information, and treatment by physicians and other qualified health professionals. Information and suggestions offered by group members are not a substitute for medical or mental health treatment by a professional. --- ### [11 - Blog](https://www.autoimmuneinstitute.org/11-blog/) **Published:** February 23, 2024 **Author:** agustin.fernandezb@elevationweb.org **Content:** ## Blog [addtoany] ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/diagnosing-AD.png) October 22, 2026 by Carolyn Serraino, MS Misdiagnosed and Undiagnosed: Expert Insights on the Autoimmune Diagnosis Process Diagnosing autoimmune diseases is often a complex and challenging process because autoimmune diseases vary widely. Identifying patterns and clusters of… - [Autoimmune Care & Caregiver Support](https://www.autoimmuneinstitute.org/category/autoimmune-care-and-support/) - [Diagnosis & Treatment](https://www.autoimmuneinstitute.org/category/diagnosis-treatment/) 22 October 2026 [Read Post](https://www.autoimmuneinstitute.org/articles/misdiagnosed-undiagnosed-expert-insights-on-the-autoimmune-diagnosis-process) Search Categories\* Category About Autoimmune Disease Autoimmune Care & Caregiver Support COVID-19 and Long Covid Diagnosis & Treatment Living Well with Autoimmune Disease Search Clear all filters Displaying Results For: ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/diagnosing-AD.png) October 22, 2026 by Carolyn Serraino Misdiagnosed and Undiagnosed: Expert Insights on the Autoimmune Diagnosis Process Diagnosing autoimmune diseases is often a complex and challenging process because autoimmune diseases vary widely. Identifying patterns and clusters of… - [Autoimmune Care & Caregiver Support](https://www.autoimmuneinstitute.org/category/autoimmune-care-and-support/) - [Diagnosis & Treatment](https://www.autoimmuneinstitute.org/category/diagnosis-treatment/) [Read Post](https://www.autoimmuneinstitute.org/articles/misdiagnosed-undiagnosed-expert-insights-on-the-autoimmune-diagnosis-process) ![Conceptual medical illustration of a human silhouette showing the effects of environmental and lifestyle factors on autoimmune disease risk, including airborne pathogens, lung exposure, stress-related brain activity, and gut microbiome dysbiosis.](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/08/environmental-toxins-autoimmune-disease-2.jpg) August 24, 2026 by Carolyn Serraino Environmental Toxins and Autoimmune Disease Environmental toxins are part of everyday life, but not all exposures carry the same risk. Learn how pollutants, household… - [Living Well with Autoimmune Disease](https://www.autoimmuneinstitute.org/category/living-well-understanding-the-body/) [Read Post](https://www.autoimmuneinstitute.org/articles/environmental-triggers-autoimmune-disease) ![Illustration of a person surrounded by reaching shadow-like hands, representing trauma, chronic stress, and their potential effects on health and autoimmune disease.](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/08/trauma-autoimmune-disease-stress-response.jpg) August 24, 2026 by Carolyn Serraino Trauma and Autoimmune Disease: What the Research Shows Research suggests trauma and PTSD may affect inflammation, immune function, and autoimmune disease risk. Here’s what scientists know about… - [Living Well with Autoimmune Disease](https://www.autoimmuneinstitute.org/category/living-well-understanding-the-body/) [Read Post](https://www.autoimmuneinstitute.org/articles/trauma-and-autoimmune-disease) ![Industrial facility beside polluted water with discarded chemical containers, representing environmental chemical exposure and autoimmune disease risk.](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/08/Chemical-Exposure-and-Autoimmune-Disease.jpg) August 24, 2026 by Carolyn Serraino Chemical Exposure and Autoimmune Disease: What the Research Shows Which chemicals are linked to autoimmune disease? Experts explain what research shows about PFAS, pesticides, heavy metals, TCE, silica,… - [Living Well with Autoimmune Disease](https://www.autoimmuneinstitute.org/category/living-well-understanding-the-body/) [Read Post](https://www.autoimmuneinstitute.org/articles/chemical-exposure-autoimmune-disease) ![Supportive hands holding one another, representing compassion and emotional support for people living with autoimmune or chronic disease.](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/07/supporting-someone-with-autoimmune-or-chronic-disease.jpg) July 16, 2026 by Carolyn Serraino How to Support Someone with Autoimmune or Chronic Disease Many people want to support a parent, sibling, friend, partner, colleague, or neighbor living with an autoimmune or chronic… - [Autoimmune Care & Caregiver Support](https://www.autoimmuneinstitute.org/category/autoimmune-care-and-support/) [Read Post](https://www.autoimmuneinstitute.org/articles/how-to-support-someone-with-autoimmune-or-chronic-disease) ![Illustration of a person with lungs surrounded by viruses, bacteria, and fungi representing infection risk in people with autoimmune diseases receiving immunosuppressive therapy.](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/07/navigating-immunosuppression-infection-risk-autoimmune-disease.jpg) July 16, 2026 by Carolyn Serraino Navigating Immunosuppression and Infection Risk Modern immunosuppressive therapies have transformed the treatment of autoimmune diseases, allowing many people to live healthier, more active lives…. - [Living Well with Autoimmune Disease](https://www.autoimmuneinstitute.org/category/living-well-understanding-the-body/) [Read Post](https://www.autoimmuneinstitute.org/articles/navigating-immunosuppression-and-infection-risk) ![GLP-1 Receptor Agonists and Autoimmune Diseases](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/06/GLP-1-Receptor-Agonists-and-Autoimmune-Diseases-1.jpg) June 18, 2026 by Carolyn Serraino GLP-1 Receptor Agonists and Autoimmune Diseases If you have an autoimmune disease, should you be concerned about GLP-1 medications? Here’s what experts and current research… - [Diagnosis & Treatment](https://www.autoimmuneinstitute.org/category/diagnosis-treatment/) [Read Post](https://www.autoimmuneinstitute.org/articles/glp-1-receptor-agonists-and-autoimmune-diseases) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/06/A-Guide-to-Interpreting-Clinical-Trial-Stories.jpg) June 8, 2026 by Carolyn Serraino A Guide to Interpreting Clinical Trial Stories How to evaluate pre-clinical research, clinical trial phases, study results, and key questions to ask with expert insights from… - [About Autoimmune Disease](https://www.autoimmuneinstitute.org/category/about-autoimmune-disease/) [Read Post](https://www.autoimmuneinstitute.org/articles/a-guide-to-interpreting-clinical-trial-stories) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/06/living-with-multiple-ADs-4.jpg) June 8, 2026 by Carolyn Serraino Living with Multiple Autoimmune Conditions Learn how to manage multiple autoimmune diseases with expert insights on polyautoimmunity, symptom tracking, specialist coordination, medication management, and… - [Living Well with Autoimmune Disease](https://www.autoimmuneinstitute.org/category/living-well-understanding-the-body/) [Read Post](https://www.autoimmuneinstitute.org/articles/living-with-multiple-autoimmune-conditions) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/06/Autoimmune-or-Not-2.jpg) June 5, 2026 by Carolyn Serraino Autoimmune or Not? The Diseases That Blur the Lines Many diseases affect the immune system without being classified as autoimmune. Experts explain why conditions like fibromyalgia, endometriosis, POTS,… - [About Autoimmune Disease](https://www.autoimmuneinstitute.org/category/about-autoimmune-disease/) [Read Post](https://www.autoimmuneinstitute.org/articles/autoimmune-or-not-the-diseases-that-blur-the-lines) ![Immune Nodes and Vessels in Lymphatic System 3d illustration](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/02/Restoring-Immune-Tolerance.jpg) April 13, 2026 by Carolyn Serraino Restoring Immune Tolerance in Autoimmune Disease Immune tolerance prevents the body from attacking itself. Learn how it breaks down in autoimmune disease and how new… - [About Autoimmune Disease](https://www.autoimmuneinstitute.org/category/about-autoimmune-disease/) - [Diagnosis & Treatment](https://www.autoimmuneinstitute.org/category/diagnosis-treatment/) [Read Post](https://www.autoimmuneinstitute.org/articles/restoring-immune-tolerance-in-autoimmune-disease) ![Lymphocytes and biological immune system, 3d rendering. 3D illustration.](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/02/AD-and-cancer.jpg) April 13, 2026 by Carolyn Serraino The Immune Balancing Act: Cancer and Autoimmunity Cancer and autoimmune disease sit at opposite ends of the immune spectrum. Yet treating one condition can sometimes increase… - [About Autoimmune Disease](https://www.autoimmuneinstitute.org/category/about-autoimmune-disease/) [Read Post](https://www.autoimmuneinstitute.org/articles/the-immune-balancing-act-cancer-and-autoimmunity) ![Flying blue 3d antibodies interacting with red viruses. Immune defense, immunotherapy, disease prevention, vaccination, pathogen neutralization, molecular biology concept. Low poly wireframe.](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/02/The-Immune-Spectrum-From-Autoimmunity-to-Cancer.jpg) April 13, 2026 by Carolyn Serraino The Immune Spectrum: From Autoimmunity to Cancer How are autoimmune disease and cancer connected? Learn how immune balance, inflammation, and immune dysfunction shape disease across the… - [About Autoimmune Disease](https://www.autoimmuneinstitute.org/category/about-autoimmune-disease/) [Read Post](https://www.autoimmuneinstitute.org/articles/the-immune-spectrum-from-autoimmunity-to-cancer) ![silhouette of a woman in front of a sunset peering into the distance](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/03/Finding-Purpose-with-Autoimmune-Disease-and-Chronic-Illness-GAI.jpg) February 5, 2026 by Carolyn Serraino Finding Purpose & Fulfillment with Autoimmune and Chronic Disease People with autoimmune diseases or other severe chronic illnesses learn how to manage their condition but also strive to… - [Living Well with Autoimmune Disease](https://www.autoimmuneinstitute.org/category/living-well-understanding-the-body/) [Read Post](https://www.autoimmuneinstitute.org/articles/finding-purpose-and-fulfillment-with-autoimmune-and-chronic-disease) ## Posts navigation 1[2](https://www.autoimmuneinstitute.org/wp-admin/admin-ajax.php/page/2/?action=as_async_request_queue_runner&nonce=03efbfba2b)[3](https://www.autoimmuneinstitute.org/wp-admin/admin-ajax.php/page/3/?action=as_async_request_queue_runner&nonce=03efbfba2b)…[8](https://www.autoimmuneinstitute.org/wp-admin/admin-ajax.php/page/8/?action=as_async_request_queue_runner&nonce=03efbfba2b)[Next »](https://www.autoimmuneinstitute.org/wp-admin/admin-ajax.php/page/2/?action=as_async_request_queue_runner&nonce=03efbfba2b) --- ### [10 - COVID-19 News & Research Updates about Autoimmune Disease](https://www.autoimmuneinstitute.org/10-covid-19-news-research-updates-about-autoimmune-disease/) **Published:** February 23, 2024 **Author:** agustin.fernandezb@elevationweb.org **Content:** # COVID-19 News & Research Updates about Autoimmune Disease Want to know what’s going on in coronavirus news? Check out our ongoing timeline summarizing key COVID-19 scientific developments, especially as they pertain to autoimmune disease. Search Displaying Results For: Clear all filters Apply Filters Autoimmune Diseases & Covid-19 Celiac disease & Covid-19 GBS & Covid-19 IBD & Covid-19 Lupus & Covid-19 ME/CFS & Covid-19 MS & Covid-19 Myasthenia gravis & Covid-19 RA & Covid-19 Sjögren disease & Covid-19 T1D & Covid-19 Thyroid disease & Covid-19 Covid-19 & Long Covid Treatments Covid-19 Antibodies Covid-19 Boosters Covid-19 Clinical Trials Covid-19 Infections Covid-19 Policy Covid-19 Research Studies Covid-19 Vaccines Vaccine Adverse Events Vaccine Manufacturers Covid-19 Variants Long COVID Apply Filters Oct 06, 2026 Study Finds Stable Autoantibody Profiles 6 Months After COVID-19 Booster Researchers found stable autoantibody profiles six months after COVID-19 booster vaccination in 30 healthy adults, providing new insights into immune responses and autoimmune disease research. - Covid-19 Antibodies - Covid-19 Vaccines [Read Post](https://www.autoimmuneinstitute.org/covid_timeline/study-finds-stable-autoantibody-profiles-6-months-after-covid-19-booster/) Sep 08, 2026 Paul Offit on Vaccine Trust, Policy, and Public Communication Dr. Paul Offit reflects on vaccine trust, lessons from the COVID-19 pandemic, and why clear, credible communication will be essential to rebuilding confidence in vaccine policy. [Read Post](https://www.autoimmuneinstitute.org/covid_timeline/paul-offit-vaccine-trust-public-communication/) Aug 20, 2026 Vaccine Responses Vary Even Among Immunosuppressed Individuals Many studies have looked at how our immune system responds to a vaccine by measuring whether the immune system created antibodies against the vaccine. However, a new study finds that already circulating antibodies could hold clues into how well the immune system will respond to a future vaccine.  This study involved 2,445 healthy individuals and 1,644 immunosuppressed individuals. The researchers used blood samples from the participants to measure antibodies against almost 200 antigens including those from common infections and autoantigens associated with autoimmune diseases. They then compared the levels of these antibodies to how well the study participants responded to the \[…\] - Autoimmune Diseases & Covid-19 - Covid-19 Antibodies - Covid-19 Vaccines [Read Post](https://www.autoimmuneinstitute.org/covid_timeline/vaccine-responses-vary-even-among-immunosuppressed-individuals/) Aug 13, 2026 Study Identifies Molecular Pathways Involved in COVID-19-Related Heart Damage Researchers identified changes in gene regulation associated with inflammation, fibrosis, and heart muscle damage following SARS-CoV-2 infection, highlighting potential biomarkers and therapeutic targets for COVID-19-related cardiac complications. - Covid-19 Infections - Covid-19 Research Studies [Read Post](https://www.autoimmuneinstitute.org/covid_timeline/covid-19-heart-damage-molecular-pathways/) Aug 05, 2026 COVID-19 May Reactivate Dormant Viruses, Study Finds A large study of people hospitalized with COVID-19 found that the infection was frequently accompanied by reactivation of viruses that can remain dormant in the body for years. Conducted across 15 biomedical research institutions in the United States, the findings may help us better understand how severe infections disrupt the immune system and whether reactivated viruses contribute to complications of acute COVID-19 or long COVID. Researchers analyzed samples from 1,154 people hospitalized with COVID-19 at 20 U.S. hospitals, collecting more than 200,000 samples and generating more than 1 billion data points over the course of a year. Using RNA sequencing and \[…\] - Covid-19 Antibodies - Covid-19 Infections - Covid-19 Research Studies [Read Post](https://www.autoimmuneinstitute.org/covid_timeline/covid-19-may-reactivate-dormant-viruses-study-finds/) Jul 21, 2026 Resources for Interpreting Long COVID Clinical Trials As Long COVID clinical trials continue to report new findings, understanding how to interpret those results is just as important as keeping up with the latest research. Clinical trial headlines can sometimes overstate what a study actually shows, particularly when early-stage or preliminary findings are reported. Resources For readers looking to better understand clinical trial evidence, GAI’s article, “A Guide to Interpreting Clinical Trial Stories,” explains how treatments progress from preclinical research through Phase 4 clinical trials and offers practical questions to ask when evaluating research. Topics include understanding study populations, trial phases, endpoints, control groups, replication, and how to look beyond attention-grabbing headlines \[…\] - Covid-19 Clinical Trials - Long COVID [Read Post](https://www.autoimmuneinstitute.org/covid_timeline/resources-for-interpreting-long-covid-clinical-trials/) Jul 16, 2026 RECOVER-TLC July 2026 Update: Long COVID Clinical Trial Progress The NIH hosted a community webinar on July 16, 2026, to provide updates on the RECOVER-Treating Long COVID (RECOVER-TLC) initiative. NIH leaders emphasized that Long COVID research and treatment development remain priorities across NIAID and NIH before researchers reviewed four clinical trials underway or in development, discussed how biomarkers will be incorporated into the studies, explained the clinical trial development process, and answered questions from the Long COVID community. - Covid-19 Clinical Trials - Covid-19 Research Studies - Long COVID [Read Post](https://www.autoimmuneinstitute.org/covid_timeline/recover-tlc-july-2026-update-long-covid-clinical-trial-progress/) Jul 13, 2026 COVID-19 and Autoimmune Disease: Current Evidence A new review published in the Korean Journal of Internal Medicine synthesizes evidence from epidemiologic studies, immunology research, clinical registries, vaccine studies, and Long COVID investigations to examine how COVID-19 influences autoimmune disease and how autoimmune diseases, in turn, affect COVID-19 outcomes. - Autoimmune Diseases & Covid-19 - Celiac disease & Covid-19 - Covid-19 Infections - Covid-19 Research Studies - Covid-19 Vaccines - GBS & Covid-19 - IBD & Covid-19 - Long COVID - Lupus & Covid-19 - MS & Covid-19 - RA & Covid-19 - Sjögren disease & Covid-19 - T1D & Covid-19 [Read Post](https://www.autoimmuneinstitute.org/covid_timeline/covid-19-and-autoimmune-disease-current-evidence/) ## Posts navigation 1[2](https://www.autoimmuneinstitute.org/wp-admin/admin-ajax.php/page/2/?action=as_async_request_queue_runner&nonce=03efbfba2b)[3](https://www.autoimmuneinstitute.org/wp-admin/admin-ajax.php/page/3/?action=as_async_request_queue_runner&nonce=03efbfba2b)…[46](https://www.autoimmuneinstitute.org/wp-admin/admin-ajax.php/page/46/?action=as_async_request_queue_runner&nonce=03efbfba2b)[Next »](https://www.autoimmuneinstitute.org/wp-admin/admin-ajax.php/page/2/?action=as_async_request_queue_runner&nonce=03efbfba2b) --- ### [08 - Find Medical Institutions Near You](https://www.autoimmuneinstitute.org/08-find-medical-institutions-near-you/) **Published:** February 23, 2024 **Author:** agustin.fernandezb@elevationweb.org **Content:** # Find Medical Institutions Near You A comprehensive list of medical institutions across the United States specializing in diagnosing and treating various autoimmune diseases in an easy-to-use keyword and location search format. Search Apply Filters Autoimmune Disease Addison’s Disease Agammaglobulinemia Alopecia Areata Amyloidosis Ankylosing Spondylitis Anti-NMDA Receptor Encephalitis Antiphospholipid Syndrome Aplastic Anemia Arteriosclerosis / atherosclerosis Autoimmune Autonomic Ganglionopathy Autoimmune Cytopenia Autoimmune Encephalitis/Acute Disseminated Encephalomyelitis (ADEM) Autoimmune Enteropathy Autoimmune Hemolytic Anemia Autoimmune Hepatitis Autoimmune Inner Ear Disease Autoimmune Lymphoproliferative Syndrome Autoimmune Pancreatitis Autoimmune Polyglandular Syndrome Autonomic Neuropathy Behçet’s Disease Bullous Pemphigoid Celiac Disease Central Nervous System Vasculitis Chilblain Lupus Erythematosus Chronic Granulomatous Disease Chronic Inflammatory Demyelinating Polyneuropathy Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA) Cogan Syndrome Connective Tissue Disease Crohn’s Disease Cronkhite-Canada Syndrome Cryoglobulinemia Cryoglobulinemic Vasculitis Cutaneous Lupus Cutaneous Vasculitis Dermatitis Herpetiformis Dermatomyositis Discoid Lupus Dressler’s Syndrome Dysautonomia Ehlers-Danlos Syndrome Eosinophilic Esophagitis Eosinophilic Fasciitis Evans Syndrome Giant Cell Arteritis Glomerulonephritis Goodpasture Syndrome Graves’ Disease Guillain-Barre Syndrome Hashimoto’s Thyroiditis/Autoimmune Thyroiditis Hashimoto’s Encephalopathy Henoch–Schönlein Purpura Hyperthyroidism Iga Nephropathy/Berger’s Disease Igg4-Related Disease Immune Thrombocytopenia Purpura Juvenile Ankylosing Spondylitis Juvenile Arthritis Juvenile Dermatomyositis Juvenile Idiopathic Arthritis Juvenile Idiopathic Arthritis/Adult-Onset Still’s Disease Juvenile Lupus Juvenile Myositis Juvenile Polymyositis Juvenile Psoriatic Arthritis Juvenile Rheumatoid Arthritis Juvenile Scleroderma Kawasaki Disease Lambert-Eaton Myasthenic Syndrome Lichen Planus Linear IgA Bullous Dermatosis Lupus Nephritis Lyme Disease Ménière’s disease Microscopic Polyangiitis (MPA)/ANCA-Associated Vasculitis Mixed Connective Tissue Disease Multiple Sclerosis Myasthenia Gravis Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease (MOGAD) Myositis Necrobiosis Lipoidica Neuromyelitis Optica/Devic’s Disease Nonvasculitic Autoimmune Inflammatory Meningoencephalitis Oligoarticular Juvenile Arthritis Paraneoplastic Pemphigus Parsonage-Turner Syndrome Pemphigoid Pemphigus Plaque Psoriasis POEMS Syndrome Polyarteritis Nodosa Polyarticular Juvenile Arthritis Polymyalgia Rheumatica Polymyositis Postural Orthostatic Tachycardia Syndrome (POTS) Primary Adrenal Insufficiency Primary Biliary Cholangitis Primary Biliary Cirrhosis Primary Immunodeficiency Primary Immunodeficiency Disorders Primary Sclerosing Cholangitis Psoriasis Psoriatic Arthritis Pulmonary Alveolar Proteinosis Pyoderma Gangrenosum Raynaud Syndrome/Phenomenon Reactive Arthritis Relapsing Polychondritis Rheumatoid Arthritis Sarcoidosis Scleroderma Sclerosing Mesenteritis Sjögren Syndrome Spondyloarthritis Stiff Person Syndrome Sydenham’s Chorea Systemic Lupus Erythematosus Takayasu’s arteritis Temporal Arteritis Transverse Myelitis Type 1 Diabetes Ulcerative Colitis Undifferentiated Connective Tissue Disease Uveitis Various Autoimmune Diseases Vasculitis Vexas Syndrome Vitiligo Show more State California Colorado Delaware Maryland Massachusetts Minnesota New Jersey New York North Carolina Ohio Pennsylvania Washington DC Show more Apply Filters Displaying Results For: Clear all filters New Jersey Penn Medicine Becker ENT & Allergy Freehold Penn Medicine Address: [303 West Main Street Freehold,7728 ](https://www.google.com/maps?q=303+West+Main+StreetFreehold7728) [visit website](https://www.pennmedicine.org/practices/becker-ent-allergy-freehold?fadf=pennmedicine) - Ménière’s disease Pennsylvania Penn Medicine Becker ENT & Allergy Walnut Street Penn Medicine Address: [1608 Walnut Street Philadelphia,19103 ](https://www.google.com/maps?q=1608+Walnut+StreetPhiladelphia19103) [visit website](https://www.pennmedicine.org/practices/becker-ent-allergy-walnut-street?fadf=pennmedicine) - Ménière’s disease Pennsylvania Penn Medicine Becker ENT & Allergy South Street Penn Medicine Address: [1740 South Street Philadelphia,19146 ](https://www.google.com/maps?q=1740+South+StreetPhiladelphia19146) [visit website](https://www.pennmedicine.org/practices/becker-ent-allergy-south-street?fadf=pennmedicine) - Ménière’s disease New Jersey Penn Medicine Becker ENT & Allergy Mullica Hill Penn Medicine Address: [199 Mullica Hill Road Mullica Hill,8062 ](https://www.google.com/maps?q=199+Mullica+Hill+RoadMullica+Hill8062) [visit website](https://www.pennmedicine.org/practices/becker-ent-allergy-mullica-hill?fadf=pennmedicine) - Ménière’s disease New Jersey Penn Medicine Becker ENT & Allergy Mount Laurel Penn Medicine Address: [5000 Dearborn Circle Mount Laurel,8054 ](https://www.google.com/maps?q=5000+Dearborn+CircleMount+Laurel8054) [visit website](https://www.pennmedicine.org/practices/becker-ent-allergy-mount-laurel?fadf=pennmedicine) - Ménière’s disease ## Posts navigation 1[2](https://www.autoimmuneinstitute.org/wp-admin/admin-ajax.php/page/2/?action=as_async_request_queue_runner&nonce=03efbfba2b)[3](https://www.autoimmuneinstitute.org/wp-admin/admin-ajax.php/page/3/?action=as_async_request_queue_runner&nonce=03efbfba2b)…[117](https://www.autoimmuneinstitute.org/wp-admin/admin-ajax.php/page/117/?action=as_async_request_queue_runner&nonce=03efbfba2b)[Next »](https://www.autoimmuneinstitute.org/wp-admin/admin-ajax.php/page/2/?action=as_async_request_queue_runner&nonce=03efbfba2b) --- ### [Terms of Use](https://www.autoimmuneinstitute.org/terms-of-use/) **Published:** February 20, 2024 **Author:** agustin.fernandezb@elevationweb.org **Content:** ###### Global Autoimmune Institute (“us”, “we”, or “our”) operates <http://www.autoimmuneinstitute.org> (the “Site”). ###### Please review the following Terms of Use. By accessing or using any part of our website, you agree to be bound by these Terms of Use. ### Privacy Any information you provide to us is subject to our Privacy Policy. ### Restrictions on Use of Materials We provide information and resources on autoimmune disease, including articles and illustrations. Unless otherwise expressly stated, all articles and illustrations provided on our Site are intellectual property that belongs to us and may not be reproduced, displayed, modified, performed, distributed, edited, translated, rented, or otherwise used without our prior consent. You may not use or duplicate any logos or trademarks without express written permission from us. To request permission for use of Site materials, trademarks, or logos, send an email to <info@autoimmuneinstitute.org>. ### Third Party Content We respect copyright and trademark laws. 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If any particular provision of these Terms of Use is found to be unenforceable, that provision will be severable and will not affect any of the other provisions. The Site is owned and operated by us. We are a 501(c)(3) not-for-profit corporation. Your use of the Site, and any related legal action, will be governed by the laws incorporated in the District of Columbia, without regard to conflict of laws principles. The sole jurisdiction for any litigation arising out of your use of or inquiries to the Site will be an appropriate federal or state court located in the District of Columbia. ### Changes to the Terms of Use We reserve the right to make changes to any information or services on our Site, including these Terms of Use, without notice to you. The most current Terms of Use will be posted here and will be effective upon posting. Be sure to return to this page periodically to ensure familiarity with the most current version of these Terms of Use. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/SpacerShield.jpg) --- ## A-Z List Directory ### [Systemic lupus erythematosus (SLE)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/) **Published:** July 15, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** SLE is the most common form of lupus in which the immune system attacks its own healthy tissues resulting in widespread inflammation and tissue damage of joints, skin, brain, lungs, kidneys, and blood vessels. --- ### [Autoimmune hemolytic anemia](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-hemolytic-anemia/) **Published:** July 15, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Autoimmune hemolytic anemia (AIHA) occurs when autoantibodies attack red blood cells at a faster rate than they can be replaced, leading to dangerously low red blood cell levels. --- ### [Ulcerative colitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ulcerative-colitis/) **Published:** July 15, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** A condition involving the formation of ulcers and inflammation of the innermost layer of the colon and rectum of the digestive tract.  --- ### [Crohn's disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crohns-disease/) **Published:** July 15, 2021 **Author:** Carolyn Serraino **Excerpt:** Crohn's disease is a type of chronic inflammatory bowel disease that causes inflammation throughout the gastrointestinal (GI) tract. --- ### [Neuromyelitis optica (NMO, Devic’s disease)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/neuromyelitis-optica/) **Published:** July 15, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Neuromyelitis optica (NMO), also called Devic’s disease or neuromyelitis optica spectrum disorder (NMOSD), is a rare autoimmune disease characterized by inflammation of the optic nerve, which carries information from the eye to the brain, and the spinal cord. The disease can take on either a monophasic form that involves a single attack of symptoms or a relapsing form involving periodic flares of symptoms. --- ### [Myasthenia gravis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/myasthenia-gravis/) **Published:** July 15, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Myasthenia Gravis (MG) occurs when nerve impulse transmission is interrupted at the neuromuscular junction where nerve cells and muscles connect, due to acetylcholine receptors being blocked or destroyed by antibodies. --- ### [Celiac disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/celiac-disease/) **Published:** July 15, 2021 **Author:** Carolyn Serraino **Excerpt:** Also known as celiac sprue or gluten-sensitive enteropathy, celiac disease causes damage to the small intestine in response to gluten consumption. --- ### [Balo disease (concentric sclerosis)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/balo-disease/) **Published:** July 15, 2021 **Author:** Carolyn Serraino **Excerpt:** Baló disease (also called Baló concentric sclerosis) is a rare inflammatory demyelinating disease of the central nervous system that is generally considered a rare variant within the spectrum of multiple sclerosis (MS). --- ### [Fibromyalgia](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/fibromyalgia/) **Published:** February 12, 2025 **Author:** Elevation --- ### [Sjögren disease (SjD)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sjogren-syndrome/) **Published:** July 15, 2021 **Author:** Carolyn Serraino **Excerpt:** When the glands responsible for producing moisture in the eyes, mouth, and other parts of the body are destroyed by autoantibodies. --- ### [Immune thrombocytopenia (autoimmune thrombocytopenic purpura)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/immune-thrombocytopenia/) **Published:** July 15, 2021 **Author:** Carolyn Serraino **Excerpt:** Immune thrombocytopenia (ITP), also known as autoimmune thrombocytopenia purpura, involves low levels of cells that help with blood clotting, resulting in significant bruising or bleeding. --- ### [Complex regional pain syndrome (CRPS)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/complex-regional-pain-syndrome-crps/) **Published:** July 21, 2026 **Author:** Carolyn Serraino --- ### [Adult-onset Still's disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/adult-onset-stills-disease/) **Published:** July 8, 2026 **Author:** Carolyn Serraino **Excerpt:** Adult-onset Still's disease (AOSD) is a rare systemic inflammatory disease characterized by recurrent high fevers, inflammatory arthritis, a distinctive salmon-colored rash, and elevated inflammatory markers. Although its exact cause remains unknown, current research recognizes AOSD and systemic juvenile idiopathic arthritis (systemic JIA) as age-specific forms of the same disease spectrum, collectively referred to as Still's disease. --- ### [Autoimmune hepatitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-hepatitis/) **Published:** July 15, 2021 **Author:** Carolyn Serraino **Excerpt:** Autoimmune Hepatitis involves inflammation of the liver resulting from the immune system attacking liver cells. --- ### [Congenital heart block](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/congenital-heart-block/) **Published:** July 10, 2026 **Author:** Carolyn Serraino **Excerpt:** Congenital heart block (CHB), also called autoimmune congenital heart block when caused by maternal autoantibodies, is a rare disorder in which the electrical signals that coordinate the heartbeat become slowed or blocked before birth or during the newborn period. --- ### [Neonatal lupus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/neonatal-lupus/) **Published:** July 10, 2026 **Author:** Carolyn Serraino **Excerpt:** Neonatal lupus (also called neonatal lupus erythematosus [NLE]) is a rare acquired autoimmune condition caused by the transfer of maternal autoantibodies across the placenta during pregnancy. --- ### [Churg-Strauss syndrome (eosinophilic granulomatosis with polyangiitis, EGPA)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/churg-strauss-syndrome/) **Published:** July 15, 2021 **Author:** Carolyn Serraino **Excerpt:** Also known as Churg-Strauss Syndrome, EGPA is a specific type of ANCA-associated vasculitis (AAV) characterized by inflammation of blood vessels, clustering of white blood cells, and the development of granulomas (inflammatory nodular lesions). --- ### [Goodpasture’s syndrome (anti-GBM disease)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/goodpastures-syndrome/) **Published:** July 15, 2021 **Author:** Carolyn Serraino **Excerpt:** Anti-GBM disease (Goodpasture’s syndrome) occurs when autoantibodies attack the lungs and kidneys and if left untreated this can quickly escalate to glomerulonephritis, kidney failure, or even death. --- ### [Dressler’s syndrome (postmyocardial infarction syndrome)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/dresslers-syndrome/) **Published:** December 30, 2021 **Author:** Carolyn Serraino **Excerpt:** Also known as postmyocardial infarction syndrome or postpericardiotomy syndrome, Dressler’s syndrome is characterized by pericarditis (inflammation of the sac surrounding the heart that occurs after damage to the organ itself or to the pericardium).  --- ### [Autoimmune neutropenia](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-neutropenia/) **Published:** July 9, 2026 **Author:** Carolyn Serraino **Excerpt:** Autoimmune neutropenia (AIN) is a rare autoimmune disorder in which the immune system mistakenly attacks neutrophils, a type of white blood cell that plays a critical role in defending the body against bacterial and fungal infections. --- ### [Anti-NMDAR encephalitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/anti-nmda-receptor-encephalitis/) **Published:** December 30, 2021 **Author:** Carolyn Serraino **Excerpt:** A form of encephalitis that occurs when the immune system attacks NMDA receptors in the brain, resulting in brain swelling and disruption of signaling pathways. --- ### [Autoimmune encephalitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-encephalitis/) **Published:** July 8, 2026 **Author:** Carolyn Serraino **Excerpt:** Autoimmune encephalitis is a neurological and immune-mediated disease that causes brief but widespread inflammation and demyelination (white matter tissue damage) of the brain and spinal cord. --- ### [Autoimmune gastritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-gastritis/) **Published:** July 15, 2021 **Author:** Carolyn Serraino **Excerpt:** Autoimmune gastritis is characterized by the destruction of parietal cells, which are cells in the stomach that make stomach acid and a protein called intrinsic factor that is needed to absorb the essential vitamin B12, autoimmune gastritis causes vitamin B12 deficiency which can lead to subsequent illnesses such as anemia. --- ### [Lyme disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/lyme-disease/) **Published:** July 15, 2021 **Author:** Carolyn Serraino **Excerpt:** Lyme disease is a vector-borne (results from an infection transmitted to humans and other animals by blood-feeding arthropods such as mosquitoes, ticks, and fleas) disease characterized by four specific species of bacteria. --- ### [Juvenile idiopathic arthritis (JIA)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/juvenile-idiopathic-arthritis-stills/) **Published:** July 15, 2021 **Author:** Carolyn Serraino **Excerpt:** Juvenile Idiopathic Arthritis (JIA) is a diagnosis that covers all forms of arthritis in individuals under 16 that last more than 6 weeks and whose origin is unknown. When diagnosed in adults, JIA is called adult-onset Still's disease. --- ### [Autoimmune autonomic disorders (autoimmune dysautonomia)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-autonomic-disorders-autoimmune-dysautonomia/) **Published:** July 8, 2026 **Author:** Carolyn Serraino --- ### [Autoimmune autonomic ganglionopathy (AAG)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-autonomic-ganglionopathy/) **Published:** July 15, 2021 **Author:** Carolyn Serraino **Excerpt:** Autoimmune Autonomic Ganglionopathy (AAG) is caused by the immune system’s attack on the autonomic nervous system, which regulates non-voluntary bodily functions such as heartbeat, AAG can either be classified as being associated with high levels of g-AchR antibodies (seropositive) or as having no detectable levels of the antibodies (seronegative). --- ### [Leukocytoclastic vasculitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/leukocytoclastic-vasculitis/) **Published:** February 6, 2025 **Author:** Carolyn Serraino **Excerpt:** Leukocytoclastic vasculitis (LCV) is an immune-mediated condition that results in inflammation of small blood vessels. While not formally considered an autoimmune disease, LCV is often triggered by an abnormal immune response. --- ### [Autoimmune vasculitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-vasculitis/) **Published:** July 8, 2026 **Author:** Carolyn Serraino **Excerpt:** Autoimmune vasculitis refers to a group of autoimmune diseases in which the immune system mistakenly attacks blood vessels, causing inflammation that can damage tissues and organs. Different forms of autoimmune vasculitis affect blood vessels of different sizes and may involve the skin, kidneys, lungs, nervous system, eyes, heart, or other organs. --- ### [Mucous membrane pemphigoid (MMP)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/mucous-membrane-pemphigoid/) **Published:** July 15, 2021 **Author:** Carolyn Serraino **Excerpt:** Ocular cicatricial pemphigoid is a form of mucous membrane pemphigoid that causes scarring of the conjunctiva (the inside lining) of the eyes. Benign Mucosal Pemphigoid --- ### [Bullous pemphigoid](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/bullous-pemphigoid/) **Published:** July 15, 2021 **Author:** Carolyn Serraino **Excerpt:** Bullous pemphigoid is a skin disease characterized by large fluid-filled blisters on the areas that flex, such as the lower abdomen, upper thighs, or armpits, due to autoantibodies targeting the skin. --- ### [Acute disseminated encephalomyelitis (ADEM)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/acute-disseminated-encephalomyelitis/) **Published:** July 15, 2021 **Author:** Carolyn Serraino **Excerpt:** Acute disseminated encephalomyelitis (ADEM) is an immune-mediated condition that causes widespread inflammation and damage to myelin in the brain and spinal cord. It most often occurs following an infection, particularly in children, although the exact cause is not always known. --- ### [Myelin oligodendrocyte glycoprotein antibody disease (MOGAD)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/myelin-oligodendrocyte-glycoprotein-antibody-disease-mogad/) **Published:** December 23, 2025 **Author:** Carolyn Serraino **Excerpt:** MOGAD, also referred to as MOG antibody-associated disease, is an immune-mediated inflammatory demyelinating disorder of the central nervous system characterized by antibodies directed against myelin oligodendrocyte glycoprotein (MOG), a protein located on the outer surface of myelin in the brain, optic nerves, and spinal cord. --- ### [Acute hemorrhagic leukoencephalitis (AHLE, Hurst’s disease)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/hursts-disease/) **Published:** July 15, 2021 **Author:** Carolyn Serraino **Excerpt:** Acute hemorrhagic leukoencephalitis (AHLE), or Hurst’s disease, is a severe subtype of acute disseminated encephalomyelitis (ADEM) characterized by a rapidly progressive inflammation of the myelin sheath (the protective covering of nerves). --- ### [Autoimmune myocarditis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-myocarditis/) **Published:** July 15, 2021 **Author:** Carolyn Serraino **Excerpt:** Autoimmune myocarditis involves inflammation of the heart muscle which reduces your heart’s ability to pump and causes heart arrhythmias. --- ### [Takayasu arteritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/takayasu-arteritis/) **Published:** March 25, 2025 **Author:** Carolyn Serraino **Excerpt:** Takayasu’s arteritis is a rare form of vasculitis caused by inflammation of the aorta—the large artery that carries blood from the heart to the rest of the body—and its major branches. It is believed to be immune-mediated, meaning the immune system may mistakenly attack the arteries, causing damage and narrowing. --- ### [Lambert-Eaton myasthenic syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/lambert-eaton-myasthenic-syndrome/) **Published:** July 15, 2021 **Author:** Carolyn Serraino **Excerpt:** Lambert-Eaton myasthenic syndrome (LEMS) occurs when the immune system attacks the areas where the nerves and muscles of the body connect (neuromuscular junctions). As a result, patients experience muscular weakness. --- ### [Pemphigoid gestationis (herpes gestationis)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/pemphigoid-gestationis/) **Published:** July 15, 2021 **Author:** Carolyn Serraino **Excerpt:** Pemphigoid gestationis (PG) occurs when an autoantibody attack separates the epidermis (outermost layer of the skin) from the dermis (layer of skin below the epidermis). --- ### [Pemphigus foliaceus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/pemphigus-foliaceus/) **Published:** July 15, 2021 **Author:** Carolyn Serraino **Excerpt:** Pemphigus foliaceus is characterized by the loss of intercellular adhesion of keratinocytes (keratin-producing skin cells) in the upper parts of the epidermis (surface layer of the skin), resulting in the keratinocytes separating from each other and being replaced by fluid (making blisters). --- ### [Pemphigus vulgaris](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/pemphigus-vulgaris/) **Published:** July 15, 2021 **Author:** Carolyn Serraino **Excerpt:** Pemphigus vulgaris is the more common of the two forms of pemphigus, which is an autoimmune disease that causes blisters on your skin and mucous membranes to rupture, creating open sores that may become infected.   --- ### [CREST syndrome (limited cutaneous systemic sclerosis)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crest-syndrome/) **Published:** July 15, 2021 **Author:** Carolyn Serraino **Excerpt:** CREST syndrome is a type of limited scleroderma. It is a systemic connective tissue disease characterized by the chronic hardening and tightening of the skin. --- ### [Mixed connective tissue disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/mixed-connective-tissue-disease/) **Published:** July 15, 2021 **Author:** Carolyn Serraino **Excerpt:** Mixed Connective Tissue Disease develops as RNP (ribonucleoprotein) molecules are attacked by antibodies, inhibiting the production of messenger RNA. --- ### [Undifferentiated connective tissue disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/undifferentiated-connective-tissue-disease/) **Published:** July 15, 2021 **Author:** Carolyn Serraino **Excerpt:** When the symptoms and lab test results of a systemic connective tissue disease are present but do not meet enough characteristics for a specific diagnosis (such as rheumatoid arthritis or lupus). --- ### [Progesterone dermatitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-progesterone-dermatitis/) **Published:** July 15, 2021 **Author:** Carolyn Serraino **Excerpt:** Autoimmune progesterone dermatitis (APD) is a reaction to the progesterone hormone produced during the menstrual cycle, causing various eruptions to form on the skin. --- ### [Myositis/polymyositis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/polymyositis/) **Published:** July 15, 2021 **Author:** Carolyn Serraino **Excerpt:** Polymyositis involves inflammation of the muscles and associated tissues, affecting the skeletal muscles that control movement. --- ### [Fibrosing alveolitis (idiopathic pulmonary fibrosis)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/fibrosing-alveolitis/) **Published:** July 20, 2022 **Author:** Carolyn Serraino **Excerpt:** Idiopathic pulmonary fibrosis (IPF, fibrosing alveolitis) is a condition characterized by respiratory issues and scarring or thickening of the lungs over time. --- ### [Parsonage-Turner syndrome (brachial neuritis)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/parsonage-turner-syndrome/) **Published:** July 15, 2021 **Author:** Carolyn Serraino **Excerpt:** Parsonage-Turner syndrome (PTS) is a neurological autoimmune disease characterized by rapid development of severe shoulder and arm pain followed by muscular atrophy in the areas affected. --- ### [Scleroderma (systemic sclerosis)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/scleroderma/) **Published:** July 15, 2021 **Author:** Carolyn Serraino **Excerpt:** Scleroderma involves an overproduction of collagen protein which leads to the hardening and inflammation of connective tissues and skin. --- ### [Microscopic colitis (lymphocytic colitis and collagenous colitis)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/microscopic-colitis/) **Published:** June 29, 2026 **Author:** Carolyn Serraino --- ### [Autoimmune urticaria (chronic spontaneous urticaria)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/chronic-urticaria/) **Published:** December 30, 2021 **Author:** Carolyn Serraino **Excerpt:** Urticaria is an allergic skin reaction that results in hives. --- ### [Autoimmune polyglandular syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-polyglandular-syndromes/) **Published:** July 15, 2021 **Author:** Carolyn Serraino **Excerpt:** Autoimmune polyglandular syndrome is a combination of endocrine and nonendocrine autoimmune diseases causing increased thyroid secretion and thyroid gland enlargement.  --- ### [Addison’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-addisons-disease/) **Published:** July 15, 2021 **Author:** Carolyn Serraino **Excerpt:** Addison’s disease affects the function of the adrenal glands, which disrupts the production of several hormones including cortisol and aldosterone, which regulate stress response (fight or flight) and blood pressure. --- ### [Pars planitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/pars-planitis/) **Published:** June 30, 2026 **Author:** Carolyn Serraino **Excerpt:** Pars planitis, also known as idiopathic intermediate uveitis and historically referred to as chronic cyclitis or peripheral uveitis, is a rare, chronic inflammatory eye disease and a subtype of intermediate uveitis that affects the pars plana, a part of the ciliary body located behind the iris. --- ### [Autoimmune uveitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-uveitis/) **Published:** June 30, 2026 **Author:** Carolyn Serraino **Excerpt:** Autoimmune uveitis, also referred to as noninfectious immune-mediated uveitis, is a group of inflammatory eye diseases in which the immune system mistakenly attacks tissues (retinal proteins) within the eye. --- ### [Opsoclonus-myoclonus syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/opsoclonus-myoclonus-syndrome/) **Published:** June 29, 2026 **Author:** Carolyn Serraino **Excerpt:** Multifocal motor neuropathy (MMN) is a rare immune-mediated neurological disorder that affects the peripheral motor nerves, causing progressive muscle weakness without significant sensory loss. --- ### [Multifocal motor neuropathy](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multifocal-motor-neuropathy/) **Published:** June 29, 2026 **Author:** Carolyn Serraino **Excerpt:** Multifocal motor neuropathy (MMN) is a rare immune-mediated neurological disorder that affects the peripheral motor nerves, causing progressive muscle weakness without significant sensory loss. --- ### [Pediatric acute-onset neuropsychiatric syndrome (PANS, PANDAS)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/pans-pandas/) **Published:** June 29, 2026 **Author:** Carolyn Serraino **Excerpt:** Pediatric acute-onset neuropsychiatric syndrome (PANS) is characterized by the sudden onset of obsessive-compulsive disorder (OCD) symptoms or severely restricted food intake, accompanied by other neurological, behavioral, or psychiatric symptoms. --- ### [Sydenham’s chorea](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sydenhams-chorea/) **Published:** December 30, 2021 **Author:** Carolyn Serraino **Excerpt:** Sydenham’s chorea is characterized by rapid, jerky, irregular, and involuntary movements (especially of the face and limbs). --- ### [Ligneous conjunctivitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ligneous-conjunctivitis/) **Published:** June 29, 2026 **Author:** Carolyn Serraino --- ### [Mooren's ulcer](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/moorens-ulcer/) **Published:** June 29, 2026 **Author:** Carolyn Serraino **Excerpt:** Mooren's ulcer is a rare inflammatory disease of the cornea (the clear front surface of the eye) that causes painful, progressive ulceration along the cornea's outer edge. It is generally considered to be an immune-mediated form of peripheral ulcerative keratitis. --- ### [Pityriasis lichenoides et varioliformis acuta (PLEVA, Mucha-Habermann disease)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/pityriasis-lichenoides-et-varioliformis-acuta-pleva/) **Published:** February 19, 2025 **Author:** Carolyn Serraino **Excerpt:** Pityriasis lichenoides et varioliformis acuta (PLEVA), also known as Mucha-Habermann disease, is a rare inflammatory skin disorder characterized by the sudden eruption of small, red-brown papules that may evolve into vesicles, pustules, or necrotic ulcers. The exact cause is unknown, but it is considered an immune-mediated condition, possibly triggered by infections or hypersensitivity reactions. --- ### [IgA nephropathy (Berger's disease)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/iga-nephropathy/) **Published:** July 15, 2021 **Author:** Carolyn Serraino **Excerpt:** IgA nephropathy/Berger’s disease occurs when immunoglobulin A (IgA) antibodies build up in the kidneys, causing inflammation that hinders the ability of the kidneys to filter waste from the blood. --- ### [Granulomatosis with polyangiitis (GPA, Wegener’s granulomatosis)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/wegeners/) **Published:** July 15, 2021 **Author:** Carolyn Serraino **Excerpt:** Granulomatosis with polyangiitis (GPA), formerly called Wegener’s granulomatosis, is a rare form of ANCA-associated vasculitis in which the immune system attacks small- and medium-sized blood vessels. --- ### [Giant cell arteritis (temporal arteritis, Horton’s disease)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/giant-cell-arteritis-temporal-arteritis-hortons-disease/) **Published:** July 20, 2022 **Author:** Carolyn Serraino **Excerpt:** Giant cell arteritis (GCA), also known as temporal arteritis or Horton’s disease, is a disease of the blood vessels. --- ### [Primary biliary cholangitis (PBC)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/primary-biliary-cirrhosis/) **Published:** July 15, 2021 **Author:** Carolyn Serraino **Excerpt:** Primary biliary cirrhosis (PBC) is caused by a buildup of bile (a substance used to facilitate digestion and eliminate toxins in the liver) due to progressive destruction of the bile ducts by the immune system, this disease can eventually lead to liver damage and cirrhosis. --- ### [Type 1 diabetes (T1D)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/type-1-diabetes-insulin-dependent-diabetes/) **Published:** July 15, 2021 **Author:** Carolyn Serraino **Excerpt:** Historically called juvenile diabetes or insulin-dependent diabetes, Type 1 diabetes occurs when the body’s immune system attacks insulin-producing pancreatic beta cells (islets), causing the body to have insufficient insulin stores. --- ### [Thyroid eye disease (Graves’ ophthalmopathy, thyroid-associated orbitopathy)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/thyroid-eye-disease-graves-ophthalmopathy-thyroid-associated-orbitopathy/) **Published:** February 19, 2025 **Author:** Elevation **Excerpt:** Thyroid eye disease (TED), also known as Graves’ ophthalmopathy or thyroid-associated orbitopathy, is an autoimmune disorder that affects the muscles and tissues around the eyes. It is most commonly associated with Graves’ disease, an autoimmune condition that leads to hyperthyroidism, but can also occur in individuals with normal thyroid function or hypothyroidism due to Hashimoto’s thyroiditis. TED causes inflammation, swelling, and tissue remodeling in the orbit, leading to symptoms that can range from mild irritation to severe vision impairment. --- ### [Autoimmune orchitis (testicular autoimmunity)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/testicular-autoimmunity/) **Published:** July 15, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Testicular autoimmunity arises in the forms of testicular vasculitis and orchitis. --- ### [Raynaud’s](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/raynauds-syndrome/) **Published:** July 15, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Narrowing of arteries that carry blood from the heart to other parts of the body, known as vasospasm attacks, results in reduced blood flow in the fingers and toes and is typically triggered by cold temperatures and emotional stress. --- ### [Postural orthostatic tachycardia syndrome (POTS)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/postural-orthostatic-tachycardia-syndrome/) **Published:** March 31, 2022 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Postural orthostatic tachycardia syndrome (POTS) is a condition that affects how the body regulates blood flow and heart rate when moving from lying down to standing. In people with POTS, standing causes the heart to beat much faster than normal because not enough blood returns to the heart and brain. --- ### [Parry-Romberg syndrome (progressive hemifacial atrophy)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/parry-romberg-syndrome/) **Published:** December 30, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Parry-Romberg syndrome (PRS)/Hemifacial atrophy (HFA)/Progressive facial hemiatrophy is characterized by slow, progressive skin and soft tissue deterioration on half of the face (typically on the left side). --- ### [Optic neuritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/optic-neuritis/) **Published:** March 25, 2025 **Author:** Carolyn Serraino **Excerpt:** Optic neuritis is an inflammation of the optic nerve that can cause sudden vision loss, eye pain, and color vision changes. It is considered an immune-mediated condition, meaning that the immune system mistakenly targets the optic nerve. While optic neuritis can occur on its own, it is frequently associated with autoimmune diseases such as multiple sclerosis (MS), neuromyelitis optica spectrum disorder (NMOSD), and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD). In some cases, optic neuritis may be the first symptom of an underlying autoimmune or demyelinating disorder. --- ### [Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/me-cfs/) **Published:** December 30, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Myalgic encephalomyelitis (ME), also known as Chronic fatigue syndrome (CFS), is characterized by overwhelming tiredness that is not improved by rest. --- ### [Microscopic polyangiitis (MPA)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/microscopic-polyangiitis-anca-associated-vasculitis/) **Published:** March 31, 2022 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Microscopic polyangiitis (MPA) is a rare autoimmune disease and a form of ANCA-associated vasculitis in which the immune system attacks small blood vessels, leading to inflammation and damage in organs throughout the body. --- ### [Lichen planus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/lichen-planus/) **Published:** July 15, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Lichen Planus is characterized by inflammation of the mucous membranes in the mouth and of skin cells, resulting in the swelling and irritation of the skin, mouth, scalp, nails, and genitals. Lichen Planopilaris is a variant of Lichen Planus in which T-lymphocytes attack hair follicles. --- ### [Hashimoto’s thyroiditis (autoimmune thyroiditis)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/hashimotos-thyroiditis/) **Published:** July 15, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Hashimoto’s thyroiditis (autoimmune thyroiditis) occurs when the thyroid gland becomes inflamed, impairing its ability to produce thyroid hormones. --- ### [Guillain-Barré syndrome (GBS)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/guillain-barre-syndrome/) **Published:** July 13, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Guillain-Barré syndrome (GBS) occurs when the immune system attacks part of the nerves in the peripheral nervous system. --- ### [Eosinophilic esophagitis (eosinophilic gastroenteritis)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/eosinophilic-esophagitis/) **Published:** October 31, 2023 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Eosinophilic esophagitis (eosinophilic gastroenteritis) is an immune system condition of chronic esophagus inflammation, marked by an abnormal presence of eosinophils (white blood cells) in the lining of the esophagus. --- ### [Eczema (atopic dermatitis)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/eczema/) **Published:** December 30, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Eczema (atopic dermatitis) involves chronic inflammation that leaves the skin covered in scaly, itchy lesions. --- ### [Chronic inflammatory demyelinating polyneuropathy (CIDP)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/chronic-inflammatory-demyelinating-polyneuropathy/) **Published:** July 15, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Chronic inflammatory demyelinating polyneuropathy (CIDP) is caused by the inflammation of the nerves and destruction of the myelin sheath (insulated covering) of the nerve fibers. --- ### [Autoimmune interstitial lung disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-interstitial-lung-disease/) **Published:** July 11, 2025 **Author:** Carolyn Serraino **Excerpt:** A rare condition that occurs when the immune system attacks blood-clotting proteins known as Factor VIII, resulting in spontaneous bleeding. --- ### [Autoimmune hypophysitis (lymphocytic hypophysitis)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-hypophysitis/) **Published:** July 15, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Also known as lymphocytic hypophysitis, autoimmune hypophysitis is characterized by chronic inflammation of the pituitary gland resulting in a reduction of several pituitary hormones related to various metabolic functions. --- ### [Narcolepsy](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/narcolepsy/) **Published:** February 12, 2025 **Author:** Elevation **Excerpt:** Narcolepsy is a chronic neurological disorder that disrupts the brain’s ability to regulate sleep-wake cycles. It is characterized by excessive daytime sleepiness and sudden sleep attacks. --- ### [Acquired hemophilia](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/acquired-hemophilia/) **Published:** December 30, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** A rare condition that occurs when the immune system attacks blood-clotting proteins known as Factor VIII, resulting in spontaneous bleeding. --- ### [Transverse myelitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/transverse-myelitis/) **Published:** January 3, 2025 **Author:** Carolyn Serraino --- ### [Dermatitis herpetiformis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/dermatitis-herpetiformis/) **Published:** July 15, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Dermatitis herpetiformis (DH) involves chronic skin rashes of bumps and blisters. --- ### [Pernicious anemia](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/pernicious-anemia/) **Published:** March 14, 2025 **Author:** Carolyn Serraino **Excerpt:** Pernicious anemia is a type of anemia caused by the body's inability to absorb vitamin B12, leading to insufficient production of healthy red blood cells. --- ### [Juvenile myositis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/juvenile-myositis/) **Published:** July 16, 2025 **Author:** Carolyn Serraino --- ### [Cronkhite-Canada syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/cronkhite-canada-syndrome/) **Published:** June 10, 2020 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Cronkhite-Canada Syndrome (CCS) is a non-hereditary disease affecting the gastrointestinal tract, with a possible autoimmune etiology. --- ### [Polymyalgia rheumatica](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/polymyalgia-rheumatica/) **Published:** July 15, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Polymyalgia rheumatica is characterized by muscle pain and stiffness in the neck, shoulders, and hips, equally affecting both sides of the body.  --- ### [Autoimmune angioedema](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-angioedema/) **Published:** March 13, 2025 **Author:** Carolyn Serraino --- ### [Endometriosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/endometriosis/) **Published:** July 20, 2022 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Endometriosis is a condition in which the tissue lining the inside of the uterus (endometrium) grows outside of the uterus. --- ### [Amyloidosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/amyloidosis/) **Published:** February 24, 2025 **Author:** Elevation --- ### [Pyoderma gangrenosum](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/pyoderma-gangrenosum/) **Published:** February 19, 2025 **Author:** Elevation --- ### [Giant cell myocarditis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/giant-cell-myocarditis/) **Published:** February 12, 2025 **Author:** Elevation **Excerpt:** Giant cell myocarditis is a rare and severe form of myocarditis characterized by severe inflammation in the heart muscle. It happens when the immune system mistakenly attacks the heart, leading to damage and the buildup of large, abnormal cells called giant cells. --- ### [Cogan's syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/cogan-syndrome/) **Published:** December 30, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Cogan's Syndrome (CS) occurs when the immune system attacks the tissues and blood vessels of the eyes and ears. The disease can present either in a typical or atypical form. --- ### [Kawasaki disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/kawasaki-disease/) **Published:** February 5, 2025 **Author:** Elevation --- ### [Psoriasis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/psoriasis/) **Published:** July 15, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Psoriasis is a skin disease that causes red, itchy, or scaly patches, usually on the knees, elbows, trunk, and scalp, occurring in cycles of flare-ups that may last for weeks or months before subsiding.  --- ### [Rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/) **Published:** July 15, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** In Rheumatoid Arthritis, the most common chronic inflammatory joint disease, autoantibodies attack the joints and cause joint destruction.  --- ### [Rheumatic fever](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatic-fever/) **Published:** July 15, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Rheumatic fever is a disease that affects the heart, joints, brain, and skin and can cause permanent damage to the heart if left untreated.  --- ### [Pure red cell aplasia](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/pure-red-cell-aplasia/) **Published:** July 15, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Pure Red Cell Aplasia (PRCA) involves the production of red blood cells declines due to bone marrow damage, which leads to anemia. --- ### [Psoriatic arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/psoriatic-arthritis/) **Published:** July 15, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** A type of arthritis that develops after psoriasis. Cycles of flares and remission are common and treatment can help manage symptoms, but usually the condition does not entirely resolve.  --- ### [Multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/) **Published:** July 15, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Multiple Sclerosis (MS) causes immune attacks on the axons and myelin in the CNS that cover nerve fibers, which causes permanent communication problems between your brain and the rest of your body. --- ### [Lupus nephritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/lupus-nephritis/) **Published:** July 15, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Lupus Nephritis is a type of kidney disease caused by Systemic Lupus Erythematosus (SLE). Autoantibodies attack structures in the kidneys that filter out waste leading to impaired kidney function and potentially kidney failure. --- ### [Inclusion body myositis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/inclusion-body-myositis/) **Published:** March 31, 2022 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Inclusion body myositis (IBM) occurs when the immune system turns against the muscles, damaging muscle tissue. This causes weakness, inflammation, and atrophy. --- ### [IgG4-related sclerosing disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/igg4-related-sclerosing-disease/) **Published:** March 31, 2022 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** A systemic fibroinflammatory disease that has the potential to impact all organ systems, but tends to affect the following organs: pancreas, bile ducts, lacrimal glands, major salivary glands (parotid, submandibular, sublingual), lungs, kidneys, aorta, meninges, and thyroid gland. --- ### [Erythema nodosum](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/erythema-nodosum/) **Published:** March 31, 2022 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Erythema nodosum is a form of panniculitis (a disorder affecting the skin and its fatty tissue), which causes inflammation in the form of tender bumps under the skin. --- ### [Cryptogenic organizing pneumonia](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/cryptogenic-organizing-pneumonia/) **Published:** December 30, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** A rare lung condition that affects the alveoli (air-exchange sacs), the walls of the small bronchi, and bronchioles (small airways). --- ### [Alopecia areata](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/alopecia-areata/) **Published:** July 15, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Alopecia Areata is an unpredictable, transient, non-skin-scarring hair loss caused by destruction of hair follicles, which can eventually lead to the loss of all scalp hair (alopecia totalis) or all body hair (alopecia universalis). --- ### [Ankylosing spondylitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ankylosing-spondylitis/) **Published:** July 15, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Ankylosing Spondylitis is a chronic form of arthritis that causes inflammation of the joints and over time can cause some of the vertebrae of the spine to fuse. --- ### [Antiphospholipid syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/antiphospholipid-syndrome/) **Published:** July 15, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Antiphospholipid Syndrome (APS) is caused by autoantibodies that damage proteins attached to fat molecules (phospholipids) causing blood clots to form in the body’s arteries and veins and making the blood “stickier” than normal. --- ### [Aplastic anemia](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/aplastic-anemia/) **Published:** July 15, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Acquired Aplastic Anemia is a blood disorder that occurs when bone marrow (where red and white blood cell and platelet production occurs) is attacked by autoantibodies. --- ### [Autoimmune retinopathy](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-retinopathy/) **Published:** March 31, 2022 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Autoimmune retinopathy occurs when the immune system attacks the eye’s retina, causing inflammation. --- ### [Vitiligo](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/vitiligo/) **Published:** July 15, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** A skin disease that occurs when autoantibodies attack melanocytes (the skin cells that produce melanin or the chemical that produces skin color). --- ### [Small fiber sensory neuropathy](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/small-fiber-sensory-neuropathy/) **Published:** July 15, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Small fiber sensory neuropathy affects the small fibers of the peripheral nervous system, resulting in sensory disturbances which affect different areas of the body. --- ### [Scleritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/scleritis/) **Published:** July 15, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Scleritis involves inflammation of the sclera, or the white part of the eye. --- ### [Schmidt syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/schmidt-syndrome/) **Published:** July 15, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Schmidt syndrome, also known as autoimmune polyendocrine syndrome type II, affects several glands at once and causes decreased production of several essential hormones.  --- ### [Sarcoidosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sarcoidosis/) **Published:** July 15, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Characterized by the growth of granulomas, which are abnormal accumulations of inflammatory immune system cells called macrophages. --- ### [Relapsing polychondritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/relapsing-polychondritis/) **Published:** July 15, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Characterized by recurrent inflammation of the cartilage and other tissues, Relapsing Polychondritis affects the ears, nose, joints, eyes, skin, heart valves, and brain. --- ### [Reactive arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/reactive-arthritis/) **Published:** July 15, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Formerly referred to as Reiter’s syndrome, reactive arthritis causes inflammation in various joints in the body, especially the knees, feet, toes, hips and ankles. --- ### [Primary sclerosing cholangitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/primary-sclerosing-cholangitis/) **Published:** December 30, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Primary sclerosing cholangitis (PSC) is characterized by inflammation and destruction of the bile ducts, a series of tubes carrying bile (digestive fluid) from the liver to the small intestine. --- ### [Paroxysmal nocturnal hemoglobinuria](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/paroxysmal-nocturnal-hemoglobinuria/) **Published:** July 15, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Paroxysmal nocturnal hemoglobinuria (PNH) is a rare disease in which the body’s red blood cells are prematurely destroyed. --- ### [Paraneoplastic pemphigus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/paraneoplastic-pemphigus/) **Published:** July 15, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Paraneoplastic pemphigus is the least common but most severe form of pemphigus disease resulting in painful blisters on the mouth, lips, skin, and esophagus. --- ### [Paraneoplastic cerebellar degeneration](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/paraneoplastic-cerebellar-degeneration/) **Published:** July 15, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Paraneoplastic cerebellar degeneration (PCD) is an inflammatory autoimmune process that occurs due to the destruction of cells in the cerebellum, the part of the brain which coordinates muscular activity.  --- ### [Palmoplantar pustulosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/palmoplantar-pustulosis/) **Published:** July 15, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Palmoplantar pustulosis (PPP) is a rare, recurrent inflammatory disease typically associated with psoriasis, characterized by painful or burning pustules (small bumps on the skin that contain fluid or pus) on the palms of the hands and soles of the feet. --- ### [Palindromic rheumatism](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/palindromic-rheumatism/) **Published:** July 15, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Palindromic rheumatism is a type of arthritis characterized by episodes of joint pain flare-ups, which fortunately do not cause any lasting damage to joints. --- ### [Polyarteritis nodosa](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/polyarteritis-nodosa/) **Published:** July 15, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Polyarteritis nodosa (PAN) is a systemic blood vessel disease characterized by inflammation of small and medium-sized arteries which prevents their transport of oxygen and food to organs. --- ### [POEMS syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/poems-syndrome/) **Published:** July 15, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** POEMS syndrome is characterized by polyneuropathy (simultaneous malfunction of many peripheral nerves throughout the body), organomegaly (enlargement of an organ or organs), endocrinopathy (endocrine gland disease that disrupts hormone production), monoclonal gammopathy (abnormal proteins found in the blood), and skin changes. --- ### [Ménière’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/menierers-disease/) **Published:** July 15, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Meniere’s Disease is a chronic disease that affects the inner ear, though typically only one ear. --- ### [Linear IgA disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/linear-igadisease/) **Published:** July 15, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Linear IgA disease causes blisters on the skin and mucous membranes. Typically, the skin blisters form in a line, and a corresponding line of IgA antibodies is found below the epidermis during skin biopsies. --- ### [Lichen sclerosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/lichen-sclerosus/) **Published:** December 30, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Lichen sclerosus is a recurrent uncommon condition characterized by patches of white skin that appear thinner than usual, particularly around the genitals and anus. --- ### [Interstitial cystitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/interstitial-cystitis/) **Published:** July 20, 2022 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Interstitial cystitis is a chronic bladder condition that results in bladder pressure, bladder pain and pelvic pain. --- ### [Immune-mediated necrotizing myopathy](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/immune-mediated-necrotizing-myopathy/) **Published:** December 30, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Characterized by proximal muscle weakness (muscles closest to the body's midline), Immune-mediated necrotizing myopathy (IMNM) can exist in three different subtypes. --- ### [Hypogammaglobulinemia](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/hypogammaglobulinemia/) **Published:** July 20, 2022 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Hypogammaglobulinemia occurs when the immune system dysfunctions to prevent the body from making sufficient immunoglobulins (antibodies). --- ### [Hidradenitis suppurativa](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/hidradenitis-suppurativa/) **Published:** December 30, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Hidradenitis suppurativa is characterized by painful subcutaneous lumps that can break open or result in tunnels under the skin. --- ### [Henoch-Schonlein purpura](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/henoch-schonlein-purpura/) **Published:** July 15, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Henoch-Schölein purpura (HSP), also known as IgA vasculitis, is characterized by inflammation of the small blood vessels located in the skin, joints, intestines, and kidneys, sometimes accompanied by bleeding. --- ### [Graves' disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/graves-disease/) **Published:** July 15, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Graves Disease occurs when specific antibodies mistakenly bind to thyroid cells, overriding the normal regulation of the thyroid, causing the thyroid to produce and release excessive thyroid hormones (hyperthyroidism). --- ### [Glomerulonephritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/glomerulonephritis/) **Published:** July 15, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Glomerulonephritis (GN) is the name given to various conditions that develop when the kidney’s glomeruli become inflamed. --- ### [Evans syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/evans-syndrome/) **Published:** July 15, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Evans Syndrome occurs when autoantibodies attack healthy red blood cells, platelets, and neutrophils (white blood cells), depleting the levels of blood cells necessary for normal functioning. --- ### [Essential mixed cryoglobulinemia](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/essential-mixed-cryoglobulinemia/) **Published:** July 20, 2022 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Essential mixed cryoglobulinemia is a rare immune-mediated/autoimmune condition that features cryoglobulins, which are abnormal proteins in the blood that clump together at temperatures below 98.6 degrees Fahrenheit. --- ### [Eosinophilic fasciitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/eosinophilic-fasciitis/) **Published:** July 15, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Eosinophilic fasciitis involves inflammation of the fascia (the tough band of tissue under the skin) along the arms and legs due to abnormal accumulation of white blood cells which causes skin swelling, thickening, and hardening. --- ### [Discoid lupus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/discoid-lupus/) **Published:** July 15, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Discoid lupus erythematosus (DLE) is a type of lupus that is limited to the skin and presents as coin-shaped lesions on the skin form, either localized (on the face, ears, scalp) or disseminated (above and below the neck). --- ### [Dermatomyositis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/dermatomyositis/) **Published:** July 15, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Dermatomyositis involves degenerative changes of the muscles and skin, caused by an inappropriate autoimmune reaction that leads to obstructive inflammatory changes of blood vessels within muscle, connective tissues of the skin, and other tissues.  --- ### [Cold agglutinin disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/cold-agglutinin-disease/) **Published:** July 15, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Cold agglutinin disease (CAD) is a subtype of anemia in which abnormal bone marrow cells (called cold agglutinins) activate an immune system mechanism called the complement pathway, resulting in the destruction of red blood cells as they are attacked by antibodies. --- ### [Chagas disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/chagas-disease/) **Published:** December 30, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Also referred to as American trypanosomiasis, Chagas disease is a condition caused by the Trypanosoma cruzi parasite commonly found in the Americas (particularly in rural areas of South and Central America). --- ### [Castleman disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/castleman-disease/) **Published:** December 30, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Characterized by an overgrowth of cells in the body’s lymph nodes, Castleman disease can manifest in several different forms, affecting different parts of the body. --- ### [Birdshot chorioretinopathy](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/birdshot-chorioretinopathy/) **Published:** December 30, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Birdshot chorioretinopathy/birdshot uveitis is a rare form of posterior uveitis that affects the retina and choroid of the eye. --- ### [Behçet’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/behcets/) **Published:** July 15, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Behçet’s disease is a systemic disease that manifests as blood vessel inflammation throughout the entire body. --- ### [Autoimmune sudden sensorineural hearing loss](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-sudden-sensorineural-hearing-loss/) **Published:** December 30, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Autoimmune sudden sensorineural hearing loss is characterized by bilateral, (affecting both sides) rapidly progressive hearing loss that may occur suddenly or develop over several weeks to months. --- ### [Autoimmune pancreatitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-pancreatitis/) **Published:** July 15, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Also known as immunoglobulin G4-related disease, Autoimmune pancreatitis (AIP) is caused by an immune system attack on the pancreas which causes chronic inflammation, enlargement, or a mass in the pancreas. --- ### [Autoimmune oophoritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-oophoritis/) **Published:** July 15, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Autoimmune oophoritis occurs when autoantibodies attack the ovaries, disrupting their regular functioning. --- ### [Autoimmune myelofibrosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-myelofibrosis/) **Published:** December 30, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Autoimmune myelofibrosis (AIMF) is a form of non-cancerous myelofibrosis occurring with an autoimmune disease. --- ### [Autoimmune lymphoproliferative syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-lymphoproliferative-syndrome/) **Published:** July 15, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Autoimmune lymphoproliferative syndrome (ALPS) involves dysregulation of lymphocytes (immune system cells) resulting in overproduction and subsequent enlargement of the lymph nodes, spleen, and liver. --- ### [Autoimmune inner ear disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-inner-ear-disease/) **Published:** July 15, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Autoimmune inner ear disease (AIED) involves rapidly progressive hearing loss and/or dizziness caused by antibodies attacking the inner ear, usually occurring suddenly and beginning in one ear before spreading to both. --- ### [Autoimmune hyperlipidemia](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-hyperlipidemia/) **Published:** July 15, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Autoimmune hyperlipidemia is characterized by major hypertriglyceridemia, an abnormally high level of fat in the blood, due to autoantibodies preventing a specific type of protein (chylomicrons) in the plasma from properly circulating and transporting dietary lipids throughout the body. --- ### [Arteriosclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/arteriosclerosis/) **Published:** December 30, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Arteriosclerosis can cause a buildup of blood cells and fatty deposits in the arteries, which can enter the bloodstream and potentially cause a blood clot.  --- ### [Agammaglobulinemia](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/agammaglobulinemia/) **Published:** July 15, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Agammaglobulinemia, primary is characterized by the attack of antibodies known as gammaglobulins (responsible for defending the body from infection), leaving those affected very susceptible to illnesses, which then progress aggressively and are more likely to prove deadly. --- ### [Acromegaly](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/acromegaly/) **Published:** December 30, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Acromegaly involves the overproduction of growth hormones by the pituitary gland that takes place during adulthood, resulting in excessive growth in the bones of the hands, feet, and face. --- ## Medical Institutions ### [Columbia Doctors Neurology](https://www.autoimmuneinstitute.org/medical_institutions/columbiadoctors-neurology/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Multiple Sclerosis **Autoimmune Disease:** Multiple Sclerosis **State:** New York --- ### [Columbia Doctors Immunology](https://www.autoimmuneinstitute.org/medical_institutions/columbiadoctors-immunology/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Primary Immunodeficiency Disorders **Autoimmune Disease:** Primary Immunodeficiency Disorders **State:** New York --- ### [Columbia Doctors Ear, Nose & Throat](https://www.autoimmuneinstitute.org/medical_institutions/columbiadoctors-ear-nose-throat/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Graves’ Disease, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis, Sjögren Syndrome **Autoimmune Disease:** Graves' Disease, Hashimoto's Thyroiditis/Autoimmune Thyroiditis, Sjögren Syndrome **State:** New York --- ### [Columbia Doctors Digestive & Liver Disorders](https://www.autoimmuneinstitute.org/medical_institutions/columbiadoctors-digestive-liver-disorders/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Celiac Disease, Crohn’s Disease, Ulcerative Colitis **Autoimmune Disease:** Celiac Disease, Crohn's Disease, Ulcerative Colitis **State:** New York --- ### [Stanford Neuroscience Health Center](https://www.autoimmuneinstitute.org/medical_institutions/stanford-neuroscience-health-center/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Spondyloarthritis **Autoimmune Disease:** Spondyloarthritis **State:** California --- ### [Stanford Health Care Multispecialty Clinic in Emeryville](https://www.autoimmuneinstitute.org/medical_institutions/stanford-health-care-multispecialty-clinic-in-emeryville/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Amyloidosis, Glomerulonephritis, Lupus Nephritis **Autoimmune Disease:** Amyloidosis, Glomerulonephritis, Lupus Nephritis **State:** California --- ### [Stanford Dermatology Clinic in Livermore](https://www.autoimmuneinstitute.org/medical_institutions/stanford-dermatology-clinic-in-livermore/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Psoriasis **Autoimmune Disease:** Psoriasis **State:** California --- ### [Pain Management Center at Stanford Medicine Outpatient Center](https://www.autoimmuneinstitute.org/medical_institutions/pain-management-center-at-stanford-medicine-outpatient-center/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Crohn’s Disease, Ulcerative Colitis **Autoimmune Disease:** Crohn's Disease, Ulcerative Colitis **State:** California --- ### [Abramson Cancer Center Cherry Hill](https://www.autoimmuneinstitute.org/medical_institutions/abramson-cancer-center-cherry-hill/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Amyloidosis **Autoimmune Disease:** Amyloidosis **State:** New Jersey --- ### [Abramson Cancer Center Chester County Hospital](https://www.autoimmuneinstitute.org/medical_institutions/abramson-cancer-center-chester-county-hospital/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Amyloidosis **Autoimmune Disease:** Amyloidosis **State:** Pennsylvania --- ### [Westwood Specialty Care](https://www.autoimmuneinstitute.org/medical_institutions/westwood-specialty-care/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Ankylosing Spondylitis, Central Nervous System Vasculitis, Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA), Dermatomyositis, Giant Cell Arteritis, Henoch–Schönlein Purpura, Microscopic Polyangiitis (MPA)/ANCA-Associated Vasculitis, Polyarteritis Nodosa, Polymyalgia Rheumatica, Polymyositis, Psoriatic Arthritis, Rheumatoid Arthritis, Scleroderma, Systemic Lupus Erythematosus, Takayasu’s arteritis **Autoimmune Disease:** Ankylosing Spondylitis, Central Nervous System Vasculitis, Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA), Dermatomyositis, Giant Cell Arteritis, Henoch–Schönlein Purpura, Microscopic Polyangiitis (MPA)/ANCA-Associated Vasculitis, Polyarteritis Nodosa, Polymyalgia Rheumatica, Polymyositis, Psoriatic Arthritis, Rheumatoid Arthritis, Scleroderma, Systemic Lupus Erythematosus, Takayasu's arteritis **State:** California --- ### [Westwood Digestive Diseases](https://www.autoimmuneinstitute.org/medical_institutions/westwood-digestive-diseases/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Hepatitis, Celiac Disease, Crohn’s Disease, Eosinophilic Esophagitis, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis, Primary Biliary Cirrhosis, Primary Sclerosing Cholangitis, Scleroderma, Ulcerative Colitis **Autoimmune Disease:** Autoimmune Hepatitis, Celiac Disease, Crohn's Disease, Eosinophilic Esophagitis, Hashimoto's Thyroiditis/Autoimmune Thyroiditis, Primary Biliary Cirrhosis, Primary Sclerosing Cholangitis, Scleroderma, Ulcerative Colitis **State:** California --- ### [West Hills Digestive Diseases](https://www.autoimmuneinstitute.org/medical_institutions/west-hills-digestive-diseases/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Hepatitis, Celiac Disease, Crohn’s Disease, Eosinophilic Esophagitis, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis, Primary Biliary Cirrhosis, Primary Sclerosing Cholangitis, Scleroderma, Ulcerative Colitis **Autoimmune Disease:** Autoimmune Hepatitis, Celiac Disease, Crohn's Disease, Eosinophilic Esophagitis, Hashimoto's Thyroiditis/Autoimmune Thyroiditis, Primary Biliary Cirrhosis, Primary Sclerosing Cholangitis, Scleroderma, Ulcerative Colitis **State:** California --- ### [Westwood Neurology](https://www.autoimmuneinstitute.org/medical_institutions/westwood-neurology/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Multiple Sclerosis **Autoimmune Disease:** Multiple Sclerosis **State:** California --- ### [Westwood Pediatrics](https://www.autoimmuneinstitute.org/medical_institutions/westwood-pediatrics/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Various Autoimmune Diseases **Autoimmune Disease:** Various Autoimmune Diseases **State:** California --- ### [Westlake Village Triunfo Primary & Specialty Care](https://www.autoimmuneinstitute.org/medical_institutions/westlake-village-triunfo-primary-specialty-care/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Central Nervous System Vasculitis, Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA), Dermatomyositis, Giant Cell Arteritis, Glomerulonephritis, Henoch–Schönlein Purpura, Lupus Nephritis, Microscopic Polyangiitis (MPA)/ANCA-Associated Vasculitis, Mixed Connective Tissue Disease, Polyarteritis Nodosa, Polymyalgia Rheumatica, Polymyositis, Rheumatoid Arthritis, Scleroderma, Sjögren Syndrome, Systemic Lupus Erythematosus, Takayasu’s arteritis **Autoimmune Disease:** Central Nervous System Vasculitis, Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA), Dermatomyositis, Giant Cell Arteritis, Glomerulonephritis, Henoch–Schönlein Purpura, Lupus Nephritis, Microscopic Polyangiitis (MPA)/ANCA-Associated Vasculitis, Mixed Connective Tissue Disease, Polyarteritis Nodosa, Polymyalgia Rheumatica, Polymyositis, Rheumatoid Arthritis, Scleroderma, Sjögren Syndrome, Systemic Lupus Erythematosus, Takayasu's arteritis **State:** California --- ### [West Hills Primary & Specialty Care](https://www.autoimmuneinstitute.org/medical_institutions/west-hills-primary-specialty-care/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Hepatitis, Celiac Disease, Crohn’s Disease, Eosinophilic Esophagitis, Graves’ Disease, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis, Ulcerative Colitis **Autoimmune Disease:** Autoimmune Hepatitis, Celiac Disease, Crohn's Disease, Eosinophilic Esophagitis, Graves' Disease, Hashimoto's Thyroiditis/Autoimmune Thyroiditis, Ulcerative Colitis **State:** California --- ### [Vestibular Balance Disorders Program](https://www.autoimmuneinstitute.org/medical_institutions/vestibular-balance-disorders-program/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Ménière’s disease **Autoimmune Disease:** Ménière's disease **State:** California --- ### [Vasculitis Center](https://www.autoimmuneinstitute.org/medical_institutions/vasculitis-center/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Behçet’s Disease, Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA), Cryoglobulinemia, Giant Cell Arteritis, Henoch–Schönlein Purpura, Microscopic Polyangiitis (MPA)/ANCA-Associated Vasculitis, Polyarteritis Nodosa, Takayasu’s arteritis **Autoimmune Disease:** Behçet’s Disease, Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA), Cryoglobulinemia, Giant Cell Arteritis, Henoch–Schönlein Purpura, Microscopic Polyangiitis (MPA)/ANCA-Associated Vasculitis, Polyarteritis Nodosa, Takayasu's arteritis **State:** Maryland --- ### [Vascular Center](https://www.autoimmuneinstitute.org/medical_institutions/vascular-center/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Raynaud Syndrome/Phenomenon, Takayasu’s arteritis **Autoimmune Disease:** Raynaud Syndrome/Phenomenon, Takayasu's arteritis **State:** California --- ### [UCI Health Digestive Disease Center](https://www.autoimmuneinstitute.org/medical_institutions/uci-health-digestive-disease-center/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Hepatitis, Crohn’s Disease, Primary Biliary Cirrhosis, Primary Sclerosing Cholangitis, Type 1 Diabetes, Ulcerative Colitis **Autoimmune Disease:** Autoimmune Hepatitis, Crohn's Disease, Primary Biliary Cirrhosis, Primary Sclerosing Cholangitis, Type 1 Diabetes, Ulcerative Colitis **State:** California --- ### [UCI Health Digestive Disease Center](https://www.autoimmuneinstitute.org/medical_institutions/uci-health-digestive-disease-center-3/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Hepatitis, Crohn’s Disease, Primary Biliary Cirrhosis, Primary Sclerosing Cholangitis, Type 1 Diabetes, Ulcerative Colitis **Autoimmune Disease:** Autoimmune Hepatitis, Crohn's Disease, Primary Biliary Cirrhosis, Primary Sclerosing Cholangitis, Type 1 Diabetes, Ulcerative Colitis **State:** California --- ### [UCLA Santa Monica Medical Center](https://www.autoimmuneinstitute.org/medical_institutions/ucla-santa-monica-medical-center/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Hepatitis, Celiac Disease, Crohn’s Disease, Eosinophilic Esophagitis, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis, Primary Biliary Cirrhosis, Primary Sclerosing Cholangitis, Scleroderma, Ulcerative Colitis **Autoimmune Disease:** Autoimmune Hepatitis, Celiac Disease, Crohn's Disease, Eosinophilic Esophagitis, Hashimoto's Thyroiditis/Autoimmune Thyroiditis, Primary Biliary Cirrhosis, Primary Sclerosing Cholangitis, Scleroderma, Ulcerative Colitis **State:** California --- ### [UCLA Neurology Outpatient Clinic at Westwood](https://www.autoimmuneinstitute.org/medical_institutions/ucla-neurology-outpatient-clinic-at-westwood/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Encephalitis/Acute Disseminated Encephalomyelitis (ADEM), Chronic Inflammatory Demyelinating Polyneuropathy, Guillain-Barre Syndrome, Lambert-Eaton Myasthenic Syndrome, Ménière’s disease, Multiple Sclerosis, Myasthenia Gravis, Neuromyelitis Optica/Devic’s Disease, Transverse Myelitis **Autoimmune Disease:** Autoimmune Encephalitis/Acute Disseminated Encephalomyelitis (ADEM), Chronic Inflammatory Demyelinating Polyneuropathy, Guillain-Barre Syndrome, Lambert-Eaton Myasthenic Syndrome, Ménière's disease, Multiple Sclerosis, Myasthenia Gravis, Neuromyelitis Optica/Devic's Disease, Transverse Myelitis **State:** California --- ### [UCLA Neurology Outpatient Clinic at Santa Monica](https://www.autoimmuneinstitute.org/medical_institutions/ucla-neurology-outpatient-clinic-at-santa-monica/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Encephalitis/Acute Disseminated Encephalomyelitis (ADEM), Chronic Inflammatory Demyelinating Polyneuropathy, Guillain-Barre Syndrome, Lambert-Eaton Myasthenic Syndrome, Ménière’s disease, Multiple Sclerosis, Myasthenia Gravis, Neuromyelitis Optica/Devic’s Disease, Transverse Myelitis **Autoimmune Disease:** Autoimmune Encephalitis/Acute Disseminated Encephalomyelitis (ADEM), Chronic Inflammatory Demyelinating Polyneuropathy, Guillain-Barre Syndrome, Lambert-Eaton Myasthenic Syndrome, Ménière's disease, Multiple Sclerosis, Myasthenia Gravis, Neuromyelitis Optica/Devic's Disease, Transverse Myelitis **State:** California --- ### [Ventura Primary & Specialty Care](https://www.autoimmuneinstitute.org/medical_institutions/ventura-primary-specialty-care/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Addison’s Disease, Autoimmune Polyglandular Syndrome, Central Nervous System Vasculitis, Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA), Giant Cell Arteritis, Glomerulonephritis, Graves’ Disease, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis, Henoch–Schönlein Purpura, Microscopic Polyangiitis (MPA)/ANCA-Associated Vasculitis, Mixed Connective Tissue Disease, Polyarteritis Nodosa, Polymyalgia Rheumatica, Polymyositis, Rheumatoid Arthritis, Scleroderma, Sjögren Syndrome, Systemic Lupus Erythematosus, Takayasu’s arteritis, Type 1 Diabetes **Autoimmune Disease:** Addison's Disease, Autoimmune Polyglandular Syndrome, Central Nervous System Vasculitis, Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA), Giant Cell Arteritis, Glomerulonephritis, Graves' Disease, Hashimoto's Thyroiditis/Autoimmune Thyroiditis, Henoch–Schönlein Purpura, Microscopic Polyangiitis (MPA)/ANCA-Associated Vasculitis, Mixed Connective Tissue Disease, Polyarteritis Nodosa, Polymyalgia Rheumatica, Polymyositis, Rheumatoid Arthritis, Scleroderma, Sjögren Syndrome, Systemic Lupus Erythematosus, Takayasu's arteritis, Type 1 Diabetes **State:** California --- ### [UCLA Mattel Children's Hospital](https://www.autoimmuneinstitute.org/medical_institutions/ucla-mattel-childrens-hospital/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Behçet’s Disease, Celiac Disease, Crohn’s Disease, Dermatomyositis, Eosinophilic Esophagitis, Henoch–Schönlein Purpura, Juvenile Ankylosing Spondylitis, Juvenile Arthritis, Lichen Planus, Mixed Connective Tissue Disease, Psoriasis, Psoriatic Arthritis, Scleroderma, Sjögren Syndrome, Systemic Lupus Erythematosus, Ulcerative Colitis, Vitiligo **Autoimmune Disease:** Behçet’s Disease, Celiac Disease, Crohn's Disease, Dermatomyositis, Eosinophilic Esophagitis, Henoch–Schönlein Purpura, Juvenile Ankylosing Spondylitis, Juvenile Arthritis, Lichen Planus, Mixed Connective Tissue Disease, Psoriasis, Psoriatic Arthritis, Scleroderma, Sjögren Syndrome, Systemic Lupus Erythematosus, Ulcerative Colitis, Vitiligo **State:** California --- ### [UCLA Stein Eye Center Calabasas](https://www.autoimmuneinstitute.org/medical_institutions/ucla-stein-eye-center-calabasas/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Graves’ Disease, Myasthenia Gravis, Uveitis **Autoimmune Disease:** Graves' Disease, Myasthenia Gravis, Uveitis **State:** California --- ### [UCLA Stein Eye Center Santa Monica](https://www.autoimmuneinstitute.org/medical_institutions/ucla-stein-eye-center-santa-monica/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Graves’ Disease, Myasthenia Gravis, Uveitis **Autoimmune Disease:** Graves' Disease, Myasthenia Gravis, Uveitis **State:** California --- ### [UCLA Stein Eye Institute](https://www.autoimmuneinstitute.org/medical_institutions/ucla-stein-eye-institute/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Graves’ Disease, Myasthenia Gravis, Uveitis **Autoimmune Disease:** Graves' Disease, Myasthenia Gravis, Uveitis **State:** California --- ### [Vasculitis Program](https://www.autoimmuneinstitute.org/medical_institutions/vasculitis-program/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA), Giant Cell Arteritis, Henoch–Schönlein Purpura, Polyarteritis Nodosa, Takayasu’s arteritis **Autoimmune Disease:** Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA), Giant Cell Arteritis, Henoch–Schönlein Purpura, Polyarteritis Nodosa, Takayasu's arteritis **State:** Massachusetts --- ### [Vascular Care Clinic in Emeryville](https://www.autoimmuneinstitute.org/medical_institutions/vascular-care-clinic-in-emeryville/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Raynaud Syndrome/Phenomenon **Autoimmune Disease:** Raynaud Syndrome/Phenomenon **State:** California --- ### [Vascular Care Clinic in Pleasanton](https://www.autoimmuneinstitute.org/medical_institutions/vascular-care-clinic-in-pleasanton/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Raynaud Syndrome/Phenomenon **Autoimmune Disease:** Raynaud Syndrome/Phenomenon **State:** California --- ### [Vascular and Endovascular Care in Palo Alto](https://www.autoimmuneinstitute.org/medical_institutions/vascular-and-endovascular-care-in-palo-alto/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Raynaud Syndrome/Phenomenon **Autoimmune Disease:** Raynaud Syndrome/Phenomenon **State:** California --- ### [The Hematology Program](https://www.autoimmuneinstitute.org/medical_institutions/the-hematology-program/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Aplastic Anemia, Autoimmune Cytopenia, Autoimmune Hemolytic Anemia, Autoimmune Lymphoproliferative Syndrome **Autoimmune Disease:** Aplastic Anemia, Autoimmune Cytopenia, Autoimmune Hemolytic Anemia, Autoimmune Lymphoproliferative Syndrome **State:** Colorado --- ### [The R.J. Fasenmyer Center for Clinical Immunology](https://www.autoimmuneinstitute.org/medical_institutions/the-r-j-fasenmyer-center-for-clinical-immunology/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Primary Immunodeficiency, Vasculitis **Autoimmune Disease:** Primary Immunodeficiency, Vasculitis **State:** Ohio --- ### [Thyroid and Parathyroid Center](https://www.autoimmuneinstitute.org/medical_institutions/thyroid-and-parathyroid-center/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Hashimoto’s Thyroiditis/Autoimmune Thyroiditis **Autoimmune Disease:** Hashimoto's Thyroiditis/Autoimmune Thyroiditis **State:** Pennsylvania --- ### [Thymic Disorders Program](https://www.autoimmuneinstitute.org/medical_institutions/thymic-disorders-program/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Myasthenia Gravis **Autoimmune Disease:** Myasthenia Gravis **State:** Massachusetts --- ### [UCI Health Chao Family Comprehensive Digestive Disease Center](https://www.autoimmuneinstitute.org/medical_institutions/uci-health-chao-family-comprehensive-digestive-disease-center/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Hepatitis, Crohn’s Disease, Primary Biliary Cirrhosis, Primary Sclerosing Cholangitis, Type 1 Diabetes, Ulcerative Colitis **Autoimmune Disease:** Autoimmune Hepatitis, Crohn's Disease, Primary Biliary Cirrhosis, Primary Sclerosing Cholangitis, Type 1 Diabetes, Ulcerative Colitis **State:** California --- ### [UCI Health](https://www.autoimmuneinstitute.org/medical_institutions/uci-health/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Hepatitis, Crohn’s Disease, Primary Biliary Cirrhosis, Primary Sclerosing Cholangitis, Ulcerative Colitis **Autoimmune Disease:** Autoimmune Hepatitis, Crohn's Disease, Primary Biliary Cirrhosis, Primary Sclerosing Cholangitis, Ulcerative Colitis **State:** California --- ### [UCI Health](https://www.autoimmuneinstitute.org/medical_institutions/uci-health-5/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Hepatitis, Crohn’s Disease, Primary Biliary Cirrhosis, Primary Sclerosing Cholangitis, Ulcerative Colitis **Autoimmune Disease:** Autoimmune Hepatitis, Crohn's Disease, Primary Biliary Cirrhosis, Primary Sclerosing Cholangitis, Ulcerative Colitis **State:** California --- ### [Thousand Oaks Digestive Diseases](https://www.autoimmuneinstitute.org/medical_institutions/thousand-oaks-digestive-diseases/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Addison’s Disease, Autoimmune Hepatitis, Celiac Disease, Crohn’s Disease, Eosinophilic Esophagitis, Graves’ Disease, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis, Primary Biliary Cirrhosis, Primary Sclerosing Cholangitis, Scleroderma, Type 1 Diabetes, Ulcerative Colitis **Autoimmune Disease:** Addison's Disease, Autoimmune Hepatitis, Celiac Disease, Crohn's Disease, Eosinophilic Esophagitis, Graves' Disease, Hashimoto's Thyroiditis/Autoimmune Thyroiditis, Primary Biliary Cirrhosis, Primary Sclerosing Cholangitis, Scleroderma, Type 1 Diabetes, Ulcerative Colitis **State:** California --- ### [Torrence Digestive Diseases](https://www.autoimmuneinstitute.org/medical_institutions/torrence-digestive-diseases/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Hepatitis, Celiac Disease, Crohn’s Disease, Eosinophilic Esophagitis, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis, Primary Biliary Cirrhosis, Primary Sclerosing Cholangitis, Scleroderma, Ulcerative Colitis **Autoimmune Disease:** Autoimmune Hepatitis, Celiac Disease, Crohn's Disease, Eosinophilic Esophagitis, Hashimoto's Thyroiditis/Autoimmune Thyroiditis, Primary Biliary Cirrhosis, Primary Sclerosing Cholangitis, Scleroderma, Ulcerative Colitis **State:** California --- ### [Thousand Oaks Neurology](https://www.autoimmuneinstitute.org/medical_institutions/thousand-oaks-neurology/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Multiple Sclerosis **Autoimmune Disease:** Multiple Sclerosis **State:** California --- ### [Torrance Skypark Specialty Care](https://www.autoimmuneinstitute.org/medical_institutions/torrance-skypark-specialty-care/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Various Autoimmune Diseases **Autoimmune Disease:** Various Autoimmune Diseases **State:** California --- ### [Torrance Lomita Specialty Care](https://www.autoimmuneinstitute.org/medical_institutions/torrance-lomita-specialty-care/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Central Nervous System Vasculitis, Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA), Dermatomyositis, Giant Cell Arteritis, Henoch–Schönlein Purpura, Microscopic Polyangiitis (MPA)/ANCA-Associated Vasculitis, Polyarteritis Nodosa, Polymyalgia Rheumatica, Polymyositis, Rheumatoid Arthritis, Scleroderma, Sjögren Syndrome, Systemic Lupus Erythematosus, Takayasu’s arteritis **Autoimmune Disease:** Central Nervous System Vasculitis, Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA), Dermatomyositis, Giant Cell Arteritis, Henoch–Schönlein Purpura, Microscopic Polyangiitis (MPA)/ANCA-Associated Vasculitis, Polyarteritis Nodosa, Polymyalgia Rheumatica, Polymyositis, Rheumatoid Arthritis, Scleroderma, Sjögren Syndrome, Systemic Lupus Erythematosus, Takayasu's arteritis **State:** California --- ### [Thousand Oaks Primary & Specialty Care](https://www.autoimmuneinstitute.org/medical_institutions/thousand-oaks-primary-specialty-care/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Addison’s Disease, Autoimmune Polyglandular Syndrome, Graves’ Disease, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis, Type 1 Diabetes **Autoimmune Disease:** Addison's Disease, Autoimmune Polyglandular Syndrome, Graves' Disease, Hashimoto's Thyroiditis/Autoimmune Thyroiditis, Type 1 Diabetes **State:** California --- ### [The Heart Group of Lancaster General Health Women's Specialty Center](https://www.autoimmuneinstitute.org/medical_institutions/the-heart-group-of-lancaster-general-health-womens-specialty-center/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Arteriosclerosis/atherosclerosis **Autoimmune Disease:** Arteriosclerosis / atherosclerosis **State:** Pennsylvania --- ### [The Heart Group of Lancaster General Health Elizabethtown](https://www.autoimmuneinstitute.org/medical_institutions/the-heart-group-of-lancaster-general-health-elizabethtown/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Amyloidosis, Arteriosclerosis/atherosclerosis **Autoimmune Disease:** Amyloidosis, Arteriosclerosis / atherosclerosis **State:** Pennsylvania --- ### [The Heart Group of Lancaster General Health Kissel Hill](https://www.autoimmuneinstitute.org/medical_institutions/the-heart-group-of-lancaster-general-health-kissel-hill/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Amyloidosis, Arteriosclerosis/atherosclerosis **Autoimmune Disease:** Amyloidosis, Arteriosclerosis / atherosclerosis **State:** Pennsylvania --- ### [The Heart Group of Lancaster General Health Lebanon](https://www.autoimmuneinstitute.org/medical_institutions/the-heart-group-of-lancaster-general-health-lebanon/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Arteriosclerosis/atherosclerosis **Autoimmune Disease:** Arteriosclerosis / atherosclerosis **State:** Pennsylvania --- ### [The Heart Group of Lancaster General Health Ephrata](https://www.autoimmuneinstitute.org/medical_institutions/the-heart-group-of-lancaster-general-health-ephrata/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Amyloidosis **Autoimmune Disease:** Amyloidosis **State:** Pennsylvania --- ### [Sarcoidosis Program](https://www.autoimmuneinstitute.org/medical_institutions/sarcoidosis-program/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Sarcoidosis **Autoimmune Disease:** Sarcoidosis **State:** Pennsylvania --- ### [Scleroderma Center](https://www.autoimmuneinstitute.org/medical_institutions/scleroderma-center/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Scleroderma **Autoimmune Disease:** Scleroderma **State:** Maryland --- ### [Scleroderma Center](https://www.autoimmuneinstitute.org/medical_institutions/scleroderma-center-2/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Scleroderma **Autoimmune Disease:** Scleroderma **State:** New York --- ### [The Center for Autoimmune Neurology](https://www.autoimmuneinstitute.org/medical_institutions/the-center-for-autoimmune-neurology/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Anti-NMDA Receptor Encephalitis, Autoimmune Encephalitis/Acute Disseminated Encephalomyelitis (ADEM), Chronic Inflammatory Demyelinating Polyneuropathy, Dermatomyositis, Guillain-Barre Syndrome, Multiple Sclerosis, Myasthenia Gravis, Neuromyelitis Optica/Devic’s Disease, Polymyositis, Stiff Person Syndrome **Autoimmune Disease:** Anti-NMDA Receptor Encephalitis, Autoimmune Encephalitis/Acute Disseminated Encephalomyelitis (ADEM), Chronic Inflammatory Demyelinating Polyneuropathy, Dermatomyositis, Guillain-Barre Syndrome, Multiple Sclerosis, Myasthenia Gravis, Neuromyelitis Optica/Devic's Disease, Polymyositis, Stiff Person Syndrome **State:** Pennsylvania --- ### [Simi Valley Alamo Specialty Care](https://www.autoimmuneinstitute.org/medical_institutions/simi-valley-alamo-specialty-care/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Hepatitis, Celiac Disease, Crohn’s Disease, Eosinophilic Esophagitis, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis, Primary Biliary Cirrhosis, Primary Sclerosing Cholangitis, Scleroderma, Ulcerative Colitis **Autoimmune Disease:** Autoimmune Hepatitis, Celiac Disease, Crohn's Disease, Eosinophilic Esophagitis, Hashimoto's Thyroiditis/Autoimmune Thyroiditis, Primary Biliary Cirrhosis, Primary Sclerosing Cholangitis, Scleroderma, Ulcerative Colitis **State:** California --- ### [Stein Eye Institute](https://www.autoimmuneinstitute.org/medical_institutions/stein-eye-institute/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Graves’ Disease, Myasthenia Gravis, Uveitis **Autoimmune Disease:** Graves' Disease, Myasthenia Gravis, Uveitis **State:** California --- ### [Sjögren’s Syndrome Clinic](https://www.autoimmuneinstitute.org/medical_institutions/sjogrens-syndrome-clinic/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Sjögren Syndrome **Autoimmune Disease:** Sjögren Syndrome **State:** California --- ### [Scleroderma Center](https://www.autoimmuneinstitute.org/medical_institutions/scleroderma-center-3/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Scleroderma **Autoimmune Disease:** Scleroderma **State:** Massachusetts --- ### [Spondyloarthritis Program](https://www.autoimmuneinstitute.org/medical_institutions/spondyloarthritis-program/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Ankylosing Spondylitis, Psoriatic Arthritis **Autoimmune Disease:** Ankylosing Spondylitis, Psoriatic Arthritis **State:** Massachusetts --- ### [Sarcoidosis Program](https://www.autoimmuneinstitute.org/medical_institutions/sarcoidosis-program-2/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Sarcoidosis **Autoimmune Disease:** Sarcoidosis **State:** Massachusetts --- ### [Spruce Internal Medicine](https://www.autoimmuneinstitute.org/medical_institutions/spruce-internal-medicine/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata **Autoimmune Disease:** Alopecia Areata **State:** Pennsylvania --- ### [Scheie Eye Institute Perelman](https://www.autoimmuneinstitute.org/medical_institutions/scheie-eye-institute-perelman/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Graves’ Disease, Myasthenia Gravis, Neuromyelitis Optica/Devic’s Disease, Temporal Arteritis **Autoimmune Disease:** Graves' Disease, Myasthenia Gravis, Neuromyelitis Optica/Devic's Disease, Temporal Arteritis **State:** Pennsylvania --- ### [Scheie Eye Institute Penn Presbyterian](https://www.autoimmuneinstitute.org/medical_institutions/scheie-eye-institute-penn-presbyterian/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Graves’ Disease, Myasthenia Gravis, Neuromyelitis Optica/Devic’s Disease, Sjögren Syndrome, Temporal Arteritis **Autoimmune Disease:** Graves' Disease, Myasthenia Gravis, Neuromyelitis Optica/Devic's Disease, Sjögren Syndrome, Temporal Arteritis **State:** Pennsylvania --- ### [Scheie Eye Institute Media](https://www.autoimmuneinstitute.org/medical_institutions/scheie-eye-institute-media/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Graves’ Disease, Myasthenia Gravis, Sjögren Syndrome, Temporal Arteritis **Autoimmune Disease:** Graves' Disease, Myasthenia Gravis, Sjögren Syndrome, Temporal Arteritis **State:** Pennsylvania --- ### [Scheie Eye Institute Radnor](https://www.autoimmuneinstitute.org/medical_institutions/scheie-eye-institute-radnor/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Graves’ Disease, Myasthenia Gravis, Sjögren Syndrome, Temporal Arteritis **Autoimmune Disease:** Graves' Disease, Myasthenia Gravis, Sjögren Syndrome, Temporal Arteritis **State:** Pennsylvania --- ### [The Heart Group of Lancaster General Health](https://www.autoimmuneinstitute.org/medical_institutions/the-heart-group-of-lancaster-general-health/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Amyloidosis, Arteriosclerosis/atherosclerosis **Autoimmune Disease:** Amyloidosis, Arteriosclerosis / atherosclerosis **State:** Pennsylvania --- ### [Samara Jan Turkel Clinical Center for Pediatric Autoimmune Disease](https://www.autoimmuneinstitute.org/medical_institutions/samara-jan-turkel-clinical-center-for-pediatric-autoimmune-disease/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Ankylosing Spondylitis, Dermatomyositis, Sarcoidosis, Scleroderma, Systemic Lupus Erythematosus **Autoimmune Disease:** Ankylosing Spondylitis, Dermatomyositis, Sarcoidosis, Scleroderma, Systemic Lupus Erythematosus **State:** Massachusetts --- ### [Rheumatology Program](https://www.autoimmuneinstitute.org/medical_institutions/rheumatology-program/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Myositis, Rheumatoid Arthritis, Scleroderma, Sjögren Syndrome, Systemic Lupus Erythematosus, Vasculitis **Autoimmune Disease:** Myositis, Rheumatoid Arthritis, Scleroderma, Sjögren Syndrome, Systemic Lupus Erythematosus, Vasculitis **State:** North Carolina --- ### [Rheumatology Unit](https://www.autoimmuneinstitute.org/medical_institutions/rheumatology-unit/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Behçet’s Disease, Cryoglobulinemic Vasculitis, Dermatomyositis, Giant Cell Arteritis, Henoch–Schönlein Purpura, Microscopic Polyangiitis (MPA)/ANCA-Associated Vasculitis, Mixed Connective Tissue Disease, Polyarteritis Nodosa, Polymyositis, Psoriasis, Raynaud Syndrome/Phenomenon, Rheumatoid Arthritis, Sarcoidosis, Scleroderma, Systemic Lupus Erythematosus, Takayasu’s arteritis, Vasculitis **Autoimmune Disease:** Behçet’s Disease, Cryoglobulinemic Vasculitis, Dermatomyositis, Giant Cell Arteritis, Henoch–Schönlein Purpura, Microscopic Polyangiitis (MPA)/ANCA-Associated Vasculitis, Mixed Connective Tissue Disease, Polyarteritis Nodosa, Polymyositis, Psoriasis, Raynaud Syndrome/Phenomenon, Rheumatoid Arthritis, Sarcoidosis, Scleroderma, Systemic Lupus Erythematosus, Takayasu's arteritis, Vasculitis **State:** Massachusetts --- ### [Rheumatology Department](https://www.autoimmuneinstitute.org/medical_institutions/rheumatology-department/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Ankylosing Spondylitis, Antiphospholipid Syndrome, Behçet’s Disease, Central Nervous System Vasculitis, Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA), Cryoglobulinemia, Dermatomyositis, Eosinophilic Fasciitis, Giant Cell Arteritis, Henoch–Schönlein Purpura, Igg4-Related Disease, Juvenile Dermatomyositis, Juvenile Idiopathic Arthritis, Mixed Connective Tissue Disease, Myositis, Polyarteritis Nodosa, Polymyalgia Rheumatica, Polymyositis, Psoriatic Arthritis, Raynaud Syndrome/Phenomenon, Relapsing Polychondritis, Rheumatoid Arthritis, Sarcoidosis, Scleroderma, Sjögren Syndrome, Systemic Lupus Erythematosus, Takayasu’s arteritis, Vasculitis **Autoimmune Disease:** Ankylosing Spondylitis, Antiphospholipid Syndrome, Behçet’s Disease, Central Nervous System Vasculitis, Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA), Cryoglobulinemia, Dermatomyositis, Eosinophilic Fasciitis, Giant Cell Arteritis, Henoch–Schönlein Purpura, Igg4-Related Disease, Juvenile Dermatomyositis, Juvenile Idiopathic Arthritis, Mixed Connective Tissue Disease, Myositis, Polyarteritis Nodosa, Polymyalgia Rheumatica, Polymyositis, Psoriatic Arthritis, Raynaud Syndrome/Phenomenon, Relapsing Polychondritis, Rheumatoid Arthritis, Sarcoidosis, Scleroderma, Sjögren Syndrome, Systemic Lupus Erythematosus, Takayasu's arteritis, Vasculitis **State:** Minnesota --- ### [Rheumatology, Allergy, and Clinical Immunology](https://www.autoimmuneinstitute.org/medical_institutions/rheumatology-allergy-and-clinical-immunology/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Primary Biliary Cirrhosis, Rheumatoid Arthritis, Systemic Lupus Erythematosus **Autoimmune Disease:** Primary Biliary Cirrhosis, Rheumatoid Arthritis, Systemic Lupus Erythematosus **State:** California --- ### [Rheumatology](https://www.autoimmuneinstitute.org/medical_institutions/rheumatology-5/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Ankylosing Spondylitis, Dermatomyositis, Giant Cell Arteritis, Myositis, Polymyalgia Rheumatica, Polymyositis, Psoriatic Arthritis, Rheumatoid Arthritis, Scleroderma, Takayasu’s arteritis, Vasculitis **Autoimmune Disease:** Ankylosing Spondylitis, Dermatomyositis, Giant Cell Arteritis, Myositis, Polymyalgia Rheumatica, Polymyositis, Psoriatic Arthritis, Rheumatoid Arthritis, Scleroderma, Takayasu's arteritis, Vasculitis **State:** California --- ### [Santa Clarita Digestive Diseases](https://www.autoimmuneinstitute.org/medical_institutions/santa-clarita-digestive-diseases/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Hepatitis, Celiac Disease, Crohn’s Disease, Eosinophilic Esophagitis, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis, Primary Biliary Cirrhosis, Primary Sclerosing Cholangitis, Scleroderma, Ulcerative Colitis **Autoimmune Disease:** Autoimmune Hepatitis, Celiac Disease, Crohn's Disease, Eosinophilic Esophagitis, Hashimoto's Thyroiditis/Autoimmune Thyroiditis, Primary Biliary Cirrhosis, Primary Sclerosing Cholangitis, Scleroderma, Ulcerative Colitis **State:** California --- ### [Santa Monica Digestive Diseases](https://www.autoimmuneinstitute.org/medical_institutions/santa-monica-digestive-diseases/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Addison’s Disease, Autoimmune Hepatitis, Celiac Disease, Crohn’s Disease, Eosinophilic Esophagitis, Graves’ Disease, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis, Primary Biliary Cirrhosis, Primary Sclerosing Cholangitis, Scleroderma, Type 1 Diabetes, Ulcerative Colitis **Autoimmune Disease:** Addison's Disease, Autoimmune Hepatitis, Celiac Disease, Crohn's Disease, Eosinophilic Esophagitis, Graves' Disease, Hashimoto's Thyroiditis/Autoimmune Thyroiditis, Primary Biliary Cirrhosis, Primary Sclerosing Cholangitis, Scleroderma, Type 1 Diabetes, Ulcerative Colitis **State:** California --- ### [Ronald Reagan UCLA Medical Center](https://www.autoimmuneinstitute.org/medical_institutions/ronald-reagan-ucla-medical-center/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Addison’s Disease, Autoimmune Hepatitis, Celiac Disease, Crohn’s Disease, Eosinophilic Esophagitis, Graves’ Disease, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis, Primary Biliary Cirrhosis, Primary Sclerosing Cholangitis, Scleroderma, Type 1 Diabetes, Ulcerative Colitis **Autoimmune Disease:** Addison's Disease, Autoimmune Hepatitis, Celiac Disease, Crohn's Disease, Eosinophilic Esophagitis, Graves' Disease, Hashimoto's Thyroiditis/Autoimmune Thyroiditis, Primary Biliary Cirrhosis, Primary Sclerosing Cholangitis, Scleroderma, Type 1 Diabetes, Ulcerative Colitis **State:** California --- ### [Santa Monica Neurology](https://www.autoimmuneinstitute.org/medical_institutions/santa-monica-neurology/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Multiple Sclerosis **Autoimmune Disease:** Multiple Sclerosis **State:** California --- ### [Santa Monica Allergy & Immunology](https://www.autoimmuneinstitute.org/medical_institutions/santa-monica-allergy-immunology/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Various Autoimmune Diseases **Autoimmune Disease:** Various Autoimmune Diseases **State:** California --- ### [Santa Clarita Primary & Specialty Care](https://www.autoimmuneinstitute.org/medical_institutions/santa-clarita-primary-specialty-care/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Various Autoimmune Diseases **Autoimmune Disease:** Various Autoimmune Diseases **State:** California --- ### [Santa Monica Pediatric Specialty Care](https://www.autoimmuneinstitute.org/medical_institutions/santa-monica-pediatric-specialty-care/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Various Autoimmune Diseases **Autoimmune Disease:** Various Autoimmune Diseases **State:** California --- ### [Santa Clarita Tourney Road Primary & Specialty Care](https://www.autoimmuneinstitute.org/medical_institutions/santa-clarita-tourney-road-primary-specialty-care/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Central Nervous System Vasculitis, Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA), Dermatomyositis, Giant Cell Arteritis, Henoch–Schönlein Purpura, Lichen Planus, Microscopic Polyangiitis (MPA)/ANCA-Associated Vasculitis, Polyarteritis Nodosa, Polymyalgia Rheumatica, Polymyositis, Psoriasis, Psoriatic Arthritis, Rheumatoid Arthritis, Scleroderma, Sjögren Syndrome, Systemic Lupus Erythematosus, Takayasu’s arteritis, Vitiligo **Autoimmune Disease:** Central Nervous System Vasculitis, Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA), Dermatomyositis, Giant Cell Arteritis, Henoch–Schönlein Purpura, Lichen Planus, Microscopic Polyangiitis (MPA)/ANCA-Associated Vasculitis, Polyarteritis Nodosa, Polymyalgia Rheumatica, Polymyositis, Psoriasis, Psoriatic Arthritis, Rheumatoid Arthritis, Scleroderma, Sjögren Syndrome, Systemic Lupus Erythematosus, Takayasu's arteritis, Vitiligo **State:** California --- ### [Santa Monica Pediatric Specialty Care](https://www.autoimmuneinstitute.org/medical_institutions/santa-monica-pediatric-specialty-care-2/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Behçet’s Disease, Celiac Disease, Crohn’s Disease, Dermatomyositis, Eosinophilic Esophagitis, Guillain-Barre Syndrome, Henoch–Schönlein Purpura, Juvenile Ankylosing Spondylitis, Juvenile Arthritis, Juvenile Idiopathic Arthritis, Lichen Planus, Lupus Nephritis, Mixed Connective Tissue Disease, Myasthenia Gravis, Psoriasis, Psoriatic Arthritis, Scleroderma, Sjögren Syndrome, Systemic Lupus Erythematosus, Ulcerative Colitis, Vitiligo **Autoimmune Disease:** Behçet’s Disease, Celiac Disease, Crohn's Disease, Dermatomyositis, Eosinophilic Esophagitis, Guillain-Barre Syndrome, Henoch–Schönlein Purpura, Juvenile Ankylosing Spondylitis, Juvenile Arthritis, Juvenile Idiopathic Arthritis, Lichen Planus, Lupus Nephritis, Mixed Connective Tissue Disease, Myasthenia Gravis, Psoriasis, Psoriatic Arthritis, Scleroderma, Sjögren Syndrome, Systemic Lupus Erythematosus, Ulcerative Colitis, Vitiligo **State:** California --- ### [Respiratory Institute](https://www.autoimmuneinstitute.org/medical_institutions/respiratory-institute/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Autonomic Ganglionopathy, Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA), Connective Tissue Disease, Goodpasture Syndrome, Pulmonary Alveolar Proteinosis, Sarcoidosis **Autoimmune Disease:** Autoimmune Autonomic Ganglionopathy, Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA), Connective Tissue Disease, Goodpasture Syndrome, Pulmonary Alveolar Proteinosis, Sarcoidosis **State:** Ohio --- ### [Psoriasis Center](https://www.autoimmuneinstitute.org/medical_institutions/psoriasis-center/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Psoriasis **Autoimmune Disease:** Psoriasis **State:** Pennsylvania --- ### [Pulmonary and Critical Care Medicine](https://www.autoimmuneinstitute.org/medical_institutions/pulmonary-and-critical-care-medicine/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA), Myositis, Rheumatoid Arthritis, Sarcoidosis, Scleroderma, Sjögren Syndrome **Autoimmune Disease:** Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA), Myositis, Rheumatoid Arthritis, Sarcoidosis, Scleroderma, Sjögren Syndrome **State:** Massachusetts --- ### [Pulmonary Department](https://www.autoimmuneinstitute.org/medical_institutions/pulmonary-department/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Amyloidosis, Sarcoidosis **Autoimmune Disease:** Amyloidosis, Sarcoidosis **State:** Minnesota --- ### [Psoriasis Clinic](https://www.autoimmuneinstitute.org/medical_institutions/psoriasis-clinic/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Psoriasis **Autoimmune Disease:** Psoriasis **State:** California --- ### [Rheumatology](https://www.autoimmuneinstitute.org/medical_institutions/rheumatology/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Ankylosing Spondylitis, Dermatomyositis, Giant Cell Arteritis, Myositis, Polymyalgia Rheumatica, Polymyositis, Psoriatic Arthritis, Rheumatoid Arthritis, Scleroderma, Takayasu’s arteritis, Vasculitis **Autoimmune Disease:** Ankylosing Spondylitis, Dermatomyositis, Giant Cell Arteritis, Myositis, Polymyalgia Rheumatica, Polymyositis, Psoriatic Arthritis, Rheumatoid Arthritis, Scleroderma, Takayasu's arteritis, Vasculitis **State:** California --- ### [Redondo Beach Primary & Specialty Care](https://www.autoimmuneinstitute.org/medical_institutions/redondo-beach-primary-specialty-care/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Hepatitis, Celiac Disease, Crohn’s Disease, Eosinophilic Esophagitis, Graves’ Disease, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis, Lichen Planus, Psoriasis, Psoriatic Arthritis, Ulcerative Colitis, Vitiligo **Autoimmune Disease:** Autoimmune Hepatitis, Celiac Disease, Crohn's Disease, Eosinophilic Esophagitis, Graves' Disease, Hashimoto's Thyroiditis/Autoimmune Thyroiditis, Lichen Planus, Psoriasis, Psoriatic Arthritis, Ulcerative Colitis, Vitiligo **State:** California --- ### [Psoriasis and Skin Treatment Center](https://www.autoimmuneinstitute.org/medical_institutions/psoriasis-and-skin-treatment-center/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Lichen Planus, Psoriasis, Vitiligo **Autoimmune Disease:** Lichen Planus, Psoriasis, Vitiligo **State:** California --- ### [Rheumatology](https://www.autoimmuneinstitute.org/medical_institutions/rheumatology-8/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Ankylosing Spondylitis, Lupus Nephritis, Mixed Connective Tissue Disease, Myositis, Psoriatic Arthritis, Reactive Arthritis, Rheumatoid Arthritis, Scleroderma, Sjögren Syndrome, Systemic Lupus Erythematosus, Vasculitis **Autoimmune Disease:** Ankylosing Spondylitis, Lupus Nephritis, Mixed Connective Tissue Disease, Myositis, Psoriatic Arthritis, Reactive Arthritis, Rheumatoid Arthritis, Scleroderma, Sjögren Syndrome, Systemic Lupus Erythematosus, Vasculitis **State:** California --- ### [Rheumatology](https://www.autoimmuneinstitute.org/medical_institutions/rheumatology-9/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Ankylosing Spondylitis, Behçet’s Disease, Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA), Dermatomyositis, Giant Cell Arteritis, Henoch–Schönlein Purpura, Polyarteritis Nodosa, Polymyositis, Psoriatic Arthritis, Rheumatoid Arthritis, Scleroderma, Systemic Lupus Erythematosus, Takayasu’s arteritis, Vasculitis **Autoimmune Disease:** Ankylosing Spondylitis, Behçet’s Disease, Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA), Dermatomyositis, Giant Cell Arteritis, Henoch–Schönlein Purpura, Polyarteritis Nodosa, Polymyositis, Psoriatic Arthritis, Rheumatoid Arthritis, Scleroderma, Systemic Lupus Erythematosus, Takayasu's arteritis, Vasculitis **State:** Massachusetts --- ### [Pulmonology Department](https://www.autoimmuneinstitute.org/medical_institutions/pulmonology-department/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Primary Immunodeficiency Disorders, Sarcoidosis, Scleroderma **Autoimmune Disease:** Primary Immunodeficiency Disorders, Sarcoidosis, Scleroderma **State:** Massachusetts --- ### [Psoriasis Clinic](https://www.autoimmuneinstitute.org/medical_institutions/psoriasis-clinic-2/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Psoriasis **Autoimmune Disease:** Psoriasis **State:** California --- ### [Princeton Medicine Physicians - Family Medicine Dayton](https://www.autoimmuneinstitute.org/medical_institutions/princeton-medicine-physicians-family-medicine-dayton/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata **Autoimmune Disease:** Alopecia Areata **State:** New Jersey --- ### [Princeton Medicine Physicians - Family Medicine Monroe](https://www.autoimmuneinstitute.org/medical_institutions/princeton-medicine-physicians-family-medicine-monroe/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata **Autoimmune Disease:** Alopecia Areata **State:** New Jersey --- ### [Princeton Medicine Physicians - Internal Medicine Plainsboro](https://www.autoimmuneinstitute.org/medical_institutions/princeton-medicine-physicians-internal-medicine-plainsboro/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata **Autoimmune Disease:** Alopecia Areata **State:** New Jersey --- ### [Princeton Medicine Physicians - Rednor Risi Family Medicine](https://www.autoimmuneinstitute.org/medical_institutions/princeton-medicine-physicians-rednor-risi-family-medicine/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata **Autoimmune Disease:** Alopecia Areata **State:** New Jersey --- ### [Princeton Medicine Physicians - Plainsboro Family Physicians](https://www.autoimmuneinstitute.org/medical_institutions/princeton-medicine-physicians-plainsboro-family-physicians/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata **Autoimmune Disease:** Alopecia Areata **State:** New Jersey --- ### [Princeton Medicine Physicians - Rheumatology Lawrenceville](https://www.autoimmuneinstitute.org/medical_institutions/princeton-medicine-physicians-rheumatology-lawrenceville/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Dermatomyositis, Myositis, Rheumatoid Arthritis, Sarcoidosis, Scleroderma, Sjögren Syndrome, Temporal Arteritis **Autoimmune Disease:** Dermatomyositis, Myositis, Rheumatoid Arthritis, Sarcoidosis, Scleroderma, Sjögren Syndrome, Temporal Arteritis **State:** New Jersey --- ### [Princeton Medicine Physicians - Rheumatology Plainsboro](https://www.autoimmuneinstitute.org/medical_institutions/princeton-medicine-physicians-rheumatology-plainsboro/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Dermatomyositis, Myositis, Rheumatoid Arthritis, Sarcoidosis, Scleroderma, Sjögren Syndrome, Temporal Arteritis **Autoimmune Disease:** Dermatomyositis, Myositis, Rheumatoid Arthritis, Sarcoidosis, Scleroderma, Sjögren Syndrome, Temporal Arteritis **State:** New Jersey --- ### [Princeton Medicine Physicians - Internal Medicine Monroe](https://www.autoimmuneinstitute.org/medical_institutions/princeton-medicine-physicians-internal-medicine-monroe/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Celiac Disease, Type 1 Diabetes **Autoimmune Disease:** Celiac Disease, Type 1 Diabetes **State:** New Jersey --- ### [Primary Immunodeficiency Center](https://www.autoimmuneinstitute.org/medical_institutions/primary-immunodeficiency-center/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Agammaglobulinemia, Autoimmune Polyglandular Syndrome, Chronic Granulomatous Disease **Autoimmune Disease:** Agammaglobulinemia, Autoimmune Polyglandular Syndrome, Chronic Granulomatous Disease **State:** Minnesota --- ### [Porter Ranch Primary & Specialty Care](https://www.autoimmuneinstitute.org/medical_institutions/porter-ranch-primary-specialty-care/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Addison’s Disease, Autoimmune Hepatitis, Celiac Disease, Crohn’s Disease, Eosinophilic Esophagitis, Graves’ Disease, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis, Primary Biliary Cirrhosis, Primary Sclerosing Cholangitis, Scleroderma, Type 1 Diabetes, Ulcerative Colitis **Autoimmune Disease:** Addison's Disease, Autoimmune Hepatitis, Celiac Disease, Crohn's Disease, Eosinophilic Esophagitis, Graves' Disease, Hashimoto's Thyroiditis/Autoimmune Thyroiditis, Primary Biliary Cirrhosis, Primary Sclerosing Cholangitis, Scleroderma, Type 1 Diabetes, Ulcerative Colitis **State:** California --- ### [Princeton Medicine Physicians - Endocrinology Downtown Robbinsville](https://www.autoimmuneinstitute.org/medical_institutions/princeton-medicine-physicians-endocrinology-downtown-robbinsville/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Graves’ Disease, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis, Hyperthyroidism, Type 1 Diabetes **Autoimmune Disease:** Graves' Disease, Hashimoto's Thyroiditis/Autoimmune Thyroiditis, Hyperthyroidism, Type 1 Diabetes **State:** New Jersey --- ### [Princeton Medicine Physicians - Endocrinology Plainsboro](https://www.autoimmuneinstitute.org/medical_institutions/princeton-medicine-physicians-endocrinology-plainsboro/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Graves’ Disease, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis, Hyperthyroidism, Type 1 Diabetes **Autoimmune Disease:** Graves' Disease, Hashimoto's Thyroiditis/Autoimmune Thyroiditis, Hyperthyroidism, Type 1 Diabetes **State:** New Jersey --- ### [Princeton Medicine Physicians - Endocrinology Hillsborough](https://www.autoimmuneinstitute.org/medical_institutions/princeton-medicine-physicians-endocrinology-hillsborough/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Graves’ Disease, Hyperthyroidism, Type 1 Diabetes **Autoimmune Disease:** Graves' Disease, Hyperthyroidism, Type 1 Diabetes **State:** New Jersey --- ### [Princeton Medicine Physicians - Center for Digestive Health Pennington](https://www.autoimmuneinstitute.org/medical_institutions/princeton-medicine-physicians-center-for-digestive-health-pennington/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Hepatitis, Celiac Disease, Crohn’s Disease, Eosinophilic Esophagitis, Primary Biliary Cirrhosis, Ulcerative Colitis **Autoimmune Disease:** Autoimmune Hepatitis, Celiac Disease, Crohn's Disease, Eosinophilic Esophagitis, Primary Biliary Cirrhosis, Ulcerative Colitis **State:** New Jersey --- ### [Princeton Medicine Physicians - Center for Digestive Health Plainsboro](https://www.autoimmuneinstitute.org/medical_institutions/princeton-medicine-physicians-center-for-digestive-health-plainsboro/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Hepatitis, Celiac Disease, Crohn’s Disease, Eosinophilic Esophagitis, Primary Biliary Cirrhosis, Ulcerative Colitis **Autoimmune Disease:** Autoimmune Hepatitis, Celiac Disease, Crohn's Disease, Eosinophilic Esophagitis, Primary Biliary Cirrhosis, Ulcerative Colitis **State:** New Jersey --- ### [Princeton Medicine Physicians - Center for Digestive Health Monroe](https://www.autoimmuneinstitute.org/medical_institutions/princeton-medicine-physicians-center-for-digestive-health-monroe/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Hepatitis, Celiac Disease, Crohn’s Disease, Eosinophilic Esophagitis, Ulcerative Colitis **Autoimmune Disease:** Autoimmune Hepatitis, Celiac Disease, Crohn's Disease, Eosinophilic Esophagitis, Ulcerative Colitis **State:** New Jersey --- ### [Princeton Medicine Physicians - Center for Digestive Health Morganville](https://www.autoimmuneinstitute.org/medical_institutions/princeton-medicine-physicians-center-for-digestive-health-morganville/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Hepatitis, Celiac Disease, Crohn’s Disease, Eosinophilic Esophagitis, Ulcerative Colitis **Autoimmune Disease:** Autoimmune Hepatitis, Celiac Disease, Crohn's Disease, Eosinophilic Esophagitis, Ulcerative Colitis **State:** New Jersey --- ### [Princeton Medicine Physicians - Center for Digestive Health Hillsborough](https://www.autoimmuneinstitute.org/medical_institutions/princeton-medicine-physicians-center-for-digestive-health-hillsborough/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Hepatitis, Celiac Disease, Crohn’s Disease, Eosinophilic Esophagitis, Ulcerative Colitis **Autoimmune Disease:** Autoimmune Hepatitis, Celiac Disease, Crohn's Disease, Eosinophilic Esophagitis, Ulcerative Colitis **State:** New Jersey --- ### [Princeton Medicine Physicians - Center for Digestive Health Downtown Robbinsville](https://www.autoimmuneinstitute.org/medical_institutions/princeton-medicine-physicians-center-for-digestive-health-downtown-robbinsville/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Hepatitis, Celiac Disease, Crohn’s Disease, Eosinophilic Esophagitis, Primary Biliary Cirrhosis, Ulcerative Colitis **Autoimmune Disease:** Autoimmune Hepatitis, Celiac Disease, Crohn's Disease, Eosinophilic Esophagitis, Primary Biliary Cirrhosis, Ulcerative Colitis **State:** New Jersey --- ### [Princeton Medicine Physicians - Center for Digestive Health Dayton](https://www.autoimmuneinstitute.org/medical_institutions/princeton-medicine-physicians-center-for-digestive-health-dayton/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Hepatitis, Celiac Disease, Crohn’s Disease, Eosinophilic Esophagitis, Ulcerative Colitis **Autoimmune Disease:** Autoimmune Hepatitis, Celiac Disease, Crohn's Disease, Eosinophilic Esophagitis, Ulcerative Colitis **State:** New Jersey --- ### [Princeton Medicine Physicians - Ewing Medical Associates, PA](https://www.autoimmuneinstitute.org/medical_institutions/princeton-medicine-physicians-ewing-medical-associates-pa/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata **Autoimmune Disease:** Alopecia Areata **State:** New Jersey --- ### [Princeton Medicine Physicians - Cardiology Monroe](https://www.autoimmuneinstitute.org/medical_institutions/princeton-medicine-physicians-cardiology-monroe/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Arteriosclerosis/atherosclerosis **Autoimmune Disease:** Arteriosclerosis / atherosclerosis **State:** New Jersey --- ### [Princeton Medicine Physicians - Cardiology Plainsboro](https://www.autoimmuneinstitute.org/medical_institutions/princeton-medicine-physicians-cardiology-plainsboro/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Arteriosclerosis/atherosclerosis **Autoimmune Disease:** Arteriosclerosis / atherosclerosis **State:** New Jersey --- ### [Princeton Medicine Physicians - Cardiology Downtown Robbinsville](https://www.autoimmuneinstitute.org/medical_institutions/princeton-medicine-physicians-cardiology-downtown-robbinsville/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Arteriosclerosis/atherosclerosis **Autoimmune Disease:** Arteriosclerosis / atherosclerosis **State:** New Jersey --- ### [Princeton Medicine Physicians - Cardiology Pennington](https://www.autoimmuneinstitute.org/medical_institutions/princeton-medicine-physicians-cardiology-pennington/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Arteriosclerosis/atherosclerosis **Autoimmune Disease:** Arteriosclerosis / atherosclerosis **State:** New Jersey --- ### [Porter Ranch Primary & Specialty Care](https://www.autoimmuneinstitute.org/medical_institutions/porter-ranch-primary-specialty-care-2/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Various Autoimmune Diseases **Autoimmune Disease:** Various Autoimmune Diseases **State:** California --- ### [Porter Ranch Primary & Specialty Care](https://www.autoimmuneinstitute.org/medical_institutions/porter-ranch-primary-specialty-care-3/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Addison’s Disease, Autoimmune Hepatitis, Autoimmune Polyglandular Syndrome, Celiac Disease, Central Nervous System Vasculitis, Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA), Crohn’s Disease, Dermatomyositis, Eosinophilic Esophagitis, Giant Cell Arteritis, Glomerulonephritis, Graves’ Disease, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis, Henoch–Schönlein Purpura, Lichen Planus, Microscopic Polyangiitis (MPA)/ANCA-Associated Vasculitis, Mixed Connective Tissue Disease, Polyarteritis Nodosa, Polymyalgia Rheumatica, Polymyositis, Psoriasis, Psoriatic Arthritis, Rheumatoid Arthritis, Scleroderma, Sjögren Syndrome, Systemic Lupus Erythematosus, Takayasu’s arteritis, Type 1 Diabetes, Ulcerative Colitis, Vitiligo **Autoimmune Disease:** Addison's Disease, Autoimmune Hepatitis, Autoimmune Polyglandular Syndrome, Celiac Disease, Central Nervous System Vasculitis, Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA), Crohn's Disease, Dermatomyositis, Eosinophilic Esophagitis, Giant Cell Arteritis, Glomerulonephritis, Graves' Disease, Hashimoto's Thyroiditis/Autoimmune Thyroiditis, Henoch–Schönlein Purpura, Lichen Planus, Microscopic Polyangiitis (MPA)/ANCA-Associated Vasculitis, Mixed Connective Tissue Disease, Polyarteritis Nodosa, Polymyalgia Rheumatica, Polymyositis, Psoriasis, Psoriatic Arthritis, Rheumatoid Arthritis, Scleroderma, Sjögren Syndrome, Systemic Lupus Erythematosus, Takayasu's arteritis, Type 1 Diabetes, Ulcerative Colitis, Vitiligo **State:** California --- ### [Penn Transplant Institute - Liver Transplant](https://www.autoimmuneinstitute.org/medical_institutions/penn-transplant-institute-liver-transplant/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Hepatitis **Autoimmune Disease:** Autoimmune Hepatitis **State:** Pennsylvania --- ### [Perelman Center for Advanced Medicine](https://www.autoimmuneinstitute.org/medical_institutions/perelman-center-for-advanced-medicine/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Hepatitis **Autoimmune Disease:** Autoimmune Hepatitis **State:** Pennsylvania --- ### [Penn Transplant Institute - Kidney and Pancreas Transplant](https://www.autoimmuneinstitute.org/medical_institutions/penn-transplant-institute-kidney-and-pancreas-transplant/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Goodpasture Syndrome, Henoch–Schönlein Purpura, Lupus Nephritis, Type 1 Diabetes **Autoimmune Disease:** Goodpasture Syndrome, Henoch–Schönlein Purpura, Lupus Nephritis, Type 1 Diabetes **State:** Pennsylvania --- ### [PHMC Health Center on Cedar](https://www.autoimmuneinstitute.org/medical_institutions/phmc-health-center-on-cedar/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata, Graves’ Disease **Autoimmune Disease:** Alopecia Areata, Graves' Disease **State:** Pennsylvania --- ### [Penn Women's FIRST Clinic](https://www.autoimmuneinstitute.org/medical_institutions/penn-womens-first-clinic/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Celiac Disease, Crohn’s Disease, Eosinophilic Esophagitis, Ulcerative Colitis **Autoimmune Disease:** Celiac Disease, Crohn's Disease, Eosinophilic Esophagitis, Ulcerative Colitis **State:** Pennsylvania --- ### [Penn Rodebaugh Diabetes Center](https://www.autoimmuneinstitute.org/medical_institutions/penn-rodebaugh-diabetes-center/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Type 1 Diabetes **Autoimmune Disease:** Type 1 Diabetes **State:** Pennsylvania --- ### [Penn Vascular Surgery and Endovascular Therapy University City](https://www.autoimmuneinstitute.org/medical_institutions/penn-vascular-surgery-and-endovascular-therapy-university-city/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Arteriosclerosis/atherosclerosis **Autoimmune Disease:** Arteriosclerosis / atherosclerosis **State:** Pennsylvania --- ### [Penn Vascular Surgery and Endovascular Therapy Woodbury Heights](https://www.autoimmuneinstitute.org/medical_institutions/penn-vascular-surgery-and-endovascular-therapy-woodbury-heights/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Arteriosclerosis/atherosclerosis **Autoimmune Disease:** Arteriosclerosis / atherosclerosis **State:** New Jersey --- ### [Penn Vascular Surgery and Endovascular Therapy Pennsylvania Hospital](https://www.autoimmuneinstitute.org/medical_institutions/penn-vascular-surgery-and-endovascular-therapy-pennsylvania-hospital/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Arteriosclerosis/atherosclerosis **Autoimmune Disease:** Arteriosclerosis / atherosclerosis **State:** Pennsylvania --- ### [Penn Vascular Surgery and Endovascular Therapy Cape May Court House](https://www.autoimmuneinstitute.org/medical_institutions/penn-vascular-surgery-and-endovascular-therapy-cape-may-court-house/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Arteriosclerosis/atherosclerosis **Autoimmune Disease:** Arteriosclerosis / atherosclerosis **State:** New Jersey --- ### [Penn Spine Center Pennsylvania Hospital](https://www.autoimmuneinstitute.org/medical_institutions/penn-spine-center-pennsylvania-hospital/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Multiple Sclerosis, Rheumatoid Arthritis **Autoimmune Disease:** Multiple Sclerosis, Rheumatoid Arthritis **State:** Pennsylvania --- ### [Penn Spine Center Cherry Hill](https://www.autoimmuneinstitute.org/medical_institutions/penn-spine-center-cherry-hill/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Multiple Sclerosis, Rheumatoid Arthritis **Autoimmune Disease:** Multiple Sclerosis, Rheumatoid Arthritis **State:** New Jersey --- ### [PennCare for Kids Limerick](https://www.autoimmuneinstitute.org/medical_institutions/penncare-for-kids-limerick/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Myositis **Autoimmune Disease:** Myositis **State:** Pennsylvania --- ### [PennCare for Kids Phoenixville](https://www.autoimmuneinstitute.org/medical_institutions/penncare-for-kids-phoenixville/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Myositis **Autoimmune Disease:** Myositis **State:** Pennsylvania --- ### [Penn Smell and Taste Center](https://www.autoimmuneinstitute.org/medical_institutions/penn-smell-and-taste-center/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Ménière’s disease **Autoimmune Disease:** Ménière's disease **State:** Pennsylvania --- ### [Penn Rheumatology](https://www.autoimmuneinstitute.org/medical_institutions/penn-rheumatology/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Antiphospholipid Syndrome, Juvenile Idiopathic Arthritis/Adult-Onset Still’s Disease, Psoriatic Arthritis, Relapsing Polychondritis, Rheumatoid Arthritis, Sarcoidosis, Scleroderma, Sjögren Syndrome, Spondyloarthritis, Systemic Lupus Erythematosus, Vasculitis **Autoimmune Disease:** Antiphospholipid Syndrome, Juvenile Idiopathic Arthritis/Adult-Onset Still's Disease, Psoriatic Arthritis, Relapsing Polychondritis, Rheumatoid Arthritis, Sarcoidosis, Scleroderma, Sjögren Syndrome, Spondyloarthritis, Systemic Lupus Erythematosus, Vasculitis **State:** Pennsylvania --- ### [Penn Renal Electrolyte and Hypertension Perelman](https://www.autoimmuneinstitute.org/medical_institutions/penn-renal-electrolyte-and-hypertension-perelman/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Amyloidosis, Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA), Goodpasture Syndrome, Henoch–Schönlein Purpura, Iga Nephropathy/Berger’s Disease, Lupus Nephritis **Autoimmune Disease:** Amyloidosis, Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA), Goodpasture Syndrome, Henoch–Schönlein Purpura, Iga Nephropathy/Berger's Disease, Lupus Nephritis **State:** Pennsylvania --- ### [Penn Renal Electrolyte and Hypertension Penn Presbyterian](https://www.autoimmuneinstitute.org/medical_institutions/penn-renal-electrolyte-and-hypertension-penn-presbyterian/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA), Goodpasture Syndrome, Henoch–Schönlein Purpura, Iga Nephropathy/Berger’s Disease, Lupus Nephritis **Autoimmune Disease:** Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA), Goodpasture Syndrome, Henoch–Schönlein Purpura, Iga Nephropathy/Berger's Disease, Lupus Nephritis **State:** Pennsylvania --- ### [Penn Renal Electrolyte and Hypertension Cherry Hill](https://www.autoimmuneinstitute.org/medical_institutions/penn-renal-electrolyte-and-hypertension-cherry-hill/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Amyloidosis, Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA), Goodpasture Syndrome, Henoch–Schönlein Purpura, Iga Nephropathy/Berger’s Disease, Lupus Nephritis **Autoimmune Disease:** Amyloidosis, Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA), Goodpasture Syndrome, Henoch–Schönlein Purpura, Iga Nephropathy/Berger's Disease, Lupus Nephritis **State:** New Jersey --- ### [Penn Renal Electrolyte and Hypertension Radnor](https://www.autoimmuneinstitute.org/medical_institutions/penn-renal-electrolyte-and-hypertension-radnor/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA), Goodpasture Syndrome, Henoch–Schönlein Purpura, Iga Nephropathy/Berger’s Disease, Lupus Nephritis **Autoimmune Disease:** Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA), Goodpasture Syndrome, Henoch–Schönlein Purpura, Iga Nephropathy/Berger's Disease, Lupus Nephritis **State:** Pennsylvania --- ### [Penn Primary Care West Chester Pike](https://www.autoimmuneinstitute.org/medical_institutions/penn-primary-care-west-chester-pike/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata **Autoimmune Disease:** Alopecia Areata **State:** Pennsylvania --- ### [Penn Primary Care Collegeville](https://www.autoimmuneinstitute.org/medical_institutions/penn-primary-care-collegeville/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata **Autoimmune Disease:** Alopecia Areata **State:** Pennsylvania --- ### [Penn Primary Care and Integrative Medicine Whiteland](https://www.autoimmuneinstitute.org/medical_institutions/penn-primary-care-and-integrative-medicine-whiteland/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis **Autoimmune Disease:** Alopecia Areata, Hashimoto's Thyroiditis/Autoimmune Thyroiditis **State:** Pennsylvania --- ### [Penn Primary Care Schwenksville](https://www.autoimmuneinstitute.org/medical_institutions/penn-primary-care-schwenksville/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata **Autoimmune Disease:** Alopecia Areata **State:** Pennsylvania --- ### [Penn Primary Care Exton](https://www.autoimmuneinstitute.org/medical_institutions/penn-primary-care-exton/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata **Autoimmune Disease:** Alopecia Areata **State:** Pennsylvania --- ### [Penn Primary Care Havertown](https://www.autoimmuneinstitute.org/medical_institutions/penn-primary-care-havertown/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata **Autoimmune Disease:** Alopecia Areata **State:** Pennsylvania --- ### [Penn Primary and Specialty Care Pottstown](https://www.autoimmuneinstitute.org/medical_institutions/penn-primary-and-specialty-care-pottstown/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata **Autoimmune Disease:** Alopecia Areata **State:** Pennsylvania --- ### [Penn Primary Care French Creek](https://www.autoimmuneinstitute.org/medical_institutions/penn-primary-care-french-creek/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata **Autoimmune Disease:** Alopecia Areata **State:** Pennsylvania --- ### [Penn Primary Care Springfield](https://www.autoimmuneinstitute.org/medical_institutions/penn-primary-care-springfield/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata **Autoimmune Disease:** Alopecia Areata **State:** Pennsylvania --- ### [Penn Rheumatology Perelman](https://www.autoimmuneinstitute.org/medical_institutions/penn-rheumatology-perelman/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Dermatomyositis, Juvenile Arthritis, Myositis, Psoriatic Arthritis, Rheumatoid Arthritis, Sarcoidosis, Scleroderma, Sjögren Syndrome, Temporal Arteritis **Autoimmune Disease:** Dermatomyositis, Juvenile Arthritis, Myositis, Psoriatic Arthritis, Rheumatoid Arthritis, Sarcoidosis, Scleroderma, Sjögren Syndrome, Temporal Arteritis **State:** Pennsylvania --- ### [Penn Rheumatology Radnor](https://www.autoimmuneinstitute.org/medical_institutions/penn-rheumatology-radnor/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Dermatomyositis, Myositis, Psoriatic Arthritis, Rheumatoid Arthritis, Sarcoidosis, Scleroderma, Sjögren Syndrome **Autoimmune Disease:** Dermatomyositis, Myositis, Psoriatic Arthritis, Rheumatoid Arthritis, Sarcoidosis, Scleroderma, Sjögren Syndrome **State:** Pennsylvania --- ### [Penn Rheumatology Cherry Hill](https://www.autoimmuneinstitute.org/medical_institutions/penn-rheumatology-cherry-hill/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Psoriatic Arthritis, Rheumatoid Arthritis, Sarcoidosis **Autoimmune Disease:** Psoriatic Arthritis, Rheumatoid Arthritis, Sarcoidosis **State:** New Jersey --- ### [Penn Rheumatology Valley Forge](https://www.autoimmuneinstitute.org/medical_institutions/penn-rheumatology-valley-forge/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Rheumatoid Arthritis, Sarcoidosis **Autoimmune Disease:** Rheumatoid Arthritis, Sarcoidosis **State:** Pennsylvania --- ### [Penn Pituitary Center](https://www.autoimmuneinstitute.org/medical_institutions/penn-pituitary-center/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Addison’s Disease, Graves’ Disease, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis, Temporal Arteritis **Autoimmune Disease:** Addison's Disease, Graves' Disease, Hashimoto's Thyroiditis/Autoimmune Thyroiditis, Temporal Arteritis **State:** Pennsylvania --- ### [Penn Primary and Specialty Care Phoenixville](https://www.autoimmuneinstitute.org/medical_institutions/penn-primary-and-specialty-care-phoenixville/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA), Dermatomyositis, Myositis, Rheumatoid Arthritis, Sarcoidosis, Temporal Arteritis **Autoimmune Disease:** Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA), Dermatomyositis, Myositis, Rheumatoid Arthritis, Sarcoidosis, Temporal Arteritis **State:** Pennsylvania --- ### [Penn Primary and Specialty Care Limerick](https://www.autoimmuneinstitute.org/medical_institutions/penn-primary-and-specialty-care-limerick/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA), Dermatomyositis, Myositis, Rheumatoid Arthritis, Sarcoidosis, Scleroderma, Sjögren Syndrome, Temporal Arteritis, Type 1 Diabetes **Autoimmune Disease:** Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA), Dermatomyositis, Myositis, Rheumatoid Arthritis, Sarcoidosis, Scleroderma, Sjögren Syndrome, Temporal Arteritis, Type 1 Diabetes **State:** Pennsylvania --- ### [Penn Orthopaedics Radnor](https://www.autoimmuneinstitute.org/medical_institutions/penn-orthopaedics-radnor/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Psoriatic Arthritis, Rheumatoid Arthritis **Autoimmune Disease:** Psoriatic Arthritis, Rheumatoid Arthritis **State:** Pennsylvania --- ### [Penn Physical Medicine and Rehabilitation Rittenhouse](https://www.autoimmuneinstitute.org/medical_institutions/penn-physical-medicine-and-rehabilitation-rittenhouse/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Multiple Sclerosis, Rheumatoid Arthritis **Autoimmune Disease:** Multiple Sclerosis, Rheumatoid Arthritis **State:** Pennsylvania --- ### [Penn Plastic Surgery Perelman](https://www.autoimmuneinstitute.org/medical_institutions/penn-plastic-surgery-perelman/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Psoriatic Arthritis, Rheumatoid Arthritis **Autoimmune Disease:** Psoriatic Arthritis, Rheumatoid Arthritis **State:** Pennsylvania --- ### [Penn Orthopaedics Marmora](https://www.autoimmuneinstitute.org/medical_institutions/penn-orthopaedics-marmora/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Psoriatic Arthritis, Rheumatoid Arthritis **Autoimmune Disease:** Psoriatic Arthritis, Rheumatoid Arthritis **State:** New Jersey --- ### [Penn Orthopaedics Pennsylvania Hospital - Cathcart Building](https://www.autoimmuneinstitute.org/medical_institutions/penn-orthopaedics-pennsylvania-hospital-cathcart-building/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Multiple Sclerosis, Rheumatoid Arthritis **Autoimmune Disease:** Multiple Sclerosis, Rheumatoid Arthritis **State:** Pennsylvania --- ### [Penn Orthopaedics Valley Forge](https://www.autoimmuneinstitute.org/medical_institutions/penn-orthopaedics-valley-forge/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Rheumatoid Arthritis **Autoimmune Disease:** Rheumatoid Arthritis **State:** Pennsylvania --- ### [Penn Plastic Surgery Pennsylvania Hospital](https://www.autoimmuneinstitute.org/medical_institutions/penn-plastic-surgery-pennsylvania-hospital/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Rheumatoid Arthritis **Autoimmune Disease:** Rheumatoid Arthritis **State:** Pennsylvania --- ### [Penn Plastic Surgery Radnor](https://www.autoimmuneinstitute.org/medical_institutions/penn-plastic-surgery-radnor/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Rheumatoid Arthritis **Autoimmune Disease:** Rheumatoid Arthritis **State:** Pennsylvania --- ### [Penn Physical Medicine and Rehabilitation Cherry Hill](https://www.autoimmuneinstitute.org/medical_institutions/penn-physical-medicine-and-rehabilitation-cherry-hill/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Multiple Sclerosis, Rheumatoid Arthritis **Autoimmune Disease:** Multiple Sclerosis, Rheumatoid Arthritis **State:** New Jersey --- ### [Penn Plastic Surgery Cherry Hill](https://www.autoimmuneinstitute.org/medical_institutions/penn-plastic-surgery-cherry-hill/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Rheumatoid Arthritis **Autoimmune Disease:** Rheumatoid Arthritis **State:** New Jersey --- ### [Penn Plastic Surgery University City](https://www.autoimmuneinstitute.org/medical_institutions/penn-plastic-surgery-university-city/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Rheumatoid Arthritis **Autoimmune Disease:** Rheumatoid Arthritis **State:** Pennsylvania --- ### [Penn Otorhinolaryngology - Head and Neck Surgery Radnor](https://www.autoimmuneinstitute.org/medical_institutions/penn-otorhinolaryngology-head-and-neck-surgery-radnor/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Ménière’s disease **Autoimmune Disease:** Ménière's disease **State:** Pennsylvania --- ### [Penn Otorhinolaryngology - Head and Neck Surgery University City](https://www.autoimmuneinstitute.org/medical_institutions/penn-otorhinolaryngology-head-and-neck-surgery-university-city/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Ménière’s disease **Autoimmune Disease:** Ménière's disease **State:** Pennsylvania --- ### [Penn Otorhinolaryngology - Head and Neck Surgery Perelman](https://www.autoimmuneinstitute.org/medical_institutions/penn-otorhinolaryngology-head-and-neck-surgery-perelman/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Ménière’s disease **Autoimmune Disease:** Ménière's disease **State:** Pennsylvania --- ### [Penn Neurology Pennsylvania Hospital](https://www.autoimmuneinstitute.org/medical_institutions/penn-neurology-pennsylvania-hospital/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Chronic Inflammatory Demyelinating Polyneuropathy, Guillain-Barre Syndrome, Multiple Sclerosis, Myasthenia Gravis, Myositis, Neuromyelitis Optica/Devic’s Disease, Temporal Arteritis **Autoimmune Disease:** Chronic Inflammatory Demyelinating Polyneuropathy, Guillain-Barre Syndrome, Multiple Sclerosis, Myasthenia Gravis, Myositis, Neuromyelitis Optica/Devic's Disease, Temporal Arteritis **State:** Pennsylvania --- ### [Penn Neuroscience Center - Neurology](https://www.autoimmuneinstitute.org/medical_institutions/penn-neuroscience-center-neurology/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Amyloidosis, Chronic Inflammatory Demyelinating Polyneuropathy, Guillain-Barre Syndrome, Multiple Sclerosis, Myasthenia Gravis, Myositis, Neuromyelitis Optica/Devic’s Disease, Sarcoidosis, Temporal Arteritis **Autoimmune Disease:** Amyloidosis, Chronic Inflammatory Demyelinating Polyneuropathy, Guillain-Barre Syndrome, Multiple Sclerosis, Myasthenia Gravis, Myositis, Neuromyelitis Optica/Devic's Disease, Sarcoidosis, Temporal Arteritis **State:** Pennsylvania --- ### [Penn Neuroscience Center Radnor - Neurology](https://www.autoimmuneinstitute.org/medical_institutions/penn-neuroscience-center-radnor-neurology/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Chronic Inflammatory Demyelinating Polyneuropathy, Guillain-Barre Syndrome, Multiple Sclerosis, Myasthenia Gravis, Neuromyelitis Optica/Devic’s Disease, Sarcoidosis **Autoimmune Disease:** Chronic Inflammatory Demyelinating Polyneuropathy, Guillain-Barre Syndrome, Multiple Sclerosis, Myasthenia Gravis, Neuromyelitis Optica/Devic's Disease, Sarcoidosis **State:** Pennsylvania --- ### [Penn Neurology Kennett Square](https://www.autoimmuneinstitute.org/medical_institutions/penn-neurology-kennett-square/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Guillain-Barre Syndrome, Multiple Sclerosis, Myasthenia Gravis **Autoimmune Disease:** Guillain-Barre Syndrome, Multiple Sclerosis, Myasthenia Gravis **State:** Pennsylvania --- ### [Penn Neurology Westtown](https://www.autoimmuneinstitute.org/medical_institutions/penn-neurology-westtown/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Guillain-Barre Syndrome, Multiple Sclerosis, Myasthenia Gravis **Autoimmune Disease:** Guillain-Barre Syndrome, Multiple Sclerosis, Myasthenia Gravis **State:** Pennsylvania --- ### [Penn Neurology Chalfont](https://www.autoimmuneinstitute.org/medical_institutions/penn-neurology-chalfont/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Guillain-Barre Syndrome, Multiple Sclerosis, Myasthenia Gravis **Autoimmune Disease:** Guillain-Barre Syndrome, Multiple Sclerosis, Myasthenia Gravis **State:** Pennsylvania --- ### [Penn Neurology Sellersville](https://www.autoimmuneinstitute.org/medical_institutions/penn-neurology-sellersville/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Guillain-Barre Syndrome, Multiple Sclerosis, Myasthenia Gravis **Autoimmune Disease:** Guillain-Barre Syndrome, Multiple Sclerosis, Myasthenia Gravis **State:** Pennsylvania --- ### [Penn Neurology Valley Forge](https://www.autoimmuneinstitute.org/medical_institutions/penn-neurology-valley-forge/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Chronic Inflammatory Demyelinating Polyneuropathy, Guillain-Barre Syndrome, Myasthenia Gravis **Autoimmune Disease:** Chronic Inflammatory Demyelinating Polyneuropathy, Guillain-Barre Syndrome, Myasthenia Gravis **State:** Pennsylvania --- ### [Penn Neurology Cherry Hill](https://www.autoimmuneinstitute.org/medical_institutions/penn-neurology-cherry-hill/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Guillain-Barre Syndrome, Multiple Sclerosis, Myasthenia Gravis, Sarcoidosis **Autoimmune Disease:** Guillain-Barre Syndrome, Multiple Sclerosis, Myasthenia Gravis, Sarcoidosis **State:** New Jersey --- ### [Penn Neurology University City](https://www.autoimmuneinstitute.org/medical_institutions/penn-neurology-university-city/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Amyloidosis, Chronic Inflammatory Demyelinating Polyneuropathy, Guillain-Barre Syndrome, Multiple Sclerosis, Myasthenia Gravis **Autoimmune Disease:** Amyloidosis, Chronic Inflammatory Demyelinating Polyneuropathy, Guillain-Barre Syndrome, Multiple Sclerosis, Myasthenia Gravis **State:** Pennsylvania --- ### [Penn Neurology Rittenhouse](https://www.autoimmuneinstitute.org/medical_institutions/penn-neurology-rittenhouse/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Guillain-Barre Syndrome, Multiple Sclerosis, Myasthenia Gravis **Autoimmune Disease:** Guillain-Barre Syndrome, Multiple Sclerosis, Myasthenia Gravis **State:** Pennsylvania --- ### [Penn Neurology Mount Laurel](https://www.autoimmuneinstitute.org/medical_institutions/penn-neurology-mount-laurel/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Guillain-Barre Syndrome, Multiple Sclerosis, Myasthenia Gravis **Autoimmune Disease:** Guillain-Barre Syndrome, Multiple Sclerosis, Myasthenia Gravis **State:** New Jersey --- ### [Penn Neurology Woodbury Heights](https://www.autoimmuneinstitute.org/medical_institutions/penn-neurology-woodbury-heights/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Guillain-Barre Syndrome, Multiple Sclerosis, Myasthenia Gravis **Autoimmune Disease:** Guillain-Barre Syndrome, Multiple Sclerosis, Myasthenia Gravis **State:** New Jersey --- ### [Penn Orthopaedics Cape May Court House](https://www.autoimmuneinstitute.org/medical_institutions/penn-orthopaedics-cape-may-court-house/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Psoriatic Arthritis, Rheumatoid Arthritis **Autoimmune Disease:** Psoriatic Arthritis, Rheumatoid Arthritis **State:** New Jersey --- ### [Penn Orthopaedics Exton](https://www.autoimmuneinstitute.org/medical_institutions/penn-orthopaedics-exton/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Rheumatoid Arthritis **Autoimmune Disease:** Rheumatoid Arthritis **State:** Pennsylvania --- ### [Penn Orthopaedics Cherry Hill](https://www.autoimmuneinstitute.org/medical_institutions/penn-orthopaedics-cherry-hill/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Rheumatoid Arthritis **Autoimmune Disease:** Rheumatoid Arthritis **State:** New Jersey --- ### [Penn Metabolic Medicine University City](https://www.autoimmuneinstitute.org/medical_institutions/penn-metabolic-medicine-university-city/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Addison’s Disease, Graves’ Disease, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis, Hyperthyroidism, Type 1 Diabetes **Autoimmune Disease:** Addison's Disease, Graves' Disease, Hashimoto's Thyroiditis/Autoimmune Thyroiditis, Hyperthyroidism, Type 1 Diabetes **State:** Pennsylvania --- ### [Penn Medicine HealthWorks - Willow Street](https://www.autoimmuneinstitute.org/medical_institutions/penn-medicine-healthworks-willow-street/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata **Autoimmune Disease:** Alopecia Areata **State:** Pennsylvania --- ### [Penn Medicine HealthWorks - Lititz](https://www.autoimmuneinstitute.org/medical_institutions/penn-medicine-healthworks-lititz/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata **Autoimmune Disease:** Alopecia Areata **State:** Pennsylvania --- ### [Penn Nerve Center University City](https://www.autoimmuneinstitute.org/medical_institutions/penn-nerve-center-university-city/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Amyloidosis, Chronic Inflammatory Demyelinating Polyneuropathy, Guillain-Barre Syndrome, Multiple Sclerosis, Myasthenia Gravis, Myositis, Psoriatic Arthritis, Rheumatoid Arthritis **Autoimmune Disease:** Amyloidosis, Chronic Inflammatory Demyelinating Polyneuropathy, Guillain-Barre Syndrome, Multiple Sclerosis, Myasthenia Gravis, Myositis, Psoriatic Arthritis, Rheumatoid Arthritis **State:** Pennsylvania --- ### [Penn Musculoskeletal Center - University City, 8th Floor](https://www.autoimmuneinstitute.org/medical_institutions/penn-musculoskeletal-center-university-city-8th-floor/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA), Dermatomyositis, Myositis, Psoriatic Arthritis, Rheumatoid Arthritis, Sarcoidosis, Scleroderma, Sjögren Syndrome, Temporal Arteritis **Autoimmune Disease:** Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA), Dermatomyositis, Myositis, Psoriatic Arthritis, Rheumatoid Arthritis, Sarcoidosis, Scleroderma, Sjögren Syndrome, Temporal Arteritis **State:** Pennsylvania --- ### [Penn Metabolic and Bariatric Surgery Program University City](https://www.autoimmuneinstitute.org/medical_institutions/penn-metabolic-and-bariatric-surgery-program-university-city/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Type 1 Diabetes **Autoimmune Disease:** Type 1 Diabetes **State:** Pennsylvania --- ### [Penn Liver Transplant Clinic Reading](https://www.autoimmuneinstitute.org/medical_institutions/penn-liver-transplant-clinic-reading/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Hepatitis, Primary Biliary Cirrhosis **Autoimmune Disease:** Autoimmune Hepatitis, Primary Biliary Cirrhosis **State:** Pennsylvania --- ### [Penn Medicine Bala Cynwyd](https://www.autoimmuneinstitute.org/medical_institutions/penn-medicine-bala-cynwyd/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata, Arteriosclerosis/atherosclerosis **Autoimmune Disease:** Alopecia Areata, Arteriosclerosis / atherosclerosis **State:** Pennsylvania --- ### [Penn Medicine Becker ENT & Allergy Ewing Street](https://www.autoimmuneinstitute.org/medical_institutions/penn-medicine-becker-ent-allergy-ewing-street/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Eosinophilic Esophagitis, Ménière’s disease **Autoimmune Disease:** Eosinophilic Esophagitis, Ménière's disease **State:** New Jersey --- ### [Penn Medicine Becker ENT & Allergy Robbinsville](https://www.autoimmuneinstitute.org/medical_institutions/penn-medicine-becker-ent-allergy-robbinsville/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Eosinophilic Esophagitis **Autoimmune Disease:** Eosinophilic Esophagitis **State:** New Jersey --- ### [Penn Medicine Becker ENT & Allergy Sewell](https://www.autoimmuneinstitute.org/medical_institutions/penn-medicine-becker-ent-allergy-sewell/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Eosinophilic Esophagitis, Ménière’s disease **Autoimmune Disease:** Eosinophilic Esophagitis, Ménière's disease **State:** New Jersey --- ### [Penn Medicine Becker ENT & Allergy Sheppard Road](https://www.autoimmuneinstitute.org/medical_institutions/penn-medicine-becker-ent-allergy-sheppard-road/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Eosinophilic Esophagitis, Ménière’s disease **Autoimmune Disease:** Eosinophilic Esophagitis, Ménière's disease **State:** New Jersey --- ### [Penn Medicine Becker ENT & Allergy Lawrenceville](https://www.autoimmuneinstitute.org/medical_institutions/penn-medicine-becker-ent-allergy-lawrenceville/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Ménière’s disease **Autoimmune Disease:** Ménière's disease **State:** New Jersey --- ### [Penn Medicine Becker ENT & Allergy Robbinsville](https://www.autoimmuneinstitute.org/medical_institutions/penn-medicine-becker-ent-allergy-robbinsville-2/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Ménière’s disease **Autoimmune Disease:** Ménière's disease **State:** New Jersey --- ### [Penn Medicine Becker ENT & Allergy Yardley](https://www.autoimmuneinstitute.org/medical_institutions/penn-medicine-becker-ent-allergy-yardley/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Ménière’s disease **Autoimmune Disease:** Ménière's disease **State:** New Jersey --- ### [Penn Medicine Becker ENT & Allergy Bunn Drive](https://www.autoimmuneinstitute.org/medical_institutions/penn-medicine-becker-ent-allergy-bunn-drive/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Ménière’s disease **Autoimmune Disease:** Ménière's disease **State:** New Jersey --- ### [Penn Medicine Becker ENT & Allergy Hillsborough](https://www.autoimmuneinstitute.org/medical_institutions/penn-medicine-becker-ent-allergy-hillsborough/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Ménière’s disease **Autoimmune Disease:** Ménière's disease **State:** New Jersey --- ### [Penn Medicine Becker ENT & Allergy Monroe](https://www.autoimmuneinstitute.org/medical_institutions/penn-medicine-becker-ent-allergy-monroe/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Ménière’s disease **Autoimmune Disease:** Ménière's disease **State:** New Jersey --- ### [Penn Medicine Becker ENT & Allergy Evesham Road](https://www.autoimmuneinstitute.org/medical_institutions/penn-medicine-becker-ent-allergy-evesham-road/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Ménière’s disease **Autoimmune Disease:** Ménière's disease **State:** New Jersey --- ### [Penn Medicine Becker ENT & Allergy Mount Laurel](https://www.autoimmuneinstitute.org/medical_institutions/penn-medicine-becker-ent-allergy-mount-laurel/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Ménière’s disease **Autoimmune Disease:** Ménière's disease **State:** New Jersey --- ### [Penn Medicine Becker ENT & Allergy Mullica Hill](https://www.autoimmuneinstitute.org/medical_institutions/penn-medicine-becker-ent-allergy-mullica-hill/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Ménière’s disease **Autoimmune Disease:** Ménière's disease **State:** New Jersey --- ### [Penn Medicine Becker ENT & Allergy South Street](https://www.autoimmuneinstitute.org/medical_institutions/penn-medicine-becker-ent-allergy-south-street/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Ménière’s disease **Autoimmune Disease:** Ménière's disease **State:** Pennsylvania --- ### [Penn Medicine Becker ENT & Allergy Walnut Street](https://www.autoimmuneinstitute.org/medical_institutions/penn-medicine-becker-ent-allergy-walnut-street/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Ménière’s disease **Autoimmune Disease:** Ménière's disease **State:** Pennsylvania --- ### [Penn Medicine Becker ENT & Allergy Freehold](https://www.autoimmuneinstitute.org/medical_institutions/penn-medicine-becker-ent-allergy-freehold/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Ménière’s disease **Autoimmune Disease:** Ménière's disease **State:** New Jersey --- ### [Penn Liver Transplant Clinic Lancaster General Health](https://www.autoimmuneinstitute.org/medical_institutions/penn-liver-transplant-clinic-lancaster-general-health/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Hepatitis, Primary Biliary Cirrhosis **Autoimmune Disease:** Autoimmune Hepatitis, Primary Biliary Cirrhosis **State:** Pennsylvania --- ### [Penn Liver Transplant Clinic Princeton](https://www.autoimmuneinstitute.org/medical_institutions/penn-liver-transplant-clinic-princeton/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Hepatitis, Primary Biliary Cirrhosis **Autoimmune Disease:** Autoimmune Hepatitis, Primary Biliary Cirrhosis **State:** New Jersey --- ### [Penn Liver Transplant Clinic Newark](https://www.autoimmuneinstitute.org/medical_institutions/penn-liver-transplant-clinic-newark/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Hepatitis, Primary Biliary Cirrhosis **Autoimmune Disease:** Autoimmune Hepatitis, Primary Biliary Cirrhosis **State:** Delaware --- ### [Penn Liver Transplant Clinic Bucks County](https://www.autoimmuneinstitute.org/medical_institutions/penn-liver-transplant-clinic-bucks-county/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Hepatitis, Primary Biliary Cirrhosis **Autoimmune Disease:** Autoimmune Hepatitis, Primary Biliary Cirrhosis **State:** Pennsylvania --- ### [Penn Liver Transplant Clinic Cherry Hill](https://www.autoimmuneinstitute.org/medical_institutions/penn-liver-transplant-clinic-cherry-hill/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Hepatitis, Primary Biliary Cirrhosis **Autoimmune Disease:** Autoimmune Hepatitis, Primary Biliary Cirrhosis **State:** New Jersey --- ### [Penn Liver Transplant Clinic Darby](https://www.autoimmuneinstitute.org/medical_institutions/penn-liver-transplant-clinic-darby/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Hepatitis, Primary Biliary Cirrhosis **Autoimmune Disease:** Autoimmune Hepatitis, Primary Biliary Cirrhosis **State:** Pennsylvania --- ### [Penn Liver Transplant Clinic Lehighton](https://www.autoimmuneinstitute.org/medical_institutions/penn-liver-transplant-clinic-lehighton/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Hepatitis, Primary Biliary Cirrhosis **Autoimmune Disease:** Autoimmune Hepatitis, Primary Biliary Cirrhosis **State:** Pennsylvania --- ### [Penn Liver Transplant Clinic Lehigh Valley](https://www.autoimmuneinstitute.org/medical_institutions/penn-liver-transplant-clinic-lehigh-valley/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Hepatitis **Autoimmune Disease:** Autoimmune Hepatitis **State:** Pennsylvania --- ### [Penn Internal Medicine Woodbury Heights](https://www.autoimmuneinstitute.org/medical_institutions/penn-internal-medicine-woodbury-heights/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata **Autoimmune Disease:** Alopecia Areata **State:** New Jersey --- ### [Penn Internal and Family Medicine Bucks County](https://www.autoimmuneinstitute.org/medical_institutions/penn-internal-and-family-medicine-bucks-county/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata **Autoimmune Disease:** Alopecia Areata **State:** Pennsylvania --- ### [Penn Internal Medicine Radnor](https://www.autoimmuneinstitute.org/medical_institutions/penn-internal-medicine-radnor/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata **Autoimmune Disease:** Alopecia Areata **State:** Pennsylvania --- ### [Penn Interventional Cardiology - Cape Regional Medical Center](https://www.autoimmuneinstitute.org/medical_institutions/penn-interventional-cardiology-cape-regional-medical-center/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Arteriosclerosis/atherosclerosis **Autoimmune Disease:** Arteriosclerosis / atherosclerosis **State:** New Jersey --- ### [Penn Interventional Cardiology - Shore Medical Center](https://www.autoimmuneinstitute.org/medical_institutions/penn-interventional-cardiology-shore-medical-center/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Arteriosclerosis/atherosclerosis **Autoimmune Disease:** Arteriosclerosis / atherosclerosis **State:** New Jersey --- ### [Penn Internal Medicine Media](https://www.autoimmuneinstitute.org/medical_institutions/penn-internal-medicine-media/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Arteriosclerosis/atherosclerosis **Autoimmune Disease:** Arteriosclerosis / atherosclerosis **State:** Pennsylvania --- ### [Penn Hematology/Oncology West Chester](https://www.autoimmuneinstitute.org/medical_institutions/penn-hematology-oncology-west-chester/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Amyloidosis **Autoimmune Disease:** Amyloidosis **State:** Pennsylvania --- ### [Penn Hematology/Oncology Woodbury Heights](https://www.autoimmuneinstitute.org/medical_institutions/penn-hematology-oncology-woodbury-heights/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Amyloidosis **Autoimmune Disease:** Amyloidosis **State:** New Jersey --- ### [Penn Hematology/Oncology Sewell](https://www.autoimmuneinstitute.org/medical_institutions/penn-hematology-oncology-sewell/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Amyloidosis **Autoimmune Disease:** Amyloidosis **State:** New Jersey --- ### [Penn Hematology/Oncology Voorhees](https://www.autoimmuneinstitute.org/medical_institutions/penn-hematology-oncology-voorhees/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Amyloidosis **Autoimmune Disease:** Amyloidosis **State:** New Jersey --- ### [Penn Gastroenterology Perelman](https://www.autoimmuneinstitute.org/medical_institutions/penn-gastroenterology-perelman/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Hepatitis, Celiac Disease, Crohn’s Disease, Eosinophilic Esophagitis, Primary Biliary Cirrhosis, Scleroderma, Ulcerative Colitis **Autoimmune Disease:** Autoimmune Hepatitis, Celiac Disease, Crohn's Disease, Eosinophilic Esophagitis, Primary Biliary Cirrhosis, Scleroderma, Ulcerative Colitis **State:** Pennsylvania --- ### [Penn Gastroenterology Pennsylvania Hospital](https://www.autoimmuneinstitute.org/medical_institutions/penn-gastroenterology-pennsylvania-hospital/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Hepatitis, Celiac Disease, Crohn’s Disease, Eosinophilic Esophagitis, Primary Biliary Cirrhosis, Ulcerative Colitis **Autoimmune Disease:** Autoimmune Hepatitis, Celiac Disease, Crohn's Disease, Eosinophilic Esophagitis, Primary Biliary Cirrhosis, Ulcerative Colitis **State:** Pennsylvania --- ### [Penn Gastroenterology Radnor](https://www.autoimmuneinstitute.org/medical_institutions/penn-gastroenterology-radnor/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Hepatitis, Celiac Disease, Crohn’s Disease, Eosinophilic Esophagitis, Primary Biliary Cirrhosis, Ulcerative Colitis **Autoimmune Disease:** Autoimmune Hepatitis, Celiac Disease, Crohn's Disease, Eosinophilic Esophagitis, Primary Biliary Cirrhosis, Ulcerative Colitis **State:** Pennsylvania --- ### [Penn Gastroenterology Limerick](https://www.autoimmuneinstitute.org/medical_institutions/penn-gastroenterology-limerick/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Hepatitis, Celiac Disease, Crohn’s Disease, Eosinophilic Esophagitis, Ulcerative Colitis **Autoimmune Disease:** Autoimmune Hepatitis, Celiac Disease, Crohn's Disease, Eosinophilic Esophagitis, Ulcerative Colitis **State:** Pennsylvania --- ### [Penn Gastroenterology Penn Presbyterian](https://www.autoimmuneinstitute.org/medical_institutions/penn-gastroenterology-penn-presbyterian/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Hepatitis, Celiac Disease, Crohn’s Disease, Eosinophilic Esophagitis, Ulcerative Colitis **Autoimmune Disease:** Autoimmune Hepatitis, Celiac Disease, Crohn's Disease, Eosinophilic Esophagitis, Ulcerative Colitis **State:** Pennsylvania --- ### [Penn Gastroenterology Cherry Hill](https://www.autoimmuneinstitute.org/medical_institutions/penn-gastroenterology-cherry-hill/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Hepatitis, Celiac Disease, Crohn’s Disease, Eosinophilic Esophagitis, Ulcerative Colitis **Autoimmune Disease:** Autoimmune Hepatitis, Celiac Disease, Crohn's Disease, Eosinophilic Esophagitis, Ulcerative Colitis **State:** New Jersey --- ### [Penn Heart and Vascular Center](https://www.autoimmuneinstitute.org/medical_institutions/penn-heart-and-vascular-center/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Amyloidosis, Arteriosclerosis/atherosclerosis, Sarcoidosis **Autoimmune Disease:** Amyloidosis, Arteriosclerosis / atherosclerosis, Sarcoidosis **State:** Pennsylvania --- ### [Penn Heart and Vascular Center Bucks County](https://www.autoimmuneinstitute.org/medical_institutions/penn-heart-and-vascular-center-bucks-county/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Amyloidosis, Arteriosclerosis/atherosclerosis, Sarcoidosis **Autoimmune Disease:** Amyloidosis, Arteriosclerosis / atherosclerosis, Sarcoidosis **State:** Pennsylvania --- ### [Penn Heart and Vascular Center Pennsylvania Hospital](https://www.autoimmuneinstitute.org/medical_institutions/penn-heart-and-vascular-center-pennsylvania-hospital/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Amyloidosis, Arteriosclerosis/atherosclerosis **Autoimmune Disease:** Amyloidosis, Arteriosclerosis / atherosclerosis **State:** Pennsylvania --- ### [Penn Heart and Vascular Center Washington Square](https://www.autoimmuneinstitute.org/medical_institutions/penn-heart-and-vascular-center-washington-square/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Amyloidosis, Arteriosclerosis/atherosclerosis **Autoimmune Disease:** Amyloidosis, Arteriosclerosis / atherosclerosis **State:** Pennsylvania --- ### [Penn Heart and Vascular Center Cherry Hill](https://www.autoimmuneinstitute.org/medical_institutions/penn-heart-and-vascular-center-cherry-hill/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Amyloidosis, Arteriosclerosis/atherosclerosis, Sarcoidosis **Autoimmune Disease:** Amyloidosis, Arteriosclerosis / atherosclerosis, Sarcoidosis **State:** New Jersey --- ### [Penn Heart and Vascular Center Radnor](https://www.autoimmuneinstitute.org/medical_institutions/penn-heart-and-vascular-center-radnor/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Amyloidosis, Arteriosclerosis/atherosclerosis, Sarcoidosis **Autoimmune Disease:** Amyloidosis, Arteriosclerosis / atherosclerosis, Sarcoidosis **State:** Pennsylvania --- ### [Penn Heart and Vascular Center Valley Forge](https://www.autoimmuneinstitute.org/medical_institutions/penn-heart-and-vascular-center-valley-forge/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Arteriosclerosis/atherosclerosis, Sarcoidosis **Autoimmune Disease:** Arteriosclerosis / atherosclerosis, Sarcoidosis **State:** Pennsylvania --- ### [Penn Hematology/Oncology Exton](https://www.autoimmuneinstitute.org/medical_institutions/penn-hematology-oncology-exton/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Amyloidosis **Autoimmune Disease:** Amyloidosis **State:** Pennsylvania --- ### [Penn Hematology/Oncology Pennsylvania Hospital](https://www.autoimmuneinstitute.org/medical_institutions/penn-hematology-oncology-pennsylvania-hospital/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Amyloidosis **Autoimmune Disease:** Amyloidosis **State:** Pennsylvania --- ### [Penn Hematology/Oncology Kennett Square](https://www.autoimmuneinstitute.org/medical_institutions/penn-hematology-oncology-kennett-square/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Amyloidosis **Autoimmune Disease:** Amyloidosis **State:** Pennsylvania --- ### [Penn Endocrinology, Diabetes and Metabolism Radnor](https://www.autoimmuneinstitute.org/medical_institutions/penn-endocrinology-diabetes-and-metabolism-radnor/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Addison’s Disease, Graves’ Disease, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis, Hyperthyroidism, Type 1 Diabetes **Autoimmune Disease:** Addison's Disease, Graves' Disease, Hashimoto's Thyroiditis/Autoimmune Thyroiditis, Hyperthyroidism, Type 1 Diabetes **State:** Pennsylvania --- ### [Penn Endocrinology, Diabetes and Metabolism Valley Forge](https://www.autoimmuneinstitute.org/medical_institutions/penn-endocrinology-diabetes-and-metabolism-valley-forge/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Addison’s Disease, Graves’ Disease, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis, Hyperthyroidism, Type 1 Diabetes **Autoimmune Disease:** Addison's Disease, Graves' Disease, Hashimoto's Thyroiditis/Autoimmune Thyroiditis, Hyperthyroidism, Type 1 Diabetes **State:** Pennsylvania --- ### [Penn Endocrinology, Diabetes and Metabolism Bucks County](https://www.autoimmuneinstitute.org/medical_institutions/penn-endocrinology-diabetes-and-metabolism-bucks-county/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Addison’s Disease, Graves’ Disease, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis, Hyperthyroidism, Type 1 Diabetes **Autoimmune Disease:** Addison's Disease, Graves' Disease, Hashimoto's Thyroiditis/Autoimmune Thyroiditis, Hyperthyroidism, Type 1 Diabetes **State:** Pennsylvania --- ### [Penn Family Medicine Voorhees](https://www.autoimmuneinstitute.org/medical_institutions/penn-family-medicine-voorhees/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata, Psoriasis **Autoimmune Disease:** Alopecia Areata, Psoriasis **State:** New Jersey --- ### [Penn Family Care](https://www.autoimmuneinstitute.org/medical_institutions/penn-family-care/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata **Autoimmune Disease:** Alopecia Areata **State:** Pennsylvania --- ### [Penn Family and Internal Medicine Cherry Hill](https://www.autoimmuneinstitute.org/medical_institutions/penn-family-and-internal-medicine-cherry-hill/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata, Type 1 Diabetes **Autoimmune Disease:** Alopecia Areata, Type 1 Diabetes **State:** New Jersey --- ### [Penn Family and Internal Medicine Mount Laurel](https://www.autoimmuneinstitute.org/medical_institutions/penn-family-and-internal-medicine-mount-laurel/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata **Autoimmune Disease:** Alopecia Areata **State:** New Jersey --- ### [Penn Family Medicine University City](https://www.autoimmuneinstitute.org/medical_institutions/penn-family-medicine-university-city/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata **Autoimmune Disease:** Alopecia Areata **State:** Pennsylvania --- ### [Penn Family Medicine Kennett](https://www.autoimmuneinstitute.org/medical_institutions/penn-family-medicine-kennett/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata **Autoimmune Disease:** Alopecia Areata **State:** Pennsylvania --- ### [Penn Family Medicine Valley Forge](https://www.autoimmuneinstitute.org/medical_institutions/penn-family-medicine-valley-forge/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata **Autoimmune Disease:** Alopecia Areata **State:** Pennsylvania --- ### [Penn Family Medicine Limerick](https://www.autoimmuneinstitute.org/medical_institutions/penn-family-medicine-limerick/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata **Autoimmune Disease:** Alopecia Areata **State:** Pennsylvania --- ### [Penn Family Medicine Phoenixville](https://www.autoimmuneinstitute.org/medical_institutions/penn-family-medicine-phoenixville/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata **Autoimmune Disease:** Alopecia Areata **State:** Pennsylvania --- ### [Penn Family Medicine Chestnut Hill](https://www.autoimmuneinstitute.org/medical_institutions/penn-family-medicine-chestnut-hill/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata **Autoimmune Disease:** Alopecia Areata **State:** Pennsylvania --- ### [Penn Family Medicine West Chester](https://www.autoimmuneinstitute.org/medical_institutions/penn-family-medicine-west-chester/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata **Autoimmune Disease:** Alopecia Areata **State:** Pennsylvania --- ### [Penn Family Medicine Southern Chester County](https://www.autoimmuneinstitute.org/medical_institutions/penn-family-medicine-southern-chester-county/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata **Autoimmune Disease:** Alopecia Areata **State:** Pennsylvania --- ### [Penn Family and Internal Medicine Longwood](https://www.autoimmuneinstitute.org/medical_institutions/penn-family-and-internal-medicine-longwood/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata **Autoimmune Disease:** Alopecia Areata **State:** Pennsylvania --- ### [Penn Family Medicine New Garden](https://www.autoimmuneinstitute.org/medical_institutions/penn-family-medicine-new-garden/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata **Autoimmune Disease:** Alopecia Areata **State:** Pennsylvania --- ### [Penn Endocrinology Perelman](https://www.autoimmuneinstitute.org/medical_institutions/penn-endocrinology-perelman/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Addison’s Disease, Graves’ Disease, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis, Hyperthyroidism, Type 1 Diabetes **Autoimmune Disease:** Addison's Disease, Graves' Disease, Hashimoto's Thyroiditis/Autoimmune Thyroiditis, Hyperthyroidism, Type 1 Diabetes **State:** Pennsylvania --- ### [Penn Endocrinology Pennsylvania Hospital](https://www.autoimmuneinstitute.org/medical_institutions/penn-endocrinology-pennsylvania-hospital/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Addison’s Disease, Graves’ Disease, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis, Hyperthyroidism, Type 1 Diabetes **Autoimmune Disease:** Addison's Disease, Graves' Disease, Hashimoto's Thyroiditis/Autoimmune Thyroiditis, Hyperthyroidism, Type 1 Diabetes **State:** Pennsylvania --- ### [Penn Endocrinology Woodbury Heights](https://www.autoimmuneinstitute.org/medical_institutions/penn-endocrinology-woodbury-heights/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Addison’s Disease, Graves’ Disease, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis, Hyperthyroidism, Type 1 Diabetes **Autoimmune Disease:** Addison's Disease, Graves' Disease, Hashimoto's Thyroiditis/Autoimmune Thyroiditis, Hyperthyroidism, Type 1 Diabetes **State:** New Jersey --- ### [Penn Endocrinology Cherry Hill](https://www.autoimmuneinstitute.org/medical_institutions/penn-endocrinology-cherry-hill/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Addison’s Disease, Graves’ Disease, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis, Hyperthyroidism, Type 1 Diabetes **Autoimmune Disease:** Addison's Disease, Graves' Disease, Hashimoto's Thyroiditis/Autoimmune Thyroiditis, Hyperthyroidism, Type 1 Diabetes **State:** New Jersey --- ### [Penn Digestive and Liver Health Center University City](https://www.autoimmuneinstitute.org/medical_institutions/penn-digestive-and-liver-health-center-university-city/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Hepatitis, Celiac Disease, Crohn’s Disease, Eosinophilic Esophagitis, Ulcerative Colitis **Autoimmune Disease:** Autoimmune Hepatitis, Celiac Disease, Crohn's Disease, Eosinophilic Esophagitis, Ulcerative Colitis **State:** Pennsylvania --- ### [Penn Dermatology Pennsylvania Hospital](https://www.autoimmuneinstitute.org/medical_institutions/penn-dermatology-pennsylvania-hospital/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata, Amyloidosis, Bullous Pemphigoid, Dermatomyositis, Henoch–Schönlein Purpura, Psoriasis, Scleroderma, Vitiligo **Autoimmune Disease:** Alopecia Areata, Amyloidosis, Bullous Pemphigoid, Dermatomyositis, Henoch–Schönlein Purpura, Psoriasis, Scleroderma, Vitiligo **State:** Pennsylvania --- ### [Penn Dermatology Perelman](https://www.autoimmuneinstitute.org/medical_institutions/penn-dermatology-perelman/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata, Amyloidosis, Bullous Pemphigoid, Dermatomyositis, Henoch–Schönlein Purpura, Psoriasis, Sarcoidosis, Scleroderma, Vitiligo **Autoimmune Disease:** Alopecia Areata, Amyloidosis, Bullous Pemphigoid, Dermatomyositis, Henoch–Schönlein Purpura, Psoriasis, Sarcoidosis, Scleroderma, Vitiligo **State:** Pennsylvania --- ### [Penn Dermatology Radnor](https://www.autoimmuneinstitute.org/medical_institutions/penn-dermatology-radnor/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata, Amyloidosis, Bullous Pemphigoid, Dermatomyositis, Henoch–Schönlein Purpura, Scleroderma, Vitiligo **Autoimmune Disease:** Alopecia Areata, Amyloidosis, Bullous Pemphigoid, Dermatomyositis, Henoch–Schönlein Purpura, Scleroderma, Vitiligo **State:** Pennsylvania --- ### [Penn Dermatology University City](https://www.autoimmuneinstitute.org/medical_institutions/penn-dermatology-university-city/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata, Amyloidosis, Bullous Pemphigoid, Dermatomyositis, Henoch–Schönlein Purpura, Scleroderma, Vitiligo **Autoimmune Disease:** Alopecia Areata, Amyloidosis, Bullous Pemphigoid, Dermatomyositis, Henoch–Schönlein Purpura, Scleroderma, Vitiligo **State:** Pennsylvania --- ### [Penn Dermatology Bucks County](https://www.autoimmuneinstitute.org/medical_institutions/penn-dermatology-bucks-county/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata, Amyloidosis, Bullous Pemphigoid, Dermatomyositis, Myositis, Psoriasis, Scleroderma, Vitiligo **Autoimmune Disease:** Alopecia Areata, Amyloidosis, Bullous Pemphigoid, Dermatomyositis, Myositis, Psoriasis, Scleroderma, Vitiligo **State:** Pennsylvania --- ### [Penn Dermatology Cherry Hill](https://www.autoimmuneinstitute.org/medical_institutions/penn-dermatology-cherry-hill/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata, Amyloidosis, Bullous Pemphigoid, Dermatomyositis, Scleroderma, Vitiligo **Autoimmune Disease:** Alopecia Areata, Amyloidosis, Bullous Pemphigoid, Dermatomyositis, Scleroderma, Vitiligo **State:** New Jersey --- ### [Penn Dermatology Woodbury Heights](https://www.autoimmuneinstitute.org/medical_institutions/penn-dermatology-woodbury-heights/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata, Bullous Pemphigoid, Dermatomyositis, Vitiligo **Autoimmune Disease:** Alopecia Areata, Bullous Pemphigoid, Dermatomyositis, Vitiligo **State:** New Jersey --- ### [Penn Endocrinology and Penn Rodebaugh Diabetes Center](https://www.autoimmuneinstitute.org/medical_institutions/penn-endocrinology-and-penn-rodebaugh-diabetes-center/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Type 1 Diabetes **Autoimmune Disease:** Type 1 Diabetes **State:** Pennsylvania --- ### [Penn Colon and Rectal Surgery Washington Square](https://www.autoimmuneinstitute.org/medical_institutions/penn-colon-and-rectal-surgery-washington-square/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Crohn’s Disease, Ulcerative Colitis **Autoimmune Disease:** Crohn's Disease, Ulcerative Colitis **State:** Pennsylvania --- ### [Penn Colon and Rectal Surgery University City](https://www.autoimmuneinstitute.org/medical_institutions/penn-colon-and-rectal-surgery-university-city/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Crohn’s Disease, Ulcerative Colitis **Autoimmune Disease:** Crohn's Disease, Ulcerative Colitis **State:** Pennsylvania --- ### [Penn Colon and Rectal Surgery Perelman](https://www.autoimmuneinstitute.org/medical_institutions/penn-colon-and-rectal-surgery-perelman/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Crohn’s Disease, Ulcerative Colitis **Autoimmune Disease:** Crohn's Disease, Ulcerative Colitis **State:** Pennsylvania --- ### [Penn Colon and Rectal Surgery Radnor](https://www.autoimmuneinstitute.org/medical_institutions/penn-colon-and-rectal-surgery-radnor/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Crohn’s Disease, Ulcerative Colitis **Autoimmune Disease:** Crohn's Disease, Ulcerative Colitis **State:** Pennsylvania --- ### [Penn Cardiology Penn Presbyterian, 3rd Floor](https://www.autoimmuneinstitute.org/medical_institutions/penn-cardiology-penn-presbyterian-3rd-floor/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Amyloidosis, Arteriosclerosis/atherosclerosis, Sarcoidosis **Autoimmune Disease:** Amyloidosis, Arteriosclerosis / atherosclerosis, Sarcoidosis **State:** Pennsylvania --- ### [Penn Cardiology Somers Point](https://www.autoimmuneinstitute.org/medical_institutions/penn-cardiology-somers-point/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Amyloidosis, Arteriosclerosis/atherosclerosis, Sarcoidosis **Autoimmune Disease:** Amyloidosis, Arteriosclerosis / atherosclerosis, Sarcoidosis **State:** New Jersey --- ### [Penn Cardiology Vineland](https://www.autoimmuneinstitute.org/medical_institutions/penn-cardiology-vineland/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Amyloidosis, Arteriosclerosis/atherosclerosis, Sarcoidosis **Autoimmune Disease:** Amyloidosis, Arteriosclerosis / atherosclerosis, Sarcoidosis **State:** New Jersey --- ### [Penn Cardiology Woodbury Heights](https://www.autoimmuneinstitute.org/medical_institutions/penn-cardiology-woodbury-heights/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Amyloidosis, Arteriosclerosis/atherosclerosis **Autoimmune Disease:** Amyloidosis, Arteriosclerosis / atherosclerosis **State:** New Jersey --- ### [Penn Cardiology Mayfair](https://www.autoimmuneinstitute.org/medical_institutions/penn-cardiology-mayfair/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Amyloidosis, Arteriosclerosis/atherosclerosis, Sarcoidosis **Autoimmune Disease:** Amyloidosis, Arteriosclerosis / atherosclerosis, Sarcoidosis **State:** Pennsylvania --- ### [Penn Cardiology South Philadelphia](https://www.autoimmuneinstitute.org/medical_institutions/penn-cardiology-south-philadelphia/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Arteriosclerosis/atherosclerosis **Autoimmune Disease:** Arteriosclerosis / atherosclerosis **State:** Pennsylvania --- ### [Penn Cardiology HUP - Cedar Avenu](https://www.autoimmuneinstitute.org/medical_institutions/penn-cardiology-hup-cedar-avenu/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Amyloidosis, Arteriosclerosis/atherosclerosis **Autoimmune Disease:** Amyloidosis, Arteriosclerosis / atherosclerosis **State:** Pennsylvania --- ### [Penn Cardiology Media](https://www.autoimmuneinstitute.org/medical_institutions/penn-cardiology-media/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Amyloidosis, Arteriosclerosis/atherosclerosis, Sarcoidosis **Autoimmune Disease:** Amyloidosis, Arteriosclerosis / atherosclerosis, Sarcoidosis **State:** Pennsylvania --- ### [Penn Cardiology Mount Laurel](https://www.autoimmuneinstitute.org/medical_institutions/penn-cardiology-mount-laurel/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Amyloidosis, Arteriosclerosis/atherosclerosis **Autoimmune Disease:** Amyloidosis, Arteriosclerosis / atherosclerosis **State:** New Jersey --- ### [Penn Cardiology Bensalem](https://www.autoimmuneinstitute.org/medical_institutions/penn-cardiology-bensalem/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Arteriosclerosis/atherosclerosis **Autoimmune Disease:** Arteriosclerosis / atherosclerosis **State:** Pennsylvania --- ### [Penn Cardiology Chestnut Hill](https://www.autoimmuneinstitute.org/medical_institutions/penn-cardiology-chestnut-hill/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Amyloidosis, Arteriosclerosis/atherosclerosis, Sarcoidosis **Autoimmune Disease:** Amyloidosis, Arteriosclerosis / atherosclerosis, Sarcoidosis **State:** Pennsylvania --- ### [Penn Cardiology Cape May Court House](https://www.autoimmuneinstitute.org/medical_institutions/penn-cardiology-cape-may-court-house/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Amyloidosis, Arteriosclerosis/atherosclerosis **Autoimmune Disease:** Amyloidosis, Arteriosclerosis / atherosclerosis **State:** New Jersey --- ### [Penn Blood Disorders Center](https://www.autoimmuneinstitute.org/medical_institutions/penn-blood-disorders-center/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Amyloidosis **Autoimmune Disease:** Amyloidosis **State:** Pennsylvania --- ### [Pediatric Rheumatology Clinics](https://www.autoimmuneinstitute.org/medical_institutions/pediatric-rheumatology-clinics/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Antiphospholipid Syndrome, Dermatomyositis, Juvenile Idiopathic Arthritis, Scleroderma, Systemic Lupus Erythematosus, Vasculitis **Autoimmune Disease:** Antiphospholipid Syndrome, Dermatomyositis, Juvenile Idiopathic Arthritis, Scleroderma, Systemic Lupus Erythematosus, Vasculitis **State:** Colorado --- ### [Pediatric Rheumatology Program](https://www.autoimmuneinstitute.org/medical_institutions/pediatric-rheumatology-program/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Encephalitis/Acute Disseminated Encephalomyelitis (ADEM), Behçet’s Disease, Central Nervous System Vasculitis, Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA), Hashimoto’s Encephalopathy, Henoch–Schönlein Purpura, Juvenile Dermatomyositis, Juvenile Lupus, Juvenile Myositis, Juvenile Polymyositis, Juvenile Psoriatic Arthritis, Juvenile Rheumatoid Arthritis, Microscopic Polyangiitis (MPA)/ANCA-Associated Vasculitis, Neuromyelitis Optica/Devic’s Disease, Oligoarticular Juvenile Arthritis, Polyarticular Juvenile Arthritis, Sarcoidosis, Scleroderma, Takayasu’s arteritis, Vasculitis **Autoimmune Disease:** Autoimmune Encephalitis/Acute Disseminated Encephalomyelitis (ADEM), Behçet’s Disease, Central Nervous System Vasculitis, Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA), Hashimoto’s Encephalopathy, Henoch–Schönlein Purpura, Juvenile Dermatomyositis, Juvenile Lupus, Juvenile Myositis, Juvenile Polymyositis, Juvenile Psoriatic Arthritis, Juvenile Rheumatoid Arthritis, Microscopic Polyangiitis (MPA)/ANCA-Associated Vasculitis, Neuromyelitis Optica/Devic's Disease, Oligoarticular Juvenile Arthritis, Polyarticular Juvenile Arthritis, Sarcoidosis, Scleroderma, Takayasu's arteritis, Vasculitis **State:** North Carolina --- ### [Pediatrics in Calabasas](https://www.autoimmuneinstitute.org/medical_institutions/pediatrics-in-calabasas/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Addison’s Disease, Autoimmune Encephalitis/Acute Disseminated Encephalomyelitis (ADEM), Celiac Disease, Crohn’s Disease, Eosinophilic Esophagitis, Graves’ Disease, Guillain-Barre Syndrome, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis, Myasthenia Gravis, Type 1 Diabetes, Ulcerative Colitis **Autoimmune Disease:** Addison's Disease, Autoimmune Encephalitis/Acute Disseminated Encephalomyelitis (ADEM), Celiac Disease, Crohn's Disease, Eosinophilic Esophagitis, Graves' Disease, Guillain-Barre Syndrome, Hashimoto's Thyroiditis/Autoimmune Thyroiditis, Myasthenia Gravis, Type 1 Diabetes, Ulcerative Colitis **State:** California --- ### [Pediatric Inflammatory Bowel Disease (IBD) Center](https://www.autoimmuneinstitute.org/medical_institutions/pediatric-inflammatory-bowel-disease-ibd-center/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Crohn’s Disease, Ulcerative Colitis **Autoimmune Disease:** Crohn's Disease, Ulcerative Colitis **State:** Colorado --- ### [Pediatric Liver Center](https://www.autoimmuneinstitute.org/medical_institutions/pediatric-liver-center/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Hepatitis, Primary Sclerosing Cholangitis **Autoimmune Disease:** Autoimmune Hepatitis, Primary Sclerosing Cholangitis **State:** Colorado --- ### [Pediatric Neurology Program](https://www.autoimmuneinstitute.org/medical_institutions/pediatric-neurology-program/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Myasthenia Gravis **Autoimmune Disease:** Myasthenia Gravis **State:** North Carolina --- ### [Pediatric Ophthalmology Program](https://www.autoimmuneinstitute.org/medical_institutions/pediatric-ophthalmology-program/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Juvenile Idiopathic Arthritis, Scleroderma **Autoimmune Disease:** Juvenile Idiopathic Arthritis, Scleroderma **State:** North Carolina --- ### [Pediatric Orthopaedics Program](https://www.autoimmuneinstitute.org/medical_institutions/pediatric-orthopaedics-program/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Myasthenia Gravis **Autoimmune Disease:** Myasthenia Gravis **State:** North Carolina --- ### [Pediatric Endocrinology Program](https://www.autoimmuneinstitute.org/medical_institutions/pediatric-endocrinology-program/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Graves’ Disease, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis, Type 1 Diabetes **Autoimmune Disease:** Graves' Disease, Hashimoto's Thyroiditis/Autoimmune Thyroiditis, Type 1 Diabetes **State:** North Carolina --- ### [Pediatric Gastroenterology Program](https://www.autoimmuneinstitute.org/medical_institutions/pediatric-gastroenterology-program/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Hepatitis, Crohn’s Disease, Ulcerative Colitis **Autoimmune Disease:** Autoimmune Hepatitis, Crohn's Disease, Ulcerative Colitis **State:** North Carolina --- ### [Pediatric Dermatology Program](https://www.autoimmuneinstitute.org/medical_institutions/pediatric-dermatology-program/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Scleroderma, Sjögren Syndrome, Systemic Lupus Erythematosus, Vasculitis **Autoimmune Disease:** Scleroderma, Sjögren Syndrome, Systemic Lupus Erythematosus, Vasculitis **State:** North Carolina --- ### [Pediatric Otolaryngology Program](https://www.autoimmuneinstitute.org/medical_institutions/pediatric-otolaryngology-program/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Graves’ Disease, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis **Autoimmune Disease:** Graves' Disease, Hashimoto's Thyroiditis/Autoimmune Thyroiditis **State:** North Carolina --- ### [Pediatric Dermatology Program](https://www.autoimmuneinstitute.org/medical_institutions/pediatric-dermatology-program-2/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata, Psoriasis, Vitiligo **Autoimmune Disease:** Alopecia Areata, Psoriasis, Vitiligo **State:** Massachusetts --- ### [Pediatric Multiple Sclerosis](https://www.autoimmuneinstitute.org/medical_institutions/pediatric-multiple-sclerosis/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Multiple Sclerosis **Autoimmune Disease:** Multiple Sclerosis **State:** Massachusetts --- ### [Pediatric Endocrine Program and Diabetes Center](https://www.autoimmuneinstitute.org/medical_institutions/pediatric-endocrine-program-and-diabetes-center/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Addison’s Disease, Graves’ Disease, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis, Type 1 Diabetes **Autoimmune Disease:** Addison's Disease, Graves' Disease, Hashimoto's Thyroiditis/Autoimmune Thyroiditis, Type 1 Diabetes **State:** Massachusetts --- ### [Pediatric and Adolescent Rheumatology](https://www.autoimmuneinstitute.org/medical_institutions/pediatric-and-adolescent-rheumatology/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Hepatitis, Henoch–Schönlein Purpura, Juvenile Dermatomyositis, Juvenile Idiopathic Arthritis, Scleroderma, Systemic Lupus Erythematosus, Vasculitis **Autoimmune Disease:** Autoimmune Hepatitis, Henoch–Schönlein Purpura, Juvenile Dermatomyositis, Juvenile Idiopathic Arthritis, Scleroderma, Systemic Lupus Erythematosus, Vasculitis **State:** New York --- ### [Pediatric Neurology](https://www.autoimmuneinstitute.org/medical_institutions/pediatric-neurology/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Encephalitis/Acute Disseminated Encephalomyelitis (ADEM), Guillain-Barre Syndrome, Myasthenia Gravis **Autoimmune Disease:** Autoimmune Encephalitis/Acute Disseminated Encephalomyelitis (ADEM), Guillain-Barre Syndrome, Myasthenia Gravis **State:** California --- ### [Pediatric Diabetes and Endocrinology](https://www.autoimmuneinstitute.org/medical_institutions/pediatric-diabetes-and-endocrinology/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Graves’ Disease, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis, Type 1 Diabetes **Autoimmune Disease:** Graves' Disease, Hashimoto's Thyroiditis/Autoimmune Thyroiditis, Type 1 Diabetes **State:** Massachusetts --- ### [Pediatric Gastroenterology Clinic](https://www.autoimmuneinstitute.org/medical_institutions/pediatric-gastroenterology-clinic/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Hepatitis, Celiac Disease, Crohn’s Disease, Ulcerative Colitis **Autoimmune Disease:** Autoimmune Hepatitis, Celiac Disease, Crohn's Disease, Ulcerative Colitis **State:** Massachusetts --- ### [Pediatric Hematology & Oncology Program](https://www.autoimmuneinstitute.org/medical_institutions/pediatric-hematology-oncology-program/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Hemolytic Anemia, Evans Syndrome **Autoimmune Disease:** Autoimmune Hemolytic Anemia, Evans Syndrome **State:** Massachusetts --- ### [Pediatric Rheumatology](https://www.autoimmuneinstitute.org/medical_institutions/pediatric-rheumatology/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Juvenile Dermatomyositis, Juvenile Idiopathic Arthritis, Juvenile Lupus, Juvenile Scleroderma **Autoimmune Disease:** Juvenile Dermatomyositis, Juvenile Idiopathic Arthritis, Juvenile Lupus, Juvenile Scleroderma **State:** Massachusetts --- ### [Orthopedic and Rheumatologic Institute](https://www.autoimmuneinstitute.org/medical_institutions/orthopedic-and-rheumatologic-institute/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Antiphospholipid Syndrome, Behçet’s Disease, Central Nervous System Vasculitis, Chilblain Lupus Erythematosus, Chronic Granulomatous Disease, Cutaneous Lupus, Dermatomyositis, Discoid Lupus, Eosinophilic Fasciitis, Juvenile Dermatomyositis, Juvenile Idiopathic Arthritis, Juvenile Idiopathic Arthritis/Adult-Onset Still’s Disease, Mixed Connective Tissue Disease, Myositis, Polymyositis, Primary Immunodeficiency, Psoriatic Arthritis, Raynaud Syndrome/Phenomenon, Relapsing Polychondritis, Rheumatoid Arthritis, Scleroderma, Sjögren Syndrome, Systemic Lupus Erythematosus, Takayasu’s arteritis, Vexas Syndrome **Autoimmune Disease:** Antiphospholipid Syndrome, Behçet’s Disease, Central Nervous System Vasculitis, Chilblain Lupus Erythematosus, Chronic Granulomatous Disease, Cutaneous Lupus, Dermatomyositis, Discoid Lupus, Eosinophilic Fasciitis, Juvenile Dermatomyositis, Juvenile Idiopathic Arthritis, Juvenile Idiopathic Arthritis/Adult-Onset Still's Disease, Mixed Connective Tissue Disease, Myositis, Polymyositis, Primary Immunodeficiency, Psoriatic Arthritis, Raynaud Syndrome/Phenomenon, Relapsing Polychondritis, Rheumatoid Arthritis, Scleroderma, Sjögren Syndrome, Systemic Lupus Erythematosus, Takayasu's arteritis, Vexas Syndrome **State:** Ohio --- ### [Orthopaedic Care Program](https://www.autoimmuneinstitute.org/medical_institutions/orthopaedic-care-program/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Rheumatoid Arthritis **Autoimmune Disease:** Rheumatoid Arthritis **State:** North Carolina --- ### [Otolaryngology Program](https://www.autoimmuneinstitute.org/medical_institutions/otolaryngology-program/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Graves’ Disease, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis, Ménière’s disease **Autoimmune Disease:** Graves' Disease, Hashimoto's Thyroiditis/Autoimmune Thyroiditis, Ménière's disease **State:** North Carolina --- ### [Pancreas and Biliary Program](https://www.autoimmuneinstitute.org/medical_institutions/pancreas-and-biliary-program/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Pancreatitis, Primary Biliary Cholangitis, Primary Sclerosing Cholangitis **Autoimmune Disease:** Autoimmune Pancreatitis, Primary Biliary Cholangitis, Primary Sclerosing Cholangitis **State:** Massachusetts --- ### [NYU Langone Hospital Long Island](https://www.autoimmuneinstitute.org/medical_institutions/nyu-langone-hospital-long-island/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Antiphospholipid Syndrome, Autoimmune Hepatitis, Behçet’s Disease, Celiac Disease, Connective Tissue Disease, Cutaneous Lupus, Eosinophilic Esophagitis, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis, Myasthenia Gravis, Rheumatoid Arthritis, Sarcoidosis, Systemic Lupus Erythematosus **Autoimmune Disease:** Antiphospholipid Syndrome, Autoimmune Hepatitis, Behçet’s Disease, Celiac Disease, Connective Tissue Disease, Cutaneous Lupus, Eosinophilic Esophagitis, Hashimoto's Thyroiditis/Autoimmune Thyroiditis, Myasthenia Gravis, Rheumatoid Arthritis, Sarcoidosis, Systemic Lupus Erythematosus **State:** New York --- ### [North Hollywood Specialty Care](https://www.autoimmuneinstitute.org/medical_institutions/north-hollywood-specialty-care/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Hepatitis, Celiac Disease, Crohn’s Disease, Eosinophilic Esophagitis, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis, Primary Biliary Cirrhosis, Primary Sclerosing Cholangitis, Scleroderma, Ulcerative Colitis **Autoimmune Disease:** Autoimmune Hepatitis, Celiac Disease, Crohn's Disease, Eosinophilic Esophagitis, Hashimoto's Thyroiditis/Autoimmune Thyroiditis, Primary Biliary Cirrhosis, Primary Sclerosing Cholangitis, Scleroderma, Ulcerative Colitis **State:** California --- ### [Otolaryngology](https://www.autoimmuneinstitute.org/medical_institutions/otolaryngology/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Inner Ear Disease, Graves’ Disease, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis, Ménière’s disease **Autoimmune Disease:** Autoimmune Inner Ear Disease, Graves' Disease, Hashimoto's Thyroiditis/Autoimmune Thyroiditis, Ménière's disease **State:** Massachusetts --- ### [Orthopaedics and Sports Medicine in Emeryville](https://www.autoimmuneinstitute.org/medical_institutions/orthopaedics-and-sports-medicine-in-emeryville/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Ankylosing Spondylitis **Autoimmune Disease:** Ankylosing Spondylitis **State:** California --- ### [Orthopaedics and Sports Medicine in Los Gatos](https://www.autoimmuneinstitute.org/medical_institutions/orthopaedics-and-sports-medicine-in-los-gatos/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Ankylosing Spondylitis, Spondyloarthritis **Autoimmune Disease:** Ankylosing Spondylitis, Spondyloarthritis **State:** California --- ### [Orthopaedics and Sports Medicine in Pleasanton](https://www.autoimmuneinstitute.org/medical_institutions/orthopaedics-and-sports-medicine-in-pleasanton/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Ankylosing Spondylitis, Spondyloarthritis **Autoimmune Disease:** Ankylosing Spondylitis, Spondyloarthritis **State:** California --- ### [Orthopaedics and Sports Medicine in Redwood City](https://www.autoimmuneinstitute.org/medical_institutions/orthopaedics-and-sports-medicine-in-redwood-city/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Ankylosing Spondylitis, Spondyloarthritis **Autoimmune Disease:** Ankylosing Spondylitis, Spondyloarthritis **State:** California --- ### [Pain Management Center in Emeryville](https://www.autoimmuneinstitute.org/medical_institutions/pain-management-center-in-emeryville/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Crohn’s Disease, Ulcerative Colitis **Autoimmune Disease:** Crohn's Disease, Ulcerative Colitis **State:** California --- ### [Pain Management Center in Livermore](https://www.autoimmuneinstitute.org/medical_institutions/pain-management-center-in-livermore/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Crohn’s Disease, Ulcerative Colitis **Autoimmune Disease:** Crohn's Disease, Ulcerative Colitis **State:** California --- ### [Pain Management Center in San Jose](https://www.autoimmuneinstitute.org/medical_institutions/pain-management-center-in-san-jose/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Crohn’s Disease, Ulcerative Colitis **Autoimmune Disease:** Crohn's Disease, Ulcerative Colitis **State:** California --- ### [Pain Management Center in San Pablo](https://www.autoimmuneinstitute.org/medical_institutions/pain-management-center-in-san-pablo/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Crohn’s Disease, Ulcerative Colitis **Autoimmune Disease:** Crohn's Disease, Ulcerative Colitis **State:** California --- ### [Office of David M. Finkel, MD](https://www.autoimmuneinstitute.org/medical_institutions/office-of-david-m-finkel-md/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Graves’ Disease, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis, Hyperthyroidism, Type 1 Diabetes **Autoimmune Disease:** Graves' Disease, Hashimoto's Thyroiditis/Autoimmune Thyroiditis, Hyperthyroidism, Type 1 Diabetes **State:** Pennsylvania --- ### [Neurological Institute](https://www.autoimmuneinstitute.org/medical_institutions/neurological-institute/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Encephalitis/Acute Disseminated Encephalomyelitis (ADEM), Autonomic Neuropathy, Multiple Sclerosis, Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease (MOGAD), Neuromyelitis Optica/Devic’s Disease, Transverse Myelitis **Autoimmune Disease:** Autoimmune Encephalitis/Acute Disseminated Encephalomyelitis (ADEM), Autonomic Neuropathy, Multiple Sclerosis, Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease (MOGAD), Neuromyelitis Optica/Devic's Disease, Transverse Myelitis **State:** Ohio --- ### [Neurology Program](https://www.autoimmuneinstitute.org/medical_institutions/neurology-program/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Amyloidosis, Dermatomyositis, Guillain-Barre Syndrome, Lambert-Eaton Myasthenic Syndrome, Multiple Sclerosis, Myasthenia Gravis, Myositis, Polymyositis, Vasculitis **Autoimmune Disease:** Amyloidosis, Dermatomyositis, Guillain-Barre Syndrome, Lambert-Eaton Myasthenic Syndrome, Multiple Sclerosis, Myasthenia Gravis, Myositis, Polymyositis, Vasculitis **State:** North Carolina --- ### [Nephrology Program](https://www.autoimmuneinstitute.org/medical_institutions/nephrology-program/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Systemic Lupus Erythematosus, Type 1 Diabetes **Autoimmune Disease:** Systemic Lupus Erythematosus, Type 1 Diabetes **State:** North Carolina --- ### [Myositis Center](https://www.autoimmuneinstitute.org/medical_institutions/myositis-center/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Myositis **Autoimmune Disease:** Myositis **State:** Maryland --- ### [Neurology](https://www.autoimmuneinstitute.org/medical_institutions/neurology/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Antiphospholipid Syndrome, Autoimmune Encephalitis/Acute Disseminated Encephalomyelitis (ADEM), Chronic Inflammatory Demyelinating Polyneuropathy, Dermatomyositis, Dysautonomia, Giant Cell Arteritis, Guillain-Barre Syndrome, Lambert-Eaton Myasthenic Syndrome, Multiple Sclerosis, Myasthenia Gravis, Neuromyelitis Optica/Devic’s Disease, Nonvasculitic Autoimmune Inflammatory Meningoencephalitis, POEMS Syndrome, Polymyositis, Postural Orthostatic Tachycardia Syndrome (POTS), Sarcoidosis, Takayasu’s arteritis **Autoimmune Disease:** Antiphospholipid Syndrome, Autoimmune Encephalitis/Acute Disseminated Encephalomyelitis (ADEM), Chronic Inflammatory Demyelinating Polyneuropathy, Dermatomyositis, Dysautonomia, Giant Cell Arteritis, Guillain-Barre Syndrome, Lambert-Eaton Myasthenic Syndrome, Multiple Sclerosis, Myasthenia Gravis, Neuromyelitis Optica/Devic's Disease, Nonvasculitic Autoimmune Inflammatory Meningoencephalitis, POEMS Syndrome, Polymyositis, Postural Orthostatic Tachycardia Syndrome (POTS), Sarcoidosis, Takayasu's arteritis **State:** Minnesota --- ### [Naomi Barrie Diabetes Center](https://www.autoimmuneinstitute.org/medical_institutions/naomi-barrie-diabetes-center/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Type 1 Diabetes **Autoimmune Disease:** Type 1 Diabetes **State:** New York --- ### [Myasthenia Gravis Clinic](https://www.autoimmuneinstitute.org/medical_institutions/myasthenia-gravis-clinic/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Dermatomyositis, Lambert-Eaton Myasthenic Syndrome, Myasthenia Gravis, Polymyositis **Autoimmune Disease:** Dermatomyositis, Lambert-Eaton Myasthenic Syndrome, Myasthenia Gravis, Polymyositis **State:** California --- ### [Neurology Program](https://www.autoimmuneinstitute.org/medical_institutions/neurology-program-2/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Chronic Inflammatory Demyelinating Polyneuropathy, Dermatomyositis, Guillain-Barre Syndrome, Lambert-Eaton Myasthenic Syndrome, Multiple Sclerosis, Myasthenia Gravis, Polymyositis **Autoimmune Disease:** Chronic Inflammatory Demyelinating Polyneuropathy, Dermatomyositis, Guillain-Barre Syndrome, Lambert-Eaton Myasthenic Syndrome, Multiple Sclerosis, Myasthenia Gravis, Polymyositis **State:** California --- ### [Neurological Institute](https://www.autoimmuneinstitute.org/medical_institutions/neurological-institute-2/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Multiple Sclerosis, Myasthenia Gravis **Autoimmune Disease:** Multiple Sclerosis, Myasthenia Gravis **State:** California --- ### [Neurology & Neurosurgery](https://www.autoimmuneinstitute.org/medical_institutions/neurology-neurosurgery/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Multiple Sclerosis **Autoimmune Disease:** Multiple Sclerosis **State:** California --- ### [Myositis Program](https://www.autoimmuneinstitute.org/medical_institutions/myositis-program/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Dermatomyositis, Polymyositis **Autoimmune Disease:** Dermatomyositis, Polymyositis **State:** Massachusetts --- ### [Neuromuscular Disorder Program](https://www.autoimmuneinstitute.org/medical_institutions/neuromuscular-disorder-program/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Myasthenia Gravis, Sarcoidosis **Autoimmune Disease:** Myasthenia Gravis, Sarcoidosis **State:** Massachusetts --- ### [Neuroscience Health Center](https://www.autoimmuneinstitute.org/medical_institutions/neuroscience-health-center/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Ankylosing Spondylitis **Autoimmune Disease:** Ankylosing Spondylitis **State:** California --- ### [Neurosurgery Clinic in Santa Cruz](https://www.autoimmuneinstitute.org/medical_institutions/neurosurgery-clinic-in-santa-cruz/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Ankylosing Spondylitis, Spondyloarthritis **Autoimmune Disease:** Ankylosing Spondylitis, Spondyloarthritis **State:** California --- ### [Neuromuscular Program at the Neuroscience Health Center](https://www.autoimmuneinstitute.org/medical_institutions/neuromuscular-program-at-the-neuroscience-health-center/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Lambert-Eaton Myasthenic Syndrome **Autoimmune Disease:** Lambert-Eaton Myasthenic Syndrome **State:** California --- ### [Neuromuscular Program in the Tri-Valley](https://www.autoimmuneinstitute.org/medical_institutions/neuromuscular-program-in-the-tri-valley/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Lambert-Eaton Myasthenic Syndrome **Autoimmune Disease:** Lambert-Eaton Myasthenic Syndrome **State:** California --- ### [Neurocritical Care Program](https://www.autoimmuneinstitute.org/medical_institutions/neurocritical-care-program/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Encephalitis/Acute Disseminated Encephalomyelitis (ADEM) **Autoimmune Disease:** Autoimmune Encephalitis/Acute Disseminated Encephalomyelitis (ADEM) **State:** California --- ### [Lupus Clinic at Boston Medical Center](https://www.autoimmuneinstitute.org/medical_institutions/lupus-clinic-at-boston-medical-center/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Lupus Nephritis, Systemic Lupus Erythematosus **Autoimmune Disease:** Lupus Nephritis, Systemic Lupus Erythematosus **State:** Massachusetts --- ### [Lupus Center](https://www.autoimmuneinstitute.org/medical_institutions/lupus-center/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Systemic Lupus Erythematosus **Autoimmune Disease:** Systemic Lupus Erythematosus **State:** Maryland --- ### [Multiple Sclerosis Clinic](https://www.autoimmuneinstitute.org/medical_institutions/multiple-sclerosis-clinic/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Multiple Sclerosis **Autoimmune Disease:** Multiple Sclerosis **State:** Massachusetts --- ### [Lupus Center](https://www.autoimmuneinstitute.org/medical_institutions/lupus-center-2/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Systemic Lupus Erythematosus **Autoimmune Disease:** Systemic Lupus Erythematosus **State:** New York --- ### [Lupus Nephritis Clinic](https://www.autoimmuneinstitute.org/medical_institutions/lupus-nephritis-clinic/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Lupus Nephritis **Autoimmune Disease:** Lupus Nephritis **State:** Pennsylvania --- ### [Lupus Clinic](https://www.autoimmuneinstitute.org/medical_institutions/lupus-clinic/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Raynaud Syndrome/Phenomenon, Systemic Lupus Erythematosus **Autoimmune Disease:** Raynaud Syndrome/Phenomenon, Systemic Lupus Erythematosus **State:** California --- ### [Multiple Sclerosis Clinic](https://www.autoimmuneinstitute.org/medical_institutions/multiple-sclerosis-clinic-2/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Multiple Sclerosis **Autoimmune Disease:** Multiple Sclerosis **State:** California --- ### [Manhattan Beach Pediatrics](https://www.autoimmuneinstitute.org/medical_institutions/manhattan-beach-pediatrics/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Addison’s Disease, Autoimmune Encephalitis/Acute Disseminated Encephalomyelitis (ADEM), Celiac Disease, Crohn’s Disease, Eosinophilic Esophagitis, Graves’ Disease, Guillain-Barre Syndrome, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis, Myasthenia Gravis, Type 1 Diabetes, Ulcerative Colitis **Autoimmune Disease:** Addison's Disease, Autoimmune Encephalitis/Acute Disseminated Encephalomyelitis (ADEM), Celiac Disease, Crohn's Disease, Eosinophilic Esophagitis, Graves' Disease, Guillain-Barre Syndrome, Hashimoto's Thyroiditis/Autoimmune Thyroiditis, Myasthenia Gravis, Type 1 Diabetes, Ulcerative Colitis **State:** California --- ### [Liver Disease Care](https://www.autoimmuneinstitute.org/medical_institutions/liver-disease-care/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Hepatitis **Autoimmune Disease:** Autoimmune Hepatitis **State:** California --- ### [Multiple Sclerosis](https://www.autoimmuneinstitute.org/medical_institutions/multiple-sclerosis/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Multiple Sclerosis **Autoimmune Disease:** Multiple Sclerosis **State:** California --- ### [Multiple Sclerosis and Neuroinflammation Center](https://www.autoimmuneinstitute.org/medical_institutions/multiple-sclerosis-and-neuroinflammation-center/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Multiple Sclerosis **Autoimmune Disease:** Multiple Sclerosis **State:** California --- ### [MarinHealth Rheumatology](https://www.autoimmuneinstitute.org/medical_institutions/marinhealth-rheumatology/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Polymyalgia Rheumatica, Psoriatic Arthritis, Rheumatoid Arthritis, Sarcoidosis, Sjögren Syndrome, Systemic Lupus Erythematosus **Autoimmune Disease:** Polymyalgia Rheumatica, Psoriatic Arthritis, Rheumatoid Arthritis, Sarcoidosis, Sjögren Syndrome, Systemic Lupus Erythematosus **State:** California --- ### [Lupus Clinic](https://www.autoimmuneinstitute.org/medical_institutions/lupus-clinic-2/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Systemic Lupus Erythematosus **Autoimmune Disease:** Systemic Lupus Erythematosus **State:** Massachusetts --- ### [Multiple Sclerosis Center](https://www.autoimmuneinstitute.org/medical_institutions/multiple-sclerosis-center/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Multiple Sclerosis **Autoimmune Disease:** Multiple Sclerosis **State:** Massachusetts --- ### [Multiple Sclerosis Center in Palo Alto](https://www.autoimmuneinstitute.org/medical_institutions/multiple-sclerosis-center-in-palo-alto/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Encephalitis/Acute Disseminated Encephalomyelitis (ADEM), Multiple Sclerosis, Neuromyelitis Optica/Devic’s Disease, Stiff Person Syndrome, Transverse Myelitis **Autoimmune Disease:** Autoimmune Encephalitis/Acute Disseminated Encephalomyelitis (ADEM), Multiple Sclerosis, Neuromyelitis Optica/Devic's Disease, Stiff Person Syndrome, Transverse Myelitis **State:** California --- ### [Multiple Sclerosis Center in Tri-Valley](https://www.autoimmuneinstitute.org/medical_institutions/multiple-sclerosis-center-in-tri-valley/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Encephalitis/Acute Disseminated Encephalomyelitis (ADEM), Multiple Sclerosis, Neuromyelitis Optica/Devic’s Disease, Stiff Person Syndrome, Transverse Myelitis **Autoimmune Disease:** Autoimmune Encephalitis/Acute Disseminated Encephalomyelitis (ADEM), Multiple Sclerosis, Neuromyelitis Optica/Devic's Disease, Stiff Person Syndrome, Transverse Myelitis **State:** California --- ### [Liver and Hepatitis Program](https://www.autoimmuneinstitute.org/medical_institutions/liver-and-hepatitis-program/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Hepatitis **Autoimmune Disease:** Autoimmune Hepatitis **State:** Massachusetts --- ### [Liver Center](https://www.autoimmuneinstitute.org/medical_institutions/liver-center/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Hepatitis **Autoimmune Disease:** Autoimmune Hepatitis **State:** Massachusetts --- ### [Liver (Hepatology) Clinic in Fremont](https://www.autoimmuneinstitute.org/medical_institutions/liver-hepatology-clinic-in-fremont/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Hepatitis, Primary Biliary Cholangitis, Primary Sclerosing Cholangitis **Autoimmune Disease:** Autoimmune Hepatitis, Primary Biliary Cholangitis, Primary Sclerosing Cholangitis **State:** California --- ### [Liver (Hepatology) Clinic in Fresno](https://www.autoimmuneinstitute.org/medical_institutions/liver-hepatology-clinic-in-fresno/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Hepatitis, Primary Biliary Cholangitis, Primary Sclerosing Cholangitis **Autoimmune Disease:** Autoimmune Hepatitis, Primary Biliary Cholangitis, Primary Sclerosing Cholangitis **State:** California --- ### [Liver (Hepatology) Clinic in Redwood City](https://www.autoimmuneinstitute.org/medical_institutions/liver-hepatology-clinic-in-redwood-city/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Hepatitis, Primary Biliary Cholangitis, Primary Sclerosing Cholangitis **Autoimmune Disease:** Autoimmune Hepatitis, Primary Biliary Cholangitis, Primary Sclerosing Cholangitis **State:** California --- ### [LG Health Physicians Specialty Medicine](https://www.autoimmuneinstitute.org/medical_institutions/lg-health-physicians-specialty-medicine/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Arteriosclerosis/atherosclerosis, Graves’ Disease, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis, Hyperthyroidism, Type 1 Diabetes **Autoimmune Disease:** Arteriosclerosis / atherosclerosis, Graves' Disease, Hashimoto's Thyroiditis/Autoimmune Thyroiditis, Hyperthyroidism, Type 1 Diabetes **State:** Pennsylvania --- ### [LG Health Physicians Walter L. Aument Family Health Center (Family Medicine Practice)](https://www.autoimmuneinstitute.org/medical_institutions/lg-health-physicians-walter-l-aument-family-health-center-family-medicine-practice/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata **Autoimmune Disease:** Alopecia Areata **State:** Pennsylvania --- ### [LG Health Physicians Family Medicine Willow Street](https://www.autoimmuneinstitute.org/medical_institutions/lg-health-physicians-family-medicine-willow-street/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata **Autoimmune Disease:** Alopecia Areata **State:** Pennsylvania --- ### [LG Health Physicians Hospitalists](https://www.autoimmuneinstitute.org/medical_institutions/lg-health-physicians-hospitalists/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata **Autoimmune Disease:** Alopecia Areata **State:** Pennsylvania --- ### [LG Health Physicians Neurology Harrisburg Pike](https://www.autoimmuneinstitute.org/medical_institutions/lg-health-physicians-neurology-harrisburg-pike/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Guillain-Barre Syndrome, Multiple Sclerosis, Myasthenia Gravis **Autoimmune Disease:** Guillain-Barre Syndrome, Multiple Sclerosis, Myasthenia Gravis **State:** Pennsylvania --- ### [LG Health Physicians Neurology Sycamore Square](https://www.autoimmuneinstitute.org/medical_institutions/lg-health-physicians-neurology-sycamore-square/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Guillain-Barre Syndrome, Multiple Sclerosis, Myasthenia Gravis **Autoimmune Disease:** Guillain-Barre Syndrome, Multiple Sclerosis, Myasthenia Gravis **State:** Pennsylvania --- ### [LG Health Physicians Surgical Group](https://www.autoimmuneinstitute.org/medical_institutions/lg-health-physicians-surgical-group/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Arteriosclerosis/atherosclerosis, Crohn’s Disease, Ulcerative Colitis **Autoimmune Disease:** Arteriosclerosis / atherosclerosis, Crohn's Disease, Ulcerative Colitis **State:** Pennsylvania --- ### [LG Health Physicians Surgical Group Ephrata](https://www.autoimmuneinstitute.org/medical_institutions/lg-health-physicians-surgical-group-ephrata/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Arteriosclerosis/atherosclerosis **Autoimmune Disease:** Arteriosclerosis / atherosclerosis **State:** Pennsylvania --- ### [LG Health Specialty Center Ephrata](https://www.autoimmuneinstitute.org/medical_institutions/lg-health-specialty-center-ephrata/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Amyloidosis, Arteriosclerosis/atherosclerosis **Autoimmune Disease:** Amyloidosis, Arteriosclerosis / atherosclerosis **State:** Pennsylvania --- ### [LG Health Physicians Pain Management](https://www.autoimmuneinstitute.org/medical_institutions/lg-health-physicians-pain-management/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Multiple Sclerosis, Rheumatoid Arthritis **Autoimmune Disease:** Multiple Sclerosis, Rheumatoid Arthritis **State:** Pennsylvania --- ### [LG Health Physicians Hematology and Medical Oncology](https://www.autoimmuneinstitute.org/medical_institutions/lg-health-physicians-hematology-and-medical-oncology/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Amyloidosis **Autoimmune Disease:** Amyloidosis **State:** Pennsylvania --- ### [LG Health Physicians Roseville Pediatrics CityGate Lancaster](https://www.autoimmuneinstitute.org/medical_institutions/lg-health-physicians-roseville-pediatrics-citygate-lancaster/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Myositis **Autoimmune Disease:** Myositis **State:** Pennsylvania --- ### [LG Health Physicians Roseville Pediatrics Kissel Hill](https://www.autoimmuneinstitute.org/medical_institutions/lg-health-physicians-roseville-pediatrics-kissel-hill/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Myositis **Autoimmune Disease:** Myositis **State:** Pennsylvania --- ### [LG Health Physicians Family Medicine Quentin](https://www.autoimmuneinstitute.org/medical_institutions/lg-health-physicians-family-medicine-quentin/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata, Hyperthyroidism **Autoimmune Disease:** Alopecia Areata, Hyperthyroidism **State:** Pennsylvania --- ### [LG Health Physicians Family Medicine Twin Rose - Columbia](https://www.autoimmuneinstitute.org/medical_institutions/lg-health-physicians-family-medicine-twin-rose-columbia/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata, Celiac Disease, Hyperthyroidism **Autoimmune Disease:** Alopecia Areata, Celiac Disease, Hyperthyroidism **State:** Pennsylvania --- ### [LG Health Physicians Family Medicine Twin Rose - Wrightsville](https://www.autoimmuneinstitute.org/medical_institutions/lg-health-physicians-family-medicine-twin-rose-wrightsville/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata, Celiac Disease, Hyperthyroidism **Autoimmune Disease:** Alopecia Areata, Celiac Disease, Hyperthyroidism **State:** Pennsylvania --- ### [LG Health Physicians Family Medicine Sycamore Square](https://www.autoimmuneinstitute.org/medical_institutions/lg-health-physicians-family-medicine-sycamore-square/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata **Autoimmune Disease:** Alopecia Areata **State:** Pennsylvania --- ### [LG Health Physicians Family Medicine Norlanco](https://www.autoimmuneinstitute.org/medical_institutions/lg-health-physicians-family-medicine-norlanco/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata **Autoimmune Disease:** Alopecia Areata **State:** Pennsylvania --- ### [LG Health Physicians Family Medicine Strasburg](https://www.autoimmuneinstitute.org/medical_institutions/lg-health-physicians-family-medicine-strasburg/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata **Autoimmune Disease:** Alopecia Areata **State:** Pennsylvania --- ### [LG Health Physicians Family Medicine Susquehanna](https://www.autoimmuneinstitute.org/medical_institutions/lg-health-physicians-family-medicine-susquehanna/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata **Autoimmune Disease:** Alopecia Areata **State:** Pennsylvania --- ### [LG Health Physicians Family Medicine Parkesburg](https://www.autoimmuneinstitute.org/medical_institutions/lg-health-physicians-family-medicine-parkesburg/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata **Autoimmune Disease:** Alopecia Areata **State:** Pennsylvania --- ### [LG Health Physicians Family Medicine Oxford](https://www.autoimmuneinstitute.org/medical_institutions/lg-health-physicians-family-medicine-oxford/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata **Autoimmune Disease:** Alopecia Areata **State:** Pennsylvania --- ### [LG Health Physicians Family Medicine Red Rose](https://www.autoimmuneinstitute.org/medical_institutions/lg-health-physicians-family-medicine-red-rose/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata **Autoimmune Disease:** Alopecia Areata **State:** Pennsylvania --- ### [LG Health Physicians Family Medicine Leola](https://www.autoimmuneinstitute.org/medical_institutions/lg-health-physicians-family-medicine-leola/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata, Hyperthyroidism **Autoimmune Disease:** Alopecia Areata, Hyperthyroidism **State:** Pennsylvania --- ### [LG Health Physicians Family Medicine Mount Joy](https://www.autoimmuneinstitute.org/medical_institutions/lg-health-physicians-family-medicine-mount-joy/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata **Autoimmune Disease:** Alopecia Areata **State:** Pennsylvania --- ### [LG Health Physicians Family Medicine Lititz](https://www.autoimmuneinstitute.org/medical_institutions/lg-health-physicians-family-medicine-lititz/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata **Autoimmune Disease:** Alopecia Areata **State:** Pennsylvania --- ### [LG Health Physicians Family Medicine Lititz Kissel Hill](https://www.autoimmuneinstitute.org/medical_institutions/lg-health-physicians-family-medicine-lititz-kissel-hill/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata **Autoimmune Disease:** Alopecia Areata **State:** Pennsylvania --- ### [LG Health Physicians Family Medicine New Holland](https://www.autoimmuneinstitute.org/medical_institutions/lg-health-physicians-family-medicine-new-holland/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata **Autoimmune Disease:** Alopecia Areata **State:** Pennsylvania --- ### [LG Health Physicians Family Medicine Manheim](https://www.autoimmuneinstitute.org/medical_institutions/lg-health-physicians-family-medicine-manheim/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata **Autoimmune Disease:** Alopecia Areata **State:** Pennsylvania --- ### [LG Health Physicians Family Medicine Manor Ridge Downtown Lancaster](https://www.autoimmuneinstitute.org/medical_institutions/lg-health-physicians-family-medicine-manor-ridge-downtown-lancaster/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata, Type 1 Diabetes **Autoimmune Disease:** Alopecia Areata, Type 1 Diabetes **State:** Pennsylvania --- ### [LG Health Physicians Family Medicine Manor Ridge Marietta Avenue](https://www.autoimmuneinstitute.org/medical_institutions/lg-health-physicians-family-medicine-manor-ridge-marietta-avenue/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata, Type 1 Diabetes **Autoimmune Disease:** Alopecia Areata, Type 1 Diabetes **State:** Pennsylvania --- ### [LG Health Physicians Family Medicine Manheim - Pleasant View](https://www.autoimmuneinstitute.org/medical_institutions/lg-health-physicians-family-medicine-manheim-pleasant-view/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata **Autoimmune Disease:** Alopecia Areata **State:** Pennsylvania --- ### [LG Health Physicians Family Medicine Lincoln](https://www.autoimmuneinstitute.org/medical_institutions/lg-health-physicians-family-medicine-lincoln/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata, Type 1 Diabetes **Autoimmune Disease:** Alopecia Areata, Type 1 Diabetes **State:** Pennsylvania --- ### [LG Health Physicians Family Medicine Lincoln Division Highway](https://www.autoimmuneinstitute.org/medical_institutions/lg-health-physicians-family-medicine-lincoln-division-highway/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata, Type 1 Diabetes **Autoimmune Disease:** Alopecia Areata, Type 1 Diabetes **State:** Pennsylvania --- ### [LG Health Physicians Family Medicine East Petersburg](https://www.autoimmuneinstitute.org/medical_institutions/lg-health-physicians-family-medicine-east-petersburg/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis **Autoimmune Disease:** Alopecia Areata, Hashimoto's Thyroiditis/Autoimmune Thyroiditis **State:** Pennsylvania --- ### [LG Health Physicians Diabetes and Endocrinology](https://www.autoimmuneinstitute.org/medical_institutions/lg-health-physicians-diabetes-and-endocrinology/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Graves’ Disease, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis, Hyperthyroidism, Type 1 Diabetes **Autoimmune Disease:** Graves' Disease, Hashimoto's Thyroiditis/Autoimmune Thyroiditis, Hyperthyroidism, Type 1 Diabetes **State:** Pennsylvania --- ### [LG Health Physicians Diabetes and Endocrinology Lebanon](https://www.autoimmuneinstitute.org/medical_institutions/lg-health-physicians-diabetes-and-endocrinology-lebanon/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Graves’ Disease, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis, Hyperthyroidism, Type 1 Diabetes **Autoimmune Disease:** Graves' Disease, Hashimoto's Thyroiditis/Autoimmune Thyroiditis, Hyperthyroidism, Type 1 Diabetes **State:** Pennsylvania --- ### [LG Health Physicians Family Medicine Abbeyville](https://www.autoimmuneinstitute.org/medical_institutions/lg-health-physicians-family-medicine-abbeyville/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Hyperthyroidism **Autoimmune Disease:** Hyperthyroidism **State:** Pennsylvania --- ### [LG Health Physicians Family Medicine Abbeyville Embassy Drive](https://www.autoimmuneinstitute.org/medical_institutions/lg-health-physicians-family-medicine-abbeyville-embassy-drive/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Hyperthyroidism **Autoimmune Disease:** Hyperthyroidism **State:** Pennsylvania --- ### [LG Health Physicians Comprehensive Care](https://www.autoimmuneinstitute.org/medical_institutions/lg-health-physicians-comprehensive-care/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata, Celiac Disease, Graves’ Disease, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis, Hyperthyroidism, Type 1 Diabetes **Autoimmune Disease:** Alopecia Areata, Celiac Disease, Graves' Disease, Hashimoto's Thyroiditis/Autoimmune Thyroiditis, Hyperthyroidism, Type 1 Diabetes **State:** Pennsylvania --- ### [LG Health Physicians Diabetes and Endocrinology Ephrata](https://www.autoimmuneinstitute.org/medical_institutions/lg-health-physicians-diabetes-and-endocrinology-ephrata/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Graves’ Disease, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis, Hyperthyroidism, Type 1 Diabetes **Autoimmune Disease:** Graves' Disease, Hashimoto's Thyroiditis/Autoimmune Thyroiditis, Hyperthyroidism, Type 1 Diabetes **State:** Pennsylvania --- ### [LG Health Physicians Diabetes and Endocrinology Elizabethtown](https://www.autoimmuneinstitute.org/medical_institutions/lg-health-physicians-diabetes-and-endocrinology-elizabethtown/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Graves’ Disease, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis, Hyperthyroidism, Type 1 Diabetes **Autoimmune Disease:** Graves' Disease, Hashimoto's Thyroiditis/Autoimmune Thyroiditis, Hyperthyroidism, Type 1 Diabetes **State:** Pennsylvania --- ### [LG Health Physicians Diabetes and Endocrinology Parkesburg](https://www.autoimmuneinstitute.org/medical_institutions/lg-health-physicians-diabetes-and-endocrinology-parkesburg/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Graves’ Disease, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis, Hyperthyroidism, Type 1 Diabetes **Autoimmune Disease:** Graves' Disease, Hashimoto's Thyroiditis/Autoimmune Thyroiditis, Hyperthyroidism, Type 1 Diabetes **State:** Pennsylvania --- ### [LG Health Physicians Family and Maternity Medicine](https://www.autoimmuneinstitute.org/medical_institutions/lg-health-physicians-family-and-maternity-medicine/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata **Autoimmune Disease:** Alopecia Areata **State:** Pennsylvania --- ### [LG Health Physicians Family Medicine Crooked Oak](https://www.autoimmuneinstitute.org/medical_institutions/lg-health-physicians-family-medicine-crooked-oak/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata **Autoimmune Disease:** Alopecia Areata **State:** Pennsylvania --- ### [LG Health Physicians Family Medicine County Line](https://www.autoimmuneinstitute.org/medical_institutions/lg-health-physicians-family-medicine-county-line/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata, Celiac Disease **Autoimmune Disease:** Alopecia Areata, Celiac Disease **State:** Pennsylvania --- ### [LG Health Physicians Family Medicine Downtown](https://www.autoimmuneinstitute.org/medical_institutions/lg-health-physicians-family-medicine-downtown/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata **Autoimmune Disease:** Alopecia Areata **State:** Pennsylvania --- ### [LG Health Physicians Family Medicine Buck](https://www.autoimmuneinstitute.org/medical_institutions/lg-health-physicians-family-medicine-buck/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata **Autoimmune Disease:** Alopecia Areata **State:** Pennsylvania --- ### [LG Health Physicians Arthritis and Rheumatology Ephrata](https://www.autoimmuneinstitute.org/medical_institutions/lg-health-physicians-arthritis-and-rheumatology-ephrata/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA), Dermatomyositis, Myositis, Psoriatic Arthritis, Rheumatoid Arthritis, Sarcoidosis, Scleroderma, Sjögren Syndrome, Temporal Arteritis **Autoimmune Disease:** Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA), Dermatomyositis, Myositis, Psoriatic Arthritis, Rheumatoid Arthritis, Sarcoidosis, Scleroderma, Sjögren Syndrome, Temporal Arteritis **State:** Pennsylvania --- ### [LG Health Physicians Arthritis and Rheumatology Elizabethtown](https://www.autoimmuneinstitute.org/medical_institutions/lg-health-physicians-arthritis-and-rheumatology-elizabethtown/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA), Dermatomyositis, Myositis, Rheumatoid Arthritis, Sarcoidosis, Scleroderma, Sjögren Syndrome **Autoimmune Disease:** Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA), Dermatomyositis, Myositis, Rheumatoid Arthritis, Sarcoidosis, Scleroderma, Sjögren Syndrome **State:** Pennsylvania --- ### [Kidney Center](https://www.autoimmuneinstitute.org/medical_institutions/kidney-center/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Glomerulonephritis, Henoch–Schönlein Purpura, Iga Nephropathy/Berger’s Disease, Systemic Lupus Erythematosus **Autoimmune Disease:** Glomerulonephritis, Henoch–Schönlein Purpura, Iga Nephropathy/Berger's Disease, Systemic Lupus Erythematosus **State:** Colorado --- ### [Kidney Disease in Children](https://www.autoimmuneinstitute.org/medical_institutions/kidney-disease-in-children/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Systemic Lupus Erythematosus, Type 1 Diabetes, Vasculitis **Autoimmune Disease:** Systemic Lupus Erythematosus, Type 1 Diabetes, Vasculitis **State:** North Carolina --- ### [Jane and Leonard Korman Respiratory Institute](https://www.autoimmuneinstitute.org/medical_institutions/jane-and-leonard-korman-respiratory-institute/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Sarcoidosis **Autoimmune Disease:** Sarcoidosis **State:** Pennsylvania --- ### [Jerome L. Greene Sjogren’s Syndrome Center](https://www.autoimmuneinstitute.org/medical_institutions/jerome-l-greene-sjogrens-syndrome-center/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Sjögren Syndrome **Autoimmune Disease:** Sjögren Syndrome **State:** Maryland --- ### [Infectious Diseases Department](https://www.autoimmuneinstitute.org/medical_institutions/infectious-diseases-department/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Encephalitis/Acute Disseminated Encephalomyelitis (ADEM) **Autoimmune Disease:** Autoimmune Encephalitis/Acute Disseminated Encephalomyelitis (ADEM) **State:** Minnesota --- ### [Inflammatory Arthritis Center](https://www.autoimmuneinstitute.org/medical_institutions/inflammatory-arthritis-center/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Psoriatic Arthritis, Rheumatoid Arthritis, Spondyloarthritis **Autoimmune Disease:** Psoriatic Arthritis, Rheumatoid Arthritis, Spondyloarthritis **State:** New York --- ### [Inflammatory Bowel Disease Center](https://www.autoimmuneinstitute.org/medical_institutions/inflammatory-bowel-disease-center/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Crohn’s Disease, Ulcerative Colitis **Autoimmune Disease:** Crohn's Disease, Ulcerative Colitis **State:** New York --- ### [Joint Penn-CHOP Center for Digestive, Liver and Pancreatic Medicine](https://www.autoimmuneinstitute.org/medical_institutions/joint-penn-chop-center-for-digestive-liver-and-pancreatic-medicine/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Celiac Disease, Crohn’s Disease, Eosinophilic Esophagitis, Ulcerative Colitis **Autoimmune Disease:** Celiac Disease, Crohn's Disease, Eosinophilic Esophagitis, Ulcerative Colitis **State:** Pennsylvania --- ### [Inflammatory Bowel Disease Center](https://www.autoimmuneinstitute.org/medical_institutions/inflammatory-bowel-disease-center-2/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Crohn’s Disease, Ulcerative Colitis **Autoimmune Disease:** Crohn's Disease, Ulcerative Colitis **State:** California --- ### [Kidney Clinic (Nephrology) in Santa Clara](https://www.autoimmuneinstitute.org/medical_institutions/kidney-clinic-nephrology-in-santa-clara/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Amyloidosis, Glomerulonephritis, Lupus Nephritis **Autoimmune Disease:** Amyloidosis, Glomerulonephritis, Lupus Nephritis **State:** California --- ### [Kidney Clinic (Nephrology) at Boswell Building](https://www.autoimmuneinstitute.org/medical_institutions/kidney-clinic-nephrology-at-boswell-building/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Amyloidosis, Glomerulonephritis, Lupus Nephritis **Autoimmune Disease:** Amyloidosis, Glomerulonephritis, Lupus Nephritis **State:** California --- ### [Lancaster General Health Wellness Express](https://www.autoimmuneinstitute.org/medical_institutions/lancaster-general-health-wellness-express/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata **Autoimmune Disease:** Alopecia Areata **State:** Pennsylvania --- ### [LG Health Care Connections](https://www.autoimmuneinstitute.org/medical_institutions/lg-health-care-connections/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata **Autoimmune Disease:** Alopecia Areata **State:** Pennsylvania --- ### [LG Health Physicians Arthritis and Rheumatology](https://www.autoimmuneinstitute.org/medical_institutions/lg-health-physicians-arthritis-and-rheumatology/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA), Dermatomyositis, Lupus Nephritis, Myositis, Psoriatic Arthritis, Rheumatoid Arthritis, Sarcoidosis, Scleroderma, Sjögren Syndrome, Temporal Arteritis **Autoimmune Disease:** Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA), Dermatomyositis, Lupus Nephritis, Myositis, Psoriatic Arthritis, Rheumatoid Arthritis, Sarcoidosis, Scleroderma, Sjögren Syndrome, Temporal Arteritis **State:** Pennsylvania --- ### [LG Health Physicians Arthritis and Rheumatology - Women's Specialty Center](https://www.autoimmuneinstitute.org/medical_institutions/lg-health-physicians-arthritis-and-rheumatology-womens-specialty-center/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA), Dermatomyositis, Lupus Nephritis, Myositis, Rheumatoid Arthritis, Sarcoidosis, Sjögren Syndrome, Temporal Arteritis **Autoimmune Disease:** Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA), Dermatomyositis, Lupus Nephritis, Myositis, Rheumatoid Arthritis, Sarcoidosis, Sjögren Syndrome, Temporal Arteritis **State:** Pennsylvania --- ### [Hepatology Program](https://www.autoimmuneinstitute.org/medical_institutions/hepatology-program/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Hepatitis **Autoimmune Disease:** Autoimmune Hepatitis **State:** Washington DC --- ### [General Rheumatology – interdisciplinary with Lupus Clinic](https://www.autoimmuneinstitute.org/medical_institutions/general-rheumatology-interdisciplinary-with-lupus-clinic/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Ankylosing Spondylitis, Behçet’s Disease, Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA), Dermatomyositis, Juvenile Arthritis, Microscopic Polyangiitis (MPA)/ANCA-Associated Vasculitis, Mixed Connective Tissue Disease, Polymyalgia Rheumatica, Polymyositis, Psoriatic Arthritis, Raynaud Syndrome/Phenomenon, Rheumatoid Arthritis, Sarcoidosis, Scleroderma, Sjögren Syndrome, Systemic Lupus Erythematosus, Takayasu’s arteritis, Undifferentiated Connective Tissue Disease, Vasculitis **Autoimmune Disease:** Ankylosing Spondylitis, Behçet’s Disease, Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA), Dermatomyositis, Juvenile Arthritis, Microscopic Polyangiitis (MPA)/ANCA-Associated Vasculitis, Mixed Connective Tissue Disease, Polymyalgia Rheumatica, Polymyositis, Psoriatic Arthritis, Raynaud Syndrome/Phenomenon, Rheumatoid Arthritis, Sarcoidosis, Scleroderma, Sjögren Syndrome, Systemic Lupus Erythematosus, Takayasu's arteritis, Undifferentiated Connective Tissue Disease, Vasculitis **State:** Ohio --- ### [Heart, Vascular & Thoracic Institute](https://www.autoimmuneinstitute.org/medical_institutions/heart-vascular-thoracic-institute/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Amyloidosis, Antiphospholipid Syndrome, Behçet’s Disease, Dressler’s Syndrome, Ehlers-Danlos Syndrome, Immune Thrombocytopenia Purpura, Postural Orthostatic Tachycardia Syndrome (POTS), Raynaud Syndrome/Phenomenon, Sydenham’s Chorea **Autoimmune Disease:** Amyloidosis, Antiphospholipid Syndrome, Behçet’s Disease, Dressler’s Syndrome, Ehlers-Danlos Syndrome, Immune Thrombocytopenia Purpura, Postural Orthostatic Tachycardia Syndrome (POTS), Raynaud Syndrome/Phenomenon, Sydenham's Chorea **State:** Ohio --- ### [Glickman Urological and Kidney Institute](https://www.autoimmuneinstitute.org/medical_institutions/glickman-urological-and-kidney-institute/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Addison’s Disease, Cutaneous Lupus, Goodpasture Syndrome, Iga Nephropathy/Berger’s Disease, Lupus Nephritis, Primary Adrenal Insufficiency, Systemic Lupus Erythematosus **Autoimmune Disease:** Addison's Disease, Cutaneous Lupus, Goodpasture Syndrome, Iga Nephropathy/Berger's Disease, Lupus Nephritis, Primary Adrenal Insufficiency, Systemic Lupus Erythematosus **State:** Ohio --- ### [Hair and Scalp Disorders](https://www.autoimmuneinstitute.org/medical_institutions/hair-and-scalp-disorders/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata **Autoimmune Disease:** Alopecia Areata **State:** New York --- ### [Hair Disorders Clinic](https://www.autoimmuneinstitute.org/medical_institutions/hair-disorders-clinic/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata **Autoimmune Disease:** Alopecia Areata **State:** California --- ### [Immunology and Rheumatology Clinic](https://www.autoimmuneinstitute.org/medical_institutions/immunology-and-rheumatology-clinic/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Rheumatoid Arthritis, Systemic Lupus Erythematosus **Autoimmune Disease:** Rheumatoid Arthritis, Systemic Lupus Erythematosus **State:** California --- ### [General Dermatology Clinic in San Pablo](https://www.autoimmuneinstitute.org/medical_institutions/general-dermatology-clinic-in-san-pablo/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Psoriasis **Autoimmune Disease:** Psoriasis **State:** California --- ### [General Dermatology Clinic in San Ramon](https://www.autoimmuneinstitute.org/medical_institutions/general-dermatology-clinic-in-san-ramon/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Psoriasis **Autoimmune Disease:** Psoriasis **State:** California --- ### [General Dermatology Clinic in Santa Clara](https://www.autoimmuneinstitute.org/medical_institutions/general-dermatology-clinic-in-santa-clara/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Psoriasis **Autoimmune Disease:** Psoriasis **State:** California --- ### [Hair Loss Clinic](https://www.autoimmuneinstitute.org/medical_institutions/hair-loss-clinic/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata **Autoimmune Disease:** Alopecia Areata **State:** California --- ### [Hematology Program](https://www.autoimmuneinstitute.org/medical_institutions/hematology-program/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Aplastic Anemia, Immune Thrombocytopenia Purpura **Autoimmune Disease:** Aplastic Anemia, Immune Thrombocytopenia Purpura **State:** California --- ### [Harron Lung Center Perelman](https://www.autoimmuneinstitute.org/medical_institutions/harron-lung-center-perelman/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA), Goodpasture Syndrome, Sarcoidosis, Scleroderma **Autoimmune Disease:** Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA), Goodpasture Syndrome, Sarcoidosis, Scleroderma **State:** Pennsylvania --- ### [Harron Lung Center University City](https://www.autoimmuneinstitute.org/medical_institutions/harron-lung-center-university-city/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA), Goodpasture Syndrome, Sarcoidosis, Scleroderma **Autoimmune Disease:** Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA), Goodpasture Syndrome, Sarcoidosis, Scleroderma **State:** Pennsylvania --- ### [Harron Lung Center Washington Square](https://www.autoimmuneinstitute.org/medical_institutions/harron-lung-center-washington-square/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA), Goodpasture Syndrome, Sarcoidosis **Autoimmune Disease:** Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA), Goodpasture Syndrome, Sarcoidosis **State:** Pennsylvania --- ### [Gastroenterology, Hepatology & Nutrition](https://www.autoimmuneinstitute.org/medical_institutions/gastroenterology-hepatology-nutrition/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Hepatitis, Autoimmune Pancreatitis, Celiac Disease, Crohn’s Disease, Parsonage-Turner Syndrome, Primary Biliary Cholangitis, Primary Sclerosing Cholangitis, Sclerosing Mesenteritis, Ulcerative Colitis **Autoimmune Disease:** Autoimmune Hepatitis, Autoimmune Pancreatitis, Celiac Disease, Crohn's Disease, Parsonage-Turner Syndrome, Primary Biliary Cholangitis, Primary Sclerosing Cholangitis, Sclerosing Mesenteritis, Ulcerative Colitis **State:** Ohio --- ### [Gastroenterology Program](https://www.autoimmuneinstitute.org/medical_institutions/gastroenterology-program/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Hepatitis, Crohn’s Disease, Ulcerative Colitis **Autoimmune Disease:** Autoimmune Hepatitis, Crohn's Disease, Ulcerative Colitis **State:** North Carolina --- ### [Gastroenterology and Hepatology Department](https://www.autoimmuneinstitute.org/medical_institutions/gastroenterology-and-hepatology-department/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Enteropathy, Autoimmune Hepatitis, Autoimmune Pancreatitis, Celiac Disease, Crohn’s Disease, Cronkhite-Canada Syndrome, Primary Biliary Cholangitis, Primary Sclerosing Cholangitis, Ulcerative Colitis **Autoimmune Disease:** Autoimmune Enteropathy, Autoimmune Hepatitis, Autoimmune Pancreatitis, Celiac Disease, Crohn's Disease, Cronkhite-Canada Syndrome, Primary Biliary Cholangitis, Primary Sclerosing Cholangitis, Ulcerative Colitis **State:** Minnesota --- ### [General Dermatology](https://www.autoimmuneinstitute.org/medical_institutions/general-dermatology/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Psoriasis **Autoimmune Disease:** Psoriasis **State:** New York --- ### [Gastroenterology & Hepatology](https://www.autoimmuneinstitute.org/medical_institutions/gastroenterology-hepatology/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Crohn’s Disease, Ulcerative Colitis **Autoimmune Disease:** Crohn's Disease, Ulcerative Colitis **State:** California --- ### [Endocrinology, Diabetes, & Metabolism](https://www.autoimmuneinstitute.org/medical_institutions/endocrinology-diabetes-metabolism/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Graves’ Disease, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis **Autoimmune Disease:** Graves' Disease, Hashimoto's Thyroiditis/Autoimmune Thyroiditis **State:** California --- ### [Gastroenterology and Digestive Diseases](https://www.autoimmuneinstitute.org/medical_institutions/gastroenterology-and-digestive-diseases/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Hepatitis, Autoimmune Pancreatitis, Celiac Disease, Crohn’s Disease, Eosinophilic Esophagitis, Ulcerative Colitis **Autoimmune Disease:** Autoimmune Hepatitis, Autoimmune Pancreatitis, Celiac Disease, Crohn's Disease, Eosinophilic Esophagitis, Ulcerative Colitis **State:** California --- ### [Gastroenterology](https://www.autoimmuneinstitute.org/medical_institutions/gastroenterology/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Hepatitis, Crohn’s Disease, Primary Biliary Cholangitis, Primary Sclerosing Cholangitis, Ulcerative Colitis **Autoimmune Disease:** Autoimmune Hepatitis, Crohn's Disease, Primary Biliary Cholangitis, Primary Sclerosing Cholangitis, Ulcerative Colitis **State:** Massachusetts --- ### [Esophagus Center](https://www.autoimmuneinstitute.org/medical_institutions/esophagus-center/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Eosinophilic Esophagitis **Autoimmune Disease:** Eosinophilic Esophagitis **State:** California --- ### [Gastrointestinal (GI) Pain Clinic at Boswell](https://www.autoimmuneinstitute.org/medical_institutions/gastrointestinal-gi-pain-clinic-at-boswell/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Crohn’s Disease, Ulcerative Colitis **Autoimmune Disease:** Crohn's Disease, Ulcerative Colitis **State:** California --- ### [Gastrointestinal (GI) Pain Clinic in Redwood City](https://www.autoimmuneinstitute.org/medical_institutions/gastrointestinal-gi-pain-clinic-in-redwood-city/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Crohn’s Disease, Ulcerative Colitis **Autoimmune Disease:** Crohn's Disease, Ulcerative Colitis **State:** California --- ### [Gastrointestinal Motility Program](https://www.autoimmuneinstitute.org/medical_institutions/gastrointestinal-motility-program/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Crohn’s Disease, Ulcerative Colitis **Autoimmune Disease:** Crohn's Disease, Ulcerative Colitis **State:** California --- ### [General Dermatology Clinic at Hoover Pavilion](https://www.autoimmuneinstitute.org/medical_institutions/general-dermatology-clinic-at-hoover-pavilion/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Psoriasis **Autoimmune Disease:** Psoriasis **State:** California --- ### [General Dermatology Clinic in Danville](https://www.autoimmuneinstitute.org/medical_institutions/general-dermatology-clinic-in-danville/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Psoriasis **Autoimmune Disease:** Psoriasis **State:** California --- ### [General Dermatology Clinic in Emeryville](https://www.autoimmuneinstitute.org/medical_institutions/general-dermatology-clinic-in-emeryville/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Psoriasis **Autoimmune Disease:** Psoriasis **State:** California --- ### [General Dermatology Clinic in Los Altos](https://www.autoimmuneinstitute.org/medical_institutions/general-dermatology-clinic-in-los-altos/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Psoriasis **Autoimmune Disease:** Psoriasis **State:** California --- ### [General Dermatology Clinic in Portola Valley](https://www.autoimmuneinstitute.org/medical_institutions/general-dermatology-clinic-in-portola-valley/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Psoriasis **Autoimmune Disease:** Psoriasis **State:** California --- ### [General Dermatology Clinic in Redwood City](https://www.autoimmuneinstitute.org/medical_institutions/general-dermatology-clinic-in-redwood-city/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Psoriasis **Autoimmune Disease:** Psoriasis **State:** California --- ### [e.g. Boston Children's Hospital - Center for Childhood Liver Disease](https://www.autoimmuneinstitute.org/medical_institutions/e-g-boston-childrens-hospital-center-for-childhood-liver-disease/) **Published:** February 20, 2024 **Author:** Elevation --- ### [Endocrinology & Metabolism Institute](https://www.autoimmuneinstitute.org/medical_institutions/endocrinology-metabolism-institute/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Addison’s Disease, Central Nervous System Vasculitis, Graves’ Disease, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis, Type 1 Diabetes, Vitiligo **Autoimmune Disease:** Addison's Disease, Central Nervous System Vasculitis, Graves' Disease, Hashimoto's Thyroiditis/Autoimmune Thyroiditis, Type 1 Diabetes, Vitiligo **State:** Ohio --- ### [Endocrinology Program](https://www.autoimmuneinstitute.org/medical_institutions/endocrinology-program/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Addison’s Disease, Graves’ Disease, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis, Type 1 Diabetes **Autoimmune Disease:** Addison's Disease, Graves' Disease, Hashimoto's Thyroiditis/Autoimmune Thyroiditis, Type 1 Diabetes **State:** North Carolina --- ### [Endocrinology Department](https://www.autoimmuneinstitute.org/medical_institutions/endocrinology-department/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Addison’s Disease, Graves’ Disease, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis, Type 1 Diabetes **Autoimmune Disease:** Addison's Disease, Graves' Disease, Hashimoto's Thyroiditis/Autoimmune Thyroiditis, Type 1 Diabetes **State:** Minnesota --- ### [Endocrinology](https://www.autoimmuneinstitute.org/medical_institutions/endocrinology/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Addison’s Disease, Alopecia Areata, Graves’ Disease, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis, Type 1 Diabetes **Autoimmune Disease:** Addison's Disease, Alopecia Areata, Graves' Disease, Hashimoto's Thyroiditis/Autoimmune Thyroiditis, Type 1 Diabetes **State:** California --- ### [Downtown Los Angeles Primary & Specialty Care](https://www.autoimmuneinstitute.org/medical_institutions/downtown-los-angeles-primary-specialty-care/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Addison’s Disease, Autoimmune Hepatitis, Celiac Disease, Crohn’s Disease, Eosinophilic Esophagitis, Graves’ Disease, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis, Primary Biliary Cirrhosis, Primary Sclerosing Cholangitis, Scleroderma, Type 1 Diabetes, Ulcerative Colitis **Autoimmune Disease:** Addison's Disease, Autoimmune Hepatitis, Celiac Disease, Crohn's Disease, Eosinophilic Esophagitis, Graves' Disease, Hashimoto's Thyroiditis/Autoimmune Thyroiditis, Primary Biliary Cirrhosis, Primary Sclerosing Cholangitis, Scleroderma, Type 1 Diabetes, Ulcerative Colitis **State:** California --- ### [Encino Specialty Care](https://www.autoimmuneinstitute.org/medical_institutions/encino-specialty-care/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Hepatitis, Celiac Disease, Crohn’s Disease, Eosinophilic Esophagitis, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis, Primary Biliary Cirrhosis, Primary Sclerosing Cholangitis, Scleroderma, Ulcerative Colitis **Autoimmune Disease:** Autoimmune Hepatitis, Celiac Disease, Crohn's Disease, Eosinophilic Esophagitis, Hashimoto's Thyroiditis/Autoimmune Thyroiditis, Primary Biliary Cirrhosis, Primary Sclerosing Cholangitis, Scleroderma, Ulcerative Colitis **State:** California --- ### [Endocrinology, Diabetes, & Metabolism](https://www.autoimmuneinstitute.org/medical_institutions/endocrinology-diabetes-metabolism-2/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Addison’s Disease, Autoimmune Polyglandular Syndrome, Graves’ Disease, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis, Type 1 Diabetes **Autoimmune Disease:** Addison's Disease, Autoimmune Polyglandular Syndrome, Graves' Disease, Hashimoto's Thyroiditis/Autoimmune Thyroiditis, Type 1 Diabetes **State:** California --- ### [Encino Specialty Care](https://www.autoimmuneinstitute.org/medical_institutions/encino-specialty-care-2/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Various Autoimmune Diseases **Autoimmune Disease:** Various Autoimmune Diseases **State:** California --- ### [Encino Specialty Care](https://www.autoimmuneinstitute.org/medical_institutions/encino-specialty-care-3/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Addison’s Disease, Ankylosing Spondylitis, Autoimmune Hepatitis, Autoimmune Polyglandular Syndrome, Celiac Disease, Central Nervous System Vasculitis, Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA), Crohn’s Disease, Dermatomyositis, Eosinophilic Esophagitis, Giant Cell Arteritis, Glomerulonephritis, Graves’ Disease, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis, Henoch–Schönlein Purpura, Lichen Planus, Microscopic Polyangiitis (MPA)/ANCA-Associated Vasculitis, Mixed Connective Tissue Disease, Polyarteritis Nodosa, Polymyalgia Rheumatica, Polymyositis, Psoriasis, Psoriatic Arthritis, Rheumatoid Arthritis, Scleroderma, Sjögren Syndrome, Systemic Lupus Erythematosus, Takayasu’s arteritis, Type 1 Diabetes, Ulcerative Colitis, Vitiligo **Autoimmune Disease:** Addison's Disease, Ankylosing Spondylitis, Autoimmune Hepatitis, Autoimmune Polyglandular Syndrome, Celiac Disease, Central Nervous System Vasculitis, Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA), Crohn's Disease, Dermatomyositis, Eosinophilic Esophagitis, Giant Cell Arteritis, Glomerulonephritis, Graves' Disease, Hashimoto's Thyroiditis/Autoimmune Thyroiditis, Henoch–Schönlein Purpura, Lichen Planus, Microscopic Polyangiitis (MPA)/ANCA-Associated Vasculitis, Mixed Connective Tissue Disease, Polyarteritis Nodosa, Polymyalgia Rheumatica, Polymyositis, Psoriasis, Psoriatic Arthritis, Rheumatoid Arthritis, Scleroderma, Sjögren Syndrome, Systemic Lupus Erythematosus, Takayasu's arteritis, Type 1 Diabetes, Ulcerative Colitis, Vitiligo **State:** California --- ### [Endocrinology](https://www.autoimmuneinstitute.org/medical_institutions/endocrinology-2/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Graves’ Disease, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis **Autoimmune Disease:** Graves' Disease, Hashimoto's Thyroiditis/Autoimmune Thyroiditis **State:** California --- ### [Endocrinology Clinic in Danville](https://www.autoimmuneinstitute.org/medical_institutions/endocrinology-clinic-in-danville/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Addison’s Disease, Graves’ Disease, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis, Type 1 Diabetes **Autoimmune Disease:** Addison's Disease, Graves' Disease, Hashimoto's Thyroiditis/Autoimmune Thyroiditis, Type 1 Diabetes **State:** California --- ### [Endocrinology Clinic in Pleasanton](https://www.autoimmuneinstitute.org/medical_institutions/endocrinology-clinic-in-pleasanton/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Addison’s Disease, Graves’ Disease, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis, Type 1 Diabetes **Autoimmune Disease:** Addison's Disease, Graves' Disease, Hashimoto's Thyroiditis/Autoimmune Thyroiditis, Type 1 Diabetes **State:** California --- ### [Endocrinology Clinic at Boswell Building](https://www.autoimmuneinstitute.org/medical_institutions/endocrinology-clinic-at-boswell-building/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Addison’s Disease, Graves’ Disease, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis **Autoimmune Disease:** Addison's Disease, Graves' Disease, Hashimoto's Thyroiditis/Autoimmune Thyroiditis **State:** California --- ### [Endocrinology Clinic at Hoover Pavilion](https://www.autoimmuneinstitute.org/medical_institutions/endocrinology-clinic-at-hoover-pavilion/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Addison’s Disease, Graves’ Disease, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis **Autoimmune Disease:** Addison's Disease, Graves' Disease, Hashimoto's Thyroiditis/Autoimmune Thyroiditis **State:** California --- ### [Division of Rheumatology](https://www.autoimmuneinstitute.org/medical_institutions/division-of-rheumatology/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Ankylosing Spondylitis, Dermatomyositis, Henoch–Schönlein Purpura, Kawasaki Disease, Psoriatic Arthritis, Scleroderma, Systemic Lupus Erythematosus **Autoimmune Disease:** Ankylosing Spondylitis, Dermatomyositis, Henoch–Schönlein Purpura, Kawasaki Disease, Psoriatic Arthritis, Scleroderma, Systemic Lupus Erythematosus **State:** Washington DC --- ### [Downtown Los Angeles Primary & Specialty Care](https://www.autoimmuneinstitute.org/medical_institutions/downtown-los-angeles-primary-specialty-care-2/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Various Autoimmune Diseases **Autoimmune Disease:** Various Autoimmune Diseases **State:** California --- ### [Doheny Eye Center UCLA Arcadia](https://www.autoimmuneinstitute.org/medical_institutions/doheny-eye-center-ucla-arcadia/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Graves’ Disease, Myasthenia Gravis, Uveitis **Autoimmune Disease:** Graves' Disease, Myasthenia Gravis, Uveitis **State:** California --- ### [Doheny Eye Center UCLA Pasadena](https://www.autoimmuneinstitute.org/medical_institutions/doheny-eye-center-ucla-pasadena/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Graves’ Disease, Myasthenia Gravis, Uveitis **Autoimmune Disease:** Graves' Disease, Myasthenia Gravis, Uveitis **State:** California --- ### [Doheny Eye Center UCLA Orange County](https://www.autoimmuneinstitute.org/medical_institutions/doheny-eye-center-ucla-orange-county/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Graves’ Disease, Myasthenia Gravis, Uveitis **Autoimmune Disease:** Graves' Disease, Myasthenia Gravis, Uveitis **State:** California --- ### [Doris Stein Eye Research Center](https://www.autoimmuneinstitute.org/medical_institutions/doris-stein-eye-research-center/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Graves’ Disease, Myasthenia Gravis, Uveitis **Autoimmune Disease:** Graves' Disease, Myasthenia Gravis, Uveitis **State:** California --- ### [Downtown Los Angeles Primary & Specialty Care](https://www.autoimmuneinstitute.org/medical_institutions/downtown-los-angeles-primary-specialty-care-3/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Addison’s Disease, Autoimmune Hepatitis, Autoimmune Pancreatitis, Autoimmune Polyglandular Syndrome, Celiac Disease, Central Nervous System Vasculitis, Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA), Crohn’s Disease, Dermatomyositis, Eosinophilic Esophagitis, Giant Cell Arteritis, Glomerulonephritis, Graves’ Disease, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis, Henoch–Schönlein Purpura, Lichen Planus, Microscopic Polyangiitis (MPA)/ANCA-Associated Vasculitis, Mixed Connective Tissue Disease, Polyarteritis Nodosa, Polymyalgia Rheumatica, Polymyositis, Psoriasis, Psoriatic Arthritis, Rheumatoid Arthritis, Scleroderma, Sjögren Syndrome, Systemic Lupus Erythematosus, Takayasu’s arteritis, Type 1 Diabetes, Ulcerative Colitis, Vitiligo **Autoimmune Disease:** Addison's Disease, Autoimmune Hepatitis, Autoimmune Pancreatitis, Autoimmune Polyglandular Syndrome, Celiac Disease, Central Nervous System Vasculitis, Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA), Crohn's Disease, Dermatomyositis, Eosinophilic Esophagitis, Giant Cell Arteritis, Glomerulonephritis, Graves' Disease, Hashimoto's Thyroiditis/Autoimmune Thyroiditis, Henoch–Schönlein Purpura, Lichen Planus, Microscopic Polyangiitis (MPA)/ANCA-Associated Vasculitis, Mixed Connective Tissue Disease, Polyarteritis Nodosa, Polymyalgia Rheumatica, Polymyositis, Psoriasis, Psoriatic Arthritis, Rheumatoid Arthritis, Scleroderma, Sjögren Syndrome, Systemic Lupus Erythematosus, Takayasu's arteritis, Type 1 Diabetes, Ulcerative Colitis, Vitiligo **State:** California --- ### [Division of Rheumatology/Allergy & Immunology](https://www.autoimmuneinstitute.org/medical_institutions/division-of-rheumatology-allergy-immunology/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Glomerulonephritis, Rheumatoid Arthritis, Sarcoidosis, Systemic Lupus Erythematosus, Type 1 Diabetes, Vasculitis **Autoimmune Disease:** Glomerulonephritis, Rheumatoid Arthritis, Sarcoidosis, Systemic Lupus Erythematosus, Type 1 Diabetes, Vasculitis **State:** California --- ### [Division of Nephrology](https://www.autoimmuneinstitute.org/medical_institutions/division-of-nephrology/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Lupus Nephritis, Vasculitis **Autoimmune Disease:** Lupus Nephritis, Vasculitis **State:** California --- ### [Division of Endocrinology and Diabetes](https://www.autoimmuneinstitute.org/medical_institutions/division-of-endocrinology-and-diabetes/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Graves’ Disease, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis, Type 1 Diabetes **Autoimmune Disease:** Graves' Disease, Hashimoto's Thyroiditis/Autoimmune Thyroiditis, Type 1 Diabetes **State:** Washington DC --- ### [Diabetes Program](https://www.autoimmuneinstitute.org/medical_institutions/diabetes-program/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Type 1 Diabetes **Autoimmune Disease:** Type 1 Diabetes **State:** Washington DC --- ### [Digestive Health Institute](https://www.autoimmuneinstitute.org/medical_institutions/digestive-health-institute/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Hepatitis, Celiac Disease, Type 1 Diabetes **Autoimmune Disease:** Autoimmune Hepatitis, Celiac Disease, Type 1 Diabetes **State:** Pennsylvania --- ### [Division of Endocrinology, Diabetes and Metabolic Diseases](https://www.autoimmuneinstitute.org/medical_institutions/division-of-endocrinology-diabetes-and-metabolic-diseases/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Addison’s Disease, Graves’ Disease, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis, Type 1 Diabetes **Autoimmune Disease:** Addison's Disease, Graves' Disease, Hashimoto's Thyroiditis/Autoimmune Thyroiditis, Type 1 Diabetes **State:** Pennsylvania --- ### [Diabetes Center](https://www.autoimmuneinstitute.org/medical_institutions/diabetes-center/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Type 1 Diabetes **Autoimmune Disease:** Type 1 Diabetes **State:** Pennsylvania --- ### [Diabetes and Endocrinology](https://www.autoimmuneinstitute.org/medical_institutions/diabetes-and-endocrinology/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Addison’s Disease, Graves’ Disease, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis, Type 1 Diabetes **Autoimmune Disease:** Addison's Disease, Graves' Disease, Hashimoto's Thyroiditis/Autoimmune Thyroiditis, Type 1 Diabetes **State:** California --- ### [Division of Endocrinology, Diabetes and Metabolism](https://www.autoimmuneinstitute.org/medical_institutions/division-of-endocrinology-diabetes-and-metabolism/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Addison’s Disease, Graves’ Disease, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis, Type 1 Diabetes **Autoimmune Disease:** Addison's Disease, Graves' Disease, Hashimoto's Thyroiditis/Autoimmune Thyroiditis, Type 1 Diabetes **State:** California --- ### [Digestive Health Center in Portola Valley](https://www.autoimmuneinstitute.org/medical_institutions/digestive-health-center-in-portola-valley/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Celiac Disease **Autoimmune Disease:** Celiac Disease **State:** California --- ### [Digestive Health Center in Pleasanton](https://www.autoimmuneinstitute.org/medical_institutions/digestive-health-center-in-pleasanton/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Celiac Disease **Autoimmune Disease:** Celiac Disease **State:** California --- ### [Diabetes Care Program](https://www.autoimmuneinstitute.org/medical_institutions/diabetes-care-program/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Type 1 Diabetes **Autoimmune Disease:** Type 1 Diabetes **State:** California --- ### [Department of Endocrinology](https://www.autoimmuneinstitute.org/medical_institutions/department-of-endocrinology/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Graves’ Disease, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis, Type 1 Diabetes **Autoimmune Disease:** Graves' Disease, Hashimoto's Thyroiditis/Autoimmune Thyroiditis, Type 1 Diabetes **State:** Colorado --- ### [Department of Pediatric Rheumatology](https://www.autoimmuneinstitute.org/medical_institutions/department-of-pediatric-rheumatology/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Antiphospholipid Syndrome, Dermatomyositis, Juvenile Idiopathic Arthritis, Scleroderma, Systemic Lupus Erythematosus, Vasculitis **Autoimmune Disease:** Antiphospholipid Syndrome, Dermatomyositis, Juvenile Idiopathic Arthritis, Scleroderma, Systemic Lupus Erythematosus, Vasculitis **State:** Colorado --- ### [Dermatology and Plastic Surgery Institute](https://www.autoimmuneinstitute.org/medical_institutions/dermatology-and-plastic-surgery-institute/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Psoriasis, Vitiligo **Autoimmune Disease:** Psoriasis, Vitiligo **State:** Ohio --- ### [Dermatology Program](https://www.autoimmuneinstitute.org/medical_institutions/dermatology-program/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Dermatomyositis, Pemphigoid, Pemphigus, Scleroderma, Sjögren Syndrome, Systemic Lupus Erythematosus, Vasculitis **Autoimmune Disease:** Dermatomyositis, Pemphigoid, Pemphigus, Scleroderma, Sjögren Syndrome, Systemic Lupus Erythematosus, Vasculitis **State:** North Carolina --- ### [Department of Ophthalmology](https://www.autoimmuneinstitute.org/medical_institutions/department-of-ophthalmology/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Multiple Sclerosis, Sjögren Syndrome, Type 1 Diabetes **Autoimmune Disease:** Multiple Sclerosis, Sjögren Syndrome, Type 1 Diabetes **State:** Pennsylvania --- ### [Department of Dermatology and Cutaneous Biology](https://www.autoimmuneinstitute.org/medical_institutions/department-of-dermatology-and-cutaneous-biology/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Raynaud Syndrome/Phenomenon, Scleroderma **Autoimmune Disease:** Raynaud Syndrome/Phenomenon, Scleroderma **State:** Pennsylvania --- ### [Department of Otolaryngology – Head and Neck Surgery](https://www.autoimmuneinstitute.org/medical_institutions/department-of-otolaryngology-head-and-neck-surgery/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Hashimoto’s Thyroiditis/Autoimmune Thyroiditis **Autoimmune Disease:** Hashimoto's Thyroiditis/Autoimmune Thyroiditis **State:** Pennsylvania --- ### [Department of Orthopedic Surgery](https://www.autoimmuneinstitute.org/medical_institutions/department-of-orthopedic-surgery/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Rheumatoid Arthritis **Autoimmune Disease:** Rheumatoid Arthritis **State:** Pennsylvania --- ### [Dermatology-General Program](https://www.autoimmuneinstitute.org/medical_institutions/dermatology-general-program/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Cutaneous Lupus, Dermatomyositis, Discoid Lupus, Eosinophilic Fasciitis, Mixed Connective Tissue Disease, Polymyositis, Psoriasis, Raynaud Syndrome/Phenomenon, Scleroderma, Systemic Lupus Erythematosus, Undifferentiated Connective Tissue Disease, Vitiligo **Autoimmune Disease:** Cutaneous Lupus, Dermatomyositis, Discoid Lupus, Eosinophilic Fasciitis, Mixed Connective Tissue Disease, Polymyositis, Psoriasis, Raynaud Syndrome/Phenomenon, Scleroderma, Systemic Lupus Erythematosus, Undifferentiated Connective Tissue Disease, Vitiligo **State:** Massachusetts --- ### [Dermatology Department](https://www.autoimmuneinstitute.org/medical_institutions/dermatology-department/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Bullous Pemphigoid, Dermatomyositis, Ehlers-Danlos Syndrome, Graves’ Disease, Lichen Planus, Pemphigus, Primary Biliary Cholangitis, Psoriasis, Scleroderma, Vasculitis, Vitiligo **Autoimmune Disease:** Bullous Pemphigoid, Dermatomyositis, Ehlers-Danlos Syndrome, Graves' Disease, Lichen Planus, Pemphigus, Primary Biliary Cholangitis, Psoriasis, Scleroderma, Vasculitis, Vitiligo **State:** Minnesota --- ### [Dermatology](https://www.autoimmuneinstitute.org/medical_institutions/dermatology/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata, Dermatomyositis, Eosinophilic Fasciitis, Necrobiosis Lipoidica, Psoriasis, Psoriatic Arthritis, Pyoderma Gangrenosum, Scleroderma, Systemic Lupus Erythematosus, Vitiligo **Autoimmune Disease:** Alopecia Areata, Dermatomyositis, Eosinophilic Fasciitis, Necrobiosis Lipoidica, Psoriasis, Psoriatic Arthritis, Pyoderma Gangrenosum, Scleroderma, Systemic Lupus Erythematosus, Vitiligo **State:** California --- ### [Dermatology](https://www.autoimmuneinstitute.org/medical_institutions/dermatology-2/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata, Lichen Planus, Psoriasis, Psoriatic Arthritis, Vitiligo **Autoimmune Disease:** Alopecia Areata, Lichen Planus, Psoriasis, Psoriatic Arthritis, Vitiligo **State:** California --- ### [Department of Neurology](https://www.autoimmuneinstitute.org/medical_institutions/department-of-neurology/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Encephalitis/Acute Disseminated Encephalomyelitis (ADEM), Chronic Inflammatory Demyelinating Polyneuropathy, Dermatomyositis, Guillain-Barre Syndrome, Ménière’s disease, Multiple Sclerosis, Myasthenia Gravis, Neuromyelitis Optica/Devic’s Disease, Polymyositis, Transverse Myelitis **Autoimmune Disease:** Autoimmune Encephalitis/Acute Disseminated Encephalomyelitis (ADEM), Chronic Inflammatory Demyelinating Polyneuropathy, Dermatomyositis, Guillain-Barre Syndrome, Ménière's disease, Multiple Sclerosis, Myasthenia Gravis, Neuromyelitis Optica/Devic's Disease, Polymyositis, Transverse Myelitis **State:** California --- ### [Dermatology](https://www.autoimmuneinstitute.org/medical_institutions/dermatology-13/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Cutaneous Vasculitis, Dermatomyositis, Scleroderma, Systemic Lupus Erythematosus **Autoimmune Disease:** Cutaneous Vasculitis, Dermatomyositis, Scleroderma, Systemic Lupus Erythematosus **State:** California --- ### [Dermatology](https://www.autoimmuneinstitute.org/medical_institutions/dermatology-14/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Psoriasis **Autoimmune Disease:** Psoriasis **State:** California --- ### [Dana-Farber/Boston Children's Cancer and Blood Disorders Center](https://www.autoimmuneinstitute.org/medical_institutions/dana-farber-boston-childrens-cancer-and-blood-disorders-center/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Aplastic Anemia, Autoimmune Hemolytic Anemia, Evans Syndrome, Immune Thrombocytopenia Purpura **Autoimmune Disease:** Aplastic Anemia, Autoimmune Hemolytic Anemia, Evans Syndrome, Immune Thrombocytopenia Purpura **State:** Massachusetts --- ### [Children’s Hospital Colorado North Campus Broomfield: Neuromuscular Program for Muscle Disorders, Digestive Health Institute, Center for Cancer and Blood Disorders, Department of Dermatology, Department of Pediatric Rheumatology](https://www.autoimmuneinstitute.org/medical_institutions/childrens-hospital-colorado-north-campus-broomfield-neuromuscular-program-for-muscle-disorders-digestive-health-institute-center-for-cancer-and-blood-disorders-department-of-dermatology/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Guillain-Barre Syndrome, Myasthenia Gravis **Autoimmune Disease:** Guillain-Barre Syndrome, Myasthenia Gravis **State:** Colorado --- ### [Children’s Hospital Colorado Pediatric Neuroscience Institute](https://www.autoimmuneinstitute.org/medical_institutions/childrens-hospital-colorado-pediatric-neuroscience-institute/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Dermatomyositis, Guillain-Barre Syndrome, Multiple Sclerosis, Myasthenia Gravis, Polymyositis **Autoimmune Disease:** Dermatomyositis, Guillain-Barre Syndrome, Multiple Sclerosis, Myasthenia Gravis, Polymyositis **State:** Colorado --- ### [Colorado Center for Celiac Disease](https://www.autoimmuneinstitute.org/medical_institutions/colorado-center-for-celiac-disease/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Celiac Disease **Autoimmune Disease:** Celiac Disease **State:** Colorado --- ### [Department of Dermatology](https://www.autoimmuneinstitute.org/medical_institutions/department-of-dermatology/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Psoriasis, Vitiligo **Autoimmune Disease:** Psoriasis, Vitiligo **State:** Colorado --- ### [Cleveland Clinic Children’s Hospital for Rehabilitation](https://www.autoimmuneinstitute.org/medical_institutions/cleveland-clinic-childrens-hospital-for-rehabilitation/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Juvenile Arthritis, Postural Orthostatic Tachycardia Syndrome (POTS) **Autoimmune Disease:** Juvenile Arthritis, Postural Orthostatic Tachycardia Syndrome (POTS) **State:** Ohio --- ### [Cole Eye Institute](https://www.autoimmuneinstitute.org/medical_institutions/cole-eye-institute/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Graves’ Disease, Neuromyelitis Optica/Devic’s Disease **Autoimmune Disease:** Graves' Disease, Neuromyelitis Optica/Devic's Disease **State:** Ohio --- ### [Crohn’s and Colitis Center](https://www.autoimmuneinstitute.org/medical_institutions/crohns-and-colitis-center/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Crohn’s Disease, Ulcerative Colitis **Autoimmune Disease:** Crohn's Disease, Ulcerative Colitis **State:** Massachusetts --- ### [Columbia University Multiple Sclerosis Center](https://www.autoimmuneinstitute.org/medical_institutions/columbia-university-multiple-sclerosis-center/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Multiple Sclerosis **Autoimmune Disease:** Multiple Sclerosis **State:** New York --- ### [Columbia Doctors Endocrinology](https://www.autoimmuneinstitute.org/medical_institutions/columbia-doctors-endocrinology/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Graves’ Disease, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis, Type 1 Diabetes **Autoimmune Disease:** Graves' Disease, Hashimoto's Thyroiditis/Autoimmune Thyroiditis, Type 1 Diabetes **State:** New York --- ### [Crohn’s & Colitis Program](https://www.autoimmuneinstitute.org/medical_institutions/crohns-colitis-program/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Crohn’s Disease, Ulcerative Colitis **Autoimmune Disease:** Crohn's Disease, Ulcerative Colitis **State:** Massachusetts --- ### [Delancey Internal Medicine Rittenhouse](https://www.autoimmuneinstitute.org/medical_institutions/delancey-internal-medicine-rittenhouse/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata **Autoimmune Disease:** Alopecia Areata **State:** Pennsylvania --- ### [Delancey Internal Medicine Washington Square](https://www.autoimmuneinstitute.org/medical_institutions/delancey-internal-medicine-washington-square/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata, Psoriasis **Autoimmune Disease:** Alopecia Areata, Psoriasis **State:** Pennsylvania --- ### [Delancey Internal Medicine South Philadelphia](https://www.autoimmuneinstitute.org/medical_institutions/delancey-internal-medicine-south-philadelphia/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Alopecia Areata **Autoimmune Disease:** Alopecia Areata **State:** Pennsylvania --- ### [Cedars-Sinai Pediatric Gastroenterology](https://www.autoimmuneinstitute.org/medical_institutions/cedars-sinai-pediatric-gastroenterology/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Celiac Disease, Crohn’s Disease, Ulcerative Colitis **Autoimmune Disease:** Celiac Disease, Crohn's Disease, Ulcerative Colitis **State:** California --- ### [Cedars-Sinai Small Bowel Diseases and Nutrition Program](https://www.autoimmuneinstitute.org/medical_institutions/cedars-sinai-small-bowel-diseases-and-nutrition-program/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Celiac Disease **Autoimmune Disease:** Celiac Disease **State:** California --- ### [Children’s Colorado Health Pavilion, Neuroimmunology Center for Children](https://www.autoimmuneinstitute.org/medical_institutions/childrens-colorado-health-pavilion-neuroimmunology-center-for-children/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Encephalitis/Acute Disseminated Encephalomyelitis (ADEM), Behçet’s Disease, Neuromyelitis Optica/Devic’s Disease, Transverse Myelitis **Autoimmune Disease:** Autoimmune Encephalitis/Acute Disseminated Encephalomyelitis (ADEM), Behçet’s Disease, Neuromyelitis Optica/Devic's Disease, Transverse Myelitis **State:** Colorado --- ### [Children’s Hospital Colorado Colorado Springs, Digestive Health Institute](https://www.autoimmuneinstitute.org/medical_institutions/childrens-hospital-colorado-colorado-springs-digestive-health-institute/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Celiac Disease, Crohn’s Disease, Eosinophilic Esophagitis, Ulcerative Colitis **Autoimmune Disease:** Celiac Disease, Crohn's Disease, Eosinophilic Esophagitis, Ulcerative Colitis **State:** Colorado --- ### [Center for Cancer and Blood Disorders](https://www.autoimmuneinstitute.org/medical_institutions/center-for-cancer-and-blood-disorders/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Lymphoproliferative Syndrome **Autoimmune Disease:** Autoimmune Lymphoproliferative Syndrome **State:** Colorado --- ### [Celiac Disease Program](https://www.autoimmuneinstitute.org/medical_institutions/celiac-disease-program/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Celiac Disease **Autoimmune Disease:** Celiac Disease **State:** Washington DC --- ### [Center for Vasculitis Care and Research](https://www.autoimmuneinstitute.org/medical_institutions/center-for-vasculitis-care-and-research/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Behçet’s Disease, Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA), Cogan Syndrome, Giant Cell Arteritis, Henoch–Schönlein Purpura, Kawasaki Disease, Microscopic Polyangiitis (MPA)/ANCA-Associated Vasculitis, Polyarteritis Nodosa, Polymyalgia Rheumatica, Takayasu’s arteritis, Vasculitis **Autoimmune Disease:** Behçet’s Disease, Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA), Cogan Syndrome, Giant Cell Arteritis, Henoch–Schönlein Purpura, Kawasaki Disease, Microscopic Polyangiitis (MPA)/ANCA-Associated Vasculitis, Polyarteritis Nodosa, Polymyalgia Rheumatica, Takayasu's arteritis, Vasculitis **State:** Ohio --- ### [Celiac Center](https://www.autoimmuneinstitute.org/medical_institutions/celiac-center/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Celiac Disease **Autoimmune Disease:** Celiac Disease **State:** Pennsylvania --- ### [Celiac Disease Program](https://www.autoimmuneinstitute.org/medical_institutions/celiac-disease-program-2/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Celiac Disease **Autoimmune Disease:** Celiac Disease **State:** Massachusetts --- ### [Celiac Disease Center](https://www.autoimmuneinstitute.org/medical_institutions/celiac-disease-center/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Celiac Disease **Autoimmune Disease:** Celiac Disease **State:** New York --- ### [Center for Esophageal Disease](https://www.autoimmuneinstitute.org/medical_institutions/center-for-esophageal-disease/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Eosinophilic Esophagitis **Autoimmune Disease:** Eosinophilic Esophagitis **State:** New York --- ### [Center for Digestive Health](https://www.autoimmuneinstitute.org/medical_institutions/center-for-digestive-health/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Hepatitis, Celiac Disease, Crohn’s Disease, Primary Biliary Cirrhosis, Primary Sclerosing Cholangitis, Ulcerative Colitis **Autoimmune Disease:** Autoimmune Hepatitis, Celiac Disease, Crohn's Disease, Primary Biliary Cirrhosis, Primary Sclerosing Cholangitis, Ulcerative Colitis **State:** New York --- ### [Center for Arthritis and Autoimmunity](https://www.autoimmuneinstitute.org/medical_institutions/center-for-arthritis-and-autoimmunity/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Antiphospholipid Syndrome, Behçet’s Disease, Mixed Connective Tissue Disease, Psoriatic Arthritis, Raynaud Syndrome/Phenomenon, Rheumatoid Arthritis, Scleroderma, Sjögren Syndrome, Spondyloarthritis, Systemic Lupus Erythematosus **Autoimmune Disease:** Antiphospholipid Syndrome, Behçet’s Disease, Mixed Connective Tissue Disease, Psoriatic Arthritis, Raynaud Syndrome/Phenomenon, Rheumatoid Arthritis, Scleroderma, Sjögren Syndrome, Spondyloarthritis, Systemic Lupus Erythematosus **State:** New York --- ### [Child Neurology](https://www.autoimmuneinstitute.org/medical_institutions/child-neurology/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Myasthenia Gravis **Autoimmune Disease:** Myasthenia Gravis **State:** California --- ### [Celiac Disease Clinic](https://www.autoimmuneinstitute.org/medical_institutions/celiac-disease-clinic/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Celiac Disease **Autoimmune Disease:** Celiac Disease **State:** California --- ### [Celiac Disease Program](https://www.autoimmuneinstitute.org/medical_institutions/celiac-disease-program-3/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Celiac Disease **Autoimmune Disease:** Celiac Disease **State:** California --- ### [Cerebrovascular Program](https://www.autoimmuneinstitute.org/medical_institutions/cerebrovascular-program/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Vasculitis **Autoimmune Disease:** Vasculitis **State:** California --- ### [Boston Children's Hospital - Immunology Program](https://www.autoimmuneinstitute.org/medical_institutions/boston-childrens-hospital-immunology-program/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Agammaglobulinemia, Autoimmune Hepatitis **Autoimmune Disease:** Agammaglobulinemia, Autoimmune Hepatitis **State:** Massachusetts --- ### [Boston Children's Hospital - Rheumatology Program](https://www.autoimmuneinstitute.org/medical_institutions/boston-childrens-hospital-rheumatology-program/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Ankylosing Spondylitis, Dermatomyositis, Juvenile Idiopathic Arthritis, Raynaud Syndrome/Phenomenon, Scleroderma, Systemic Lupus Erythematosus **Autoimmune Disease:** Ankylosing Spondylitis, Dermatomyositis, Juvenile Idiopathic Arthritis, Raynaud Syndrome/Phenomenon, Scleroderma, Systemic Lupus Erythematosus **State:** Massachusetts --- ### [Boston Children's Hospital - Department of Neurology](https://www.autoimmuneinstitute.org/medical_institutions/boston-childrens-hospital-department-of-neurology/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Encephalitis/Acute Disseminated Encephalomyelitis (ADEM), Guillain-Barre Syndrome, Henoch–Schönlein Purpura, Multiple Sclerosis, Myasthenia Gravis, Scleroderma, Systemic Lupus Erythematosus **Autoimmune Disease:** Autoimmune Encephalitis/Acute Disseminated Encephalomyelitis (ADEM), Guillain-Barre Syndrome, Henoch–Schönlein Purpura, Multiple Sclerosis, Myasthenia Gravis, Scleroderma, Systemic Lupus Erythematosus **State:** Massachusetts --- ### [Boston Children's Hospital - Pediatric Neuro-Immunology Program](https://www.autoimmuneinstitute.org/medical_institutions/boston-childrens-hospital-pediatric-neuro-immunology-program/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Encephalitis/Acute Disseminated Encephalomyelitis (ADEM), Hashimoto’s Encephalopathy, Multiple Sclerosis, Systemic Lupus Erythematosus, Transverse Myelitis, Vasculitis **Autoimmune Disease:** Autoimmune Encephalitis/Acute Disseminated Encephalomyelitis (ADEM), Hashimoto’s Encephalopathy, Multiple Sclerosis, Systemic Lupus Erythematosus, Transverse Myelitis, Vasculitis **State:** Massachusetts --- ### [Boston Children's Hospital - Neuromuscular Center](https://www.autoimmuneinstitute.org/medical_institutions/boston-childrens-hospital-neuromuscular-center/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Dermatomyositis, Guillain-Barre Syndrome, Myasthenia Gravis, Polymyositis **Autoimmune Disease:** Dermatomyositis, Guillain-Barre Syndrome, Myasthenia Gravis, Polymyositis **State:** Massachusetts --- ### [Boston Children's Physicians Weymouth, BCH Blood Disorders Center](https://www.autoimmuneinstitute.org/medical_institutions/boston-childrens-physicians-weymouth-bch-blood-disorders-center/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Addison’s Disease, Ankylosing Spondylitis, Autoimmune Encephalitis/Acute Disseminated Encephalomyelitis (ADEM), Autoimmune Hemolytic Anemia, Autoimmune Hepatitis, Celiac Disease, Crohn’s Disease, Evans Syndrome, Guillain-Barre Syndrome, Henoch–Schönlein Purpura, Immune Thrombocytopenia Purpura, Juvenile Arthritis, Juvenile Dermatomyositis, Multiple Sclerosis, Myasthenia Gravis, Raynaud Syndrome/Phenomenon, Sarcoidosis, Scleroderma, Systemic Lupus Erythematosus, Transverse Myelitis, Type 1 Diabetes, Ulcerative Colitis, Vasculitis **Autoimmune Disease:** Addison's Disease, Ankylosing Spondylitis, Autoimmune Encephalitis/Acute Disseminated Encephalomyelitis (ADEM), Autoimmune Hemolytic Anemia, Autoimmune Hepatitis, Celiac Disease, Crohn's Disease, Evans Syndrome, Guillain-Barre Syndrome, Henoch–Schönlein Purpura, Immune Thrombocytopenia Purpura, Juvenile Arthritis, Juvenile Dermatomyositis, Multiple Sclerosis, Myasthenia Gravis, Raynaud Syndrome/Phenomenon, Sarcoidosis, Scleroderma, Systemic Lupus Erythematosus, Transverse Myelitis, Type 1 Diabetes, Ulcerative Colitis, Vasculitis **State:** Massachusetts --- ### [Cedars-Sinai Multiple Sclerosis and Neuroimmunology Center](https://www.autoimmuneinstitute.org/medical_institutions/cedars-sinai-multiple-sclerosis-and-neuroimmunology-center/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Encephalitis/Acute Disseminated Encephalomyelitis (ADEM), Multiple Sclerosis, Neuromyelitis Optica/Devic’s Disease, Sarcoidosis, Transverse Myelitis **Autoimmune Disease:** Autoimmune Encephalitis/Acute Disseminated Encephalomyelitis (ADEM), Multiple Sclerosis, Neuromyelitis Optica/Devic's Disease, Sarcoidosis, Transverse Myelitis **State:** California --- ### [Cedars-Sinai Gastroenterology - East Tower](https://www.autoimmuneinstitute.org/medical_institutions/cedars-sinai-gastroenterology-east-tower/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Hepatitis, Celiac Disease, Crohn’s Disease, Primary Biliary Cholangitis, Ulcerative Colitis **Autoimmune Disease:** Autoimmune Hepatitis, Celiac Disease, Crohn's Disease, Primary Biliary Cholangitis, Ulcerative Colitis **State:** California --- ### [Cedars-Sinai Gastroenterology - Santa Monica](https://www.autoimmuneinstitute.org/medical_institutions/cedars-sinai-gastroenterology-santa-monica/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Hepatitis, Celiac Disease, Crohn’s Disease, Primary Biliary Cholangitis, Ulcerative Colitis **Autoimmune Disease:** Autoimmune Hepatitis, Celiac Disease, Crohn's Disease, Primary Biliary Cholangitis, Ulcerative Colitis **State:** California --- ### [Cedars-Sinai Gastroenterology - Wilshire](https://www.autoimmuneinstitute.org/medical_institutions/cedars-sinai-gastroenterology-wilshire/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Hepatitis, Celiac Disease, Crohn’s Disease, Primary Biliary Cholangitis, Ulcerative Colitis **Autoimmune Disease:** Autoimmune Hepatitis, Celiac Disease, Crohn's Disease, Primary Biliary Cholangitis, Ulcerative Colitis **State:** California --- ### [Cedars-Sinai Inflammatory Bowel Disease Center, Cedars-Sinai Pediatric Inflammatory Disease Program](https://www.autoimmuneinstitute.org/medical_institutions/cedars-sinai-inflammatory-bowel-disease-center-cedars-sinai-pediatric-inflammatory-disease-program/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Crohn’s Disease, Ulcerative Colitis **Autoimmune Disease:** Crohn's Disease, Ulcerative Colitis **State:** California --- ### [Cedars-Sinai Hepatology Program](https://www.autoimmuneinstitute.org/medical_institutions/cedars-sinai-hepatology-program/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Hepatitis, Primary Biliary Cholangitis, Primary Sclerosing Cholangitis **Autoimmune Disease:** Autoimmune Hepatitis, Primary Biliary Cholangitis, Primary Sclerosing Cholangitis **State:** California --- ### [Burbank Neurology](https://www.autoimmuneinstitute.org/medical_institutions/burbank-neurology/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Multiple Sclerosis **Autoimmune Disease:** Multiple Sclerosis **State:** California --- ### [Calabasas Neurology](https://www.autoimmuneinstitute.org/medical_institutions/calabasas-neurology/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Multiple Sclerosis **Autoimmune Disease:** Multiple Sclerosis **State:** California --- ### [Burbank Rheumatology & Endocrinology](https://www.autoimmuneinstitute.org/medical_institutions/burbank-rheumatology-endocrinology/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Addison’s Disease, Ankylosing Spondylitis, Autoimmune Polyglandular Syndrome, Central Nervous System Vasculitis, Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA), Dermatomyositis, Giant Cell Arteritis, Graves’ Disease, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis, Henoch–Schönlein Purpura, Microscopic Polyangiitis (MPA)/ANCA-Associated Vasculitis, Mixed Connective Tissue Disease, Polyarteritis Nodosa, Polymyalgia Rheumatica, Polymyositis, Psoriatic Arthritis, Rheumatoid Arthritis, Scleroderma, Sjögren Syndrome, Systemic Lupus Erythematosus, Takayasu’s arteritis, Type 1 Diabetes **Autoimmune Disease:** Addison's Disease, Ankylosing Spondylitis, Autoimmune Polyglandular Syndrome, Central Nervous System Vasculitis, Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA), Dermatomyositis, Giant Cell Arteritis, Graves' Disease, Hashimoto's Thyroiditis/Autoimmune Thyroiditis, Henoch–Schönlein Purpura, Microscopic Polyangiitis (MPA)/ANCA-Associated Vasculitis, Mixed Connective Tissue Disease, Polyarteritis Nodosa, Polymyalgia Rheumatica, Polymyositis, Psoriatic Arthritis, Rheumatoid Arthritis, Scleroderma, Sjögren Syndrome, Systemic Lupus Erythematosus, Takayasu's arteritis, Type 1 Diabetes **State:** California --- ### [Byers Eye Institute](https://www.autoimmuneinstitute.org/medical_institutions/byers-eye-institute/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Graves’ Disease **Autoimmune Disease:** Graves' Disease **State:** California --- ### [Boston Children's Hospital - Center for Gastroenterology, Hepatology, and Nutrition](https://www.autoimmuneinstitute.org/medical_institutions/boston-childrens-hospital-center-for-gastroenterology-hepatology-and-nutrition/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Hepatitis, Celiac Disease, Crohn’s Disease, Eosinophilic Esophagitis, Ulcerative Colitis **Autoimmune Disease:** Autoimmune Hepatitis, Celiac Disease, Crohn's Disease, Eosinophilic Esophagitis, Ulcerative Colitis **State:** Massachusetts --- ### [Boston Children's at Lexington, BCH Blood Disorders Center](https://www.autoimmuneinstitute.org/medical_institutions/boston-childrens-at-lexington-bch-blood-disorders-center/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Addison’s Disease, Agammaglobulinemia, Ankylosing Spondylitis, Aplastic Anemia, Autoimmune Encephalitis/Acute Disseminated Encephalomyelitis (ADEM), Autoimmune Hemolytic Anemia, Autoimmune Hepatitis, Celiac Disease, Crohn’s Disease, Dermatomyositis, Evans Syndrome, Guillain-Barre Syndrome, Henoch–Schönlein Purpura, Juvenile Arthritis, Juvenile Dermatomyositis, Lyme Disease, Multiple Sclerosis, Myasthenia Gravis, Raynaud Syndrome/Phenomenon, Sarcoidosis, Scleroderma, Systemic Lupus Erythematosus, Transverse Myelitis, Type 1 Diabetes, Ulcerative Colitis **Autoimmune Disease:** Addison's Disease, Agammaglobulinemia, Ankylosing Spondylitis, Aplastic Anemia, Autoimmune Encephalitis/Acute Disseminated Encephalomyelitis (ADEM), Autoimmune Hemolytic Anemia, Autoimmune Hepatitis, Celiac Disease, Crohn's Disease, Dermatomyositis, Evans Syndrome, Guillain-Barre Syndrome, Henoch–Schönlein Purpura, Juvenile Arthritis, Juvenile Dermatomyositis, Lyme Disease, Multiple Sclerosis, Myasthenia Gravis, Raynaud Syndrome/Phenomenon, Sarcoidosis, Scleroderma, Systemic Lupus Erythematosus, Transverse Myelitis, Type 1 Diabetes, Ulcerative Colitis **State:** Massachusetts --- ### [Boston Children's at Peabody, BCH Blood Disorders Center](https://www.autoimmuneinstitute.org/medical_institutions/boston-childrens-at-peabody-bch-blood-disorders-center/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Addison’s Disease, Aplastic Anemia, Autoimmune Encephalitis/Acute Disseminated Encephalomyelitis (ADEM), Autoimmune Hemolytic Anemia, Autoimmune Hepatitis, Celiac Disease, Crohn’s Disease, Evans Syndrome, Guillain-Barre Syndrome, Henoch–Schönlein Purpura, Immune Thrombocytopenia Purpura, Lyme Disease, Multiple Sclerosis, Myasthenia Gravis, Sarcoidosis, Scleroderma, Systemic Lupus Erythematosus, Transverse Myelitis, Type 1 Diabetes, Ulcerative Colitis, Vasculitis **Autoimmune Disease:** Addison's Disease, Aplastic Anemia, Autoimmune Encephalitis/Acute Disseminated Encephalomyelitis (ADEM), Autoimmune Hemolytic Anemia, Autoimmune Hepatitis, Celiac Disease, Crohn's Disease, Evans Syndrome, Guillain-Barre Syndrome, Henoch–Schönlein Purpura, Immune Thrombocytopenia Purpura, Lyme Disease, Multiple Sclerosis, Myasthenia Gravis, Sarcoidosis, Scleroderma, Systemic Lupus Erythematosus, Transverse Myelitis, Type 1 Diabetes, Ulcerative Colitis, Vasculitis **State:** Massachusetts --- ### [Boston Children's at Waltham, BCH Blood Disorders Center](https://www.autoimmuneinstitute.org/medical_institutions/boston-childrens-at-waltham-bch-blood-disorders-center/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Addison’s Disease, Ankylosing Spondylitis, Autoimmune Hepatitis, Crohn’s Disease, Dermatomyositis, Henoch–Schönlein Purpura, Juvenile Dermatomyositis, Juvenile Idiopathic Arthritis, Multiple Sclerosis, Myasthenia Gravis, Raynaud Syndrome/Phenomenon, Sarcoidosis, Scleroderma, Systemic Lupus Erythematosus, Type 1 Diabetes, Ulcerative Colitis, Vasculitis **Autoimmune Disease:** Addison's Disease, Ankylosing Spondylitis, Autoimmune Hepatitis, Crohn's Disease, Dermatomyositis, Henoch–Schönlein Purpura, Juvenile Dermatomyositis, Juvenile Idiopathic Arthritis, Multiple Sclerosis, Myasthenia Gravis, Raynaud Syndrome/Phenomenon, Sarcoidosis, Scleroderma, Systemic Lupus Erythematosus, Type 1 Diabetes, Ulcerative Colitis, Vasculitis **State:** Massachusetts --- ### [Arthritis Center](https://www.autoimmuneinstitute.org/medical_institutions/arthritis-center/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Ankylosing Spondylitis, Psoriatic Arthritis, Reactive Arthritis, Rheumatoid Arthritis **Autoimmune Disease:** Ankylosing Spondylitis, Psoriatic Arthritis, Reactive Arthritis, Rheumatoid Arthritis **State:** Maryland --- ### [Autoimmune and Cholestatic Liver Clinic](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune-and-cholestatic-liver-clinic/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Autoimmune Hepatitis, Primary Biliary Cirrhosis, Primary Sclerosing Cholangitis **Autoimmune Disease:** Autoimmune Hepatitis, Primary Biliary Cirrhosis, Primary Sclerosing Cholangitis **State:** Massachusetts --- ### [Autoimmune Diseases Center](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune-diseases-center/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Ankylosing Spondylitis, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis, Multiple Sclerosis, Plaque Psoriasis, Psoriatic Arthritis, Rheumatoid Arthritis, Sarcoidosis, Scleroderma, Systemic Lupus Erythematosus **Autoimmune Disease:** Ankylosing Spondylitis, Hashimoto's Thyroiditis/Autoimmune Thyroiditis, Multiple Sclerosis, Plaque Psoriasis, Psoriatic Arthritis, Rheumatoid Arthritis, Sarcoidosis, Scleroderma, Systemic Lupus Erythematosus **State:** New York --- ### [Autoimmune Skin Disease Clinic](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune-skin-disease-clinic/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Dermatomyositis, Myositis, Scleroderma, Systemic Lupus Erythematosus **Autoimmune Disease:** Dermatomyositis, Myositis, Scleroderma, Systemic Lupus Erythematosus **State:** California --- ### [Beverly Hills Digestive Diseases](https://www.autoimmuneinstitute.org/medical_institutions/beverly-hills-digestive-diseases/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Addison’s Disease, Autoimmune Hepatitis, Celiac Disease, Crohn’s Disease, Eosinophilic Esophagitis, Graves’ Disease, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis, Primary Biliary Cirrhosis, Primary Sclerosing Cholangitis, Scleroderma, Type 1 Diabetes, Ulcerative Colitis **Autoimmune Disease:** Addison's Disease, Autoimmune Hepatitis, Celiac Disease, Crohn's Disease, Eosinophilic Esophagitis, Graves' Disease, Hashimoto's Thyroiditis/Autoimmune Thyroiditis, Primary Biliary Cirrhosis, Primary Sclerosing Cholangitis, Scleroderma, Type 1 Diabetes, Ulcerative Colitis **State:** California --- ### [Beverly Hills Wilshire Specialty Care](https://www.autoimmuneinstitute.org/medical_institutions/beverly-hills-wilshire-specialty-care/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Various Autoimmune Diseases **Autoimmune Disease:** Various Autoimmune Diseases **State:** California --- ### [Beverly Hills Wilshire Specialty Care](https://www.autoimmuneinstitute.org/medical_institutions/beverly-hills-wilshire-specialty-care-2/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Central Nervous System Vasculitis, Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA), Dermatomyositis, Giant Cell Arteritis, Henoch–Schönlein Purpura, Microscopic Polyangiitis (MPA)/ANCA-Associated Vasculitis, Polyarteritis Nodosa, Polymyalgia Rheumatica, Polymyositis, Rheumatoid Arthritis, Scleroderma, Systemic Lupus Erythematosus, Takayasu’s arteritis **Autoimmune Disease:** Central Nervous System Vasculitis, Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA), Dermatomyositis, Giant Cell Arteritis, Henoch–Schönlein Purpura, Microscopic Polyangiitis (MPA)/ANCA-Associated Vasculitis, Polyarteritis Nodosa, Polymyalgia Rheumatica, Polymyositis, Rheumatoid Arthritis, Scleroderma, Systemic Lupus Erythematosus, Takayasu's arteritis **State:** California --- ### [Arthritis and Rheumatology](https://www.autoimmuneinstitute.org/medical_institutions/arthritis-and-rheumatology/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Ankylosing Spondylitis, Polymyalgia Rheumatica, Psoriatic Arthritis, Rheumatoid Arthritis, Scleroderma, Systemic Lupus Erythematosus **Autoimmune Disease:** Ankylosing Spondylitis, Polymyalgia Rheumatica, Psoriatic Arthritis, Rheumatoid Arthritis, Scleroderma, Systemic Lupus Erythematosus **State:** California --- ### [Autoimmune Skin Disease Clinic](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune-skin-disease-clinic-2/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Dermatomyositis, Myositis, Scleroderma, Systemic Lupus Erythematosus **Autoimmune Disease:** Dermatomyositis, Myositis, Scleroderma, Systemic Lupus Erythematosus **State:** California --- ### [Autonomic Disorders Program](https://www.autoimmuneinstitute.org/medical_institutions/autonomic-disorders-program/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Amyloidosis, Autoimmune Autonomic Ganglionopathy, Dysautonomia, Postural Orthostatic Tachycardia Syndrome (POTS) **Autoimmune Disease:** Amyloidosis, Autoimmune Autonomic Ganglionopathy, Dysautonomia, Postural Orthostatic Tachycardia Syndrome (POTS) **State:** California --- ### [Blistering Disease Clinic](https://www.autoimmuneinstitute.org/medical_institutions/blistering-disease-clinic/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Bullous Pemphigoid, Dermatitis Herpetiformis, Linear IgA Bullous Dermatosis, Paraneoplastic Pemphigus **Autoimmune Disease:** Bullous Pemphigoid, Dermatitis Herpetiformis, Linear IgA Bullous Dermatosis, Paraneoplastic Pemphigus **State:** California --- ### [Adult Eosinophilic Esophagitis Program](https://www.autoimmuneinstitute.org/medical_institutions/adult-eosinophilic-esophagitis-program/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Eosinophilic Esophagitis **Autoimmune Disease:** Eosinophilic Esophagitis **State:** Massachusetts --- ### [Allergy, Asthma, and Immunodeficiency Clinic in Atherton](https://www.autoimmuneinstitute.org/medical_institutions/allergy-asthma-and-immunodeficiency-clinic-in-atherton/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Eosinophilic Esophagitis **Autoimmune Disease:** Eosinophilic Esophagitis **State:** California --- ### [Arthritis and Joint Replacement](https://www.autoimmuneinstitute.org/medical_institutions/arthritis-and-joint-replacement/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Ankylosing Spondylitis, Juvenile Arthritis, Psoriatic Arthritis, Reactive Arthritis, Rheumatoid Arthritis, Systemic Lupus Erythematosus **Autoimmune Disease:** Ankylosing Spondylitis, Juvenile Arthritis, Psoriatic Arthritis, Reactive Arthritis, Rheumatoid Arthritis, Systemic Lupus Erythematosus **State:** California --- ### [addison's disease, hyperthyroidism, Hashimoto Thyroiditis, Graves' Disease, Granulomatosis with Polyangiitis](https://www.autoimmuneinstitute.org/medical_institutions/addisons-disease-hyperthyroidism-hashimoto-thyroiditis-graves-disease-granulomatosis-with-polyangiitis/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Addison’s Disease, Graves’ Disease, Hashimoto’s Thyroiditis/Autoimmune Thyroiditis, Hyperthyroidism **Autoimmune Disease:** Addison's Disease, Graves' Disease, Hashimoto's Thyroiditis/Autoimmune Thyroiditis, Hyperthyroidism **State:** Pennsylvania --- ### [Abramson Cancer Center Perelman](https://www.autoimmuneinstitute.org/medical_institutions/abramson-cancer-center-perelman/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Amyloidosis **Autoimmune Disease:** Amyloidosis **State:** Pennsylvania --- ### [Abramson Cancer Center Radnor](https://www.autoimmuneinstitute.org/medical_institutions/abramson-cancer-center-radnor/) **Published:** February 20, 2024 **Author:** Elevation **Content:** Amyloidosis **Autoimmune Disease:** Amyloidosis **State:** Pennsylvania --- ## COVID Timeline ### [Study Finds Stable Autoantibody Profiles 6 Months After COVID-19 Booster](https://www.autoimmuneinstitute.org/covid_timeline/study-finds-stable-autoantibody-profiles-6-months-after-covid-19-booster/) **Published:** October 6, 2026 **Author:** Carolyn Serraino **Excerpt:** Researchers found stable autoantibody profiles six months after COVID-19 booster vaccination in 30 healthy adults, providing new insights into immune responses and autoimmune disease research. **Content:** A recent 2026 study published in *Human Vaccines & Immunotherapeutics* found no significant changes in circulating [autoantibody](https://www.autoimmuneinstitute.org/articles/decoding-the-role-of-autoantibodies-in-autoimmunity) profiles six months after COVID-19 booster vaccination in healthy adults. The findings offer new evidence about immune stability following a mixed-platform vaccination regimen and contribute to research investigating potential connections between vaccination and autoimmunity. ### Examining Autoantibodies Following COVID-19 Vaccination Researchers at Universiti Sains Malaysia examined the *[autoantibodyome](https://www.autoimmuneinstitute.org/research_updates/autoantibodyome-neurodegeneration/)*, the collection of antibodies that recognize the body’s own proteins, in 30 healthy adults who received two doses of CoronaVac, an inactivated-virus vaccine, followed by a Pfizer-BioNTech (BNT162b2) mRNA booster. Using a protein microarray, researchers assessed antibody reactivity against 1,610 human proteins associated with autoimmune diseases, cancer, and immune regulation. After quality-control filtering, 534 autoantigens were included in the detailed analysis. Blood samples collected before vaccination were compared with samples obtained 26 weeks after the booster. The researchers found no statistically significant changes in autoantibody reactivity across the analyzed proteins. Overall autoantibody profiles remained stable, including among participants who experienced mild breakthrough SARS-CoV-2 infections during the study period. ### What the Findings Mean for Autoimmune Disease Research Autoantibodies are often associated with autoimmune diseases, but they can also occur naturally in healthy individuals without causing illness. Previous research has identified common autoantibodies in healthy people, emphasizing the importance of distinguishing normal immune activity from potentially disease-associated responses. Because vaccination activates the immune system, researchers have investigated whether it can also influence the production of autoantibodies. This study found no evidence of sustained, widespread changes in the measured autoantibody repertoire following the specific CoronaVac–BNT162b2 vaccination regimen. However, the study included only 30 predominantly young, healthy adults and evaluated autoantibodies at two time points. It could not determine whether temporary changes occurred between measurements or rule out rare or delayed autoimmune complications. Larger studies involving more diverse populations, including individuals with existing autoimmune diseases, are needed. The findings demonstrate how comprehensive autoantibody profiling can help researchers investigate immune responses following vaccination and assess potential changes associated with autoimmune disease. ##### Citation Mat Yassim, A. S., Mohd Hisham, A. A., Mohd Rosdan, B. S., Tan, T. M., Anuar, N. D., Mohamed Hashim, E. K., & Norazmi, M. N. (2026). **Absence of autoantibodies linked to cancer and autoimmune disorders 26 weeks after BNT162b2 boosting in CoronaVac- primed individuals**. *Human vaccines & immunotherapeutics*, *22*(1), 2661499. <https://doi.org/10.1080/21645515.2026.2661499> **Category:** Covid-19 Antibodies, Covid-19 Vaccines --- ### [Study Identifies Molecular Pathways Involved in COVID-19-Related Heart Damage](https://www.autoimmuneinstitute.org/covid_timeline/covid-19-heart-damage-molecular-pathways/) **Published:** August 13, 2026 **Author:** Carolyn Serraino **Excerpt:** Researchers identified changes in gene regulation associated with inflammation, fibrosis, and heart muscle damage following SARS-CoV-2 infection, highlighting potential biomarkers and therapeutic targets for COVID-19-related cardiac complications. **Content:** A 2026 study published in *npj Systems Biology and Applications* identified molecular changes associated with inflammation, tissue scarring, and impaired heart muscle function following SARS-CoV-2 infection. The findings offer new insights into how COVID-19 may affect the cardiovascular system and highlight potential targets for future research into post-viral heart complications. ### Investigating Immune and Molecular Changes in the Heart Researchers examined heart tissue from 29 individuals who died from COVID-19, identifying immune cell infiltration, damage to heart muscle cells, and fibrotic remodeling, a process in which scar tissue develops. To investigate the underlying mechanisms, the team analyzed 42 gene-expression profiles from SARS-CoV-2-infected cardiomyocytes, the muscle cells responsible for the heart’s contractions. They identified 871 genes with altered expression associated with immune activation, changes in the extracellular matrix, and disrupted cardiac function. The researchers then investigated microRNAs (miRNAs), small RNA molecules that help regulate gene expression. Their analysis identified 331 potential miRNA regulators of the altered genes, including several associated with inflammation, fibrosis, and cardiomyocyte survival. Additional analysis of blood samples from individuals with COVID-19 identified 32 miRNAs with altered expression, including 11 that overlapped with the predicted regulatory network. One molecule, miR-29a, showed reduced expression associated with pathways involved in fibrosis, while miR-21, which helps regulate immune responses, was elevated in mild disease. ### COVID-19 Heart Damage and Immune-Mediated Inflammation The findings suggest that changes in gene regulation may contribute to the inflammatory and structural damage observed in the hearts of individuals with COVID-19. These results are particularly relevant to research investigating how immune responses to viral infections affect the cardiovascular system. Although the study did not establish an autoimmune mechanism, it provides additional insight into inflammatory pathways that may be relevant to conditions involving immune-mediated heart injury, including [myocarditis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-myocarditis/). The researchers identified several molecular candidates that could be investigated as potential biomarkers or therapeutic targets for COVID-19-associated cardiac complications. However, the findings remain preliminary. Larger studies are needed to validate the identified pathways and determine their clinical significance. The study also contributes to a broader understanding of how viral infections and immune responses affect the heart. Related GAI-funded research at Johns Hopkins University has examined the organization and gene-expression characteristics of immune activity in [viral myocarditis](https://www.autoimmuneinstitute.org/research_updates/whole-heart-3d-analysis-redefines-myocarditis/), while other research has investigated [the immune system’s role in cardiovascular disease](https://www.autoimmuneinstitute.org/research_updates/the-immune-systems-role-in-heart-disease/). These findings are also relevant to questions being investigated through GAI’s [support of Long COVID research at Johns Hopkins](https://www.autoimmuneinstitute.org/current-research-grants-projects/), including how immune responses may contribute to persistent cardiac symptoms following SARS-CoV-2 infection. ##### Citation Freire, P. P., Fonseca, D. L. M., Lopes, L. O., Ferreira, I. S., Veras, F. P., Fabro, A. T., Batah, S. S., Freitas, D. G. A., do Vale, F. Y. N., Marques, A. H. C., Schimke, L. F., Bastos, G. M., Borges, J. B., Ciconelli, R. M., Sampaio, M. F., Hiyane, M. I., Russo, M., Carvalho, R. F., Cabral-Miranda, G., Dalmolin, R. J. S., … Cabral-Marques, O. (2026). **Systems biology analysis reveals miRNA-mRNA networks associated with cardiomyocyte responses to SARS-CoV-2 infection**. *NPJ systems biology and applications*, *12*(1), 147. <https://doi.org/10.1038/s41540-026-00795-z> **Category:** Covid-19 Infections, Covid-19 Research Studies --- ### [Paul Offit on Vaccine Trust, Policy, and Public Communication](https://www.autoimmuneinstitute.org/covid_timeline/paul-offit-vaccine-trust-public-communication/) **Published:** September 8, 2026 **Author:** Carolyn Serraino **Excerpt:** Dr. Paul Offit reflects on vaccine trust, lessons from the COVID-19 pandemic, and why clear, credible communication will be essential to rebuilding confidence in vaccine policy. **Content:** In a recent interview with *[The Evidence Collective](https://evidencecollective.substack.com/)*, vaccine expert **Dr. Paul Offit** reflects on the current state of vaccine governance in the U.S. and what may be needed to rebuild public trust. He argues that scientific expertise alone is not enough. Vaccine policy also needs clear, credible communication from people who can explain evidence, acknowledge uncertainty, and respond thoughtfully to public concerns. Offit points to lessons from the COVID-19 pandemic, including instances where public messaging overstated what vaccines could realistically accomplish, and discusses the risks of a fragmented vaccine policy landscape. He also emphasizes the importance of expert advisory bodies, trusted clinicians, and local community messengers in helping people understand vaccine recommendations. The interview is part of The *Evidence Collective’s* **“[Next Era of Vaccine Governance” series](https://evidencecollective.substack.com/s/next-era-of-vaccines)**, which brings together perspectives from clinicians, scientists, policymakers, community leaders, parents, and others involved in shaping or experiencing vaccine policy in the U.S. The series is being developed alongside the **[Vaccine Integrity Project](https://vaxintegrity.cidrap.umn.edu/cidraps-vaccine-integrity-project-and-evidence-collective-launch-complementary-initiatives)**, with the goal of examining what stronger, more trustworthy vaccine governance could look like in the future. **Recommended Reading:** [Read the full interview with Dr. Paul Offit](https://evidencecollective.substack.com/p/the-science-is-sound-the-delivery) **More from the series:** [Next Era of Vaccine Governance](https://evidencecollective.substack.com/s/next-era-of-vaccines?utm_source=chatgpt.com) --- ### [Vaccine Responses Vary Even Among Immunosuppressed Individuals](https://www.autoimmuneinstitute.org/covid_timeline/vaccine-responses-vary-even-among-immunosuppressed-individuals/) **Published:** August 20, 2026 **Author:** Carolyn Serraino **Content:** Many studies have looked at how our immune system responds to a vaccine by measuring whether the immune system created antibodies against the vaccine. However, a new study finds that already circulating antibodies could hold clues into how well the immune system will respond to a future vaccine. This study involved 2,445 healthy individuals and 1,644 immunosuppressed individuals. The researchers used blood samples from the participants to measure antibodies against almost 200 antigens including those from common infections and autoantigens associated with autoimmune diseases. They then compared the levels of these antibodies to how well the study participants responded to the COVID-19 vaccine. This study shows that while several immunosuppressed groups have a weaker response to the COVID-19 vaccination, being [immunosuppressed](https://www.autoimmuneinstitute.org/articles/navigating-immunosuppression-and-infection-risk) alone doesn’t necessarily dictate the immune response. Some participants who were immunosuppressed had strong responses to the COVID-19 vaccine and still, 5-6% of healthy individuals mounted a weak response. This work found that pre-existing antibodies to common microbes could predict the vaccine response in both healthy and immunosuppressed participants. These pre-existing antimicrobial antibodies could be used in the future to predict vaccine responses before vaccination and help guide vaccination strategies on the individual level. ##### **Citation** Song L, Park JG, Qiu J, et al. (2026) Pre-vaccine sentinel antibodies predict blunted vaccine responses. *Cell Press Blue* 100088. <https://doi.org/10.1016/j.cpblue.2026.100088> **Category:** Autoimmune Diseases & Covid-19, Covid-19 Antibodies, Covid-19 Vaccines --- ### [COVID-19 May Reactivate Dormant Viruses, Study Finds](https://www.autoimmuneinstitute.org/covid_timeline/covid-19-may-reactivate-dormant-viruses-study-finds/) **Published:** August 5, 2026 **Author:** Carolyn Serraino **Content:** A large study of people hospitalized with COVID-19 found that the infection was frequently accompanied by reactivation of viruses that can remain dormant in the body for years. Conducted across 15 biomedical research institutions in the United States, the findings may help us better understand how severe infections disrupt the immune system and whether reactivated viruses contribute to complications of acute COVID-19 or long COVID. Researchers analyzed samples from 1,154 people hospitalized with COVID-19 at 20 U.S. hospitals, collecting more than 200,000 samples and generating more than 1 billion data points over the course of a year. Using RNA sequencing and other molecular analyses, they looked for evidence that persistent viruses had become active again and tracked these changes over time. #### Nearly half of participants had evidence of at least one reactivated virus during the first 40 days after hospitalization. Several viruses showed distinct patterns of reactivation. Epstein-Barr virus (EBV) tended to become active early in the course of illness, while cytomegalovirus (CMV) and herpes simplex virus 1 (HSV-1) were more likely to appear later. Reactivation of viruses from the Herpesviridae and Anelloviridae families was associated with more severe COVID-19, greater systemic inflammation, and several clinical complications. #### Importantly, these reactivations were not limited to people taking immunosuppressive medications, suggesting that severe illness and inflammation may be enough to disrupt the normal control of persistent viruses. The researchers also examined whether viral activity was associated with long COVID. They did not find that EBV reactivation during acute COVID-19 predicted who later developed long COVID. However, during recovery, members of the Anelloviridae family were detected more often in people who reported persistent physical limitations, even after the researchers accounted for factors including age, COVID-19 severity, and use of immunosuppressive medications. Anelloviruses are extremely common and remain poorly understood, so the finding does not establish that they cause long COVID. Persistent viral infections have also been studied in connection with autoimmune disease, making the interaction between SARS-CoV-2, dormant viruses, and the immune system particularly relevant to autoimmune research. The authors emphasize that their findings show associations rather than cause and effect. Future studies will be needed to determine whether viral reactivation contributes directly to ongoing inflammation or disease, or instead serves as a marker of broader immune disruption during and after severe infection. ###### Citation Maguire, C., Chen, J., Rouphael, N. *et al.* Virus reactivation in acute and long COVID-19. *Nature* (2026). <https://doi.org/10.1038/s41586-026-10740-z> **Category:** Covid-19 Antibodies, Covid-19 Infections, Covid-19 Research Studies --- ### [Resources for Interpreting Long COVID Clinical Trials](https://www.autoimmuneinstitute.org/covid_timeline/resources-for-interpreting-long-covid-clinical-trials/) **Published:** July 21, 2026 **Author:** Carolyn Serraino **Content:** As Long COVID clinical trials [continue to report new findings](https://www.autoimmuneinstitute.org/covid_timeline/recover-tlc-july-2026-update-long-covid-clinical-trial-progress/ "RECOVER-TLC July 2026 Update: Long COVID Clinical Trial Progress"), understanding how to interpret those results is just as important as keeping up with the latest research. Clinical trial headlines can sometimes overstate what a study actually shows, particularly when early-stage or preliminary findings are reported. #### **Resources** - **The Sick Times:** - *[How to Interpret Clinical Trial Results for Long COVID](https://thesicktimes.org/2026/07/21/how-to-interpret-clinical-trial-results-for-long-covid/)* - *[Questions to Ask When Evaluating Evidence from Clinical Trials](https://thesicktimes.org/questions-to-ask-when-evaluating-evidence-from-clinical-trials/)* - **Global Autoimmune Institute:** *[A Guide to Interpreting Clinical Trial Stories](https://www.autoimmuneinstitute.org/articles/a-guide-to-interpreting-clinical-trial-stories "A Guide to Interpreting Clinical Trial Stories")* For readers looking to better understand clinical trial evidence, GAI’s article, **“A Guide to Interpreting Clinical Trial Stories,”** explains how treatments progress from preclinical research through Phase 4 clinical trials and offers practical questions to ask when evaluating research. Topics include understanding study populations, trial phases, endpoints, control groups, replication, and how to look beyond attention-grabbing headlines to place new findings in the broader context of medical research. For those interested in a more in-depth look specifically at Long COVID research, *The Sick Times* has also published two excellent complementary resources by science journalist Simon Spichak. **“How to Interpret Clinical Trial Results for Long COVID”** explores why interpreting Long COVID trials can be particularly challenging due to the condition’s diverse presentations and discusses concepts such as statistical versus clinical significance, placebo controls, trial registration, and common pitfalls in trial interpretation. The accompanying reference guide, **“Questions to Ask When Evaluating Evidence from Clinical Trials,”** serves as a practical checklist covering trial phases, research terminology, primary and secondary outcomes, subgroup analyses, outcome measures, funding sources, biological plausibility, and other key questions readers can use when evaluating new clinical trial results. Together, these resources provide a valuable foundation for understanding emerging Long COVID research and offer principles that can also be applied when interpreting clinical trials across autoimmune diseases and other chronic conditions. **Category:** Covid-19 Clinical Trials, Long COVID --- ### [RECOVER-TLC July 2026 Update: Long COVID Clinical Trial Progress](https://www.autoimmuneinstitute.org/covid_timeline/recover-tlc-july-2026-update-long-covid-clinical-trial-progress/) **Published:** July 16, 2026 **Author:** Carolyn Serraino **Excerpt:** The NIH hosted a community webinar on July 16, 2026, to provide updates on the RECOVER-Treating Long COVID (RECOVER-TLC) initiative. NIH leaders emphasized that Long COVID research and treatment development remain priorities across NIAID and NIH before researchers reviewed four clinical trials underway or in development, discussed how biomarkers will be incorporated into the studies, explained the clinical trial development process, and answered questions from the Long COVID community. **Content:** July 16, 2026 The National Institutes of Health (NIH) hosted a community webinar on July 16, 2026, to provide updates on the RECOVER-Treating Long COVID ([RECOVER-TLC](https://recover-tlc.org/)) initiative. NIH leaders emphasized that Long COVID research and treatment development remain priorities across NIAID and NIH before researchers reviewed four clinical trials underway or in development, discussed how biomarkers will be incorporated into the studies, explained the clinical trial development process, and answered questions from the Long COVID community. ### **RECOVER-TLC Moves From Planning to Clinical Trials** The webinar opened by acknowledging the frustration many people living with Long COVID have expressed over the pace of therapeutic research. Investigators emphasized that although no treatment has yet been proven effective, the RECOVER-TLC program has now reached an important transition point. Originally envisioned in late 2024, RECOVER-TLC was created to rapidly evaluate both pharmacologic and non-pharmacologic therapies for Long COVID while remaining guided by emerging science and ongoing community input. Researchers said the program continues to build on findings from the larger RECOVER observational studies, evolving pathobiology research, and recommendations from scientific experts, industry partners, and people with lived experience. ### **Four Long COVID Treatment Trials Continue to Advance** Researchers then provided updates on the four therapeutic interventions currently included in the RECOVER-TLC portfolio. The **Reverse LC** trial evaluating **baricitinib** is actively enrolling participants. As of early July 2026, the study had enrolled **279 participants** toward its goal of **550**, with enrollment expected to accelerate as additional study sites become active. The **Brave LC** trial evaluating **low-dose naltrexone (LDN)** has completed protocol development and is currently undergoing regulatory review. Investigators expect the study to begin enrolling participants in **late September or early October 2026**, assuming manufacturing proceeds as planned. The **Tame LC** trial evaluating **semaglutide**, a [GLP-1 receptor agonist](https://www.autoimmuneinstitute.org/articles/glp-1-receptor-agonists-and-autoimmune-diseases "GLP-1 Receptor Agonists and Autoimmune Diseases"), is also progressing. The protocol has been updated following public comment and collaboration with Novo Nordisk, and researchers anticipate enrollment will begin in **late fall 2026** while study site selection continues across the United States. The fourth study, **Block LC**, will evaluate **stellate ganglion nerve block** and is advancing through protocol development and site selection. Investigators said its enrollment timeline is expected to be similar to the semaglutide trial, with recruitment potentially beginning in the **fall or late fall of 2026**, although the schedule may change as regulatory and site preparation work continues. ### **Long COVID Biomarkers Could Help Explain Why Treatments Work** Investigators also discussed how biomarkers will be incorporated into each trial. Although researchers have identified several promising biological signals associated with Long COVID, they noted that **there is still no consensus on a reliable biomarker for the condition**. To develop the core biomarker panel, the team reviewed the scientific literature and prioritized biomarkers that had shown differences between people with Long COVID and comparison groups in at least two published studies. These core biomarkers will be collected across all RECOVER-TLC trials, while additional trial-specific panels will explore how individual treatments affect different biological pathways. The biomarkers are exploratory and are not being used as established diagnostic tests. Researchers hope these measurements will help show whether biological changes correspond with improvements in symptoms, patient-reported outcomes, and objective measures such as grip strength and active stand testing. ### **Why Do Long COVID Clinical Trials Take So Long?** One of the webinar’s most detailed discussions focused on why launching national clinical trials requires substantial time before participants can be enrolled. Researchers explained that developing a clinical trial involves far more than selecting a promising treatment. Each study requires extensive protocol development, statistical planning, participant safety monitoring, FDA review, Institutional Review Board approval, site selection, staff training, standardized data collection systems, and manufacturing of study medications when needed. The team highlighted low-dose naltrexone as an example. Because LDN is commonly prepared by compounding pharmacies rather than manufactured as a standardized commercial product, researchers have needed to develop a uniform formulation that is stable, consistent, and free of impurities before it can be used in a national clinical trial. They noted that this manufacturing process has taken longer than anticipated but is essential to ensuring participant safety and producing reliable scientific results. Investigators also emphasized that community participation has shaped every stage of protocol development. People living with Long COVID have contributed through protocol review groups, therapeutic evaluation panels, and a newly established community advisory board, helping ensure the studies address meaningful patient priorities while remaining scientifically rigorous. ### **Community Questions** During the question-and-answer session, researchers addressed questions about eligibility, enrollment timelines, biomarkers, and future therapeutic development. **Investigators said people who developed Long COVID after infections during the first wave of the pandemic in 2020 may still be eligible**. The length of time a person has been ill does not automatically exclude them, but participants must meet the program’s definition of Long COVID, including at least three months of symptoms, as well as the specific eligibility requirements for the individual trial. Investigators also reiterated that the **RECOVER-TLC therapeutic submission portal remains open**. 625 treatment proposals have already been submitted by nearly 400 individuals, and new interventions will continue to be reviewed as additional scientific evidence emerges. ### ****What Comes Next for RECOVER-TLC**** While investigators acknowledged that many people are eager for effective Long COVID treatments, they emphasized that carefully designed clinical trials remain the fastest path toward identifying therapies that are both safe and effective. With enrollment already underway for one study and several additional trials expected to begin recruiting this fall, RECOVER-TLC is entering a new phase focused on evaluating potential treatments including baricitinib, low-dose naltrexone, semaglutide, and stellate ganglion nerve block. Results from these studies may help guide future Long COVID treatment strategies while advancing understanding of the condition’s underlying biology. Additional RECOVER-TLC updates are expected through an August newsletter, another community webinar planned for September, and the initiative’s third annual workshop on November 4 and 5, 2026. ##### Citation National Institute of Allergy and Infectious Diseases (NIAID) and Foundation for the National Institutes of Health (FNIH). *RECOVER-TLC: Long COVID Clinical Trials Update.* Community webinar. July 16, 2026. Available at: <https://youtu.be/zNFFfDbMfpc?si=SHpXJry86k1e3fNw> **Category:** Covid-19 Clinical Trials, Covid-19 Research Studies, Long COVID --- ### [COVID-19 and Autoimmune Disease: Current Evidence](https://www.autoimmuneinstitute.org/covid_timeline/covid-19-and-autoimmune-disease-current-evidence/) **Published:** July 13, 2026 **Author:** Carolyn Serraino **Excerpt:** A new review published in the Korean Journal of Internal Medicine synthesizes evidence from epidemiologic studies, immunology research, clinical registries, vaccine studies, and Long COVID investigations to examine how COVID-19 influences autoimmune disease and how autoimmune diseases, in turn, affect COVID-19 outcomes. **Content:** ***July 2026*** > More than six years after the COVID-19 pandemic began, researchers continue to uncover how SARS-CoV-2 interacts with the immune system. A new review published in the *Korean Journal of Internal Medicine* synthesizes evidence from epidemiologic studies, immunology research, clinical registries, vaccine studies, and Long COVID investigations to examine how COVID-19 influences autoimmune disease and how autoimmune diseases, in turn, affect COVID-19 outcomes. The review also outlines practical considerations for clinical care and identifies priorities for future research. #### COVID-19 and Autoimmune Disease Are Closely Connected The authors describe the relationship between COVID-19 and autoimmune disease as bidirectional. On one hand, people living with autoimmune diseases often have a higher risk of severe COVID-19 because of underlying immune dysregulation and, in some cases, the immunosuppressive medications used to control autoimmune activity. On the other hand, SARS-CoV-2 infection itself may contribute to the development or worsening of autoimmune diseases in susceptible individuals. Researchers note that COVID-19 and autoimmune diseases share several immunological features, including abnormal cytokine production, lymphocyte dysfunction, impaired regulatory immune control, and persistent immune activation. Studies of Long COVID have also identified lasting changes in both the innate and adaptive immune system months after infection, providing additional evidence that immune dysregulation may persist well beyond the acute illness. Several mechanisms have been proposed to explain how SARS-CoV-2 could contribute to autoimmunity. These include molecular mimicry, in which viral proteins resemble human proteins and may trigger mistaken immune attacks; bystander activation, in which widespread inflammation activates self-reactive immune cells; epitope spreading, in which the immune response expands to target additional self-antigens; and prolonged cytokine activation, which disrupts immune tolerance. Researchers have also identified dozens of human proteins that share similarities with SARS-CoV-2 peptides, offering potential targets for autoimmune responses following infection. The review also notes that severe COVID-19 can produce immune changes that resemble those seen in autoimmune diseases, including prolonged lymphopenia, expansion of activated T cells and plasmablasts, elevated inflammatory cytokines, and the development of autoantibodies such as antinuclear antibodies, antiphospholipid antibodies, and antibodies targeting type I interferons. Together, these findings suggest that SARS-CoV-2 infection can disrupt immune regulation in ways that may contribute to the development or worsening of autoimmune disease in susceptible individuals. #### How COVID-19 Affects Autoimmune Diseases The review summarizes evidence for five well-studied autoimmune diseases: [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus (SLE)") (SLE), [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid arthritis") (RA), [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/ "Multiple sclerosis") (MS), inflammatory bowel disease ([Crohn’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crohns-disease/ "Crohn’s disease") and [ulcerative colitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ulcerative-colitis/ "Ulcerative colitis")), and [Guillain-Barré syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/guillain-barre-syndrome/ "Guillain-Barré syndrome (GBS)") (GBS). For **systemic lupus erythematosus**, studies suggest that SARS-CoV-2 infection is associated with both an increased risk of developing lupus and a higher likelihood of disease flares in people already diagnosed. Those with lupus also experience higher rates of hospitalization and mortality following COVID-19 compared with the general population. For **rheumatoid arthritis**, multiple studies have reported an increased incidence following SARS-CoV-2 infection, while people already living with RA remain at greater risk of hospitalization and severe COVID-19, particularly those receiving rituximab, Janus kinase (JAK) inhibitors, or higher-dose corticosteroids. Evidence for **multiple sclerosis** has been more mixed. While some studies have found little effect of COVID-19 on relapse rates or disability progression, others have reported worsening MRI findings or increased disability after infection. Anti-CD20 therapies consistently appear to increase the risk of severe COVID-19 and reduce vaccine responses, whereas interferon therapy has been associated with more favorable outcomes in some studies. For **inflammatory bowel disease**, current evidence suggests that people with Crohn’s disease or ulcerative colitis are not substantially more likely to become infected with SARS-CoV-2 than the general population. However, more severe disease activity and treatment with systemic corticosteroids have been associated with poorer COVID-19 outcomes. The review also discusses **Guillain-Barré syndrome**, an autoimmune disorder affecting the peripheral nervous system that is often triggered by infections. Multiple studies have reported an increased risk of GBS following SARS-CoV-2 infection. The authors also note that while adenoviral vector COVID-19 vaccines have been associated with a small increase in the risk of GBS in some studies, no similar association has been observed for mRNA vaccines at the population level. Although each autoimmune disease has unique characteristics, the review identifies several recurring themes. Patients with systemic lupus erythematosus and rheumatoid arthritis consistently experience higher risks of severe COVID-19, while evidence for multiple sclerosis remains more variable depending on disease subtype and treatment. In inflammatory bowel disease, disease activity and corticosteroid use appear to be stronger predictors of poor COVID-19 outcomes than the diagnosis itself. Guillain-Barré syndrome differs from the others because it is often triggered by infections, making it an important model for studying virus-associated autoimmunity. #### Long COVID and Autoimmune Disease The review also highlights growing evidence that autoimmune disease may represent one component of the long-term consequences of SARS-CoV-2 infection. The authors summarize multiple large cohort studies from the United States, South Korea, Japan, Germany, Hong Kong, and the United Kingdom that have reported increased risks of developing a wide range of autoimmune diseases after COVID-19, including [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid arthritis"), [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus (SLE)"), [Sjögren syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sjogren-syndrome/ "Sjögren disease (SjD)"), inflammatory bowel disease ([Crohn’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crohns-disease/ "Crohn’s disease") and [ulcerative colitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ulcerative-colitis/ "Ulcerative colitis")), [psoriasis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/psoriasis/ "Psoriasis"), [celiac disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/celiac-disease/), [type 1 diabetes](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/type-1-diabetes-insulin-dependent-diabetes/ "Type 1 diabetes (T1D)"), [vasculitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-vasculitis/ "Autoimmune vasculitis"), [alopecia areata](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/alopecia-areata/ "Alopecia areata"), [vitiligo](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/vitiligo/ "Vitiligo"), [Behçet disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/behcets/ "Behçet’s disease"), [bullous pemphigoid](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/bullous-pemphigoid/ "Bullous pemphigoid"), and several other immune-mediated conditions. While the magnitude of risk varies across diseases and studies, the overall pattern suggests that SARS-CoV-2 infection can increase the likelihood of autoimmune disease in susceptible individuals. The review also notes encouraging evidence that COVID-19 vaccination may reduce this risk. In one large binational cohort study, vaccination was associated with significantly lower rates of autoimmune inflammatory rheumatic diseases following SARS-CoV-2 infection, supporting the idea that preventing severe infection may also reduce downstream immune complications. #### COVID-19 Vaccination and Autoimmune Disease Although concerns have been raised about vaccine responses in people receiving immunosuppressive therapies, the review concludes that COVID-19 vaccination remains generally safe for patients with autoimmune diseases. Certain medications, including rituximab, methotrexate, mycophenolate mofetil, tacrolimus, belimumab, anti-CD20 therapies, sphingosine-1-phosphate receptor modulators, and some JAK inhibitors, may reduce antibody or cellular immune responses after vaccination. Because of this, researchers recommend individualized approaches that may include timing vaccination around immunosuppressive treatment, temporarily holding certain medications when appropriate, and administering booster doses to improve protection. #### Future Research on COVID-19 and Autoimmune Disease Despite these findings, the authors caution that important limitations remain. Most studies followed participants for less than one year; many were conducted within a single country, and differences in diagnostic criteria and circulating SARS-CoV-2 variants make direct comparisons challenging. All of these factors make it difficult to determine the full long-term impact of SARS-CoV-2 on autoimmune disease. Researchers hope to better understand why only certain individuals develop autoimmune complications, how different viral variants affect risk, and whether immune profiling or genetic markers can identify those most susceptible. Beyond summarizing current evidence, the review proposes a roadmap for future care. The authors call for: - Personalized risk assessments - Closer monitoring of vaccine responses and Long COVID - Stronger collaboration among rheumatologists, neurologists, gastroenterologists, infectious disease specialists, and primary care physicians - Improved electronic health record systems that integrate vaccination history, immunosuppressive treatments, and prior SARS-CoV-2 infection The authors also emphasize the need for long-term international studies, immune profiling, and genetic research to better understand why some individuals develop autoimmune disease after COVID-19 while others do not. ##### Citation Kong, J., Hong, S., Oh, J., Lee, S., Smith, L., Branda, F., Cho, H., Hwang, J., & Yon, D. K. (2026). **Autoimmune diseases in the era of COVID-19: emerging mechanisms, clinical implications, vaccine considerations, and future directions**. *The Korean journal of internal medicine*, *41*(4), 597–619. <https://doi.org/10.3904/kjim.2025.301> **Category:** Autoimmune Diseases & Covid-19, Celiac disease & Covid-19, Covid-19 Infections, Covid-19 Research Studies, Covid-19 Vaccines, GBS & Covid-19, IBD & Covid-19, Long COVID, Lupus & Covid-19, MS & Covid-19, RA & Covid-19, Sjögren disease & Covid-19, T1D & Covid-19 --- ### [The Future of Wastewater Surveillance and Immune Research](https://www.autoimmuneinstitute.org/covid_timeline/the-future-of-wastewater-surveillance-and-immune-research/) **Published:** July 1, 2026 **Author:** Carolyn Serraino **Excerpt:** During the COVID-19 pandemic, wastewater surveillance transformed how scientists tracked the spread of disease, providing an early warning system that did not depend on individual testing. Now, just as researchers are finding new ways to use the technology, the future of the CDC’s national wastewater surveillance program is uncertain. **Content:** *July 1, 2026* During the COVID-19 pandemic, wastewater surveillance transformed how scientists tracked the spread of disease, providing an early warning system that did not depend on individual testing. Now, just as researchers are finding new ways to use the technology, the future of the CDC’s national wastewater surveillance program is uncertain. **The CDC’s National Wastewater Surveillance System ([NWSS](https://www.cdc.gov/wastewater/ "NWSS")), established in 2021, supports approximately 1,300 testing sites serving an estimated 144 million Americans**. #### Today, the network tracks COVID-19, influenza, RSV, measles, mpox, avian influenza, and emerging viral variants, helping public health officials identify outbreaks and monitor disease trends across the country. **However, the federal funding that launched the program is expected to expire this fall**. Although many state health departments have planned ahead and expect to continue testing into 2027 using remaining grant funds, public health organizations say temporary funding is not enough to sustain a nationwide surveillance system. To address the funding gap, the American Society for Microbiology and nearly 20 partner organizations are urging Congress to provide dedicated funding for NWSS in the CDC’s fiscal year 2027 budget. The group has requested at least $120 million to support continued wastewater surveillance, arguing that it has become an essential part of the nation’s public health infrastructure. Congress is considering two bipartisan bills, the [**PREDICT Act**](https://www.congress.gov/bill/119th-congress/senate-bill/4048/text) in the Senate and the [**SEWER Act**](https://www.congress.gov/bill/119th-congress/house-bill/766) in the House, which would strengthen and expand federal support for wastewater surveillance programs. #### For many people living with autoimmune disease, Long COVID, and other conditions that increase the risk of severe infections, wastewater data has become a valuable tool for monitoring virus activity in their communities. Because the data reflects overall community transmission rather than individual testing, it can help people make informed decisions about masking, travel, medical appointments, and other activities, and researchers believe the technology is only beginning to show its potential. #### New advances are allowing scientists to detect not only viruses but also antibodies, inflammatory proteins, and other immune-related markers in wastewater. Some of these proteins, including **S100A8 (calprotectin)**, are already familiar to autoimmune disease researchers because they are elevated in conditions such as inflammatory bowel disease ([Crohn’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crohns-disease/ "Crohn’s disease") and [ulcerative colitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ulcerative-colitis/ "Ulcerative colitis")) and [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid arthritis"). Although this work is still in its early stages, researchers believe wastewater surveillance could eventually help track patterns of immune activity across entire communities while preserving individual privacy. #### Whether Congress approves new funding will shape more than the future of COVID-19 wastewater maps. Researchers say continued investment could preserve an important early warning system while helping expand wastewater surveillance into new areas of public health, including the study of immune responses, chronic inflammation, and emerging infectious diseases for years to come. ##### Citations Devianto, L. A., Amarasiri, M., Wang, L., Iizuka, T., & Sano, D. (2024). Identification of protein biomarkers in wastewater linked to the incidence of COVID-19. *The Science of the total environment*, *951*, 175649. https://doi.org/10.1016/j.scitotenv.2024.175649 Maggi, J., Abian, J., Ginebreda, A., Barceló, D., & Carrascal, M. (2025). Immunoproteomics for wastewater-based health surveillance: A review. *Environmental science and ecotechnology*, *28*, 100626. <https://doi.org/10.1016/j.ese.2025.100626> Claudia G Tugui, Filine Cordesius, Willem van Holthe, Mark C M van Loosdrecht, Martin Pabst, Wastewater metaproteomics: tracking microbial and human protein biomarkers, *ISME Communications*, Volume 6, Issue 1, January 2026, ycaf243, <https://doi.org/10.1093/ismeco/ycaf243> **Category:** Autoimmune Diseases & Covid-19, Covid-19 Antibodies, Covid-19 Infections, Covid-19 Policy, Covid-19 Research Studies, Long COVID --- ### [New NIH-Funded Trial Tests Different Approaches to Long COVID Fatigue](https://www.autoimmuneinstitute.org/covid_timeline/new-nih-funded-trial-tests-different-approaches-to-long-covid-fatigue/) **Published:** June 8, 2026 **Author:** Carolyn Serraino **Excerpt:** A new NIH-funded clinical trial will test whether rehabilitation and pacing strategies should be tailored based on post-exertional malaise in people with Long COVID. **Content:** In our recent article, ***[Exercise and Autoimmune Disease: Evidence-Based, Low-Impact Approaches](https://www.autoimmuneinstitute.org/articles/exercise-and-autoimmune-disease-evidence-based-low-impact-approaches-3/)***, experts emphasized that physical activity is not one-size-fits-all, particularly for people living with chronic illness. While movement can provide important benefits, some individuals experience symptom worsening after exertion and may require a more individualized approach. A new NIH-funded clinical trial is now exploring that question in Long COVID. While [Long COVID is not classified as an autoimmune disease](https://www.autoimmuneinstitute.org/articles/is-long-covid-a-new-autoimmune-disease "Is Long Covid a New Autoimmune Disease?"), symptoms such as fatigue, exercise intolerance, and post-exertional symptom worsening are familiar challenges for many people living with autoimmune and other chronic illnesses. The [**RECOVER-ENERGIZE**](https://trials.recovercovid.org/ENERGIZE) platform trial will enroll approximately 660 participants with Long COVID-related exercise intolerance. #### Researchers designed the study around an important distinction: some people experience post-exertional malaise (PEM), a worsening of symptoms after physical or mental activity, while others do not.  To account for these differences, RECOVER-ENERGIZE consists of two parallel clinical trials. About 360 participants will be enrolled in a personalized cardiopulmonary rehabilitation study for people without significant PEM, while about 300 participants will participate in a structured pacing study designed for those who experience PEM. Participants without significant PEM will be assigned to a 12-week personalized cardiopulmonary rehabilitation program designed to improve endurance and physical function. Researchers emphasize that this is not traditional graded exercise therapy but an individualized program that adjusts activity levels based on symptoms and tolerance. Participants with PEM will instead take part in a structured pacing program that focuses on identifying symptom triggers, balancing activity and rest, and reducing symptom flare-ups. #### According to the study authors, the pacing intervention has not previously been tested in a large randomized Long COVID trial. To minimize the risk of symptom worsening, participants with PEM will not be assigned to exercise-based study activities. A notable feature of the study is the use of the modified DePaul Symptom Questionnaire to identify and monitor PEM throughout the trial. Participants who develop significant PEM during rehabilitation may be transitioned to the pacing pathway, helping researchers tailor interventions based on symptom profiles. #### The study was developed with input from Long COVID patients, caregivers, and community representatives, whose feedback helped shape eligibility criteria, outcome measures, and safety measures. Patient advocates were particularly involved in ensuring that people with significant PEM were evaluated separately from those participating in rehabilitation-based interventions. While RECOVER-ENERGIZE is still underway, the trial may help researchers determine whether different rehabilitation strategies are needed for people with Long COVID depending on the presence of PEM and other symptoms, ultimately helping clinicians better match treatment approaches to individual patient needs. **Note:** This study is a preprint and has not yet been peer reviewed by a scientific journal. The paper describes the design of an upcoming clinical trial rather than study results. Findings should be considered preliminary until they have undergone independent scientific review. ##### Citation Friedly, J., Bateman, L., Berdan, L. G., Casaburi, R., Erdmann, N., Felker, G. M., Itchon-Ramos, N., Keteyian, S. J., MacIntyre, N., O’Brien, L., Reist, C., Rossiter, H. B., Silverstein, A., Taylor, E., Pike Welch, H., Yanez, N. D., Zimmerman, K. O., & Make, B. (2026). **Rationale and Design of RECOVER-ENERGIZE: A Platform Clinical Trial of Interventions for Exercise Intolerance With and Without Post-exertional Malaise in Long COVID**. *medRxiv : the preprint server for health sciences*, 2026.06.02.26354455. <https://doi.org/10.64898/2026.06.02.26354455> **Category:** Covid-19 Research Studies, Long COVID, ME/CFS & Covid-19 --- ### [Long Covid Symptoms Vary Between Hospital and Home Patients](https://www.autoimmuneinstitute.org/covid_timeline/long-covid-symptoms-vary-between-hospital-and-home-patients/) **Published:** June 1, 2026 **Author:** Carolyn Serraino **Content:** A new study from Italy found that long COVID remains a significant health concern years after SARS-CoV-2 infection, with the risk varying substantially depending on whether patients required hospitalization during their initial illness. Researchers followed 1,162 adults who contracted COVID-19 between 2020 and 2022, including 616 patients managed in the community and 546 hospitalized patients. **Within the first year after infection, approximately 40% of previously hospitalized patients developed post-COVID condition (long COVID), compared with about 9% of community-managed patients**. One year after infection, persistent symptoms remained in 30.2% of hospitalized patients but only 1.9% of those who had not required hospitalization. The researchers found that [neurological symptoms](https://www.autoimmuneinstitute.org/covid_timeline/autoantibodies-linked-to-long-covid-neurological-symptoms/ "Autoantibodies Linked to Long COVID Neurological Symptoms"), headaches, and musculoskeletal complaints such as muscle and joint pain were among the strongest predictors of long COVID in community-managed patients. Among hospitalized patients, musculoskeletal and cardiovascular symptoms were most strongly associated with the condition. The study also evaluated the [NIH RECOVER](https://www.autoimmuneinstitute.org/covid_timeline/nih-recover-2026-publications-long-covid-research-updates/ "NIH RECOVER 2026 Publications: Long Covid Research Updates") symptom score, a research tool that uses a combination of symptoms commonly reported in long COVID to estimate the likelihood that a person is experiencing post-COVID condition. Researchers found that each increase in RECOVER score was associated with higher odds of developing long COVID during the first year after infection. The authors suggest that such tools could help identify patients who may otherwise go unrecognized and could benefit from additional evaluation and follow-up care. ##### Citation Antolini L, Valsecchi MG, Bussi A*, et al*. Unveiling the burden of long covid in hospital and community settings: findings from the Post-Acute Sequelae of SARS-CoV-2 Network (PASCNET) cohort study in Italy’s pandemic epicentre. *BMJ Open* 2026;**16:**e114399. doi: 10.1136/bmjopen-2025-114399 **Category:** Covid-19 Infections, Covid-19 Research Studies, Long COVID --- ### [Could Herpes Zoster Signal Post-COVID Immune Dysfunction?](https://www.autoimmuneinstitute.org/covid_timeline/could-herpes-zoster-signal-post-covid-immune-dysfunction/) **Published:** May 13, 2026 **Author:** Carolyn Serraino **Content:** Researchers analyzing health records from more than 110,000 COVID-19 survivors found that people who later experienced herpes zoster reactivation were more likely to develop certain neurological conditions, including Bell’s palsy, [Guillain-Barré syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/guillain-barre-syndrome/ "Guillain-Barré syndrome (GBS)") (GBS), and [myasthenia gravis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/myasthenia-gravis/ "Myasthenia gravis") (MG), during the following three years. The timing of these conditions differed. Bell’s palsy tended to appear relatively soon after herpes zoster reactivation, while Guillain-Barré syndrome and myasthenia gravis were more likely to emerge later, often more than a year afterward. The researchers suggest that herpes zoster reactivation may reflect lingering immune dysregulation following COVID-19 infection. They propose that some neurological complications may result from direct effects on nerve tissue, while others could involve longer-term immune-mediated processes. Because the study was observational, it cannot determine whether herpes zoster reactivation directly causes these conditions. However, the findings add to growing evidence that COVID-19 may have lasting effects on immune and neurological health in some individuals. ##### Citation Cheng YC, Lu CL, Wang J, Hou YC, Lu KC. **Association Between Post-COVID-19 Herpes Zoster Reactivation and Peripheral Nervous System Disorders: Multinational Real-World Evidence from TriNetX**. *Int J Med Sci* 2026; 23(6):2006-2015. doi:10.7150/ijms.127617. <https://www.medsci.org/v23p2006.htm> **Category:** Covid-19 Infections, Covid-19 Research Studies, GBS & Covid-19, Myasthenia gravis & Covid-19 --- ### [Long COVID Study Links Fatigue to Mitochondrial Dysfunction](https://www.autoimmuneinstitute.org/covid_timeline/long-covid-study-links-fatigue-to-mitochondrial-dysfunction/) **Published:** May 20, 2026 **Author:** Carolyn Serraino **Content:** Researchers have identified persistent mitochondrial dysfunction and immune dysregulation as recurring biological features of long COVID, offering new clues about why symptoms such as **[fatigue](https://www.autoimmuneinstitute.org/covid_timeline/fatigue-and-cognitive-impairment-in-long-covid-patients/ "Fatigue and Cognitive Impairment in Long Covid Patients"), [exercise intolerance](https://www.autoimmuneinstitute.org/articles/exercise-and-autoimmune-disease-evidence-based-low-impact-approaches-3 "Exercise and Autoimmune Disease: Evidence-Based, Low-Impact Approaches"), [brain fog](https://www.autoimmuneinstitute.org/articles/understanding-brain-fog-in-autoimmune-disease "Understanding Brain Fog in Autoimmune Disease"), and muscle weakness** can linger long after the initial infection has resolved. In a new multi-omics study published in *Frontiers in Immunology*, scientists analyzed transcriptomic, proteomic, and metabolomic data from both human cohorts and animal models. #### Across multiple tissues, they found evidence of ongoing suppression of oxidative phosphorylation (OXPHOS), the process by which mitochondria generate most of the body’s cellular energy. The most persistent abnormalities were seen in **skeletal muscle**, where mitochondrial dysfunction remained **detectable months after infection** and was associated with fatigue-related changes. The researchers also observed signs of continued immune activation, oxidative stress, and metabolic abnormalities in blood and serum samples collected up to **two years after infection**. Patients with long COVID showed evidence of persistent inflammatory signaling and incomplete recovery of normal energy metabolism compared with individuals who had fully recovered. The findings are particularly notable because long COVID shares many symptoms with conditions such as [**myalgic encephalomyelitis/chronic fatigue syndrome**](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/me-cfs/ "Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)") (ME/CFS), [**fibromyalgia**](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/fibromyalgia/ "Fibromyalgia"), and [**postural orthostatic tachycardia syndrome**](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/postural-orthostatic-tachycardia-syndrome/ "Postural orthostatic tachycardia syndrome (POTS)") (POTS). #### The authors propose that ongoing mitochondrial dysfunction may contribute to a cycle of chronic immune activation and impaired recovery in some individuals.  While the study does not prove that mitochondrial dysfunction causes long COVID, it adds to growing evidence that persistent biological changes may underlie many long-term symptoms and could eventually help guide future treatments. #### Citation Tasoula A, Arif S, Waisberg E, Bauer L, Aslinger E and Guarnieri JW (2026) **[Multi-omics analysis of long COVID (post-COVID-19 condition) reveals persistent mitochondrial dysfunction, suppressed oxidative phosphorylation, and immune dysregulation](https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2026.1776555/full)**. Front. Immunol. 17:1776555. doi: 10.3389/fimmu.2026.1776555 **Category:** Covid-19 Infections, Covid-19 Research Studies, Long COVID, ME/CFS & Covid-19 --- ### [Autoimmune-Associated PTPN22 Variant May Improve Immune Defense Against Covid](https://www.autoimmuneinstitute.org/covid_timeline/autoimmune-associated-ptpn22-variant-may-improve-immune-defense-against-covid/) **Published:** May 5, 2026 **Author:** Carolyn Serraino **Content:** A [recent study](https://www.pnas.org/doi/10.1073/pnas.2519903123) found that a common mutation that’s associated with a higher risk of developing autoimmune diseases is also linked to protection from viral infections. This mutation in the *PTPN22* gene is called the *PTPN22* 1858C>T allele and is found in 5-15% of people in North America. It is considered the highest non-HLA risk allele for autoimmunity. *PTPN22* is associated with regulating T cell receptor signaling and regulatory T cells. To study the role of this mutation in acute infections, the researchers turned to a mouse model where coronavirus infections lead to liver infection and death in half the mice. In mice with the *PTPN22* 1858C>T allele, they saw that the infected mice had reduced viral titers, lost less weight, and had increased survival compared to mice without the mutant allele. Digging into the mechanism behind this, the team looked at how the mutation affected a type of immune cell called [natural killer cells](https://blog.dana-farber.org/insight/2022/09/what-are-natural-killer-cells-and-how-do-they-fight-cancer/) that normally destroy infected cells. The mice with the *PTPN22* 1858C>T allele had more mature natural killer cells in the liver and spleen, which could help the mice better fight coronavirus infection. The current work used a common mouse strain of coronavirus called mouse hepatitis virus (MHV) strain A59, so the researchers plan to test whether the *PTPN22* 1858C>T allele protects against respiratory viruses like SARS-CoV-2. [Previous work](https://academic.oup.com/immunohorizons/article/9/11/vlaf063/8317563?login=false#539501933) from this group found that mice with this mutation are also protected from chronic viral infections and [tumors](https://www.autoimmuneinstitute.org/articles/the-immune-balancing-act-cancer-and-autoimmunity "The Immune Balancing Act: Cancer and Autoimmunity"). ##### Citations Barnes, J. R., Shaikh, A. F., Bevis, A. M., Cockerham, T. R., & Orozco, R. C. (2025). Type I interferon production in myeloid cells is regulated by factors independent of Ptpn22. ImmunoHorizons, 9(11), vlaf063. <https://doi.org/10.1093/immhor/vlaf063> Bevis, A. M., Rosa, K. J. L. H., Schwarting, N., Cockerham, T. R., Kerr, C. M., More, S., Fehr, A. R., & Orozco, R. C. (2026). An autoimmunity-associated allele of PTPN22 enhances innate antiviral immunity to protect against acute coronavirus infection, Proc. Natl. Acad. Sci., 123(12), e2519903123. <https://doi.org/10.1073/pnas.2519903123> **Category:** Autoimmune Diseases & Covid-19, Covid-19 Infections, Covid-19 Research Studies --- ### [Autoimmune Drugs May Prolong COVID Viral Signals](https://www.autoimmuneinstitute.org/covid_timeline/autoimmune-drugs-may-prolong-covid-viral-signals/) **Published:** April 30, 2026 **Author:** Carolyn Serraino **Content:** A new study suggests that people with systemic autoimmune rheumatic diseases (SARDs) may retain pieces of the COVID-19 virus in their bodies for longer periods after infection, particularly if they are taking immunosuppressive [medications](https://www.autoimmuneinstitute.org/articles/biologics-for-autoimmune-disease-what-you-should-know "Biologics for Autoimmune Disease: What You Should Know"). Researchers found that 40% of patients with autoimmune rheumatic diseases still had detectable SARS-CoV-2 antigens in their blood three months after infection, compared to 17.5% of those without these conditions. At 6 months, persistence remained higher in the autoimmune group. Notably, a viral protein called nucleocapsid, which is not produced by vaccines and indicates prior infection, was still detectable in nearly 20% of autoimmune patients after 6 months, compared with just 2.5% in others. The researchers suggest that immunosuppressive therapies may contribute to the prolonged presence of viral antigens by altering the immune system’s clearance of viral material. However, it remains unclear whether the difference is driven by these medications, the underlying autoimmune condition, or other factors. The study also did not find a clear link between antigen persistence and long COVID symptoms. Overall, the clinical significance of persistent viral proteins remains uncertain, and further research is needed to determine what these findings mean for patients. #### Citation Patel, N. J., Swank, Z., Wang, J., Wang, X., O’Keeffe, L. A., Negron, M., Getachew, L. S., Hansen, L. L., Qian, G., Saavedra, A. A., Mueller, K. T., Davis, N. A., Vanni, K. M. M., Savage, S., Lam, J. S., Wallace, Z. S., Walt, D. R., Sparks, J. A., & RECOVER‐Adult (2026). Differences in SARS-CoV-2 antigen persistence in individuals with systemic autoimmune rheumatic diseases compared to the general population: A RECOVER-Adult Cohort Study. *Arthritis & rheumatology (Hoboken, N.J.)*, 10.1002/art.70205. Advance online publication. <https://doi.org/10.1002/art.70205> **Category:** Autoimmune Diseases & Covid-19, Covid-19 Antibodies, Covid-19 Infections, Covid-19 Research Studies, Long COVID --- ### [What New Research Reveals About Long COVID](https://www.autoimmuneinstitute.org/covid_timeline/what-new-research-reveals-about-long-covid/) **Published:** April 16, 2026 **Author:** Carolyn Serraino **Excerpt:** New studies suggest Long COVID may be driven by persistent inflammation and immune disruption, helping explain why symptoms can last months or even years after infection. **Content:** New research is offering a clearer picture of why Long COVID can persist months or even years after infection, pointing to overlapping roles of inflammation, immune dysfunction, and early infection severity. One study of 300 adults who had mild COVID-19 found that **59% continued to experience symptoms nearly 10 months later**, most commonly affecting the brain and nervous system, followed by musculoskeletal symptoms (1). These individuals showed **higher levels of inflammatory markers such as interleukin-6 (IL-6) and ferritin**, along with **lower levels of vitamin D and vitamin B12**, suggesting ongoing biological changes well after the initial infection. The same study also found that **higher viral load during the initial infection** was associated with later development of neurological and musculoskeletal symptoms, indicating that early immune responses may influence long-term outcomes. In a separate study using single-cell immune profiling, researchers identified **persistent immune dysregulation up to 1.5 to 2 years after infection**, including signs of immune cell exhaustion and continued activation (2). Changes in T cells and natural killer cells suggest that the immune system may not fully return to baseline, even long after recovery from the acute illness. A broader narrative review synthesizing data from over 120 studies with diverse patient cohorts supports these findings, highlighting **chronic inflammation, immune imbalance, and organ-specific immune responses** as key features of Long COVID (3). The review emphasizes that Long COVID is not a single condition, but rather a collection of overlapping biological processes that can affect multiple systems throughout the body. Importantly, the review also highlights that certain groups may be more vulnerable to prolonged illness, including individuals with underlying autoimmune and immune-related conditions. At the same time, some people may experience new or worsening health issues after infection, suggesting that Long COVID can both reveal and contribute to ongoing health challenges. Together, these studies reinforce a growing understanding that Long COVID may be driven by **persistent immune disruption**, with early infection dynamics, inflammatory responses, and individual biological factors all playing a role. This evolving picture may help guide future research toward more targeted and personalized approaches to treatment. ##### Citations 1. Abbas, U., Laghari, R. N., Ahmed, I., Musawwir, U. A., Riaz, H., Anwar, K., Hussain, N., Mubeen, M., Khan, M., Khalid, M. U., & Ashraf, S. (2026). **Acute SARS-CoV-2 viral load and systemic inflammation are associated with neuropsychiatric and musculoskeletal symptoms in long COVID**. *PloS one*, *21*(4), e0346978. [https://doi.org/10.1371/journal.pone.0346978](https://pmc.ncbi.nlm.nih.gov/articles/PMC13082598/) 2. Springe, M.L., Vaivode, K., Saksis, R. *et al.* **Immune dysregulation in prolonged Long-COVID: lymphocytes emerge as key mediators of persistent inflammation, exhaustion and cytotoxicity**. *J Transl Med* **24**, 527 (2026). <https://doi.org/10.1186/s12967-026-08081-6> 3. Mahajan, S., Mahajan, S., & Kaushik, N. (2026). **Integrative Insights into the Immunopathogenesis and Organ-Specific Immunological Mechanisms of Long COVID: A Narrative Review**. *Viruses*, 18(4), 458. <https://doi.org/10.3390/v18040458> **Category:** Covid-19 Infections, Covid-19 Research Studies, Long COVID --- ### [Long COVID Symptoms Linked to Autoantibodies](https://www.autoimmuneinstitute.org/covid_timeline/long-covid-symptoms-auto-antibodies/) **Published:** March 24, 2026 **Author:** Carolyn Serraino **Content:** A new study published in *Cell Reports Medicine* provides some of the strongest evidence to date that antibodies may play a direct role in Long COVID symptoms. Researchers found that immunoglobulin G (IgG) antibodies taken from Long COVID patients caused persistent pain-like sensitivity when transferred into mice, suggesting these antibodies may actively contribute to the condition rather than simply reflect immune dysfunction. Importantly, this effect was still observed when antibodies collected from the same patients two years later were tested, indicating that the underlying immune response may persist long after the initial infection. The study also identified distinct biological subgroups of patients, each with different immune markers and autoantibody patterns, supporting the idea that Long COVID is not a single condition but a collection of related syndromes with different underlying mechanisms. These autoantibodies were found to target a wide range of the body’s own proteins, including those involved in nerve signaling, immune regulation, and metabolism. This may help explain the wide range of symptoms seen in Long COVID, such as pain, fatigue, and cognitive difficulties. While further research is needed, the findings suggest that treatments aimed at removing or neutralizing harmful antibodies, such as plasmapheresis or targeted immunotherapy, could offer new options for some patients. ##### Citation Chen, H. J., Appelman, B., Willemen, H. L. D. M., Bos, A., Prado, J., Mak, W. A., Keijzer, N., Santos Ribeiro, P. S., Goncalves, S. V., Versteeg, S., Geyer, C. E., Larsen, M., Schüchner, E., Bomers, M. K., Lavell, A. H. A., Amsterdam UMC COVID-19 biobank, Charlton, B., Wüst, R., Wiersinga, W. J., van Vugt, M., … den Dunnen, J. (2026). Transfer of IgG from long COVID patients induces symptomology in mice. *Cell reports. Medicine*, 102693. Advance online publication. [https://doi.org/10.1016/j.xcrm.2026.102693](https://www.cell.com/cell-reports-medicine/pdfExtended/S2666-3791(26)00110-2) **Category:** Covid-19 Antibodies, Covid-19 Infections, Covid-19 Research Studies, Long COVID --- ### [Long COVID Immune Dysfunction Linked to NK Cells](https://www.autoimmuneinstitute.org/covid_timeline/long-covid-immune-dysfunction-linked-to-nk-cells/) **Published:** March 9, 2026 **Author:** Carolyn Serraino **Content:** A study published in *Frontiers in Immunology* found that long COVID is associated with significant dysfunction of Natural Killer (NK) cells, key components of the innate immune system that identify and eliminate infected or abnormal cells. Researchers observed that individuals with long COVID had both reduced NK cell numbers and signs of functional exhaustion, suggesting these cells may be less effective at carrying out their normal immune roles. Despite this, patients showed elevated antibody levels alongside reduced cytokine signaling, indicating a mismatch in immune activity rather than a fully resolved response. The study also identified gene expression changes linked to neurological symptoms, including pathways associated with smell, taste, and cognitive function. These findings suggest that immune dysfunction may contribute not only to systemic symptoms like fatigue but also to the neurological effects commonly reported in long COVID. Overall, the findings support a state of persistent immune dysregulation, in which the immune system remains altered long after the initial infection has resolved. ##### Citation Ray U, Schulze Selting A, Perera RP, Yang Z, Lysenkov V, Göpel S, Bitzer M, Salker MS, Ossowski S, Riess O, Casadei N and Singh Y (2026) **[Dysregulated NK-cell gene expression defines the enduring symptoms of long COVID-19](https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2026.1720551/full)**. *Front. Immunol*. 17:1720551. doi: 10.3389/fimmu.2026.1720551 **Category:** Covid-19 Infections, Covid-19 Research Studies, Long COVID --- ### [NIH RECOVER 2026 Publications: Long Covid Research Updates](https://www.autoimmuneinstitute.org/covid_timeline/nih-recover-2026-publications-long-covid-research-updates/) **Published:** February 16, 2026 **Author:** Carolyn Serraino **Excerpt:** New NIH RECOVER studies published in early 2026 highlight emerging findings on long COVID biology, immune dysfunction, and ongoing research aimed at improving diagnosis and treatment. **Content:** ## **RECOVER Research Output \| February 2026** In early 2026, the [NIH RECOVER Initiative published multiple studies](https://recovercovid.org/publications) aimed at better understanding Long COVID and related post-infectious conditions in both adults and children. One study in *Nature Immunology* found evidence that people with Long COVID show **ongoing activation of inflammatory pathways along with signs of “immune exhaustion,”** a state in which immune cells may become less responsive after prolonged activation (1). This supports the idea that Long COVID may involve persistent immune system imbalance rather than a single lingering infection. A related preprint reported **differences in antibody responses to SARS-CoV-2 structural proteins**, including envelope and nucleocapsid proteins, suggesting that immune signaling patterns remain altered in some individuals months after infection (2). Several 2026 publications focused on children. An EHR-based study in the Journal of Infection examined whether **body mass index** before COVID-19 influenced later cardiovascular, gastrointestinal, or neuropsychiatric outcomes in young people (3). Another RECOVER study in The Journal of Pediatrics found associations between prior COVID-19 and later dyslipidemia (abnormal cholesterol levels) and changes in body mass index in children and adolescents (4). A separate pregnancy cohort study evaluated infant neurodevelopment through 18 months following **in utero SARS-CoV-2 exposure** (5). Researchers also examined broader structural influences. A *JAMA Pediatrics* study analyzed how social determinants of health, such as socioeconomic factors and access to care, intersect with **pediatric Long COVID risk** (6). In addition to Long COVID, RECOVER investigators published new data on **[multisystem inflammatory syndrome in children](https://www.autoimmuneinstitute.org/covid_timeline/covid-19-autoantibodies-and-multisystem-inflammatory-syndrome-in-children/ "COVID-19, Autoantibodies, and Multisystem Inflammatory Syndrome in Children")** (MIS-C). A replication study found that children with MIS-C showed high levels of inflammation-related proteins and an intensified immune response involving interferon-γ, a key immune messenger. These results support earlier evidence that MIS-C involves an overactive immune response (7). Finally, a paper in the *American Heart Journal* described the design of RECOVER-AUTONOMIC, a randomized platform trial evaluating potential treatments for **Long COVID–associated postural orthostatic tachycardia syndrome** ([POTS](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/postural-orthostatic-tachycardia-syndrome/ "Postural orthostatic tachycardia syndrome")), a form of autonomic dysfunction characterized by rapid heart rate upon standing (8). #### Together, these 2026 publications reflect a shift from simply describing Long COVID symptoms to identifying biological mechanisms, long-term pediatric patterns, and structured pathways for clinical trials. [A separate update outlines the status of RECOVER’s active Long COVID treatment trials](https://www.autoimmuneinstitute.org/covid_timeline/long-covid-treatment-trials-2026-recover-update/) ##### Citations 1. Aid, M., Boero-Teyssier, V., McMahan, K., Dang, R., Doyle, M., Belabbaci, N., Borducchi, E., Collier, A. Y., Mullington, J., & Barouch, D. H. (2026). **Long COVID involves activation of proinflammatory and immune exhaustion pathways**. *Nature immunology*, *27*(1), 61–71. <https://doi.org/10.1038/s41590-025-02353-x> 2. Kwissa, M., Mathayan, M., Salunkhe, S. S., Bakthavachalam, V., Ye, Z., Sanborn, M. A., Condo, S., Upadhye, A., Nemakal, A., Richner, J. M., Basu, S., Novak, R. M., Jacobson, J. R., Ganesh, B. B., Cerda, M., Utz, P. J., Krishnan, J. A., Prabhakar, B. S., & Rehman, J. (2025). **Persistent Immune Dysregulation during Post-Acute Sequelae of COVID-19 is Manifested in Antibodies Targeting Envelope and Nucleocapsid Proteins**. *bioRxiv : the preprint server for biology*, 2025.08.18.670908. <https://doi.org/10.1101/2025.08.18.670908> 3. Zhou, T., Zhang, B., Zhang, D., Jhaveri, R., Chen, J., Becich, M. J., Castro, L., Chen, Y., Chilukuri, N., Herring, S. J., Lei, Y., Li, L., Lu, Y., Hornig, M., Khalsa, A. S., Liebovitz, D., Mosa, A. S. M., Taylor, B. W., Tedla, Y. G., Thodeson, D., … Chen, Y. (2026). **Pre-COVID-19 body mass index and post-acute cardiovascular, gastrointestinal, and neuropsychiatric outcomes among children and young adults with SARS-CoV-2 infection: An EHR-based cohort study from the RECOVER Initiative**. *The Journal of infection*, *92*(3), 106702. Advance online publication. <https://doi.org/10.1016/j.jinf.2026.106702> 4. Lei, Y., Zhou, T., Zhang, B., Zhang, D., Tang, H., Chen, J., Wu, Q., Li, L., Bailey, L. C., Becich, M. J., Blecker, S., Christakis, D. A., Fort, D., Herring, S. J., Hwang, W., Khalsa, A. S., Kim, S., Liebovitz, D. M., Mosa, A. S. M., Rao, S., … RECOVER Consortium (2026). **Post-Acute Dyslipidemia and Abnormal Body Mass Index in Children and Adolescents with COVID-19: A Cohort Study from the RECOVER Initiative**. *The Journal of pediatrics*, *291*, 114996. Advance online publication. <https://doi.org/10.1016/j.jpeds.2026.114996> 5. Flaherman, V. J., Reeder, H. T., Martin-Herz, S. P., Gallagher, R., Cohen, A. K., Brown, H. E., Clifton, R. G., Fischbein, N., Foulkes, A. S., Jacoby, V. L., Jain, N., Beamon, C. J., Bahtiyar, M. O., Chang, A., Costantine, M. M., Cruz Irving, A., Gibson, K. S., Hoffman, M. C., Hoffman, M. K., Hughes, B. L., … RECOVER-Pregnancy Consortium (2026). **Intrauterine SARS-CoV-2 Exposure and Infant Neurodevelopment through 18 Months of Age: Findings from the Researching COVID to Enhance Recovery (RECOVER) Pregnancy Study**. *The Journal of pediatrics*, *292*, 114997. Advance online publication. <https://doi.org/10.1016/j.jpeds.2026.114997> 6. Rhee, K. E., Thaweethai, T., Pant, D. B., Stein, C. R., Salisbury, A. L., Kinser, P. A., Kleinman, L. C., Gallagher, R., Warburton, D., Mohandas, S., Snowden, J. N., Stockwell, M. S., Tantisira, K. G., Flaherman, V. J., Teufel, R. J., Castro, L., Chung, A., Espinoza Esparza, J., Hockett, C. W., Isidoro-Chino, M., … Yurgelun-Todd, D. A. (2026). **Social Determinants of Health and Pediatric Long COVID in the US**. *JAMA pediatrics*, e255485. Advance online publication. <https://doi.org/10.1001/jamapediatrics.2025.5485> 7. McCuaig, S., Toland, C., Konvinse, K. C., Yang, E., Utz, P. J., Vella, L. A., Odom John, A. R., Bassiri, H., & Behrens, E. M. (2026). **Macrophage Activation Syndrome-Associated Proteins and Enhanced Interferon-γ Responsiveness in the Plasma Proteome of Patients With Multisystem Inflammatory Syndrome in Children in a Pretreatment Replication Single-Center Cohort**. *ACR open rheumatology*, *8*(2), e70181. <https://doi.org/10.1002/acr2.70181> 8. Fudim, M., Novak, P., Taub, P. R., Chung, T., Zimmerman, K. O., Moy, O. V., Fissler, H. Z., Wen, J., Freeman, N. L. B., O’Brien, S., Marti, H., Cook, D., Low, P., Kim, D. Y., Rosenberg, Y., Granger, C. B., & Shibao, C. A. (2026). **Design and rationale of RECOVER-AUTONOMIC: a randomized platform trial evaluating interventions for Long COVID postural orthostatic tachycardia syndrome**. *American heart journal*, 107384. Advance online publication. <https://doi.org/10.1016/j.ahj.2026.107384> **Category:** Covid-19 Clinical Trials, Covid-19 Infections, Covid-19 Research Studies, Long COVID --- ### [Long COVID Treatment Trials: 2026 RECOVER Update](https://www.autoimmuneinstitute.org/covid_timeline/long-covid-treatment-trials-2026-recover-update/) **Published:** February 9, 2026 **Author:** Carolyn Serraino **Excerpt:** The NIH RECOVER initiative released new updates on clinical trials investigating treatments for long COVID, including therapies targeting inflammation, immune dysfunction, and viral persistence. **Content:** ## **NIH RECOVER Initiative Status Report \| February 2026** The [NIH RECOVER](https://recovercovid.org/)-Treating Long COVID ([RECOVER-TLC](https://recover-tlc.org/)) initiative is advancing the first large-scale, federally coordinated clinical trials for Long COVID treatments. As of early 2026, four treatment strategies are in development, though most trials are still in protocol preparation or early recruitment phases. [![](https://recovercovid.org/sites/default/files/images/pages/about/aboutWheel042025.svg)](https://recovercovid.org/about) ### How NIH RECOVER-TLC Selects Long COVID Treatment Targets RECOVER-TLC operates through an open submission portal managed by the Foundation for the National Institutes of Health (NIH). Nearly 600 proposed therapies, including medications, devices, and behavioral interventions, have been submitted. Proposals are reviewed by multidisciplinary working groups that include researchers, clinicians, federal agency representatives (including FDA and NIAID), and patient advocates. Selected treatment candidates move through a structured clinical trial process: - Protocol drafting - Public comment period - Protocol revision - Institutional Review Board (IRB) approval - Site selection and staff training - Participant recruitment - Data collection and analysis This federally coordinated review structure increases transparency and scientific rigor but extends timelines before enrollment begins. ### Current RECOVER-TLC Priority Targets #### Baricitinib Trial for Long COVID Cognitive Symptoms Baricitinib, a JAK inhibitor that reduces pro-inflammatory cytokine signaling, is the only RECOVER-TLC trial currently recruiting. - 4 mg daily for 24 weeks - Randomized, placebo-controlled - Primary outcomes: neurocognitive and neuropsychiatric function - Secondary outcomes: exercise capacity and quality of life This trial tests whether immune pathway modulation can improve persistent cognitive and mood-related symptoms. #### Low-Dose Naltrexone (LDN) Trial for Long COVID Pain and Fatigue The planned LDN trial aims to enroll 1,300 participants, including children aged 6 and older. - 16-week randomized, placebo-controlled design - Outcomes: quality of life, pain, neurocognitive function Pediatric inclusion was incorporated following community advocacy. LDN is hypothesized to modulate neuroinflammation through effects on microglial activation. #### Semaglutide (GLP-1) Trial for Long COVID Inflammation and Metabolic Effects Semaglutide, a [GLP-1 receptor agonist](https://www.autoimmuneinstitute.org/covid_timeline/glp-1-drugs-enter-formal-testing-for-long-covid-treatment/ "GLP-1 Drugs Enter Formal Testing for Long COVID Treatment"), was selected in part due to extensive safety and cardiovascular data. - Randomized, placebo-controlled - Adults and adolescents - Planned mechanistic components (e.g., neuroimaging, wearable data) This trial reflects growing interest in metabolic and inflammatory pathways in Long COVID. #### Stellate Ganglion Block Trial for Long COVID Dysautonomia RECOVER-TLC is also advancing a Phase 2 randomized sham-controlled trial of stellate ganglion block (SGB), a procedure targeting sympathetic nervous system overactivity. - Four staged injections - Initially enrolling adults - Focus: autonomic dysfunction and dysautonomia symptoms This represents a procedural, non-drug approach to Long COVID treatment. ### Why Long COVID Treatment Approval Will Take Time Only one RECOVER-TLC trial is actively recruiting. Others remain in protocol development or pre-enrollment phases. Even after enrollment begins, clinical trials require extended follow-up, data analysis, and regulatory review. Because Long COVID does not affect everyone in the same way, RECOVER’s strategy involves testing multiple therapeutic pathways rather than pursuing a single universal treatment. [A separate update outlines RECOVER’s 2026 research publications and emerging findings](https://www.autoimmuneinstitute.org/covid_timeline/nih-recover-2026-publications-long-covid-research-updates/) ### Watch the Full Webinar On January 23, 2026, NIH’s RECOVER-TLC program hosted a public webinar outlining progress on immune-targeted long COVID treatment trials, including updates on baricitinib (a JAK inhibitor), low-dose naltrexone, GLP-1 receptor agonists, and stellate ganglion block. The presentation also reviewed how therapeutic proposals are evaluated and how patient input shapes protocol design. ##### Citations *National Institutes of Health*. (2026, February 4). **[5 years in, RECOVER continues to advance its patient-centered mission](https://recovercovid.org/news/5-years-recover-continues-advance-its-patient-centered-mission)**. RECOVER Initiative. https://recovercovid.org/news/5-years-recover-continues-advance-its-patient-centered-mission *National Institutes of Health* (2026, January 13). **[A year of discovery: Looking back at 2025 and ahead to 2026](https://recovercovid.org/news/year-discovery-looking-back-2025-and-ahead-2026 "A year of discovery: Looking back at 2025 and ahead to 2026")**. RECOVER Initiative. https://recovercovid.org/news/year-discovery-looking-back-2025-and-ahead-2026 **National Institutes of Health**. **[RECOVER Clinical Trials](https://trials.recovercovid.org/)**. RECOVER Initiative. https://trials.recovercovid.org/ *Foundation for the National Institutes of Health* (2026, January 23). **[RECOVER TLC Webinar – January 2026](https://www.youtube.com/watch?v=XHBov861Vsk)** **Category:** Covid-19 & Long Covid Treatments, Covid-19 Clinical Trials, Covid-19 Research Studies, Long COVID --- ### [Can COVID-19 Reactivate the Epstein-Barr Virus?](https://www.autoimmuneinstitute.org/covid_timeline/can-covid-19-reactivate-the-epstein-barr-virus/) **Published:** August 31, 2024 **Author:** Elevation **Content:** Results from a study called [Incidence of Epstein-Barr virus reactivation is elevated in COVID-19 patients](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10292739/) published in the journal *Virus Research* explored the link between COVID-19 and the Epstein-Barr virus (EBV). Infection with EBV, a very [common herpes virus](https://www.ncbi.nlm.nih.gov/books/NBK559285/), causes mononucleosis. Children and adolescents are often most affected, as transmission occurs through kissing or sharing food. Symptoms of mononucleosis include headache, fever, and malaise (feeling generally unwell). Even after symptoms are resolved, EBV can stay in the body by remaining dormant in immune cells. Researchers in this study compared the incidence of EBV reactivation in COVID-positive patients compared to COVID-negative patients as prior research has indicated that EBV reactivation may be related to COVID severity and length of illness. Blood samples (N=106) were collected from 54 people who tested positive for COVID-19 and 52 people who tested negative for COVID-19, as confirmed by PCR analysis. DNA and immunological assays were performed to evaluate the presence or absence of EBV and associated antibodies. Results showed COVID-positive patients had a significantly higher incidence of EBV reactivation compared to COVID-negative patients (27.1% vs 12.5%, respectively). Researchers also measured levels of C-reactive protein, a marker of inflammation linked to COVID-19 severity, and did not find any differences between the groups. While over 90% of all patients were positive for previous EBV infection, there were variations in the number of patients positive for related antibodies. It’s important to note that this study was conducted during the time when the Omicron variant of COVID-19 was most prevalent in the area where patients were evaluated; therefore, these results may not be applicable to prior or more recent COVID-19 variants. Further research may elucidate the potential role of EBV reactivation in contributing to long-term outcomes following COVID-19 infection. ##### Citation: Bernal, K. D. E., & Whitehurst, C. B. (2023). Incidence of Epstein-Barr virus reactivation is elevated in COVID-19 patients. *Virus research*, *334*, 199157. <https://doi.org/10.1016/j.virusres.2023.199157> **Category:** Covid-19 Infections, Covid-19 Research Studies --- ### [Post-Viral Illness: Long COVID Isn’t New](https://www.autoimmuneinstitute.org/covid_timeline/long-covid-follows-a-pattern-of-post-viral-illness/) **Published:** March 25, 2025 **Author:** Carolyn Serraino **Content:** For decades, researchers and patients have documented chronic health issues that emerge after viral infections. These conditions often involve complex immune, neurological, or systemic symptoms and have long struggled for medical recognition and research support. Long COVID is the most recent example, but not the first—and without continued investment, it risks following the now-familiar path of being misunderstood, underfunded, and left behind. ### **Long COVID and ME/CFS Share a Familiar Story** One of the clearest parallels is [myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/me-cfs/ "Myalgic encephalomyelitis / chronic fatigue syndrome"), a debilitating condition that often begins after viral illness. For decades, patients with ME/CFS were told their symptoms were psychological, even as research slowly uncovered patterns of immune dysfunction, energy metabolism issues, and neurological changes. #### Today, long COVID patients face many of the same challenges: fatigue, brain fog, post-exertional crashes, and skepticism. According to NIH-funded research, [up to 4.5% of people who’ve had COVID-19 now meet the diagnostic criteria for ME/CFS](https://recovercovid.org/news/nih-funded-study-finds-cases-mecfs-increase-following-covid-19)—compared to just 0.6% of those who were never infected. ### **Chronic Conditions With Similar Dismissal** While the causes vary, several chronic illnesses have shared the same trajectory of delayed recognition and underinvestment: #### **Gulf War Illness (GWI)** Veterans of the 1990–91 Gulf War reported lasting fatigue, pain, and cognitive symptoms but faced years of disbelief before the condition was acknowledged and studied. Like long COVID, [GWI involves immune and nervous system dysfunction](https://www.autoimmuneinstitute.org/covid_timeline/do-long-covid-and-gulf-war-illness-share-an-underlying-mechanism/ "Do Long COVID and Gulf War Illness Share an Underlying Mechanism?"). #### **Endometriosis** This immune-mediated disease affects at least 1 in 10 women, yet many still go years without a diagnosis. For decades, those with [endometriosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/endometriosis/ "Endometriosis") were told their pain was normal or psychosomatic. #### **Fibromyalgia** Characterized by widespread pain and fatigue, [fibromyalgia](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/fibromyalgia/ "Fibromyalgia") was long stigmatized as “not real.” It is now medically recognized, but gaps in research, understanding, and treatment persist. ### **A Pattern Worth Recognizing—and Breaking** ##### These illnesses vary in origin and presentation, but they share key features: They primarily affect women. Their symptoms are often invisible or difficult to measure. They face delays in diagnosis and lack reliable biomarkers. Research funding has historically lagged far behind the disease burden. Patients often report feeling dismissed or disbelieved. ##### **Long COVID is at risk of becoming the next chapter in this pattern.** ### **Sustained Support Is a Public Health Imperative** The early creation of the Office of Long COVID Research and Practice recognized that this condition is real, complex, and deserving of coordinated attention. Its planned closure has raised concerns about whether that recognition will continue. History shows what happens when post-viral illness is ignored. We can do better now—by continuing to fund research, support patients, and treat long COVID not as an anomaly but as part of a larger, long-overdue conversation. [Read More: The Federal Long COVID Office Is Closing](https://www.autoimmuneinstitute.org/covid_timeline/office-of-long-covid-research-and-practice-closure/) **Category:** Long COVID, ME/CFS & Covid-19 --- ### [More Evidence Linking COVID-19 and Thyroid Disease](https://www.autoimmuneinstitute.org/covid_timeline/more-evidence-linking-covid-19-and-thyroid-disease/) **Published:** January 19, 2026 **Author:** Carolyn Serraino **Content:** A new 4.5-year observational study published in *The Journal of Clinical Endocrinology & Metabolism* found that SARS-CoV-2 infection is associated with a significantly increased risk of developing new-onset thyroid disease, even in people who were not hospitalized. Researchers from Montefiore Health System analyzed electronic health records from patients without prior thyroid disease. The study included 15,372 individuals hospitalized with COVID-19, 41,757 nonhospitalized patients with confirmed COVID-19, and large control groups without documented infection. Compared with COVID-negative controls, patients hospitalized for COVID-19 had more than double the risk of developing thyroid disease. They also had an increased risk of hypothyroidism and hyperthyroidism. Nonhospitalized patients showed a more modest but still statistically significant increase in thyroid disease risk. #### Overall, 2.99% of hospitalized patients developed thyroid disease, compared with 1.39% of nonhospitalized patients and 1.03% of controls. While the absolute differences may appear small, researchers note that even modest increases could translate into a substantial healthcare burden given the large number of people infected worldwide. One possible explanation is immune dysregulation. Severe COVID-19 can trigger elevated inflammatory signaling, including cytokines such as interleukin-6 and tumor necrosis factor-alpha. This inflammatory environment may contribute to thyroid tissue damage or the development of thyroid autoantibodies. #### The authors suggest clinicians consider monitoring thyroid function in individuals recovering from COVID-19, particularly those with additional risk factors such as autoimmune disease. ### Related Timeline Updates This study builds on earlier research exploring how COVID-19 may affect thyroid function over time: - [ The Connection Between COVID-19 and Thyroid Disease ](https://www.autoimmuneinstitute.org/covid_timeline/the-connection-between-covid-19-and-thyroid-disease/) - [ Thyroid Dysfunction After COVID-19 Infection ](https://www.autoimmuneinstitute.org/covid_timeline/thyroid-dysfunction-after-covid-19-infection/) ##### Citation Mehrotra-Varma, S., Hadidchi, R., Henry, S., Quangnguyen, H., Mehrotra-Varma, J., Coard, M. C., Changela, S., Collins, J., & Duong, T. Q. (2025). Elevated risk of new-onset thyroid disease associated with SARS-CoV-2 infection: a 4.5-year observational study. *The Journal of clinical endocrinology and metabolism*, dgaf688. Advance online publication. <https://doi.org/10.1210/clinem/dgaf688> **Category:** Covid-19 Infections, Covid-19 Research Studies, Thyroid disease & Covid-19 --- ### [Can a Pacing App Prevent Long COVID Crashes? Trial Results](https://www.autoimmuneinstitute.org/covid_timeline/can-a-pacing-app-prevent-long-covid-crashes-trial-results/) **Published:** February 2, 2026 **Author:** Carolyn Serraino **Content:** A six-month randomized controlled trial tested whether a digital pacing platform combined with a wearable activity tracker could reduce [post-exertional malaise](https://www.autoimmuneinstitute.org/research_updates/exercise-triggers-immune-and-energy-strain-in-me-cfs/), or PEM, in adults with long COVID. Quick Definition ### What Is a Long COVID Crash? A “long COVID crash” refers to **post-exertional malaise (PEM)**, a worsening of symptoms after physical or mental effort. Unlike normal tiredness, symptoms can intensify hours later and may last more than a day. **How this study defined a crash:** The trial measured PEM using the DePaul Symptom Questionnaire (DSQ-PEM). Symptoms were considered a crash if they worsened after exertion and lasted **more than 14 hours**, sometimes **several days**. A key feature is timing. A person may feel stable during activity but significantly worse later that day or the following day. #### Common Symptoms Severe fatigue or “energy drain” out of proportion to activity Brain fog or slowed thinking Muscle pain, joint pain, or body aches Headache or flu-like symptoms Dizziness or feeling faint Worsening of other long COVID symptoms #### Common Triggers Physical activity, even light activity Mental effort such as computer work or long meetings Emotional stress Poor sleep, illness, or reduced recovery time In this study, 250 participants were randomized to either receive the “Pace Me” app plus a Fitbit with real-time activity alerts or an app-only control version. The intervention sent notifications when participants reached 50, 75, and 100 percent of their personalized activity limit. The primary outcome was PEM severity measured by the DePaul Symptom Questionnaire. After six months, there was no meaningful difference between the intervention and control groups. Both groups showed some improvement over time, suggesting gradual recovery rather than a specific benefit from the app. Energy management and pacing are widely recommended for conditions that involve PEM, including long COVID and some autoimmune diseases. This well-designed trial found that adding real-time digital alerts did not reduce PEM compared to usual care. For patients and clinicians, this highlights an important point. Digital tools may feel supportive and safe, but they are not guaranteed to reduce symptom crashes. More research is needed to determine whether similar approaches could help in conditions where recovery is less common, such as [myalgic encephalomyelitis/chronic fatigue syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/me-cfs/ "Myalgic encephalomyelitis / chronic fatigue syndrome") (ME/CFS) or autoimmune diseases associated with persistent fatigue. ##### Citation Sanal-Hayes, N.E., Hayes, L.D., Mair, J.L. *et al.* A digital platform with activity tracking for energy management support in long COVID: a randomised controlled trial. *Nat Commun* **17**, 945 (2026). <https://doi.org/10.1038/s41467-025-64831-y> **Category:** Covid-19 & Long Covid Treatments, Covid-19 Clinical Trials, Covid-19 Research Studies, Long COVID, ME/CFS & Covid-19 --- ### [COVID-19 Infection Linked to 49% Higher Risk of Autoimmune Disease](https://www.autoimmuneinstitute.org/covid_timeline/covid-19-infection-linked-to-49-higher-risk-of-autoimmune-disease/) **Published:** January 12, 2026 **Author:** Carolyn Serraino **Content:** A new meta-analysis study combed through **data from over 97 million individuals** from population-based cohort studies and found that COVID-19 infection was linked to a 49% increased risk of developing new autoimmune diseases. #### This study compared individuals with and without COVID-19 and examined many parameters, including disease severity and vaccination status. Key Study Highlights - Severe COVID-19 infection was linked to a higher risk of developing autoimmune diseases. - COVID-19 vaccination was associated with a reduced risk. #### The highest risks were associated with developing autoimmune diseases that affect vascular and connective tissue, including: - [**Antiphospholipid syndrome**](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/antiphospholipid-syndrome/): A disease where the immune system produces antibodies against fat molecules and makes blood more likely to clot - [**ANCA-associated vasculitis**](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/microscopic-polyangiitis-anca-associated-vasculitis/): This disease involves inflammation in blood vessels and affects multiple systems - [**Mixed connective tissue disease**](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/mixed-connective-tissue-disease/): This disease occurs when the immune system attacks ribonucleoproteins, which are important to produce messenger RNA necessary for protein production - [**Immune thrombocytopenic purpura**](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/immune-thrombocytopenia/): This disease lowers blood platelet counts, leading to bruising and bleeding. For more prevalent autoimmune diseases, such as [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid arthritis"), [psoriasis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/psoriasis/ "Psoriasis"), and [Sjogren’s syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sjogren-syndrome/ "Sjögren disease (SjD)"), the authors reported a “modest but statistically significant rise” in the increased risk after COVID-19 infection. [Systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus"), [systemic sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/scleroderma/ "Scleroderma / systemic sclerosis"), and [Hashimoto’s thyroiditis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/hashimotos-thyroiditis/ "Hashimoto’s thyroiditis / autoimmune thyroiditis") didn’t show an increased risk in their study. ##### **Citation** Tzang, C. C., Sheng, H., Kuo, V. F., Luo, C. A., Lin, T. A., Lee, Y. T., Huang, E. S., Wu, P. H., Tzang, B. S., & Hsu, T. C. (2025). Association between COVID-19 and New-Onset Autoimmune Diseases: Updated Systematic Review and Meta-Analysis of 97 Million Individuals. *Clinical Reviews in Allergy & Immunology*, 68(1), 111. <https://doi.org/10.1007/s12016-025-09124-4> **Category:** Autoimmune Diseases & Covid-19, Covid-19 Infections, Covid-19 Research Studies --- ### [COVID-19 Still Causes Major Illness and Deaths Study Finds](https://www.autoimmuneinstitute.org/covid_timeline/covid-19-still-causes-major-illness-and-deaths-study-finds/) **Published:** January 5, 2026 **Author:** Carolyn Serraino **Content:** A new CDC-led study published in *JAMA Internal Medicine* estimates that COVID-19 continued to cause a substantial health burden in the United States from October 2022 through September 2024, even after the end of the public health emergency. #### Researchers estimate that COVID-19 led to approximately 43.6 million illnesses and 101,300 deaths in 2022–2023, and 33.0 million illnesses and 100,800 deaths in 2023–2024. Although overall illness, outpatient visits, and hospitalizations declined between the two periods, deaths remained high. Adults aged 65 and older, who make up less than one-fifth of the U.S. population, accounted for about two-thirds of hospitalizations and more than 80% of deaths in both years. The study also found that children, including infants, continued to experience hospitalizations and deaths, underscoring that COVID-19 affects all age groups. #### For people living with autoimmune disease and other immune-mediated conditions, these findings reinforce that COVID-19 remains a meaningful health risk. Immune dysregulation, immunosuppressive therapies, and age-related immune decline can all increase vulnerability to severe infection and complications. The authors emphasize that vaccination and early antiviral treatment continue to play an important role in reducing severe outcomes, particularly in higher-risk populations. ##### Citation Koumans, E. H. A., Khan, D., Trejo, I., Deng, L., Devine, O., Smith-Jeffcoat, S. E., Hamid, S., Patton, M. E., Carter, E., Aggarwal, M., Pham, H., Patel, K., Whitaker, M., Wiegand, R. E., Gregory, C. O., Ortega-Sanchez, I. R., Derado, G., Iuliano, A. D., Reed, C., Hall, A. J., … Witt, L. S. (2026). Estimated Burden of COVID-19 Illnesses, Medical Visits, Hospitalizations, and Deaths in the US From October 2022 to September 2024. *JAMA internal medicine*, 10.1001/jamainternmed.2025.7179. Advance online publication. <https://doi.org/10.1001/jamainternmed.2025.7179> **Category:** Covid-19 Infections, Covid-19 Research Studies --- ### [Study Links Long COVID to Lasting Inflammation and Immune Exhaustion](https://www.autoimmuneinstitute.org/covid_timeline/study-links-long-covid-to-lasting-inflammation-and-immune-exhaustion/) **Published:** December 16, 2025 **Author:** Carolyn Serraino **Content:** A study published in *Nature Immunology* examined immune responses in people with long COVID and found evidence of sustained inflammation and immune exhaustion that can persist for months after initial infection. The researchers analyzed immune, transcriptomic, and proteomic data from 142 participants enrolled between 2020 and 2021, including individuals with long COVID, people who recovered fully, acutely infected patients, and uninfected controls. Compared with recovered individuals, those with long COVID showed persistent activation of inflammatory immune pathways more than 180 days after infection. These included IL-6 signaling, JAK–STAT signaling, complement activation, and metabolic pathways linked to chronic inflammation. At the same time, markers of T cell activation were reduced, while signatures of T cell exhaustion were increased, suggesting that prolonged immune stimulation may impair normal immune function. #### Notably, the researchers did not find evidence of ongoing viral replication in people with long COVID, indicating that persistent symptoms are more likely driven by immune dysregulation rather than lingering infection. The same immune patterns were confirmed in an independent validation cohort recruited between 2023 and 2024. #### The study also found that inflammatory responses during the acute phase of COVID-19 were predictive of who later developed long COVID. Elevated inflammatory and JAK–STAT–related signaling early in infection was strongly associated with long-term symptoms, highlighting the potential value of early immune biomarkers. Based on these findings, the authors suggest that targeting inflammatory pathways may offer new treatment approaches. #### A [clinical trial](https://clinicaltrials.gov/study/NCT06597396) has already been initiated to evaluate the JAK1 inhibitor abrocitinib as a potential therapy for long COVID. ##### Citation Aid, M., Boero-Teyssier, V., McMahan, K. *et al.* Long COVID involves activation of proinflammatory and immune exhaustion pathways. *Nat Immunol* (2025). <https://doi.org/10.1038/s41590-025-02353-x> **Category:** Covid-19 Research Studies, Long COVID --- ### [Persistent Inflammation May Link Long COVID to Autoimmune Disease](https://www.autoimmuneinstitute.org/covid_timeline/persistent-inflammation-may-link-long-covid-to-autoimmune-disease/) **Published:** September 24, 2025 **Author:** Carolyn Serraino **Content:** A paper recently published in *Autoimmunity Reviews* examines evidence suggesting that persistent inflammation following SARS-CoV-2 infection may link Long COVID to the development and exacerbation of autoimmune diseases. While the exact mechanisms driving Long COVID have not been fully established, the authors emphasize that a sustained inflammatory response after infection can lead to widespread immune dysregulation, even after the acute virus has resolved. Long COVID is described as a multi-system condition with symptoms that may persist for months or years, affecting neurological, immune, respiratory, and other organ systems. The review highlights how continued activation of the innate and adaptive immune systems may trigger a cascade of inflammatory signaling. When immune pathways remain activated, cytokines can become persistently elevated, contributing to chronic inflammation. The authors discuss the role of pro-inflammatory cytokines such as interleukins and tumor necrosis factors, which can disrupt immune balance, alter T cell regulation, and impair immune tolerance over time. Several biological mechanisms are explored as contributors to this sustained immune activation, including mast cell activation, inflammasome signaling, coagulation abnormalities, cytokine storms and prolonged pro-inflammatory responses, and changes in the gut microbiota. The authors note that lingering viral components may continue to stimulate immune responses through ACE2-related pathways, maintaining inflammation even in the absence of active infection. The review also connects these inflammatory processes to autoimmune diseases observed following COVID-19. [Systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus") (SLE) is discussed in the context of immune dysregulation and chronic inflammation that may promote autoantibody production. [Guillain-Barré syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/guillain-barre-syndrome/ "Guillain-Barrè syndrome") (GBS) is highlighted as a post-infectious autoimmune neurological condition, with molecular mimicry and immune cross-reactivity proposed as potential mechanisms. [Rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid arthritis") (RA) is also included, reflecting how persistent inflammatory signaling may unmask or exacerbate joint-targeted autoimmunity. ##### **Citation** Chen, K., Wang, Z., Li, J., Xu, Y., Gu, S., Li, H., Li, J., Zhang, Y., & Mao, N. (2025). *Chronic inflammation in Long COVID relationship to autoimmune diseases*. *Autoimmunity Reviews, 24*(10), 103882. <https://doi.org/10.1016/j.autrev.2025.103882> **Category:** Autoimmune Diseases & Covid-19, Covid-19 Infections, Covid-19 Research Studies, GBS & Covid-19, Long COVID, Lupus & Covid-19, RA & Covid-19 --- ### [Long COVID, PCC, and PASC: Understanding the Terminology](https://www.autoimmuneinstitute.org/covid_timeline/long-covid-pcc-and-pasc-understanding-the-terminology/) **Published:** December 9, 2025 **Author:** Carolyn Serraino **Content:** Researchers and public health organizations use various terms to describe the persistent and emerging health problems that can follow SARS-CoV-2 infection. The most widely recognized term is *[long COVID](https://www.autoimmuneinstitute.org/covid_timeline/autoimmune-experts-debate-long-covid-definition-concerns/ "Autoimmune Experts Debate Long COVID Definition Concerns")*, which originated with patients and has since been adopted in both clinical and research contexts, as it succinctly captures the experience of ongoing symptoms after acute COVID-19. In formal health communications, the term *[Post-COVID Conditions](https://archive.cdc.gov/www_cdc_gov/coronavirus/2019-ncov/hcp/clinical-care/post-covid-conditions.html?utm) (PCC)* is often used as an umbrella term for the wide range of ongoing physical, neurological, and multi-system symptoms that continue or develop weeks to months after initial infection. This label is meant to encompass all long-term sequelae of COVID-19. The [World Health Organization](https://www.who.int/news-room/fact-sheets/detail/post-covid-19-condition-(long-covid)) (WHO) also uses the term post-COVID-19 condition in its clinical case definitions, which highlight symptom persistence beyond the acute phase and the absence of alternative explanations. Scientific research frequently uses the technical term *Post-acute sequelae of SARS-CoV-2 infection (PASC).* As a clinical descriptor, PASC refers to the persistent health effects that follow the acute phase of infection and is commonly used in epidemiological studies. Other terms encountered in both clinical and research settings include *post-acute COVID-19*, *post-acute COVID-19 syndrome*, *post-COVID syndrome*, *long-haul COVID*, *chronic COVI*D, and *long-term effects of COVID.* These labels all refer to the same phenomenon, ongoing health challenges after acute illness, though varying in formality and context. Additionally, they aim to identify and categorize the diverse and often debilitating health outcomes that persist after COVID-19 infection, to support research, and to guide clinical care as understanding of the condition grows. **Category:** Covid-19 Infections, Long COVID --- ### [Meta-Analysis Links COVID-19 to 11 Autoimmune Diseases](https://www.autoimmuneinstitute.org/covid_timeline/meta-analysis-links-covid-19-to-11-autoimmune-diseases/) **Published:** August 5, 2025 **Author:** Carolyn Serraino **Content:** In a recent study, authors conducted a meta-analysis of six observational studies to gather evidence of confirmed SARS-CoV-2 infection increasing the risk of developing immune-mediated diseases (IMIDs). While reviews on case reports have been previously published, a gap exists for analytic studies. Previous reviews also include IMID diagnoses less than 30 days post-infection, without considering the potential bias in symptom development that may occur regardless of infection. Confirmed SARS-CoV-2 cases were compared against individuals without a prior history of infection, and diagnoses made within the first 30 days post-infection were excluded to avoid capturing early post-infection effects. Findings across all six studies showed a higher risk of developing at least 11 IMIDs in the confirmed COVID-19 group compared to the non-exposed group. These include: [Sjögren disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sjogren-syndrome/ "Sjögren disease (SjD)"), [Behçet’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/behcets/ "Behçet’s disease"), spondyloarthritis, [Systemic sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/scleroderma/ "Scleroderma / systemic sclerosis"), [Systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus"), [psoriasis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/psoriasis/ "Psoriasis"), [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid arthritis"), [polymyalgia rheumatica](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/polymyalgia-rheumatica/ "Polymyalgia rheumatica"), [type 1 diabetes](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/type-1-diabetes-insulin-dependent-diabetes/ "Type 1 diabetes / insulin-dependent diabetes") (in adults), [vasculitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/leukocytoclastic-vasculitis/ "Leukocytoclastic vasculitis"), and [inflammatory bowel disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crohns-disease/ "Crohn’s disease"). The association between confirmed infection and IMIDs ranged from a relative risk of ~2.31 (systemic sclerosis) to ~3.71 (Behcet’s disease). Polymyalgia rheumatica, psoriasis, Rheumatoid arthritis, Sjogren’s syndrome, and SLE were also reported to have significantly elevated or elevated levels of risk. On the flip side, [Guillain-Barré Syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/guillain-barre-syndrome/ "Guillain-Barrè syndrome") and type 1 diabetes in the pediatric population showed no clear increased risk in the data if accounted for 30+ days after initial infection. Authors emphasized that autoimmune conditions are being increasingly recognized under the umbrella of “long Covid,” calling for increased monitoring of IMIDs and other autoimmune diseases post-COVID-19 infection, especially past the 30-day mark. They also note that observational data cannot prove a causative effect between SARS-CoV-2 infection and the development of autoimmune disease, especially since the time between acute infection and diagnosis ranged among the six studies. ##### Citation Gil, A. M., et al. (2025). Risk of new onset of immune-mediated diseases after SARS-CoV-2 infection: A systematic review and meta-analysis. *Seminars in arthritis and rheumatism*, *74*, 152805. <https://doi.org/10.1016/j.semarthrit.2025.152805> **Category:** Autoimmune Diseases & Covid-19, Covid-19 Antibodies, Covid-19 Infections, Covid-19 Research Studies, GBS & Covid-19, IBD & Covid-19, Long COVID, Lupus & Covid-19, RA & Covid-19, Sjögren disease & Covid-19, T1D & Covid-19 --- ### [COVID-19 Vaccine Cuts Autoimmune Blistering Risk](https://www.autoimmuneinstitute.org/covid_timeline/covid-19-vaccine-cuts-autoimmune-blistering-risk/) **Published:** August 13, 2025 **Author:** Carolyn Serraino **Content:** Autoimmune blistering diseases (AIBD), such as [pemphigus and pemphigoid](https://www.autoimmuneinstitute.org/resources/autoimmune-diseases-list/ "A-Z Disease List"), occur when the immune system attacks the skin and mucous membranes. This causes blisters to form, negatively impacting quality of life and risk of infection. Due to the [connections between COVID-19 infection and autoimmunity](https://www.autoimmuneinstitute.org/articles/is-long-covid-an-autoimmune-disease-is-sars-cov-2-an-autoimmune-virus/), a new research study examined the risk of developing AIBD in relation to COVID-19 infection and vaccination. This study combed through data from 112 million patients and divided them into three groups: those who had a COVID-19 infection, those who received a vaccination, and those who had no infection or vaccination. The researchers found that: 1. COVID-19 infection was linked to an increased AIBD risk 2. Vaccination cut the risk of AIBD in half compared to those who had no infection or vaccination 3. Those with COVID-19 infection had a threefold higher risk of AIBD compared to those vaccinated Other studies have found connections between COVID-19 and autoimmune diseases like [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/ "Multiple sclerosis") and [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid arthritis"). While more work needs to be done in studying these links, it’s possible that vaccinating for COVID-19 is protective against other autoimmune conditions as well. ##### **Citation** Curman, P., et al. (2025). COVID-19 infection is associated with an elevated risk for autoimmune blistering diseases while COVID-19 vaccination decreases the risk: A large-scale population-based cohort study of 112 million individuals. Journal of the American Academy of Dermatology, 92(3), 452–463. <https://doi.org/10.1016/j.jaad.2024.10.063> **Category:** Autoimmune Diseases & Covid-19, Covid-19 Infections, Covid-19 Research Studies --- ### [New Study Tracks Post-COVID Illness and New-Onset Diseases](https://www.autoimmuneinstitute.org/covid_timeline/new-study-tracks-post-covid-illness-and-new-onset-diseases/) **Published:** August 1, 2025 **Author:** Carolyn Serraino **Content:** A prospective [study](https://journals.lww.com/smj/fulltext/2025/07000/post_covid_19_syndrome_and_new_onset_diseases__a.2.aspx) from India followed COVID-19 patients for 16 weeks and found that over half developed post-COVID-19 syndrome (PCS), and more than one in four developed new diseases or symptoms that hadn’t been present during their acute infection. Researchers at a post-COVID clinic in New Delhi followed 95 patients who had confirmed SARS-CoV-2 infection. Based on NICE guidelines, participants were classified into: - **Acute COVID-19**: symptoms ≤4 weeks - **Ongoing symptomatic COVID-19**: symptoms 4–12 weeks - **Post-COVID syndrome (PCS)**: symptoms >12 weeks **Key findings:** - 51.6% of patients developed PCS - Fatigue (62%), breathlessness (50%), and cough (27%) were the most common lingering symptoms - 26.3% developed new-onset diseases or symptoms, including: - [Rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid arthritis") - Hypertension, diabetes - Pulmonary fibrosis, thromboembolism - Sinus tachycardia, obstructive airway disease - Tuberculosis reactivation - Psychiatric conditions like psychosis and depression Patients with PCS had significantly worse health scores than those who recovered earlier. Risk factors for developing PCS included severe COVID-19, longer hospital stay, higher white blood cell count, and prolonged steroid use. This study adds to growing evidence that [COVID-19 may trigger new-onset autoimmune conditions](https://www.autoimmuneinstitute.org/covid_timeline/covid-infection-may-trigger-chronic-fatigue-syndrome/ "COVID Infection May Trigger Chronic Fatigue Syndrome"), including rheumatoid arthritis. For people already living with autoimmune or immune-mediated disease, this raises several concerns: - Post-COVID flares or new symptoms may be dismissed or misdiagnosed - New autoimmune conditions may emerge after infection, especially in those with genetic susceptibility - Long COVID symptoms can overlap with autoimmune fatigue, breathlessness, and inflammation, making a clear diagnosis harder The findings support the need for long-term follow-up care after COVID-19, particularly for those with existing immune conditions or high inflammatory responses during infection. ##### Citation Sinha, N., et al. (2025). **Post COVID-19 syndrome and new onset diseases: a prospective observational study**. *Singapore medical journal*, *66*(7), 354–361. <https://doi.org/10.4103/singaporemedj.SMJ-2022-055> **Category:** Covid-19 Infections, Covid-19 Research Studies, Long COVID, RA & Covid-19 --- ### [MRI Shows Brain Changes in People With Post COVID Symptoms](https://www.autoimmuneinstitute.org/covid_timeline/mri-shows-brain-changes-in-people-with-post-covid-symptoms/) **Published:** November 10, 2025 **Author:** Carolyn Serraino **Content:** A new study in *Nature Communications* reports that people experiencing persistent cognitive impairment after COVID-19 exhibit measurable, biologically distinct changes in the brain. #### The researchers used MRI, blood biomarkers, and proteomic profiling to examine a subgroup of the study identified as having cognitive impairment in post-acute sequelae of COVID-19 (referred to as Cog PASC). This group showed neuroinflammatory and neurodegenerative patterns that did not appear in people with PASC who did not report cognitive symptoms or in recovered controls. Participants classified as Cog PASC had higher levels of GFAP and NfL, proteins that increase during astroglial and neuronal injury. MRI scans revealed more pronounced cortical thinning in the cingulate and insular regions, along with increased iron accumulation and an enlarged choroid plexus. #### These features may reflect ongoing immune activation within the central nervous system. Proteomic analyses also showed disruptions in pathways related to oxidative stress, mitochondrial activity, and synaptic function, providing possible explanations for the persistent [brain fog](https://www.autoimmuneinstitute.org/articles/understanding-brain-fog-in-autoimmune-disease "Understanding Brain Fog in Autoimmune Disease") experienced by many after mild COVID-19. The findings were validated in independent cohorts, which strengthens confidence in the observed biological pattern. While the cross-sectional design limits conclusions about cause and effect, the study underscores the need for targeted research and interventions for individuals facing long-term cognitive symptoms after COVID-19. ##### Citation Knopman, D. S., Koltai, D., Laskowitz, D., Becker, J., Charvet, L., Wisnivesky, J., Federman, A., Silverstein, A., Lokhnygina, Y., Pilloni, G., Haddad, M., Mahncke, H., Van Vleet, T., Huang, R., Cox, W., Terry, D., Karwowski, J., McCray, N., Lin, J. J., McComsey, G. A., … RECOVER-NEURO Clinical Trial Group (2025). Evaluation of Interventions for Cognitive Symptoms in Long COVID: A Randomized Clinical Trial. *JAMA neurology*, e254415. Advance online publication. [https://doi.org/10.1001/jamaneurol.2025.4415](https://jamanetwork.com/journals/jamaneurology/fullarticle/2841155) **Category:** Covid-19 Antibodies, Covid-19 Infections, Covid-19 Research Studies, Long COVID --- ### [New Research Reveals Genetic Clues to Long COVID Subtypes](https://www.autoimmuneinstitute.org/covid_timeline/new-research-reveals-genetic-clues-to-long-covid-subtypes/) **Published:** December 1, 2025 **Author:** Carolyn Serraino **Content:** A new study in *PLOS Computational Biology* employs a large-scale “multi-omics” approach, integrating genetic data, gene-expression information, and network analysis to better understand why Long Covid affects people in so many different ways. #### Using this integrative framework, the researchers identified 32 “putative causal genes” that may help drive Long Covid. Nineteen of these genes had already been reported in prior COVID-19 research, lending confidence to the results. These genes point to several biological processes that may be involved, including immune regulation, viral carcinogenesis (how viruses can influence cell behavior), cell-cycle control (how cells grow, divide, and repair themselves), and metabolic adaptation (how cells adjust under stress). #### The study also grouped patients by linking their symptom profiles to gene-expression clustering, revealing three “biologically meaningful subtypes” of Long COVID. In simple terms, people tended to fall into symptom clusters that matched underlying gene-expression patterns, helping explain why Long Covid can look so different from one person to another. The authors suggest that understanding Long Covid through these subtypes could help future research and clinical trials become more targeted, matching treatments to the biology driving each group rather than treating Long Covid as one single condition. ##### Citation Pinero, S., Li, X., Liu, L., Li, J., Lee, S. H., Winter, M., Nguyen, T., Zhang, J., & Le, T. D. (2025). Integrative multi-omics framework for causal gene discovery in Long COVID. *PLoS computational biology*, *21*(12), e1013725. <https://doi.org/10.1371/journal.pcbi.1013725> **Category:** Covid-19 Infections, Long COVID --- ### [PCC Shows Clear Link to Autoimmune Disease](https://www.autoimmuneinstitute.org/covid_timeline/pcc-shows-clear-link-to-autoimmune-disease/) **Published:** December 5, 2025 **Author:** Carolyn Serraino **Content:** **About Post COVID Condition (PCC)** Post COVID Condition, often called Long Covid, refers to symptoms that begin during or after a SARS-CoV-2 infection and continue for at least two months. Symptoms cannot be explained by another diagnosis and may appear shortly after the initial infection or emerge later. PCC can affect multiple body systems, may fluctuate over time, and can range from mild to disabling. Source: [WHO](https://www.who.int/europe/news-room/fact-sheets/item/post-covid-19-condition) #### A new community-based study of 38,327 COVID-19 patients provides more substantial evidence that autoimmune diseases may shape vulnerability to PCC and may also emerge after infection. Of these individuals, 1,143 were diagnosed with PCC, and 37,184 did not develop PCC. For clarity, this summary refers to those without PCC as the non-PCC group, which corresponds to how the authors describe this population in the study (COVID-19 patients without a PCC diagnosis). People who had [psoriasis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/psoriasis/ "Psoriasis") before infection were 41 percent more likely to develop PCC compared with the non-PCC group. Individuals with [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid arthritis") before COVID-19 were 64 percent more likely to develop PCC. Pre-existing autoimmune diseases overall were linked to a small increase in PCC risk. #### The study also found that people with PCC were more likely to receive a new autoimmune diagnosis after their COVID-19 infection than those in the non-PCC group. New diagnoses of [Sjögren’s](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sjogren-syndrome/ "Sjögren disease (SjD)") syndrome were four times more common in the PCC group than in the non-PCC group, and new rheumatoid arthritis diagnoses were about three times more common. Additional factors associated with PCC included high BMI and chronic respiratory disease. Women accounted for 63 percent of all PCC cases. While symptoms such as fatigue, shortness of breath, palpitations, and changes in taste or smell were documented at low overall levels, they were consistently recorded more often in people with PCC. Healthcare needs also differed. On average, individuals with PCC required about one additional medical encounter day per month compared with those who did not develop PCC, highlighting the ongoing care burden associated with this condition. ##### Citation Sama, S. R., Gore, R., Bauer, A. Z., Garber, L., Rosiello, R., Fair, M., & Kriebel, D. (2025). **[Autoimmune diseases as pre-existing conditions and sequelae of post COVID-19 condition in a Massachusetts community based observational study of COVID-19 patients](https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0337848)**. *PloS one*, *20*(12), e0337848. https://doi.org/10.1371/journal.pone.0337848 **Category:** Covid-19 Infections, Covid-19 Research Studies, Long COVID, RA & Covid-19, Sjögren disease & Covid-19 --- ### [Major Funding Boost for Long COVID and ME/CFS Research](https://www.autoimmuneinstitute.org/covid_timeline/major-funding-boost-for-long-covid-and-me-cfs-research/) **Published:** November 14, 2025 **Author:** Carolyn Serraino **Content:** On November 13, 2025, €500 million (US $582 million) in funding was [committed to long COVID and other post-infection syndromes for 2026 to 2036 under Germany’s new National Decade Against Post-Infectious Diseases](https://www-bmftr-bund-de.translate.goog/SharedDocs/Kurzmeldungen/DE/2025/11/nationale-dekade-postinfekti%C3%B6se-erkrankungen.html?_x_tr_sl=auto&_x_tr_tl=en&_x_tr_hl=en-US&_x_tr_pto=wapp%E2%86%97). The initiative aims to address the significant public health burden created by long COVID and [ME/CFS](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/me-cfs/ "Myalgic encephalomyelitis / chronic fatigue syndrome"), both of which lack effective diagnostics and treatments. Global estimates suggest that six in every one hundred people who contract COVID-19 develop long COVID, and studies have documented substantial impacts on healthcare systems, disability, and the global economy. #### The funding is designed to support research across a broad range of areas, including immunology, biomarkers, diagnostics, neurology, mental health, and long-term outcomes. Experts emphasize the importance of identifying the mechanisms driving illness in each patient so that clinical trials can be targeted at those most likely to benefit, such as using antivirals in individuals with evidence of persistent viral infection or testing therapies that lower autoimmune-driven autoantibody activity. Researchers also hope to expand work on the public health burden of post-infectious disease, including how acute viral infections can lead to chronic illness and how risk factors can be addressed. #### The announcement follows a period of instability in global long COVID research funding, including the [abrupt cancellation and partial restoration of several US National Institutes of Health projects earlier this year](https://www.autoimmuneinstitute.org/research_updates/nih-clinical-trial-cuts-widen-gaps-in-autoimmune-research/ "NIH Clinical Trial Cuts Widen Gaps in Autoimmune Research"). Despite setbacks, scientists say the field has made significant progress in understanding biological mechanisms, including immune dysregulation, viral persistence, and reactivation of latent pathogens such as the Epstein-Barr virus. **Category:** Covid-19 Infections, Long COVID, ME/CFS & Covid-19 --- ### [Autoimmune Markers Persist Two Years After COVID-19](https://www.autoimmuneinstitute.org/covid_timeline/autoimmune-markers-persist-two-years-after-covid-19/) **Published:** November 21, 2025 **Author:** Carolyn Serraino **Content:** A study published in an international medical research journal examined autoantibody expression in patients with Long Covid two years after hospital discharge from Covid-19 infection. Long Covid may partly result from immune alterations caused by SARS-CoV-2, including hyperinflammation, loss of immune tolerance, excessive NET (neutrophil extracellular trap) production, molecular mimicry, and immune dysregulation. According to the authors, an estimated 10% of those infected with Covid-19 develop Long Covid; in hospitalized patients, the incidence is 50–70%. Viral particles have been found to persist for up to 4 months after initial infection, leading to prolonged immune activation. The study included 55 participants aged 21–85 years who had tested positive for SARS-CoV-2. Blood samples were collected 2 years post-discharge and analyzed for inflammatory and autoimmune markers, then compared with a control group of 21 individuals with no prior history of COVID-19. Forty-four patients also completed a health questionnaire; the most frequently reported symptoms two years after infection included headache, muscle weakness in the arms or legs, confusion or lack of concentration, a “pins and needles” sensation, shortness of breath, and persistent muscle pain (in that order). Less frequent symptoms included skin rashes and joint swelling. #### Among the 55 Covid-19 patients, 47.3% had reactive ANA, 3.6% had reactive rheumatoid factor (RF), and 20% had elevated CRP levels (not 120%). Anti-CCP antibodies were negative in all patients.  ANA autoantibodies have distinct fluorescence patterns with clinical associations. The most common pattern in this study was the nuclear fine-speckled pattern (27%), which can be associated with [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus") (SLE), [systemic sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/scleroderma/ "Scleroderma / systemic sclerosis"), and [autoimmune myositis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/inclusion-body-myositis/ "Inclusion body myositis") overlap syndromes. The authors note that ANA testing is not sufficient to diagnose autoimmune diseases, but is a valuable screening tool. “Among the seven reactive samples, three patients exhibited symptoms consistent with SLE, including joint pain or swelling and a tingling sensation.” Additional biomarkers recorded in serum, such as CRP and RF, have been associated with rheumatoid arthritis and other autoimmune conditions. Only five participants had received a COVID-19 vaccine, and autoantibody positivity showed minimal overlap with vaccination status. The authors conclude that “it is plausible that the observed autoimmune markers are associated with the infection itself rather than an immunization response.” ##### Citation Bianchi, C.C.R., Gritte, R.B., Klauss, P.H.A., & Leal, N.F.S.M. (2025). [Detection of autoantibodies in severe COVID-19 patients two years after hospital discharge](https://www.scielo.br/j/bjmbr/a/qTpDGZycYQ4RR8qDB4sHd9q/?lang=en). *Brazilian Journal of Medical and Biological Research, 58*, e14927. **Category:** Covid-19 Antibodies, Covid-19 Infections, Covid-19 Research Studies, Long COVID --- ### [GLP-1 Drugs Enter Formal Testing for Long COVID Treatment](https://www.autoimmuneinstitute.org/covid_timeline/glp-1-drugs-enter-formal-testing-for-long-covid-treatment/) **Published:** November 18, 2025 **Author:** Carolyn Serraino **Content:** Scripps Research has launched a large, fully remote clinical trial to test whether the GLP-1/GIP medication **tirzepatide** (the active ingredient in Zepbound) can reduce long COVID symptoms. The **LoCITT-T Trial** (“locket”) is a randomized, placebo-controlled study enrolling 1,000 adults across the U.S., with no travel required. #### Early interest is high: more than 500 participants enrolled in the first two weeks. GLP-1 drugs gained attention after clinicians began noticing improvements in [fatigue](https://www.autoimmuneinstitute.org/covid_timeline/fatigue-and-cognitive-impairment-in-long-covid-patients/ "Fatigue and Cognitive Impairment in Long Covid Patients"), [brain fog](https://www.autoimmuneinstitute.org/articles/understanding-brain-fog-in-autoimmune-disease "Understanding Brain Fog in Autoimmune Disease"), [MCAS](https://www.autoimmuneinstitute.org/research_updates/mast-cell-activation-syndrome-and-autoimmune-disease/) symptoms, and [POTS](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/postural-orthostatic-tachycardia-syndrome/ "Postural orthostatic tachycardia syndrome")-related symptoms among patients prescribed these medications for unrelated reasons. #### One clinician-reported dataset (including 350 long COVID patients) found 60–90% experienced some improvement, prompting researchers to test the approach formally. The Scripps trial focuses on fatigue as its primary outcome, using the validated Fatigue Severity Scale. Secondary measures include cognitive issues, post-exertional malaise, MCAS symptoms, autonomic symptoms, functional capacity, and full symptom profiles. Participants also receive a Garmin wearable to track sleep, heart rate, step count, and energy metrics. #### Because many people with long COVID cannot safely travel, the study is completely decentralized: surveys, dose adjustments, safety checks, and optional at-home blood collection are done from home. Participants begin at standard FDA-approved tirzepatide doses, with physicians monitoring tolerance and safety. Microdosing will require separate future trials. Each participant takes part for one year, with a planned interim safety and efficacy review at three months. #### If enrollment stays on pace, final results could be available in 2027. The team emphasizes urgency and accessibility. As principal investigator, [Dr. Julia Moore-Vogel](https://www.scripps.edu/science-and-medicine/translational-institute/about/people/julia-moore-vogel/), who also lives with long COVID, explains: “[Let’s do everything we can to meet the patient where they are](https://youtu.be/0WZyfudIV5U?si=MMKrzz7bPVYHgNDf).” #### Enrollment details are available at [longcovid.scripps.edu](https://longcovid.scripps.edu/). [Check your eligibility here!](https://mydatahelps.org/e/LOCITT/Screener?utm_source=locitt&utm_medium=direct&utm_campaign=scripps-locitt-t-landing-page&sa=D&source=editors&ust=1759437823094635&usg=AOvVaw0Guqo_GdF2g7AaEr9qtZFw) **Category:** Covid-19 & Long Covid Treatments, Covid-19 Clinical Trials, Covid-19 Research Studies, Long COVID --- ### [Thyroid Dysfunction After COVID-19 Infection](https://www.autoimmuneinstitute.org/covid_timeline/thyroid-dysfunction-after-covid-19-infection/) **Published:** November 4, 2025 **Author:** Carolyn Serraino **Content:** Cureus recently published a retrospective study on thyroid disruption following COVID-19 infection. While SARS-CoV-2 is known to affect the respiratory system, the virus can also attack the cardiovascular, nervous, and gastrointestinal systems within the body, including the thyroid. Thyroid follicular cells have ACE2 and TMPRSS2 receptors that facilitate the invasion of SARS-CoV-2, triggering an inflammatory cascade and hyperactive immune response. Immune-mediated mechanisms, namely cytokines such as IL-6 and IL-1β, have been shown to suppress the hypothalamic-pituitary-thyroid axis and alter thyroid hormone metabolism. The University of Missouri conducted a single-center retrospective study of 615 adults with confirmed COVID-19 infection and thyroid function tests between March 2020 and December 2023. Patients with pre-existing thyroid conditions or on medications that affect the thyroid were excluded; “thyroid dysfunction was defined as any abnormality in TFTs \[thyroid function tests\].” Eighty-four patients (13.6%) had thyroid dysfunction involving direct viral effects and systemic inflammatory responses. The largest group presented as non-thyroidal illness syndrome (NTIS; 39 patients), followed by subclinical hypothyroidism (37), overt hyperthyroidism (6), and overt hypothyroidism (2). Cases were followed for around one year by chart review; overt progression was noted among 7% of individuals with subclinical hypothyroidism, while 21% of patients with NTIS returned to normal thyroid levels. The authors note that these findings are consistent with other reports showing normal thyroid function 12 months post-COVID-19 infection and no increase in thyroid autoimmunity markers. “Such transient abnormalities may reflect an adaptive endocrine response to acute illness, rather than a sign of permanent dysfunction.” They add that the potential for autoimmune thyroid disease post-COVID-19 infection, particularly [Graves’ disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/graves-disease/ "Graves’ disease"), is still being explored. ##### Citation Tadisina, S., Mohammed, S., Asad, R., Tselovalnikova, T., Nguyen, B., Akella, P. V., & Abu Kishk, M. (2025). Prevalence and Evolution of Thyroid Dysfunction in COVID-19: A Retrospective Study. *Cureus*, *17*(9), e93542. <https://doi.org/10.7759/cureus.93542> **Category:** Covid-19 Infections, Covid-19 Research Studies --- ### [COVID mRNA Shots May Boost Cancer Immunotherapy](https://www.autoimmuneinstitute.org/covid_timeline/covid-mrna-shots-may-boost-cancer-immunotherapy/) **Published:** October 28, 2025 **Author:** Carolyn Serraino **Content:** A surprising benefit of mRNA COVID-19 vaccines may reach beyond protection from infection. Researchers at [MD Anderson Cancer Center](https://www.mdanderson.org/) found that cancer patients who received an mRNA COVID-19 vaccine shortly before starting immunotherapy lived significantly longer than those who did not. The retrospective study, now published in *Nature* and presented at the [European Society for Medical Oncology (ESMO) 2025 Congress](https://www.esmo.org/meeting-calendar/esmo-congress-2025), analyzed data from more than 1,000 patients with advanced melanoma or lung cancer. Among those treated with checkpoint inhibitors, three-year survival was nearly twice as high in vaccinated patients. Laboratory experiments in mice supported these findings, showing that mRNA vaccination strengthens immune signaling and helps immune cells better recognize and attack tumors. #### The COVID-19 vaccines were not designed to target cancer, but their ability to activate type I interferon and other immune pathways appears to “prime” the body for a stronger response to therapy. The effect was most pronounced in patients whose tumors usually respond poorly to immunotherapy, and similar benefits were not seen with flu vaccination. If confirmed in upcoming clinical trials, a widely available vaccine could become a low-cost and straightforward way to improve outcomes for people receiving immune-based cancer treatments, while offering new insight into how immune activation and regulation intersect across diseases. ##### Citations Jacobs, P. (2025). [COVID-19 vaccines may boost cancer immunotherapy](https://www.science.org/content/article/surprise-bonus-covid-19-vaccines-bolstering-cancer-treatment). Science (New York, N.Y.), 390(6771), 321–322. https://doi.org/10.1126/science.aed2823 Grippin, A. J., et al. (2025). [SARS-CoV-2 mRNA vaccines sensitize tumours to immune checkpoint blockade](https://www.nature.com/articles/s41586-025-09655-y). Nature, 10.1038/s41586-025-09655-y. Advance online publication. https://doi.org/10.1038/s41586-025-09655-y European Society for Medical Oncology: [Grippin AJ, et al “SARS-CoV-2 mRNA vaccines sensitize tumors to immune checkpoint blockade” ESMO 2025; Abstract LBA54.](https://www.esmo.org/meeting-calendar/esmo-congress-2025) **Category:** Covid-19 Antibodies, Covid-19 Boosters, Covid-19 Research Studies, Covid-19 Vaccines --- ### [How SARS-CoV-2 May Disrupt Immune Tolerance](https://www.autoimmuneinstitute.org/covid_timeline/how-sars-cov-2-may-disrupt-immune-tolerance/) **Published:** October 21, 2025 **Author:** Carolyn Serraino **Content:** The recently published article, *“Mechanistic Considerations Linking SARS-CoV-2 Infection, Inflammation, and the Loss of Immune Tolerance,”* explores ways in which infection with SARS-CoV-2 may reset the immune system toward a state of autoimmunity. The authors begin by noting that the intense immune activation seen during a COVID-19 infection, while it helps fight the infection, may represent a mechanistic bridge between viral infection and breakdown of immune self-tolerance. This process could help explain why some people develop autoimmune conditions after COVID-19. The paper focuses on how certain immune cells, like macrophages and dendritic cells, respond when they encounter the SARS-CoV-2 virus. These cells take in virus particles that are coated with antibodies and break them down within the cell. Normally, this helps the body learn what to fight the next time it encounters the virus. In the case of SARS-CoV-2, the authors suggest that the process might sometimes go awry. #### A key protein called **TRIM21 (also known as Ro52)** may play a central role. When TRIM21 attaches to antibody-covered viruses, it directs them into degradation pathways such as autophagy. During this process, the cell may present pieces of both viral and self-proteins to the immune system, which can blur the distinction between the body’s own tissues and foreign material. The intense inflammation that happens during COVID-19 can add fuel to the fire. When infected immune cells die in a highly inflammatory state, they release molecules that alert nearby cells to increase immune reactivity. In this environment, immune cells that were previously quiet or harmless might become activated against the body’s own tissues. The authors make it clear that COVID-19 infection does not automatically cause autoimmune disease. They echo what other studies have also explored and addressed: that infection can trigger an autoimmune reaction in people who are already genetically or environmentally prone to autoimmunity, similar to how other viral infections have been linked to autoimmune conditions in the past. While more research is needed to confirm these mechanisms, the study adds to growing evidence that SARS-CoV-2 has the ability to cause long-term immune changes and contribute to autoimmune risk. ##### Citation Tonutti, A., et al. (2025). Mechanistic considerations linking SARS-CoV-2 infection, inflammation, and the loss of immune tolerance. *Current opinion in immunology*, *95*, 102567. https://doi.org/10.1016/j.coi.2025.102567 **Category:** Covid-19 Antibodies, Covid-19 Infections, Covid-19 Research Studies, Long COVID --- ### [Long COVID’s Cognitive Effects Depend on Sex, MRI Study Finds](https://www.autoimmuneinstitute.org/covid_timeline/long-covids-cognitive-effects-depend-on-sex-mri-study-finds/) **Published:** October 14, 2025 **Author:** Carolyn Serraino **Content:** A new MRI study published in *Frontiers in Psychiatry* in October 2025 found that long COVID may alter brain structure in ways that differ by sex. Researchers compared gray matter volume (GMV) in people with cognitive impairment following a COVID-19 infection to both healthy controls and long-COVID patients without cognitive issues. #### These findings add to a growing body of research on how immune, hormonal, and structural factors shape recovery from infection: - Long-COVID patients showed significant gray-matter alterations across multiple regions Echoing findings in [a Nature study](https://www.autoimmuneinstitute.org/covid_timeline/can-getting-covid-shrink-your-brain/) showing that even mild COVID-19 can cause gray matter loss and structural changes linked to smell, memory, and emotion. - Women exhibited more localized changes in frontal and limbic regions tied to mood and emotion Consistent with studies showing that [women experience longer-lasting inflammation](https://www.autoimmuneinstitute.org/covid_timeline/biological-sex-differences-in-long-covid/) and [greater cardiovascular stiffness and inflammatory markers](https://www.autoimmuneinstitute.org/covid_timeline/long-covid-hits-women-harder-especially-heart-health/). - Men showed more widespread gray-matter alterations across parietal, occipital, and motor cortices Aligning with [wearable sensor data](https://www.autoimmuneinstitute.org/covid_timeline/autoantibody-responses-in-males-vs-females-following-covid-19-infection/) showing stronger stress responses in men and [autoantibody studies](https://www.autoimmuneinstitute.org/covid_timeline/autoantibody-responses-in-males-vs-females-following-covid-19-infection/) finding broader immune activation compared to women. - These patterns may arise from hormonal and chromosomal influences on immune signaling As explored in [research on hormones and sex chromosomes](https://www.autoimmuneinstitute.org/research_updates/the-role-of-hormones-and-sex-chromosomes-in-autoimmune-disease/) that shape autoimmune risk and [findings suggesting estrogen may influence Long COVID vulnerability](https://www.autoimmuneinstitute.org/covid_timeline/influence-of-sex-hormones-on-long-covid/). - Understanding sex-specific mechanisms could improve personalized rehabilitation and mental-health support Supporting the need for targeted care, as discussed in [genetic and hormonal studies of autoimmunity](https://www.autoimmuneinstitute.org/articles/how-sex-genetics-influence-autoimmunity/) and [recent analyses linking Long COVID to anxiety, depression, and financial hardship](https://www.autoimmuneinstitute.org/covid_timeline/whos-most-at-risk-from-long-covids-mental-toll/). ###### Citation Toepffer, A., et al. (2025). **Cognition-associated gray matter volume alterations in long-COVID show sex-specific patterns***.* *Frontiers in Psychiatry, 16.*<https://doi.org/10.3389/fpsyt.2025.1653295> **Category:** Covid-19 Infections, Covid-19 Research Studies, Long COVID --- ### [Who’s Most at Risk from Long COVID’s Mental Toll?](https://www.autoimmuneinstitute.org/covid_timeline/whos-most-at-risk-from-long-covids-mental-toll/) **Published:** May 2, 2025 **Author:** Lukshmi Solos **Content:** By late 2023, nearly one in seven U.S. adults reported having experienced long COVID symptoms. A study published in *Communications Medicine* last month examined data from over 375,000 adults (ages 18-64 years) across the United States to identify which demographics are most affected by long COVID, as well as how the long lasting symptoms associated with long Covid are shaping broader health and economic outcomes. For the purposes of this study, long COVID was defined as “reporting any symptoms lasting 3 months or longer that were not present prior to having COVID-19 including fatigue, difficulty concentrating and forgetfulness, “brain fog”, shortness of breath, joint or muscle pain, heart palpitations, changes to taste/smell, and inability to exercise.” Adults aged 30–49 years and 40–49 years had the highest risks of developing long Covid, versus those 65+ who significantly lower risks (13-22% higher versus 31-40% lower, respectively). Those with any (versus no) children, of Hispanic ethnicity, and from lower income households, were more likely to report long Covid. Members of the LGBT community and females were also observed as higher risk. “Black and Asian adults and never-married adults were at 20–43% lower risk and 7% lower risk than White adults and married adults, respectively.” The author examined four economic outcomes for those reporting long Covid symptoms. These included employment status, financial hardship, difficulty paying for usual household expenses, and the frequency of experiencing anxiety and/or depressive symptoms. “The estimated percentages of those with long COVID still experiencing symptoms and reporting a modest to considerable impact on daily functioning were 55.3% and 24.6%, respectively.” In many cases, the severity of these challenges appeared to increase with the duration or intensity of symptoms. As a whole, the economic impact of long COVID in the US has been particularly significant. Estimated lost earnings among working-age adults due to long COVID totaled $211 billion in 2022 and rose to $218 billion in 2023. These results underscore the far-reaching consequences of long COVID, highlighting the urgent need for targeted public health strategies and support systems to address the condition’s lasting effects. ##### Citation Kim, D. (2025). A nationwide study of risk factors for long COVID and its economic and mental health consequences in the United States. *Commun Med* 5, 104. <https://doi.org/10.1038/s43856-025-00759-0> **Category:** Covid-19 Research Studies, Long COVID --- ### [Is Long COVID an Estrogen-Linked Autoimmune Disease?](https://www.autoimmuneinstitute.org/covid_timeline/influence-of-sex-hormones-on-long-covid/) **Published:** July 28, 2021 **Author:** Elevation **Excerpt:** Recent scientific discussion has correlated Long Covid with estrogen-associated autoimmune disease. There has yet to be a consensus on the definition of “Long Covid.” That being said, it is widely acknowledged that Long Covid symptoms, including shortness of breath, persistent fatigue, brain fog, and GI disturbances, typically last more than 2 months after a COVID-19 infection. “Women appear to be twice as likely to develop Long Covid as men, but only until around age 60, when the risk level becomes similar.” **Content:** A commentary published in *Cell Death Discovery* in 2021 proposed that Long COVID may represent an estrogen-associated autoimmune disease. The authors highlighted that women appear to be about twice as likely as men to develop Long COVID, though this difference narrows after age 60, when estrogen levels naturally decline. The authors describe two complementary hypotheses. First, organ damage from an excessive inflammatory response could contribute to prolonged symptoms. Second, a viral infection might “unmask” an autoimmune reaction through molecular mimicry, where viral proteins resemble components of the body’s own tissues, prompting self-reactive immune responses. This mechanism could explain both the persistence of symptoms and the higher incidence in women, whose immune systems are generally more reactive. They emphasize that these hormonal and immune differences are a double-edged sword: men are more likely to experience severe acute COVID-19, while women are more prone to post-infectious or autoimmune complications. The authors propose that identifying and characterizing [autoantibodies in Long COVID](https://www.autoimmuneinstitute.org/covid_timeline/autoantibodies-long-covid/ "Autoantibodies & Long Covid") patients could help clarify these mechanisms and enable the development of sex-specific diagnostic and treatment strategies. Although their preliminary analysis of pediatric cases found no significant sex differences, they note that hormonal effects are likely smaller in children due to lower levels of sex hormone influence on immune activity. ##### Citation Ortona, E., Buonsenso, D., Carfi, A., Malorni, W., & Long Covid Kids study group (2021). Long COVID: an estrogen-associated autoimmune disease?. *Cell death discovery*, *7*(1), 77. <https://doi.org/10.1038/s41420-021-00464-6> **Category:** Autoimmune Diseases & Covid-19, Covid-19 Research Studies, Long COVID --- ### [Sex-Based Body Responses to COVID-19](https://www.autoimmuneinstitute.org/covid_timeline/sex-specific-differences-in-physiological-responses-to-covid-19-infection/) **Published:** March 8, 2024 **Author:** Elevation **Excerpt:** The article “Sex-specific differences in physiological parameters related to SARS-CoV-2 infections among a national cohort (COVI-GAPP study)” explores sex-based variations in physiological responses to COVID-19 using wearable technology. **Content:** A study published in *PLOS ONE* in March 2024 examined how men and women differ in their body’s physiological responses to COVID-19 using continuous data from wearable sensors. The research, part of the COVI-GAPP cohort in Liechtenstein, tracked more than 1.5 million hours of biometric data from 1,163 participants (57% female).Devices recorded nightly changes in breathing rate, heart rate, heart rate variability, and skin temperature before, during, and after infection. Men showed greater increases in skin temperature, breathing rate, and heart rate during the symptomatic period, as well as more pronounced decreases in heart rate variability, a measure of nervous-system balance and stress response. These changes also persisted longer into recovery. Despite these physiological differences, antibody levels were similar between men and women. The study’s machine-learning detection algorithm performed comparably across sexes, though it identified slightly more infections in women, likely due to sample size differences. The findings suggest that wearable technology can help detect infections early and reveal sex-specific biological responses tied to immune and autonomic regulation. Understanding these patterns may support more personalized approaches to infection monitoring and treatment in the future. ##### **Citation** COVID-19 remote early detection (COVID-RED) consortium (2024) et al. **Sex-specific differences in physiological parameters related to SARS-CoV-2 infections among a national cohort (COVI-GAPP study)**. *PloS one*, *19*(3), e0292203. <https://doi.org/10.1371/journal.pone.0292203> **Category:** Covid-19 Research Studies --- ### [Biological Sex Differences in Long COVID](https://www.autoimmuneinstitute.org/covid_timeline/biological-sex-differences-in-long-covid/) **Published:** May 1, 2023 **Author:** Elevation **Excerpt:** Long COVID has been shown to have a greater impact on premenopausal women, yet there has been limited research on how and why it specifically affects female reproductive health. Additionally, symptoms of Long COVID appear to vary between sexes, with hair loss more prevalent in women and sexual dysfunction in men. **Content:** **Key Takeaways** - Researchers are beginning to connect Long COVID’s lingering effects with known patterns in immune and hormonal regulation. - Evidence from 2023 points to overlaps with other [infection-associated chronic illnesses](https://www.autoimmuneinstitute.org/covid_timeline/long-covid-follows-a-pattern-of-post-viral-illness/ "Long COVID Isn’t New—It Follows a Pattern of Post-Viral Illness"), suggesting shared biological roots. - Understanding how sex influences [inflammation](https://www.autoimmuneinstitute.org/articles/inflammation-a-driving-force-of-autoimmune-disease "Inflammation: A Driving Force of Autoimmune Disease"), autoimmunity, and hormone balance could guide more precise diagnostics and treatments. #### Recent research is shedding light on how biological sex shapes immune responses and long-term recovery after COVID-19. A 2023 review in *Frontiers in Rehabilitation Sciences* examined reproductive and hormonal aspects of Long COVID. The authors identified reports of menstrual irregularities, premature menopause, and possible effects on ovarian function and fertility. They also noted overlaps with other infection-associated chronic conditions such as [ME/CFS](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/me-cfs/ "Myalgic encephalomyelitis / chronic fatigue syndrome"), [POTS](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/postural-orthostatic-tachycardia-syndrome/ "Postural orthostatic tachycardia syndrome"), and [connective tissue disorders](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/mixed-connective-tissue-disease/ "Mixed connective tissue disease"), which share immune and hormonal characteristics and predominantly affect women. An editorial in *The Lancet* called for stronger international collaboration to study Long Covid’s biological causes, including viral persistence, autoimmunity, and inflammation, and to incorporate sex-based differences into research and care. Earlier work by Takahashi and Iwasaki described how immune responses differ between sexes. Estrogen can enhance antiviral defense and modulate inflammation, while testosterone may dampen certain immune pathways. However, women’s stronger immune activation may also increase the risk of persistent inflammation or autoantibody production, potential mechanisms behind Long COVID’s chronic effects. #### Together, these studies and more highlight the importance of sex-specific research and greater attention to hormonal and immune factors in understanding and managing Long COVID. ##### **Citations** Pollack, B., von Saltza, E., McCorkell, L., Santos, L., Hultman, A., Cohen, A. K., & Soares, L. (2023). **Female reproductive health impacts of Long COVID and associated illnesses including ME/CFS, POTS, and connective tissue disorders: a literature review**. *Frontiers in rehabilitation sciences*, *4*, 1122673. <https://doi.org/10.3389/fresc.2023.1122673> Takahashi, T., & Iwasaki, A. (2021). **Sex differences in immune responses**. *Science (New York, N.Y.)*, *371*(6527), 347–348. <https://doi.org/10.1126/science.abe7199> The Lancet (2023). **Long COVID: 3 years in**. *Lancet (London, England)*, *401*(10379), 795. <https://doi.org/10.1016/S0140-6736(23)00493-2> **Category:** Covid-19 Research Studies, Long COVID --- ### [Can Catching COVID-19 Shrink Your Brain?](https://www.autoimmuneinstitute.org/covid_timeline/can-getting-covid-shrink-your-brain/) **Published:** March 11, 2022 **Author:** Elevation **Excerpt:** In an article, published this week in Nature, researchers studied changes in brain structure following a SARS-CoV-2 infection. What they found suggests that COVID-19 may have the ability to damage the brain, potentially causing long-term deleterious effects. **Content:** ![Fig. 2: Vertex-wise and voxel-wise longitudinal group differences in grey matter thickness and mean diffusivity changes. From: SARS-CoV-2 is associated with changes in brain structure in UK Biobank](https://media.springernature.com/full/springer-static/image/art%3A10.1038%2Fs41586-022-04569-5/MediaObjects/41586_2022_4569_Fig2_HTML.png?as=webp)Fig 2. from [SARS-CoV-2 is associated with changes in brain structure in UK Biobank](https://www.nature.com/articles/s41586-022-04569-5/figures/2) #### Empirical evidence is beginning to clarify how COVID-19 may affect the brain. In a large-scale study published in *Nature* in March 2022, researchers from the University of Oxford analyzed brain scans from 785 adults, ages 51 to 81, participating in the UK Biobank project. Among them, 401 had tested positive for COVID-19, and 384 served as uninfected controls. By comparing scans taken before and after infection, researchers found that those who had COVID-19 showed greater reductions in gray matter and overall brain volume than those who had not been infected. #### The areas most affected were the orbitofrontal cortex and parahippocampal gyrus, regions linked to smell, memory, and emotion. Subtle signs of tissue damage also appeared in regions connected to the olfactory cortex, consistent with the loss of smell that often accompanies infection. These regions are part of the limbic system, which helps regulate emotion and memory. Participants who had been infected also showed slightly greater cognitive decline over time, performing more slowly on tests of attention and executive function. #### Importantly, these changes were observed even among people who had mild or asymptomatic infections. Researchers believe they may reflect inflammation or reduced sensory input through smell pathways rather than direct viral invasion of the brain. Ongoing follow-up studies aim to determine whether these structural and cognitive changes improve with time or contribute to persistent symptoms seen in Long COVID. ##### Citation Douaud, G., Lee, S., Alfaro-Almagro, F. *et al.* SARS-CoV-2 is associated with changes in brain structure in UK Biobank. *Nature* **604**, 697–707 (2022). <https://doi.org/10.1038/s41586-022-04569-5> **Category:** Covid-19 Infections, Covid-19 Research Studies --- ### [Autoantibody Responses in Males versus Females Following COVID-19](https://www.autoimmuneinstitute.org/covid_timeline/autoantibody-responses-in-males-vs-females-following-covid-19-infection/) **Published:** January 31, 2022 **Author:** Elevation **Excerpt:** Researchers at Cedars-Sinai recruited 177 healthcare workers with confirmed SARS-CoV-2 infection to study autoantibody levels depending on the severity of COVID-19 between males and females. 65% of the patients included in the study were female; 35% were male. Autoantibody reactivity was compared to a cohort of SLE patients, as well as 91 antigens which span typical autoimmune diseases. **Content:** A study published in the *Journal of Translational Medicine* in late December 2021 explored how COVID-19 infection can trigger immune reactions that differ between men and women. Researchers at Cedars-Sinai Medical Center analyzed blood samples from 177 healthcare workers who had recovered from COVID-19, 65% women and 35% men. Their results were compared to samples from healthy pre-pandemic controls and from patients with [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus") (SLE). The researchers looked for [autoantibodies](https://www.autoimmuneinstitute.org/covid_timeline/autoantibodies-long-covid/ "Autoantibodies & Long Covid"), which are immune proteins that mistakenly target the body’s own cells. Normally, antibodies help fight infections, but when they persist or attack healthy tissue, they can [contribute to autoimmune disease](https://www.autoimmuneinstitute.org/articles/decoding-the-role-of-autoantibodies-in-autoimmunity "Decoding the Role of Autoantibodies in Autoimmunity") or [post-viral complications](https://www.autoimmuneinstitute.org/covid_timeline/long-covid-follows-a-pattern-of-post-viral-illness/ "Long COVID Isn’t New—It Follows a Pattern of Post-Viral Illness"). All participants who had been infected with SARS-CoV-2 showed increased autoantibody activity, but the pattern varied by sex and symptom severity. - **Asymptomatic infections:** Women showed broader autoantibody activity, reacting to about 72% of the tested proteins, compared to 28% in men. - **Mild infections:** Men showed stronger activity, reacting to 64% of the proteins, compared to 36% in women. - **Moderate infections:** The difference widened further, with 80% of autoantibodies elevated in men and 18% in women. #### This was the first study to show that even mild or symptom-free COVID-19 can set off lasting autoimmune activity, and that the pattern is reversed between men and women. While [autoimmune diseases are generally more common in women](https://www.autoimmuneinstitute.org/research_updates/sciencetalks-recap-why-autoimmune-diseases-are-more-common-in-women/ "ScienceTALKS Recap: Why Autoimmune Diseases Are More Common in Women"), men were more likely to experience strong immune activation after symptomatic infection. In contrast, women tended to develop autoimmune responses quietly, even when no symptoms were present. The immune changes persisted for up to six months after infection. According to the researchers, these findings may help explain why men often have more severe cases of COVID-19, while women may be more prone to lingering, immune-related effects such as Long COVID. ##### Citation Liu, Y., Ebinger, J.E., Mostafa, R. *et al.* Paradoxical sex-specific patterns of autoantibody response to SARS-CoV-2 infection. *J Transl Med* **19**, 524 (2021). <https://doi.org/10.1186/s12967-021-03184-8> **Category:** Autoimmune Diseases & Covid-19, Covid-19 Antibodies, Covid-19 Research Studies, Long COVID, Lupus & Covid-19 --- ### [Second Infection May Double Long COVID Risk for Kids](https://www.autoimmuneinstitute.org/covid_timeline/second-infection-may-double-long-covid-risk-for-kids/) **Published:** October 3, 2025 **Author:** Carolyn Serraino **Content:** Children who were infected with Omicron-variant SARS-CoV-2 more than once had twice the risk of developing Long COVID compared to those who had only one infection, according to a large U.S. study. #### Researchers analyzed data from 465,717 children and adolescents in the NIH’s RECOVER Initiative, spanning 40 hospitals between January 2022 and October 2023, the period when Omicron variants were dominant. The results showed that the relative risk of Long COVID was 2.08 times higher among kids with a second Omicron infection, regardless of vaccination status. Long COVID was defined as symptoms or diagnoses recorded 90–179 days after infection. #### The elevated risk persisted across multiple conditions linked to Long COVID, including [myocarditis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-myocarditis/ "Autoimmune myocarditis"), heart disease, blood clots, kidney injury, fatigue, cognitive impairment, and dysautonomia ([POTS](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/postural-orthostatic-tachycardia-syndrome/ "Postural orthostatic tachycardia syndrome")). Experts say the findings highlight how reinfections with Omicron compounds risk and that Long COVID may become a lasting pediatric health issue. Editorial author Dr. Danilo Buonsenso emphasized that “Long COVID is here to stay—even in children,” and urged governments to prioritize dedicated pediatric research centers and clinical support programs. The study also noted that low vaccination and booster rates continue to leave many children vulnerable. Researchers have called for stronger public health messaging to reduce infections and reinfections, as well as for expanded investment in research for Long COVID care and a cure. ###### Citations Zhang, B., Wu, Q., Jhaveri, R., Zhou, T., Becich, M. J., Bisyuk, Y., Blanceró, F., Chrischilles, E. A., Chuang, C. H., Cowell, L. G., Fort, D., Horowitz, C. R., Kim, S., Ladino, N., Liebovitz, D. M., Liu, M., Mosa, A. S. M., Schwenk, H. T., Suresh, S., Taylor, B. W., … RECOVER Consortium (2025). **Long COVID associated with SARS-CoV-2 reinfection among children and adolescents in the omicron era (RECOVER-EHR): a retrospective cohort study**. *The Lancet. Infectious diseases*, S1473-3099(25)00476-1. <https://doi.org/10.1016/S1473-3099(25)00476-1> Buonsenso, D. (2025). **Long COVID is here to stay—even in children***.* *The Lancet Infectious Diseases.* Advance online publication. [https://doi.org/10.1016/S1473-3099(25)00496-7](https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(25)00496-7/fulltext) **Category:** Covid-19 Infections, Covid-19 Research Studies, Covid-19 Variants, Long COVID --- ### [Mindfulness Therapy Trial for Long COVID Begins](https://www.autoimmuneinstitute.org/covid_timeline/mindfulness-therapy-trial-for-long-covid-begins/) **Published:** September 19, 2025 **Author:** Carolyn Serraino **Content:** Columbia University has launched a clinical trial to test whether structured mindfulness practices can ease symptoms of Long COVID. The study, called **[LONG-CALM](https://clinicaltrials.gov/study/NCT07140094?mc_cid=1f09bb7b91&mc_eid=a1c0c3d099) (Long-COVID-19 Alleviation Through Learning Mindfulness)**, is recruiting participants with lingering post-COVID symptoms such as fatigue, cognitive problems, and reduced quality of life. The randomized, parallel trial will compare outcomes between patients who receive mindfulness-based therapy and those in a control group. Researchers will track changes using patient-reported measures of symptom burden, quality of life, and mental health. This trial builds on earlier work that explored the use of mindfulness for Long COVID. A small 2025 study found that a six-week mindfulness-based group therapy did not significantly improve depression or anxiety symptoms, though there was a slight downward trend in anxiety scores. Broader reviews suggest meditation can sometimes reduce stress and alter immune and inflammatory markers, but results have been inconsistent, especially in populations with chronic disease. The trial commenced in May 2024 and is anticipated to conclude by late 2027. #### LONG-CALM findings could provide non-drug strategies for managing Long COVID, which has limited treatment options. **Note**: *Many researchers and patient advocates have expressed concern that while mindfulness may help some individuals cope with stress, it does not address the suspected biological drivers of Long COVID, such as immune dysregulation, viral persistence, or reactivated infections. Critics warn that focusing on behavioral approaches could risk diverting funding away from biomedical studies needed to uncover root causes.* ###### Citations Columbia University. (2025, August 24). *Long-Covid-19 alleviation through learning mindfulness (LONG-CALM)* \[Clinical trial registration\]. ClinicalTrials.gov. <https://clinicaltrials.gov/study/NCT07140094> Welbel, R., Rutha, E., Ording, J., Wang, D., & Hirschtick, J. (2025). The effects of a mindfulness-based intervention on depression and anxiety in the long-COVID population. *Journal of Patient-Centered Research and Reviews, 12*(3), 134–139. <https://doi.org/10.17294/2330-0698.2128> Porter, N. S., & Jason, L. A. (2022). Mindfulness meditation interventions for Long COVID: Biobehavioral gene expression and neuroimmune functioning. *Neuropsychiatric Disease and Treatment, 18*, 2599–2626. <https://doi.org/10.2147/NDT.S379653> **Category:** Covid-19 & Long Covid Treatments, Covid-19 Clinical Trials, Long COVID --- ### [Antiphospholipid Autoantibodies May Lead to Blood Clots After COVID-19 Infection](https://www.autoimmuneinstitute.org/covid_timeline/antiphospholipid-autoantibodies-may-lead-to-blood-clots-after-covid-19-infection/) **Published:** February 23, 2022 **Author:** Elevation **Excerpt:** Antiphospholipid autoantibodies can be present in multiple autoimmune diseases, including rheumatoid arthritis, lupus, and ANCA vasculitis. A recent study pinpointed antiphospholipid autoantibodies as a possible culprit in severe blood clotting following a COVID-19 infection. **Content:** Last week, on February 17, 2022, the NIH released a [media advisory](https://www.nhlbi.nih.gov/news/2022/scientists-pinpoint-mechanisms-associated-severe-covid-19-blood-clotting) discussing a recent study on rogue antibodies. These rogue antibodies, identified as circulating antiphospholipid autoantibodies, are thought to be involved in severe blood clotting following a COVID-19 infection. Antiphospholipid autoantibodies can be present in multiple autoimmune diseases, including [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid arthritis"), [lupus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus"), [ANCA vasculitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/microscopic-polyangiitis-anca-associated-vasculitis/ "Microscopic polyangiitis / ANCA-associated vasculitis"), and [antiphospholipid syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/antiphospholipid-syndrome/ "Antiphospholipid syndrome"), and can activate other immune responses. Click [here](https://www.autoimmuneinstitute.org/covid-19-vaccines-in-patients-with-antiphospholipid-antibodies/) for a study on COVID-19 vaccines in patients with antiphospholipid antibodies, as well as [another study](https://www.autoimmuneinstitute.org/toleration-of-mrna-vaccines-in-those-with-antiphospholipid-antibodies/) testing the safety and tolerability of mRNA vaccines in those with antiphospholipid antibodies. Scientists in the [study](https://onlinelibrary.wiley.com/doi/10.1002/art.42094) compared blood samples from COVID-19 patients to healthy controls. They found that the “presence of circulating antiphospholipid antibodies was a strong marker of the ability of COVID-19 serum to activate endothelium,” meaning these autoantibodies may cause cells to lose their ability to resist clotting. Endothelium is a thin membrane that lines the inside of blood vessels, controlling enzymes which regulate blood clotting amongst other functions. Additionally, when researchers removed the these autoantibodies from COVID-19 blood samples and added them to healthy control samples, they witnessed an inflammatory response within the blood vessels. When the antiphospholipid autoantibodies were removed from the COVID-19 blood samples, endothelial cell indicators for clotting fell. This finding shows that higher levels of antiphospholipid autoantibodies can be associated with severe disease outcomes for COVID-19 patients. ###### Citation National Heart, Lung, and Blood Institute. (2022, February 17). Scientists pinpoint mechanisms associated with severe COVID-19 blood clotting. *National Institutes of Health*. <https://www.nhlbi.nih.gov/news/2022/scientists-pinpoint-mechanisms-associated-severe-covid-19-blood-clotting> Shi, H., et al. (2022). Endothelial Cell-Activating Antibodies in COVID-19. *Arthritis & rheumatology (Hoboken, N.J.)*, *74*(7), 1132–1138. <https://doi.org/10.1002/art.42094> **Category:** Autoimmune Diseases & Covid-19, Covid-19 Antibodies, Covid-19 Infections, Covid-19 Research Studies, Lupus & Covid-19, RA & Covid-19 --- ### [COVID-19 and Fertility Autoantibodies](https://www.autoimmuneinstitute.org/covid_timeline/spermatogenesis-related-autoantibodies-in-patients-with-acute-and-long-covid-19/) **Published:** June 24, 2022 **Author:** Elevation **Excerpt:** COVID-19 was shown to induce the production of autoantibodies linked to spermatogenesis (a cell differentiation process that ensures the production of fertilizing sperm, which ultimately fuse with an egg to form a zygote) while vaccination was not shown to induce autoantibodies linked to spermatogenesis. **Content:** ### Spermatogenesis-Related Autoantibodies in Acute and Long COVID-19 #### **Presented at the 13th International Congress on Autoimmunity** **Speaker: [Laura Talamini](https://www.researchgate.net/profile/Laura-Talamini)** COVID-19 has been linked to the production of autoantibodies targeting proteins involved in spermatogenesis, the process by which sperm cells develop. Because the reproductive system is especially vulnerable to infection and expresses high levels of the ACE2 receptor used by SARS-CoV-2, researchers investigated whether autoantibodies might interfere with fertility in both men and women. Talamini’s team examined serum samples from patients with acute and long COVID-19, comparing them with healthy controls and vaccinated individuals. They identified cross-reactivity between the SARS-CoV-2 spike protein and spermatogenesis-related proteins, focusing on four key peptides. ##### Findings showed that: - **Acute COVID-19** patients had elevated antibodies against peptide 2. - **Long COVID** patients had elevated antibodies against peptide 4. - **Females with long COVID** also showed increased antibodies against peptide 2. - **Vaccinated individuals** did not show elevated antibodies against peptides 2 or 4. These results suggest COVID-19, but not vaccination, may trigger immune responses against reproductive proteins, raising concern about possible fertility-related complications after infection. The study has not yet been published. ###### Citations Sharma, I., Kumari, P., Sharma, A., & Saha, S. C. (2021). SARS-CoV-2 and the reproductive system: known and the unknown..!!. *Middle East Fertility Society journal*, *26*(1), 1. <https://doi.org/10.1186/s43043-020-00046-z> Dutta, S., & Sengupta, P. (2021). SARS-CoV-2 and Male Infertility: Possible Multifaceted Pathology. *Reproductive sciences (Thousand Oaks, Calif.)*, *28*(1), 23–26. <https://doi.org/10.1007/s43032-020-00261-z> Stanley, K. E., Thomas, E., Leaver, M., & Wells, D. (2020). Coronavirus disease-19 and fertility: viral host entry protein expression in male and female reproductive tissues. *Fertility and sterility*, *114*(1), 33–43. <https://doi.org/10.1016/j.fertnstert.2020.05.001> Verma, S., Saksena, S., & Sadri-Ardekani, H. (2020). ACE2 receptor expression in testes: implications in coronavirus disease 2019 pathogenesis†. *Biology of reproduction*, *103*(3), 449–451. <https://doi.org/10.1093/biolre/ioaa080> Wang, Z., & Xu, X. (2020). scRNA-seq Profiling of Human Testes Reveals the Presence of the ACE2 Receptor, A Target for SARS-CoV-2 Infection in Spermatogonia, Leydig and Sertoli Cells. *Cells*, *9*(4), 920. <https://doi.org/10.3390/cells9040920> Shen, Q., Xiao, X., Aierken, A., Yue, W., Wu, X., Liao, M., & Hua, J. (2020). The ACE2 expression in Sertoli cells and germ cells may cause male reproductive disorder after SARS-CoV-2 infection. *Journal of cellular and molecular medicine*, *24*(16), 9472–9477. <https://doi.org/10.1111/jcmm.15541> Yang, M., et al. (2020). Pathological Findings in the Testes of COVID-19 Patients: Clinical Implications. *European urology focus*, *6*(5), 1124–1129. <https://doi.org/10.1016/j.euf.2020.05.009> Li, R., et al. (2020). Potential risks of SARS-CoV-2 infection on reproductive health. *Reproductive biomedicine online*, *41*(1), 89–95. <https://doi.org/10.1016/j.rbmo.2020.04.018> Haghpanah, A., et al. (2021). Potential mechanisms of SARS-CoV-2 action on male gonadal function and fertility: Current status and future prospects. *Andrologia*, *53*(1), e13883. <https://doi.org/10.1111/and.13883> Jing, Y., et al. (2020). Potential influence of COVID-19/ACE2 on the female reproductive system. *Molecular human reproduction*, *26*(6), 367–373. <https://doi.org/10.1093/molehr/gaaa030> **Category:** Covid-19 Antibodies, Covid-19 Infections, Covid-19 Research Studies, Long COVID --- ### [COVID-19 Severity and Autoantibody Production](https://www.autoimmuneinstitute.org/covid_timeline/covid-19-severity-and-autoantibody-production/) **Published:** April 25, 2023 **Author:** Elevation **Excerpt:** To better characterize the immunopathology of COVID-19, researchers studied the range of autoantibodies triggered by a SARS-CoV-2 infection, as well as infection severity. Generally, the autoantibodies in patients with mild COVID-19 only slightly differed compared to healthy controls. Patients with moderate COVID-19 exhibited more elevated autoantibody counts, whereas those with severe COVID-19 were observed to have the highest levels of autoantibodies. **Content:** COVID-19 is known to trigger autoantibody production, but researchers are still uncovering how this relates to infection severity. A study published in the *Journal of Medical Virology* examined the types and levels of autoantibodies produced after SARS-CoV-2 infection. The study analyzed 161 unvaccinated COVID-19 patients (72 with mild cases, 61 with moderate cases, and 28 with severe cases) alongside 77 healthy controls. Researchers measured IgG and IgA antibodies, rheumatoid factor, and ENA antibodies in blood samples collected at comparable time points across groups. Results showed a clear link between infection severity and autoantibody levels. Patients with mild COVID-19 had only slightly higher autoantibody counts compared to controls. In moderate cases, autoantibody levels rose more significantly, while those with severe infections had the highest levels. Importantly, older patients with severe COVID-19 showed exceptionally high IgA and IgG autoantibodies. This study suggests that SARS-CoV-2 infection can disturb normal immune tolerance, leading to a severity-dependent increase in autoantibodies. These findings may help explain why some patients develop prolonged immune complications after COVID-19. ###### **Citation:** Baiocchi, G. C., et al. (2023). **Cross-sectional analysis reveals autoantibody signatures associated with COVID-19 severity**. *Journal of medical virology*, *95*(2), e28538. <https://doi.org/10.1002/jmv.28538> **Category:** Autoimmune Diseases & Covid-19, Covid-19 Antibodies, Covid-19 Infections, Covid-19 Research Studies --- ### [Autoantibodies & Long Covid](https://www.autoimmuneinstitute.org/covid_timeline/autoantibodies-long-covid/) **Published:** June 20, 2023 **Author:** Elevation **Excerpt:** Researchers have identified several biomarkers correlating with long Covid symptoms, further suggesting an autoimmune process activating one year post-Covid infection. **Content:** A recent [paper](https://pubmed.ncbi.nlm.nih.gov/36137590/) shared the results of a longitudinal study on autoantibodies in those with long Covid. Researchers measured levels of a variety of autoantibodies (ANA) and inflammatory markers in 106 patients who experienced a COVID-19 infection, as well as 34 patients who had a non-COVID infection, at 3, 6, and 12 months post-infection and compared them to 22 healthy controls. No participants included in the study had a personal or family history of autoimmune disease. At three months post-COVID infection, approximately one-third of patients had at least one type of IgG autoantibody. 43% of autoantibodies identified in these patients have been associated with autoimmune diseases. Furthermore, the presence of autoantibodies correlated with the severity of COVID-19 infection, with those who were hospitalized or admitted to the ICU having higher levels of ANAs. Autoantibody levels were observed to decrease over time, and severity of COVID-19 infection was no longer predictive of autoantibody levels after 12 months. As a point of interest, some patients displayed new autoantibodies at one year post-Covid that were not recorded at the three or six month intervals. #### This suggests that there may be an autoimmune process at work.  Two autoantibodies (anti-U1-snRNP and anti-SS-B/La) were identified that are predictive of long Covid symptoms (fatigue and shortness of breath, respectively). A couple of inflammatory mediators (TNFα and D-dimer) correlated with ANA levels and were also elevated in symptomatic patients. The authors of the paper emphasize the ongoing need for research on the mechanisms of long Covid and for better symptom screening in future studies as more long Covid symptoms have become apparent since this study began. ###### **Citation:** Son, K., et al. (2023). **Circulating anti-nuclear autoantibodies in COVID-19 survivors predict long COVID symptoms**. *The European respiratory journal*, *61*(1), 2200970. <https://doi.org/10.1183/13993003.00970-2022> **Category:** Autoimmune Diseases & Covid-19, Covid-19 Antibodies, Covid-19 Research Studies, Long COVID --- ### [Autoimmunity & Severe COVID-19: Omicron Meta-Analysis](https://www.autoimmuneinstitute.org/covid_timeline/autoimmunity-severe-covid-19-omicron-meta-analysis/) **Published:** September 11, 2025 **Author:** Carolyn Serraino **Content:** A systematic review and meta-analysis was recently published on the risk of severe COVID-19 in immunocompromised people. The study analyzed SARS-CoV-2 Omicron strain infections between January 2022 and March 2024 and is the first large-scale assessment of outcomes in this population. **The review included people of all ages with at least one of the following conditions:** #### autoimmunity, transplant, liver disease, malignancy, chronic or end-stage renal disease, HIV, or unspecified immunocompromising/immunosuppressive (IC/IS) conditions. Outcomes measured were death, hospitalization, and intensive care unit (ICU) admission. ## Severe COVID-19 Risk for Immunocompromised Patients Those with IC/IS conditions, including autoimmune disease, are more likely to be impacted by COVID-19, even with milder Omicron strains. This group may experience persistent symptoms and faces a higher risk of severe outcomes compared to those without IC/IS conditions. Of 21,937 records screened, 66 studies were included. **Across these 66 studies, outcomes were reported at different frequencies: death in 65% (43 studies), hospitalization in 33% (22), ICU admission in 24% (16), and combined outcomes in 29% (19).** These figures reflect how often outcomes were assessed, not the proportion of patients who experienced them. Thirteen studies specifically assessed autoimmune disease, with more than 2.5 million participants across them. ## COVID-19 Outcomes by Comorbidity - **Renal disease:** People with advanced kidney disease were most often reported as being at higher risk of death from COVID-19. - **Autoimmune disease:** Too few studies focused on autoimmune disease to calculate reliable risks for hospitalization or ICU admission. - **Cancer:** People with cancer were at least twice as likely to die, need hospitalization, or require ICU care. - **Transplant:** Transplant patients were at least six times more likely to face severe outcomes. - **IC/IS unspecified group:** People in the “immunocompromised/immunosuppressed (unspecified)” group had the highest risk of ICU admission. ## COVID-19 Outcomes & Autoimmune Disease For people with autoimmune disease, the analysis did not show a clear increase in risk of death or combined severe outcomes from COVID-19. However, the researchers note this may simply be because there were too few autoimmune-focused studies to draw firm conclusions. There also weren’t enough studies to properly measure the risks of hospitalization or ICU admission in this group. Interestingly, some studies did find that people were more likely to develop a new autoimmune disease after a COVID-19 infection, pointing to what the authors describe as “a potential positive feedback loop between autoimmunity and COVID-19.” ###### Citation Chapman, A., et al. (2025). Risk of Severe Outcomes From COVID-19 in Immunocompromised People During the Omicron Era: A Systematic Review and Meta-Analysis. *Clinical therapeutics*, *47*(9), 770–787.[ https://doi.org/10.1016/j.clinthera.2025.07.006](https://doi.org/10.1016/j.clinthera.2025.07.006) **Category:** Covid-19 Infections, Covid-19 Research Studies, Covid-19 Variants --- ### [When Doctors Don’t Have Answers, People Turn to Each Other](https://www.autoimmuneinstitute.org/covid_timeline/when-doctors-dont-have-answers-people-turn-to-each-other/) **Published:** July 11, 2025 **Author:** Carolyn Serraino **Content:** More and more people living with long COVID are trying to manage their condition based on information they’ve found online through Facebook groups, TikTok videos, Reddit threads, and YouTube channels. These posts often share personal stories about treatments that worked for someone else, from vitamins and supplements to medications not officially approved for this use. It’s easy to dismiss this behavior as risky or misinformed. However, the truth is that many people turn to the internet because [they feel ignored or unsupported by the healthcare system](https://www.autoimmuneinstitute.org/articles/when-youve-lost-trust-in-doctors/ "they feel ignored or unsupported by the healthcare system"). They’ve been outright dismissed or offered vague answers. And in that gap, it makes sense to seek help wherever it seems available. The autoimmune disease community knows this pattern well. People with complex, hard-to-diagnose illnesses are often left to figure things out on their own. Online spaces can offer comfort, connection, and even helpful ideas. But they can also spread misinformation, particularly when sensational stories are shared more widely than careful, evidence-based guidance. This blurs the line between emotional support and medical advice. The World Health Organization refers to this situation as an “[infodemic](https://www.who.int/news-room/spotlight/let-s-flatten-the-infodemic-curve),” an overwhelming amount of information, some of which is helpful, but much of it is misleading or even harmful. Everyone wants to feel better. And sometimes, doing your own research *does* lead to something that helps. But it’s also important to recognize that what works for one person might not work for another and could even cause harm. That’s why we need a better system. One that listens, validates, and responds. One that’s faster, more accessible, and more attuned to the real-world experiences of people living with chronic illness. We urge caution for now, not because people can’t look out for themselves, but because they deserve better tools, better answers, and better care. [![](https://cdn.who.int/media/images/default-source/health-topics/coronavirus/misinformation-infographic-v4.tmb-1920v.png?sfvrsn=25443a25_20)](https://cdn.who.int/media/images/default-source/health-topics/coronavirus/misinformation-infographic-v4.tmb-1920v.png?sfvrsn=25443a25_20) **Category:** Covid-19 & Long Covid Treatments, Long COVID --- ### [EBV Reactivation After COVID-19: What We Know (and Don’t)](https://www.autoimmuneinstitute.org/covid_timeline/ebv-reactivation-after-covid-19-what-we-know-and-dont/) **Published:** September 8, 2025 **Author:** Carolyn Serraino **Content:** Epstein-Barr virus (EBV) activation and reactivation have [long been cited](https://www.autoimmuneinstitute.org/covid_timeline/can-covid-19-reactivate-the-epstein-barr-virus/ "Can COVID-19 Reactivate the Epstein-Barr Virus?") as a possibility after a COVID-19 infection. EBV has the ability to trigger the development of autoimmune diseases such as [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/), [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/), [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/), and [myasthenia gravis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/myasthenia-gravis/). While the exact mechanisms behind EBV triggering autoimmunity have not been defined, the most plausible hypothesis is that EBV disrupts B cell regulatory checkpoints, ultimately leading to the development of autoimmune plasma cells. Viruses can reactivate EBV, which is crucial in the pathophysiology of certain autoimmune diseases. A literature review recently published in the *Journal of Microbiology, Immunology and Infection* summarized the most recent data on COVID-19 and EBV reactivation. Authors also highlight the role of the SARS-CoV-2-reactivated EBV in the development of autoimmunity, as well as flares and long Covid manifestations. Documented mechanisms by which a Covid-19 infection may trigger autoimmunity include a “hyper-stimulation of inflammatory responses” with cytokine storm, molecular mimicry, and dysregulation of innate and adaptive immune cells (more [here](https://www.autoimmuneinstitute.org/articles/is-long-covid-an-autoimmune-disease-is-sars-cov-2-an-autoimmune-virus/)). The activation of T cells and immune cells without a specific target (also known as bystander activation), as well as persistent infection (e.g. long Covid) are also mechanisms for an autoimmune response. While the correlation between SARS-CoV-2 infection and autoimmunity has been observed, the authors point out that direct causality has yet to be proven. #### Several mechanisms affecting immune regulation after a COVID-19 infection can [reactivate latent viruses](https://www.autoimmuneinstitute.org/research_updates/infections-and-pathogens-as-triggers-of-autoimmune-disease/ "Long COVID Isn’t New—It Follows a Pattern of Post-Viral Illness"), including EBV. This suggests an additional, indirect effect of the SARS-CoV-2 virus, as “acute infection by different pathogens may provide suitable conditions for EBV to reactivate, increasing the risk for EBV-associated pathologies.” One study included in this review cited EBV as one of the most frequently observed viruses by studies reporting viral reactivation specifically in patients with severe COVID-19. 58% of 895 patients showed EBV reactivation, the highest among viruses studied. In another study with 539 patients infected with Covid-19 and Herpesviridae were reviewed, and EBV was highlighted as one of the top three reactivated viruses concomitant with infection. Authors also cite several studies that support the relationship between SARS-CoV-2 infection and EBV reactivation, with high incidences of EBV co-infection/ reactivation in COVID-19 patients. EBV reactivation can occur soon after or simultaneously with a COVID-19 infection, even in asymptomatic cases. Additionally, “a direct positive correlation has been reported between EBV reactivation and the severity of SARS-CoV-2 infection and its symptoms.” In one study, EBV reactivation was reported in 92.5% of severe COVID-19 patients hospitalized in the ICU; EBV reactivation has also been associated with longer hospitalization. Patients with long Covid symptoms have shown signs of EBV reactivation, suggesting a contribution of EBV to long-term inflammatory symptoms. In one retrospective study, 66.7% of patients with long Covid symptoms showed EBV reactivation. #### Viral reactivation has been noted as a risk factor for in-hospital mortality. The mortality rate in patients with COVID-19 and the need for more intense immunosuppressive therapies were higher in patients with EBV reactivation. This indicates a strong impact of EBV on the “patho-immunological alterations and outcomes of COVID-19 illness.” In one study evaluating the incidence of EBV reactivation amongst other herpesviruses, EBV was the most and earliest reactivated herpesvirus amongst patients (65%). ![](https://ars.els-cdn.com/content/image/1-s2.0-S1684118225000763-gr1_lrg.jpg)Image from: Tarasco, M. C., Iacomino, N., Mantegazza, R., & Cavalcante, P. (2025). **COVID-19, Epstein-Barr virus reactivation and autoimmunity: Casual or causal liaisons?**. *Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi*, *58*(5), 508–516. <https://doi.org/10.1016/j.jmii.2025.03.014> The association between EBV and long Covid in patients with asymptomatic or mild infection has not been successfully made. The authors note that the molecular mechanisms underlying EBV’s contribution to COVID-19 infection and symptomatology are also not fully understood. #### Studies show that patients experiencing EBV reactivation triggered long Covid fatigue and neurocognitive dysfunction in a statistically significantly higher percentage of Covid-19 patients. Additionally, authors summarized a proposed model for the pathophysiological link between COVID-19 and EBV to support the susceptibility of autoimmune disease development and reactivation of symptoms. These points include SARS-CoV-2 infection being associated with an increased risk of development or worsening of autoimmune disease, and EBV reactivation being reported in patients with severe COVID-19 and long Covid, including autoimmune diseases. Reactivated EBV promotes the expression of ACE2, the main SARS-CoV-2 surface receptor, which opens the entryway of the virus into epithelial cells, which then has the ability to switch EBV from a latent state to an active state, aka reactivation. It is not clear whether immune system cell exhaustion or hyper-activation is the underlying mechanism for EBV reactivation from SARS-CoV-2 infection. Overall, the review concludes that EBV reactivation is frequently observed in severe COVID-19 and long Covid and may contribute to autoimmune flares. However, whether this link is causal or coincidental remains unresolved. ###### Citation Tarasco, M. C., et al. (2025). **COVID-19, Epstein-Barr virus reactivation and autoimmunity: Casual or causal liaisons?**. *Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi*, *58*(5), 508–516. <https://doi.org/10.1016/j.jmii.2025.03.014> **Category:** Autoimmune Diseases & Covid-19, Covid-19 Infections, Covid-19 Research Studies, Long COVID, Lupus & Covid-19, MS & Covid-19, Myasthenia gravis & Covid-19, RA & Covid-19 --- ### [Shingles Cases Reported After COVID mRNA Vaccine in Autoimmune Patients](https://www.autoimmuneinstitute.org/covid_timeline/6-patients-with-autoimmune-inflammatory-disorders-develop-shingles-after-mrna-vaccine/) **Published:** April 21, 2021 **Author:** Elevation **Excerpt:** The Tel Aviv Medical Center and Carmel Medical Center are conducting a study monitoring adverse events in patients with autoimmune inflammatory disorders. This includes patients with rheumatoid arthritis, vasculitis, myositis, Sjogren’s and spondyloarthritis for 6-weeks post COVID-19 vaccination. Of 491 patients with autoimmune inflammatory rheumatic diseases, six have been diagnosed with herpes zoster (shingles) for the first time after receiving an mRNA vaccine. Five cases occurred after receiving the first dose, and one after the second dose. Five of the six patients had not been vaccinated for shingles prior to receiving the COVID-19 vaccine.  **Content:** The Tel Aviv Medical Center and Carmel Medical Center are conducting a [study monitoring adverse events in patients with autoimmune inflammatory disorders](https://academic.oup.com/rheumatology/advance-article/doi/10.1093/rheumatology/keab345/6225015). This includes patients with [rheumatoid arthritis](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/rheumatoid-arthritis/), vasculitis, myositis, [Sjogren’s](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/sjogrens-syndrome/), and spondyloarthritis for 6 weeks post-COVID-19 vaccination. Of 491 patients with autoimmune inflammatory rheumatic diseases, six have been diagnosed with herpes zoster (shingles) for the first time after receiving an mRNA vaccine. Five cases occurred after receiving the first dose, and one after the second dose. Five of the six patients had not been vaccinated for shingles prior to receiving the COVID-19 vaccine. As of now, there have not been reports of shingles in clinical trials. That being said, there is limited data regarding the safety of COVID-19 vaccines in those with autoimmune and rheumatic diseases, as immunocompromised participants were not included in clinical trials. The authors of this study emphasize that these six cases do not establish a causal link, particularly since other factors may have influenced these outcomes. For example, the risk of shingles doubles in patients with rheumatoid arthritis. Risk also increases when taking high doses of prednisone, and doubles when being treated with certain anti-rheumatic drugs (such as tofacitinib, e.g., Xeljanz). “Potential mechanisms that might explain the pathogenetic link between mRNA-COVID-19 vaccination and herpes zoster reactivation are related to stimulation of innate immunity through toll-like receptors by mRNA-based vaccines” ([1](https://academic.oup.com/rheumatology/advance-article/doi/10.1093/rheumatology/keab345/6225015)).  Five patients received antiviral treatments, which resolved their shingles; the five patients who had only received one dose before the onset of their symptoms received the second dose and did not experience other adverse effects. Herpes zoster reactivation after vaccination has been studied in conjunction with other diseases, such as Hepatitis A and rabies ([2](https://pubmed.ncbi.nlm.nih.gov/10459967/)). According to the authors of this study, these are the first reported cases of shingles reactivation after a COVID-19 vaccine. There has also been an uptick in shingles cases reported globally in the context of COVID-19 infection. Further investigation and reporting of adverse events are crucial to understanding the prevalence of herpes zoster reactivation after COVID-19 infection. This study started in December 2020 and is ongoing. ###### Citations 1. Victoria Furer, et al. Herpes zoster following BNT162b2 mRNA COVID-19 vaccination in patients with autoimmune inflammatory rheumatic diseases: a case series, *Rheumatology*, Volume 60, Issue SI, October 2021, Pages SI90–SI95, <https://doi.org/10.1093/rheumatology/keab345> 2. Walter, R., Hartmann, K., Fleisch, F., Reinhart, W. H., & Kuhn, M. (1999). Reactivation of herpesvirus infections after vaccinations?. *Lancet (London, England)*, *353*(9155), 810. <https://doi.org/10.1016/S0140-6736(99)00623-6> **Category:** Autoimmune Diseases & Covid-19, Vaccine Adverse Events, Vaccine Manufacturers --- ### [Wildfire Smoke Exposure Worsened COVID-19 Outcomes](https://www.autoimmuneinstitute.org/covid_timeline/wildfire-smoke-exposure-covid-19-double-whammy-for-the-immune-system/) **Published:** August 18, 2021 **Author:** Elevation **Excerpt:** A new study explored a notable association between wildfire smoke exposure and the sizable number of COVID-19 cases and deaths in Oregon, Washington, and California in 2020. There are numerous compounds that make up wildfire smoke, but one of the most prevalent and dangerous is called PM2.5 (particulate matter measuring 2.5 micrometers or less). Due to its small size, PM2.5 can penetrate deep into human lungs, unlike larger pieces of particulate matter. Identified by the Environmental Protection Agency as a health threat, PM2.5 has been found to compromise the immune system, particularly by clogging up the upper respiratory system and by prompting an immune attack from the body following lung penetration. Researchers proposed that having to respond to this PM2.5 attack distracts and overwhelms the immune system, leaving it more vulnerable to a COVID-19 infection. **Content:** A [new study](https://advances.sciencemag.org/content/advances/7/33/eabi8789.full.pdf) published in *Science Advances* found that wildfire smoke significantly worsened the toll of COVID-19 in California, Oregon, and Washington during the record 2020 fire season. Researchers linked spikes in fine particulate matter (PM2.5: tiny particles less than 2.5 micrometers in diameter that burrow deep into the lungs) with thousands of additional COVID-19 cases and hundreds of deaths. PM2.5 is considered one of the [most harmful components of smoke](https://www.epa.gov/pm-pollution/particulate-matter-pm-basics) because of its ability to slip past the body’s natural defenses and trigger inflammation in the respiratory system. The study suggests that this immune “distraction” may weaken the body’s ability to fight off SARS-CoV-2, effectively creating a one-two punch: wildfire smoke stresses the lungs, while COVID-19 exploits the compromised defenses. ###### Citation Zhou, X., et al. (2021). Excess of COVID-19 cases and deaths due to fine particulate matter exposure during the 2020 wildfires in the United States. *Science advances*, *7*(33), eabi8789. <https://doi.org/10.1126/sciadv.abi8789> **Category:** Covid-19 Infections, Covid-19 Research Studies --- ### [How Immunology Shaped COVID Vaccines and Beyond](https://www.autoimmuneinstitute.org/covid_timeline/how-immunology-shaped-covid-vaccines-and-beyond/) **Published:** August 25, 2025 **Author:** Carolyn Serraino **Content:** In a recent *Immune* *MicrobeTV* podcast interview, [Dr. Shane Crotty](https://www.lji.org/labs/crotty-lab/) of the La Jolla Institute for Immunology shared his journey into science and the lessons learned from leading vaccine research during COVID-19. Crotty described how he “fell into” immunology while studying viral evolution, eventually becoming fascinated with how T follicular helper (TFH) cells guide B cells to produce long-lasting antibody responses. ##### This work has helped define why some vaccines succeed while others fail, knowledge crucial for infectious diseases and potentially for autoimmune conditions where antibody regulation goes awry. During the early days of COVID-19, Crotty’s lab was among the first to show that people who recovered produced normal, effective immune responses. This finding reassured scientists and vaccine developers worldwide that protective vaccines were possible. The speed of this research was truly exceptional, with patient enrollment, assay conduct, and result publication occurring in a matter of weeks. Crotty credits collaboration, agility, and a willingness to share data openly. He also reflected on the balance between collaboration and competition in science, the value of failure as a teacher, and why vaccines remain his greatest passion: ##### *“They’ve saved more children’s lives globally than anything besides clean water.”* For the autoimmune community, Crotty’s work on TFH cells shows how the immune pathways that protect us through vaccines can also misfire, fueling autoimmunity when antibodies attack the body itself, as seen in diseases like [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus"), [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid arthritis"), and [Sjögren’s syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sjogren-syndrome/ "Sjögren’s syndrome"). #### Vaccine ground rules with Shane Crotty **Category:** Covid-19 Vaccines --- ### [Celiac Drug Shows Promise for Post-COVID Inflammation in Kids](https://www.autoimmuneinstitute.org/covid_timeline/celiac-drug-shows-promise-for-post-covid-inflammation-in-kids/) **Published:** August 19, 2025 **Author:** Carolyn Serraino **Content:** Multisystem inflammatory syndrome in children (MIS-C) occurs after COVID-19 infection in a rare subset of children. The symptoms include high fevers, rash, nausea, diarrhea, and cardiovascular injury. A recent clinical trial found that larazotide, which was initially investigated to treat celiac disease, is safe and effective in treating MIS-C. Because of the rarity of MIS-C, the trial included 12 children with early-stage MIS-C. Those who received larazotide could more quickly clear SARS-CoV-2 particles, recover from gastrointestinal symptoms, and go back to regular activity. Larazotide works by improving the intestinal barrier. This can help prevent SARS-CoV-2 particles from leaving the intestines and entering the circulation. Currently, larazotide hasn’t been FDA-approved for any indication, but it’s possible that in the future, it could have applications for various conditions related to long COVID. ##### Citation Yonker, L. M., et al. (2025). [Viral spike antigen clearance and augmented recovery in children with post-COVID multisystem inflammatory syndrome treated with larazotide](https://doi.org/10.1126/scitranslmed.adu4284). *Science translational medicine*, *17*(809), eadu4284. **Category:** Celiac disease & Covid-19, Covid-19 Clinical Trials, Covid-19 Infections --- ### [Synthetic Nanoparticle Blocks COVID-19 by Nearly 99% in Lab Tests](https://www.autoimmuneinstitute.org/covid_timeline/synthetic-nanoparticle-blocks-covid-19-by-nearly-99-in-lab-tests/) **Published:** August 15, 2025 **Author:** Carolyn Serraino **Content:** Scientists from Swansea University, Freie Universität Berlin, and Charité–Universitätsmedizin Berlin have developed a synthetic sugar-coated nanoparticle that can almost completely block SARS-CoV-2 from infecting human lung cells. The tiny particle is coated with polysialosides, chains of a natural sugar called *sialic acid* found on human cells. Many viruses, including coronaviruses, use these sugars as docking points to start infection. #### By mimicking this natural structure, the nanoparticle acts as a decoy, latching onto the virus’s spike protein and preventing it from binding to real cells. In lab experiments, the most effective version bound to the virus 500 times more strongly than a similar compound made with sulfates instead of sugars. > *“The dendritic polyglycerol based polysialosides dPG500SA0.55 and dPG500SA0.25, with a dissociation constant Kd of 4.78 nm and 10.85 nm, respectively, bind ≈500 times stronger than the high density polysulfated analog dPG500S0.55, to intact SARS-CoV-2 virus particles or isolated spike protein.”* – Khatri, V., et al. Even at lower doses, it blocked infection by up to 98.9% and worked against both the original SARS-CoV-2 strain and the more infectious D614G variant. > *“In the presence of dPG500SA0.55 SARS-CoV-2 replication was inhibited up to 83.8% at 24 hours post-infection and to 98.9% at 48 hours post-infection at the maximum applied compound concentration of 1 mg ml−1 which is equivalent to 0.5 μm, when compared to untreated Calu-3 cells.”* – Khatri, V., et al. #### Importantly, it was not toxic to human cells. > *“A cell viability assay was conducted to exclude the possibility that the compounds were cytotoxic. The number of viable cells remained at a constant level with increasing compound concentration at the highest dose of 1 mg ml−1 after 24h and 48h post treatment “* – Khatri, V., et al. #### Unlike vaccines, which train the immune system, this approach is a physical shield directly stopping the virus from attaching to cells. Researchers say the technology could lead to new antiviral tools such as nasal sprays, surface disinfectants, or treatments to protect high-risk groups from COVID-19 and potentially other viral threats. ##### **Citation** Khatri, V., et al. (2025). *Polysialosides Outperform Sulfated Analogs for Binding with SARS-CoV-2.* *Small*. <https://doi.org/10.1002/smll.202500719> **Category:** Covid-19 & Long Covid Treatments, Covid-19 Infections, Covid-19 Research Studies --- ### [Many Long COVID Studies Lack Comparison Groups, Review Finds](https://www.autoimmuneinstitute.org/covid_timeline/many-long-covid-studies-lack-comparison-groups-review-finds/) **Published:** January 31, 2025 **Author:** Carolyn Serraino **Content:** A new [study](https://www.amjmed.com/article/S0002-9343(23)00038-4/fulltext) published in *The American Journal of Medicine* raises important concerns about how long COVID has been studied and how [its definition](https://www.autoimmuneinstitute.org/covid_timeline/autoimmune-experts-debate-long-covid-definition-concerns/ "Autoimmune Experts Debate Long COVID Definition Concerns") may have been shaped by flawed or incomplete evidence. Researchers analyzed **83 long COVID studies** published in top medical journals. They found that: - 42% didn’t include a control or comparison group, making it hard to know if certain symptoms are truly caused by COVID-19. - About 49% didn’t adjust for confounding factors like age or preexisting conditions. - Of those that did, nearly 40% adjusted for only four or fewer variables, often not enough to rule out other causes. This doesn’t mean long COVID isn’t real, it absolutely is. But it does mean some definitions and statistics may be based on flawed or incomplete evidence. That could impact who gets diagnosed, who gets care, and how resources are allocated. The authors stress the need for more rigorous, better-controlled studies to refine our understanding, not to discredit patients or [defund research](https://www.autoimmuneinstitute.org/covid_timeline/office-of-long-covid-research-and-practice-closure/ "The Federal Long COVID Office Is Closing—Here’s What We Know"). In fact, their findings point to a need for more investment, especially in: - Randomized trials (only 3 studies met this standard) - Intervention research (only 2 studies tested treatments) For those living with long COVID, autoimmune disease, or related conditions, stronger studies will mean clearer answers, better diagnostics, and more effective care. ##### Citation Haslam, A., & Prasad, V. (2025). **Comparability of Control and Comparison Groups in Studies Assessing Long COVID**. *The American journal of medicine*, *138*(1), 148–152.e3. <https://doi.org/10.1016/j.amjmed.2023.01.005> **Category:** Covid-19 Research Studies, Long COVID --- ### [Long COVID Hits Women Harder, Especially Heart Health](https://www.autoimmuneinstitute.org/covid_timeline/long-covid-hits-women-harder-especially-heart-health/) **Published:** July 31, 2025 **Author:** Carolyn Serraino **Content:** A new [study](https://pmc.ncbi.nlm.nih.gov/articles/PMC12304274/) published in *Scientific Reports* found that women who developed long COVID had the highest levels of inflammation, gut damage, and blood vessel stiffness, suggesting they may face greater long-term health risks than men. Researchers compared 89 COVID-positive adults with 89 matched participants who never had COVID. Among the COVID group, 64% had long COVID, defined as symptoms lasting at least 3 months. **Key findings:** - Markers of gut permeability and inflammation, like zonulin, IL-6, and oxidized LDL, were significantly higher in people with long COVID. - These markers are linked to “leaky gut,” chronic inflammation, and damage to blood vessels, all of which can raise cardiovascular risk. - Women with long COVID were 29 times more likely to have poor arterial elasticity (a sign of stiff or damaged arteries) compared to men without long COVID. - The more symptoms a woman had, the worse her vascular health. Those with 13+ symptoms were 11 times more likely to have stiff arteries than men with fewer symptoms. - Even without long COVID, female sex alone increased vascular risk 4-fold, highlighting a biological difference in recovery. Researchers used a noninvasive tool (EndoPAT) to measure arterial stiffness. A higher score (called the augmentation index) meant worse blood vessel flexibility, which has been tied to heart disease risk. The study concludes that female COVID survivors, especially those with lingering symptoms, need long-term monitoring and support to reduce the risk of chronic cardiovascular complications. ##### Citation Durieux, J. C., et al. (2025). Sex differences in inflammation and markers of gut integrity in long COVID. *Scientific reports*, *15*(1), 27374. <https://doi.org/10.1038/s41598-025>-11470-4 **Category:** Covid-19 Infections, Covid-19 Research Studies, Long COVID --- ### [COVID Infection May Trigger Chronic Fatigue Syndrome](https://www.autoimmuneinstitute.org/covid_timeline/covid-infection-may-trigger-chronic-fatigue-syndrome/) **Published:** July 25, 2025 **Author:** Carolyn Serraino **Content:** A major [new study](https://translational-medicine.biomedcentral.com/articles/10.1186/s12967-025-06625-w) confirms that SARS-CoV-2 infection significantly increases the risk of developing new-onset [chronic fatigue syndrome/myalgic encephalomyelitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/me-cfs/ "Myalgic encephalomyelitis / chronic fatigue syndrome") (CFS/ME), a complex and often disabling condition. ##### Researchers analyzed data from over 147,000 adults in the Montefiore Health System and found elevated risk for CFS/ME up to four years post-infection, regardless of whether the patient had been hospitalized for COVID-19. #### **Key findings include:** - COVID-19 infection increased the risk of CFS/ME by 46%–56%. - Women were 54% more likely to develop CFS/ME than men. - People with existing autoimmune disease had a 57% higher risk of developing CFS/ME than those without. - Pre-existing anxiety also raised the risk of CFS/ME by 35%. - CFS/ME risk was *not* elevated by SARS-CoV-2 reinfection. [![](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/07/Screenshot-2025-07-25-at-3.35.46-PM.png)](https://translational-medicine.biomedcentral.com/articles/10.1186/s12967-025-06625-w/tables/2)***Table 2.** Adjusted hazard ratios (HR) for developing chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) more than 30 days after COVID-19 infection. Reproduced from [Hadidchi et al., 2025.](https://translational-medicine.biomedcentral.com/articles/10.1186/s12967-025-06625-w/tables/2)* While the exact mechanisms remain unclear, this study strengthens the link between [viral infections and long-term autoimmune-like syndromes](https://www.autoimmuneinstitute.org/covid_timeline/long-covid-follows-a-pattern-of-post-viral-illness/ "Long COVID Isn’t New—It Follows a Pattern of Post-Viral Illness"). The overlap between long COVID and CFS/ME, including fatigue, brain fog, and post-exertional malaise, underscores the urgent need for better recognition and care. ###### Citation Hadidchi, R., Patel, B., Madan, J. *et al.* Elevated risk of new-onset chronic fatigue syndrome/myalgic encephalomyelitis up to four years after SARS-CoV-2 infection. *J Transl Med* **23**, 815 (2025). <https://doi.org/10.1186/s12967-025-06625-w> **Category:** Covid-19 Infections, Covid-19 Research Studies, ME/CFS & Covid-19 --- ### [Pandemic Brain Is Real, Even If You Didn't Get COVID](https://www.autoimmuneinstitute.org/covid_timeline/pandemic-brain/) **Published:** July 22, 2025 **Author:** Carolyn Serraino **Content:** A new [study](https://www.nature.com/articles/s41467-025-61033-4) in *Nature Communications* confirms what many of us have long suspected: the stress of the pandemic changed our brains even if we never contracted COVID. Researchers analyzed brain scans from nearly 1,000 healthy adults in the UK Biobank. They used machine learning to estimate each person’s “brain age” based on hundreds of imaging features, then compared it to their actual age over time. For those who had a scan before and after the pandemic began, **the brain aged 5.5 months more than expected**, a measurable sign of biological stress. While 5.5 months may seem small, researchers described the change as “striking” given how quickly and consistently it appeared across the population. > “*These findings suggest that the COVID-19 pandemic was detrimental to brain health and induced accelerated brain ageing in a manner that was independent of infection status. This highlights the major role of pandemic-related stressors such as anxiety, social isolation, and economic, and health insecurity on brain changes* “ > > Mohammadi-Nejad et al., *Nature Communications*, 2025 The “pandemic brain” effect was observed in both gray and white matter and was most pronounced in older adults, men, and individuals with lower socioeconomic status (as indicated by income, education, or health scores). The brain changes were observed in areas associated with focus, memory, and emotional regulation, including the prefrontal cortex, insula, and thalamus. ##### While the accelerated aging showed up in everyone, only people who got COVID showed actual cognitive decline with slower mental processing and flexibility on tests. For people with autoimmune and chronic illnesses, this is more proof that [stress](https://www.autoimmuneinstitute.org/articles/stress-autoimmune-disease-navigating-the-complex-relationship "Stress & Autoimmune Disease: Navigating the Complex Relationship"), [isolation](https://www.autoimmuneinstitute.org/articles/managing-mental-health-with-an-autoimmune-disease "A Guide for Immunocompromised Individuals in a Post-Pandemic World"), and [disrupted medical care access](https://www.autoimmuneinstitute.org/articles/a-guide-for-immunocompromised-individuals-in-a-post-pandemic-world "A Guide for Immunocompromised Individuals in a Post-Pandemic World") are just as biologically damaging as they are frustrating. Even without infection, the pandemic altered brain structure. That matters for a community already vulnerable to cognitive symptoms like brain fog, fatigue, and dysautonomia. This study reinforces what many have known all along: **you didn’t imagine it**. ###### Citation Mohammadi-Nejad, A. R., et al. (2025). **Accelerated brain ageing during the COVID-19 pandemic**. *Nature communications*, *16*(1), 6411. <https://doi.org/10.1038/s41467-025-61033-4> **Category:** Covid-19 Research Studies --- ### [Severe COVID May Cause Lung Scarring That Lasts for Years](https://www.autoimmuneinstitute.org/covid_timeline/severe-covid-may-cause-lung-scarring-that-lasts-for-years/) **Published:** June 10, 2025 **Author:** Carolyn Serraino **Content:** A new longitudinal study \[preprint\] reveals that severe COVID-19 can leave lasting damage in the lungs, years after the initial infection. Published in 2025, the research followed a group of patients who had been hospitalized with severe COVID-19, and found that: - 61% of these survivors still showed fibrotic-like abnormalities (lung scarring) three years later - These changes were most common in: - Men - Individuals with lower body mass index (BMI) - Patients who required prolonged mechanical ventilation during the acute illness Even as some lung function showed slight improvement over time, **no patient with scarring had fully recovered after three years**. People with persistent abnormalities also performed significantly worse on: - Pulmonary function tests - Physical endurance assessments (e.g., six-minute walk tests) ### Autoimmune Disease Risk These findings support a growing body of evidence that severe COVID can lead to chronic inflammatory or fibrotic changes in the lungs. For people already living with—or at risk for—**autoimmune or immune-mediated lung disease**, this has serious implications. The damage could compound existing conditions such as: - [Autoimmune interstitial lung disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-interstitial-lung-disease/ "Autoimmune Interstitial Lung Disease") (ILD) - [Rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid arthritis")-associated lung involvement - Systemic sclerosis ([scleroderma](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/scleroderma/ "Scleroderma")) This study underscores the need for ongoing lung monitoring and supportive care in COVID survivors, especially those with underlying autoimmune conditions or a predisposition to immune system dysregulation. ##### Citation Murphy, S. O., et al. (2024). Imaging, Pulmonary Function, and Histopathologic Findings of Persistent Fibrosis in a Longitudinal Cohort Three Years after Severe COVID-19 Infection. *medRxiv : the preprint server for health sciences*, 2024.10.16.24315602. <https://doi.org/10.1101/2024.10.16.24315602> **Category:** Covid-19 Infections, Covid-19 Research Studies, Long COVID, RA & Covid-19 --- ### [Sleep Troubles Are Common in Long COVID, but Treatments Still Lacking](https://www.autoimmuneinstitute.org/covid_timeline/sleep-troubles-are-common-in-long-covid-but-treatments-still-lacking/) **Published:** July 2, 2025 **Author:** Carolyn Serraino **Content:** A [new review](https://jcsm.aasm.org/doi/10.5664/jcsm.11782) in the *Journal of Clinical Sleep Medicine* highlights that sleep disturbances are widespread in people with long COVID, but we still don’t have clear, evidence-backed treatments to address them. Researchers analyzed 14 clinical trials assessing different interventions for long COVID-related sleep problems. While some studies showed mild to moderate improvements in sleep quality, the overall evidence was rated as low to moderate in quality, and only two studies met the standards for inclusion in a formal meta-analysis. Both pharmacological and non-drug therapies were explored, but non-drug options like cognitive behavioral strategies appeared more promising. Given that sleep dysfunction is a major symptom for many with long COVID — especially those with autoimmune or neurological overlap — these findings underscore the urgent need for better research. Future large-scale, well-designed trials will be critical to finding safe and effective solutions for improving sleep, recovery, and quality of life in this growing patient population. While sleep disturbances are common in long COVID, they’re also a major and often overlooked symptom in many autoimmune diseases. Immune-related brain changes can disrupt sleep-wake cycles, and for some, this becomes one of the most debilitating parts of living with chronic illness. Several autoimmune conditions are known to cause or worsen insomnia, non-restorative sleep, or frequent nighttime awakenings: | **Autoimmune Disease** | **How It Affects Sleep** | |---|---| | **[Systemic Lupus Erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus")** | Inflammation and neuropsychiatric symptoms interfere with sleep quality | | **[Multiple Sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/ "Multiple sclerosis")** | Brain lesions can affect sleep regulation; often co-occurs with restless legs | | **[Hashimoto’s Thyroiditis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/hashimotos-thyroiditis/ "Hashimoto’s thyroiditis / autoimmune thyroiditis")** | Thyroid hormone imbalances may cause insomnia or sleep disruptions | | **[Fibromyalgia](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/fibromyalgia/ "Fibromyalgia")** | Characterized by non-restorative sleep and disordered sleep architecture | | **[ME/CFS](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/me-cfs/ "Myalgic encephalomyelitis / chronic fatigue syndrome")** | Diagnosed in part by unrefreshing sleep and post-exertional malaise | Sleep dysfunction doesn’t just impact rest—it can worsen fatigue, pain sensitivity, and mental health, compounding disease burden. That’s why understanding and addressing sleep disturbances is crucial not only in long COVID, but across the autoimmune spectrum. ##### Citation Yi, G. D., Ching, L. W., & Zhong, L. L. D. (2025). **Effect of interventions for the management of sleep disturbances in patients with long COVID: a systematic review and meta-analysis of randomized controlled trials**. *Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine*, 10.5664/jcsm.11782. Advance online publication. <https://doi.org/10.5664/jcsm.11782> **Category:** Covid-19 Research Studies, Long COVID --- ### [Enlarged Brain Structure May Be Behind Long COVID Brain Fog](https://www.autoimmuneinstitute.org/covid_timeline/enlarged-brain-structure-may-be-behind-long-covid-brain-fog/) **Published:** June 6, 2025 **Author:** Carolyn Serraino **Content:** A [new study](https://www.nature.com/articles/s41380-024-02886-x) published in *Molecular Psychiatry* has found that people with long COVID may have an enlarged choroid plexus — a small but important structure in the brain that helps produce cerebrospinal fluid and regulate immune activity. Researchers observed that patients with post-COVID condition (PCC) had significantly larger choroid plexus (ChP) volumes compared to healthy individuals, more than a year after infection. #### Crucially, those with the greatest ChP enlargement also showed the most severe cognitive problems, especially in areas like attention, memory, and executive function. The findings suggest that inflammation or immune dysregulation in this brain region may contribute to the lingering neurological symptoms many long COVID patients report. This structural change was also linked to alterations in brain connectivity and white matter integrity, pointing to a possible mechanism behind persistent brain fog. As more studies explore immune-brain interactions in long COVID, the choroid plexus may emerge as a key target for future diagnostics and treatments, especially for those with overlapping neuroimmune or autoimmune conditions. ##### Citation Diez-Cirarda, M., Yus-Fuertes, M., Delgado-Alonso, C. *et al.* **Choroid plexus volume is enlarged in long COVID and associated with cognitive and brain changes**. *Mol Psychiatry* 30, 2821–2830 (2025). <https://doi.org/10.1038/s41380-024-02886-x> **Category:** Covid-19 Research Studies, Long COVID --- ### [ACIP Update: COVID Still Dangerous for People with Chronic Conditions](https://www.autoimmuneinstitute.org/covid_timeline/acip-update-covid-still-dangerous-for-people-with-chronic-conditions/) **Published:** April 15, 2025 **Author:** Carolyn Serraino **Content:** At the [April 15, 2025 ACIP meeting](https://www.youtube.com/live/dNCVr9AvFB8), the CDC presented updated epidemiologic data from COVID-NET and RESP-NET, showing that COVID-19 hospitalizations continue to follow a seasonal pattern, with peaks in both winter and summer months, and disproportionately affect people with underlying medical conditions. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/06/Screenshot-2025-06-11-at-12.15.16 PM-1024x560.png) Among adults aged 18 and older, individuals with chronic kidney disease, coronary artery disease, diabetes, or a history of stroke were at significantly higher risk of COVID–19–associated hospitalization across all age groups. Rates were especially high among adults over age 75. Notably, most adults hospitalized during the 2023–2024 season had not received an updated COVID-19 vaccine since September 2022. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/06/Screenshot-2025-06-11-at-12.20.53 PM-1024x564.png) **Among children and adolescents (ages 6 months–17 years):** - **59%** had at least one underlying medical condition. - **Fewer than 5%** had received the most recently recommended COVID-19 vaccine dose for the 2023–2024 season. - Roughly **1 in 5 hospitalized children** required intensive care. - Children under 6 months and those with conditions such as asthma, neurological disorders, and diabetes were most at risk. #### The data reinforce that underlying medical conditions — including many autoimmune and immune-related diseases — remain key risk factors for severe COVID-19 across age groups. These findings support continued prioritization of updated vaccination and early treatment access for high-risk individuals. > “**Rates of COVID-19–associated hospitalizations are highest among those with chronic illnesses, yet vaccination coverage among these groups remains low**,” noted Dr. Fiona Havers of the CDC’s Coronavirus and Respiratory Virus Division. > [April 2025 ACIP Meeting: Autoimmune and Immunocompromised Key Updates](https://www.autoimmuneinstitute.org/research_updates/april-2025-acip-meeting-autoimmune-and-immunocompromised-key-updates/) **Category:** Autoimmune Diseases & Covid-19, Covid-19 Boosters, Covid-19 Research Studies, Covid-19 Vaccines --- ### [Why Men Are More Often Affected by Severe COVID-19](https://www.autoimmuneinstitute.org/covid_timeline/why-men-are-more-often-affected-by-severe-covid-19/) **Published:** May 23, 2025 **Author:** Carolyn Serraino **Content:** Men are three times more likely to need intensive care compared to women during COVID-19 infection. The reason behind this isn’t fully understood, but previous research has found that complications from COVID-19 arise because of a dysregulated and hyperinflammatory immune response. Normally, the immune response produces neutrophil extracellular traps (NETs) that entangle and restrict invading pathogens. These NETs allow immune cells called neutrophils to kill the pathogen without damaging host cells. However, in a hyperinflammatory state, such as that seen during severe COVID-19, NETs are linked to [immunothrombosis](https://pmc.ncbi.nlm.nih.gov/articles/PMC9958829/#:~:text=Immunothrombosis%20is%20defined%20as%20a,inflammation%20control%20have%20been%20investigated.) and increased mortality. A recent study examined plasma from study participants with confirmed SARS-CoV-2 infection. In this study, researchers treated neutrophils with the plasma samples from the patients and observed what happened to the neutrophils. They saw that neutrophils treated with plasma from COVID-19 patients triggered more NET release and that the response depended on disease severity: plasma from individuals with more severe disease triggered more NET release. The researchers also looked at cytokine levels, finding that samples from patients with severe COVID-19 had higher levels of some proinflammatory cytokines that activate neutrophils. One cytokine known to be involved in NET formation was higher in men than in women. This research paves the way for other studies and potential treatments that target neutrophil activation and NET production. #### Citation Backman, E., et al. (2025). Elevated Plasma Levels of NET Components in Men with Severe COVID-19 Correlates to Increased Amounts of IL-18. *European Journal of Immunology*, 55(5), e202451546. <https://doi.org/10.1002/eji.202451546> **Category:** Covid-19 Infections, Covid-19 Research Studies --- ### [COVID-19’s Link to Myasthenia Gravis: New Research Insights](https://www.autoimmuneinstitute.org/covid_timeline/covid-19s-link-to-myasthenia-gravis-new-research-insights/) **Published:** May 30, 2025 **Author:** Carolyn Serraino **Content:** Over the years, studies have found connections between COVID-19 and multiple autoimmune neurological disorders. In 2020, the first reported case of myasthenia gravis (MG) associated with COVID-19 was identified in a patient with high levels of anti-acetylcholine receptor antibodies in their serum. Acetylcholine receptors, which are needed to activate muscle contractions, are generally blocked or destroyed with antibodies in myasthenia gravis. [Myasthenia gravis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/myasthenia-gravis/) results in symptoms such as difficulty swallowing, drooping eyelids, and muscle weakness, and can lead to respiratory failure. Previous studies have found that COVID-19 could increase the risk of triggering or worsening MG. A new study published this year looks at patients who develop MG before and after the Dec. 8, 2022 – Nov. 30, 2023 COVID-19 outbreak in China. The study found that new-onset MG after the COVID-19 outbreak had different patterns than MG cases before the outbreak. While new-onset MG patients after the outbreak had higher rates of pulmonary infections, they had milder disease. The study also finds that new-onset MG cases after the outbreak had a higher onset age of ocular MG and altered seasonal onset patterns. This study took place in one study center and the researchers hope to gain a more comprehensive view by using multi-center studies. #### Citation Huang, Y., Wu, Y., Zhou, S., Que, X., Jiang, A., Shi, D., Lu, T., Chen, Y., Lin, Z., Liu, C., Wen, Y., Zhang, S., & Huang, W. (2025). The characteristics of new-onset myasthenia gravis after COVID-19 outbreak: a cross-sectional study. Virology journal, 22(1), 140. <https://doi.org/10.1186/s12985-025-02774-y> **Category:** Autoimmune Diseases & Covid-19, Covid-19 Research Studies, Myasthenia gravis & Covid-19 --- ### [SARS-CoV-2 Infection May Trigger Celiac Disease in Adolescents](https://www.autoimmuneinstitute.org/covid_timeline/sars-cov-2-infection-may-trigger-celiac-disease-in-adolescents/) **Published:** May 16, 2025 **Author:** Lukshmi Solos **Content:** SARS-CoV-2 infection has been shown to trigger the production of autoantibodies for a number of autoimmune diseases, including [systemic lupus erythematous](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus"), [celiac disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/celiac-disease/ "Celiac disease"), and [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid arthritis"). Studies drawing these associations have typically been done on adults. The results of a study were recently published on the prevalence of autoimmunity related to [type 1 diabetes ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/type-1-diabetes-insulin-dependent-diabetes/ "Type 1 diabetes / insulin-dependent diabetes")(T1D), celiac disease and autoimmune thyroid disease among children in Sweden between August 2021 and February 2022. The study utilized home-based capillary blood sampling to screen 2,271 children ages 6–9 and 13–16 years for disease-specific autoantibodies. The findings revealed that 9.3% of participants were consistently positive for at least one autoantibody. Specifically, 2.6% exhibited T1D-related autoantibodies, 2.7% had celiac-associated autoantibodies, and 2.4% tested positive for autoimmune thyroid disease-related autoantibodies. Following clinical evaluations, 1.5% of the children were diagnosed with one of these autoimmune conditions: 1.1% with celiac disease, 0.3% with autoimmune thyroid disease, and 0.1% with T1D. Notably, the prevalence of autoantibodies and diagnosed cases was higher among younger children ages 6-9 years and females. Importantly, the study did not find evidence linking SARS-CoV-2 infection to an increased risk of developing autoimmunity for T1D or AITD. This aligns with other research indicating no significant association between SARS-CoV-2 infection and the onset of these autoimmune conditions. Authors do note an indication for a potential association between Covid infection and celiac autoantibodies in children 13-16 years of age, with four possible explanations as to why. First, those with celiac autoantibodies may have an increased susceptibility to viral infections, thereby accelerating disease. Viral infections such as SARS-CoV-2 can disrupt immune homeostasis; this loss of self-tolerance can lead to cytokine storms, furthermore inducing permeability within the gut. Because there was an observed increase of celiac disease in 13-16 year olds but not 6-9 year olds, authors point out there may be an age-specific window in which celiac disease is more likely to be triggered. This could be due to hyper-inflammation within this subset of adolescents, as well as stronger T-cell reactivity and antibody response from Covid infection. Authors also posit the psychological stress of the pandemic and pandemic-related circumstances in predisposed individuals accounting for disease progression. ##### Citations Lind, A., et al. (2025). Risk of celiac disease, type 1 diabetes, and thyroid disease autoimmunity during the SARS-CoV-2 pandemic in South of Sweden: insights from the TRIAD study. *Autoimmunity*, *58*(1), 2490491. <https://doi.org/10.1080/08916934.2025.2490491> **Category:** Autoimmune Diseases & Covid-19, Celiac disease & Covid-19, Covid-19 Infections, Covid-19 Research Studies, T1D & Covid-19 --- ### [Data Confirms Long COVID Can Mirror ME/CFS](https://www.autoimmuneinstitute.org/covid_timeline/long-covid-mirrors-me-cfs/) **Published:** April 25, 2025 **Author:** Carolyn Serraino **Content:** A major new study from the [NIH RECOVER Initiative](https://recovercovid.org/) confirms what patients have reported for years: Long COVID and myalgic encephalomyelitis/chronic fatigue syndrome ([ME/CFS](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/me-cfs/ "Myalgic encephalomyelitis / chronic fatigue syndrome")) can look remarkably similar. Using electronic health records from 6.5 million adults, researchers developed machine learning models to identify clinical patterns and found that about half of the patients flagged for one condition were also flagged for the other. Fatigue, shortness of breath (dyspnea), and cognitive impairment were top predictors for both conditions. While cardiopulmonary symptoms were more common in Long COVID, ME/CFS was more often linked with pain, sleep disruption, immune dysfunction, and nutritional deficiencies. These patterns suggest shared biological mechanisms, such as immune dysregulation and mitochondrial dysfunction. This large-scale, data-driven analysis adds weight to the growing recognition that both conditions may belong to the same family of post-infectious, immune-mediated chronic diseases. It builds on the [known history of post-viral illness](https://www.autoimmuneinstitute.org/covid_timeline/long-covid-follows-a-pattern-of-post-viral-illness/ "Long COVID Isn’t New—It Follows a Pattern of Post-Viral Illness") and expands on [Dr. Azola’s reflections](https://www.autoimmuneinstitute.org/covid_timeline/long-covid-me-cfs-and-pots/ "Long COVID, ME/CFS, and POTS") about overlapping care needs for patients with Long COVID and ME/CFS. As public health agencies weigh future research investments, this study strengthens the case for integrated approaches to diagnosis, management, and funding across these deeply intertwined conditions. ##### Citation Powers, J. P., et al, & N3C Consortium and RECOVER-EHR (2025). Identifying commonalities and differences between EHR representations of PASC and ME/CFS in the RECOVER EHR cohort. *Communications medicine*, *5*(1), 109. <https://doi.org/10.1038/s43856-025-00827-5> **Category:** Autoimmune Diseases & Covid-19, Covid-19 Infections, Covid-19 Research Studies, Long COVID --- ### [How is Long Covid Manifesting in Pediatric Patients?](https://www.autoimmuneinstitute.org/covid_timeline/how-long-covid-is-manifesting-in-pediatric-patients/) **Published:** April 17, 2025 **Author:** Lukshmi Solos **Content:** A recently published article explores the diverse manifestations of Long Covid in pediatric patients. Using findings from a large-scale analysis of electronic health record data across 38 U.S. healthcare institutions, authors identified distinct clinical presentations of Long Covid in children and adolescents under 21 years of age without pre-existing chronic conditions. Researchers analyzed data from over 87,000 children who tested positive for COVID-19 and compared them to matched controls. Through this, they identified six distinct subphenotypes based on symptom patterns, timing, and severity. Each subgroup revealed different clinical features and potential mechanisms. Respiratory/ cardiac symptoms was the most prevalent subphenotype, affecting approximately 54% of patients. Around 14% of patients presented musculoskeletal pain and discomfort. Neuropyshiatric conditions, gastrointestinal symptoms, headache and fatigue were the other four prevalent subphenotypes recorded in the study. Younger children, particularly those under four years of age, were predominately represented in the resipratory/ cardiac subphenotype. Female patients were more prevalent in the fatigue, headache, gastrointestinal, and neuropsychiatric subphenotypes, while male patients were more common in the respiratory/cardiac and musculoskeletal pain groups. The findings emphasize the importance of tailored clinical approaches and the need for further research to better understand the biological foundations of these variations. By identifying distinct subphenotypes, healthcare providers can better understand and manage the varied presentations of Long COVID in children. This work contributes to the growing understanding of Long COVID in the pediatric population and emphasizes the role of data-driven methods in shaping effective care and treatment strategies. ##### Citations 1. Lorman V, et al. (2025) Pediatric Long COVID Subphenotypes: An EHR-based study from the RECOVER program. PLOS Digit Health 4(4): e0000747. <https://doi.org/10.1371/journal.pdig.0000747> **Category:** Covid-19 Research Studies, Long COVID --- ### [Long COVID Research Moonshot Act: A Turning Point for Chronic Illness](https://www.autoimmuneinstitute.org/covid_timeline/long-covid-research-moonshot-act-a-turning-point-for-chronic-illness/) **Published:** August 23, 2024 **Author:** Carolyn Serraino **Content:** The *[Long COVID Research Moonshot Act](https://www.congress.gov/bill/118th-congress/senate-bill/4964)* (S. 4964), introduced in August 2024, proposes a $1 billion annual investment through 2034 to address the long-term effects of COVID-19 and other infection-associated chronic conditions. The legislation aims to accelerate research, improve patient care, and lay the groundwork for a broader understanding of how infections can contribute to chronic disease. The bill directs the NIH to establish a **Long COVID Research Program**, a centralized initiative to investigate causes, risk factors, and treatment strategies. The program would support scientific studies, clinical trials, and public health efforts, with a strong emphasis on collaboration across agencies, transparency, and input from patient communities. Key features of the bill include: - **Fast-tracked research funding** for therapies, diagnostics, and data collection, including for children and underserved populations. - **Comparative studies** examining the overlap between Long COVID and conditions such as [ME/CFS](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/me-cfs/ "Myalgic encephalomyelitis / chronic fatigue syndrome"), postural orthostatic tachycardia syndrome ([POTS](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/postural-orthostatic-tachycardia-syndrome/ "Postural orthostatic tachycardia syndrome")), and chronic [Lyme disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/lyme-disease/ "Lyme disease"). - **Public data sharing** through a registry of clinical trials and a centralized research clearinghouse. - **Pricing protections** to ensure federally funded treatments are affordable to the public. - **Public health infrastructure**, including grants to state and local health departments for education, training, and care coordination. - **Dedicated Long COVID clinics** to deliver integrated, multidisciplinary care nationwide. The bill recognizes that [post-viral illness is not unique to COVID-19](https://www.autoimmuneinstitute.org/covid_timeline/long-covid-follows-a-pattern-of-post-viral-illness/ "Long COVID Isn’t New—It Follows a Pattern of Post-Viral Illness"). Increasing evidence links infection to a wide range of chronic conditions, including autoimmune diseases, neurodegenerative disorders, and cardiovascular issues. ##### By investing in this field, the United States could not only improve outcomes for millions currently living with Long COVID but also unlock new insights into the infectious roots of chronic disease more broadly. **Category:** Autoimmune Diseases & Covid-19, Covid-19 Infections, Covid-19 Policy, Covid-19 Research Studies, Long COVID --- ### [Do Long COVID and Gulf War Illness Share an Underlying Mechanism?](https://www.autoimmuneinstitute.org/covid_timeline/do-long-covid-and-gulf-war-illness-share-an-underlying-mechanism/) **Published:** March 28, 2025 **Author:** Carolyn Serraino **Content:** In 2023, immunologist James Iredell Moss published a hypothesis suggesting that symptoms of long COVID may be driven by an autoimmune-like mechanism. He proposed that SARS-CoV-2 may disrupt the immune system by reactivating B cells that are usually kept in an inactive, or “anergic,” state to prevent them from attacking the body \[1\]. He has also pointed to research showing that disruption of PTEN—a gene that helps regulate immune cell signaling—can activate inflammatory pathways like PI3K/AKT and may contribute to loss of immune tolerance \[2\]. According to the hypothesis, COVID-19 may elevate levels of angiotensin II, which can activate signaling pathways in these inactive B cells. This may reverse their tolerance, triggering the production of autoantibodies—a possible explanation for the lingering symptoms seen in Long COVID, such as fatigue, brain fog, and joint pain. This idea aligns with growing research showing new-onset autoantibodies in COVID-19 patients \[3\], the presence of diverse autoreactive antibodies affecting different body systems \[4\], and the wide range of long COVID symptoms being documented across patient populations \[5\]. Moss also draws parallels to Gulf War Illness (GWI), a chronic condition affecting many veterans from the 1991 Gulf War. In a 2019 paper, he proposed that a nerve agent protection drug taken during deployment may have caused a similar immune response by reactivating anergic lymphocytes \[6\]. Although this theory has not been confirmed through clinical trials, it highlights a potential mechanism worth further investigation. ##### Citations 1. James Iredell Moss (2023). [**Long Haul COVID 19 is the Result of B Lymphocyte Anergy Reversal**](https://crimsonpublishers.com/mapp/pdf/MAPP.000554.pdf). *Mod Appl Pharm Pharmacol*. 3(1). MAPP.000554. 2. Mei, P., et al. (2024). **Downregulation of Serum PTEN Expression in Mercury-Exposed Population and PI3K/AKT Pathway-Induced Inflammation**. *Biomedical and environmental sciences : BES*, *37*(4), 354–366. <https://doi.org/10.3967/bes2024.040> 3. Chang, S.E., et al. **New-onset IgG autoantibodies in hospitalized patients with COVID-19**. *Nat Commun* **12**, 5417 (2021). <https://doi.org/10.1038/s41467-021-25509-3> 4. Wang EY, et al (2021). **Diverse functional autoantibodies in patients with COVID-19**. *Nature*. <https://doi.org/10.1038/s41586-021-03631-y> 5. Al-Aly, Z., Xie, Y., & Bowe, B. (2021). **High-dimensional characterization of post-acute sequelae of COVID-19**. *Nature*, *594*(7862), 259–264. <https://doi.org/10.1038/s41586-021-03553-9> 6. Moss J. I. (2019). **Gulf War Illnesses are autoimmune conditions caused by the direct effect of the nerve gas prophylaxis drug (pyridostigmine bromide) on anergic immune system lymphocytes**. *Medical hypotheses*, *132*, 109373. <https://doi.org/10.1016/j.mehy.2019.109373> **Category:** Covid-19 Antibodies, Covid-19 Infections, Long COVID --- ### [The Federal Long COVID Office Is Closing—Here’s What We Know](https://www.autoimmuneinstitute.org/covid_timeline/office-of-long-covid-research-and-practice-closure/) **Published:** March 24, 2025 **Author:** Carolyn Serraino **Content:** ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/03/Untitled-design-59-e1742996961655.png) The **Office of Long COVID Research and Practice ([OLC](https://www.hhs.gov/longcovid/index.html))**—established by the U.S. Department of Health and Human Services (HHS) in August 2023—is now scheduled to shut down. [Internal communications](https://www.politico.com/news/2025/03/24/trump-administration-shuttering-office-of-long-covid-research-and-practice-00246836) confirmed that the office will wind down operations as part of a broader reorganization, though a specific end date has not been announced. The office was created to lead a whole-of-government response to the long-term effects of COVID-19—an effort rooted in [decades of evidence that viral infections can leave lasting, complex health consequences](https://www.autoimmuneinstitute.org/covid_timeline/long-covid-follows-a-pattern-of-post-viral-illness/ "Long COVID Isn’t New—It Follows a Pattern of Post-Viral Illness"). #### **Post-viral illness is not a new phenomenon; COVID-19 is simply the most recent virus to trigger chronic symptoms in a significant number of people.** The decision to establish the office was grounded in both science and precedent. Its planned closure raises concerns about whether hard-earned momentum in research, treatment development, and patient care will be sustained. Given the historical underrecognition of post-viral conditions like ME/CFS, some worry that long COVID may follow the same path: met with skepticism, fragmented care, and insufficient federal investment—even as evidence continues to grow. ### **What the Federal Long COVID Office Closure Means for People With Long COVID** The planned closure of the OLC has significant implications for people living with long COVID, as well as for researchers and clinicians working to understand and address the condition. #### How the **Office’s Closure Impacts Federal Research Coordination** The OLC aligned activities across multiple agencies, including the CDC, NIH, and VA. Without this centralized leadership: - Research efforts may become less coordinated, risking duplication or gaps. - Clinical guidance may vary widely, affecting patient care quality. - Patients and providers may struggle to access consolidated resources on long COVID. #### **Long COVID Research, Treatment, and Funding: What’s at Risk** The OLC was tasked with implementing the **National Research Action Plan on Long COVID**, which was released in August 2022 and developed by 14 federal agencies. The office’s closure could: - Slow the development of diagnostic tools and treatments. - Disrupt long-term planning for clinical trials and data sharing. - Reduce federal focus on the intersection between long COVID and chronic illnesses, including autoimmune conditions. #### **Why Advocates Are Concerned About HHS’s Long COVID Strategy** Advocates worry that shuttering the office may reduce visibility and urgency around long COVID: - Without a dedicated office, long COVID may receive less emphasis in public health agendas. - Policy decisions may become fragmented, with varying approaches across states and systems. - It may be harder to amplify patient voices in federal policy conversations. ##### **“While our office is closing, we hope that the work we have been dedicated to will continue in some form,”** *read an [internal message](https://www.politico.com/news/2025/03/24/trump-administration-shuttering-office-of-long-covid-research-and-practice-00246836) from OLC Director Ian Simon.* ### **What’s Next for Long COVID Research and Advocacy** Although the OLC is set to close, we hope to see work on long COVID continue with clinicians and researchers remaining engaged through academic and nonprofit collaborations, the NIH RECOVER Initiative remaining a key research hub, and advocacy groups continuing to push for funding, visibility, and patient support. If the [OLC page](https://www.hhs.gov/longcovid/index.html) disappears—as many other federal health resources have recently—we’ve preserved the available materials for continued access. **Download them here:** - [Open Letter to National Academies for Long COVID Definition \[PDF, 160 KB\]](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/03/Open-Letter-to-National-Academies-for-Long-COVID-Definition.pdf) - [A Long COVID Definition, A Chronic Systemic Disease State with Profound Consequences \[PDF, 2.7 MB\]](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/03/A-Long-COVID-Definition-A-Chronic-Systemic-Disease-State-with-Profound-Consequences.pdf) - [The Implementation of the Government-Wide Response to Long COVID \[PDF, 1.77 MB\]](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/03/Implementation-of-the-Government-wide-Response-to-Long-COVID.pdf) - [Health+ Long COVID Report \[PDF, 16.40 MB\]](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/03/Health-Long-COVID-Report.pdf) - [The National Research Action Plan on Long COVID \[PDF, 1.3 MB\]](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/03/The-National-Research-Action-Plan-on-Long-COVID.pdf) [Learn how long COVID fits into the larger post-viral illness landscape](https://www.autoimmuneinstitute.org/covid_timeline/long-covid-follows-a-pattern-of-post-viral-illness/) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/04/GAI-Logo-Image-1.png) **Category:** Covid-19 Policy, Long COVID, ME/CFS & Covid-19 --- ### [COVID-19 and Multiple Sclerosis: 2025 Updates](https://www.autoimmuneinstitute.org/covid_timeline/covid-19-and-multiple-sclerosis-2025-updates/) **Published:** March 23, 2025 **Author:** Carolyn Serraino **Content:** *This summary is based on two articles published in the April 2025 issue of* *The Lancet Neurology*: *[a Personal View by Zabalza et al.](https://pubmed.ncbi.nlm.nih.gov/40120619/) and a [Comment by Fitzgerald](https://pubmed.ncbi.nlm.nih.gov/40120603/), both exploring the latest insights into how COVID-19 interacts with [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/) (MS).* #### Infection Risk & Severity People with MS are *not more likely* to catch COVID-19 than others. However, some may face more serious illness—especially those who: - Are older or have other health conditions like diabetes or obesity - Have more advanced MS or higher disability levels - Take certain medications that weaken the immune system (like **rituximab or ocrelizumab**) #### Vaccine Response Most people with MS respond well to COVID-19 vaccines. But two treatments—**anti-CD20 therapies** and **S1P modulators**—can make vaccine responses weaker. Even then: - Some protection still exists, especially from *T cells* (another part of the immune system) - Getting the **Moderna (mRNA-1273)** vaccine gives better antibody levels than Pfizer #### Timing Strategies - If you’re on an anti-CD20 therapy, getting vaccinated **3+ months after your last dose** can help improve your body’s response. - Annual booster doses are recommended, especially for people with weaker immune systems. #### Long COVID & MS About **1 in 4** people with MS may develop long COVID—higher than the general population. Common symptoms include: - Tiredness - Shortness of breath - Loss of smell You may be more likely to get long COVID if you had anxiety, depression, or a high level of disability before infection. #### Other Prevention Tools For people at higher risk: - **Antiviral medications** (like Paxlovid) can help prevent severe illness if taken early. - Some older **antibody treatments** don’t work as well against new variants, but newer options are being studied. ###### Citations Zabalza, A., Thompson, A., Rotstein, D. L., Bar-Or, A., & Montalban, X. (2025). Multiple sclerosis and COVID-19: interactions and unresolved issues. *The Lancet. Neurology*, *24*(4), 361–370. <https://doi.org/10.1016/S1474-4422(25)00006-7> Fitzgerald K. C. (2025). SARS-CoV-2 infection in people with multiple sclerosis. *The Lancet. Neurology*, *24*(4), 281–282. <https://doi.org/10.1016/S1474-4422(25)00069-9> **Category:** Covid-19 Research Studies, Covid-19 Vaccines, MS & Covid-19 --- ### [Can Your Blood Predict Your Vaccine Response?](https://www.autoimmuneinstitute.org/covid_timeline/can-your-blood-predict-your-vaccine-response/) **Published:** March 21, 2025 **Author:** Carolyn Serraino **Content:** A recent [study](https://pubmed.ncbi.nlm.nih.gov/40110889/) published in *International Immunology* identified key predictors of immune response to COVID-19 mRNA vaccines using data from 216 healthy adults aged 23–81 in Japan. Researchers analyzed participants’ clinical data, blood counts, and T-cell phenotypes before and after receiving two doses of the Pfizer-BioNTech (BNT162b2) vaccine. The strongest predictor of higher antibody (anti-RBD IgG) levels was a higher frequency of naïve CD8+ T cells, especially in older adults. Conversely, lower naïve CD8+ T cells, low hemoglobin, low lymphocyte counts, and higher mean corpuscular volume (MCV) were associated with weaker antibody responses. Consistent with past findings, [older age](https://www.autoimmuneinstitute.org/research_updates/how-aging-exacerbates-autoimmune-disease/ "How Aging Exacerbates Autoimmune Disease") and autoimmune disease history predicted lower antibody levels, likely due to age-related immune decline. Interestingly, spike-specific CD4+ T-cell responses after the first dose also strongly predicted stronger antibody levels after the second dose, highlighting the importance of early immune activation. While pre-existing spike-reactive T cells did not influence antibody titers, this research provides potential biomarkers—measurable before vaccination—for forecasting vaccine efficacy. These insights could support more personalized vaccine strategies, especially for at-risk populations such as older adults and those with autoimmune conditions. ##### Citation Hidaka, Y., et al. (2025). Effect of pre-vaccination blood and T-cell phenotypes on antibody responses to COVID-19 mRNA vaccine. *International immunology*, dxaf013. Advance online publication. <https://doi.org/10.1093/intimm/dxaf013> **Category:** Covid-19 Antibodies, Covid-19 Research Studies, Covid-19 Vaccines --- ### [Bispecific Antibodies Effectively Neutralize Omicron Variants](https://www.autoimmuneinstitute.org/covid_timeline/bispecific-antibodies-effectively-neutralize-omicron-variants/) **Published:** March 11, 2025 **Author:** Carolyn Serraino **Content:** Researchers have developed bispecific antibodies (bsAbs) that provide potent neutralization against emerging SARS-CoV-2 variants, including XBB.1.5, BA.2.86, and JN.1, according to a new study published in *[Science Translational Medicine](https://www.science.org/doi/10.1126/scitranslmed.adq5720)*. The study evaluated CoV2-biRNs, a series of next-generation antibodies targeting both the N-terminal domain (NTD) and the receptor binding domain (RBD) of the SARS-CoV-2 spike protein. Among them, CoV2-biRN5 and CoV2-biRN7 demonstrated the highest efficacy, surpassing the potency of traditional monoclonal antibody therapies. #### Key findings include: - **Broader protection**: CoV2-biRN5 and CoV2-biRN7 neutralized multiple Omicron variants, including those resistant to earlier antibody treatments. - **Enhanced durability**: The dual-targeting approach reduced the risk of viral escape mutations. - **Preclinical success**: Prophylactic treatment with CoV2-biRN5 significantly reduced viral load in lung tissue of infected mice. With the declining efficacy of earlier monoclonal antibody treatments, these bispecific antibodies could serve as a critical tool for immunocompromised individuals who remain at high risk for severe COVID-19. Further clinical trials will be needed to confirm their safety and efficacy in humans.​ ###### Citation Adonis A. Rubio *et al.*, Bispecific antibodies targeting the N-terminal and receptor binding domains potently neutralize SARS-CoV-2 variants of concern.*Sci. Transl. Med.***17**,eadq5720(2025).DOI:[10.1126/scitranslmed.adq5720](https://doi.org/10.1126/scitranslmed.adq5720) **Category:** Covid-19 & Long Covid Treatments, Covid-19 Antibodies, Covid-19 Variants --- ### [Advancing Research for Infection-Associated Chronic Conditions](https://www.autoimmuneinstitute.org/covid_timeline/advancing-research-for-infection-associated-chronic-conditions/) **Published:** March 4, 2025 **Author:** Carolyn Serraino **Content:** Rory Preston, a data scientist who has lived with myalgic encephalomyelitis (ME/CFS) since 2018, founded CrunchME to address the growing crisis of infection-associated chronic conditions (IACCs) like [ME/CFS](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/me-cfs/ "Myalgic encephalomyelitis / chronic fatigue syndrome"), [POTS](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/postural-orthostatic-tachycardia-syndrome/ "Postural orthostatic tachycardia syndrome"), and Long COVID. These conditions exhibit strong immune system dysfunction, with overlapping characteristics of autoimmune diseases, including chronic inflammation and post-viral immune dysregulation. ##### Key findings from CrunchME’s research: - **Infection-linked autoimmunity**: Emerging studies suggest infections like SARS-CoV-2 may trigger autoimmune processes, contributing to Long COVID and ME/CFS. - **Common pathways with autoimmune diseases**: IACCs share biological mechanisms with conditions like multiple sclerosis and lupus, highlighting the role of chronic inflammation and neuroinflammation. - **Severe disease burden**: Long COVID alone affects up to 5.5% of the U.S. population, with significant disability rates, yet research funding remains critically low. - **Policy and research gaps**: Despite the rising prevalence of IACCs, government funding and clinical trials are limited, delaying potential treatments. ##### CrunchME’s mission and impact: 1. **Advocacy for research funding**: Addressing the disproportionate underfunding of IACCs compared to their disease burden. 2. **Data-driven collaboration**: Connecting researchers, patients, and policymakers to accelerate scientific breakthroughs. 3. **Shaping policy change**: Calling for specialist clinics, improved diagnostics, and better clinical care to address post-infection chronic illnesses. By leveraging data science, CrunchME is paving the way for new treatments and improved understanding of IACCs, helping redefine the future of post-infectious and autoimmune-related diseases. **Learn more on the [CrunchME website](https://crunchme.notion.site/homepage)** **Category:** Covid-19 Infections, Long COVID, ME/CFS & Covid-19 --- ### [Thyroid Autoimmunity in Type 1 Diabetes: Pre- & Post-COVID](https://www.autoimmuneinstitute.org/covid_timeline/thyroid-autoimmunity-in-type-1-diabetes-pre-post-covid/) **Published:** February 28, 2025 **Author:** Carolyn Serraino **Content:** A new study published in *Frontiers in Endocrinology* examined the prevalence of thyroid autoimmunity in children and young adults with Type 1 diabetes over a ten-year period. Some past studies suggested that COVID-19 might have increased the number of cases of autoimmune thyroid disease, but this research found no evidence of that. Researchers studied 1,361 children and young adults with Type 1 diabetes and checked for thyroid-related issues using blood tests and ultrasounds. They found that 22.8% of these patients had thyroid autoimmunity. Between 2013 and 2022, the number of cases increased from 15.9% to 20.6%, but this rise mostly happened before COVID-19, between 2013 and 2019. During 2021 and 2022, thyroid autoimmunity levels stayed the same. The study also looked at changes in thyroid hormone levels. Among 282 children with thyroid autoimmunity, 15.6% developed thyroid hormone changes that could lead to an underactive thyroid, while 2.8% had a decrease in their thyroid hormone levels. The researchers noted that autoimmune diseases in general are becoming more common, but they did not find any connection between COVID-19 and increased thyroid autoimmunity in children with Type 1 diabetes. Citation: Herczeg V, Muzslay E, Czipo´ D, Terkovics L, Taka´ cs J, Garai R, Kova´ cs F, Luczay A, Körner A and To´ th-Heyn P (2025) **[Increasing prevalence of thyroid autoimmunity in childhood type 1 diabetes in the pre-COVID but not during the COVID era](https://pubmed.ncbi.nlm.nih.gov/39926395/)**. *Frontiers in Endocrinol*ogy. 15:1496155. doi: 10.3389/fendo.2024.1496155 **Category:** Autoimmune Diseases & Covid-19, Covid-19 Infections, Covid-19 Research Studies --- ### [Long COVID Symptom Clusters Identified by NIH Study](https://www.autoimmuneinstitute.org/covid_timeline/long-covid-symptom-clusters-identified-by-nih-study/) **Published:** December 23, 2024 **Author:** Carolyn Serraino **Content:** A large-scale study from the National Institutes of Health’s RECOVER Initiative has categorized long COVID into five distinct symptom clusters. By analyzing data from over 14,000 patients, researchers aim to improve how long COVID is studied, diagnosed, and treated. This classification could help doctors provide more precise care and guide future research into targeted therapies. ### Why Categorizing Long COVID Matters Long COVID has been challenging to treat because it affects people in widely different ways. By identifying patterns among patients, researchers have grouped symptoms into five main clusters, reflecting distinct experiences of the condition. This refined approach may help healthcare providers tailor treatments more effectively and shed light on potential underlying mechanisms. ### The Five Symptom Profiles of Long COVID Long COVID presents differently for different people. These newly identified categories group symptoms based on their severity and impact on daily life. 1. **Cardiovascular & Renal** – Symptoms include chest pain, palpitations, and kidney-related issues. 2. **Respiratory, Sleep & Anxiety** – Shortness of breath, chronic cough, sleep disturbances, and anxiety. 3. **Musculoskeletal & Neurological** – Muscle pain, joint pain, brain fog, and dizziness. 4. **Gastrointestinal & Immune-Related** – Nausea, diarrhea, autoimmune-like symptoms, and inflammation. 5. **Severe Multisystem Involvement** – Widespread symptoms affecting multiple organ systems, often with high severity. ###### **With these classifications, doctors may be able to better understand what their patients are experiencing and provide more personalized care.** While long COVID treatments remain limited, recognizing distinct symptom patterns is a step toward more effective management and future treatment development. ###### Citation Geng LN, Erlandson KM, Hornig M, et al. 2024 **[Update of the RECOVER-Adult Long COVID Research Index](https://jamanetwork.com/journals/jama/article-abstract/2828329)**. *JAMA.* 2025;333(8):694–700. doi:10.1001/jama.2024.24184 **Category:** Covid-19 Research Studies, Long COVID --- ### [Post-COVID-19 Autoimmune Rhombencephalitis](https://www.autoimmuneinstitute.org/covid_timeline/post-covid-19-autoimmune-rhombencephalitis/) **Published:** February 24, 2025 **Author:** Elevation **Excerpt:** A recent case study highlights autoimmune rhombencephalitis, a rare inflammatory condition affecting the brainstem and cerebellum, in a patient who developed neurological symptoms two weeks after recovering from mild COVID-19. The 31-year-old male experienced facial weakness, slurred speech, and limb paralysis, leading to a diagnosis of post-infectious autoimmune rhombencephalitis. Extensive testing ruled out other causes, and treatment with high-dose corticosteroids resulted in significant recovery. This case reinforces the growing evidence of post-COVID-19 autoimmune complications and the potential for early immunotherapy intervention to improve outcomes. **Content:** #### Case Study Highlights Neurological Risks A [recent case study](https://www.cureus.com/articles/118917-autoimmune-rhombencephalitis-as-a-presentation-of-post-covid-19-syndrome-a-case-report#!/) published in *Cureus* describes a rare instance of [autoimmune rhombencephalitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/acute-disseminated-encephalomyelitis/ "Autoimmune encephalitis / acute disseminated encephalomyelitis (ADEM)"), an inflammatory disease affecting the brainstem and cerebellum that can cause weakness, facial paralysis, and speech difficulties**,** adding to growing concerns about the virus’s neurological complications. The report details a 31-year-old male who developed severe brainstem and cerebellar inflammation two weeks after recovering from a mild COVID-19 infection. His symptoms included unilateral weakness, facial droop, slurred speech, and altered mental status. Despite an extensive infectious and autoimmune workup, no clear alternative cause was found, leading to a diagnosis of post-infectious autoimmune rhombencephalitis. Treatment with high-dose corticosteroids led to significant recovery, reinforcing the role of immunotherapy in managing COVID-19-related neurological sequelae. This case underscores the importance of recognizing autoimmune-mediated neurological disorders as potential post-COVID-19 complications. It also highlights the need for early intervention with immunosuppressive therapy to improve outcomes. As autoimmune diseases continue to be linked to viral infections, further research is needed to understand the long-term neurological impact of COVID-19. ##### Citation Mohamed A S, Jahani N, Li M, et al. (February 23, 2025) Autoimmune Rhombencephalitis as a Presentation of Post-COVID-19 Syndrome: A Case Report. *Cureus* 17(2): e79517. [doi:10.7759/cureus.79517](https://www.cureus.com/articles/118917-autoimmune-rhombencephalitis-as-a-presentation-of-post-covid-19-syndrome-a-case-report#!/ "doi:10.7759/cureus.79517") **Category:** Autoimmune Diseases & Covid-19, Covid-19 Antibodies, Covid-19 Infections, Long COVID --- ### [Autoimmune Experts Debate Long COVID Definition Concerns](https://www.autoimmuneinstitute.org/covid_timeline/autoimmune-experts-debate-long-covid-definition-concerns/) **Published:** February 10, 2025 **Author:** Elevation **Excerpt:** A broad definition of long COVID was introduced, categorizing it as an infection-associated chronic condition lasting at least three months. While intended to be inclusive, rheumatologists worry that such a broad scope may lead to misdiagnoses, particularly in patients with autoimmune diseases that share overlapping symptoms. **Content:** **Key Takeaway:** The National Academies of Sciences, Engineering, and Medicine (NASEM) has introduced a broad definition of long COVID, categorizing it as an infection-associated chronic condition lasting at least three months. While intended to be inclusive, rheumatologists worry that such a broad scope may lead to misdiagnoses, particularly in patients with autoimmune diseases that share overlapping symptoms. Researchers argue that clearer diagnostic criteria are needed to ensure patients receive accurate diagnoses and appropriate care. NASEM’s updated definition of long COVID describes it as a condition that develops after a SARS-CoV-2 infection and persists for at least three months with continuous, relapsing, or episodic symptoms. The definition does not mandate lab-confirmed evidence or other verification of the initial infection. Long COVID can develop after a SARS-CoV-2 infection of any severity, including cases with no symptoms, even if the infection was never formally diagnosed. This expansive classification aims to encompass all individuals experiencing prolonged post-COVID effects. However, a group of rheumatology researchers has raised concerns that the definition may be too broad, potentially leading to misclassification and complicating patient care. In a newly published [analysis](https://acrjournals.onlinelibrary.wiley.com/doi/10.1002/art.43114), these researchers argue that lumping a wide array of symptoms under the long COVID umbrella may result in overdiagnosis and inappropriate treatment, especially for those with autoimmune diseases like [lupus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus") or [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid arthritis"). Since these conditions often present with symptoms similar to long COVID—such as fatigue, joint pain, and brain fog—rheumatologists caution that some patients may be incorrectly categorized, delaying accurate diagnoses and specialized care. This debate highlights the [ongoing challenges in defining long COVID](https://www.autoimmuneinstitute.org/covid_timeline/meeting-reviews-long-covid-definition-and-care-challenges/ "Meeting Reviews Long COVID Definition and Care Challenges") while balancing inclusivity with diagnostic precision. As research into long COVID continues to uncover links between post-viral syndromes and immune dysregulation, experts emphasize the importance of refining diagnostic frameworks to ensure that patients receive appropriate treatment without conflating distinct medical conditions. ##### Citations Calabrese, L. H., et al. (2025). The National Academies’ 2024 Diagnostic Criteria for Long COVID: Concerns That Could Affect the Rheumatology Community. *Arthritis & rheumatology (Hoboken, N.J.)*, 10.1002/art.43114. Advance online publication. <https://doi.org/10.1002/art.43114> National Academies of Sciences, Engineering, and Medicine. [A Long COVID Definition: A Chronic, Systemic Disease State with Profound Consequences](https://nap.nationalacademies.org/catalog/27768/a-long-covid-definition-a-chronic-systemic-disease-state-with). *The National Academies Press*; 2024: 186. ![Loader](https://www.autoimmuneinstitute.org/wp-content/plugins/embed-any-document/images/loading.svg) Loading… ![EAD Logo](https://www.autoimmuneinstitute.org/wp-content/plugins/embed-any-document/images/EAD-logo.svg) Taking too long? ![Reload](https://www.autoimmuneinstitute.org/wp-content/plugins/embed-any-document/images/reload.svg) Reload document \| [ ![Open](https://www.autoimmuneinstitute.org/wp-content/plugins/embed-any-document/images/open.svg) Open in new tab ](https://nap.nationalacademies.org/resource/27768/One_pager_Long_COVID_Definition.pdf) ![Loader](https://www.autoimmuneinstitute.org/wp-content/plugins/embed-any-document/images/loading.svg) Loading… ![EAD Logo](https://www.autoimmuneinstitute.org/wp-content/plugins/embed-any-document/images/EAD-logo.svg) Taking too long? ![Reload](https://www.autoimmuneinstitute.org/wp-content/plugins/embed-any-document/images/reload.svg) Reload document \| [ ![Open](https://www.autoimmuneinstitute.org/wp-content/plugins/embed-any-document/images/open.svg) Open in new tab ](https://nap.nationalacademies.org/resource/27768/Long_COVID_Definition_infographic.pdf) **Category:** Autoimmune Diseases & Covid-19, Covid-19 Infections, Long COVID --- ### [Meeting Reviews Long COVID Definition and Care Challenges](https://www.autoimmuneinstitute.org/covid_timeline/meeting-reviews-long-covid-definition-and-care-challenges/) **Published:** January 26, 2024 **Author:** Elevation **Content:** A National Academies of Sciences, Engineering, and Medicine (NASEM) meeting held on January 18, 2024, reviewed the U.S. government’s working definition of Long COVID, with a focus on refining diagnostic criteria, symptom classifications, and healthcare challenges. Experts, including Dr. Ravindra Ganesh and Dr. Ryan Hurt (Mayo Clinic) and Dr. Emily Mendenhall (Georgetown University), presented findings on **symptom variability, post-viral complications, and gaps in medical care**. ##### **Key findings included:** - **Defining Long COVID:** The condition should encompass both persistent and newly emerging symptoms after the initial infection. Symptoms often fluctuate, and some patients experience a brief asymptomatic period before symptoms reappear. - **Symptom Overlap with Other Conditions:** Long COVID has similarities to ME/CFS, fibromyalgia, small fiber neuropathy, dysautonomia (e.g., POTS), and post-viral syndromes, requiring a phenotyping approach to guide treatment. - **Barriers to Diagnosis and Treatment:** Many patients struggle to obtain recognition, diagnosis, and coordinated care due to medical gaslighting, healthcare inequities, and lack of physician awareness. - **The Role of Long COVID Clinics:** The committee emphasized that specialized clinics should provide holistic, multidisciplinary care rather than exhausting patients with excessive referrals and fragmented treatment. These insights could influence future healthcare policies and research efforts, particularly in post-viral and autoimmune-related conditions. The meeting underscored the need for updated diagnostic criteria, improved physician education, and comprehensive patient care. ###### Citation Mendenhall, E. (2024, January 18). **[Implementation Considerations for Long COVID Definition](https://www.nationalacademies.org/documents/embed/link/LF2255DA3DD1C41C0A42D3BEF0989ACAECE3053A6A9B/file/D501E73D910B26094FF19CEAD21BE6BF3E09BF3A7460?noSaveAs=1)***.* *Presentation at the National Academies of Sciences, Engineering, and Medicine, Committee on Examining the Working Definition for Long COVID*. Ganesh, R., & Hurt, R. (2024, January 18). **[Long COVID Definition Considerations](https://www.nationalacademies.org/documents/embed/link/LF2255DA3DD1C41C0A42D3BEF0989ACAECE3053A6A9B/file/DA4FB37A0A4C6DBEA0DFBB0BBBA8653BD0F0B853D0D7?noSaveAs=1)***.* *Presentation at the National Academies of Sciences, Engineering, and Medicine, Committee on Examining the Working Definition for Long COVID*. *National Academies of Sciences, Engineering, and Medicine.* (2024, January 18). **[Final Public Agenda: Committee Meeting 7 – Long COVID Definition](https://www.nationalacademies.org/documents/embed/link/LF2255DA3DD1C41C0A42D3BEF0989ACAECE3053A6A9B/file/D8A406E2B6B8CB4BD6DCCAF430351C688BFEE1CF7B3A?noSaveAs=1).** ![Loader](https://www.autoimmuneinstitute.org/wp-content/plugins/embed-any-document/images/loading.svg) Loading… ![EAD Logo](https://www.autoimmuneinstitute.org/wp-content/plugins/embed-any-document/images/EAD-logo.svg) Taking too long? ![Reload](https://www.autoimmuneinstitute.org/wp-content/plugins/embed-any-document/images/reload.svg) Reload document \| [ ![Open](https://www.autoimmuneinstitute.org/wp-content/plugins/embed-any-document/images/open.svg) Open in new tab ](https://docs.google.com/viewer?url=https%3A%2F%2Fwww.nationalacademies.org%2Fdocuments%2Fembed%2Flink%2FLF2255DA3DD1C41C0A42D3BEF0989ACAECE3053A6A9B%2Ffile%2FD8A406E2B6B8CB4BD6DCCAF430351C688BFEE1CF7B3A%3FnoSaveAs%3D1&hl=en) ![Loader](https://www.autoimmuneinstitute.org/wp-content/plugins/embed-any-document/images/loading.svg) Loading… ![EAD Logo](https://www.autoimmuneinstitute.org/wp-content/plugins/embed-any-document/images/EAD-logo.svg) Taking too long? ![Reload](https://www.autoimmuneinstitute.org/wp-content/plugins/embed-any-document/images/reload.svg) Reload document \| [ ![Open](https://www.autoimmuneinstitute.org/wp-content/plugins/embed-any-document/images/open.svg) Open in new tab ](https://docs.google.com/viewer?url=https%3A%2F%2Fwww.nationalacademies.org%2Fdocuments%2Fembed%2Flink%2FLF2255DA3DD1C41C0A42D3BEF0989ACAECE3053A6A9B%2Ffile%2FDA4FB37A0A4C6DBEA0DFBB0BBBA8653BD0F0B853D0D7%3FnoSaveAs%3D1&hl=en) ![Loader](https://www.autoimmuneinstitute.org/wp-content/plugins/embed-any-document/images/loading.svg) Loading… ![EAD Logo](https://www.autoimmuneinstitute.org/wp-content/plugins/embed-any-document/images/EAD-logo.svg) Taking too long? ![Reload](https://www.autoimmuneinstitute.org/wp-content/plugins/embed-any-document/images/reload.svg) Reload document \| [ ![Open](https://www.autoimmuneinstitute.org/wp-content/plugins/embed-any-document/images/open.svg) Open in new tab ](https://docs.google.com/viewer?url=https%3A%2F%2Fwww.nationalacademies.org%2Fdocuments%2Fembed%2Flink%2FLF2255DA3DD1C41C0A42D3BEF0989ACAECE3053A6A9B%2Ffile%2FD501E73D910B26094FF19CEAD21BE6BF3E09BF3A7460%3FnoSaveAs%3D1&hl=en) **Category:** Autoimmune Diseases & Covid-19, Long COVID --- ### [Autoimmune Dermatological Symptoms after Covid-19 Infection](https://www.autoimmuneinstitute.org/covid_timeline/autoimmune-dermatological-symptoms-after-covid-19-infection/) **Published:** December 20, 2024 **Author:** Elevation **Content:** #### **It has been estimated that 20% of patients who recover from Covid-19 develop dermatological issues.** A [literature review](https://pubmed.ncbi.nlm.nih.gov/39640203/) was recently published of studies accessed across several peer-reviewed research platforms using the keywords “post-Covid and skin manifestations.” A total of 44 studies published between January 2020 and January 2024 were analyzed in the review, and it was determined that up to 50% of subjects were observed to develop alopecia post-Covid infection. The average follow-up period following Covid-19 diagnosis for the studies included in the review was 7 months, with a minimum follow-up period of 6 weeks and a maximum of 12 months. Several studies addressed the prevalence of autoantibodies targeting the epidermis specifically, and dermatological lesions associated with autoimmunity were identified and found to be more pronounced among females and those who had severe Covid-19. While the majority of cutaneous conditions were non-autoimmune in nature, six studies covered cases of dermatitis with a significant inflammatory component, as well as worsening or reactivation of autoimmune-related conditions like dermatomyositis and psoriasis. #### **“In two studies, antibodies against the epidermis were found in up to 41% of the affected subjects.”** Overall, there were two possible pathophysiological mechanisms involved in these dermatological symptoms outlined in the studies included in this review: hyperinflammation and immune dysregulation. One possibility cited the cytotoxic potential of the coronavirus interacting with ACE2 receptors on the skin, causing endothelial dysfunction characterized by hyperinflammation, vasculitis, as well as the development of skin lesions. “Persistence of this inflammatory state would increase the production of specific interleukins (IL), such as IL-6 and IL-4. The former has been linked to the loss of immune regulation that normally maintains hair follicles in an immune-privileged state, thereby ensuring their normal growth.” Interleukins can modify the cellular microenvironment at the base of the hair bulb and can trigger hair fallout. Other studies cited anti-epidermal antibodies and mitochondrial dysfunction in epidermal cells. These and other mechanisms have been previously identified as contributors to dermatological symptoms from Covid-19 as well as other viral infections. #### **The development of autoimmunity and the reactivation of autoimmune symptoms show that Covid-19 can trigger T-lymphocytes to create an autoimmune environment, especially in females.** These cases confirm previous findings that patients have the ability to develop autoantibodies following infection, regardless of whether they have a history of autoimmunity. ##### Citation: Cayón Figueroa, B. A., et al. (2024). Dermatological complications due to post‑COVID‑19 syndrome: A systematic review. *Medicine international*, *5*(1), 9. <https://doi.org/10.3892/mi.2024.208> **Category:** Autoimmune Diseases & Covid-19, Covid-19 Antibodies, Covid-19 Infections, Covid-19 Research Studies --- ### [Genetic Variant Tied to Autoimmune Disease Raises COVID-19 Risk](https://www.autoimmuneinstitute.org/covid_timeline/genetic-variant-tied-to-autoimmune-disease-raises-covid-19-risk/) **Published:** February 3, 2025 **Author:** Elevation **Content:** New research has identified a genetic variant in the PTPN2 gene, commonly associated with autoimmune diseases like inflammatory bowel disease (IBD), that may elevate the risk of SARS-CoV-2 infection. This variant causes increased expression of the ACE2 receptor—the primary entry point for the coronavirus—making cells more susceptible to viral invasion. Normally, PTPN2 regulates protein activity to control inflammation, but the variant disrupts this process, leading to heightened inflammatory signaling and upregulation of ACE2 receptors. The study also highlights the potential of Tofacitinib, an ulcerative colitis treatment, to lower ACE2 expression and reduce COVID-19 infection risk. Future clinical trials could explore the use of Tofacitinib and similar drugs for preventing or managing SARS-CoV-2 infections in at-risk populations. ##### Citation: Spalinger. M. R., et al. (2025). Tofacitinib Mitigates the Increased SARS-CoV-2 Infection Susceptibility Caused by an IBD Risk Variant in the PTPN2 Gene. *Cell Mol Gastroenterol Hepatol*, 101447. <https://doi.org/10.1016/j.jcmgh.2024.101447> **Category:** Autoimmune Diseases & Covid-19, IBD & Covid-19 --- ### [COVID-19 and Autoimmunity: The Role of Autoantibodies](https://www.autoimmuneinstitute.org/covid_timeline/covid-19-and-autoimmunity-the-role-of-autoantibodies/) **Published:** February 6, 2025 **Author:** Elevation **Content:** The research article *“[Autoantibodies in COVID-19: Implications for Disease Severity and Clinical Outcomes](https://pubmed.ncbi.nlm.nih.gov/39835117/)“* explores the complex relationship between COVID-19 and autoimmune disease. The study highlights how SARS-CoV-2 infection can lead to the production of autoantibodies, which may contribute to disease severity, long COVID, and the development of autoimmune conditions. Autoantibodies, which mistakenly target the body’s own tissues, have been detected in patients with severe COVID-19 and long-COVID. These include anti-nuclear antibodies (ANA), anti-cytokine antibodies (ACA), and anti-ACE2 antibodies. ##### The presence of these autoantibodies suggests that COVID-19 could act as a trigger for autoimmune disorders, similar to other viral infections like Epstein-Barr virus. The study outlines several mechanisms that may explain how COVID-19 induces autoimmunity, including molecular mimicry (where viral proteins resemble human proteins), bystander activation (where an overactive immune response inadvertently attacks the body), and epitope spreading (where an immune response broadens to attack self-antigens). The findings suggest that individuals with pre-existing autoantibodies may be at greater risk for severe COVID-19, while others may develop new autoimmune conditions post-infection. ##### Understanding the overlap between COVID-19 and autoimmunity is crucial for predicting long-term health outcomes and developing targeted treatments for those affected by persistent symptoms. A second study, *“[Dysregulated Autoantibodies Targeting AGTR1 Are Associated with the Accumulation of COVID-19 Symptoms,](https://www.nature.com/articles/s41540-025-00488-z)“* expands on these findings by identifying specific autoantibodies that may contribute to prolonged and severe COVID-19 symptoms. The study focuses on anti-AGTR1 autoantibodies, which target the angiotensin II type 1 receptor (AGTR1), a key component of the renin-angiotensin system (RAS) that regulates blood pressure and inflammation. Researchers found that these autoantibodies were strongly linked to severe COVID-19 symptoms such as fever, muscle aches, anosmia (loss of smell), and dysgeusia (loss of taste). One of the major implications of this study is the role of AGTR1 autoantibodies in vascular and immune system dysfunction. The research suggests that these autoantibodies contribute to endothelial damage, which can lead to blood vessel inflammation, microclots, and increased severity of COVID-19. Additionally, the degradation of the endothelial glycocalyx—a protective layer lining blood vessels—was observed in patients with high levels of anti-AGTR1 antibodies. This damage disrupts normal circulation and may play a role in long-COVID symptoms like persistent fatigue and cognitive issues. ##### The study also found that the **severity of COVID-19 symptoms increased with the number of autoantibodies present**. Patients with multiple autoantibodies, including those targeting interferons and cytokines, had a higher risk of complications and prolonged illness. This aligns with previous research showing that autoantibodies can interfere with the immune system’s ability to clear the virus, leading to more severe disease and persistent symptoms. Another key finding was that losartan, a commonly prescribed medication for high blood pressure that blocks AGTR1, was able to reverse some of the effects of anti-AGTR1 autoantibodies in lab tests. This suggests that RAS-targeting therapies might have potential as treatments for severe or long-COVID cases. ##### These studies provide strong evidence that **COVID-19 is not just a respiratory illness but also an immune-disrupting disease** with long-term consequences. The identification of autoantibodies like anti-AGTR1 adds to growing concerns that **COVID-19 could act as a trigger for autoimmune conditions**, even in people who had no prior autoimmune disease. As researchers continue to study these immune system abnormalities, targeted therapies for post-COVID complications and long-COVID may become more available. ###### Citations Galipeau, Y., Cooper, C., & Langlois, M. A. (2025). **Autoantibodies in COVID-19: implications for disease severity and clinical outcomes**. *Frontiers in immunology*, *15*, 1509289. <https://doi.org/10.3389/fimmu.2024.1509289> Fonseca, D.L.M., Jäpel, M., Gyamfi, M.A. *et al.* **Dysregulated autoantibodies targeting AGTR1 are associated with the accumulation of COVID-19 symptoms**. *npj Syst Biol Appl* **11**, 7 (2025). <https://doi.org/10.1038/s41540-025-00488-z> **Category:** Autoimmune Diseases & Covid-19, Covid-19 Antibodies, Covid-19 Infections, Covid-19 Research Studies, Long COVID --- ### [Why COVID-19 Vaccines Are Less Effective in Lupus Patients](https://www.autoimmuneinstitute.org/covid_timeline/why-covid-19-vaccines-are-less-effective-in-lupus-patients/) **Published:** January 24, 2025 **Author:** Elevation **Content:** Immunocompromised people don’t develop as robust a response to vaccines as immunocompetent individuals. This is the case for the COVID-19 vaccine, but the reasons why aren’t well understood. Researchers from Emory University are closer to an answer with their [study on vaccination in lupus patients](https://www.nature.com/articles/s41590-024-02010-9). Lupus patients have compromised immune systems either because of the disease itself or because of the immunosuppressive drugs used to treat the disease. In this work, they compared the B cell response of 79 lupus patients and 64 healthy people after receiving the COVID-19 mRNA vaccine. B cells are the immune cells that produce antibodies (ex: against the SARS-CoV-2 spike protein) which make them a good subject of study. In lupus patients, the researchers noticed that the B cell response is not as efficient in creating antibodies against SARS-CoV-2. In healthy individuals, nearly all subjects produced B cells that attacked the virus while 10-30% of lupus patients generated B cells that did not attack. One of the culprits behind this difference is a pathway that involves “double negative” B cells called DN2. These cells were more prevalent in their vaccinated lupus cohort than vaccinated individuals without lupus. These cells, which were previously linked to autoimmune responses, also correlated with a poor neutralizing antibody response to the spike protein. The knowledge gained from this work could help inform vaccine strategies in the future for immunocompromised individuals that can better fine-tune vaccine dosage and timing around immunosuppressive therapy. ##### Citation: Faliti, C. E., et al. (2025). **Disease-associated B cells and immune endotypes shape adaptive immune responses to SARS-CoV-2 mRNA vaccination in human SLE**. *Nature immunology*, 26(1), 131–145. <https://doi.org/10.1038/s41590-024-02010-9> **Category:** Covid-19 Research Studies, Covid-19 Vaccines, Lupus & Covid-19 --- ### [Does Sperm Have an Immune Function?](https://www.autoimmuneinstitute.org/covid_timeline/does-sperm-have-an-immune-function/) **Published:** October 29, 2024 **Author:** Elevation **Excerpt:** New research suggests how COVID-19 adenovirus vaccines may lead to extremely rare cases of thrombosis with thrombocytopenia syndrome (TTS), an autoimmune response which can lead to fatal blood clots. Thrombosis with thrombocytopenia was verified by the WHO as a possible adverse event to AstraZeneca and Johnson & Johnson COVID-19 vaccines earlier this year, following the first but rarely after the second dose. **Content:** Over the last year, it’s become clear that SARS-CoV-2 infects a variety of tissues and can persist for months in them. In a recent study titled, [Transmission electron microscopy reveals the presence of SARS-CoV-2 in human spermatozoa associated with an ETosis-like response](https://doi.org/10.1111/andr.13612); scientists found that when SARS-CoV-2 invades the testes, the virus can persist for months in sperm cells and causes them to release DNA-based extracellular. This process is called ETosis and is a response common to specific types of immune cells where they release DNA to trap and kill microbes. ETosis has not been reported in mammalian reproductive cells before. The findings from this study could have implications for assisted reproductive technologies. ##### Citation: Hallak, J., et al. (2024). Transmission electron microscopy reveals the presence of SARS-CoV-2 in human spermatozoa associated with an ETosis-like response. Andrology, 10.1111/andr.13612. <https://doi.org/10.1111/andr.13612> **Category:** Covid-19 Research Studies --- ### [Covid-19 as a Risk Factor for Celiac Disease](https://www.autoimmuneinstitute.org/covid_timeline/covid-19-as-a-risk-factor-for-celiac-disease/) **Published:** January 13, 2025 **Author:** Elevation **Content:** Eliminating gluten is the most important lifestyle change for celiac patients. For some, however, symptoms associated with their disease still remain, even after undergoing a gluten-free diet. One factor related to the pathogenesis of [celiac disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/celiac-disease/ "Celiac disease") is viral and bacterial infections, including Covid-19. This can potentially occur as the viral infection disrupts immunological tolerance, “influencing the expression of both pro-inflammatory and immunosuppressive factors, which may initiate the pathogenic processes,” namely cytokine production which activates an immune response to gluten. A [literature review](https://pubmed.ncbi.nlm.nih.gov/39731690/) published last month covers current scientific literature on viral infections and celiac disease to better understand the relationship between the two, as well as to help researchers develop ideas around preventative measures, diagnostics, and therapeutics for celiac disease. Current research has not shown a significant increase in disease outcomes for celiac patients with Covid-19, nor are they at an additional risk of contracting Covid-19. In fact, one study has shown that high levels of anti-inflammatory mediators in celiac patients may actually keep them from developing severe Covid-19. One small study of 21 participants reported no cases of Covid-19 even though their celiac symptoms were not put into remission despite a strict gluten-free diet. On the flip side, Covid-19 has been shown to disrupt the gut microbiome, and has now been deemed a risk factor in the development of celiac disease, especially those with a genetic predisposition. The authors of this literature review acknowledge that even with a strict gluten-fee diet, some celiac patients do not experience complete remission of their symptoms, and need additional support via suppressive therapy. “Given that different viral infections can trigger or worsen gastrointestinal symptoms in these patients, \[this\] study serves as a catalyst for the healthcare system to focus more on assessing the viral infection history of \[celiac disease\] patients,” especially those who do not respond completely to a gluten free diet. Focusing on prevention, promoting awareness about risk factors, and having tools on hand for treating suspected viral infections may minimize the impact of viruses on disease outcomes. ##### Citation Asri, N., et al. (2024). Viral infections in celiac disease: what should be considered for better management. *Clinical and experimental medicine*, *25*(1), 25. <https://doi.org/10.1007/s10238-024-01542-6> **Category:** Celiac disease & Covid-19 --- ### [COVID-19 Vaccines for Children](https://www.autoimmuneinstitute.org/covid_timeline/covid-19-vaccines-for-children/) **Published:** December 9, 2024 **Author:** Elevation **Excerpt:** The U.S. pediatric COVID-19 vaccine program aimed to reduce risks of severe disease, including multisystem inflammatory syndrome in children (MIS-C) and death, but encountered challenges in achieving high vaccination coverage and widespread acceptance. **Content:** ### U.S. Pediatric COVID-19 Vaccine Program The [U.S. pediatric COVID-19 vaccine program](https://pubmed.ncbi.nlm.nih.gov/38429152/) aimed to reduce risks of severe disease, including multisystem inflammatory syndrome in children (MIS-C) and death, but encountered challenges in achieving high vaccination coverage and widespread acceptance. Primary challenges included vaccine hesitancy, programmatic challenges (such as vaccine packaging, provider enrollment, and timing of availability), equity and disparities, communication and public perceptions. The challenges in achieving high vaccination rates for children reflect a complex interplay of logistical, societal, and perceptual barriers. The pediatric COVID-19 vaccine program succeeded in making vaccines widely accessible but struggled to overcome hesitancy, misinformation, and logistical hurdles, particularly for younger age groups. Addressing these challenges in future campaigns will require early and clear communication, community-specific outreach, and better support for vaccine providers. ### COVID-19 Vaccine Requirements for Childcare and School (K-12) *Requirements are current as of May 2024* ##### Citation: Chatham-Stephens, K., et al. (2024). An overview of the COVID-19 pediatric vaccine program – The U.S. experience vaccinating children ages 6 months through 17 years. *Vaccine*, *42 Suppl 3*, 125702. <https://doi.org/10.1016/j.vaccine.2024.02.019> Map from: <https://www.immunize.org/official-guidance/state-policies/vaccine-requirements/covid-child-school-2024/> **Category:** Covid-19 Research Studies, Covid-19 Vaccines --- ### [Long COVID, ME/CFS, and POTS](https://www.autoimmuneinstitute.org/covid_timeline/long-covid-me-cfs-and-pots/) **Published:** December 12, 2024 **Author:** Elevation **Content:** In an [interview](https://www.contagionlive.com/view/navigating-long-covid-and-me-cfs-overlap) with Alba Azola, MD, lead author of the AAPM&R autonomic dysfunction guidance and member of the Johns Hopkins Post-Acute COVID-19 Team, key insights were shared about the overlap between Long COVID and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Both conditions share debilitating symptoms like fatigue, brain fog, and post-exertional malaise (PEM), but their underlying mechanisms remain under investigation. Azola noted that many Long COVID patients meet ME/CFS criteria and benefit from similar symptom management approaches. Long COVID is defined as a chronic condition lasting at least three months post-COVID-19 infection, presenting with diverse symptoms such as fatigue, cognitive difficulties, and postural orthostatic tachycardia syndrome (POTS). It affects people across all severity levels of initial infection and can significantly impair daily activities. Diagnosis relies on clinical assessment due to a lack of biomarkers. PEM, a hallmark of both conditions, is a severe exacerbation of symptoms following minimal activity, distinct from typical fatigue. Azola emphasized that this can severely limit patients’ functionality, likening their challenges to those faced by individuals recovering from neurological injuries. Research is crucial to understanding the similarities and differences between Long COVID and ME/CFS, including their pathophysiology and treatment. Existing ME/CFS rehabilitation protocols offer a foundation for treating Long COVID, but further studies are needed to refine approaches and explore biomarkers. **Category:** Long COVID, ME/CFS & Covid-19 --- ### [Persistent Post-COVID Symptoms Linked to Brain Stem Changes](https://www.autoimmuneinstitute.org/covid_timeline/persistent-post-covid-symptoms-linked-to-brain-stem-changes/) **Published:** December 2, 2024 **Author:** Elevation **Content:** Since COVD-19 is still relatively new, there is a lot we are still learning about this virus. Prior research has shown that patients who have died from COVID-19 had abnormal changes to their brain stem and central nervous system (CNS). Additionally, patients who were hospitalized often develop persistent fatigue, breathlessness, and chest pain, referred to as long COVID. However, the cause of these ongoing symptoms is unknown. In a [recent ](https://academic.oup.com/brain/advance-article/doi/10.1093/brain/awae215/7811070?login=false)study, scientists examined whether brain stem changes might be associated with these persistent symptoms in post-COVID patients. To do this, they used a special type of MRI called 7t quantitative susceptibility mapping (QSM). This technique is better able to see small abnormalities than traditional MRI. The researchers used 7t QSM on 30 recovered, hospitalized COVID-19 patients and 51 age-matched uninfected controls. Their analysis revealed evidence of brain stem changes associated with inflammation following COVID-19. This small study provides an important starting point for understanding changes that may contribute to persistent post-COVID symptoms. Further research is needed to understand how common brainstem changes are, how long they last after infection, and whether they can be prevented or treated. ##### Citation: Rua, C., et al. (2024). **Quantitative susceptibility mapping at 7 T in COVID-19: Brainstem effects and outcome associations**. *Brain*, *awae215*.[ https://doi.org/10.1093/brain/awae215](https://doi.org/10.1093/brain/awae215) **Category:** Covid-19 Infections, Covid-19 Research Studies --- ### [COVID-19 Spike Protein Linked to Autoimmune Brain Disorders](https://www.autoimmuneinstitute.org/covid_timeline/covid-19-spike-protein-linked-to-autoimmune-brain-disorders/) **Published:** December 5, 2024 **Author:** Elevation **Content:** A [recent study](https://www.cell.com/cell-host-microbe/fulltext/S1931-3128(24)00438-4) has found that pieces of the COVID-19 virus, specifically its spike protein, can stay in parts of the brain’s protective layers and the skull long after the initial infection. ### **These leftover spike proteins can trigger ongoing inflammation in the body, which might increase the risk of developing autoimmune disease.** > The researchers discovered that these spike proteins could damage certain parts of the brain by disrupting proteins needed for brain health, like those that protect nerve fibers. This can make people more vulnerable to issues like brain fog, memory problems, and even diseases similar to [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/ "multiple sclerosis"). The study also suggests that even though vaccines help reduce the amount of spike protein, they don’t eliminate it entirely. This highlights the importance of continuing research to better understand and manage the long-term effects of COVID-19 on the immune system and brain health. ##### Citation: Rong, Z., et al. (2024). **[Persistence of spike protein at the skull-meninges-brain axis may contribute to the neurological sequelae of COVID-19](https://www.cell.com/action/showPdf?pii=S1931-3128%2824%2900438-4)**. *Cell host & microbe*, S1931-3128(24)00438-4. Advance online publication. <https://doi.org/10.1016/j.chom.2024.11.007> **Category:** Covid-19 Infections, Covid-19 Research Studies, Long COVID, MS & Covid-19 --- ### [Long COVID: Brain Changes and Cognitive Impact 2 Years Later](https://www.autoimmuneinstitute.org/covid_timeline/long-covid-brain-changes-and-cognitive-impact-2-years-later/) **Published:** November 26, 2024 **Author:** Elevation **Content:** The recently published study “Cognitive impact and brain structural changes in long COVID patients: a cross-sectional MRI study two years post-infection in a cohort from Argentina” investigates the long-term neurological and cognitive effects of long COVID in a Latin American cohort. This research provides significant insights into individuals’ structural brain changes and cognitive performance approximately two years after their initial infection. ### Key Points and Findings: #### Study Participants: - The study involved 137 participants: 109 with long COVID symptoms and 28 healthy controls. - The long COVID group reported symptoms including memory problems (83.5%), fatigue (78.9%), and brain fog (79.8%). #### **Structural Brain Changes:** MRI analysis showed: - Reduced volume in regions such as the cerebellum, lingual gyrus, and inferior parietal regions. - Decreased cortical thickness in areas including the postcentral gyri, precuneus, and superior temporal gyrus. - These changes highlight potential long-term neurological impacts, even when cognitive performance is not severely compromised. #### **Cognitive Assessment:** - Despite subjective complaints of cognitive difficulties, cognitive tests revealed minimal impairment. - Marginally significant differences were observed in the Trail Making Test-A (TMT-A), suggesting structural brain changes might not always correlate with observable cognitive deficits. #### **Quality of Life and Physical Activity:** - Long COVID patients exhibited reduced health-related quality of life and lower physical activity levels compared to controls. - Pain/discomfort and anxiety/depression were frequently reported, emphasizing a broader impact on well-being. #### **Implications:** - Structural brain alterations may precede or occur independently of measurable cognitive changes. - These findings suggest a need for comprehensive, longitudinal studies to understand the progression and potential for neurodegenerative risks. ##### Citation Cataldo, S. A., et al. (2024). Cognitive impact and brain structural changes in long COVID patients: a cross-sectional MRI study two years post infection in a cohort from Argentina. *BMC neurology*, *24*(1), 450. <https://doi.org/10.1186/s12883-024-03959-8> **Category:** Covid-19 Research Studies, Long COVID --- ### [COVID-19 Linked to Autoimmune Skin Diseases: Key Findings](https://www.autoimmuneinstitute.org/covid_timeline/covid-19-linked-to-autoimmune-skin-diseases-key-findings/) **Published:** November 20, 2024 **Author:** Elevation **Content:** A recent [study](https://pubmed.ncbi.nlm.nih.gov/39504013/) highlights the long-term implications of COVID-19, particularly its association with autoimmune and autoinflammatory disorders. Researchers found that individuals who had confirmed SARS-CoV-2 infections faced a significantly higher risk of autoimmune diseases like [alopecia areata](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/alopecia-areata/ "Alopecia Areata"), [vitiligo](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/vitiligo/ "Vitiligo"), and [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic Lupus Erythematosus"). The risk was especially pronounced during the Delta variant period and among unvaccinated individuals or those with severe infections. Severe cases can lead to a delayed or uncontrolled immune response, causing the body to attack its own tissues. This process is similar to what happens in autoimmune diseases. Although the chance of developing these conditions is low, people with more severe COVID-19 infections are at higher risk. The study emphasizes the need for continued research to understand the interplay between COVID-19, autoimmunity, and genetic predispositions, as the pandemic’s effects on immune health will likely persist for years. ##### Citation: Arkin, L. M., Barbieri, J. S., & Cowen, E. W. (2024). COVID-19 as a Risk Factor For Autoimmune Skin Disease. *JAMA dermatology*, 10.1001/jamadermatol.2024.4222. Advance online publication. <https://doi.org/10.1001/jamadermatol.2024.4222> **Category:** Autoimmune Diseases & Covid-19, Covid-19 Infections, Lupus & Covid-19 --- ### [Long COVID Symptoms Differ in Adolescents and Children](https://www.autoimmuneinstitute.org/covid_timeline/long-covid-symptoms-differ-in-adolescents-and-children/) **Published:** August 1, 2024 **Author:** Elevation **Content:** While most research on Long COVID focuses on adults, these studies do not represent the common symptoms of Long COVID in adolescents and children. An observational study titled [Characterizing Long COVID in Children and Adolescents](https://jamanetwork.com/journals/jama/article-abstract/2822770) finds that headaches were the most common prolonged symptom in children (6-11 years), while daytime tiredness and low energy was the most common symptom in adolescents (12-17 years). In total, they identified 14 symptoms in children and adolescents that were more common in those with prior SARS-CoV-2 infection versus those without prior infection. The researchers next plan to study Long COVID symptoms in children less than 5 years old. ##### Citation: Gross, R.S., *et al*. Characterizing Long COVID in Children and Adolescents. *JAMA*. Published online August 21, 2024. [https://doi.org/10.1001/jama.2024.12747 ](https://doi.org/10.1001/jama.2024.12747) **Category:** Covid-19 Research Studies, Long COVID --- ### [Holistic Vagus Nerve Treatment Cures Teen’s Long COVID](https://www.autoimmuneinstitute.org/covid_timeline/holistic-vagus-nerve-treatment-cures-teens-long-covid/) **Published:** October 22, 2024 **Author:** Elevation **Content:** [Dylan Smith](https://youtu.be/eL-sph9z2UI?si=PgIk5E6DWQRVbbHd), a teen from Maryland, suffered from severe pediatric long COVID, leaving him bedridden, unable to speak, and reliant on a feeding tube for three years. Seeking a solution, his family turned to the Spero Clinic in Arkansas, which specializes in treating Long COVID through vagus nerve therapy—a key part of the nervous system involved in regulating vital functions. After 15 weeks of holistic treatments targeting this nerve, Dylan regained mobility and speech. His recovery highlights the role of neuromodulation and alternative therapies in addressing Long COVID symptoms and restoring quality of life. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/10/Screenshot-2024-10-22-at-11.07.54 AM.png) [Watch Dylan Ring the Full Remission Bell and Tell His Experience Here](https://youtu.be/eL-sph9z2UI?si=2Bhc2H8nGaiHPybK) Play ##### videoTextBlockModalblock\_652630e4138832ccf4123c3f09a3eb36Title × Your browser does not support the video tag. Close Popup **Category:** Covid-19 & Long Covid Treatments, Long COVID --- ### [The Role of COVID-19 in Rheumatic Disease](https://www.autoimmuneinstitute.org/covid_timeline/the-role-of-covid-19-in-rheumatic-disease/) **Published:** October 18, 2024 **Author:** Elevation **Content:** Leonard H. Calabrese, DO, speaks about special considerations in patients with rheumatic diseases and COVID-19. These considerations include complications in immunosuppressed patients and COVID-19’s role in promoting inflammation. He touched on some conditions that may be produced by COVID-19, including [Sjogren disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sjogren-syndrome/ "Sjögren’s Syndrome"), multisystem inflammatory syndrome in adults, and COVID-related anti-MDA5 (Melanoma differentiation-associated protein 5) myositis. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/10/Screenshot-2024-10-18-at-9.54.32 AM.png) [Watch on YouTube](https://www.youtube.com/watch?v=lpqG9PC0f_s) play ##### videoTextBlockModalblock\_a0f2353704f95f205c00e5e93555b82bTitle × Your browser does not support the video tag. Close Popup **Category:** Covid-19 Infections, Covid-19 Research Studies, RA & Covid-19, Sjögren disease & Covid-19 --- ### [Understanding Long COVID in Children](https://www.autoimmuneinstitute.org/covid_timeline/understanding-long-covid-in-children/) **Published:** September 30, 2024 **Author:** Elevation **Excerpt:** A recent paper published in eClinicalMedicine addresses the impact of long Covid in children after conducting a 3-year follow-up in patients aged 0-18 years. They were monitored for the development of Long COVID and autoimmune diseases following infection. **Content:** Since the COVID-19 pandemic, numerous studies have shown a link between infection and the development of complications afterward, known as Long COVID. Those with Long COVID experience a wide range of symptoms, and research indicates an increased risk of autoimmune disease. However, the impact on children is less clear. A recent paper published in *eClinicalMedicine*, titled “[Characteristics and Predictors of Long COVID in Children: A 3-Year Prospective Cohort Study](https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370%2824%2900394-8/fulltext#author-abstract),” addresses this issue. In this study, researchers conducted a 3-year follow-up on children aged 0-18 who had confirmed cases of COVID-19. They were monitored for the development of Long COVID and autoimmune diseases following infection. The researchers found that children do develop Long COVID, with higher risks among those with comorbidities, those infected with original variants, and females. The study also identified an association between Long COVID and the development of autoimmune diseases. Vaccination provided a protective effect in reducing the risk of Long COVID, though the level of protection varied by the number of doses and the age group. In general, three doses of the COVID-19 vaccine were associated with a lower risk in most groups, particularly in reducing the risk of gastrointestinal symptoms. This study demonstrates that children are affected by Long COVID, with some remaining symptomatic 36 months after their initial infection. These findings underscore the need for further research to better prevent and treat Long COVID in children. ##### Citation: Camporesi, A., Morello, R., La Rocca, A., Zampino, G., Vezzulli, F., Munblit, D., Raffaelli, F., Valentini, P., & Buonsenso, D. (2024). Characteristics and predictors of long covid in children: A 3-year prospective Cohort Study. *eClinicalMedicine*, *76*. <https://doi.org/10.1016/j.eclinm.2024.102815> **Category:** Covid-19 Research Studies, Long COVID --- ### [Vaccination's Impact on Autoimmune Disease Risk After COVID-19](https://www.autoimmuneinstitute.org/covid_timeline/vaccinations-impact-on-autoimmune-disease-risk-after-covid-19/) **Published:** September 3, 2024 **Author:** Elevation **Excerpt:** There is now an established risk between SARS-CoV-2 infection and the subsequent development of autoimmune diseases. However, what remains less clear is how vaccination may alter this risk. A recent paper published in JAMA Infectious Diseases titled “Autoimmune Sequelae After Delta or Omicron Variant SARS-CoV-2 Infection in a Highly Vaccinated Cohort” explored this issue. **Content:** There is now an [established risk](https://link.springer.com/article/10.1007/s10067-023-06670-0) between [SARS-CoV-2 infection](https://journals.lww.com/jclinrheum/fulltext/2024/03000/persistent_risk_of_developing_autoimmune_diseases.5.aspx) and the subsequent development of autoimmune diseases. However, what remains less clear is how vaccination may alter this risk. A recent paper published in *JAMA Infectious Diseases* titled “[Autoimmune Sequelae After Delta or Omicron Variant SARS-CoV-2 Infection in a Highly Vaccinated Cohort](https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2823018?widget=personalizedcontent&previousarticle=0)” explored this issue. The study examined the risk of developing new autoimmune diseases following a COVID-19 infection in a highly vaccinated population compared to uninfected controls. The study followed more than 1.7 million patients with and without COVID-19 infection and found no significant increase in the risk of new-onset autoimmune diseases when analyzed as a whole. However, when disease severity was factored in, the researchers did find an association between hospitalization for COVID-19, and the development of inflammatory bowel disease and bullous skin disorders. They also noted an elevated risk of vasculitis in breakthrough Omicron infections, but not in those who had received a COVID-19 booster. This data suggests that vaccination helps reduce the likelihood of new-onset autoimmune diseases following COVID-19 infection. However, more research is needed to fully understand the association between COVID-19 and the risk of autoimmune diseases. ##### Citation Wee LE, Lim JT, Tay AT, et al. Autoimmune Sequelae After Delta or Omicron Variant SARS-CoV-2 Infection in a Highly Vaccinated Cohort. *JAMA Netw Open.* 2024;7(8):e2430983. [doi:10.1001/jamanetworkopen.2024.30983](10.1001/jamanetworkopen.2024.30983) **Category:** Covid-19 Infections --- ### [Distinct Antibodies Present in Those with Long Covid](https://www.autoimmuneinstitute.org/covid_timeline/distinct-antibodies-present-in-those-with-long-covid/) **Published:** August 13, 2024 **Author:** Elevation **Excerpt:** Yale researchers have uncovered distinct immune characteristics in long COVID patients, revealing crucial differences in their immune responses compared to those without the condition. In a study titled Distinguishing features of long COVID identified through immune profiling, 275 individuals were analyzed to identify specific immunological traits associated with long COVID. The study found that patients with long COVID exhibited altered immune responses to both coronavirus and non-coronavirus pathogens. Moreover, these individuals showed changes in their immune and stress responses. **Content:** Yale researchers identified immunological features characteristic of long COVID. In this study, titled [Distinguishing features of long COVID identified through immune profiling](https://www.nature.com/articles/s41586-023-06651-y), they enrolled 275 individuals with or without long COVID in a cross-sectional study to pinpoint differences associated with long COVID. They found that individuals with long COVID had altered immune responses against coronavirus and non-coronavirus pathogens and other changes to their immune and stress response. The researchers isolated and transferred antibodies into mice from the blood samples generated from this study. While most of the mice fared no different than mice not given antibodies, a fraction of mice had increased pain sensitivity, balance issues, and lowered grip strength. When the scientists looked back at the blood samples, they found that mice with these symptoms were given antibodies from patients who shared the same symptoms. Long COVID patients have elevated levels of autoantibodies that target the nervous system. These results are reported in their recent preprint: [A causal link between autoantibodies and neurological symptoms in long COVID](https://www.medrxiv.org/content/10.1101/2024.06.18.24309100v1). ##### Citations Klein, J., Wood, J., Jaycox, J.R. *et al.* **Distinguishing features of long COVID identified through immune profiling**. *Nature* **623**, 139–148 (2023). <https://doi.org/10.1038/s41586-023-06651-y> *\[PREPRINT\]* Santos Guedes de Sa, K., et al. (2024). **A causal link between autoantibodies and neurological symptoms in long COVID**. *medRxiv : the preprint server for health sciences*, 2024.06.18.24309100. <https://doi.org/10.1101/2024.06.18.24309100> **Category:** Covid-19 Antibodies, Covid-19 Research Studies, Long COVID --- ### [Autoantibodies Linked to Long COVID Neurological Symptoms](https://www.autoimmuneinstitute.org/covid_timeline/autoantibodies-linked-to-long-covid-neurological-symptoms/) **Published:** July 1, 2024 **Author:** Elevation **Excerpt:** As COVID-19 continues to circulate, more individuals are being diagnosed with long COVID. This increasing incidence highlights the need to understand the causes and develop treatment options for the symptoms patients are experiencing. A landmark preprint article on medRxiv, titled “A causal link between autoantibodies and neurological symptoms in long COVID,” suggests that autoantibodies are likely responsible for some of these symptoms. **Content:** As COVID-19 continues to circulate, more individuals are being diagnosed with long COVID. This increasing incidence highlights the need to understand the causes and develop treatment options for the symptoms patients are experiencing. A landmark preprint article on medRxiv, titled “[A causal link between autoantibodies and neurological symptoms in long COVID](https://www.medrxiv.org/content/10.1101/2024.06.18.24309100v1),” suggests that autoantibodies are likely responsible for some of these symptoms. In this study, scientists isolated serum from patients with a high burden of neurological long COVID symptoms (nLC), recovered patients, and uninfected controls. Through a series of experiments, they compared these samples and found that nLC patients have more autoantibodies that bind to proteins within the central nervous system, spinal cord, and lining of the brain. When autoantibodies bind to tissues it can cause inflammation and damage and could be causing the symptoms in these patients. To verify that these autoantibodies could contribute to the symptoms, the scientists transferred serum from patients into mice. The mice that received nLC serum exhibited noticeable differences, including increased pain sensitivity, dizziness, and loss of balance and coordination. These signs were similar to the donor-reported symptoms. Further investigation revealed that these mice developed evidence of peripheral nerve damage, specifically small fiber neuropathy. This study makes a significant contribution to the field by demonstrating that COVID-19 infection can lead to the development of autoantibodies, supporting the theory that at least some patients with long COVID are experiencing autoimmunity. However, more research is needed because this study focused only on patients with neurological symptoms. Further work is required to determine if autoantibodies also contribute to the development of non-neurological symptoms. ##### Citation: Santos Guedes de Sa, K., et al. (2024). **A causal link between autoantibodies and neurological symptoms in long COVID**. *medRxiv : the preprint server for health sciences*, 2024.06.18.24309100. <https://doi.org/10.1101/2024.06.18.24309100> **Category:** Autoimmune Diseases & Covid-19, Covid-19 Antibodies, Covid-19 Research Studies, Long COVID --- ### [New Potential Target for Long Covid Fatigue Treatment Discovered](https://www.autoimmuneinstitute.org/covid_timeline/new-potential-target-for-long-covid-fatigue-discovered/) **Published:** July 29, 2024 **Author:** Elevation **Excerpt:** Researchers have discovered a process in fruit flies linking inflammation to muscle fatigue, offering a potential target for treating persistent muscle fatigue following infections. This finding is especially relevant for Long COVID, which often includes debilitating muscle fatigue and intolerance to exertion. This research shows how brain inflammation can impact the entire body, leading to new treatment possibilities for chronic muscle fatigue and dysfunction. **Content:** [Researchers](https://pubmed.ncbi.nlm.nih.gov/38996009/) have discovered a process in fruit flies linking inflammation to muscle fatigue, offering a potential target for treating persistent muscle fatigue following infections. This finding is especially relevant for Long COVID, which often includes debilitating muscle fatigue and intolerance to exertion. This research shows how brain inflammation can impact the entire body, leading to new treatment possibilities for chronic muscle fatigue and dysfunction. ### **Key Findings:** 1. **Brain to Muscle Signaling:** - Infections (like E. coli and COVID-19) and diseases (like Alzheimer’s) cause inflammation in the brain. - This inflammation leads to the release of a protein called IL-6. - IL-6 travels from the brain to the muscles, causing them to produce less energy and function poorly. 2. **How It Was Studied:** - The researchers used models, including fruit flies and mice, to study this process. - They found that when the brain is inflamed, it affects muscle function through this IL-6 pathway. 3. **Potential Treatments:** - Blocking the IL-6 pathway could help treat muscle problems in diseases like rheumatoid arthritis, COVID-19, and other conditions involving chronic inflammation. ### **Implications for Autoimmune Diseases:** - Autoimmune diseases, like [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/ "Multiple Sclerosis") and [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid Arthritis"), often involve brain inflammation that can lead to muscle issues through the same IL-6 pathway. - Targeting IL-6 might help treat muscle problems in these diseases. ### **Implications for Long COVID:** - Long COVID patients experience ongoing muscle fatigue and pain, even after the virus is gone. - This study suggests that inflammation in the brain keeps the IL-6 pathway active, causing these long-term muscle issues. - Understanding this pathway can help develop treatments to relieve muscle symptoms in Long COVID. ##### Citation: Yang, S., Tian, M., Dai, Y., Wang, R., Yamada, S., Feng, S., Wang, Y., Chhangani, D., Ou, T., Li, W., Guo, X., McAdow, J., Rincon-Limas, D. E., Yin, X., Tai, W., Cheng, G., & Johnson, A. (2024). **Infection and chronic disease activate a systemic brain-muscle signaling axis**. *Science immunology*, *9*(97), eadm7908. <https://doi.org/10.1126/sciimmunol.adm7908> **Category:** Covid-19 & Long Covid Treatments, Covid-19 Infections, Covid-19 Research Studies, Long COVID --- ### [COVID-19 Impact & Vaccine Safety in Young Adults with Autoimmune Disease](https://www.autoimmuneinstitute.org/covid_timeline/covid-19-impact-vaccine-safety-in-young-adults-with-autoimmune-disease/) **Published:** July 15, 2024 **Author:** Elevation **Excerpt:** A recent article published in Rheumatology International examines how COVID-19 infection and vaccination affect young people with autoimmune disease, especially regarding disease flares, COVID-19 severity, and breakthrough infection. Using responses from the COVAD study, researchers analyzed data from over 20,000 participants and categorized them into two groups: those with rheumatic disease and those with non-rheumatic autoimmune disease, and compared them to healthy controls. **Content:** July 15, 2024 While older age is a risk factor for severe COVID-19, “young adults with a chronic inflammatory disease are often exposed to prolonged periods of immunosuppression (IS), particularly when diagnosed in childhood, and their health-related outcomes may be worse than those of individuals diagnosed in adulthood.” A [recent article](https://link.springer.com/article/10.1007/s00296-024-05654-w) published in *Rheumatology International* examines how COVID-19 infection and vaccination affect young people with autoimmune disease, especially regarding disease flares, COVID-19 severity, and breakthrough infection. Using responses from the COVAD study, researchers analyzed data from over 20,000 participants and categorized them into two groups: those with rheumatic disease and those with non-rheumatic autoimmune disease, and compared them to healthy controls. Researchers identified 6,010 valid responses from participants 18-35 years of age: 1,692 had rheumatic diseases, 400 had non-rheumatic autoimmune diseases, and 3,918 participants represented healthy controls. The Pfizer vaccine (BNT162b2) was the most frequently administered vaccine among the autoimmune disease groups versus Sinopharm among the control group. Prior to vaccination, only 7% of participants with non-rheumatic autoimmune diseases were taking immunosuppressants, versus 80% among the rheumatic disease group. Less than 5% of people with non-rheumatic autoimmune diseases were taking glucocorticoids compared to 30% of people with rheumatic disease. At least 75% of participants across all groups received 2 or more vaccine doses at the time of the survey. Early mild reactions such as injection site pain, headache, fatigue, and myalgia occurred in 93% of those in the rheumatic disease group, versus 92% in the non-rheumatic autoimmune disease group. Early mild adverse events occurred in 85% of the healthy controls. Fever and chills were also reported most often within the non-rheumatic autoimmune disease group. Late mild adverse events (occurring at or after 7 days post-vaccination) were less than 20% across all three groups. Severe adverse events after the third dose were rare, at no more than 3.5% of participants. The frequency of COVID-19 infection post-vaccination was similar across all three groups. Severe infection (including hospitalization) was rarely reported. Patients with rheumatic disease reported experiencing a single episode of infection more frequently than the non-rheumatic autoimmune disease group and healthy controls, while the non-rheumatic autoimmune disease group reported experiencing infections more than once and more frequently than the rheumatic disease group. Disease flares after the second vaccine dose were reported by 10% of patients with rheumatic disease and 7% with non-rheumatic autoimmune disease. Of these, 41% of those in the rheumatic group and 27% of those with non-rheumatic autoimmune disease reported needing an increase or new immunosuppressant or glucocorticoid. “Self-reported disease flares after SARS-CoV2 infection were reported by 5% of patients with rheumatic disease and 1.5% of patients with non-rheumatic autoimmune disease.” Citation: Alunno, A., Carubbi, F., Tan, A.L. *et al.* **COVID-19 severity, breakthrough infections and vaccine safety in young individuals with autoimmune diseases: insights from the COVAD study**. *Rheumatol Int* (2024). <https://doi.org/10.1007/s00296-024-05654-w> **Category:** Autoimmune Diseases & Covid-19, Vaccine Adverse Events --- ### [Can a COVID-19 infection Accelerate Type 1 Diabetes Progression?](https://www.autoimmuneinstitute.org/covid_timeline/can-a-covid-19-infection-accelerate-type-1-diabetes-progression/) **Published:** July 17, 2024 **Author:** Elevation **Excerpt:** The Covid-19 pandemic has highlighted potential impacts on autoimmune diseases, including type 1 diabetes. A study by German researchers, published in JAMA, suggests that young individuals with presymptomatic type 1 diabetes may progress to clinical disease faster following a Covid-19 infection. **Content:** July 17, 2024 The Covid-19 pandemic has highlighted potential impacts on autoimmune diseases, including [type 1 diabetes](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/diabetes-type-1/ "Diabetes, Type 1 (T1D)"). A [study](https://www.bmj.com/content/386/bmj.q1557.long) by German researchers, published in JAMA, suggests that young individuals with presymptomatic type 1 diabetes may progress to clinical disease faster following a Covid-19 infection. The study analyzed data from 591 young people aged 1 to 16 with presymptomatic type 1 diabetes, identified through Germany’s FrIda screening program from 2015 to 2023. Participants were regularly monitored, with Covid-19 infections reported by parents and SARS-CoV-2 antibodies confirmed during study visits. The researchers compared diabetes progression rates before and during the pandemic. **Results showed a significant increase in type 1 diabetes cases during the pandemic, with 113 participants developing the disease compared to 57 pre-pandemic.** The incidence rate was 6.4 per 100 person-years pre-pandemic and 12.1 during the pandemic. The study underscores the need for further research to determine if Covid-19 accelerates type 1 diabetes progression in adults and to explore the benefits of vaccination and monitoring for Covid-19 symptoms in individuals with presymptomatic type 1 diabetes. Citation for report: Wise J. **Covid-19: Progression to clinical type 1 diabetes accelerated after infection, study suggests** *BMJ* 2024; 386 :q1557 [doi:10.1136/bmj.q1557](10.1136/bmj.q1557) **Category:** Covid-19 Infections, Covid-19 Research Studies, T1D & Covid-19 --- ### [Lack of Association between COVID-19 Vaccination and Autoimmune Rheumatic Disease Flares](https://www.autoimmuneinstitute.org/covid_timeline/lack-of-association-between-covid-19-vaccination-and-autoimmune-rheumatic-disease-flares/) **Published:** January 4, 2023 **Author:** Elevation **Excerpt:** Whether AIRD flares were associated with the vaccination or just happened by chance around the time following vaccination is not clear. In a new study from the UK, researchers asked whether vaccination against COVID-19 is associated with AIRD flare. **Content:** January 4, 2023 Some patients with an autoimmune rheumatic disease (AIRD) are hesitant about taking COVID-19 vaccines. This hesitancy is partly driven by the possibility of vaccine-induced disease flares, self-reported by some AIRD patients following vaccination. However, whether AIRD flares were associated with the vaccination or just happened by chance around the time following vaccination is not clear. In a [new study](https://academic.oup.com/rheumatology/advance-article/doi/10.1093/rheumatology/keac484/6682823) from the UK, researchers asked whether vaccination against COVID-19 is associated with AIRD flare. They extracted the patients’ data from Clinical Practice Research Datalink and analyzed the impact of COVID-19 vaccination on 3554 cases. They specifically looked at whether the incidence of flares increased 21 days after immunization (for first, second or third doses of the vaccine). Based on the analysis, the scientists didn’t find an association between vaccination against COVID-19 and increased AIRD flares. AIRD type, vaccine type (Astra Zeneca or Pfizer – BioNTech), or prior exposure to COVID-19 also had no influence on AIRD flares following COVID-19 vaccination. The authors discuss other studies regarding AIRD flares and COVID-19 vaccines, with some pointing to an increased possibility of flares. However, those studies often used different data types (e.g., self-reported) or different types of analyses. The authors point out that the data they used for their analysis is reliable since it was collected by NHS Digital, which added strength to their research. **Citation for report:** Nakafero, G., Grainge, M. J., Card, T., Mallen, C. D., Nguyen Van-Tam, J. S., Williams, H. C., & Abhishek, A. (2023). **Is vaccination against COVID-19 associated with autoimmune rheumatic disease flare? A self-controlled case series analysis**. *Rheumatology (Oxford, England)*, *62*(4), 1445–1450. <https://doi.org/10.1093/rheumatology/keac484> **Category:** Autoimmune Diseases & Covid-19, Covid-19 Research Studies, RA & Covid-19, Vaccine Adverse Events --- ### [Occurrence of Autoimmune Diseases following COVID-19](https://www.autoimmuneinstitute.org/covid_timeline/occurrence-of-autoimmune-diseases-following-covid-19/) **Published:** January 10, 2023 **Author:** Elevation **Excerpt:** COVID-19 and autoimmune disease share some similarities regarding molecular mechanisms of diseases. The authors of a paper published in November 2022 suggest that drugs used to treat autoimmune patients can serve as a potential treatment for COVID-19 patients. **Content:** January 10, 2023 Several studies have reported the co-occurrence of autoimmune diseases (such as systemic lupus erythematosus, Guillain-Barre syndrome, autoimmune thyroid disease, and immune thrombocytopenic purpura) following COVID-19. The time between COVID-19 symptoms and the autoimmune disease symptoms in those reports ranges between 2 and 33 days. Scientists identified several components and mechanisms of the immune system that can be involved in the connection between COVID-19 and autoimmune diseases; this includes SARS-CoV-2 hyperactivation of the immune system and molecular mimicry. Molecular mimicry occurs when there is a resemblance between foreign proteins, in this case, COVID-19 proteins, and the proteins in the human body. In such cases, the antibodies created against the viral proteins can turn against human proteins. Researchers found COVID-19 and human proteins that share similar parts. Those proteins can be candidates for molecular mimicry.  Understanding the immune system response to SARS-CoV-2 can help design better therapies targeting specific components of the overreacting immune system. COVID-19 and autoimmune disease share some similarities regarding molecular mechanisms of diseases. **The authors of** [**a paper published in November 2022**](https://www.sciencedirect.com/science/article/pii/S1567576922006671?via%3Dihub) **suggest that drugs used to treat autoimmune patients can serve as a potential treatment for COVID-19 patients**. Some reports show that drugs used to treat autoimmune diseases can be effective in COVID-19 patients. However, some may be harmful as well. Generally, in the initial COVID-19 phase, the immune response is needed to stop the virus from replicating. In this phase, immunosuppressive drugs can be harmful. However, when the patient experiences hyperactivation of the immune system, in later phases, immunosuppressive drugs can be beneficial as they can suppress the hyper-activated immune system. There is still much to be understood about the connection between COVID-19 and autoimmune diseases. Since most of the studies on autoimmune disease occurrence following COVID-19 report on a single or a few patients, there is a need for systemic research regarding the frequency of autoimmune diseases following COVID-19. **Citation for report:** Vahabi, M., Ghazanfari, T., & Sepehrnia, S. (2022). **Molecular mimicry, hyperactive immune system, and SARS-COV-2 are three prerequisites of the autoimmune disease triangle following COVID-19 infection**. *International immunopharmacology*, *112*, 109183. <https://doi.org/10.1016/j.intimp.2022.109183> **Category:** Autoimmune Diseases & Covid-19, Covid-19 Research Studies, GBS & Covid-19, Lupus & Covid-19 --- ### [COVID-19 Vaccine Tolerance in Patients with Rheumatoid Arthritis](https://www.autoimmuneinstitute.org/covid_timeline/covid-19-vaccine-tolerance-in-patients-with-rheumatoid-arthritis/) **Published:** January 26, 2023 **Author:** Elevation **Excerpt:** Researchers created an online questionnaire for RA and AIRD patients to self-report short-term COVID-19 vaccine-related adverse events. Vaccines included in the study were Pfizer, Moderna, Johnson & Johnson, AstraZeneca, Covaxin, and Sinopharm. The most common coexisting autoimmune diseases were thyroid disorders, systemic lupus erythematosus (SLE) and Sjogren’s syndrome (10.0%, 2.6%, and 2.5%, respectively). **Content:** January 26, 2023 Researchers from around the world collaborated to create an online survey for rheumatoid arthritis (RA) and other autoimmune rheumatic disease (AIRD) patients (excluding inflammatory myositis) to self-report COVID-19 vaccine-related adverse events occurring within 7 days post-vaccination ([1](https://pubmed.ncbi.nlm.nih.gov/36315075/)). 1,347 RA patients participated in the survey between March and December 2021. The most common coexisting autoimmune diseases were thyroid disorders, [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/systemic-lupus-erythematosus/) (SLE) and [Sjogren’s syndrome](https://www.autoimmuneinstitute.org/sjogrens-syndrome/) (10.0%, 2.6%, and 2.5%, respectively). 76.9% of RA patients reported minor adverse effects, including pain at the injection site, fatigue, headache, and body aches. Major adverse effects were reported by 4.2% of patients; these included anaphylaxis, difficulty breathing, throat closure, and severe rashes. Three of these patients were hospitalized (.2%). The frequency of adverse effects and hospitalizations was mostly similar among patients with both active and inactive RA. **Patients with RA experienced similar total adverse events and hospitalizations when compared to healthy controls.** Data reported by patients pointed to different outcomes between vaccines, as minor adverse effects were most frequently reported by people who received Pfizer-BioNTech and Moderna, and less frequently reported by Covaxin (Bharat Biotech) recipients. However, hospitalizations and major adverse effects were similar among RA patients regardless of the vaccine type, except for Johnson & Johnson recipients, who reported a higher frequency of any major adverse effects. Other COVID-19 vaccines included in the study were AstraZeneca and Sinopharm. In regard to receiving immunosuppressive therapies, RA patients receiving methotrexate and hydroxychloroquine experienced a smaller number of minor adverse effects compared to patients who were not taking these medications. Hospitalization rates were similar among patients receiving different immunosuppressants. In all, this study adds to the growing body of scientific literature showing COVID-19 vaccines are generally well tolerated amongst RA patients when compared to those without RA. **Citation for report:** Naveen, R., Parodis, I., Joshi, M., Sen, P., Lindblom, J., Agarwal, V., Lilleker, J. B., Tan, A. L., Nune, A., Shinjo, S. K., Salim, B., Ziade, N., Velikova, T., Edgar Gracia-Ramos, A., Saavedra, M. A., Day, J., Makol, A., Distler, O., Chinoy, H., Agarwal, V., … COVAD Study Group (2023). **COVID-19 vaccination in autoimmune diseases (COVAD) study: vaccine safety and tolerance in rheumatoid arthritis**. *Rheumatology (Oxford, England)*, *62*(7), 2366–2376. <https://doi.org/10.1093/rheumatology/keac624> **Category:** Autoimmune Diseases & Covid-19, Covid-19 Research Studies, Johnson & Johnson, Lupus & Covid-19, Moderna, Pfizer, RA & Covid-19, Sjögren disease & Covid-19, Vaccine Adverse Events, Vaccine Manufacturers --- ### [COVID-19 Boosters in Autoimmune Rheumatic and Musculoskeletal Patients](https://www.autoimmuneinstitute.org/covid_timeline/covid-19-boosters-in-autoimmune-rheumatic-and-musculoskeletal-patients/) **Published:** February 1, 2023 **Author:** Elevation **Excerpt:** Researchers in Hungary investigated the efficacy of COVID-19 boosters in patients with autoimmune rheumatic and musculoskeletal diseases. They also studied whether a SARS-CoV-2 infection following a two-dose primary series increased antibody production by the immune system in lieu of a booster. **Content:** February 1, 2023 Even though COVID-19 vaccination is recommended for patients with autoimmune rheumatic and musculoskeletal diseases (aiRMDs), clinical research is scarce on how a booster dose or infection following a two-dose primary series influences the immune system. [Researchers in Hungary](https://pubmed.ncbi.nlm.nih.gov/36232710/) analyzed the immune response in aiRMDs patients after receiving a COVID-19 booster, as well as those who experienced a SARS-CoV-2 infection after receiving two doses of a COVID-19 vaccine. The cohort consisted of 46 patients with aiRMDs who received two doses of either Sinopharm, Sputnik V, AstraZeneca, or Pfizer, followed by a Pfizer COVID-19 booster dose or who experienced a SARS-CoV-2 infection six months after their second vaccine dose. Researchers compared the immune responses in patients who received three vaccines from the same manufacturer, a primary series from one manufacturer with a mix-and-match booster, and a third group who was infected with SARS-CoV-2 following immunization with two vaccine doses. Participants’ underlying diseases were in remission or had low activity. Additionally, all participants were on stable medication for at least eight weeks prior to enrollment; patients were advised to discontinue medication for two weeks during their vaccination or infection period. Researchers analyzed the immune system of study participants four months after booster shots or SARS-CoV-2 infection. While levels of specific antibodies differed, generally, a booster dose or infection helped to increase the levels of antibodies in patients, thus increasing protection against the virus. This data aligns with findings from other studies showing that vaccination and boosters reduced hospitalizations and deaths among aiRMDs patients. Boosters were similarly effective regardless of whether the booster was from the same manufacturer as the primary series, mix-and-matched, or if a SARS-CoV-2 infection was serving as a booster. **Importantly, boosters were not observed to increase the clinical activity of aiRMDs.** Researchers did not observe any significant flares or relapses among patients following a booster dose or infection. Patients infected with SARS-CoV-2 following the two-dose vaccination suffered only mild symptoms, and none of the aiRMDs patients in the study were hospitalized or died. **Citation for report:** Honfi, D., Gémes, N., Szabó, E., Neuperger, P., Balog, J. Á., Nagy, L. I., Toldi, G., Puskás, L. G., Szebeni, G. J., & Balog, A. (2022). **Comparison of Homologous and Heterologous Booster SARS-CoV-2 Vaccination in Autoimmune Rheumatic and Musculoskeletal Patients**. *International journal of molecular sciences*, *23*(19), 11411. <https://doi.org/10.3390/ijms231911411> **Category:** AstraZeneca, Autoimmune Diseases & Covid-19, Covid-19 Antibodies, Covid-19 Boosters, Covid-19 Infections, Covid-19 Research Studies, Moderna, Pfizer, RA & Covid-19, Vaccine Adverse Events, Vaccine Manufacturers --- ### [COVID-19 Drives Autoimmunity](https://www.autoimmuneinstitute.org/covid_timeline/covid-19-drives-autoimmunity/) **Published:** March 20, 2023 **Author:** Elevation **Excerpt:** This Week in Virology podcast discusses the finding that infection with SARS-CoV-2 leads to an increase in new and preexisting autoantibodies. Find the episode here! **Content:** March 20, 2023 *This Week in Virology* podcast discusses the finding that infection with SARS-CoV-2 leads to an increase in new and preexisting autoantibodies. Find the episode here! <https://youtu.be/f9nx9NaVu2s> \[embedyt\] https://www.youtube.com/watch?v=f9nx9NaVu2s\[/embedyt\] **Citation for report:** *[Youtube](https://www.youtube.com/).* [**TWiV 993: COVID-19 drives autoimmunity**](https://youtu.be/f9nx9NaVu2s) **Category:** Autoimmune Diseases & Covid-19, Covid-19 Antibodies --- ### [Chronic Fatigue Syndrome & Long COVID: Similarities and Differences](https://www.autoimmuneinstitute.org/covid_timeline/chronic-fatigue-syndrome-long-covid-similarities-and-differences/) **Published:** March 29, 2023 **Author:** Elevation **Excerpt:** Are ME/CFS and long COVID similar conditions, with the only difference being the trigger driving their development? Scientists evaluated levels of depressive symptoms, fatigue, sleep quality, anxiety, and olfactory and cognitive functions in 42 ME/CFS patients and 73 long COVID patients to find out if this is the case. **Content:** March 29, 2023 Over 60% of patients who experience a COVID-19 infection report physical and mental fatigue and what they refer to as “brain fog.” These symptoms are often grouped as a post‑COVID‑19 condition or long COVID. Patients suffering from [Myalgic Encephalomyelitis](https://www.autoimmuneinstitute.org/me-cfs/) (ME), commonly known as Chronic Fatigue Syndrome (CFS), are also affected by similar symptoms, and people affected by both conditions suffer from “slow processing speed, deficient sustained attention, and verbal memory impairment” ([1](https://translational-medicine.biomedcentral.com/articles/10.1186/s12967-022-03764-2)). Researchers asked whether these two conditions are the same, with the only difference being the initial trigger. Levels of depressive symptoms, fatigue, sleep quality, anxiety, as well as olfactory and cognitive functions were evaluated amongst 42 ME/ CFS patients and 73 long COVID patients. Based on the available data, researchers concluded that even though ME/ CFS patients’ symptoms were more severe, there were similarities between patients in both groups. ME/ CFS and long COVID patients suffered from “high levels of fatigue, poor sleep quality, anxiety, and depressive symptoms.” However, ME/ CFS patients suffered more frequently from “dizziness, instability, high-temperature sensation, and muscle weakness.” Patients with ME/ CFS also performed worse in attention and visual perception tasks. Researchers observed that the cognitive performance of long COVID patients correlated with physical ailments and mood disturbances, while for ME/ CFS patients, cognitive performance correlated with anxiety symptoms and physical fatigue. The authors of this study mention the importance of treating anxiety and depressive symptoms in patients with both conditions as they can have ties to suicidal thoughts. They also point to some limitations in the study; for example, the lack of a control group (including healthy participants who do not have a history of COVID-19 infection and don’t suffer from ME/ CFS). Additionally, most of the study’s participants were Caucasian and unvaccinated, making it difficult to draw conclusions about vaccinated patients who experienced COVID-19 infection or people of different races. **Citation for report:** Azcue, N., Gómez-Esteban, J. C., Acera, M., Tijero, B., Fernandez, T., Ayo-Mentxakatorre, N., Pérez-Concha, T., Murueta-Goyena, A., Lafuente, J. V., Prada, Á., López de Munain, A., Ruiz-Irastorza, G., Ribacoba, L., Gabilondo, I., & Del Pino, R. (2022). **Brain fog of post-COVID-19 condition and Chronic Fatigue Syndrome, same medical disorder?**. *Journal of translational medicine*, *20*(1), 569. <https://doi.org/10.1186/s12967-022-03764-2> **Category:** Autoimmune Diseases & Covid-19, Covid-19 Infections, Covid-19 Research Studies, Long COVID, ME/CFS & Covid-19 --- ### [Long COVID and its Effects on the Central Nervous System](https://www.autoimmuneinstitute.org/covid_timeline/long-covid-and-its-effects-on-the-central-nervous-system/) **Published:** March 31, 2023 **Author:** Elevation **Excerpt:** Researchers are uncovering how long COVID affects the central nervous system and the mechanisms that drive long COVID symptoms. A recent paper published in Cell aimed to gather information on the various hypotheses covering these two topics. **Content:** March 31, 2023 Post-acute COVID-19 syndrome, known as long COVID, affects many COVID-19 patients. Symptoms that characterize long COVID include loss of sense of smell and taste, cognitive impairments, depression, anxiety, Chronic Fatigue Syndrome ([ME/ CFS](https://www.autoimmuneinstitute.org/me-cfs/)), and so-called “brain fog,” an umbrella term for a collection of symptoms like impaired attention, concentration, memory, speed of information processing, and executive function. Studies have shown that two months after initial infection, more than 70% of people experience at least one long COVID symptom, with many symptoms lasting for months after the infection. While long COVID symptoms can affect people who experienced mild COVID-19 symptoms, the risk is higher for those with severe illness. A recent paper published in [*Cell*](https://www.cell.com/neuron/pdf/S0896-6273(22)00910-2.pdf) collected different hypotheses regarding the central nervous system and the mechanisms driving long COVID. The central nervous system can be affected by COVID-19 in several ways. One of them is the immune system’s response, which can lead to neuro-inflammation. Increased production of cytokines, chemokines, and immune cells can result in the dysregulation of immune cell function in the brain and brain borders. SARS-CoV-2 can also induce an autoimmune response against the immune system. Studies analyzing antibodies of COVID-19 patients found autoantibodies against numerous organs, including the central nervous system. Additionally, rare cases of autoimmune disease, namely, Acute Disseminated Encephalomyelitis ([ADEM](https://www.autoimmuneinstitute.org/acute-disseminated-encephalomyelitis/)), have been reported following a COVID-19 infection. Scientists advise long-term studies, as the autoimmune disease may take time to exhibit symptoms. Another mechanism can involve the reactivation of dormant herpes viruses. Most humans are infected with viruses, which reside in a dormant state. These viruses can be reactivated by another viral infection, such as SARS-CoV-2. One such virus is the Epstein-Barr virus (EBV). EBV reactivation can contribute to neuroinflammation through the production of viral proteins and the immune system’s response. Studies show that more than 60% of patients with long COVID are positive for EBV reactivation, compared to only 10% of controls. **SARS-CoV-2 can also, although rarely, directly infect the nervous system.** There are also hypotheses that multi-organ dysfunction during severe COVID-19 can lead to low oxygen levels in the blood, very low blood pressure, and metabolic perturbations that negatively affect neural cells. COVID-19 infection increases the risk of ischemic stroke, a condition that prevents the brain from getting enough oxygen due to interruptions in the brain’s blood supply. Disruptions in blood flow or blood-brain barrier function can also play a role in neuroinflammation. While there are many possibilities of how COVID-19 influences the central nervous system and causes long COVID, they are not exclusive and can occur in combination; understanding them will offer better treatment options for patients with long COVID. **Citation for report:** Monje, M., & Iwasaki, A. (2022). **The neurobiology of long COVID**. *Neuron*, *110*(21), 3484–3496. <https://doi.org/10.1016/j.neuron.2022.10.006> **Category:** Autoimmune Diseases & Covid-19, Covid-19 Infections, Covid-19 Research Studies, Long COVID, ME/CFS & Covid-19 --- ### [COVID-19 in Patients with Systemic Autoimmune Rheumatic Diseases](https://www.autoimmuneinstitute.org/covid_timeline/covid-19-in-patients-with-systemic-autoimmune-rheumatic-diseases/) **Published:** April 4, 2023 **Author:** Elevation **Excerpt:** Researchers evaluated the characteristics, severity, course of infection, and disease outcomes in COVID-19 patients with and without Systemic Autoimmune Rheumatic Diseases (SARDs). Patients with rheumatoid arthritis, systemic lupus erythematosus (SLE), Sjögren’s syndrome, Psoriasis, Type 1 Diabetes, Inflammatory Bowel Disease, and Glomerulonephritis, amongst others, were included in the study.  **Content:** April 4, 2023 To better understand the impact of COVID-19 infections in patients with Systemic Autoimmune Rheumatic Diseases (SARDs), researchers compared 185 SARD patients to a control group of over 8,000 COVID-19 cases from the Polish national database  – SARSTer ([1](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9781406/)). They evaluated the characteristics, severity, course of infection, and disease outcomes. Patients with [rheumatoid arthritis](https://www.autoimmuneinstitute.org/rheumatoid-arthritis/), [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/systemic-lupus-erythematosus/) (SLE), [Sjögren’s syndrome](https://www.autoimmuneinstitute.org/sjogrens-syndrome/), [Psoriasis](https://www.autoimmuneinstitute.org/psoriasis/), [Type 1 Diabetes](https://www.autoimmuneinstitute.org/diabetes-type-1/), Inflammatory Bowel Disease, and Glomerulonephritis, amongst others, were included in the study. Compared to the control group, SARD patients experienced more prolonged hospitalizations, with longer durations of oxygen therapy, a higher need for high-flow nasal oxygen and/or noninvasive ventilation, and higher mortality. Authors noted that SARD patients often had coexisting co-morbidities, such as cardiovascular, pulmonary, and chronic kidney diseases, and were typically older than patients in the control group. Based on the data, researchers were also able to define risk factors for mortality among SARD patients affected by COVID-19; these included “the presence of cardiovascular disease, more severe conditions on admission, and higher inflammatory marker values.” Authors also analyzed the clinical outcomes of SARD patients treated with remdesivir. Remdesivir was developed to treat infections caused by Ebola virus; it has since been adapted to treat patients with COVID-19, but its effectiveness in SARD patients infected with SARS-CoV-2 was not evaluated previously. The authors of this study analyzed mortality rates of SARD patients treated with remdesivir and compared them to SARD patients who didn’t receive remdesivir. Even though they noticed a trend suggesting remdesivir helped reduce mortality among SARD patients, this trend was not statistically significant, meaning the improvement could have happened by chance and not as a result of remdesivir treatment. The authors point to a few limitations of this study, for example, a small number of SARD patients. Since the number of patients in this study might have been too small to obtain statistically significant results, conducting a similar study on a bigger group of patients may give a more definitive answer. Additionally, authors did not collect patients’ vaccination status, rheumatic disease activity, which SARS-CoV-2 variant patients were infected with, or the doses of drugs used, which limit the study’s conclusions. **Citation for report:** Rorat, M., Zarębska-Michaluk, D., Kowalska, J., Kujawa, K., Rogalska, M., Kozielewicz, D., Lorenc, B., Sikorska, K., Czupryna, P., Bolewska, B., Maciukajć, J., Piekoś, T., Podlasin, R., Dworzańska, A., Mazur, W., Brzdęk, M., Szymanek-Pasternak, A., & Flisiak, R. (2022). **The Course of COVID-19 in Patients with Systemic Autoimmune Rheumatic Diseases**. *Journal of clinical medicine*, *11*(24), 7342. <https://doi.org/10.3390/jcm11247342> **Category:** Autoimmune Diseases & Covid-19, Covid-19 & Long Covid Treatments, Covid-19 Infections, Covid-19 Research Studies, IBD & Covid-19, Lupus & Covid-19, RA & Covid-19, Sjögren disease & Covid-19, T1D & Covid-19 --- ### [COVID-19 Risk Factors & Mortality in SLE Patients](https://www.autoimmuneinstitute.org/covid_timeline/covid-19-risk-factors-mortality-in-sle-patients/) **Published:** April 12, 2023 **Author:** Elevation **Excerpt:** “Systemic Lupus Erythematosus (SLE) is uniquely poised at crossroads between the dysregulated immune system and the risk of viral infections, especially in the context of the current COVID-19 pandemic." Researchers in India studied the impact of common SLE immunosuppressive drugs in SLE patents with COVID-19, as well as risk factors associated with COVID-19 in this patient population. **Content:** April 12, 2023 “[Systemic Lupus Erythematosus](https://www.autoimmuneinstitute.org/systemic-lupus-erythematosus/) (SLE) is uniquely poised at crossroads between the dysregulated immune system and the risk of viral infections, especially in the context of the current COVID-19 pandemic. This risk can be attributed to a multitude of factors such as lupus-related critical organ system dysfunction, accompanying comorbidities and the use of immunosuppressive drugs” ([1](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9899665/)). Researchers in India aimed to study the impact of common SLE immunosuppressive drugs in SLE patents with COVID-19, as well as to reaffirm the risk factors associated with COVID-19 in this patient population. 1,379 SLE patients amongst a cohort of 9,212 patients with AIRDs (autoimmune rheumatic diseases) were included in the study and followed-up for six months between April and December 2020. A series of baseline datapoints were evaluated by researchers, including SLE disease characteristics, current immunosuppressants and doses, and comorbidities. 2.6% of SLE patients experienced PCR-test confirmed COVID-19 during the six month study period; of this group, one patient died of COVID-19. Researchers note that incidence of COVID-19 was 1.7% amongst the general population where patients lived (Kerala and Karnataka, India). In an adjusted model, male sex and diabetes correlated with a higher risk for acquiring COVID-19. That being said, duration of illness and disease subsets (including [lupus nephritis](https://www.autoimmuneinstitute.org/lupus-nephritis/), neurophsyiatric and antiphospholipid positivity) did not have a significant impact on mortality. Additionally, low dose prednisolone or moderate-to-high doses of steroids (namely, glucocorticoids) were found to influence the risk of contracting COVID-19. Immmunosuppressive therapies did not have “any impact” on the risk of COVID-19 in patients with SLE. Researchers note that these results both confirm and differ from similarly run studies in other parts of the world. **Citation for report:** Patil, A., Shobha, V., Shenoy, P., S, C., Kumar, S., Daware, M., Haridas, V., Janardana, R., Pinto, B., Kodishala, C., Ramaswamy, S., S, N., Jain, V., Singh, Y. P., Singhai, S., C, S., Jois, R., Rao, V. K., Dharmapalaiah, C., Kn, S., … Balebail, D. (2023). **Risk factors associated with COVID-19 in systemic lupus erythematosus: Results from a longitudinal prospective cohort**. *Lupus*, *32*(4), 560–564. <https://doi.org/10.1177/09612033231155837> **Category:** Autoimmune Diseases & Covid-19, Covid-19 Infections, Covid-19 Research Studies, Lupus & Covid-19 --- ### [Risk of Developing Autoimmune Disease Following COVID-19 Infection](https://www.autoimmuneinstitute.org/covid_timeline/risk-of-developing-autoimmune-disease-following-covid-19-infection/) **Published:** May 1, 2023 **Author:** Elevation **Excerpt:** A recent study exploring the association between COVID-19 infection and the risk of developing autoimmune diseases was conducted by a team of researchers from various institutions in Taiwan using data from the “TriNetX database, which holds the largest global COVID-19 dataset.” The team analyzed the medical record data of 3.8 million patients in the U.S., of which 888,460 had received a COVID-19 diagnosis (polymerase chain reaction–confirmed) between January 1, 2020, and December 31, 2021. **Content:** May 1, 2023 A recent [study](https://pubmed.ncbi.nlm.nih.gov/36643619/) exploring the association between COVID-19 infection and the risk of developing autoimmune diseases was published in the *EClinicalMedicine* journal. The retrospective cohort study was conducted by a team of researchers from various institutions in Taiwan using data from the “TriNetX database, which holds the largest global COVID-19 dataset.” The team analyzed the medical record data of 3.8 million patients in the U.S., of which 888,460 had received a COVID-19 diagnosis (polymerase chain reaction–confirmed) between January 1, 2020, and December 31, 2021. This group was referred to as the COVID-19 cohort. The control group, referred to as the non-COVID-19 cohort, was matched to the COVID-19 cohort for age, sex, race, adverse socioeconomic status, lifestyle-related variables, and comorbidities. Patients who had received any COVID-19 vaccination throughout the study were intentionally excluded for clarity of interpretation. **The study results showed that patients from the COVID-19 cohort were 2-3 times more likely to develop autoimmune diseases than the non-COVID-19 cohort**. The most commonly observed autoimmune diseases in the COVID-19 cohort were [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/rheumatoid-arthritis/), [ankylosing spondylitis](https://www.autoimmuneinstitute.org/autoimmune-resources/ankylosing-spondylitis/), [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/systemic-lupus-erythematosus/), [dermatopolymyositis](https://www.autoimmuneinstitute.org/autoimmune-resources/dermatomyositis/), systemic sclerosis, [Sjögren’s syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/sjogrens-syndrome/), [mixed connective tissue disease](https://www.autoimmuneinstitute.org/autoimmune-resources/mixed-connective-tissue-disease/), [Behçet’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/behcets/), [polymyalgia rheumatica](https://www.autoimmuneinstitute.org/autoimmune-resources/polymyalgia-rheumatica/), vasculitis, [psoriasis](https://www.autoimmuneinstitute.org/autoimmune-resources/psoriasis/), inflammatory bowel disease ([Crohn’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/crohns-disease/) and [ulcerative colitis](https://www.autoimmuneinstitute.org/autoimmune-resources/ulcerative-colitis/)), [celiac disease](https://www.autoimmuneinstitute.org/autoimmune-resources/celiac-disease/), and [type 1 diabetes](https://www.autoimmuneinstitute.org/autoimmune-resources/diabetes-type-1/). The findings highlight the importance of monitoring COVID-19 patients for the development of autoimmune diseases and providing appropriate follow-up care. **Citation for report:** Chang, R., Yen-Ting Chen, T., Wang, S. I., Hung, Y. M., Chen, H. Y., & Wei, C. J. (2023). **Risk of autoimmune diseases in patients with COVID-19: A retrospective cohort study**. *EClinicalMedicine*, *56*, 101783. <https://doi.org/10.1016/j.eclinm.2022.101783> **Category:** Autoimmune Diseases & Covid-19, Celiac disease & Covid-19, Covid-19 Research Studies, Long COVID, Lupus & Covid-19, RA & Covid-19, Sjögren disease & Covid-19, T1D & Covid-19 --- ### [Those with Autoimmune Conditions Have Higher Long Covid Risk](https://www.autoimmuneinstitute.org/covid_timeline/those-with-autoimmune-conditions-have-higher-long-covid-risk/) **Published:** May 5, 2023 **Author:** Elevation **Excerpt:** In a study called “pre-existing conditions associated with post-acute sequelae of COVID-19” published in the Journal of Autoimmunity, researchers investigated which pre-existing conditions increase the risk of a person developing long COVID. They analyzed data from 1224 patients who participated in the COVID-19 study in Arizona called CoVHORT. The statistical analysis showed respiratory, gastrointestinal, and autoimmune conditions associated with the increased risk for long COVID. **Content:** May 5, 2023 In a [study](https://pubmed.ncbi.nlm.nih.gov/36634460/) called “pre-existing conditions associated with post-acute sequelae of COVID-19” published in the *Journal of Autoimmunity*, researchers investigated **which pre-existing conditions increase the risk of a person developing long COVID**. They analyzed data from 1224 patients who participated in the COVID-19 study in Arizona called CoVHORT. **The statistical analysis showed respiratory, gastrointestinal, and autoimmune conditions associated with the increased risk for long COVID.** Regarding specific pre-existing conditions, the analysis indicated that asthma; chronic constipation; reflux; [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/rheumatoid-arthritis/); seasonal allergies; and depression/anxiety were associated with long COVID. Authors note that the CoVHORT study provided extensive data that allowed for analyzing many factors regarding study participants, e.g., demographics and pre-existing conditions.  However, the study also had some limitations; for example, a large portion of the data in the CoVHORT study is self-reported, which can bring in some biases regarding what patients remember and report. It is also possible that some symptoms reported by study participants following COVID-19 aren’t related to COVID but to pre-existing diseases. The authors also point out that to improve the study, the group of participants needs to be more diverse, which will allow for determining risk factors in different subgroups of patients. Identifications of patients with the highest risk of long COVID can help develop public health measures to inform those people about the risks and protect those individuals from infection. **Citation for report:** Jacobs, E. T., Catalfamo, C. J., Colombo, P. M., Khan, S. M., Austhof, E., Cordova-Marks, F., Ernst, K. C., Farland, L. V., & Pogreba-Brown, K. (2023). **Pre-existing conditions associated with post-acute sequelae of COVID-19**. *Journal of autoimmunity*, *135*, 102991. <https://doi.org/10.1016/j.jaut.2022.102991> **Category:** Autoimmune Diseases & Covid-19, Covid-19 Research Studies, Long COVID, RA & Covid-19 --- ### [The Genetic Connection between COVID-19 and Lupus](https://www.autoimmuneinstitute.org/covid_timeline/the-genetic-connection-between-covid-19-and-lupus/) **Published:** May 16, 2023 **Author:** Elevation **Excerpt:** Studies on COVID-19 reveal that genetic differences between people impact the severity of the disease. Those genetic differences affect the immune response pathways, including those that play a part in autoimmune diseases. That prompted scientists to compare the genetics of severe COVID-19 and autoimmune diseases such as systemic lupus erythematosus (lupus). **Content:** May 16, 2023 Studies on COVID-19 reveal that genetic differences between people impact the severity of the disease. Those genetic differences affect the immune response pathways, including those that play a part in autoimmune diseases. That prompted scientists to [compare the genetics of severe COVID-19 and autoimmune diseases such as systemic lupus erythematosus (lupus)](https://pubmed.ncbi.nlm.nih.gov/36327221/). They embarked on the question of which genetic loci (a fragment of a person’s DNA) impact both diseases and which biological processes are involved. **The research revealed several genetic loci that impacted the severity of COVID-19 were also involved in [lupus](https://www.autoimmuneinstitute.org/autoimmune-resources/systemic-lupus-erythematosus/)**. In those loci, researchers identified alleles, that is, versions of the genes, that influenced the severity of COVID-19 and Lupus. Research revealed that the locus that shows the most association between COVID-19 and Lupus contains the gene TYK2, which codes for a protein involved in interferon production. Interferon production plays an important role in response to viral infection. It is known that this process is dysregulated in Lupus patients. The TYK2 had opposing effects on COVID-19 severity and Lupus susceptibility, which is in line with the hypothesis stating that some alleles that persist in the human population represent a risk for Lupus, but at the same time, they have a protective effect against pathogens (including viruses). Researchers also identified locus presenting a risk for Lupus and severe COVID-19. This shared locus contains a gene called CLEC1A; it codes for a protein known as a lectin that plays a role in signaling between cells. Researchers hypothesized that despite being a risk for Lupus and COVID-19, it still exists in the population because it plays a protective role in fungal infections. Results presented in this study are an additional piece of evidence pointing to the existence of alleles in human DNA that protect against viral infection and can affect a person’s susceptibility to autoimmune diseases. **Citation for report:** Wang, Y., Guga, S., Wu, K., Khaw, Z., Tzoumkas, K., Tombleson, P., Comeau, M. E., Langefeld, C. D., Cunninghame Graham, D. S., Morris, D. L., & Vyse, T. J. (2022). **COVID-19 and systemic lupus erythematosus genetics: A balance between autoimmune disease risk and protection against infection**. *PLoS genetics*, *18*(11), e1010253. <https://doi.org/10.1371/journal.pgen.1010253> **Category:** Autoimmune Diseases & Covid-19, Covid-19 Research Studies, Lupus & Covid-19 --- ### [Can You Get Celiac Disease From a COVID-19 Infection?](https://www.autoimmuneinstitute.org/covid_timeline/can-you-get-celiac-disease-from-a-covid-19-infection/) **Published:** May 22, 2023 **Author:** Elevation **Excerpt:** A recent article explores the potential association between COVID-19 infection and the development of celiac disease. The researchers hypothesized that there might be an increased risk of developing celiac disease due to a COVID-19 infection potentially triggering an autoimmune response in genetically predisposed individuals or the COVID-19 infection disrupting the intestinal barrier function, altering the immune response and contributing to the development of celiac disease. **Category:** Autoimmune Diseases & Covid-19, Celiac disease & Covid-19, Covid-19 Research Studies --- ### [Is Long Covid a Mitochondrial Disease?](https://www.autoimmuneinstitute.org/covid_timeline/is-long-covid-a-mitochondrial-disease/) **Published:** May 25, 2023 **Author:** Elevation **Excerpt:** A paper published this month in the International Journal of Molecular Sciences outlines the increasing evidence that Long Covid may be caused by mitochondrial dysfunction. Exhaustion and/or weakness exacerbated by exercise is a well-known Long Covid symptom and mirrors symptoms experienced by patients with Chronic fatigue or genetic mitochondrial diseases. **Content:** May 25, 2023 A [paper](https://www.mdpi.com/1422-0067/24/9/8034) published this month in the *International Journal of Molecular Sciences* outlines the increasing evidence that Long Covid may be caused by mitochondrial dysfunction. Exhaustion and/or weakness exacerbated by exercise is a well-known Long Covid symptom and mirrors symptoms experienced by patients with [Chronic fatigue](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/me-cfs/) or genetic mitochondrial diseases. In addition, comorbidities associated with serious illness from a Covid-19 infection such as diabetes, liver disease, and obesity are often metabolic, having a mitochondrial component. The neurological symptoms of Long Covid have been associated with both SARS-CoV-2 proteins and abnormal mitochondrial proteins in nerve cells. This evidence all points to mitochondrial involvement during both acute infection and Long Covid. Mitochondria can be directly and indirectly affected by the SARS-CoV-2 virus. [Recent studies](https://pubmed.ncbi.nlm.nih.gov/32673562/) have shown that the SARS-CoV-2 virus targets mitochondria and can be housed within the mitochondrial matrix (the innermost compartment of the mitochondria containing enzymes needed for cellular energy production). This not only damages the mitochondrial membranes and impairs their function but down-regulates (the process by which a cell decreases the quantity of a cellular component in response to an external stimulus) genes related to them. The virus has also been found to affect cell signaling via calcium channels. Infected cells often have elevated levels of calcium which negatively affects mitochondria. Because mitochondria are not only involved with cellular metabolism but also the immune response, the net effect is cellular metabolic dysfunction, cell death, and runaway inflammation. The hope with these findings is that drugs that both reduce viral load and support mitochondrial health will help Long Covid patients. The authors suggest a number of antioxidants and existing medications as targets for further research, including mPTP inhibitors, IL-6R and IL-1 receptor blockers, and MCU inhibitors. **Citations for report:** Chen, T. H., Chang, C. J., & Hung, P. H. (2023). **Possible Pathogenesis and Prevention of Long COVID: SARS-CoV-2-Induced Mitochondrial Disorder**. *International journal of molecular sciences*, *24*(9), 8034. <https://doi.org/10.3390/ijms24098034> Wu, K. E., Fazal, F. M., Parker, K. R., Zou, J., & Chang, H. Y. (2020). **RNA-GPS Predicts SARS-CoV-2 RNA Residency to Host Mitochondria and Nucleolus**. *Cell systems*, *11*(1), 102–108.e3. <https://doi.org/10.1016/j.cels.2020.06.008> **Category:** Covid-19 Research Studies, Long COVID --- ### [COVID-19 Symptoms & Treatments in Autoimmune Disease Patients](https://www.autoimmuneinstitute.org/covid_timeline/covid-19-symptoms-treatments-in-autoimmune-disease-patients/) **Published:** May 30, 2023 **Author:** Elevation **Excerpt:** A recent article published in the Virology Journal outlined what is currently known about COVID-19 infection and treatments in autoimmune disease patients, including specific diseases which pose a higher risk of infection, disease severity and hospitalization. **Content:** May 30, 2023 A recent [paper](https://pubmed.ncbi.nlm.nih.gov/36611166/) published in the *Virology Journal* reviewed what is currently known about COVID-19 and autoimmune diseases. Authors of this article state that patients with most autoimmune conditions are generally at a higher risk of covid 19 infection. That being said, those with [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/multiple-sclerosis/), [psoriasis](https://www.autoimmuneinstitute.org/autoimmune-resources/psoriasis/), vasculitis, and [type 1 diabetes](https://www.autoimmuneinstitute.org/autoimmune-resources/diabetes-type-1/) in particular may not have a higher risk of serious infection or hospitalization. Those with [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/systemic-lupus-erythematosus/), [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/rheumatoid-arthritis/), [myasthenia gravis](https://www.autoimmuneinstitute.org/autoimmune-resources/myasthenia-gravis/), or [scleroderma](https://www.autoimmuneinstitute.org/autoimmune-resources/scleroderma/) are thought to have an increased risk of serious infection, hospitalization, and mortality. For Type 1 diabetes, there is conflicting evidence as to the risk or protective nature of the autoimmune condition. **Drugs used to treat COVID-19 can impact autoimmune disease patients differently than the general population.** In diabetic patients, Hydroxychloroquine decreases the rate of insulin degradation and can lead to hypoglycemia, while medications such as glucocorticoids and antivirals like Ritonavir and Lopinavir can lead to hyperglycemia. Hydroxychloroquine and Azithromycin have both been shown to increase the risk of myasthenic crisis in patients with myasthenia gravis. **Most treatments for autoimmune diseases have not been found to increase hospitalization rates following a COVID-19 infection nor are they associated with negative outcomes post-infection.** Some treatments have even been shown to decrease hospitalization rates: TNF-inhibitors in vasculitis patients, Apremilast in psoriasis patients, and Tocilizumab in scleroderma patients. However with B-cell depleting therapies, Prednisone and Rituximab have all been implicated in higher hospitalization rates and/or negative outcomes. The COVID-19 pandemic decreased the access to medical care for those with autoimmune conditions due to lockdowns and an over-stretched healthcare system. This negatively impacted many patients and led to missed diagnoses of autoimmune conditions during this time. Those with autoimmune diseases are known to be at higher risk of mental health problems and pandemic isolation, illness, and fear of infection have exacerbated the issue. **Citation for report:** Hamidi, Z., Jabraeili-Siahroud, S., Taati-Alamdari, Y., Aghbash, P. S., Shamekh, A., & Baghi, H. B. (2023). **A comprehensive review of COVID-19 symptoms and treatments in the setting of autoimmune diseases**. *Virology journal*, *20*(1), 1. <https://doi.org/10.1186/s12985-023-01967-7> **Category:** Autoimmune Diseases & Covid-19, Covid-19 & Long Covid Treatments, Covid-19 Infections, Lupus & Covid-19, MS & Covid-19, Myasthenia gravis & Covid-19, RA & Covid-19, T1D & Covid-19 --- ### [Thyroid Health Following a COVID-19 Infection](https://www.autoimmuneinstitute.org/covid_timeline/thyroid-health-following-a-covid-19-infection/) **Published:** June 7, 2023 **Author:** Elevation **Excerpt:** Research on COVID-19 and thyroid health has indicated a connection between acute COVID-19 and thyroid dysfunction. However, there has been a lack of information regarding the long-term effects of a COVID-19 infection on the thyroid. Authors of a recent scientific paper investigated thyroid function, autoimmunity, the occurrence of long COVID, and the effect of interferon beta-1b treatment among 250 COVID-19 patients for six months after infection. **Content:** June 7, 2023 Research on COVID-19 and thyroid health has indicated a connection between acute COVID-19 and thyroid dysfunction. However, there has been a lack of information regarding the long-term effects of a COVID-19 infection on the thyroid. Authors of a recent [scientific paper](https://link.springer.com/article/10.1007/s12020-022-03281-8) investigated thyroid function, autoimmunity, the occurrence of long COVID, and the effect of interferon beta-1b treatment among 250 COVID-19 patients for six months after infection. Researchers used thyroid function tests and anti-thyroid antibody titer measures (measurement of antibody levels) during the acute COVID-19 phase, as well as three and six months after. Results showed that patients with abnormal thyroid function test results during the acute phase of a COVID-19 infection are more likely to have persistent thyroid function abnormalities. However, most abnormalities resolved during the follow-up period (82.4%). For patients with normal thyroid function test results during acute-infection, only a small fraction (4.5%) exhibited abnormal thyroid function tests at the three or six month mark. While most patients did not exhibit a change in anti-thyroid antibody levels during the six-month follow-up period, interferon-treated patients did show a slight increase in the anti-thyroid antibody levels. This was the case with the 4.5% of patients who exhibited abnormal thyroid function during follow-up. **These numbers suggest that SARS-CoV-2 infection does not lead to significant thyroid dysfunction.** Researchers also observed an increased prevalence of long Covid amongst this patient cohort, with 19.5% and 10.4% of patients experiencing long Covid symptoms at three and six months post-acute infection, respectively. That being said, results of thyroid function tests and anti-thyroid antibody titers did not influence the occurrence of long COVID. Authors point out that most patients who took part in the study experienced mild-to-moderate COVID-19 symptoms, making results relevant to a wider population. However, this also points to the limitations. For example, results may not apply to all COVID-19 variants since most patients included in the study were infected with the original strain. Additionally, the subgroups analyzed in the study were relatively small, thus warranting additional research with a bigger, more diverse group of participants. Authors agree with current recommendations that thyroid function monitoring is unnecessary after a COVID-19 infection, unless patients are being treated with interferon beta-1b or experienced thyroid function abnormalities during acute-infection. **Citation for report:** Lui, D. T. W., Tsoi, K. H., Lee, C. H., Cheung, C. Y. Y., Fong, C. H. Y., Lee, A. C. H., Tam, A. R., Pang, P., Ho, T. Y., Law, C. Y., Lam, C. W., To, K. K. W., Chow, W. S., Woo, Y. C., Hung, I. F. N., Tan, K. C. B., & Lam, K. S. L. (2023). **A prospective follow-up on thyroid function, thyroid autoimmunity and long COVID among 250 COVID-19 survivors**. *Endocrine*, *80*(2), 380–391. <https://doi.org/10.1007/s12020-022-03281-8> **Category:** Long COVID --- ### [How COVID-19 Triggers an Autoimmune Reaction](https://www.autoimmuneinstitute.org/covid_timeline/how-covid-19-triggers-an-autoimmune-reaction/) **Published:** June 13, 2023 **Author:** Elevation **Excerpt:** Researchers have hypothesized how a Covid-19 infection may trigger the development of autoimmune diseases through three different mechanisms, which may intersect at different points of the inflammatory process. Various autoimmune diseases include rheumatoid arthritis, ankylosing spondylitis, Guillain-Barre syndrome, as well as Hashimoto's and Graves disease. **Content:** June 13, 2023 A [paper](https://pubmed.ncbi.nlm.nih.gov/36858313/) published earlier this year clearly outlines how a Covid-19 infection may be triggering the development of autoimmune diseases through three different mechanisms, which may intersect at different points of the inflammatory process. The first mechanism involves SARS CoV-2 virus infecting cells by binding to the ACE2 receptors. These ACE2 receptors are part of the renin-angiotensin system which helps regulate blood pressure and normally plays an anti-inflammatory role; however, this function can be inhibited when the COVID-19 virus binds to the ACE2 receptors. This contributes to high levels of inflammation that are characteristic of the disease. There are more ACE2 receptors in some organs than in others, making certain organs more susceptible to SARS-CoV-2 infection. It is hypothesized that cases of [Type 1 diabetes](https://www.autoimmuneinstitute.org/autoimmune-resources/diabetes-type-1/) caused by a COVID-19 infection are due to this mechanism. Molecular mimicry is also thought to play a significant role in the development of autoimmune diseases post-COVID-19-infection. SARS-CoV-2 spike proteins share a similar structure to many of our own proteins, so when the immune system creates antibodies that recognize the viral proteins, it can inadvertently create autoantibodies for proteins such as nuclear antigens, isolable nuclear antigen, thyroglobulin, as well as those of the mitochondria. This process of molecular mimicry is thought to be involved in the development of a number of autoimmune diseases post-infection. Another mechanism by which COVID-19 may trigger autoimmunity is the cytokine storm, a dangerous occurrence in which the immune system overreacts to the infection leading to high levels of inflammation. These high levels of inflammation may in turn lead to autoimmunity, though the precise route is not yet fully understood. Researchers hypothesize that there are shared mechanisms between COVID-19 and various autoimmune diseases. [Rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/rheumatoid-arthritis/), [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/systemic-lupus-erythematosus/), [ankylosing spondylitis](https://www.autoimmuneinstitute.org/autoimmune-resources/ankylosing-spondylitis/), [Hashimoto’s thyroiditis](https://www.autoimmuneinstitute.org/autoimmune-resources/hashimotos-thyroiditis/), [Graves’ disease](https://www.autoimmuneinstitute.org/autoimmune-resources/graves-disease/), [immune thrombocytopenia](https://www.autoimmuneinstitute.org/autoimmune-resources/immune-thrombocytopenia/), [autoimmune hemolytic anemia](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-hemolytic-anemia/), [antiphospholipid syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/antiphospholipid-syndrome/), [Guillain-Barre syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/guillain-barre-syndrome/), and Type 1 diabetes are all thought to share mechanisms with COVID-19, either through molecular mimicry, cytokine storm, or general inflammation. **Citation for report:** Sher, E. K., Ćosović, A., Džidić-Krivić, A., Farhat, E. K., Pinjić, E., & Sher, F. (2023). **Covid-19 a triggering factor of autoimmune and multi-inflammatory diseases**. *Life sciences*, *319*, 121531. <https://doi.org/10.1016/j.lfs.2023.121531> **Category:** Autoimmune Diseases & Covid-19, Covid-19 Infections, GBS & Covid-19, Lupus & Covid-19, RA & Covid-19, T1D & Covid-19, Thyroid disease & Covid-19 --- ### [T-cell Responses in Long Covid Patients](https://www.autoimmuneinstitute.org/covid_timeline/t-cell-responses-in-long-covid-patients/) **Published:** June 28, 2023 **Author:** Elevation **Excerpt:** In a research letter on long Covid and pulmonary sequelae of COVID-19, authors shared findings around the possibility of viral reservoirs causing prolonged T-cell response in COVID-19 affected patients. The main finding indicated that prolonged infection led to T-cell exhaustion, especially in patients with abnormal lung function and/or structure following a COVID-19 infection. **Content:** June 28, 2023 In a [research letter](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10204814/) on long Covid and abnormal lung function and/or structure (pulmonary sequelae) following a COVID-19 infection, authors shared findings around the possibility of viral reservoirs causing a prolonged T-cell response in this patient population. Researchers in Spain measured the subpopulations of CD8+ and CD4+ T lymphocytes in the blood of 40 patients who had been hospitalized with COVID-19 pneumonia, 6 and 12 months after hospital discharge. Eleven patients experienced long Covid, 17 had pulmonary sequelae, and 12 patients were fully recovered. Patients were followed after discharge if they presented with respiratory symptoms, fatigue, muscle pain, chest pain, joint pain, and headache, as well as neurocognitive or autonomic dysfunction. Researchers found that those with long Covid expressed less human leukocyte antigen-DR on their CD8+ T-cells, as well as a weaker Type 1 T-helper cell response than those who had fully recovered. **These abnormalities indicate an exhaustion of the T-cells from prolonged infection.** Researchers also tested patients’ immune responses to two different SARS-CoV-2 peptides. They found that 82% of patients with pulmonary sequelae and 72% of patients with long Covid conveyed an immune response, while only 50% of fully recovered patients did. Types of T-cell responses were also different between long Covid patients and those with pulmonary sequelae. Those with pulmonary sequelae also experienced decreased lung function between 6 and 12 months after hospital discharge; this correlated with SARS-CoV-2 specific T-cells. Researchers believe that this is likely an effect of a prolonged immune response to the SARS-CoV-2 virus leading to T-cell exhaustion and may be due to remaining viral reservoirs in these patients. **Citation for report:** Cruz, T., Mendoza, N., Lledó, G. M., Perea, L., Albacar, N., Agustí, A., Sellares, J., Sibila, O., & Faner, R. (2023). **Persistence of a SARS-CoV-2 T-cell response in patients with long COVID and lung sequelae after COVID-19**. *ERJ open research*, *9*(3), 00020-2023. <https://doi.org/10.1183/23120541.00020-2023> **Category:** Covid-19 Infections, Covid-19 Research Studies, Long COVID --- ### [COVID-19 Does Not Increase Risk of Celiac Disease](https://www.autoimmuneinstitute.org/covid_timeline/covid-19-does-not-increase-risk-of-celiac-disease/) **Published:** June 30, 2023 **Author:** Elevation **Excerpt:** Researchers in Sweden used 1.4 million health records to examine the rate of new Celiac disease diagnoses in those who had experienced a COVID-19 infection versus those who had not. Findings suggested that respiratory diseases do not increase the risk of developing Celiac disease the way gastrointestinal infections do. **Content:** June 30, 2023 A [study](https://pubmed.ncbi.nlm.nih.gov/37217874/) published last month suggests that a COVID-19 infection does not increase the risk of developing [Celiac disease](https://www.autoimmuneinstitute.org/autoimmune-resources/celiac-disease/). Researchers in Sweden used the health records of 1.4 million inhabitants to examine the rates of new Celiac disease diagnoses in those who experienced a COVID-19 infection and those who had not. They also examined the rate of Celiac disease diagnoses before the pandemic as a control. Researchers found fewer cases of Celiac disease during the pandemic timeframe than before. Researchers state that this is most likely *not* due to a lack of access to testing, as rates of Celiac disease in the country were decreasing before the pandemic. That being said, it remains a possibility. More importantly, they did not find any difference in the rates of Celiac disease diagnoses in those who had a positive COVID test and those who didn’t. They acknowledge that a lack of access to COVID-19 testing, especially early in the pandemic, makes it impossible to know whether all participants who had COVID-19 were correctly assigned to the “Covid positive” group. However, there was no noticeable relationship between the time of COVID-19 infection and the time of Celiac disease diagnosis. There is a known timeframe at which Celiac disease tends to be diagnosed after other certain infections. The researchers concluded that COVID-19 does not increase the risk of developing Celiac disease, at least in the short term. This suggests that respiratory infections do not increase the risk of developing Celiac disease in the same manner that gastrointestinal infections do. Scientists emphasized the need for further research to confirm their findings. **Citation for report:** Lexner, J., Lindroth, Y., & Sjöberg, K. (2023). **The risk for celiac disease after Covid-19 infection**. *BMC gastroenterology*, *23*(1), 174. <https://doi.org/10.1186/s12876-023-02795-3> **Category:** Autoimmune Diseases & Covid-19, Celiac disease & Covid-19, Covid-19 Infections, Covid-19 Research Studies --- ### [Caring for Autoimmunity & Long COVID with a Personalized Approach](https://www.autoimmuneinstitute.org/covid_timeline/caring-for-autoimmunity-long-covid-with-a-personalized-approach/) **Published:** July 5, 2023 **Author:** Elevation **Excerpt:** The company Mymee recently published a study on their personalized digital care program for patients living with autoimmune diseases as well as long Covid. Researchers found that over 85% of patients with moderate to severe symptoms saw improvements with their anxiety, depression, fatigue, pain interference, sleep disturbance, and pain intensity while increasing cognitive and physical function. **Content:** July 5, 2023 There is no one-size-fits-all diet or lifestyle to improve autoimmune disease symptoms for all patients. What works for one person may trigger worse symptoms in another, even if they share a diagnosis. Because of this, personalized interventions are being explored to help patients find what works for them in a safe and efficient way. The company [Mymee](https://www.mymee.com/blog/mymees-personalized-trial-care-platform-helps-autoimmune-disease-patients-reverse-flares) recently published a [study](https://rmdopen.bmj.com/content/9/2/e003061.info) on their personalized digital care program for patients with autoimmune diseases and long Covid. The study included 202 people with conditions such as [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/rheumatoid-arthritis/), long Covid, [psoriatic arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/psoriatic-arthritis/), [psoriasis](https://www.autoimmuneinstitute.org/autoimmune-resources/psoriasis/), [SLE](https://www.autoimmuneinstitute.org/autoimmune-resources/systemic-lupus-erythematosus/), [Crohn’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/crohns-disease/), [ulcerative colitis](https://www.autoimmuneinstitute.org/autoimmune-resources/ulcerative-colitis/), [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/multiple-sclerosis/), and [ankylosing spondylitis](https://www.autoimmuneinstitute.org/autoimmune-resources/ankylosing-spondylitis/). The app-based program includes three elements: personalized symptom and potential trigger tracking, data visualization, and weekly health coaching to help patients identify triggers and make lifestyle and dietary modifications to improve their symptoms. Coaches and symptom tracking allowed patients to identify triggers unique to them. This included poor sleep quality, specific foods, supplements, and medications as well as various combinations that triggered symptoms. Recommendations were made to help participants manage their symptoms and improve their quality of life. This coaching did not take the place of routine management of participants’ diseases; patients remained in the care of their medical team and any medication changes were done through them. Participants were surveyed at the beginning and end of the program to determine their health-related quality of “life score.” Researchers found that “>85% of patients with moderate to severe symptoms saw improvements in \[health-related quality of life\]” ([1](https://www.mymee.com/blog/mymees-personalized-trial-care-platform-helps-autoimmune-disease-patients-reverse-flares)). The program was seen to decrease patient reports of anxiety, depression, fatigue, pain interference, sleep disturbance, and pain intensity while increasing cognitive and physical function and improving patients’ ability to engage in social activities and manage their symptoms. The greatest improvements were seen in patients who had the most symptoms at the baseline, but those with less severe symptoms also benefited. The researchers identified over a hundred triggers – some that were common, others that were more unusual – including some foods and medications commonly thought to improve symptoms. This study highlights the diversity of autoimmunity and the promise of personalized medicine for those who do not fully respond to traditional medications and interventions. **Citations for report:** Bundy, N., De Jesus, M., Lytle, M., Calabrese, L., Gobin, C., & Dyhrberg, M. (2023). **Self-evidence-based digital care programme improves health-related quality of life in adults with a variety of autoimmune diseases and long COVID: a retrospective study**. *RMD open*, *9*(2), e003061. <https://doi.org/10.1136/rmdopen-2023-003061> *[Mymee](https://www.mymee.com/).* [**Mymee’s Personalized Trial & Care Platform Helps Autoimmune Disease Patients Reverse Flares, New Research Shows**](https://www.mymee.com/blog/mymees-personalized-trial-care-platform-helps-autoimmune-disease-patients-reverse-flares) **Category:** Autoimmune Diseases & Covid-19, Covid-19 & Long Covid Treatments, Covid-19 Research Studies, IBD & Covid-19, Long COVID, Lupus & Covid-19, MS & Covid-19, RA & Covid-19 --- ### [The Connection Between COVID-19 & Autoimmune Diseases of the Nervous System](https://www.autoimmuneinstitute.org/covid_timeline/the-connection-between-covid-19-autoimmune-diseases-of-the-nervous-system/) **Published:** July 6, 2023 **Author:** Elevation **Excerpt:** Authors of a literature review recently compiled scientific and clinical observations from the past three years regarding COVID-19 and autoimmunity. These included how a COVID-19 infection can affect the course of autoimmune disease, response to treatment(s), and how autoimmunity affects the severity of a COVID-19 infection. **Content:** July 6, 2023 Authors of a literature [review](https://pubmed.ncbi.nlm.nih.gov/36799522/) recently compiled scientific and clinical observations from the past three years regarding COVID-19 and autoimmunity. These included how a COVID-19 infection can affect the course of autoimmune disease, response to treatment(s), and how autoimmunity affects the severity of a COVID-19 infection. The authors noted the most pertinent findings, including: 1. Many reports indicate that autoimmune disease did not significantly impact the course of COVID-19. However, higher mortality and hospitalization rates during COVID-19 were associated with older age, advanced stages of diseases, and comorbidities. 2. Several reports showed that SARS-CoV-2 infection could exacerbate autoimmune diseases such as multiple sclerosis, causing COVID-19-induced relapse of multiple sclerosis. COVID-19 has also been seen to exacerbate myasthenia gravis and contribute to new myasthenia gravis episodes. 3. Reports also point out that COVID-19 infection and rarely vaccination has been associated with newly diagnosed autoimmune diseases. These include myasthenia gravis, Guillain-Barré syndrome, acute disseminated encephalomyelitis, and neuromyelitis optica spectrum disorder. 4. Some drugs used to treat autoimmune diseases have been tested to treat COVID-19. For example, glucocorticoids, used in treating autoimmune diseases, can also reduce mortality rates during severe COVID-19. The authors point out that in most cases, continuing immunosuppressant therapy is safe. However, they advise that care protocols should be tailored to the individual needs of autoimmune disease patients, especially by their physician. **Citation for report:** Morawiec, N., Adamczyk, B., & Adamczyk-Sowa, M. (2023). **COVID-19 and autoimmune diseases of the nervous system – an update**. *Neurologia i neurochirurgia polska*, *57*(1), 77–89. <https://doi.org/10.5603/PJNNS.a2023.0008> **Category:** Autoimmune Diseases & Covid-19 --- ### [COVID-19 Vaccination in Adults with Inflammatory Bowel Disease](https://www.autoimmuneinstitute.org/covid_timeline/covid-19-vaccination-in-adults-with-inflammatory-bowel-disease/) **Published:** July 10, 2023 **Author:** Elevation **Excerpt:** A recent review article covers current knowledge about COVID-19 vaccination in those with inflammatory bowel disease (IBD), which includes Crohn’s disease and ulcerative colitis. The authors concluded that IBD patients are not at increased risk of infection or serious illness from Covid-19. With the exception of patients taking corticosteroids, most IBD therapies have been shown not to increase the risk of covid-19. **Content:** July 10, 2023 A [recent review article](https://pubmed.ncbi.nlm.nih.gov/37234702/) covers current knowledge about COVID-19 vaccination in those with inflammatory bowel disease (IBD), which includes [Crohn’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/crohns-disease/) and [ulcerative colitis](https://www.autoimmuneinstitute.org/autoimmune-resources/ulcerative-colitis/). The authors concluded that **IBD patients are not at increased risk of infection or serious illness from Covid-19.** With the exception of patients taking corticosteroids, most IBD therapies have been shown not to increase the risk of covid-19. There is even evidence that biologics, including anti-TNF, anti-integrins, and anti-interleukin (IL) 12/23 therapies, can decrease the likelihood of hospitalization and/or death due to COVID-19 infection. **Current research suggests that patients with IBD have a normal ability to generate humoral immunity from vaccination.** Several studies have shown that those with IBD, generate antibodies after vaccination at similar rates to healthy controls ([1](https://pubmed.ncbi.nlm.nih.gov/35150924/)) ([2](https://pubmed.ncbi.nlm.nih.gov/36088954/)) ([3](https://pubmed.ncbi.nlm.nih.gov/35396992/)) ([4](https://pubmed.ncbi.nlm.nih.gov/35606090)). However, the seroconversion (ability to generate antibodies following vaccination) rates for those on anti-TNF therapy, tofacitinib, and systemic corticosteroids are slightly lower. Cell-mediated immunity, even for patients on immunosuppressant medications, was similar to that of healthy controls (except for [patients on tofacitinib](https://pubmed.ncbi.nlm.nih.gov/36088954/), who had a slightly lower response). So far, no relationship has been found between biologic drug levels at the time of vaccination and vaccine response. **IBD has not been associated with increased rates of adverse effects from vaccines.** Several studies have reported similar rates of adverse effects in IBD patients as in the general population. While [previous studies](https://pubmed.ncbi.nlm.nih.gov/34529987) expressed a concern that the drug mesalamine was associated with an increased risk of severe effects, [current findings](https://pubmed.ncbi.nlm.nih.gov/32425234) suggest this was a side effect of biased reporting, and found no increased risk associated with the medication. There is also [evidence](https://pubmed.ncbi.nlm.nih.gov/34954338/) that **vaccination does not increase the risk of IBD flares.** Current research supports Covid-19 vaccination for all IBD patients following CDC recommendations. An additional booster is recommended for patients who are moderately to severely immunosuppressed (those on high doses of prednisone, taking anti-TNF agents, or immunomodulators including thiopurines and methotrexate). While having IBD does not increase the risk of contracting covid or developing severe disease, being unvaccinated is a known risk factor; evidence supports vaccination for all IBD patients. **Citations for report:** Alexander, J. L., Liu, Z., Muñoz Sandoval, D., Reynolds, C., Ibraheim, H., Anandabaskaran, S., Saifuddin, A., Castro Seoane, R., Anand, N., Nice, R., Bewshea, C., D’Mello, A., Constable, L., Jones, G. R., Balarajah, S., Fiorentino, F., Sebastian, S., Irving, P. M., Hicks, L. C., Williams, H. R. T., … VIP study investigators (2022). **COVID-19 vaccine-induced antibody and T-cell responses in immunosuppressed patients with inflammatory bowel disease after the third vaccine dose (VIP): a multicentre, prospective, case-control study**. *The lancet. Gastroenterology & hepatology*, *7*(11), 1005–1015. <https://doi.org/10.1016/S2468-1253(22)00274-6> Brenner, E. J., Ungaro, R. C., Gearry, R. B., Kaplan, G. G., Kissous-Hunt, M., Lewis, J. D., Ng, S. C., Rahier, J. F., Reinisch, W., Ruemmele, F. M., Steinwurz, F., Underwood, F. E., Zhang, X., Colombel, J. F., & Kappelman, M. D. (2020). **Corticosteroids, But Not TNF Antagonists, Are Associated With Adverse COVID-19 Outcomes in Patients With Inflammatory Bowel Diseases: Results From an International Registry**. *Gastroenterology*, *159*(2), 481–491.e3. <https://doi.org/10.1053/j.gastro.2020.05.032> Lev-Tzion, R., Focht, G., Lujan, R., Mendelovici, A., Friss, C., Greenfeld, S., Kariv, R., Ben-Tov, A., Matz, E., Nevo, D., Barak-Corren, Y., Dotan, I., & Turner, D. (2022). **COVID-19 Vaccine Is Effective in Inflammatory Bowel Disease Patients and Is Not Associated With Disease Exacerbation**. *Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association*, *20*(6), e1263–e1282. <https://doi.org/10.1016/j.cgh.2021.12.026> Long, M. D., Weaver, K. N., Zhang, X., Chun, K., Kappelman, M. D., & PREVENT-COVID Study Group (2022). **Strong Response to SARS-CoV-2 Vaccine Additional Doses Among Patients With Inflammatory Bowel Diseases**. *Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association*, *20*(8), 1881–1883.e1. <https://doi.org/10.1016/j.cgh.2022.01.056> Lutz, M., Lazarus, S., & Caldera, F. (2023). **COVID-19 vaccination in adults with inflammatory bowel disease**. *Therapeutic advances in gastroenterology*, *16*, 17562848231173130. <https://doi.org/10.1177/17562848231173130> Quan, J., Ma, C., Panaccione, R., Hracs, L., Sharifi, N., Herauf, M., Makovinović, A., Coward, S., Windsor, J. W., Caplan, L., Ingram, R. J. M., Kanji, J. N., Tipples, G., Holodinsky, J. K., Bernstein, C. N., Mahoney, D. J., Bernatsky, S., Benchimol, E. I., Kaplan, G. G., & STOP COVID-19 in IBD Research Group (2023). **Serological responses to three doses of SARS-CoV-2 vaccination in inflammatory bowel disease**. *Gut*, *72*(4), 802–804. <https://doi.org/10.1136/gutjnl-2022-327440> Schell, T. L., Knutson, K. L., Saha, S., Wald, A., Phan, H. S., Almasry, M., Chun, K., Grimes, I., Lutz, M., Hayney, M. S., Farraye, F. A., & Caldera, F. (2022). **Humoral Immunogenicity of 3 COVID-19 Messenger RNA Vaccine Doses in Patients With Inflammatory Bowel Disease**. *Inflammatory bowel diseases*, *28*(11), 1781–1786. <https://doi.org/10.1093/ibd/izac082> Ungaro, R. C., Brenner, E. J., Agrawal, M., Zhang, X., Kappelman, M. D., Colombel, J. F., & Surveillance Epidemiology of Coronavirus Under Research Exclusion for Inflammatory Bowel Disease (SECURE-IBD) Research Group (2022). **Impact of Medications on COVID-19 Outcomes in Inflammatory Bowel Disease: Analysis of More Than 6000 Patients From an International Registry**. *Gastroenterology*, *162*(1), 316–319.e5. <https://doi.org/10.1053/j.gastro.2021.09.011> **Category:** Autoimmune Diseases & Covid-19, Covid-19 Research Studies, IBD & Covid-19 --- ### [Safety of COVID-19 Vaccination in Those with MS, NMOSD, and MOGAD](https://www.autoimmuneinstitute.org/covid_timeline/safety-of-covid-19-vaccination-in-those-with-ms-nmosd-and-mogad/) **Published:** July 12, 2023 **Author:** Elevation **Excerpt:** A recent paper outlined the findings of a new study on the safety and efficacy of COVID-19 vaccines in patients with Multiple Sclerosis (MS), Neuromyelitis Optica spectrum disorder (NMOSD), and Myelin Oligodendrocyte Glycoprotein antibody disease (MOGAD). Researchers in South Korea examined the medical records of 56 patients (19 with MS, 22 with NMOSD, and 15 with MOGAD) to determine the effects of vaccination on this population.  **Content:** July 12, 2023 A [recent paper](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9924883/) outlined the findings of a new study on the safety and efficacy of COVID-19 vaccines in patients with [Multiple Sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/multiple-sclerosis/) (MS), [Neuromyelitis Optica spectrum disorder](https://www.autoimmuneinstitute.org/autoimmune-resources/neuromyelitis-optica/) (NMOSD), and Myelin Oligodendrocyte Glycoprotein antibody disease (MOGAD). Researchers in South Korea examined the medical records of 56 patients (19 with MS, 22 with NMOSD, and 15 with MOGAD) to determine the effects of vaccination on this population. **Most vaccine side effects were minor**. Researchers found that about a third of patients experienced minor side effects after vaccination, such as fever or injection site pain. 7% of patients in the study had neurological side effects from vaccination, such as tingling sensations or muscle weakness; another 7% experienced disease relapse after vaccination. Researchers also reported that three patients experienced disease worsening or new onset. One MS patient experienced “Facial sensory changes with a brainstem lesion” following vaccination, and a MOGAD patient got myelitis ([1](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9924883/)).  A third patient was diagnosed with optic neuritis and MOGAD following vaccination ([1](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9924883/)) (though a causal link cannot be established from this information). The efficacy of COVID vaccines in this population is unclear. The majority of patients in the study were vaccinated (43 people out of 56); however, 32% (14 people) of the vaccinated patients got covid, while only 23% (3 people) of the unvaccinated patients got the disease. The rates of hospitalization between the two groups remained the same. All three (100%) of the unvaccinated patients who caught covid experienced neurologic deterioration following their illness, while only three (21%) of the fourteen vaccinated patients did. This suggests that **the COVID-19 vaccine may prevent neurological exacerbations related to COVID-19**, even if it does not prevent infection. The lower level of immunity following vaccination in patients with MS, NMOSD, and MOGAD is thought to be caused by the immunosuppressive drugs taken to manage these diseases. [Previous research](https://www.nationalmssociety.org/coronavirus-covid-19-information/covid-19-vaccine-guidance) has shown that MS patients taking fingolimod, alemtuzumab, or anti-CD20 monoclonal antibodies (ocrelizumab and rituximab) and NMOSD patients on corticosteroids have less response to vaccination. The authors of the study concluded that their study “demonstrated a favorable safety profile with no serious adverse events associated with COVID-19 vaccines in patients with MS, NMOSD, and MOGAD” ([1](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9924883/)). **Citations for report:** Kim, S., & Seok, H. Y. (2023). **Evaluation of the safety profile of COVID-19 vaccines in patients with MS, NMOSD, and MOGAD**. *Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology*, *44*(6), 1841–1848. <https://doi.org/10.1007/s10072-023-06676-1> [*National Multiple Sclerosis Society*](https://www.nationalmssociety.org/). **[Multiple Sclerosis and COVID-19](https://www.nationalmssociety.org/managing-ms/living-with-ms/diet-exercise-and-healthy-behaviors/vaccination/covid)** **Category:** Autoimmune Diseases & Covid-19, Covid-19 Research Studies, MS & Covid-19, Vaccine Adverse Events --- ### [Long Vax: Rare Link Between COVID Vaccination, POTS, and SFN](https://www.autoimmuneinstitute.org/covid_timeline/long-vax-rare-link-between-covid-vaccination-pots-and-sfn/) **Published:** July 17, 2023 **Author:** Elevation **Excerpt:** A recent article published by Science Insider discussed a new concern about COVID-19 vaccine side effects colloquially termed “Long Vax.” There have been rare reports of people developing symptoms of small fiber neuropathy (SFN) and/or postural orthostatic tachycardia syndrome (POTS) following vaccination for COVID-19. These conditions lead to persistent headaches, fatigue, and problems with heart rate and blood pressure, similar to those developed in cases of Long Covid.  **Content:** July 17, 2023 A [recent article](https://www.science.org/content/article/rare-link-between-coronavirus-vaccines-and-long-covid-illness-starts-gain-acceptance) published by *Science Insider* discussed a new concern about COVID-19 vaccine side effects colloquially termed “Long Vax.” There have been rare reports of people developing symptoms of [small fiber neuropathy](https://www.autoimmuneinstitute.org/autoimmune-resources/small-fiber-sensory-neuropathy/) (SFN) and/or [postural orthostatic tachycardia syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/postural-orthostatic-tachycardia-syndrome/) (POTS) following vaccination for COVID-19. These conditions lead to persistent headaches, fatigue, and problems with heart rate and blood pressure, similar to those developed in cases of Long Covid. **Relatively little is known about the potential connection between COVID-19 vaccines and POTS or SFN, though there have been case reports outlining incidences of either POTS or SFN developing after COVID-19 vaccines (**[**1**](https://pubmed.ncbi.nlm.nih.gov/33968543/)**) (**[**2**](https://doaj.org/article/73ace4a9d7954f0295a0aa61300a4032)**) (**[**3**](https://onlinelibrary.wiley.com/doi/full/10.1111/jns.12509)**).** A [preprint](https://www.medrxiv.org/content/10.1101/2022.05.16.22274439v1) of a small observational study on neuropathic symptoms [caused some stir](https://www.science.org/content/article/rare-cases-coronavirus-vaccines-may-cause-long-covid-symptoms) on the subject in January of 2022 but was never peer-reviewed or published. One [peer-reviewed study](https://www.nature.com/articles/s44161-022-00194-7) found that POTS was diagnosed at a higher rate following vaccination, but that was still lower than the rate of POTS following COVID-19 infection. This suggests that the risk of developing POTS after vaccination is lower than the risk of developing POTS after a Covid-19 infection. **Researchers from the *Yale School of Medicine* are currently working on a** [**study**](https://medicine.yale.edu/ycci/listen-study/) **of immune markers in patients’ blood with Long Covid and post-vaccination side effects.** At this point, “Long Vax” seems to be incredibly rare. **Researchers emphasize that the benefit of COVID-19 vaccines far outweighs the risk** **of side effects, and those who did not experience POTS or SFN after previous doses of the vaccine are extremely unlikely to do so after future doses.** **Citations for report:** Abbott, M. G., Allawi, Z., Hofer, M., Ansorge, O., Brady, S., Fadic, R., Torres, G., Knight, R., Calvo, M., Bennett, D. L. H., & Themistocleous, A. C. (2022). **Acute small fiber neuropathy after Oxford-AstraZeneca ChAdOx1-S vaccination: A report of three cases and review of the literature**. *Journal of the peripheral nervous system : JPNS*, *27*(4), 325–329. <https://doi.org/10.1111/jns.12509> Hermel, M., Sweeney, M., Abud, E., Luskin, K., Criado, J. P., Bonakdar, R., Gray, J., & Ahern, T. (2022). **COVID-19 Vaccination Might Induce Postural Orthostatic Tachycardia Syndrome: A Case Report**. *Vaccines*, *10*(7), 991. <https://doi.org/10.3390/vaccines10070991> **Potential POTS association with COVID-19 vaccination weaker than with COVID-19 infection**. (2022). *Nature cardiovascular research*, *1*(12), 1132–1133. <https://doi.org/10.1038/s44161-022-00194-7> Reddy, S., Reddy, S., & Arora, M. (2021). **A Case of Postural Orthostatic Tachycardia Syndrome Secondary to the Messenger RNA COVID-19 Vaccine**. *Cureus*, *13*(5), e14837. <https://doi.org/10.7759/cureus.14837> Safavi, F., Gustafson, L., Walitt, B., Lehky, T., Dehbashi, S., Wiebold, A., Mina, Y., Shin, S., Pan, B., Polydefkis, M., Oaklander, A. L., & Nath, A. (2022). **Neuropathic symptoms with SARS-CoV-2 vaccination**. *medRxiv : the preprint server for health sciences*, 2022.05.16.22274439. <https://doi.org/10.1101/2022.05.16.22274439> [*Science*](https://www.science.org/). [**In rare cases, coronavirus vaccines may cause Long Covid–like symptoms**](https://www.science.org/content/article/rare-cases-coronavirus-vaccines-may-cause-long-covid-symptoms) *[Science](https://www.science.org/).* [**Rare link between coronavirus vaccines and Long Covid–like illness starts to gain acceptance**](https://www.science.org/content/article/rare-link-between-coronavirus-vaccines-and-long-covid-illness-starts-gain-acceptance) *[Yale School of Medicine](https://medicine.yale.edu/).* **[The Yale LISTEN Study](https://medicine.yale.edu/ycci/listen-study/)** **Category:** Autoimmune Diseases & Covid-19, Covid-19 Research Studies, Long COVID, Vaccine Adverse Events --- ### [COVID’s Effect on the Brain, Gut, and the Role of the Epstein-Barr Virus](https://www.autoimmuneinstitute.org/covid_timeline/covids-effect-on-the-brain-gut-and-the-role-of-the-epstein-barr-virus/) **Published:** July 21, 2023 **Author:** Elevation **Excerpt:** A paper recently released in Nature: Molecular Psychiatry presents current thinking on the mechanisms behind potential Long Covid treatments. Some of the most common and debilitating symptoms of Long Covid are neurological or psychiatric. Several studies have shown that the COVID-19 virus can cross the blood-brain barrier and enter the brain. **Content:** July 21, 2023 A [paper](https://www.nature.com/articles/s41380-023-02161-5) recently released in *Nature: Molecular Psychiatry* presents current thinking on the mechanisms behind potential Long Covid treatments. Some of the most common and debilitating symptoms of Long Covid are neurological or psychiatric. Several studies have shown that **the COVID-19 virus can cross the blood-brain barrier and enter the brain** ([1](https://doi.org/10.1056/NEJMc2011400)) ([2](https://doi.org/10.1056/NEJMc2019373)) ([3](https://doi.org/10.1084/jem.20202135)) ([4](https://doi.org/10.1038/s41586-022-05542-y)). Covid infection of the brain has been shown to lead to [structural changes](https://www.nature.com/articles/s41392-022-01072-1) and neuroinflammation which could be responsible for the persistent neurological and psychiatric symptoms. [One study](https://doi.org/10.1038/s41586-022-04569-5) found that damage to the olfactory cortex of COVID-19 survivors was associated with loss of taste and smell. But viral presence in the brain does not explain all symptoms. Researchers have found evidence of **COVID-19 reactivating Epstein-Barr Virus** **(EBV) causing more severe illness and persistent symptoms of fatigue and cognitive impairment** ([5](https://doi.org/10.1038/s41598-021-90351-y)) ([6](https://doi.org/10.3390/pathogens10060763)) ([7](https://doi.org/10.1016/j.cell.2022.01.014)) ([8](https://doi.org/10.1172/JCI163669)). The drug fluvoxamine is [being studied](https://clinicaltrials.gov/study/NCT05874037?cond=long%20covid&term=fluvoxamine&rank=1) as a potential treatment to block the reactivation of EBV and has [shown promise](https://doi.org/10.1186/s12879-023-08172-5) for preventing fatigue in Long Covid. Another area of ongoing research is **disruption in the microbiome caused by COVID-19 infection.** Viral particles are known to persist in the gut for up to four months after recovery ([9](https://doi.org/10.1016/j.medj.2022.04.001)) ([10](https://doi.org/10.1136/gutjnl-2020-322294)), and persistent gastrointestinal symptoms have been associated with changes in the gut microbiome of COVID-19 patients even after recovery ([11](https://doi.org/10.3389/fmicb.2021.732838)) ([12](https://doi.org/10.3389/fimmu.2021.686029)) ([13](https://doi.org/10.1053/j.gastro.2021.10.013)) ([14](https://doi.org/10.1016/j.gpb.2021.09.004)). [Additional research](https://doi.org/10.1186/s12866-022-02686-9) found a reduction in anti-inflammatory microbes in the guts of such patients. The COVID-19 virus may also be [damaging the lining of the intestinal tract](https://doi.org/10.3389/fmicb.2022.860931) leading to intestinal symptoms. Outside the gut, changes in the nasal microbiota have been [associated with loss of smell](https://doi.org/10.1007/s00284-022-03106-x) in COVID-19 patients, and research in rodent models suggests that lung microbes may also play a role ([15](https://doi.org/10.1016/j.lfs.2022.120885)) ([16](https://doi.org/10.1038/s41586-022-04427-4)). Current research on treatment and prevention of both acute infection and Long Covid is underway, including: - Implementing **[plant-based](https://doi.org/10.1136/gutjnl-2021-325353) and [vegetarian diets](https://www.frontiersin.org/articles/10.3389/fnut.2022.837458/full)** was shown to reduce the risk of infection and COVID-19 severity, especially in elderly populations. - Supplementation with **probiotics** showed improved outcomes for patients with acute COVID-19 and was suggested as a treatment for Long Covid ([17](https://doi.org/10.1080/19490976.2021.2018899)) ([18](https://doi.org/10.1017/S0007114521001926)) ([19](https://doi.org/10.1080/10408398.2022.2128713)). - **Short-chain fatty acid** [**butyrate**](https://www.nature.com/articles/s41380-023-02161-5) and the use of [**fecal microbial transplants**](https://pubmed.ncbi.nlm.nih.gov/33557941/) have been suggested as means of improving intestinal dysbiosis during and after COVID-19 infection, but more research is needed to determine their efficacy. - **Vagus nerve stimulation**, which has [several clinical trials](https://clinicaltrials.gov/search?cond=long%20covid&intr=Vagus%20Nerve%20Stimulation) underway. Similarly used to treat refractory epilepsy and depression, vagus nerve stimulation is thought to treat systemic inflammation from Long Covid. While a comprehensive understanding of COVID-19 and Long Covid is still a long way off, current research suggests that multiple pathways are involved, and many different treatments may be effective. **Citations for report:** Chen, T., Song, J., Liu, H., Zheng, H., & Chen, C. (2021). **Positive Epstein-Barr virus detection in coronavirus disease 2019 (COVID-19) patients**. *Scientific reports*, *11*(1), 10902. <https://doi.org/10.1038/s41598-021-90351-y> Cheng, X., Zhang, Y., Li, Y., Wu, Q., Wu, J., Park, S. K., Guo, C., & Lu, J. (2022). **Meta-analysis of 16S rRNA microbial data identified alterations of the gut microbiota in COVID-19 patients during the acute and recovery phases**. *BMC microbiology*, *22*(1), 274. <https://doi.org/10.1186/s12866-022-02686-9> Douaud, G., Lee, S., Alfaro-Almagro, F., Arthofer, C., Wang, C., McCarthy, P., Lange, F., Andersson, J. L. R., Griffanti, L., Duff, E., Jbabdi, S., Taschler, B., Keating, P., Winkler, A. M., Collins, R., Matthews, P. M., Allen, N., Miller, K. L., Nichols, T. E., & Smith, S. M. (2022). **SARS-CoV-2 is associated with changes in brain structure in UK Biobank**. *Nature*, *604*(7907), 697–707. <https://doi.org/10.1038/s41586-022-04569-5> Farahani, R. H., Ajam, A., & Naeini, A. R. (2023). **Effect of fluvoxamine on preventing neuropsychiatric symptoms of post COVID syndrome in mild to moderate patients, a randomized placebo-controlled double-blind clinical trial**. *BMC infectious diseases*, *23*(1), 197. <https://doi.org/10.1186/s12879-023-08172-5> Gold, J. E., Okyay, R. A., Licht, W. E., & Hurley, D. J. (2021). **Investigation of Long COVID Prevalence and Its Relationship to Epstein-Barr Virus Reactivation**. *Pathogens (Basel, Switzerland)*, *10*(6), 763. <https://doi.org/10.3390/pathogens10060763> Gutiérrez-Castrellón, P., Gandara-Martí, T., Abreu Y Abreu, A. T., Nieto-Rufino, C. D., López-Orduña, E., Jiménez-Escobar, I., Jiménez-Gutiérrez, C., López-Velazquez, G., & Espadaler-Mazo, J. (2022). **Probiotic improves symptomatic and viral clearance in Covid19 outpatients: a randomized, quadruple-blinded, placebo-controlled trial**. *Gut microbes*, *14*(1), 2018899. <https://doi.org/10.1080/19490976.2021.2018899> Hegazy, M., Ahmed Ashoush, O., Tharwat Hegazy, M., Wahba, M., Lithy, R. M., Abdel-Hamid, H. M., Ahmed Abd Elshafy, S., Abdelfatah, D., El-Din Ibrahim, M. H., & Abdelghani, A. (2022). **Beyond probiotic legend: ESSAP gut microbiota health score to delineate SARS-COV-2 infection severity**. *The British journal of nutrition*, *127*(8), 1180–1189. <https://doi.org/10.1017/S0007114521001926> Hilpert, K., & Mikut, R. (2021). **Is There a Connection Between Gut Microbiome Dysbiosis Occurring in COVID-19 Patients and Post-COVID-19 Symptoms?**. *Frontiers in microbiology*, *12*, 732838. <https://doi.org/10.3389/fmicb.2021.732838> Hashimoto K. (2023). **Detrimental effects of COVID-19 in the brain and therapeutic options for long COVID: The role of Epstein-Barr virus and the gut-brain axis**. *Molecular psychiatry*, *28*(12), 4968–4976. <https://doi.org/10.1038/s41380-023-02161-5> Hashimoto, Y., Eguchi, A., Wei, Y., Shinno-Hashimoto, H., Fujita, Y., Ishima, T., Chang, L., Mori, C., Suzuki, T., & Hashimoto, K. (2022). **Antibiotic-induced microbiome depletion improves LPS-induced acute lung injury via gut-lung axis**. *Life sciences*, *307*, 120885. <https://doi.org/10.1016/j.lfs.2022.120885> Hosang, L., Canals, R. C., van der Flier, F. J., Hollensteiner, J., Daniel, R., Flügel, A., & Odoardi, F. (2022). **The lung microbiome regulates brain autoimmunity**. *Nature*, *603*(7899), 138–144. <https://doi.org/10.1038/s41586-022-04427-4> Hou, Y. C., Su, W. L., & Chao, Y. C. (2022). **COVID-19 Illness Severity in the Elderly in Relation to Vegetarian and Non-vegetarian Diets: A Single-Center Experience**. *Frontiers in nutrition*, *9*, 837458. <https://doi.org/10.3389/fnut.2022.837458> Liu, F., Ye, S., Zhu, X., He, X., Wang, S., Li, Y., Lin, J., Wang, J., Lin, Y., Ren, X., Li, Y., & Deng, Z. (2021). **Gastrointestinal disturbance and effect of fecal microbiota transplantation in discharged COVID-19 patients**. *Journal of medical case reports*, *15*(1), 60. <https://doi.org/10.1186/s13256-020-02583-7> Merino, J., Joshi, A. D., Nguyen, L. H., Leeming, E. R., Mazidi, M., Drew, D. A., Gibson, R., Graham, M. S., Lo, C. H., Capdevila, J., Murray, B., Hu, C., Selvachandran, S., Hammers, A., Bhupathiraju, S. N., Sharma, S. V., Sudre, C., Astley, C. M., Chavarro, J. E., Kwon, S., … Chan, A. T. (2021). **Diet quality and risk and severity of COVID-19: a prospective cohort study**. *Gut*, *70*(11), 2096–2104. <https://doi.org/10.1136/gutjnl-2021-325353> Nardelli, C., Scaglione, G. L., Testa, D., Setaro, M., Russo, F., Di Domenico, C., Atripaldi, L., Zollo, M., Corrado, F., Salvatore, P., Pinchera, B., Gentile, I., & Capoluongo, E. (2022). **Nasal Microbiome in COVID-19: A Potential Role of Corynebacterium in Anosmia**. *Current microbiology*, *80*(1), 53. <https://doi.org/10.1007/s00284-022-03106-x> Natarajan, A., Zlitni, S., Brooks, E. F., Vance, S. E., Dahlen, A., Hedlin, H., Park, R. M., Han, A., Schmidtke, D. T., Verma, R., Jacobson, K. B., Parsonnet, J., Bonilla, H. F., Singh, U., Pinsky, B. A., Andrews, J. R., Jagannathan, P., & Bhatt, A. S. (2022). **Gastrointestinal symptoms and fecal shedding of SARS-CoV-2 RNA suggest prolonged gastrointestinal infection**. *Med (New York, N.Y.)*, *3*(6), 371–387.e9. <https://doi.org/10.1016/j.medj.2022.04.001> Neris Almeida Viana, S., do Reis Santos Pereira, T., de Carvalho Alves, J., Tianeze de Castro, C., Santana C da Silva, L., Henrique Sousa Pinheiro, L., & Nougalli Roselino, M. (2024). **Benefits of probiotic use on COVID-19: A systematic review and meta-analysis**. *Critical reviews in food science and nutrition*, *64*(10), 2986–2998. <https://doi.org/10.1080/10408398.2022.2128713> Peluso, M. J., Deveau, T. M., Munter, S. E., Ryder, D., Buck, A., Beck-Engeser, G., Chan, F., Lu, S., Goldberg, S. A., Hoh, R., Tai, V., Torres, L., Iyer, N. S., Deswal, M., Ngo, L. H., Buitrago, M., Rodriguez, A., Chen, J. Y., Yee, B. C., Chenna, A., … Henrich, T. J. (2023). **Chronic viral coinfections differentially affect the likelihood of developing long COVID**. *The Journal of clinical investigation*, *133*(3), e163669. <https://doi.org/10.1172/JCI163669> Puelles, V. G., Lütgehetmann, M., Lindenmeyer, M. T., Sperhake, J. P., Wong, M. N., Allweiss, L., Chilla, S., Heinemann, A., Wanner, N., Liu, S., Braun, F., Lu, S., Pfefferle, S., Schröder, A. S., Edler, C., Gross, O., Glatzel, M., Wichmann, D., Wiech, T., Kluge, S., … Huber, T. B. (2020). **Multiorgan and Renal Tropism of SARS-CoV-2**. *The New England journal of medicine*, *383*(6), 590–592. <https://doi.org/10.1056/NEJMc2011400> Ramakrishnan, R. K., Kashour, T., Hamid, Q., Halwani, R., & Tleyjeh, I. M. (2021). **Unraveling the Mystery Surrounding Post-Acute Sequelae of COVID-19**. *Frontiers in immunology*, *12*, 686029. <https://doi.org/10.3389/fimmu.2021.686029> Sollmann, N., Beer, A. J., & Kirchhoff, F. (2022). **SARS-CoV-2 infection and the brain: direct evidence for brain changes in milder cases**. *Signal transduction and targeted therapy*, *7*(1), 230. <https://doi.org/10.1038/s41392-022-01072-1> Solomon, I. H., Normandin, E., Bhattacharyya, S., Mukerji, S. S., Keller, K., Ali, A. S., Adams, G., Hornick, J. L., Padera, R. F., Jr, & Sabeti, P. (2020). **Neuropathological Features of Covid-19**. *The New England journal of medicine*, *383*(10), 989–992. <https://doi.org/10.1056/NEJMc2019373> Song, E., Zhang, C., Israelow, B., Lu-Culligan, A., Prado, A. V., Skriabine, S., Lu, P., Weizman, O. E., Liu, F., Dai, Y., Szigeti-Buck, K., Yasumoto, Y., Wang, G., Castaldi, C., Heltke, J., Ng, E., Wheeler, J., Alfajaro, M. M., Levavasseur, E., Fontes, B., … Iwasaki, A. (2021). **Neuroinvasion of SARS-CoV-2 in human and mouse brain**. *The Journal of experimental medicine*, *218*(3), e20202135. <https://doi.org/10.1084/jem.20202135> Stein, S. R., Ramelli, S. C., Grazioli, A., Chung, J. Y., Singh, M., Yinda, C. K., Winkler, C. W., Sun, J., Dickey, J. M., Ylaya, K., Ko, S. H., Platt, A. P., Burbelo, P. D., Quezado, M., Pittaluga, S., Purcell, M., Munster, V. J., Belinky, F., Ramos-Benitez, M. J., Boritz, E. A., … Chertow, D. S. (2022). **SARS-CoV-2 infection and persistence in the human body and brain at autopsy**. *Nature*, *612*(7941), 758–763. <https://doi.org/10.1038/s41586-022-05542-y> Su, Y., Yuan, D., Chen, D. G., Ng, R. H., Wang, K., Choi, J., Li, S., Hong, S., Zhang, R., Xie, J., Kornilov, S. A., Scherler, K., Pavlovitch-Bedzyk, A. J., Dong, S., Lausted, C., Lee, I., Fallen, S., Dai, C. L., Baloni, P., Smith, B., … Heath, J. R. (2022). **Multiple early factors anticipate post-acute COVID-19 sequelae**. *Cell*, *185*(5), 881–895.e20. <https://doi.org/10.1016/j.cell.2022.01.014> Wu, X., Jing, H., Wang, C., Wang, Y., Zuo, N., Jiang, T., Novakovic, V. A., & Shi, J. (2022). **Intestinal Damage in COVID-19: SARS-CoV-2 Infection and Intestinal Thrombosis**. *Frontiers in microbiology*, *13*, 860931. <https://doi.org/10.3389/fmicb.2022.860931> Zhang, F., Wan, Y., Zuo, T., Yeoh, Y. K., Liu, Q., Zhang, L., Zhan, H., Lu, W., Xu, W., Lui, G. C. Y., Li, A. Y. L., Cheung, C. P., Wong, C. K., Chan, P. K. S., Chan, F. K. L., & Ng, S. C. (2022). **Prolonged Impairment of Short-Chain Fatty Acid and L-Isoleucine Biosynthesis in Gut Microbiome in Patients With COVID-19**. *Gastroenterology*, *162*(2), 548–561.e4. <https://doi.org/10.1053/j.gastro.2021.10.013> Zuo, T., Liu, Q., Zhang, F., Lui, G. C., Tso, E. Y., Yeoh, Y. K., Chen, Z., Boon, S. S., Chan, F. K., Chan, P. K., & Ng, S. C. (2021). **Depicting SARS-CoV-2 faecal viral activity in association with gut microbiota composition in patients with COVID-19**. *Gut*, *70*(2), 276–284. <https://doi.org/10.1136/gutjnl-2020-322294> Zuo, T., Wu, X., Wen, W., & Lan, P. (2021). **Gut Microbiome Alterations in COVID-19**. *Genomics, proteomics & bioinformatics*, *19*(5), 679–688. <https://doi.org/10.1016/j.gpb.2021.09.004> **Category:** Long COVID --- ### [Side Effects & Rate of Flare-Ups in SLE Patients after COVID-19 Vaccination](https://www.autoimmuneinstitute.org/covid_timeline/side-effects-rate-of-flare-ups-in-sle-patients-after-covid-19-vaccination/) **Published:** September 5, 2023 **Author:** Elevation **Excerpt:** A recent study cited in Lupus Science and Medicine covered vaccine safety in patients with Systemic Lupus Erythematosus. 237 vaccinated SLE participants were included, and researchers found that rates of vaccine side effects reported by those with SLE were statistically similar to those in the general public; additionally, the majority of patients did not experience disease flare-ups in response to vaccination. **Content:** September 5, 2023 A [letter](https://lupus.bmj.com/content/10/2/e000975) published in *Lupus Science and Medicine* announced the findings of a recent study on Covid vaccine safety in those living with [Systemic Lupus Erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/systemic-lupus-erythematosus/). Researchers examined medical records and utilized a questionnaire to study the experiences of 237 Lupus patients after receiving COVID-19 vaccines. They found the **rates of vaccine side effects reported by those with SLE were statistically similar to those in the general public**. 8.9% reported injection site pain and/or redness, 14.8% had fever, hives, fatigue, and/or drowsiness, and 2.1% experienced mild renal dysfunction. No serious adverse effects were reported. 17.7% reported a disease flare-up in response to vaccination. Symptoms varied across participants, to include “complement decline, hair loss, facial erythema, proteinuria, and joint swelling and pain” ([1](https://lupus.bmj.com/content/10/2/e000975)). Changes in lab values for blood cell counts, liver function, kidney function, complement profiles, and antibody profiles were seen in 11.4% of patients. Researchers compared the rate of side effects and flare-ups between those who received only one vaccine dose and those who were fully vaccinated and found no differences between the groups. The study included 222 SLE patients who did *not* receive a COVID-19 vaccine. Within this group, about 42% cited concerns about vaccine safety, roughly 4% were worried about its efficacy, and approximately 13% were unwilling to be vaccinated. These findings support the need for further research into the safety and efficacy of Covid vaccination in this population. Researchers concluded that an established vaccination protocol for those with SLE would likely increase vaccination rates within this group. **Citation for report:** Cheng, R. J., Li, Y. H., Liu, Z. H., Zhou, A., Li, Z., Ma, L., & Liu, Y. (2023). **COVID-19 vaccination questionnaire in patients with systemic lupus erythematosus: an observational study**. *Lupus science & medicine*, *10*(2), e000975. <https://doi.org/10.1136/lupus-2023-000975> **Category:** Autoimmune Diseases & Covid-19, Covid-19 Research Studies, Lupus & Covid-19, Vaccine Adverse Events --- ### [Susceptibility Gene Identified as Potential Long Covid Risk Factor](https://www.autoimmuneinstitute.org/covid_timeline/susceptibility-gene-identified-as-potential-long-covid-risk-factor/) **Published:** July 27, 2023 **Author:** Elevation **Excerpt:** A recent preprint from medRxiv identified a gene that is thought to be a risk factor for developing Long Covid, complementing another article published in Nature which also reported that the gene FOXP4 increases the risk of Long COVID by 1.6-fold. The current study pooled data from several previous COVID-19 genetics studies, including one identifying FOXP4 as increasing the risk of severe COVID. **Content:** July 27, 2023 A recent [preprint](https://www.medrxiv.org/content/10.1101/2023.06.29.23292056v1) from *medRxiv* identified a gene that is thought to be a risk factor for developing Long COVID, complementing another [article](https://www.nature.com/articles/d41586-023-02269-2?utm_source=Nature+Briefing&utm_campaign=b4d0f609c4-briefing-dy-20230712&utm_medium=email&utm_term=0_c9dfd39373-b4d0f609c4-46551886) published in *Nature* which also reported that **the gene FOXP4 increases the risk of Long COVID by 1.6-fold**. FOXP4 is expressed in some immune cells, lung cells, and other organs to a lesser extent. This is not the first time FOXP4 has been implicated in disease development. The current study pooled data from several previous COVID-19 genetics studies, including one identifying FOXP4 as increasing the risk of severe COVID. Furthermore, research has associated the gene with lung cancer. Although the research included data from 6,450 people with Long COVID in 16 countries, it is possible that some confounding variables may have unintentionally been introduced given that it was pooled from 24 different studies. With the help of sophisticated statistics, researchers determined that it is not just the increased risk of lung cancer or severe COVID producing this result. Interestingly, it also appears that the gene’s correlation with increased Long COVID risk is even stronger than its association with increased risk of severe COVID. Further research is ongoing to study the genomes of larger cohorts of people, both to confirm the effect of FOXP4 and to identify other genetic risk factors for Long COVID. **Citations for report:** *[Nature](https://www.nature.com/).* [**Gene linked to long COVID found in analysis of thousands of patients**](https://www.nature.com/articles/d41586-023-02269-2?utm_source=Nature+Briefing&utm_campaign=b4d0f609c4-briefing-dy-20230712&utm_medium=email&utm_term=0_c9dfd39373-b4d0f609c4-46551886) **Category:** Covid-19 Research Studies, Long COVID --- ### [Micro Clots & Long COVID](https://www.autoimmuneinstitute.org/covid_timeline/micro-clots-long-covid/) **Published:** July 25, 2023 **Author:** Elevation **Excerpt:** One of the leading theories used to explain Long Covid symptoms involves micro clots. A publication in Nature last August tackled the topic. Researchers have observed abnormal clots in the blood of people with COVID-19 and Long Covid. The clots are very small and break down slowly. The theory is that the viral spike protein binds to fibrin (a clotting protein) and causes it to misfold into a stickier version called amyloid. **Content:** July 25, 2023 One of the leading theories used to explain Long Covid symptoms involves micro clots. A [publication](https://www.nature.com/articles/d41586-022-02286-7#ref-CR12) in *Nature* last August tackled the topic. [Researchers](https://pubmed.ncbi.nlm.nih.gov/35195253/) have observed abnormal clots in the blood of people with COVID-19 and Long Covid. The clots are very small and break down slowly. The theory is that the viral spike protein binds to fibrin (a clotting protein) and causes it to misfold into a stickier version called amyloid. This may cause a cascade effect where more fibrin misfolds and more amyloid micro clots are formed. Microclots can slow down and restrict blood flow perhaps resulting in Long Covid symptoms. Researchers have even found that micro clots[ can cause capillaries to split in order to reroute blood](https://pubmed.ncbi.nlm.nih.gov/32437596/) around a blockage. Micro clots are not unique to Long Covid or COVID-19 infections; they have been observed in a variety of conditions: diabetes, Alzheimer’s disease, Parkinson’s disease, and [Myalgic Encephalomyelitis /Chronic Fatigue Syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/me-cfs/) ([1](https://pubmed.ncbi.nlm.nih.gov/35195253/)) ([2](https://www.mdpi.com/1424-8247/15/8/931)). However, relatively little research has been done on micro clots, and much is still unknown. There is conflicting evidence on whether micro clots are even a cause of symptoms. The results of [one clinical trial](https://www.researchsquare.com/article/rs-1205453/v2) on using antiplatelet and anticoagulants to treat Long Covid were promising: patients had fewer micro clots and experienced some symptom relief. Additionally, levels of microclots have been seen to correlate with fatigue ([3](https://www.acpjournals.org/doi/10.7326/M21-4905)). However, some experts find that evidence for micro clots causing Long Covid is lacking. Some [researchers](https://pubmed.ncbi.nlm.nih.gov/35605238/) have been unable to find micro clots in the blood of Long Covid patients, and others did not observe the expected anemia and tissue damage to the lungs and kidneys (organs with lots of capillaries that could become blocked) that such clots would cause. They argue that more research is needed before trialing pharmaceutical therapies. Fortunately, research on Long Covid is ongoing. There are currently no clinical trials of anticoagulants for Long Covid listed on the [clinicaltrials.gov](https://clinicaltrials.gov/search?cond=long%20covid&intr=Anticoagulation) website, but this may change as new studies are released. The Global Autoimmune Institute is proud to [fund one such study](https://www.autoimmuneinstitute.org/about-us/whatwedo/research/): The Long Covid PASC study at Johns Hopkins [Čiháková research laboratory](https://labs.pathology.jhu.edu/cihakova/). Such research is crucial to understanding this disease and developing treatments. **Citations for report:** Ackermann, M., Verleden, S. E., Kuehnel, M., Haverich, A., Welte, T., Laenger, F., Vanstapel, A., Werlein, C., Stark, H., Tzankov, A., Li, W. W., Li, V. W., Mentzer, S. J., & Jonigk, D. (2020). **Pulmonary Vascular Endothelialitis, Thrombosis, and Angiogenesis in Covid-19**. *The New England journal of medicine*, *383*(2), 120–128. <https://doi.org/10.1056/NEJMoa2015432> Kell, D. B., Laubscher, G. J., & Pretorius, E. (2022). **A central role for amyloid fibrin microclots in long COVID/PASC: origins and therapeutic implications**. *The Biochemical journal*, *479*(4), 537–559. <https://doi.org/10.1042/BCJ20220016> [*Nature*](https://www.nature.com/). [**Could tiny blood clots cause long COVID’s puzzling symptoms?**](https://www.nature.com/articles/d41586-022-02286-7#ref-CR12) Nunes, J. M., Kruger, A., Proal, A., Kell, D. B., & Pretorius, E. (2022). **The Occurrence of Hyperactivated Platelets and Fibrinaloid Microclots in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)**. *Pharmaceuticals (Basel, Switzerland)*, *15*(8), 931. <https://doi.org/10.3390/ph15080931> Sneller, M. C., Liang, C. J., Marques, A. R., Chung, J. Y., Shanbhag, S. M., Fontana, J. R., Raza, H., Okeke, O., Dewar, R. L., Higgins, B. P., Tolstenko, K., Kwan, R. W., Gittens, K. R., Seamon, C. A., McCormack, G., Shaw, J. S., Okpali, G. M., Law, M., Trihemasava, K., Kennedy, B. D., … Lane, H. C. (2022). **A Longitudinal Study of COVID-19 Sequelae and Immunity: Baseline Findings**. *Annals of internal medicine*, *175*(7), 969–979. <https://doi.org/10.7326/M21-4905> **Category:** Covid-19 Clinical Trials, Long COVID --- ### [COVID-19 Vaccination Effects in Those with Multiple Sclerosis](https://www.autoimmuneinstitute.org/covid_timeline/covid-19-vaccination-effects-in-those-with-multiple-sclerosis/) **Published:** August 1, 2023 **Author:** Elevation **Excerpt:** A study published in Neurology Neuroimmunology & Neuroinflammation examined the safety of COVID-19 vaccines in people with multiple sclerosis (MS). The COVER-MS study funded by the National MS Society used an online self-reporting database called iConquerMS to gather information from 719 adults with MS and record information on vaccine side effects. In addition, they were also able to compare the effects of vaccines from different manufacturers and various MS therapies.  **Content:** August 1, 2023 A [study](https://nn.neurology.org/content/9/1/e1104) published in *Neurology Neuroimmunology & Neuroinflammation* examined the safety of COVID-19 vaccines in people with [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/) (MS). [The COVER-MS study](https://www.iconquerms.org/cover-ms-description) funded by the [National MS Society](https://www.nationalmssociety.org/) used an online self-reporting database called iConquerMS to gather information from 719 adults with MS and record information on [vaccine side effects](https://www.autoimmuneinstitute.org/covid-news-and-autoimmune-disease/vaccine-adverse-events/). In addition, they were also able to compare the effects of vaccines from different manufacturers and various MS therapies. **Researchers found similar levels of vaccine side effects in people with MS as have been reported in the general population**. After the first shot, 64% of participants reported some type of reaction within the first day (most commonly injection site pain, fatigue, and headache), and 17% reported a severe reaction. As with the general population, they found that women, White people, Latinx, younger people, and those who had already had a COVID-19 infection were at greater risk of vaccine reactions. The [Oxford Astrazeneca vaccine](https://www.autoimmuneinstitute.org/covid-news-and-autoimmune-disease/vaccine-manufacturers/astrazeneca/) was associated with more vaccine reactions than vaccines from other manufacturers. Of the 442 participants who received a second vaccine dose, 74% experienced a reaction, and 22% reported a severe reaction. The effects of the second shot were similar to those of the first shot, and again younger people were at higher risk, though the [Moderna vaccine](https://www.autoimmuneinstitute.org/covid-news-and-autoimmune-disease/vaccine-manufacturers/moderna/) was more likely (than the [Pfizer vaccine](https://www.autoimmuneinstitute.org/covid-news-and-autoimmune-disease/vaccine-manufacturers/pfizer/)) to cause a reaction in the second dose. **Taking disease-modifying therapies for MS was associated with a lower risk of a vaccine reaction.** In particular, those on S1PR modulators, alpha4-integrin blockers, and fumarates were seen to have fewer vaccine reactions. Those on B-cell-depleting therapies did not see this benefit, even when researchers accounted for the timing of the most recent dose. **Citation for report:** Briggs, F. B. S., Mateen, F. J., Schmidt, H., Currie, K. M., Siefers, H. M., Crouthamel, S., Bebo, B. F., Fiol, J., Racke, M. K., O’Connor, K. C., Kolaczkowski, L. G., Klein, P., Loud, S., & McBurney, R. N. (2021). **COVID-19 Vaccination Reactogenicity in Persons With Multiple Sclerosis**. *Neurology(R) neuroimmunology & neuroinflammation*, *9*(1), e1104. <https://doi.org/10.1212/NXI.0000000000001104> **Category:** AstraZeneca, Autoimmune Diseases & Covid-19, Covid-19 Research Studies, Moderna, MS & Covid-19, Pfizer, Vaccine Adverse Events --- ### [NIH Opens Enrollment for Long COVID Clinical Trials](https://www.autoimmuneinstitute.org/covid_timeline/nih-opens-enrollment-for-long-covid-clinical-trials/) **Published:** August 31, 2023 **Author:** Elevation **Excerpt:** As part of its Researching COVID to Enhance Recovery (RECOVER) Initiative, NIH has opened enrollment for clinical trials at sites around the country that will test potential treatments for Long COVID. Treatments include drugs, biologics, medical devices, and other therapies. A protocol that will be launched n the coming months will study treatments related to symptoms of the autonomic nervous system and the first trials will focus on treatments for people who develop postural orthostatic tachycardia syndrome (POTS) following SARS-CoV-2 infection. **Content:** August 31, 2023 As part of its [Researching COVID to Enhance Recovery (RECOVER) Initiative](http://recovercovid.org/), [NIH has opened enrollment](https://covid19.nih.gov/news-and-stories/nih-launches-clinical-trials-long-covid-treatments) for clinical trials at sites around the country that will test potential treatments for Long COVID. Treatments include drugs, biologics, medical devices, and other therapies. > **What is being tested?** The RECOVER clinical trials will be conducted using “platform protocols,” under which multiple treatments for a single disease can be tested simultaneously. As of August 2023, two protocols are active. - [**RECOVER-VITAL**](https://trials.recovercovid.org/vital) will test whether a longer course of Paxlovid, an antiviral drug used to treat acute SARS-CoV-2 infection, is also effective at ridding the body of chronic SARS-CoV-2 infection. Researchers believe that the persistence of the virus in the body may lead to symptoms of Long COVID. - [**RECOVER-NEURO**](https://trials.recovercovid.org/neuro) will test brain-training and stimulation interventions for brain fog, memory and problem-solving issues, and other cognitive effects of Long COVID. Treatments tested will include web-based brain training and goal management programs and a device used to stimulate brain activity and blood flow. Additional protocols will launch in the coming months. - **RECOVER-SLEEP** will study treatments for changes in sleep patterns and the ability to sleep after having COVID-19. Treatments tested will include drugs that promote wakefulness (to treat excessive daytime sleepiness) and other interventions to improve sleep quality. - **RECOVER-AUTONOMIC** will study treatments related to symptoms of the autonomic nervous system, which regulates heart rate, breathing, and digestion, among other functions. The first trials will focus on treatments for people who develop [postural orthostatic tachycardia syndrome (POTS)](https://www.nhlbi.nih.gov/news/2021/decoding-mysteries-postural-orthostatic-tachycardia-syndrome) following SARS-CoV-2 infection. A fifth protocol is being developed to study interventions for exercise intolerance and fatigue associated with Long COVID. **Citations for report:** [*National Heart, Lung, and Blood Institute*](https://www.nhlbi.nih.gov/). [**Decoding the Mysteries of Postural Orthostatic Tachycardia Syndrome**](https://www.nhlbi.nih.gov/news/2021/decoding-mysteries-postural-orthostatic-tachycardia-syndrome) *[National Institutes of Health: COVID-19 Research](https://covid19.nih.gov/)*. [**NIH Launches Clinical Trials for Long COVID Treatments**](https://covid19.nih.gov/news-and-stories/nih-launches-clinical-trials-long-covid-treatments) **Category:** Long COVID --- ### [New Therapeutic Target for Clearing post-Covid Brain Fog](https://www.autoimmuneinstitute.org/covid_timeline/new-therapeutic-target-for-clearing-post-covid-brain-fog/) **Published:** March 22, 2024 **Author:** Elevation **Excerpt:** In a groundbreaking study, researchers at the University of Illinois Chicago investigated the neurological effects of a COVID-19 infection in mice and identified a promising treatment to mitigate cognitive impairments including symptoms such as brain fog and issues with memory. **Content:** March 22, 2024 In a groundbreaking study, researchers at the University of Illinois Chicago investigated the neurological effects of SARS-CoV-2 infection in mice and identified a promising treatment to mitigate cognitive impairments. In their paper, titled [Engineered Wnt7a ligands rescue blood–brain barrier and cognitive deficits in a COVID-19 mouse model](https://academic.oup.com/brain/advance-article/doi/10.1093/brain/awae031/7596660?utm_source=authortollfreelink&utm_campaign=brain&utm_medium=email&guestAccessKey=9f97fc7c-5d28-4292-88f0-0a2479917fa2&login=false), recently published in *Brain*, they discuss that the team focused on the blood-brain barrier, discovering that infected mice exhibited leaky vessels and impaired memory due to suppressed Wnt/beta-catenin signaling, crucial for blood-brain barrier integrity. Essentially, they found that the **COVID-19 virus can make the brain’s protective barrier leaky and worsen memory**, what some describe as “brain fog.” Brain fog is a “general term used to describe the feeling of being mentally slow, fuzzy, or spaced out. It affects one’s ability to think or concentrate ([1](https://pubmed.ncbi.nlm.nih.gov/34672377/)) ([2](https://sjogrens.org/sites/default/files/inline-files/Brain%20Fog%20Patient%20Education%20Sheet_0.pdf)).” However, they also discovered a treatment that might help fix these problems. They used special molecules called Wnt7a to boost the brain’s protection, which worked! Employing engineered Wnt7a ligands targeted at enhancing this pathway, the researchers observed notable improvements: **reduced blood-brain barrier leakage, decreased immune cell infiltration into the brain, and enhanced learning and memory abilities** in infected mice. The study underscores the importance of understanding the molecular mechanisms underlying COVID-19-related neurological complications, particularly in older individuals who are at higher risk. While the research is preliminary, it sheds light on potential therapeutic avenues for preventing post-infection cognitive impairments giving hope for new treatments to keep our brains healthy after a COVID-19 infection. The team notes that studying how viruses affect the brain could lead to more ways to protect it from harm. This is good news for anyone worried about their brain health after COVID-19 or other illnesses. **Citations:** Asadi-Pooya, A. A., Akbari, A., Emami, A., Lotfi, M., Rostamihosseinkhani, M., Nemati, H., Barzegar, Z., Kabiri, M., Zeraatpisheh, Z., Farjoud-Kouhanjani, M., Jafari, A., Sasannia, S., Ashrafi, S., Nazeri, M., Nasiri, S., & Shahisavandi, M. (2022). **Long COVID syndrome-associated brain fog**. *Journal of medical virology*, *94*(3), 979–984. <https://doi.org/10.1002/jmv.27404> [*Sjögren’s Foundation*](https://sjogrens.org/). [**Patient Education Sheet – Brain Fog**](https://sjogrens.org/sites/default/files/inline-files/Brain%20Fog%20Patient%20Education%20Sheet_0.pdf). Trevino, T. N., Fogel, A. B., Otkiran, G., Niladhuri, S. B., Sanborn, M. A., Class, J., Almousawi, A. A., Vanhollebeke, B., Tai, L. M., Rehman, J., Richner, J. M., & Lutz, S. E. (2024). **Engineered Wnt7a ligands rescue blood-brain barrier and cognitive deficits in a COVID-19 mouse model**. *Brain : a journal of neurology*, *147*(5), 1636–1643. <https://doi.org/10.1093/brain/awae031> **Category:** Covid-19 & Long Covid Treatments, Covid-19 Infections, Covid-19 Research Studies, Long COVID --- ### [Long Covid: One Disease or Several?](https://www.autoimmuneinstitute.org/covid_timeline/long-covid-one-disease-or-several/) **Published:** September 15, 2023 **Author:** Elevation **Excerpt:** An article published in Nature provides the most comprehensive compilation of research on Long Covid to date, discussing what is currently known about its symptoms, prevalence, biomarkers, and disease mechanisms. Because Long Covid does not have a single unifying mechanism, and has such broad multi-systemic symptoms, it likely has a broad range of causes and will likely be classified into separate illnesses in the future. **Content:** September 15, 2023 A recent review [article](https://www.nature.com/articles/s41577-023-00904-7) published in *Nature* provides the most comprehensive compilation of research on long Covid to date, discussing what is currently known about its symptoms, prevalence, biomarkers, and disease mechanisms. The [most common symptoms of Long Covid](https://pubmed.ncbi.nlm.nih.gov/34580069/) appear to be weakness, malaise, fatigue, impaired concentration, and breathlessness. Researchers agree that at least 10% of people who’ve had COVID-19 develop Long Covid. Estimates vary based on how researchers define Long Covid, the time frame post-infection, and the population under study. Some report closer to [50%](http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=36224173) and others less than [10%](http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=35764621); the search for a definitive diagnostic test for Long Covid is ongoing. Biomarkers include [low serum cortisol](http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=36597525), [chemokine CCL-11](http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=35768006), [autoantibodies](http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=36137590) [shared with known autoimmune diseases](http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=32315487), and certain [intestinal microbiota](http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=35082169). It remains unclear how protective COVID-19 vaccination is against Long Covid. Some studies suggest that breakthrough infections are just as likely to result in Long Covid as infections in unvaccinated individuals, and vaccination may not reduce the severity of symptoms ([1](http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=35584848)) ([2](http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=34480857)) ([3](http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=35447302)). Others find vaccination to be protective or even beneficial for treating those who already have Long Covid symptoms ([4](http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=35238053)) ([5](https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/conditionsanddiseases/bulletins/selfreportedlongcovidaftertwodosesofacoronaviruscovid19vaccineintheuk/26january2022)) ([6](http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=35584848)) ([7](https://pubmed.ncbi.nlm.nih.gov/35584816/)). The authors argue that because Long Covid has such broad multi-systemic symptoms, it likely has a broad range of causes and will likely be classified into separate illnesses in the future. They support this argument with the lack of a single unifying mechanism. Research [supports](http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=35195253) [microclots](http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=36002482), [viral reservoirs](http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=36517603), [organ damage](https://www.nature.com/articles/s41577-023-00904-7#Sec8), [autoimmunity](https://www.nature.com/articles/s41577-023-00904-7#Tab2), [viral reactivation](http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=34204243), and [dys](http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=35082169)[bio](http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=36357381)[sis](https://doi.org/10.1136/gutjnl-2022-328757) as potential causes for Long Covid symptoms. It is unlikely that all of these mechanisms play a role for every Long Covid patient, but some patients are affected by each. Future studies, diagnostic tests, and treatments will likely target specific sub-groups within the larger Long Covid population. **Category:** Covid-19 Infections, Covid-19 Research Studies, Long COVID --- ### [Graves' Disease & COVID-19 Vaccination](https://www.autoimmuneinstitute.org/covid_timeline/graves-disease-covid-19-vaccination/) **Published:** September 25, 2023 **Author:** Elevation **Excerpt:** A study from the University of Washington Seattle studied the incidence of Graves' disease before and after receiving the COVID-19 vaccine, determining no significant difference. Researchers also looked at levels of thyroid antibodies in the blood of patients with Graves' hyperthyroidism before and after vaccination and found no significant difference. **Content:** September 25, 2023 A number of case reports have been published discussing patients developing [Graves’ disease](https://www.autoimmuneinstitute.org/autoimmune-resources/graves-disease/) following COVID-19 vaccination ([1](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10306414/), [2](https://pubmed.ncbi.nlm.nih.gov/36237182/), [3](https://pubmed.ncbi.nlm.nih.gov/36130234/)).  [Some have hypothesized](https://pubmed.ncbi.nlm.nih.gov/20708902/) that adjuvants used in mRNA vaccines could cause the condition via molecular mimicry. A [new study](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10306414/) from the University of Washington Seattle may help assuage concern. Researchers used clinical records to examine the rates of Graves’ hyperthyroidism diagnosis during two time periods: one before Covid vaccines were approved for emergency use (from December 2017 to October 2019), and one after Covid vaccine approval (from December 2020 to October 2022). Because this was a retrospective study and the pandemic likely caused a lower rate of hospital visits, researchers used the number of people already diagnosed with Graves’ disease who came into the hospital during both time periods as controls. **The study found no significant difference in rates of Graves’ disease before and after Covid vaccination.** Additionally, researchers did not find any demographic differences between patients who were diagnosed with Graves’ disease before vaccination, and those diagnosed after. When comparing vaccine manufacturers, there was still no difference in rates of Graves’ disease. Researchers also looked at levels of thyroid antibodies in the blood of patients with Graves’ hyperthyroidism before and after vaccination (after a month and after three months) and found no significant difference. The findings of this study suggest that **Covid vaccination does not cause Graves’ disease**, nor does it increase the levels of antibodies in those who already have the condition. **Citations for report:** di Filippo, L., Castellino, L., Allora, A., Frara, S., Lanzi, R., Perticone, F., Valsecchi, F., Vassallo, A., Giubbini, R., Rosen, C. J., & Giustina, A. (2022). **Distinct Clinical Features of Post-COVID-19 Vaccination Early-onset Graves’ Disease**. *The Journal of clinical endocrinology and metabolism*, *108*(1), 107–113. <https://doi.org/10.1210/clinem/dgac550> Endo, M., Pinto, J., Roth, M. Y., Hoofnagle, A. N., Failor, R. A., & Tylee, T. S. (2023). **The Incidence of Graves’ Hyperthyroidism Before and After COVID-19 Messenger RNA Vaccination**. *Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists*, *29*(8), 618–622. <https://doi.org/10.1016/j.eprac.2023.05.005> Shoenfeld, Y., & Agmon-Levin, N. (2011). **‘ASIA’ – autoimmune/inflammatory syndrome induced by adjuvants**. *Journal of autoimmunity*, *36*(1), 4–8. <https://doi.org/10.1016/j.jaut.2010.07.003> Triantafyllidis, K. K., Giannos, P., Stathi, D., & Kechagias, K. S. (2022). **Graves’ disease following vaccination against SARS-CoV-2: A systematic review of the reported cases**. *Frontiers in endocrinology*, *13*, 938001. <https://doi.org/10.3389/fendo.2022.938001> **Category:** Autoimmune Diseases & Covid-19, Covid-19 Research Studies, Thyroid disease & Covid-19, Vaccine Adverse Events --- ### [A COVID-19 Infection Can Trigger Graves' disease](https://www.autoimmuneinstitute.org/covid_timeline/a-covid-19-infection-can-trigger-graves-disease/) **Published:** November 10, 2023 **Author:** Elevation **Excerpt:** A new case study highlights an 81-year-old male who developed Graves' disease and thyroid storm one week after a COVID-19 diagnosis. This case adds to the somewhat limited reports linking COVID-19 to new-onset Graves' disease, emphasizing the need for recognizing and promptly treating autoimmune effects post-COVID-19 infection to prevent severe complications. **Content:** November 10, 2023 A new [case study](https://www.cureus.com/articles/174667-new-onset-graves-disease-with-thyroid-storm-after-covid-19-infection?score_article=true#!/) highlights an 81-year-old male who **developed [Graves’ disease](https://www.autoimmuneinstitute.org/autoimmune-resources/graves-disease/) and thyroid storm one week after a COVID-19 diagnosis**. A thyroid storm is a rare but severe and life-threatening complication of hyperthyroidism that occurs when overactive thyroid activity leads to hypermetabolism and can result in death from cardiac arrest or multiple organ failure. The patient, **with no history of autoimmune or thyroid conditions**, presented with symptoms such as palpitations, tremors, and diarrhea. The diagnosis was confirmed through a Burch-Wartofsky score of 45 and thyroid studies. Treatment involved hydrocortisone, cholestyramine, potassium, and propylthiouracil, resulting in symptom resolution and improved thyroid studies. **This case adds to the somewhat limited reports linking COVID-19 to new-onset Graves’ disease** ([1](https://dx.doi.org/10.1111/cen.14860?utm_medium=email&utm_source=transaction)) ([2](https://dx.doi.org/10.1002/jmv.27292?utm_medium=email&utm_source=transaction)) ([3](https://dx.doi.org/10.7759/cureus.22260?utm_medium=email&utm_source=transaction)) ([4](https://dx.doi.org/10.1016/j.ando.2021.12.004?utm_medium=email&utm_source=transaction)) ([5](https://dx.doi.org/10.5811/cpcem.2021.5.52692?utm_medium=email&utm_source=transaction)), **emphasizing the need for recognizing and promptly treating autoimmune effects post-COVID-19 infection to prevent severe complications**. **Citations for report:** Barajas Galindo, D. E., Ramos Bachiller, B., González Roza, L., García Ruiz de Morales, J. M., Sánchez Lasheras, F., González Arnáiz, E., Ariadel Cobo, D., Ballesteros Pomar, M. D., & Rodríguez, I. C. (2023). **Increased incidence of Graves’ disease during the SARS-CoV2 pandemic**. *Clinical endocrinology*, *98*(5), 730–737. <https://doi.org/10.1111/cen.14860> Geslot, A., Chanson, P., & Caron, P. (2022). **Covid-19, the thyroid and the pituitary – The real state of play**. *Annales d’endocrinologie*, *83*(2), 103–108. <https://doi.org/10.1016/j.ando.2021.12.004> Ghareebian, H., & Mariash, C. (2022). **COVID-19-Induced Graves’ Disease**. *Cureus*, *14*(2), e22260. <https://doi.org/10.7759/cureus.22260> Shermetaro, A., & Bushman, J. (2023). **New-Onset Graves’ Disease With Thyroid Storm After COVID-19 Infection**. *Cureus*, *15*(10), e47995. <https://doi.org/10.7759/cureus.47995> Sullivan, K., Helgeson, J., & McGowan, A. (2021). **COVID-19 Associated Thyroid Storm: A Case Report**. *Clinical practice and cases in emergency medicine*, *5*(4), 412–414. <https://doi.org/10.5811/cpcem.2021.5.52692> Yazdanpanah, N., & Rezaei, N. (2022). **Autoimmune complications of COVID-19**. *Journal of medical virology*, *94*(1), 54–62. <https://doi.org/10.1002/jmv.27292> **Category:** Autoimmune Diseases & Covid-19, Covid-19 Infections, Thyroid disease & Covid-19 --- ### [Acute and Longterm Health Implications of Covid-19 versus Seasonal Influenza](https://www.autoimmuneinstitute.org/covid_timeline/acute-and-longterm-health-implications-of-covid-19-versus-seasonal-influenza/) **Published:** December 22, 2023 **Author:** Elevation **Excerpt:** In a research paper published this month, researchers utilized data from the Department of Veterans Affairs to compare both acute and long-term risks and health outcomes following hospital admission for COVID-19 and the seasonal flu. **Content:** December 22, 2023 In a [research paper](https://www.thelancet.com/action/showPdf?pii=S1473-3099%2823%2900684-9) published this month, researchers utilized data from the Department of Veterans Affairs to compare both acute and long-term risks and health outcomes following hospital admission for COVID-19 and the seasonal flu. Health data from over 81,000 COVID-19 patients hospitalized between March 1, 2020, and June 30, 2022, was compared to data from just under 11,000 patients hospitalized for seasonal influenza between October 1, 2015, and February 28, 2019. Both COVID-19 and seasonal flu patients were admitted to the hospital with an admission diagnosis within five days before or within 30 days after positive test results. Within the seasonal influenza group, 76% were diagnosed with influenza type A. COVID-19 participants were separated into three groups: pre-delta, delta, and omicron, depending on which months they were admitted into the hospital for infection. Researchers followed up with participants for up to 18 months, evaluating their profiles against 94 pre-specified health outcomes and other factors, including organ systems (cardiovascular, coagulation and hematological, fatigue, gastrointestinal, kidney, mental health, metabolic, musculoskeletal, neurological, and pulmonary). Researchers identified two key findings through their analysis. For both COVID-19 infection and seasonal flu infections, there was an increased burden of disease and health loss during the post-acute phase versus the acute phase of infection. COVID-19 also had a higher burden of disease across all organ systems in both the acute and post-acute phases besides the pulmonary system. COVID-19 patients had an increased risk of hospital readmission and admission into intensive care; hospital admission for COVID-19 was also associated with a higher risk of death. Over 18 months of follow-up, COVID-19 patients had an increased risk of death versus the influenza group. Compared to the seasonal flu, COVID-19 had a higher risk of death and risk to all organs except for the pulmonary system, regardless of both COVID-19 and seasonal influenza vaccination status. The results of the study suggest that while “both viruses exact a substantial toll of health loss across multiple organ systems… comparative evaluation of the risks of adverse health outcomes across ten organ systems suggests that seasonal influenza is more of a respiratory virus than SARS-CoV-2 and that the latter is a more multi-systemic virus than seasonal influenza.” Furthermore, the results of the analysis imply that COVID-19 infections have a “longer-term risk horizon for organ damage than seasonal influenza.” Providing post-acute care has the ability to improve health outcomes and reduce hospital readmissions. **Citation for report:** Xie, Y., Choi, T., & Al-Aly, Z. (2024). **Long-term outcomes following hospital admission for COVID-19 versus seasonal influenza: a cohort study**. *The Lancet. Infectious diseases*, *24*(3), 239–255. <https://doi.org/10.1016/S1473-3099(23)00684-9> **Category:** Covid-19 Infections, Covid-19 Research Studies --- ### [COVID-19's Connection to the Recent Rise in Respiratory Infections](https://www.autoimmuneinstitute.org/covid_timeline/covid-19s-connection-to-the-recent-rise-in-respiratory-infections/) **Published:** January 11, 2024 **Author:** Elevation **Excerpt:** An article discusses the surge in respiratory illnesses in children in the US, China, and other regions during 2021 and 2022. The unusual timing and increased cases have sparked a debate on how the COVID-19 pandemic may have influenced the rates of other infectious diseases. Terms like "immunity debt" and "immunity theft" have been coined to describe potential explanations for this correlation. **Category:** Covid-19 Infections, Covid-19 Research Studies --- ### [Increased Risk of Developing Alopecia Areata Seen Following COVID-19 Infection](https://www.autoimmuneinstitute.org/covid_timeline/alopecia-areata-after-covid-19-infection/) **Published:** January 12, 2024 **Author:** Elevation **Excerpt:** A research letter published this week discussed a study aimed to explore the association between COVID-19 infection and alopecia areata, given that COVID-19 infection has been previously found to trigger other autoimmune diseases such as systemic lupus erythematosus, inflammatory bowel disease, and rheumatoid arthritis. **Category:** Autoimmune Diseases & Covid-19, Covid-19 Infections, Covid-19 Research Studies --- ### [Potential New Marker for Assessing Long Covid and Cognitive Slowing](https://www.autoimmuneinstitute.org/covid_timeline/potential-new-marker-for-assessing-long-covid-and-cognitive-slowing/) **Published:** January 29, 2024 **Author:** Elevation **Excerpt:** A study published last week found that Long COVID patients exhibit pronounced cognitive slowing, particularly in simple reaction time tasks, compared to both recovered COVID patients and those who never had COVID. This cognitive deficit was significant, with long COVID patients responding about three standard deviations slower than healthy controls. **Content:** January 29, 2024 A [study](https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(24)00013-0/fulltext) published last week found that Long COVID patients exhibit pronounced cognitive slowing, particularly in simple reaction time tasks, compared to both recovered COVID patients and those who never had COVID. This cognitive deficit was significant, with long COVID patients responding about three standard deviations slower than healthy controls. The study, conducted by Sijia Zhao and colleagues at the University of Oxford, suggests that cognitive slowing may be an objective marker for tracking the progress of Long COVID rehabilitation and can conveniently be easily measured using a 30-second web-based task. The research also revealed that cognitive slowing persisted even when comparing Long COVID patients to those who had COVID but did not develop long-term symptoms, indicating it’s not solely due to the acute phase of the illness. **Citation for report:** Zhao, S., Martin, E. M., Reuken, P. A., Scholcz, A., Ganse-Dumrath, A., Srowig, A., Utech, I., Kozik, V., Radscheidt, M., Brodoehl, S., Stallmach, A., Schwab, M., Fraser, E., Finke, K., & Husain, M. (2024). **Long COVID is associated with severe cognitive slowing: a multicentre cross-sectional study**. *EClinicalMedicine*, *68*, 102434. <https://doi.org/10.1016/j.eclinm.2024.102434> **Category:** Covid-19 Research Studies, Long COVID --- ### [The Connection Between COVID-19 and Thyroid Disease](https://www.autoimmuneinstitute.org/covid_timeline/the-connection-between-covid-19-and-thyroid-disease/) **Published:** February 13, 2024 **Author:** Elevation **Excerpt:** An informative article written by Dr. Jessica Nelson explores the potential relationship between COVID-19 and autoimmune thyroid diseases, such as Graves' disease and Hashimoto's thyroiditis, as well as the emerging connection between COVID-19 and Type 1 diabetes. **Content:** February 13, 2024 Lorem An informatives [article by Dr. Jessica Nelson](https://medriva.com/covid-19/unraveling-the-connection-between-covid-19-and-thyroid-illnesses-an-in-depth-analysis/) explores the relationship between COVID-19 and autoimmune thyroid diseases, such as [Graves’ disease](https://www.autoimmuneinstitute.org/autoimmune-resources/graves-disease/) and [Hashimoto’s thyroiditis](https://www.autoimmuneinstitute.org/autoimmune-resources/hashimotos-thyroiditis/). It discusses how COVID-19 may impact thyroid function, potentially leading to non-thyroidal illness syndrome and subacute thyroiditis. The presence of ACE2 receptors in thyroid cells suggests a mechanism for how the virus may infect them. Additionally, the article touches on the emerging connection between COVID-19 and [Type 1 diabetes](https://www.autoimmuneinstitute.org/autoimmune-resources/diabetes-type-1/). Monitoring thyroid function in COVID-19 patients is highlighted as crucial, emphasizing the need for further research to establish concrete connections and treatment protocols. **Citation for report:** [*Medriva*](https://medriva.com/). [**Unraveling the Connection Between COVID-19 and Thyroid Illnesses: An In-depth Analysis**](https://medriva.com/covid-19/unraveling-the-connection-between-covid-19-and-thyroid-illnesses-an-in-depth-analysis/) **Category:** Autoimmune Diseases & Covid-19, T1D & Covid-19, Thyroid disease & Covid-19 --- ### [Can Long Covid Cause POTS?](https://www.autoimmuneinstitute.org/covid_timeline/can-long-covid-cause-pots/) **Published:** February 29, 2024 **Author:** Elevation **Excerpt:** An opinion piece titled “Possible Role of Fibrinoid Microclots in Postural Orthostatic Tachycardia Syndrome (POTS): Focus on Long COVID” was recently published in the Journal of Personalized Medicine. It explores the relationship between postural orthostatic tachycardia syndrome (POTS), fibrinaloid microclots, and fatigue, particularly in the context of chronic inflammatory diseases like long COVID. **Content:** February 29, 2024 An opinion piece titled “**[Possible Role of Fibrinoid Microclots in Postural Orthostatic Tachycardia Syndrome (POTS): Focus on Long COVID](https://ncbi.nlm.nih.gov/pmc/articles/PMC10890060/pdf/jpm-14-00170.pdf)**” was recently published in the *Journal of Personalized Medicine.* It explores the relationship between postural orthostatic tachycardia syndrome (POTS), fibrinaloid microclots, and fatigue, particularly in the context of chronic inflammatory diseases like Long COVID. [POTS](https://journals.sagepub.com/doi/10.1177/0961203316629558) is a manifestation of autonomic dysregulation and is clinically characterized as excessive tachycardia upon standing in the presence of symptomatic orthostatic intolerance. Essentially, this means that those with POTS experience autonomic system malfunctions resulting in excessive heart racing, dizziness, and lightheadedness upon standing. The diagnosis of POTS is relatively straightforward and involves monitoring heart rate changes upon standing. POTS frequently co-occurs with fatigue, likely sharing common underlying mechanisms, such as microclot-induced tissue hypoxia. The authors suggest that fibrinaloid microclots, [found in conditions like Long COVID](https://pubmed.ncbi.nlm.nih.gov/37809592/), may be a key factor in causing POTS. These microclots, by blocking blood flow in microcapillaries, induce tissue hypoxia (oxygen deprivation), triggering exaggerated tachycardia (heart rate that exceeds the normal resting rate) as a physiological response. This understanding could have implications for the treatment of such diseases. **Citations for report:** Dahan, S., Tomljenovic, L., & Shoenfeld, Y. (2016). **Postural Orthostatic Tachycardia Syndrome (POTS)–A novel member of the autoimmune family**. *Lupus*, *25*(4), 339–342. <https://doi.org/10.1177/0961203316629558> Kell, D. B., Khan, M. A., Kane, B., Lip, G. Y. H., & Pretorius, E. (2024). **Possible Role of Fibrinaloid Microclots in Postural Orthostatic Tachycardia Syndrome (POTS): Focus on Long COVID**. *Journal of personalized medicine*, *14*(2), 170. <https://doi.org/10.3390/jpm14020170> Turner, S., Laubscher, G. J., Khan, M. A., Kell, D. B., & Pretorius, E. (2023). **Accelerating discovery: A novel flow cytometric method for detecting fibrin(ogen) amyloid microclots using long COVID as a model**. *Heliyon*, *9*(9), e19605. <https://doi.org/10.1016/j.heliyon.2023.e19605> **Category:** Long COVID --- ### [Is it Long Covid or Multiple Sclerosis Symptoms?](https://www.autoimmuneinstitute.org/covid_timeline/is-it-long-covid-or-multiple-sclerosis-symptoms/) **Published:** March 4, 2024 **Author:** Elevation **Excerpt:** The North American Research Committee on Multiple Sclerosis (NARCOMS) registry analyses presented at the 2024 Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) Forum highlight the importance of understanding the unique impact of COVID-19 and Long Covid on MS patients and the challenges in distinguishing COVID-19 symptoms from MS symptoms. **Content:** March 4, 2024 The North American Research Committee on Multiple Sclerosis ([NARCOMS](https://www.narcoms.org/)) registry analyses presented at the 2024 Americas Committee for Treatment and Research in Multiple Sclerosis ([ACTRIMS](https://forum.actrims.org/)) Forum indicated a relatively low risk of long COVID in people with [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/) (MS). Only 1.5% of MS patients met post-acute sequelae of COVID-19 (PASC – also known as Long Covid) criteria. However, 15.7% of MS patients with COVID-19 reported persistent symptoms after six months, comparable to 17.2% of those without COVID-19 or other infections. Dr. Robert Fox [highlighted challenges in distinguishing COVID-19 symptoms from MS symptoms](https://www.abstractsonline.com/pp8/#!/20258/presentation/440), noting the need for tailored assessment criteria. [Another analysis by Dr. Amber Salter and colleagues](https://www.abstractsonline.com/pp8/#!/20258/presentation/441) revealed infrequent new persistent symptoms after infections, with differences observed between COVID-19 and other infections, suggesting a complex interaction in symptom development. Both presentations highlight the importance of understanding the unique impact of COVID-19 and Long Covid on MS patients and the challenges in distinguishing COVID-19 symptoms from MS symptoms. **Citations for report:** *[ACTRIMS](https://forum.actrims.org/).* [**P274. Characterizing Post-acute Sequelae of COVID-19 in NARCOMS**](https://www.abstractsonline.com/pp8/#!/20258/presentation/440) *[ACTRIMS](https://forum.actrims.org/).* [**P275. Symptom Comparison After Infections Among People With MS**](https://www.abstractsonline.com/pp8/#!/20258/presentation/441) **Category:** Autoimmune Diseases & Covid-19, Covid-19 Research Studies, Long COVID, MS & Covid-19 --- ### [A Form of Long Covid? Autoimmune Inflammatory Rheumatic Disease Following Covid-19](https://www.autoimmuneinstitute.org/covid_timeline/a-form-of-long-covid-autoimmune-inflammatory-rheumatic-disease-following-covid-19/) **Published:** March 5, 2024 **Author:** Elevation **Excerpt:** An article published today called the Long-Term Autoimmune Inflammatory Rheumatic Outcomes of COVID-19, reports that rates of new-onset autoimmune inflammatory rheumatic diseases (AIRD), like rheumatoid arthritis and lupus, increased significantly post-COVID-19 in South Korea and Japan. **Content:** March 5, 2024 An article published today called the **[Long-Term Autoimmune Inflammatory Rheumatic Outcomes of COVID-19](https://www.acpjournals.org/doi/10.7326/M23-1831)**, reports that rates of new-onset autoimmune inflammatory rheumatic diseases (AIRD), like [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/) and [lupus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/), increased significantly post-COVID-19 in South Korea and Japan. **Data from both countries revealed a 25% increase in Korea and a 79% increase in Japan among COVID-19 patients compared to uninfected controls**. However, vaccination reduced the risk of AIRD after breakthrough infections, except in severe cases. **AIRD was considered a long-term COVID-19 complication, with elevated rates persisting for up to a year or more post-infection**. The risk increase wasn’t due to healthcare contact, as it was significantly higher in COVID-19 patients compared to influenza patients. The analysis, encompassing large cohorts, revealed variations between countries and when comparing COVID and influenza. While limitations exist, including reliance on administrative data and pre-Omicron data, the findings highlight the potential long-term impacts of COVID-19 on autoimmune diseases and the protective role of vaccination. **Citation for report:** Kim, M. S., Lee, H., Lee, S. W., Kwon, R., Rhee, S. Y., Lee, J. A., Koyanagi, A., Smith, L., Fond, G., Boyer, L., Lee, J., Rahmati, M., Shin, J. Y., Min, C., Shin, J. I., & Yon, D. K. (2024). **Long-Term Autoimmune Inflammatory Rheumatic Outcomes of COVID-19 : A Binational Cohort Study**. *Annals of internal medicine*, *177*(3), 291–302. <https://doi.org/10.7326/M23-1831> **Category:** Autoimmune Diseases & Covid-19, Covid-19 Infections, Covid-19 Research Studies, Long COVID, Lupus & Covid-19, RA & Covid-19 --- ### [NIH Launches Trials for Long COVID Treatment Breakthroughs](https://www.autoimmuneinstitute.org/covid_timeline/nih-launches-trials-for-long-covid-treatment-breakthroughs/) **Published:** March 13, 2024 **Author:** Elevation **Excerpt:** The National Institutes of Health (NIH) just released a news release announcing that they have initiated two phase 2 clinical trials, part of the RECOVER Initiative, to assess treatments for autonomic nervous system dysfunction in Long Covid patients. **Content:** March 13, 2024 Yesterday, the National Institutes of Health (NIH) posted a [news release](https://www.nih.gov/news-events/news-releases/nih-opens-long-covid-trials-evaluate-treatments-autonomic-nervous-system-dysfunction) announcing that they have initiated two phase 2 clinical trials, part of the [RECOVER Initiative](https://recovercovid.org/), to assess treatments for autonomic nervous system dysfunction in Long Covid patients. The two trials, collectively known as RECOVER-AUTONOMIC, are testing three potential treatments in adults who, following COVID-19, now have postural orthostatic tachycardia syndrome ([POTS](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/postural-orthostatic-tachycardia-syndrome/)). These trials aim to address symptoms like rapid heart rate, dizziness, and fatigue, which are debilitating for many Long Covid sufferers. The trials will initially examine three potential treatments: - Gamunex-C, a form of intravenous immunoglobulin (IVIG), contains antibodies to help the body protect itself against infection from various diseases and is given by intravenous infusion. - Ivabradine, an oral medication that reduces heart rate. - Coordinator-guided, non-drug care, which includes a series of activities managed through weekly phone calls with a care coordinator, such as wearing a compression belt and eating a high-salt diet, which are recommended for patients with POTS to counteract excessive loss of fluids. Participants will be randomly assigned to receive these treatments and monitored for effectiveness. The trials, called RECOVER-AUTONOMIC, will enroll 380 participants across 50 sites in the U.S., prioritizing diverse representation. This effort is part of the broader NIH RECOVER Initiative, aimed at understanding and treating Long Covid. The initiative aligns with the National Research Action Plan and aims to provide comprehensive support for individuals experiencing Long Covid symptoms. **Citation for report:** [*[National Institutes of Health](https://www.nih.gov/)*. **[NIH opens long COVID trials to evaluate treatments for autonomic nervous system dysfunction](https://www.nih.gov/news-events/news-releases/nih-opens-long-covid-trials-evaluate-treatments-autonomic-nervous-system-dysfunction)**](https://www.nih.gov/) People 18 years of age and older who are interested in learning more about these trials can visit [https://trials.RECOVERCovid.org/autonomic](https://trials.recovercovid.org/autonomic) or [ClinicalTrials.gov](https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fclinicaltrials.gov%2F&data=05%7C02%7Colib%40od.nih.gov%7C3205e9c8bb494884458708dc421426bc%7C14b77578977342d58507251ca2dc2b06%7C0%7C0%7C638457902049952230%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C0%7C%7C%7C&sdata=uX%2Fg%2FbmQxza8G%2FkOYvVZAFxNwFbfPXr37phpJJPh%2FNg%3D&reserved=0) and search identifier [NCT06305793](https://clinicaltrials.gov/study/NCT06305793?term=NCT06305793&rank=1), [NCT06305806 ](https://clinicaltrials.gov/study/NCT06305806?term=NCT06305806&rank=1)and [NCT06305780](https://clinicaltrials.gov/study/NCT06305780?term=NCT06305780&rank=1). **Category:** Covid-19 & Long Covid Treatments, Covid-19 Research Studies, Long COVID --- ### [Long Covid and ME/CFS: Shared Pathologies and Promising Therapies](https://www.autoimmuneinstitute.org/covid_timeline/long-covid-and-me-cfs-shared-pathologies-and-promising-therapies/) **Published:** March 18, 2024 **Author:** Elevation **Excerpt:** Roughly half of Long Covid patients meet the diagnostic criteria for myalgic encephalomyelitis/ chronic fatigue syndrome (ME/CFS) according to a review article published recently in Trends in Molecular Medicine, called “Unravelling shared mechanisms: insights from recent ME/CFS research to illuminate long COVID pathologies”. **Content:** March 18, 2024 Roughly half of Long Covid patients meet the diagnostic criteria for myalgic encephalomyelitis/ chronic fatigue syndrome ([ME/CFS](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/me-cfs/)) according to a review article published recently in *Trends in Molecular Medicine*, called “[Unravelling shared mechanisms: insights from recent ME/CFS research to illuminate long COVID pathologies”.](https://www.cell.com/trends/molecular-medicine/fulltext/S1471-4914(24)00028-5?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS1471491424000285%3Fshowall%3Dtrue) Despite their similar symptoms and likely causes, it’s not clear if they also share the same underlying molecular issues. Both ME/CFS and Long Covid show consistent changes in how the body produces energy and in the makeup of gut bacteria, with a decrease in bacteria that make a substance called butyrate. Early attempts to treat ME/CFS and Long Covid by targeting the immune system showed promise, but further studies are needed. Researchers have found possible signs in the body that could help diagnose these conditions, but more research is needed to confirm their accuracy. The most promising method for ME/CFS seems to involve measuring certain types of RNAs. **Citation for report:** Annesley, S. J., Missailidis, D., Heng, B., Josev, E. K., & Armstrong, C. W. (2024). **Unravelling shared mechanisms: insights from recent ME/CFS research to illuminate long COVID pathologies**. *Trends in molecular medicine*, *30*(5), 443–458. <https://doi.org/10.1016/j.molmed.2024.02.003> **Category:** Autoimmune Diseases & Covid-19, Covid-19 Research Studies, Long COVID, ME/CFS & Covid-19 --- ### [COVID-19 False-Positives Rampant in Those with Autoimmune Disease](https://www.autoimmuneinstitute.org/covid_timeline/covid-19-false-positives-rampant-in-those-with-autoimmune-disease/) **Published:** March 11, 2024 **Author:** Elevation **Excerpt:** A research correspondence published in the New England Journal of Medicine, titled Persistent False Positive Covid-19 Rapid Antigen Tests, highlights a phenomenon observed in rapid antigen testing for SARS-CoV-2, where some individuals, particularly women with autoimmune disorders, repeatedly test positive on rapid antigen tests despite negative molecular tests. **Content:** March 11, 2024 A research correspondence published in the *New England Journal of Medicine*, titled [Persistent False Positive Covid-19 Rapid Antigen Tests](https://www.nejm.org/doi/10.1056/NEJMc2313517?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed), highlights a phenomenon observed in rapid antigen testing for SARS-CoV-2, where some individuals, particularly women with autoimmune disorders, repeatedly test positive on rapid antigen tests despite negative molecular tests. The study involved two longitudinal cohort studies with participants undergoing serial rapid antigen and RT-PCR testing. Persistent false positives were more common among women and individuals with autoimmune disorders, particularly those with rheumatoid factor. The study suggests that the cross-reactivity of test antibodies with rheumatoid factor may lead to persistent false positivity. It recommends repeat testing with a different brand of rapid antigen test for individuals with autoimmune diseases and persistent false positive results. This finding is crucial for clinical practice and public health efforts to distinguish between cross-reactive false positivity and actual SARS-CoV-2 infection. **Citation for report:** Herbert, C., McManus, D. D., & Soni, A. (2024). **Persistent False Positive Covid-19 Rapid Antigen Tests**. *The New England journal of medicine*, *390*(8), 764–765. <https://doi.org/10.1056/NEJMc2313517> **Category:** Autoimmune Diseases & Covid-19, Covid-19 Research Studies --- ### [6 Month Effects of Multisystem Inflammatory Syndrome in Children](https://www.autoimmuneinstitute.org/covid_timeline/6-month-effects-of-multisystem-inflammatory-syndrome-in-children/) **Published:** May 27, 2021 **Author:** Elevation **Excerpt:** MIS-C is a hyper-inflammatory response occurring in children following COVID-19 infection. While more research has been conducted on the symptoms of this syndrome, not much is known about its long term impact on the overall health of children. **Content:** May 27, 2021 Multisystem Inflammatory Syndrome (MIS-C) is a hyper-inflammatory response occurring in children following COVID-19 infection. While more research has been conducted on the symptoms of this syndrome, not much is known about its long-term impact on the overall health of children. [The Lancet Child and Adolescent Health Journal](https://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(21)00138-3/fulltext) published a study giving closer insight into the long-term effects of MIS-C. The study followed the outcomes of 46 adolescents with MIS-C (known as PIMS-TS in the United Kingdom) 6 months after being discharged from the hospital. All of the children included in the sample experienced systemic inflammation, as well as gastrointestinal and neurological symptoms. The most notable symptoms among the findings were psychological distress such as “trauma and anxiety,” along with a reduction in “functional exercise capacity.” It is still unclear, however, if these symptoms are a result of preexisting physical and psychological conditions or the impact of the COVID-19 pandemic in general. Nonetheless, **the most severe symptoms from MIS-C were resolved by 6 months.** Future research regarding outcomes of MIS-C beyond the 6-month mark will be necessary to further understand the long-term impact of this syndrome. **Citation for report:** Penner, J., Abdel-Mannan, O., Grant, K., Maillard, S., Kucera, F., Hassell, J., Eyre, M., Berger, Z., Hacohen, Y., Moshal, K., & GOSH PIMS-TS MDT Group (2021). **6-month multidisciplinary follow-up and outcomes of patients with paediatric inflammatory multisystem syndrome (PIMS-TS) at a UK tertiary paediatric hospital: a retrospective cohort study**. *The Lancet. Child & adolescent health*, *5*(7), 473–482. <https://doi.org/10.1016/S2352-4642(21)00138-3> **Category:** Covid-19 Research Studies --- ### [CDC Announces Recommendation of Pfizer Vaccine for 12-15 Year Olds](https://www.autoimmuneinstitute.org/covid_timeline/cdc-announces-recommendation-of-pfizer-vaccine-for-12-15-year-olds/) **Published:** May 13, 2021 **Author:** Elevation **Excerpt:** There have been over 1.5 million cases of COVID-19 amongst children, with more hospital cases than the annual flu in an average year. Most children with COVID-19 have mild or no symptoms, however, some children can develop multisystem inflammatory syndrome (MIS-C) after a COVID-19 infection and require hospitalization. **Content:** May 13, 2021 There have been over 1.5 million cases of COVID-19 among children, with more hospital cases than the annual flu in an average year ([1](https://archive.cdc.gov/#/details?url=https://www.cdc.gov/flu/about/burden/2018-2019.html)). Most children with COVID-19 have mild or no symptoms. However, some children can develop multisystem inflammatory syndrome (MIS-C) after a COVID-19 infection and require hospitalization. Yesterday, the **CDC announced their recommendation to use the Pfizer vaccine in children ages 12-15** ([2](https://www.cdc.gov/media/releases/2021/s0512-advisory-committee-signing.html)). While 12-15-year-olds account for roughly 5% of the US population, their [ability to transmit the virus is thought to increase with age](https://www.pnas.org/content/pnas/118/8/e2021830118.full.pdf), and inoculating this age group against COVID-19 will increase immunity as a whole. Reports from clinical trials submitted to the FDA and reviewed by the CDC’s Advisory Committee on Immunization Practices verify the dose used for adults is safe and effective in this younger age group. This means many of the unused vaccine doses can be redirected to inoculate children. **Category:** Covid-19 Policy, Pfizer, Vaccine Manufacturers --- ### [Autoimmune Disease May Not Put You at Higher Risk of COVID-19](https://www.autoimmuneinstitute.org/covid_timeline/autoimmune-disease-may-not-put-you-at-higher-risk-of-covid19/) **Published:** May 24, 2020 **Author:** Elevation **Excerpt:** From what we know thus far, if you have an underlying condition or are taking immunosuppressant medication, you may be at high risk for severe complications. --- ### [Unexpected Discovery in RA](https://www.autoimmuneinstitute.org/covid_timeline/unexpected-discovery-in-ra/) **Published:** May 5, 2019 **Author:** Elevation **Excerpt:** Rheumatoid Arthritis (RA) is a systemic, inflammatory autoimmune disease in which the immune system attacks the synovial membrane of the joints. While exploring the cause of inflammation in rheumatoid arthritis, researchers found that deleting a gene called ELM01 actually decreases, rather than increases, joint inflammation in mice. **Category:** Covid-19 Research Studies --- ### [Molecular and Immunological Evidence for SARS-CoV-2 being the Autoimmune Virus](https://www.autoimmuneinstitute.org/covid_timeline/molecular-and-immunological-evidence-for-sars-cov-2-being-the-autoimmune-virus/) **Published:** June 17, 2022 **Author:** Elevation **Excerpt:** “This extensive immune cross-reactivity between SARS-CoV-2 antibodies and different antigen groups may play a role in the multi-system disease process of COVID-19, influence the severity of the disease, precipitate the onset of autoimmunity in susceptible subgroups, and potentially exacerbate autoimmunity in subjects that have pre-existing autoimmune diseases.” **Category:** Autoimmune Diseases & Covid-19, Covid-19 Antibodies, Covid-19 Research Studies --- ### [Autoantibodies linked to ADs associated with COVID-19](https://www.autoimmuneinstitute.org/covid_timeline/autoantibodies-linked-to-ads-associated-with-covid-19/) **Published:** June 20, 2022 **Author:** Elevation **Excerpt:** Several studies have reported autoantibody production being induced by COVID-19 infection though we still do not understand their full spectrum. This work reinforces the idea that a COVID-19 infection may trigger serious autoimmune disease, “suggesting that this occurs against multiple molecules with key functions in immune and vascular homeostasis such as GPCRs and RAS-related molecules.” **Category:** Autoimmune Diseases & Covid-19, Covid-19 Antibodies, Covid-19 Research Studies --- ### [Vaccines and Autoimmune Disease](https://www.autoimmuneinstitute.org/covid_timeline/vaccines-and-autoimmune-disease/) **Published:** January 12, 2021 **Author:** Elevation **Excerpt:** As distribution continues, experts are working diligently to uncover everything we need to know about the safety and efficacy of the emerging COVID-19 vaccines. The CDC advises the following: “People with autoimmune conditions may receive an mRNA COVID-19 vaccine. However, they should be aware that no data are currently available on the safety of mRNA COVID-19 vaccines for them. Individuals from this group were eligible for enrollment in clinical trials.” (1) **Content:** January 12, 2021 As distribution continues, experts are working diligently to uncover everything we need to know about the safety and efficacy of the emerging COVID-19 vaccines. The CDC advises the following: “**People with autoimmune conditions may receive an mRNA COVID-19 vaccine. However, they should be aware that no data are currently available on the safety of mRNA COVID-19 vaccines for them. Individuals from this group were eligible for enrollment in clinical trials**.” ([1](https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/immuno.html)) Despite lingering questions and uncertainties, there is one concern that researchers have been able to adequately address: Do vaccines cause autoimmune diseases? Check out [Deplatform Disease’s article](https://www.deplatformdisease.com/blog/vaccines-and-autoimmune-disease) outlining what we already know about immunological function, autoimmune disease, and the science of vaccines. ([2](https://www.deplatformdisease.com/blog/vaccines-and-autoimmune-disease)) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2021/01/25374138940_1d28f16d75_o-1011x1024.jpg) *Red protein sequences indicate a potential target for vaccines to neutralize the coronavirus.* *Credit: NIH Image Gallery* **Category:** Autoimmune Diseases & Covid-19 --- ### [The P.1 Coronavirus Variant](https://www.autoimmuneinstitute.org/covid_timeline/the-p-1-coronavirus-variant/) **Published:** January 25, 2021 **Author:** Elevation **Excerpt:** A coronavirus variant (called P.1) that was first detected in Brazil was just confirmed by the Minnesota Department of Health as being the first documented case of the variant in the United States. This variant has been particularly worrying scientists because of the mutations it has that let the virus spread faster and evade the immune system more effectively. This evolution could make it easier for COVID-19 survivors to contract the disease again and could potentially impede the effectiveness of vaccines. While this is a daunting premonition, Marion Pepper, an immunologist at the University of Washington, wants us to remember that “even though everyone is obviously concerned about a virus evolving, your memory B cell responsiveness also evolves over time.” **Content:** January 25, 2021 A **coronavirus variant** (called P.1) that was first detected in Brazil was just confirmed by the Minnesota Department of Health as being the first documented case of the variant in the United States. ([1](https://www.health.state.mn.us/news/pressrel/2021/covid012521.html)) This variant has been particularly worrying scientists because of the mutations it has that let the virus spread faster and evade the immune system more effectively. This evolution could make it easier for COVID-19 survivors to contract the disease again and could potentially impede the effectiveness of vaccines. ([2](https://www.npr.org/sections/coronavirus-live-updates/2021/01/25/960566484/a-more-contagious-coronavirus-variant-from-brazil-is-found-in-minnesota)) While this is a daunting premonition, Marion Pepper, an immunologist at the University of Washington, wants us to remember that “even though everyone is obviously concerned about a virus evolving, your memory B cell responsiveness also evolves over time.” ([3](https://www.npr.org/sections/health-shots/2021/01/18/957322501/3-questions-and-the-emerging-answers-about-covid-19-vaccine-protection)) So, let’s talk about these hero **memory B cells** – how do they actually help fight our battles? The main function of the memory B cells is to retain and recall an infection (when presented with one that the body has experienced before) and react accordingly by producing corresponding antibodies. This sounds great, but what about when the body is presented with a new virus variant like the P.1 variant? The way **these cells keep up with ever-evolving viruses is by randomly generating new antibodies that are similar to ones they’ve created in the past**. ([3](https://www.npr.org/sections/health-shots/2021/01/18/957322501/3-questions-and-the-emerging-answers-about-covid-19-vaccine-protection)) This essentially gives our immune system an unlimited defense arsenal. For more information on memory B cells, check out [this great summary](https://askabiologist.asu.edu/memory-b-cell) created at Arizona State University. #####   ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/04/28696835953_4126c05723_o-1-1024x768.jpg)Blue and green colorized scanning electron micrograph of a human B cell. ###### Colorized scanning electron micrograph of a human B cell. Credit: NIAID, NIH **Category:** Covid-19 Infections, Covid-19 Variants --- ### [The B.1.1.7 Coronavirus Variant](https://www.autoimmuneinstitute.org/covid_timeline/the-b-1-1-7-coronavirus-variant/) **Published:** February 11, 2021 **Author:** Elevation **Excerpt:** The B.1.1.7 coronavirus variant was first identified in the UK this past fall, emerging in Colorado soon thereafter. According to the CDC, there have been upwards of 1,000 cases caused by the B.1.1.7 variant across 34 states as of February 9, 2021. California and Florida, two states that have taken vastly different approaches for containing the novel coronavirus, have both reported the highest numbers of B.1.1.7 cases.  **Content:** February 11, 2021 The B.1.1.7 coronavirus variant was first identified in the UK this past fall, emerging in Colorado soon thereafter. According to the [CDC](https://www.cdc.gov/coronavirus/2019-ncov/variants/variant-classifications.html), there have been upwards of 1,000 cases caused by the B.1.1.7 variant across 34 states as of February 9, 2021. California and Florida, two states that have taken vastly different approaches for containing the novel coronavirus, have both reported the highest numbers of B.1.1.7 cases. While a preliminary [report](https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/955239/NERVTAG_paper_on_variant_of_concern__VOC__B.1.1.7.pdf) by the UK government’s NERVT advisory group indicates “there is a realistic possibility that…B.1.1.7 is associated with an increased risk of death,” **research has yet to officially state if the B.1.1.7 variant causes more severe COVID symptoms** ([1](https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/955239/NERVTAG_paper_on_variant_of_concern__VOC__B.1.1.7.pdf)). That being said, this variant has the potential to become the dominant strain of SARS-CoV-2, as its mutation is associated with a higher transmission rate than its predecessors. According to preliminary data, **the B.1.1.7 variant is doubling in frequency every 9-10 days across the U.S.** [Moderna](https://news.modernatx.com/news/news-details/2021/Moderna-Announces-it-has-Shipped-Variant-Specific-Vaccine-Candidate-mRNA-1273.351-to-NIH-for-Clinical-Study/default.aspx) and [Pfizer ](https://www.cam.ac.uk/research/news/pfizer-biontech-vaccine-likely-to-be-effective-against-b117-strain-of-sars-cov-2)have released preliminary data verifying that their vaccines are likely to neutralize the B.1.1.7 variant; however, the efficacy rate may be negatively affected. For regularly updated information and news on coronavirus mutations and variants, check out this [comprehensive tracker](https://www.nytimes.com/interactive/2021/health/coronavirus-variant-tracker.html) created by The New York Times. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/04/49565158953_d638bcf076_o-1024x830.jpg)Scanning electron microscope image of SARS-CoV-2 emerging from the surface of cells. **Category:** Covid-19 Infections, Covid-19 Variants, Moderna, Pfizer, Vaccine Manufacturers --- ### [Autoimmune Diseases Reported to be Triggered by SARS-CoV-2](https://www.autoimmuneinstitute.org/covid_timeline/autoimmune-diseases-reported-to-be-triggered-by-sars-cov-2/) **Published:** March 4, 2021 **Author:** Elevation **Excerpt:** The group at the Zabludowicz Center for Autoimmune Diseases of the Sheba Medical Center and the Laboratory of the Mosaic of Autoimmunity at Saint Petersburg State University have comprehensively investigated and reported the association between various common pathogenic viruses and the development of autoimmune and chronic inflammatory diseases. In light of the current global pandemic, they have also shifted their focus to include a recent (December 2020) review of the appearance of autoimmune diseases reported to be triggered by a SARS-CoV-2 infection. **Content:** March 4, 2021 The group at the [Zabludowicz Center for Autoimmune Diseases](https://www.shebaonline.org/department/the-zabludowicz-center-for-autoimmune-diseases-rheumatology-unit/) of the Sheba Medical Center and the Laboratory of the Mosaic of Autoimmunity at Saint Petersburg State University have comprehensively investigated and reported the association between various common pathogenic viruses and the development of autoimmune and chronic inflammatory diseases. **In light of the current global pandemic, they have also shifted their focus to include a recent (December 2020) review of the appearance of autoimmune diseases reported to be triggered by a SARS-CoV-2 infection.** [(1)](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7598743/) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/04/Screen-Shot-2021-03-03-at-2.10.02-PM-1024x976.png)A list of Autoimmune Diseases and Autoantibodies associated with COVID-19 Infection Table 1: Halpert, G., & Shoenfeld, Y. (2020). [SARS-CoV-2, the autoimmune virus](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7598743/). *Autoimmunity reviews*, *19*(12), 102695. https://doi.org/10.1016/j.autrev.2020.102695 ***To learn more about the autoimmune diseases listed above, check out our [A-Z disease list](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/).*** **Category:** Autoimmune Diseases & Covid-19, Covid-19 Antibodies, Covid-19 Infections, Covid-19 Research Studies, GBS & Covid-19, Lupus & Covid-19, RA & Covid-19 --- ### [Some Immunosuppressants Dampen Vaccine’s Ability to Create Immune Response](https://www.autoimmuneinstitute.org/covid_timeline/some-immunosuppressants-dampen-vaccines-ability-to-create-immune-response/) **Published:** March 24, 2021 **Author:** Elevation **Excerpt:** Last week, researchers at Johns Hopkins released the results of a cohort study measuring the antibody production of 436 solid organ transplant recipients following their first dose of an mRNA vaccine. Immunocompromised patients were excluded from mRNA clinical trials. **Content:** March 24, 2021 Last week, researchers at Johns Hopkins released the results of a cohort study measuring the [antibody production](https://jamanetwork.com/journals/jama/fullarticle/2777685) of 436 solid organ transplant recipients following their first dose of an mRNA vaccine. Immunocompromised patients were excluded from mRNA clinical trials. The results of this study – although they’re exclusive to solid organ transplant recipients – can shed light on antibody production for those on immunosuppressant therapies. Participants collected blood samples at home with a TAII blood collection device or standard venipuncture in a medical office, which was then tested for antibodies against the SARS-CoV-2 spike protein. Tests were conducted 14-21 days after receiving the first dose of the Moderna or Pfizer vaccine. The median time since transplant was 6.2 years, and participants reported taking tacrolimus, corticosteroids, mycophenolate, azathioprine, sirolimus and everolimus as part of their maintenance regimen. Mycophenolate and Azathioprine have antimetabolite agents and can be used to treat autoimmune diseases such as [lupus](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/systemic-lupus-erythematosus/), [rheumatoid arthritis](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/rheumatoid-arthritis/), and IBD ([Crohn’s Disease](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/crohns-disease/) and [Ulcerative Colitis](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/ulcerative-colitis/)) ([1](https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Treatments/Mycophenolate-Mofetil-Mycophenolate-Sodium), [2](https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Treatments/Azathioprine-Imuran)). **Antibodies were detectable in 75 of 436 participants following the first dose of the vaccine. This is approximately 17% of participants. Transplant recipients on antimetabolite therapies like Mycophenolate and Azathioprine were around 5x less likely to develop an antibody response than those not receiving such immunosuppression therapy.** Overall, younger participants who were not under antimetabolite maintenance immunosuppression and received the Moderna vaccine were more likely to develop antibodies. Those who received the Moderna vaccine were more likely to develop antibodies than those who received the Pfizer vaccine (60% versus 31%). While clinical trials observed a 100% antibody response for both the Moderna and Pfizer vaccines, this vast discrepancy shows the **impact of immunosuppressants on the vaccine’s ability to create a robust immune response.** **Vaccine recipients taking immunosuppressants should be made aware that they may still be high-risk to COVID-19**. Dr. Segev, associate vice chair of surgery at Johns Hopkins University School of Medicine and Bloomberg School of Public Health, as well as a co-author of the study, is calling for the CDC to update their guidelines to reflect the ongoing risk immunosuppressed people, as well as certain autoimmune patients, may have to COVID-19 even after vaccination ([3](https://www.medpagetoday.com/infectiousdisease/vaccines/91631)). This study is ongoing and researchers are in the process of collecting data on antibody production after receiving a second dose of the vaccine, as well as T-cell and B-cell responses when antibodies are scarce. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/04/Copy-of-Untitled-2-1.png)3-D rendering of B cell antibodies attacking COVID-19 cell ###### Graphic rendition of yellow B cells (antibodies) attacking a COVID-19 cell **Category:** Autoimmune Diseases & Covid-19, Covid-19 Antibodies, Lupus & Covid-19, Moderna, Pfizer, RA & Covid-19, Vaccine Manufacturers --- ### [Vaccine and Immune Response Efficacy Against SARS-CoV-2 Variants ](https://www.autoimmuneinstitute.org/covid_timeline/vaccine-and-immune-response-efficacy-against-sars-cov-2-variants/) **Published:** April 6, 2021 **Author:** Elevation **Excerpt:** The NIH published a news release on a recent NIAID study evaluating blood samples of COVID-19 patients to determine the efficacy of vaccines and the immune system’s ability to recognize and combat new SARS-CoV-2 variants.  **Content:** April 6, 2021 The NIH published a [news release ](https://www.nih.gov/news-events/news-releases/t-cells-recognize-recent-sars-cov-2-variants)on a recent NIAID study evaluating blood samples of COVID-19 patients to determine the efficacy of vaccines and the immune system’s ability to recognize and combat new SARS-CoV-2 variants. The emergence of new SARS-CoV-2 variants has raised concerns across the scientific community in regard to variant severity. COVID-19 variants are mutations in the SARS-CoV-2 virus, which ultimately make the virus less recognizable to antibodies and have the possibility to impact immune response and vaccine efficacy in future COVID-19 infections. The study focused on CD8+ T cells; these are critical in establishing adaptive immunity against the virus by recognizing and killing viral proteins. The NIAID’s findings determined that the CD8+ T cells **“are largely *not affected* by the mutations found in these variants, and should offer protection against emerging variants.”** Prime immunity through vaccination and antibody creation requires strong CD8+ T cell responses to recognize and protect against evolving SARS-CoV-2 strains. Investigators noted that more research is needed in understanding T cell defense against current and variant strains of SARS-CoV-2. That being said, this study provides a greater understanding of the SARS-CoV-2 virus, which is critical in developing vaccines with high efficacy rates against variants. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/04/24752854106_52d13f1d9e_o-1-1024x768.jpg)Lymphocyte ###### Colorized scanning electron micrograph of a T cell. Credit: NIAID, NIH **Category:** Covid-19 Research Studies, Covid-19 Variants --- ### [COVID and the Development of Autoimmune Thyroid Disease ](https://www.autoimmuneinstitute.org/covid_timeline/covid-19-and-the-development-of-autoimmune-thyroid-disease/) **Published:** May 25, 2021 **Author:** Elevation **Excerpt:** A recent literature review illuminated the association between both relapsing and newly diagnosed thyroid disease, including Grave’s disease, following a COVID-19 infection. Graves’ disease is an autoimmune disease where the immune system attacks the thyroid, causing an overproduction of hormones (hyperthyroidism).  **Content:** May 25, 2021 A recent [literature review](https://academic.oup.com/jes/article/5/8/bvab076/6255554) illuminated the association between both relapsing and newly diagnosed thyroid disease, including [Grave’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/graves-disease/), following a COVID-19 infection. Graves’ disease is an autoimmune disease where the immune system attacks the thyroid, causing an overproduction of hormones (hyperthyroidism). Reports were usually documented one month after a COVID-19 infection. Cases showed that a COVID-19 infection may aggravate autoimmune thyroid disease through the development of a cytokine storm. Read more about cytokine storms, autoimmune disease, and COVID-19 infection in our article that dives into the juxtaposition of both the [Sars-CoV-2 virus and autoimmunity](https://www.autoimmuneinstitute.org/sars-cov-2-autoimmune-virus-long-covid/). ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2021/05/COVID_AD-update-article_Carolyn-11.webp) **Data accumulated in the literature review indicates that the thyroid hormone plays a role in protecting the lungs from injury, including injury from COVID-19.** Only a small fraction of the literature covers patients developing autoimmune hypothyroidism, and it has yet to be determined if these cases preceded infection or were triggered by it. The literature is also unclear whether COVID-19 definitively *increases the risk* of developing autoimmune hypothyroidism. That being said, the “**known association between COVID-19, the development of cytokine release syndrome, and the triggering of autoimmunity support the hypothesis of COVID-19 triggering autoimmune thyroid disease, including autoimmune hypothyroidism.**” There has been an influx of literature covering patients with Graves’ disease (one type of hyperthyroidism), including how these patients may experience enhanced symptoms of both Graves’ disease and COVID-19. **Additionally, around 15% of patients experiencing mild to moderate cases of COVID-19 have experienced thyroid dysfunction.** Researchers from this study are calling out for thyroid function to be routinely assessed when caring for patients with a COVID-19 infection. Further research must be conducted to clarify whether a SARS-CoV-2 infection targeting the thyroid is influenced by patient comorbidities, genetic factors, or disease history. **Category:** Autoimmune Diseases & Covid-19, Covid-19 Infections, Covid-19 Research Studies, Thyroid disease & Covid-19 --- ### [COVID Infection May Lead to Influx of Autoantibody Production](https://www.autoimmuneinstitute.org/covid_timeline/covid-19-infection-may-lead-to-influx-of-autoantibody-production/) **Published:** June 4, 2021 **Author:** Elevation **Excerpt:** Yesterday, The University of Birmingham published the results of a study investigating the autoimmune response of COVID-19 patients. More specifically, researchers explored the type and frequency of autoantibody production in both short and long-term symptoms. Autoantibodies – antibodies produced by the immune system that can cause autoimmune disease by targeting one or more of the body’s own proteins – have recently been of particular interest to researchers looking into COVID-19. To learn more about autoantibodies in the development of autoimmune diseases, check out our article.  **Content:** June 4, 2021 Yesterday, The University of Birmingham published the results of a study [investigating the autoimmune response of COVID-19 patients](https://onlinelibrary.wiley.com/doi/10.1111/cei.13623). More specifically, researchers explored the type and frequency of autoantibody production in both short and long-term symptoms. **Autoantibodies – antibodies produced by the immune system that can cause autoimmune disease by targeting one or more of the body’s own proteins – have recently been of particular interest to researchers looking into COVID-19.** To learn more about [autoantibodies in the development of autoimmune diseases](https://www.autoimmuneinstitute.org/sars-cov-2-autoimmune-virus-long-covid/), check out our article. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2021/06/COVID_AD-update-article_Carolyn-12.webp) In their study, researchers split test subjects into four cohorts to compare the common autoantibodies produced in COVID-19 patients versus non-COVID-19 patients. The first cohort consisted of a control group of non-COVID-19 patients in the intensive treatment unit (ITU). The other cohorts included patients with acute cases of COVID-19 in the ITU and patients with previously severe cases of COVID-19 who had since left the ITU. The final test group included patients with mild cases of COVID-19 who had not been admitted to the ITU. For each of these groups, the researchers tested patient samples for specific autoantibodies. The study, supported by the National Institute for Health Research (NIHR) and UK Research and Innovation (UKRI), found that **COVID-19 patients had significantly more autoantibodies than those in the control group.** The subgroups of COVID-19 patients who exhibited severe active or recovered cases also demonstrated significantly more frequent instances of possessing autoantibodies than the control group. Mild cases exhibited autoantibodies in their system less frequently but still more than the control group. These findings imply that COVID-19 cases are still open-ended and do not necessarily resolve when patients are no longer contagious. **Category:** Autoimmune Diseases & Covid-19, Covid-19 Antibodies --- ### [What is a Sarbecovirus and How Can it Help Protect Us Against Variants?](https://www.autoimmuneinstitute.org/covid_timeline/what-is-a-sarbecovirus-and-how-can-it-help-protect-us-against-variants/) **Published:** September 14, 2021 **Author:** Elevation **Excerpt:** SARS-CoV-2 is a subspecies of virus within the subgenus of sarbecovirus, which are all respiratory viruses. The easiest way to picture the lineage is by thinking of a family tree with a grandparent, parent, and kids. **Content:** September 14, 2021 ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2021/09/sarbecovirus-chart-3-1024x1024.png) SARS-CoV-2 is a subspecies of virus within the subgenus of *sarbecovirus*, which are all respiratory viruses. The easiest way to picture the lineage is by thinking of a family tree with a grandparent, parent, and kids. Here we can see that the “grandparent” is the overarching genus of beta coronaviruses (one of four types of coronaviruses, which include alpha-, gamma-, and delta-). Following the family tree, we can think of the sarbecoviruses as being the “parent” and under that we have the group of “kids” which are the types of coronaviruses we have been battling in recent years (SARS in early 2000, MERS in the mid-2010s, and now COVID-19). They may all be in the same family tree and share a good amount of their genetic material, but as we have learned through the evolution of SARS-CoV-2 variants, they are not all identical. We know this because having COVID-19 does not mean you are protected against SARS or MERS, just as having a SARS or MERS infection does not protect you against COVID-19. In a recent *Nature*[ article](https://www.nature.com/articles/s41586-021-03817-4.pdf)*,* researchers gave a COVID vaccine to a group of individuals who had previously experienced a MERS and SARS infection. They found that the **subjects were not only able to develop antibodies against those viruses, but also another 8-10 of the virus’ variants.** This led the team to explore the idea of developing a vaccine at the “parent” level as opposed to creating multiple vaccines against all the “kids” and their variants. The authors concluded their study by stating “we anticipate \[this\] data will guide future efforts to develop vaccines that overcome the emergence of SARS-CoV-2 variants and that are effective against all sarbecoviruses”. This means that if we focus on developing antibodies and creating vaccines one level up, they may provide protection against all the subtypes of coronaviruses that we are seeing now and may see in the future. **Category:** Covid-19 Research Studies, Covid-19 Variants --- ### [Autoantibodies Driving Severe COVID and the Presence of SARS-CoV-2 RNA in Feces](https://www.autoimmuneinstitute.org/covid_timeline/autoantibodies-driving-severe-covid-and-the-presence-of-sars-cov-2-rna-in-feces/) **Published:** May 23, 2022 **Author:** Elevation **Excerpt:** This Week in Virology podcast discusses the presence of SARS-CoV-2 RNA but not infectious virus in feces, and the association of autoantibodies to interferons with severe COVID-19. **Content:** May 23, 2022 *This Week in Virology* podcast discusses the presence of SARS-CoV-2 RNA but not infectious virus in feces, and the association of autoantibodies to interferons with severe COVID-19. Find the episode here! <https://www.youtube.com/watch?v=Ni6KtUtBZhk&feature=emb_imp_woyt> [![](https://www.autoimmuneinstitute.org/wp-content/uploads/2022/05/Screen-Shot-2022-05-25-at-1.41.00-PM-1024x578-1.jpg)](https://www.youtube.com/watch?v=Ni6KtUtBZhk&feature=emb_imp_woyt) **Category:** Covid-19 Antibodies, Covid-19 Research Studies --- ### [Molnupiravir & Nirmatrelvir/Ritonavir in the Treatment of Systemic Autoimmune Rheumatic Diseases](https://www.autoimmuneinstitute.org/covid_timeline/molnupiravir-nirmatrelvir-ritonavir-in-the-treatment-of-systemic-autoimmune-rheumatic-diseases/) **Published:** July 7, 2023 **Author:** Elevation **Excerpt:** Molnupiravir (MP) and Nirmatrelvir/ritonavir (NM/R) were the first two orally administered antiviral drugs authorized to treat COVID-19. However, the last two phases of clinical trials testing MP and NM/R in COVID-19 were conducted in unvaccinated individuals and before the emergence of the Omicron variant. Additionally, clinical trials didn’t include people suffering from systemic autoimmune rheumatic diseases (SARDs). **Content:** July 7, 2023 Molnupiravir (MP) and Nirmatrelvir/ritonavir (NM/R) were the first two orally administered antiviral drugs authorized to treat COVID-19. However, the last two phases of clinical trials testing MP and NM/R in COVID-19 were conducted in unvaccinated individuals and before the emergence of the Omicron variant. Additionally, clinical trials didn’t include people suffering from systemic autoimmune rheumatic diseases (SARDs). To assess the effectiveness and safety of MP and NM/R treatment in SARD patients, researchers [analyzed data](https://pubmed.ncbi.nlm.nih.gov/36521909/) from 74 (mostly vaccinated) patients with SARDs (findings were published in December 2022). Patients were infected with SARS-CoV-2 between February and August 2022 and were treated with MP or NM/R. SARD patients included in the study were most commonly treated with corticosteroids, mycophenolate, TNF inhibitors, methotrexate, and rituximab. Four patients who received NM/R experienced adverse effects: metallic taste, gastrointestinal upset, and hypertension. The majority of treated patients recovered at home without complications. However, two patients experienced COVID-19 “rebound” and experienced severe COVID-19. Upon follow-up, patients’ symptoms resolved. The authors mention that COVID-19 rebound after NM/R  treatment was observed previously and is reported on in earlier studies. Researchers state that the data suggests these two antiviral drugs present acceptable safety profiles among the population of vaccinated high-risk SARD patients infected with the Omicron variant and have been used with positive outcomes. However, it is necessary to monitor patients for cases of COVID-19 rebound. This will allow for gaining better insight into real-world data regarding the efficacy and safety of  MP and NM/R in the SARD population. **Category:** Autoimmune Diseases & Covid-19, Covid-19 & Long Covid Treatments, Covid-19 Research Studies, RA & Covid-19 --- ### [COVID‑19 & Breakthrough Infection in Patients with Systemic Autoimmune and Inflammatory Diseases](https://www.autoimmuneinstitute.org/covid_timeline/covid‑19-breakthrough-infection-in-patients-with-systemic-autoimmune-and-inflammatory-diseases/) **Published:** December 15, 2022 **Author:** Elevation **Excerpt:** Researchers analyzed 10,900 self-reported patient responses from the COVAD online global survey. The survey included data regarding COVID-19 severity and breakthrough infections amongst those with myositis and other systemic autoimmune and inflammatory diseases. **Content:** December 15, 2022 Idiopathic inflammatory myopathies (IIM) are a group of systemic autoimmune disorders, with subgroups such as [dermatomyositis](https://www.autoimmuneinstitute.org/dermatomyositis/) and [polymyositis](https://www.autoimmuneinstitute.org/polymyositis/). COVID-19 infection is of special concern to patients with IIM and other systemic autoimmune and inflammatory diseases (SAIDs), as they often take immunosuppressive and immunomodulatory therapies for co-morbidities related to their disease. While the data is scarce, an additional concern is that immunosuppressive and immunomodulatory therapies may reduce the efficacy of COVID-19 vaccines in these populations. To address these concerns, authors of a [recent study](https://pubmed.ncbi.nlm.nih.gov/36271958/) analyzed 10,900 self-reported patient responses from the COVAD online global survey. The survey included data regarding COVID-19 severity and breakthrough infections (defined as an infection at least two weeks after a first or second dose of the COVID-19 vaccine) in IIM and SAIDs patients, from April to September 2021. Based on the COVAD data, 1.4% of patients with IIM, 1.9% of patients with SAIDs, and 3.2% of healthy controls experienced breakthrough infections. Among 17 IIM patients who experienced breakthrough infection, 13 were on immunosuppressants, and three needed hospitalization. Data analysis showed that using immunosuppressants was associated with a higher risk of breakthrough infection. Participants in the study received at least one dose of a COVID-19 vaccine. Due to the small number of breakthrough cases, authors couldn‘t reliably define whether any specific vaccine type lead to increased chances of breakthrough infection. Among the patients who filled out the survey, 6.2% of unvaccinated IIM patients reported testing positive for COVID-19, less than SAIDs patients (10.5%) or healthy controls (14.6%). The lower number of COVID-19 cases among IIM patients is likely due to the protective measures taken by these patients. That being said, the chance of IIM patients being hospitalized for COVID-19 was higher than healthy controls. For unvaccinated responders, 30% of IIM patients were hospitalized, compared to 8% of healthy controls. **Category:** Autoimmune Diseases & Covid-19, Covid-19 Infections, Covid-19 Research Studies, Vaccine Manufacturers --- ### [COVID-19 in Patients with Myasthenia Gravis](https://www.autoimmuneinstitute.org/covid_timeline/covid-19-in-patients-with-myasthenia-gravis/) **Published:** December 8, 2022 **Author:** Elevation **Excerpt:** To better understand the effect of a SARS-CoV-2 infection in patients living with Myasthenia Gravis, researchers analyzed 83 Myasthenia Gravis patients who tested positive for COVID-19.  **Content:** December 8. 2022 Infections can exacerbate symptoms of [Myasthenia Gravis](https://www.autoimmuneinstitute.org/myasthenia-gravis/) (MG). To help understand the effect of a SARS-CoV-2 infection in this population, [researchers](https://pubmed.ncbi.nlm.nih.gov/36174408/) in Iran analyzed 83 MG patients who tested positive for COVID-19. Among the patients in the study, 42% needed hospitalization, 14.5% were admitted to the ICU, and 5% required mechanical ventilation. 80% of hospitalized patients recovered without complications and did not require rehabilitation or nursing care after leaving the hospital. COVID-19 infection exacerbated MG symptoms in 19% of patients for 15 days on average. 75% of patients who experienced disease worsening also experienced relief from complications after treatment; two patients died, and two needed rehabilitation and the help of a skilled nurse after leaving the hospital. Analyzed data suggests that exacerbation of MG symptoms was not associated with thymoma, patients’ age, co-morbidities, or duration of disease. Still, older patients or those with a history of thymoma were more susceptible to hospitalization. Researchers note that patients who took immunosuppressive drugs were more likely to be hospitalized. At the same time, those who received prednisolone were less likely to be hospitalized. Despite immunosuppressive drugs increasing the likelihood of hospitalization, patients who left the hospital did not require any nursing or rehabilitation. Due to this, authors recommend that baseline immunosuppressive therapy should be continued during the course of COVID-19 infection. **Category:** Autoimmune Diseases & Covid-19, Covid-19 Infections, Covid-19 Research Studies, Myasthenia gravis & Covid-19 --- ### [Risk of Glomerular Disease Relapse Following COVID-19 Vaccination](https://www.autoimmuneinstitute.org/covid_timeline/risk-of-glomerular-disease-relapse-following-covid-19-vaccination/) **Published:** December 5, 2022 **Author:** Elevation **Excerpt:** Researchers in British Columbia, Canada, conducted a retrospective cohort study with 1,105 adult patients to determine the risk of glomerular disease relapse following COVID-19 vaccination. **Content:** December 5, 2022 Authors of a recent [study](https://jasn.asnjournals.org/content/33/12/2247.abstract) aimed to determine the risk of glomerular disease relapse following COVID-19 vaccination. Researchers looked at a group of 1,105 people living in Canada suffering from biopsy-confirmed glomerular disease, including membranous nephropathy, [IgA nephropathy](https://www.autoimmuneinstitute.org/iga-nephropathy/), [Lupus Nephritis](https://www.autoimmuneinstitute.org/lupus-nephritis/), [ANCA Glomerulonephritis](https://www.autoimmuneinstitute.org/microscopic-polyangiitis-anca-associated-vasculitis/), and [C3 Glomerulonephritis](https://www.autoimmuneinstitute.org/glomerulonephritis/). Vaccines most commonly used among patients were Pfizer (67%) and Moderna (30%), and researchers communicated with patients for 281 days, during which 92% of patients received at least 1 dose of a COVID-19 vaccine, and 89% received two or three doses. Within that time, 12.1% of patients experienced a relapse, which was confirmed via blood and urine tests. “Proteinuria increased at the time of relapse in all types of glomerular disease.” Among patients who received at least two vaccine doses, 87% received two doses of the same type, 10% received a mixed regimen, and 3% received AstraZeneca’s COVID-19 vaccine with either Moderna or Pfizer. The authors concluded that there was no association between the first dose of the vaccine and disease flare. While receiving subsequent (second and third) doses increased the risk of relapse, the *absolute risk* was low (between 1% to 5%), depending on the disease type. There was no association between the risk of relapse and the type of COVID-19 vaccine. Among the 1,105 patients in the study, 24 experienced a vaccine-associated relapse within 30 days post-vaccination. Only four patients needed a change in immunosuppression or a repeat kidney biopsy, suggesting that symptoms associated with relapse were mild for the majority of patients. **Category:** AstraZeneca, Covid-19 Boosters, Covid-19 Research Studies, Moderna, Pfizer, Vaccine Adverse Events, Vaccine Manufacturers --- ### [COVID-19 Vaccine Responses in Autoimmune Liver Disease Patients](https://www.autoimmuneinstitute.org/covid_timeline/covid-19-vaccine-responses-in-autoimmune-liver-disease-patients/) **Published:** December 1, 2022 **Author:** Elevation **Excerpt:** Researchers conducted a prospective observational study with autoimmune liver disease patients to determine the effect of immunosuppressive drugs on antibody production after being vaccinated against COVID-19. **Content:** December 1, 2022 [Researchers](https://pubmed.ncbi.nlm.nih.gov/36275639/) conducted a prospective observational study of 76 autoimmune liver disease (AILD) patients, with about half receiving immunosuppressive medications. Participants included in the study did not have a COVID-19 infection prior to being vaccinated, and received a full course of either Sinopharm’s BBIBP-CorV or Sinovac’s CoronaVac COVID-19 vaccine. AILD patients were compared against a control group of 136 healthy participants. Scientists measured the antibody response in AILD patients compared to the control group. 97.4% of AILD patients and 100% of healthy people produced anti-RBD-IgG (an antibody against the spike protein receptor-binding domain of SARS-CoV-2) after vaccination. However, AILD patients taking immunosuppressants had significantly lower levels of anti-RBD-IgG. Similarly, neutralizing antibodies (antibodies that neutralize the biological effects of a virus, making it no longer capable of causing disease) were produced in smaller amounts in AILD patients. Only 63.2% of AILD patients produced neutralizing antibodies; 84.6% of people in the control group produced neutralizing antibodies. Researchers note that immunosuppressive drug therapy in AILD patients was responsible for the reduced number of neutralizing antibodies. “Regardless of immunosuppressants, the SARS-CoV-2-specific memory B cells responses were comparable between the AILD and \[health controls\].” Observed adverse effects caused by the vaccination were mild, and included pain at the injection site. Symptoms resolved within days. This study had a few limitations, including a small number of participants, lack of longitudinal antibody testing to assess changes in the antibody levels over time, and testing only at the part of the immune response. However, results still provide initial data regarding AILD patient responses to COVID-19 vaccination. **Category:** Autoimmune Diseases & Covid-19, Covid-19 Antibodies, Covid-19 Research Studies, Vaccine Adverse Events, Vaccine Manufacturers --- ### [COVID-19 Vaccination and Uveitis Relapse](https://www.autoimmuneinstitute.org/covid_timeline/covid-19-vaccination-and-uveitis-relapse/) **Published:** November 10, 2022 **Author:** Elevation **Excerpt:** Scientists analyzed a group of 438 participants with a history of uveitis who received at least one dose of the COVID-19 vaccine but had no history of previous COVID-19 infection. **Content:** November 10, 2022 [Uveitis](https://www.autoimmuneinstitute.org/autoimmunity-and-the-eyes-a-spotlight-on-uveitis/) is a vision-threatening inflammation of the eye associated with multiple autoimmune diseases. Several studies have suggested that COVID-19 vaccination can lead to the relapse of uveitis. However, this event is sporadic (0.9 cases per million vaccine doses). Recently, scientists studied factors influencing the risk of uveitis relapse in patients with a history of uveitis ([1](https://pubmed.ncbi.nlm.nih.gov/36209692/#:~:text=A%20total%20of%2039%20episodes,range%2C%201%20to%2014%29.)). The study included 438 participants with a history of uveitis who received at least one dose of the COVID-19 vaccine but had no history of previous COVID-19 infection. Since the study was conducted in China, participants received one of the vaccines available in China at the time (Sinovac, Sinopharm, CanSino, and Zhifei). Uveitis relapse occurred in 34 of the participants within 15 days post-vaccination. Analysis of the study group revealed that there was *no increased risk* of uveitis between the four vaccines. However, if study participants received glucocorticoids at the time of vaccination, the risk of uveitis *decreased*. The mechanism behind post-vaccination flares is not properly understood, but it seems to be linked to a hyperactive immune system or inflammatory processes. Authors of this study suggest that the use of corticosteroids may help with the hyperactivity of the immune system following the COVID-19 vaccine. They highlight other studies showing that post-vaccination uveitis responds well to corticosteroid therapy. Authors cite earlier studies pointing to glucocorticoid use increasing the risk of COVID-19 infection, hospitalization, and death in patients with a history of uveitis. However, those studies were conducted in 2020 when vaccines were not available. Authors state that uveitis patients would benefit from further studies analyzing the risks and benefits of using glucocorticoids at the time of vaccination. Additional studies are also needed to see if the relapse events occur when different COVID-19 vaccines are used and to establish causation that vaccination is responsible for uveitis relapse. **Category:** Covid-19 Research Studies, Vaccine Adverse Events, Vaccine Manufacturers --- ### [COVID-19 in Patients with Behçet's disease](https://www.autoimmuneinstitute.org/covid_timeline/covid-19-in-patients-with-behcets-disease/) **Published:** November 9, 2022 **Author:** Elevation **Excerpt:** Behçet's disease patients are usually on long-term therapy with colchicine, TNF inhibitors, or glucocorticoids; a recent study aimed to understand the prevalence of COVID-19-related clinical outcomes in Behçet's disease patients treated with these therapies. **Content:** November 9, 2022 The authors of a [recent study](https://pubmed.ncbi.nlm.nih.gov/35058051/) aimed to understand the prevalence of COVID-19-related clinical outcomes in patients with [Behçet’s disease](https://www.autoimmuneinstitute.org/behcets/) treated with colchicine, TNF inhibitors, or glucocorticoids. The study included an online questionnaire with 244 Behcet’s disease patients, 36 (14.75%) of which were infected with SARS-CoV-2. The infection rate among Behçet’s disease patients was higher than the rate in the general population in Spain (5.8%), where the study took place. In patients who took colchicine at the dose of 0.5 mg/day, researchers observed a lower prevalence of ageusia (loss of taste) than in patients taking 1.5 mg/day of colchicine. Patients taking TNF inhibitors had a higher prevalence of dyspnea (shortness of breath) compared to those not taking TNF inhibitors, but there was no difference regarding analyzed COVID-19 symptoms found in patients taking oral glucocorticoids. Even though the study gives a first glance at the COVID-19 outcomes in Behçet’s disease patients, the authors admit that the study results need to be analyzed with caution as the results are preliminary and the study has limitations, including a small sample size and bias due to the online questionnaire. Additionally, the authors did not collect information on daily doses of TNF inhibitors, oral glucocorticoids or other medications taken by patients, which could influence the results. **Category:** Autoimmune Diseases & Covid-19, Covid-19 Infections, Covid-19 Research Studies --- ### [SARS-CoV-2 Vaccination in Patients with Primary and Secondary Immunodeficiency ](https://www.autoimmuneinstitute.org/covid_timeline/sars-cov-2-vaccination-in-patients-with-primary-and-secondary-immunodeficiency/) **Published:** November 8, 2022 **Author:** Elevation **Excerpt:** A recent study investigated COVID-19 outcomes in patients with primary and secondary immunodeficiency, comparing hospitalization rates and mortality between both vaccinated and unvaccinated patients. **Content:** November 8, 2022 A [recent study](https://pubmed.ncbi.nlm.nih.gov/36211396/), conducted in the UK, aimed to understand the risks associated with COVID-19 vaccination, monoclonal antibodies, and antiviral therapies in patients with primary and secondary immunodeficiency. Since people with immunodeficiency often experience impaired vaccine responses, investigating real-world vaccine efficacy in this group of patients is essential, especially since they are considered at-risk for severe COVID-19. Researchers compared two groups of patients: the first group included patients infected with SARS-CoV-2 before vaccines became available, and the second group included patients who were infected after SARS-CoV-2 vaccines were widely distributed. In this second group, participants received an average of 2.73 vaccines at the time of infection. Hospitalization rates for patients with primary immunodeficiency who had access to vaccines were 17.9%, compared to 53.3% for the unvaccinated group. Similarly, mortality rates improved in the second group (3.4%) compared to 20% in the group of unvaccinated patients. Patients with secondary immunodeficiency also showed improvements. In the group that had access to vaccines, researchers observed an 18.4% hospitalization rate compared to 75.8% amongst unvaccinated patients. Similarly, mortality improved from 33.3% to 7.89%. As vaccines became available, COVID-19 treatments also improved. To determine the effectiveness of COVID-19 vaccination, excluding other factors, researchers compared the unvaccinated group with people who were vaccinated but didn’t receive any pharmacological treatment upon infection. Once again, hospitalization and mortality rates improved. Researchers also considered the differences between SARS-CoV-2 variants, specifically Omicron, which is believed to be more transmissible but causes less severe symptoms. They compared patients from the second group who had access to vaccines, who were infected with Omicron, to those infected with other variants. They observed lower hospitalization rates for patients infected with Omicron (41.5% vs. 9.9%, respectively) and lower mortality (9.8% vs. 2.7%, respectively). This could be due to boosters being readily available during the Omicron wave compared to periods where other variants were prevalent. Overall, researchers observed improvements in COVID-19 outcomes in patients with immunodeficiency. They suggest that these improvements are most likely caused by several factors alongside vaccination, including therapeutics, the emergence of potentially less virulent SARS-CoV-2 variants, and non-pharmacological interventions, such as restricting social interactions. **Category:** Covid-19 & Long Covid Treatments, Covid-19 Boosters, Covid-19 Infections, Covid-19 Research Studies, Covid-19 Variants, Vaccine Manufacturers --- ### [Long COVID & Systemic Autoimmune Rheumatic Diseases](https://www.autoimmuneinstitute.org/covid_timeline/long-covid-systemic-autoimmune-rheumatic-diseases/) **Published:** November 1, 2022 **Author:** Elevation **Excerpt:** Those suffering from systemic autoimmune rheumatic diseases have an increased risk of severe outcomes from a COVID-19 infection. Due to factors such as altered immunity or the use of immunosuppressive medications, they may also be at risk of developing Long COVID. **Content:** November 1, 2022 Altered immunity and the use of immunosuppressive medications are factors which increase the risk of Long Covid in those suffering from systemic autoimmune rheumatic diseases (SARDs). A [recent study](https://pubmed.ncbi.nlm.nih.gov/36104117/) investigated prolonged COVID-19 symptoms in SARDs patients using data from the Global Rheumatology Alliance Vaccine Survey. Researchers identified 441 people who suffered from systemic autoimmune rheumatic diseases and COVID-19. Patients with [Rheumatoid Arthritis](https://www.autoimmuneinstitute.org/rheumatoid-arthritis/), [Systemic Lupus Erythematosus](https://www.autoimmuneinstitute.org/systemic-lupus-erythematosus/), [Sjögren’s syndrome](https://www.autoimmuneinstitute.org/sjogrens-syndrome/), [Psoriatic Arthritis](https://www.autoimmuneinstitute.org/psoriatic-arthritis/), and [Antiphospholipid syndrome](https://www.autoimmuneinstitute.org/antiphospholipid-syndrome/) were included in the study. 82% of participants were on at least one disease-modifying antirheumatic drug (DMARD) at time of survey, including methotrexate, antimalarials and TNF-inhibitors. Out of 441 people, 107 suffered prolonged symptom duration of 28 days or longer, and 42 experienced symptoms for more than 90 days. However, the overhaul median symptom duration was 15 days. In comparison, Covid symptoms are usually between 7 and 12 days in the general population. When analyzing the group that experienced 28 days or longer symptom duration, researchers did not observe statistical associations of SARD types with prolonged symptom duration. However, prolonged COVID-19 symptoms were associated with fibromyalgia in the group that experienced symptoms for 90 days or longer. Factors associated with prolonged COVID-19 symptoms included: severe COVID-19, hospitalization, number of co-morbidities, and osteoarthritis. Additionally, the onset of COVID-19 between January and July 2021 (compared to June 2020 or earlier) correlated with lower chances of prolonged COVID-19 symptom duration. Several factors can influence this observation. In  2021, patients had access to COVID-19 vaccines and treatments, e.g., monoclonal antibodies. Additionally, COVID-19 variants may have influenced the possibility of developing prolonged COVID-19 symptoms. It is possible that recall bias could also have affected results, as people who most recently had COVID-19 could more accurately report the duration of the symptoms. This could be an issue as the survey for this study relied on self-reporting. Further studies are needed to define what treatments and disease management options are best for these patients. **Category:** Autoimmune Diseases & Covid-19, Covid-19 Research Studies, Long COVID, Lupus & Covid-19, RA & Covid-19, Sjögren disease & Covid-19 --- ### [Treating COVID-19 with Anti-inflammatory Medications](https://www.autoimmuneinstitute.org/covid_timeline/treating-covid-19-with-anti-inflammatory-medications/) **Published:** October 24, 2022 **Author:** Elevation **Excerpt:** Authors of a recent study looked into the effects of NSAIDs and corticosteroids on inflammation from SARS-CoV-2 infection, as well as their ability to reduce disease progression, including hospitalization. **Content:** October 24, 2022 Researchers and physicians are developing strategies to decrease the inflammatory response in the early stages of COVID-19 ([1](https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(22)00433-9/fulltext)). One possibility is using anti-inflammatory drugs, like non-steroidal anti-inflammatory drugs (NSAIDs), as an early treatment. NSAIDs are commonly used worldwide to reduce pain or fever, e.g., ibuprofen, or to treat inflammatory diseases, such as osteoarthritis and [rheumatoid arthritis](https://www.autoimmuneinstitute.org/rheumatoid-arthritis/). NSAIDs inhibit the COX-1 and COX-2 proteins, which are essential for the formation of molecules called prostanoids. Prostanoids have many functions within the body, including involvement in inflammatory processes. There is emerging evidence that coronaviruses, including SARS-CoV-2, activate COX-1 and COX-2 genes, leading to increased prostanoids levels. Studies also suggest that prostanoids may be an important player in SARS-CoV-2 infection, and aiming to reduce prostanoids levels in the early stages of infection can be a useful treatment strategy. Researchers are looking at different NSAID doses and regimens that could be applied as an early at-home COVID-19 treatment; however, these are often observational, small sample studies that involve other drugs combined with NSAIDs. Nevertheless, the results are encouraging and point to NSAIDs (especially COX-2 inhibitors) as a possible treatment for early COVID-19 that could help reduce disease progression, including severe disease. A different group of anti-inflammatory drugs is corticosteroids, widely used to treat chronic inflammatory and autoimmune diseases. They have different molecular ways of suppressing inflammation to NSAIDs; thus, their effects on COVID-19 patients can also differ. The small amount of data that has been provided so far shows the use of systemic corticosteroids during the early phases of COVID-19 having delayed recovery and worse outcomes. On the flip side, using corticosteroids during late, inflammatory stages of severe COVID-19 can have a beneficial effect. Due to the small number of studies, optimal treatment regimens have not been defined. While the authors of this scientific paper made recommendations regarding anti-inflammatory drug doses and treatment length for multiple early COVID-19 treatment strategies, *patients should always consult their doctor regarding their COVID-19 treatment plan*, as the timing, dose, and length of treatment is dependent upon a person’s individual medical profile, and should be considered against any other medications they may be taking. **Category:** Autoimmune Diseases & Covid-19, Covid-19 & Long Covid Treatments, Covid-19 Infections, Covid-19 Research Studies --- ### [SARS-CoV-2 Vaccination in Patients with Multiple Sclerosis](https://www.autoimmuneinstitute.org/covid_timeline/sars-cov-2-vaccination-in-patients-with-multiple-sclerosis/) **Published:** October 19, 2022 **Author:** Elevation **Excerpt:** A survey-based study analyzed vaccination reactions and disease deterioration after SARS-CoV-2 vaccination among more than 6,000 MS patients in Germany and the United Kingdom. **Content:** October 19, 2022 Patients with chronic diseases like [Multiple Sclerosis](https://www.autoimmuneinstitute.org/multiple-sclerosis/) (MS) were excluded from SARS-CoV-2 vaccination trials. At the same time, vaccination is recommended for this vulnerable population. A survey-based [study](https://www.thelancet.com/journals/lanepe/article/PIIS2666-7762(22)00198-3/fulltext) recently published in *The Lancet* analyzed vaccination reactions and disease deterioration after SARS-CoV-2 vaccination among more than 6,000 MS patients in Germany and the United Kingdom. The most frequently used vaccines in Germany were by Pfizer and Moderna, while in the UK, the majority of people included in the study received AstraZeneca’s COVID-19 vaccine. The most common vaccination reactions recorded in the study were fatigue, headache, and pain at the injection site; reactions were observed more frequently in women than in men. 19% of study participants from Germany experienced worsened MS symptoms or the onset of new symptoms. The most common reported symptom was fatigue, followed by impaired mobility and pain. Gender-specific differences were not observed. Researchers hypothesized a few reasons for worsened symptoms or the uptick in new symptoms: 1. Worsened MS symptoms or the onset of new symptoms were associated with moderate or severe disability. Authors hypothesized that since more disabled patients have more severe disease progression, this may correlate with the perception of worsened or new symptoms. 2. Lack of DMD treatment (disease-modifying drugs), which also correlated with worsened MS symptoms or new symptoms, may result in a more robust immune response to vaccination. 3. There is a possibility that people who experienced more severe symptoms were more likely to follow up during the study. In contrast, those who did not experience negative reactions were less likely to follow up with the survey, creating bias in reporting. Authors of the study could not determine whether vaccination *directly caused* the worsening or onset of new symptoms. Additional research and improved study design could help to answer those questions. Authors mentioned that it would be worth comparing vaccinated MS patients with unvaccinated MS patients to determine whether the worsening of MS symptoms is associated with vaccination status. The authors also point out the need for longitudinal studies to determine the prevalence of long-term vaccination reactions and MS deterioration. **Category:** AstraZeneca, Autoimmune Diseases & Covid-19, Covid-19 Research Studies, Moderna, MS & Covid-19, Pfizer, Vaccine Adverse Events, Vaccine Manufacturers --- ### [Risk of Severe COVID-19 in those with IMIDs](https://www.autoimmuneinstitute.org/covid_timeline/risk-of-severe-covid-19-in-those-with-imids/) **Published:** October 17, 2022 **Author:** Elevation **Excerpt:** In a recent study, researchers evaluated whether the patients suffering from various immune-mediated inflammatory diseases (IMIDs) and malignancies had an increased risk of severe COVID-19. **Content:** October 17, 2022 Immunocompromised patients are generally considered to have an increased risk for severe COVID-19. However, studies usually put immunocompromised patients in one category without distinguishing the conditions they suffer from, or they only observe a small subset of patients. In a recent [study](https://pubmed.ncbi.nlm.nih.gov/36153800/), researchers evaluated whether the patients suffering from various immune-mediated inflammatory diseases (IMIDs) and malignancies had an increased risk of severe COVID-19. IMIDs included in the study were [SLE](https://www.autoimmuneinstitute.org/systemic-lupus-erythematosus/), [Psoriasis](https://www.autoimmuneinstitute.org/psoriasis/), [Psoriatic](https://www.autoimmuneinstitute.org/psoriatic-arthritis/) and [Rheumatoid Arthritis](https://www.autoimmuneinstitute.org/rheumatoid-arthritis/), [Crohn’s disease,](https://www.autoimmuneinstitute.org/crohns-disease/) [Ulcerative Colitis](https://www.autoimmuneinstitute.org/ulcerative-colitis/), and [Ankylosing Spondylitis](https://www.autoimmuneinstitute.org/ankylosing-spondylitis/). Researchers analyzed patient data from over 700 hospitals and 7000 clinics across the USA and concluded that the risk of severe COVID-19 was different for patients suffering from various IMIDs. The risk of severe COVID-19 was higher in patients with Rheumatoid Arthritis. On the other hand, the risk of severe COVID-19 was comparable between the general population and patients suffering from SLE, Psoriasis, Ulcerative Colitis, Crohn’s disease, or Ankylosing Spondylitis. Patients with Psoriatic Arthritis had a lower risk for severe disease. It is important to note that authors did not include patient vaccination status in their analysis as access to the COVID-19 vaccine was still limited during the study period. Authors concluded that vaccination status should not have a significant effect on the study’s results and conclusions. Additionally, information on SARS-CoV-2 variants and whether the patients were undergoing immunosuppressive therapies was also not included. **Category:** Autoimmune Diseases & Covid-19, Covid-19 Infections, Covid-19 Research Studies, Lupus & Covid-19, RA & Covid-19 --- ### [Fatigue and Cognitive Impairment in Long Covid Patients](https://www.autoimmuneinstitute.org/covid_timeline/fatigue-and-cognitive-impairment-in-long-covid-patients/) **Published:** October 10, 2022 **Author:** Elevation **Excerpt:** A subset of COVID-19 patients have been observed to develop post-COVID syndrome - a collection of symptoms that develop during or after COVID-19 that lasts longer than 12 months. Researchers in Germany asked whether fatigue and cognitive impairment are indeed associated with a COVID-19 infection, and whether fatigue and cognitive impairment are separate conditions or appear together in the same cohort of patients. **Content:** October 10, 2022 In a recent [study](https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(22)00381-9/fulltext), researchers asked whether fatigue and cognitive impairment are indeed associated with a COVID-19 infection, and whether fatigue and cognitive impairment are separate conditions or appear together in the same patients. 969 people with a history of COVID-19 infection at least six months prior to the study were compared to a group of people who were not infected with COVID-19. Study results showed that 19% of people who had COVID-19 suffered from clinically relevant fatigue; this figure fell to 8% for those without prior COVID-19 infection. Acute COVID-19 symptoms – especially altered consciousness, dizziness, and myalgia (muscle pain) – were associated with a higher likelihood of fatigue. Factors such as female sex, younger age, and history of depression were also associated with post-COVID fatigue. The authors observed that fatigue severity decreased over time; however, more extended and detailed studies are needed to confirm this trend. Cognitive impairment was also a more prevalent symptom among people who suffered from COVID-19, with 26% of patients experiencing mild and 1% experience moderate cognitive impairment. However, the factors associated with cognitive impairment differed from those associated with fatigue. Cognitive impairment was associated with factors such as older age, male sex, and a history of neuropsychiatric diseases. Researchers concluded that fatigue and cognitive impairment are more frequent in people who suffer from COVID-19, but these two conditions are separate and triggered by different molecular mechanisms. While the authors did not investigate this further, they highlight the possible connection between post-COVID fatigue, inflammation markers, and autoimmune disease. They point out that there is evidence that fatigue and increased autoimmunity are frequent consequences of infection from several viruses, including SARS-CoV-1, MERS, Epstein-Barr, herpes, and hepatitis viruses. Fatigue is also a symptom of several autoimmune diseases, including multiple sclerosis, and evidence suggests a correlation between COVID-19 symptoms and inflammation markers. The authors recommend further studies to shed more light on these emerging connections. **Category:** Autoimmune Diseases & Covid-19, Covid-19 Infections, Covid-19 Research Studies, Long COVID, ME/CFS & Covid-19 --- ### [COVID-19 Outcomes in Myasthenia Gravis Patients](https://www.autoimmuneinstitute.org/covid_timeline/covid-19-outcomes-in-myasthenia-gravis-patients/) **Published:** October 6, 2022 **Author:** Elevation **Excerpt:** Symptoms related to COVID-19 infections such as systemic inflammation, neurological complications, and a dysregulated immune response can lead to worse clinical outcomes for patients with Myasthenia Gravis (MG). Researchers conducted an observational retrospective study to measure COVID-19 outcomes in these patients, especially in regard to exacerbation of MG symptoms. **Content:** October 6, 2022 Researchers in Iran conducted an observational retrospective [study](https://www.sciencedirect.com/science/article/pii/S0303846722003225?via%3Dihub) to measure COVID-19 outcomes in patients previously diagnosed with [Myasthenia Gravis](https://www.autoimmuneinstitute.org/covid-19-outcomes-in-myasthenia-gravis-patients/) (MG). COVID-19 infections can cause systemic inflammation, severe respiratory and neurological symptoms, and trigger a dysregulated immune response. These complications can lead to worse clinical outcomes for MG patients. In total, 83 patients were included in the study between April 2020 and August 2021, with the average patient being 45 years old. 67 patients were classified as having generalized MG and 16 patients were classified as having ocular MG. 35 patients had co-morbidities including hypothyroidism, [Systemic Lupus Erythematosus](https://www.autoimmuneinstitute.org/systemic-lupus-erythematosus/), Immunodeficiency disease, [Rheumatoid Arthritis](https://www.autoimmuneinstitute.org/rheumatoid-arthritis/), [Multiple Sclerosis](https://www.autoimmuneinstitute.org/multiple-sclerosis/), and [Sarcoidosis](https://www.autoimmuneinstitute.org/sarcoidosis/). During the study period, 35 of 83 (42.1%) patients were admitted to the hospital, with 12 patients entering the ICU and 4 patients being intubated. 16 patients experienced exacerbated MG symptoms. “Two patients with exacerbation died and two patients were discharged with rehabilitation or skills nursing… There was no significant difference between exacerbation and clinical outcome of discharge patients after hospitalization.” Researchers highlight that there was no significant relationship between the rates of hospitalization and co-morbidities. Regarding MG therapy at the time of infection, “there was no significant difference between those who stopped or continued \[the oral immunosuppressant azahioprine\] regarding hospitalization, MG exacerbation, and death.” At the time of the study, 70 patients were taking prednisone, 34 were taking a second oral immunosuppressant, and 12 patients were taking Rituximab. Two patients were receiving  monthly intravenous immunoglobulin. Overall, researchers found clinical outcomes to be “favorable” within this cohort as 80% of patients did not experience exacerbated MG symptoms, and the majority of patients were not hospitalized. **Category:** Autoimmune Diseases & Covid-19, Covid-19 Infections, Covid-19 Research Studies, Lupus & Covid-19, MS & Covid-19, Myasthenia gravis & Covid-19, RA & Covid-19 --- ### [Omicron Breakthrough Infections in IMID Patients](https://www.autoimmuneinstitute.org/covid_timeline/omicron-breakthrough-infections-in-imid-patients/) **Published:** October 4, 2022 **Author:** Elevation **Content:** October 4, 2022 Researchers in Amsterdam conducted a [study](https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(22)00221-1/fulltext#:~:text=SARS%2DCoV%2D2%20omicron%20breakthrough,%25%5D%20of%20210%20healthy%20controls%3B) to compare the severity of Omicron SARS-CoV-2 breakthrough infections in patients with immune mediated inflammatory diseases (IMID) versus healthy controls. IMID patients were invited to participate between April 2020 and March 2021, and were requested (but not obligated) to recruit a healthy control of same sex and similar age within a five year range. In total, 1882 patients with IMIDs and 708 health controls were included in the study. Online questionnaires were distributed to participants for demographic and clinical data, and to document breakthrough infections four times within the designated time frame. “Breakthrough infections were classified as delta or omicron SARS-CoV-2 infections on the basis of publicly available data on the predominant circulating SARS-CoV-2 variant in the Netherlands at the time.” 431 IMID patients (23%) and 210 (30%) controls experienced a breakthrough infection, with 304 of 431 IMID patients and 142 of 210 controls having received a SARS-CoV-2 vaccine dose within 3 months of infection. Hospitalization was required by five IMID patients and in one healthy control. One IMID patient who experienced a breakthrough infection and was treated with anti-CD20 therapy died; three of the five hospitalized patients with a breakthrough infection were on anti-CD20 therapy generally. Researchers found that “patients with immune-mediated inflammatory diseases are less frequently hospitalized when infected with the SARSCoV-2 omicron variant than with previous variants.” Researchers also found that a history of COVID-19 infection and a third vaccine dose were associated with a lower risk of experiencing breakthrough infection in both the control group and IMID patients. **Category:** Autoimmune Diseases & Covid-19, Covid-19 Infections, Covid-19 Research Studies, Covid-19 Variants --- ### [SLE Flares Post COVID-19 Vaccine](https://www.autoimmuneinstitute.org/covid_timeline/sle-flares-post-covid-19-vaccine/) **Published:** September 29, 2022 **Author:** Elevation **Excerpt:** A study in Japan analyzed the association between mRNA Covid-19 vaccination and medium-term SLE flare-ups. At 30 days after completion of a primary series, the rate of mild or moderate SLE flares was 20.3% within the vaccinated group, versus 23.3% in the unvaccinated group. Flare rates at 60 and 90 days were similar between both groups.  **Content:** September 29, 2022 A [study](https://pubmed.ncbi.nlm.nih.gov/35961691/) published in *Lupus Science & Medicine* analyzed the association between mRNA Covid-19 vaccination and [SLE](https://www.autoimmuneinstitute.org/systemic-lupus-erythematosus/) flare-ups using subjective and objective methods of measuring disease activity. 74 patients with SLE who received a COVID-19 primary series (Pfizer or Moderna) were each matched with an unvaccinated SLE patient (74 total). Co-morbidities included [Rheumatoid Arthritis](https://www.autoimmuneinstitute.org/rheumatoid-arthritis/), [Sjogren’s Syndrome](https://www.autoimmuneinstitute.org/sjogrens-syndrome/), and [Mixed Connective Tissue Disease](https://www.autoimmuneinstitute.org/mixed-connective-tissue-disease/). “There were no significant differences in patients’ characteristics, including age, sex, disease duration and medications, between the two groups. The baseline serological disease activity and disease activity scores did not differ. In the vaccinated group, 16 out of 74 (21%) patients had high disease activity.” Using three methods to measure disease activity – including the SLE Disease Activity Index-2000 (SLEDAI-2K) and a variation of the SLE Symptom Checklist Questionnaire – researchers measured flares at the 30, 60, and 90 day mark after a completed primary series. Disease activities were also assessed prior to first vaccination and after the second vaccination; disease activities up to three months prior to the initial index date were used as a baseline for each patient. “The quantitative changes in the SLEDAI-2K scores from the prefirst vaccination baseline to 30 days after the second vaccination were not significantly different between the vaccinated and unvaccinated groups.” Results were similar after adjusting for sex, age, SLEDAI-2K at baseline, and the use of immunosuppressive therapies or biologics (amongst others, including Glucocorticoids). The rate of mild or moderate SLE flares 30 days after the completion of a primary series was 20.3% within the vaccinated group, versus 23.3% in the unvaccinated group. Flare rates at 60 and 90 days were similar between both groups. “Serological disease activity indices showed no clinically significant differences at 30 days after vaccination.” However, platelet count was lower and C3 (protein activity) was higher in the vaccinated group compared to the unvaccinated group. Simply put, high C3 complement levels indicate an inflammatory response. While symptoms like arthritis and joint pain have been previously observed as the most common short-term symptoms following vaccination, musculoskeletal symptoms showed no significant difference between both groups in the study. **Category:** Autoimmune Diseases & Covid-19, Covid-19 Research Studies, Lupus & Covid-19, Moderna, Pfizer, RA & Covid-19, Sjögren disease & Covid-19, Vaccine Manufacturers --- ### [RA and SLE-related Autoreactivities Present in Those with COVID-19](https://www.autoimmuneinstitute.org/covid_timeline/ra-and-sle-related-autoreactivities-present-in-those-with-covid-19/) **Published:** September 26, 2022 **Author:** Elevation **Excerpt:** A recent study found antibodies associated with RA and SLE in hospital patients with severe COVID-19. Additionally, one third of long Covid patients included in the study were observed to have elevated levels of autoantibodies for months post initial-infection. **Content:** September 26, 2022 A recent [study](https://www.nature.com/articles/s41586-022-05273-0) was published as an accelerated article preview addressing the origin of autoantibodies by looking at patients with acute infection of SARS-CoV-2. Autoantibodies are a key characteristic of [COVID-19 triggered autoimmunity](https://www.autoimmuneinstitute.org/sars-cov-2-autoimmune-virus-long-covid/), when B-cells self-direct instead of attacking foreign invaders (SARS-CoV-2 cells). At the time of the study, “evidence of autoreactivity was mounting in severe disease, with observations of autoantibody-linked blood clotting, anti-interferon antibodies, connective tissue disease-associated interstitial lung disease, and generalized observations of clinical autoreactivity.” Within the study, anti-nuclear antigens (ANA) and anti-carbmamylated protein responses (CarP) were found in over 40% of the 27 ICU patients with COVID-19. These antibodies are also associated with tissue damage in [RA](https://www.autoimmuneinstitute.org/rheumatoid-arthritis/) and [SLE](https://www.autoimmuneinstitute.org/systemic-lupus-erythematosus/). When compared to ICU patients hospitalized with bacterial pneumonia, auto-reactivity profiles were “highly similar… strongly suggesting that the autoimmune phenomena described in COVID-19 to-date may be generalizable to other severe pulmonary infections.” Autoimmunity is considered to be a [mechanism of long Covid](https://www.autoimmuneinstitute.org/is-long-covid-a-new-autoimmune-disease/). **Researchers found that approximately one third of patients with long Covid had elevated levels of autoantibodies for months post initial-infection.** For most COVID-19 patients, autoantibodies rid themself from the body after the acute infection phase is resolved. However, those with long Covid continued to circulate autoantibodies. What has yet to be studied is whether these autoantibodies are directly contributing to long Covid symptoms, and whether certain therapies can decrease autoantibody counts to thereby decrease symptoms. Researchers also hope to address the development of autoantibodies in regard to viral infections more broadly. **Category:** Autoimmune Diseases & Covid-19, Covid-19 Antibodies, Covid-19 Infections, Covid-19 Research Studies, Long COVID, Lupus & Covid-19, RA & Covid-19 --- ### [Severe COVID-19 in Rheumatoid Arthritis Patients](https://www.autoimmuneinstitute.org/covid_timeline/severe-covid-19-in-rheumatoid-arthritis-patients/) **Published:** September 22, 2022 **Author:** Elevation **Excerpt:** Researchers at the Mayo Clinic ran a retrospective, comparative, multi-center study to determine if specific RA phenotypes may be responsible for poor COVID-19 outcomes. **Content:** September 22, 2022 RA patients have been observed to experience severe COVID-19 at higher rates than those without [rheumatoid arthritis](https://www.autoimmuneinstitute.org/rheumatoid-arthritis/). To further understand this association, researchers at the Mayo Clinic investigated severe COVID-19 and RA phenotypes (observable characteristics) such as rheumatoid arthritis-associated interstitial lung disease, seropositive rheumatoid arthritis, and erosive rheumatoid arthritis, to determine if specific manifestations may be responsible for poor COVID-19 outcomes ([1](https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(22)00227-2/fulltext)). Researchers ran a retrospective, comparative study with RA patients from 33 hospitals and affiliated outpatient centers at the Mayo Clinic and Mass General Brigham. 582 RA patients were compared against 2875 non-RA patients in a comparison group; each RA patient was matched to five patients without recorded RA of similar sex and age. All patients had a positive history of COVID-19 between March 1, 2020 and June 6, 2021, and a follow-up was conducted for each patient within 90 days of a positive SARS-CoV-2 test. Among patients with rheumatoid arthritis, 9% had RA and interstitial lung disease, 68% were seropositive (for rheumatoid factor or anti-CCP), and 25% had bone erosions. 163 and 457 patients were taking glucocorticoids and DMARDs, respectively, at the time of SARS-CoV-2 infection. 63% of patients from both cohorts contracted COVID-19 before vaccines were available. “In adjusted analyses for age, sex, race, and smoking status, patients with rheumatoid arthritis had increased risk of severe COVID-19 compared with patients without rheumatoid arthritis.” This was the same across all phenotype subgroups, especially those with interstitial lung disease. “There was no association when comparing seropositive patients to seronegative patients, or when comparing patients with erosive disease to patients without erosive disease. Patients with rheumatoid arthritis positive for rheumatoid factor or anti-CCP had similarly increased risk of severe COVID-19 compared with patients without rheumatoid arthritis.” Associations overall *decreased* slightly when factoring BMI and co-morbidities. Severe COVID-19 (marked by hospitalization or death) occurred in 22% of RA patients versus 13% in the comparison group. When adjusted for age, sex, race, and smoking status, the risk of hospitalization increased in those with RA versus the comparison group. This association *did not decrease* when factoring BMI and co-morbidities. “The risk of severe COVID-19 among women with rheumatoid arthritis was two-fold higher than women without rheumatoid arthritis… Men with rheumatoid arthritis had no difference in their risk compared with men without rheumatoid arthritis.” While exposure to medications such as Rituximab may impact the severity of COVID-19, due to the nature of this study, researchers were unable to draw associations on disease activity and pharmacologic therapies. Future studies are also needed to assess whether the risk of severe COVID-19 persists in RA patients after being vaccinated. **Category:** Autoimmune Diseases & Covid-19, Covid-19 Infections, Covid-19 Research Studies, RA & Covid-19 --- ### [COVID-19 Vaccine Responses in those with Renal Autoimmune Diseases ](https://www.autoimmuneinstitute.org/covid_timeline/covid-19-vaccine-responses-in-those-with-renal-autoimmune-diseases/) **Published:** September 16, 2022 **Author:** Elevation **Excerpt:** A new study investigated how effective a two-dose SARS-CoV-2 vaccine regimen is for patients receiving Rituximab. Researchers measured the humoral and cellular immune responses, which correlate to antibody and T-cell production, respectively. **Content:** September 16, 2022 A [study](https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-022-07722-7) published earlier this week investigated how effective a two-dose SARS-CoV-2 vaccine regimen is for patients receiving Rituximab. Rituximab and other anti-CD20 B-cell depleting therapies lead to “impaired maturation of memory B-cells and reduced numbers of antibody-producing plasma cells.” Researchers measured the humoral and cellular immune responses, which correlate to antibody and T-cell production, respectively. T-cells drive an overall immune response. The study included 34 patients with autoimmune renal disease – including [ANCA vasculitis](https://www.autoimmuneinstitute.org/microscopic-polyangiitis-anca-associated-vasculitis/) (64.7%), Focal Segmental Glomerulosclerosis (2.9%), Membranous Glomerulopathy (8.8%), Minimal Change Disease (8.8%), [Goodpasture Syndrome](https://www.autoimmuneinstitute.org/goodpastures-syndrome/) (11.8%), and Thrombotic Microangiopathy (11.8%).  COVID-19 vaccines in the study include Pfizer (73.5%), Moderna (2.9%), AstraZeneca (8.8%), and Johnson & Johnson (8.8%). Those with a history of prior COVID-19 infection were excluded from the study, as well as those receiving antimetabolite therapies within two months before vaccination. All patients received two doses of the same vaccine besides two patients who received a mixed regimen. Amongst the cohort, anti-CD20 therapy was either administered every 6 months as part of a standard regimen or prescribed separately for comorbidities. B-cell counts were measured within 5 weeks prior to vaccination, as well as 12 weeks post-vaccination. A humoral response was detected in 11 (32.4%) patients, and cellular response in 23 patients (92%). “One individual had neither response, while an isolated response was observed in another individual. Kidney function, proteinuria, or hematuria, as well as time spans between first and second vaccinations and the time point of testing after vaccination were not altered between response groups.” Kidney function, proteinuria, and hematuria did not correlate with IgG antibodies or IFN-γ (cytokine) release. Patients whose B-cell counts at vaccination correlated with the time from their last Rituximab treatment (having a slight B-cell recovery prior to vaccination) had a significantly higher humoral response. Researchers also found a linear correlation between B-cell counts and IgG antibodies. Patients receiving regular anti-CD20 treatments (every 6 months) had a “significantly lower” B-cell count and IgG antibody levels. This shows a strong correlation between humoral response and B-cell counts in regard to the time interval between last Rituximab treatment and vaccination. Researchers did not observe “reduced kidney function to be a statistically significant risk factor for impaired vaccination response. However, parallel studies report reduced response to mRNA SARS-CoV-2 vaccines in subjects with both chronic and end stage renal disease.” There were also no significant differences in the humoral response in patients receiving vaccines amongst the four manufacturers included in the study. **Category:** AstraZeneca, Autoimmune Diseases & Covid-19, Covid-19 Antibodies, Covid-19 Research Studies, Johnson & Johnson, Moderna, Pfizer, Vaccine Manufacturers --- ### [Severe COVID-19 Cases and Death Rates show Downward Trend for those with Systemic Autoimmune Rheumatic Diseases](https://www.autoimmuneinstitute.org/covid_timeline/severe-covid-19-cases-and-death-rates-show-downward-trend-in-those-with-systemic-autoimmune-rheumatic-diseases/) **Published:** August 15, 2022 **Author:** Elevation **Excerpt:** A recent study, published in Epidemiology, analyzed trends in patients with systemic autoimmune rheumatic diseases (SARDs) from the first COVID-19 wave through the initial Omicron wave. Their goal was to investigate how trends of incidence and severity of COVID-19 in those with SARDs have changed over time. **Content:** August 15, 2022 A recent [study](https://ard.bmj.com/content/early/2022/08/09/ard-2022-222954), published in *Epidemiology,* analyzed trends in patients with systemic autoimmune rheumatic diseases (SARDs) from the first COVID-19 wave through the initial Omicron wave. Their goal was to investigate how trends of incidence and severity of COVID-19 in those with SARDs have changed over time. Out of the 1,449 SARD patients with COVID-19 identified for this study, “the most common type of SARD was [rheumatoid arthritis](https://www.autoimmuneinstitute.org/rheumatoid-arthritis/) (33.9%), followed by [psoriatic arthritis](https://www.autoimmuneinstitute.org/psoriatic-arthritis/) and [spondyloarthritis](https://www.autoimmuneinstitute.org/ankylosing-spondylitis/) (14.7%) and [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/systemic-lupus-erythematosus/) (13.1%). Most patients (74.1%) were in remission or had low disease activity at time of COVID-19 onset. Baseline glucocorticoids were used in 26.0% of cases. The most commonly used DMARD \[disease modifying antirheumatic drug\] was methotrexate (22.0%), followed by antimalarials (21.7%) and TNF inhibitors (20.2%). Rituximab was used in 9.2% of cases.” Overall, it appears that worst outcomes have lessened for those with SARDs (as well as for the general population) when comparing the Omicron wave versus the early months of the pandemic. When comparing rates of severe\* COVID-19 cases in those with SARDs, the rate dropped from 46% in March-June 2020 to 15% in December 2021-January 2022. Death rates for those same time periods also dropped from 8.8% to 2%. \* Severe cases were defined as those that required either hospitalization or resulted in death within 30 days of COVID-19 diagnosis. **Category:** Autoimmune Diseases & Covid-19, Covid-19 Research Studies, Lupus & Covid-19, RA & Covid-19 --- ### [Autoimmunity, SARS-CoV-2 Infections, and Neurological Disorders](https://www.autoimmuneinstitute.org/covid_timeline/autoimmunity-and-sars-cov-2-infection-unraveling-the-link-in-neurological-disorders/) **Published:** August 5, 2022 **Author:** Elevation **Excerpt:** New evidence suggests that an autoimmune response to the SARS-CoV-2 virus is responsible for neurological disorders in some COVID-19 patients. A 2022 review by Dr. Daniela Latorre from the Institute of Microbiology in Zurich, Switzerland, explains the “current knowledge of immune responses occurring in Neuro-COVID patients” and the potential mechanisms for developing neurological complications alongside SARS-CoV-2 infection.  **Content:** August 5, 2022 Patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) present with a wide range of symptoms, from none at all to new neurological and neuropsychiatric syndromes. New evidence suggests that an autoimmune response to the SARS-CoV-2 virus is responsible for neurological disorders in some COVID-19 patients. A [2022 review](https://pubmed.ncbi.nlm.nih.gov/35833748/) by Dr. Daniela Latorre from the Institute of Microbiology in Zurich, Switzerland, explains the “current knowledge of immune responses occurring in Neuro-COVID patients” and the potential mechanisms for developing neurological complications alongside SARS-CoV-2 infection. Neuro-COVID refers to the range of neurological conditions in COVID-19 patients from loss of taste, headache, and fatigue to encephalitis, stroke, and polyneuropathies. In order to understand the causes of Neuro-COVID development, the cerebrospinal fluid (CSF) of patients was tested. CSF is the fluid surrounding the brain and spinal cord, the central nervous system (CNS). It was found that the cerebrospinal fluid had higher levels of specific biomarkers in Neuro-COVID patients with CNS diseases, suggesting the SARS-CoV-2 virus infected the CNS. It is still unknown whether this occurs due to a direct viral invasion of the neurons or an indirect effect of “immune-related mechanisms”. COVID-19 infection has often been linked to a “cytokine storm,” where the patient’s immune system becomes hyperactivated, causing greater disease severity. The immune system releases large amounts of proinflammatory cytokines, which have been associated with neurological complications in other diseases. The CSF of Neuro-COVID patients in various studies was found to have high levels of these cytokines, supporting the argument that neurological manifestations of COVID-19 are immune-related. Some COVID-19 patients developed autoantibodies, often targeting white blood cell, or lymphocyte, function. Further, some patients developed many autoantibodies targeting antigens in the CNS. The paper hypothesizes that among a subclass of COVID-19 patients, autoantibodies develop as part of a humoral immune response, interfering with normal neurological function, which causes complications in Neuro-COVID disorders. On the other hand, it is emphasized that little research has been done on T lymphocyte behavior in Neuro-COVID patients, which makes up 80% of the CSF. This review states that the mechanisms behind the immune response in Neuro-COVID patients are likely a combination of [molecular mimicry, bystander activation, and epitope spreading](https://www.autoimmuneinstitute.org/sars-cov-2-autoimmune-virus-long-covid/). These mechanisms cause the immune response to a foreign antigen to become elevated and to attack the body’s antigens. Still, the author underscores the need for further immunological studies of Neuro-COVID patients and those with Long COVID syndrome in order to fully understand how neurological conditions arise from the SARS-CoV-2 virus and to develop therapeutic treatment options. **Category:** Autoimmune Diseases & Covid-19, Covid-19 Infections, Covid-19 Research Studies, Long COVID --- ### [Responses in Patients with Autoimmune Hepatitis following Third COVID-19 Vaccine Dose](https://www.autoimmuneinstitute.org/covid_timeline/responses-in-patients-with-autoimmune-hepatitis-following-third-covid-19-vaccine-dose/) **Published:** July 25, 2022 **Author:** Elevation **Excerpt:** A 2022 study by the University Medical Center Hamburg-Eppendorf in Germany investigated the effect of the third COVID-19 vaccination on patients of autoimmune hepatitis (AIH). The level of anti-SARS-CoV-2 antibodies was measured in the blood of 81 autoimmune hepatitis patients. **Content:** July 25, 2022 Patients with autoimmune diseases often take immunosuppressant drugs in order to limit their immune system from attacking itself. These drugs have corresponded to a reduced immune response in patients after receiving a COVID-19 vaccination. More specifically, autoimmune hepatitis (AIH) patients appear to have an [increased risk of acquiring COVID-19](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9004241/). A 2022 [study](https://pubmed.ncbi.nlm.nih.gov/35840342/) by the University Medical Center Hamburg-Eppendorf in Germany investigated the effect of the third COVID-19 vaccination on patients of [autoimmune hepatitis (AIH)](https://www.autoimmuneinstitute.org/autoimmune-hepatitis/). The level of anti-SARS-CoV-2 antibodies was measured in the blood of 81 autoimmune hepatitis patients. It was found that a sufficient humoral immune response, dependent on the formation of antibodies, was developed by all the patients after vaccination. Yet, the number of antibodies and T-cells created were significantly lower in the AIH patients compared to the healthy control population, with 48% of patients having antibody levels below the 10th percentile of healthy levels. Based on statistical analyses, AIH patients taking immunosuppressive MMF or steroid medications had a greater risk for these low antibody levels after vaccination. The paper suggests continued monitoring of antibody levels and even additional booster vaccinations for patients with weak immune responses. **Category:** Autoimmune Diseases & Covid-19, Covid-19 Antibodies, Covid-19 Research Studies --- ### [IgG Antibody Responses Across 3 Doses of mRNA Vaccines](https://www.autoimmuneinstitute.org/covid_timeline/igg-antibody-responses-across-3-doses-of-mrna-vaccines/) **Published:** July 21, 2022 **Author:** Elevation **Excerpt:** A study published in the Journal of Autoimmunity evaluated the immune response of Pfizer and Moderna’s mRNA COVID-19 vaccines in participants with autoimmune systemic diseases. In total, serum samples from 244 AD patients were collected 2-4 weeks and six months after their first vaccine cycle, and 2-4 weeks following their booster dose; 502 people from the general population were used as a control group. **Content:** July 21, 2022 A [study](https://www.sciencedirect.com/science/article/pii/S0896841122000749?via%3Dihub) published in the *Journal of Autoimmunity* evaluated the immune response of Pfizer and Moderna’s mRNA COVID-19 vaccines in participants with autoimmune systemic diseases. Diseases included [rheumatoid arthritis](https://www.autoimmuneinstitute.org/rheumatoid-arthritis/), [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/systemic-lupus-erythematosus/), systemic sclerosis, and cryoglobulinemic vasculitis. In total, serum samples from 244 AD patients were collected 2-4 weeks and six months after their first vaccine cycle, and 2-4 weeks following their booster dose; 502 people from the general population were used as a control group. 93.7% and 6.3% in the AD cohort were vaccinated with the Pfizer and Moderna COVID-19 vaccines, respectively; this was comparable in the control group. “Significantly lower levels of \[neutralizing antibodies\] were observed in the whole patients’ series and in the single \[AD\] subgroups at both time 1 and time 2, compared to the control group.” That being said, serum samples showed a sharp increase in antibodies after the booster dose, and the percentage of patients with no or suboptimal responses decreased significantly between the first and second check-in versus after the booster dose (from from approximately 28% to 46% – a significant rise in absent/ suboptimal response – down to approximately 8%). “The percentage of patients with absent/suboptimal response after the booster dose was significantly higher compared to controls,” which hovered at 0.2%. This was especially true for patients on immune-modifying drugs, including Rituximab, and glucocorticoids. “The percentage of \[AD\] patients reporting one or more side effects within four weeks after booster administration was 40%; the side effects were usually mild and transitory. Remarkably, \[AD\] reactivation following the booster shot was observed in only 2% of cases although the events were invariably self-limiting.” **Category:** Autoimmune Diseases & Covid-19, Covid-19 Antibodies, Covid-19 Boosters, Covid-19 Research Studies, Lupus & Covid-19, Moderna, Pfizer, RA & Covid-19, Vaccine Manufacturers --- ### [Vaccine Efficacy in SLE Patients Across Multiple Variants](https://www.autoimmuneinstitute.org/covid_timeline/vaccine-efficacy-in-sle-patients-across-multiple-variants/) **Published:** July 15, 2022 **Author:** Elevation **Excerpt:** A new study investigated vaccine efficacy of a primary series and booster dose across multiple variants, including the BA.1 omicron variant, in SLE patients. This is one of the first studies on vaccine efficacy of a primary series and booster dose across multiple variants, including the BA.1 omicron variant, especially in an autoimmune disease patient cohort. **Content:** July 15, 2022 A [study](https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(22)00190-4/fulltext) published earlier this week investigated vaccine immune responses in [SLE](https://www.autoimmuneinstitute.org/systemic-lupus-erythematosus/) patients. This is one of the first studies on vaccine efficacy of a primary series and booster dose across multiple variants, including the BA.1 omicron variant, especially in an autoimmune disease patient cohort. Vaccine responses from 163 patients vaccinated between December 2021 and February 2022 were evaluated for clinical efficacy and seroreactivity. Patients were members of the New York University Lupus Cohort, and received a two-dose primary series of an mRNA vaccine, or one dose primary series of the Johnson & Johnson COVID-19 vaccine. 125 of 163 patients received an additional dose. “At the time of initial vaccination, 82 (50%) of 163 patients were on at least one immunosuppressant and 26 (16%) were on more than one immunosuppressant.” Of 125 patients who received a booster dose, 28 experienced a breakthrough infection. 16 patients who did not receive a booster experienced a breakthrough infection. 13 of 43 patients taking the immunosuppressant mycophenolate mofetil at the time of their primary series and 2 of 4 patients taking rituximab in the six months prior to vaccination experienced a breakthrough infection. “There was no association between antibody titre after the additional dose and breakthrough SARS-CoV-2 infection.” Overall, patients with SLE showed favorable serological responses after a booster dose compared to a primary series. That being said, “SARS-CoV-2 spike antibody titre was not associated with breakthrough SARS-CoV-2 infection, potentially indicating the known immune evasion of the omicron variant or a plateau effect beyond a particular antibody titre.” Authors suggest that mild cases of COVID-19 amongst the cohort point to the the power of T-cell immunity, which is constant across the alpha strain and omicron variants. It is important to note that one limitation of the study was the incidence of self-reported COVID-19 infection in many cases. **Category:** Autoimmune Diseases & Covid-19, Covid-19 Boosters, Covid-19 Infections, Covid-19 Research Studies, Covid-19 Variants, Johnson & Johnson, Lupus & Covid-19, Moderna, Pfizer --- ### [Mechanisms Behind COVID ‘Brain Fog’ Beginning to Come to Light](https://www.autoimmuneinstitute.org/covid_timeline/mechanisms-behind-covid-brain-fog-beginning-to-come-to-light/) **Published:** July 11, 2022 **Author:** Elevation **Excerpt:** New research published in Cell analyzed the brains of mice previously infected with mild respiratory COVID-19 and found residual signs of inflammation in several brain cell populations. These damages are thought to potentially explain the mechanisms behind the cognitive disruptions seen in some post-COVID-19 infections. The cognitive disruptions have become known as “COVID fog” or “brain fog” and is characterized by “impaired attention, concentration, speed of information processing, memory, and executive function.” **Content:** July 11, 2022 [New research published in *Cell*](https://www.cell.com/cell/fulltext/S0092-8674(22)00713-9) analyzed the brains of mice previously infected with mild respiratory COVID-19 and found residual signs of inflammation in several brain cell populations. These damages are thought to potentially explain the mechanisms behind the cognitive disruptions seen in some post-COVID-19 infections. The cognitive disruptions have become known as “COVID fog” or “brain fog” and is characterized by “impaired attention, concentration, speed of information processing, memory, and executive function” ([Becker et al., 2021](https://doi.org/10.1001/jamanetworkopen.2021.30645); [Nasserie et al., 2021](https://doi.org/10.1001/jamanetworkopen.2021.11417)). Interestingly, there appears to be a resemblance between the syndrome of cancer-therapy-related cognitive impairment (CRCI), also referred to as “chemo fog” and the brain fog seen in those with long COVID. This similarity has led some researchers to look into whether the two share pathophysiological mechanisms. The neurological symptoms in CRCI have been linked to “[a distinct subpopulation of microglia that reside in white matter](https://doi.org/10.1016/j.immuni.2018.11.004) \[that\] are selectively activated by systemic insults such as exposure to the chemotherapy drug [methotrexate](https://doi.org/10.1016/j.cell.2018.10.049).” The subsequent damage leads to an impairment of cellular homeostasis (maintaining a balance of several factors that make a cell healthy) and plasticity (the ability of the nervous system to change its activity in response to intrinsic or extrinsic stimuli by reorganizing its structure, functions, or connections) processes. **Category:** Covid-19 Infections, Covid-19 Research Studies --- ### [Chronic COVID Infections Could be Causing New Variants](https://www.autoimmuneinstitute.org/covid_timeline/chronic-covid-infections-could-be-causing-new-variants/) **Published:** June 15, 2022 **Author:** Elevation **Excerpt:** Nature magazine addresses what scientists are discovering about the evolutionary battle COVID is undergoing inside our bodies. Throughout the course of a chronic SARS-CoV-2 infection, the virus might be evolving into dangerous new variants. **Content:** June 15, 2022 *[Nature](https://www.nature.com/articles/d41586-022-01613-2?utm_source=Nature+Briefing&utm_campaign=84730d2057-briefing-dy-20220615&utm_medium=email&utm_term=0_c9dfd39373-84730d2057-46551886)* magazine addresses what scientists are discovering about the evolutionary battle COVID is causing inside our bodies. Throughout the course of a chronic SARS-CoV-2 infection, the virus might be evolving into dangerous new variants. “Each person’s infection is its own universe, where new mutations arise as the infection spreads from cell to cell. Most of these changes won’t matter to the virus, and many will do it harm. But some might give it a slight advantage over other versions of the virus in that person’s body, enhancing its ability to spread or providing some resistance to immune defenses. These two traits — infectivity and immune evasion — are the main ways in which SARS-CoV-2 has evolved since it first emerged in 2019.” **Category:** Covid-19 Infections, Covid-19 Variants, Long COVID --- ### [Treating COVID-19 with Immune Modulator Drugs](https://www.autoimmuneinstitute.org/covid_timeline/treating-covid-19-with-immune-modulator-drugs/) **Published:** June 10, 2022 **Author:** Elevation **Excerpt:** Topline results of a recent clinical trial showed that infliximab or abatacept “substantially improve[ed] clinical status and reduc[ed] deaths” in adult patients hospitalized with severe COVID-19. These drugs are often used to treat certain autoimmune diseases, including rheumatoid arthritis, psoriatic arthritis, Crohn’s disease, and ankylosing spondylitis. **Content:** June 10, 2022 Earlier this month, the NIH published a [news release](https://www.nih.gov/news-events/news-releases/immune-modulator-drugs-improved-survival-people-hospitalized-covid-19) covering the results of a clinical trial with COVID-19 hospital patients treated with infliximab or abatacept. These drugs are often used to treat certain autoimmune diseases, including [rheumatoid arthritis](https://www.autoimmuneinstitute.org/rheumatoid-arthritis/), [psoriatic arthritis](https://www.autoimmuneinstitute.org/psoriatic-arthritis/), [Crohn’s disease](https://www.autoimmuneinstitute.org/crohns-disease/), and [ankylosing spondylitis.](https://www.autoimmuneinstitute.org/ankylosing-spondylitis/) Topline results showed that these two immune modulator drugs “substantially improve\[ed\] clinical status and reduc\[ed\] deaths” in adult patients when used in conjunction with the “standard of care” for COVID-19 patients, which could also include remdesivir and dexamethasone. Patients who received infliximab had a decreased death rate of 10% compared to 14.5% for patients who received a placebo. “People in the infliximab group had 43.8% better odds of clinical improvement than those in the placebo group.” Patients who received abatacept had a death rate of 11.0%, compared to 15.0% of patients who received a placebo. This trial is part of a larger, ongoing trial, studying the impact of certain drugs to reduce mortality in patients hospitalized with moderate-to-severe COVID-19 ([1](https://clinicaltrials.gov/ct2/show/study/NCT04593940?term=NCT04593940&draw=2&rank=1)). **Category:** Autoimmune Diseases & Covid-19, Covid-19 & Long Covid Treatments, Covid-19 Clinical Trials, Covid-19 Infections --- ### [Antibody Responses after Additional COVID-19 Vaccines in Immunocompromised Persons](https://www.autoimmuneinstitute.org/covid_timeline/antibody-responses-after-additional-covid-19-vaccines-in-immunocompromised-persons/) **Published:** June 6, 2022 **Author:** Elevation **Excerpt:** The Lancet recently conducted a literature review of antibody responses after COVID-19 vaccination in immunocompromised persons published between July 1, 2020, and September 27, 2021. Authors aggregated information from 23 studies with a total of 1722 persons who received an additional dose of a COVID-19 vaccine due to their immunocompromised status. **Content:** June 6, 2022 *[The Lancet](https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(21)00593-3/fulltext) recently conducted a literature review of antibody responses after COVID-19 vaccination in immunocompromised persons published between July 1, 2020, and September 27, 2021. Authors aggregated information from 23 studies with a total of 1722 persons who received an additional dose of a COVID-19 vaccine due to their immunocompromised status. Of the 23 studies included in the review, 18 exclusively offered mRNA vaccines, versus 2 offering AstraZeneca or Johnson & Johnson as additional doses after an mRNA primary series. Additional doses were administered 1-3 months after a primary series in 20 studies. Overall, seroconversion rates (method of assessing vaccine efficacy) after two COVID-19 vaccine doses were 99% for immunocompetent persons, versus 78% for persons with immune-mediated inflammatory disorders. “No studies reported on the efficacy or effectiveness of an additional COVID-19 vaccine dose among people who are immunocompromised.” That being said, studies stated that an additional dose “appeared to have a modest additive effect” on immunogenicity levels. Also, reactions after receiving an additional dose were consistent with reactogenicity profiles after the first and second doses. Persons who elicited a low or undetectable antibody response after a primary series were able to elicit a median antibody response rate of 44%. It is still unclear how long protection after a third dose lasts, although it is assumed that the benefits of a third dose “are likely to outweigh the risks on the basis of the available data.” **Category:** Covid-19 Antibodies, Covid-19 Boosters, Covid-19 Research Studies, Vaccine Manufacturers --- ### [Evidence Shows Thyroid Dysfunction Following Moderate-to-Severe COVID](https://www.autoimmuneinstitute.org/covid_timeline/evidence-shows-thyroid-dysfunction-following-moderate-to-severe-covid/) **Published:** June 2, 2022 **Author:** Elevation **Excerpt:** Research was recently presented at the 24th European Congress of Endocrinology in Milan, Italy demonstrating a link between thyroid dysfunction and a previous moderate-to-severe COVID-19 infection. **Content:** June 2, 2022 Research was recently presented at the [24th European Congress of Endocrinology](https://ese-hormonesapps.m-anage.com/ProgramSearch/Person?eventname=ece2022&language=en-GB&searchstring=muller&userid=1306604&pProgramGrade=Scientific&pShowPrivate=False&pHidePersonal=False&pHideLogin=False) in Milan, Italy demonstrating a link between thyroid dysfunction and a previous moderate-to-severe COVID-19 infection. 100 patients who had been hospitalized for severe COVID had their thyroid-stimulating hormone (TSH) levels [analyzed](https://www.thelancet.com/journals/landia/article/PIIS2213-8587(20)30266-7/fulltext) upon admission and a high occurrence of thyroiditis was seen, though their thyroids normalized soon after recovery. Decreased TSH production is also seen in [Hashimoto’s thyroiditis](https://www.autoimmuneinstitute.org/hashimotos-thyroiditis/), an autoimmune disease where the thyroid is attacked by the body’s own cells. A follow-up study was conducted 12 months later in the same population of patients and regions of thyroiditis were still visible in half. They also found decreased uptake abilities in the thyroids of four out of six patients (a thyroiditis hallmark). **Category:** Covid-19 Research Studies --- ### [Inactivated COVID-19 Vaccine Efficacy in Those with SLE and RA](https://www.autoimmuneinstitute.org/covid_timeline/inactivated-covid-19-vaccine-efficacy-in-those-with-sle-and-ra/) **Published:** May 31, 2022 **Author:** Elevation **Excerpt:** A recent study, published in Biomedicine & Pharmacotherapy, aimed to investigate the seroreactivity of COVID-19 vaccination and its adverse events among systemic lupus erythematosus (SLE) patients, rheumatoid arthritis (RA) patients, and healthy controls (HCs). **Content:** May 31, 2022 A recent [study](https://pubmed.ncbi.nlm.nih.gov/35486976/), published in *Biomedicine & Pharmacotherapy,* aimed to “investigate the seroreactivity of Coronavirus disease 2019 (COVID-19) vaccination and its adverse events among [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/systemic-lupus-erythematosus/) (SLE) patients, [rheumatoid arthritis](https://www.autoimmuneinstitute.org/rheumatoid-arthritis/) (RA) patients, and healthy controls (HCs)”. Seroreactivity is the reactivity of blood serum, especially to a virus, and involves the analysis of the presence of specific antibodies. 60 SLE patients, 70 RA patients, and 35 age- and sex-matched healthy controls were recruited for the study. Serum samples, collected 2 weeks after 2 doses of the inactivated COVID-19 vaccine had been administered, were tested for immunoglobin G (IgG) and M (IgM) antibodies against SARS-CoV-2. The results indicated that “**there were no significant differences regarding the seroprevalences of IgG and IgM antibodies against SARS-CoV-2, and the self-reported vaccination-related adverse events among SLE patients, RA patients, and HCs. The inactivated COVID-19 vaccines appeared to be well-tolerated and moderately immunogenic**.” More specifically, 50% of those with SLE, 57.1% of those with RA, and 65.7% of the healthy controls had IgG antibodies against SARS-CoV-2 present and 8.3% of those with SLE, 8.6% of those with RA, and 2.9% of the healthy controls had IgM antibodies against SARS-CoV-2 present. **Category:** Autoimmune Diseases & Covid-19, Covid-19 Antibodies, Covid-19 Research Studies, Lupus & Covid-19, RA & Covid-19, Vaccine Adverse Events --- ### [Autoimmune Hepatitis Reported Following COVID-19 mRNA Vaccination](https://www.autoimmuneinstitute.org/covid_timeline/autoimmune-hepatitis-reported-following-covid-19-mrna-vaccination/) **Published:** May 26, 2022 **Author:** Elevation **Excerpt:** A peer-reviewed case report published yesterday in the journal Cureus discusses the first documented case of a reactivation of autoimmune hepatitis in remission following the administration of a COVID-19 vaccine. Nine previously published case studies have also reported cases of autoimmune hepatitis being diagnosed after the administration of a COVID-19 vaccine. **Content:** May 26, 2022 [Autoimmune hepatitis](https://www.autoimmuneinstitute.org/autoimmune-hepatitis/) involves inflammation of the liver resulting from the immune system mistakenly attacking liver cells, which can result in cirrhosis and liver failure. The exact cause of the disease has been unclear up to this point, though genetic and environmental factors have been suspected to interact and trigger the disease over time. A peer-reviewed [case report](https://www.cureus.com/articles/92665-recurrence-of-autoimmunehepatitisafter-covid-19vaccination#references) published yesterday in the journal *Cureus* discusses the first documented case of a reactivation of autoimmune hepatitis in remission following the administration of a COVID-19 vaccine. Two weeks after the patient’s second dose of the Pfizer COVID-19 vaccine, routine labs showed that her liver enzymes were elevated for the first time since her initial diagnosis of autoimmune hepatitis in 2016. Her only other past medical history included chronic sinusitis and insomnia. Nine previously published case studies have also reported cases of autoimmune hepatitis being diagnosed after the administration of a COVID-19 vaccine ([1](https://www.journal-of-hepatology.eu/article/S0168-8278(21)00237-3/fulltext), [2](https://www.journal-of-hepatology.eu/article/S0168-8278(21)00427-X/fulltext), [3](https://www.sciencedirect.com/science/article/pii/S0896841121001141?via%3Dihub), [4](https://www.journal-of-hepatology.eu/article/S0168-8278(21)01904-8/fulltext), [5](https://www.journal-of-hepatology.eu/article/S0168-8278(21)00417-7/fulltext), [6](https://www.journal-of-hepatology.eu/article/S0168-8278(21)01896-1/fulltext), [7](https://www.journal-of-hepatology.eu/article/S0168-8278(21)00412-8/fulltext), [8](https://www.journal-of-hepatology.eu/article/S0168-8278(21)00424-4/fulltext), [9](https://www.sciencedirect.com/science/article/pii/S0896841121001189?via%3Dihub)). There has been a debate within the medical literature on whether these associations between COVID vaccination and autoimmune hepatitis are due to causality or coincidence.  Further research is needed to investigate the possibility of potential autoimmune dysregulation in some individuals following receipt of mRNA vaccines. **Category:** Autoimmune Diseases & Covid-19, Moderna, Pfizer, Vaccine Adverse Events --- ### [COVID-19 Outcomes in Those with Rheumatic Diseases](https://www.autoimmuneinstitute.org/covid_timeline/covid-19-outcomes-in-those-with-rheumatic-diseases/) **Published:** May 17, 2022 **Author:** Elevation **Excerpt:** A study published recently in the International Journal of Rheumatic Diseases looked to “assess the characteristics of inflammatory rheumatic disease (IRD) patients in Kuwait diagnosed with COVID-19 and the factors linked with hospitalization, complications, and mortality.” **Content:** May 17, 2022 A [study](https://onlinelibrary.wiley.com/doi/full/10.1111/1756-185X.14332) published recently in the *International Journal of Rheumatic Diseases* looked to “assess the characteristics of inflammatory rheumatic disease (IRD) patients in Kuwait diagnosed with COVID-19 and the factors linked with hospitalization, complications, and mortality.” The study population included 52 patients with a mean age of 55 years. “The majority of patients were ≤65 years (77%), female (77%), non-smokers (80.8%), and diagnosed with rheumatoid arthritis (67.0%). Of the included patients, 19.2%, 9.6%, and 7.7% reported having methotrexate monotherapy, antimalarials monotherapy, and interleukin-6 inhibitors monotherapy immediately before COVID-19, respectively. Most of the included patients (92.3%) were either in remission or had minimal/low disease activity, while others (7.7%) had moderate disease activity.” Researchers found that the most reported COVID-19 symptoms at the time of presentation were “cough (60%), fever (54%), and shortness of breath (48%)”. In addition, “forty-three patients (82.7%) were hospitalized, while 11 patients (25.6%) required ventilation (invasive or non-invasive). Ten of the ventilated patients (90.9%) received glucocorticoids as part of the local protocol to treat severe COVID symptoms, and 4 patients (7.69%) died. The duration till symptom-free ranged between 0 to 30 days, with a mean value of 10 days (±6.5).” **Category:** Autoimmune Diseases & Covid-19, Covid-19 Research Studies, Lupus & Covid-19, RA & Covid-19 --- ### [What can a TLR7 Gene Mutation Tell us About Lupus and Severe COVID-19 Infections?](https://www.autoimmuneinstitute.org/covid_timeline/what-can-a-tlr7-gene-mutation-tell-us-about-lupus-and-severe-covid-19-infections/) **Published:** May 12, 2022 **Author:** Elevation **Excerpt:** A study published recently in Nature analyzed the whole-genome sequencing of a 7-year-old child diagnosed with severe lupus. Her genetics were of particular interest due to the fact that such a severe case of lupus with early-onset symptoms is considered rare and strongly indicates a single genetic cause. Their analysis revealed a single-point mutation in the TLR7 gene. **Content:** May 12, 2022 A [study](https://www.nature.com/articles/s41586-022-04642-z) published recently in *Nature* analyzed the whole-genome sequencing of a 7-year-old child diagnosed with severe lupus. Her genetics were of particular interest due to the fact that such a severe case of lupus with early-onset symptoms is considered rare and strongly indicates a single genetic cause. Their analysis revealed a single-point mutation in the *TLR7* gene. This finding was corroborated when the same gene mutation was also seen in other severe lupus cases from the US and the China Australia Centre of Personlised Immunology at Shanghai Renji Hospital. To further verify that it was this specific gene mutation causing lupus, the researchers utilized CRISPR gene-editing technology allowing them to introduce the gene mutation in mice. After the mice seemingly developed lupus themselves (by presenting similar symptoms), this provided significant evidence that the TLR7 gene mutation was the cause. This gene mutation has been shown to cause TLR7 (Toll-Like Receptor 7 – a receptor on immune cells that acts as a sensor) to bind more easily and become more active. This increased activity essentially causes the immune cell to “overreact” and be more sensitive, leading to healthy tissues being incorrectly identified as pathogens/damaged tissue and the immune system unnecessarily attacking them. Other research teams have also studied TLR7 mutations specifically regarding severe COVID-19 infections ([1](https://www.science.org/doi/10.1126/sciimmunol.abl4348)) ([2](https://jamanetwork.com/journals/jama/fullarticle/2768926)), and they found that the mutation was actually causing TLR7 to become less active in that case. It is interesting to note that both an overactive TLR7 and a disabled TLR7 can cause immune cells to respond incorrectly and lead to autoimmune conditions. More study is needed to help illuminate the role TLR7 may play in other systemic autoimmune diseases, but it is clearly an area of importance. **Category:** Autoimmune Diseases & Covid-19, Covid-19 Research Studies, Lupus & Covid-19 --- ### [Brain Changes Observed in COVID Survivors Aged 60+](https://www.autoimmuneinstitute.org/covid_timeline/brain-changes-observed-in-covid-survivors-aged-60/) **Published:** May 2, 2022 **Author:** Elevation **Excerpt:** A recent study published in JAMA Neurology looked at 3,233 COVID-19 survivors 60 years of age and older who had been discharged from hospitalization in Wuhan, China. The purpose of the study was to determine the long-term impact of COVID-19 on cognition and “investigate the 1-year trajectory of cognitive changes in older COVID-19 survivors.” **Content:** May 2, 2022 A recent [study](https://jamanetwork.com/journals/jamaneurology/fullarticle/2789919?utm_campaign=articlePDF&utm_medium=articlePDFlink&utm_source=articlePDF&utm_content=jamaneurol.2022.0461) published in *JAMA Neurology* looked at 3,233 COVID-19 survivors 60 years of age and older who had been discharged from hospitalization in Wuhan, China. The purpose of the study was to determine the long-term impact of COVID-19 on cognition and “investigate the 1-year trajectory of cognitive changes in older COVID-19 survivors.” Their 466 uninfected spouses served as the control population. The study did not include those that had a family history of dementia, cognitive impairment, or neurological disorders prior to their COVID infection. The final follow-up, conducted at 6 and 12 months, included 1,438 COVID survivors and 438 controls. It was found that “**the incidence of cognitive impairment in survivors 12 months after discharge was 12.45%.”** Researchers also discovered that “severe COVID-19 was associated with a higher risk of early-onset cognitive decline, late-onset cognitive decline, and progressive cognitive decline.” **Category:** Covid-19 Research Studies --- ### [Altered Gut Microbiome in Children with MIS-C and Previous COVID-19 Infection](https://www.autoimmuneinstitute.org/covid_timeline/altered-gut-microbiome-in-children-with-mis-c-and-previous-covid-19-infection/) **Published:** April 29, 2022 **Author:** Elevation **Excerpt:** A recent study was conducted by a team of researchers in Turkey looking at the composition and diversity of gut microbiota in children who had been diagnosed with multisystem inflammatory syndrome (MIS-C) and COVID-19. **Content:** **April 29, 2022** A recent study was conducted by a team of researchers in Turkey looking at the composition and diversity of gut microbiota in children who had been diagnosed with multisystem inflammatory syndrome (MIS-C) and COVID-19. “MIS-C is a condition where different body parts can become inflamed, including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs…many children with MIS-C had the virus that causes COVID-19, or had been around someone with COVID-19.” ([CDC](https://www.cdc.gov/mis/mis-c.html)) The team is in the process of publishing their findings in the *[Research Square](https://assets.researchsquare.com/files/rs-1446687/v1/4f072f13-38da-44ee-ac23-d077dd80e55e.pdf?c=1647956425)*, and wrote that they “observed changes of diversity, richness, and composition of intestinal microbiota in MIS-C cases than in COVID-19 cases and in the healthy controls.” More specifically, the substantial changes included: “(1) reduction of *F. prausnitzii* in children with MIS-C and COVID-19, (2) an increase of *Eggerthella lenta* which is related with autoimmunity; (3) the predominance of *E. dolichum* is associated with metabolic dysfunctions and obesity in children with MIS-C.” **Category:** Covid-19 Infections, Covid-19 Research Studies --- ### [Brain Fog Likely Caused by Brain Inflammation – It’s Not Just “All in Their Head”](https://www.autoimmuneinstitute.org/covid_timeline/brain-fog-likely-caused-by-brain-inflammation-its-not-just-all-in-their-head/) **Published:** April 12, 2022 **Author:** Elevation **Excerpt:** “Brain fog” has been documented as a neurologic and long-term symptom plaguing those with some autoimmune diseases and more recently those with prior COVID-19 infection. A team of researchers presented their findings last week at the American Academy of Neurology (AAN) 2022 Annual Meeting where they discussed the neurological implications of long-haul covid infection. **Content:** April 12, 2022 “Brain fog” has been documented as a neurologic and long-term symptom plaguing those with some autoimmune diseases and more recently those with prior COVID-19 infection. A team of researchers presented their [findings](https://www.aan.com/MSA/Public/Events/Details/14093) last week at the American Academy of Neurology (AAN) 2022 Annual Meeting where they discussed the neurological implications of long-haul covid infection. Their study involved measuring the cerebrospinal fluid (CSF) levels in patients with prior COVID-19 infection. They discovered that patients with cognitive post-acute sequelae of SARS-CoV-2 infection (PASC) had higher levels of inflammatory markers in their CSF while those without cognitive impairments had normal CSF. These findings support the biological basis of the brain fog symptom, which is both validating and helpful because cognitive PASC does not currently have any diagnostic tests or treatments. **Category:** Covid-19 Research Studies, Long COVID --- ### [Weighing the Pros and Cons of Pausing Methotrexate for COVID shots](https://www.autoimmuneinstitute.org/covid_timeline/weighing-the-pros-and-cons-of-pausing-methotrexate-for-covid-shots/) **Published:** April 5, 2022 **Author:** Elevation **Excerpt:** A recently published study in the Annals of the Rheumatic Diseases analyzed the pros and cons of pausing methotrexate usage. The group that continued their regular medication regimen demonstrated a 55% antibody response from the COVID vaccines whereas the group that paused methotrexate demonstrated an 80% antibody response. **Content:** April 5, 2022 Methotrexate, a medication taken by many people with [rheumatoid arthritis](https://www.autoimmuneinstitute.org/rheumatoid-arthritis/) (RA), is an immunosuppressant. This means that it reduces the activity of the immune system, which could potentially hinder protective vaccine responses. The [American College of Rheumatology](https://rheumatology.org/covid-19-guidance) along with many rheumatologists have advised RA patients to pause their methotrexate usage for 1-2 weeks following the receipt of their COVID-19 vaccine. A recently published [study](https://ard.bmj.com/content/early/2022/02/21/annrheumdis-2021-221916) in the *Annals of the Rheumatic Diseases* analyzed the pros and cons of pausing methotrexate usage. The study included 129 RA patients in Brazil who received two doses of Sinovac’s CoronaVac vaccine\*. 60 of the RA patients paused their methotrexate usage for two weeks after each vaccine dose, while the remaining 69 RA patients were told to continue their regular methotrexate usage. The group that continued their regular medication regimen demonstrated a 55% antibody response from the COVID vaccines whereas the group that paused methotrexate demonstrated an 80% antibody response. However, there was an increase in RA disease activity in 38% of those who had paused their medication regimen. *\* The CoronaVac vaccine is an inactivated vaccine, not an mRNA vaccine (as are Pfizer and Moderna). For more information on the differences between the COVID-19 vaccines, check out our [Vaccine Comparison Chart](https://www.autoimmuneinstitute.org/vaccine-comparison-chart/).* **Category:** Autoimmune Diseases & Covid-19, Covid-19 Research Studies, RA & Covid-19 --- ### [Increased risk of Lupus, Scleroderma, and other Autoimmune-Related Diseases following COVID-19 Infection](https://www.autoimmuneinstitute.org/covid_timeline/increased-risk-of-lupus-scleroderma-and-other-autoimmune-related-diseases-following-covid-19-infection/) **Published:** April 1, 2022 **Author:** Elevation **Excerpt:** The findings presented at the American Academy of Dermatology 2022 Annual Meeting showed a definite signal triggering various autoimmune disease risks following infection of the pandemic virus. **Content:** April 1, 2022 The [American Academy of Dermatology 2022 Annual Meeting](https://am2022.aad.org/sessions) was held last weekend. A session presented by Brigham and Women’s Hospital clinical fellow of medicine Zachary Holcomb, MD showed that their research findings demonstrated a “signal triggering various autoimmune disease risks” following COVID-19 infection. Holcomb went on to state, “now we’re seeing some of the more long-term sequelae. I think we’re going to have more and more data that comes out over the years of the rate of these autoimmune diseases and long-term health implications of things like long COVID and development of additional systemic and autoimmune processes.” Specific diseases mentioned included [dermatomyositis](https://www.autoimmuneinstitute.org/dermatomyositis/), [scleroderma](https://www.autoimmuneinstitute.org/scleroderma/), [lupus](https://www.autoimmuneinstitute.org/systemic-lupus-erythematosus/), and [psoriasis](https://www.autoimmuneinstitute.org/psoriasis/). For more information, watch the interview [here](https://www.hcplive.com/view/how-autoimmune-disease-risks-heightens-after-sars-cov-2). **Category:** Autoimmune Diseases & Covid-19, Covid-19 Research Studies, Lupus & Covid-19 --- ### [Assessing the Safety of mRNA COVID-19 Vaccination in the Immunocompromised](https://www.autoimmuneinstitute.org/covid_timeline/assessing-the-safety-of-mrna-covid-19-vaccination-in-the-immunocompromised/) **Published:** March 18, 2022 **Author:** Elevation **Excerpt:** In a research article published yesterday in Frontiers in Oncology, COVID-19 vaccine (Pfizer and Moderna) safety was evaluated in a population of 566 immunocompromised patients including those with hematological malignancies (131), solid tumors (191), immune-rheumatological diseases (86), and neurological disease (158) including multiple sclerosis and generalized myasthenia. **Content:** March 18, 2022 In a [research article](https://www.frontiersin.org/articles/10.3389/fonc.2022.855723/full) published yesterday in *Frontiers in Oncology*, COVID-19 vaccine (Pfizer and Moderna) safety was evaluated in a population of 566 immunocompromised patients including those with hematological malignancies (131), solid tumors (191), immune-rheumatological diseases (86), and neurological disease (158) including multiple sclerosis and generalized myasthenia. Overall, the “incidence of severe adverse events after vaccine administration was generally low and <3%. Most frequent complaints were pain at the injection site (severe, 6.3%) and fatigue (severe, 4.5%) after the first dose; pain at the injection site (severe, 5.1%), fatigue (severe, 6.8%), bone pain (severe, 3.9%) and fever (severe, 6%) after the second dose.” **Category:** Autoimmune Diseases & Covid-19, Covid-19 Research Studies, Moderna, MS & Covid-19, Pfizer, Vaccine Adverse Events --- ### [FDA Updates Recommendation Around AstraZeneca’s Evusheld](https://www.autoimmuneinstitute.org/covid_timeline/fda-updates-recommendation-around-astrazenecas-evusheld/) **Published:** February 28, 2022 **Author:** Elevation **Excerpt:** The FDA has revised its emergency use authorization for AstraZeneca's Evusheld, a monoclonal antibody treatment for COVID-19. Due to emerging data, it has been observed that the original 150mg dose of each monoclonal antibody may be less likely to prevent infection than originally indicated. Thus, the FDA has authorized a double dose of each antibody for immunocompromised patients. **Content:** February 28, 2022 The [FDA](https://www.fda.gov/drugs/drug-safety-and-availability/fda-authorizes-revisions-evusheld-dosing?fbclid=IwAR1a8ck2cUPgmPDkJlwZOaUIlXyk179CZjJiAbUoIb4uJpDtpzBIvCT2ZKA) has revised its emergency use authorization for AstraZeneca’s Evusheld, which has been recommended for immunocompromised persons 12 years of age and older. Due to emerging data, it has been observed that the original 150mg dose of each monoclonal antibody may be less likely to prevent infection than [originally indicated](https://www.autoimmuneinstitute.org/monoclonal-antibody-treatment-authorized-for-immunocompromised-persons/). Thus, the FDA has authorized an double dose of each monoclonal antibody. “Patients who have already received the previously authorized dose (150mg of tixagevimab and 150mg of cilgavimab) should receive an additional dose of 150mg of tixagevimab and 150 mg of cilgavimab as soon as possible to raise their monoclonal antibody levels to those expected for patients receiving the higher dose.” According to the FDA website, “The duration of protection provided by Evusheld against symptomatic SARS-CoV-2 infection may not be as long as was shown in the clinical trial supporting the initial authorization because the clinical trial data came from a time period before the emergence of the BA.1 and BA.1.1 subvariants. However, it is not known whether BA.1 and BA1.1 will still be circulating in the coming months or whether another Omicron subvariant, BA.2, for which Evusheld is expected to have greater neutralizing activity, will become dominant. Because it is unclear which SARS-CoV-2 variant or Omicron subvariant will become dominant in the United States over the next few months, the recommended timing for repeat dosing cannot be provided at this time.” Dosing and timing between doses should be determined with a health care provider. You can read more about various monoclonal antibody treatments, including AstraZeneca’s Evusheld, and their efficacy against the Omicron variant, in this study published in *[Nature](https://www.nature.com/articles/s41591-021-01678-y)*. **Category:** AstraZeneca, Autoimmune Diseases & Covid-19, Covid-19 & Long Covid Treatments, Covid-19 Antibodies, Covid-19 Policy, Covid-19 Research Studies, Covid-19 Variants, Vaccine Manufacturers --- ### [FDA Authorizes Fourth Monoclonal Antibody Drug](https://www.autoimmuneinstitute.org/covid_timeline/fda-authorizes-fourth-monoclonal-antibody-drug/) **Published:** February 15, 2022 **Author:** Elevation **Excerpt:** Last Friday, the FDA authorized emergency use of Eli Lilly’s monoclonal antibody treatment, bebtelovimab, for treating mild-to-moderate COVID-19. Bebtelovimab has been shown to be highly effective against the Omicron variant, and is the fourth treatment made available for high-risk COVID patients. It has not been proven whether bebtelovimab can prevent severe disease, but trial data suggest that bebtelovimab may reduce viral replication when taken within 7 days upon onset of COVID-19 symptoms. **Content:** February 15, 2022 Last Friday, the [FDA authorized](https://investor.lilly.com/news-releases/news-release-details/lillys-bebtelovimab-receives-emergency-use-authorization) emergency use of Eli Lilly’s monoclonal antibody treatment, bebtelovimab, for treating mild-to-moderate COVID-19. Bebtelovimab has been shown to be highly effective against the Omicron variant, and is the fourth treatment made available for high-risk COVID patients. It has not been proven whether bebtelovimab can prevent severe disease, but trial data suggest that bebtelovimab may reduce viral replication when taken within 7 days upon onset of COVID-19 symptoms. Bebtelovimab is authorized for patients who are vulnerable to severe disease due to age and comorbidities, and is available for those 12+ years of age. Bebtelovimab should not be used when other COVID-19 treatment options are available or clinically appropriate. Bebtelovimab is not authorized for those who are already hospitalized for COVID-19 or require oxygen therapy/respiratory support due to COVID-19 or comorbidity. Side effects may occur, as well as “clinical worsening of COVID-19” after the administration of bebtelovimab, although “it is not known if these events were related to SARS-CoV-2 monoclonal antibody use or were due to progression of COVID-19.” **Category:** Covid-19 & Long Covid Treatments, Covid-19 Clinical Trials, Covid-19 Infections, Covid-19 Policy --- ### [Autoimmunity & COVID: Are You More at Risk?](https://www.autoimmuneinstitute.org/covid_timeline/autoimmunity-and-covid-19-are-you-more-at-risk/) **Published:** February 7, 2022 **Author:** Elevation **Excerpt:** Researchers in Italy studied whether autoimmunity increased the risk of SARS-CoV-2 infection in patients not taking immunosuppressive drugs. Researchers contacted 400 patients with the following autoimmune diseases: autoimmune gastritis, celiac disease, autoimmune thyroid disease (both Graves’ disease and Hashimoto's thyroiditis), and Type 1 diabetes. Positive COVID-19 test results were reported in 33 patients. Only 3 of the 33 patients required hospitalization, while 8 were asymptomatic, and 22 had mild symptoms. No deaths were recorded. **Content:** February 7, 2022 Researchers in Italy studied whether [autoimmunity increased the risk of SARS-CoV-2 infection](https://onlinelibrary.wiley.com/doi/full/10.1111/pai.13646) in patients *not* taking immunosuppressive drugs. Researchers contacted 400 patients for phone interviews, 100 each with the following autoimmune diseases: [autoimmune gastritis](https://www.autoimmuneinstitute.org/autoimmune-gastritis/), [celiac disease](https://www.autoimmuneinstitute.org/celiac-disease/), autoimmune thyroid disease (both [Graves’ disease](https://www.autoimmuneinstitute.org/graves-disease/) and [Hashimoto’s thyroiditis](https://www.autoimmuneinstitute.org/hashimotos-thyroiditis/)), and [Type 1 diabetes](https://www.autoimmuneinstitute.org/diabetes-type-1/). Patients with more than one autoimmune diseases and those on immunosuppressants and biologics were excluded. All patients with autoimmune gastritis were on B12 supplements, those with celiac disease had been on a gluten-free diet for one year (at least), T1 diabetes patients were on insulin therapy, and those with autoimmune thyroid disease were either on hormone replacement therapy or anti-thyroid drugs. 235 patients had received at least one dose of a COVID-19 vaccine by the time of the study. This “is in line with the Italian situation, which prioritized elderly patients and those with T1D, regardless of the presence/absence of complications.” Positive COVID-19 test results were reported in 33 patients, which is comparable to the general population of the area in which the study took place. Only 3 of the 33 patients required hospitalization, while 8 were asymptomatic, and 22 had mild symptoms. No deaths were recorded. Overall, researchers found that autoimmunity does not increase the risk of COVID-19 infection. It should be noted that 400 patients is a relatively small sample size, and that the patients included in the study were mostly young adults. That being said, patients spanned the first and second waves of the pandemic, which is a notable amount of time. **Category:** Autoimmune Diseases & Covid-19, Celiac disease & Covid-19, Covid-19 Infections, Covid-19 Research Studies, T1D & Covid-19, Thyroid disease & Covid-19 --- ### [COVID-19 Vaccine Outcomes in Dermatomyositis Patients](https://www.autoimmuneinstitute.org/covid_timeline/covid-19-vaccine-outcomes-in-dermatomyositis-patients/) **Published:** February 4, 2022 **Author:** Elevation **Excerpt:** A recent study evaluated the safety and efficacy of the Moderna, Pfizer, and Johnson & Johnson COVID-19 vaccines in dermatomyositis (DM) patients compared to non-DM patients at 1, 30, and 60 days post-vaccination. At 60 days post-vaccination, the DM group was observed to be at greater risk for adverse events of special interest compared to controls, albeit very small (absolute risk was .6%). No differences were observed for breakthrough infection or all-cause hospitalization at 60 days post-vaccination. **Content:** February 4, 2022 A recent [study](https://link.springer.com/article/10.1007/s10067-022-06081-7) published in *Clinical Rheumatology* evaluated the safety and efficacy of the Moderna, Pfizer, and Johnson & Johnson COVID-19 vaccines in 6,103 dermatomyositis (DM) patients compared to non-DM patients. DM patients were not observed to have a difference in anaphylaxis (allergic reactions) one day post-vaccination. DM patients were also not observed to experience adverse events of special interest, breakthrough infection, or all-cause hospitalization at 30 days post-vaccination compared to controls. At 60 days post-vaccination, the DM group was observed to be at greater risk for adverse events of special interest compared to controls, albeit very small (absolute risk was .6%). No differences were observed for breakthrough infection or all-cause hospitalization at 60 days post-vaccination. DMARDs and glucocorticosteroids did not impact the risk of adverse events of special interest, breakthrough infection, or all-cause hospitalization at 1, 30, or 60 days post-vaccination. While the absolute risk of adverse events in DM patients was small, “the statistically significant rise in 60-day vaccine adverse events may be attributed to autoimmunity being triggered or change in immunosuppressive treatment in patients with autoimmune diseases.” The authors of this study note that the benefits of getting vaccinated outweigh the risks in this population given this small percentage of absolute risk. **Category:** Autoimmune Diseases & Covid-19, Covid-19 Research Studies, Johnson & Johnson, Moderna, Pfizer, Vaccine Adverse Events, Vaccine Manufacturers --- ### [Antibody Levels in Immunocompromised Patients after Second Dose of mRNA Vaccine](https://www.autoimmuneinstitute.org/covid_timeline/antibody-levels-in-immunocompromised-patients-after-second-dose-of-mrna-vaccine/) **Published:** February 2, 2022 **Author:** Elevation **Excerpt:** Researchers at Johns Hopkins tested antibody levels in patients at 1, 3, and 6 months after the second dose of an mRNA vaccine. Overall, 96% of patients had positive antibody titers 6 months after the second dose of an mRNA vaccine. Antibody responses decreased from 1 to 6 months, but remained above the threshold for “predicted neutralizing capacity” in the majority of patients. **Content:** February 2, 2022 A [Comment piece](https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(21)00417-3/fulltext) was recently published in *The Lancet Rheumatology* regarding the antibody responses in immunosuppressed patients with rheumatic and muscoskeletal diseases. Researchers at Johns Hopkins tested antibody levels in patients at 1, 3, and 6 months after the second dose of an mRNA COVID-19 vaccine (Moderna and Pfizer). Patients with a previous infection of COVID-19 and those who received additional doses prior to antibody testing were excluded. Of 302 participants, inflammatory arthritis was the most common disorder (43%). Hydroxychloroquine and TNF inhibitors were the most frequently reported immunosuppressive medications (41% and 26%, respectively). “Overall, 313 (96%) of 326 patients had positive antibody titers 6 months after two doses of the mRNA vaccines.” Antibody responses decreased from 1 to 6 months, but remained above the threshold for “predicted neutralizing capacity” in the majority of patients. Those who received the Moderna vaccine had a higher rate of positive antibody titers than those who received the Pfizer vaccine; this may be due to the fact that one dose of the Moderna vaccine is 100 micrograms versus 30 micrograms for Pfizer. Additionally, those on monotherapy produced more positive antibodies than those on combination therapy (94% versus 71%, respectively). “All 13 patients (4%) with negative response at 6 months were on lymphodepleting therapy consisting of rituximab (ten patients), abatacept (two), or belimumab (one) in combination with another immunosuppressive therapy; nine (69%) were on concomitant glucocorticoid therapy.” Memory B cells and cellular response were not recorded as part of this study. **Category:** Covid-19 Antibodies, Covid-19 Research Studies, Moderna, Pfizer, Vaccine Manufacturers --- ### [FDA Expands Authorization Around Remdesivir to Treat COVID-19](https://www.autoimmuneinstitute.org/covid_timeline/fda-expands-authorization-around-remdesivir-to-treat-covid-19/) **Published:** January 25, 2022 **Author:** Elevation **Excerpt:** On January 21, the FDA expanded the use of remdesivir to non-hospitalized adults and children who have mild-to-moderate COVID-19, who are at risk of severe disease. Previously, remdesivir was only available to hospitalized patients. This decision was based on a clinical trial including 562 participants with mild-to-moderate COVID-19, who had displayed symptoms within the previous 7 days and had at least one risk factor for severe disease. **Content:** January 25, 2022 On January 21, the FDA [expanded the use of remdesivir](https://www.fda.gov/news-events/press-announcements/fda-takes-actions-expand-use-treatment-outpatients-mild-moderate-covid-19) to non-hospitalized adults and children who have mild-to-moderate COVID-19, who are at risk of severe disease. Previously, remdesivir was only available to hospitalized patients. Remdesivir is administered via intravenous infusion over a three day period, and doses will be adjusted for pediatric patients depending on their weight. “Given the similar course of COVID-19 disease, the authorization of \[remdesivir\] in certain pediatric patients is based on extrapolation of efficacy from adequate and well-controlled studies in adults.” This decision was based on a [clinical trial](https://www.nejm.org/doi/full/10.1056/NEJMoa2116846) including 562 participants with mild-to-moderate COVID-19, who had displayed symptoms within the previous 7 days and had at least one risk factor for severe disease. 279 patients were given at least one dose of remdesivir, and 283 were given a placebo. “A total of 4 of 246 patients (1.6%) in the remdesivir group and 21 of 252 (8.3%) in the placebo group had a Covid-19–related medically attended visit by day 28. No patients had died by day 28. Adverse events occurred in 42.3% of the patients in the remdesivir group and in 46.3% of those in the placebo group.” Laboratory tests have shown that remdesivir is effective at neutralizing the Omicron variant. Gilead, who owns remdesivir, has recently started a Phase 1 clinical trial for a [remdesivir pill](https://www.gilead.com/news-and-press/press-room/press-releases/2022/1/fda-approves-veklury-remdesivir-for-the-treatment-of-nonhospitalized-patients-at-high-risk-for-covid19-disease-progression) to combat COVID-19. **Category:** Covid-19 & Long Covid Treatments, Covid-19 Clinical Trials, Covid-19 Infections, Covid-19 Policy, Covid-19 Variants --- ### [WHO Recommends Two More COVID-19 Therapies ](https://www.autoimmuneinstitute.org/covid_timeline/who-recommends-two-more-covid-19-therapies/) **Published:** January 21, 2022 **Author:** Elevation **Excerpt:** The WHO has recommended the use of two more COVID-19 drugs, Baricitinib and Sotrovimab, for both mild-to-moderate and severe disease. **Content:** January 21, 2022 The [WHO](https://www.who.int/news/item/14-01-2022-who-recommends-two-new-drugs-to-treat-covid-19) has recommended the use of two more COVID-19 drugs, one of which is a JAK inhibitor (baricitinib) used to treat [rheumatoid arthritis.](https://www.autoimmuneinstitute.org/rheumatoid-arthritis/) Baricitinib has been recommended for those with severe disease, given in conjunction with corticosteroids. Sotrovimab, a monoclonal antibody, has also been conditionally recommended for those with mild-to-moderate COVID-19 with underlying conditions, including compromised immune systems. Sotrovimab has been shown to [effectively neutralize](https://www.autoimmuneinstitute.org/sotrovimab-and-the-omicron-variant/) the Omicron variant. Baricitinib and Sotrovimab “have been invited for WHO Prequalification, which assesses the quality, efficacy and safety of priority health products to increase access in lower income countries.” Read more about the research and development process, as well as authorized COVID-19 treatments [here](https://www.autoimmuneinstitute.org/covid-news-and-autoimmune-disease/treatments/). **Category:** Autoimmune Diseases & Covid-19, Covid-19 & Long Covid Treatments, Covid-19 Infections, RA & Covid-19 --- ### [Covid-19 Outcomes in Autoimmune Disease Patients](https://www.autoimmuneinstitute.org/covid_timeline/covid-19-outcomes-in-autoimmune-disease-patients/) **Published:** January 19, 2022 **Author:** Elevation **Excerpt:** Autoimmune disease is currently considered a risk factor for severe COVID-19. A research article published in Rheumatology last Fall summarized 30-day outcomes of autoimmune disease (AD) patients following hospitalization with COVID-19. AD patients diagnosed and/or hospitalized between January and June 2020 with COVID-19 were included, and their 30 day outcomes were compared to patients with at least one AD hospitalized with influenza from September 2017 through April 2018. **Content:** January 19, 2021 A [research article](https://pubmed.ncbi.nlm.nih.gov/33725121/) published in *Rheumatology* last Fall summarized 30-day outcomes of autoimmune disease (AD) patients following hospitalization with COVID-19. Systemic inflammation present in many AD patients may increase the risk of blood clots and cardiovascular disease, which may lead to worse outcomes associated with pro-inflammatory cytokine storm. This has been found to [occur during COVID-19 infections](https://www.autoimmuneinstitute.org/sars-cov-2-autoimmune-virus-long-covid/). Autoimmune disease is also currently considered a risk factor for severe COVID-19, which includes complications and hospitalization. Electronic health records were collected from Columbia University Irving Medical Center and the Department of Veterans Affairs, as well as hospitalization and open claims insurance data from Spain, the U.S., and South Korea. AD patients diagnosed and/or hospitalized between January and June 2020 with COVID-19 were included, and their 30 day outcomes were compared to patients with at least one AD hospitalized with influenza from September 2017 through April 2018. Autoimmune diseases included in the study were: [Type 1 diabetes](https://www.autoimmuneinstitute.org/diabetes-type-1/), [rheumatoid arthritis](https://www.autoimmuneinstitute.org/rheumatoid-arthritis/), [psoriatic arthritis](https://www.autoimmuneinstitute.org/psoriatic-arthritis/), [psoriasis](https://www.autoimmuneinstitute.org/psoriasis/), [multiple sclerosis](https://www.autoimmuneinstitute.org/multiple-sclerosis/), [SLE](https://www.autoimmuneinstitute.org/systemic-lupus-erythematosus/), [Addison’s disease](https://www.autoimmuneinstitute.org/autoimmune-addisons-disease/), [Graves’ disease](https://www.autoimmuneinstitute.org/graves-disease/), [Hashimoto’s thyroiditis](https://www.autoimmuneinstitute.org/hashimotos-thyroiditis/), [Sjogren’s Syndrome](https://www.autoimmuneinstitute.org/sjogrens-syndrome/), [Myasthenia gravis](https://www.autoimmuneinstitute.org/myasthenia-gravis/), vasculitis, pernicious anaemia, [Celiac disease](https://www.autoimmuneinstitute.org/celiac-disease/), [Crohn’s disease](https://www.autoimmuneinstitute.org/crohns-disease/), [ulcerative colitis](https://www.autoimmuneinstitute.org/ulcerative-colitis/), [scleroderma](https://www.autoimmuneinstitute.org/scleroderma/), and [sarcoidosis](https://www.autoimmuneinstitute.org/sarcoidosis/). **Over 48,000 AD patients hospitalized with COVID-19 were studied.** The majority of cases included those 65+ years of age; 54.8% were female. The most common autoimmune diseases in patients diagnosed with COVID-19 included psoriasis, rheumatoid arthritis, and vasculitis. The most common co-morbidities were hypertension, heart disease, Type 2 diabetes, and high cholesterol. In all databases besides one, obesity was also a frequently diagnosed comorbidity. The most frequently prescribed medications in the year prior to COVID-19 diagnosis included systemic antibiotics, pharmacological treatments for GERD, and NSAIDs. “The proportion of hospitalization episodes was higher in the cohort diagnosed with COVID-19 as compared to influenza,” even though researchers compared COVID-19 hospitalized patients against almost 400,000 patients with AD diagnosed with influenza. 70,660 patients hospitalized with influenza were included in the study. At 30 days post-hospitalization, the most common severe outcomes included ARDS (acute respiratory distress syndrome) and pneumonia. “The presence of co-morbidities such as hypertension, diabetes and obesity among patients with autoimmune diseases was associated with higher rates of hospitalization, ventilation and death due to COVID-19.” In all, AD patients hospitalized with COVID-19 had higher 30 day mortality compared to AD patients hospitalized with influenza. The researchers noted that while the study found a “greater proportion of hospitalization with COVID-19 as compared with influenza, the hospitalization rate may not directly reflect the severity of prognosis in COVID-19. The higher hospitalization rate could also be contributed by quarantine measures in the hospital after diagnosis or monitoring of patients receiving investigative treatments repurposed for COVID-19.” **Category:** Autoimmune Diseases & Covid-19, Celiac disease & Covid-19, Covid-19 Infections, Covid-19 Research Studies, IBD & Covid-19, Lupus & Covid-19, MS & Covid-19, Myasthenia gravis & Covid-19, RA & Covid-19, Sjögren disease & Covid-19, T1D & Covid-19, Thyroid disease & Covid-19 --- ### [Pfizer COVID-19 Vaccine Immune Responses in Axial Spondyloarthritis Patients](https://www.autoimmuneinstitute.org/covid_timeline/pfizer-covid-19-vaccine-immune-responses-in-axial-spondyloarthritis-patients/) **Published:** January 13, 2022 **Author:** Elevation **Excerpt:** A Comment piece was recently published in The Lancet regarding a small study evaluating the immunogenicity of the Pfizer COVID-19 vaccine in 17 axial spondyloarthritis patients on TNF or IL-17A inhibitors. “All patients were managed according to treatment guidelines; secukinumab (150 mg) was administered every four weeks, and adalimumab (40 mg) was administered either every 2 weeks or every three weeks.” **Content:** January 13, 2022 A Comment [piece](https://www.thelancet.com/action/showPdf?pii=S2665-9913%2821%2900393-3) was recently published in *The Lancet* regarding a small study evaluating the immunogenicity of the Pfizer COVID-19 vaccine in 17 axial spondyloarthritis patients on TNF or IL-17A inhibitors. “All patients were managed according to treatment guidelines; secukinumab (150 mg) was administered every four weeks, and adalimumab (40 mg) was administered either every 2 weeks or every three weeks.” Researchers evaluated antibody and T-cell responses against six healthy controls. No participants in the study had been previously infected with SARS-CoV-2, and all participants received two doses of the Pfizer COVID-19 vaccine with three weeks between doses. Researchers “observed a robust seroconversion in all study participants… \[and there were\] no significant differences in the proportion of SARS-CoV-2 reactive T cells between the study groups.” Seroconversion is the process of when a viral infection transitions to produce antibodies. T-cell responses were undetectable in 20% of participants in each group. Results of the study indicate that participants on the TNF inhibitor adalimubab, also used to treat [psoriasis](https://www.autoimmuneinstitute.org/psoriasis/), [Crohn’s disease](https://www.autoimmuneinstitute.org/crohns-disease/), and [ulcerative colitis](https://www.autoimmuneinstitute.org/ulcerative-colitis/), did not substantially affect the immune response from the Pfizer vaccine. This was also observed for participants on secukinumab, an IL-17A inhibitor. “Patients receiving these biological DMARDs \[disease-modifying antirheumatic drugs\] were able to develop cellular immune responses after vaccination with the \[Pfizer\] vaccine, and the overall humoral and cellular immune response did not differ significantly between patients and health individuals.” Cellular immunity is primarily driven by the production of T cells in response to an antigen (in this case SARS-CoV-2). Humoral immunity occurs during the process of adaptive immunity to produce B cell lymphocytes, which produce antibodies against against a specific antigen. Neutralizing antibody titers were not assessed in this particular study, nor were cellular or humoral immune responses recorded over a period of time past the initial assessment. It is still unclear what the  antibody threshold is for protection against COVID-19. **Category:** Covid-19 Antibodies, Covid-19 Research Studies, IBD & Covid-19, Pfizer, Vaccine Manufacturers --- ### [Immunocompromised persons may soon receive 4th dose](https://www.autoimmuneinstitute.org/covid_timeline/immunocompromised-persons-may-soon-receive-4th-dose/) **Published:** January 12, 2022 **Author:** Elevation **Excerpt:** Last Friday, the CDC updated their vaccine guidance for immunocompromised persons. It is now recommended that persons 12+ who are immunocompromised receive a booster dose. “If you are eligible for an additional primary shot, you should get this done before you get a booster shot.” **Content:** January 12, 2022 Last Friday, the [CDC](https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/immuno.html) updated their vaccine guidance for immunocompromised persons. It is now recommended that persons 12+ who are immunocompromised receive a booster dose. “If you are eligible for an additional primary shot, you should get this done before you get a booster shot.” Read more about booster doses for autoimmune disease patients [here](https://www.autoimmuneinstitute.org/vaccine-autoimmune-disease-faq/#should-i-get-a-booster-dose). Read amendments to CDC recommendations and FDA authorizations on our [Vaccine FAQ](https://www.autoimmuneinstitute.org/vaccine-autoimmune-disease-faq/) and [vaccine chart](https://www.autoimmuneinstitute.org/vaccine-comparison-chart/)! We update these resources regularly, and will be keeping our News page separate for scientific and medical developments pertaining to COVID-19 and autoimmune disease. **Category:** Covid-19 Boosters, Covid-19 Policy --- ### [Results of Com-Cov Mix-and-Match Vaccine Study](https://www.autoimmuneinstitute.org/covid_timeline/results-of-com-cov-mix-and-match-vaccine-study/) **Published:** January 7, 2022 **Author:** Elevation **Excerpt:** The Com-Cov2 study tested the efficacy and safety of mix-and-matching COVID-19 vaccines, including Pfizer, AstraZeneca, Moderna and Novavax. Moderna or Novavax vaccines were administered 8-12 weeks after a first dose of the Pfizer or AstraZeneca vaccine, measuring for IgG antibodies at 28 days after the second dose. **Content:** January 7, 2022 Earlier last month, results of the Com-Cov2 study were published in *[The Lancet](https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)02718-5/fulltext)*. The Com-Cov2 study tested the efficacy and safety of mix-and-matching COVID-19 vaccines, including Pfizer, AstraZeneca, Moderna and Novavax. The study included 1,072 participants 50 years of age and older. Exclusionary criteria included “history of confirmed SARS-CoV-2 infection, comorbidities that were considered severe or poorly controlled, anaphylaxis or allergy to a vaccine component, pregnancy, or intent to conceive, breastfeeding, and use of anticoagulants.” Moderna or Novavax vaccines were administered 8-12 weeks after a first dose of the Pfizer or AstraZeneca vaccine, measuring for IgG antibodies at 28 days after the second dose. IgG antibodies develop during an initial infection, and multiply for several weeks after exposure, eventually plateauing. These antibodies are stored in the body and reproduce if exposed to the same pathogen, forming the basis for long-term protection, and even preventing re-infection. An AstraZeneca or Pfizer first dose followed by a dose of the Moderna vaccine induced more neutralizing antibodies than two doses of Pfizer or AstraZeneca. Additionally, antibodies induced by a Pfizer first dose and Novavax second dose were higher than antibodies produced after two doses of AstraZeneca, demonstrating “effectiveness of 65–70% against symptomatic SARS-CoV-2 infection and over 90% against hospitalization and death… Strikingly, the Pfizer/ Novavax schedule produced a response below that of all other schedules studied, suggesting important differences in the ability of adenoviral-vectored and mRNA vaccines to prime T cells for subsequent stimulation by protein antigens.” An AstraZeneca first dose followed by a Novavax second dose demonstrated higher levels of neutralizing antibodies and T cells than two doses of AstraZeneca. In fact, T-cell responses across all groups were highest in those who received an AstraZeneca first dose and Novavax second dose. Participants who received at least one mRNA vaccine dose showed the greatest neutralizing antibody response, generating a greater humoral immune response than two Pfizer vaccines. The highest antibody concentrations were observed in participants who received a Moderna vaccine; this may be due to the fact that the Moderna vaccine dose is 100 micrograms versus a 30 microgram Pfizer vaccine dose. The authors of this article note that the data does not show “any convincing evidence of additional benefit of mixed schedules in maintaining neutralizing activity against variants of concern,” mainly the delta and beta variant… \[additionally,\] the T-cell response was maintained across all variants of concern, regardless of schedule.” Local reactions were observed less frequently in participants vaccinated with the Novavax vaccine. 589 adverse events across 357 participants were recorded, being distributed relatively evenly across the various vaccine groups. “Blood results were taken at enrollment, day 7, and day 28 after boost and graded by modified US Food and Drug Administration toxicity scale. There were no notable differences in biochemical adverse events between groups, with some minor variations reported in white blood cell indices.” 18 participants tested positive for COVID-19 after enrollment, occurring at least two months after a second dose. **Category:** AstraZeneca, Covid-19 Antibodies, Covid-19 Research Studies, Covid-19 Variants, Moderna, Novavax, Pfizer, Vaccine Adverse Events, Vaccine Manufacturers --- ### [Hybrid Immunity in Autoimmune Rheumatic Disease Patients](https://www.autoimmuneinstitute.org/covid_timeline/hybrid-immunity-in-autoimmune-rheumatic-disease-patients-2/) **Published:** January 6, 2022 **Author:** Elevation **Excerpt:** Researchers at the Center For Arthritis and Rheumatism Excellence in Kerala, India, tested immune responses in autoimmune rheumatic disease patients (AIRD) after one dose of a COVID-19 vaccine following a SARS-CoV-2 infection versus two doses of a COVID-19 vaccine without a previous infection.  **Content:** January 6, 2022 Researchers at the Center For Arthritis and Rheumatism Excellence in Kerala, India, tested [immune responses in autoimmune rheumatic disease patients](https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(21)00356-8/fulltext) (AIRD) after one dose of a COVID-19 vaccine following a SARS-CoV-2 infection versus two doses of a COVID-19 vaccine without a previous infection. Serum and plasma samples were collected from AIRD patients who had a previous COVID-19 infection, who then received one dose of the AstraZeneca vaccine. These samples were compared to serum samples from three groups with participants matching in age, sex, and disease. The first patient group included participants who had COVID-19 in the past 6 months, but had not received a COVID-19 vaccine. The second patient group included participants who received only one dose of the AstraZeneca vaccine, and a third group included participants who received a complete primary series of the AstraZeneca vaccine. Of 120 patients across the four groups, AIRD patients who recovered from COVID-19 and received one dose of the AstraZeneca vaccine had the highest number of neutralizing antibodies. “There was 100% seroconversion in the infection plus vaccine group, compared with 90% in the double dose vaccine group. The infection plus vaccine group also had higher neutralisation capacity (87% of individuals with at least 30% neutralisation) compared with the double dose vaccine group.” The effect of immunosuppressants was not studied. **Category:** AstraZeneca, Autoimmune Diseases & Covid-19, Covid-19 Antibodies, Covid-19 Infections, Covid-19 Research Studies, RA & Covid-19, Vaccine Manufacturers --- ### [Antibody Responses in Pfizer-Vaccinated Immunocompromised Patients](https://www.autoimmuneinstitute.org/covid_timeline/antibody-responses-in-pfizer-vaccinated-immunocompromised-patients/) **Published:** January 3, 2022 **Author:** Elevation **Excerpt:** Researchers in Israel conducted a prospective cohort study analyzing antibody responses in immunocompromised patients after receiving the Pfizer COVID-19 vaccine. This cohort of patients was not included in original COVID-19 vaccine clinical trials, but they may benefit most from vaccination as they experience higher mortality rates from COVID-19 compared to immunocompetent persons. **Content:** January 3, 2022 Researchers in Israel conducted a [prospective cohort study](https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(21)00438-7/fulltext) analyzing antibody responses in immunocompromised patients after receiving the Pfizer COVID-19 vaccine. This cohort of patients was not included in [original COVID-19 vaccine clinical trials](https://gaistaging.wpengine.com/articles/vaccine-autoimmune-disease-faq/#where-can-i-find-clinical-trial-data), but they may benefit most from vaccination as they experience higher mortality rates from COVID-19 compared to immunocompetent persons. Furthermore, “persistent infection of SARS-CoV-2 within immunocompromised hosts could serve as a reservoir for the generation of mutations and the subsequent emergence of novel strains with the potential to evade immune responses.” Weak antibody responses in immunocompromised patients may contribute to this phenomenon. Antibodies from 1002 immunocompromised patients and 272 immunocompetent healthcare workers were measured 2-4 weeks after completion of a Pfizer COVID-19 primary series. Treatments taken during the study include prednisone, anti-metabolites, and glucocorticosteroids. IgG antibodies were detected in: - 98.7% of patients with HIV - 83.3% of patients with solid malignancies - 79.7% of patients with myeloma - 74.8% of patients following hematopoietic stem cell transplants - 69.4% of patients following liver transplantation - 60.5% of patients with myelodysplastic syndrome - 51.0% of patients with chronic lymphocytic leukemia/non-Hodgkin’s lymphoma - 45.5% of patients following kidney transplantation - 18.8% of patients following heart transplantation - 98.9% of immunocompetent health care workers The most robust antibody response was observed in HIV patients within the cohort of immunosuppressed patients; older age and those with underlying immunosuppression experienced a “significantly associated” antibody response. The FDA and CDC’s COVID-19 vaccination guidance for immunocompromised persons has centered around solid organ transplantees and those with an “equivalent level of immunocompromise,” which includes autoimmune disease patients taking immunosuppressants ([1](https://gaistaging.wpengine.com/articles/vaccine-autoimmune-disease-faq/)). Even though this particular study did not include autoimmune disease patients, studies such as this can provide clarity for autoimmune disease patients navigating COVID-19 vaccination. ***<< Back to [COVID News & Research Updates](https://gaistaging.wpengine.com/articles/covid-19-information/covid-news-and-autoimmune-disease/)*** **Category:** Covid-19 Antibodies, Covid-19 Research Studies, Pfizer, Vaccine Manufacturers --- ### [Mortality Rates Among Rheumatic Disease Patients During the First Wave of COVID-19](https://www.autoimmuneinstitute.org/covid_timeline/mortality-rates-among-rheumatic-disease-patients-during-the-first-wave-of-covid-19/) **Published:** December 30, 2021 **Author:** Elevation **Excerpt:** Research published in Rheumatology found that patients living with rare autoimmune rheumatic diseases (RAIRD) were at double the risk of death from COVID-19 than the general population during the first wave of the pandemic. **Content:** December 30, 2021 Research published in [*Rheumatology* ](https://academic.oup.com/rheumatology/advance-article/doi/10.1093/rheumatology/keab794/6410658#312798326)found that patients living with rare autoimmune rheumatic diseases (RAIRD) were at double the risk of death from COVID-19 than the general population during the first wave of the pandemic. Rare autoimmune rheumatic diseases include [lupus](https://gaistaging.wpengine.com/resources/autoimmune-disease-list/systemic-lupus-erythematosus/), giant cell arteritis, [Juvenile idiopathic arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/juvenile-idiopathic-arthritis-stills/), [polymyositis](https://www.autoimmuneinstitute.org/autoimmune-resources/polymyositis/), [scleroderma](https://www.autoimmuneinstitute.org/autoimmune-resources/scleroderma/), and [Behcet’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/behcets/), amongst others. In order to determine mortality rates, researchers compared health records from Public Health England and the Office of National Statistics for the general population and 168,680 RAIRD patients. Within this cohort, 1,874 RAIRD patients tested positive for COVID-19. Records from March 1 – July 31, 2020 were included for analysis. Researchers found that patients with rare autoimmune rheumatic diseases were 1.54x more likely to be infected with COVID-19, and the mortality rate was 2.41x higher. The median length of hospital stays within this cohort was 8 days, and the median length of stay for ICU admissions was 6 days. “Deaths due to cardiovascular disease were recorded in 703 (21.1%), COVID-19 652 (19.6%), malignancy 581 (17.4%), respiratory 404 (12.1%), dementia 280 (8.4%), underlying RAIRD 113 (3.4%) and non-COVID-19 infection 19 (0.6%), with the remaining 580 (17.4%) ascribed to other causes.” These results show that COVID-19 infection was responsible for increased mortality within this cohort of patients, rather than rheumatic disease or other co-morbidities. Furthermore, those living with rare autoimmune rheumatic diseases are at an increased risk for COVID-19 compared to those with common rheumatic diseases; this may be due to the fact that those living with rare autoimmune rheumatic disease require long-term immunosuppression. Data on immunosuppressive medications was not included in this study. Researchers noted that “further work is needed to describe the outcomes in the second wave, and assess the influence of immunosuppression, shielding policies and the vaccination programme.” **Category:** Autoimmune Diseases & Covid-19, Covid-19 Infections, Covid-19 Research Studies, Lupus & Covid-19 --- ### [COVID-19 Vaccines in Patients with Antiphospholipid Antibodies](https://www.autoimmuneinstitute.org/covid_timeline/covid-19-vaccines-in-patients-with-antiphospholipid-antibodies/) **Published:** December 28, 2021 **Author:** Elevation **Excerpt:** 102 patients at the Center of Research for Immunopathology and Rare Diseases in Turin, Italy, were surveyed to better understand the safety of COVID-19 vaccines in patients with... **Content:** December 28, 2021 102 patients at the Center of Research for Immunopathology and Rare Diseases in Turin, Italy, were [surveyed](https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(21)00320-9/fulltext) to better understand the safety of COVID-19 vaccines in patients with antiphospholipid antibodies. These autoantibodies increase the risk of blood clotting, which is also a verified albeit rare adverse event to vaccination with [some COVID-19 vaccines](https://www.autoimmuneinstitute.org/covid-news-and-autoimmune-disease/page/2/?s=vaccine+blood+clot). Within the survey, 67 patients received Pfizer’s COVID-19 vaccine and 35 received the Moderna vaccine; 89 patients received two doses associated with a primary series. 14 patients had antiphospholipid syndrome associated with [SLE](https://gaistaging.wpengine.com/resources/autoimmune-disease-list/systemic-lupus-erythematosus/). Immunogenecity data from the survey showed that mRNA COVID-19 vaccines “seem to have an acceptable safety and tolerability profile in patients with antiphospholipid antibodies. No major adverse effects nor thrombotic events were reported. Side-effects seem frequent, but mild and transient in nature.” 78 of 102 patients had at least one side-effect, which included fatigue, headache, and pain at the injected site. No new thrombotic events were reported. **Category:** Autoimmune Diseases & Covid-19, Covid-19 Research Studies, Lupus & Covid-19, Moderna, Pfizer, Vaccine Adverse Events, Vaccine Manufacturers --- ### [UK Data on Vaccine Efficacy against the Omicron Variant](https://www.autoimmuneinstitute.org/covid_timeline/uk-data-on-vaccine-efficacy-against-the-omicron-variant/) **Published:** December 27, 2021 **Author:** Elevation **Excerpt:** A UK Health Security Agency technical briefing has reported that the new Omicron variant is able to evade antibodies from both vaccination and previous infection. Vaccine effectiveness was reportedly lower for Omicron than the Delta variant, with evidence of waning protection against symptomatic disease by 10 weeks after a booster dose. **Content:** December 27, 2021 A UK Health Security Agency [technical briefing](https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1043807/technical-briefing-33.pdf) has reported that the new Omicron variant is able to evade antibodies from both vaccination and previous infection. Vaccine effectiveness was reportedly lower for Omicron than the Delta variant, with evidence of waning protection against symptomatic disease by 10 weeks after a booster dose. Using data up until December 20, 2021, 132 individuals with laboratory confirmed cases of Omicron were hospitalized. 17 had received a booster dose, 74 had received a second dose to a primary series, and 27 were not vaccinated. Less than 10 patients’ vaccine statuses were unaccounted for or had only received one dose. Vaccines included for analysis were AstraZeneca, Pfizer and Moderna. Regardless of mixing-and-matching, “effectiveness was lower for Omicron compared to Delta.” It was assessed that an AstraZeneca primary series followed by an mRNA booster dose was 60% effective at preventing symptomatic infection 2-4 weeks after the booster dose. When given a Pfizer booster, efficacy decreased by the 10 week mark to 35%; vaccine effectiveness decreased to 45% when given a Moderna booster. “Among those who received a Pfizer primary course, vaccine effectiveness was around 70% after a Pfizer booster, dropping to 45% after 10-plus weeks and stayed around 70 to 75% after a Moderna booster up to 9 weeks after booster.” Compared to Delta, Omicron is “currently more concentrated in young adult age groups (20 to 29) and less prevalent in children… \[Moreover,\] the risk of hospital admission for a person detected as a case of Omicron appears reduced compared to a case of Delta.” In fact, the risk of emergency care or hospital admission with the Omicron variant was assessed to be 3/5 of that for Delta. That being said, these figures are based on preliminary analysis using data from small cohorts of emergency department and hospital admissions of patients infected with the Omicron variant. **Category:** AstraZeneca, Covid-19 Boosters, Covid-19 Infections, Covid-19 Research Studies, Covid-19 Variants, Moderna, Pfizer, Vaccine Manufacturers --- ### [Two COVID-19 Antiviral Pills Granted EUA](https://www.autoimmuneinstitute.org/covid_timeline/two-covid-antiviral-pills-granted-eua/) **Published:** December 24, 2021 **Author:** Elevation **Excerpt:** This week, the FDA granted EUA for two COVID-19 oral antiviral pills, which will be added as a second treatment protocol for COVID-19. Up until now, monoclonal antibodies have been the only authorized treatment for patients with COVID-19. **Content:** December 24, 2021 This week, the FDA granted EUA for two COVID-19 oral antiviral pills, which will be added as a second treatment protocol for COVID-19. Up until now, monoclonal antibodies have been the only authorized treatment for patients with COVID-19. Currently, Pfizer’s COVID-19 antiviral pill has been [authorized](https://www.pfizer.com/news/press-release/press-release-detail/pfizer-receives-us-fda-emergency-use-authorization-novel) for high-risk adults and children 12+ years in age. In a clinical trial, [Paxlovid](https://www.autoimmuneinstitute.org/pfizer-announces-covid-19-antiviral-pill/) reduced the risk of hospitalization and death by 89% when taken within three days of experiencing symptoms, and 88% when taken within five days. Paxlovid has shown a significantly higher rate of efficacy than Merck’s antiviral pill, [Molnupiravir](https://www.autoimmuneinstitute.org/final-analysis-caps-mercks-covid-19-antiviral-pill-at-30-efficacy/), which reduced the risk of hospitalization and death by 30% in a Merck clinical trial. In order to receive a Pfizer regimen, patients will need to receive a positive test result and get a prescription within five days upon the onset of symptoms. The regimen includes 30 pills taken over five days. Patients taking the [following medications](https://www.fda.gov/media/155050/download#page=6) should not take Paxlovid. Molnupiravir has been [authorized](https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-authorizes-additional-oral-antiviral-treatment-covid-19-certain) for adults 18+ in the US who are at risk of severe disease, of which other treatment options are not available, and taken within 5 days upon the onset of symptoms. This is due to the fact Merck’s pill has a relatively low efficacy rate compared to Paxlovid and [monoclonal antibody treatments](https://www.autoimmuneinstitute.org/covid-news-and-autoimmune-disease/?s=monoclonal). Additionally, “Molnupiravir is not authorized for use in patients younger than 18 years of age because molnupiravir may affect bone and cartilage growth. It is not authorized for the pre-exposure or post-exposure prevention of COVID-19 or for initiation of treatment in patients hospitalized due to COVID-19 because benefit of treatment has not been observed in people when treatment started after hospitalization due to COVID-19.” Those who are pregnant should not take Merck’s antiviral pill, as it may lead to birth defects. Those who may become pregnant should use contraception while taking the antiviral pills and for four days after the final dose; male partners of women who could become pregnant should use contraception during the treatment protocol and for at least three months after the final dose. During an [ACIP meeting](https://www.youtube.com/watch?v=fR9FNSJT64M) regarding Molnupiravir, panelists questioned the safety of Merck’s pill given its mutagenic qualities – Merck’s pill introduces errors into the virus’s genetic code to prevent replication ([1](https://www.science.org/content/article/prominent-virologist-warns-covid-19-pill-could-unleash-dangerous-mutants-others-see-little-cause-alarm)). The regimen includes 40 pills taken over five days. **Category:** Covid-19 & Long Covid Treatments, Covid-19 Policy, Covid-19 Research Studies, Moderna, Pfizer, Vaccine Manufacturers --- ### [Sotrovimab and the Omicron Variant](https://www.autoimmuneinstitute.org/covid_timeline/sotrovimab-and-the-omicron-variant/) **Published:** December 22, 2021 **Author:** Elevation **Excerpt:** Preliminary laboratory tests have indicated that Sotrovimab performs best against the Omicron variant. This may be due to the fact that Sotrovimab was designed to target a part of the spike protein that did not mutate between previous coronavirus strains and the Omicron variant. **Content:** December 22, 2021 Sotrovimab, a COVID-19 monoclonal antibody treatment, [was granted EUA](https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-authorizes-additional-monoclonal-antibody-treatment-covid-19) in May 2021. The EUA includes mild-to-moderate cases of COVID-19 in those 12+ years of age with a positive COVID-19 test result, who are at high risk of severe COVID-19. Sotrovimab has not been authorized for use in those already hospitalized for COVID-19, or those requiring oxygen therapy due to COVID-19, including higher oxygen rates than administered for a non-Covid-19 related underlying condition. A medley of monoclonal antibody treatments have been authorized in the battle against COVID-19 – including treatments by [Regeneron](https://www.autoimmuneinstitute.org/regenerons-antibody-cocktail-authorized-for-use-as-prophylaxis/), [Eli Lilly](https://www.autoimmuneinstitute.org/fda-authorizes-eli-lillys-covid-19-antibody-treatment-for-children-under-12/) and [AstraZeneca](https://www.autoimmuneinstitute.org/monoclonal-antibody-treatment-authorized-for-immunocompromised-persons/). Preliminary laboratory tests have indicated that Sotrovimab performs best against the Omicron variant. This may be due to the fact that Sotrovimab was designed to target a part of the spike protein that hasn’t mutated between previous coronavirus strains and the Omicron variant. While these [experimental results](https://www.medrxiv.org/content/10.1101/2021.12.14.21267772v1) have yet to be peer-reviewed, the U.S. is considering to pause purchasing doses of other monoclonal antibody treatments, and rationing Sotrovimab to states where the prevalence of Omicron is highest. That being said, the concentration necessary for halving viral replication is 3x higher for Omicron than previous strains. **Category:** AstraZeneca, Covid-19 & Long Covid Treatments, Covid-19 Research Studies, Covid-19 Variants, Vaccine Manufacturers --- ### [Efficacy of Moderna, Pfizer and Johnson & Johnson COVID-19 Vaccines Against the Omicron Variant](https://www.autoimmuneinstitute.org/covid_timeline/efficacy-of-moderna-pfizer-and-johnson-johnson-covid-19-vaccines-against-the-omicron-variant/) **Published:** December 21, 2021 **Author:** Elevation **Excerpt:** Read synopses of how each vaccine fares against the Omicron variant according to the latest data: **Content:** December 21, 2021 In the past month, COVID-19 news has shown a spotlight on covering the spread of the [Omicron variant](https://www.autoimmuneinstitute.org/the-omicron-variant/), which has now been labeled the [leading variant](https://covid.cdc.gov/covid-data-tracker/#variant-proportions) in the U.S. and accounts for three-fourths of total cases. Data coming out of South Africa, where the Omicron variant was first identified, shows a much lower hospitalization rate than initially expected, with signs that the current wave may already be peaking in South Africa. In fact, national data shows that while the average number of infections jumped by almost 5x in the second week of December, less than 2% resulted in hospitalization ([1](https://www.bloomberg.com/news/articles/2021-12-17/s-africa-says-hospitalizations-in-omicron-wave-much-lower), [2](https://www.nytimes.com/2021/12/17/world/south-africa-omicron-hospitalizations.html)). Since the Omicron variant was identified as a variant of concern, [Pfizer](https://www.autoimmuneinstitute.org/covid-news-and-autoimmune-disease/vaccine-manufacturers/pfizer/), [Moderna](https://www.autoimmuneinstitute.org/covid-news-and-autoimmune-disease/vaccine-manufacturers/moderna/), and [Johnson & Johnson](https://www.autoimmuneinstitute.org/covid-news-and-autoimmune-disease/vaccine-manufacturers/johnson-and-johnson/) have been testing the efficacy of their vaccines, including booster doses, as an extra form of protection. Below are synopses of how each vaccine fares against the Omicron variant according to the latest data: **MODERNA** [Moderna](https://investors.modernatx.com/news/news-details/2021/Moderna-Announces-Preliminary-Booster-Data-and-Updates-Strategy-to-Address-Omicron-Variant/default.aspx) found the two-dose primary series of their COVID-19 vaccine to be significantly less effective at preventing infection against the Omicron variant than the alpha or “wild type” variant. A 50-microgram booster, which is half the size of the primary series, increased antibodies by ~37x. While this is a significant increase, a 100-microgram booster dose was shown to increase antibody levels by ~83x compared to antibody levels following the primary series. **PFIZER** Earlier in December, [Pfizer](https://www.pfizer.com/news/press-release/press-release-detail/pfizer-and-biontech-provide-update-omicron-variant) released data from a laboratory study demonstrating a booster dose of their COVID-19 vaccine also increased antibody levels to neutralize the Omicron variant. While “two doses show significantly reduced neutralization titers,” three doses increased antibody titers by 25x, providing protection comparable to that of two doses against the alpha variant. Two doses have demonstrated protection against severe disease; results were collected from under 40 samples. **JOHNSON & JOHNSON** Johnson & Johnson’s vaccine has been shown to fare the worst against Omicron, providing low levels of protection. The ACIP, the advisory committee to the CDC, convened last week to discuss Johnson & Johnson COVID-19 vaccines and booster doses in light of Omicron and regarding cases of thrombosis with thrombocytopenia (TTS). TTS has been verified by the FDA and CDC as a rare but possible adverse event after receiving the J&J vaccine. On Thursday, the ACIP and [CDC](https://www.cdc.gov/media/releases/2021/s1216-covid-19-vaccines.html) recommended against the use of a second J&J dose following the primary series. The CDC’s official stance now recommends an mRNA vaccine after the initial J&J primary dose. Studies have shown that a J&J COVID-19 primary series followed by an mRNA vaccine as a booster dose provides a significant jump in antibodies. Read more about mixing and matching COVID-19 vaccine doses [here](https://www.autoimmuneinstitute.org/covid-news-and-autoimmune-disease/?s=mix). **Category:** Covid-19 Boosters, Covid-19 Infections, Covid-19 Research Studies, Covid-19 Variants, Johnson & Johnson, Moderna, Pfizer, Vaccine Manufacturers --- ### [Role of RNAaemia and the Immunopathology of Moderate-to-Severe COVID](https://www.autoimmuneinstitute.org/covid_timeline/role-of-rnaaemia-and-the-immunopathology-of-moderate-to-severe-covid-19/) **Published:** December 17, 2021 **Author:** Elevation **Excerpt:** A Viewpoint article published in The Lancet Rheumatology proposed that different presentations of COVID-19 may require varied approaches for treatment. **Content:** December 17, 2021 A [Viewpoint article](https://www.sciencedirect.com/science/article/pii/S2665991321003222) published in *The Lancet Rheumatology* proposed that different presentations of COVID-19 may require varied approaches for treatment. Researchers shared that while mild COVID-19 may best be treated with antiviral cocktails, immunomodulatory therapy may benefit those with excessive innate immune responses in the lungs, including pulmonary immunothrombosis. One hallmark sign of COVID-19 is the activation of [cytokine storm](https://www.autoimmuneinstitute.org/articles/sars-cov-2-autoimmune-virus-long-covid/) with the release of pro-inflammatory cytokines. This aggressive inflammatory response may increase the risk of mortality. Tocilizumab, used to treat severe rheumatoid arthritis and juvenile arthritis, is an interleukin (IL)-6 receptor blocker, effective in treating cytokine storm syndromes. While clinical studies have emerged using corticosteroids and IL-6 inhibitors, the use of therapies specifically targeted at mitigating cytokine storm syndromes has only recently been tested. Authors of this Viewpoint article shared that “immunotherapy would improve survival only in clinical settings in which excessive innate and adaptive immune responses (including autoimmune responses) occur in the context of rapid control of SARS-CoV-2 replication.” The benefits of corticosteroid or IL-6 receptor blockade in patients with COVID-19 have not been replicated consistently in controlled studies; this includes Tocilizumab. Moreover, distinguishing ongoing infections from excessive inflammatory responses and immunothrombosis, “could be useful to improve survival.” Viral RNA can linger in the blood for weeks after initial infection, also persisting in the respiratory and gastrointestinal tracts for several weeks in some patients with more severe cases of COVID-19. Additionally, high serum cytokine concentrations can be linked to ongoing replication of SARS-CoV-2. “A key observation in patients with severe COVID-19 is that RNAaemia or detectible SARS-CoV-2 RNA in the blood, but not proven cultivable virus, is linked to serum concentrations of IL-6 up to 10 times higher than in patients without RNAaemia.” RNAaemia is the occurrence of COVID-19 pneumonia with the presence of viral RNA in the blood. Modest RNAaemia has been linked with high IL-6 concentrations and mortality in severe COVID-19 pneumonia patients. Those in acquired immunodeficiency states with rheumatological conditions, including those with prolonged corticosteroid treatment, B-cell depleting therapy, and immunosuppressive drugs, have “marked effects” on T-cell function, and may lead to higher rates of COVID-19 mortality. Authors highlighted that these factors may contribute to ongoing viral replication, “which might be a major challenge in selecting patients for immunosuppression and means that consideration of early immunomodulatory therapy in patients with moderate-to-severe COVID-19 pneumonia needs careful re-evaluation.” That being said, some forms of immunotherapy actually seem to improve survival in severe cases of COVID-19. It is possible for cases where viral replication is controlled but a hyper-inflammatory response still occurs and creates immunothrombosis. In fact, pulmonary immunothrombosis occurs in over 90% of severe COVID-19 cases. Immunothrombosis involves the innate immune system to form blood clots. SARS-CoV-2 RNA in the blood of severe COVID-19 patients versus mild cases supports the idea that the blood-air barrier within the lungs breaks down, allowing viral RNA to spread and immunothrombosis to develop. The authors point out that immunothrombosis without viral replication may help explain the benefits of immunomodulatory therapy when used in the post-viral replication phase of severe COVID-19 pneumonia cases. It was discovered in earlier research that [heparin](https://www.autoimmuneinstitute.org/adenovirus-vaccines-and-blood-clots/) has not been seen to improve outcomes in patients with severe COVID-19. Additionally, the presence of viral RNA is “likely to result in temporary failure of immunological tolerance against many self-proteins, with emergency of multiple autoantibodies.” In mouse models, certain autoantibodies were shown to exacerbate disease. Immunotherapy may suppress these autoantibodies, including hyper T-cell responses. **Category:** Covid-19 & Long Covid Treatments, Covid-19 Antibodies, Covid-19 Infections, Covid-19 Research Studies, Long COVID, RA & Covid-19 --- ### [FDA Authorizes Pfizer Booster for Young Adults](https://www.autoimmuneinstitute.org/covid_timeline/fda-authorizes-pfizer-booster-for-young-adults/) **Published:** December 10, 2021 **Author:** Elevation **Excerpt:** Yesterday, the FDA authorized COVID-19 booster shots for 16 and 17 year olds. Young adults in this age group who’ve received two shots of the Pfizer vaccine may now receive a third dose, 6 months after their primary series. **Content:** December 10, 2021 Yesterday, the [FDA authorized](https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-expands-eligibility-pfizer-biontech-covid-19-booster-dose-16-and-17) COVID-19 booster shots for 16 and 17 year olds. Young adults in this age group who’ve received two shots of the Pfizer vaccine may now receive a third dose, 6 months after their primary series. As of now, Pfizer is the only vaccine manufacturer authorized for emergency use in children; Moderna and Johnson & Johnson’s vaccines are only authorized for adults 18+. To read more about the development process for these vaccines, as well as the authorization process, check out our [chart](https://www.autoimmuneinstitute.org/vaccine-comparison-chart/). The FDA made this decision for booster doses due to the emergence of the [Omicron variant](https://www.autoimmuneinstitute.org/the-omicron-variant/), following [Pfizer’s announcement](https://investors.pfizer.com/Investors/News/news-details/2021/Pfizer-and-BioNTech-Provide-Update-on-Omicron-Variant/default.aspx) that two doses may not provide ample protection against Omicron. The company stated that a third dose of the vaccine will provide protection against Omicron similar to that of two doses against the Alpha variant. In fact, “data indicate that a third dose of \[the Pfizer vaccine\] increases the neutralizing antibody titers by 25-fold compared to two doses against the Omicron variant.” **Category:** Covid-19 Boosters, Covid-19 Policy, Covid-19 Variants, Pfizer, Vaccine Manufacturers --- ### [Monoclonal Antibody Treatment Authorized for Immunocompromised Persons](https://www.autoimmuneinstitute.org/covid_timeline/monoclonal-antibody-treatment-authorized-for-immunocompromised-persons/) **Published:** December 9, 2021 **Author:** Elevation **Excerpt:** Last night, the FDA authorized a COVID-19 monoclonal antibody treatment by AstraZeneca for immunocompromised individuals, who did not produce sufficient antibodies following vaccination. **Content:** December 9, 2021 Last night, the [FDA authorized](https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-authorizes-new-long-acting-monoclonal-antibodies-pre-exposure) a COVID-19 monoclonal antibody treatment by AstraZeneca for immunocompromised individuals, who did not produce sufficient antibodies following vaccination. This includes patients taking immunosuppressants. Evusheld was specifically developed to metabolize over a matter of months – perhaps up to six – meaning it offers longer-lasting protection against COVID-19. Evusheld differs from other monoclonal antibody treatments, such as [Eli Lilly’s](https://www.autoimmuneinstitute.org/covid-news-and-autoimmune-disease/?s=eli+lilly) or [Merck’s](https://www.autoimmuneinstitute.org/covid-news-and-autoimmune-disease/?s=merck), in that it is administered as a long-acting prophylactic (disease preventative) as opposed to being a treatment for those already infected by Covid or short-term protective treatment. Evusheld is not authorized for those already infected with COVID-19, nor those who have been exposed to someone with COVID-19. In its clinical trial, AstraZeneca’s Evusheld reduced the risk of symptomatic infection by 83%; these results included both immunocompromised and immunocompetent participants. The treatment includes two separate intramuscular injections given back-to-back, each with one monoclonal antibody. “Monoclonal antibodies are laboratory-made proteins that mimic the immune system’s ability to fight off harmful pathogens such as viruses. Tixagevimab and cilgavimab are long-acting monoclonal antibodies that are specifically directed against the spike protein of SARS-CoV-2, designed to block the virus’ attachment and entry into human cells. Tixagevimab and cilgavimab bind to different, non-overlapping sites on the spike protein of the virus.” Evusheld will be available for certain adults as well as pediatric patients 12+ years of age. **Category:** AstraZeneca, Covid-19 & Long Covid Treatments, Covid-19 Antibodies, Covid-19 Policy --- ### [Adenovirus Vaccines and Blood Clots](https://www.autoimmuneinstitute.org/covid_timeline/adenovirus-vaccines-and-blood-clots/) **Published:** December 8, 2021 **Author:** Elevation **Excerpt:** New research suggests how COVID-19 adenovirus vaccines may lead to extremely rare cases of thrombosis with thrombocytopenia syndrome (TTS), an autoimmune response which can lead to fatal blood clots. Thrombosis with thrombocytopenia was verified by the WHO as a possible adverse event to AstraZeneca and Johnson & Johnson COVID-19 vaccines earlier this year, following the first but rarely after the second dose. **Content:** December 8, 2021 [New research](https://www.science.org/doi/10.1126/sciadv.abl8213) suggests how COVID-19 adenovirus vaccines may lead to extremely rare cases of thrombosis with thrombocytopenia syndrome (TTS), an autoimmune response which can lead to fatal blood clots. Thrombosis with thrombocytopenia was verified by the WHO as a *possible* adverse event to AstraZeneca and Johnson & Johnson COVID-19 vaccines earlier this year, following the first but rarely after the second dose. If the adenovirus – the mechanism used to deliver the coronavirus gene into human cells – leaks into the bloodstream, it has the potential to bind to blood proteins responsible for clotting. Current evidence indicates that TTS appears to be driven by specific autoantibodies (anti-PF4) which cluster and create more autoantibodies. “This creates a positive feedback loop as antibodies bind to increasing copies of PF4, stimulating further platelet activation, culminating in the activation of the clotting cascade.” As a response, the body releases antibodies against the protein, with the extremely rare chance of causing blood clots to form. Researchers note that whether anti-PF4 autoantibodies induce thrombosis or not, “is a function of concentration and antibody affinity for PF4.” Recent case reports indicated that over 90% of patients presenting with TTS tested positive for anti-PF4 antibodies. The study’s investigators found that patients who developed TTS had not been treated with heparin before vaccination. Heparin is an anticoagulant used to prevent blood clots, but it is not recommended that patients take heparin to inhibit the interaction between adenovirus vaccines and PF4 antibodies, nor should patients take heparin following the development of symptoms after vaccination. Researchers hypothesize that understanding the interaction between adenoviruses and blood proteins may present an opportunity to engineer the outer shell of the vaccine to prevent this from happening. Furthermore, studies are needed to confirm whether adenovirus complexes can induce thrombosis when anti-PF4 antibodies are present. **Category:** AstraZeneca, Covid-19 Antibodies, Covid-19 Research Studies, Johnson & Johnson, Vaccine Adverse Events --- ### [FDA Authorizes Eli Lilly’s COVID Antibody Treatment for Children under 12](https://www.autoimmuneinstitute.org/covid_timeline/fda-authorizes-eli-lillys-covid-19-antibody-treatment-for-children-under-12/) **Published:** December 7, 2021 **Author:** Elevation **Excerpt:** Last Friday, the FDA authorized the use of Eli Lilly’s monoclonal antibody treatment for young children, including newborns. “Monoclonal antibodies are laboratory-made proteins that mimic the immune system’s ability to fight off harmful pathogens, such as viruses. **Content:** December 7, 2021 Last Friday, the [FDA authorized](https://www.fda.gov/news-events/press-announcements/fda-expands-authorization-two-monoclonal-antibodies-treatment-and-post-exposure-prevention-covid-19) the use of Eli Lilly’s monoclonal antibody treatment for young children, including newborns. “Monoclonal antibodies are laboratory-made proteins that mimic the immune system’s ability to fight off harmful pathogens, such as viruses. Bamlanivimab and etesevimab \[which comprise Eli Lilly’s antibody cocktail\] are monoclonal antibodies that are specifically directed against the spike protein of SARS-CoV-2, designed to block the virus’ attachment and entry into human cells. Bamlanivimab and etesevimab bind to different but overlapping sites on the spike protein of the virus.” The protocol has been available for children 12+ who were at risk of developing severe COVID-19 since February of this year, and as a post-exposure prophylaxis since September. This authorization will be available for the treatment of mild to moderate COVID-19 in all pediatric patients, who have a positive COVID-19 test and are at high risk of severe COVID-19. This includes hospitalization or death. The authorization also includes the possibility of receiving treatment as a post-exposure prophylaxis for prevention of COVID-19 in pediatric patients, who are at high risk of severe COVID-19. **Category:** Covid-19 & Long Covid Treatments, Covid-19 Antibodies, Covid-19 Infections, Covid-19 Policy --- ### [Antibodies, BMI, and COVID](https://www.autoimmuneinstitute.org/covid_timeline/antibodies-bmi-and-covid-19/) **Published:** December 6, 2021 **Author:** Elevation **Excerpt:** New research has studied the impact of BMI on the production of IgG (Immunoglobulin G) antibodies in patients infected with SARS-CoV-2. Researchers collected serum samples from 30 patients who tested positive for COVID-19: 15 of which with a BMI < 25 and 15 with a BMI ≥ 30. **Content:** December 6, 2021 [New research](https://www.nature.com/articles/s41366-021-01016-9.pdf) has studied the impact of BMI on the production of IgG (Immunoglobulin G) antibodies in patients infected with SARS-CoV-2. Researchers collected serum samples from 30 patients who tested positive for COVID-19: 15 of which with a BMI < 25 and 15 with a BMI ≥ 30. 30 uninfected individuals served as age-, gender-, and BMI- matched controls. Following examination of the serum samples, it was concluded that SARS-CoV-2 infection-induced neutralizing antibodies in all of those with a BMI of <25. Only a few of those with a COVID-19 infection and a BMI ≥ 30 presented neutralizing antibodies. Conversely, those whose BMI ≥ 30 recorded higher levels of autoimmune antibodies (autoantibodies). A neutralizing antibody is an antibody that defends our cells from infectious particles/pathogens by neutralizing any biological effect it has to render it no longer infectious or pathogenic. Autoantibodies, on the other hand, are antibodies produced by the immune system and are directed against the body’s own proteins. The autoantibodies studied in this research were malondialdehyde (MDA)-specific IgG and adipocyte-derived (AD)-specific antibodies. These autoantibodies have been correlated with serum levels of C-reactive protein (CRP), a general marker of inflammation, which has been found to induce oxidative stress and tissue damage in those with obesity. ***<< Back to [COVID News & Research Updates](https://www.autoimmuneinstitute.org/articles/covid-19-information/covid-news-and-autoimmune-disease/)*** **Category:** Covid-19 Antibodies, Covid-19 Research Studies --- ### [Final Analysis Caps Merck’s COVID-19 Antiviral Pill at 30% Efficacy ](https://www.autoimmuneinstitute.org/covid_timeline/final-analysis-caps-mercks-covid-19-antiviral-pill-at-30-efficacy/) **Published:** November 30, 2021 **Author:** Elevation **Excerpt:** Last Friday, Merck released a final analysis of its clinical trial for molnupiravir, their COVID-19 antiviral pill. An interim analysis stated molnupiravir reduced the risk of hospitalization and death by 50%; it has now been lowered to 30%. **Content:** November 30, 2021 Last Friday, Merck released a [final analysis](https://www.merck.com/news/merck-and-ridgeback-biotherapeutics-provide-update-on-results-from-move-out-study-of-molnupiravir-an-investigational-oral-antiviral-medicine-in-at-risk-adults-with-mild-to-moderate-covid-19/) of its clinical trial for molnupiravir, their COVID-19 antiviral pill. An interim analysis stated molnupiravir reduced the risk of hospitalization and death by 50%; it has now been lowered to 30%. Monoclonal antibodies, which are administered intravenously, have been found to reduce hospitalization and death by 70% or more. [Paxlovid](https://www.autoimmuneinstitute.org/pfizer-announces-covid-19-antiviral-pill/), Pfizer’s antiviral pill, was found to cut the risk of hospitalization and death by 89% in their clinical trial. Merck’s clinical trial included over 1,400 participants and did not show major safety concerns. Participants who received molnupiravir demonstrated a 6.8% risk of being hospitalized, versus 9.7% in the placebo group. One patient who received the drug died, versus nine in the placebo group. The biggest reduction in mortality can be seen in patients who begin the regimen early into their COVID-19 infection when symptoms are still mild. The advisory panel to the FDA will be [meeting today](https://www.youtube.com/watch?v=fR9FNSJT64M) to discuss emergency use authorization of molnupiravir for mild to moderate COVID-19 in adults. **Category:** Covid-19 & Long Covid Treatments, Covid-19 Clinical Trials, Covid-19 Infections --- ### [The Omicron Variant](https://www.autoimmuneinstitute.org/covid_timeline/the-omicron-variant/) **Published:** November 29, 2021 **Author:** Elevation **Excerpt:** The WHO announced a new variant of concern last Friday. The Omicron variant has around 50 mutations from previous strains of the coronavirus, including over 30 mutations on the spike protein. **Content:** November 29, 2021 The [WHO](https://www.who.int/news/item/26-11-2021-classification-of-omicron-(b.1.1.529)-sars-cov-2-variant-of-concern) announced a new variant of concern last Friday. The Omicron variant has around 50 mutations from previous strains of the coronavirus, including over 30 mutations on the spike protein. Spike proteins are responsible for invading cells, but it is still unclear whether mutations in the spike protein allow variants to evade antibodies produced by infection or vaccination. *The New York Times* displays the visual differences between coronavirus strains [here](https://www.nytimes.com/interactive/2021/health/coronavirus-variant-tracker.html), including differences in the spike protein between variants. In comparison to other variants of concern (VOCs), “preliminary evidence suggests an increased risk of reinfection with this variant.” Even if the efficacy is reduced, vaccination is expected to provide some level of protection against the Omicron variant as it triggers immune cells to attack infected cells, along with the production of antibodies. In an [official statement](https://www.whitehouse.gov/briefing-room/statements-releases/2021/11/28/readout-of-president-bidens-meeting-with-covid-19-response-team-on-the-omicron-variant/) from the White House, Dr. Fauci stated it will take approximately two weeks to learn more about the transmissibility and severity of the Omicron variant. You can read why variants are more infectious [here](https://www.autoimmuneinstitute.org/why-are-variants-more-infectious/). **Category:** Covid-19 Infections, Covid-19 Variants --- ### [EMA Recommends Merck’s COVID-19 Antiviral Pill](https://www.autoimmuneinstitute.org/covid_timeline/ema-recommends-mercks-covid-19-antiviral-pill/) **Published:** November 23, 2021 **Author:** Elevation **Excerpt:** Last Friday, the European Union’s drug regulator recommended the use of Merck’s COVID-19 antiviral pill, molnupiravir. Earlier this month, Britain became the first country to grant authorization. **Content:** November 23, 2021 [Last Friday](https://www.ema.europa.eu/en/news/ema-issues-advice-use-lagevrio-molnupiravir-treatment-covid-19), the European Union’s drug regulator recommended the use of Merck’s COVID-19 antiviral pill, molnupiravir. Earlier this month, Britain became the first country to grant authorization. While molnupiravir has yet to be authorized by E.U. countries or the U.S., this can be expected in the upcoming months. In an earlier clinical trial, molnupiravir was observed to cut the rate of hospitalization and death in high-risk COVID patients by half, especially when taken early into a COVID-19 infection. It can be taken orally from home to treat mild to moderate symptoms. Read more about molnupiravir [here](https://www.autoimmuneinstitute.org/uk-approves-mercks-covid-19-antiviral-pill/). Pfizer has also developed a COVID-19 antiviral pill, which is pending FDA authorization. Pfizer’s pill, [Paxlovid](https://www.autoimmuneinstitute.org/pfizer-announces-covid-19-antiviral-pill/), and molnupiravir, are currently the only two candidates catering to at-home treatment. [Monocolonal antibodies](https://www.autoimmuneinstitute.org/who-endorses-regenerons-covid-19-antibody-treatment/), which are being used to treat COVID-19 infections, must be administered by infusion. AstraZeneca’s antibody treatment, [AZD7442](https://www.autoimmuneinstitute.org/astrazeneca-announces-non-vaccine-covid-prevention-therapy-with-77-efficacy/), is a single injection. **Category:** Covid-19 & Long Covid Treatments, Covid-19 Policy --- ### [CDC expands eligibility of boosters for 18+](https://www.autoimmuneinstitute.org/covid_timeline/cdc-expands-eligibility-of-boosters-for-18/) **Published:** November 22, 2021 **Author:** Elevation **Excerpt:** Last Friday, the CDC expanded booster eligibility for everyone over 18 years of age. Those who received a Pfizer or Moderna vaccine may now receive a booster dose 6 months after their primary series. **Content:** November 22, 2021 Last Friday, the CDC [expanded booster eligibility](https://www.cdc.gov/media/releases/2021/s1119-booster-shots.html) for everyone over 18 years of age. Those who received a Pfizer or Moderna vaccine may now receive a booster dose 6 months after their primary series. Ahead of the CDC’s endorsement, an advisory committee to the CDC convened to discuss two new recommendations. Members voted 11-0 in favor of both recommendations: \#1 – A single COVID-19 vaccine booster dose is recommended for persons aged 18+ who received an mRNA COVID-19 vaccine primary series based on individual benefit and risk, at least 6 months after the primary series, under the FDA’s EUA. \#2 – A single COVID-19 vaccine booster dose is recommended for persons 50+ years who received an mRNA COVID-19 vaccine at least 6 months after the primary series under the FDA’s EUA. During the ACIP meeting, both Pfizer and Moderna [presented](https://www.cdc.gov/vaccines/acip/meetings/slides-2021-11-19.html) on clinical studies for booster doses. The Pfizer booster will measure the same as the primary series at 30 micrograms; the Moderna booster is a half dose at 50 micrograms versus 100 micrograms for the primary series and third dose. It is not recommended that those who received a Johnson & Johnson vaccine for their primary series, followed by a second dose, receive a third dose of Johnson & Johnson at this time. The ACIP also clarified that those who have received a primary series are still considered “fully vaccinated,” and that booster doses should be assessed individually based on age and a person’s medical profile. As of now, booster doses have not been proven to decrease hospitalization; it has only been extrapolated from existing data. Existing data supports booster doses improving protection against symptomatic infection. **Category:** Covid-19 Boosters, Covid-19 Policy, Johnson & Johnson, Moderna, Pfizer, Vaccine Manufacturers --- ### [FDA Authorizes Pfizer and Moderna Boosters for 18+](https://www.autoimmuneinstitute.org/covid_timeline/fda-authorizes-pfizer-and-moderna-boosters-for-18/) **Published:** November 19, 2021 **Author:** Elevation **Excerpt:** This morning, the FDA expanded eligibility around booster shots of both the Pfizer and Moderna vaccines for adults 18+, six months after their primary series. Those who have received a Johnson & Johnson vaccine for their primary series can receive a Pfizer or Moderna booster dose two months after their single dose primary series **Content:** November 19, 2021 This morning, the [FDA expanded eligibility](https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-expands-eligibility-covid-19-vaccine-boosters) around booster shots of both the Pfizer and Moderna vaccines for adults 18+, six months after their primary series. Those who have received a Johnson & Johnson vaccine for their primary series can receive a Pfizer or Moderna booster dose two months after their single dose primary series. The booster shot will be a single dose. A main reason for expanding eligibility will “help to eliminate confusion about who may receive a booster dose and to ensure booster doses are available to all who may need one.” Recommendations on third doses versus booster doses for those who are immunocompromised may differ on a [case-by-case basis](https://www.autoimmuneinstitute.org/articles/vaccine-autoimmune-disease-faq/#should-i-get-a-booster-dose). The ACIP, the advisory panel to the CDC, will be meeting later today from 12-3pm EST to discuss clinical recommendations on the FDA’s amendment. The CDC must approve the decision before booster doses can be administered in accordance with federal authorization. The ACIP meeting is open to the public, and available to watch [here](https://www.cdc.gov/vaccines/acip/index.html). **Category:** Covid-19 Boosters, Covid-19 Policy, Johnson & Johnson, Moderna, Pfizer, Vaccine Manufacturers --- ### [Antibody Responses in Rheumatic Disease Patients Following mRNA Vaccination](https://www.autoimmuneinstitute.org/covid_timeline/antibody-responses-in-rheumatic-disease-patients-following-mrna-vaccination/) **Published:** November 15, 2021 **Author:** Elevation **Excerpt:** A prospective observational study presented at the American College of Rheumatology’s annual meeting measured the immunogenicity (ability to provoke an immune response) of mRNA vaccines in fully vaccinated rheumatic disease patients. **Content:** November 15, 2021 A [prospective observational study](https://acrabstracts.org/abstract/immunogenicity-of-mrna-covid-19-vaccines-at-4-and-12-weeks-post-full-vaccination-in-patients-with-inflammatory-rheumatic-diseases/) presented at the American College of Rheumatology’s annual meeting measured the immunogenicity (ability to provoke an immune response) of mRNA vaccines in fully vaccinated rheumatic disease patients. Researchers used the Swiss long-term observational registry to study 441 patients with [rheumatoid arthritis](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/rheumatoid-arthritis/), [psoriatic arthritis](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/psoriatic-arthritis/) and axial spondyloarthritis. Participants completed an app-based questionnaire and provided self-collected blood samples before being vaccinated as well as at 4, 12, and 24 weeks post-vaccination. Samples were tested for IgG anti-spike (S1) antibodies; these antibodies recognize the SARS-CoV-2 spike protein, the agent which binds to and invades cells to develop a COVID-19 infection. Antibody levels differed significantly depending on the therapies patients were taking. Patients on TNF inhibitors were observed to produce less anti-S1 antibodies compared to those on DMARD therapy at the 4 and 12 week intervals. This association was more significant in those taking combination therapy. Patients taking rituximab also had a reduced anti-S1 response, as “4/11 of rituximab-treated patients failed to seroconvert after a full mRNA COVID-19 vaccination.” Additionally, preliminary results demonstrated a decline of anti-spike S1 antibodies from weeks 4-12 in those without prior SARS-CoV-2 infection. Further analysis will allow for the assessment of anti-spike S1 responses at the 24 week mark. **Category:** Autoimmune Diseases & Covid-19, Covid-19 Antibodies, Covid-19 Research Studies, RA & Covid-19 --- ### [Antibody Responses in Vaccinated IBD Patients](https://www.autoimmuneinstitute.org/covid_timeline/antibody-responses-in-vaccinated-ibd-patients/) **Published:** November 11, 2021 **Author:** Elevation **Excerpt:** A study conducted out of Cedars-Sinai found that patients with IBD (ulcerative colitis and Crohn’s disease) produced strong antibodies following COVID-19 vaccination. Patients taking medications for other chronic inflammatory disorders have been observed to produce less antibodies depending on the medication they are taking to treat their autoimmune disease. **Content:** November 11, 2021 A [study](https://www.acpjournals.org/doi/10.7326/M21-2483) conducted out of Cedars-Sinai found that patients with IBD ([ulcerative colitis](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/ulcerative-colitis/) and [Crohn’s disease](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/crohns-disease/)) produced strong antibodies following COVID-19 vaccination. Patients taking medications for other [chronic inflammatory disorders](https://www.autoimmuneinstitute.org/89-of-those-with-chronic-inflammatory-conditions-produce-antibodies-following-vaccination-despite-immunosuppressant-usage/) have been observed to produce less antibodies depending on the medication they are taking to treat their autoimmune disease. Researchers measured the antibody titers in patients with IBD who received an mRNA COVID-19 vaccine. Antibody titers were measured after the first and second doses, as well as three additional times after receiving the second dose. Of 582 participants, “proportions of participants receiving no immune suppression, anti-integrin therapy, anti–interleukin-12/23 therapy, immunomodulator monotherapy, anti–tumor necrosis factor monotherapy, Janus kinase inhibition, anti–tumor necrosis factor therapy combined with an immunomodulator, and systemic corticosteroids were 15.8%, 13.7%, 20.4%, 2.1%, 31.4%, 1.2%, 8.6%, and 6.0%, respectively.” Overall, 854 antibody samples were collected; **almost all IBD patients produced an antibody response to the mRNA vaccines.** 49% of participants had positive antibody levels after the first dose, 92% had positive antibodies after the second dose, and 99% had positive antibodies week 2 after the second dose. After week 2, antibody levels decreased. Researchers also found that antibody responses after the second dose differed according to the immunosuppressant participants were taking. After eight weeks, patients on anti-TNF therapies or corticosteroids had lower antibody counts than patients on anti-tegrin or anti-IL 12/23 therapies. That being said, the initial response to vaccination parallels the antibody response of IBD patients not on immunosuppressive therapies. Researchers shared that those currently on anti-TNF therapies or corticosteroids may benefit from a third dose of the vaccine. **Category:** Autoimmune Diseases & Covid-19, Covid-19 Research Studies, IBD & Covid-19, Moderna, Pfizer, Vaccine Manufacturers --- ### [Why are Variants More Infectious?](https://www.autoimmuneinstitute.org/covid_timeline/why-are-variants-more-infectious/) **Published:** November 10, 2021 **Author:** Elevation **Excerpt:** New insights into the SARS-CoV-2 virus indicate that mutations in the alpha and delta variants may boost the virus’s ability to spread. Spike proteins are responsible for invading cells, but it’s been unclear how mutation alters the virus’s function.  **Content:** November 10, 2021 New insights into the SARS-CoV-2 virus indicate that mutations in the alpha and delta variants may boost the virus’s ability to spread. Spike proteins are responsible for invading cells, but it’s been unclear how mutation alters the virus’s function. [New research](https://www.pnas.org/content/118/47/e2109905118) funded by the NIH focuses on the infectivity of both the alpha and delta variants, which will provide a framework for future treatment options as the virus continues to mutate. SARS-CoV-2 contains a unique set of amino acids that is not present in other coronaviruses, with the spike protein present in the outermost layer and being responsible for binding to host cells. Before this can happen, “the spike protein must be activated by a series of cuts, or cleavages, by host proteins” ([1](https://www.nih.gov/news-events/news-releases/nih-scientists-identify-mechanism-may-influence-infectivity-sars-cov-2-variants)). In both the alpha and delta variants, mutations appear to change a specific novel cleavage site, called the furin cleavage. These changes are thought to make the virus more effective at invading cells. Researchers were able to show that this specific type of cleavage in the alpha and delta variants go “unchecked.” Researchers also observed the cells’ tendency to fuse with surrounding cells, “a behavior that may facilitate spread of the virus during infection.” Additionally, cells with mutated spike proteins fused with their neighbors more often than the original, “wild-type” spike protein. This indicates that mutations do enhance the virus’ ability to attach to and invade cells. While research was first conducted in fruit fly and mammalian cells, the team analyzed cells from healthy volunteers to find that the enzymes which impact cleavages could influence the severity of infection in humans. It was hypothesized that a person’s expression of these enzymes could also affect the virus’ ability to spread. **Category:** Covid-19 Infections, Covid-19 Research Studies, Covid-19 Variants --- ### [Pfizer Announces COVID-19 Antiviral Pill](https://www.autoimmuneinstitute.org/covid_timeline/pfizer-announces-covid-19-antiviral-pill/) **Published:** November 9, 2021 **Author:** Elevation **Excerpt:** Last Friday, Pfizer announced that the clinical trial for their COVID-19 antiviral pill, Paxlovid, demonstrated high efficacy in preventing severe COVID-19 in at-risk persons. Paxlovid is unique and differs from Merck’s COVID-19 antiviral, Molnupiravir, by binding to enzymes responsible for the replication of SARS-CoV-2 and inhibiting its life cycle. **Content:** November 9, 2021 Last Friday, [Pfizer announced](https://www.pfizer.com/news/press-release/press-release-detail/pfizers-novel-covid-19-oral-antiviral-treatment-candidate) that the clinical trial for their COVID-19 antiviral pill, Paxlovid, demonstrated high efficacy in preventing severe COVID-19 in at-risk persons. Paxlovid is unique and differs from [Merck’s COVID-19 antiviral, Molnupiravir](https://www.autoimmuneinstitute.org/uk-approves-mercks-covid-19-antiviral-pill/), by binding to enzymes responsible for the replication of SARS-CoV-2 and inhibiting its life cycle. In their [Phase 2/3 clinical trial](https://clinicaltrials.gov/ct2/show/NCT04960202), those who received the drug within three days of experiencing symptoms were 89% less likely to be hospitalized or die. In the overall study population through Day 28, no deaths were reported in patients treated with Paxlovid, and only .8% of patients who received Paxlovid were hospitalized through Day 28. 10 deaths occurred in the placebo group. Like Merck’s trial for Molnupiravir, the Pfizer clinical trial has been ended early due to the “overwhelming efficacy demonstrated in these results” ([1](https://www.pfizer.com/news/press-release/press-release-detail/pfizers-novel-covid-19-oral-antiviral-treatment-candidate)). **Category:** Covid-19 & Long Covid Treatments, Covid-19 Clinical Trials, Covid-19 Infections, Pfizer --- ### [UK Approves Merck’s COVID-19 Antiviral Pill ](https://www.autoimmuneinstitute.org/covid_timeline/uk-approves-mercks-covid-19-antiviral-pill/) **Published:** November 8, 2021 **Author:** Elevation **Excerpt:** Last Thursday, the UK became the first country to approve an antiviral drug for COVID-19. Molnupiravir, developed by Merck and Ridgeback Biotherapeutics, is designed to stop SARS-CoV-2 from replicating by disrupting its genetic code. **Content:** November 8, 2021 Last Thursday, the UK became the first country to approve an antiviral drug for COVID-19. [Molnupiravir](https://www.merck.com/news/merck-and-ridgebacks-molnupiravir-an-oral-covid-19-antiviral-medicine-receives-first-authorization-in-the-world/), developed by Merck and Ridgeback Biotherapeutics, is designed to stop SARS-CoV-2 from replicating by disrupting its genetic code. It can be taken orally from home to treat mild to moderate symptoms. Trial research shows that the pill is most effective when taken early into a COVID-19 infection, within the first five days of experiencing symptoms. In October 2020, Merck started a Phase 2/3 safety and efficacy trial in patients hospitalized with COVID-19. While using Molnupiravir in hospitalized patients did not show promising results, another trial showed that high-risk participants who took Molnupiravir at home, upon onset of symptoms, were 50% less likely to be hospitalized or die. In the clinical trial, the most common risk factors for severe COVID-19 included being 60+ years of age, being obese, or having diabetes. Data around Molnupiravir was assessed by the Medicines and Healthcare Products Regulatory Agency (MHRA) in Britain. Merck submitted its application for Molnupiravir to the FDA on [October 11](https://www.autoimmuneinstitute.org/merck-submits-covid-19-antiviral-pill-for-eua/). **Category:** Covid-19 & Long Covid Treatments, Covid-19 Clinical Trials, Covid-19 Infections, Covid-19 Policy --- ### [CDC Report Addresses Vaccine Efficacy in Immunocompromised Persons](https://www.autoimmuneinstitute.org/covid_timeline/cdc-report-addresses-vaccine-efficacy-in-immunocompromised-persons/) **Published:** November 5, 2021 **Author:** Elevation **Excerpt:** In this week’s Morbidity and Mortality Weekly Report (MMWR), the CDC addressed COVID-19 vaccine efficacy in immunocompromised persons. **Content:** November 5, 2021 In this week’s [Morbidity and Mortality Weekly Report](https://www.cdc.gov/mmwr/volumes/70/wr/mm7044e3.htm?s_cid=mm7044e3_w) (MMWR), the CDC addressed COVID-19 vaccine efficacy in immunocompromised persons. Studies and clinical data suggest that immunocompromised persons who receive COVID-19 vaccines may not develop robust antibodies, and may not be protected against severe COVID-19 like immunocompetent persons who have been vaccinated. In a retrospective analysis of 20,000 hospitalized COVID cases, immunocompromised persons given two doses of an mRNA vaccine mounted 77% efficacy against COVID-19 hospitalization. Patients with rheumatic and inflammatory disorders were included in this cohort. MRNA vaccines in immunocompetent adults (as part of the control group) demonstrated 90% efficacy. “This difference persisted irrespective of mRNA vaccine product, age group, and timing of hospitalization relative to SARS-CoV-2.” Use of immunosuppressive therapies was not collected for data analysis. The median age of immunocompetent and immunocompromised patients was 68 years and 70 years, respectively. “Among immunocompetent patients, 42% had received the Moderna vaccine and 58% had received the Pfizer-BioNTech vaccine, and among immunocompromised patients, 41% and 59% had received Moderna and Pfizer-BioNTech vaccines, respectively.” Among immunocompetent patients, the median time between receiving the second dose of the Moderna vaccine and hospital admission was 89 days; this increased to 90 days for Pfizer vaccine recipients. Among immunocompromised patients, intervals were 89 days for both Moderna and Pfizer vaccine recipients. **Category:** Covid-19 Infections, Covid-19 Research Studies, Moderna, Pfizer, Vaccine Manufacturers --- ### [WHO Grants EUL to Covavaxin in India](https://www.autoimmuneinstitute.org/covid_timeline/who-grants-eul-to-covavaxin-in-india/) **Published:** November 4, 2021 **Author:** Elevation **Excerpt:** Yesterday, the WHO granted emergency use listing (EUL) to Covavaxin, the first COVID-19 vaccine developed in India. The WHO stated that the vaccine met standards for protection at 78% efficacy against COVID-19 at any severity, and that “the benefits of the vaccine far outweigh risks. **Content:** November 4, 2021 Yesterday, the WHO [granted emergency use listing (EUL) to Covavaxin](https://twitter.com/WHO/status/1455869992965181441/photo/1), the first COVID-19 vaccine developed in India. The WHO stated that the vaccine met standards for protection at 78% efficacy against COVID-19 at any severity, and that “the benefits of the vaccine far outweigh risks.” The vaccine can be used worldwide for adults 18+ using a two-dose method. Covavaxin was approved for use in India by the government in January and applied for EUL in April. Approximately 50 million doses are currently being manufactured each month. Other WHO authorized vaccines include AstraZeneca (and their partner, Serum Institute of India, which uses a version of AstraZeneca’s vaccine called Covishield), Pfizer-BioNTech, Moderna, Johnson & Jonson, as well as Sinovac and Sinopharm. Learn more about these WHO authorized vaccines, including highlights of their research and development, [here](https://www.autoimmuneinstitute.org/vaccine-comparison-chart/). **Category:** Covid-19 Policy, Vaccine Manufacturers --- ### [CDC Recommends Pfizer Vaccine For 5-11 Year Olds](https://www.autoimmuneinstitute.org/covid_timeline/cdc-recommends-pfizer-vaccine-for-5-11-year-olds/) **Published:** November 3, 2021 **Author:** Elevation **Excerpt:** Last night, the CDC endorsed the ACIP’s recommendation to allow vaccination in 5-11-year-olds using the Pfizer-BioNTech vaccine. 5-11-year-olds will be administered two 10-microgram doses; those 12+ years of age are given two 30-microgram doses. **Content:** November 3, 2021 Last night, the [CDC](https://www.cdc.gov/media/releases/2021/s1102-PediatricCOVID-19Vaccine.html) endorsed the ACIP’s recommendation to allow vaccination in 5-11-year-olds using the Pfizer-BioNTech vaccine. 5-11-year-olds will be administered two 10-microgram doses; those 12+ years of age are given two 30-microgram doses. During the ACIP meeting preceding the CDC’s endorsement, data was reviewed from Pfizer’s clinical trial in which 3,100 children ages 5-11 were given a low dose of the Pfizer vaccine. The trial demonstrated 91% efficacy in preventing COVID-19 within this age group; vaccine side effects were mild, self-limiting, and similar to side effects seen in older age groups. Moreover, antibody responses were comparable to those seen in 16-25-year-olds. While children have been shown to fare a COVID-19 infection better than adults, the Delta surge brought on an influx of pediatric COVID-19 cases. It is still unknown what the long-term ramifications may be of COVID-19 in children. As of recent, close to 2 million COVID-19 cases have been reported in 5-11-year-olds; within this age group, over 2,000 children have developed MIS-C after their COVID-19 infection. Of all pediatric cases, those in the 5-11 age range have experienced the highest number of MIS-C cases. In regard to myocarditis in children, the ACIP clarified that a COVID-19 infection poses a bigger risk to heart complications than vaccination. **Category:** Covid-19 Antibodies, Covid-19 Policy, Pfizer, Vaccine Manufacturers --- ### [COVID Vaccination Did Not Lead to Severe Disease Flares in Rheumatic Disease Patients in New Study](https://www.autoimmuneinstitute.org/covid_timeline/covid-vaccination-did-not-lead-to-severe-disease-flares-in-rheumatic-disease-patients-in-new-study/) **Published:** November 2, 2021 **Author:** Elevation **Excerpt:** New research demonstrating that the COVID-19 vaccine was not linked to severe flare-ups in patients with rheumatic diseases was presented this week at the American College of Rheumatology’s annual meeting. **Content:** November 2, 2021 [New research](https://acrabstracts.org/abstract/covid-19-vaccine-in-immunosuppressed-adults-with-autoimmune-diseases/) demonstrating that the COVID-19 vaccine was not linked to severe flare-ups in patients with rheumatic diseases was presented this week at the American College of Rheumatology’s annual meeting. The research also found a reduction in vaccine-induced antibody responses to be associated with rheumatic disease medications. Research trial participants included adults with seropositive [rheumatoid arthritis](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/rheumatoid-arthritis/) (RA) on stable treatment for more than three months, [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/systemic-lupus-erythematosus/) (SLE) on stable treatment with mycophenolate mofetil (MMF), patients with another rheumatic disease receiving greater than 10 mg of prednisone per day, and a control group of age and sex-matched adults without rheumatic diseases. Of the 220 participants enrolled in the study, 131 had RA, 23 had SLE, 8 had other rheumatic diseases, and 58 served as healthy controls. Adverse events were reported more frequently following the second dose and included pain in the injection site most commonly. While swollen joints following both doses were reported by RA patients more frequently than the controls, **there was no observed increase in disease activity following vaccination and no serious adverse events were attributable to vaccination**. Regarding medications, it was discovered that most rheumatology patients in this study had good vaccine responses aside from RA patients on rituximab and SLE patients on MMF. **Category:** Autoimmune Diseases & Covid-19, Covid-19 Research Studies, Lupus & Covid-19, RA & Covid-19, Vaccine Manufacturers --- ### [Can a COVID Infection Trigger GBS?](https://www.autoimmuneinstitute.org/covid_timeline/can-a-covid-infection-trigger-gbs/) **Published:** November 1, 2021 **Author:** Elevation **Excerpt:** Cases of GBS have been verified by the FDA as a rare side effect to certain vaccines, including Johnson & Johnson’s COVID-19 vaccine. GBS has also been known to develop after certain respiratory or gastrointestinal viral infections and may be triggered by a COVID-19 infection.  **Content:** November 1, 2021 [Guillain-Barré Syndrome](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/guillain-barre-syndrome/) (GBS) is an autoimmune neurological condition that results in damaged nerve cells. Cases of GBS have been verified by the FDA as a *rare* side effect to certain vaccines, including Johnson & Johnson’s COVID-19 vaccine. GBS has also been known to develop after certain respiratory or gastrointestinal viral infections and may be triggered by a COVID-19 infection. The International GBS Outcome Study is an ongoing prospective observational cohort study with GBS patients. Data from January 30 – May 30, 2020, was [collected and analyzed](https://pubmed.ncbi.nlm.nih.gov/34553216/) to investigate the connection between GBS and COVID-19 infections. 49 GBS patients were included and 48 completed questionnaires assessing clinical suspicion for SARS-CoV-2. Of this cohort, 8 patients (16%) had a confirmed previous SARS-CoV-2 infection, and 3 patients (6%) had a probable SARS-CoV-2 infection. The median age of patients within the cohort was 56 years; the median age of patients with a confirmed or probable COVID-19 infection was 63 years. 73% of GBS patients with a COVID-19 infection presented increased inflammatory markers; 64% had facial palsy. Overall, 22% of GBS patients had a preceding COVID-19 infection. It was not determined whether recovery was more difficult for the patients versus other GBS patients, especially when factoring severity of COVID-19 infection. Researchers emphasized that **analysis from the first four months of the pandemic did not show an increase in GBS cases compared to previous years.** Therefore, while Covid-19 infections may trigger the development of GBS, a stronger causal relationship has yet to be determined. “Should SARS-CoV-2 indeed be able to trigger GBS, our data are consistent with a post-infectious disease mechanism rather than direct viral invasion, as the time between the onset of SARS-CoV-2 symptoms and GBS ranged from 2 to 3.5 weeks.” **Category:** Autoimmune Diseases & Covid-19, Covid-19 Research Studies, GBS & Covid-19 --- ### [Toleration of mRNA Vaccines in Those with Antiphospholipid Antibodies](https://www.autoimmuneinstitute.org/covid_timeline/toleration-of-mrna-vaccines-in-those-with-antiphospholipid-antibodies/) **Published:** October 28, 2021 **Author:** Elevation **Excerpt:** A research article published last week in The Lancet assessed the safety and tolerability of mRNA COVID-19 vaccines in people with antiphospholipid antibodies. In a survey of 102 vaccinated patients (67 who received Pfizer and 35 who received Moderna), 52 had an antiphospholipid syndrome diagnosis and 50 had antiphospholipid antibodies without clinical features of the syndrome. While 76% experienced at least one side effect, they were reported to be mild in 72 patients and moderate in 30. Side effects included pain at the injection site (44%), fatigue (36%), and headache (28%) and were reportedly transient and self-limiting within 10 days. **Content:** October 28, 2021 A [research article](https://www.thelancet.com/action/showPdf?pii=S2665-9913%2821%2900320-9) published last week in *The Lancet* assessed the safety and tolerability of mRNA COVID-19 vaccines in people with antiphospholipid antibodies. In a survey of 102 vaccinated patients (67 who received Pfizer and 35 who received Moderna), 52 had an [antiphospholipid syndrome](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/antiphospholipid-syndrome/) diagnosis and 50 had antiphospholipid antibodies without clinical features of the syndrome. While 76% experienced at least one side effect, they were reported to be mild in 72 patients and moderate in 30. Side effects included pain at the injection site (44%), fatigue (36%), and headache (28%) and were reportedly transient and self-limiting within 10 days. More specific vaccine responses included “one patient with thrombotic antiphospholipid syndrome and a known history of mild thrombocytopenia (110,000/mm³), who was on long-term vitamin K antagonist therapy, reported the occurrence of self-limiting purpuric lesions on her calves 10 days after the second dose. Blood tests were unremarkable except for a single transient fluctuation of platelet count (88,000/mm³). Consequent investigations (during an observation time of 5 months) showed a platelet count persistently above 100,000/mm³.” Overall, there were no major adverse effects nor thrombotic events and side effects were mild and transient in nature. While more investigation is needed, the researchers concluded that the mRNA vaccines seem to have an “acceptable safety and tolerability profile in patients with antiphospholipid antibodies.” **Category:** Autoimmune Diseases & Covid-19, Covid-19 Antibodies, Moderna, Pfizer, Vaccine Manufacturers --- ### [CDC Amends EUA to Include 4th Dose for Immunocompromised](https://www.autoimmuneinstitute.org/covid_timeline/cdc-amends-eua-to-include-4th-dose-for-immunocompromised/) **Published:** October 27, 2021 **Author:** Elevation **Excerpt:** Yesterday, the CDC updated their guidelines on COVID-19 vaccines for those who are “moderately and severely” immunocompromised. People who fall into this category include those living with autoimmune disease, who are currently on therapies such as high-dose corticosteroids and other drugs that suppress the immune system. **Content:** October 27, 2021 Yesterday, the CDC updated their [guidelines](https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/immuno.html) on COVID-19 vaccines for those who are “moderately and severely” immunocompromised. People who fall into this category include those living with autoimmune disease, who are currently on therapies such as high-dose corticosteroids and other drugs that suppress the immune system. Those who received an mRNA vaccine for their primary series and received an additional dose of an mRNA vaccine, **may** receive a fourth COVID-19 booster dose at 6+ months. This fourth dose may be administered using a Moderna, Pfizer or Johnson & Johnson (J&J) vaccine. **“In such situations, people who are moderately and severely immunocompromised may receive a total of four COVID-19 vaccine doses.”** If obtaining a Moderna vaccine for a third dose, one should receive a half dose at 50 micrograms, followed by an additional, fourth 50 microgram dose at 6+ months. Those who are immunocompromised and received the J&J vaccine for their primary series should get a second COVID-19 vaccine. If the J&J primary dose is followed by a Moderna booster, it should measure 50 micrograms. **Those who received a J&J vaccine for their primary series followed by either a second dose of the J&J, Moderna or Pfizer vaccine should not obtain a third dose at this time.** **Category:** Covid-19 Boosters, Covid-19 Policy, Johnson & Johnson, Moderna, Pfizer, Vaccine Manufacturers --- ### [Rheumatoid Arthritis Drug May Prevent Lung Damage From COVID](https://www.autoimmuneinstitute.org/covid_timeline/rheumatoid-arthritis-drug-may-prevent-lung-damage-from-covid-19/) **Published:** October 25, 2021 **Author:** Elevation **Excerpt:** A recent study has indicated that the autoimmune disease drug anakinra aided in the prevention of lung damage and death in mice infected with SARS-CoV-2. Inflammatory lung vascular leakage can be presented in cases of severe COVID-19, when severe inflammation leads to the buildup of fluid in the lungs, and directly impacts the absorption of oxygen. **Content:** October 25, 2021 A [recent study](https://www.ahajournals.org/doi/pdf/10.1161/ATVBAHA.121.316925) has indicated that the autoimmune disease drug anakinra aided in the prevention of lung damage and death in mice infected with SARS-CoV-2. Inflammatory lung vascular leakage can be presented in cases of severe COVID-19, when severe inflammation leads to the buildup of fluid in the lungs, and directly impacts the absorption of oxygen. It is estimated that 5-10% of patients develop acute respiratory distress syndrome (ARDS). “Hyperinflammation and cytokine storm are key pathogenic features underlying severe COVID-19 mediating ARDS and respiratory failure.” Mice in the study also showed signs of leakage from blood vessels in their lungs, as “analyses of postmortem lungs from COVID-19 patients and animal models show\[ed\] severe lung endothelial injury following the SARS-CoV-2 infection.” The rheumatoid arthritis drug targets a specific molecular receptor that regulates inflammation, thereby suppressing a select immune pathway, versus suppressing the entire immune system. **Mice who received the drug showed reduced signs of severe COVID-19, including less fluid buildup and less scarring of the lung tissue. Survival outcomes also increased.** Researchers hypothesized that by assessing IL-1 receptor pathways, physicians may be able to detect when a patient’s immune system is about have a hyper response. The next step is conducting a clinical trial to investigate this drug in human participants experiencing severe COVID-19. **Category:** Autoimmune Diseases & Covid-19, Covid-19 & Long Covid Treatments, Covid-19 Research Studies, RA & Covid-19 --- ### [CDC Endorses Boosters for Moderna and J&J Vaccines](https://www.autoimmuneinstitute.org/covid_timeline/cdc-endorses-boosters-for-moderna-and-jj-vaccines/) **Published:** October 22, 2021 **Author:** Elevation **Excerpt:** Last night, the CDC endorsed the Advisory Committee on Immunization Practices’ (ACIP) recommendation in favor of booster doses for the Moderna and Johnson & Johnson (J&J) vaccines. The Moderna vaccine has been endorsed for use as a booster vaccine (at least 6 months after the primary series) in the following populations: **Content:** October 22, 2021 Last night, the CDC endorsed the Advisory Committee on Immunization Practices’ (ACIP) [recommendation](https://www.cdc.gov/media/releases/2021/p1021-covid-booster.html) in favor of booster doses for the Moderna and Johnson & Johnson (J&J) vaccines. The Moderna vaccine has been endorsed for use as a booster vaccine (at least 6 months after the primary series) in the following populations: - those 65+ years in age - those 18+in long-term care settings - those 18+ who have certain underlying medical conditions - those 18+ who work or live in high-risk settings The J&J vaccine has been recommended for persons 18+ years of age, 2 months after their primary dose. Unlike the Moderna booster (which is a half dose at 50 micrograms), Pfizer and J&J booster doses will measure the same as the primary series. Those who are immunocompromised and completing a primary series as well as an additional dose, are recommended to utilize vaccines from the same manufacturer. Those who are “moderately to severely” immunocompromised and received a J&J primary series, should receive a 50 microgram dose of the Moderna vaccine should they decide to mix-and-match between the primary series and booster. Those who receive a third, 100 microgram dose of the Moderna vaccine due to their immunocompromised status, should not get a 4th booster shot from Pfizer or J&J at this time ([1](https://www.cdc.gov/vaccines/acip/meetings/downloads/slides-2021-10-20-21/12-COVID-Reddy-508.pdf)). It was emphasized that those who completed a primary series of COVID-19 vaccination are still considered fully immunized. The Moderna and J&J vaccines have been shown to remain protective with only a slight decline in efficacy over time. **Category:** Covid-19 Boosters, Covid-19 Policy, Johnson & Johnson, Moderna, Vaccine Manufacturers --- ### [FDA Authorizes Use of J&J and Moderna Boosters, as well as Mix-and-Matching](https://www.autoimmuneinstitute.org/covid_timeline/fda-authorizes-use-of-johnson-johnson-and-moderna-boosters-as-well-as-mix-and-matching/) **Published:** October 21, 2021 **Author:** Elevation **Excerpt:** Last night, the FDA issued a news release on the use of the Moderna and Johnson & Johnson (J&J) vaccines, including implementation of the mix-and-match method for boosters. The agency amended the emergency use authorization (EUA) for COVID-19 vaccines to allow for booster doses, adding that, “the use of a single booster dose of the Moderna COVID-19 Vaccine that may be administered at least 6 months after completion of the primary series” to individuals: **Content:** October 21, 2021 Last night, the FDA issued a [news release](https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-takes-additional-actions-use-booster-dose-covid-19-vaccines) on the use of the Moderna and Johnson & Johnson (J&J) vaccines, including implementation of the mix-and-match method for boosters. The agency amended the emergency use authorization (EUA) for COVID-19 vaccines to allow for booster doses, adding that, “the use of a single booster dose of the Moderna COVID-19 Vaccine that may be administered at least 6 months after completion of the primary series” to individuals: - 65+ years in age - 18-64 years in age at high risk of severe COVID-19 - 18-64 years in age with frequent institutional or occupational exposure to SARS-CoV-2 The amendment also includes the use of a single booster dose of the J&J vaccine at least two months after completion of the primary-dose series in those 18+ years of age. The Moderna, Pfizer, and J&J vaccines were granted EUA for mix-and-matching as a booster dose. “For example, Janssen COVID-19 Vaccine recipients 18 years of age and older may receive a single booster dose of Janssen COVID-19 Vaccine, Moderna COVID-19 Vaccine (half dose) or Pfizer-BioNTech COVID-19 Vaccine at least two months after receiving their Janssen COVID-19 Vaccine primary vaccination.” The FDA also included a [fact sheet](https://www.fda.gov/emergency-preparedness-and-response/coronavirus-disease-2019-covid-19/janssen-covid-19-vaccine) for each available vaccine for healthcare providers and vaccine recipients to review. The ACIP is the advisory committee to the CDC, which determines policy around vaccines granted EUA or approval by the FDA. They will be [convening today](https://video.ibm.com/channel/VWBXKBR8af4) to discuss implementation of the J&J, Moderna and mix-and-matching boosters. **Category:** Covid-19 Boosters, Covid-19 Policy, Johnson & Johnson, Moderna, Pfizer, Vaccine Manufacturers --- ### [FDA Advisory Committee Discusses J&J Booster](https://www.autoimmuneinstitute.org/covid_timeline/fda-advisory-committee-discusses-johnson-johnson-booster/) **Published:** October 18, 2021 **Author:** Elevation **Excerpt:** On Friday, an advisory committee to the FDA convened to discuss an additional dose of Janssen’s Johnson & Johnson (J&J) COVID-19 vaccine. The voting question was: **Content:** October 18, 2021 On Friday, an advisory committee to the FDA convened to discuss an additional dose of Janssen’s Johnson & Johnson (J&J) COVID-19 vaccine. The voting question was: *Do available data support the safety and effectiveness of Janssen COVID-19 Vaccine for use under EUA as a booster dose in individuals 18 years and older at least 2 months after a single dose primary vaccination?* The committee voted yes unanimously (19 to 0) in favor of a booster dose. **Panelists clarified that their recommendation will not change the primary series from one to two doses.** A single dose is consistent with immunity; the second dose will be viewed as a booster to the primary series. Those who have just received one dose are still considered fully vaccinated in terms of efficacy in protecting against COVID-19. A second dose raises efficacy by boosting neutralizing antibody titers, as well as CD4 and CD8 responses. The Johnson & Johnson booster dose will measure the same as the primary series. One argument in favor of a booster is to raise efficacy that parallels the efficacy ratings of Pfizer and Moderna’s vaccines. While the efficacy of one dose of Johnson & Johnson’s vaccine is lower than Moderna and Pfizer, a single dose still neutralizes COVID-19 and prevents severe disease. A single J&J vaccine also does not appear to show waning efficacy; rather, receiving a booster increases the efficacy on par with the Moderna and Pfizer vaccines. Efficacy ratings from a 30,000 patient study increased from 74% to 94% after the administration of a booster dose (in US participants). **Category:** Covid-19 Boosters, Covid-19 Policy, Johnson & Johnson, Vaccine Manufacturers --- ### [FDA Advisory Committee Convenes to Discuss Moderna Booster](https://www.autoimmuneinstitute.org/covid_timeline/fda-advisory-committee-convenes-to-discuss-moderna-booster/) **Published:** October 15, 2021 **Author:** Elevation **Excerpt:** Yesterday, an advisory committee to the FDA convened to discuss the use of booster shots by Moderna. The committee voted unanimously in favor (19 to 0) of a booster dose for the following groups: **Content:** October 15, 2021 Yesterday, an advisory committee to the FDA convened to discuss the use of booster shots by Moderna. The committee voted unanimously in favor (19 to 0) of a booster dose for the following groups: - those 65+ years in age - those 18-64 years in age who are at high risk of severe COVID-19 - those 18-64 years in age whose frequent institutional or occupational exposure to SARS-CoV-2 puts them at high risk of serious complications due to COVID-19, including severe COVID-19 This parallels the committee’s recommendation for Pfizer boosters last month. On a different note, the Moderna booster shot will be 50 micrograms, compared to doses in the primary series, which are 100 micrograms. The reason for a smaller dose comes down to observing less side effects (such as fever), without compromising an increase in antibody titers when a primary series elicited a robust immune response. **Committee members clarified that a *third dose* (for those who are immunocompromised) is 100 micrograms.** They also clarified that “risk of exposure” does not necessarily equate to being at higher risk for severe disease. **While Moderna has stated that its vaccine does not require a booster to continue preventing severe COVID-19, a booster will increase prevention of infection, as well as mild to moderate disease.** The committee will be discussing booster doses for the Johnson & Johnson vaccine, as well as mix-and-matching doses in [today’s meeting](https://www.fda.gov/advisory-committees/advisory-committee-calendar/vaccines-and-related-biological-products-advisory-committee-october-14-15-2021-meeting-announcement#event-materials), around 1:15pm and 3:30 pm EST, respectively. **Category:** Covid-19 Boosters, Covid-19 Policy, Moderna, Vaccine Manufacturers --- ### [Incidence of Vaccine Adverse Events in Autoimmune Disease Patients](https://www.autoimmuneinstitute.org/covid_timeline/incidence-of-vaccine-adverse-events-in-autoimmune-disease-patients/) **Published:** October 14, 2021 **Author:** Elevation **Excerpt:** A comment piece published in The Lancet Rheumatology examined the results of a questionnaire assessing adverse events in those with autoimmune disease (AD) following their first COVID-19 vaccination. Participants were asked (but not obligated) to recruit a “healthy” control of similar age and sex. They were asked whether they had 1) received a COVID-19 vaccine 2) if so, whether they experienced any local or systemic adverse events in the 7 days following vaccination 3) if so, to report the severity and duration of such adverse events. Patients were also asked to monitor any changes in their autoimmune disease for up to two months post-vaccination. **Content:** October 14, 2021 A comment piece published in *[The Lancet Rheumatology](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8213359/pdf/main.pdf) examined the results of a questionnaire assessing adverse events in those with autoimmune disease (AD) following their first COVID-19 vaccination. Participants were asked (but not obligated) to recruit a “healthy” control of similar age and sex. They were asked whether they had 1) received a COVID-19 vaccine 2) if so, whether they experienced any local or systemic adverse events in the 7 days following vaccination 3) if so, to report the severity and duration of such adverse events. Patients were also asked to monitor any changes in their autoimmune disease for up to two months post-vaccination. Questionnaires from 505 patients (including 204 with [rheumatoid arthritis](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/rheumatoid-arthritis/) and 81 with [multiple sclerosis](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/multiple-sclerosis/)) and 203 controls were included for analysis. 328 of 505 patients were on immunosuppressive medications at the time of the questionnaire, most commonly anti-CD20 and TNF-inhibitors. AstraZeneca and Pfizer were the most common vaccines administered to both patients and controls; less than 20% of both AD and healthy participants were given the Moderna vaccine. 51% of patients and 52% of controls reported at least one mild adverse event post-vaccination. 21% and 19%, respectively, reported moderate adverse events. 1% of AD patients experienced severe adverse events. The most common adverse event reported was pain at the injection site. “Joint complaints were reported more frequently by patients with rheumatic diseases than controls (49 \[10%\] vs 3 \[1%\]), but only a small proportion of patients (26 \[5%\]) reported a deterioration of their autoimmune disease up to 2 months after COVID-19 vaccination.” The AstraZeneca vaccine in females less than 55 years of age were “independently associated with an increased likelihood” of reporting an adverse event. Overall, analysis of the data showed that **adverse events to the COVID-19 vaccine were similar for both AD patients and healthy controls.** “The observed adverse events consisted of expected transient local or systemic reactions that were mostly self-limiting.” Moreover, COVID-19 vaccinations did not seem to trigger AD flares. **Category:** AstraZeneca, Autoimmune Diseases & Covid-19, Moderna, MS & Covid-19, Pfizer, RA & Covid-19, Vaccine Adverse Events, Vaccine Manufacturers --- ### [Study Finds That SLE Diagnosis Doubles Risk of Death From COVID Infection](https://www.autoimmuneinstitute.org/covid_timeline/study-finds-that-sle-diagnosis-doubles-risk-of-death-from-covid-19-infection/) **Published:** October 13, 2021 **Author:** Elevation **Excerpt:** Data coming from Brazil has indicated that those living with systemic lupus erythematosus (SLE) are at higher risk of acute respiratory death syndrome (ARDS) from COVID-19 than the general population. ARDS is responsible for up to 20% of COVID-19 deaths in Brazil, and includes a positive COVID-19 PCR test and flu-like symptoms, “in addition to any of the following criteria: dyspnea/ respiratory discomfort, persistent pressure in the chest, desaturation less than 95% in room air, or having a bluish color of the lips or face.” **Content:** October 13, 2021 [Data coming from Brazil](https://onlinelibrary.wiley.com/doi/10.1002/acr2.11329) has indicated that those living with [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/systemic-lupus-erythematosus/) (SLE) are at higher risk of acute respiratory death syndrome (ARDS) from COVID-19 than the general population. ARDS is responsible for up to 20% of COVID-19 deaths in Brazil, and includes a positive COVID-19 PCR test and flu-like symptoms, “in addition to any of the following criteria: dyspnea/ respiratory discomfort, persistent pressure in the chest, desaturation less than 95% in room air, or having a bluish color of the lips or face.” Lupus patients are known to be more susceptible to infections due to chronic inflammatory autoimmune dysregulation, as well as the use of immunosuppressive drugs. These factors may also be associated with a higher risk for SARS-CoV-2 and severe COVID-19. The data presented in this report included 319 SLE patients with a positive SARS-CoV-2 infection. **It was determined that the risk of death from COVID-19 induced ARDS was more than double for those with SLE.** The positive cohort analysis also revealed that patients with SLE were younger in age and more often women. The data was compiled using 2020 COVID-19 patient profiles, when vaccines were not available. Analysis of future data will determine whether vaccination decreases risk amongst this population. **Category:** Autoimmune Diseases & Covid-19, Lupus & Covid-19 --- ### [WHO Committee Recommends That Immunocompromised Get Third Dose of COVID Vaccine](https://www.autoimmuneinstitute.org/covid_timeline/who-committee-recommends-that-immunocompromised-get-third-dose-of-covid-19-vaccine/) **Published:** October 12, 2021 **Author:** Elevation **Excerpt:** Yesterday, an advisory committee to the WHO made a recommendation for immunocompromised persons to receive a third dose of the COVID-19 vaccine, from one of seven manufacturers. These include Pfizer, Moderna, AstraZeneca, Johnson & Johnson, Sinovac, Sinopharm and Serum Institute of India. Committee members also recommended a third dose for those 60+ who were inoculated with the Sinopharm or Sinovac vaccine. To learn more on the research and development behind the world’s leading vaccines, check out our vaccine chart. **Content:** October 12, 2021 Yesterday, an advisory committee to the WHO made a recommendation for [immunocompromised persons to receive a third dose](https://news.un.org/en/story/2021/10/1102732) of the COVID-19 vaccine, from one of seven manufacturers. These include Pfizer, Moderna, AstraZeneca, Johnson & Johnson, Sinovac, Sinopharm and Serum Institute of India. Committee members also recommended a third dose for those 60+ who were inoculated with the Sinopharm or Sinovac vaccine. To learn more on the research and development behind the world’s leading vaccines, check out our [vaccine chart](https://www.autoimmuneinstitute.org/vaccine-comparison-chart/). While “booster” and “third dose” have often been used interchangeably, the WHO committee made a point to distinguish their recommendation of an additional dose from the institution of a booster regimen currently being implemented in the United States, as well as other countries around the world. Booster programs are being implemented to “boost” the immunity in healthy adults. The committee’s recommendation differs from boosters in that *immunocompromised persons may not have had an adequate response to a primary vaccination series*. The WHO has not made a recommendation for healthy individuals receiving a booster dose of a COVID-19 vaccine, but has plans to discuss boosters in a November 11, 2021 meeting. **Category:** Autoimmune Diseases & Covid-19, Covid-19 Boosters, Covid-19 Policy --- ### [Merck Submits COVID Antiviral Pill for EUA](https://www.autoimmuneinstitute.org/covid_timeline/merck-submits-covid-19-antiviral-pill-for-eua/) **Published:** October 11, 2021 **Author:** Elevation **Excerpt:** This morning, the pharmaceutical company Merck submitted an application for EUA of their COVID-19 oral antiviral pill. If accepted, this will become the first pill authorized by the FDA to treat COVID-19. Other FDA authorized COVID-19 treatments must be administered intravenously or via injection. **Content:** October 11, 2021 This morning, the pharmaceutical company Merck submitted an [application for EUA of their COVID-19 oral antiviral pill](https://www.merck.com/news/merck-and-ridgeback-announce-submission-of-emergency-use-authorization-application-to-the-u-s-fda-for-molnupiravir-an-investigational-oral-antiviral-medicine-for-the-treatment-of-mild-to-moderate-c/). If accepted, this will become the first pill authorized by the FDA to treat COVID-19. Other FDA authorized COVID-19 treatments must be administered intravenously or via injection. The antiviral, called Molnupiravir, will be used to treat mild-to-moderate COVID-19 in adults who are at risk of progressing to severe COVID-19, including hospitalization. “Molnupiravir has been shown to be active in several preclinical models of SARS-CoV-2, including for prophylaxis, treatment, and prevention of transmission. Additionally, pre-clinical and clinical data have shown Molnupiravir to be active against the most common SARS-CoV-2 variants.” Interim analysis of trial data has indicated that the antiviral cuts the risk of hospitalization and death by approximately 50%. 7.3% of patients who received the drug were hospitalized or died during the trial, versus 14.1% of those who received a placebo. Additionally, 0 deaths were reported in patients who received the antiviral, compared to 8 deaths in those who received a placebo, by day 29 of the trial. The trial was stopped after observing such positive results. Molnupiravir has been compared to Tamiflu, an antiviral used to treat and prevent influenza. **Category:** Covid-19 & Long Covid Treatments, Covid-19 Clinical Trials, Covid-19 Policy --- ### [Could 'COVID Toes' Be An Autoimmune Response?](https://www.autoimmuneinstitute.org/covid_timeline/could-covid-toes-be-an-autoimmune-response-2/) **Published:** October 7, 2021 **Author:** Elevation **Excerpt:** Doctors from the Saint-Louis Hospital in Paris published a study this week in the British Journal of Dermatology, examining a skin condition called chilblain-like lesions (CLL) that some are developing alongside their COVID-19 infection. Chilblains is a skin condition thought to be triggered by cold that causes redness, swelling, blisters, or red/purple bumps on toes and sometimes fingers. This outbreak of CLL during the pandemic has been reported extensively and has since been called ‘COVID toes.’ **Content:** October 7, 2021 Doctors from the Saint-Louis Hospital in Paris published a [study](https://onlinelibrary.wiley.com/doi/10.1111/bjd.20707) this week in the British Journal of Dermatology, examining a skin condition called chilblain-like lesions (CLL) that some are developing alongside their COVID-19 infection. Chilblains is a skin condition thought to be triggered by cold that causes redness, swelling, blisters, or red/purple bumps on toes and sometimes fingers. This outbreak of CLL during the pandemic has been reported extensively and has since been called ‘COVID toes.’ The link between a SARS-CoV-2 infection and CLL has not been well established; the doctors in this study compared 50 patients with COVID toes against 13 patients who had experienced chilblains prior to the start of the pandemic. They found that patients in both groups had high amounts of a protein called type 1 interferon (IFN) and an antibody called anti-neutrophil cytoplasmic antibodies (ANCA). This finding led the researchers to believe that the **COVID toes may be caused by an autoimmune response to the virus.** IFN is released during an immune response to infection and has been found to mediate diseases such as [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/systemic-lupus-erythematosus/). ANCA has also been linked to autoimmune diseases such as [granulomatosis with polyangiitis](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/wegeners/) (formerly known as Wegener granulomatosis), [eosinophilic granulomatosis with polyangiitis](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/churg-strauss-syndrome/) (previously known as Churg-Strauss syndrome), and [microscopic polyangiitis](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/microscopic-polyangiitis/). It is still unknown whether people living with these autoimmune diseases are more prone to developing COVID toes with a SARS-CoV-2 infection, or whether COVID toes may lead to the development of autoimmune diseases with the same antibodies. **Category:** Autoimmune Diseases & Covid-19, Covid-19 Infections, Covid-19 Research Studies, Lupus & Covid-19 --- ### [AstraZeneca Submits EUA for COVID Antibody Prophylaxis](https://www.autoimmuneinstitute.org/covid_timeline/astrazeneca-submits-eua-for-covid-19-antibody-prophylaxis/) **Published:** October 5, 2021 **Author:** Elevation **Excerpt:** AstraZeneca released a press release today stating that their long-acting antibody (LAAB) combination, AZD7442, has been shown to reduce the risk of symptomatic Covid-19 by 77% in a clinical trial. The trial included many participants who had medical conditions placing them at greater risk of severe illness and those who had not been producing sufficient antibodies after vaccination. **Content:** October 5, 2021 AstraZeneca published a [press release](https://www.astrazeneca.com/media-centre/press-releases/2021/azd7442-request-for-emergency-use-authorization-for-covid-19-prophylaxis-filed-in-us.html) today stating that their long-acting antibody (LAAB) combination, **AZD7442, has been shown to reduce the risk of symptomatic Covid-19 by 77% in a clinical trial.** The trial included many participants who had medical conditions placing them at greater risk of severe illness and those who had not been producing sufficient antibodies after vaccination. **AstraZeneca has requested that the FDA grant emergency authorization for this new treatment.** If this happens, it will be the first treatment of its kind available in the United States. AZD7442 differs from the Regeneron antibody treatment because it is meant to prevent someone from becoming infected with COVID-19, as opposed to treating someone who has already been infected with COVID-19. The company stated that this treatment could be used in conjunction with vaccines, benefitting those with weaker immune systems, including those who are immunocompromised. **Category:** AstraZeneca, Covid-19 & Long Covid Treatments, Covid-19 Clinical Trials, Covid-19 Policy, Vaccine Manufacturers --- ### [IBD Patients Taking Biologics Are Not More Prone to Severe COVID](https://www.autoimmuneinstitute.org/covid_timeline/ibd-patients-taking-biologics-are-not-more-prone-to-severe-covid-19/) **Published:** October 4, 2021 **Author:** Elevation **Excerpt:** SECURE-IBD is an international collaborative database monitoring COVID-19 outcomes in IBD patients. Previous reports have indicated that IBD patients on corticosteroids and mesalamine/ sulfasalazine have an increased risk of severe COVID-19, while those on TNF antagonists do not. Proceeding analysis indicated that patients on combination therapy with TNF antagonists and thiopurines also appeared to be at higher risk of severe COVID-19 outcomes; that being said, the analysis was based on a small number of reported cases.  **Content:** October 4, 2021 [SECURE-IBD](https://www.crohnscolitisfoundation.org/PublicHealth/secure-ibd) is an international collaborative database monitoring COVID-19 outcomes in IBD patients. Previous reports have indicated that IBD patients on corticosteroids and mesalamine/ sulfasalazine have an increased risk of severe COVID-19, while those on TNF antagonists do not. Proceeding analysis indicated that patients on combination therapy with TNF antagonists and thiopurines also appeared to be at higher risk of severe COVID-19 outcomes; that being said, the analysis was based on a small number of reported cases. A [recent analysis](https://reader.elsevier.com/reader/sd/pii/S0016508521034909?token=A7FC1CB2E0B16EC326DBB8AFA489867C748902ADD20E19B5F22C4688CF25B22895593E4ACD2303266B01692C5EB709A5&originRegion=us-east-1&originCreation=20211004150033) completed by the Icahn School of Medicine at Mount Sinai, New York City, has concluded that **there is no association indicating mesalamine/sulfasalazine and biologics cause more severe COVID-19 outcomes**. Analyzing reports from March 2020 – May 2021, researchers reviewed data from over 6,000 IBD patients taking immunosuppressive drugs like thiopurines, mesalamine or sulfasalazine, TNF antagonists, and systemic corticosteroids, amongst others. More than half of patients included in the registry had [Crohn’s disease](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/crohns-disease/), followed by [ulcerative colitis](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/ulcerative-colitis/). Of 27 deaths, 14 patients were taking TNF antagonists, 8 were taking integrin antagonists, and 5 were on IL-12/23 antagonists. The findings concluded, in short, that systemic corticosteroids and methotrexate were *“marginally” associated with an increased odds* of hospitalization and/or death, including severe COVID-19. Moreover, TNF, interleukin (IL)-12/23, and integrin antagonists were associated with a *decreased odds* of COVID-19-related hospitalization and/or death, to include severe COVID-19. **Category:** Autoimmune Diseases & Covid-19, Covid-19 Infections, Covid-19 Research Studies, IBD & Covid-19 --- ### [Dose 3 Adverse Reactions Similar to Dose 2](https://www.autoimmuneinstitute.org/covid_timeline/dose-3-adverse-reactions-similar-to-dose-2/) **Published:** October 1, 2021 **Author:** Elevation **Excerpt:** This morning, the CDC released their Morbidity and Mortality Weekly Report focusing on third doses of the COVID-19 vaccine. The report referenced Pfizer’s Phase 3 clinical trial, which included 306 participants, ages 18-55, who received a booster dose. Doses were administered 5-8 months after completion of a primary series using mRNA vaccines. Adverse reactions were similar to those after the second dose, and “included mild to moderate injection site and systemic reactions” (1). **Content:** October 1, 2021 This morning, the CDC released their[ Morbidity and Mortality Weekly Report](https://www.cdc.gov/mmwr/volumes/70/wr/mm7039e4.htm?s_cid=mm7039e4_w) focusing on third doses of the COVID-19 vaccine. The report referenced [Pfizer’s Phase 3 clinical trial](https://www.pfizer.com/news/press-release/press-release-detail/pfizer-and-biontech-initiate-rolling-submission), which included 306 participants, ages 18-55, who received a booster dose. Doses were administered 5-8 months after completion of a primary series using mRNA vaccines. Adverse reactions were similar to those after the second dose, and “included mild to moderate injection site and systemic reactions” ([1](https://www.cdc.gov/mmwr/volumes/70/wr/mm7039e4.htm?s_cid=mm7039e4_w)). V-safe was developed by the CDC as a voluntary, self-reporting surveillance system for “local injection site and systemic reactions and health impacts” post-vaccination. From August 12 – September 19, 2021, over 22,000 registrants reported getting a third dose of the COVID-19 vaccine into v-safe. Over 97% reported getting a mRNA vaccine for their primary series, followed by a third dose of the same vaccine. **“Voluntary reports to v-safe found no unexpected patterns of adverse reactions after an additional dose of COVID-19 vaccine.”** Of those who completed check-ins for all three doses, 79.4% and 74.1% reported local or systemic reactions, respectively, after their third dose. 77.6% and 76.5% reported local or system reactions following their second dose. Moreover, the majority of adverse reactions were mild or moderate in nature. Safety and efficacy data on mix-and-matching doses from different manufacturers is still limited. **Category:** Covid-19 Boosters, Covid-19 Clinical Trials, Pfizer, Vaccine Adverse Events, Vaccine Manufacturers --- ### [Multiple Sclerosis Patients on Anti-CD20 Therapy Create Antibodies Following COVID Vaccination ](https://www.autoimmuneinstitute.org/covid_timeline/multiple-sclerosis-patients-on-anti-cd20-therapy-create-antibodies-following-covid-19-vaccination-2/) **Published:** September 30, 2021 **Author:** Elevation **Excerpt:** A study published in Nature has shown that multiple sclerosis patients undergoing anti-CD20 therapy were able to create robust T-cells following vaccination with an mRNA vaccine.  **Content:** September 30, 2021 A [study](https://www.nature.com/articles/s41591-021-01507-2) published in *Nature* has shown that [multiple sclerosis](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/multiple-sclerosis/) patients undergoing anti-CD20 therapy were able to create robust T-cells following vaccination with an mRNA vaccine. Anti-CD20 treatments are often used for cancer immunotherapy, neurology, and rheumatology, depleting B cells which attack the myelin sheath and eventually erode the nerves in those living with MS. These B cells contribute to antibody production; without them, the body’s ability to produce antibodies against SARS-CoV-2 is decreased. The study measured the antibody and T cell responses in 20 MS patients on anti-CD20 therapy. No participants had COVID-19 prior to enrolling in the study. By 30 days after the second dose of a Pfizer or Moderna mRNA vaccine, 85% of participants had developed anti-spike antibodies. **This antibody response was generally delayed and lower compared to the control group, but antibodies were still detectable.** That being said, those on anti-CD20 therapies may not neutralize viral particles after coming into contact as quickly as others not on anti-CD20 therapies, making them more likely to be contagious, as well as carry the virus. Timing of anti-CD20 infusion correlated with the patient’s immune response – patients with more B cells prior to vaccination mounted a more robust antibody response to the vaccine. The results of this study provide insight on how MS patients, as well as patients living with other autoimmune diseases, can approach vaccination while on immunosuppressive treatments. Additionally, testing for antibodies as well as T-cells offers more understanding into whether someone is protected after receiving the COVID-19 vaccine. **Category:** Autoimmune Diseases & Covid-19, Covid-19 Antibodies, Covid-19 Research Studies, MS & Covid-19 --- ### [COVID Infection May Trigger Development of Autoantibodies](https://www.autoimmuneinstitute.org/covid_timeline/covid-19-infection-may-trigger-development-of-autoantibodies/) **Published:** September 28, 2021 **Author:** Elevation **Excerpt:** New research indicates that cases of severe COVID-19 may lead to the production of autoantibodies, antibodies which mistakenly attack a person’s own cells. Recent reports have compared these autoantibodies to those seen in autoimmune diseases like MS and lupus. This being said, there have also been cases of autoimmune responses in those with asymptomatic and mild infection to SARS-CoV-2. **Content:** September 28, 2021 New research indicates that cases of severe COVID-19 may lead to the production of autoantibodies, antibodies which mistakenly attack a person’s own cells. Recent reports have compared these autoantibodies to those seen in autoimmune diseases like [MS](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/multiple-sclerosis/) and [lupus](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/systemic-lupus-erythematosus/). This being said, there have also been **cases of autoimmune responses in those with asymptomatic and mild infection to SARS-CoV-2**. In a [study](https://www.nature.com/articles/s41467-021-25509-3) published this month, autoantibodies were identified in 50% of patients infected with COVID-19, versus only 15% in healthy controls. Blood samples were drawn over various days, including the day of hospital admission. Within a week of admission, 20% of patients developed new antibodies that were not present the day they were admitted into the hospital. “When present, autoantibodies largely target autoantigens associated with rare disorders such as myositis, systemic sclerosis and overlap syndromes.” Enough time has not passed to study autoantibodies in COVID-19 patients long-term following their initial infection. **Category:** Autoimmune Diseases & Covid-19, Covid-19 Antibodies, Covid-19 Infections, Covid-19 Research Studies --- ### [WHO Endorses Regeneron’s COVID-19 Antibody Treatment](https://www.autoimmuneinstitute.org/covid_timeline/who-endorses-regenerons-covid-19-antibody-treatment/) **Published:** September 27, 2021 **Author:** Elevation **Excerpt:** Last Friday, the WHO endorsed the use of Regeneron’s monoclonal antibody cocktail for patients at high risk of being hospitalized due to severe COVID-19. Others eligible for treatment include those unable to develop antibodies to COVID-19, through previous infection or vaccination. This includes immunocompromised persons. Regeneron’s casirivimab and imdevimab antibody cocktail, administered by infusion, was the first combination therapy to receive FDA EUA. **Content:** September 27, 2021 Last Friday, the [WHO endorsed](https://www.who.int/news/item/24-09-2021-on-new-recommendation-for-treatment-of-covid-19-patients-who-calls-for-equitable-access-to-casirivimab-and-imdevimab-for-covid-19) the use of Regeneron’s monoclonal antibody cocktail for patients at high risk of being hospitalized due to severe COVID-19. Others eligible for treatment include those unable to develop antibodies to COVID-19, through previous infection or vaccination. This includes immunocompromised persons. Regeneron’s casirivimab and imdevimab antibody cocktail, administered by infusion, was the first combination therapy to receive FDA EUA. In the UK Recovery trial, the treatment reduced the risk of hospitalization in mild COVID-19 cases and decreased the risk of being placed on a ventilator or dying while hospitalized. “This second recommendation is based on data from the RECOVERY trial showing that casirivimab and imdevimab probably reduce deaths (ranging from 49 fewer per 1,000 in the severely ill to 87 fewer in the critically ill) and the need for mechanical ventilation in seronegative patients” ([1](https://www.eurekalert.org/news-releases/929175)). The treatment did not significantly shorten or decrease symptoms in less serious cases. **Category:** Covid-19 & Long Covid Treatments, Covid-19 Clinical Trials, Covid-19 Policy --- ### [CDC Statement on ACIP Booster Recommendations](https://www.autoimmuneinstitute.org/covid_timeline/cdc-statement-on-acip-booster-recommendations-2/) **Published:** September 24, 2021 **Author:** Elevation **Excerpt:** This morning, the CDC released a statement regarding who should get a Pfizer COVID-19 vaccine booster. In an unexpected move, the CDC overruled the Advisory Committee on Immunization Practices’ (ACIP) recommendations from yesterday, when they voted 6-9 against recommending a booster for those at high risk of occupational exposure (such as healthcare workers). **Content:** September 24, 2021 This morning, the CDC released a [statement](https://www.cdc.gov/media/releases/2021/p0924-booster-recommendations-.html) regarding who should get a Pfizer COVID-19 vaccine booster. In an unexpected move, the CDC overruled the Advisory Committee on Immunization Practices’ (ACIP) recommendations from yesterday, when they voted 6-9 against recommending a booster for those at high risk of occupational exposure (such as healthcare workers). These are the updated CDC recommendations: - people 65 years and older and residents in long-term care settings **should receive** a booster shot of Pfizer-BioNTech’s COVID-19 vaccine at least 6 months after their Pfizer-BioNTech primary series, - people aged 50–64 years with [underlying medical ](https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html)conditions should receive a booster shot of Pfizer-BioNTech’s COVID-19 vaccine at least 6 months after their Pfizer-BioNTech primary series, - people aged 18–49 years with underlying medical conditions may receive a booster shot of Pfizer-BioNTech’s COVID-19 vaccine at least 6 months after their Pfizer-BioNTech primary series, based on their individual benefits and risks, and - people aged 18-64 years who are at increased risk for COVID-19 exposure and transmission because of occupational or institutional setting **may receive** a booster shot of Pfizer-BioNTech’s COVID-19 vaccine at least 6 months after their Pfizer-BioNTech primary series, based on their individual benefits and risks. **Category:** Covid-19 Boosters, Covid-19 Policy --- ### [New Study Investigates COVID Vaccine in Rheumatoid Arthritis, Scleroderma, Myositis, and Sjogren’s Syndrome Patients](https://www.autoimmuneinstitute.org/covid_timeline/new-study-investigates-covid-19-vaccine-in-rheumatoid-arthritis-scleroderma-myositis-and-sjogrens-syndrome-patients/) **Published:** September 23, 2021 **Author:** Elevation **Excerpt:** The University of Pittsburgh Medical Center is recruiting participants for a new study investigating the immune response to the COVID-19 vaccine in those living with autoimmune disease, including rheumatoid arthritis, scleroderma, myositis, and Sjogren’s syndrome. **Content:** September 23, 2021 The University of Pittsburgh Medical Center is recruiting participants for a new study investigating the immune response to the COVID-19 vaccine in those living with autoimmune disease, including [rheumatoid arthritis](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/rheumatoid-arthritis/), [scleroderma](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/scleroderma/), myositis, and [Sjogren’s syndrome](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/sjogrens-syndrome/). Autoimmune disease patients were not included in original COVID-19 vaccine clinical trials, and there is “little information regarding the COVID-19 vaccine’s effectiveness and overall safety for patients with autoimmune diseases.” The study will measure antibody levels against SARS-CoV-2, and track whether vaccination leads to disease flares, changes in symptoms, or adverse effects. To learn more about the study, as well as information on participating, click [here](https://inside.upmc.com/pitt-cover-study-aims-to-understand-covid-19-vaccine-response-in-patients-with-autoimmune-diseases/). **Category:** Autoimmune Diseases & Covid-19, Covid-19 Research Studies, RA & Covid-19, Sjögren disease & Covid-19 --- ### [Results of Friday’s FDA Advisory Committee Meeting](https://www.autoimmuneinstitute.org/covid_timeline/results-of-fridays-fda-advisory-committee-meeting/) **Published:** September 20, 2021 **Author:** Elevation **Excerpt:** Last Friday, the FDA’s key advisory committee convened for an 8-hour meeting to discuss and vote on boosters for those 16+ years of age. 84% of committee members voted “no” on boosters for the general population, citing safety concerns and a lack of data on the reduction of transmission after a third dose. In an unexpected turn of events, the FDA advisory committee created and voted on a second question, as to whether the known and potential benefits outweigh the known and potential risks of the Pfizer Covid booster – at least 6 months after the primary series – for use in those 65+ and those at high risk of severe COVID-19. Panelists voted “yes” unanimously.  **Content:** September 20, 2021 [Last Friday](https://www.fda.gov/advisory-committees/advisory-committee-calendar/vaccines-and-related-biological-products-advisory-committee-september-17-2021-meeting-announcement), the FDA’s key advisory committee convened for an 8-hour meeting to discuss and vote on boosters for those 16+ years of age. 84% of committee members voted “no” on boosters for the general population, citing safety concerns and a lack of data on the reduction of transmission after a third dose. In an unexpected turn of events, the FDA advisory committee created and voted on a second question, as to whether the known and potential benefits outweigh the known and potential risks of the Pfizer Covid booster – at least 6 months after the primary series – for use in those *65+ and those at high risk of severe COVID-19*. **Panelists voted “yes” unanimously.** Since “high risk” can be broadly interpreted, many Americans who wish to be given a booster may be eligible. Additional doses for immunocompromised persons, including those with autoimmune disease who may not have developed sufficient antibodies after their primary vaccination series, are eligible for a COVID-19 booster dose. The FDA typically follows the committee’s recommendations, but it is not mandatory that they do so. The FDA will most likely issue a decision this week, possibly before the CDC’s ACIP meeting on Wednesday. The CDC will develop vaccine policy based on the recommendations of the CDC advisory committee. **Category:** Covid-19 Boosters, Covid-19 Policy, Pfizer, Vaccine Manufacturers --- ### [Autoantibodies Can Predict Development of Severe COVID by Up To 92.8%](https://www.autoimmuneinstitute.org/covid_timeline/autoantibodies-can-predict-development-of-severe-covid-19-by-up-to-92-8/) **Published:** September 16, 2021 **Author:** Elevation **Excerpt:** A study published last week in Life Science Alliance analyzed blood samples from 115 patients hospitalized with SARS-CoV-2 and 42 uninfected controls and discovered the presence of autoantibodies in 36% of COVID-19 hospital patients. A strong association was made between the presence of these self-attacking immune system defense molecules and the more severe COVID-19 cases. Researchers focused on anti-DNA and anti-PS antibodies, determining that these antibodies could predict the later development of severe disease by 85.7% and 92.8%, respectively. **Content:** September 16, 2021 A[ study](https://www.life-science-alliance.org/content/4/11/e202101180) published last week in *Life Science Alliance* analyzed blood samples from 115 patients hospitalized with SARS-CoV-2 and 42 uninfected controls and discovered the presence of **autoantibodies in 36% of COVID-19 hospital patients**. A strong association was made between the presence of these self-attacking immune system defense molecules and the more severe COVID-19 cases. Researchers focused on anti-DNA and anti-PS antibodies, determining that these antibodies could predict the later development of severe disease by 85.7% and 92.8%, respectively. The authors went on to conclude that “anti-DNA and anti-PS autoantibodies may play an important role in the pathogenesis of COVID-19 and could be developed as predictive biomarkers for disease severity and specific clinical manifestations.” Their observations suggest that **the most severe forms of disease observed in COVID-19 patients may be a result of the host response to infection, rather than a direct consequence of viral cytopathic effect** (structural changes in host cells that are caused by viral invasion), which is similar to what occurs in some autoimmune diseases. **Category:** Covid-19 Antibodies, Covid-19 Research Studies --- ### [Risk of Relapse is Low for MS patients After COVID Vaccination, Study Finds](https://www.autoimmuneinstitute.org/covid_timeline/risk-of-relapse-is-low-for-ms-patients-after-covid-19-vaccination-study-finds/) **Published:** September 15, 2021 **Author:** Elevation **Excerpt:** Research published in the Journal of Neurology, Neurosurgery, and Psychiatry has indicated that multiple sclerosis (MS) patients did not see a rise in symptoms following COVID-19 vaccination with the Pfizer vaccine. Cohort characteristics included 93.5% of patients having relapsing-remitting MS, 4.6% having secondary progressive disease, and 1.9% having primary progressive disease. **Content:** September 15, 2021 Research published in the [*Journal of Neurology, Neurosurgery, and Psychiatry* ](https://jnnp.bmj.com/content/jnnp/early/2021/08/17/jnnp-2021-327200.full.pdf)has indicated that [multiple sclerosis](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/multiple-sclerosis/) (MS) patients did not see a rise in symptoms following COVID-19 vaccination with the Pfizer vaccine. Cohort characteristics included 93.5% of patients having relapsing-remitting MS, 4.6% having secondary progressive disease, and 1.9% having primary progressive disease. The study included 324 MS patients, of which six experienced relapses in the two months *prior* to vaccination, and seven encountered clinical relapses within two months *after* being vaccinated. **“The incidence of relapses in the 2 months before and after vaccination was not statistically different.”** The mean time between receiving the first vaccine and experiencing a relapse was 44 days, with no effect from factors such as age, gender, and duration of disease. This is the first study to follow MS patients for at least two months after receiving the first dose of the Pfizer vaccine. Of the 324 participants included in the study, 322 received both doses. **Category:** Autoimmune Diseases & Covid-19, Covid-19 Research Studies, MS & Covid-19 --- ### [Hot Off the Press: “Considerations in Boosting COVID Vaccine Immune Responses”](https://www.autoimmuneinstitute.org/covid_timeline/hot-off-the-press-considerations-in-boosting-covid-19-vaccine-immune-responses/) **Published:** September 13, 2021 **Author:** Elevation **Excerpt:** This morning, The Lancet published a viewpoint article regarding COVID-19 boosters; co-authors include Dr. Krause and Dr. Gruber from the Office of Vaccines Research and Review, Food and Drug Administration (FDA). **Content:** September 13, 2021 This morning, [*The Lancet* ](https://www.thelancet.com/pb-assets/Lancet/pdfs/S0140673621020468.pdf)published a viewpoint article regarding COVID-19 boosters; co-authors include Dr. Krause and Dr. Gruber from the Office of Vaccines Research and Review, Food and Drug Administration (FDA). The authors begin by addressing boosters for immunocompromised persons, stating it is still unknown whether this population would receive worthwhile benefit from an additional dose of the same vaccine, or if implementing a mix-and-match method may complement the primary immune response more effectively. **Randomized trials and observational studies have not yet shown a need for boosting the general population.** “A consistent finding is that vaccine efficacy is substantially greater against severe disease than against any infection… although the efficacy of most vaccines against symptomatic disease is somewhat less for the delta variant than for the alpha variant, there is still high vaccine efficacy against both symptomatic and severe disease due to the delta variant.” **Even if antibodies appear to decrease, their reduction does not necessarily predict reductions in vaccine efficacy against mild and severe disease.** Protection against severe disease utilizes antibody responses as well as memory responses and cell-mediated immunity. Developing variant-based boosters in the same way as the influenza vaccine will increase the likelihood of the vaccine remaining effective even if there is further strain mutation. As of now, the current vaccines elicit a humoral response against circulating variants. **Category:** Covid-19 Antibodies, Covid-19 Boosters, Covid-19 Policy --- ### [Granulocytes May Weaken the COVID Immune Response](https://www.autoimmuneinstitute.org/covid_timeline/granulocytes-may-weaken-the-covid-19-immune-response/) **Published:** September 10, 2021 **Author:** Elevation **Excerpt:** Low-density granulocytes (LDG) are a type of white blood cell known to circulate at increased levels in certain autoimmune diseases (such as rheumatoid arthritis) but are still poorly understood in relation to viral infections. The rise of SARS-CoV-2 highlighted the need to investigate these cells and their mechanisms, as they are known to be one of the first cellular responders to infection. **Content:** September 10, 2021 Low-density granulocytes (LDG) are a type of white blood cell known to circulate at increased levels in certain autoimmune diseases (such as [rheumatoid arthritis](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/rheumatoid-arthritis/)) but are still poorly understood in relation to viral infections. The rise of SARS-CoV-2 highlighted the need to investigate these cells and their mechanisms, as they are known to be one of the first cellular responders to infection. A [study](https://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1009721) recently published in *PLOS Pathogens* sought to determine the role that LDGs may play in the disease progression of COVID-19. The study included 55 COVID-19 infected patients (34 hospitalized and 21 outpatients), along with 14 healthy age- and sex-matched controls. After measuring LDG levels, the researchers detected a **significant increase in LDGs in the blood of COVID-19 patients compared to healthy control subjects and an even more prominent increase in severe COVID-19 cases**. Further testing demonstrated the immunosuppressive capacities of these cells. LDGs are typically associated with the early innate immune response, though researchers found that their involvement in the fight against COVID-19 included inhibition of the proliferation and division of T lymphocytes. This impairment of T lymphocytes subsequently weakens the adaptive immune response against the virus and research has shown that **low levels of T lymphocytes are a major indicator of developing a severe COVID-19 case versus a milder infection**. **Category:** Covid-19 Antibodies, Covid-19 Research Studies --- ### [COVID Vaccination Responses in IMID Patients](https://www.autoimmuneinstitute.org/covid_timeline/covid-19-vaccination-responses-in-imid-patients/) **Published:** September 9, 2021 **Author:** Elevation **Excerpt:** Today, the Research Institute of the McGill University Health Center announced a new study evaluating the impact of COVID-19 vaccines in participants living with immune-mediated inflammatory diseases (IMID). Common IMIDs include lupus, rheumatoid arthritis, Crohn’s disease, and Type 1 Diabetes. The study will include 2,500 patients with IMIDs, testing antibody levels up to 12 months after a full dose of the COVID-19 vaccine. **Content:** September 9, 2021 Today, the Research Institute of the McGill University Health Center announced a [new study evaluating the impact of COVID-19 vaccines in participants living with immune-mediated inflammatory diseases](https://www.biospace.com/article/releases/new-study-will-assess-impact-of-covid-19-vaccination-on-canadians-with-immune-mediated-inflammatory-disease/) (IMID). Common IMIDs include [lupus](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/systemic-lupus-erythematosus/), [rheumatoid arthritis](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/rheumatoid-arthritis/), [Crohn’s disease](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/crohns-disease/), and [Type 1 Diabetes](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/diabetes-type-1/). The study will include 2,500 patients with IMIDs, testing antibody levels up to 12 months after a full dose of the COVID-19 vaccine. The efficacy and safety of COVID-19 vaccines in those with IMIDs has yet to be thoroughly studied, but merits specific investigation as this population often requires immunosuppressive drugs as part of treating their disease. These drugs have been known to inhibit a sufficient antibody response to vaccination. One [study](https://ard.bmj.com/content/annrheumdis/early/2021/05/05/annrheumdis-2021-220461.full.pdf) conducted in Germany analyzed vaccine responses in untreated, conventionally treated, and anti-cytokine-treated patients with IMIDs. The most common autoimmune diseases included in the study were spondyloarthritis, rheumatoid arthritis, inflammatory bowel disease, and [psoriasis](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/psoriasis/). 42.9% of patients received biologic or targeted synthetic disease-modifying anti-rheumatic drugs, 23% were treated with conventional synthetic DMARDs, and 26.8% were not on any treatment. 181 of 182 control participants created anti-SARS-CoV-2 IgG antibodies. Of 84 patients with IMIDs, 76 developed neutralizing antibodies; 5 failed to respond to vaccination altogether. Of the eight who failed to develop neutralizing activity, three were taking Janus kinase inhibitors, two methotrexate, one was being treated with an interleukin-17 inhibitor, and two IMID patients were untreated. “Roughly 1 out of 10 patients with IMID fails to develop neutralizing antibodies after SARS-CoV-2 vaccination, while it is only 1 out of 100 in the controls.” **These results show that overall responses were delayed and reduced in IMID patients regardless of treatment method compared to controls.** This may be due to the fact that “patients affected by immune-mediated inflammatory diseases (IMIDs) show aberrant immune responses, increased risk to infections and are exposed by drugs that interfere with immune pathways.” **Category:** Autoimmune Diseases & Covid-19, Covid-19 Antibodies, Covid-19 Research Studies --- ### [Vaccination Reduces Risk of Long COVID by 49% ](https://www.autoimmuneinstitute.org/covid_timeline/vaccination-reduces-risk-of-long-covid-by-49/) **Published:** September 8, 2021 **Author:** Elevation **Excerpt:** According to a study published in The Lancet Infectious Diseases, those who are fully vaccinated against COVID-19 are 49% less likely to develop Long Covid in the unlikely event they contract COVID-19. **Content:** September 8, 2021 According to a [study](https://www.thelancet.com/action/showPdf?pii=S1473-3099%2821%2900460-6) published in *The Lancet Infectious Diseases*, those who are **fully vaccinated against COVID-19 are 49% less likely to develop Long Covid in the unlikely event they contract COVID-19.** Researchers at King’s College London analyzed self-reported data on the UK ZOE Covid app from approximately 1.2 million participants who received a first dose, and 970,000 participants who received a second dose of the COVID-19 vaccine. Of these cohorts, 6,030 and 2,370 tested positive for COVID-19 at least 14 and 7 days after vaccination, respectively. Users reported a COVID-19 infection an average of 73 days after their first vaccination, and an average of 51 days after their second-vaccination. The most commonly reported co-morbidities were asthma and lung disease. While almost halving the risk of Long Covid, researchers also found that there were **73% less hospitalizations and 31% less acute symptoms by those who were fully vaccinated versus those who were unvaccinated.** Symptoms were milder and less frequently reported by vaccinated individuals, and most commonly included loss of smell, fatigue, headaches, cough and fever. UK data indicates that mortality rates across all ages parallel that of the first wave (March-April 2020) in those who are hospitalized. “Data from the International Severe Acute Respiratory and Emerging Infection Consortium have shown a mortality of 27% (400 of 1482 died) in individuals hospitalized with COVID-19 in the UK more than 21 days after vaccination.” This suggests that while COVID-19 vaccination reduces the risk of severe COVID symptoms, mortality rates in COVID-19 hospital cases remain high, at least in the UK. **Category:** Covid-19 Research Studies, Long COVID --- ### [Can GBS Return Following COVID Vaccination?](https://www.autoimmuneinstitute.org/covid_timeline/can-gbs-return-following-covid-vaccination/) **Published:** September 7, 2021 **Author:** Elevation **Excerpt:** A research letter, published in JAMA Network last week, studied the rate of recurrent Guillain-Barré Syndrome (GBS) following vaccination with the mRNA Pfizer-BioNTech COVID-19 vaccine and found the risk to be extremely low. This retrospective cohort study utilized medical data from the second largest health maintenance organization in Israel **Content:** September 7, 2021 A [research letter](https://jamanetwork.com/journals/jamaneurology/fullarticle/2783708?alert=article), published in *JAMA Network* last week, **studied the rate of recurrent [Guillain-Barré Syndrome (GBS)](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/guillain-barre-syndrome/) following vaccination with the mRNA Pfizer-BioNTech COVID-19 vaccine and found the risk to be extremely low**. This retrospective cohort study utilized medical data from the second largest health maintenance organization in Israel,\* including 579 previously diagnosed GBS patients who had received at least one vaccine dose, 539 who had received two doses, and 38 who had COVID-19 and needed only one dose according to the Israeli Ministry of Health guidelines. Of these 579 patients, 48 were seen in a hospital following vaccination, though only one needed “short medical care for relapse of previous syndrome, which represents a minimal risk” according to the researchers. *\* The investigators point out that the study only included hospital visits, and that details on the reason for hospitalization remained vague. Additionally, the inclusion of hospital visits alone may “underestimate other symptoms that presented only in the community. Nevertheless, any significant serious neurologic concern would probably have been evaluated in a hospital setting.”* **Category:** Autoimmune Diseases & Covid-19, Covid-19 Research Studies, GBS & Covid-19, Vaccine Adverse Events --- ### [Experiences of COVID Infection and Vaccination in Those with Sjogren’s](https://www.autoimmuneinstitute.org/covid_timeline/experiences-of-covid-19-infection-and-vaccination-in-those-with-sjogrens/) **Published:** September 3, 2021 **Author:** Elevation **Excerpt:** This week, Rheumatology International published a study on the impact of COVID-19 infection and vaccination in patients with Sjogren’s syndrome.  **Content:** September 3, 2021 This week, *Rheumatology International* published a [study](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8397857/) on the impact of COVID-19 infection and vaccination in patients with [Sjogren’s syndrome](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/sjogrens-syndrome/). The study included 137 participants who completed an online questionnaire-based survey. 31 patients responded that they previously experienced a COVID-19 infection, one of which had been completely asymptomatic. 17 patients said their symptoms lasted for at least two weeks, with the most frequent long-lasting symptoms being fatigue (40%) and weakness (36%). While three participants were hospitalized, none required admission into the ICU. **Symptoms specific to Sjogren’s patients included more severe eye, oral, and nasal dryness (32%, 40%, and 32%, respectively).** Additionally, 53 participants received at least one dose of the COVID-19 vaccine and cited pain at the injection site, weakness, and myalgia as the most prevalent side effects. 10% of the study’s participants reported experiencing joint pain and fever, as well as aggravated dryness-related symptoms. The most common reason for not getting vaccinated was feeling unsure of how the vaccine would impact their Sjogren’s diagnosis. **Category:** Autoimmune Diseases & Covid-19, Covid-19 Infections, Covid-19 Research Studies, Sjögren disease & Covid-19 --- ### [~89% of Those with Chronic Inflammatory Conditions Produce Antibodies Following Vaccination, Despite Immunosuppressant Usage](https://www.autoimmuneinstitute.org/covid_timeline/89-of-those-with-chronic-inflammatory-conditions-produce-antibodies-following-vaccination-despite-immunosuppressant-usage/) **Published:** September 2, 2021 **Author:** Elevation **Excerpt:** The Washington University School of Medicine is conducting a study called COVaRiPAD (COVID-19 Vaccine Responses in Patients with Autoimmune Disease). The team just published research looking at the effect of immunosuppression on the efficacy of mRNA COVID-19 vaccines. They found that 88.7% of patients with chronic inflammatory conditions* (CID), including rheumatoid arthritis (28.5%), Crohn’s disease (16.5%), spondyloarthritis (15%), ulcerative colitis (13.5%), systemic lupus erythematosus (11.3%), multiple sclerosis (6.8%), and sjögrens syndrome (6%), produced detectable antibodies in response to the vaccine. **Content:** September 2, 2021 The Washington University School of Medicine is conducting a study called COVaRiPAD ([COVID-19 Vaccine Responses in Patients with Autoimmune Disease](https://studysearch.wustl.edu/studies/357)). The team just[ published research](https://www.acpjournals.org/doi/10.7326/M21-1757) looking at the effect of immunosuppression on the efficacy of mRNA COVID-19 vaccines. They found that 88.7% of patients with chronic inflammatory conditions\* (CID), including [rheumatoid arthritis](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/rheumatoid-arthritis/) (28.5%), [Crohn’s disease](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/crohns-disease/) (16.5%), [spondyloarthritis](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/psoriatic-arthritis/) (15%), [ulcerative colitis](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/ulcerative-colitis/) (13.5%), [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/systemic-lupus-erythematosus/) (11.3%), [multiple sclerosis](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/multiple-sclerosis/) (6.8%), and [sjögrens syndrome](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/sjogrens-syndrome/) (6%), produced detectable antibodies in response to the vaccine. Researchers found that immune responses varied depending on the medication being taken, which included glucocorticoids, antimetabolites, tumor necrosis factor inhibitors (TNFis), B-cell depleting therapy (BCDT), and Janus kinase inhibitors (JAKis). All CID participants continued use of their immunosuppressive medications during the study per their treating physician, except for 3 who held methotrexate (antimetabolite) within 1 week of immunization. **Those taking BCDT (60%) and glucocorticoids (65%) had absent or numerically lower antibody levels after both vaccinations, while the other immunosuppressives did not generate much lower antibody levels when compared to those not taking the drugs.** It should be noted that the antibody levels in CID participants were one-third of the levels seen in the healthy controls. The researchers highlighted the difficulty of determining whether the levels achieved by those on immune-suppressing drugs are high enough to protect them from severe COVID-19 given that a minimum level of antibodies required for protection against COVID-19 has yet to be established. Nonetheless, evidence supporting that vaccination does elicit a response in those with compromised immune systems is still encouraging for a population that has a high risk of serious illness.  *\* Those with acquired or inherited immunocompromised conditions and those using systemic immunosuppression were excluded.* **Category:** Autoimmune Diseases & Covid-19, Covid-19 Antibodies, Covid-19 Research Studies, Covid-19 Variants, Lupus & Covid-19, MS & Covid-19, RA & Covid-19 --- ### [NIH Launches Clinical Trial Studying COVID Booster Response in Autoimmune Disease Non‐Responders](https://www.autoimmuneinstitute.org/covid_timeline/nih-launches-clinical-trial-studying-covid‐19-booster-response-in-autoimmune-disease-non‐responders/) **Published:** September 1, 2021 **Author:** Elevation **Excerpt:** Earlier this week, the NIH announced that they are launching a new clinical trial to determine the antibody response of a booster dose in autoimmune disease patients who did not respond to an initial full dose of the COVID-19 vaccine.  **Content:** September 1, 2021 Earlier this week, the NIH announced that they are launching a new [clinical trial](https://clinicaltrials.gov/ct2/show/NCT05000216) to determine the antibody response of a booster dose in autoimmune disease patients who did not respond to an initial full dose of the COVID-19 vaccine. The NIH estimates that 8% of Americans live with an autoimmune disease and this population has experienced higher rates of severe disease from COVID-19 than the general population. “It is unclear whether this is attributable to the autoimmune disease, the immunosuppressive medications taken to treat it, or both” ([1](https://www.nih.gov/news-events/news-releases/nih-launches-study-extra-covid-19-vaccine-dose-people-autoimmune-disease)). The trial will include 600 participants, 18+ years of age, living with one of five autoimmune diseases: [rheumatoid arthritis](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/rheumatoid-arthritis/), pemphigus, [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/systemic-lupus-erythematosus/), systemic sclerosis, or [multiple sclerosis](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/multiple-sclerosis/). Participants must be taking one of three immunosuppressive therapies, including mycophenolate mofetil (MMF) or mycophenolic acid (MPA), methotrexate (MTX), or B cell-depleting drugs. These immunosuppressive therapies have been associated with low antibody production after the COVID-19 vaccine. Participants will receive an extra dose of the same COVID-19 vaccine as their original dose (Moderna, Pfizer, or Johnson & Johnson). Participants taking MPA or MTX therapies will be assigned to continue or pause their medication before and after receiving the booster dose at random. Preliminary results are expected in November of this year. **Category:** Autoimmune Diseases & Covid-19, Covid-19 Boosters, Covid-19 Clinical Trials, Johnson & Johnson, Lupus & Covid-19, Moderna, MS & Covid-19, Pfizer, RA & Covid-19, Vaccine Manufacturers --- ### [ACIP Votes in Favor of the Pfizer Vaccine](https://www.autoimmuneinstitute.org/covid_timeline/the-acip-votes-in-favor-of-the-pfizer-vaccine/) **Published:** August 31, 2021 **Author:** Elevation **Excerpt:** Yesterday, the CDC’s Advisory Committee on Immunization Practices (ACIP) convened to discuss the FDA approval of Pfizer’s COVID-19 vaccine, booster shots, and updates around vaccine safety. Committee members voted unanimously in favor of the vaccine for those 16+ years of age. **Content:** August 31, 2021 Yesterday, the CDC’s Advisory Committee on Immunization Practices (ACIP) [convened](https://www.cdc.gov/vaccines/acip/meetings/slides-2021-08-30.html) to discuss the FDA approval of Pfizer’s COVID-19 vaccine, booster shots, and updates around vaccine safety. **Committee members voted unanimously in favor of the vaccine for those 16+ years of age.** Pfizer’s COVID-19 vaccine was approved by the FDA on August 23, 2021; the ACIP’s recommendation forms the basis of the CDC’s public health guidance around use of the vaccine. A representative from Pfizer offered an overview regarding safety updates of the vaccine, as well as a study currently in the recruitment phase which will measure the efficacy of the booster dose. Results can be expected in 2022. A potential recommendation around boosters is expected to be made by September 20th. The ACIP will be convening in September to discuss the efficacy of booster shots based on available data, as well as distribution amongst at-risk populations. **Category:** Covid-19 Boosters, Covid-19 Policy, Pfizer, Vaccine Manufacturers --- ### [Study Links Risk of Myocarditis with Pfizer Vaccination but Finds Even Higher Risk of Myocarditis Following COVID Infection](https://www.autoimmuneinstitute.org/covid_timeline/study-links-risk-of-myocarditis-with-pfizer-vaccination-but-finds-even-higher-risk-of-myocarditis-following-covid-19-infection/) **Published:** August 26, 2021 **Author:** Elevation **Excerpt:** A real-world case-control study from Israel, published yesterday, studied cohorts of individuals vaccinated with the Pfizer COVID-19 mRNA vaccine and unvaccinated individuals who became infected with SARS-CoV-2 for adverse effects. The vaccination cohorts included a mean of 884,828 vaccinated persons, with a median age of 38 years, and the SARS-CoV-2 infection cohort had a total of 173,106 persons with a median age of 34 years. **Content:** August 26, 2021 A real-world case-control [study](https://www.nejm.org/doi/full/10.1056/NEJMoa2110475?query=featured_home) from Israel, published yesterday, studied cohorts of individuals vaccinated with the Pfizer COVID-19 mRNA vaccine and unvaccinated individuals who became infected with SARS-CoV-2 for adverse effects. The vaccination cohorts included a mean of 884,828 vaccinated persons, with a median age of 38 years, and the SARS-CoV-2 infection cohort had a total of 173,106 persons with a median age of 34 years. They found that the vaccinated cohort was associated with an increased risk of myocarditis (2.7 events per 100,000 persons) as well as lymphadenopathy (78.4 events per 100,000 persons), appendicitis (5.0 events per 100,000 persons), and herpes zoster infection (15.8 events per 100,000 persons). Researchers noted that vaccination was “substantially protective against adverse events such as anemia, acute kidney injury, intracranial hemorrhage, and lymphopenia.” However, it should be noted that in a separate cohort\*, an even **higher risk of myocarditis was found to be associated with SARS-CoV-2 infection** (11.0 events per 100,000 persons), in addition to other cardiovascular complications including acute kidney injury (125.4 events per 100,000 persons), pulmonary embolism (61.7 events per 100,000 persons), and intracranial hemorrhage (7.6 events per 100,000 persons). *\* The researchers pointed out that “the effects of vaccination and of SARS-CoV-2 infection were estimated with different cohorts. Thus, they should be treated as separate sets of results rather than directly compared.”* **Category:** Covid-19 Research Studies, Pfizer, Vaccine Adverse Events, Vaccine Manufacturers --- ### [RSV Cases are Too High and Too Early This Year](https://www.autoimmuneinstitute.org/covid_timeline/rsv-cases-are-too-high-and-too-early-this-year/) **Published:** August 23, 2021 **Author:** Elevation **Excerpt:** Cases of respiratory syncytial virus (RSV) have been on the rise this summer, which is unusual given that RSV typically strikes in November and peaks in December/January. This unexpected increase prompted officials with the Ohio Department of Health to hold a briefing today discussing the rise in this common respiratory virus that typically produces mild, cold-like symptoms. Unlike the seasonal flu, which is caused by the influenza virus and has an annual shot available for protection, there is no RSV vaccine at this time. However, researchers have been working to develop one. **Content:** August 23, 2021 Cases of respiratory syncytial virus (RSV) have been on the rise this summer, which is unusual given that RSV typically strikes in November and peaks in December/January. This unexpected increase prompted officials with the Ohio Department of Health to hold [a briefing](https://youtu.be/Bx03uR16nWQ) today discussing the rise in this common respiratory virus that typically produces mild, cold-like symptoms. Unlike the seasonal flu, which is caused by the influenza virus and has an annual shot available for protection, **there is no RSV vaccine at this time**. However, researchers have been working to develop one. According to Ohio Department of Health Director Dr. Bruce Vanderhoff, **it is not uncommon for children to be infected with two respiratory illnesses at one time and there have already been national reports of children simultaneously developing RSV and COVID-19**. Not enough is yet known about the impact of having both viruses together and whether having COVID-19 can worsen the course of RSV. **Category:** Covid-19 Infections, Covid-19 Research Studies --- ### [Pfizer-BioNTech COVID Vaccine Receives Full FDA Approval](https://www.autoimmuneinstitute.org/covid_timeline/pfizer-biontech-covid-19-vaccine-receives-full-fda-approval/) **Published:** August 23, 2021 **Author:** Elevation **Excerpt:** Today, the U.S. Food and Drug Administration approved the first COVID-19 vaccine. “The vaccine has been known as the Pfizer-BioNTech COVID-19 Vaccine, and will now be marketed as Comirnaty (koe-mir’-na-tee), for the prevention of COVID-19 disease in individuals 16 years of age and older. The vaccine also continues to be available under emergency use authorization (EUA), including for individuals 12 through 15 years of age and for the administration of a third dose in certain immunocompromised individuals.” **Content:** August 23, 2021 Today, the [U.S. Food and Drug Administration approved the first COVID-19 vaccine](https://www.fda.gov/news-events/press-announcements/fda-approves-first-covid-19-vaccine). “The vaccine has been known as the Pfizer-BioNTech COVID-19 Vaccine, and will now be marketed as Comirnaty (koe-mir’-na-tee), for the prevention of COVID-19 disease in individuals 16 years of age and older. The vaccine also continues to be available under emergency use authorization (EUA), including for individuals 12 through 15 years of age and for the administration of a third dose in certain immunocompromised individuals.” Moderna filed its requests for full approval after Pfizer, and Johnson & Johnson is expected to go through the same steps in the coming months. **Category:** Covid-19 Policy, Johnson & Johnson, Moderna, Pfizer, Vaccine Manufacturers --- ### [AstraZeneca Announces Non-Vaccine COVID Prevention Therapy with 77% Efficacy](https://www.autoimmuneinstitute.org/covid_timeline/astrazeneca-announces-non-vaccine-covid-prevention-therapy-with-77-efficacy/) **Published:** August 20, 2021 **Author:** Elevation **Excerpt:** AstraZeneca just announced that they’ve developed a non-vaccine therapy, called AZD7442, which reduces the risk of developing COVID-19. This combination of two long-acting antibodies* (LAAB) is administered intramuscularly and was found to cut the risk of developing symptomatic COVID-19 by 77% compared to placebo in the clinical trial. **Content:** August 20, 2021 AstraZeneca [just announced](https://www.astrazeneca.com/content/astraz/media-centre/press-releases/2021/azd7442-prophylaxis-trial-met-primary-endpoint.html) that they’ve developed a **non-vaccine therapy**, called AZD7442, which reduces the risk of developing COVID-19. This combination of two long-acting antibodies\* (LAAB) is administered intramuscularly and was **found to cut the risk of developing symptomatic COVID-19 by 77%** compared to placebo in the clinical trial. The trial included 5,197 unvaccinated participants and **more than 75% had comorbidities, including those with immunosuppressive disease or taking immunosuppressive medications**, diabetes, severe obesity or cardiac disease, chronic obstructive pulmonary disease, chronic kidney, and chronic liver disease. *\* AZD7442 is a combination of two LAABs – tixagevimab (AZD8895) and cilgavimab (AZD1061) – derived from B-cells donated by recovering patients after SARS-CoV-2 virus infection.* **Category:** AstraZeneca, Covid-19 & Long Covid Treatments, Vaccine Manufacturers --- ### [Increase in JIA Flare-Ups Seen During COVID Lockdown in Italy](https://www.autoimmuneinstitute.org/covid_timeline/increase-in-jia-flare-ups-seen-during-covid-lockdown-in-italy/) **Published:** August 19, 2021 **Author:** Elevation **Excerpt:** This week, a team of researchers reported online in Arthritis Care & Research that the rate of disease flares among juvenile idiopathic arthritis (JIA) patients* increased from 6.3% in 2019 to 16.9% in 2020. The elevation was seen even though the patients had adhered to their medication regimens and had been in a state of inactive disease. **Content:** August 19, 2021 This week, a team of researchers reported online in *Arthritis Care & Research* that the **rate of disease flares among [juvenile idiopathic arthritis](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/juvenile-idiopathic-arthritis/) (JIA) patients\* increased from [6.3% in 2019 to 16.9% in 2020](https://onlinelibrary.wiley.com/doi/10.1002/acr.24768)**. The elevation was seen even though the patients had adhered to their medication regimens and had been in a state of inactive disease. While a small handful of researchers have been studying the pandemic’s effects on adults with autoimmune and inflammatory diseases, very little is known about the specific impact on pediatric patients. This gap in the research is what inspired this team of researchers to focus on this specific population. The researchers noted that **“the physical inactivity associated with home confinement could be a possible explanation for clinical worsening in our patients”** and emphasized the need for implementing personalized at-home exercise plans for JIA patients confined to their homes. *\* A single-center retrospective study was conducted, including patients presenting inactive JIA between September 1st, 2018 and March 9th, 2019 (group A – 126 patients) and between September 1st, 2019 and March 9th, 2020 (group B – 124 patients).* **Category:** Autoimmune Diseases & Covid-19, Covid-19 Research Studies, RA & Covid-19 --- ### [Immune Response and Disease Flares Low in SLE Patients Following COVID Vaccination](https://www.autoimmuneinstitute.org/covid_timeline/immune-response-and-disease-flares-low-in-sle-patients-following-covid-19-vaccination/) **Published:** August 17, 2021 **Author:** Elevation **Excerpt:** Recently, the results of a study focusing on patients with systemic lupus erythematosus (SLE) who were fully vaccinated against COVID-19 was published, making it the first study of its kind. The 90 SLE patients participating in the study were recruited from the NYU Lupus Cohort and were compared against a group of 20 healthy controls with no known rheumatological diseases. Controls had only received the Pfizer-BioNTech and Moderna vaccines, whereas SLE patients received all three vaccines in the U.S., which includes the Johnson and Johnson vaccine. Overall, nearly 30% of SLE patients had a lower immune response to the COVID-19 vaccine than the control group. The low levels of response to the vaccine were likely associated with taking non-antimalarial immunosuppressant medications. **Content:** August 17, 2021 Recently, the results of a [study](https://onlinelibrary.wiley.com/doi/epdf/10.1002/art.41937) focusing on patients with [systemic lupus erythematosus (SLE)](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/systemic-lupus-erythematosus/) who were fully vaccinated against COVID-19 was published, making it the first study of its kind. The 90 SLE patients participating in the study were recruited from the NYU Lupus Cohort and were compared against a group of 20 healthy controls with no known rheumatological diseases. Controls had only received the Pfizer-BioNTech and Moderna vaccines, whereas SLE patients received all three vaccines in the U.S., which includes the Johnson and Johnson vaccine. Overall, **nearly 30% of SLE patients had a lower immune response to the COVID-19 vaccine than the control group.** The low levels of response to the vaccine were likely associated with taking non-antimalarial immunosuppressant medications. In addition to immune response following vaccination, disease flares were also assessed in the study. **Flares were low post-vaccination, with 11.4% of patients reporting a mild to moderate flare, and 1.3% having a severe flare.** **Category:** Autoimmune Diseases & Covid-19, Covid-19 Research Studies, Johnson & Johnson, Lupus & Covid-19, Moderna, Pfizer, Vaccine Adverse Events, Vaccine Manufacturers --- ### [First Dose of Pfizer Vaccine Increases Antibodies in Those with Prior COVID Infection](https://www.autoimmuneinstitute.org/covid_timeline/first-dose-of-pfizer-vaccine-increases-antibodies-in-those-with-prior-covid-19-infection/) **Published:** August 16, 2021 **Author:** Elevation **Excerpt:** A team of doctors affiliated with the Rush University Medical Center recently wrote a research letter summarizing recent findings on Pfizer’s COVID-19 vaccine. Notably, the investigators “observed higher SARS-CoV-2 antibody levels in previously infected individuals after 1 dose of [Pfizer] compared with infection-naive individuals after two doses.” The study also found that those previously infected with COVID-19 saw an increased antibody response after the first dose, but did not see another significant increase following the second dose. **Content:** August 16, 2021 A team of doctors affiliated with the Rush University Medical Center recently wrote a research letter summarizing [recent findings on Pfizer’s COVID-19 vaccine](https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2782762). Notably, the investigators “observed higher SARS-CoV-2 antibody levels in previously infected individuals after 1 dose of \[Pfizer\] compared with infection-naive individuals after two doses.” The study also found that those previously infected with COVID-19 saw an increased antibody response after the first dose, but did not see another significant increase following the second dose. **Category:** Covid-19 Antibodies, Covid-19 Research Studies, Pfizer, Vaccine Manufacturers --- ### [Cognitive Consequences of COVID](https://www.autoimmuneinstitute.org/covid_timeline/cognitive-consequences-of-covid-19/) **Published:** August 15, 2021 **Author:** Elevation **Excerpt:** A recent study conducted in the UK sought to confirm whether there was an association between cognitive performance data from 81,337 participants and COVID-19 case data. **Content:** August 15, 2021 A recent [study](https://www.thelancet.com/action/showPdf?pii=S2589-5370%2821%2900324-2) conducted in the UK sought to confirm whether there was an association between cognitive performance data from 81,337 participants and COVID-19 case data. Data included in the study were collected between January and December 2020, and participants completed an extended questionnaire (with questions pertaining to COVID-19 infection), as well as a series of cognitive tasks via The Great British Intelligence Test. **Researchers found that people who had recovered from COVID-19, including those no longer reporting symptoms, “exhibited significant cognitive deficits” compared to those in the control group.** Notably, the severity of cognitive deficits was associated with the degree of illness severity from COVID-19 infection. Those who were hospitalized and placed on a ventilator exhibited the greatest deficits. These deficits were even larger than the deficits present in those who had previously suffered a stroke or had learning disabilities. The most pronounced cognitive deficits detected in the study parallel the cognitive symptoms present in “long Covid.” These deficits presented themselves in tasks involving reasoning, spatial planning, target detection, and problem-solving. **Category:** Covid-19 Infections, Covid-19 Research Studies, Long COVID --- ### [FDA Authorizes Additional Dose for Immunocompromised Patients](https://www.autoimmuneinstitute.org/covid_timeline/fda-authorizes-additional-dose-for-immunocompromised-patients/) **Published:** August 13, 2021 **Author:** Elevation **Excerpt:** Last night, the FDA authorized use of an additional dose of Pfizer-BioNTech and Moderna’s COVID-19 vaccines for those who are immunocompromised and may not have developed sufficient antibodies after a full dose of the COVID-19 vaccine. These patients include those who have received solid organ transplants, as well as “those who are diagnosed with conditions that are considered to have an equivalent level of immunocompromise.” **Content:** August 13, 2021 Last night, [the FDA authorized the use of an additional dose](https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-authorizes-additional-vaccine-dose-certain-immunocompromised) of Pfizer-BioNTech and Moderna’s COVID-19 vaccines for those who are immunocompromised and may not have developed sufficient antibodies after a full dose of the COVID-19 vaccine. These patients include those who have received solid organ transplants, as well as “those who are diagnosed with conditions that are considered to have an equivalent level of immunocompromise.” The statement added that those who are fully vaccinated do not need an additional dose of the COVID-19 vaccine at this time. The FDA is currently assessing the need for a booster dose amongst the general population and will consider whether this is needed in the future. On August 10, the NIH launched a [study testing the efficacy of a third COVID-19 vaccine in kidney transplant recipients](https://www.nih.gov/news-events/news-releases/nih-launches-study-third-covid-19-vaccine-dose-kidney-transplant-recipients). This pilot study aims to identify characteristics that can help distinguish kidney transplant recipients who will benefit from a third dose from those who will need a different means of achieving full protection. “The pilot study findings will inform a subsequent, larger phase of the trial that includes higher-risk strategies to induce a protective immune response against SARS-CoV-2 in solid organ transplant recipients who do not respond to a third dose of an mRNA vaccine.” The CDC’s Advisory Committee on Immunization Practices (ACIP) will be meeting today to discuss further recommendations for immunocompromised patients. **Category:** Autoimmune Diseases & Covid-19, Covid-19 Boosters, Covid-19 Policy, Moderna, Pfizer, Vaccine Manufacturers --- ### [Using Infliximab to Treat COVID](https://www.autoimmuneinstitute.org/covid_timeline/using-infliximab-to-treat-covid-19/) **Published:** August 12, 2021 **Author:** Elevation **Excerpt:** Yesterday, the WHO announced that three drugs are being tested as effective treatments for COVID-19. The trial will include infliximab, which is currently approved to treat autoimmune diseases such as Crohn’s disease, ulcerative colitis, psoriatic arthritis, and rheumatoid arthritis. **Content:** August 12, 2021 Yesterday, the WHO announced that [three drugs are being tested as effective treatments for COVID-19](https://www.who.int/director-general/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-august-2021). The trial will include infliximab, which is currently approved to treat autoimmune diseases such as [Crohn’s disease](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/crohns-disease/), [ulcerative colitis](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/ulcerative-colitis/), [psoriatic arthritis](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/psoriatic-arthritis/), and [rheumatoid arthritis](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/rheumatoid-arthritis/). So far, infliximab has shown decreased mortality risks for those infected with COVID-19 when used as a treatment, regardless of whether they have an autoimmune disease. In fact, one [study](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7366555/) found that its use helped drop mortality rates for hospitalized COVID-19 patients by 35%. Other [studies](https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(20)30309-X/fulltext) have also noted a marked improvement for infected patients being treated with infliximab. The NIH and Tufts Medical Center are currently conducting a [Phase 2 clinical trial](https://clinicaltrials.gov/ct2/show/NCT04425538) testing whether TNF inhibitors like infliximab reduce the need for respiratory support in severe COVID-19 infections. **Category:** Autoimmune Diseases & Covid-19, Covid-19 & Long Covid Treatments, Covid-19 Clinical Trials, Covid-19 Research Studies, RA & Covid-19 --- ### [The Effect of Anti-CD20 Therapies on SARS-CoV-2 Immune Responses in Multiple Sclerosis Patients](https://www.autoimmuneinstitute.org/covid_timeline/the-effect-of-anti-cd20-therapies-on-sars-cov-2-immune-responses-in-multiple-sclerosis-patients/) **Published:** August 11, 2021 **Author:** Elevation **Excerpt:** Researchers in France investigated the humoral immune response to COVID-19 in patients with multiple sclerosis (MS) and neuromyelitis optica spectrum disorders (NMO-SD). Humoral immune responses use antibodies to protect against reinfection when exposed to a foreign invader. **Content:** August 11, 2021 Researchers in France[ investigated the humoral immune response to COVID-19 in patients with multiple sclerosis (MS)](https://jnnp.bmj.com/content/early/2021/08/01/jnnp-2021-326904) and neuromyelitis optica spectrum disorders (NMO-SD). Humoral immune responses use antibodies to protect against reinfection when exposed to a foreign invader. The results of the study showed a high seroconversion rate in patients with [MS](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/multiple-sclerosis/) and NMO-SD after COVID-19. However, patients treated with anti-CD20 therapies had a seroconversion rate twice as low as untreated patients and patients receiving a different treatment. In other words, **patients treated with anti-CD20 therapies exhibited a weaker antibody response against a COVID-19 infection.** Some factors found to influence seroconversion rates included IgG levels and severity of COVID-19 infection. The time between the last anti-CD20 infusion and COVID-19 was also longer in seropositive patients. **Category:** Autoimmune Diseases & Covid-19, Covid-19 & Long Covid Treatments, Covid-19 Antibodies, MS & Covid-19 --- ### [Antibody Development Following COVID Vaccine in Autoimmune Disease Patients](https://www.autoimmuneinstitute.org/covid_timeline/antibody-development-following-covid-19-vaccine-in-autoimmune-disease-patients/) **Published:** August 10, 2021 **Author:** Elevation **Excerpt:** A study coming from the Netherlands looks at the immune response following COVID-19 vaccination in patients with autoimmune disease, focusing specifically on the effects of different immunosuppressive drugs on antibody development. Researchers used serum samples from 289 patients without autoimmune disease, who served as the control group, and 632 patients with autoimmune disease (including rheumatoid arthritis, ankylosing spondylitis, systemic lupus erythematous and multiple sclerosis). The mean age of participants was 63 years and 57% of participants were female. **Content:** August 10, 2021 A study coming from the Netherlands looks at the[ immune response following COVID-19 vaccination in patients with autoimmune disease](https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(21)00222-8/fulltext), focusing specifically on the effects of different immunosuppressive drugs on antibody development. Researchers used serum samples from 289 patients without autoimmune disease, who served as the control group, and 632 patients with autoimmune disease (including [rheumatoid arthritis](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/rheumatoid-arthritis/), [ankylosing spondylitis](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/ankylosing-spondylitis/), [systemic lupus erythematous](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/systemic-lupus-erythematosus/), and [multiple sclerosis](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/multiple-sclerosis/)). The mean age of participants was 63 years and 57% of participants were female. Serum samples were collected from participants after their first or second dose of the COVID-19 vaccine (to include Johnson & Johnson, Pfizer, AstraZeneca, and Moderna). “**Among participants without previous SARS-CoV-2 infection, seroconversion after first vaccination were significantly lower in patients than in \[the\] control**,” mainly due to the use of immunosuppressive therapies in autoimmune disease patients (namely, methotrexate or anti-CD20 therapies versus prednisone or TNF inhibitors). Seroconversion is the transition from viral infection to antibody presence in the body. **After the second dose, seroconversion surpassed 80% in all patients regardless of treatment, except those treated with anti-CD20 therapies.** In this treatment subgroup, 3 of 7 patients exceeded 80% seroconversion. Seroconversion rates and antibody titers were similar across autoimmune disease types and vaccine types included in the study, “suggesting that **treatment with immunosuppressive medication, rather than the underlying autoimmune disease, is the main factor that influences immunogenicity of vaccines**.” Researchers did not observe a difference in seroconversion and IgG antibody titers between patients with a previous COVID-19 infection who received one dose of the vaccine and patients without a previous COVID-19 infection who received both doses. Researchers also stated that a second or repeated exposure to SARS-CoV-2 via infection improves immunity in patients on immunosuppressive therapies. This is an interesting remark as studies and clinical data suggest the autoimmune disease population is at increased risk of developing severe disease from a COVID-19 infection ([1](https://ard.bmj.com/content/79/7/859), [2](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7194066/), [3](https://www.jrheum.org/content/jrheum/48/3/454.full.pdf)). That being said, “delayed second dosing of COVID-19 vaccines should be avoided in patients receiving immunosuppressive drugs.” While the results of this study are informative and provide clarity for the autoimmune disease population, further studies should be conducted with younger patients. Additionally, the study did not measure the timing of anti-CD20 therapy prior to vaccination. **Category:** AstraZeneca, Autoimmune Diseases & Covid-19, Covid-19 Antibodies, Covid-19 Research Studies, Johnson & Johnson, Lupus & Covid-19, Moderna, MS & Covid-19, Pfizer, RA & Covid-19, Vaccine Manufacturers --- ### [Pending Authorization of COVID Booster for Immunocompromised Population](https://www.autoimmuneinstitute.org/covid_timeline/pending-authorization-of-covid-19-booster-for-immunocompromised-population/) **Published:** August 9, 2021 **Author:** Elevation **Excerpt:** Last Thursday during a White House briefing, Dr. Fauci stated the need for a booster shot in immunocompromised persons, as they are often unable to produce sufficient antibodies against COVID-19. Dr. Fauci stated that CDC and FDA officials are working to get this population an additional dose “as quickly as possible,” with speculations that this may be possible within the next few weeks. **Content:** August 9, 2021 Last Thursday during a White House briefing, Dr. Fauci stated the need for a [booster shot in immunocompromised persons](https://www.reuters.com/world/us/us-plans-give-extra-covid-19-shots-at-risk-americans-fauci-2021-08-05/), as they are often unable to produce sufficient antibodies against COVID-19. Dr. Fauci stated that CDC and FDA officials are working to get this population an additional dose “as quickly as possible,” with speculations that this may be possible within the next few weeks. This group includes those who have received organ transplants, chemotherapy patients, and those who are currently on other immunosuppressive therapies. In a [joint statement](https://www.hhs.gov/about/news/2021/07/08/joint-cdc-and-fda-statement-vaccine-boosters.html) released last month, the FDA and CDC stated that “people who are fully vaccinated are protected from severe disease and death, including from the variants currently circulating in the country such as Delta.” The need for boosters amongst the general population has not reached a consensus within the scientific community, and as of now the FDA, CDC, and NIH’s position remains that “Americans who have been fully vaccinated do not need a booster shot at this time.” Vaccine manufacturers have reported high levels of protection against the Delta variant ([1](https://cdn.pfizer.com/pfizercom/2021-07/Delta_Variant_Study_Press_Statement_Final_7.8.21.pdf?IPpR1xZjlwvaUMQ9sRn2FkePcBiRPGqw), [2](https://www.jnj.com/positive-new-data-for-johnson-johnson-single-shot-covid-19-vaccine-on-activity-against-delta-variant-and-long-lasting-durability-of-response), [3](https://investors.modernatx.com/news-releases/news-release-details/moderna-provides-clinical-update-neutralizing-activity-its-covid)). **Category:** Covid-19 Boosters, Covid-19 Policy, Covid-19 Variants, Vaccine Manufacturers --- ### [Rheumatic Flares Uncommon Following COVID Vaccination](https://www.autoimmuneinstitute.org/covid_timeline/rheumatic-flares-uncommon-following-covid-19-vaccination/) **Published:** August 6, 2021 **Author:** Elevation **Excerpt:** A recent study published by Arthritis & Rheumatology evaluated disease flares and post-vaccination reactions in patients with rheumatic and musculoskeletal diseases (RMD) following two-doses of an mRNA vaccine. The most common diseases amongst patients in the study were inflammatory arthritis (47%), systemic lupus erythematosus (20%), and mixed connective tissue disease (20%). Types of inflammatory arthritis include ankylosing spondylitis, psoriatic arthritis, and rhuematoid arthritis.  **Content:** August 6, 2021 A recent study published by [*Arthritis & Rheumatology* ](https://onlinelibrary.wiley.com/doi/epdf/10.1002/art.41924)evaluated disease flares and post-vaccination reactions in patients with rheumatic and musculoskeletal diseases (RMD) following two doses of an mRNA vaccine. The most common diseases amongst patients in the study were inflammatory arthritis (47%), [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/systemic-lupus-erythematosus/) (20%), and [mixed connective tissue disease](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/mixed-connective-tissue-disease/) (20%). Types of inflammatory arthritis include [ankylosing spondylitis](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/ankylosing-spondylitis/), [psoriatic arthritis](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/psoriatic-arthritis/), and [rheumatoid arthritis](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/rheumatoid-arthritis/). Of the 1,377 participants given two doses of the vaccine, **11% reported flares that required treatment.** **There were no reports of severe flares.** Moreover, no participant required intravenous therapy or hospitalization. Factors associated with flares requiring treatment included a previous COVID-19 diagnosis, history of a flare 6 months before the first dose of the vaccine, and the use of combination immunomodulatory therapy. Post-vaccination reactions commonly reported included pain at the injection site and fatigue. Reactions were heightened after the second dose with systemic reactions such as headache, myalgia, fatigue, and chills. It should be noted that none of the patients reported cases of anaphylaxis or a newly diagnosed SARS-CoV-2 infection during the study period. **Category:** Autoimmune Diseases & Covid-19, Covid-19 Research Studies, Lupus & Covid-19, RA & Covid-19, Vaccine Adverse Events --- ### [Antibody Response in IBD Patients After COVID Infection](https://www.autoimmuneinstitute.org/covid_timeline/antibody-response-in-ibd-patients-after-covid-19-infection/) **Published:** August 5, 2021 **Author:** Elevation **Excerpt:** Canadian researchers at the University of Calgary have published a study testing the antibody response after a COVID-19 infection in those with inflammatory bowel disease (IBD). Many IBD patients take immunosuppressive therapies for their autoimmune disease, which may inhibit the development of antibodies after a COVID-19 infection or the vaccine. **Content:** August 5, 2021 Canadian researchers at the University of Calgary have published a study [testing the antibody response after a COVID-19 infection in those with inflammatory bowel disease](https://gut.bmj.com/content/gutjnl/early/2021/08/01/gutjnl-2021-325238.full.pdf) (IBD). Many IBD patients take immunosuppressive therapies for their autoimmune disease, which may inhibit the development of antibodies after a COVID-19 infection or the vaccine. This population is also considered high-risk for severe disease outcomes from a COVID-19 infection. Serosurveillance provides estimates of antibody levels against infectious diseases and is considered the gold standard for measuring population immunity due to past infection or vaccination. This serosurveillance study included 324 patients from October 2020 to April 2021; 279 patients were in the serosurveillance group and did not have a prior COVID-19 diagnosis. 45 patients had been previously infected and recovered from COVID-19. The majority of participants had [Crohn’s disease](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/crohns-disease/); 60% of recovered patients and 48.5% of the serosurveillance group were on anti-TNF agents. At baseline, 53.3% of recovered patients had positive nucleocapsid antibodies, whereas 1.08% of the serosurveillance cohort tested positive. Nucleocapsid proteins are the most sensitive target for serologicical diagnosis of a COVID-19 infection; neutralizing antibodies appear later in immune development ([1](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7239070/#:~:text=Antibodies%20to%20the%20nucleocapsid%20protein,those%20against%20the%20nucleocapsid%20protein.)). “The proportion of patients who were nucleocapsid antibody positive was 80.9% from 0-90 days from diagnosis.” **Only 21.7% of patients tested positive for antibodies after 90 days post-infection.** **Category:** Autoimmune Diseases & Covid-19, Covid-19 Antibodies, Covid-19 Research Studies, IBD & Covid-19 --- ### [Regeneron's Antibody Cocktail Authorized For Use as Prophylaxis](https://www.autoimmuneinstitute.org/covid_timeline/regenerons-antibody-cocktail-authorized-for-use-as-prophylaxis/) **Published:** August 3, 2021 **Author:** Elevation **Excerpt:** Last Friday, Regeneron announced the FDA’s decision to expand the EUA for their antibody cocktail as a prophylaxis (action taken to prevent disease, especially by specified means or against a specified disease). Previously, it was authorized for non-hospitalized patients aged 12+ who tested positive for a COVID-19 infection and were at risk of experiencing severe disease. **Content:** August 3, 2021 Last Friday, Regeneron announced the [FDA’s decision to expand the EUA for their antibody cocktail as a prophylaxis](https://investor.regeneron.com/news-releases/news-release-details/fda-expands-authorized-use-regen-covtm-casirivimab-and-imdevimab) (action taken to prevent disease, especially by specified means or against a specified disease). Previously, it was authorized for non-hospitalized patients aged 12+ who tested positive for a COVID-19 infection and were at risk of experiencing severe disease. **In a Phase 3 trial, the cocktail reduced the risk of symptomatic infection by 81% when used as a post-exposure prophylaxis.** This is the first monoclonal antibody treatment that can be used as both a treatment and prophylactic after exposure to COVID-19. The EUA applies to those 12+ who are exposed to someone with the virus, or through certain institutional settings. **“With this authorization, the FDA specifically highlights the needs of immunocompromised people, including those taking immunosuppressive medicines, who may not mount an adequate response to vaccination, who are exposed to a person with COVID-19 or are in an institutional setting and are at high risk of exposure because of infection occurring in the same setting.”** It is estimated that approximately 3% of the U.S. may not respond to the COVID-19 vaccine due to certain health conditions or immunosuppressive therapies. Regeneron noted the cocktail’s potency against the Delta variant in particular. **Category:** Covid-19 & Long Covid Treatments, Covid-19 Antibodies, Covid-19 Infections, Covid-19 Policy, Covid-19 Variants --- ### [The Immunogenicity and Safety of the CoronaVac Vaccine in Patients with Autoimmune Rheumatic Diseases](https://www.autoimmuneinstitute.org/covid_timeline/the-immunogenicity-and-safety-of-the-coronavac-vaccine-in-patients-with-autoimmune-rheumatic-diseases/) **Published:** August 2, 2021 **Author:** Elevation **Excerpt:** Last Friday, Nature Medicine published the results of a Phase 4 trial on the CoronaVac vaccine, which took place in Brazil. This trial aimed to evaluate both the immunogenicity and safety of CoronaVac in 910 patients with autoimmune rheumatic diseases (ARD). Immunogenicity measures the ability of a vaccine to induce an immune response in someone who’s been vaccinated (1). In this particular study, immunogenicity was indicated by the presence of anti-SARS-CoV-2 IgG and neutralizing antibodies. The results found that the vaccine produced an immune response in patients with ARD, but at lower levels when compared to the control group. **Content:** August 2, 2021 Last Friday, *Nature Medicine* published the results of a [Phase 4 trial on the CoronaVac vaccine](https://www.nature.com/articles/s41591-021-01469-5), which took place in Brazil. This trial aimed to evaluate both the immunogenicity and safety of CoronaVac in 910 patients with autoimmune rheumatic diseases (ARD). Immunogenicity measures the ability of a vaccine to induce an immune response in someone who’s been vaccinated [(1)](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3819562/). In this particular study, immunogenicity was indicated by the presence of anti-SARS-CoV-2 IgG and neutralizing antibodies. **The results found that the vaccine produced an immune response in patients with ARD, but at lower levels when compared to the control group.** Factors that contributed to negative anti-SARS-CoV-2 antibodies were older age and female sex. Old age was also more common among patients with negative neutralizing antibodies after complete vaccination. In addition to immunogenicity, vaccine safety was explored as a secondary outcome in the study. **Overall, there were no moderate or severe adverse events reported.** General reactions such as back pain, nausea, joint pain, sweating, and fatigue were more frequently reported among the cohort. **Category:** Autoimmune Diseases & Covid-19, Covid-19 Antibodies, Covid-19 Clinical Trials, Covid-19 Research Studies, RA & Covid-19, Vaccine Adverse Events, Vaccine Manufacturers --- ### [Breakthrough Infections After COVID Vaccination](https://www.autoimmuneinstitute.org/covid_timeline/breakthrough-infections-after-covid-19-vaccination/) **Published:** July 30, 2021 **Author:** Elevation **Excerpt:** On Wednesday, the New England Journal of Medicine published a study evaluating data obtained from fully vaccinated healthcare workers at Israel’s largest hospital. The study focused on breakthrough Covid-19 infections, defined as detection of the SARS-CoV-2 virus via a RT-PCR test 11 or more days after receiving the second dose of the Pfizer vaccine. Of 11,453 vaccinated healthcare workers, 1,497 were tested for COVID-19 during the study, and 39 breakthrough infections were documented. **Content:** July 30, 2021 On Wednesday, the *New England Journal of Medicine* published a study [evaluating data obtained from fully vaccinated healthcare workers at Israel’s largest hospital](https://www.nejm.org/doi/10.1056/NEJMoa2109072). The study focused on breakthrough Covid-19 infections, defined as detection of the SARS-CoV-2 virus via a RT-PCR test 11 or more days after receiving the second dose of the Pfizer vaccine. Of 11,453 vaccinated healthcare workers, 1,497 were tested for COVID-19 during the study, and 39 breakthrough infections were documented. **Of all the workers with breakthrough infection, 26 (67%) had mild symptoms at some stage, 13 were asymptomatic, and none required hospitalization.** The investigators of the study obtained antibody titers from 22 of the employees from before they were infected with SARS-CoV-2. Serological samples from breakthrough cases were matched with 4-5 samples from uninfected controls based on a series of factors (including age, sex, immunosuppression status, and the amount of time between receiving the second dose of the Pfizer vaccine to getting tested). **The breakthrough cases showed lower levels of neutralizing antibodies.** This is an important first step in discovering the threshold of neutralizing antibody protection that is needed to combat breakthrough infections. **Category:** Covid-19 Antibodies, Covid-19 Research Studies, Pfizer, Vaccine Manufacturers --- ### [Clinical Research Supports Efficacy of COVID Booster for Immunocompromised Patients, Federal Authorization Expected to Follow](https://www.autoimmuneinstitute.org/covid_timeline/clinical-research-supports-efficacy-of-covid-19-booster-for-immunocompromised-patients-federal-authorization-expected-to-follow/) **Published:** July 27, 2021 **Author:** Elevation **Excerpt:** During an Advisory Committee on Immunization Practices (ACIP) meeting last week, CDC staff confirmed that a third dose booster may be on the horizon for those who are immunocompromised. This comes after promising data of a third dose eliciting a robust immune response in those who had previously received a full dose of the COVID-19 vaccine, but were unable to produce detectable antibodies. **Content:** July 27, 2021 During an Advisory Committee on Immunization Practices (ACIP) [meeting last week](https://www.cdc.gov/vaccines/acip/meetings/slides-2021-07-22.html), CDC staff confirmed that a third dose booster may be on the horizon for those who are immunocompromised. This comes after promising data of a third dose eliciting a robust immune response in those who had previously received a full dose of the COVID-19 vaccine but were unable to produce detectable antibodies. The meeting referenced [a study of 99 solid-organ transplant patients](https://www.nejm.org/doi/full/10.1056/NEJMc2108861) who received a third dose. In the study, **the prevalence of anti–SARS-CoV-2 antibodies was 4% after the first dose, 40% after the second dose, and 68% 4 weeks after the third dose.** “Among the 59 patients who had been seronegative (no presence of virus in blood serum) before the third dose, 26 (44%) were seropositive at 4 weeks after the third dose.” Patients who did not elicit an antibody response were typically older, with a higher degree of immunosuppression, and a lower rate of kidney function. **No serious adverse events were reported by the cohort.** As of now, the use of a third dose would require a separate Emergency Use Authorization by the FDA. Once vaccines are FDA approved, doctors will be able to prescribe a booster to patients directly. Until then, patients may be able to access a third dose through investigational studies; some patients have also taken it upon themselves to obtain a third dose. **Category:** Autoimmune Diseases & Covid-19, Covid-19 Boosters, Covid-19 Clinical Trials, Covid-19 Policy, Covid-19 Research Studies --- ### [EMA Authorizes the Use of Moderna’s COVID Vaccine in Children 12+](https://www.autoimmuneinstitute.org/covid_timeline/ema-authorizes-the-use-of-modernas-covid-19-vaccine-in-children-12/) **Published:** July 26, 2021 **Author:** Elevation **Excerpt:** This past Friday, the European Medicines Agency (EMA) authorized the use of Moderna’s COVID-19 vaccine in children 12+ years of age. This will be the second vaccine manufacturer to be authorized for use in those 12+, alongside Pfizer. Children will be given two shots, four weeks apart, which is the same dosing schedule for adults. **Content:** July 26, 2021 This past Friday, the European Medicines Agency (EMA) [authorized the use of Moderna’s COVID-19 vaccine in children 12+ years of age](https://www.ema.europa.eu/en/news/covid-19-vaccine-spikevax-approved-children-aged-12-17-eu). This will be the second vaccine manufacturer to be authorized for use in those 12+, alongside Pfizer. Children will be given two shots, four weeks apart, which is the same dosing schedule for adults. The European Commission will take the next steps to approve if and when the vaccine will be used in each of the E.U.’s countries. As of now, more than a dozen E.U. countries have been vaccinating children between the ages of 12 and 17 with the Pfizer vaccine. The EMA’s decision was influenced by an ongoing pediatric study involving 3,732 children (2,163 of which received the vaccine and 1,569 receiving a placebo) showing that the Moderna vaccine “produced a comparable antibody response in 12 to 17-year-olds to that seen in young adults aged 18 to 25 years (as measured by the level of antibodies against SARS-CoV-2).” None of the 2,163 children who received the COVID-19 vaccine contracted the virus. The Committee for Medicinal Products for Human Use (CHMP) noted that, at this time, “due to the limited number of children and adolescents included in the study, the trial could not have detected new uncommon side effects or estimated the risk of known side effects such as myocarditis (inflammation of the heart muscle) and pericarditis (inflammation of the membrane around the heart).” **Category:** Covid-19 Policy, Pfizer, Vaccine Manufacturers --- ### [Are Pericytes How the Coronavirus Can Sneak Past the Blood-Brain Barrier?](https://www.autoimmuneinstitute.org/covid_timeline/are-pericytes-how-the-coronavirus-can-sneak-past-the-blood-brain-barrier/) **Published:** July 23, 2021 **Author:** Elevation **Excerpt:** Research and clinical observations have shown that the central nervous system (brain and spinal cord) is directly or indirectly affected by SARS-CoV-2 infection, though there has been no evidence of the virus infecting nerve cells themselves. In this recent study, an artificially grown mass of cells was created, mimicking a brain, and was infected with the coronavirus. The “cortical brain organoids” remained impervious to COVID-19. However, knowing that autopsy studies have shown that SAR-CoV-2 has the potential to spread throughout the brain, the researchers pressed on. **Content:** July 23, 2021 Research and clinical observations have shown that the central nervous system (brain and spinal cord) is directly or indirectly affected by SARS-CoV-2 infection, though there has been no evidence of the virus infecting nerve cells themselves. In this recent [study](https://www.nature.com/articles/s41591-021-01443-1), an artificially grown mass of cells was created, mimicking a brain, and was infected with the coronavirus. The “cortical brain organoids” remained impervious to COVID-19. However, knowing that autopsy studies have shown that SAR-CoV-2 has the potential to spread throughout the brain, the researchers pressed on. **The main function of pericytes is to regulate blood flow in the brain, help maintain homeostasis within the body, and sustain the blood-brain barrier.** What made these cells of particular interest to the researchers is that pericytes, unlike most neural cells, have high expressions of ACE2, the surface protein that SARS-CoV-2 uses to enter and infect cells. The researchers attempted to infect the cortical brain organoid again with the coronavirus, only this time they added pericytes, and an incredibly robust infection occurred. They found that the **pericytes acted like ‘viral replication hubs’ following infection, allowing the virus to multiply** and begin targeting astrocytes (immune cells crucial for several protective and regulatory functions in the brain). **The researchers stated that the findings suggest that pericytes could potentially serve as an entry point for SARS-CoV-2.** **Category:** Covid-19 Infections, Covid-19 Research Studies --- ### [COVID Vaccination in Patients with SLE](https://www.autoimmuneinstitute.org/covid_timeline/covid-19-vaccination-in-patients-with-sle/) **Published:** July 22, 2021 **Author:** Elevation **Excerpt:** Patients with systemic lupus erythematous (SLE) were excluded from COVID-19 vaccine trials. To better understand the tolerability of COVID-19 vaccines amongst patients with SLE, the international vaccination against COVID in systemic lupus (VACOLUP) study was initiated via online survey. Participants included those with a self-reported, medically confirmed diagnosis of SLE. **Content:** July 22, 2021 Patients with [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/systemic-lupus-erythematosus/) (SLE) were excluded from COVID-19 vaccine trials. To better understand the tolerability of COVID-19 vaccines amongst patients with SLE, the international vaccination against COVID in systemic lupus (VACOLUP)[ study](https://www.thelancet.com/action/showPdf?pii=S2665-9913%2821%2900221-6) was initiated via an online survey. Participants included those with a self-reported, medically confirmed diagnosis of SLE. The study included 696 participants from 30 countries. All patients had received at least one dose by the time of the study, most commonly from Pfizer, Sinovac, AstraZeneca, and Moderna. 343 patients received a second dose. 316 participants reported side effects after the first dose; 181 of the 343 patients who received the second dose reported side effects. “Patients who received both vaccine doses and reported side-effects after the first dose were more likely to report side-effects after the second dose.” 3% of study participants reported a medically confirmed flare-up of SLE. “Having a flare during the past year before vaccination was associated with an increased risk of SLE flare after COVID-19 vaccination.” Approximately 50% of patients with SLE reported side effects that, more often than not, did not impair daily function. There was no difference in occurrence between those who received an mRNA vaccine versus a vaccine with a different method of delivery. **It is important to note that the short median time between vaccination and onset of flare-ups suggests that these side effects may parallel expected post-vaccine reactions and that the “3% figure could be an overestimation of the actual flare rate.”** **Category:** AstraZeneca, Autoimmune Diseases & Covid-19, Covid-19 Research Studies, Lupus & Covid-19, Moderna, Pfizer, Vaccine Adverse Events, Vaccine Manufacturers --- ### [Breakthrough Cases of COVID in Those Who Are Immunocompromised](https://www.autoimmuneinstitute.org/covid_timeline/breakthrough-cases-of-covid-19-in-those-who-are-immunocompromised/) **Published:** July 21, 2021 **Author:** Elevation **Excerpt:** The European Society of Clinical Microbiology and Infectious Diseases published the results of a retrospective study of 17 hospitals throughout Israel. The study included 152 patients who tested positive for COVID-19 after being fully vaccinated with the Pfizer vaccine (breakthrough cases) and required hospitalization. This study aimed to “characterize vaccinated patients with breakthrough COVID-19 requiring hospitalization and define the main risk factors associated with poor outcomes in this group.” Notably, 40% of breakthrough cases included patients who were immunocompromised.  **Content:** July 21, 2021 The *European Society of Clinical Microbiology and Infectious Diseases* published the results of a retrospective study of 17 hospitals throughout Israel. The [study](https://www.clinicalmicrobiologyandinfection.com/action/showPdf?pii=S1198-743X%2821%2900367-0) included **152 patients who tested positive for COVID-19 after being fully vaccinated with the Pfizer vaccine (breakthrough cases) and required hospitalization**. This study aimed to “characterize vaccinated patients with breakthrough COVID-19 requiring hospitalization and define the main risk factors associated with poor outcomes in this group.” **Notably, 40% of breakthrough cases included patients who were immunocompromised.** Real-world data coming from Israel’s mass vaccination campaign parallel Phase 3 clinical trial data, supporting Pfizer vaccine’s 95% efficacy rate. That being said, **efficacy was shown to be lower in those with multiple comorbidities and the immunocompromised**. The most common causes of immunosuppression included chronic corticosteroid treatment, antimetabolite therapy, and anti-CD20 treatment (Rituximab, commonly used to treat [rheumatoid arthritis](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/rheumatoid-arthritis/), is an anti-CD20 biologic agent). Overall, “comorbidities were more common in patients with vaccine breakthrough infections compared with large case series on unvaccinated hospitalized patients.” This reconfirms the hypothesis that the vaccine elicits a lower efficacy rate amongst those with certain comorbidities, especially if they are on immunosuppressive therapies. “Immunosuppression was not associated with a worse outcome, except for anti-CD20 treatment, which had a threefold higher odds ratio to be in the poor outcome group (13% versus 4%).” **The overall mortality rate amongst these cases paralleled unvaccinated hospitalized COVID-19 patients.** **Category:** Autoimmune Diseases & Covid-19, Pfizer, RA & Covid-19, Vaccine Manufacturers --- ### [Anti-NET Autoantibodies May Be a Factor in Severe COVID](https://www.autoimmuneinstitute.org/covid_timeline/anti-net-autoantibodies-may-be-a-factor-in-severe-covid-19/) **Published:** July 20, 2021 **Author:** Elevation **Excerpt:** Recently, a study was published in which samples from 328 COVID-19 patients were measured for an autoantibody presence which protects neutrophil extracellular traps (NETs) from being destroyed. **Content:** July 20, 2021 Recently, a [study](https://insight.jci.org/articles/view/150111) was published in which samples from 328 COVID-19 patients were measured for an autoantibody presence which protects neutrophil extracellular traps (NETs) from being destroyed. NETs are extracellular webs of DNA and proteins that protect against infection and have been implicated in the pathology of many immune-mediated diseases, including [lupus](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/systemic-lupus-erythematosus/), [rheumatoid arthritis](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/rheumatoid-arthritis/), and ANCA vasculitis. Anti-NET antibodies disrupt the body’s ability to achieve immune homeostasis during a COVID-19 infection. These antibodies are also likely to contribute to the inflammatory storm which leads to severe COVID-19, including blood clots. Patients with increased levels of anti-NET antibodies were less likely to disintegrate the toxins, as the anti-NET antibodies coat the NETs, creating a barrier for the body to rid itself of the toxins. Additionally, **patients who required ventilation had a “greater burden of anti-NET antibodies” than those whose symptoms did not require oxygen supplementation.** Anti-NETs have also been found in those with [antiphospholipid syndrome](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/antiphospholipid-syndrome/), and present similar outcomes as COVID-19 patients. It is unknown how the body creates these autoantibodies; further studies may shed light on the persistence behind many long COVID symptoms, as well as the pathology of autoimmune disease. **Category:** Autoimmune Diseases & Covid-19, Covid-19 Antibodies, Covid-19 Infections, Covid-19 Research Studies, Lupus & Covid-19, RA & Covid-19 --- ### [J&J Add Autoimmune Adverse Reaction to COVID Vaccine Warning Label](https://www.autoimmuneinstitute.org/covid_timeline/johnson-johnson-add-autoimmune-adverse-reaction-to-covid-19-vaccine-warning-label/) **Published:** July 13, 2021 **Author:** Elevation **Excerpt:** Yesterday, Johnson & Johnson COVID-19 vaccine supplier Janssen Biotech, Inc. released a statement regarding the potential risks of their adenovirus vaccine. The updated disclaimer states: **Content:** July 13, 2021 Yesterday, Johnson & Johnson COVID-19 vaccine supplier Janssen Biotech, Inc. released a [statement regarding the potential risks of their adenovirus vaccine](https://www.fda.gov/media/150723/download). The updated disclaimer states: “The reporting rate of thrombosis with thrombocytopenia following administration of the Janssen COVID-19 Vaccine has been highest in females ages 18 through 49 years; some have been fatal.” This edit was meant to clarify the current understanding around the risk of clotting in females 18-49 years old. **The notice also featured a new warning regarding the vaccine’s ability to trigger Guillain-Barré Syndrome (GBS) in recipients.** GBS is an autoimmune condition where the body attacks its own nerve cells, causing muscle weakness and, sometimes, paralysis. Learn more about GBS [here](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/guillain-barre-syndrome/).  **It is important to note that GBS is typically triggered by a viral infection, and most people fully recover.** In their recent press release, Janssen Biotech, Inc. explained that there are increased (but still very low) risks of developing GBS in the 42 days that follow vaccinations. VAERS cases were typically reported by males over 50 years of age, within two weeks of vaccination. The report recommends that those who are experiencing tingling in their legs or arms, troubles walking, or other symptoms seek medical attention immediately.  Interestingly, the statement also noted that adverse reactions following vaccination are reported voluntarily. **Preliminary reports have concluded that only about 8 people per million of those who had been vaccinated with the Johnson & Johnson vaccine experienced problems with GBS.** This means that the frequency of reactions like the onset of GBS and blood clotting have still yet to be pinpointed as casual relationships. For this reason, Johnson & Johnson and the FDA consider this vaccine to be safe, and that the risks of COVID-19 infection outweigh the risks of the vaccine’s potential side effects at this time. **Category:** Autoimmune Diseases & Covid-19, GBS & Covid-19, Johnson & Johnson, Vaccine Adverse Events, Vaccine Manufacturers --- ### [Israel Begins Pfizer Booster Shots for Immunocompromised, Including Those with Autoimmune Disease](https://www.autoimmuneinstitute.org/covid_timeline/israel-begins-pfizer-booster-shots-for-immunocompromised-including-those-with-autoimmune-disease/) **Published:** July 12, 2021 **Author:** Elevation **Excerpt:** Israel is now the first country whose Ministry of Health is officially recommending the use of booster shots for those with compromised immune systems, who may be unable to develop sufficient antibodies after a full dose of the vaccine. **Content:** July 12, 2021 Israel is now the first country whose [Ministry of Health is officially recommending the use of booster shots](https://www.bloomberg.com/news/articles/2021-07-12/israel-approves-3rd-vaccine-dose-for-immunocompromised-tv-says) for those with compromised immune systems, who may be unable to develop sufficient antibodies after a full dose of the vaccine. The majority of those currently hospitalized in Israel for COVID-19, who have already been vaccinated, include those in high-risk groups. While organ transplant patients take priority for a third shot, [people with autoimmune disease will be eligible](https://www.haaretz.com/israel-news/israel-may-push-for-third-covid-vaccine-dose-for-high-risk-groups-1.9968943). Independent clinical cases have already shown an [uptake in antibody production after a third dose](https://www.medpagetoday.com/special-reports/exclusives/92698?xid=nl_mpt_investigative2021-05-26&eun=g1829540d0r&utm_source=Sailthru&utm_medium=email&utm_campaign=InvestigativeMD_052621&utm_term=NL_Gen_Int_InvestigateMD_Active) in those who are immunocompromised. The Israeli government has not come to a decision regarding booster shots for the general population. **Category:** Autoimmune Diseases & Covid-19, Covid-19 Antibodies, Covid-19 Policy, GBS & Covid-19, Pfizer, Vaccine Adverse Events, Vaccine Manufacturers --- ### [What Makes COVID Affect People Differently?](https://www.autoimmuneinstitute.org/covid_timeline/what-makes-covid-19-affect-people-differently/) **Published:** July 9, 2021 **Author:** Elevation **Excerpt:** A study published yesterday in Nature, called Mapping the human genetic architecture of COVID-19, suggests that genetics may be the answer. This is the biggest single genetic study in history looking at how the variances in DNA amongst individuals around the world respond differently to a virus. Researchers were able to identify and confirm 13 genes that seem to play a part in determining susceptibility to becoming infected as well as the severity of the infection. **Content:** July 9, 2021 A study published yesterday in *Nature*, called [Ma](https://www.nature.com/articles/s41586-021-03767-x_reference.pdf)[pping](https://www.nature.com/articles/s41586-021-03767-x_reference.pdf)[ the human](https://www.nature.com/articles/s41586-021-03767-x_reference.pdf)[ g](https://www.nature.com/articles/s41586-021-03767-x_reference.pdf)[enetic](https://www.nature.com/articles/s41586-021-03767-x_reference.pdf)[ architecture of COVID-19](https://www.nature.com/articles/s41586-021-03767-x_reference.pdf), suggests that genetics may be the answer. **This is the biggest single genetic study in history looking at how the variances in DNA amongst individuals around the world respond differently to a virus.** Researchers were able to identify and confirm 13 genes that seem to play a part in determining susceptibility to becoming infected as well as the severity of the infection. Some genes, particularly ones involved with lung-related phenotypes or autoimmune/inflammatory diseases, directly correlated with common coronavirus symptoms; other genes will require more investigation. Researchers are also hoping to use this information to investigate why some individuals develop long COVID while others don’t. **Category:** Covid-19 Infections, Covid-19 Research Studies, Long COVID --- ### [Clinical Trial to Commence Testing COVID Booster Shot in Participants Who Are Immunocompromised and Living with Autoimmune Disease](https://www.autoimmuneinstitute.org/covid_timeline/clinical-trial-to-commence-testing-covid-19-booster-shot-in-participants-who-are-immunocompromised-and-living-with-autoimmune-disease/) **Published:** July 6, 2021 **Author:** Elevation **Excerpt:** Pfizer is planning a clinical trial on the efficacy of a third vaccine to boost the creation of antibodies in immunocompromised individuals. This trial will include 360 participants who are ages 2+ and immunocompromised (to include those on immunomodulator therapy for an autoimmune disease). **Content:** July 6, 2021 Pfizer is planning a clinical trial on the [efficacy of a third vaccine to boost the creation of antibodies in immunocompromised individuals](https://clinicaltrials.gov/ct2/show/NCT04895982?term=c4591024&recrs=ab&cond=covid-19&draw=2&rank=1). This trial will include 360 participants who are ages 2+ and immunocompromised (to include those on immunomodulator therapy for autoimmune disease). Those on immunotherapies are particularly vulnerable to complications due to COVID-19 infection; however, this population group is often unable to produce detectible antibodies after a full dose of the COVID-19 vaccine. **This will be the first study including those who are immunocompromised or living with an autoimmune disease to see if antibody production increases after a third dose of the COVID-19 vaccine.** Clinical observations of [patients getting a third dose](https://www.acpjournals.org/doi/10.7326/L21-0282) show seemingly impressive antibody production but must be considered on a case-by-case basis. Around 5% of the US population is considered to be immunocompromised. While organ transplant and cancer patients have been a focus of COVID-19 and vaccine research, those taking Rituximab, corticosteroids, and methotrexate – often taken by those living with certain autoimmune diseases – may be resistant to protection from the COVID-19 vaccine. The clinical trial is estimated to begin in September 2021 and conclude in January 2023. **Category:** Autoimmune Diseases & Covid-19, Covid-19 Antibodies, Covid-19 Boosters, Covid-19 Clinical Trials, Pfizer, Vaccine Manufacturers --- ### [FDA Fact Sheets Have Been Updated to Include Risk of Myocarditis and Pericarditis Following COVID Vaccine](https://www.autoimmuneinstitute.org/covid_timeline/fda-fact-sheets-have-been-updated-to-include-risk-of-myocarditis-and-pericarditis-following-covid-vaccine/) **Published:** June 29, 2021 **Author:** Elevation **Excerpt:** Last week, the CDC Advisory Committee on Immunization Practices convened to discuss the uptake in myocarditis and pericarditis cases in young adults following a COVID-19 vaccination. During the advisory meeting, it was stated that there was a “likely association.” FDA Fact Sheets have since been updated to include the risk of developing myocarditis and pericarditis, particularly following a second dose of the mRNA vaccine.  **Content:** June 29, 2021 Last week, the CDC Advisory Committee on Immunization Practices convened to discuss the uptake in myocarditis and pericarditis cases in young adults following a COVID-19 vaccination. During the advisory meeting, it was stated that there was a “likely association.” FDA Fact Sheets have since been updated to include [the risk of developing myocarditis and pericarditis](https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-june-25-2021), particularly following a second dose of the mRNA vaccine.  The CDC Advisory Committee meeting was organized as over 1200 cases of myocarditis have been reported in young persons 30 years and younger. Because 300 million doses have been administered thus far, **cases of myocarditis and pericarditis are still considered rare adverse events.** The majority of cases were presented in males, most often one week after the second dose; chest pain was the most common reported symptom. It was emphasized that heart inflammation and heart function are separate, and that heart inflammation was reduced with prescription medications, over-the-counter medications, or resolved on their own. It should also be noted that close to 1600 young athletes have undergone a cardiac MRI following a SARS-CoV-2 infection. It was recommended that those who experience myocarditis following their first dose should wait until symptoms resolve completely before receiving a second dose of the vaccine. Additionally, it was stated that **the risk of side effects following an mRNA vaccine do not outweigh their benefits within this age group, as post-Covid conditions often pose a greater risk in children, such as the development of MIS-C.**  **4,018 MIS-C cases have been reported as of June 2, 2021, with 60-70% of patients being admitted into the ICU. 12-20-year-olds account for 36% of cases.** **Category:** Covid-19 Policy, Vaccine Adverse Events --- ### [mRNa Vaccine May Produce Long-Lasting Immunity to SARS-CoV-2](https://www.autoimmuneinstitute.org/covid_timeline/mrna-vaccine-may-produce-long-lasting-immunity-to-sars-cov-2/) **Published:** June 28, 2021 **Author:** Elevation **Excerpt:** New research indicates that mRNA vaccines may produce long-lasting immunity. This morning, the medical school at Washington University of St. Louis released results from a study showing that the immune response to the Pfizer vaccine continued at high levels 15 weeks post-vaccination.  **Content:** June 28, 2021 New research indicates that mRNA vaccines may produce long-lasting immunity. This morning, the medical school at Washington University of St. Louis released results from a study showing that the **immune response to the Pfizer vaccine continued at high levels 15 weeks post-vaccination**. Additionally, patients vaccinated with the Pfizer and Moderna vaccines produced high levels of antibodies three weeks after their first dose, which are effectively able to neutralize three strains of the SARS-CoV-2 virus. This response was even higher in those previously infected with COVID-19 and then vaccinated. This is the first study to show evidence of prolonged [B cell production in germinal centers post-vaccination](https://www.nature.com/articles/s41586-021-03738-2_reference.pdf). Germinal centers are created within the lymphoid tissue and create memory B cells. The longer a germinal center remains active, the stronger the immune response will be. Once antibodies are created, they flow into the bloodstream.  The study’s researchers sampled the germinal centers in the lymph nodes of 14 vaccinated patients, three weeks after the first dose. Samples were obtained at the four, five and seven week marks as well. 10 participants gave samples 15 weeks after their first vaccine. In the three-week sample, all 14 participants had formed germinal centers that were producing antibodies against SARS-CoV-2. This immune response peaked after the booster and decreased (yet remained detectable) at the 15 week mark. Studies have found that antigen-specific B cells can persist for at least one year, though it should be noted that studies on the extended durability of vaccine-induced antibody responses are rare. “The persistence of S-binding germinal center B cells and plasma blasts in draining lymph nodes is a positive indicator for induction of long-lived plasma cell responses.” “Future studies will be needed to examine whether mRNA vaccination induces a robust S-specific long-lived plasma cell compartment in the bone marrow.” It has been previously shown that a COVID-19[ infection does in fact produce B cells which remain dormant in bone marrow](https://www.nature.com/articles/s41586-021-03647-4_reference.pdf). Further studies will elucidate the influence of a previous COVID-19 infection on germinal centers compared to vaccine-induced germinal center responses. **Category:** Covid-19 Antibodies, Covid-19 Research Studies, Pfizer, Vaccine Manufacturers --- ### [Questions Surround Rare Development of GBS After COVID Vaccination](https://www.autoimmuneinstitute.org/covid_timeline/questions-surround-rare-development-of-gbs-after-covid-19-vaccination/) **Published:** June 25, 2021 **Author:** Elevation **Excerpt:** Recently, reports have been published associating adenovirus vector COVID-19 vaccines and the onset of unusual variants of Guillain-Barré syndrome (GBS). Notably, experts highlight that there have been no findings suggesting COVID vaccines cause GBS. However, the timing of the condition’s onset occurring shortly after vaccination has raised questions among researchers.  **Content:** June 25, 2021 Recently, reports have been published associating adenovirus vector COVID-19 vaccines and the onset of unusual variants of Guillain-Barré syndrome (GBS). **Notably, experts highlight that there have been no findings suggesting COVID vaccines *cause* GBS.** However, the timing of the condition’s onset occurring shortly after vaccination has raised questions among researchers. Within the past month, there have been three different reports linking the AstraZeneca and Johnson & Johnson adenovirus vector COVID-19 vaccines to unusual variants of GBS. Two studies published in the *Annals of Neurology* on June 10, 2021, linked the development of GBS with the AstraZeneca vaccines in Nottingham, [England,](https://onlinelibrary.wiley.com/doi/epdf/10.1002/ana.26144) and Kerala, [India](https://onlinelibrary.wiley.com/doi/epdf/10.1002/ana.26143), and involved both men and women. Additionally, during a [clinical trial](https://n.neurology.org/content/neurology/96/22/1052.full.pdf), a woman with a history of migraines who had received the Johnson & Johnson vaccine experienced GBS-like symptoms but recovered after being treated for GBS. In each study, researchers found the cases to develop in people 10-22 days after their vaccination. **This time period coincides with the maximal immune response to the vaccine,  the point at which the vaccine becomes fully effective.** Traditional forms of GBS are characterized by muscle weakness and, sometimes, paralysis following infection with a virus or bacteria. Interestingly, reports of facial weakness were less common in these cases when compared to traditional GBS cases. Cases of GBS have been reported to VAERS after vaccination with Moderna and Pfizer vaccines as well. **While rare, reporting adverse events to** **[VAERS](https://vaers.hhs.gov/) notifies the CDC and FDA on which adverse events to investigate further.** **Category:** AstraZeneca, Autoimmune Diseases & Covid-19, Covid-19 Variants, GBS & Covid-19, Johnson & Johnson, Vaccine Manufacturers --- ### [Can a SARS-CoV-2 Infection Trigger Celiac Disease?](https://www.autoimmuneinstitute.org/covid_timeline/can-a-sars-cov-2-infection-trigger-celiac-disease/) **Published:** June 24, 2021 **Author:** Elevation **Excerpt:** A study published in the International Journal of Clinical Practice has hypothesized that genetically-predisposed patients could be more likely to develop celiac disease following a SARS-CoV-2 infection. **Content:** June 24, 2021 A study published in the *International Journal of Clinical Practice* has hypothesized that genetically-predisposed patients could be more likely to [develop celiac disease following a SARS-CoV-2 infection](https://onlinelibrary.wiley.com/doi/epdf/10.1111/ijcp.14452). This hypothesis is based on several pathogenic mechanisms observed in patients following a COVID-19 infection, which could promote the onset of celiac disease. More specifically, a SARS-CoV-2 infection might damage the mucosal membrane, resulting in increased permeability of the intestinal barrier. A weakened intestinal barrier allows microbial components, including wheat protein, to pass into a layer of the epithelium where they can potentially bind with certain immune system cells to trigger an autoimmune response. If an individual is already genetically predisposed, **some researchers hypothesize that damage to the intestinal barrier caused by COVID-19 could prove to be a risk factor for developing celiac disease.** Further investigation is necessary to understand whether a COVID-19 infection triggers celiac disease. This is not the first connection to be highlighted in the scientific literature on the development of an autoimmune disease after a COVID-19 infection. Recently, [type 1 diabetes was also observed to be connected to SARS-CoV-2 infection](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7669477/?report=reader), leading researchers to hypothesize that COVID-19 may be an additional risk factor for developing autoimmune conditions. **Category:** Autoimmune Diseases & Covid-19, Celiac disease & Covid-19, Covid-19 Infections, Covid-19 Research Studies, T1D & Covid-19 --- ### [Analysis of Remaining Long-COVID Symptoms Following Recovery of Initial Infection](https://www.autoimmuneinstitute.org/covid_timeline/analysis-of-remaining-long-covid-symptoms-following-recovery-of-initial-infection/) **Published:** June 18, 2021 **Author:** Elevation **Excerpt:** FAIRHealth published its eighth white paper study on COVID-19 this past Tuesday. This iteration of the report detailed findings regarding the experiences of long-haul COVID patients who were 30 days or more removed from their initial COVID-19 diagnosis.  **Content:** June 18, 2021 *FAIRHealth* published its eighth white paper study on COVID-19 this past Tuesday. This iteration of the report detailed findings regarding the experiences of [long-haul COVID patients ](https://s3.amazonaws.com/media2.fairhealth.org/whitepaper/asset/A%20Detailed%20Study%20of%20Patients%20with%20Long-Haul%20COVID--An%20Analysis%20of%20Private%20Healthcare%20Claims--A%20FAIR%20Health%20White%20Paper.pdf)who were 30 days or more removed from their initial COVID-19 diagnosis. One key finding identified that **23.2% of patients who had COVID-19 experienced at least one post-COVID condition.** Moreover, the severity of one’s COVID-19 case seemed to play a role in one’s susceptibility to long-haul COVID conditions. **Regardless of whether a person was hospitalized or experienced no symptoms, at least some portion of those who had COVID-19 were found to be susceptible to developing long-haul COVID conditions.** Specifically, 50% of patients were hospitalized for their COVID-19 symptoms, 27.5% of those who were symptomatic but not hospitalized, and 19% of asymptomatic patients developed a post-COVID condition. The most common post-COVID conditions for these individuals across every age group included pain, difficulties breathing, hyperlipidemia, malaise and fatigue, and hypertension. In more refined sample populations, there were some notable variances. Specifically, there were some slight variations between the different age groups. For example, the pediatric population (those between 0 and 18) had intestinal issues as the third most common post-COVID condition rather than hyperlipidemia. The study also focused on the mental health implications of COVID-19. Four different mental conditions were also a focal point of the study. **The research found that anxiety cases were the most common out of the four, with depression, adjustment disorders, and tic disorders following.** Notably, females were generally more affected by long-COVID conditions than males were, except for 12 specific conditions (including post-COVID cardiac inflammation).  Mortality rates were the final focus of the long-haul COVID patient study. With this lens, researchers found that the severity of one’s COVID-19 experience played a role in their likelihood of surviving following 30+ days after their initial diagnosis. Specifically, the study found that **those hospitalized and later discharged were 46 times more likely to die than those who had never been hospitalized.** Additionally, those with intellectual disabilities who suffered from COVID-19 were the most likely group out of all preexisting conditions to die 30+ days after their COVID-19 diagnosis. **Category:** Covid-19 Infections, Long COVID --- ### [REGEN-COV Phase 3 Trial Improves Survival in Patients Hospitalized with Severe COVID-19](https://www.autoimmuneinstitute.org/covid_timeline/regen-cov-phase-3-trial-improves-survival-in-patients-hospitalized-with-severe-covid-19/) **Published:** June 17, 2021 **Author:** Elevation **Excerpt:** A Phase 3 RECOVERY trial in the UK found that Regeneron’s REGEN-COV antibody treatment reduced the risk of death by 20% in patients who had not mounted their own immune response against COVID-19. In addition, among patients without their own immune response, the median duration of hospital stay was 4 days shorter in the REGEN-COV group, and there was a greater proportion of patients discharged by 28 days. Research has also shown that the treatment remains effective against the main variants of COVID-19 in the United States.  **Content:** June 17, 2021 A Phase 3 RECOVERY trial in the UK found that Regeneron’s [REGEN-COV antibody treatment reduced the risk of death by 20%](https://investor.regeneron.com/news-releases/news-release-details/regen-covtm-casirivimab-and-imdevimab-phase-3-recovery-trial) in patients who had not mounted their own immune response against COVID-19. In addition, among patients without their own immune response, the median duration of hospital stay was 4 days shorter in the REGEN-COV group, and there was a greater proportion of patients discharged by 28 days. [Research](https://www.cell.com/cell/fulltext/S0092-8674(21)00703-0) has also shown that the treatment remains effective against the main variants of COVID-19 in the United States. REGEN-COV is a mix of two monoclonal antibodies known as casirivimab and imdevimab. These antibodies block the infection ability of SARS-COV-2, the virus that causes COVID-19. The results of the RECOVERY trial demonstrate that REGEN-COV can **“alter the course of COVID-19 infection from prevention to very early infection, all the way through to when patients are on a ventilator in the hospital.**” Regeneron is working with the FDA to expand its current EUA to other populations such as hospitalized patients. **Category:** Covid-19 & Long Covid Treatments, Covid-19 Clinical Trials, Covid-19 Policy, Covid-19 Research Studies, Covid-19 Variants --- ### [Safety, Immunogenicity and Efficacy of the Pfizer Vaccine Amongst 686 Patients with Autoimmune Inflammatory Rheumatic Diseases](https://www.autoimmuneinstitute.org/covid_timeline/safety-immunogenicity-and-efficacy-of-the-pfizer-vaccine-amongst-686-patients-with-autoimmune-inflammatory-rheumatic-diseases/) **Published:** June 16, 2021 **Author:** Elevation **Excerpt:** Israel has been a model for vaccination success against COVID-19, with over 56% of the country being fully vaccinated. On Monday, June 13, Israeli researchers published the findings of the largest observational prospective study confirming the immunogenicity, efficacy, and safety of the Pfizer vaccine amongst 686 patients with autoimmune inflammatory rheumatic diseases (AIIRD).  **Content:** June 16, 2021 Israel has been a model for vaccination success against COVID-19, with over 56% of the country being fully vaccinated. On Monday, June 13, Israeli researchers published the findings of the largest observational prospective study confirming the [immunogenicity, efficacy, and safety of the Pfizer vaccine amongst 686 patients with autoimmune inflammatory rheumatic diseases](https://ard.bmj.com/content/annrheumdis/early/2021/06/13/annrheumdis-2021-220647.full.pdf) (AIIRD). Rheumatoid arthritis, psoriatic arthritis, axial spondyloarthritis, systemic lupus erythematosus (SLE), systemic vasculitis, Behcet’s disease, and Susac syndrome were included under the umbrella of AIIRD. Patients were instructed to continue all medications besides rituximab (pending physician’s recommendations). Healthcare providers made up the majority of the control group (121 participants), and all participants were given a complete dose of the Pfizer vaccine three weeks apart. Post-vaccination status and activity were assessed within 2-6 weeks following the second dose. While the immunogenicity rates (immune response towards a vaccine over a long period of time) amongst those on immunosuppressive therapies such as rituximab and glucocorticoids were lower than average, **there were no post-vaccination symptomatic COVID-19 cases amongst those with AAIRD**. This data is concurrent with available data recorded in the US and short-term efficacy research published by the American College of Rheumatology. The prevalence of adverse events was also similar between patients with AIIRD and the control group. **Post-vaccination disease remained relatively stable in the majority of patients with AIIRD, and adverse events were typically mild in nature.** Major adverse events included herpes zoster (6 cases), uveitis (2), pericarditis (1), and two deaths several weeks after receiving the second dose. AIIRD patients exhibited a reduced antibody production rate of 86% following the vaccine compared to 100% in controls. Patients with psoriatic arthritis, axial spondyloarthritis, systemic lupus erythematosus (SLE), and systemic vasculitis demonstrated a seropositivity rate (positive serum reaction when testing for antibodies) above 90%. The seropositivity rate amongst patients with rheumatoid arthritis was 82.1%. “The seropositivity rate in patients vaccinated within 6 months after rituximab treatment was below 20% but increased to about 50% in patients vaccinated 1 year after rituximab treatment.” **Category:** Autoimmune Diseases & Covid-19, Lupus & Covid-19, Pfizer, RA & Covid-19, Vaccine Manufacturers --- ### [Treating MIS-C with Phase 3 Celiac Drug](https://www.autoimmuneinstitute.org/covid_timeline/treating-mis-c-with-phase-3-celiac-drug/) **Published:** June 15, 2021 **Author:** Elevation **Excerpt:** Even after a COVID-19 infection has passed, SARS-CoV-2 particles may linger in the gut and make their way into the bloodstream. This often triggers a cytokine storm and hyper-inflammatory response (MIS-C) within multiple areas of the body. These include the heart, lungs, kidneys, brain, and GI organs.  **Content:** June 15, 2021 Even after a COVID-19 infection has passed, **SARS-CoV-2 particles may linger in the gut and make their way into the bloodstream**. This often triggers a [cytokine storm](https://www.autoimmuneinstitute.org/sars-cov-2-autoimmune-virus-long-covid/) and hyper-inflammatory response (MIS-C) within multiple areas of the body. These include the heart, lungs, kidneys, brain, and GI organs. A new study published in the Journal of Clinical Investigation focuses on the role of SARS-CoV-2 particles in the gut as [the root cause of MIS-C ](https://dm5migu4zj3pb.cloudfront.net/manuscripts/149000/149633/cache/149633.1-20210608125913-covered-e0fd13ba177f913fd3156f593ead4cfd.pdf)weeks to months after a COVID-19 infection. The study tested the stool of 100 children, 19 of which had MIS-C and 26 who tested positive for a COVID-19 infection. 55 children served as healthy controls. 18 of the 19 children who developed MIS-C had high levels of the SARS-CoV-2 virus in their stool. They also presented with high levels of zonulin, a protein that regulates the permeability of the digestive tract. **“Increased circulating zonulin levels resulting in increased intestinal permeability have been reported in several diseases including auto-immune and hyper-inflammatory diseases such as celiac disease, inflammatory bowel disease, and Kawasaki disease.”** Investigators obtained permission to treat one patient with Larazotide – a zonulin antagonist that strengthens the gut barrier and is currently in Phase 3 clinical trials for use in celiac patients. “Inhibition of intestinal permeability in a patient with MIS-C prevents SARS-CoV-2 antigens from trafficking into the bloodstream, conferring clinical benefit by addressing the underlying trigger for MIS-C rather than just the inflammatory consequences.” Researchers from this study are planning to conduct a clinical trial using Larazotide to treat MIS-C. They will use this as a **starting point for the development of an effective treatment or even prophylaxis for COVID-19 infections amongst children.** **Category:** Autoimmune Diseases & Covid-19, Celiac disease & Covid-19, Covid-19 & Long Covid Treatments, Covid-19 Clinical Trials, Covid-19 Research Studies --- ### [Targeted COVID Therapy: What Can we Learn From Autoimmune Kidney Diseases?](https://www.autoimmuneinstitute.org/covid_timeline/targeted-covid-19-therapy-what-can-we-learn-from-autoimmune-kidney-diseases/) **Published:** June 10, 2021 **Author:** Elevation **Excerpt:** A study was recently published on the ability of antiphospholipid antibodies (aPLs) to bind to the “EPCR-LBPA” complex. Antiphospholipid antibodies are autoantibodies that target and attack phospholipid-binding proteins. This, researchers found, initiates a self-amplifying signaling loop related to the innate immune complement and coagulation pathways.  **Content:** June 10, 2021 A [study](https://science.sciencemag.org/content/371/6534/eabc0956) was recently published on the ability of antiphospholipid antibodies (aPLs) to bind to the “EPCR-LBPA” complex. Antiphospholipid antibodies are autoantibodies that target and attack phospholipid-binding proteins. This, researchers, found, initiates a self-amplifying signaling loop related to the innate immune complement and coagulation pathways. The EPCR-LBPA complex contains lipid-proteins that are located on the interior of blood vessels involved in the innate immune and clotting systems. The complex activates in the face of antiphospholipid antibodies **and has been found to be involved in severe COVID-19 and systemic lupus erythematosus (SLE) cases.** Once activated, the body’s inflammatory pathways and the primary pathway for blood coagulation are initiated. This initiation results in the exponentially increased production of autoantibodies as immune cell and B cell synthesis increases. This finding by the German-based research group has proved notable, particularly because of its implications for treating both SLE and COVID-19 patients. Specifically, the study group found that **blocking the EPCR-LBPA signaling pathway in mice subjects helped prevent aPL-related blood clotting and autoimmune response, further illuminating a potential treatment path for human patients.** **Category:** Autoimmune Diseases & Covid-19, Covid-19 & Long Covid Treatments, Covid-19 Antibodies, Covid-19 Research Studies, Lupus & Covid-19 --- ### [Oxford-AstraZeneca Vaccine Found to be Associated with Small Risk of Developing Rare Autoimmune Blood Disorder](https://www.autoimmuneinstitute.org/covid_timeline/oxford-astrazeneca-vaccine-found-to-be-associated-with-small-risk-of-developing-rare-autoimmune-blood-disorder/) **Published:** June 9, 2021 **Author:** Elevation **Excerpt:** A new study, published today in Nature, has reported the observance of a slightly increased risk of developing immune thrombocytopenic purpura (ITP) following inoculation with the Oxford-AstraZeneca vaccine. ITP is a rare autoimmune condition that results in excessive bruising or bleeding due to a decrease in the number of platelets in the blood. **Content:** June 9, 2021 A new study, published today in *Nature*, has reported the observance of [a slightly increased risk of developing immune thrombocytopenic purpura (ITP)](https://www.nature.com/articles/s41591-021-01408-4) following inoculation with the Oxford-AstraZeneca vaccine. ITP is a rare autoimmune condition that results in excessive bruising or bleeding due to a decrease in the number of platelets in the blood. The study looked at 2.53 million adults in Scotland who received their first doses of either the Oxford-AstraZeneca or Pfizer-BioNTech vaccine. There was **no increased risk of blood disorders observed with the Pfizer-BioNTech vaccine.** However, the Oxford-AstraZeneca vaccine risk of developing ITP was estimated at 1.13 cases per 100,000 people\*. Risk factors found to be associated with developing post-vaccination ITP and other blood disorders included older age, male sex, smoking, and having other underlying conditions. \* This very small risk is important but needs to be seen within the context of the overall benefits of receiving the vaccine for most people. ITP is still a very rare vaccine-induced adverse event and researchers plan to update their analysis as the vaccine program is extended to a larger demographic. **Category:** AstraZeneca, Autoimmune Diseases & Covid-19, Vaccine Adverse Events, Vaccine Manufacturers --- ### [Can Vitiligo Protect Against the SARS-CoV-2 Virus?](https://www.autoimmuneinstitute.org/covid_timeline/can-vitiligo-protect-against-the-sars-cov-2-virus/) **Published:** June 8, 2021 **Author:** Elevation **Excerpt:** The Amsterdam Institute for Infection and Immunity has released a research proposal hypothesizing that non-segmental vitiligo, an autoimmune skin disorder, may protect against the SARS-CoV-2 virus developing into a COVID-19 infection. **Content:** June 8. 2021 The *Amsterdam Institute for Infection and Immunity* has released a research proposal hypothesizing that non-segmental [vitiligo, an autoimmune skin disorder, may protect against the SARS-CoV-2 virus](https://onlinelibrary.wiley.com/doi/10.1111/exd.14407) developing into a COVID-19 infection. **The researchers hypothesize that vitiligo could lower the risk for COVID-19 development and clear the viral infection more efficiently. “**Conversely, in case of COVID-19 development, vitiligo autoimmunity may influence the cytokine storm-related disease burden.” There is also a potential for a **COVID-19 infection to increase vitiligo flare-ups**, or increase the activity of the autoimmune condition. Read more about the [influence of cytokine storms in the development of autoimmune disease](https://www.autoimmuneinstitute.org/sars-cov-2-autoimmune-virus-long-covid/) in our article. Protection against COVID-19 relies on both [innate and adaptive immunity](https://www.autoimmuneinstitute.org/covid-vaccine-side-effects-in-women-and-the-purpose-of-two-doses/). Patients with vitiligo display both adaptive and innate immune responses which, according to the study’s researchers, can result in clearing COVID-19 infections. To test this hypothesis, the researchers propose reviewing patient data registries while also employing a questionnaire study amongst patients with vitiligo and controls. Participants will range from ages 16-55, and the study will account for gender differences and co-morbidities with other autoimmune diseases in its analysis. “Since the history of autoimmune co-morbidities of both vitiligo patients and controls is also collected, we can subsequently determine the effect of other frequently found autoimmune diseases on COVID-19 disease development and severity.” Due to the high prevalence of vitiligo worldwide, the study will be conducted internationally. **Category:** Autoimmune Diseases & Covid-19, Covid-19 Infections, Covid-19 Research Studies --- ### [Data from 1,500 Rheumatic Disease Patients Shows Vaccine is Well Tolerated](https://www.autoimmuneinstitute.org/covid_timeline/data-from-1500-rheumatic-disease-patients-shows-vaccine-is-well-tolerated/) **Published:** June 7, 2021 **Author:** Elevation **Excerpt:** Data recently sourced from the European League Against Rheumatism (EULAR) shows that the COVID-19 vaccine is well tolerated amongst patients with rheumatic disease. The registry was launched February 5, 2021, and includes reports from 28 countries across Europe. 1,519 patients were reported to the registry as of April 27, with close to two-thirds being from women. To learn why women experience side-effects from vaccines more often than men, check out our article.  **Content:** June 7, 2021 Data recently sourced from the European League Against Rheumatism (EULAR) shows that the [COVID-19 vaccine is well tolerated amongst patients with rheumatic disease](https://ard.bmj.com/content/80/Suppl_1/199.abstract). The registry was launched on February 5, 2021, and includes reports from 28 countries across Europe. 1,519 patients were reported to the registry as of April 27, with close to two-thirds being from women. To learn [why women experience side effects from vaccines](https://www.autoimmuneinstitute.org/covid-vaccine-side-effects-in-women-and-the-purpose-of-two-doses/) more often than men, check out our article. “The majority (91%) had inflammatory RMDs \[rheumatic and musculoskeletal diseases\]. Inflammatory joint diseases accounted for 51% of cases, connective tissue diseases 19%, vasculitis 16%, other immune-mediated inflammatory diseases 4%, and non-inflammatory/mechanical RMDs 9%.” Reports of side effects were submitted most often from patients living with these common diseases: rheumatoid arthritis, psoriatic arthritis, systemic lupus erythematosus, and axial spondyloarthritis. Potential vaccine side effects were reported by 31% of patients included in the registry, while disease flares – to include arthritis, joint pain, cutaneous flare, and fatigue – occurred in 5% of patients. 1.2% were labeled as severe flares. Mild symptoms included fatigue, headache, muscle pain, and most commonly, pain at the injection site. Overall, experts are reassured by these safety profiles, as the majority of adverse events were similar to the general population, short-term and mild in nature. **Category:** Autoimmune Diseases & Covid-19, Covid-19 Research Studies, Lupus & Covid-19, RA & Covid-19, Vaccine Adverse Events --- ### [Immunocompromised Patients Exhibit Low Antibody Response Even After 2 Doses of mRNA Vaccine](https://www.autoimmuneinstitute.org/covid_timeline/immunocompromised-patients-exhibit-low-antibody-response-even-after-2-doses-of-mrna-vaccine/) **Published:** June 3, 2021 **Author:** Elevation **Excerpt:** This past March, results of a study monitoring the immune response to the COVID-19 vaccine in solid organ transplant patients indicated that antibodies were detected in only 17% of patients after the first dose of an mRNA vaccine. Since then, data from the same study has been published on the antibody response to the second dose of an mRNA vaccine in immunocompromised persons. Among 658 participants who received two doses of an mRNA vaccine, 15% had measurable antibody response after dose 1 and dose 2. Among 473 participants on antimetabolites, 8% exhibited an antibody response after dose 1 and dose 2.  **Content:** June 3, 2021 This past March, results of a study monitoring the immune response to the COVID-19 vaccine in solid organ transplant patients indicated that antibodies were detected in only 17% of patients after the first dose of an mRNA vaccine. Since then, data from the same study has been published on the [antibody response to the second dose of an mRNA vaccine in immunocompromised persons](https://jamanetwork.com/journals/jama/fullarticle/2779852). **Among 658 participants who received two doses of an mRNA vaccine, 15% had measurable antibody response after dose 1 and dose 2. Among 473 participants on antimetabolites, 8% exhibited an antibody response after dose 1 and dose 2.** “Poor humoral response was persistently associated with use of antimetabolite immunosuppression.” **Unfortunately, this may mean that immunocompromised individuals, even after taking a full dose of the vaccine, will not exhibit protective immunity to SARS-CoV-2. “**Although no threshold has been established for protective immunity, antibody levels were well below that which has been observed in immunocompetent vaccines.” To read more about how people living with autoimmune disease and taking medications with antimetabolites may be affected by the vaccine, check out our [Vaccine and Autoimmune Disease FAQ](https://www.autoimmuneinstitute.org/vaccine-autoimmune-disease-faq/) page and [recommendations for those with specific autoimmune diseases](https://www.autoimmuneinstitute.org/vaccines-covid-19-autoimmune-disease-developments/). “If someone had no, or limited, immune response to two doses, [will a third dose help](https://www.medpagetoday.com/special-reports/exclusives/92698?xid=nl_mpt_investigative2021-05-26&eun=g1829540d0r&utm_source=Sailthru&utm_medium=email&utm_campaign=InvestigativeMD_052621&utm_term=NL_Gen_Int_InvestigateMD_Active)? Should the third dose be of the sample platform or a different platform? Is it reasonable for some patients to reduce immunosuppression, risking rejection, just to achieve an immune response? How do B cell and T cell responses look in immunosuppressed people?” These are some questions the[ National Vaccine Research Study for Transplant Recipients](https://transplantvaccine.org/) hopes to answer, which is ongoing and currently still open for enrollment. **Category:** Autoimmune Diseases & Covid-19, Covid-19 Antibodies, Covid-19 Boosters, Covid-19 Research Studies, Vaccine Manufacturers --- ### [The NIH Begins Trial on Mixing COVID Vaccine Boosters](https://www.autoimmuneinstitute.org/covid_timeline/the-nih-begins-trial-on-mixing-covid-19-vaccine-boosters/) **Published:** June 2, 2021 **Author:** Elevation **Excerpt:** A trial funded by the NIH has entered Phase 1/2 testing to study COVID-19 vaccine boosters from different manufacturers on fully vaccinated adults. While it has not been determined whether boosters will be necessary, Dr. Fauci has stated that “we need to prepare for the possibility… to counter waning immunity and to keep pace with an evolving virus” **Content:** June 2, 2021 A trial funded by the NIH has entered Phase 1/2 testing to study [COVID-19 vaccine boosters from different manufacturers on fully vaccinated adults](https://www.nih.gov/news-events/news-releases/nih-clinical-trial-evaluating-mixed-covid-19-vaccine-schedules-begins). While it has not been determined whether boosters will be necessary, Dr. Fauci has stated that “we need to prepare for the possibility… to counter waning immunity and to keep pace with an evolving virus” ([1](https://www.nih.gov/news-events/news-releases/nih-clinical-trial-evaluating-mixed-covid-19-vaccine-schedules-begins)). The trial includes 150 participants who have been fully immunized with either the Johnson & Johnson, Moderna, or Pfizer vaccine. “Twelve to 20 weeks following their initial vaccination regimen, participants will receive a single booster dose of the Moderna COVID-19 vaccine as part of the trial.” Those who have not been fully vaccinated are eligible to enroll as part of a separate cohort, in which volunteers will receive two doses of the Moderna vaccine and will receive a third dose of a vaccine 12-20 weeks later. “All trial participants will be followed for one year after receiving their last vaccination as part of the study,” and will provide blood samples to evaluate the antibody response to current and variant strains of SARS-CoV-2. The initial results are expected by the end of Summer 2021. **This is the first US trial to test the effects of mixing vaccines**, while the Com-COV study began earlier this spring. Com-COV is a “UK multi-centre, participant-masked, randomized heterologous prime-boost COVID-19 vaccination study,” monitoring the effects of mixing vaccine doses between AstraZeneca, Pfizer, Moderna, and Novavax ([2](https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)01115-6/fulltext)). While participants are experiencing higher rates of adverse events, the vaccine is still being deemed safe as the side effects are not severe. Reported side effects include fever, chills, headache, fatigue, joint pain, malaise, and aching muscles. Symptoms have reportedly been “short-lived, and there \[are\] no concerns from the limited hematology and biochemistry data available.” **Preliminary data shows that those vaccinated with both the AstraZeneca and Pfizer vaccines are producing robust antibodies to SARS-CoV-2**. Studies incorporating the Moderna and Novavax vaccines are also ongoing. Data around the primary immunological outcome is planned to be released in June 2021. *Update June 3\** Canada has also instituted a new policy in which citizens may receive a Pfizer booster after one dose of the AstraZeneca vaccine. This is due to vaccine shortages across Canada; currently, less than 6% of Canada’s population has been fully vaccinated. [The National Advisory Committee on Immunization](https://www.canada.ca/content/dam/phac-aspc/documents/services/immunization/national-advisory-committee-on-immunization-naci/naci-rapid-response-interchangeability-authorized-covid-19-vaccines-en.pdf) also stated that Moderna and Pfizer vaccines may be used interchangeably between doses, although it’s recommended that people complete their vaccination schedule using the same manufacturer. **Category:** AstraZeneca, Covid-19 Boosters, Covid-19 Clinical Trials, Covid-19 Variants, Johnson & Johnson, Moderna, Novavax, Pfizer, Vaccine Manufacturers --- ### [Research on Lasting Immunity to SARS-CoV-2](https://www.autoimmuneinstitute.org/covid_timeline/research-on-lasting-immunity-to-sars-cov-2/) **Published:** June 1, 2021 **Author:** Elevation **Excerpt:** New research published in Nature has shown that immunity to SARS-CoV-2 can last from one year to possibly a lifetime, as a “SARS-CoV-2 infection induces a robust antigen-specific, long-lived humoral immune response in humans.” **Content:** June 1, 2021 New research published in *Nature* has shown that [immunity to SARS-CoV-2 can last from one year to possibly a lifetime](https://www.nature.com/articles/s41586-021-03647-4_reference.pdf), as a “SARS-CoV-2 infection induces a robust antigen-specific, long-lived humoral immune response in humans.” The research, conducted at Washington University in St. Louis, studied participants who had been previously infected with COVID-19. Blood samples from 77 participants who experienced mild Covid infection were studied at three-month intervals starting at one month post-infection. Antibody levels declined sharply during the first four months and then steadily thereafter, and remained detectable at least 11 months post-infection. Bone marrow samples were also taken from 18 participants 7-8 months after infection, 15 of which exhibited memory B cells. “Bone marrow plasma cells are a persistent and essential source of protective antibodies,” and memory B cells contained in the bone marrow remain dormant and ready to produce antibodies in case of re-exposure to the virus. **This may even include variants.** **Immune memory after fighting a live virus from natural infection is different to vaccine immunity,** in which the body is exposed to a deconstructed viral protein. Those immunized 6-12 months post-Covid-infection may have a different immune response than those who have not experienced infection and get immunized. Thus, **boosters are not necessary for those previously infected with COVID-19 who have also been inoculated with a full dose of the vaccine.** To learn more about how each dose of the mRNA [vaccine produces separate antibody responses](https://www.autoimmuneinstitute.org/covid-vaccine-side-effects-in-women-and-the-purpose-of-two-doses/), check out our article. **Category:** Covid-19 Antibodies, Covid-19 Boosters, Covid-19 Research Studies, Covid-19 Variants --- ### [Gastrointestinal Issues Persist in Many, Months After COVID Infection](https://www.autoimmuneinstitute.org/covid_timeline/gastrointestinal-issues-persist-in-many-months-after-covid-19-infection/) **Published:** May 26, 2021 **Author:** Elevation **Excerpt:** Diarrhea and other gastrointestinal (GI) issues are known to be non-respiratory COVID-19 symptoms during an active infection. However, a team of researchers in Italy were curious whether their patients were continuing to experience these symptoms after their period of infection ended. Their study utilized a self-report survey, which was emailed to patients that had been treated for COVID-19 in March and May 2020 at Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico in Milan. Hospital workers who had tested negative for COVID served as controls. 164 COVID-19 survivors and 183 uninfected controls submitted their survey responses. The results indicated that loose stool was ranked as the most commonly experienced GI issue and it appeared twice as frequently in the responses of survivors when compared to controls. **Content:** May 26, 2021 Diarrhea and other gastrointestinal (GI) issues are known to be non-respiratory COVID-19 symptoms during an active infection. However, a team of researchers in Italy were curious whether their patients were continuing to experience these symptoms after their period of infection ended. Their [study](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8108222/pdf/main.pdf) utilized a self-report survey, which was emailed to patients that had been treated for COVID-19 in March and May 2020 at Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico in Milan. Hospital workers who had tested negative for COVID served as controls. 164 COVID-19 survivors and 183 uninfected controls submitted their survey responses. The results indicated that loose stool was ranked as the most commonly experienced GI issue and it appeared twice as frequently in the responses of survivors when compared to controls. **Category:** Covid-19 Infections, Covid-19 Research Studies, Long COVID --- ### [Research Developments on the World’s Prominent COVID-19 Vaccines](https://www.autoimmuneinstitute.org/covid_timeline/research-developments-on-the-worlds-prominent-covid-19-vaccines/) **Published:** May 19, 2021 **Author:** Elevation **Excerpt:** Researchers around the world are creating and testing close to 100 vaccines in an effort to combat the novel coronavirus. The following Vaccine Comparison Chart provides a breakdown of leading vaccines that have shown promise through pre-clinical data, completed Phase 1/2/3 clinical trials, and have been authorized for emergency use. **Content:** May 19, 2021 Researchers around the world are creating and testing close to 100 vaccines in an effort to combat the novel coronavirus. The following [Vaccine Comparison Chart](https://www.autoimmuneinstitute.org/vaccine-comparison-chart/) provides a breakdown of leading vaccines that have shown promise through pre-clinical data, completed Phase 1/2/3 clinical trials, and have been authorized for emergency use. *Preclinical data* is collected when testing a vaccine on cells and animals. If an immune response is detected, the study moves forward as a *Phase 1* safety trial by testing the safety of the vaccine on a select number of people (typically around 20-80 people). If the dosage is deemed safe and effective, the trial progresses to a *Phase 2* expanded trial, in which hundreds of people receive the vaccine. At this stage, participants are split into groups to observe the vaccine’s efficacy and safety across a spectrum of ages. A *Phase 3* efficacy trial tests for vaccine efficacy against volunteers who receive a placebo. Thousands of participants are included in the trial, and an efficacy rate is determined for the vaccine against a virus. Due to the nature of the coronavirus, some vaccine trials underwent combined phases (e.g. Phase 1/2) in order to accelerate development. **Category:** Covid-19 Clinical Trials, Covid-19 Research Studies, Vaccine Manufacturers --- ### [FDA Extends Pfizer Vaccine EUA to Children 12-15 Years Old](https://www.autoimmuneinstitute.org/covid_timeline/fda-extends-pfizer-vaccine-eua-to-children-12-15-years-old/) **Published:** May 11, 2021 **Author:** Elevation **Excerpt:** On Monday, the FDA granted Pfizer emergency use authorization of their vaccine in children ages 12-15 years old. This is the first vaccine authorized for persons 12+ years old.  **Content:** May 11, 2021 On Monday, the FDA granted Pfizer emergency use authorization of their [vaccine in children ages 12-15 years old](https://www.pfizer.com/news/press-release/press-release-detail/pfizer-and-biontech-receive-first-us-authorization). This is the first vaccine authorized for persons 12+ years old. In a Phase 3 clinical trial, 2,260 participants ages 12-15 were given a placebo or two doses of the vaccine, 21-days apart. Eighteen cases of symptomatic COVID-19 were recorded in the placebo group, but none were recorded amongst children who received the vaccine. The trial showed a “**vaccine efficacy of 100% in participants with or without prior SARS-CoV-2 infection and robust antibody responses**.” The vaccine was also “well-tolerated,” and side effects were comparable to those seen in clinical trials amongst young adults, ranging from 16-25 years of age. Pfizer is continuing to collect data on asymptomatic cases from clinical trial participants, and participants will be monitored “for long-term protection and safety for an additional two years after their second dose.”  While the risk of children catching COVID-19 is low, the risk of developing multi-inflammatory syndrome (MIS-C) is higher than the potential risk of experiencing symptoms from the vaccine. **Additionally, being vaccinated against COVID-19 mitigates the development and spread of variants**. The CDC’s Advisory Committee on Immunization Practices will be convening shortly to review the clinical data and make recommendations on the vaccine’s use in adolescents. After their endorsement, immunizations can begin. The data from Pfizer’s trial has also been submitted to the European Medicines Agency and other regulators to extend the EUA. **Category:** Covid-19 Antibodies, Covid-19 Clinical Trials, Covid-19 Policy, Covid-19 Variants, Pfizer, Vaccine Manufacturers --- ### [The CureVac Vaccine](https://www.autoimmuneinstitute.org/covid_timeline/the-curevac-vaccine/) **Published:** May 10, 2021 **Author:** Elevation **Excerpt:** The German company, CureVac, is in the process of finalizing an RNA vaccine against COVID-19 with the culmination of its Phase 3 trial. The trial included 40,000 participants across Latin America and Europe. If the data shows the vaccine to be safe and effective, this may be the third RNA vaccine authorized for emergency use. Moreover, the CureVac vaccine is refrigerator-stable, making it more transportable than the Pfizer and Moderna vaccines. This gives CureVac an unique opportunity to supply vaccines to more remote locations, as well as locations that have yet to be supplied with ample doses, like lower and middle-income countries. **Content:** May 10, 2021 The German company, CureVac, is in the process of finalizing an RNA vaccine against COVID-19 with the culmination of its [Phase 3 trial](https://clinicaltrials.gov/ct2/show/NCT04652102) ([1](https://www.curevac.com/en/covid-19/#timeline)). The trial included 40,000 participants across Latin America and Europe. If the data shows the vaccine to be safe and effective, this may be the third RNA vaccine authorized for emergency use. Moreover, the CureVac vaccine is refrigerator-stable, making it more transportable than the Pfizer and Moderna vaccines. This gives CureVac a unique opportunity to supply vaccines to more remote locations, as well as locations that have yet to be supplied with ample doses, like lower and middle-income countries. Data from the trial is expected by mid-May with promising results against variants such as the B.1.351 variant. **Category:** Covid-19 Clinical Trials, Covid-19 Variants, Vaccine Manufacturers --- ### [Pfizer Submits Application for FDA Approval of COVID-19 Vaccine](https://www.autoimmuneinstitute.org/covid_timeline/pfizer-submits-application-for-fda-approval-of-covid-19-vaccine/) **Published:** May 7, 2021 **Author:** Elevation **Excerpt:** This morning, Pfizer-BioNTech submitted a Biologics License Application (BLA) to the FDA for approval of their COVID-19 vaccine. Currently, the Pfizer vaccine has been granted an EUA due to the state of the pandemic, which allowed them to provide safety and efficacy data from two months of trials versus the standard six months. “Data to support the BLA will be submitted by the companies to the FDA on a rolling basis over the coming weeks, with a request for Priority Review” (1).   **Content:** May 7, 2021 This morning, Pfizer-BioNTech submitted a Biologics License Application (BLA) to the FDA for [approval of their COVID-19 vaccine](https://www.pfizer.com/news/press-release/press-release-detail/pfizer-and-biontech-initiate-rolling-submission-biologics). Currently, the Pfizer vaccine has been granted an EUA due to the state of the pandemic, which allowed them to provide safety and efficacy data from two months of trials versus the standard six months. “Data to support the BLA will be submitted by the companies to the FDA on a rolling basis over the coming weeks, with a request for Priority Review” ([1](https://www.pfizer.com/news/press-release/press-release-detail/pfizer-and-biontech-initiate-rolling-submission-biologics)). The Pfizer vaccine has been readily available since mid-December 2020. Alongside their [Phase 3 clinical trial](https://www.pfizer.com/news/press-release/press-release-detail/pfizer-and-biontech-confirm-high-efficacy-and-no-serious), **data regarding the vaccine’s safety and efficacy has been collected from the 170+ million doses administered in the U.S.** Pfizer is currently the only vaccine manufacturer authorized for people 16+ years of age. The approval would cover the same ages, even though Pfizer is currently applying for an EUA extending use of their vaccine to children 12-15 years of age. They expect to apply for final approval after acquiring six months worth of data after the second dose is administered. **Category:** Covid-19 Clinical Trials, Covid-19 Policy, Pfizer, Vaccine Manufacturers --- ### [Yale to Begin Study on COVID Long-Haulers](https://www.autoimmuneinstitute.org/covid_timeline/yale-to-begin-study-on-covid-long-haulers/) **Published:** May 6, 2021 **Author:** Elevation **Excerpt:** Yale Medicine is launching a collaborative study on Covid long-haulers and the Covid vaccine.  **Content:** May 6, 2021 Yale Medicine is launching a collaborative study on [Covid long-haulers and the Covid vaccine](https://www.yalemedicine.org/news/vaccines-long-covid). Yale will be recruiting participants with long-term symptoms following a COVID-19 infection, who have not been vaccinated yet. Blood and saliva samples will be collected prior to and post-vaccination to compare and correlate immune responses in long-haulers and symptom changes (if any). Participants will evaluate any changes to their post-Covid conditions after being vaccinated. Researchers will also study the mechanisms behind how the vaccine resolves post-Covid conditions – whether the vaccine is stopping a harmful immune response, resetting the immune system, or is fighting against the residual virus. Reportedly, 30-40% of long haulers who receive the vaccine experience improvement of symptoms like brain fog, gastrointestinal issues, and shortness of breath. **Autoimmune reactions are one possible reason why COVID-19 patients continue to experience symptoms 4+ weeks after infection**, and those with compromised immune systems are thought to be more likely to experience long Covid. **Category:** Covid-19 Infections, Covid-19 Research Studies, Long COVID --- ### [Rare Skin Reactions Following COVID-19 Vaccines Are Being Studied](https://www.autoimmuneinstitute.org/covid_timeline/rare-skin-reactions-following-covid-19-vaccines-are-being-studied/) **Published:** May 5, 2021 **Author:** Elevation **Excerpt:** Recent findings from the COVID-19 Dermatology Registry, run by the AAD and the International League of Dermatologic Societies, helped shed some light on the skin reactions reported after Moderna and Pfizer COVID-19 vaccinations in some individuals. In this study, 414 cutaneous reactions were reviewed, ranging from minor injection-site inflammation to an episode of shingles. **Content:** May 5, 2021 Recent findings from the [COVID-19 Dermatology Registry](https://www.aad.org/member/practice/coronavirus/registry), run by the American Academy of Dermatology (AAD) and the International League of Dermatologic Societies, helped shed some light on the **skin reactions reported after Moderna and Pfizer COVID-19 vaccinations** **in some individuals**. In this [study](https://www.jaad.org/article/S0190-9622(21)00658-7/fulltext), 414 cutaneous reactions were reviewed, ranging from minor injection-site inflammation to an episode of shingles. This research is unique because it delves into a whole range of reactions that had not been reported in vaccine clinical trials. Detailed information was collected from registry participants, including which type of vaccine was received and when and the morphology, timing, duration, and treatment of the skin reactions. The most common morphologies seen in this study were “[delayed large local reactions, local injection site reactions, urticaria, and morbilliform eruptions](https://www.jaad.org/article/S0190-9622(21)00658-7/fulltext).” **The skin reaction seen most often following the Moderna vaccine was urticaria, also known as hives**. Researchers have found that in 50% of patients who experience chronic idiopathic urticaria, the immune system behaves erratically and attacks the body’s normal tissues, causing hives. Could this be the same mechanism happening in these rare cases following the COVID-19 vaccine? What can these post-vaccine reactions tell us about the field of autoimmunity as a whole? While we wait for scientists to uncover these answers, the good news is that **none of the patients who had skin reactions reported severe adverse events, and less than half did not experience a recurrence with their second dose.** **Category:** Autoimmune Diseases & Covid-19, Covid-19 Clinical Trials, Covid-19 Research Studies, Moderna, Pfizer, Vaccine Adverse Events, Vaccine Manufacturers --- ### [FDA May Expand EUA of Pfizer Vaccine to Include 12-15 Year Olds](https://www.autoimmuneinstitute.org/covid_timeline/fda-may-expand-eua-of-pfizer-vaccine-to-include-12-15-year-olds/) **Published:** May 4, 2021 **Author:** Elevation **Excerpt:** In March, Pfizer released the results of a clinical trial announcing that their COVID-19 vaccine displayed 100% efficacy in adolescents ages 12-15 years of age. The FDA has been reviewing the results of this Phase 3 trial, and an amendment to the current Emergency Use Authorization (EUA) of Pfizer’s vaccine is said to be determined next week. While 22% of the U.S. population is composed of children under 18 years of age, Pfizer is the only vaccine manufacturer in the U.S. currently authorized for ages 16-18. If the EUA is amended, Pfizer will be the first vaccine manufacturer authorized for use in people ages 12-18. **Content:** May 4, 2021 In March, Pfizer released the results of a clinical trial announcing that their [COVID-19 vaccine displayed 100% efficacy in adolescents ages 12-15 years of age](https://www.pfizer.com/news/press-release/press-release-detail/pfizer-biontech-announce-positive-topline-results-pivotal). The FDA has been reviewing the results of this Phase 3 trial, and an amendment to the current Emergency Use Authorization (EUA) of Pfizer’s vaccine is said to be determined [next week](https://www.cnn.com/2021/05/03/health/pfizer-covid-vaccine-teens-fda/index.html). While 22% of the U.S. population is composed of children under 18 years of age, Pfizer is the only vaccine manufacturer in the U.S. currently authorized for ages 16-18. If the EUA is amended, Pfizer will be the first vaccine manufacturer authorized for use in people ages 12-18. **Category:** Covid-19 Clinical Trials, Covid-19 Policy, Pfizer, Vaccine Manufacturers --- ### [The COVID-19 Vaccine and Immune Disorders](https://www.autoimmuneinstitute.org/covid_timeline/the-covid-19-vaccine-and-immune-disorders/) **Published:** April 27, 2021 **Author:** Elevation **Excerpt:** The NIH will be conducting a clinical trial testing COVID-19 vaccine responses in people with immune deficiencies. These will include primary and secondary immune system disorders. In addition to learning how this population responds to the COVID-19 vaccine, this study aims to fill the gap regarding the clinical presentation of COVID-19 in those with immune deficiencies, “especially those who have inborn conditions involving deficits or dysregulations in antibody or cell-based immune responses to infections.” **Content:** April 27, 2021 The NIH will be conducting a clinical trial testing [COVID-19 vaccine responses in people with immune deficiencies](https://www.nih.gov/news-events/news-releases/covid-19-vaccine-responses-be-studied-people-immune-deficits). These will include primary and secondary immune system disorders. In addition to learning how this population responds to the COVID-19 vaccine, **this study aims to fill the gap regarding the clinical presentation of COVID-19 in those with immune deficiencies**, “especially those who have inborn conditions involving deficits or dysregulations in antibody or cell-based immune responses to infections.” Because those with immune disorders were excluded from the COVID-19 vaccine clinical trials prior to emergency authorization, this study will “characterize the features and adequacy of immune responses to COVID-19 vaccination in people with a range of immune deficiencies and dysregulation syndromes.” The study will include 500 participants, 400 of which have primary or secondary immune system disorders and are 16 years of age or older. If participants get vaccinated during the study, blood samples will be taken before and after vaccination and studied for “short-term immunological effects of immunization.” Participants may voluntarily provide blood samples at different intervals following their last dose of the vaccine. Researchers will then assess the T-cell response and vaccine-induced antibody production in those with immune disorders compared to those without immune system disorders. For more information regarding the study and enrollment, visit [clinicaltrials.gov](https://clinicaltrials.gov/ct2/home) and use the search code [NCT04852276](https://clinicaltrials.gov/ct2/show/NCT04852276?term=NCT04852276&draw=2&rank=1). **Category:** Autoimmune Diseases & Covid-19, Covid-19 Antibodies, Covid-19 Clinical Trials --- ### [Johnson & Johnson's COVID-19 Vaccine Has Been Resumed](https://www.autoimmuneinstitute.org/covid_timeline/johnson-johnsons-covid-19-vaccine-has-been-resumed/) **Published:** April 26, 2021 **Author:** Elevation **Excerpt:** This past Friday, the CDC lifted the pause on Johnson & Johnson’s COVID-19 vaccine usage. During this pause, which was announced on April 13, the CDC confirmed an additional 9 cases of women developing thrombosis with thrombocytopenia syndrome (TTS) blood clots with low platelet count after receiving the J&J vaccine. The pause was initiated after 6 cases were presumed to be linked to the J&J vaccine. 13 of the 15 women were between the ages of 18-49. **Content:** April 26, 2021 This past Friday, the [CDC lifted the pause on Johnson & Johnson’s COVID-19 vaccine usage](https://www.fda.gov/news-events/press-announcements/fda-and-cdc-lift-recommended-pause-johnson-johnson-janssen-covid-19-vaccine-use-following-thorough). During this pause, which was announced April 13, the CDC confirmed an additional 9 cases of women developing thrombosis with thrombocytopenia syndrome (TTS) – blood clots with low platelet count – after receiving the J&J vaccine. The pause was initiated after 6 cases were presumed to be linked to the J&J vaccine. 13 of the 15 women were between the ages of 18-49. Before getting the vaccine, recipients are encouraged to review the Janssen COVID-19 Vaccine [fact sheet for recipients and caregivers](https://www.fda.gov/media/146305/download), which includes side effects and risk information. That being said, **the FDA and CDC state this vaccine is safe and effective in preventing COVID-19, and that the potential risks are outweighed by the benefits of receiving the COVID-19 vaccine**. Furthermore, “at this time, the available data suggests that **the chance of TTS occurring is very low, but the FDA and CDC will remain vigilant in continuing to investigate this risk**” ([1](https://www.fda.gov/news-events/press-announcements/fda-and-cdc-lift-recommended-pause-johnson-johnson-janssen-covid-19-vaccine-use-following-thorough)). The CDC and FDA continue to encourage those who have received the vaccine and experienced adverse effects to submit a report to the [Vaccine Adverse Event Reporting System](https://vaers.hhs.gov/reportevent.html). **Category:** Autoimmune Diseases & Covid-19, Johnson & Johnson, Vaccine Adverse Events, Vaccine Manufacturers --- ### [Americans 16+ Are Eligible for COVID-19 Vaccine](https://www.autoimmuneinstitute.org/covid_timeline/americans-16-are-eligible-for-covid-19-vaccine/) **Published:** April 20, 2021 **Author:** Elevation **Excerpt:** As of yesterday, Monday, April 19, all Americans ages 16+ are eligible to get the COVID-19 vaccine. According to the CDC’s COVID Data Tracker, over 132 million Americans have received one dose of the vaccine, and over 85 million have been fully vaccinated against the novel coronavirus. This 85 million figure represents 64.9% of Americans 65+ years of age.  **Content:** April 20, 2021 As of yesterday, Monday, April 19, [all Americans ages 16+ are eligible to get the COVID-19 vaccine](https://www.cdc.gov/coronavirus/2019-ncov/vaccines/). According to the [CDC’s COVID Data Tracker](https://covid.cdc.gov/covid-data-tracker/#vaccinations), over 132 million Americans have received one dose of the vaccine, and over 85 million have been fully vaccinated against the novel coronavirus. This 85 million figure represents 64.9% of Americans 65+ years of age. As of now, the Johnson & Johnson vaccine has been paused in all 50 states, with facilities distributing Moderna and Pfizer vaccines. During a press briefing this past Sunday, Dr. Fauci stated he expects a decision to be made by this upcoming Friday whether or not to continue the pause of Johnson & Johnson’s vaccine ([1](https://www.cbsnews.com/video/dr-fauci-on-politics-driven-vaccine-hesitancy-johnson-johnson-pause/#x)). This will be decided by the FDA. **Category:** Covid-19 Policy, Johnson & Johnson, Moderna, Pfizer, Vaccine Manufacturers --- ### [NIH Funds Clinical Trial For New COVID-19 Antibody Therapy](https://www.autoimmuneinstitute.org/covid_timeline/nih-funds-clinical-trial-for-new-covid-19-antibody-therapy/) **Published:** April 19, 2021 **Author:** Elevation **Excerpt:** The NIH is funding a Phase 2 clinical trial testing a monoclonal antibody for COVID-19 patients hospitalized with respiratory disease and low blood oxygen count. The FDA has previously issued emergency use authorization for COVID-19 antibody therapies by Eli Lilly and Regeneron.  **Content:** April 19, 2021 The NIH is funding a Phase 2 clinical trial testing a [monoclonal antibody for COVID-19 patients hospitalized with respiratory disease and low blood oxygen count](https://www.nih.gov/news-events/news-releases/nih-trial-anti-cd14-antibody-treat-covid-19-respiratory-disease-begins). The FDA has previously issued emergency use authorization for COVID-19 antibody therapies by [Eli Lilly](https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-authorizes-monoclonal-antibody-treatment-covid-19) and [Regeneron](https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-authorizes-monoclonal-antibodies-treatment-covid-19). This new IC14 monoclonal antibody “binds to a human protein, CD14, that is found on the surface of immune cells circulating in the blood and airway fluid… CD14 helps immune cells recognize pathogens and injured or dying cells, alerting the immune system to danger and prompting it to respond” ([1](https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-authorizes-monoclonal-antibody-treatment-covid-19)). CD14 may be one factor that induces a “cytokine storm.” Cytokines play an influential role in the immune response to a viral infection. Moreover, a cytokine storm provokes a severe immune reaction, and in COVID-19 patients, often causes “dangerous levels” of inflammation and tissue damage in the lungs, which can result in acute respiratory distress syndrome and failure ([1](https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-authorizes-monoclonal-antibody-treatment-covid-19)). Blocking CD14 proteins using the IC14 antibody may decrease the immune system’s hyper response to a COVID-19 infection. To read more about [cytokines and the overlap between a COVID-19 infection and autoimmune disease](https://www.autoimmuneinstitute.org/sars-cov-2-autoimmune-virus-long-covid/), check out our featured article.  Researchers hope to determine whether the IC14 antibody decreases in-hospital recovery time for patients with COVID-19-induced respiratory disease, as well as its severity. **Category:** Autoimmune Diseases & Covid-19, Covid-19 & Long Covid Treatments, Covid-19 Antibodies, Covid-19 Clinical Trials, Covid-19 Infections, Covid-19 Policy --- ### [U.K. Expands Clinical Trial for Mixing COVID-19 Vaccines Between Four Manufacturers](https://www.autoimmuneinstitute.org/covid_timeline/u-k-expands-clinical-trial-for-mixing-covid-19-vaccines-between-four-manufacturers/) **Published:** April 16, 2021 **Author:** Elevation **Excerpt:** The University of Oxford has expanded its clinical trial investigating the safety and efficacy of interchanging COVID-19 vaccines. While interchanging doses will primarily reduce vaccine shortages and allow for more rapid vaccinations, countries such as Germany have already updated vaccine recommendations for mixing vaccines. Those under 60 years of age who have received the AstraZeneca vaccine are recommended to get Pfizer or Moderna for their second dose. This is in response to several dozen blood clotting cases amongst German citizens under 60 years old.  **Content:** April 16, 2021 The University of Oxford has expanded its clinical trial investigating the safety and efficacy of interchanging COVID-19 vaccines ([1](https://comcovstudy.org.uk/about-com-cov2)). While interchanging doses will primarily reduce vaccine shortages and allow for more rapid vaccinations, countries such as Germany have already updated vaccine recommendations for mixing vaccines. Those under 60 years of age who have received the AstraZeneca vaccine are recommended to get Pfizer or Moderna for their second dose. This is in response to several dozen blood clotting cases amongst German citizens under 60 years old ([2](https://www.bbc.com/news/world-europe-56580728)). **The U.K. clinical trial began in February, interchanging vaccine doses between AstraZeneca and Pfizer. As of this past Wednesday, it will expand to include the Novavax and Moderna vaccines.** Participants will include women and men 50 years of age and older, who have already received one dose of the COVID-19 vaccine. Investigators will observe any adverse reactions and compare efficacy rates between mixing doses versus using one manufacturer to complete the vaccine schedule. **Category:** AstraZeneca, Covid-19 Clinical Trials, Moderna, Novavax, Pfizer, Vaccine Manufacturers --- ### [NIH to Study Allergic Reactions to mRNA Vaccines](https://www.autoimmuneinstitute.org/covid_timeline/nih-to-study-allergic-reactions-to-mrna-vaccines/) **Published:** April 14, 2021 **Author:** Elevation **Excerpt:** The NIH is sponsoring a clinical trial focusing on the risk of allergic reactions to Moderna and Pfizer’s mRNA vaccines. The COVID-19 mRNA vaccines are the first mRNA vaccines to be authorized by the FDA.  **Content:** April 14, 2021 The NIH is sponsoring a clinical trial [focusing on the risk of allergic reactions to Moderna and Pfizer’s mRNA vaccines](https://www.nih.gov/news-events/news-releases/nih-begins-study-allergic-reactions-moderna-pfizer-biontech-covid-19-vaccines). **The COVID-19 mRNA vaccines are the first mRNA vaccines to be authorized by the FDA.**  This clinical trial will “determine whether people who are highly allergic or have a mast cell disorder are at increased risk for an immediate, systemic allergic reaction to the Moderna or Pfizer-BioNTech COVID-19 vaccines.” A systemic allergic reaction is qualified as a vaccine reaction in one or more regions of the body outside of the injection site. A mast cell disorder occurs when mast cells (white blood cells) are overly active or behaving abnormally, causing allergic reactions. Investigators will also “examine the biological mechanism behind the reactions and whether a genetic pattern or other factors can predict who is at most risk.” Investigators aim to enroll 3,400 adults, aged 18-69, across 35 allergy-research centers. Approximately 60% of participants will need to have a history of “severe allergic reactions or a diagnosis of a mast cell disorder.” Allergic reactions can be related to food, insect stings, or allergen immunotherapy that requires treatment with an epi-pen (epinephrine). Participants may also enroll if they have a history of immediate allergic reactions to a vaccine or one or more drugs. **This study plans to enroll more women than men, as women account for the majority of severe allergic reactions to the COVID-19 vaccine.**  The clinical trial is currently enrolling participants. **Category:** Covid-19 Clinical Trials, Covid-19 Policy, Moderna, Pfizer, Vaccine Adverse Events, Vaccine Manufacturers --- ### [Adenovirus Vaccines Shown to Have Hematological Side Effect Concerns](https://www.autoimmuneinstitute.org/covid_timeline/adenovirus-vaccines-shown-to-have-hematological-side-effect-concerns/) **Published:** April 13, 2021 **Author:** Elevation **Excerpt:** As of yesterday, 6.8 million doses of the Johnson & Johnson (Janssen) vaccine have been administered throughout the United States. As of today, the CDC and FDA announced that they are reviewing six reported cases of a rare severe type of blood clot in individuals after receiving the vaccine” and are recommending a pause in the use of the single-dose Johnson & Johnson COVID-19 vaccine until a more thorough investigation can be conducted. The CDC will convene a meeting of the Advisory Committee on immunization practices (ACIP) tomorrow, Wednesday, April 14th, to further review these cases and assess their potential significance, and this analysis will also be reviewed by the FDA. **Content:** April 13, 2021 As of yesterday, 6.8 million doses of the Johnson & Johnson (Janssen) vaccine have been administered throughout the United States. As of today, **the CDC and FDA announced that they are reviewing** [**six reported cases of a “rare & severe type of blood clot in individuals after receiving the vaccine”** ](https://www.cdc.gov/media/releases/2021/s0413-JJ-vaccine.html)and are recommending a “pause” in the use of the single-dose Johnson & Johnson COVID-19 vaccine until a more thorough investigation can be conducted. The CDC will convene a meeting of the Advisory Committee on immunization practices (ACIP) tomorrow, Wednesday, April 14th, to further review these cases and assess their potential significance, and this analysis will also be reviewed by the FDA. [Embed from Getty Images](http://www.gettyimages.com/detail/1209912760) This is not the first time we’re hearing about rare blood clots forming following COVID-19 vaccination, as reports from the Oxford-AstraZeneca vaccine have shown similar concerns. **As of this week in Europe, 34 million people have received their first dose of the AstraZeneca vaccine and there are at least 222 suspected cases of dangerous blood clots and low platelet counts**. On April 7, the UK Medicines and Healthcare Products Regulatory Agency stated that it had been “[investigating at least 79 cases of strokes and clotting events tied to the vaccine, at least 18 of them fatal](https://www.gov.uk/government/news/mhra-issues-new-advice-concluding-a-possible-link-between-covid-19-vaccine-astrazeneca-and-extremely-rare-unlikely-to-occur-blood-clots).” [Embed from Getty Images](http://www.gettyimages.com/detail/1214025046) The side effects being observed following vaccination are a combination of **cerebral venous sinus thrombosis** (blood clotting in the sinus that drains blood from the brain) and **thrombocytopenia** (low levels of blood platelets that stop bleeding). Researchers have concluded that the side effects resemble an autoimmune disorder called heparin-induced thrombocytopenia (HIT) and significantly all six cases occurred among **women between the ages of 18 and 48**. Some experts initially theorized that vaccine-induced immune thrombotic thrombocytopenia (VITT) was occurring as a result of the antibodies created to fight the virus’ spike protein cross-reacting with Platelet Factor 4 (PF4). PF4 is involved in wound repair and inflammatory responses. If this were the case, it would be a safety concern for all COVID-19 vaccines. However, **there is currently no evidence that messenger RNA-based vaccines (such as Pfizer and Moderna), which have been received by tens of millions of people, are causing similar blood clotting and low platelet issues**. **Category:** AstraZeneca, Covid-19 Antibodies, Johnson & Johnson, Moderna, Pfizer, Vaccine Adverse Events, Vaccine Manufacturers --- ### [Regeneron Antibody Cocktail Protects Against COVID-19](https://www.autoimmuneinstitute.org/covid_timeline/regeneron-antibody-cocktail-protects-against-covid-19/) **Published:** April 12, 2021 **Author:** Elevation **Excerpt:** Regeneron published a news release this morning stating their REGEN-COV antibody drug demonstrated high levels of protection against COVID-19 in a Phase 3 clinical trial. Those eligible to enroll in the study were not infected with COVID-19, did not show symptoms, did not have SARS-Cov-2 antibodies, and were living with someone who tested positive for COVID-19 within four days of enrolling. Of 1,505 volunteers, the antibody drug demonstrated 72% protection against symptomatic infection in the first week, and 93% in weeks thereafter. Those who received the antibody drug were also 81% less likely to get sick with COVID compared to those who received the placebo. On average, those experiencing symptoms “resolved their symptoms in 1 week, compared to 3 weeks with placebo. Infected individuals also cleared the virus faster with REGEN-COV.” **Content:** April 12, 2021 Regeneron published a news release this morning stating their [REGEN-COV antibody-drug demonstrated high levels of protection against COVID-19](https://investor.regeneron.com/news-releases/news-release-details/phase-3-prevention-trial-showed-81-reduced-risk-symptomatic-sars) in a Phase 3 clinical trial. Those eligible to enroll in the study were not infected with COVID-19, did not show symptoms, did not have SARS-Cov-2 antibodies, and were living with someone who tested positive for COVID-19 within four days of enrolling. Of 1,505 volunteers, the antibody-drug demonstrated 72% protection against symptomatic infection in the first week, and 93% in weeks thereafter. **Those who received the antibody-drug were also 81% less likely to get sick with COVID** compared to those who received the placebo. On average, those experiencing symptoms “resolved their symptoms in 1 week, compared to 3 weeks with placebo. Infected individuals also cleared the virus faster with REGEN-COV.” The REGEN-COV cocktail combines two drugs that mimic the antibodies created by the immune system when exposed to the virus. These monoclonal antibodies block the COVID-19 infection and neutralize the virus by diminishing its ability to “escape treatment.” Even though experts are hoping Regeneron’s antibody cocktail will be used as a preventative measure for those who are immunocompromised, this population was not included in the clinical trial. That being said, this can be used as another option for high-risk COVID patients, those who experienced an adverse reaction after receiving their first dose of the COVID-19 vaccine, or those currently on immunosuppressive therapies (whose immune system may not respond well to the vaccine). Regeneron plans to seek emergency authorization by the F.D.A to use the antibody cocktail as a preventative measure against the coronavirus. They are also seeking approval to administer the cocktail via injection versus intravenous infusion. **Category:** Covid-19 & Long Covid Treatments, Covid-19 Antibodies, Covid-19 Clinical Trials, Covid-19 Policy, Vaccine Adverse Events --- ### [Risk of Contracting SARS-CoV-2 from Surfaces is Less Than 1 in 10,000](https://www.autoimmuneinstitute.org/covid_timeline/risk-of-contracting-sars-cov-2-from-surfaces-is-less-than-1-in-10000/) **Published:** April 9, 2021 **Author:** Elevation **Excerpt:** The CDC has updated their SARS-CoV-2 and Surface Transmission guidelines, stating that the chance of contracting the coronavirus from surfaces is less than 1 in 10,000. **Content:** April 9, 2021 The CDC has updated their SARS-CoV-2 and Surface Transmission guidelines, stating that the [chance of contracting the coronavirus from surfaces is less than 1 in 10,000](https://www.cdc.gov/coronavirus/2019-ncov/more/science-and-research/surface-transmission.html). This comes after mounting evidence that the virus primarily spreads through airborne droplets, which can remain in the air for minutes to hours. “The length of time \[the\] virus remains suspended and is infectious depends on numerous factors, including viral load in respiratory droplets or in small particles, disturbance of air and surfaces, ventilation, temperature, and humidity.” The infection rate within the community, the amount of viral shedding by those who are infected, and the interaction between virus particles and the environment, are some factors that can increase the risk of viral transmission. This reinforces the necessity of wearing masks, especially in closed spaces, to reduce the spread of the virus both in the air and on surfaces. The CDC also states that **“in most situations, cleaning surfaces using soap or detergent, and not disinfecting, is enough to reduce risk.”** The envelope (the outer layer of proteins and lipids) housing the genetic material of the SARS-CoV-2 virus is easily altered and can “degrade quickly upon contact with surfactants contained in cleaning agents and under environmental conditions.” Cleaning agents alone can remove the virus from surfaces. However, to “substantially inactivate” the virus on surfaces, it must be treated with a [disinfectant product](https://www.epa.gov/pesticide-registration/list-n-disinfectants-coronavirus-covid-19). Increasing ventilation is one way of reducing the risk of airborne transmission. **Category:** Covid-19 Infections --- ### [Vaccine Eligibility by State ](https://www.autoimmuneinstitute.org/covid_timeline/vaccine-eligibility-by-state/) **Published:** April 5, 2021 **Author:** Elevation **Excerpt:** As eligibility requirements expand to include more occupations and health statuses, those living with autoimmune disease will have access to the COVID-19 vaccine. Many states have already instituted universal eligibility, with others set to expand eligibility requirements in April. Check out this vaccine eligibility tracker updated regularly by the New York Times to view vaccine eligibility by state. **Content:** April 5, 2021 As eligibility requirements expand to include more occupations and health statuses, those living with autoimmune disease will have access to the COVID-19 vaccine. Many states have already instituted universal eligibility, with others set to expand eligibility requirements in April. Check out this [vaccine eligibility tracker](https://www.nytimes.com/interactive/2021/us/covid-19-vaccine-eligibility.html?action=click&module=RelatedLinks&pgtype=Article) updated regularly by the New York Times to view vaccine eligibility by state. **Category:** Covid-19 Policy --- ### [Changing Vaccine Manufacturers Between Doses](https://www.autoimmuneinstitute.org/covid_timeline/changing-vaccine-manufacturers-between-doses/) **Published:** April 2, 2021 **Author:** Elevation **Excerpt:** The UK has established a vaccine protocol allowing patients to receive their first and second vaccine doses from different manufacturers. This is permissible if a second dose of the vaccine is unavailable or the manufacturer of the first dose is unknown. Currently, the only vaccines authorized for emergency use in the UK are by Pfizer, Moderna, and AstraZeneca. **Content:** April 2, 2021 The UK has established a vaccine protocol allowing [patients to receive their first and second vaccine doses from different manufacturers](https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/961287/Greenbook_chapter_14a_v7_12Feb2021.pdf). This is permissible if a second dose of the vaccine is unavailable or the manufacturer of the first dose is unknown. Currently, the only vaccines authorized for emergency use in the UK are by Pfizer, Moderna, and AstraZeneca. The government protocol adds that “this option is preferred if the individual is likely to be at immediate high risk or is considered unlikely to attend again” ([1](https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/961287/Greenbook_chapter_14a_v7_12Feb2021.pdf)). **It is not required that patients receive a second dose if it means using a vaccine from a different manufacturer than the first dose.** It is important to note that the [Pfizer](https://www.nytimes.com/interactive/2020/health/pfizer-biontech-covid-19-vaccine.html) and [Moderna](https://www.nytimes.com/interactive/2020/health/moderna-covid-19-vaccine.html) vaccines use lipid nanoparticles (non-water-soluble liquids) to deliver the mRNA, whereas [AstraZeneca](https://www.nytimes.com/interactive/2020/health/oxford-astrazeneca-covid-19-vaccine.html) uses an adenovirus to deliver a coronavirus spike protein. The double-stranded DNA is a “cousin” of mRNA, and the vehicles for delivery are unique. **Trials are currently underway studying the safety and efficacy of mixing vaccines from different manufacturers.** The CDC has made it clear that patients in the US [should receive doses from the same vaccine manufacturer](https://www.cdc.gov/vaccines/covid-19/info-by-product/clinical-considerations.html#:~:text=Interchangeability%20with%20other%20COVID%2D19%20vaccine%20products,-Either%20of%20the&text=Both%20doses%20of%20the%20series,are%20recommended%20at%20this%20time.)**. The only time vaccines should be mixed is after receiving an mRNA vaccine and using a single-dose of Johnson & Johnson’s (J&J) vaccine as the second dose**. The protocol for changing vaccine manufacturers between doses has not been tested and should be limited to “exceptional situations;” for example, where the patient experienced an adverse reaction after receiving the first mRNA vaccine ([2](https://www.cdc.gov/vaccines/covid-19/info-by-product/clinical-considerations.html#:~:text=Interchangeability%20with%20other%20COVID%2D19%20vaccine%20products,-Either%20of%20the&text=Both%20doses%20of%20the%20series,are%20recommended%20at%20this%20time.)). The J&J vaccine may be administered 28+ days after the first mRNA COVID-19 vaccine. Patients are encouraged to view the CDC’s list of [Contraindications and Precautions](https://www.cdc.gov/vaccines/covid-19/info-by-product/clinical-considerations.html#Contraindications) beforehand if they’ve experienced an adverse reaction to the mRNA COVID-19 vaccine and are hoping to get the J&J vaccine. To learn more about[ getting vaccinated when you have an autoimmune disease ](https://www.autoimmuneinstitute.org/vaccines-covid-19-autoimmune-disease-developments/)and why contraindications can occur, check out our article. Because the vaccines deliver genetic material through different methods, use different fillers, and are designed to induce an immune response over a two-step process using the same delivery method, it is not yet possible to say whether interchanging vaccines will offer the same rate of efficacy or safety demonstrated in clinical trials. **Category:** AstraZeneca, Autoimmune Diseases & Covid-19, Covid-19 Clinical Trials, Moderna, Pfizer, Vaccine Manufacturers --- ### [Pfizer Confirms High Efficacy and Safety 6 Months Following Second Vaccine](https://www.autoimmuneinstitute.org/covid_timeline/pfizer-confirms-high-efficacy-and-safety-6-months-following-second-vaccine/) **Published:** April 1, 2021 **Author:** Elevation **Excerpt:** Today, Pfizer released a statement confirming their vaccine has exhibited “high efficacy and no serious safety concerns through up to six months following the second dose.”  **Content:** April 1, 2021 Today, Pfizer released a statement confirming their vaccine has exhibited “[high efficacy and no serious safety concerns through up to six months following \[the\] second dose](https://www.pfizer.com/news/press-release/press-release-detail/pfizer-and-biontech-confirm-high-efficacy-and-no-serious).” **The Pfizer vaccine has demonstrated a 91.3% efficacy rate against COVID-19 from seven days through up to six months after delivery of the second dose**. The vaccine was 100% effective against *severe* COVID-19. The vaccine also demonstrated 100% efficacy against the B1.351 variant. **This data provides “the first clinical results that a vaccine can effectively protect against currently circulating variants.”**  “Vaccine safety has now been evaluated in more than 44,000 participants aged 16 years and older with more than 12,000 vaccinated participants having at least six months of follow-up after their second dose.” **Over the six-month period, no serious safety concerns were observed after receiving the second dose.** It should be noted that “**immunocompromised persons, including individuals receiving immunosuppressant therapy, may have a diminished immune response to the Pfizer-BioNTech COVID-19 Vaccine,**” according to the U.S. FDA Emergency Use Authorization Prescribing Information. Data on Pfizer’s COVID-19 Vaccine administered to immunocompromised patients and people with autoimmune disease are incomplete and are insufficient in informing risks for this population group. That being said, the FDA has said that those living with autoimmune disease may receive the COVID-19 vaccine. Patients should speak with their doctors regarding their healthcare plan before receiving the vaccine. **Category:** Autoimmune Diseases & Covid-19, Covid-19 Policy, Covid-19 Research Studies, Covid-19 Variants, Pfizer, Vaccine Manufacturers --- ### [Pfizer Vaccine Demonstrates 100% Efficacy in 12-15 Year Olds](https://www.autoimmuneinstitute.org/covid_timeline/pfizer-vaccine-demonstrates-100-efficacy-in-12-15-year-olds/) **Published:** March 31, 2021 **Author:** Elevation **Excerpt:** Today, Pfizer-BioNTech published a press release announcing the results of their Phase 3 clinical trial in adolescents. The trial enrolled 2,260 participants in the United States, aged 12 to 15, with 1,129 participants in the placebo group and 1,131 participants in the vaccinated group. In the trial, 18 cases of COVID-19 infections were observed in the placebo group. Comparatively, none of the participants from the vaccinated group contracted COVID-19. **Content:** March 31, 2021 Today, Pfizer-BioNTech published a [press release](https://www.pfizer.com/news/press-release/press-release-detail/pfizer-biontech-announce-positive-topline-results-pivotal) announcing the results of their Phase 3 clinical trial in adolescents. The trial enrolled 2,260 participants in the United States, aged 12 to 15, with 1,129 participants in the placebo group and 1,131 participants in the vaccinated group. **In the trial, 18 cases of COVID-19 infections were observed in the placebo group. Comparatively, none of the participants from the vaccinated group contracted COVID-19.** The vaccine is currently only authorized for people aged 16 and older in the United States, so this data may play a role in amending the vaccine’s emergency use authorization. It is important to note that while this data is still under review, this is promising news. The next steps include requesting expansion of the Emergency Use Authorization (EUA) by the FDA in the United States. **Category:** Covid-19 Clinical Trials, Pfizer, Vaccine Manufacturers --- ### [UK Begins First COVID-19 Human Challenge Trial](https://www.autoimmuneinstitute.org/covid_timeline/uk-begins-first-covid-19-human-challenge-trial/) **Published:** March 30, 2021 **Author:** Elevation **Excerpt:** On February 17, 2021, the UK approved the world’s first COVID-19 human challenge trial. The trial includes infecting up to 90 healthy participants with the virus and tracking just how it affects the human body, in an effort to aid the development of new vaccines and treatments for the novel coronavirus. This trial differs from typical clinical trials in that participants are not receiving an experimental vaccine but rather the pathogen itself.  **Content:** March 30, 2021 On February 17, 2021, the UK approved the[ world’s first COVID-19 human challenge trial](https://www.gov.uk/government/news/worlds-first-coronavirus-human-challenge-study-receives-ethics-approval-in-the-uk). The trial includes infecting up to 90 healthy participants with the virus and tracking just how it affects the human body, in an effort to aid the development of new vaccines and treatments for the novel coronavirus. This trial differs from typical clinical trials in that participants are not receiving an experimental vaccine but rather the pathogen itself. As of March 25, three volunteers who had been exposed to SARS-CoV-2 via nasal droplets finished quarantining at the Royal Free Hospital in London and will continue to be monitored by a clinical team ([1](https://www.imperial.ac.uk/news/218294/first-volunteers-covid-19-human-challenge-study/)). These three patients did not experience unexpected issues or complications, and “are in good health” ([1](https://www.imperial.ac.uk/news/218294/first-volunteers-covid-19-human-challenge-study/)). While further details of the study – including symptoms – will be kept confidential, researchers are recruiting more healthy volunteers between the ages of 18-30 to “establish the lowest possible dose of virus needed to cause viral replication in the nose and throat” ([1](https://www.imperial.ac.uk/news/218294/first-volunteers-covid-19-human-challenge-study/)). This study will also assist in understanding the progression of the virus once inside the body, natural immune response, and transmission. **Category:** Covid-19 Clinical Trials, Covid-19 Infections --- ### [COVID-19 Versus Seasonal Influenza Outcomes in Autoimmune Disease Patients ](https://www.autoimmuneinstitute.org/covid_timeline/covid-19-versus-seasonal-influenza-outcomes-in-autoimmune-disease-patients/) **Published:** March 29, 2021 **Author:** Elevation **Excerpt:** A recent multi-national study evaluated 30-day outcomes in hospitalized COVID-19 patients living with autoimmune disease (AD). Data was aggregated from centers including Columbia University Irving Medical Center and Information System for Research in Primary Care-Hospitalisation Linked Data in Spain. 133,589 patients diagnosed and 48,428 hospitalized with COVID-19 and living with autoimmune disease were included in the study.   **Content:** March 29, 2021 A recent [multi-national study](https://academic.oup.com/rheumatology/advance-article/doi/10.1093/rheumatology/keab250/6174122) evaluated 30-day outcomes in hospitalized COVID-19 patients living with autoimmune disease (AD). Data was aggregated from centers including Columbia University Irving Medical Center and Information System for Research in Primary Care-Hospitalisation Linked Data in Spain. 133,589 patients diagnosed and 48,428 hospitalized with COVID-19 and living with autoimmune disease were included in the study.   This international study used inpatient electronic health records (EHR) to collect and compare data of autoimmune disease patients infected with COVID-19 (between January and June 2020) to those infected with seasonal influenza (between 2017-2018). The most prevalent autoimmune diseases reported in the study were [psoriasis](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/psoriasis/), [rheumatoid arthritis](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/rheumatoid-arthritis/), and vasculitis. **Data showed that roughly 30% of patients infected with COVID-19 were hospitalized while roughly 17% of influenza patients were hospitalized**. On average, 30% of COVID-19 patients developed acute respiratory distress syndrome (ARDS) compared to 22% of seasonal influenza patients. Overall, hospitalized patients with COVID-19 and living with autoimmune disease experienced higher mortality rates and intensive care requirements compared to seasonal influenza patients ([1](https://academic.oup.com/rheumatology/advance-article/doi/10.1093/rheumatology/keab250/6174122)). This study highlights the prevalence of respiratory complications in COVID-19 patients versus influenza patients. It is clear that **patients with autoimmune disease are at risk of more severe outcomes, complications, and higher mortality rates after COVID-19 infection compared to influenza**. This data is especially significant to confute assertions that the severity of COVID-19 parallels seasonal influenza; those who are immunocompromised should continue to take proper preventative measures to decrease the risk of infection. **Category:** Autoimmune Diseases & Covid-19, Covid-19 Infections, Covid-19 Research Studies --- ### [Astrazeneca's COVID-19 Vaccine Demonstrates 76% Efficacy](https://www.autoimmuneinstitute.org/covid_timeline/astrazenecas-covid-19-vaccine-demonstrates-76-efficacy/) **Published:** March 26, 2021 **Author:** Elevation **Excerpt:** AstraZeneca has released an updated statement revealing their vaccine demonstrates 76% efficacy against symptomatic COVID-19 and 100% efficacy against severe COVID-19 and hospitalization. They previously stated a 79% efficacy based on data through February 17, 2021. Experts credit this discrepancy to a rounding error. **Content:** March 26, 2021 [AstraZeneca](https://www.astrazeneca-us.com/media/press-releases/2021/azd1222-us-phase-iii-primary-analysis-confirms-safety-and-efficacy-03242021.html) has released an updated statement revealing their vaccine demonstrates 76% efficacy against symptomatic COVID-19 and 100% efficacy against severe COVID-19 and hospitalization. They previously stated a 79% efficacy based on data through February 17, 2021. Experts credit this discrepancy to a rounding error ([1](https://www.bloomberg.com/news/articles/2021-03-25/astra-reports-lower-efficacy-for-covid-vaccine-after-criticism)). These results have been submitted for review to the Data Safety Monitoring Board and will be the “basis for a regulatory submission for Emergency Use Authorization to the US Food and Drug Administration in the coming weeks” ([2](https://www.astrazeneca-us.com/media/press-releases/2021/azd1222-us-phase-iii-primary-analysis-confirms-safety-and-efficacy-03242021.html)). **Category:** AstraZeneca, Covid-19 Policy, Vaccine Manufacturers --- ### [NIH Releases Statement Regarding AstraZeneca Vaccine](https://www.autoimmuneinstitute.org/covid_timeline/nih-releases-statement-regarding-astrazeneca-vaccine/) **Published:** March 23, 2021 **Author:** Elevation **Excerpt:** The National Institute of Allergy and Infectious Diseases (NIAID) published a news release today regarding AstraZeneca’s COVID-19 vaccine clinical trial, after being notified by the Data and Safety Monitoring Board that outdated information “may have provided an incomplete view of the efficacy data” (1). Which information is outdated has not been specifically disclosed. This statement was released one day after the NIH published a media advisory that the investigational AstraZeneca vaccine prevents COVID-19.  **Content:** March 23, 2021 The National Institute of Allergy and Infectious Diseases (NIAID) published a [news release](https://www.nih.gov/news-events/news-releases/niaid-statement-astrazeneca-vaccine) today regarding AstraZeneca’s COVID-19 vaccine clinical trial, after being notified by the Data and Safety Monitoring Board that outdated information “may have provided an incomplete view of the efficacy data” ([1](https://www.nih.gov/news-events/news-releases/niaid-statement-astrazeneca-vaccine)). Which information is outdated has not been specifically disclosed. This statement was released one day after the NIH published a media advisory that the investigational AstraZeneca vaccine prevents COVID-19. The placebo-controlled trial included 32,449 adult participants across the US, Chile, and Peru, with approximately 20,000 receiving the vaccine versus 10,000 receiving a placebo. The vaccine was administered as two doses, four weeks apart, and demonstrated 79% efficacy in preventing symptomatic COVID-19. The vaccine showed 100% efficacy in preventing severe symptoms. Symptomatic COVID-19 was defined as having a SARS-CoV-2 infection and at least one respiratory symptom, or at least *two* of the following: loss of taste and/or smell, fever, muscle pain, fatigue, vomiting and/or diarrhea, and cough. Severe symptoms included a SARS-CoV-2 infection and at least *one* of the following: signs of severe systemic illness, respiratory failure, shock, significant acute renal, hepatic or neurologic dysfunction, ICU admission, and death. Similar to Johnson & Johnson’s COVID-19 vaccine, the AstraZeneca vaccine uses an adenovirus to deliver incomplete SARS-CoV-2 genetic material to the body; it does not carry a live SARS-CoV-2 virus.  **AstraZeneca published an [update](https://www.astrazeneca.com/media-centre/press-releases/2021/update-following-statement-by-niaid-on-azd1222-us-phase-iii-trial-data.html) this morning following NIAID’s follow-up statement, stating they will “immediately engage” with the Data and Safety Monitoring Board** **and share the most up-to-date efficacy data within the next 48 hours**. Any updated information provided by AstraZeneca will be reviewed by independent advisory committees to ensure accuracy before the FDA and CDC start the authorization process for the use of AstraZeneca’s vaccine in the U.S. It is currently available for use in over 70 countries ([2](https://www.nih.gov/news-events/news-releases/investigational-astrazeneca-vaccine-prevents-covid-19)). **Category:** AstraZeneca, Covid-19 Clinical Trials, Vaccine Manufacturers --- ### [Some States are Lifting Vaccine Eligibility Requirements](https://www.autoimmuneinstitute.org/covid_timeline/some-states-are-lifting-vaccine-eligibility-requirements/) **Published:** March 19, 2021 **Author:** Elevation **Excerpt:** The following states will be lifting eligibility requirements for residents to be vaccinated:  **Content:** March 19, 2021 **The following states will be lifting eligibility requirements for residents to be vaccinated:** March 2021: [Utah ](https://twitter.com/GovCox/status/1372581031727927296?s=20)(week of March 21, 2021) [Ohio ](https://governor.ohio.gov/wps/portal/gov/governor/media/news-and-media/expanded-vaccine-eligibility-+cleveland-mass-vaccination-clinic-opens-to-public-03162021)(starting March 29, 2021) April 2021: [Connecticut](https://portal.ct.gov/Office-of-the-Governor/News/Press-Releases/2021/03-2021/Governor-Lamont-Announces-Accelerated-Schedule-To-Provide-COVID-19-Vaccines) [Illinois](https://www2.illinois.gov/Pages/news-item.aspx?ReleaseID=22961) [Kentucky](https://kentucky.gov/Pages/Activity-stream.aspx?n=GovernorBeshear&prId=666) [Maryland](https://twitter.com/GovLarryHogan/status/1372631729698144256?s=20) [Missouri](https://governor.mo.gov/press-releases/archive/governor-parson-announces-timeline-activation-phase-2-and-3-missouris-covid) [Rhode Island](https://twitter.com/RIHEALTH/status/1372596050058416129) [Alaska](https://gov.alaska.gov/%f0%9f%93%ba-%f0%9f%8e%a5-3-9-covid-19-press-briefing/) and [Mississippi](https://twitter.com/tatereeves/status/1371496468587118594?s=20) have already instituted universal eligibility.  As of today, March 19, 39.6% of adults 65 years and older have been fully vaccinated in the U.S. View more stats and daily updates regarding vaccine distribution in the U.S. with this [COVID Data Tracker](https://covid.cdc.gov/covid-data-tracker/#vaccinations) by the CDC. You can also check out this resource by The Wall Street Journal for a state-by-state guide on [vaccine eligibility requirements](https://www.wsj.com/articles/how-to-get-a-covid-19-vaccine-a-state-by-state-guide-11611703769). **Category:** Covid-19 Policy --- ### [Some Long-Haulers Find Relief After Getting the COVID-19 Vaccine](https://www.autoimmuneinstitute.org/covid_timeline/some-long-haulers-find-relief-after-getting-the-covid-19-vaccine/) **Published:** March 18, 2021 **Author:** Elevation **Excerpt:** Long-haulers are sharing stories of symptom relief after receiving the COVID-19 vaccine. While anecdotal as of now, patients from across the country are reporting that their symptoms have improved or even resolved after getting their first dose of the COVID-19 vaccine. Survivor Corps, one of the largest patient communities advocating for COVID-19 long haulers, recently released a poll on Facebook asking members how they felt post-vaccination. As of March 18, 2021, 40% of participants said that their long-COVID symptoms improved after being vaccinated.  **Content:** March 18, 2021 [Long-haulers are sharing stories](https://www.nytimes.com/2021/03/17/health/coronavirus-patients-and-vaccine-effects.html) of symptom relief after receiving the COVID-19 vaccine. While anecdotal as of now, **patients from across the country are reporting that their symptoms have improved or even resolved after getting their first dose of the COVID-19 vaccine**. [Survivor Corps](https://www.survivorcorps.com/), one of the largest patient communities advocating for COVID-19 long haulers, recently released a poll on Facebook asking members how they felt post-vaccination. As of March 18, 2021, 40% of participants said that their long-COVID symptoms improved after being vaccinated ([1](https://www.medscape.com/viewarticle/947592)). University of California San Francisco is currently conducting a [clinical trial studying the long-term impact of a COVID-19 infection](https://clinicaltrials.ucsf.edu/trial/NCT04362150). This observational study is investigating the “clinical consequences of a SARS-CoV-2 infection” to include immune activation, changes in immunologic function, and the development of medical conditions ([2](https://clinicaltrials.ucsf.edu/trial/NCT04362150)). The [NIH](https://www.nih.gov/about-nih/who-we-are/nih-director/statements/nih-launches-new-initiative-study-long-covid) also announced on February 23 that they will be allocating more than $1.1 billion over the next four years to study the impact of long COVID. **Typically, long-haulers experience fatigue, shortness of breath, body aches, inability to concentrate, headaches, loss of taste and/or smell, as well as other symptoms continuing 6+ weeks after a COVID-19 infection** ([3](https://www.who.int/docs/default-source/coronaviruse/risk-comms-updates/update-36-long-term-symptoms.pdf?sfvrsn=5d3789a6_2)). Experts are unsure as to why or how vaccination is leading to symptom relief for some long-haulers. Long COVID has been likened to Lyme disease, and the production of autoantibodies leading to autoimmune disease has also been discussed as a theory behind some long-COVID symptoms. Some hypothesize that the immune system may be getting a “boost” from the vaccine to resolve persistent symptoms ([1](https://www.medscape.com/viewarticle/947592), [4](https://elemental.medium.com/how-vaccines-might-improve-long-covid-c1f41c4d7378)). You can find more [news on long-haulers](https://www.survivorcorps.com/news) through the Survivor Corps website. **Category:** Covid-19 Antibodies, Covid-19 Clinical Trials, Long COVID, ME/CFS & Covid-19 --- ### [Updated CDC Guidelines on Vaccinations](https://www.autoimmuneinstitute.org/covid_timeline/updated-cdc-guidelines-on-vaccinations/) **Published:** March 10, 2021 **Author:** Elevation **Excerpt:** The CDC updated their COVID-19 guidelines on March 8, 2021 for people who are vaccinated. Those who have been fully vaccinated are safe to:  **Content:** March 10, 2021 The CDC updated their COVID-19 [guidelines](https://www.cdc.gov/vaccines/covid-19/clinical-considerations/interim-considerations-us.html) on March 8, 2021 for people who are vaccinated. Those who have been **fully vaccinated** are safe to: - Gather indoors with other fully vaccinated people *without masks* - Gather indoors with unvaccinated people from one other household *without masks* - *Do not need to quarantine after exposure to someone with COVID-19* unless symptoms are present Of course, those who are immunocompromised or have an [increased risk of severe COVID-19 symptoms](https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html) should continue to take extra precautions. It is still unclear how long immunity lasts after being vaccinated, how effective these vaccines are against certain variants, and just how much vaccines mitigate the spread of COVID-19 from person-to-person contact. Bearing these unknowns in mind, the CDC cautions everyone to continue wearing a mask in public places, maintaining physical distancing, avoiding crowded spaces, as well as getting tested if COVID-19 symptoms occur, even if they are fully vaccinated ([1](https://www.cdc.gov/coronavirus/2019-ncov/vaccines/fully-vaccinated.html)). **Category:** Covid-19 Policy, Covid-19 Variants --- ### [Type 1 Diabetes Patients Become Eligible for COVID-19 Vaccine in 12+ States](https://www.autoimmuneinstitute.org/covid_timeline/type-1-diabetes-patients-become-eligible-for-covid-19-vaccine-in-12-states/) **Published:** March 5, 2021 **Author:** Elevation **Excerpt:** The Colorado Department of Health along with 11 other states just raised vaccination eligibility requirements for type 1 diabetes patients as a “high risk” group. In Colorado, anyone between the ages of 16-64 who have T1 diabetes and one other high risk condition will be eligible to get the coronavirus vaccine as early as today, March 5. They will be included in the 1B.3 vaccine group. This comes after Juvenile Diabetes Research Foundation’s (JDRF) extensive lobbying efforts to list T1 diabetes as a high risk condition alongside T2 diabetes. **Content:** March 5, 2021 The [Colorado Department of Health](https://covid19.colorado.gov/vaccine-faq) along with 11 other states **just raised vaccination eligibility requirements for type 1 diabetes patients as a “high risk” group** ([2](https://www.jdrf.org/blog/2021/01/22/answering-your-questions-about-the-covid-19-vaccines/), [3](https://www.startribune.com/type-1-diabetes-rare-diseases-added-to-minnesota-covid-19-vaccine-priority-groups/600029499/?refresh=true)). In Colorado, anyone between the ages of 16-64 who have [T1 diabetes](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/diabetes-type-1/) and one other high-risk condition will be eligible to get the coronavirus vaccine as early as today, March 5. They will be included in the 1B.3 vaccine group ([1](https://covid19.colorado.gov/vaccine-faq)). This comes after Juvenile Diabetes Research Foundation’s (JDRF) extensive lobbying efforts to list T1 diabetes as a high-risk condition alongside T2 diabetes ([2](https://www.jdrf.org/blog/2021/01/22/answering-your-questions-about-the-covid-19-vaccines/)). As of now, the [CDC’s vaccine recommendation](https://www.cdc.gov/coronavirus/2019-ncov/vaccines/) includes frontline essential workers and people 75 years and older in Phase 1B. Persons 65 years and older and those at high risk for severe COVID-19 symptoms are included in Phase 1C. **This can be seen as encouraging news for the autoimmune disease community, as health authorities begin taking certain high-risk autoimmune diseases into account for vaccination priority.** The rollout of Johnson & Johnson’s vaccine will undoubtedly aid these efforts by increasing vaccine availability. To find vaccine eligibility and prioritization criteria by state, view this [resource](https://www.kff.org/policy-watch/how-are-states-prioritizing-who-will-get-the-covid-19-vaccine-first/?utm_campaign=KFF-2020-Coronavirus&utm_medium=email&_hsmi=102982102&_hsenc=p2ANqtz-_sFQO7A3Ajhb8uoPX2BOEd0vURCSu-00Z2q4hMQ67MdOILFJQVeh2b2InRf7sti6sqiaG8X0od7eCz-K2BPNAc0TirbA&utm_content=102982102&utm_source=hs_email&_ga=2.191455402.1801341177.1614899440-377125941.1614899440) by Kaiser Family Foundation. **Category:** Autoimmune Diseases & Covid-19, Covid-19 Policy, T1D & Covid-19 --- ### [The Johnson & Johnson COVID Vaccine Receives Emergency Use Authorization by the FDA](https://www.autoimmuneinstitute.org/covid_timeline/the-johnson-johnson-covid-vaccine-receives-emergency-use-authorization-by-the-fda/) **Published:** March 2, 2021 **Author:** Elevation **Excerpt:** The J&J COVID vaccine received emergency use authorization (EUA) by the FDA this past weekend. This single-shot vaccine is the third COVID vaccine to be released in the United States, with plans to deliver 16 million doses to the federal government by the end of March. Due to production issues, this will be significantly less than the 37 million dose figure released by J&J while recommendation by the FDA was still under review. The first 3.9 million doses, created in J&J’s Netherland factory, are expected to arrive in America by today, March 2. **Content:** March 2, 2021 The [Johnson & Johnson COVID vaccine](https://www.jnj.com/latest-news/alex-gorsky-on-johnson-johnson-janssen-covid-19-vaccine-emergency-use-authorization) received emergency use authorization (EUA) by the FDA this past weekend. This single-shot vaccine is the third COVID vaccine to be released in the United States, with plans to deliver 16 million doses to the federal government by the end of March. Due to production issues, this will be significantly less than the 37 million dose figure released by Johnson & Johnson while the recommendation by the FDA was still under review. The first 3.9 million doses, created in Johnson & Johnson’s Netherland factory, are expected to arrive in America by today, March 2 ([2](https://www.nytimes.com/live/2021/02/28/world/covid-19-coronavirus)). “A committee of independent advisors to the Centers for Disease Control and Prevention voted as expected to recommend distribution of the Johnson & Johnson vaccine to all adults in the United States” ([2](https://www.nytimes.com/live/2021/02/28/world/covid-19-coronavirus)). That being said, it has not been decided whether states should prioritize this particular vaccine for certain population groups – including at-risk and immunocompromised groups – over others. The Johnson & Johnson vaccine has shown an 85% efficacy rate against severe COVID-19 cases, with complete protection against hospitalizations and death as of 28 days. A concern from officials and patients alike, it **“appears to do well against the highly contagious B.1.351 variant”** ([3](https://www.nytimes.com/2021/02/28/us/jj-vaccine-pfizer-moderna-differences.html)). In addition to being a single dose, this vaccine can be stored in standard refrigerators instead of freezers, making it easier to transport and distribute. **The Johnson & Johnson vaccine has also been shown to trigger fewer side effects than Pfizer and Moderna**; the side effects are usually more prevalent after the second dose has been administered ([3](https://www.nytimes.com/2021/02/28/us/jj-vaccine-pfizer-moderna-differences.html)). Again, this will not be an issue as Johnson & Johnson’s vaccine only requires one dose. That being said, **[Janssen Pharmaceuticals](https://www.janssencovid19vaccine.com/for-recipients.html)** **(owned and operated by Johnson & Johnson), instructs patients to let their medical provider know if they have “allergies… \[and/or\] are immunocompromised”** before getting the Johnson & Johnson vaccine, and that “there is a remote chance that the Janssen COVID-19 vaccine could cause a severe allergic reaction… \[usually\] within a few minutes to one hour after getting a dose of the Janssen COVID-19 vaccine” ([4](https://www.janssencovid19vaccine.com/for-recipients.html)). Check out this [Vaccine Tracker](https://www.nytimes.com/interactive/2020/science/coronavirus-vaccine-tracker.html) by the New York Times for up-to-date information regarding vaccine research, production, testing, and approval around the world. **Category:** Covid-19 Policy, Covid-19 Variants, Johnson & Johnson, Moderna, Pfizer, Vaccine Manufacturers --- ### [The VAXICOV Study, Autoimmune Disease and Vaccination Concerns](https://www.autoimmuneinstitute.org/covid_timeline/the-vaxicov-study-autoimmune-disease-and-vaccination-concerns/) **Published:** February 25, 2021 **Author:** Elevation **Excerpt:** The results of the international VAccinations against COVid-19 (VAXICOV) study were published this week, revealing patient concerns and expectations around receiving the COVID-19 vaccine. Patients with systemic autoimmune or inflammatory rheumatic diseases were asked to participate in the online survey across 56 countries. Health care workers were also included as a control group. The most commonly documented autoimmune conditions were systemic lupus erythematosus, spondyloarthritis, and rheumatoid arthritis. The median score for patients who reported “being afraid to get infected” with COVID-19 was 8, and afraid to “develop severe COVID-19” was 9. That being said, only 54.2% of patients with systemic autoimmune or rheumatic disease were willing to get vaccinated against COVID-19 prior to seeing their specialist. 32.2% of patients were uncertain and 13% stated they were unwilling. **Content:** February 25, 2021 The results of the international [VAccinations against COVid-19 (VAXICOV) study ](https://www.thelancet.com/pdfs/journals/lanrhe/PIIS2665-9913(21)00039-4.pdf)was published this week, revealing patient concerns and expectations around receiving the COVID-19 vaccine. Patients with systemic autoimmune or inflammatory rheumatic diseases were asked to participate in the online survey across 56 countries. Health care workers were also included as a control group. The most commonly documented autoimmune conditions were [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/systemic-lupus-erythematosus/), spondyloarthritis, and [rheumatoid arthritis](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/rheumatoid-arthritis/). The median score for patients who reported “being afraid to get infected” with COVID-19 was 8, and afraid to “develop severe COVID-19” was 9 ([1](https://www.thelancet.com/pdfs/journals/lanrhe/PIIS2665-9913(21)00039-4.pdf)). That being said, only 54.2% of patients with systemic autoimmune or rheumatic disease were willing to get vaccinated against COVID-19 prior to seeing their specialist. 32.2% of patients were uncertain and 13% stated they were unwilling. 67.5% of patients were recommended by their specialist to get vaccinated – this is confirmation that **the medical professional community at large is in favor of vaccinations for otherwise at-risk patients**. Willingness to get vaccinated jumped to 67.5% post recommendation from their specialist. Uncertainty decreased to 28.4%, and unwillingness to 8.8%. Additionally, the VAXICOV study confirms that **patients with systemic autoimmune and inflammatory rheumatic diseases are generally willing to get vaccinated against COVID-19.** “Willingness” to get a COVID-19 vaccine was associated with fear of getting a COVID-19 infection, not with fear around comorbidities or immunocompromised status. “These results show that a significant proportion of patients with systemic autoimmune or inflammatory rheumatic diseases who are at risk of severe COVID-19 do not perceive themselves as such, and highlight the importance of increasing patient education in this context” ([1](https://www.thelancet.com/pdfs/journals/lanrhe/PIIS2665-9913(21)00039-4.pdf)). Main concerns included a lack of context around COVID-19 vaccine data and testing, especially in regards to the new use of mRNA vaccines, as well as the risk of flare-ups and side effects. Given the broad span of participants from across the globe, it is reasonable to consider these answers representative of the general population living with autoimmune and rheumatic diseases. **Category:** Autoimmune Diseases & Covid-19, Covid-19 Research Studies, Lupus & Covid-19, RA & Covid-19, Vaccine Adverse Events --- ### [COVID-19, Autoantibodies, and Multisystem Inflammatory Syndrome in Children](https://www.autoimmuneinstitute.org/covid_timeline/covid-19-autoantibodies-and-multisystem-inflammatory-syndrome-in-children/) **Published:** February 23, 2021 **Author:** Elevation **Excerpt:** Throughout the pandemic, cases have been reported of children experiencing a hyper-inflammatory response after a COVID-19 infection. What was first described as a cluster of intense symptoms, has since come to be known as Multisystem Inflammatory Syndrome in Children (MIS-C).  **Content:** February 23, 2021 Throughout the pandemic, cases have been reported of children experiencing a hyper-inflammatory response after a COVID-19 infection ([1](https://www.nytimes.com/2021/02/16/health/covid-children-inflammatory-syndrome.html?smid=fb-nytimes&smtyp=cur&fbclid=IwAR1JScuNxKXlQXJEzZH7XMT24nZewvQ1_JprWVCIoSrxK16ca7sHsUE7D-U&login=email&auth=login-email), [2](https://www.nytimes.com/2020/05/17/health/coronavirus-multisystem-fnflammatory-syndrome-children-teenagers.html)). What was first described as a cluster of intense symptoms, has since come to be known as Multisystem Inflammatory Syndrome in Children (MIS-C). The pool of data around SARS-CoV-2 infection and MIS-C is still small, and **a lack of consistency in clinical presentations of MIS-C makes it easy for clinicians to misdiagnose symptoms** for other conditions where hyper inflammation is prevalent, like [Kawasaki disease](https://www.mayoclinic.org/diseases-conditions/kawasaki-disease/symptoms-causes/syc-20354598), toxic shock syndrome, and macrophage-activation syndrome (MAS). Due to the general ambiguity around MIS-C’s cause and development, as well as its mechanisms for tissue damage, the [CDC ](https://emergency.cdc.gov/han/2020/han00432.asp)and [WHO](https://www.who.int/news-room/commentaries/detail/multisystem-inflammatory-syndrome-in-children-and-adolescents-with-covid-19) have constructed different clinical criteria for the diagnosis of MIS-C ([3](https://pediatrics.aappublications.org/content/pediatrics/147/2/e2020024554.full.pdf)). The American Academy of Pediatrics (AAP) recently published the [results](https://pediatrics.aappublications.org/content/pediatrics/147/2/e2020024554.full.pdf) of an international survey detailing MIS-C cases from April-June 2020. Data was provided from 33 hospitals and included 183 pediatric patients ages 1.2 months to 18 years. In the clinical presentations of MIS-C, all patients presented with a fever (>100.4 F), and over 60% had gastrointestinal symptoms. The second most common symptom was cardiovascular. These findings coincide with previously published reports and classification criteria for MIS-C; other common clinical manifestations include [dermatologic/ mucocutaneous symptoms](https://jamanetwork.com/journals/jamadermatology/fullarticle/2773994), cardiovascular symptoms, respiratory symptoms, and neurologic symptoms ([4](https://link.springer.com/article/10.1007/s40272-020-00435-x)). Examples can include rash, swelling of hands and/or feet, change to the oral mucosa, pink eye, and swollen lymph nodes. It is unknown why a hyperimmune response occurs, and why autoantibodies against endothelial, gastrointestinal, and immune cells are produced. **One** **[study](https://www.medrxiv.org/content/10.1101/2020.07.04.20142752v1.full.pdf) conducted by the Icahn School of Medicine found that MIS-C may share some pathophysiology with autoimmune disease.**  114 of the 183 patients included in the AAP survey tested positive for current or recent SARS-CoV-2 infection ([3](http://publications.aap.org/pediatrics/article-pdf/147/2/e2020024554/1082241/peds_2020024554.pdf)). **Patients who did not test positive for COVID but presented symptoms concurrent to MIS-C may have experienced a COVID-19 exposure 2-6 weeks prior to the onset of symptoms (****[4](https://link.springer.com/article/10.1007/s40272-020-00435-x)).** Continued research studying this occurrence will help to shed light on the long-standing damage this hyperimmune response may have on the body. Additionally, as criteria for clinical diagnosis is standardized, children experiencing MIS-C can have more immediate access to tailored therapies and treatment, to mitigate the often severe symptoms that accompany MIS-C. **Category:** Autoimmune Diseases & Covid-19, Covid-19 Antibodies, Covid-19 Research Studies, Vaccine Adverse Events --- ### [The Johnson & Johnson COVID Vaccine + Autoimmune Disease](https://www.autoimmuneinstitute.org/covid_timeline/the-johnson-johnson-covid-vaccine-autoimmune-disease/) **Published:** February 16, 2021 **Author:** Elevation **Excerpt:** In early February 2021, Janssen Pharmaceutical Companies of Johnson & Johnson requested emergency authorization by the FDA to distribute their COVID-19 vaccine. Come the end of the month, the FDA will be reviewing their request; if approved, the Janssen COVID-19 vaccine could be rolled out across the U.S. as early as the end of March.  **Content:** February 16, 2021 In early February 2021, Janssen Pharmaceutical Companies of Johnson & Johnson requested emergency authorization from the FDA to distribute their COVID-19 vaccine. Come the end of the month, the FDA will be reviewing their request; if approved, the Janssen COVID-19 vaccine could be rolled out across the U.S. as early as the end of March. According to the [press release](https://www.jnj.com/johnson-johnson-announces-single-shot-janssen-covid-19-vaccine-candidate-met-primary-endpoints-in-interim-analysis-of-its-phase-3-ensemble-trial) on their website, this single-shot vaccine is “**85% effective overall in preventing severe disease**, demonstrat\[ing\] complete protection against COVID-19 related hospitalization and death as of Day 28” ([1](https://www.jnj.com/johnson-johnson-announces-single-shot-janssen-covid-19-vaccine-candidate-met-primary-endpoints-in-interim-analysis-of-its-phase-3-ensemble-trial)). Within the trial, “moderate” COVID was defined as having received a lab-confirmed COVID diagnosis as well as experiencing the following symptoms: pneumonia, DVT (deep vein thrombosis), shortness of breath, and/or abnormal oxygen and respiratory rates. “Severe” COVID includes “signs consistent with severe systemic illness, admission to an intensive care unit, respiratory failure, shock, organ failure or death” ([1](https://www.jnj.com/johnson-johnson-announces-single-shot-janssen-covid-19-vaccine-candidate-met-primary-endpoints-in-interim-analysis-of-its-phase-3-ensemble-trial)). No anaphylaxis was observed during the clinical trials, and **overall serious adverse events reported were actually higher from placebo groups than those who received the vaccine**. While the population size was not released, it was confirmed that immunocompromised participants were in the study ([1](https://www.jnj.com/johnson-johnson-announces-single-shot-janssen-covid-19-vaccine-candidate-met-primary-endpoints-in-interim-analysis-of-its-phase-3-ensemble-trial)). Janssen’s COVID-19 vaccine uses an inactive virus to deliver SARS-CoV-2 proteins to the body. These proteins are recognized as invaders by the body, signaling the production of antibodies as an immune response. This particular vaccine uses an adenovirus (which causes the common cold) as a vector (a device used to deliver genetic material) containing the incomplete genetic material of the coronavirus. The genetic makeup cannot replicate; therefore, patients are not at risk for infection of SARS-CoV-2 from inoculation ([2](https://www.jnj.com/our-company/simplifying-the-science-of-covid-19-how-adenovector-vaccines-work)). Rheumatology International recently published a [scientific review](https://link.springer.com/article/10.1007/s00296-021-04792-9) on the range of SARS-CoV-2 vaccines as they pertain to autoimmune inflammatory diseases. As of January 2021, there has been “no experience of viral-vector based vaccines against infectious agents in patients with \[autoimmune inflammatory disorders\]” ([3](https://link.springer.com/article/10.1007/s00296-021-04792-9)). While this may spark initial concern, **available data on vector-based vaccines in immunocompromised patients shows that these vaccines are not only well tolerated, but even more, severe adverse events are unlikely to occur** ([4](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7532807/)). At the time of publication, only patients with rheumatic diseases have been included as an autoimmune disease population group in the most recent stage of clinical trials. While “well-known vaccines can provide guidance and partial confidence for the use of the ‘new vaccines,’” including more varied population groups going forward will ensure vaccine efficacy and safety for those living with autoimmune disease ([3](https://link.springer.com/article/10.1007/s00296-021-04792-9)). **Category:** Autoimmune Diseases & Covid-19, Covid-19 Clinical Trials, Covid-19 Policy, Vaccine Adverse Events, Vaccine Manufacturers --- ### [Clinical Trial Tests New Antibody Cocktail in Patients with COVID-19](https://www.autoimmuneinstitute.org/covid_timeline/clinical-trial-tests-new-antibody-cocktail-in-patients-with-covid-19/) **Published:** February 10, 2021 **Author:** Elevation **Excerpt:** On February 8, the NIH released a news statement announcing the implementation of a Phase 3 clinical trial for a new combination of antibodies as a therapy treatment for COVID-19. “Antibodies are infection-fighting proteins naturally made by the immune system… [they] prevent viruses from infecting cells, usually by binding to the surface of the virus”. **Content:** February 10, 2021 On February 8, the NIH released a [news statement](https://www.nih.gov/news-events/news-releases/clinical-trial-hospitalized-covid-19-patients-evaluates-long-acting-antibody-therapy) announcing the implementation of a Phase 3 clinical trial for a new combination of antibodies as a therapy treatment for COVID-19. **“Antibodies are infection-fighting proteins naturally made by the immune system… \[they\] prevent viruses from infecting cells, usually by binding to the surface of the virus”** ([1](https://www.nih.gov/news-events/news-releases/clinical-trial-hospitalized-covid-19-patients-evaluates-long-acting-antibody-therapy)). AZD7442 antibodies are the third antibody combination to be studied in patients currently hospitalized for COVID-19, being tested under a “master protocol” which allows investigators to trial multiple antibody combinations at the same time. **This means less patients are receiving the placebo while providing a more robust pool of results on the efficacy of antibodies as a therapeutic measure.** AZD7442 antibodies work for a longer period of time once administered in patients infected with COVID, and may also function as a preventative measure against SARS-CoV-2. **Category:** Covid-19 & Long Covid Treatments, Covid-19 Antibodies, Covid-19 Clinical Trials --- ### [Similarities Between COVID-19 and Autoimmune Disease](https://www.autoimmuneinstitute.org/covid_timeline/similarities-between-covid-19-and-autoimmune-disease/) **Published:** February 6, 2021 **Author:** Elevation **Excerpt:** Recent studies have demonstrated the distinct relationship between the infectious disease COVID-19 and autoimmune disease. The review titled “COVID-19 and Autoimmune Diseases” by Yu Liu, Amr Sawalha, and Qianjin Lu delves into the most recent research on the similarities, which include: dysregulated immune responses, the promise of immunomodulatory drugs to treat both conditions, the detection of certain autoantibodies, and the development of autoimmune diseases after SARS-CoV-2 infection. Investigating the relationship between these diseases is critical in preventing and treating COVID-19, as well as understanding the risks for individuals living with autoimmune disease. **Content:** February 6, 2021 Recent studies have demonstrated the distinct relationship between the infectious disease COVID-19 and autoimmune disease. The [review](https://journals.lww.com/co-rheumatology/Abstract/2021/03000/COVID_19_and_autoimmune_diseases.8.aspx) titled “COVID-19 and Autoimmune Diseases” by Yu Liu, Amr Sawalha, and Qianjin Lu delves into the most recent research on the similarities, which include: dysregulated immune responses, the promise of immunomodulatory drugs to treat both conditions, the detection of certain autoantibodies, and the development of autoimmune diseases after SARS-CoV-2 infection. Investigating the relationship between these diseases is critical in preventing and treating COVID-19, as well as understanding the risks for individuals living with autoimmune disease. In some individuals, SARS-CoV-2 infection triggers immune system dysregulation with the overproduction and release of pro-inflammatory cytokines and, in effect, damage to one or multiple organ systems. **Cytokines are proteins that signal the immune system to fight infection, but in excess, they indicate the breakdown of self-tolerance.** Similarly, autoimmune disease involves increased levels of pro-inflammatory cytokines, a loss of immune tolerance, and subsequent organ injury. As stated in the review, this parallel story between COVID-19 and autoimmune disease suggests that **medications effective in treating autoimmune disease can have a similar impact on COVID-19**. In fact, immunomodulatory drugs targeting excess cytokines (such as corticosteroids) are now being used to dampen the immune response in autoimmune disease as well as in severe COVID-19 in cases. While aiding in the treatment of the disease, the fact that SARS-CoV-2 triggers immune dysregulation may also “have important implications in the development of vaccine strategies against this virus,” state the authors of the review ([1](https://journals.lww.com/co-rheumatology/Abstract/2021/03000/COVID_19_and_autoimmune_diseases.8.aspx)). Another likeness between autoimmune diseases and COVID-19 is the release of autoantibodies, which are proteins that can target and attack the body’s own immune system and organs ([2](https://www.nature.com/articles/d41586-021-00149-1)). Antinuclear antibodies (ANA) and antiphospholipid antibodies (APL) are examples of autoantibodies found in both autoimmune disease and COVID-19 patients. The results of one study “showed that 45% of the \[COVID-19\] patients were positive for at least one autoantibody and patients with positive autoantibodies tended to have a worse prognosis” ([1](https://journals.lww.com/co-rheumatology/Abstract/2021/03000/COVID_19_and_autoimmune_diseases.8.aspx)). We are also beginning to learn that a loss of immune tolerance from COVID-19 can lead to full-blown autoimmune diseases such as [Guillain-Barre syndrome (GBS)](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/guillain-barre-syndrome/) and [systemic lupus erythematosus (SLE)](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/systemic-lupus-erythematosus/) ([1](https://journals.lww.com/co-rheumatology/Abstract/2021/03000/COVID_19_and_autoimmune_diseases.8.aspx)). While more of these post-infection autoimmunity cases are likely to be discovered, **researchers are still unsure whether individuals with preexisting autoimmune diseases are at higher risk of SARS-CoV-2 infection in the first place**. Studies around the world have returned with conflicting results, and thus no clear consensus on the issue. As the scale is poised to tip in either direction, the authors of the review urge autoimmune disease patients to continue physical distancing, washing their hands, wearing masks, and sticking to their medical protocols – including any prescribed immunosuppressive drugs – to prevent flare-ups and avoid potential organ damage. While there are still unknowns about COVID-19 and its connection to autoimmune diseases, the evolving clues about their relationship bring us hope in understanding and characterizing COVID-19. **Category:** Autoimmune Diseases & Covid-19, Covid-19 Antibodies, Covid-19 Infections, Covid-19 Research Studies, GBS & Covid-19, Lupus & Covid-19 --- ### [Key Points From Dr. Fauci's Coronavirus Update](https://www.autoimmuneinstitute.org/covid_timeline/key-points-from-dr-faucis-coronavirus-update/) **Published:** February 4, 2021 **Author:** Elevation **Excerpt:** In a live video update on February 3, 2021, Dr. Anthony Fauci, Director of NIAID, spoke with Dr. Howard Bauchner, editor and chief from the JAMA Network, about the status of the coronavirus pandemic in the U.S. Dr. Fauci started off by explaining that our current challenge with regard to vaccines is the issue of variants. While the overall efficacy of the vaccine is diminished with variants, it can still reduce severe cases of COVID-19. This is good news; however, we do still have to pay attention when it comes to the spread of variants. **Content:** February 4, 2021 In a [live video update](https://www.youtube.com/watch?v=HStAQYRreIc) on February 3, 2021, Dr. Anthony Fauci, Director of NIAID, spoke with Dr. Howard Bauchner, editor and chief from the JAMA Network, about the status of the coronavirus pandemic in the U.S. Dr. Fauci started off by explaining that our current challenge with regard to vaccines is the issue of variants. **While the overall efficacy of the vaccine is diminished with variants, it can still reduce severe cases of COVID-19.** This is good news; however, we do still have to pay attention when it comes to the spread of variants. When variants have the ability to spread more easily, they become dominant. You can dampen that potential negative effect by vaccinating as much of the population as possible. If you can prevent them from replicating then you’ll diminish the potential of them mutating. Dr. Bauchner asked if the coronavirus will, at some point, turn into a flu situation with yearly vaccinations. Dr. Fauci responded that it is “too early to say but it’s conceivable that some version of that would occur.” It is important to get the level so low that the virus doesn’t have the ability to replicate. The one barrier is that we need to look at this globally and figure out how to get vaccines to the developing world. **“If you can crush this virus throughout the world, you really won’t give it any chance to evolve season by season with different mutations,”** he stated. Fauci has run through the calculations of how many vaccines are on order from the various companies, and at this point, we have sufficient quantities and access. There’s not really a need to “go beyond the contractual arrangement we’ve already made” in the U.S. and look at the vaccine options being developed in other places like Russia. There are a number of treatments being used for severe COVID-19 cases, such as corticosteroids, vitamin D, convalescent plasma, and interferon. Dethamexazone has also been very successful. But what about preventing disease? Dr. Fauci stated that we don’t currently have “knockout punches.” We have things like monoclonal antibodies, but you have to administer them very early and as well as be in the hospital to get it. And convalescent plasma doesn’t work as well when people’s bodies start making too many of their own antibodies. **“We need a concerted effort for the development… of effective direct antiviral agents…” similar to what we’ve done with HIV.** This could mean something like a Z-pack for COVID that you can take right away, the minute you start to experience symptoms. **“The science is very clear that in the trials we did with Moderna and Pfizer.. the data is showing 94-95% efficacy,”** said Dr. Fauci. It is important to note there is some “wiggle room” for the period of time between taking the two doses of the vaccine, but you cannot wait for months in between. There have been many questions about vaccine safety in “protected groups” like pregnant women, children, and adolescents. In most vaccine trials – including Pfizer’s and Moderna’s – pregnant women are initially excluded. But **due to the recent issue of the Emergency Use Authorization (EUA), there have now been over 10,000 pregnant women involved in the vaccine trials.** The FDA… has found, thus far,…no red flags…about pregnant women.” Many of them were healthcare providers who would rather take their chances with a vaccine than getting infected with the coronavirus while pregnant. For children, they’re currently doing age de-escalation studies. Over the next few months, they’ll collect data from these studies to understand the vaccine’s efficacy and safety for children. Regarding the various types of vaccines (mRNA, adenovirus vector-based, or protein subunit), Dr. Fauci stated: “I feel that it is extremely likely that each of these platforms that are used will be faced with variants that don’t get completely suppressed with the vaccine-induced antibodies… and the reason for that is common sense… because **when you make a vaccine, most of them are directed at that spike protein…Sooner or later, the virus, which is replicating and mutating out there, is gonna evade that**… You still have a fixed immunogen and a virus that’s changing.” **Dr. Fauci hopes that by the summer, we have enough people vaccinated in the country to open up baseball stadiums and other similar venues for (masked up and socially distanced) use.** **Category:** Covid-19 Policy, Covid-19 Variants, Moderna, Pfizer, Vaccine Manufacturers --- ### [The Development of Autoantibodies after Contracting COVID-19](https://www.autoimmuneinstitute.org/covid_timeline/the-development-of-autoantibodies-after-contracting-covid-19/) **Published:** February 3, 2021 **Author:** Elevation **Excerpt:** While COVID-19 short-term impacts have been identified, the long-term effects of the disease are still widely unknown. Many new studies have shed some light on the potential long-term consequences of COVID-19, focusing on autoimmunity. A recent study from The University of Stanford School of Medicine directly links COVID-19 to autoimmunity and autoantibody development. This suggests that severe cases of COVID-19 can lead to a progression of “symptomatic classifiable autoimmunity in the future” (1). The linking of coronavirus to an increase in autoimmunity indicates significant concerns, especially for those with autoimmune diseases, whose immune systems are already impacted. **Content:** February 3, 2021 While COVID-19 short-term impacts have been identified, the long-term effects of the disease are still widely unknown. Many new studies have shed some light on the potential long-term consequences of COVID-19, focusing on autoimmunity. A recent [study from The University of Stanford School of Medicine](https://www.medrxiv.org/content/10.1101/2021.01.27.21250559v1.full.pdf) directly links COVID-19 to autoimmunity and autoantibody development. This suggests that **severe cases of COVID-19 can lead to a progression of “symptomatic classifiable autoimmunity in the future”** ([1](https://www.medrxiv.org/content/10.1101/2021.01.27.21250559v1.full.pdf)). The linking of coronavirus to an increase in autoimmunity indicates significant concerns, especially for those with autoimmune diseases, whose immune systems are already impacted. Many autoantibodies were found in this study’s COVID-19 patients, but the most common was **Immunoglobin G (IgG) autoantibodies**. IgG antibodies make up most of our blood’s antibodies, protecting us from infection, meaning that IgG autoantibodies pose potential threats as they could be pathogenic. The study used protein chips to track protein interactions that measure distinct IgG autoantibodies associated with connective tissue disease (CTD), anti-cytokine antibodies (ACA), and anti-viral antibody response. This study’s findings signify that over 58% of the COVID-19 patients had at least one ACA that targeted interferons (IFN), which are proteins that inhibit virus replication. This emphasizes that the autoantibodies produced by infection from COVID-19 attack the vital proteins needed to protect the immune system. This study also measured autoantibodies levels throughout the patient’s sickness period, distinctly showing that the levels of autoantibodies increased in many patients over time. **Category:** Covid-19 Antibodies, Covid-19 Infections, Covid-19 Research Studies --- ### [The mRNA Vaccine](https://www.autoimmuneinstitute.org/covid_timeline/the-mrna-vaccine/) **Published:** January 19, 2021 **Author:** Elevation **Excerpt:** These are truly novel times that we are experiencing, and the scientific community is no different. Interest in messenger RNA (mRNA) continues to grow within the medical community, especially since the developments of breakthrough COVID-19 vaccines. It is important to note that even after 30 years of research, mRNA vaccines have never before been approved for use in any disease, until now. However, researchers in Germany recently used mRNA technology to reduce disease activity in mice with Experimental Autoimmune Encephalomyelitis (EAE), a disease similar to multiple sclerosis. **Content:** January 19, 2021 These are truly novel times that we are experiencing, and the scientific community is no different. Interest in messenger RNA (mRNA) continues to grow within the medical community, especially since the developments of breakthrough COVID-19 vaccines. It is important to note that even **after 30 years of research, mRNA vaccines have never before been approved for use in any disease, until now** ([1](https://www.health.harvard.edu/blog/why-are-mrna-vaccines-so-exciting-2020121021599)). However, researchers in Germany recently used mRNA technology to reduce disease activity in mice with Experimental Autoimmune Encephalomyelitis (EAE), a disease similar to [multiple sclerosis](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/multiple-sclerosis/) ([2](https://science.sciencemag.org/content/371/6525/145)). mRNA vaccines involve using a small strand of distinct genetic material that carries the instructions for building a specific part of a cell. In the case of COVID-19, the mRNA vaccine contains instructions for building the virus’s “spike” protein. When a person receives the mRNA vaccine for the virus that causes COVID-19, their own cells are able to build the spike protein. This ramps up an immune system response against the virus. This response is especially important when it comes to battling the virus that causes COVID-19 because the SARS-CoV-2 virus in particular has the ability to dampen the immune system response while it is still replicating. This can lead to infected individuals spreading the virus to others while still asymptomatic. **This technique has never been seen before**. Virologist Benjamin TenOever of the Icahn School of Medicine at Mount Sinai stated that “it’s something I have never seen in my 20 years of studying viruses” when discussing the virus’ ability to commandeer cells’ genomes ([3](https://www.statnews.com/2020/05/21/coronavirus-hijacks-cells-in-unique-ways/)). Although it may be quite a while before human clinical trials become a possibility, this research is significant. It **shows the potential of mRNA vaccines to treat disease-specific autoimmunity without relying on therapies that suppress immune system function as a whole**. Wondering how mRNA vaccines are processed? Check out [this video](https://www.chop.edu/video/how-mrna-vaccines-work)! **Category:** Autoimmune Diseases & Covid-19, Covid-19 Infections --- ### [Increase in Coronavirus Variants and Their Effects on the Vaccine](https://www.autoimmuneinstitute.org/covid_timeline/increase-in-coronavirus-variants-and-their-effects-on-the-vaccine/) **Published:** January 7, 2021 **Author:** Elevation **Excerpt:** Recent developments concerning the COVID-19 virus are leading to an increase in questions and unknowns about it. While various vaccines are being distributed across the globe, recent findings on SARS-CoV-2 variants are worrying many. Some of these variants are known to spread faster and transmit more efficiently than other variants of the virus. Three of the most widespread variants are the UK variant (D614G), the Y453F mutation found in minks, and the N501Y cluster spreading in England. **Content:** January 7, 2021 Recent developments concerning the COVID-19 virus are leading to an increase in questions and unknowns about it. While various vaccines are being distributed across the globe, recent findings on SARS-CoV-2 variants are worrying many. Some of these variants are known to spread faster and transmit more efficiently than other variants of the virus. **Three of the most widespread variants are the UK variant (D614G), the Y453F mutation found in minks, and the N501Y cluster spreading in England.** The research article [“Genetic Variants of SARS-CoV-2—What Do They Mean?”](https://jamanetwork.com/journals/jama/fullarticle/2775006) explains that while the specific manifestation of these variants differs, the Y453F brings into question other evolutionary challenges, such as an abundance of a new COVID-19 from other mammals to humans. What makes these coronavirus variants even more worrisome is that they are advanced concerning “viral replication, transmission, and escape immunity,” making them even more difficult to contend with than the original COVID-19 virus ([1](https://jamanetwork.com/journals/jama/fullarticle/2775006)). One primary concern is the vaccine effectiveness of these variants. The variants are mostly mutations in the spike protein; therefore, scientists have to consider if the vaccines, which stimulate an immune response to the spike protein, are still effective. Thus far, the major consensus regarding vaccine effectiveness is that **since current vaccines target the entire spike protein, they are effective regardless of the few changes in the variant.** It is also important to note that while the mutations are considered efficient for the virus, they can make it inefficient in the future. To be certain, the evolution of SARS-CoV-2 must be carefully monitored over time. In addition, regulation of mask mandates and physical distancing guidelines is essential in stopping the spread of COVID-19 and all of its variants. **Category:** Covid-19 Infections, Covid-19 Variants --- ### [Uncovering Long COVID](https://www.autoimmuneinstitute.org/covid_timeline/uncovering-long-covid/) **Published:** December 22, 2020 **Author:** Elevation **Excerpt:** Signs or symptoms that continue or develop after a COVID-19 infection is known as long COVID. A recent study indicated that as many as 1 in 20 people will develop an illness that persists for weeks or months after they’ve had COVID-19. (1) Long COVID symptoms vary greatly from person to person, and in some cases, bear a close resemblance to autoimmune-related diseases like myalgic encephalomyelitis (ME/CFS). **Content:** December 22, 2020 Signs or symptoms that continue or develop after a COVID-19 infection is known as long COVID. A [recent study](https://www.kcl.ac.uk/news/study-identifies-those-most-risk-long-covid) indicated that as many as **1 in 20 people will develop an illness that persists for weeks or months after they’ve had COVID-19**. Long COVID symptoms vary greatly from person to person, and in some cases, bear a close resemblance to autoimmune-related diseases like myalgic encephalomyelitis ([ME/CFS)](https://www.autoimmuneinstitute.org/me-cfs/). Researchers across the world are working to answer key questions, like who is at risk for long COVID? What is the link between COVID-19 and autoimmune disease? What are the most useful treatments for long COVID? Check out our latest article, “[Understanding Long COVID](https://www.autoimmuneinstitute.org/articles/understanding-long-covid/)” for a breakdown of this condition and how the experts are working to address it. **Category:** Long COVID, ME/CFS & Covid-19 --- ## AD News & Research Updates ### [GLP-1 Drugs and the Immune System: New Research on Autoimmune Disease](https://www.autoimmuneinstitute.org/research_updates/glp-1-drugs-and-the-immune-system-new-research-on-autoimmune-disease/) **Published:** October 22, 2026 **Author:** Carolyn Serraino **Content:** As GLP-1 medications become increasingly common, researchers are looking beyond their effects on blood sugar and weight to better understand how they influence the immune system. While previous studies suggest these medications may reduce inflammation, their [effects on autoimmune disease remain uncertain](https://www.autoimmuneinstitute.org/articles/glp-1-receptor-agonists-and-autoimmune-diseases). On October 21, 2026, the [La Jolla Institute for Immunology (LJI)](https://www.autoimmuneinstitute.org/gai-and-la-jolla-institute-for-immunology/) announced a new study led by Professor Alessandro Sette, Dr.Biol.Sci., investigating whether GLP-1 medications alter adaptive immunity, the part of the immune system responsible for recognizing specific threats and developing immune memory. Researchers will collect blood samples before individuals begin GLP-1 treatment and throughout the following months, examining whether the medications change T-cell responses to targets associated with infections, vaccines, and [neurodegenerative diseases](https://www.autoimmuneinstitute.org/articles/autoimmune-aspects-of-neurodegenerative-diseases), including Alzheimer’s and Parkinson’s. These questions are particularly relevant to autoimmune research, where the immune system mistakenly targets the body’s own tissues. Understanding whether GLP-1 medications influence how T cells recognize specific targets could provide new insight into their broader effects on immune function. #### Meanwhile, research into GLP-1 medications and autoimmune disease continues to produce mixed findings. Some observational studies suggest benefits for people with inflammatory bowel disease, including fewer hospitalizations and complications, while other studies have identified differing associations with the development of certain autoimmune conditions. Importantly, reducing inflammation does not necessarily mean a medication directly treats the underlying autoimmune disease. LJI’s study is still in its early stages and is not intended to establish GLP-1 medications as treatments for immune-related conditions. However, its findings could help researchers distinguish direct effects on immune responses from improvements associated with weight loss and metabolic health. For a closer look at the existing evidence, potential risks, and considerations for people living with autoimmune disease, read GAI’s **[GLP-1 Receptor Agonists and Autoimmune Diseases](https://www.autoimmuneinstitute.org/articles/glp-1-receptor-agonists-and-autoimmune-diseases)** by Jennifer Tsang, PhD. ##### References 1. Hernandez, R. (2026, October 21). [Could GLP-1 drugs change how the immune system responds to disease?](https://www.lji.org/news-events/news/post/could-glp-1-drugs-change-how-the-immune-system-responds-to-disease/) *La Jolla Institute for Immunology*. 2. Swearingen, K. (2026, October 20). [Are GLP-1s safe for people with autoimmune disorders? What our experts say.](https://www.healthline.com/health/drugs/glp-1-autoimmune-disorders) *Healthline*. **Category:** Research Studies, Therapies --- ### [“I Miss Who I Was”: Applegate’s MS Battle Resonates With Many](https://www.autoimmuneinstitute.org/research_updates/i-miss-who-i-was-applegates-ms-battle-resonates-with-many/) **Published:** August 8, 2025 **Author:** Carolyn Serraino **Content:** Editor’s Update (October 20, 2026) Christina Applegate has revealed that her doctor now believes she was misdiagnosed with multiple sclerosis (MS). Although she continues to experience severe neurological symptoms and mobility difficulties, the underlying cause remains uncertain. The following article reflects information available at the time of its original publication in August 2025. [ Read our October 2026 update on Applegate’s reported misdiagnosis and the challenges of diagnosing MS. ](https://www.autoimmuneinstitute.org/research_updates/christina-applegate-ms-misdiagnosis/) *August 8, 2025* This week, Christina Applegate recorded her podcast *[MeSsy](https://podcasts.apple.com/us/podcast/live-from-the-hospital/id1734318382?i=1000778074465)* from a hospital bed. After experiencing what she described as unbearable pain during a family trip to Europe, the Emmy-winning actress returned home and was hospitalized in Los Angeles. A middle-of-the-night CT scan revealed a serious infection in both kidneys. She’s now on IV antibiotics and expects to remain in the hospital for at least a week. Applegate has spoken openly about living with [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/ "Multiple sclerosis"), a progressive autoimmune disease she was diagnosed with in 2021. Her journey since then has included over 30 hospitalizations for GI issues and profound emotional challenges. #### On the podcast, she described a moment when she cried in her nurse’s arms and said she missed who she used to be. Her daughter, Sadie, diagnosed with POTS ([postural orthostatic tachycardia syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/postural-orthostatic-tachycardia-syndrome/ "Postural orthostatic tachycardia syndrome")) last year, recently told her, “I miss who you were before MS.” Applegate said hearing that “felt like a knife to the heart.” #### It’s a deeply personal glimpse into how chronic illness affects not just the body, but identity, relationships, and daily life. Let this be a reminder: we don’t need to wait for a celebrity to speak out to validate someone’s suffering. Chronic illness is real. It’s hard. And the people living with it every day, whether or not they’re in the spotlight, deserve compassion, support, and to be believed. **Category:** Autoimmune Stories, Multiple Sclerosis --- ### [Applegate's MS Misdiagnosis Highlights Challenges of Diagnosing Multiple Sclerosis](https://www.autoimmuneinstitute.org/research_updates/christina-applegate-ms-misdiagnosis/) **Published:** October 21, 2026 **Author:** Carolyn Serraino **Excerpt:** After five years of living with an MS diagnosis, Christina Applegate is searching for answers again. Her experience highlights why multiple sclerosis can be difficult to diagnose and the emotional impact of diagnostic uncertainty. **Content:** *October 21, 2026* After five years of publicly sharing her experiences with [multiple sclerosis (MS)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/), actress Christina Applegate has revealed that her doctor now believes she was misdiagnosed. Although her diagnosis has been called into question, she continues to experience debilitating neurological symptoms and significant mobility difficulties, leaving her searching for answers. ##### “I’m back at square one where I don’t know what’s going on with me,” Applegate said during a recent episode of her [*MeSsy* podcast](https://www.youtube.com/watch?v=UvDm3V8pVSQ). Applegate first announced her MS diagnosis in 2021 and has since become a prominent advocate within the MS community. The news has been particularly difficult as she considers what it means for those who have connected with her experiences. “It’s weird because I feel like I let everybody down,” she said. Her experience highlights the complexities of diagnosing MS and the emotional impact of having an established diagnosis reconsidered. Navigating the Autoimmune Diagnosis Process Why do autoimmune diseases go undiagnosed or misdiagnosed? Read expert insights on diagnostic challenges, second opinions, and advocating for better care. [ Read the Expert Insights → ](https://www.autoimmuneinstitute.org/articles/misdiagnosed-undiagnosed-expert-insights-on-the-autoimmune-diagnosis-process/) ### Why Multiple Sclerosis Can Be Difficult to Diagnose [Multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/) is a chronic immune-mediated disease affecting the central nervous system. Symptoms vary widely and may include fatigue, muscle weakness, numbness, vision changes, and difficulty walking. There is no single definitive test for MS. Diagnosis involves evaluating neurological symptoms, medical history, MRI findings, and sometimes cerebrospinal fluid analysis. Clinicians use established guidelines called the McDonald criteria while ruling out other possible explanations. This can be challenging because conditions such as migraines, vitamin B12 deficiency, vascular disease, and other autoimmune or inflammatory disorders can cause similar symptoms or MRI abnormalities. Misdiagnosis can have significant consequences, including unnecessary exposure to medications that affect the immune system and delays in identifying the actual underlying condition. At the same time, timely diagnosis and treatment of MS are important for preventing further neurological damage. ### When a Diagnosis Changes An MS diagnosis may be reconsidered as imaging technology improves, diagnostic criteria evolve, or new clinical findings emerge. This does not necessarily mean an earlier physician made a mistake, but rather reflects the importance of continually evaluating whether a diagnosis remains consistent with the available evidence. For people whose symptoms or test results raise questions, discussing concerns with a neurologist or seeking a specialist’s opinion can help determine whether further evaluation is appropriate. Applegate’s experience also illustrates something that extends beyond MS: receiving a chronic illness diagnosis can shape a person’s identity, relationships, and expectations for the future. Having that explanation suddenly called into question can be deeply unsettling, especially when the symptoms themselves persist. #### A change in diagnosis does not invalidate someone’s experience of illness. Regardless of what ultimately explains Applegate’s symptoms, her story reinforces the importance of continued medical investigation, compassionate care, and support for those living with diagnostic uncertainty. **Related GAI Coverage:** In August 2025, the Global Autoimmune Institute highlighted Applegate’s experiences with hospitalization, chronic pain, and the emotional impact of illness in [“I Miss Who I Was”: Applegate’s MS Battle Resonates With Many](https://www.autoimmuneinstitute.org/research_updates/i-miss-who-i-was-applegates-ms-battle-resonates-with-many/). ##### References [Associated Press, via PBS NewsHour, October 20, 2026.](https://www.pbs.org/newshour/health/christina-applegate-says-she-was-misdiagnosed-and-does-not-have-ms) [Medical University of South Carolina, October 21, 2026](https://www.musc.edu/content-hub/News/2026/10/21/as-christina-applegates-situation-shows-multiple-sclerosis-can-be-difficult-to-diagnose). **Category:** Autoimmune Stories, Diagnostic Testing, Multiple Sclerosis --- ### [The Autoantibodyome: New Insights Into Neurodegeneration](https://www.autoimmuneinstitute.org/research_updates/autoantibodyome-neurodegeneration/) **Published:** February 27, 2026 **Author:** Carolyn Serraino **Content:** A [study published in *iScience*](https://pubmed.ncbi.nlm.nih.gov/41704760/) identified shared patterns of [autoantibody](https://www.autoimmuneinstitute.org/articles/decoding-the-role-of-autoantibodies-in-autoimmunity) activity across [multiple sclerosis (MS)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/), Alzheimer’s disease, and Parkinson’s disease, providing new insight into the relationship between immune dysfunction and neurodegeneration. Researchers from the University of São Paulo and collaborating institutions analyzed five existing datasets comprising 596 samples from individuals with these neurological conditions and healthy controls. Using an integrative approach, they examined the ***autoantibodyome***, the collection of antibodies that recognize the body’s own proteins, to identify similarities and differences in immune activity across the three diseases. ### Shared Autoantibody Patterns Reveal Connections Between Immune and Neurological Dysfunction The researchers identified 17 autoantibodies with consistently increased reactivity and 25 with decreased reactivity across all three diseases. These shared signatures were associated with immune cell activation, inflammatory signaling, and biological processes involved in maintaining the blood-brain barrier, which helps regulate the movement of substances between the bloodstream and the brain. The analysis also revealed disease-specific patterns associated with neurological functions, including short-term memory in Alzheimer’s disease, muscle contraction in Parkinson’s disease, and pain perception in MS. #### Differences in autoantibody activity across disease stages suggest that these immune signatures may change as neurological conditions progress. Another significant finding involved autoantibodies targeting proteins associated with neurotransmitter pathways, including GABA, glutamate, serotonin, and dopamine. These chemical messengers are essential for communication between nerve cells. The findings suggest that circulating autoantibodies may reflect disruptions in neurological signaling and could potentially interact with proteins involved in these processes. Previous research has shown that autoantibodies are also present in healthy individuals and do not necessarily cause disease. A [2022 study published in *Cell Reports*](https://pubmed.ncbi.nlm.nih.gov/35649350/) identified 77 commonly occurring autoantibodies in healthy individuals, highlighting the importance of distinguishing normal immune activity from disease-associated patterns. This distinction is particularly relevant as researchers investigate whether specific autoantibody signatures could help identify neurological conditions or provide insight into their underlying mechanisms. ### Implications for Autoimmune Disease Research While MS is an established immune-mediated disease, Alzheimer’s and Parkinson’s diseases are not generally classified as autoimmune. However, growing evidence suggests that immune dysfunction contributes to their development and progression. By identifying overlapping autoantibody signatures across these conditions, the study strengthens the rationale for investigating shared[ neuroimmune](https://www.autoimmuneinstitute.org/gai-library/#neuroimmune) mechanisms. The findings also highlight the potential of circulating autoantibodies as blood-based biomarkers for understanding neurological disease activity, distinguishing disease stages, and identifying pathways for further research. Importantly, the study did not establish whether the identified autoantibodies directly cause neurological damage or serve as indicators of underlying disease processes. Further experimental and clinical research is needed to determine their functional effects and potential diagnostic or therapeutic applications. ##### Citations Nakanishi Usuda, J., Nóbile, A. L., Nery do Vale, F. Y., Corrêa, Y. L. G., Adri, A. S., Nava, R. G., de Albuquerque Freitas, D. G., Santos, R. S., Schimke, L. F., Fonseca, D. L. M., Cabral-Miranda, G., Khan, T. A., Câmara, N. O., Moll, G., Marques, A. H. C., Dalmolin, R. J. S., Nakaya, H. I., Riemekasten, G., Filgueiras, I. S., Dias, H. D., … Cabral-Marques, O. (2026). **Integrative analysis reveals the autoantibodyome neuroimmune signature of neurodegeneration**. *iScience*, *29*(2), 114781. <https://doi.org/10.1016/j.isci.2026.114781> Shome, M., Chung, Y., Chavan, R., Park, J. G., Qiu, J., & LaBaer, J. (2022). **Serum autoantibodyome reveals that healthy individuals share common autoantibodies**. *Cell reports*, *39*(9), 110873. <https://doi.org/10.1016/j.celrep.2022.110873> **Category:** Multiple Sclerosis, Neurological Disorders, Research Studies --- ### [LEAD Day 2026 Highlights Multi-Omics In Autoimmune Research](https://www.autoimmuneinstitute.org/research_updates/lead-day-2026-highlights/) **Published:** September 18, 2026 **Author:** Carolyn Serraino **Excerpt:** On September 15, 2026, the Global Autoimmune Institute and La Jolla Institute for Immunology held the second annual Lectures, Empowerment, and Awareness for Autoimmune Disease (LEAD) Day at the Scripps Seaside Forum in La Jolla, California. The event brought together scientists, clinicians, advocates, and members of the broader community to discuss emerging approaches to understanding autoimmune disease and other complex chronic conditions. **Content:** ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/09/Dr-Eric-Topol-giving-Walter-and-Jean-Boek-Leadership-in-Research-Award-Lecture-at-LEAD-Day-2026-1024x683.jpg) On September 15, 2026, the Global Autoimmune Institute and [La Jolla Institute for Immunology](https://www.autoimmuneinstitute.org/gai-and-la-jolla-institute-for-immunology/) held the second annual **[Lectures, Empowerment, and Awareness for Autoimmune Disease (LEAD) Day](https://www.autoimmuneinstitute.org/lead-day/)** at the Scripps Seaside Forum in La Jolla, California. The event brought together scientists, clinicians, advocates, and members of the broader community to discuss emerging approaches to understanding autoimmune disease and other complex chronic conditions. ### AI and Multi-Omics: Building a New Era of Autoimmune and Chronic Disease Research A scientific panel titled **“AI and Multi-Omics: Building a New Era of Autoimmune and Chronic Disease Research”** explored how artificial intelligence, genomics, proteomics, and other data-rich approaches are changing the way researchers study the immune system. Moderated by LJI Chief Scientific Officer **Shane Crotty, Ph.D.**, the discussion featured **Eric Topol, M.D.; Ferhat Ay, Ph.D.; and Sam Myers, Ph.D.** The panel focused in part on the challenge of connecting different layers of biological information, from genetic variation and gene expression to proteins, cell signaling, tissue behavior, and disease. Panelists discussed how AI may help researchers identify relationships within increasingly large and complex datasets, while also emphasizing that these tools still depend on high-quality data and experimental validation. ![LEAD Day 2026 Scientific Panel "AI and Multi-Omics: Building a New Era of Autoimmune and Chronic Disease Research" featuring (from left to right) Shane Crotty, Ph.D., Sam Myers, Ph.D., Ferhat Ay, Ph.D., and Eric Topol, M.D.](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/09/LEAD-Day-2026-Scientific-Panel-edited.jpeg)*LEAD Day 2026 Scientific Panel “AI and Multi-Omics: Building a New Era of Autoimmune and Chronic Disease Research” featuring (from left to right) Shane Crotty, Ph.D., Sam Myers, Ph.D., Ferhat Ay, Ph.D., and Eric Topol, M.D.* Another major theme was the need for better ways to assess immune health over time. The panel discussed how longitudinal monitoring and emerging molecular tools could eventually help detect changes associated with autoimmune disease earlier, including in some cases before clinical diagnosis. Speakers also emphasized that blood alone cannot capture everything happening within tissues and immune organs. ### New Autoimmune Disease Resource Guide LEAD Day also marked the release of **“Navigating Autoimmune Disease: A Guide to Research, Care, and Extending Healthspan,”** a new patient and family resource presented by LJI and GAI. [ ![Navigating Autoimmune Disease: A Guide to Research, Care, and Extending Healthspan](https://drive.google.com/thumbnail?id=1CREXAlHxFq314iTbXDyVtqGDUYJd7RZ4&sz=w1200) ](https://drive.google.com/file/d/1CREXAlHxFq314iTbXDyVtqGDUYJd7RZ4/view) [ View the Autoimmune Disease Resource Guide ](https://drive.google.com/file/d/1CREXAlHxFq314iTbXDyVtqGDUYJd7RZ4/view) The guide brings together accessible information on the causes and classification of autoimmune disease, differences between autoimmune and immune-mediated conditions, genetics and environmental factors, sex-based differences in immune function, early detection and prevention, post-viral illness, vaccines, and the growing role of AI and multi-omics in autoimmune research. It also highlights work from LJI scientists, including research supported through the GAI-LJI partnership. The guide also features **Global Autoimmune Institute Assistant Professor [Sam Myers, Ph.D.](https://www.autoimmuneinstitute.org/research_updates/myers-gai-autoimmune-research/)**, whose laboratory uses proteomics, mass spectrometry, multi-omics, and computational analysis to study the molecular pathways that drive harmful immune responses and identify opportunities for more precise approaches to autoimmune disease. ![Dr. Eric Topol presenting the Walter and Jean Boek Leadership in Research Award Lecture at LEAD Day 2026.](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/09/LJI-IMG_2266-PhotobyMelissaJacobs-1024x676.jpg)*Dr. Eric Topol presenting the Walter and Jean Boek Leadership in Research Award Lecture at LEAD Day 2026.* Following the panel, Dr. Topol delivered the Walter and Jean Boek Leadership in Research Award Lecture, “Super Agers and the Immune System,” exploring why some individuals remain remarkably healthy into old age while others develop chronic diseases much earlier. Drawing on research into immune aging, chronic inflammation, and biological aging clocks, he discussed how advances in artificial intelligence and immune profiling could help identify disease risks earlier and open new possibilities for prevention. His lecture also examined emerging connections between immune function, Alzheimer’s disease, and healthy longevity. A detailed written summary of Dr. Topol’s keynote, including highlights of the scientific research he discussed, is now available:  “[**Eric Topol on Immune Aging and the Future of Disease Prevention**](https://www.autoimmuneinstitute.org/research_updates/lead-day-2026-topol-award-lecture/).” ![Sandy Boek Werness, Executive Director of the Global Autoimmune Institute, presenting the 2026 Walter and Jean Boek Leadership in Research Award to Dr. Eric Topol at LEAD Day 2026.](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/09/Sandy-Presenting-Award-to-Eric-1024x679.jpg)*Sandy Boek Werness, Executive Director of the Global Autoimmune Institute, presenting the 2026 Walter and Jean Boek Leadership in Research Award to Dr. Eric Topol at LEAD Day 2026.* The event culminated with Dr. Topol receiving the **Walter and Jean Boek Leadership in Research Award**. Established through a partnership between the Global Autoimmune Institute and La Jolla Institute for Immunology, the award honors global leaders who have significantly advanced the understanding of autoimmune diseases and helped reshape the trajectory of the field. Guests then gathered for a beautiful sunset reception overlooking the Pacific Ocean, enjoying an entirely gluten-free menu of refreshments and live music. ![The 2026 Walter and Jean Boek Leadership in Research Award was presented to Dr. Eric Topol.](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/09/LJI-IMG_8192-PhotobyMelissaJacobs-1024x683.jpg)*The 2026 Walter and Jean Boek Leadership in Research Award was presented to Dr. Eric Topol.* #### Thank you to all attendees for being part of LEAD Day 2026. We look forward to continuing the conversation and welcoming you back for LEAD Day 2027! **More Event Photographs** ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/09/Copy-of-Shane-Eric-Sandy-Bruce-Erica-5-900x600.jpg) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/09/Copy-of-LJI-IMG_8170-PhotobyMelissaJacobs-900x600.jpg) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/09/Copy-of-Liz-Sandy-Lydia-3-900x600.jpg) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/09/Copy-of-Sam-Liz-Bob-Sandy-Bruce-Lydia-Carolyn-4-900x600.jpg) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/09/Copy-of-Elizabeth-Sandy-Lydia-Liz-3-900x600.jpg) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/09/Copy-of-Sandy-and-Bruce-3-900x600.jpg) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/09/Dr-Eric-Topol-giving-Walter-and-Jean-Boek-Leadership-in-Research-Award-Lecture-at-LEAD-Day-2026-900x600.jpg) 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![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/09/Copy-of-LJI-IMG_8479-PhotobyMelissaJacobs-900x600.jpg) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/09/Copy-of-LJI-IMG_8494-PhotobyMelissaJacobs-900x600.jpg) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/09/Copy-of-LJI-IMG_8504-PhotobyMelissaJacobs-900x600.jpg) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/09/Copy-of-LJI-IMG_8562-PhotobyMelissaJacobs-900x600.jpg) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/09/Copy-of-LJI-IMG_8516-PhotobyMelissaJacobs-824x600.jpg) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/09/Copy-of-LJI-IMG_8533-PhotobyMelissaJacobs-772x600.jpg) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/09/Copy-of-LJI-IMG_8536-PhotobyMelissaJacobs-900x600.jpg) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/09/Copy-of-LJI-IMG_8548-PhotobyMelissaJacobs-900x600.jpg) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/09/Copy-of-LJI-IMG_8556-PhotobyMelissaJacobs-900x600.jpg) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/09/Copy-of-LJI-IMG_8569-PhotobyMelissaJacobs-900x575.jpg) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/09/Copy-of-Guests-900x600.jpg) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/09/Copy-of-LJI-IMG_8523-PhotobyMelissaJacobs-900x600.jpg) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/09/Copy-of-LJI-Advancement-Team-900x600.jpg) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/09/Copy-of-Guests-and-Sunset-900x600.jpg) **Category:** Events, GAI-Funded --- ### [Eric Topol on Immune Aging and the Future of Disease Prevention](https://www.autoimmuneinstitute.org/research_updates/lead-day-2026-topol-award-lecture/) **Published:** September 15, 2026 **Author:** Carolyn Serraino **Excerpt:** At LEAD Day 2026, physician-scientist Eric Topol examined why some people remain healthy well into old age and how advances in immunology, biological aging clocks, and artificial intelligence could help identify disease risks earlier. His keynote highlighted emerging research connecting immune aging, chronic inflammation, and neurodegenerative disease. **Content:** On September 15, 2026, physician-scientist [Eric Topol, MD](https://www.autoimmuneinstitute.org/research_updates/lead-day-2026-announces-eric-topol-as-award-recipient/), delivered the keynote lecture, “Super Agers and the Immune System,” at **[LEAD Day](https://www.autoimmuneinstitute.org/lead-day/) 2026**, held at the Scripps Seaside Forum in La Jolla, California. Hosted by [La Jolla Institute for Immunology](https://www.autoimmuneinstitute.org/gai-and-la-jolla-institute-for-immunology/) (LJI) in partnership with the Global Autoimmune Institute (GAI), the event brought together researchers and supporters to discuss advances in immunology and autoimmune disease research. ![Eric Topol delivering the Super Agers and the Immune System keynote at LEAD Day 2026 in La Jolla, California.](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/09/LJI-IMG_2266-PhotobyMelissaJacobs-1024x676.jpg) Topol explored why some people remain remarkably healthy into their nineties and beyond, while others develop multiple chronic conditions decades earlier. Drawing on research into exceptionally healthy older adults, he examined how immune aging, chronic inflammation, and emerging technologies may reshape the prevention of cardiovascular disease, cancer, and neurodegenerative conditions. ## **The Immune System’s Role in Healthy Aging** Topol began by distinguishing between *lifespan*, the total number of years a person lives, and *healthspan*, the years lived without significant chronic disease. In the United States, the average healthspan is approximately 64 years, compared with a lifespan of about 79 years, leaving an estimated 15-year period during which many people experience age-related illness. He contrasted two groups of older adults: the “*wellderly*,” individuals who maintain exceptional health well into old age, and the “*illderly*,” those who develop one or more chronic diseases as they age. While most older adults experience multiple chronic conditions, some people remain remarkably healthy into their nineties and beyond. A study led by Topol and colleagues examined the genetics of healthy aging in a cohort of more than 1,300 adults aged 80 and older, including whole-genome sequencing of 600 participants. [Published in Cell in 2016](https://pubmed.ncbi.nlm.nih.gov/27114037/), the research found that healthy aging was associated with reduced genetic susceptibility to Alzheimer’s disease and coronary artery disease, suggesting that remaining healthy into old age may involve genetic factors distinct from those associated with exceptional longevity. #### This raises an important question: Why do some people maintain their health for decades longer than others? One potential explanation involves the immune system. As people age, immune function undergoes changes collectively known as immunosenescence, including declining T-cell diversity and reduced responses to new threats. Aging is also associated with inflammaging, a state of persistent, low-grade inflammation that may contribute to cardiovascular disease, cancer, and neurodegeneration. Research on centenarians and supercentenarians has identified unusual immune characteristics, including preserved immune-cell function and better regulation of inflammation. [Studies](https://www.cell.com/cell-reports/fulltext/S2211-1247(26)00806-5) of people who have lived beyond 110 have found distinctive populations of cytotoxic CD4 T cells, suggesting that some exceptionally long-lived individuals maintain immune capabilities that differ from those of the general aging population. Together, these findings support growing interest in whether maintaining immune resilience could help extend healthspan. ## **The Thymus and New Ways to Measure Biological Aging** One emerging area of research involves the thymus, an organ responsible for T-cell maturation that typically shrinks with age. Recent studies have used artificial intelligence to evaluate thymic health from routine chest CT scans. [Research published in *Nature* in 2026](https://pubmed.ncbi.nlm.nih.gov/41851466/) found that higher AI-derived thymic health scores were associated with approximately 50% lower all-cause mortality, 63% lower cardiovascular mortality, and 36% lower lung cancer incidence in reported comparisons. These findings are observational and do not establish that improving thymic health would produce equivalent reductions in disease risk. Nevertheless, they suggest that the thymus may remain important to immune function and long-term health well into adulthood. #### Topol also discussed advances in biological aging clocks, which estimate how different organs and cell types are aging based on molecular measurements. Unlike chronological age, these tools may reveal that the brain, immune system, heart, and other organs age at different rates within the same individual. [Research](https://www.nature.com/articles/s41591-025-03798-1) involving over 44,000 UK Biobank participants has identified associations between organ-specific aging patterns and long-term health outcomes. More [recent work](https://www.nature.com/articles/s41591-026-04446-y) has extended this approach to individual cell types, including immune cells and brain-associated cells. Topol emphasized that aging patterns involving the brain and immune system appear particularly informative about survival and disease risk. ## **AI, the Immunome, and Predicting Disease Before It Develops** Another major theme was the potential to combine detailed immune profiling with artificial intelligence to better understand individual disease risk. The immunome encompasses the complex network of immune cells, proteins, receptors, and molecular signals that collectively determine immune function. Efforts such as the [Human Immunome Project](https://www.humanimmunomeproject.org/) aim to characterize these components over time, including how the immune system responds to challenges such as vaccination. #### Combining immunome data with genomics, proteomics, medical records, imaging, and lifestyle information could eventually provide a more complete picture of an individual’s health. Topol highlighted Delphi-2M, an AI model described in [*Nature* in 2025](https://www.nature.com/articles/s41586-025-09529-3) that was developed using health information from approximately 400,000 UK Biobank participants and evaluated using data from 1.9 million people in Denmark. The model estimates the probability and potential timing of more than 1,200 diseases. Although such predictions remain probabilistic and require further validation, Topol envisioned increasingly sophisticated systems that could identify disease risks years in advance and help researchers evaluate how interventions might change those trajectories. For autoimmune disease research, these approaches could eventually improve the identification of immune abnormalities that precede symptoms and support more individualized strategies for prevention and treatment. ## **Alzheimer’s Disease and the Connection Between Brain and Immune Aging** Topol devoted considerable attention to Alzheimer’s disease, emphasizing the growing evidence that immune dysfunction and neuroinflammation may contribute to neurodegeneration. Alzheimer’s-related biological changes may begin 15 to 20 years before cognitive symptoms emerge, creating a potentially important window for early detection and intervention. One promising biomarker is phosphorylated tau 217 (p-tau217), a protein measurable in blood that is associated with Alzheimer’s pathology. [Recent studies](https://pubmed.ncbi.nlm.nih.gov/41714746/) suggest that changes in p-tau217 may help estimate the likelihood and timing of future cognitive impairment, particularly when combined with genetic and other risk information. #### Topol also highlighted emerging research into the role of immune cells in the aging brain. Studies published in 2026 found that [bone marrow-derived immune cells](https://www.nature.com/articles/s41586-026-10939-0) can enter the brain and contribute to its population of microglia, while other research identified [age-related changes in the hippocampus](https://www.science.org/doi/10.1126/science.adt8307) associated with increased inflammatory activity. Additional findings suggest that changes in [gene regulation within microglia may promote inflammation and cellular senescence](https://pubmed.ncbi.nlm.nih.gov/42608571/), potentially contributing to neurodegeneration. #### Research into the relationship between immune function and brain health has also raised questions about whether vaccination might influence dementia risk. Population studies in [Wales](https://www.nature.com/articles/s41586-025-08800-x), [Australia](https://pmc.ncbi.nlm.nih.gov/articles/PMC12019675/), [Canada](https://pubmed.ncbi.nlm.nih.gov/41579903/), and the [United States](https://www.nature.com/articles/s41591-024-03201-5) have reported associations between shingles vaccination and lower rates of dementia diagnoses. Although these findings do not establish that vaccination prevents Alzheimer’s disease, they suggest a potential connection between immune responses and neurological health that warrants further investigation. Topol mentioned the [Wellderly Brain trial](https://wellderly.scripps.edu/), a randomized study designed to evaluate whether intensive lifestyle interventions can influence Alzheimer’s-related biomarkers in people at elevated risk. The study plans to enroll approximately 1,200 adults aged 60 and older and assess changes in measures including p-tau217 and biological aging clocks. Together, these advances suggest a future in which immune profiling, biological aging clocks, and AI-based prediction could help identify disease risks earlier and guide more personalized preventive strategies. Topol’s lecture underscored the importance of understanding immune aging not only for extending healthspan, but also for advancing research into autoimmune disease, cancer, and other conditions involving immune dysfunction. ##### References 1. Erikson, G. A., Bodian, D. L., Rueda, M., Molparia, B., Scott, E. R., Scott-Van Zeeland, A. A., Topol, S. E., Wineinger, N. E., Niederhuber, J. E., Topol, E. J., & Torkamani, A. (2016). **Whole-Genome Sequencing of a Healthy Aging Cohort**. *Cell*, *165*(4), 1002–1011. <https://doi.org/10.1016/j.cell.2016.03.022> 2. Hashimoto, K., Kojima-Ishiyama, M., Inokuchi, H., Tagami, M., Sasaki, T., Mizuguchi, K., Okazaki, Y., Taniuchi, I., Ishigaki, K., Hirose, N., Carninci, P., & Arai, Y. (2026). **CD4 CTLs in supercentenarians: Signs of adaptive expansion in healthy aging**. *Cell reports*, *45*(9), 117728. <https://doi.org/10.1016/j.celrep.2026.117728> 3. Bernatz, S., Prudente, V., Pai, S., Attermann, A. K., Cao, Y., Chen, J., Lyass, A., Foldyna, B., Nürnberg, L., Bressem, K., Abbosh, C., Swanton, C., Jamal-Hanjani, M., Lu, M. T., Murabito, J. M., Lunetta, K. L., Birkbak, N. J., & Aerts, H. J. W. L. (2026). **Thymic health consequences in adults**. *Nature*, *652*(8111), 986–994. <https://doi.org/10.1038/s41586-026-10242-y> 4. Oh, H.SH., Le Guen, Y., Rappoport, N. *et al.* **Plasma proteomics links brain and immune system aging with healthspan and longevity**. *Nat Med* **31**, 2703–2711 (2025). <https://doi.org/10.1038/s41591-025-03798-1> 5. Ding, D.Y., Bot, V.A., Chen, K.L. *et al.* **Plasma proteomic signatures of cellular aging predict human disease**. *Nat Med* **32**, 2060–2072 (2026). <https://doi.org/10.1038/s41591-026-04446-y> 6. Shmatko, A., Jung, A.W., Gaurav, K. *et al.* **Learning the natural history of human disease with generative transformers**. *Nature* **647**, 248–256 (2025). <https://doi.org/10.1038/s41586-025-09529-3> 7. Petersen, K. K., Milà-Alomà, M., Li, Y., Du, L., Xiong, C., Tosun, D., Saef, B., Saad, Z. S., Du-Cuny, L., Coomaraswamy, J., Mordashova, Y., Rubel, C. E., Meyers, E. A., Shaw, L. M., Dage, J. L., Ashton, N. J., Zetterberg, H., Ferber, K., Triana-Baltzer, G., Baratta, M., … Foundation for the National Institutes of Health (FNIH) Biomarkers Consortium Plasma Aβ and Phosphorylated Tau as Predictors of Amyloid and Tau Positivity in Alzheimer’s Disease Project Team (2026). **Predicting onset of symptomatic Alzheimer’s disease with plasma p-tau217 clocks**. *Nature medicine*, *32*(3), 1085–1094. <https://doi.org/10.1038/s41591-026-04206-y> 8. Belk, J.A., Zhang, Y., Reilly, E.E. et al. **Somatic mutations reveal the ontogeny of microglia in human ageing**. *Nature* (2026). <https://doi.org/10.1038/s41586-026-10939-0> 9. Zemke, N. R., Lee, S., Mamde, S., Yang, B., Berchtold, N., Garduño, B. M., Indralingam, H. S., Bartosik, W. M., Lau, P. K., Dong, K., Hsu, E., Yang, A., Tani, Y., Chen, C., Zeng, Q., Ajith, V., Tong, L., Seng, C., Li, D., Wang, T., … Ren, B. (2026). **Epigenetic and 3D genome reprogramming during the aging of the human hippocampus**. *Science* (New York, N.Y.), 393(6809), eadt8307. <https://doi.org/10.1126/science.adt8307> 10. Yan, X., Georgopoulou, C., Lee, H. M., Ahrari, A., Russ, J., Chandrasekar, V., Ducksch, T., Crispatzu, G., Talevi, V., Qiao, L., Agrawal, S., Crux, S., Daman, A. W., Wischhof, L., Stork, M., Zweyer, M., Zanfi, E. D., Chevallot-Beroux, M., Li, Y., De-Domenico, E., … Salomoni, P. (2026). **Microglia activation by derepression of endogenous retroviruses drives inflammation and cellular senescence**. *Nature neuroscience*, *29*(10), 2480–2498. <https://doi.org/10.1038/s41593-026-02404-y> 11. Eyting, M., Xie, M., Michalik, F. *et al.* **A natural experiment on the effect of herpes zoster vaccination on dementia**. *Nature* **641**, 438–446 (2025). <https://doi.org/10.1038/s41586-025-08800-x> 12. Pomirchy, M., Bommer, C., Pradella, F., Michalik, F., Peters, R., & Geldsetzer, P. (2025). **Herpes Zoster Vaccination and Dementia Occurrence**. *JAMA*, *333*(23), 2083–2092. <https://doi.org/10.1001/jama.2025.5013> 13. Pomirchy, M., Chung, S., Bommer, C., Strobel, S., & Geldsetzer, P. (2026). **Herpes zoster vaccination and incident dementia in Canada: an analysis of natural experiments**. *The Lancet. Neurology*, *25*(2), 170–180. <https://doi.org/10.1016/S1474-4422(25)00455-7> 14. Taquet, M., Dercon, Q., Todd, J.A. *et al.* **The recombinant shingles vaccine is associated with lower risk of dementia**. *Nat Med* **30**, 2777–2781 (2024). <https://doi.org/10.1038/s41591-024-03201-5> **Category:** Events, GAI-Funded, Risk Factors --- ### [Advancing Patient Care: Tampere Celiac Disease Symposium 2025](https://www.autoimmuneinstitute.org/research_updates/advancing-patient-care-tampere-celiac-disease-symposium-2025/) **Published:** January 9, 2025 **Author:** Elevation **Content:** The Tampere Celiac Disease Symposium 2025, themed “**Personalizing Patient Care and Research**,” is scheduled for September 10–12, 2025, at the Arvo Building on Tampere University’s Kauppi campus in Finland. The Global Autoimmune Institute (GAI) is among the sponsors supporting this international gathering of celiac disease researchers and clinicians. The symposium will convene experts to discuss advancements in [celiac disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/celiac-disease/ "Celiac disease"), focusing on [personalized approaches](https://www.autoimmuneinstitute.org/articles/personalized-medicine-for-autoimmune-diseases) to patient care and research. A highlight of the event is the presentation of the 5th Maki Celiac Disease Tampere Prize, a €15,000 award recognizing significant contributions to the fields of celiac disease and gluten-induced disorders. The symposium will feature a comprehensive program, including keynote lectures, oral presentations, and poster sessions, covering topics such as disease modeling, risk factors, clinical heterogeneity, long-term consequences, and personalized treatment strategies. Esteemed speakers, including Professor Peter H.R. Green, recipient of the Maki Prize, will share insights from their extensive research and clinical experience. The event aims to foster collaboration among researchers, clinicians, and healthcare professionals dedicated to advancing the understanding and management of celiac disease. For more information and updates, visit the [official symposium website](https://events.tuni.fi/tcds2025/). **Category:** Celiac Disease, Events, GAI-Funded, Research Studies --- ### [Major Federal Initiative to Expand Lyme Disease Research, Diagnostics & Prevention](https://www.autoimmuneinstitute.org/research_updates/hhs-lyme-disease-research-diagnostics-prevention/) **Published:** May 29, 2026 **Author:** Carolyn Serraino **Content:** ***May 29, 2026*** The U.S. Department of Health and Human Services (HHS) has announced a broad new federal initiative aimed at improving the prevention, diagnosis, treatment, and understanding of [Lyme disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/lyme-disease/) and other tick-borne illnesses. The initiative includes a new multi-million-dollar tick-control pilot program, additional research into alpha-gal syndrome, up to $2.5 million in new LymeX innovation challenges, and continued investment in the development of faster and more accurate Lyme disease diagnostics. HHS also reaffirmed a federal goal of reducing Lyme disease cases by 25% by 2035 compared with 2022 levels. According to the department, more than 476,000 Americans are diagnosed with Lyme disease each year. ### Expanding Research Into Lyme and Other Tick-Borne Diseases The National Institutes of Health (NIH) currently invests nearly $50 million annually in Lyme disease research and approximately $122 million annually in research on tick-borne diseases more broadly, including studies of prevention, diagnostics, and treatment. HHS also announced plans to expand research into alpha-gal syndrome, a tick-associated allergic condition in which people can develop potentially serious reactions to red meat and other products derived from mammals. NIH is expected to support clinical research evaluating potential approaches to preventing the condition following a tick bite. ### New LymeX Challenges Target Diagnostics, Treatment, and Invisible Illness Three new LymeX innovation challenges will provide up to $2.5 million in prize funding. The initiatives will support public education developed with input from people affected by Lyme disease, clinicians, and advocates; explore potential treatment approaches including drug repurposing; and investigate how artificial intelligence and open data could help people with Lyme disease and other invisible illnesses receive diagnoses and access care more quickly. The new programs build on the existing LymeX Innovation Accelerator, a public-private initiative between HHS and the Steven & Alexandra Cohen Foundation. LymeX has also launched a $10 million Diagnostics Prize focused on developing faster and more accurate next-generation tests for Lyme disease. ### Targeting Ticks Before Infection Occurs Another major component of the federal strategy focuses on preventing transmission. A new CDC and HHS pilot program will work with tick-control researchers to develop practical methods of targeting ticks on wildlife before they transmit disease to humans. The initial work will involve researchers at the New England Center of Excellence in Vector-Borne Diseases and community partners in the Northeast. Together, the initiatives represent a significant expansion of federal attention to Lyme disease and related tick-borne conditions, with efforts spanning prevention, diagnostics, treatment research, emerging technologies, and access to care. ##### Citation *U.S. Department of Health and Human Services*. “**[HHS Unveils Sweeping Plan to Combat Lyme Disease and Advance Treatment](https://www.hhs.gov/press-room/hhs-unveils-plan-to-combat-lyme-disease.html)**.” May 29, 2026. **Category:** Policy & Health Decisions, Research Studies --- ### [Autoantibody Signatures May Help Identify Polyautoimmunity in Children](https://www.autoimmuneinstitute.org/research_updates/autoantibody-signatures-polyautoimmunity-children/) **Published:** November 10, 2025 **Author:** Carolyn Serraino **Content:** Researchers at Boston Children’s Hospital have published findings from a study investigating whether patterns of autoantibodies could help distinguish [children](https://www.autoimmuneinstitute.org/articles/understanding-autoimmune-disease-in-children) with a single autoimmune disease from those with multiple autoimmune conditions, known as **[polyautoimmunity](https://www.autoimmuneinstitute.org/articles/living-with-multiple-autoimmune-conditions)**. [Autoantibodies](https://www.autoimmuneinstitute.org/articles/decoding-the-role-of-autoantibodies-in-autoimmunity) can appear before the symptoms of an autoimmune disease develop, making them potentially valuable biomarkers for identifying people at risk. However, testing large numbers of autoantibodies individually can be [costly and inefficient](https://www.autoimmuneinstitute.org/articles/navigating-autoimmune-care-with-limited-resources). The researchers investigated whether **multiplex autoantibody arrays**, which can test for many autoantibodies simultaneously using a small blood sample, could reveal patterns associated with specific autoimmune diseases and polyautoimmunity. ### Testing 120 Autoantigens Across Autoimmune Disease Groups The study analyzed stored plasma samples from **114 children** in the Boston Children’s Hospital Precision Link Biobank for Health Discovery. The cohort included 31 children with [celiac disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/celiac-disease/), 20 with [juvenile idiopathic arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/juvenile-idiopathic-arthritis-stills/) (JIA), 31 with polyautoimmunity, and 32 without autoimmune disease. Researchers used a microarray containing **120 autoantigens associated with different autoimmune diseases** to measure IgG and IgA autoantibodies. Children with polyautoimmunity generally had higher levels of specific autoantibodies than the other groups. The researchers were also able to identify different autoantibody patterns associated with individual diseases, supporting the potential of multiplex testing to distinguish meaningful immune signatures among children with multiple autoimmune conditions. ### Potential Biomarkers for Celiac Disease and Polyautoimmunity One of the study’s most notable findings emerged among children with celiac disease and additional autoimmune conditions. These children had higher levels of H/K ATPase IgA, H/K ATPase IgG, and MDA5 IgG autoantibodies than children who had celiac disease alone. The researchers identified H/K ATPase and MDA5 as potentially novel autoantigens associated with celiac disease in the setting of polyautoimmunity. H/K ATPase autoantibodies have previously been associated with several autoimmune diseases, including autoimmune gastritis, autoimmune thyroid disease, type 1 diabetes, vitiligo, and autoimmune hepatitis. The researchers suggest these antibodies could potentially help identify children with celiac disease who may benefit from additional monitoring. The significance of MDA5 autoantibodies also requires further study, including whether their presence in children with celiac disease could be associated with future risk of inflammatory myopathies. ### Toward Earlier Identification of Polyautoimmunity During a median follow-up period of 31 months, six children in the study developed an additional autoimmune condition. Three children who initially had celiac disease later developed autoimmune thyroid disease, inflammatory bowel disease, or type 1 diabetes. The findings support further investigation into whether broad autoantibody profiles could eventually help identify people at greater risk of developing additional autoimmune diseases before those conditions become clinically apparent. The researchers emphasize that larger and longitudinal studies are needed to validate the findings, understand how autoantibody patterns change over time, and determine whether markers such as H/K ATPase and MDA5 could ultimately have clinical value. *The study, **“Autoantibody Signatures in Children With Celiac Disease, Juvenile Idiopathic Arthritis, and Polyautoimmunity,”** was published in JPGN Reports in 2025 and is open access, making the full paper freely available to read. The research was [funded by the Global Autoimmune Institute](https://www.autoimmuneinstitute.org/past-grants-collaborations/) as part of its support for research at Boston Children’s Hospital examining autoantibody and genetic profiles in people with multiple autoimmune conditions.* ##### Citation Du, N., Chang, D., Wong, M., Thiagarajah, J. R., Janssen, E., Henderson, L. A., Raghunathan, K., & Silvester, J. A. (2025). Autoantibody signatures in children with celiac disease, juvenile idiopathic arthritis, and polyautoimmunity. *JPGN reports*, *7*(1), 118–126. <https://doi.org/10.1002/jpr3.70119> **Category:** Case Studies, Celiac Disease, Diagnostic Testing, GAI-Funded, Research Studies --- ### [Lupus Gene Variant May Strengthen Antiviral Immunity](https://www.autoimmuneinstitute.org/research_updates/lupus-gene-variant-may-strengthen-antiviral-immunity/) **Published:** October 1, 2026 **Author:** Carolyn Serraino **Content:** New research finds that a genetic variant in the *IRF7* gene that increases risk of [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/) (lupus) also makes us more resilient to viruses. The researchers found that this variant has persisted in human populations for millennia. Around 70% of the human population carry this variant. This variant increases the amount of interferon-ɑ produced by immune cells called monocytes and in cells that line the respiratory tract. In mouse models, the researchers of this study modified the mice’s *IRF7* gene so that it matches the variant associated with lupus. After stimulating an autoimmune-like disease in these mice, the researchers saw that they made more [autoantibodies](https://www.autoimmuneinstitute.org/articles/decoding-the-role-of-autoantibodies-in-autoimmunity) but were also more resilient against viral infections. “Our team’s findings help explain why a genetic variant linked to lupus remained so common and how, biologically, it affects the immune system more broadly.” says Sam Virolainen, who is the first author of the study, [in a statement](https://www.eurekalert.org/news-releases/1143604). ## What does *IRF7* do? IRF7, or interferon regulatory factor 7, responds to foreign genetic material (ex: from a virus) by helping stimulate the production of type 1 interferons, molecules that trigger an immune response. ##### **Citation** Virolainen S, Creighton K, Dashtiahangar M et al. (2026). [A highly prevalent lupus risk haplotype increases IRF7-dependent induction of IFN-α, enhancing antiviral defense and exacerbating autoimmunity](https://doi.org/10.1016/j.ajhg.2026.08.016). *The American Journal of Human Genetics* https://doi.org/10.1016/j.ajhg.2026.08.016 **Category:** Lupus, Research Studies, Risk Factors --- ### [Celiac Disease Halloween Resources & Gluten-Free Candy List](https://www.autoimmuneinstitute.org/research_updates/celiac-disease-halloween-resources-gluten-free-candy-list/) **Published:** October 5, 2026 **Author:** Carolyn Serraino **Content:** Halloween traditions centered around candy can be difficult to navigate for children who need to [avoid certain foods](https://www.autoimmuneinstitute.org/articles/food-sensitivity-intolerance-or-allergy-whats-the-difference) for medical reasons. For children with **[celiac disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/celiac-disease/)**, an autoimmune disease triggered by gluten, trick-or-treating can mean navigating unfamiliar food labels, shared treat bowls, and the possibility of gluten exposure. [The Celiac Disease Foundation (CDF)](https://celiac.org/) is highlighting two resources for 2026 that offer practical ways to make Halloween safer and more inclusive: the Teal Pumpkin Project, which provides an alternative for children with a range of dietary restrictions, and an updated Gluten-Free Halloween Candy List for families managing celiac disease. ### **The Teal Pumpkin Project Offers an Alternative to Food Treats** CDF is once again partnering with **Food Allergy Research & Education (FARE)** to promote the Teal Pumpkin Project, a national initiative encouraging households to make non-food treats available to trick-or-treaters. Participating households can place a teal pumpkin outside to signal that alternatives such as small toys, stickers, glow sticks, or other trinkets are available. Keeping these items in a separate bowl from candy can give children with celiac disease, food allergies, intolerances, and other dietary restrictions another way to participate in trick-or-treating. For children who may frequently have to ask whether a food is safe or skip treats altogether, having a non-food option can make Halloween more welcoming and easier to navigate. [ Learn About the Teal Pumpkin Project ](https://celiac.org/2026/09/30/teal-pumpkin-project/) ### **Updated Gluten-Free Halloween Candy List for 2026** For families looking for candy options, CDF has also released its **2026 Gluten-Free Halloween Candy List**, which includes candies labeled or reported as gluten-free by their U.S. manufacturers. The guide provides a convenient starting point when shopping for Halloween treats, but CDF emphasizes that families should **always check the label on the individual product before eating it**. Ingredients, formulations, and manufacturing practices can change, and different varieties or package sizes from the same brand may not necessarily have the same gluten-free status. #### **[View the 2026 Gluten-Free Halloween Candy List](https://celiac.org/wp-content/uploads/2026/09/Halloween-Candy-List-Updated-2026.pdf).** **Category:** Celiac Disease, Events, Resources --- ### [NIH “From Mechanisms To Medicine” Workshop Highlights](https://www.autoimmuneinstitute.org/research_updates/nih-from-mechanisms-to-medicine-workshop/) **Published:** September 25, 2026 **Author:** Carolyn Serraino **Excerpt:** Researchers studying autoimmune disease, chronic pain, post-infectious illness, dysautonomia, and other complex chronic conditions are increasingly encountering the same challenge: the biology does not always fit neatly within the boundaries of individual diagnoses or medical specialties. That was a central theme of the National Institutes of Health (NIH) workshop “From Mechanisms to Medicine: Rethinking the Discovery-to-Care Continuum in Multi-System Disorders,” held September 23–24, 2026, at the Neuroscience Center in North Bethesda, Maryland. **Content:** ## *Neuroimmune Connections Across Autoimmune & Chronic Diseases* ***September 23 -24, 2026*** Researchers studying autoimmune disease, chronic pain, post-infectious illness, dysautonomia, and other complex chronic conditions are increasingly encountering the same challenge: the biology does not always fit neatly within the boundaries of individual diagnoses or medical specialties. That was a central theme of the National Institutes of Health (NIH) workshop **“[From Mechanisms to Medicine: Rethinking the Discovery-to-Care Continuum in Multi-System Disorders](https://mregs.nih.gov/channels/VF45-44Z5),”** held September 23–24, 2026, at the Neuroscience Center in North Bethesda, Maryland. The two-day meeting brought together researchers, clinicians, advocates, and people with lived experience to examine chronic overlapping pain conditions, infection-associated illnesses, and the biological mechanisms that may connect them. Discussions spanned immunology, neuroinflammation, genetics, hormones, infection, pain, and autonomic nervous system dysfunction, with an emphasis on breaking down research silos that can obscure shared biology. For autoimmune disease research, several discussions were particularly significant. Rather than viewing the immune system separately from the brain, nervous system, hormones, or cardiovascular and gastrointestinal systems, researchers highlighted the complex, bidirectional interactions that can contribute to chronic disease. ## **Infection, Autoimmunity, And The Transition From Trigger To Chronic Disease** One of the workshop’s most directly relevant sessions examined infection-associated chronic conditions, including Long COVID and [myalgic encephalomyelitis/chronic fatigue syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/me-cfs/) (ME/CFS). The session brought together researchers studying clinical immunology, autoimmune disease, Long COVID, ME/CFS, [Lyme disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/lyme-disease/), and dysautonomia. Nancy Klimas, M.D., described research examining common immune mediators across chronic illnesses that can begin with very different triggers yet produce overlapping symptoms. She emphasized that biological convergence does not necessarily mean that different conditions have the same underlying cause. That distinction is particularly important when considering autoimmunity. Long COVID, ME/CFS, and other infection-associated chronic conditions should not simply be classified as autoimmune diseases. Instead, researchers are investigating several possible mechanisms that may contribute to different disease subtypes, including persistent immune activation, altered immune regulation, neuroinflammation, autonomic dysfunction, and, in some individuals, autoimmune processes. The connection between infection and established autoimmune disease was illustrated particularly clearly by Judith James, M.D., Ph.D., whose research focuses on the development and progression of lupus and related rheumatic diseases. James discussed research on Epstein-Barr virus (EBV) and [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/) (SLE). Studies have found differences in the immune response to EBV among people with lupus, including antibodies targeting multiple regions of the viral protein EBNA-1. Some of those viral regions resemble targets of lupus [autoantibodies](https://www.autoimmuneinstitute.org/articles/decoding-the-role-of-autoantibodies-in-autoimmunity), raising the possibility of molecular mimicry, in which an immune response initially directed against a pathogen may cross-react with the body’s own molecules. This type of research is helping scientists investigate a larger question in autoimmunity: why an infection that is common in the general population might contribute to autoimmune disease only in susceptible individuals. ## **The Immune System And Nervous System Are Closely Connected** Another major theme was [neuroimmunology](https://www.autoimmuneinstitute.org/gai-library/#neuroimmune), the study of interactions between the nervous and immune systems. Notably, the workshop’s session on “Neuroimmune Dynamics of Chronic Illness” was moderated by Victoria Shanmugam, MBBS, MRCP, FACR, CCD, Director of the NIH [Office of Autoimmune Disease Research](https://www.autoimmuneinstitute.org/research_updates/office-of-autoimmune-disease-research/) (OADR). Shanmugam leads NIH-wide efforts to coordinate autoimmune disease research and helped launch the first [NIH-wide Strategic Plan for Autoimmune Disease Research](https://www.autoimmuneinstitute.org/research_updates/nih-wide-strategic-plan-for-autoimmune-disease-research/). Researchers presented several ways immune activity may influence pain and neurological symptoms, including communication between immune cells and sensory neurons, inflammatory signaling within the central nervous system, and differences related to sex and hormonal biology. The session also highlighted new approaches for making these processes more measurable. Michelle James, Ph.D., of Stanford Medicine is developing PET imaging tools designed to visualize immune cells and mitochondrial function in the body. Her research includes applications in [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/) (MS) as well as ME/CFS, offering researchers ways to investigate immune activity in locations that are otherwise difficult to study directly. These approaches could be particularly valuable in diseases where symptoms involve several organ systems or where conventional tests do not fully capture ongoing biological changes. ## **Autonomic Dysfunction May Be Part Of A Larger Multisystem Picture** The workshop also devoted an entire session to the autonomic nervous system, which regulates involuntary functions including heart rate, blood pressure, digestion, temperature regulation, and other processes necessary for maintaining internal stability. Rather than treating autonomic dysfunction as an isolated problem, researchers discussed the autonomic nervous system as part of a broader network communicating with the brain, immune system, endocrine system, gastrointestinal tract, and cardiovascular system. Susan Eshleman, M.D., Ph.D., described work at a multidisciplinary Johns Hopkins clinic treating people with moderate-to-severe dysautonomia and complex combinations of chronic pain and other symptoms. The research initiative is designed to improve diagnosis, monitoring, and treatment by examining these conditions across specialties rather than treating each manifestation independently. Her presentation also described observations from multidisciplinary clinical work in which autonomic dysfunction, gastrointestinal problems, joint hypermobility, neuropathy, and evidence of immune dysregulation or autoimmunity sometimes appeared together. These observations do not mean that dysautonomia itself is necessarily autoimmune. Instead, they raise questions about whether immune dysfunction may contribute to autonomic abnormalities in certain subgroups and whether identifying those biological differences could eventually help guide treatment. ## **The Vagus Nerve Provides A Direct Link Between The Nervous And Immune Systems** Perhaps one of the clearest examples of neuroimmune communication discussed during the workshop involves the [vagus nerve](https://www.autoimmuneinstitute.org/research_updates/vagus-nerve-research-implications-for-autoimmune-disease/). Kevin Tracey, M.D., of the Feinstein Institutes for Medical Research has studied what is known as the inflammatory reflex, a neural pathway through which the nervous system can regulate immune activity and suppress inflammation. Research stemming from this work helped lead to vagus nerve stimulation as a therapeutic approach for [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/), providing a striking example of how manipulating a neural pathway can affect an autoimmune inflammatory process. The concept challenges the traditional idea that autoimmune inflammation is controlled only through immune-targeting medications. Instead, the nervous system itself may represent another route through which inflammatory activity can be regulated. ## **Shared Symptoms Do Not Necessarily Mean Shared Disease** At the same time, the workshop repeatedly emphasized the need to distinguish overlapping symptoms from identical disease mechanisms. Conditions such as [fibromyalgia](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/fibromyalgia/), ME/CFS, Long COVID, [endometriosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/endometriosis/), dysautonomia, and autoimmune diseases may share features such as fatigue, pain, cognitive problems, or autonomic symptoms without sharing a single cause. That distinction was reinforced by research presented on fibromyalgia genetics, which pointed more strongly toward nervous-system biology than autoimmune mechanisms. Similarly, researchers studying infection-associated illnesses cautioned against assuming that biological convergence means every person with similar symptoms follows the same disease pathway. As one presentation summarized the concept, convergence should be viewed as a starting point for investigation rather than proof of a shared pathogenesis. For autoimmune research, this may be especially important. Identifying which individuals have autoimmune, inflammatory, neurological, autonomic, metabolic, or overlapping mechanisms could ultimately be more informative than grouping people solely according to symptoms. ## **Moving Toward Mechanism-Based Medicine** The workshop concluded by looking toward clinical research, translational science, and therapeutic development. Researchers discussed the need for better-defined disease subgroups, biomarkers, longitudinal studies, multidisciplinary care, and research methods capable of connecting biological mechanisms with symptoms and treatment response. That approach could have important implications for autoimmune disease. Autoimmune conditions are already highly heterogeneous. Two people with the same diagnosis may experience different organs affected, symptoms, disease trajectories, and responses to treatment. At the same time, one person may develop multiple autoimmune or immune-mediated conditions alongside neurological, autonomic, gastrointestinal, or chronic pain symptoms. Understanding those connections will require research that crosses the traditional boundaries between immunology, neurology, rheumatology, infectious disease, endocrinology, genetics, and other specialties. The NIH workshop reflected a growing effort to do exactly that: study complex chronic disease according to the biological systems and mechanisms involved, while recognizing that those mechanisms can intersect across diagnostic categories. For autoimmune disease research, that broader view may help reveal not only why autoimmunity develops, but also why its effects can extend so widely throughout the body. #### [Day 1: September 23, 2026 Videocast](https://videocast.nih.gov/watch/c19b4e7e-643f-11f1-82c0-124f0a52e769) #### [Day 2: September 24, 2026 Videocast](https://videocast.nih.gov/watch/ac67ea49-646d-11f1-82c0-124f0a52e769) #### [](https://mregsmeetingmanagement.nih.gov/FileStorage/NINDS/VF45-44Z5/From%20Mechanisms%20to%20Medicine%20NIH%20September%202026.pdf)**[CONFERENCE PROGRAM](https://mregs.nih.gov/FileStorage/NINDS/VF45-44Z5/From%20Mechanisms%20to%20Medicine%20NIH%20September%202026.pdf)**   **Category:** Events, Research Studies --- ### [Could Autoimmune Disease Be Reset Instead of Managed?](https://www.autoimmuneinstitute.org/research_updates/could-autoimmune-disease-be-reset-instead-of-managed/) **Published:** December 16, 2025 **Author:** Carolyn Serraino **Content:** For many years, autoimmune diseases have been treated by calming down the immune system. [Medications](https://www.autoimmuneinstitute.org/articles/biologics-for-autoimmune-disease-what-you-should-know "Biologics for Autoimmune Disease: What You Should Know") can reduce inflammation and symptoms, but they usually need to be taken continuously because the immune system still recognizes the body as a threat. #### Recent research has begun exploring a different idea: instead of suppressing immunity, doctors may be able to reset it. **Rheumatologist [Georg Schett](https://www.autoimmuneinstitute.org/articles/personalized-medicine-for-autoimmune-diseases "Personalized Medicine for Autoimmune Diseases")**, a [Walter and Jean Boek Leadership in Research Award](https://www.autoimmuneinstitute.org/lead-day/ "Lectures, Empowerment, and Awareness for Autoimmune Disease (LEAD) Day") recipient, reported patients with severe autoimmune diseases entering long-lasting remission after [targeted cell therapies](https://www.autoimmuneinstitute.org/articles/car-t-cell-therapy-for-autoimmune-disease "CAR T-Cell Therapy For Autoimmune Disease") that remove the specific immune B cells driving disease. In some cases, once these harmful cells were eliminated and the immune system rebuilt itself, it stopped attacking the same tissues without ongoing medication. The results suggested the immune response had been re-trained rather than simply turned down. **Physician-scientist Eric Topol** later [highlighted](https://erictopol.substack.com/p/the-exhilirating-movement-from-treatment?utm_source=) the broader importance of these findings, describing a shift from managing autoimmune disease to correcting the immune mistake itself. He outlined two emerging approaches: engineered immune cell therapies that selectively eliminate autoreactive immune cells, and [tolerance-inducing therapies](https://www.autoimmuneinstitute.org/research_updates/what-we-know-now-about-inverse-vaccines/ "Revolutionary ‘Inverse Vaccine’ Offers Hope for Autoimmune Disease Treatment") designed to teach the immune system that certain proteins belong to the body and should not trigger an attack. **Category:** Autoimmune Diseases, Therapies --- ### [Celiac Disease Experts To Address Common Myths In Upcoming Webinar](https://www.autoimmuneinstitute.org/research_updates/celiac-disease-myths-webinar/) **Published:** September 23, 2026 **Author:** Carolyn Serraino **Excerpt:** September 30: Celiac disease experts will address common myths and misconceptions about celiac disease and the gluten-free diet during a webinar hosted by the National Celiac Association and Harvard Medical School’s Celiac Education and Research Program. **Content:** The **[National Celiac Association](https://nationalceliac.org/)** and **[Harvard Medical School Celiac Education and Research Program](https://hms.harvard.edu/departments/hms-celiac-research-program)** will host a free webinar, **“Myth Busters in Celiac Disease: Q & A with Celiac Clinicians,”** on **Wednesday, September 30, 2026, from 1:00–2:15 p.m. ET**. The webinar will focus on common myths and misconceptions surrounding **[celiac disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/celiac-disease/) and the gluten-free diet**, with clinicians providing evidence-based information to help distinguish fact from fiction. The session will also include audience questions about medical care and nutrition. Featured speakers include **Denis Chang, MD**, a pediatric gastroenterologist at Boston Children’s Hospital; **Ciarán P. Kelly, MD**, an adult gastroenterologist at Beth Israel Deaconess Medical Center; and **Katarina Mollo, MEd, RDN**, a registered dietitian at Mass General Brigham for Children. **Rupa Mukherjee, MD**, of Beth Israel Deaconess Medical Center, will moderate the discussion. Dr. Chang’s research at Boston Children’s Hospital has also been [supported by the Global Autoimmune Institute](https://www.autoimmuneinstitute.org/current-research-grants-projects/). He and Jocelyn Silvester, MD, PhD, led research examining [autoantibody and genetic profiles in people with multiple autoimmune conditions](https://pubmed.ncbi.nlm.nih.gov/41695077/). The project used autoantigen microarray technology to investigate whether distinct autoantibody signatures could help identify people at risk of developing multiple autoimmune diseases. [ Register Today → ](https://mgb-org.zoom.us/webinar/register/WN_kd9aIkS5QNKtNX5wYq0ntQ?mc_cid=5d96acbf8f&mc_eid=ef2dd3256a#/registration) *Participants can submit questions for the experts when registering, and questions submitted in advance will be prioritized.* **Continuing Education Units (CEUs)**: This course (220323-RSS) is approved by the Boston Children’s Hospital’s (BCH) Continuing Education Department for 1.25 AMA PRA Category 1 Credits™ for physicians, 1.25 contact hours for nurses, 1.25 ACE CE continuing education credits for social workers, and 1.25 CEUs for Registered Dietitians. To claim credit, you will need an account on the BCH Center for Educational Excellence and Innovation website at:[https://dme.childrenshospital.org/account-registration/](https://us.list-manage.com/Y7K3rmte61n?e=ef2dd3256a&c2id=e544b1f379735c76da63545d3106cc13) A mobile phone number is required to claim CEU credit. During the webinar, information on the number to text along with the webinar-specific code will be announced. This text must be sent from the same number in order to claim credit. **Category:** Celiac Disease, Events, Resources --- ### [NIH Invests $21 Million in Research on Hormones and Treatment Response](https://www.autoimmuneinstitute.org/research_updates/nih-hormone-treatment-response-research/) **Published:** September 14, 2026 **Author:** Carolyn Serraino **Content:** September 14, 2026 The National Institutes of Health (NIH) has launched a **$21 million research initiative** to develop new computer-based models of how hormones function in the human body and how differences in hormonal biology may influence responses to medications. The **[Computational Modeling of Hormone Homeostasis Initiative](https://dpcpsi.nih.gov/hormone-homeostasis)** will support researchers developing human-based models that simulate hormone homeostasis, the processes that help regulate hormone activity and maintain balance within the body. The goal is to better account for biological differences between males and females when evaluating drug effectiveness, dosing, side effects, and toxicity. #### Hormones Affect Far More Than the Reproductive System [Sex hormones](https://www.autoimmuneinstitute.org/research_updates/the-role-of-hormones-and-sex-chromosomes-in-autoimmune-disease/) interact with tissues and systems throughout the body, including the **immune system, lungs, bones, and [microbiome](https://www.autoimmuneinstitute.org/gai-library/#microbiome)**. Hormone levels and activity also [change substantially across the lifespan](https://www.autoimmuneinstitute.org/gai-library/#disease-progression), including during puberty, the menstrual cycle, [pregnancy](https://www.autoimmuneinstitute.org/gai-library/#pregnancy), and menopause. These changes can have effects throughout the body, but current animal and mathematical models do not always adequately capture how hormonal biology differs between males and females or how those differences may affect treatment response. The new NIH-funded projects will use computational approaches including **[artificial intelligence](https://www.autoimmuneinstitute.org/articles/the-promise-of-ai-in-autoimmune-disease-from-early-detection-to-personalized-care), interactive machine learning, multiscale modeling, and digital twins**, which are virtual representations of biological systems. Researchers will use these techniques to develop models capable of predicting how drugs and biologic therapies may behave differently depending on sex-specific physiology. #### Potential Relevance for Autoimmune Disease Research The initiative is not focused specifically on autoimmune disease, but its emphasis on the relationship between **hormones, immune function, and therapeutic response** could have important implications for the field. Many autoimmune diseases show substantial differences in prevalence and disease patterns [between females and males](https://www.autoimmuneinstitute.org/articles/how-sex-genetics-influence-autoimmunity), and researchers continue to investigate the roles hormones and other sex-related biological factors may play in those differences. More sophisticated models of hormonal activity could eventually help researchers better understand why treatments work differently among individuals and support more [individualized approaches](https://www.autoimmuneinstitute.org/articles/personalized-medicine-for-autoimmune-diseases) to drug development and care. NIH says the program ultimately aims to improve the evaluation of drugs and biologics by incorporating sex as a biological variable earlier and more effectively into therapeutic research. ###### Citation *National Institutes of Health*. (2026, September 14). *[NIH launches $21 million initiative to improve understanding of sex-specific hormonal biology](https://www.nih.gov/news-events/news-releases/nih-launches-21-million-initiative-improve-understanding-sex-specific-hormonal-biology).* **Category:** Genetics, Policy & Health Decisions, Research Studies --- ### [IBD Nutrition Toolkit Updated for 2026 and Now Available in Spanish](https://www.autoimmuneinstitute.org/research_updates/ibd-nutrition-toolkit-2026-spanish/) **Published:** September 8, 2026 **Author:** Carolyn Serraino **Excerpt:** ImproveCareNow has updated its IBD Nutrition Toolkit for 2026 and released the full resource in Spanish, expanding access to practical nutrition guidance for people with Crohn’s disease and ulcerative colitis and their families. **Content:** ImproveCareNow has released an updated version of its Nutrition Toolkit, a free resource designed to help people with inflammatory bowel disease (IBD) and their families better understand the role of nutrition in IBD treatment and management. #### The 2026 update includes revised content developed with members of ImproveCareNow’s Patient Advisory Council and Registered Dietitian group. The organization focuses specifically on improving care for children and adolescents with [Crohn’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crohns-disease/) and [ulcerative colitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ulcerative-colitis/), the two major forms of IBD. The toolkit combines patient experiences with guidance from nutrition professionals, covering topics such as total parenteral nutrition (TPN), special diets, nutritional drinks, nasogastric (NG) tubes, and tube feeding. It also discusses how nutritional interventions can be incorporated into comprehensive IBD care. #### The full toolkit is also now available in Spanish. [![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/09/image-1024x1024.png)](https://assets.nationbuilder.com/improvecarenow/pages/10740/attachments/original/1788358920/Nutrition_Toolkit_v.202606.pdf?1788358920) [![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/09/image-1-1024x1024.jpg)](https://assets.nationbuilder.com/improvecarenow/pages/10740/attachments/original/1788358905/ES_Nutrition_Toolkit_v.202606.pdf?1788358905) The translation is part of an ongoing effort by ImproveCareNow’s Health Equity Committee to make patient and caregiver resources available in additional languages. Several of the organization’s other resources are also available in Spanish, including materials on IBD accommodations and finding a mental health provider. #### The Nutrition Toolkit is part of a much larger collection of [free resources available through ImproveCareNow](https://www.improvecarenow.org/all_resources_alphabetical). These patient- and caregiver-focused materials address many of the practical challenges that can come with living with IBD: - School, college, travel, and workplace accommodations - Mental health, coping, body image, and disordered eating - Nutrition, hydration, feeding tubes, and ostomy care - Transitioning from pediatric to adult care - IBD surgery and shared decision-making - Clinical research and health literacy - Travel, holidays, summer activities, and sun safety - Caregiver support and patient stories ImproveCareNow also offers video series, patient perspectives, blog resources, and educational tools created with input from young people living with IBD, caregivers, clinicians, dietitians, and other members of its collaborative network. **Category:** IBD (Crohn's and UC), Resources --- ### [Large Study Uncovers Distinct Genetic Links Across Autoimmune Diseases](https://www.autoimmuneinstitute.org/research_updates/genetic-links-autoimmune-diseases-large-study/) **Published:** August 24, 2026 **Author:** Carolyn Serraino **Excerpt:** A nationwide Swedish study of more than 6.3 million people found that autoimmune diseases share genetic risk in distinct patterns, often clustering by the tissues and organ systems they affect. Researchers also found no evidence of one strong genetic factor underlying autoimmunity as a whole. **Content:** Autoimmune diseases often cluster within families, and people with one autoimmune disease may be more likely to develop another. This pattern suggests that some autoimmune conditions may share underlying genetic risk factors. A large nationwide study from Sweden has now mapped how strongly 22 autoimmune diseases appear to be genetically connected and found that those connections tend to cluster by the tissues and organ systems they affect. #### More than 6.3 million people and 3.8 million sibling pairs Researchers analyzed national health and family registry data from 6,336,615 people born in Sweden between 1932 and 1983, including nearly 3.84 million full-sibling pairs. Diagnoses of 22 autoimmune diseases were tracked from 1969 through 2013. By comparing how often the same or different autoimmune diseases appeared among siblings, the researchers estimated the degree of shared genetic risk between conditions. Across the full study population, **707,995 people, or 11.2%, had at least one of the autoimmune diseases studied**. Autoimmune disease was more common among women than men, affecting **15.3% of women compared with 7.2% of men**. #### Autoimmune diseases were genetically connected, but not all in the same way The researchers found a broad network of genetic relationships across autoimmune diseases, but some conditions shared much more genetic risk than others. **Some of the strongest genetic links were seen between:** - **[Psoriasis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/psoriasis/) and [psoriatic arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/psoriatic-arthritis/):** genetic correlation = **0.84**\* - **[Autoimmune hepatitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-hepatitis/) and [primary biliary cholangitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/primary-biliary-cirrhosis/):** genetic correlation = **0.68** - **[Systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/) and [Sjögren disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sjogren-syndrome/):** genetic correlation = **0.61** *\* A genetic correlation closer to **1** indicates that two conditions share more of the same genetic influences, while a value closer to 0 indicates little shared genetic influence. The 0.84 correlation between psoriasis and psoriatic arthritis therefore represents a particularly strong genetic overlap.* At the other end of the spectrum, some autoimmune diseases appeared to have very little shared genetic risk. **[Type 1 diabetes](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/type-1-diabetes-insulin-dependent-diabetes/) and **[psoriasis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/psoriasis/)**** had a genetic correlation close to zero, and **[multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/)** generally showed weak genetic connections with the other autoimmune diseases studied. #### Genetic similarities tended to follow affected tissue type When the researchers grouped diseases according to the strength of their genetic relationships, clearer clusters emerged among **connective tissue diseases, endocrine autoimmune diseases, gastrointestinal disorders, and liver-related autoimmune diseases**. Diseases affecting the nervous system showed much less internal clustering. Importantly, the study found **no evidence of a single strong genetic factor that broadly predisposes people to all autoimmune diseases**. Instead, the findings suggest that shared genetic risk is concentrated within particular groups of related conditions. ##### Citation Eriksson, D., Kuja-Halkola, R., Holmqvist, M. E., Larsson, H., Butwicka, A., Gudbjörnsdottir, S., Kämpe, O., Bensing, S., & Skov, J. (2026). [**Tissue-specific clustering of genetic correlations across autoimmune diseases in a nationwide sibling study**](https://www.jci.org/articles/view/205952/pdf). *The Journal of clinical investigation*, e205952. Advance online publication. https://doi.org/10.1172/JCI205952 **Category:** Autoimmune Diseases, Genetics, Research Studies, Risk Factors --- ### [CAR T-Cell Trials for Autoimmune Diseases Paused After Safety Events](https://www.autoimmuneinstitute.org/research_updates/car-t-cell-trials-safety-events/) **Published:** September 1, 2026 **Author:** Carolyn Serraino **Excerpt:** CAR T-cell therapy has generated major excitement as a potential way to reset the immune system in autoimmune disease. Now, recent safety events have prompted Novartis and Bristol Myers Squibb to pause several trials, raising important questions about risk, patient selection, and what comes next for this rapidly evolving field. **Content:** CAR T-cell therapies have made tremendous progress in treating cancers and investigators are now looking at how they can be used to eliminate cells responsible for autoimmune reactions. Such therapies are designed to eliminate self-targeting B cells and subsequently allow the immune system to rebuild itself without these dysfunctional B cells. These trials have been underway at Novartis and BMS, which have been working on separate trials that investigated CAR T-cell therapies for a number of autoimmune diseases. Both companies have recently paused these efforts. The Novartis trials have resulted in three deaths related to [immune effector cell-associated hemophagocytic syndrome](https://pubmed.ncbi.nlm.nih.gov/40158936/) (IEC-HS), a life-threatening inflammatory reaction that can occur after CAR T-cell therapy. Trials paused include Phase 1 and 1/2 studies for a variety of indications like [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/), [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/), and [Sjogren disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sjogren-syndrome/). #### This pause will allow them to more comprehensively review clinical and safety data. BMS has also paused CAR T studies for autoimmune diseases due to “transient and reversible inflammatory events” but have not reported any associated fatalities. This type of immune reaction to CAR T-cell therapies has already been identified in cancer applications. It’s a known, uncommon, but life-threatening complication of CAR T-cell therapy. These pauses don’t determine whether CAR T-cell therapies can be effective for treating autoimmune diseases, but raises the question of how the potential long-term benefit of resetting the immune system should be weighted against the risks. ### Related Reads ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/CAR-T-CELL-THERAPY-4-1024x576.jpg) CAR T-Cell Therapy For Autoimmune Disease: What We Know Now Originally published November 17, 2023 \| Updated September 29, 2026 What CAR T-Cell Therapy Means for the Future of Autoimmune Disease Treatment Chimeric antigen receptor (CAR) T-cell therapy, a form of cellular immunotherapy first developed to treat certain blood cancers, is now being investigated as a potential treatment for severe autoimmune diseases. Much of the research has focused on using CAR T cells to deeply deplete B cells, including abnormal B-cell populations that contribute to autoantibody production and autoimmune disease. The goal is ambitious: rather than continuously suppressing the immune system with medication, researchers are investigating whether a one-time treatment could \[…\] Diagnosis & Treatment [Read Post CAR T-Cell Therapy For Autoimmune Disease: What We Know Now](https://www.autoimmuneinstitute.org/articles/car-t-cell-therapy-for-autoimmune-disease) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/06/A-Guide-to-Interpreting-Clinical-Trial-Stories-1024x576.jpg) A Guide to Interpreting Clinical Trial Stories How to evaluate pre-clinical research, clinical trial phases, study results, and key questions to ask with expert insights from Monica Wang and Sylvia Baedorf Kassis. About Autoimmune Disease [Read Post A Guide to Interpreting Clinical Trial Stories](https://www.autoimmuneinstitute.org/articles/a-guide-to-interpreting-clinical-trial-stories) ![immunotherapy research concept with cells and DNA background](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/09/shutterstock_578121100-1024x683.jpg) Immunotherapy for Those with Autoimmune Disease Immunotherapy is changing autoimmune treatment by using targeted drugs and cellular therapies to reduce flare-ups and damage. Diagnosis & Treatment [Read Post Immunotherapy for Those with Autoimmune Disease](https://www.autoimmuneinstitute.org/articles/immunotherapy-for-those-with-autoimmune-disease) ##### **Citation**s Lee, J. C., Johnson, W. T., Hines, M., & Shah, N. N. (2025). Immune Effector Cell-associated Hemophagocytic Lymphohistiocytosis-like Syndrome (IEC-HS). Hematology/oncology clinics of North America, 39(3), 617–643. <https://doi.org/10.1016/j.hoc.2025.02.005> Russo, M.  (2026, August 31). *UPDATED: Novartis halts autoimmune CAR-T trials after 3 deaths, as BMS also pauses studies*. Fierce Biotech. <https://www.fiercebiotech.com/biotech/novartis-bristol-myers-squibb-halt-car-t-cell-trials-due-immune-events> **Category:** Clinical Trials, Lupus, Rheumatoid Arthritis, Sjögren disease, Therapies --- ### [Former GAI Scholar Nikita Sivakumar Earns Research Fellowship](https://www.autoimmuneinstitute.org/research_updates/nikita-sivakumar-ntt-research-fellowship/) **Published:** August 28, 2026 **Author:** Carolyn Serraino **Excerpt:** Former GAI Scholar Nikita Sivakumar has received an NTT Research Foundation Fellowship as she continues using computational modeling and machine learning to investigate immune cell behavior and human disease. **Content:** **Nikita Sivakumar**, a Biomedical Engineering PhD student at Johns Hopkins University, [has received an NTT Research Foundation Fellowship](https://www.bme.jhu.edu/news-events/news/hopkins-bme-phd-student-receives-ntt-research-foundation-fellowship/), marking an exciting new milestone in her work at the intersection of computational modeling and human health. The **[NTT Research Foundation Fellowship](https://scholarshipamerica.org/scholarship/nttresearchfoundation/)** recognizes academic performance, leadership, and community engagement and provides support for doctoral study. The fellowship program awards up to two full-ride fellowships each year, including one for eligible Biomedical Engineering PhD students. GAI supported Nikita as the **[2025–2026 Global Autoimmune Institute Scholar](https://www.autoimmuneinstitute.org/research_updates/gai-honors-arcs-scholar-nikita-sivakumar/)** through a $15,000 award in partnership with the ARCS Foundation Metro Washington Chapter. During that time, her research focused on using machine learning, 3D imaging, and computational modeling to understand how B cells and T cells move and interact during immune responses to infection and vaccination. These interactions are an important part of the adaptive immune response and help the body produce antibodies. But it can be difficult to experimentally isolate how specific patterns of cell movement affect when and how immune cells encounter one another. Nikita develops computer models that simulate these behaviors, giving researchers another way to investigate how the movement and organization of individual cells can shape a larger immune response. Nikita has continued to advance this area of research at Johns Hopkins, studying how immune cells migrate and communicate during infection and vaccination. Her work has broader implications for understanding infectious and autoimmune diseases, as well as vaccine development. Her computational expertise has also contributed to research across other areas of health and disease. She has worked on research using machine learning to improve estimates of blood oxygen levels from pulse oximetry and to predict treatment response in [chronic spontaneous urticaria](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/chronic-urticaria/), as well as research examining aging and cardiovascular health. In the pulse oximetry study, Nikita contributed to data analysis for machine-learning models designed to address known inaccuracies in estimating blood oxygen levels, including disparities associated with skin tone. Looking ahead, Nikita hopes to lead her own laboratory developing and validating computational models to better understand the molecular and cellular mechanisms of disease. Teaching and mentoring students are also important parts of the career she hopes to build. **GAI is proud to have supported Nikita and congratulates her on this latest achievement.** ##### Recent Published Works (Open Access): Woo, J., Stapleton, O., Luo, J., Chuang, C. C., Su, Y., Sankararaman, S., Mukherjee, E., **Sivakumar, N.**, Calligy, K., Duffy, S., Mosier, R., Greenstein, J., Taylor, C. O., & Sen, D. G. (2025). **AI-Driven SaO2 prediction from pulse oximetry and electronic health records**. *BioData mining*, *18*(1), 90. <https://doi.org/10.1186/s13040-025-00511-3> Nidadavolu, L. S., Sosnowski, D. W., **Sivakumar, N.**, Merino Gomez, A., Wu, Y., Laskow, T., Bopp, T., Milcik, N., Le, A., Zhang, C., Khare, P., Zammit, A., Grodstein, F., Walston, J. D., Bennett, D. A., Mathias, R. A., Phillip, J. M., Maher, B. S., Oh, E. S., & Abadir, P. M. (2025). **Cardiovascular-Derived Circulating Cell-Free DNA Fragments Are Associated With Frailty and Increased Cardiovascular Events in Older Adults**. *The journals of gerontology. Series A, Biological sciences and medical sciences*, *80*(7), glaf081. <https://doi.org/10.1093/gerona/glaf081> Simpson S, **Sivakumar N**, Phillip J, Chen Y, Saini S, Gao L. **Machine Learning Predictive Models for Omalizumab Response in Patients with Chronic Spontaneous Urticaria (CSU).** *Journal of Allergy and Clinical Immunology.*2026;157(2):AB426. [doi:10.1016/j.jaci.2025.12.949.](https://www.jacionline.org/article/S0091-6749(25)02132-3/fulltext) **Category:** Events --- ### [GAI Honors ARCS Scholar Ian McKnight](https://www.autoimmuneinstitute.org/research_updates/gai-honors-arcs-scholar-ian-mcknight/) **Published:** September 3, 2026 **Author:** Carolyn Serraino **Excerpt:** GAI honors Ian McKnight as its 2026–2027 ARCS Scholar. His Johns Hopkins research examines how airway epithelial cells shape immune responses in allergic asthma. **Content:** ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/09/Headshot-Ian-July-2025-Ian-McKnight.jpg.webp) The Global Autoimmune Institute is proud to support **Ian McKnight as the 2026–2027 Global Autoimmune Institute Scholar** through a **$15,000 award** in partnership with the [ARCS Foundation Metro Washington Chapter](https://metro-washington.arcsfoundation.org/). Ian is a first-year scholar in **[Biomedical Engineering at Johns Hopkins University](https://www.bme.jhu.edu/)**, where he is studying how cells in the airways influence immune responses. #### His research focuses on specific populations of epithelial cells in the airways and how they shape immune responses in the context of allergic asthma. Ian is also developing **lipid nanoparticle-based delivery systems** designed to therapeutically target these cells. His work brings together airway biology, immune responses, and the development of new approaches for delivering treatment directly to specific cell populations. #### Ian will be recognized alongside the other 2026–2027 ARCS Metro Washington scholars at the Scholar Awards Reception on November 5. GAI is proud to support Ian’s research and continue investing in promising scientists working to deepen our understanding of the immune system. ### More to Read [ Ian McKnight’s Story at Johns Hopkins Biomedical Engineering ](https://www.bme.jhu.edu/news-events/news/allergy-journey-sparks-bme-graduate-students-research/) Learn more about Ian’s path into allergy research, the personal experiences that shaped his interests, and the questions driving his work today. [ Meet the 2026–2027 ARCS Scholars ](https://metro-washington.arcsfoundation.org/node/5835) See the full group of scholars selected by ARCS Foundation Metro Washington for the 2026–2027 academic year. [ GAI Honors 2025–2026 ARCS Scholar Nikita Sivakumar ](https://www.autoimmuneinstitute.org/research_updates/gai-honors-arcs-scholar-nikita-sivakumar/) Read about last year’s Global Autoimmune Institute Scholar and Nikita’s research on how immune cells move and communicate during infection and vaccination. [ Related Research at La Jolla Institute for Immunology ](https://www.lji.org/news-events/news/post/intranasal-flumist-vaccine-immunity-crotty-study/) LJI researchers are also studying immune activity in the upper airways, including how nasal vaccination can generate local immune responses that are not reflected in blood. **Category:** Events, GAI-Funded --- ### [GAI Honors ARCS Scholar Nikita Sivakumar](https://www.autoimmuneinstitute.org/research_updates/gai-honors-arcs-scholar-nikita-sivakumar/) **Published:** September 8, 2025 **Author:** Carolyn Serraino **Content:** ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/09/Nikita-Sivakumar-the-2025–2026-Global-Autoimmune-Institute-Scholar.png) The Global Autoimmune Institute is proud to support the ARCS Foundation with a $15,000 award recognizing **[Nikita Sivakumar](https://metro-washington.arcsfoundation.org/node/5706)** as the **2025–2026 Global Autoimmune Institute Scholar**, in honor of **Benjamin Kim, Esq., and Amy Neuhardt, Esq**. Nikita is a [doctoral student](https://philliptimelab.wse.jhu.edu/people/) in Biomedical Engineering at Johns Hopkins University with a focus on computational medicine. #### [Her research](https://scholar.google.com/citations?user=v40a2iYAAAAJ&hl=en) investigates how immune cells migrate and communicate during infection and vaccination, crucial processes that influence the body’s ability to generate long-lasting protection. Using advanced imaging and computational modeling, she is developing new tools to uncover how cellular behaviors drive immunity, with broad implications for infection, vaccination, and autoimmune disease. #### Nikita will be honored at the **[ARCS Awards Ceremony](https://lp.constantcontactpages.com/ev/reg/vr8pryp/lp/e4e3af9b-99df-4666-a679-e7feea1606dc) on October 23 at the National Academy of Sciences (NAS)**. The ARCS Scholar Award is a highly prestigious honor, reflecting the excellence and promise of its recipients. We are proud to recognize Nikita Sivakumar for her groundbreaking work in computational immunology and her dedication to advancing our understanding of the immune system. We also extend our gratitude to **Benjamin Kim, Esq., and Amy Neuhardt, Esq.**, whose generosity makes this scholarship possible and reflects their commitment to advancing research in immunology and autoimmune disease. **Category:** Events, GAI-Funded --- ### [LEAD Day 2026 Announces Eric Topol as Award Recipient](https://www.autoimmuneinstitute.org/research_updates/lead-day-2026-announces-eric-topol-as-award-recipient/) **Published:** July 27, 2026 **Author:** Carolyn Serraino **Excerpt:** LEAD Day 2026 will take place on Tuesday, September 15, 2026, at the Scripps Seaside Forum in La Jolla, California. This annual event brings together leading scientists, healthcare professionals, advocates, and the autoimmune disease community to explore emerging discoveries shaping the future of autoimmune disease research. **Content:** ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/07/LEAD-Day-2026-3-1-1024x576.jpg) GAI is proud to announce **LEAD Day 2026 ([Lectures, Empowerment, and Awareness in Autoimmune Disease](https://www.autoimmuneinstitute.org/lead-day/ "Lectures, Empowerment, and Awareness in Autoimmune Disease (LEAD) Day"))**, an annual event that brings together leading scientists, healthcare professionals, advocates, and the autoimmune disease community to explore emerging discoveries shaping the future of autoimmune disease research. #### LEAD Day 2026 will take place on Tuesday, September 15, 2026, at the Scripps Seaside Forum in La Jolla, California. Attendees can expect scientific discussions, audience Q&A sessions, a keynote lecture by internationally recognized physician-scientist **Eric Topol, M.D.**, presentation of the **Walter and Jean Boek Leadership in Research Award**, and a community reception. [ Space is Limited Register Today → ](http://lji.org/lead-day) ### The Future of Autoimmune Disease Research The scientific panel, **“AI and Multi-Omics: Building a New Era of Autoimmune and Chronic Disease Research,”** will examine how [artificial intelligence](https://www.autoimmuneinstitute.org/articles/the-promise-of-ai-in-autoimmune-disease-from-early-detection-to-personalized-care "The Promise of Artificial Intelligence in Autoimmune Disease Healthcare") and multi-omics technologies, including [genomics](https://www.autoimmuneinstitute.org/articles/personalized-medicine-for-autoimmune-diseases "Personalized Medicine for Autoimmune Diseases"), proteomics, transcriptomics, metabolomics, and other large-scale biological data, are helping researchers better understand disease mechanisms, identify new therapeutic targets, and accelerate [precision medicine](https://www.autoimmuneinstitute.org/articles/tailoring-autoimmune-treatment-with-precision-medicine "Tailoring Autoimmune Treatment with Precision Medicine"). The discussion will be followed by an audience question-and-answer session, giving attendees an opportunity to engage directly with experts working at the forefront of biomedical research. ### Eric Topol to Deliver Keynote Lecture ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/07/Approved-Head-Shot-Eric-Topol-794x1024.jpg) **Eric Topol, MD**, is the Executive Vice-President of Scripps Research, the largest non-profit biomedical research in the United States, where he is founder and director of the Scripps Research Translational Institute in 2007. Clinically active as a cardiologist, he previously led Cleveland Clinic cardiology to become the leading heart center in the US. He was the founder of a new medical school at Cleveland Clinic (Lerner College of Medicine), was commissioned by the UK government to lead a review of their National Health Service. Topol is a principal investigator of two large NIH grants for innovations to promote human health. He has published over 1,300 peer-reviewed articles, with more than 380,000 citations, elected to the National Academy of Medicine, and is one of the top 10 most cited researchers in medicine. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/07/2025_TIME100-Health-Logo_Web-Banner_1920x620-1024x331.png) In 2024, Topol was featured in the inaugural TIME100 Health list of most influential people in health in the world. In 2025, he was voted as one of the 25 Best Leaders in the United States (US News). He has authored four bestseller books on the future of medicine: [The Creative Destruction of Medicine, The Patient Will See You Now](https://www.amazon.com/Creative-Destruction-Medicine-Digital-Revolution/dp/0465061834/ref=sr_1_1?crid=1VR6E3V8X3BQT&dib=eyJ2IjoiMSJ9.6Vb60noLJIsuyP2BYoXKp20B6cSUDJPe8BFTSrF8RdE.Arc3SgYeNvPR1DLC-1WXc8LtEbwoWfO-PswGSGk4MRs&dib_tag=se&keywords=topol%2C+creative+destruction+of+medicine&qid=1746892666&s=books&sprefix=topol%2C+creative+destruction+of+medicen%2Cstripbooks%2C115&sr=1-1), and [Deep Medicine: How Artificial Intelligence Can Make Healthcare Human Again](https://www.amazon.com/Deep-Medicine-Artificial-Intelligence-Healthcare/dp/1541644638) and his new book, [Super Agers: An Evidence-Based Approach to Longevity](https://www.simonandschuster.com/books/Super-Agers/Eric-Topol/9781668067666). At Substack, he publishes [Ground Truths](https://erictopol.substack.com/), a weekly newsletter and podcast on cutting edge biomedical advances. #### Walter and Jean Boek Leadership in Research Award recipient Eric Topol, M.D., will give a keynote lecture titled “Super Agers and the Immune System.” Following the keynote, attendees will have the chance to engage with Dr. Topol during a live Q&A before the award presentation. Then, continue the conversation over an entirely gluten-free menu of refreshments at a sunset reception overlooking the Pacific Ocean. ### Bridging Scientific Discovery and the Autoimmune Community Autoimmune disease research continues to advance rapidly, yet many important scientific discoveries remain within research communities long before they reach the people living with these conditions. LEAD Day was created to help bridge that gap by bringing researchers and the broader community together to discuss emerging science, answer questions, and explore how new discoveries may influence the future of autoimmune disease prevention, diagnosis, and treatment. #### ***[Registration is free, but space is limited!](https://donate.lji.org/event/lead-day/e827225)*** > ### Learn More Ahead of LEAD Day 2026, readers interested in this year’s themes may also enjoy several recent *Ground Truths* articles by Eric Topol that explore emerging advances in artificial intelligence, immunology, and autoimmune disease research. [**The First Diagnostic Immunome**](https://erictopol.substack.com/p/the-first-diagnostic-immunome) explores how AI and immune receptor sequencing could transform [autoimmune disease diagnosis](https://www.autoimmuneinstitute.org/gai-library/#diagnosis). [**The Exhilarating Movement From Treatment to Cures for Autoimmune Diseases**](https://erictopol.substack.com/p/the-exhilirating-movement-from-treatment) examines emerging therapies designed to restore [immune tolerance](https://www.autoimmuneinstitute.org/articles/restoring-immune-tolerance-in-autoimmune-disease "Restoring Immune Tolerance in Autoimmune Disease") and the growing potential for curative approaches to autoimmune disease. [**Patrick Hsu: How Is AI Catalyzing Life Science?**](https://erictopol.substack.com/p/how-is-ai-catalyzing-life-science) features a conversation on how AI, genome editing, large language models for biology, and digital biology are accelerating scientific discovery and reshaping biomedical research. **Category:** Events, GAI-Funded --- ### [New Study Provides Genetic Clues to Autoimmune Disease Risk in Women](https://www.autoimmuneinstitute.org/research_updates/new-study-provides-genetic-clues-to-autoimmune-disease-risk-in-women/) **Published:** May 8, 2026 **Author:** Carolyn Serraino **Content:** Women are [disproportionately affected by many autoimmune diseases](https://www.autoimmuneinstitute.org/articles/how-sex-genetics-influence-autoimmunity "How Sex & Genetics Influence Autoimmunity"), but the biological reasons behind these differences are still not fully understood. A new study, published in May 2026, has identified sex-specific differences in immune cell populations, gene activity, and genetic regulation that may help explain why female immune systems are more prone to autoimmune disease. #### Researchers analyzed more than 1.25 million immune cells from 982 healthy individuals using single-cell RNA sequencing. This approach allowed them to examine individual types of immune cells rather than averaging signals across whole blood samples, revealing differences that can be hidden in bulk analyses. #### They found that males and females differed in the proportions of several immune cell types. Females had higher proportions of B cells, CD4+ naive T cells, regulatory T cells, and one type of natural killer cell, while males had higher proportions of CD14+ monocytes, dendritic cells, several memory T cell populations, and other natural killer cells. #### Differences also appeared in gene activity. Female-biased genes across several immune cell types were enriched in pathways involved in [inflammation](https://www.autoimmuneinstitute.org/articles/inflammation-a-driving-force-of-autoimmune-disease "Inflammation: A Driving Force of Autoimmune Disease"), including TNF-alpha signaling, while male-biased genes were more strongly associated with ribosomal functions such as protein production and RNA processing. The researchers found that most of these sex-biased genes were located on autosomes rather than the X or Y chromosomes, suggesting that differences between male and female immunity extend well beyond the sex chromosomes. The team also examined expression quantitative trait loci, or **eQTLs**, genetic variants that influence how strongly particular genes are expressed. They identified more than 1,000 sex-specific eQTLs, along with additional genetic variants whose effects differed between males and females. Many of these regulatory differences were specific to particular immune cell types. #### Two findings were particularly relevant to autoimmune disease. The researchers identified female-biased expression and sex-specific genetic regulation involving **FCGR3A** in natural killer cells and **ITGB2** in monocytes. Both genes have previously been associated with systemic lupus erythematosus or related autoimmune pathways. Lupus is one of the autoimmune diseases with the strongest sex imbalance, occurring far more often in women than in men. #### Importantly, the study looked at immune cells under baseline conditions rather than during infection or active disease. The researchers suggest that these underlying differences may create distinct starting points for male and female immune responses, which could become more pronounced when the immune system is activated. The findings add to growing evidence that sex can influence immune function at the cellular and genetic levels. Understanding these differences could ultimately help researchers better explain sex-related differences in autoimmune disease susceptibility and develop more individualized approaches to studying and treating autoimmune conditions. ##### Citation Yazar, S., Alquicira-Hernandez, J., Wing, K., Senabouth, A., Andersen, S., Fairfax, K. A., Hewitt, A. W., Powell, J. E., & Ballouz, S. (2026). The impact of sex on the immune system explored at the single-cell level. *American journal of human genetics*, *113*(5), 1006–1023. <https://doi.org/10.1016/j.ajhg.2026.04.003> **Category:** Genetics, Research Studies, Risk Factors --- ### [Potential mRNA Treatment for Autoimmune Disease](https://www.autoimmuneinstitute.org/research_updates/mrna-treatment-multiple-sclerosis/) **Published:** February 5, 2021 **Author:** Elevation **Excerpt:** These are truly novel times that we are experiencing, and the scientific community is no different. A new mRNA vaccine technology demonstrates the possibility of treating disease-specific autoimmunity for diseases like multiple sclerosis **Category:** Clinical Trials, Multiple Sclerosis, Research Studies, Therapies --- ### [Medical Dismissal, Patient Advocacy, and Finding Clinicians Who Listen](https://www.autoimmuneinstitute.org/research_updates/medical-dismissal-patient-advocacy-and-finding-clinicians-who-listen/) **Published:** August 20, 2026 **Author:** Carolyn Serraino **Content:** In an [August 2026 episode of *The Checkup with Doctor Mike*](https://youtu.be/-1XO1ND4pv0?si=wqO5oUIXGqBdC8Se), family medicine physician and health advocate **Bayo Curry-Winchell, MD, MS ([Dr. Bayo](https://www.youtube.com/@Dr_Bayo)),** discussed medical dismissal, bias in healthcare, and practical ways people can advocate for themselves when they feel their symptoms are not being taken seriously. #### Dr. Bayo shared experiences from both sides of the healthcare system. While in medical school, she developed joint swelling, fatigue, hair loss, and other symptoms and sought care from multiple doctors. She said her symptoms were repeatedly attributed to the stress of medical school before a seventh physician ultimately helped identify that she had [lupus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus (SLE)") and [antiphospholipid syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/antiphospholipid-syndrome/ "Antiphospholipid syndrome"). She also described nearly dying after the birth of her second child. Shortly after a C-section, Dr. Bayo knew something was wrong and repeatedly alerted her nurse, but said she was reassured that she looked fine and that her vital signs were normal. She was later found to have retained products of conception and internal bleeding and required a blood transfusion. Throughout the conversation, Dr. Bayo emphasized the importance of listening to people’s descriptions of their own symptoms, recognizing assumptions that can influence medical decision-making, and improving communication between clinicians and those seeking care. For people who feel their concerns are being dismissed, she suggested preparing two or three primary concerns before an appointment and describing specifically how symptoms are affecting daily life. She also recommended asking what the next steps are when test results are normal but symptoms persist and seeking additional support or another opinion when concerns remain unresolved. These experiences may be particularly familiar to people living with autoimmune and other chronic diseases, where symptoms can be complex and the path to diagnosis may be long. Dr. Bayo’s own experience of repeatedly seeking answers before receiving her lupus and antiphospholipid syndrome diagnoses illustrates how consequential it can be when persistent or unexplained symptoms are attributed to stress or otherwise dismissed. #### Dr. Bayo’s experiences also inspired her to create **[Clinicians Who Care](https://clinicianswhocare.com/)**, a free, community-built resource for finding compassionate healthcare professionals. The growing international directory includes more than 6,000 clinicians across dozens of specialties, including rheumatology, neurology, gastroenterology, endocrinology, allergy and immunology, dermatology, and other fields frequently involved in autoimmune care. Users can filter the directory by location, field of medicine, clinician type, and community-submitted tags such as “Listens & Believes Patients” and “Patient Advocate.” Recommendations in the directory are submitted by community members and are not independently verified or endorsements of individual clinicians. Instead, **[Clinicians Who Care](https://clinicianswhocare.com/)** is intended as a starting point for people searching for a healthcare professional who may be a good fit. Community members can also add clinicians who have made a positive difference in their own care. ### Related GAI Resources If this conversation resonates with you, these GAI resources offer additional guidance on navigating medical dismissal, communicating with healthcare providers, and the often complicated path to an autoimmune diagnosis. [ When You’ve Lost Trust in Doctors… ](https://www.autoimmuneinstitute.org/articles/when-youve-lost-trust-in-doctors/) Guidance for people who have felt dismissed, misdiagnosed, or unheard and are trying to rebuild trust in healthcare. [ Effective Communication Strategies for Those with Autoimmune Disease ](https://www.autoimmuneinstitute.org/articles/effective-communication-strategies-for-patients-with-autoimmune-diseases/) Practical ways to prepare for appointments, describe symptoms, ask questions, and build a more collaborative relationship with your healthcare provider. [ Experts Discuss the Complex Path to an Autoimmune Diagnosis ](https://www.autoimmuneinstitute.org/articles/experts-discuss-the-complex-path-to-an-autoimmune-diagnosis/) Expert perspectives on why autoimmune diagnoses can take time and how to keep moving forward when symptoms persist without clear answers. [ Misdiagnosed and Undiagnosed: Expert Insights on the Autoimmune Diagnosis Process ](https://www.autoimmuneinstitute.org/articles/misdiagnosed-undiagnosed-expert-insights-on-the-autoimmune-diagnosis-process/) A closer look at why autoimmune diseases may be missed or misdiagnosed and the role of continued evaluation, second opinions, and self-advocacy. [ Navigating Autoimmune Care With Limited Resources ](https://www.autoimmuneinstitute.org/articles/navigating-autoimmune-care-with-limited-resources/) Strategies for overcoming barriers to care, making the most of medical appointments, finding support, and advocating for your needs. **Category:** Autoimmune Stories, Resources --- ### [SWHR Webinar Highlights Rare Autoimmune Disease Challenges](https://www.autoimmuneinstitute.org/research_updates/swhr-webinar-august-14-2026/) **Published:** August 14, 2026 **Author:** Carolyn Serraino **Excerpt:** A Society for Women’s Health Research (SWHR) webinar brought together clinical, advocacy, and lived-experience perspectives on the challenges women face, including diagnostic delays, healthcare disparities, gaps in genetic testing, and the need for more coordinated care. **Content:** On **August 14, 2026**, the [Society for Women’s Health Research (SWHR)](https://swhr.org/) hosted a [public webinar](https://swhr.org/event/the-state-of-rare-autoimmune-diseases-in-women/) examining gaps in the diagnosis, treatment, and long-term care of women living with rare autoimmune diseases. [![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/08/SWHR-State-of-Rare-AD-in-Women-Goals-August-14.png)](https://swhr.org/event/the-state-of-rare-autoimmune-diseases-in-women/) #### The discussion brought together perspectives from clinical rheumatology practice, rare disease advocacy, and lived experience. [![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/08/SWHR-State-of-Rare-AD-in-Women-Panelists-August-14-1024x496.png)](https://swhr.org/event/the-state-of-rare-autoimmune-diseases-in-women/) Speakers emphasized that rare autoimmune diseases can be especially difficult to recognize because [symptoms often overlap](https://www.autoimmuneinstitute.org/articles/autoimmune-or-not-the-diseases-that-blur-the-lines "Autoimmune or Not? The Diseases That Blur the Lines") across conditions and may involve [multiple organ systems](https://www.autoimmuneinstitute.org/articles/body-regions-commonly-affected-by-autoimmunity "Body Regions Commonly Affected by Autoimmunity"). #### [Fragmented healthcare](https://www.autoimmuneinstitute.org/gai-library/#healthcare) can further complicate diagnosis when people must see [several specialists](https://www.autoimmuneinstitute.org/doctors-who-diagnose-treat/ "Doctors who Diagnose & Treat Autoimmune Disease") who may not routinely communicate with one another. Alexa Meara, M.D., a rheumatologist whose work includes [autoimmune disease and cancer](https://www.autoimmuneinstitute.org/gai-library/#immune-spectrum), described the challenges created by **medical “silos.”** Symptoms such as joint pain, rashes, fatigue, and a general feeling of being unwell can occur across autoimmune diseases as well as infections and other conditions, making diagnosis dependent on recognizing patterns across a person’s full medical picture. #### Dr. Meara also discussed the role of [sex hormones in autoimmune disease](https://www.autoimmuneinstitute.org/articles/how-sex-genetics-influence-autoimmunity "How Sex & Genetics Influence Autoimmunity"). Autoimmune diseases disproportionately affect women, and estrogen is known to influence immune regulation, but researchers still do not fully understand how hormonal changes interact with genetics, immune activity, environmental exposures, and disease progression across the lifespan. Jennifer Waldrop, executive director of the [Rare Disease Diversity Coalition](https://www.rarediseasediversity.org/), highlighted additional disparities affecting people from historically under-served communities. She discussed data collected with the [National Organization for Rare Disorders](https://rarediseases.org/) showing gaps in access to genetic testing among people with rare diseases, as well as [financial and healthcare access barriers](https://www.autoimmuneinstitute.org/articles/navigating-autoimmune-care-with-limited-resources "financial and healthcare access barriers"). #### Because some rare autoimmune diseases have a genetic basis, improving appropriate access to genetic testing and counseling may help shorten the diagnostic journey for some people. The patient perspective was shared by Kanasha Gunter, a [myositis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/polymyositis/ "Myositis/polymyositis") advocate who described being diagnosed with other conditions before ultimately finding a myositis specialist several years later. She emphasized the burden placed on people with complex illnesses when they must coordinate care across multiple specialists, medications, family responsibilities, and healthcare systems. Across the discussion, speakers called for better communication between specialists, greater awareness of rare autoimmune diseases, more representative research, improved access to appropriate testing, and healthcare systems that place less responsibility on individuals to bridge gaps in their own care. #### The panel also emphasized the importance of [self-advocacy](https://www.autoimmuneinstitute.org/articles/effective-communication-strategies-for-patients-with-autoimmune-diseases "Effective Communication Strategies for Those with Autoimmune Disease"). For people experiencing persistent or unexplained symptoms, speakers encouraged asking questions, seeking reliable information and patient advocacy resources, and continuing to work with healthcare professionals when something does not feel right. [See Resource: Autoimmune Terminology to Know For Your Next Doctor’s Appointment](https://www.autoimmuneinstitute.org/articles/autoimmune-terminology-to-know-for-your-next-doctors-appointment) The forum reflects a broader challenge in autoimmune disease care: although understanding of the immune system and available treatments continues to advance, significant gaps remain in translating that progress into timely diagnosis and coordinated, individualized care. **Category:** Events, Research Studies, Risk Factors --- ### [Celebrating Year One of the Walter and Jean Boek Seminar Series](https://www.autoimmuneinstitute.org/research_updates/walter-and-jean-boek-seminar-series-year-one/) **Published:** July 24, 2025 **Author:** Carolyn Serraino **Content:** The Global Autoimmune Institute and [La Jolla Institute for Immunology](https://www.autoimmuneinstitute.org/gai-and-la-jolla-institute-for-immunology/ "GAI and La Jolla Institute for Immunology") launched the [Walter and Jean Boek Seminar Series](https://www.autoimmuneinstitute.org/research_updates/walter-and-jean-boek-seminar-series-at-lji/ "Walter and Jean Boek Seminar Series at LJI") with a shared vision: to create a forum where leading scientists could exchange ideas, challenge current thinking, and accelerate discoveries that improve the lives of people affected by autoimmune disease. #### Over the past year, that vision has grown into a vibrant platform for scientific collaboration, bringing together researchers from around the world to share emerging discoveries, explore new technologies, and advance the understanding of autoimmune and inflammatory diseases. Under the scientific leadership of **Global Autoimmune Institute Assistant Professor Samuel Anthony Myers, Ph.D**., the seminar series welcomed distinguished researchers from leading institutions around the world, including Harvard Medical School, UC San Diego, Purdue University, Cold Spring Harbor Laboratory, Brigham and Women’s Hospital, Mass General Research Institute, Sanford Burnham Prebys, the University of Alabama at Birmingham, TECregen, and the National Institute of Allergy and Infectious Diseases. Together, these speakers explored topics spanning immunology, immune cell biology, cancer immunology, regenerative medicine, data science, developmental biology, metabolism, pregnancy immunology, and emerging therapeutic strategies that are shaping the future of autoimmune and inflammatory disease research. #### With approximately a dozen seminars each year and audiences of 50 to 100 attendees per session, the series continues to expand its reach while fostering meaningful dialogue across the scientific community.  The seminars attracted researchers, faculty, students, and collaborators from across the Torrey Pines Research Mesa, creating opportunities for interdisciplinary discussion and new scientific partnerships. ### Research Themes That Shaped the First Year While each seminar focused on a unique area of research, several overarching themes emerged throughout the year, reflecting where autoimmune and immunology research is headed. #### Artificial Intelligence and Data Science Benjamin Smarr’s seminar explored how large-scale health data and time series analysis are changing the way researchers understand human health, highlighting the growing role of [artificial intelligence](https://www.autoimmuneinstitute.org/articles/the-promise-of-ai-in-autoimmune-disease-from-early-detection-to-personalized-care "The Promise of Artificial Intelligence in Autoimmune Disease Healthcare"), computational biology, and advanced analytics in biomedical research. #### Engineering the Immune System Several lectures focused on harnessing immune cells as therapies, including [CAR-based approaches](https://www.autoimmuneinstitute.org/articles/car-t-cell-therapy-for-autoimmune-disease "CAR T-Cell Therapy For Autoimmune Disease"), immune checkpoint biology, cytokine signaling, and regulatory T cells, highlighting how scientists are learning to [precisely direct immune responses](https://www.autoimmuneinstitute.org/articles/restoring-immune-tolerance-in-autoimmune-disease "Restoring Immune Tolerance in Autoimmune Disease") to treat disease. #### Immune Development and Regulation Researchers examined how immune cells develop, communicate, and maintain balance, from B-cell development and gene regulation to interactions between innate and adaptive immune cells. #### Precision Medicine Presentations emphasized understanding disease at increasingly detailed levels through advanced imaging, single-cell technologies, molecular profiling, and systems biology, laying the foundation for more [personalized approaches](https://www.autoimmuneinstitute.org/articles/personalized-medicine-for-autoimmune-diseases "Personalized Medicine for Autoimmune Diseases") to diagnosing and treating autoimmune disease. #### Metabolism, Nutrition, and Regeneration Emerging research demonstrated how metabolism, [nutrition](https://www.autoimmuneinstitute.org/gai-library/#ad-food), and tissue regeneration influence immunity and disease, reinforcing the interconnected nature of immune health. #### Pregnancy and Immune Health Andrea Edlow’s lecture highlighted immune interactions during [pregnancy](https://www.autoimmuneinstitute.org/articles/pregnancy-with-an-autoimmune-disease "Pregnancy with an Autoimmune Disease"), expanding understanding of maternal-fetal immune biology and its implications for [healthy pregnancies](https://www.autoimmuneinstitute.org/articles/how-autoimmune-disease-affects-fertility "How Autoimmune Disease Affects Fertility") and immune-mediated disease. ### 2024-2025 Boek Seminar Series Lectures | **Date** | **Speaker** | **Institution** | **Lecture** | |---|---|---|---| | October 29, 2024 | Xiaoping Bao, PhD | Purdue University | Engineer CAR-Neutrophils for Targeted Chemoimmunotherapy Against Glioblastoma | | October 30, 2024 | Mikael Sigvardsson, PhD | Lund University | Gene Regulatory Networks Link Normal B-Cell Development to Human B-Lymphoid Leukemia | | November 6, 2024 | Benjamin Smarr, PhD | UC San Diego | How Big Time Series Data Change the Way We See Health | | December 4, 2024 | Vijay Sankaran, MD, PhD | Harvard Medical School / Boston Children’s Hospital | Deciphering the Mechanisms of Predisposition to Childhood B-Cell Leukemia | | January 15, 2025 | Christopher Obara | UC San Diego | Integrating Dynamic and Cryogenic Imaging Technologies to Map the Landscape of Organelle Membranes | | February 12, 2025 | Semir Beyaz, PhD | Cold Spring Harbor Laboratory | Nutritional Regulation of Tissue Regeneration, Cancer and Immunity | | March 4, 2025 | David Hoytema van Konijnenburg, PhD | Harvard Medical School | Innate and Adaptive Immune Cell Interactions in the Lung | | May 21, 2025 | Kelly Kersten, PhD | Sanford Burnham Prebys | Dissecting Macrophage-T Cell Crosstalk in Cancer | | May 28, 2025 | Ignacio Moraga Gonzalez | TECregen | Molecular and Environmental Determinants Defining the Functional Diversity of Cytokines | | June 4, 2025 | Vijay Kuchroo, PhD | Brigham and Women’s Hospital / Harvard Medical School | Checkpoint Molecules, Tregs and Induction of Anti-Tumor Immunity | | June 25, 2025 | Andrea Edlow, MD, MSc | Harvard Medical School / Mass General Research Institute | Immune Interactions at the Maternal-Fetal Interface at Single Cell Resolution | *\* Three additional seminars were scheduled during the academic year but were canceled or postponed due to government travel restrictions, scheduling conflicts, or personal circumstances.* *\*\* Please note that these seminars are open to LJI scientists, as well as scientists and clinicians from other San Diego medical institutions only. The lectures are designed for a highly specialized scientific audience* *and serve as a platform for in-depth discussions on key topics in immunology.* ### Looking Forward Rather than ending with the final seminar, these conversations continue through [LEAD Day](https://www.autoimmuneinstitute.org/lead-day/ "Lectures, Empowerment, and Awareness in Autoimmune Disease (LEAD) Day") (Lectures, Empowerment, and Awareness in Autoimmune Disease), which serves as the public extension of the seminar series by bringing researchers, clinicians, advocates, caregivers, and people living with autoimmune disease together to discuss emerging discoveries and what they may mean for the future of prevention, diagnosis, and treatment. As the Walter and Jean Boek Seminar Series begins its second year, it continues to demonstrate the value of sustained scientific collaboration. By connecting researchers across disciplines and extending those conversations beyond the laboratory, the partnership between the Global Autoimmune Institute and La Jolla Institute for Immunology is helping accelerate autoimmune disease research while ensuring scientific discoveries reach the people whose lives they are intended to improve. **Category:** Events, Resources --- ### [Preventing Biologics from Crossing the Placenta During Pregnancy](https://www.autoimmuneinstitute.org/research_updates/preventing-biologics-from-crossing-the-placenta-during-pregnancy/) **Published:** August 17, 2026 **Author:** Carolyn Serraino **Content:** [Biologics](https://www.autoimmuneinstitute.org/articles/biologics-for-autoimmune-disease-what-you-should-know "Biologics for Autoimmune Disease: What You Should Know") have been a highly effective option to treat autoimmune diseases. However, some medications used to treat autoimmune diseases, like methotrexate and thalidomide, must be discontinued during [pregnancy](https://www.autoimmuneinstitute.org/articles/pregnancy-with-an-autoimmune-disease "Pregnancy with an Autoimmune Disease") because of the exposure risk to the developing fetus. There is little evidence currently supporting the safe use of these therapies during pregnancy. Normally, biologics can cross the placenta through the neonatal Fc receptor. In a recent study, scientists found that fusing IgG antibodies, which are the basis of many biologic drugs, to the protein albumin greatly reduced their transport across the placenta. The researchers demonstrated this in mouse models and in human placental tissue. “By understanding this, we now have the opportunity to develop a new generation of biologic medicines that combine long-lasting efficacy with improved safety during pregnancy,” says Jan Terje Andersen, a professor at the University of Oslo and Oslo University Hospital who led the study. If this approach enables biologics to be used more safely during pregnancy, it could help more people with autoimmune diseases continue treatment and manage symptoms while reducing fetal exposure. ### Pregnancy and Autoimmune Disease Pregnancy can pose unique challenges for people living with autoimmune disease. This series explores how immune changes throughout conception, pregnancy, and the postpartum period influence fertility, disease activity, treatment decisions, and maternal and infant health. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/08/preg-article-1-1024x576.png) Pregnancy with an Autoimmune Disease How autoimmune disease affects pregnancy, from flare risks to medication safety, fertility, and long-term health, plus expert guidance on managing care. About Autoimmune Disease [Read Post Pregnancy with an Autoimmune Disease](https://www.autoimmuneinstitute.org/articles/pregnancy-with-an-autoimmune-disease) ![A woman lying on a bed holding a negative pregnancy test, symbolizing infertility challenges related to autoimmune disease.](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/09/Infertility-and-ADs-2-1024x576.png) How Autoimmune Disease Affects Fertility Infertility is more common in autoimmune disease. Discover how inflammation, hormones, and medications affect fertility and what treatments may help. About Autoimmune Disease [Read Post How Autoimmune Disease Affects Fertility](https://www.autoimmuneinstitute.org/articles/how-autoimmune-disease-affects-fertility) ![Why Autoimmunity Emerges Postpartum and How to Recognize It](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/08/New-Website-Banners-articles-2-1024x576.png) Why Autoimmunity Emerges Postpartum and How to Recognize It Why autoimmune disease can emerge after childbirth, common postpartum autoimmune symptoms, and treatment considerations while breastfeeding. About Autoimmune Disease [Read Post Why Autoimmunity Emerges Postpartum and How to Recognize It](https://www.autoimmuneinstitute.org/articles/why-autoimmunity-emerges-postpartum-and-how-to-recognize-it) #### **Citation** Nilsen J, Sand KMK, Al-Khabbaz HJ, et al. (2026) Fusion of IgG antibodies to albumin inhibits transport across the placenta. *Sci Immunol*. 11(122):eaee5151. <https://doi.org/10.1126/sciimmunol.aee5151> **Category:** Research Studies, Risk Factors, Therapies --- ### [Autoimmune Chapters: A New Way to Understand Life with Chronic Illness](https://www.autoimmuneinstitute.org/research_updates/autoimmune-chapters/) **Published:** August 7, 2026 **Author:** Carolyn Serraino **Excerpt:** High school student Sofie Duan has created Autoimmune Chapters, a free, ad-free interactive website designed to build greater understanding of the day-to-day realities of living with autoimmune and chronic disease. Inspired by her own experience navigating suspected Behçet’s disease, Duan developed a story-driven experience that places visitors in the role of a caregiver supporting a fictional person with chronic illness. **Content:** [ ![Interactive medication scene from Autoimmune Chapters](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/08/Autoimmune-Chapter-Experience-scaled.png) Interactive Experience ### Experience Autoimmune Chapters Spend a few minutes in someone else’s shoes and see how the small choices we make when speaking to and supporting someone with autoimmune or chronic illness make all the difference. Begin the Journey → ](https://autoimmune-chapters.netlify.app/) High school student Sofie has created **[Autoimmune Chapters](https://autoimmune-chapters.netlify.app/)**, a free, ad-free interactive website designed to build greater understanding of the day-to-day realities of living with autoimmune and chronic disease. Inspired by her own experience, Sofie developed a story-driven simulation that places visitors in the role of a caregiver supporting a fictional person with chronic illness. Throughout the approximately 10-minute journey, visitors make choices about how to respond as the story unfolds, while visuals, dialogue, soundscapes, and an interactive happiness meter illustrate how seemingly small moments can affect someone managing symptoms that others may not see. As visitors move through the story, the experience highlights how much of chronic illness can remain invisible to others and how everyday interactions can affect someone already managing symptoms such as fatigue and pain. The project encourages visitors to consider what empathy and meaningful support can look like in those moments. ### **[Share Your Story](https://www.autoimmuneinstitute.org/share-your-story/ "Share your Story")** **Your experience can help someone else feel seen.** Personal stories can build understanding, raise awareness, and remind others living with autoimmune or chronic illness that they aren’t alone. If you’re interested in sharing your experience, GAI offers prompts, writing tips, and the opportunity to submit your story for publication. ## Learn More Continue learning about the lived experience of autoimmune and chronic disease and how we can better support the people in our lives. [ Supporting Others How to Support Someone with Autoimmune or Chronic Disease Practical guidance on listening, respecting boundaries, offering meaningful help, and avoiding common mistakes when supporting someone with chronic illness. → ](https://www.autoimmuneinstitute.org/articles/how-to-support-someone-with-autoimmune-or-chronic-disease) [ Living with Chronic Illness Finding Purpose and Fulfillment with Autoimmune and Chronic Disease Expert insights on rebuilding identity, setting realistic goals, managing energy, and finding meaningful ways to work, create, volunteer, or support others. → ](https://www.autoimmuneinstitute.org/articles/finding-purpose-and-fulfillment-with-autoimmune-and-chronic-disease) [ Communication What Not to Say to Someone with a Chronic Illness A practical look at common comments that can feel dismissive or invalidating, along with more supportive ways to respond. → ](https://www.autoimmuneinstitute.org/articles/what-not-to-say-to-someone-with-a-chronic-illness) **Category:** Autoimmune Stories, Resources --- ### [C-Section Birth Linked to Higher Crohn’s Disease Risk](https://www.autoimmuneinstitute.org/research_updates/study-finds-cesarean-section-linked-to-crohns-disease-later-in-life/) **Published:** August 4, 2022 **Author:** Carolyn Serraino **Excerpt:** A Swedish study of more than 1.1 million people found that C-section birth, particularly elective C-section, was associated with a higher risk of Crohn’s disease later in life. **Content:** A study titled Delivery mode and risk of gastrointestinal disease in the offspring that followed over a million full-term babies found a possible connection between Cesarean section (also known as C-section) delivery mode and the development of Crohn’s disease later in life. Their analysis found no correlation between the delivery method and other gastrointestinal diseases, including [ulcerative colitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ulcerative-colitis/ "Ulcerative colitis") and appendicitis. The authors of the study speculate that the link between C-section and Crohn’s disease lies in the [microbiome](https://www.autoimmuneinstitute.org/gai-library/#microbiome). They found that this association only occurred with elective C-sections, and not emergency ones where the infants may briefly encounter the mother’s vaginal bacteria during delivery. C-section now accounts for approximately 20% of all births globally, underscoring the importance of studying the long-term effects of C-sections. ##### **Citation** Hellsing, C., Örtqvist, A. K., Hagel, E., Mesas-Burgos, C., Gustafsson, U. O., & Granström, A. L. (2022). Delivery mode and risk of gastrointestinal disease in the offspring. *Acta obstetricia et gynecologica Scandinavica*, *101*(10), 1146–1152. <https://doi.org/10.1111/aogs.14427> **Category:** Autoimmune Diseases, IBD (Crohn's and UC), Microbiome, Research Studies --- ### [Reverse Vaccine Reduces Immune Reactions to Protein-Based Drugs](https://www.autoimmuneinstitute.org/research_updates/revolutionary-reverse-vaccine-reduces-side-effects-in-protein-based-drugs/) **Published:** September 9, 2021 **Author:** Carolyn Serraino **Excerpt:** Researchers developed an oral nanoparticle reverse vaccine that promotes immune tolerance and reduces immune reactions to therapeutic proteins in mouse models. **Content:** In biopharma, therapeutic proteins are a fast-growing drug class because they can precisely target specific enzymes, minimizing off-target effects. However, these proteins are naturally **immunogenic**, meaning they can trigger an immune response that limits their safety and effectiveness. Preventing this immune reaction is a major challenge for drug developers. Scientists at the State University of New York are developing and testing a reverse-vaccination approach to address this issue. Published in *Scientific Reports*, their strategy uses **[nanoparticles](https://www.autoimmuneinstitute.org/articles/nanotechnology-breakthroughs-in-autoimmune-disease-treatment "Nanotechnology Breakthroughs in Autoimmune Disease Treatment")** containing phosphatidylserine, a molecule known to induce immune tolerance. They engineered lipid nanoparticles with Lyso-PS on their surface, designed for oral administration, making the treatment easier to use while targeting the mucosal immune system. By administering these Lyso-PS nanoparticles alongside an immunogenic protein, researchers aim to “teach” the immune system to tolerate specific therapeutic proteins. In mouse models, the approach significantly reduced immune responses against several proteins. In a hemophilia A model, **75% of mice pre-treated with Lyso-PS nanoparticles carrying Factor VIII developed no detectable Factor VIII inhibitors**. The researchers also found that the tolerance was specific to the targeted protein rather than the result of broad immune suppression. The researchers suggest that this oral reverse-vaccination platform could eventually help prevent immune reactions to a range of protein-based therapies, including replacement therapies and potentially gene therapies. ##### **Citation** Nguyen, N. H., Glassman, F. Y., Dingman, R. K., Shenoy, G. N., Wohlfert, E. A., Kay, J. G., Bankert, R. B., & Balu-Iyer, S. V. (2021). **Rational design of a nanoparticle platform for oral prophylactic immunotherapy to prevent immunogenicity of therapeutic proteins**. *Scientific reports*, *11*(1), 17853. <https://doi.org/10.1038/s41598-021-97333-0> **Category:** Autoimmune Diseases, Clinical Trials, Research Studies, Therapies --- ### [Blood Test Offers Hope for Faster Chronic Fatigue Syndrome Diagnosis](https://www.autoimmuneinstitute.org/research_updates/blood-test-offers-hope-for-faster-chronic-fatigue-syndrome-diagnosis/) **Published:** October 18, 2024 **Author:** Carolyn Serraino **Content:** [Researchers analyzing data](https://www.medrxiv.org/content/10.1101/2024.08.26.24312606v1) from over 132,000 people in the UK Biobank have identified 511 blood biomarkers that differ between individuals with chronic fatigue syndrome (CFS)—also known as myalgic encephalomyelitis (ME) or [ME/CFS](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/me-cfs/ "Myalgic encephalomyelitis / chronic fatigue syndrome")—and healthy controls. Of these, 116 biomarkers were found in both men and women, marking the strongest replicated evidence yet for potential biological signatures of the disease. ME/CFS is a complex, debilitating condition characterized by post-exertional malaise, brain fog, and chronic fatigue. Without a clear diagnostic test, ME/CFS is diagnosed by ruling out other illnesses, which can make it take months—or even years—for patients to get answers. This study, led by scientists at the University of Edinburgh, significantly expands on [past research](https://pubmed.ncbi.nlm.nih.gov/37226227/) by using a much larger sample size and controlling for physical activity levels. ##### **Many of the identified blood markers relate to chronic inflammation, insulin resistance, and liver function.** While no single biomarker is yet ready for clinical use, researchers hope that a future panel of these markers could support faster and more accurate diagnoses. The study’s limitations include a primarily white, middle-aged, and healthier-than-average population, suggesting a need for broader follow-up studies. Still, the findings could provide critical insights not just for ME/CFS but also for post-viral fatigue syndromes like [Long COVID](https://www.autoimmuneinstitute.org/covid_timeline/long-covid-study-links-fatigue-to-mitochondrial-dysfunction/ "Long COVID Study Links Fatigue to Mitochondrial Dysfunction"). ###### Citations Beentjes, S. V., Kaczmarczyk, J., Cassar, A., Samms, G. L., Hejazi, N. S., Khamseh, A., & Ponting, C. P. (2024). Replicated blood-based biomarkers for Myalgic Encephalomyelitis not explicable by inactivity. Cold Spring Harbor Laboratory. <https://doi.org/10.1101/2024.08.26.24312606> Maksoud, R., Magawa, C., Eaton-Fitch, N., Thapaliya, K., & Marshall-Gradisnik, S. (2023). Biomarkers for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS): a systematic review. *BMC medicine*, *21*(1), 189. <https://doi.org/10.1186/s12916-023-02893-9> Huber, K. A., Sunnquist, M., & Jason, L. A. (2018). Latent class analysis of a heterogeneous international sample of patients with myalgic encephalomyelitis/chronic fatigue syndrome. *Fatigue : biomedicine, health & behavior*, *6*(3), 163–178. <https://doi.org/10.1080/21641846.2018.1494530> **Category:** Diagnostic Testing, ME/CFS, Research Studies --- ### [Million-Cell Lung Atlas Reveals Autoimmune Clues](https://www.autoimmuneinstitute.org/research_updates/million-cell-lung-atlas-reveals-autoimmune-clues/) **Published:** August 4, 2026 **Author:** Carolyn Serraino **Excerpt:** Genetic variants linked to autoimmune disease risk were missed in blood but identified in an analysis of more than 1 million lung immune cells by LJI scientists. **Content:** Scientists at [La Jolla Institute for Immunology](https://www.autoimmuneinstitute.org/gai-and-la-jolla-institute-for-immunology/ "GAI and La Jolla Institute for Immunology") analyzed more than 1.1 million tissue-resident immune cells from healthy lung tissue donated by 128 people to better understand how genetic differences influence immune cell function. Published in *Nature Immunology*, the study found that many genetic variants associated with autoimmune and lung diseases affect immune cells residing in the lungs, but are not detected in circulating immune cells found in the blood. Unlike circulating immune cells, tissue-resident immune cells remain within the lungs, where they help defend against respiratory infections, lung cancer, and other threats. However, dysfunction of these cells can contribute to [chronic inflammation](https://www.autoimmuneinstitute.org/articles/inflammation-a-driving-force-of-autoimmune-disease "Inflammation: A Driving Force of Autoimmune Disease"), which is common in several autoimmune diseases, including [lupus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus (SLE)"), [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid arthritis"), and [systemic sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/scleroderma/ "Scleroderma (systemic sclerosis)"). Using single-cell RNA sequencing, the researchers examined gene activity in individual lung immune cells and identified approximately 1,000 genes whose expression was influenced by inherited genetic variation specifically within lung tissue. #### Many of these genetic effects were absent in blood immune cells, suggesting that studying immune cells directly within affected tissues may reveal disease mechanisms that cannot be detected through blood samples alone. The study also identified more than 1,700 genes with differences in expression between males and females, including genes involved in inflammatory pathways. These findings may help researchers better understand [why many autoimmune diseases occur more frequently in women](https://www.autoimmuneinstitute.org/articles/how-sex-genetics-influence-autoimmunity "How Sex & Genetics Influence Autoimmunity"), although additional research is needed to determine how these differences contribute to disease development. The findings expand the [Database of Immune Cell Epigenomics (DICE)](https://www.lji.org/research/database-of-immune-cell-epigenomics/), a resource designed to help scientists understand how genetic variation influences immune cell function and susceptibility to autoimmune and other immune-mediated diseases. ##### Citation Schmiedel, B. J., Gonzalez-Colin, C., Fajardo-Rosas, V., Rocha, J., Simon, H., Ottensmeier, J., Ramírez-Bernabé, I. E., Cano, A., De la Cruz Castillo, A., Márquez-Gómez, E., Ha, B., Greenbaum, J. A., Chudley, L., Cave, J., Alzetani, A., Woo, E., Shackcloth, M., Chee, S. J., Chandra, V., Kronenberg, M., … Vijayanand, P. (2026). Tissue-resident immune cells drive genetic risk in autoimmune and lung diseases. *Nature immunology*, 10.1038/s41590-026-02596-2. Advance online publication. <https://doi.org/10.1038/s41590-026-02596-2> **Category:** Autoimmune Diseases, Genetics, Research Studies, Risk Factors --- ### [STING: New Insights into Brain Aging and Autoimmune Disease](https://www.autoimmuneinstitute.org/research_updates/sting-brain-aging-autoimmune-disease/) **Published:** July 30, 2026 **Author:** Carolyn Serraino **Excerpt:** Once viewed primarily as a driver of inflammation, STING (stimulator of interferon genes) is emerging as a far more complex immune pathway with important roles in brain aging, neuroinflammation, and autoimmune disease. **Content:** Scientists are continuing to uncover the many roles of **STING (stimulator of interferon genes)**, an immune signaling protein that helps coordinate the body’s innate immune response. A recent study published in *Cell Reports* by Sulka et al. suggests that STING helps protect the brain during normal aging (1). In aged mice, loss of STING led to greater breakdown of the blood-brain barrier, more small brain hemorrhages, increased DNA damage in neurons, and worse movement-related deficits. #### Restoring STING specifically in microglia, the brain’s resident immune cells, protected against several of these age-related changes.  **STING functions within the cGAS-STING pathway.** When the enzyme cGAS detects DNA in the cytoplasm, including DNA from damaged cells or invading microbes, it produces a messenger molecule called cGAMP that activates STING. STING then triggers immune responses that include the production of type I interferons and inflammatory cytokines (2). #### Whether STING protects or harms the nervous system appears to depend on where and how it is activated. **The dual roles of cGAS-STING signaling in the brain** are discussed in a recent review by Feng et al., helping explain why STING can be protective in some situations while contributing to [neuroinflammation](https://www.autoimmuneinstitute.org/gai-library/#neuroimmune) in others (3). It found that prolonged or dysregulated cGAS-STING signaling can contribute to neuroinflammation, while STING activity in microglia may help preserve the blood-brain barrier during aging. The review warns that chronic inhibition could weaken antiviral defense or broader immune function. It proposes partial, cell-selective, brain-selective, or time-limited modulation rather than indiscriminate suppression. **STING signaling is also being studied in autoimmune disease.** A review focused on [Sjögren disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sjogren-syndrome/ "Sjögren disease (SjD)") found evidence that excessive STING activity may promote type I interferon production and inflammatory cell infiltration, although direct clinical evidence of STING activation in people with Sjögren disease remains limited (4). #### Researchers have identified multiple mechanisms that can lead to abnormal STING activation and potentially contribute to inflammatory and autoimmune diseases. These mechanisms include genetic mutations, cellular stress within the endoplasmic reticulum (ER), disruptions in how the protein moves through the cell, and problems that prevent it from being properly broken down (5). Overall, these studies reveal that STING is far more complex than previously appreciated. Its effects depend on which cells are involved, where in the body it is activated, and what is happening in the surrounding tissues. The new findings add evidence that STING can play a protective role in microglia during normal brain aging, while other research continues to uncover how the same pathway contributes to neuroinflammation and autoimmune disease in other settings. Continue the Conversation This evolving understanding of immunity and healthy aging will be part of the conversations at **LEAD Day 2026**, where keynote speaker **Eric Topol, M.D.**, will discuss scientific advances in aging, immunity, and the future of disease prevention. [ Learn More About LEAD Day 2026 ](https://www.autoimmuneinstitute.org/research_updates/lead-day-2026-announces-eric-topol-as-award-recipient/) ##### Citations 1. Sulka, K. B., Carroll, K. A., Sawden, M., Hopkins, J. W., Smolgovsky, S. A., Bayer, A. L., Reed, E., Tai, A., Alcaide, P., Haydon, P., & Sharma, S. (2025). Microglial STING is a central safeguard against neurological decline with age. Cell reports, 44(6), 115749. <https://doi.org/10.1016/j.celrep.2025.115749> 2. Liu, X., Ding, C., Lu, J., & Zhang, N. (2025). cGAS-STING: From immunology and oncology view. Chinese medical journal, 138(23), 3050–3068. <https://doi.org/10.1097/CM9.0000000000003889> 3. Feng, W., Aikedan, A., Sinha, S. C., & Gan, L. (2026). Expanding roles of cGAS-STING signaling in neuroinflammation. The Journal of clinical investigation, 136(11), e204550. <https://doi.org/10.1172/JCI204550> 4. Ka, Y., Tan, T., Fan, Y., Liu, W., Wang, A., Wang, W., Yuzhen, G., Zhang, J., Yao, X., Lin, X., & Wu, Y. (2025). STING pathways and Sjögren’s syndrome: Exploration from mechanism to treatment. Frontiers in immunology, 16, 1649046. <https://doi.org/10.3389/fimmu.2025.1649046> 5. Xu, L., Li, J., Zhu, X., Zhou, L., Sun, Z., Zhang, Z., Xu, W., & Song, Y. (2025). PRRs-Dependent and Independent Mechanisms of STING Signaling in Inflammatory and Autoimmune Diseases. Biomedicines, 13(10), 2533. <https://doi.org/10.3390/biomedicines13102533> **Category:** Research Studies, Sjögren disease --- ### [New Mouse Model Reveals Autoimmune Cause of Myocarditis](https://www.autoimmuneinstitute.org/research_updates/new-mouse-model-unveils-autoimmune-t-cell-involvement-in-checkpoint-inhibitor-induced-myocarditis/) **Published:** January 9, 2023 **Author:** Carolyn Serraino **Content:** Immune checkpoint inhibitors (ICI) are medications used to treat a variety of cancers by targeting proteins such as PD-1 or CTLA-4 on cells. These proteins normally prevent the immune system from attacking healthy cells by sending an “off” signal to the immune cells. However, cancer cells often misuse this process to escape the immune system. ICIs block this “off” signal and enable the immune system to attack cancer cells. However, many patients on these medications develop immune-related adverse events because the immune system cannot be turned off as usual. One rare, but serious side effect is myocarditis, which is fatal in 40% of cases. Understanding why this side effect happens and how it can be prevented is critical. [Scientists supported by The Global Au](https://www.cell.com/cell-reports/fulltext/S2211-1247(22)01480-2)[toimmune Institute,](https://www.cell.com/cell-reports/fulltext/S2211-1247(22)01480-2#acknowledgments) tackled this issue and developed a new mouse model of myocarditis. Using these mice, they discovered that the amount of autoimmune T cells increased, leading to an attack on cardiac muscle. With this new mouse model, researchers are better equipped to study ways of preventing ICI-induced myocarditis in patients. ##### Citation Won, T., et al. (2022). **[Cardiac myosin-specific autoimmune T cells contribute to immune-checkpoint-inhibitor-associated myocarditis](https://www.cell.com/cell-reports/fulltext/S2211-1247(22)01480-2)**. *Cell Reports, 41*(6), Article 111611. **Category:** GAI-Funded, Research Studies, Therapies --- ### [Understanding Cardiac Sarcoidosis on a Cellular Level](https://www.autoimmuneinstitute.org/research_updates/understanding-cardiac-sarcoidosis-on-a-cellular-level/) **Published:** January 6, 2025 **Author:** Carolyn Serraino **Content:** [Sarcoidosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sarcoidosis/) is an autoimmune disease characterized by granulomas that typically appear in the lungs and lymph nodes. Most sarcoidosis research has been in pulmonary sarcoidosis, with less known about cardiac sarcoidosis. To understand more about cardiac sarcoidosis and how its presentation overlaps with its pulmonary counterpart, a recent study examined datasets to pinpoint how active different genes are during these diseases. They found that immune cells and a specific type of connective tissue cells called stromal cells were increased during both types of sarcoidosis. Specifically in cardiac stromal cells, they saw an increase in proinflammatory signals during sarcoidosis. Cardiac muscle cells also showed signs of cardiac stress during cardiac sarcoidosis. While there are differences between the disease when it manifests in different tissues, the researchers were able to note some trends in the two diseases. This work can help scientists understand how cells behave in sarcoidosis and can act as a springboard for future treatments for sarcoidosis. This work was supported in part by the Global Autoimmune Institute. ##### Citation Daoud, A., Lema, D. A., Won, T., & Čiháková, D. (2023). Integrative single-cell analysis of cardiac and pulmonary sarcoidosis using publicly available cardiac and bronchoalveolar lavage fluid sequencing datasets. *Frontiers in cardiovascular medicine*, 10, 1227818. <https://doi.org/10.3389/fcvm.2023.1227818> **Category:** Autoimmune Diseases, GAI-Funded, Research Studies --- ### [Understanding Immune Checkpoint Inhibitor Myocarditis Risks](https://www.autoimmuneinstitute.org/research_updates/understanding-immune-checkpoint-inhibitor-myocarditis-risks/) **Published:** January 15, 2025 **Author:** Carolyn Serraino **Excerpt:** How immune checkpoint inhibitors can cause myocarditis, a rare but serious side effect of cancer therapy, and the research advancing safer treatments. Immune checkpoint inhibitors (ICIs) are a powerful class of cancer therapies designed to enhance the immune system's ability to attack cancer cells. While effective, these therapies can sometimes lead to immune-related side effects, with myocarditis being one of the most concerning. **Content:** Research supported by GAI has contributed to a growing understanding of immune checkpoint inhibitor (ICI)-induced [myocarditis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-myocarditis/ "Autoimmune myocarditis"), a rare but potentially life-threatening side effect of certain cancer immunotherapies. The review article, *T Cells and Macrophages Drive Pathogenesis of Immune Checkpoint Inhibitor Myocarditis*, summarizes emerging discoveries about the immune mechanisms that drive this condition. **Immune checkpoint inhibitors (ICIs)** are a powerful class of cancer therapies designed to enhance the immune system’s ability to attack cancer cells. While effective, these therapies can sometimes lead to immune-related side effects, with myocarditis being one of the most concerning. Although rare, ICI-induced myocarditis carries a mortality rate of 25% to 50%. Recent investigations have identified cardiac-specific autoimmune pathways activated during ICI therapy. The research highlights the [role of cardiac-specific immune](https://www.autoimmuneinstitute.org/research_updates/the-immune-systems-role-in-heart-disease/) cells, including T cells and macrophages, and the toxic factors they release that target the heart. Current studies are focusing on several critical areas to mitigate the risks of myocarditis: - Investigating therapies that specifically inhibit harmful immune factors implicated in heart damage. - Designing checkpoint inhibitors that retain their anticancer efficacy without triggering myocarditis. - Understanding other cardiac conditions, unrelated to myocarditis, in which cardiac-specific autoimmune cells might be present. - Identifying factors released by activated cardiac-specific immune cells to serve as early markers for myocarditis risk. - Creating therapies that inhibit cardiac-specific immune cells and their toxic effects without compromising cancer treatment outcomes. This growing understanding of the autoimmune pathways involved in ICI-induced myocarditis provides valuable insights that could lead to safer cancer treatments. By addressing these challenges, researchers aim to reduce the incidence of myocarditis while preserving the life-saving benefits of ICIs. ##### Citation Čiháková D. (2024). T Cells and Macrophages Drive Pathogenesis of Immune Checkpoint Inhibitor Myocarditis. *Circulation*, *149*(1), 67–69. <https://doi.org/10.1161/CIRCULATIONAHA.123.067189> **Category:** GAI-Funded, Research Studies, Risk Factors --- ### [Untangling the Mechanisms behind Autoimmune Myocarditis](https://www.autoimmuneinstitute.org/research_updates/untangling-the-mechanisms-behind-autoimmune-myocarditis/) **Published:** January 2, 2025 **Author:** Carolyn Serraino **Content:** [Autoimmune myocarditis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-myocarditis/), a rare disease where the immune system attacks heart tissue, results in heart muscle inflammation and reduces the heart’s ability to pump blood. It’s linked to other autoimmune diseases like [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus") and [polymyositis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/polymyositis/ "Myositis/polymyositis") as well as prior viral infection or drug reaction. Cancer patients treated with immune checkpoint inhibitors sometimes develop myocarditis when their immune cells attack a heart protein called myosin. This provides clues about the immunological mechanisms behind autoimmune carditis. Nevertheless, these mechanisms remain elusive. A review article titled [Autoimmune Myocarditis, Old Dogs and New Tricks](https://www.ahajournals.org/doi/abs/10.1161/CIRCRESAHA.124.323816) examines what we know about heart antigens, autoantibodies, and immune cells behind the disease. This article, which [received funding by the Global Autoimmune Institute](https://www.autoimmuneinstitute.org/current-research-grants-projects/ "Current Research Grants & Projects"), also provides the latest information on clinical management and insight on where autoimmune myocarditis research is going in the future. ##### **Citation** Won, T., Song, E. J., Kalinoski, H. M., Moslehi, J. J., & Čiháková, D. (2024). Autoimmune Myocarditis, Old Dogs and New Tricks. *Circulation research*, 134(12), 1767–1790. <https://doi.org/10.1161/CIRCRESAHA.124.323816> **Category:** Autoimmune Diseases, GAI-Funded, Research Studies --- ### [The Immune System’s Role in Heart Disease](https://www.autoimmuneinstitute.org/research_updates/the-immune-systems-role-in-heart-disease/) **Published:** January 17, 2025 **Author:** Carolyn Serraino **Content:** ### Insights from the Cardioimmunology Symposia A recent *Circulation Research* review article highlighted groundbreaking interdisciplinary findings from the Cardioimmunology Symposia, including research supported in part by GAI. The growing collaboration between immunology and cardiovascular science is reshaping how researchers understand heart diseases driven by immune responses. #### Key topics covered at the symposia included: - New clinical trials targeting immune-related mechanisms in heart failure - The complex communication between heart cells and the surrounding microenvironment - The immune system’s role in both infection and repair in heart diseases like acute myocarditis and chronic heart failure - Advances in non-invasive imaging to track heart inflammation and immune cell activity - The role of adaptive immune receptors in recognizing heart-specific proteins, with potential for future diagnostics - Insights into how heart cells and immune cells influence each other’s metabolism and function The symposia offer a promising glimpse into collaborations between cardiology and immunology to revolutionize our understanding and treatment of heart diseases. This collaborative research could lead to more effective therapies for immune-driven heart conditions. ##### Citation Campos Ramos, G., Čiháková, D., Maack, C., & Prabhu, S. D. (2024). [Interface Between Cardioimmunology, Myocardial Health, and Disease: A Compendium. ](https://www.ahajournals.org/doi/full/10.1161/CIRCRESAHA.124.324871)*Circulation Research*, *134*(12), 1661-1662. **Category:** Clinical Trials, Events, GAI-Funded, Research Studies, Therapies --- ### [Whole-Heart 3D Analysis Redefines Myocarditis](https://www.autoimmuneinstitute.org/research_updates/whole-heart-3d-analysis-redefines-myocarditis/) **Published:** January 12, 2026 **Author:** Carolyn Serraino **Content:** Researchers [supported by the Global Autoimmune Institute](https://www.autoimmuneinstitute.org/current-research-grants-projects/ "Current Research Grants & Projects") published a landmark study that maps [myocarditis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-myocarditis/ "Autoimmune myocarditis") in three dimensions for the first time. The findings offer new insight into how immune-driven heart inflammation develops and why it is often difficult to diagnose accurately. Led by Daniela Čiháková at Johns Hopkins University, the research team used an artificial intelligence–assisted method, called CODA, to reconstruct entire mouse hearts affected by myocarditis at extremely fine detail. Rather than being distributed evenly throughout the heart, immune damage was concentrated in a small number of large, branching inflammatory areas. #### These areas were most often found in the free wall of the left ventricle, a region that is rarely sampled during standard heart biopsies. The study also uncovered distinct immune “neighborhoods” within the heart. Areas rich in T cells were more likely to appear toward the front of the heart, while regions dominated by macrophages were more common toward the back. The T cell–dense areas were closely associated with blood vessels and showed higher activity of genes involved in immune signaling and scar formation, processes that can contribute to long-term heart damage. Importantly, similar immune patterns were seen in human hearts affected by inflammatory dilated cardiomyopathy, a serious condition that can develop after myocarditis. An accompanying editorial described the study as a major advance, helping explain why myocarditis is often missed by biopsy and highlighting how three-dimensional immune mapping could improve diagnosis, risk assessment, and future treatment strategies. #### This research highlights how targeted funding can accelerate innovative approaches to understanding autoimmune and immune-mediated heart disease, bringing the field closer to more precise and personalized care. ###### Citations Daoud, A., Kalinoski, H., Talor, M. V., Welsh, R. A., Jo, W., Jaime, C. M., Kolim, B., Mahto, N., Kveton, M., Weislová, I., Melenovský, V., Fabián, O., Kiemen, A. L., & Čiháková, D. (2025). Whole-heart 3D reconstruction of mouse CVB3 myocarditis reveals spatial and transcriptomic heterogeneity of immune foci. *Cardiovascular research*, *121*(17), 2777–2790. <https://doi.org/10.1093/cvr/cvaf209> Heidecker, B., & Fairweather, D. (2025). Mapping myocarditis in three dimensions. *Cardiovascular research*, *121*(17), 2621–2623. <https://doi.org/10.1093/cvr/cvaf222> **Category:** GAI-Funded, Research Studies --- ### [Prior Heart Disease Increases Risk of ICI-Associated Myocarditis](https://www.autoimmuneinstitute.org/research_updates/prior-heart-disease-increases-risk-of-ici-associated-myocarditis/) **Published:** October 9, 2024 **Author:** Carolyn Serraino **Content:** Immune checkpoint inhibitors (ICIs) are a type of immunotherapy used in cancer. However, in rare cases, they cause a kind of [myocarditis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-myocarditis/ "Autoimmune myocarditis") called immune checkpoint inhibitor-associated myocarditis (ICI-associated myocarditis). A [new study](https://doi.org/10.1073/pnas.2323052121), which received funding by the Global Autoimmune Institute, examined the role of tissue-resident memory T cells in ICI-associated myocarditis. This type of T cell remains in tissues and provides a fast-acting defense against invaders they’ve encountered before. However, problems arise when these cells target our own bodies. The researchers found that cardiac injury triggers the recruitment of self-reactive tissue-resident memory T cells that target cardiac myosin to the heart. Because these cells have a large amount of a molecule called PD-1 on their surface, they can be activated by anti-PD-1 blocking antibodies, a type of immune checkpoint inhibitor used to treat cancer. Normally, PD-1 acts as an “off switch” for T cells so anti-PD-1 blocking antibodies help T cells remain active to target cancer cells. However, when these therapies interact with self-reactive T cells, such as myosin-targeting T cells, they inadvertently activate T cells targeting the heart leading to ICI-associated myocarditis. ##### Citation Kalinoski, H. *et al*. **Injury-induced myosin-specific tissue-resident memory T cells drive immune checkpoint inhibitor myocarditis**. *PNAS* 121 (42) e2323052121 (2024). DOI: [10.1073/pnas.2323052121](https://doi.org/10.1073/pnas.2323052121) **Category:** GAI-Funded, Research Studies, Risk Factors --- ### [How Cancer Immunotherapy Can Affect the Heart](https://www.autoimmuneinstitute.org/research_updates/cardiovascular-immune-related-adverse-effects-from-immune-checkpoint-inhibitors-used-to-treat-cancer/) **Published:** January 3, 2025 **Author:** Elevation **Content:** Molecules on the surface of a type of immune cell called T cells help determine when an immune response is needed. Normally, these immune checkpoints keep T cells from attacking our own cells. Some cancer cells, however, have molecules on their surfaces that interact with the T cells’ inhibitory checkpoints as a way to prevent the immune system from killing the cancer cells. Therapeutics like immune checkpoint inhibitors have been a promising approach for treating cancer. Immune checkpoint inhibitors bind immune checkpoints to counteract how cancer cells suppress T cells. But still, some patients don’t respond at all to immune checkpoint inhibitors and others experience immune-related adverse effects. A [recent review article](https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2024.1340373/full), supported by the Global Autoimmune Institute, discusses how approved and upcoming immune checkpoint inhibitors work and the mechanisms behind cardiac immune-related adverse effects such as myocarditis and atherosclerosis. While immune checkpoint inhibitors have transformed cancer therapy, it’s important to monitor for adverse cardiac effects. Related GAI Series ### The Immune Spectrum: Autoimmunity and Cancer Autoimmune disease and cancer are often viewed as separate conditions, but both arise from disruptions in immune balance. Learn how the immune system connects these diseases and why restoring immune tolerance has become a promising area of research. [ Read the Series → ](https://www.autoimmuneinstitute.org/gai-library/#immune-spectrum) ##### **Citation** Jo, W., Won, T., Daoud, A., & Čiháková, D. (2024). Immune checkpoint inhibitors associated cardiovascular immune-related adverse events. Frontiers in immunology, 15, 1340373. <https://doi.org/10.3389/fimmu.2024.1340373> **Category:** GAI-Funded, Research Studies, Therapies --- ### [Sam Myers: Advancing Autoimmune Disease Research with GAI](https://www.autoimmuneinstitute.org/research_updates/myers-gai-autoimmune-research/) **Published:** March 14, 2025 **Author:** Carolyn Serraino **Excerpt:** How does philanthropic support help accelerate scientific discovery? Follow Sam Myers, Ph.D.‘s research journey and the milestones made possible through GAI’s partnership with La Jolla Institute for Immunology. **Content:** ![Sam Myers, Ph.D.](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/02/Sam-Headshot-scaled-e1740409000915.jpg) GAI-Supported Research ## Sam Myers, Ph.D. **Sam Myers, Ph.D.** is the inaugural **Global Autoimmune Institute Assistant Professor** at [La Jolla Institute for Immunology](https://www.lji.org/labs/myers-lab/). His laboratory investigates how immune cells interpret molecular signals that regulate inflammation using proteomics, functional genomics, protein engineering, and systems immunology to better understand autoimmune disease and identify new therapeutic opportunities. [Visit the Myers Lab → ](https://www.lji.org/labs/myers-lab/) ### Understanding How Inflammation Begins, Persists, and Resolves Dr. Myers leads a multidisciplinary research program focused on understanding how immune cells interpret molecular signals that determine when inflammation begins, persists, or resolves. His laboratory combines proteomics, functional genomics, protein engineering, and systems immunology to investigate the biological mechanisms underlying autoimmune disease. ### Current Areas of Research Immune Cell Signaling Pathways Macrophage Biology Cytotoxic CD4 T Cells Genome Organization & Inflammation T-Cell Regulation Proteomics & Mass Spectrometry Functional Genomics Brain–Immune Interactions Therapeutic Development Since the partnership began, GAI and Dr. Myers have expanded their work far beyond a single research award. Through scientific research, technology development, international collaboration, and public engagement, the partnership continues to accelerate discoveries that advance the understanding, prevention, diagnosis, and treatment of autoimmune disease. ## Milestones Funded 2024 [ ![Sam Myers and colleagues with the Astral mass spectrometry platform](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/03/LJI-IMG_6205F-2025.jpg) ](https://www.autoimmuneinstitute.org/gai-and-la-jolla-institute-for-immunology/) ### Launching the GAI Assistant Professorship GAI established the inaugural **Global Autoimmune Institute Assistant Professorship** at La Jolla Institute for Immunology, providing flexible support for Dr. Myers to pursue ambitious research into the molecular signals that control immune cell behavior. GAI’s support also helped the Myers lab acquire the **Astral mass spectrometry platform**, expanding LJI’s ability to study immune signaling and autoimmune disease mechanisms with greater precision. [ Explore the Partnership → ](https://www.autoimmuneinstitute.org/gai-and-la-jolla-institute-for-immunology/) 2025 [ ![The Decision Makers documentary featuring Sam Myers](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/04/The-Decision-Makers-Dr.-Sam-Myers-x-Global-Autoimmune-Institute.png) ▶ ](https://www.youtube.com/watch?v=60Vg1ZVqkDA) ### Expanding the Long-Term Research Program Following the success of the inaugural professorship, GAI made a **five-year, $1 million commitment** to support the continued growth of the Myers laboratory, including scientific personnel, collaborative research, advanced technologies, and innovative autoimmune disease studies. GAI and LJI also released ***The Decision Makers***, a short documentary exploring Dr. Myers’ research, scientific leadership, and the role philanthropy can play in accelerating progress. [ Watch the Documentary → ](https://www.youtube.com/watch?v=60Vg1ZVqkDA) 2026 [ ![Sam Myers presenting research at La Jolla Institute for Immunology](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/07/Sam-Myers-speaking-at-LWD-scaled.jpg) ](https://www.lji.org/labs/myers-lab/) ### Advancing Multiple Areas of Discovery The Myers lab advanced research into how macrophages interpret inflammatory signals, how cytotoxic CD4 T cells contribute to immune responses, and how genome organization may influence chronic inflammation. The lab also expanded collaborative studies of inflammatory T-cell regulation while moving several GAI-supported projects toward publication and future therapeutic development. [ Visit the Myers Lab → ](https://www.lji.org/labs/myers-lab/) Ongoing ### The Research Continues The Myers laboratory continues to investigate how immune cells interpret inflammatory signals using proteomics, functional genomics, protein engineering, and systems immunology. Through GAI’s ongoing partnership with LJI, new discoveries, collaborations, and technologies continue to advance understanding of autoimmune disease and identify new opportunities for prevention, diagnosis, and treatment. [ Explore the GAI and LJI Partnership → ](https://www.autoimmuneinstitute.org/gai-and-la-jolla-institute-for-immunology/) **Category:** GAI-Funded --- ### [Walter and Jean Boek Seminar Series at LJI](https://www.autoimmuneinstitute.org/research_updates/walter-and-jean-boek-seminar-series-at-lji/) **Published:** September 27, 2024 **Author:** Carolyn Serraino **Excerpt:** GAI's five-year commitment will support both the Walter and Jean Boek Seminar Series and the Walter and Jean Boek Leadership in Research Award Lecture, presented during LEAD Day (Lectures, Empowerment, and Awareness in Autoimmune Disease). **Content:** ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/09/LEAD-Day-Seminar-2025-callout-block-image-1024x260.jpg) **In 2024, the Global Autoimmune Institute (GAI) announced a new five-year investment to support [La Jolla Institute for Immunology](https://www.autoimmuneinstitute.org/gai-and-la-jolla-institute-for-immunology/ "GAI and La Jolla Institute for Immunology")‘s ([LJI](https://www.lji.org/)) seminar program, which will now be known as the Walter and Jean Boek Seminar Series.** #### The partnership strengthens scientific collaboration and advances research into autoimmune and inflammatory diseases. For years, [LJI’s seminar program](https://www.lji.org/events/seminars/) has served as a forum for leading scientists to present emerging discoveries, discuss new therapeutic approaches, and foster collaborations that accelerate research across immunology and related fields. Distinguished speakers represent universities, medical centers, and research institutions from around the world, creating opportunities for researchers to exchange ideas and build new partnerships. Renaming the series in 2024 honored Drs. Walter and Jean Boek, pioneering public health researchers, educators, and advocates for scientific advancement whose work helped shape the field of medical sociology. **This five-year commitment supports both the Walter and Jean Boek Seminar Series and the Walter and Jean Boek Leadership in Research Award Lecture, presented during [LEAD Day](https://www.autoimmuneinstitute.org/lead-day/ "Lectures, Empowerment, and Awareness for Autoimmune Disease (LEAD) Day") (Lectures, Empowerment, and Awareness in Autoimmune Disease), where scientific discussions are extended to a broader audience that includes healthcare professionals, advocates, caregivers, and the autoimmune disease community.** #### [One year later](https://www.autoimmuneinstitute.org/research_updates/walter-and-jean-boek-seminar-series-year-one/ "Celebrating Year One of the Walter and Jean Boek Seminar Series"), the seminar series has welcomed leading scientists from institutions around the world and continues to foster scientific dialogue and collaboration across the immunology research community. ## More about Drs. Walter and Jean Boek *Drs. Walter E. Boek and Jean K. Boek devoted their careers to advancing public health research, education, and scientific communication.* **Dr. Walter Boek** served as an assistant to the Commissioner of Health for New York State before leading what was considered one of the world’s most influential social science research programs. He later worked to improve communication among physicians through the Health Information Foundation and served as a professor at several colleges and universities. **Dr. Jean Boek** conducted influential public health research, including some of the first studies demonstrating the association between cigarette smoking and heart disease and showing that seatbelt use saves lives. Together, Walter and Jean Boek co-authored [*Society and Health*](https://books.google.com/books/about/Society_and_Health.html?id=aBYVAAAAIAAJ), published numerous scientific papers, and helped establish the field now known as **medical sociology**. Their commitment to interdisciplinary research, education, and improving public health continues to inspire the Global Autoimmune Institute’s mission and its partnership with La Jolla Institute for Immunology. **Category:** Events, Resources --- ### [How Scientists Can Build and Maintain Public Trust](https://www.autoimmuneinstitute.org/research_updates/how-scientists-can-build-and-maintain-public-trust/) **Published:** July 1, 2026 **Author:** Carolyn Serraino **Excerpt:** Public trust in science has become a growing topic of discussion in recent years, particularly following the COVID-19 pandemic and amid increasing concerns about misinformation and political polarization. A new special edition from Nature examines what research actually shows about public trust in science and how scientists and institutions can strengthen it moving forward. **Content:** Public trust in science has become a growing topic of discussion in recent years, particularly following the COVID-19 pandemic and amid increasing concerns about misinformation and political polarization. A [new special edition from *Nature*](https://www.nature.com/immersive/d42859-026-00025-w/index.html) examines what research actually shows about public trust in science and how scientists and institutions can strengthen it moving forward. While public discourse often describes science as facing a widespread “trust crisis,” the collection highlights a more nuanced picture. Global surveys continue to find that scientists remain among the most trusted professions, although confidence has declined in some groups and has become increasingly polarized around issues such as vaccines and public health. Rather than a collapse in trust, the authors argue that science faces a challenge of maintaining credibility in an increasingly complex information landscape. Across the collection, experts outline practical ways to strengthen public confidence, including making research more transparent and reproducible, improving access to scientific data, acknowledging uncertainty, recognizing personal and political biases, involving communities in research and policymaking, and communicating scientific findings with greater openness and humility. Several authors emphasize that trust grows when people understand not only scientific conclusions, but also how those conclusions are reached and refined over time. For organizations like the Global Autoimmune Institute, these themes reinforce the importance of providing accurate, evidence-based information while clearly communicating that science is an evolving process. Helping people understand how research develops and why recommendations may change as new evidence emerges is an important part of building lasting trust in science. **Category:** Policy & Health Decisions --- ### [Congress Introduces H.R. 9192 for Autoimmune Treatments](https://www.autoimmuneinstitute.org/research_updates/hr-9192-prior-authorization-reform-for-autoimmune-and-blood-disorders-act/) **Published:** June 8, 2026 **Author:** Carolyn Serraino **Excerpt:** H.R. 9192, the Prior Authorization Reform for Autoimmune and Blood Disorders Act, has been introduced in the U.S. House of Representatives. If enacted, the bipartisan legislation would limit how often private health insurers can require prior authorization for medications used to treat autoimmune diseases. **Content:** June 8, 2026 **[H.R. 9192](https://www.congress.gov/bill/119th-congress/house-bill/9192), the Prior Authorization Reform for Autoimmune and Blood Disorders Act,** has been introduced in the U.S. House of Representatives. If enacted, the bipartisan legislation would limit how often private health insurers can require prior authorization for [medications](https://www.autoimmuneinstitute.org/articles/biologics-for-autoimmune-disease-what-you-should-know "Biologics for Autoimmune Disease: What You Should Know") used to treat autoimmune diseases and certain inherited bleeding disorders. The bill was introduced by **Representatives Julie Johnson (D-Texas) and Mike Lawler (R-New York)**. Under H.R. 9192, group health plans and [health insurance issuers](https://www.autoimmuneinstitute.org/articles/navigating-health-insurance-for-autoimmune-disease-patients-expert-tips-and-resources "Navigating Health Insurance with Autoimmune Disease") would be required to cover medications indicated for autoimmune diseases, hemophilia, and von Willebrand disease regardless of whether they are dispensed through a pharmacy or administered as part of another covered healthcare service. The bill would also prohibit insurers from requiring prior authorization for the same medication more than once during any 12-month period for most long-term therapies. Exceptions would apply to medications typically used for one year or less, opioids, benzodiazepines, barbiturates, carisoprodol, and medications subject to an FDA Risk Evaluation and Mitigation Strategy (REMS). The legislation defines an “autoimmune or blood disorder drug” as a drug or biological product indicated and prescribed for the treatment of an [autoimmune disease](https://www.autoimmuneinstitute.org/resources/autoimmune-diseases-list/ "A-Z Disease List"), hemophilia, or von Willebrand disease. To implement these requirements, H.R. 9192 would amend the Employee Retirement Income Security Act (ERISA), the Public Health Service Act, and the Internal Revenue Code. If enacted, the changes would apply to health plan years beginning on or after January 1, 2027. #### Related Reads ![Navigating Health Insurance with Autoimmune Disease](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/10/Navigating-Health-Insurance-with-Autoimmune-Disease-1024x576.png) Navigating Health Insurance with Autoimmune Disease With insights on how to best navigate health insurance from two experts in the field, GAI delves into the complicated process of dealing with health insurance with an autoimmune disease. Autoimmune Care & Caregiver Support [Read Post Navigating Health Insurance with Autoimmune Disease](https://www.autoimmuneinstitute.org/articles/navigating-health-insurance-for-autoimmune-disease-patients-expert-tips-and-resources) ![Physician billing statement marked ‘past due’ beside a stethoscope and a one-hundred-dollar bill, illustrating the financial strain of medical care.](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/01/healthcare-with-limited-resources-1024x576.jpg) Navigating Autoimmune Care With Limited Resources Navigating the healthcare system can be challenging for almost everyone. Finding the right providers, getting timely appointments, and accessing appropriate treatments often feel overwhelming. For people living with autoimmune and other chronic conditions, these challenges can be even greater. Autoimmune Care & Caregiver Support [Read Post Navigating Autoimmune Care With Limited Resources](https://www.autoimmuneinstitute.org/articles/navigating-autoimmune-care-with-limited-resources) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/03/cenetered-Biologics-for-ADs-1024x576.png) Biologics for Autoimmune Disease: What You Should Know How biologics work to treat autoimmune diseases, their benefits, risks, costs, and what to expect if your doctor prescribes one. Diagnosis & Treatment [Read Post Biologics for Autoimmune Disease: What You Should Know](https://www.autoimmuneinstitute.org/articles/biologics-for-autoimmune-disease-what-you-should-know) **Category:** Autoimmune Diseases, Policy & Health Decisions, Therapies --- ### [PBM Reform Bill Seeks to Reduce Cost Barriers for Autoimmune Patients](https://www.autoimmuneinstitute.org/research_updates/pbm-reform-bill-seeks-to-reduce-cost-barriers-for-autoimmune-patients/) **Published:** December 4, 2025 **Author:** Carolyn Serraino **Content:** **Research Update (July 22, 2026):** Traced S.3345 after its referral to the Senate Finance Committee. Searched the [Senate Finance Committee’s legislation page](https://www.finance.senate.gov/legislation) and committee resources for evidence of hearings, markups, committee reports, or other action. No record of S.3345 or subsequent committee activity was found. The committee’s public legislation index has not been updated since December 2023, limiting its usefulness for tracking recent bills. Congress.gov likewise shows no action beyond referral to the Senate Finance Committee. On December 4, 2025, U.S. Senators Mike Crapo and Ron Wyden reintroduced bipartisan legislation, [S.3345 – PBM Price Transparency and Accountability Act](https://www.congress.gov/bill/119th-congress/senate-bill/3345), to increase transparency and accountability among Pharmacy Benefit Managers (PBMs), the intermediaries that manage prescription drug benefits for insurers and federal programs. #### For people living with autoimmune disease, PBM practices play a major role in determining whether essential medications are affordable and accessible. Many autoimmune conditions require long-term use of high-cost or specialty therapies, and PBM decisions around formularies, tier placement, and pharmacy networks can directly affect out-of-pocket costs and continuity of care. #### The PBM Price Transparency and Accountability Act targets several practices that have been linked to higher patient costs. The bill would delink PBM compensation from drug rebates, reducing incentives to favor higher-priced medications. It would also expand reporting and audit requirements, giving federal agencies and plan sponsors greater visibility into how PBMs set prices and retain revenue. Additional provisions aim to protect pharmacy access by reinforcing “any willing pharmacy” requirements, which can help preserve patient choice, including access to independent and community pharmacies. By addressing opaque pricing structures and limiting practices such as spread pricing, the legislation seeks to lower costs at the pharmacy counter and reduce disruptions in access to medically necessary treatments. #### If enacted, the bill could ease financial strain and improve medication stability for people with autoimmune disease who depend on consistent, long-term therapy to manage symptoms and prevent flares.+ ##### Sources U.S. Senate Finance Committee. *[Wyden, Crapo Introduce Bipartisan Pharmacy Benefit Manager Legislation](https://www.finance.senate.gov/ranking-members-news/wyden-crapo-introduce-bipartisan-pharmacy-benefit-manager-legislation)* (Dec. 4, 2025). U.S. Congress. *[PBM Price Transparency and Accountability Act](https://www.finance.senate.gov/imo/media/doc/pbm_price_transparency_and_accountability_act.pdf)* (2025). **Category:** Autoimmune Diseases, Policy & Health Decisions, Therapies --- ### [Support the Celiac Safety Act of 2026 to Improve Gluten Labeling](https://www.autoimmuneinstitute.org/research_updates/celiac-safety-act-of-2026-cta/) **Published:** July 2, 2026 **Author:** Carolyn Serraino **Excerpt:** The Celiac Disease Foundation is encouraging advocates nationwide to contact their U.S. Representatives and ask them to co-sponsor the Celiac Safety Act of 2026 (H.R. 9048). Sending a message through the Foundation's advocacy tool takes less than a minute. **Content:** **Did you know?** For people with [celiac disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/celiac-disease/), accidental gluten exposure can lead to intestinal damage, nutritional deficiencies, and other serious health complications. People living with celiac disease know that reading food labels is an essential part of staying healthy. Yet under current U.S. food labeling laws, only wheat is required to be declared as a major food allergen. Other gluten-containing grains, including barley and rye, are not subject to the same labeling requirements, making it more difficult to quickly identify foods that contain gluten and increasing the risk of accidental exposure. The **Celiac Safety Act of 2026 ([H.R. 9048](https://www.congress.gov/bill/119th-congress/house-bill/9048))** aims to change that. Introduced in the U.S. House of Representatives by **Representatives Emanuel Cleaver (MO) and Betty McCollum (MN)**, the bill would require clearer labeling of gluten-containing grains on packaged foods, helping people with celiac disease make safer, more informed food choices. The legislation is endorsed by the [Celiac Disease Foundation](https://celiac.org/), the [American Gastroenterological Association](https://gastro.org/), and the [Society for the Study of Celiac Disease](https://theceliacsociety.org/). ## How to Support the Celiac Safety Act of 2026 #### Contact your Representative The Celiac Disease Foundation is encouraging advocates nationwide to contact their U.S. Representatives and ask them to co-sponsor the **Celiac Safety Act of 2026 (H.R. 9048)**. ##### Using the [CDF’s advocacy tool](https://celiac.org/csa/#/24/), sending this message takes less than a minute! [![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/07/Celiac-Safety-Act-of-2026-Contact-Your-Representative.png)](https://celiac.org/csa/#/24/) #### July 9: Make the Call On Thursday, July 9, 2026, the CDF is also asking supporters across the country to **call their Representatives to help demonstrate broad public support for the legislation**. A phone call takes only a few minutes and can make a meaningful difference in showing Congress that the celiac disease community supports clearer gluten labeling. ##### **Learn more** [Advocating for Clearer Labeling of Gluten in the U.S.](https://celiac.org/2026/05/28/advocating-for-clearer-labeling-of-gluten-in-the-u-s) [Celiac Safety Act of 2026 Introduced in House of Representatives](https://celiac.org/2026/05/28/celiac-safety-act-of-2026-introduced-in-house-of-representatives) **Category:** Celiac Disease, Events, Policy & Health Decisions --- ### [Cyclospora Outbreak and Autoimmune Disease](https://www.autoimmuneinstitute.org/research_updates/cyclospora-outbreak-and-autoimmune-disease/) **Published:** July 16, 2026 **Author:** Carolyn Serraino **Content:** July 16, 2026 The Centers for Disease Control and Prevention (CDC) has issued a nationwide Health Alert Network (HAN) advisory after an unusually large increase in domestically acquired cases of [cyclosporiasis](https://jamanetwork.com/journals/jama/fullarticle/2852106) (Cyclospora infection). As of July 13, 2026, CDC had received reports of 1,645 laboratory-confirmed U.S. cases across 34 states and was aware of more than 5,100 additional reports that required further analysis to determine whether they met the definition of domestically acquired cyclosporiasis. This is substantially higher than the 249 domestically acquired cases reported during the same period in 2025. Public health officials are also investigating several outbreaks, including a multistate outbreak involving more than 400 reported cases in Michigan, Ohio, West Virginia, and Kentucky. Cyclosporiasis is a gastrointestinal illness caused by the microscopic parasite *Cyclospora cayetanensis*. People become infected by consuming contaminated food or water, most commonly fresh produce. Symptoms typically begin about one week after exposure and include prolonged watery diarrhea, abdominal cramping, nausea, fatigue, loss of appetite, and weight loss. Without treatment, illness may last for weeks or longer and can follow a relapsing course. Because routine stool ova and parasite examinations may not reliably detect *Cyclospora*, the CDC is urging clinicians to specifically request diagnostic testing when the infection is suspected. #### Although cyclosporiasis is usually not life-threatening, it can cause more severe or prolonged illness in people who are immunocompromised. The CDC advises that individuals with immunocompromising conditions may require longer treatment courses than immunocompetent patients, while published reviews identify infants, older adults, and immunocompromised individuals among those at highest risk for severe disease. ### **Related Reading** ![Illustration of a person with lungs surrounded by viruses, bacteria, and fungi representing infection risk in people with autoimmune diseases receiving immunosuppressive therapy.](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/07/navigating-immunosuppression-infection-risk-autoimmune-disease-1024x576.jpg) Navigating Immunosuppression and Infection Risk Modern immunosuppressive therapies have transformed the treatment of autoimmune diseases, allowing many people to live healthier, more active lives. At the same time, these medications can increase susceptibility to certain infections, making prevention and early recognition especially important. As seasonal viruses, emerging infections, and vaccine-preventable disease outbreaks continue, many people taking immunosuppressive medications are left wondering how to protect themselves from infection while keeping their autoimmune disease under control. Rosemary Ainley developed rheumatoid arthritis in 2007 and started treating it with methotrexate, a medication designed to reduce swelling and inflammation. By 2008, methotrexate wasn’t enough on its own, and she needed \[…\] Living Well with Autoimmune Disease [Read Post Navigating Immunosuppression and Infection Risk](https://www.autoimmuneinstitute.org/articles/navigating-immunosuppression-and-infection-risk) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Hot-Temp-1024x576.jpg) Stay Cool: How to Manage Autoimmune Flare-ups in Hot Temperatures Heat and humidity can worsen symptoms for some people with autoimmune diseases. Learn why this happens, how to reduce the risk of heat-related flare-ups, and what research suggests about the effects of a warming climate on autoimmune health. Living Well with Autoimmune Disease [Read Post Stay Cool: How to Manage Autoimmune Flare-ups in Hot Temperatures](https://www.autoimmuneinstitute.org/articles/stay-cool-how-to-manage-autoimmune-flare-ups-in-hot-temperatures) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/01/Navigating-Mask-Wearing-e1749652601982-1024x576.png) A Guide for Immunocompromised Individuals in a Post-Pandemic World Even as the world moves on from the pandemic, immunocompromised individuals continue to face heightened health risks. With fewer people wearing masks, navigating daily life safely can be challenging. This guide explores the science behind immune function, the impact of mask-wearing, legal protections, and practical strategies for advocating for personal health. Whether seeking protection in healthcare settings, workplaces, or social interactions, immunocompromised individuals can find support and solutions to maintain both physical and mental well-being in an increasingly unmasked world. Autoimmune Care & Caregiver Support [Read Post A Guide for Immunocompromised Individuals in a Post-Pandemic World](https://www.autoimmuneinstitute.org/articles/a-guide-for-immunocompromised-individuals-in-a-post-pandemic-world) For people living with autoimmune diseases, particularly those taking [biologics](https://www.autoimmuneinstitute.org/articles/biologics-for-autoimmune-disease-what-you-should-know "Biologics for Autoimmune Disease: What You Should Know"), corticosteroids, or other immunosuppressive medications, the CDC alert also serves as an important reminder that persistent diarrhea is not always caused by autoimmune disease activity. While cyclosporiasis can affect anyone, in people with [Crohn’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crohns-disease/ "Crohn’s disease") or [ulcerative colitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ulcerative-colitis/ "Ulcerative colitis"), it can closely resemble an inflammatory bowel disease (IBD) [flare](https://www.autoimmuneinstitute.org/articles/outbursts-in-autoimmunity-disease-flare-ups "Outbursts in Autoimmunity: Disease Flare-ups"), potentially delaying diagnosis or leading to unnecessary escalation of immunosuppressive treatment if an infectious cause is not considered. A recent 2025 case report illustrates this challenge. A woman with ulcerative colitis continued to experience worsening diarrhea despite biologic therapy, and her symptoms were initially presumed to represent an IBD flare. Stool testing ultimately identified *Cyclospora cayetanensis*, and after receiving targeted antiparasitic treatment, her symptoms improved rapidly, allowing her biologic therapy to be safely resumed. The authors concluded that clinicians should maintain a broad differential diagnosis for persistent diarrhea in immunosuppressed patients, even in regions where cyclosporiasis is uncommon. #### Understanding when symptoms may reflect an infection rather than autoimmune disease activity, recognizing when additional testing may be needed, and taking steps to reduce infection risk can help prevent complications and delays in appropriate treatment. ##### Citations Centers for Disease Control and Prevention. *Increase in Reported U.S. Cyclospora Infections — Health Alert Network (HAN) No. 00531.* July 15, 2026. Accessed July 16, 2026. <https://www.cdc.gov/han/php/notices/han00531.html> Centers for Disease Control and Prevention. *Cyclosporiasis Surveillance.* Updated July 15, 2026. Accessed July 16, 2026. <https://www.cdc.gov/cyclosporiasis/php/surveillance/index.html> Centers for Disease Control and Prevention. *Cyclosporiasis Outbreak Investigation — July 2026.* Updated July 15, 2026. Accessed July 16, 2026. <https://www.cdc.gov/cyclosporiasis/outbreaks/07-26/index.html> Centers for Disease Control and Prevention. *Transcript: Update on CDC’s Cyclosporiasis Response.* July 14, 2026. Accessed July 16, 2026. <https://www.cdc.gov/media/releases/2026/transcript-update-on-cdcs-cyclosporiasis-response-7-14-26.html> Connor, B. A., Johnson, E. J., & Soave, R. (2001). Reiter syndrome following protracted symptoms of Cyclospora infection. *Emerging infectious diseases*, *7*(3), 453–454. <https://doi.org/10.3201/eid0703.010317> Banasik, E., Dobrowolska, A., Woźnicka-Leśkiewicz, L., & Eder, P. (2025). Diagnostic Challenges of Cyclosporiasis in Chronic Diarrhea: A Case Study. *Microorganisms*, *13*(9), 2209. <https://doi.org/10.3390/microorganisms13092209> Li, J., Wang, R., Chen, Y., Xiao, L., & Zhang, L. (2020). *Cyclospora cayetanensis* infection in humans: biological characteristics, clinical features, epidemiology, detection method and treatment. *Parasitology*, *147*(2), 160–170. <https://doi.org/10.1017/S0031182019001471> Linder KA, Malani PN. [What Is Cyclosporiasis?](https://jamanetwork.com/journals/jama/fullarticle/2852106) *JAMA.* Published online July 21, 2026. doi:10.1001/jama.2026.14866 **Category:** IBD (Crohn's and UC), Research Studies, Risk Factors --- ### [Blood Test Could Detect Sjögren Disease Years Before Symptoms Appear](https://www.autoimmuneinstitute.org/research_updates/blood-test-could-detect-sjogren-disease-years-before-symptoms-appear/) **Published:** July 21, 2026 **Author:** Carolyn Serraino **Content:** Researchers have developed an ultrasensitive blood test that detected an immune signature associated with [Sjögren disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sjogren-syndrome/ "Sjögren disease (SjD)") up to 14 years before diagnosis, while also identifying a distinct biological subtype of the disease driven by the immune signaling protein interferon-alpha (IFN-α). Published in *The Lancet Rheumatology*, the findings could help identify people at risk earlier and improve the development of targeted therapies. #### What is IFN-α (Interferon-Alpha)?+ IFN-α (interferon-alpha) is a protein made by the immune system that helps the body respond to viral infections. It acts like a messenger, telling nearby immune cells that a virus is present and helping coordinate the body’s immune response. In some autoimmune diseases, this signaling pathway becomes overactive even when there is no infection. Researchers have linked elevated IFN-α activity to several autoimmune diseases, including Sjögren disease and [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus (SLE)"), making it an important focus of research into disease mechanisms, earlier diagnosis, and more personalized treatments. **Learn More**: Krieg A. M. (2025). New insights into the role of IFN-α/β and TLR7/8/9 in cancer immunotherapy and systemic autoimmunity. *Journal for immunotherapy of cancer*, *13*(9), e012165. <https://doi.org/10.1136/jitc-2025-012165> ### Early Immune Changes Detected Years Before Diagnosis Using an ultrasensitive assay capable of detecting individual IFN-α molecules, researchers measured the protein in blood samples from people with Sjögren disease and in stored samples from the UK Biobank. **Among 177 participants in the UK Primary Sjögren’s Syndrome Registry, 61% had elevated IFN-α levels.** Analysis of UK Biobank samples showed that an interferon-related protein signature was detectable up to 14 years before diagnosis in people who later developed Sjögren disease. The findings add to growing evidence that autoimmune diseases can begin years before symptoms appear and that biological changes may be detectable long before a clinical diagnosis is made. ### Interferon Identifies a Distinct Sjögren Disease Subtype People with elevated IFN-α were clinically similar to other participants in terms of symptoms and overall disease activity. However, they were immunologically distinct, with higher rates of cytopenias, elevated immunoglobulin levels, multiple autoantibodies, and antibodies targeting the Sjögren autoantigen TRIM21/Ro52. Because nearly 40% of participants with Sjögren disease did *not* have elevated IFN-α, the findings also reinforce that the disease is biologically heterogeneous and does not develop through a single immune pathway. To explore whether IFN-α contributes to disease rather than simply reflecting inflammation, researchers engineered mice to continuously produce high levels of the protein. The animals developed key features of the same immune subtype, and blocking interferon signaling improved many of those abnormalities, providing evidence that IFN-α may actively drive disease in this subgroup. The study suggests that future clinical trials of interferon-targeting therapies may be more effective if they enroll patients with elevated IFN-α rather than treating all people with Sjögren disease as a single group. The accompanying *Lancet Rheumatology* commentary also noted that ultrasensitive IFN-α testing could become a useful tool for classifying patients and guiding treatment decisions as precision medicine approaches continue to evolve. ##### Citations Forbes, D., Jorgacevic, I., Tarn, J., Reid, K. R., Rioux, B., Thompson, K., Kleemann, K. L., McGlasson, S., Casement, J., Berry, J., Müller, P., Eberle-Reece, H., Haase, C., Conn, B., Boon, L., McDade, K., Whiteley, W., Roers, A., Ng, W. F., Behrendt, R., … Hunt, D. (2026). [Interferon-α as a precision medicine tool in Sjögren’s disease: a cohort and experimental medicine study](https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(26)00038-X/fulltext). *The Lancet. Rheumatology*, *8*(8), e612–e624. <https://doi.org/10.1016/S2665-9913(26)00038-X> Verstappen, G. M., & Brkic, Z. (2026). [Interferon-α in Sjögren’s disease: cause or consequence?](https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(26)00106-2/fulltext). *The Lancet. Rheumatology*, *8*(8), e589–e591. <https://doi.org/10.1016/S2665-9913(26)00106-2> **Category:** Diagnostic Testing, Research Studies, Sjögren disease --- ### [ Infection vs. Vaccination: Which Raises Autoimmune Disease Risk?](https://www.autoimmuneinstitute.org/research_updates/infection-vs-vaccination-which-raises-autoimmune-disease-risk/) **Published:** July 20, 2026 **Author:** Carolyn Serraino **Excerpt:** Questions about vaccines and autoimmune disease are common, but what does the evidence actually show? This accessible review explains why researchers have linked a wide range of viral and bacterial infections to autoimmune diseases, how infections may trigger autoimmunity through mechanisms like molecular mimicry and bystander activation, and why vaccine-associated autoimmune events are exceedingly rare by comparison. **Content:** Questions about vaccines and autoimmune disease are common, but what does the evidence actually show? This accessible review explains why researchers have linked a wide range of viral and bacterial infections to autoimmune diseases, how infections may trigger autoimmunity through mechanisms like molecular mimicry and bystander activation, and why vaccine-associated autoimmune events are exceedingly rare by comparison. It also reviews examples involving Epstein-Barr virus, Group A Streptococcus, Campylobacter, Guillain-Barré syndrome, myocarditis, and Long COVID while putting the risks into important context. A thoughtful, evidence-based read for anyone interested in the relationship between infection, vaccination, and autoimmune disease. # Infection vs vaccination: which really raises autoimmune disease risk? Some like to blame vaccines for dangerous autoimmune issues, but the evidence is clear: the infections they help prevent are the bigger risk. - **30 March 2026** - **by** [Linda Geddes](https://www.gavi.org/vaccineswork/authors/linda-geddes) #### At a glance - A range of viral, bacterial, fungal and parasitic infections have been linked to the development of autoimmune conditions. - Vaccines can, in very rare cases, be linked to autoimmune responses, but this is far less common than after infection. For example, both influenza and influenza vaccination have been associated with Guillain-Barré syndrome, but the risk is much higher after infection. One study in Ontario found around one case per million vaccinations, compared with 17 per million influenza infections. - Vaccination is often the best way to reduce the risk of infection-related complications, including autoimmunity, by giving the immune system a controlled glimpse of a pathogen, without the prolonged infection and inflammation that can push it off course. Claims that vaccines can trigger autoimmune disease have circulated for years. But the far bigger and better-established risk comes from infection itself. When the immune system turns against the body, the consequences can be serious. This process underpins conditions ranging from multiple sclerosis to lupus and can cause symptoms from fatigue and joint pain to long-term organ damage. > ## Vaccines give the immune system a controlled glimpse of a pathogen, without the prolonged infection and inflammation that are more likely to push it off course. At its core, autoimmunity happens when the immune system loses its ability to distinguish between harmful invaders and the body’s own tissues, sometimes producing autoantibodies: misguided proteins that attack healthy cells instead of bacteria or viruses. Yet, while immune responses to infection are common, this kind of misfiring is not: autoimmunity is rare and cases linked to vaccination are rarer still. ### Which infections have been linked to autoimmunity? A wide range of viral, bacterial, fungal and parasitic infections have been linked to the development of autoimmune responses. Some of the strongest evidence relates to Group A *Streptococcus*, a bacterium that often lives harmlessly on the skin or in the throat but can sometimes cause illnesses ranging from [‘strep throat’ and scarlet fever](https://www.gavi.org/vaccineswork/whats-behind-recent-surge-strep-and-scarlet-fever) to skin and soft tissue infections, and life-threatening toxic shock syndrome. These infections have also been linked to several autoimmune diseases, including acute rheumatic fever, characterised by joint and heart inflammation and sometimes chronic heart problems; vasculitis, in which blood vessels become inflamed, reducing blood flow to organs and tissues; and PANDAS, a condition that can trigger the sudden onset of obsessive-compulsive behaviours or tic disorders in children. [*Campylobacter jejuni*](https://pmc.ncbi.nlm.nih.gov/articles/PMC9037470/) is another bacterium that can trigger autoimmune disease, most notably Guillain-Barré syndrome, a condition in which the immune system attacks the peripheral nerves, leading to muscle weakness and, in severe cases, paralysis. Then there’s [Epstein-Barr virus](https://www.gavi.org/vaccineswork/antibodies-fighting-epstein-barr-virus-could-misfire-and-trigger-multiple-sclerosis), best known for causing glandular fever, but which has also been linked to several autoimmune diseases, including multiple sclerosis, lupus and Sjögren’s syndrome. #### Have you read? - [Do multiple vaccines overload a child’s immune system? Here’s what the science says](https://www.gavi.org/vaccineswork/do-multiple-vaccines-overload-childs-immune-system-heres-what-science-says) - [Atomic precision: Pioneering HIV vaccine triggers key immune response](https://www.gavi.org/vaccineswork/atomic-precision-pioneering-hiv-vaccine-triggers-key-immune-response) Beyond these examples, there is mounting evidence that immune dysregulation, including possible autoimmune responses, may play a role in a range of long-term post-infectious syndromes, including [Long COVID](https://www.gavi.org/vaccineswork/four-key-pieces-research-long-covid-have-improved-our-understanding), Lyme disease and conditions following infections such as [chikungunya](https://www.gavi.org/vaccineswork/vaccine-profiles-chikungunya) and [Ebola](https://www.gavi.org/vaccineswork/could-ebola-survivors-hold-key-understanding-long-covid). “When you look for autoantibodies after infection, you find them, and you find them in a way that looks plausible as a possible driver of that disease process,” said [Prof Danny Altmann](https://profiles.imperial.ac.uk/d.altmann) at Imperial College London, who is studying the mechanisms linking infection and autoimmunity. ### How do infections trigger autoimmunity? A lot remains unknown, including why some people develop autoimmunity while the vast majority recover relatively unscathed. For instance, more than 95% of people are infected with Epstein-Barr virus, yet only a tiny fraction – under 1% – will develop conditions such as multiple sclerosis or, more rarely, lupus. “On the other hand, if you haven’t got Epstein-Barr virus, you’ve got almost no chance of having those diseases,” said Altmann. Genetic factors are almost certainly involved, along with age, sex and environmental influences, such as which infections a person has been exposed to, when they occur and how the immune system responds. When it does happen, autoimmunity appears to arise when the immune system mistakenly recognises the body’s own tissues as foreign, or these tissues are caught in the crossfire of an immune response to infection. One potential mechanism under investigation is known as molecular mimicry. This occurs when a virus or bacterium carries proteins that closely resemble those found in the human body. As the immune system learns to attack the pathogen, it may also target tissues carrying similar proteins. Epstein-Barr virus, for instance, produces proteins that resemble components of myelin – the protective coating that wraps around nerve fibres – potentially contributing to the development of [multiple sclerosis](https://www.gavi.org/vaccineswork/epstein-barr-virus-how-does-common-infection-trick-immune-system-attacking-brain). Another potential mechanism is so-called bystander activation. This occurs when an infection causes widespread inflammation that activates immune cells more broadly than intended. In the process, some immune cells that can react to the body’s own tissues may be switched on as collateral damage. In most cases, this response is short-lived, but in some people it may contribute to longer-term autoimmune disease. Then there’s epitope spreading, in which an immune response initially directed at a virus or bacterium gradually broadens to target the body’s tissues. As infection causes tissue damage, proteins that the immune system does not usually encounter may be released and taken up by immune cells, which then begin to recognise and attack them as well. In reality, scientific understanding of these mechanisms is “a work in process”. It is possible that different mechanisms are in play in different infections and there are many other avenues to explore, Altmann said. ### Can vaccines trigger autoimmune disease? Vaccines can trigger autoimmune responses but it is extremely rare, and far less common than autoimmunity triggered by infection, which is itself very rare. In fact, vaccination is often the best way to reduce that risk. Vaccines give the immune system a controlled glimpse of a pathogen, without the prolonged infection and inflammation that are more likely to push it off course. For instance, the risk of myocarditis (inflamed heart muscle) after COVID-19 infection has been estimated at around [146 cases per 100,000 infections](https://www.gavi.org/vaccineswork/myocarditis-covid-19-much-bigger-risk-heart-vaccination). After [mRNA vaccination](http://doi.org/10.1056/NEJMoa2110737) it’s much lower – about two cases per 100,000 people. Other studies suggest [between 0.3 and 5 cases per 100,000,](https://doi.org/10.1038/s41569-021-00662-w) with most cases mild and resolving quickly. Guillain-Barré syndrome is another autoimmune disorder linked to infections. Most people recover, but some are left with long-term nerve damage, and in rare cases it can be fatal. About one in every 1,000 people infected with *Campylobacter* develops [Guillain-Barré syndrome.](https://www.cdc.gov/campylobacter/signs-symptoms/guillain-barre-syndrome.html) Influenza has also been linked to Guillain-Barré syndrome, as has [influenza vaccination](https://www.chop.edu/vaccine-education-center/vaccine-safety/vaccines-and-other-conditions/guillain-barre-syndrome). But again, the risk is much higher after infection. [One study](https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(13)70104-X/fulltext) in Ontario, Canada, found around 1 case per million vaccinations, compared with 17 per million influenza infections. Taken together, these findings suggest that while vaccines can very rarely be associated with autoimmune conditions, infection itself presents a far higher risk. [Original article](https://www.gavi.org/vaccineswork/infection-vs-vaccination-which-really-raises-autoimmune-disease-risk) This article was originally published on [VaccinesWork](https://www.gavi.org/vaccineswork) **Category:** Research Studies, Risk Factors --- ### [July 2026 OADR-ORWH Autoimmune Disease Research Update](https://www.autoimmuneinstitute.org/research_updates/july-2026-oadr-orwh-autoimmune-disease-research-update/) **Published:** July 17, 2026 **Author:** Carolyn Serraino **Excerpt:** The OADR-ORWH held its quarterly community update on July 17, 2026, sharing progress on the NIH-Wide Strategic Plan for Autoimmune Disease Research, new research initiatives, funding opportunities, data infrastructure, and emerging areas of scientific interest. **Content:** July 17, 2026 The National Institutes of Health (NIH) Office of Autoimmune Disease Research within the Office of Research on Women’s Health ([OADR-ORWH](http://orwh.od.nih.gov/OADR-ORWH)) held its quarterly community update on July 17, 2026, sharing progress on the NIH-Wide Strategic Plan for Autoimmune Disease Research, new research initiatives, funding opportunities, data infrastructure, and emerging areas of scientific interest. The meeting also included a community roundtable where researchers, advocates, patients, and nonprofit representatives had the opportunity to raise questions. ### From Strategic Planning to Implementation OADR-ORWH was [established in 2023](https://www.autoimmuneinstitute.org/research_updates/office-of-autoimmune-disease-research/ "Office of Autoimmune Disease Research (OADR)") following a congressional directive to improve the coordination of autoimmune disease research across the NIH. The office’s work is guided by six congressional directives, including developing an NIH-wide strategic plan, identifying emerging areas of research opportunity, coordinating research across NIH institutes and centers, evaluating the NIH autoimmune disease research portfolio, supporting research infrastructure and collaboration, and developing resources for autoimmune disease data and biospecimens. The **[NIH-Wide Strategic Plan for Autoimmune Disease Research](https://www.autoimmuneinstitute.org/research_updates/nih-wide-strategic-plan-for-autoimmune-disease-research/ "NIH Strategic Plan for Autoimmune Disease Research 2026-2030")**, published in July 2025, is now in its implementation phase. The plan includes five major priorities: 1. Advance fundamental scientific discovery. 2. Improve health for people living with or at risk for autoimmune diseases. 3. Understand autoimmune disease across the lifespan. 4. Strengthen autoimmune research infrastructure and workforce capacity. 5. Build partnerships across research, clinical, advocacy, and patient communities. OADR-ORWH emphasized that implementation will build on existing NIH programs while also supporting new partnerships and initiatives that encourage research across diseases rather than within isolated specialties. ### Greater Focus on the Earliest Stages of Autoimmunity One of the central research priorities discussed was the need to better understand the period [before a person develops a fully defined autoimmune disease](https://www.autoimmuneinstitute.org/articles/examining-pre-autoimmunity-can-autoimmune-disease-be-prevented "Examining Pre-Autoimmunity: Can Autoimmune Disease Be Prevented?"). #### Researchers often begin studies only after participants meet established diagnostic criteria. However, immune changes may begin years before clinical disease becomes apparent. OADR-ORWH highlighted the importance of studying the progression from [genetic](https://www.autoimmuneinstitute.org/articles/how-sex-genetics-influence-autoimmunity "How Sex & Genetics Influence Autoimmunity") and [epigenetic susceptibility](https://www.autoimmuneinstitute.org/articles/the-role-of-epigenetics-in-autoimmune-disease "The Role of Epigenetics in Autoimmune Disease"), [environmental exposures](https://www.autoimmuneinstitute.org/articles/beyond-genes-and-smoking-5-more-triggers-that-heighten-autoimmune-disease-risk "Environmental and Lifestyle Risk Factors for Autoimmune Disease"), and immune disruption to asymptomatic autoimmunity, early symptoms, and eventually diagnosable disease. A better understanding of this prodromal phase could help researchers identify biomarkers, clarify disease triggers, and potentially develop interventions that delay or prevent disease progression. ### NIH Encourages More Autoimmune Disease Research Proposals The NIH is using a “[highlighted topics](https://www.autoimmuneinstitute.org/research_updates/nih-highlights-autoimmune-research-priority/ "NIH Highlights Autoimmune Research Priority")” mechanism to communicate areas of scientific interest to researchers applying through broad, parent funding announcements. #### A highlighted topic focused on advancing autoimmune disease research has support from nearly every NIH institute and center. Additional highlighted topics have been established for areas including [hidradenitis suppurativa](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/hidradenitis-suppurativa/ "Hidradenitis suppurativa") and [celiac disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/celiac-disease/). OADR-ORWH encouraged researchers to use these mechanisms when submitting proposals related to the priorities in the NIH strategic plan. The office also shared several active funding opportunities involving rare disease clinical trial readiness, understudied proteins associated with rare diseases, early-career research training, and larger collaborative research programs. ### Scleroderma Added to Major Cross-Disease Research Program OADR-ORWH announced that [scleroderma](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/scleroderma/ "Scleroderma (systemic sclerosis)"), also known as systemic sclerosis, [has been added](https://fnih.org/news/fnih-autoimmune-disease-research-collaboration-expands-adds-scleroderma/) to the [Accelerating Medicines Partnership Autoimmune and Immune-Mediated Diseases program](https://www.niams.nih.gov/grants-funding/niams-supported-research-programs/accelerating-medicines-partnership-amp), or AMP AIM. AMP AIM brings together NIH institutes, industry partners, researchers, and nonprofit organizations to study the biological pathways that autoimmune and immune-mediated diseases share, as well as the mechanisms that distinguish one disease from another. **Adding scleroderma expands the program’s ability to compare immune pathways across conditions and may support the identification of new biomarkers and therapeutic targets.** ### New Data Platform Aims to Connect Dispersed Autoimmune Research Datasets OADR-ORWH also provided an update on the **Autoimmune Disease Analysis Platform Testing Space (ADAPTS)**, a pilot platform being developed in partnership with the National Library of Medicine in response to Congress’s directive to develop a repository for autoimmune disease research. Rather than serving as a traditional centralized database, ADAPTS is being designed as a federated data platform. This approach allows researchers to analyze multiple datasets through a single interface while the data remain under the control of the institutions that maintain them. According to OADR-ORWH, this model provides a unified view across distributed data sources without requiring data to be moved or duplicated. The platform is intended to preserve privacy, governance, and institutional oversight while facilitating the identification of shared mechanisms across autoimmune and autoinflammatory diseases. #### By enabling investigators to develop common analytical tools across multiple datasets, NIH hopes the platform will accelerate the discovery of biomarkers, disease patterns, and potential therapeutic targets.   Five groups of NIH intramural investigators are currently testing the platform across several disease areas. Their projects include research on immune phenotypes, biomarkers, disease subtypes, treatment targets, and shared biological pathways. The platform remains in an early pilot phase within the NIH. If successful, OADR-ORWH envisions expanding the infrastructure into a scalable resource that could support data-driven autoimmune disease research across the broader scientific community ### Environmental Triggers and Exposomics Remain Major Priorities OADR-ORWH highlighted work supported through its Exposome in Autoimmune Disease Collaborating Teams initiative, known as the [ExACT Plan](https://www.autoimmuneinstitute.org/research_updates/autoimmune-disease-researchers-receive-exact-plan-awards/ "Autoimmune Disease Researchers Receive EXACT-PLAN Awards"), which studies how environmental exposures across the lifespan may contribute to autoimmune disease. The office also discussed its partnership with the Network for Exposomics in the U.S., or [NEXUS](https://www.nexus-exposomics.org/). Through this partnership, autoimmune disease researchers may be able to access tools, expertise, and guidance for conducting exposomics research. During the community discussion, questions were raised about ongoing research into [wildfire smoke and autoimmunity](https://www.autoimmuneinstitute.org/covid_timeline/wildfire-smoke-exposure-covid-19-double-whammy-for-the-immune-system/ "Wildfire Smoke Exposure Worsened COVID-19 Outcomes"). OADR-ORWH pointed to early work from investigators at the Benaroya Research Institute examining the immunological effects of wildfire smoke and other environmental exposures. The office described wildfire smoke and environmental triggers more broadly as important areas for continued research. ### Nutrition and the Microbiome Continue to Draw Community Interest OADR-ORWH also reviewed results from a [recent public challenge](https://www.autoimmuneinstitute.org/research_updates/nutrition-and-autoimmunity-nih-nourish-challenge/ "Nutrition and Autoimmunity: NIH NOURISH Challenge") focused on [nutrition and immune system health](https://www.autoimmuneinstitute.org/gai-library/#ad-food). Submitted ideas generally fell into four themes: - Testing specific dietary interventions - Understanding interactions among nutrition, the microbiome, and the immune system - Developing personalized and predictive approaches to nutrition - Incorporating patient and community perspectives into research The office indicated that similar public research challenges may be offered in the future. During the community roundtable, a participant living with ulcerative colitis asked why autoimmune diseases appear to be increasing and whether food or environmental factors may be involved. OADR-ORWH noted that [autoimmune disease rates appear to be rising](https://www.autoimmuneinstitute.org/articles/autoimmunity-on-the-rise "Autoimmunity on the Rise") more quickly than genetics alone can explain and said that understanding environmental, dietary, microbial, and other contributing factors remains a major research priority. ### September Workshop Will Focus on Complex Multisystem Disorders OADR-ORWH announced an upcoming workshop co-sponsored with the National Institute of Neurological Disorders and Stroke. The September 2026 workshop will focus on complex multisystem disorders, including overlapping neurologic, pain, and post-infectious conditions. The meeting will be held in person with a virtual attendance option and will be open to researchers, patients, advocates, clinicians, and other members of the community. The workshop reflects growing NIH interest in conditions that do not fit neatly within a single medical specialty, and that may involve overlapping immune, neurologic, autonomic, pain, and post-infectious mechanisms. ### Autoimmune Disease Research Needs Longitudinal Studies Beginning Early in Life Can large, long-term studies of childhood development and environmental exposures be used to investigate future autoimmune disease risk? The [NIH Environmental influences on Child Health Outcomes program](https://www.nih.gov/echo), known as [ECHO](https://echochildren.org/), collects extensive information on maternal and child health and environmental exposures. However, autoimmune disease outcomes have not traditionally been a primary focus of the program. Interest was expressed in finding ways to use ECHO and other existing cohorts to examine autoimmune disease risk across the lifespan. OADR-ORWH said that connecting and analyzing existing datasets is one of the goals of its developing data platform and noted that the office is also in discussions with the [NIH All of Us Research Program](https://allofus.nih.gov/). ### Autoimmune Disease Research Portfolio Could Use An Update During the community roundtable, GAI asked whether the NIH plans to update the list of diseases included in the [NIH autoimmune disease research portfolio](https://www.autoimmuneinstitute.org/research_updates/establishing-autoimmune-disease-categories-in-nih-research/ "Establishing Autoimmune Disease Categories in NIH Research"). [The current list](https://orwh.od.nih.gov/sites/orwh/files/docs/Updated%20Portfolio%20Table_5.15.24_508c.pdf), which includes more than 140 diseases and related conditions, was largely drawn from an appendix to the National Academies’ report that helped inform the creation of OADR-ORWH. OADR-ORWH acknowledged that additional autoimmune diseases have been identified or more [clearly defined](https://www.autoimmuneinstitute.org/articles/autoimmune-or-not-the-diseases-that-blur-the-lines "Autoimmune or Not? The Diseases That Blur the Lines") since the original list was developed and that some conditions are not adequately represented. The office said the disease list will likely need to be reconsidered over time and expressed interest in establishing a regular process for updating it with input from researchers, advocacy organizations, and the broader autoimmune disease community. This recognition is particularly important because the way diseases are classified can influence research tracking, funding analyses, public awareness, and whether emerging or historically overlooked conditions are represented in federal initiatives. ### Improving How NIH Tracks Autoimmune Disease Funding OADR-ORWH also discussed recent changes to the [NIH research funding categories](https://orwh.od.nih.gov/OADR-ORWH/Funding-Information). In fiscal year 2025, the NIH updated the criteria used to categorize autoimmune disease research in its Research, Condition, and Disease Categorization system. The changes are intended to make it easier to identify and analyze NIH-funded autoimmune disease projects. **[Sjögren disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sjogren-syndrome/ "Sjögren disease (SjD)") was also added as its own research category in fiscal year 2025, joining conditions such as [lupus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus (SLE)") and [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid arthritis") that can already be viewed separately.** OADR-ORWH encouraged disease communities to review NIH funding data and request a dedicated category when a condition receives substantial federal research support but is not separately represented. ### Looking Ahead The July meeting showed that OADR-ORWH is moving beyond the development of a strategic plan and beginning to build the programs, partnerships, funding mechanisms, and data infrastructure needed to support it. OADR-ORWH plans to continue holding quarterly community meetings and invite researchers, patients, advocates, and organizations to share emerging priorities and help shape future autoimmune disease research efforts. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/GAI-Logo-Image-e1707845715517.png) **Category:** Events, OADR (NIH Office of Autoimmune Disease Research) --- ### [Office of Autoimmune Disease Research (OADR)](https://www.autoimmuneinstitute.org/research_updates/office-of-autoimmune-disease-research/) **Published:** August 23, 2024 **Author:** Carolyn Serraino **Excerpt:** The Office of Autoimmune Disease Research (OADR) is part of the National Institutes of Health, and its job is to connect the dots between all the different autoimmune disease studies happening across the country. Instead of researchers working in separate silos, OADR helps them share knowledge, focus on the most pressing questions, and move discoveries from the lab to patients faster. **Content:** ### **What the OADR Does and How It Impacts You** The Office of Autoimmune Disease Research ([OADR](https://orwh.od.nih.gov/OADR-ORWH)) is part of the National Institutes of Health, and its job is to connect the dots between all the different autoimmune disease studies happening across the country. **Instead of researchers working in separate silos, OADR helps them share knowledge, focus on the most pressing questions, and move discoveries from the lab to patients faster.** For the autoimmune disease community, this work means: - Faster, more accurate diagnoses so people spend less time searching for answers. - New targeted therapies and more personalized treatment plans instead of one-size-fits-all approaches. - Stronger patient voice in shaping research directions so studies focus on real-world needs. - Better representation of diverse populations in studies so treatments work for everyone. By making research more coordinated, inclusive, and focused, OADR is helping turn promising science into real progress for people living with autoimmune disease. **Read On:** - [ NIH-Wide Strategic Plan for Autoimmune Disease Research FY 2026–2030 ](https://www.autoimmuneinstitute.org/research_updates/nih-wide-strategic-plan-for-autoimmune-disease-research/) — Outlines NIH’s five-year strategy to accelerate prevention, diagnosis, treatment, and cures for autoimmune diseases through coordinated research. - [ OADR Report FY 2023–2024 ](https://www.autoimmuneinstitute.org/research_updates/advancing-autoimmune-disease-research-through-coordination-and-innovation/) — Highlights the Office of Autoimmune Disease Research’s first-year achievements in uniting researchers, funding innovative projects, and expanding data-sharing tools. **Category:** OADR (NIH Office of Autoimmune Disease Research), Policy & Health Decisions --- ### [The Disappearance of the OADR-ORWH Report](https://www.autoimmuneinstitute.org/research_updates/the-disappearance-of-the-oadr-orwh-report/) **Published:** February 14, 2025 **Author:** Carolyn Serraino **Excerpt:** According to the OADR website, its inaugural report, intended to outline its mission, achievements, and activities in Fiscal Years 2023 and 2024, was just published in January 2025. However, as of February 5, all links to the document lead to "Page Not Found" errors. **Content:** #### Updated: February 14, 2025 The website link to access [*the Office of Autoimmune Disease Research Report in the Office of Research on Women’s Health (OADR-ORWH)*](https://orwh.od.nih.gov/sites/orwh/files/docs/FY23-24%20Report%20of%20the%20Office%20of%20Autoimmune%20Disease%20Research%20in%20the%20Office%20of%20Research%20on%20Women%27s%20Health.pdf) for fiscal years 2023-2024 has been restored. It is not clear whether it has been altered. *February 5, 2025* ##### Why is the Report of the Office of Autoimmune Disease Research in the Office of Research on Women’s Health for fiscal years 2023 and 2024 inaccessible? ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/02/Screenshot-2025-02-11-at-2.51.12 PM.png) According to the **Office of Autoimmune Disease Research (OADR)** [website](https://orwh.od.nih.gov/OADR-ORWH), its inaugural report, intended to outline its mission, achievements, and activities in Fiscal Years 2023 and 2024, was just published in **January 2025**. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/02/Screenshot-2025-02-11-at-2.51.26 PM.png) However, as of February 5, all links to the document on the **National Institutes of Health (NIH) Office of Research on Women’s Health (ORWH)** website lead to **“Page Not Found”** errors. It remains unclear whether the report was ever publicly accessible or if it was removed before it could be widely viewed. After reaching out to OADR-ORWH for clarification, GAI received a response stating that the website is undergoing modifications and that some links are currently unavailable. However, their message provided no timeline for when the report might be restored, only that they “hope this will be restored soon.” This leaves the possibility that the report may not return at all, or if it does, it may have been altered. Given that this was an official report meant to document OADR-ORWH’s research efforts and congressional directives, its absence raises questions about its availability and accessibility. As of now, there has been no official explanation for why the report is unavailable to the public. **Category:** Autoimmune Diseases, OADR (NIH Office of Autoimmune Disease Research), Policy & Health Decisions, Research Studies --- ### [Establishing Autoimmune Disease Categories in NIH Research](https://www.autoimmuneinstitute.org/research_updates/establishing-autoimmune-disease-categories-in-nih-research/) **Published:** April 2, 2024 **Author:** Carolyn Serraino **Excerpt:** The Autoimmune Disease Research Portfolio, compiled by the Office of Autoimmune Disease Research (OADR) within the National Institutes of Health (NIH) Office of Research on Women’s Health, provides a comprehensive overview of the numerous autoimmune diseases under investigation. **Content:** The **[Autoimmune Disease Research Portfolio](https://orwh.od.nih.gov/sites/orwh/files/docs/Updated%20Portfolio%20Table_5.15.24_508c.pdf)**, compiled by the **Office of Autoimmune Disease Research (OADR)** within the **National Institutes of Health (NIH) Office of Research on Women’s Health**, provides a comprehensive overview of the numerous autoimmune diseases under investigation. While widely recognized conditions such as **lupus, rheumatoid arthritis, Crohn’s disease, ulcerative colitis, type 1 diabetes, multiple sclerosis, psoriatic arthritis, and celiac disease** are included, the NIH’s research extends to **144 different autoimmune diseases** across multiple organ systems. ##### The portfolio categorizes diseases into various domains, including: ## Auditory/Ear [Autoimmune inner ear disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-inner-ear-disease/) [Cogan’s syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/cogan-syndrome/) [Meniere’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/menierers-disease/) ## Complex Comorbid Conditions Autoimmune dysautonomia [Chronic Lyme disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/lyme-disease/) [Fibromyalgia](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/fibromyalgia/) [Interstitial cystitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/interstitial-cystitis/) [Narcolepsy](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/narcolepsy/) ## Dermatologic/Mucosa [Alopecia areata](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/alopecia-areata/) [Autoimmune urticaria](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/chronic-urticaria/) Benign mucosal pemphigoid [Bullous pemphigoid](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/bullous-pemphigoid/) [Cicatricial pemphigoid](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ocular-cicatricial-pemphigoid/) [Hidradenitis suppurativa](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/hidradenitis-suppurativa/) [Lichen planus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/lichen-planus/) [Lichen sclerosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/lichen-sclerosus/) Pityriasis lichenoides et varioliformis acuta (PLEVA) [Pemphigus](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/#P) Pyoderma gangrenosum [Vitiligo](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/vitiligo/) ## Endocrine [Addison’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-addisons-disease/) [Graves’ disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/graves-disease/) [Hashimoto’s thyroiditis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/hashimotos-thyroiditis/) [Polyglandular syndromes types I,II,III](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-polyglandular-syndromes/) Thyroid eye disease [Type 1 diabetes](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/diabetes-type-1/) ## Gastrointestinal [Autoimmune hepatitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-hepatitis/) [Autoimmune pancreatitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-pancreatitis/) [Celiac disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/celiac-disease/) [Crohn’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crohns-disease/) [Dermatitis herpetiformis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/dermatitis-herpetiformis/) [Eosinophilic esophagitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/eosinophilic-esophagitis/) [Primary biliary cholangitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/primary-biliary-cirrhosis/) [Primary sclerosing cholangitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/primary-sclerosing-cholangitis/) [Ulcerative colitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ulcerative-colitis/) ## Gynecological and Fertility [Autoimmune oophoritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-oophoritis/) [Autoimmune orchitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/testicular-autoimmunity/) Herpes gestationis [Progesterone dermatitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-progesterone-dermatitis/) [Endometriosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/endometriosis/) ## Hematology [Agammaglobulinemia](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/agammaglobulinemia/) Amyloidosis Autoimmune angioedema [Autoimmune hemolytic anemia](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-hemolytic-anemia/) Autoimmune neutropenia [Autoimmune thrombocytopenic purpura](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/immune-thrombocytopenia/) [Castleman disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/castleman-disease/) [Cold agglutinin disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/cold-agglutinin-disease/) [Essential mixed cryoglobulinemia](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/essential-mixed-cryoglobulinemia/) [Paroxysmal nocturnal hemoglobinuria](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/paroxysmal-nocturnal-hemoglobinuria/) Pernicious anemia [POEMS syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/poems-syndrome/) [Pure red cell aplasia](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/pure-red-cell-aplasia/) ## Lupus/Scleroderma/Myositis [Antiphospholipid syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/antiphospholipid-syndrome/) Congenital heart block [CREST syndrome (Limited scleroderma)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crest-syndrome/) [Dermatomyositis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/dermatomyositis/) [Discoid lupus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/discoid-lupus/) [Eosinophilic fasciitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/eosinophilic-fasciitis/) [Evans syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/evans-syndrome/) [Inclusion body myositis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/inclusion-body-myositis/) Juvenile myositis [Mixed connective tissue disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/mixed-connective-tissue-disease/) [Myositis/Polymyositis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/polymyositis/) Neonatal lupus [Progressive hemifacial atrophy](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/parry-romberg-syndrome/) [Raynaud’s phenomenon](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/raynauds-syndrome/) [Scleroderma](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/scleroderma/) [Sjögren’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sjogren-syndrome/) [Systemic Lupus Erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/) ## Neurologic/Myelin-related Anti-Myelin oligodendrocyte glycoprotein (MOG) [Autoimmune encephalitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/acute-disseminated-encephalomyelitis/) [Baló disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/balo-disease/) [Chronic inflammatory demyelinating polyneuropathy](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/chronic-inflammatory-demyelinating-polyneuropathy/) Complex regional pain syndrome [Guillain-Barre syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/guillain-barre-syndrome/) [Lambert-Eaton syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/lambert-eaton-myasthenic-syndrome/) Multifocal motor neuropathy [Multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/) [Myasthenia gravis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/myasthenia-gravis/) [Neuromyelitis optica](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/neuromyelitis-optica/) Optic neuritis [Paraneoplastic cerebellar degeneration](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/paraneoplastic-cerebellar-degeneration/) [Brachial neuritis (Parsonage-Turner syndrome)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/parsonage-turner-syndrome/) Perivenous encephalomyelitis Stiff person syndrome Transverse myelitis ## Ocular/Eye [Autoimmune retinopathy](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-retinopathy/) Autoimmune uveitis Pars planitis [Scleritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/scleritis/) Sympathetic ophthalmia Tolosa-Hunt syndrome ## Pulmonary [Erythema nodosum](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/erythema-nodosum/) [Fibrosing alveolitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/fibrosing-alveolitis/) Pulmonary Alveolar Proteinosis [Sarcoidosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sarcoidosis/) ## Renal [Glomerulonephritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/glomerulonephritis/) [Goodpasture’s syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/goodpastures-syndrome/) [Henoch-Schonlein purpura](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/henoch-schonlein-purpura/) [IgA nephropathy](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/iga-nephropathy/) [Linear IgA disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/linear-igadisease/) ## Rheumatoid Arthritis and Seronegatives [Ankylosing spondylitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ankylosing-spondylitis/) [Juvenile idiopathic arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/juvenile-idiopathic-arthritis-stills/) [Palindromic rheumatism](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/palindromic-rheumatism/) [Psoriasis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/psoriasis/) [Psoriatic arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/psoriatic-arthritis/) [Reactive arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/reactive-arthritis/) [Rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/) ## Systemic Inflammatory Conditions [Adult Still’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/juvenile-idiopathic-arthritis-stills/) Chronic Recurrent Multifocal Osteomyelitis [Giant cell myocarditis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/giant-cell-myocarditis/) [Kawasaki disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/kawasaki-disease/) [Myocarditis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-myocarditis/) Pediatric autoimmune neuropsychiatric disorders associated with streptococcus infections (PANDAS) [Postmyocardial infarction syndrome (Dressler’s syndrome)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/dresslers-syndrome/) [Rheumatic fever](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatic-fever/) ## Vasculitis Autoimmune vasculitis [Behcet’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/behcets/) [Churg-Strauss syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/churg-strauss-syndrome/) [Giant cell arteritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/giant-cell-arteritis-temporal-arteritis-hortons-disease/) [Granulomatosis with polyangiitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/wegeners/) [IgG4-related sclerosing disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/igg4-related-sclerosing-disease/) [Microscopic polyangiitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/microscopic-polyangiitis-anca-associated-vasculitis/) [Polyarteritis nodosa](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/polyarteritis-nodosa/) [Relapsing polychondritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/relapsing-polychondritis/) [Polymyalgia rheumatica](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/polymyalgia-rheumatica/) Retroperitoneal fibrosis Susac’s syndrome Takayasu’s arteritis Vogt-Koyanagi-Harada disease This extensive research portfolio highlights the NIH’s commitment to understanding, diagnosing, and treating a broad range of autoimmune diseases, many of which remain under-recognized. **Category:** OADR (NIH Office of Autoimmune Disease Research) --- ### [OADR Report FY 2023–2024](https://www.autoimmuneinstitute.org/research_updates/oadr-report-fy23-24/) **Published:** February 17, 2025 **Author:** Carolyn Serraino **Excerpt:** Summary of the FY23-24 Report of the Office of Autoimmune Disease Research in the Office of Research on Women's Health (OADR-ORWH). **Content:** #### **Summary of the FY23-24 Report of the Office of Autoimmune Disease Research in the Office of Research on Women’s Health (OADR-ORWH)** The newly established Office of Autoimmune Disease Research (OADR-ORWH) within the Office of Research on Women’s Health (ORWH) is tasked with enhancing coordination and innovation in autoimmune disease research across the National Institutes of Health (NIH). OADR-ORWH was formed following a 2022 consensus report by the National Academies of Sciences, Engineering, and Medicine (NASEM), which highlighted the lack of a unified strategic plan for autoimmune disease research at NIH. Congress responded by directing NIH to create OADR-ORWH under the Consolidated Appropriations Act, 2023, with a mission to coordinate research efforts across NIH’s Institutes, Centers, and Offices (ICOs). ##### **Key Congressional Directives & Achievements** The office was established with six primary directives to strengthen autoimmune disease research: #### **1. Developing a **Multi-Institute and Center** Strategic Plan** - OADR-ORWH led the development of an NIH-wide strategic plan for autoimmune disease research, bringing together 22 ICO representatives. - In December 2023, they issued a Request for Information (RFI) to gather input from researchers, advocacy groups, and the public. - The strategic plan is expected to be finalized by late FY25, guiding future NIH priorities in autoimmune disease research. #### **2. Identifying Emerging Areas of Innovation** - OADR-ORWH launched initiatives to engage the autoimmune disease research community, including: - ScienceTALKS Series: Covering key research topics, such as the role of [X chromosome inactivation](https://www.autoimmuneinstitute.org/research_updates/improper-x-chromosome-inactivation-and-hormonal-fluctuations-linked-to-autoimmunity/ "Improper X Chromosome Inactivation and Hormonal Fluctuations Linked to Autoimmunity") in female-dominated autoimmune diseases and [viral triggers](https://www.autoimmuneinstitute.org/research_updates/sciencetalks-recap-viral-triggers-of-autoimmune-disease/ "ScienceTALKS Recap: Viral Triggers of Autoimmune Disease") of autoimmunity. - “[Updates on OADR-ORWH” Sessions](https://www.autoimmuneinstitute.org/research_updates/july-2024-oadr-meeting-key-updates-on-autoimmune-disease-research/ "July 2024 OADR Meeting: Key Updates on Autoimmune Disease Research"): Quarterly virtual events to inform the public about research advancements. - [8th Annual Vivian W. Pinn Symposium](https://www.autoimmuneinstitute.org/research_updates/vivian-w-pinn-symposium-innovations-in-autoimmune-disease-research-and-care/ "Vivian W. Pinn Symposium: Innovations in Autoimmune Disease Research and Care"): Focused on innovation in autoimmune disease research and patient-centered care. #### **3. Coordinating Collaborative Research Across ICOs** - NIH-funded autoimmune disease research spans [140+ diseases](https://www.autoimmuneinstitute.org/resources/autoimmune-disease-list/ "A-Z Disease List") across multiple organ systems, necessitating interdisciplinary collaboration. - OADR-ORWH co-funded 92 research projects across 15 ICOs, including: - The EXACT-PLAN Initiative: Established interdisciplinary research networks for exposome research, which examines environmental triggers of autoimmune diseases. - The Accelerating Medicines Partnership® (AMP® AIM) Program: Focused on identifying novel drug targets for autoimmune diseases. - New Collaborations with the Autoimmunity Centers of Excellence (ACE): Expanded research into [endocrine](https://www.autoimmuneinstitute.org/research_updates/impact-of-endocrine-transitions-on-autoimmunity-in-women/ "Impact of Endocrine Transitions on Autoimmunity in Women")-specific autoimmune conditions. #### **4. Evaluating the [Autoimmune Research Portfolio](https://www.autoimmuneinstitute.org/research_updates/establishing-autoimmune-disease-categories-in-nih-research/ "Establishing Autoimmune Disease Categories in NIH Research")** - OADR-ORWH analyzed NIH’s autoimmune disease funding to identify gaps and future research needs. - Their analysis included diseases ranging from systemic conditions ([lupus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus"), [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid arthritis")) to more specialized disorders ([autoimmune inner ear disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-inner-ear-disease/ "Autoimmune inner ear disease"), [myasthenia gravis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/myasthenia-gravis/ "Myasthenia gravis"), PANDAS, etc.). - Findings will inform the NIH-wide strategic plan and future funding priorities. #### **5. Providing Resources for Collaboration & Innovation** - OADR-ORWH funded initiatives to enhance research infrastructure, including: - The NEXUS Coordinating Center: Aims to integrate [exposomics](https://www.autoimmuneinstitute.org/research_updates/the-role-of-exposomes-toxic-chemicals-food-and-pathogens-in-the-pathophysiology-of-ads/ "The Role of Exposomes (Toxic Chemicals, Food, and Pathogens) in the Pathophysiology of ADs") (study of environmental exposures) across autoimmune disease research. - Editorial Publications in Scientific Journals: Highlighting the role of exposome research in autoimmune diseases. - [The EXACT-PLAN Summit](https://www.autoimmuneinstitute.org/research_updates/autoimmune-disease-researchers-receive-exact-plan-awards/ "Autoimmune Disease Researchers Receive EXACT-PLAN Awards"): Convened experts to discuss integrating environmental factors into autoimmune disease studies. #### **6. Creating a Central Repository for Autoimmune Disease Research** - OADR-ORWH partnered with the National Library of Medicine (NLM) to pilot a federated data platform for autoimmune disease research. - This approach allows researchers to analyze data without centralizing it, maintaining privacy and security while improving access to autoimmune disease datasets. - A [Common Data Elements (CDE) initiative](https://www.autoimmuneinstitute.org/research_updates/nih-funds-conferences-to-standardize-autoimmune-research-data/ "NIH Funds Conferences to Standardize Autoimmune Research Data") was launched to standardize data collection across NIH-funded autoimmune disease studies. ###### Full Report: <https://orwh.od.nih.gov/sites/orwh/files/docs/FY23-24%20Report%20of%20the%20Office%20of%20Autoimmune%20Disease%20Research%20in%20the%20Office%20of%20Research%20on%20Women%27s%20Health.pdf> **Category:** OADR (NIH Office of Autoimmune Disease Research), Policy & Health Decisions --- ### [Another Canceled OADR Event and Still No Clear Answers](https://www.autoimmuneinstitute.org/research_updates/another-canceled-oadr-event-and-still-no-clear-answers/) **Published:** March 5, 2025 **Author:** Carolyn Serraino **Excerpt:** Since the release and swift disappearance of the Office of Autoimmune Disease Research (OADR-ORWH)’s 2023–2024 report in early February, scheduled events have also begun to vanish without explanation. **Content:** Since the release and [swift disappearance](https://www.autoimmuneinstitute.org/research_updates/the-disappearance-of-the-oadr-orwh-report/ "swift disappearance") of the Office of Autoimmune Disease Research (OADR-ORWH)’s 2023–2024 report in early February, scheduled events have also begun to vanish without explanation. The most recent cancellation was the [March 4 ScienceTALKS session](https://content.govdelivery.com/accounts/USNIHORWH/bulletins/3d4167f), which was set to feature leading experts discussing advances in cellular therapies for autoimmune diseases. According to a February 25 email from the OADR-ORWH, the session was canceled due to “several challenges” and may be reinstated in the future, but no timeline has been provided. This follows an earlier message on February 11 stating that all NIH-sponsored public meetings are “on hold until further notice,” adding to the uncertainty surrounding the office’s ability to fulfill its public-facing mission. The January 31 “[Updates on OADR-ORWH](https://orwh.od.nih.gov/OADR-ORWH/updates-on-oadr-orwh)” quarterly session, a key opportunity for patients and advocates to learn about agency activities, was also quietly canceled. These continuing cancellations come at a time when people living with autoimmune diseases urgently need transparency, research progress, and community engagement. As one of the few federal offices with a specific focus on autoimmune disease, OADR-ORWH’s growing silence raises serious concerns about its future direction and accountability. **Category:** Events, OADR (NIH Office of Autoimmune Disease Research), Policy & Health Decisions --- ### [NIH Strategic Plan for Autoimmune Disease Research 2026-2030](https://www.autoimmuneinstitute.org/research_updates/nih-wide-strategic-plan-for-autoimmune-disease-research/) **Published:** July 21, 2025 **Author:** Carolyn Serraino **Excerpt:** The NIH-Wide Strategic Plan for Autoimmune Disease Research is the new federal roadmap to accelerate progress in the prevention, diagnosis, treatment, and cure of autoimmune diseases across the National Institutes of Health (NIH). This plan aligns with the work the Global Autoimmune Institute has championed for years —advancing science, education, and resources that bring research closer to the people it serves. **Content:** The **[NIH-Wide Strategic Plan for Autoimmune Disease Research](https://orwh.od.nih.gov/OADR-ORWH/Strategic-Planning-for-ADR)** is the new federal roadmap to accelerate progress in the prevention, diagnosis, treatment, and cure of autoimmune diseases across the National Institutes of Health (NIH). This plan aligns with the work the Global Autoimmune Institute has championed for years—advancing science, education, and resources that bring research closer to the people it serves. Developed by the [Office of Autoimmune Disease Research (OADR-ORWH)](https://orwh.od.nih.gov/OADR-ORWH) following a Congressional directive and enriched by researchers, clinicians, advocacy organizations, and [people living with autoimmune diseases](https://www.autoimmuneinstitute.org/autoimmune-stories/ "Autoimmune Stories"), it reflects a shared commitment to make autoimmune diseases a national research priority. ## Plan at a glance (FY2026–2030) Published in July 2025, this inaugural plan will run from 2026 through 2030 and sets shared priorities for autoimmune research across the NIH. It was informed by: - 83 public responses to a **[Request for Information (RFI)](https://grants.nih.gov/grants/guide/notice-files/NOT-OD-24-049.html)** from scientists, clinicians, advocates, and patients - [**NIH’s portfolio analysis**](https://www.autoimmuneinstitute.org/research_updates/establishing-autoimmune-disease-categories-in-nih-research/ "Establishing Autoimmune Disease Categories in NIH Research") of more than 140 autoimmune and related diseases - Recommendations from the [**2022 NASEM report**](https://nap.nationalacademies.org/read/26554/chapter/1) **The roadmap organizes work across NIH into five strategic priorities and five crosscutting themes:** #### Five Strategic Priorities: - Accelerate scientific discovery in diagnosis, treatment, prevention, and cure - Promote research to enhance health for people living with and at risk of autoimmune diseases - Understand the full complexity of autoimmune diseases - Build and maintain capacity for autoimmune disease research - Strengthen partnerships and interdisciplinary collaboration #### Five Crosscutting Themes: - Harness technologies to advance research - Build infrastructure for translation - Use multimodal, data-driven approaches - Engage all populations in research - Support community partnerships ### **What the Autoimmune Community Asked For** ### From the RFI responses, three major themes emerged: - **Scientific Advances:** Better understanding of mechanisms, risk factors, and prevention - **Research Methodology:** Studying co-occurring diseases, shared pathways, and cross-disease commonalities - **Workforce:** Building and sustaining a skilled, interdisciplinary research community Input from researchers, clinicians, advocacy groups, and people living with autoimmune diseases strengthened the plan. Common requests included: - National data systems and improved epidemiology - Focus on the autoimmune “prodrome” for earlier detection and prevention - Collaborative clinical trial models that include pediatric and multi-disease participants - A robust digital ecosystem for data sharing ## Get Involved - **Read** the [ NIH-Wide Strategic Plan for Autoimmune Disease Research (PDF) ](https://orwh.od.nih.gov/sites/orwh/files/docs/NIH-Wide-Strategic-Plan-for-Autoimmune-Disease-Research-Fiscal-Years-2026-2030.pdf). - **Join** [ OADR’s public update sessions ](https://orwh.od.nih.gov/OADR-ORWH/events) and submit questions. - **Share** your thoughts or questions with GAI via our [ contact form ](https://www.autoimmuneinstitute.org/contact-us/)—your ideas can inspire new articles, research updates, or other resources on our website. **Category:** OADR (NIH Office of Autoimmune Disease Research), Policy & Health Decisions --- ### [Why Experts Now Call It Sjögren Disease Instead of Sjögren Syndrome](https://www.autoimmuneinstitute.org/research_updates/why-experts-now-call-it-sjogren-disease-instead-of-sjogren-syndrome/) **Published:** July 10, 2026 **Author:** Carolyn Serraino **Content:** For decades, the condition was known as **Sjögren syndrome**. Today, however, many researchers, medical journals, and medical organizations are increasingly using the term **[Sjögren disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sjogren-syndrome/ "Sjögren disease (SjD)") (SjD)** instead. When an [international consensus](https://www.autoimmuneinstitute.org/research_updates/global-consensus-on-sjogren-disease/ "Global Consensus on Sjögren Disease") recommended replacing “Sjögren syndrome” with “Sjögren disease” in 2025, GAI updated its [Autoimmune Disease List](https://www.autoimmuneinstitute.org/resources/autoimmune-diseases-list/ "A-Z Disease List") accordingly. A new review published in the *Korean Journal of Internal Medicine* builds on that consensus by examining the scientific and clinical reasoning behind the evolving terminology. According to the authors, the shift is rooted in decades of research that have transformed how Sjögren is understood, recognizing it as a disease with well-defined biological mechanisms and manifestations that extend beyond the body’s moisture-producing glands. ### Why Did the Name Change from Sjögren Syndrome to Sjögren Disease? Traditionally, the term **“syndrome”** has been used to describe a group of signs and symptoms that occur together without a clearly defined underlying cause. In contrast, a **“disease”** generally refers to a condition with established biological mechanisms and characteristic pathological changes. The authors explain that Sjögren now fits the latter definition because researchers have identified many of the immune processes responsible for its development. The review highlights several well-established features of Sjögren disease, including activation of the type I interferon pathway, B-cell hyperactivity, focal lymphocytic infiltration of the salivary glands, formation of ectopic germinal centers, and local production of autoantibodies. Together, these findings support recognizing Sjögren as a biologically defined autoimmune disease rather than a syndrome defined primarily by its symptoms. The authors also note that adopting the term Sjögren disease has practical implications beyond scientific accuracy. They suggest that the updated terminology may improve medical recognition of the condition, facilitate access to care, support health policy and research initiatives, and promote clinical trials for emerging therapies. At the same time, they emphasize the importance of avoiding overdiagnosis in people who have isolated dry eyes or dry mouth without evidence of autoimmune disease. ### Why Is Sjögren Disease No Longer Considered Just a Dry Eye and Dry Mouth Condition? Although Sjögren is still widely associated with dry eyes and dry mouth, the review explains that researchers now recognize it as a disease that can affect multiple organs throughout the body. The authors note that extra-glandular manifestations may involve the joints, lungs, kidneys, skin, muscles, nervous system, lymph nodes, blood cells, and other organs. Data cited in the review show that articular, hematologic, and pulmonary involvement are among the most common systemic manifestations, while neurologic, muscular, renal, and cutaneous complications also occur in a subset of people with the disease. This broader understanding has changed how Sjögren is viewed within rheumatology. Rather than being considered primarily a disorder of the salivary and tear glands, it is increasingly recognized alongside other systemic autoimmune rheumatic diseases, including [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus (SLE)") and [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid arthritis"). ### Why Is Sjögren Disease So Difficult to Diagnose? Despite advances in understanding the biology of Sjögren disease, the review emphasizes that diagnosing it in clinical practice remains challenging. One reason is that dry eyes and dry mouth are common symptoms with many possible causes. The authors note that medications, mouth breathing, anxiety, depression, menopause, aging, and numerous other conditions can all contribute to dryness. They cite evidence suggesting that Sjögren disease is present in only about 10% of people evaluated for dry eye or dry mouth symptoms. The opposite problem also exists. Not everyone with Sjögren develops severe dryness early in the disease. According to the review, some people first experience arthritis, blood abnormalities, lung disease, kidney involvement, neurologic symptoms, or other systemic manifestations before classic sicca symptoms become apparent. The authors also caution against relying too heavily on a single laboratory test. Anti-Ro (SSA) antibodies remain one of the most important markers used in current classification criteria, but some people with Sjögren are seronegative, while anti-Ro antibodies may also be detected years before symptoms develop or in individuals who never develop Sjögren disease. For this reason, the review emphasizes that laboratory findings should always be interpreted alongside symptoms, physical examination findings, imaging, biopsy results when appropriate, and other clinical information. The review also emphasizes an important distinction between classification criteria and clinical diagnosis. The authors note that classification criteria were designed to create consistent groups of participants for research studies, not to serve as diagnostic rules for individual people in clinical practice. Because these criteria were largely developed using people with established disease, they may not identify everyone with early or atypical presentations. Instead, clinicians must integrate multiple sources of information when determining whether someone has Sjögren disease. ### Why Are “Primary” and “Secondary” Sjögren Syndrome Being Replaced? The review also discusses another important change in terminology. Historically, Sjögren was described as primary when it occurred on its own and secondary when it occurred alongside another autoimmune disease, such as rheumatoid arthritis or systemic lupus erythematosus. According to the authors, this distinction is increasingly being reconsidered. They explain that Sjögren frequently coexists with other autoimmune diseases as part of [polyautoimmunity](https://www.autoimmuneinstitute.org/articles/living-with-multiple-autoimmune-conditions "Living with Multiple Autoimmune Conditions"), and the term “secondary” may incorrectly suggest that Sjögren is less important than the accompanying condition. Instead, the review describes the growing use of the term **associated Sjögren disease**, which recognizes that multiple autoimmune diseases can coexist without implying that one is subordinate to another. The authors also acknowledge that additional clinical guidance is still needed regarding how associated Sjögren disease should be diagnosed and how disease activity should be assessed when more than one autoimmune disease is present. ##### Citation Lee, J. J., Jeon, H., Kim, H. S., Kim, H. R., Kwok, S. K., Sung, Y. K., Lee, J., Lee, S. S., Park, S. H., Lee, Y. J., & Korean Society of Sjogren Disease Research (KCR-SjD) (2026). From Sjögren syndrome to Sjögren disease: rethinking classification and diagnostic complexity. *The Korean journal of internal medicine*, *41*(4), 620–635. <https://doi.org/10.3904/kjim.2025.340> **Category:** Research Studies, Sjögren disease --- ### [Autoimmune Disease Biomarkers: Blood Protein Atlas Advances Research](https://www.autoimmuneinstitute.org/research_updates/autoimmune-disease-biomarkers-blood-protein-atlas/) **Published:** July 14, 2026 **Author:** Carolyn Serraino **Content:** #### What if one day doctors could classify autoimmune diseases by their underlying biology rather than primarily by their symptoms? Autoimmune diseases have [traditionally been classified](https://www.autoimmuneinstitute.org/articles/autoimmune-or-not-the-diseases-that-blur-the-lines "Autoimmune or Not? The Diseases That Blur the Lines") by the [organs they affect](https://www.autoimmuneinstitute.org/articles/body-regions-commonly-affected-by-autoimmunity "Body Regions Commonly Affected by Autoimmunity") and the symptoms they cause. But a growing body of research suggests these conditions may be better understood through the molecular pathways they share and the biological differences that make each disease unique. A new study published in *Communications Medicine* provides one of the largest comparisons of blood proteins across autoimmune diseases to date. By analyzing more than 1,400 proteins across five systemic autoimmune rheumatic diseases, researchers identified both shared and disease-specific molecular signatures that could help improve diagnosis, disease classification, and [future precision medicine approaches](https://www.autoimmuneinstitute.org/articles/personalized-medicine-for-autoimmune-diseases "Personalized Medicine for Autoimmune Diseases"). #### Researchers analyzed blood samples from 592 people with idiopathic inflammatory myopathies, [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid arthritis"), [systemic sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/scleroderma/ "Scleroderma (systemic sclerosis)") (scleroderma), [Sjögren disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sjogren-syndrome/ "Sjögren disease (SjD)"), or [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus (SLE)"). Their results were compared with samples from 400 healthy individuals and 218 people with acute infectious diseases, allowing the researchers to identify proteins that appear to be more specific to autoimmune disease rather than inflammation alone. The researchers found that the five autoimmune diseases shared hundreds of proteins with altered levels compared with both healthy individuals and people with acute infections. Many of these proteins are involved in immune signaling, [inflammation](https://www.autoimmuneinstitute.org/articles/inflammation-a-driving-force-of-autoimmune-disease "Inflammation: A Driving Force of Autoimmune Disease"), and tissue remodeling, reinforcing the idea that these conditions share common biological pathways despite affecting different organs and presenting with different symptoms. **Even so, each disease displayed its own distinct protein profile:** - Rheumatoid arthritis showed higher levels of cartilage-related proteins, including **COMP** and **CRTAC1**, consistent with joint damage. - Sjögren disease was associated with elevated **IRAG2**, **CRACR2A**, and **TRAF2**. - Systemic lupus erythematosus showed increased levels of proteins such as **TNFSF11 (RANK ligand)**, **AXL**, and **MFAP5**. - Systemic sclerosis was characterized by proteins involved in fibrosis and blood vessel biology, including **KLK4**, **CD93**, and **CCN3**. - Idiopathic inflammatory myopathies showed elevated muscle-associated proteins such as **CA3**, **HSPB6**, and **NOS1**, reflecting ongoing muscle injury and repair. To determine whether these protein patterns could distinguish the diseases from one another, the researchers applied machine learning. Their model identified a panel of 48 proteins that distinguished the five autoimmune diseases with remarkably high accuracy in this study. #### Rather than relying on a single biomarker, the findings suggest that combinations of proteins may ultimately provide a more reliable way to distinguish diseases that often have overlapping clinical features.  Together, these findings support a [growing shift in autoimmune disease research](https://www.autoimmuneinstitute.org/articles/innovative-diagnostic-techniques-for-detecting-autoimmune-diseases "Innovative Diagnostic Techniques for Detecting Autoimmune Diseases"). Rather than viewing these conditions as entirely separate disorders, researchers are increasingly recognizing that they share common biological mechanisms while also possessing distinct molecular signatures. Understanding both the similarities and the differences may lead to more [precise diagnostic tools](https://www.autoimmuneinstitute.org/articles/tailoring-autoimmune-treatment-with-precision-medicine "Tailoring Autoimmune Treatment with Precision Medicine"), improved disease classification, and new therapeutic targets. The authors emphasize that these protein signatures are not yet ready for clinical use and require validation in independent patient populations before they can become diagnostic tools. #### The researchers have also made the full dataset publicly available through the Human Protein Atlas, creating a resource that could accelerate future discoveries in autoimmune disease diagnosis, classification, and treatment. ##### Citation Kenrick, J., Preger, C., Álvez, M.B. *et al.* Pan-disease blood protein profiles of rheumatic autoimmune diseases. *Commun Med* **6**, 390 (2026). <https://doi.org/10.1038/s43856-026-01779-0> **Category:** Autoimmune Diseases, Diagnostic Testing, Lupus, Research Studies, Rheumatoid Arthritis, Sjögren disease --- ### [Bryan Johnson Diagnosed with Autoimmune Gastritis](https://www.autoimmuneinstitute.org/research_updates/bryan-johnson-autoimmune-gastritis/) **Published:** July 6, 2026 **Author:** Carolyn Serraino **Content:** Entrepreneur Bryan Johnson recently announced that he has been diagnosed with [autoimmune gastritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-gastritis/ "Autoimmune gastritis") (AIG), a chronic autoimmune disease in which the immune system mistakenly attacks the stomach’s acid-producing parietal cells. Johnson [shared](https://x.com/bryan_johnson/status/2072069730517860385) that years of unexplained low iron stores eventually led to additional testing, including blood work, endoscopy, and stomach biopsies, which confirmed his diagnosis. #### Even with exceptional access to healthcare and continuous health monitoring, autoimmune gastritis can remain hidden for years. Persistent iron deficiency may be one of the earliest warning signs of autoimmune gastritis, but the disease often goes unrecognized because early symptoms can be vague or absent altogether. Diagnosis typically relies on a combination of clinical evaluation, laboratory testing, endoscopy, and stomach biopsies rather than any single definitive test. Johnson’s diagnosis has also sparked discussion about whether his vegan diet or other lifestyle factors played a role in the development of autoimmune gastritis. While the exact cause of autoimmune gastritis remains unknown, current research suggests the disease develops through a complex interaction of genetic susceptibility, immune system dysfunction, and environmental factors. Featured Resource Living with Autoimmune Gastritis: What You Need to Know Read our in-depth guide to autoimmune gastritis, including early warning signs, diagnosis, treatment, nutrition, lifestyle considerations, and the latest research. [Read the Full Article → ](https://www.autoimmuneinstitute.org/articles/living-with-autoimmune-gastritis-what-you-need-to-know/) #### Research has made significant progress in understanding the factors that drive autoimmune gastritis. Rather than being caused by a single malfunction of the immune system, studies now suggest that the disease develops through a complex interplay among immune cells, inflammatory signaling pathways, [autoantibodies](https://www.autoimmuneinstitute.org/articles/decoding-the-role-of-autoantibodies-in-autoimmunity "Decoding the Role of Autoantibodies in Autoimmunity"), and changes within the stomach itself. Scientists are also investigating how disruptions to the stomach [microbiome](https://www.autoimmuneinstitute.org/gai-library/#microbiome) and breakdowns in the immune system’s normal regulatory mechanisms may contribute to disease progression, helping to paint a more complete picture of how autoimmune gastritis develops. Researchers have found that autoimmune gastritis frequently coexists with [autoimmune thyroid disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/hashimotos-thyroiditis/ "Hashimoto’s thyroiditis (autoimmune thyroiditis)"), [type 1 diabetes](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/type-1-diabetes-insulin-dependent-diabetes/ "Type 1 diabetes (T1D)"), [vitiligo](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/vitiligo/ "Vitiligo"), and other autoimmune conditions, leading experts to increasingly view it as part of a broader [autoimmune spectrum](https://www.autoimmuneinstitute.org/articles/the-immune-spectrum-from-autoimmunity-to-cancer "The Immune Spectrum: From Autoimmunity to Cancer") rather than simply a disorder of the stomach. This growing understanding may help identify people at higher risk and support earlier screening and diagnosis in individuals living with related autoimmune diseases. #### Although there is currently no cure for autoimmune gastritis, research is advancing rapidly. Scientists are developing improved diagnostic strategies that combine blood biomarkers, including anti-parietal cell antibodies, intrinsic factor antibodies, gastrin, and pepsinogen levels, with endoscopic and biopsy findings to help detect the disease earlier. More [personalized approaches](https://www.autoimmuneinstitute.org/articles/personalized-medicine-for-autoimmune-diseases "Personalized Medicine for Autoimmune Diseases") to predicting autoimmune gastritis progression and therapies that target the underlying autoimmune process rather than simply treating its complications are also being explored. Emerging areas of research include restoring [immune tolerance](https://www.autoimmuneinstitute.org/articles/restoring-immune-tolerance-in-autoimmune-disease "Restoring Immune Tolerance in Autoimmune Disease"), microbiome-based therapies, precision risk stratification, and targeted treatments such as netazepide, though these approaches remain investigational. Johnson’s diagnosis is a reminder that autoimmune gastritis can remain hidden for years, even in people who actively monitor their health. As researchers continue to unravel the biology of the disease, these discoveries are laying the foundation for earlier diagnosis, more personalized care, and future therapies that address the underlying autoimmune process rather than only managing its long-term complications. ![Illustration of autoimmune gastritis showing chronic inflammation and damage to the stomach lining with a magnified view of the gastric mucosa.](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/12/autoimmune-gastritis-stomach-lining-inflammation-1-1024x576.jpg) Living with Autoimmune Gastritis: What You Need to Know  Struggling with autoimmune gastritis? Discover symptoms, triggers, and expert tips to manage this complex condition and reclaim your health and energy. About Autoimmune Disease [Read Post Living with Autoimmune Gastritis: What You Need to Know ](https://www.autoimmuneinstitute.org/articles/living-with-autoimmune-gastritis-what-you-need-to-know) ![Vegetable farmer arranging freshly picked produce into a crate on an organic farm](https://www.autoimmuneinstitute.org/wp-content/uploads/2020/02/shutterstock_2127480059-1024x683.jpg) How Food Can Influence Autoimmune Disease While diet alone cannot guarantee the prevention of autoimmune diseases, certain foods and dietary patterns are believed to support a healthy immune system and reduce the risk of autoimmune conditions. Living Well with Autoimmune Disease [Read Post How Food Can Influence Autoimmune Disease](https://www.autoimmuneinstitute.org/articles/what-does-organic-really-mean-part-two) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Food-Sensitivity-Intolerance-or-Allergy-1024x576.jpg) Food Sensitivity, Intolerance, or Allergy: What’s the Difference? Does your autoimmune disease come with a side of food reactions that cause symptom flare-ups? You may be part of the 15-20% of people who experience food sensitivities and intolerances. The pain and discomfort can be invisible, and are often misdiagnosed or dismissed despite their severity. These buzzwords can also cause a great deal of confusion. People with food sensitivities, intolerances, and even allergies and celiac disease can exhibit similar symptoms; however each condition works in a different way. Allergy Although they are often confused with sensitivities and intolerances, allergies are fairly easy to differentiate. Allergies are specific IgE-mediated immune responses \[…\] Living Well with Autoimmune Disease [Read Post Food Sensitivity, Intolerance, or Allergy: What’s the Difference?](https://www.autoimmuneinstitute.org/articles/food-sensitivity-intolerance-or-allergy-whats-the-difference) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Culinary-Medicine-1-1024x576.jpg) Culinary Medicine: Autoimmunity and Healthy Eating You may already know that eating a balanced diet supports a healthy lifestyle. If you have an autoimmune disease, you may also know that eating well and eliminating unhealthy foods, in addition to other beneficial habits (such as managing stress and sleeping well), may reduce the risk of developing unwanted signs and symptoms. Examples of foods and food components to cut down for a healthier life include processed and fried foods, sugar-sweetened foods and drinks, and refined carbohydrates. However, identifying the foods that can specifically initiate your flare-ups may help you heal and feel better as you manage your autoimmune condition. \[…\] Living Well with Autoimmune Disease [Read Post Culinary Medicine: Autoimmunity and Healthy Eating](https://www.autoimmuneinstitute.org/articles/culinary-medicine-autoimmunity-and-healthful-eating) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Body-Regions-1024x576.png) Body Regions Commonly Affected by Autoimmunity Autoimmune diseases can affect almost any part of your body and can be classified into systemic or organ-specific diseases based on their location. “The key thing is that you can actually test for an autoimmune reaction by looking at serologies in the blood,” said Gabriella Safdieh, an integrative medicine physician. “There are various serologies that are consistent with different forms of autoimmune diseases.” Serology is the scientific study of serum (blood component) and other body fluids. The term usually refers to the diagnostic identification of antibodies in the serum. In systemic autoimmune diseases, such as rheumatoid arthritis, autoantigens are found in \[…\] About Autoimmune Disease [Read Post Body Regions Commonly Affected by Autoimmunity](https://www.autoimmuneinstitute.org/articles/body-regions-commonly-affected-by-autoimmunity) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/AD-Specialists-1-1024x576.png) Autoimmune Disease Specialist Spotlight How to find the right doctor to treat your specific autoimmune condition and how insurance factors in Finding a specialist to treat your autoimmune symptoms can be crucial to receiving an accurate diagnosis and developing a comprehensive treatment plan. How can you find the right doctor to treat your autoimmune disease (AD), and how does insurance factor into specialist appointments? How does someone with a suspected autoimmune disease know which type of doctor to see? It can be difficult for patients with a suspected autoimmune disease to know which type of doctor to see. A primary care physician or a general \[…\] Autoimmune Care & Caregiver Support [Read Post Autoimmune Disease Specialist Spotlight](https://www.autoimmuneinstitute.org/articles/autoimmune-disease-specialist-spotlight) ![Autoantibodies bond to receptor (achr) blocking the acetylcholine transmitters in Myasthenia gravis (MG) - 3d illustration isometric view](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/09/autoantibodies-1-1024x576.png) Decoding the Role of Autoantibodies in Autoimmunity Your immune system makes antibodies against foreign invaders like viruses and bacteria. Sometimes, your body makes autoantibodies, proteins that mistakenly attack your body’s tissue, leading to autoimmunity.  What are Autoantibodies? Under normal conditions, antibodies protect us by recognizing and attacking harmful substances. However, autoantibodies mistakenly identify the body’s tissues as threats.  Faulty autoantibodies can target specific body regions, leading to various autoimmune disorders including: Are Autoantibodies Always Harmful? Not always. Many healthy people are born with natural autoantibodies that are part of a normally functioning immune system (1). Autoantibodies may help the immune system by “cleaning up” dead cells after infection \[…\] About Autoimmune Disease [Read Post Decoding the Role of Autoantibodies in Autoimmunity](https://www.autoimmuneinstitute.org/articles/decoding-the-role-of-autoantibodies-in-autoimmunity) ##### Citations Feng, M., Xu, W., & Zhu, H. (2026). Autoimmune gastritis: a comprehensive review of pathophysiology, risk stratification, and management. *Frontiers in immunology*, *17*, 1878128. <https://doi.org/10.3389/fimmu.2026.1878128> Soykan, İ., Er, R. E., Baykara, Y., & Kalkan, C. (2024). Unraveling the Mysteries of Autoimmune Gastritis. *The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology*, *36*(3), 135–144. <https://doi.org/10.5152/tjg.2024.24563> Qian, J., Hu, Z., Xu, Z., Yuan, S., Zhao, J., Shi, H., & Wang, X. (2026). Immunological mechanisms of autoimmune gastritis. *Clinical and experimental medicine*, *26*(1), 147. <https://doi.org/10.1007/s10238-026-02080-z> Massironi, S., Oriani, E., Dell’Anna, G., Danese, S., & Facciotti, F. (2025). The Autoimmune Gastritis Puzzle: Emerging Cellular Crosstalk and Molecular Pathways Driving Parietal Cell Loss and ECL Cell Hyperplasia. *Cells*, *14*(20), 1576. <https://doi.org/10.3390/cells14201576> **Category:** Autoimmune Diseases, Autoimmune Stories --- ### [Polyautoimmunity Highlights the Challenges of Autoimmune Diagnosis](https://www.autoimmuneinstitute.org/research_updates/the-kaleidoscope-of-polyautoimmunity-an-odyssey-of-diagnostic-dilemmas/) **Published:** April 8, 2024 **Author:** Carolyn Serraino **Excerpt:** A case report delves into the diagnostic challenges encountered in a patient presenting with overlapping symptoms indicative of multiple autoimmune diseases. The report underscores the importance of continued surveillance and long-term follow-up in patients with autoimmune diseases, as the clinical picture may evolve over time. It also emphasizes the need for awareness of diagnostic dilemmas and the challenges posed by overlapping symptoms and laboratory findings in autoimmune disorders. **Content:** April 8, 2024 [**The Kaleidoscope of Polyautoimmunity: An Odyssey of Diagnostic Dilemmas**](https://www.cureus.com/articles/211162-the-kaleidoscope-of-polyautoimmunity-an-odyssey-of-diagnostic-dilemmas?score_article=true#!/)” is a case report that delves into the diagnostic challenges encountered in a patient presenting with overlapping symptoms indicative of multiple autoimmune diseases. The patient, a 63-year-old male with a history of [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/rheumatoid-arthritis/) (RA) on methotrexate treatment, exhibited symptoms suggestive of various connective tissue diseases (CTDs) such as [mixed connective tissue disease](https://www.autoimmuneinstitute.org/autoimmune-resources/mixed-connective-tissue-disease/) (MCTD), [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/systemic-lupus-erythematosus/) (SLE), and overlap syndrome (OS), along with [polyautoimmunity](https://www.autoimmuneinstitute.org/articles/comorbidities-multiple-autoimmune-syndrome/). The report emphasizes the complexity of diagnosing autoimmune diseases due to the absence of definitive tests and the overlapping clinical and serological features among different conditions. Polyautoimmunity, defined as the coexistence of multiple autoimmune disorders in one patient, adds another layer of complexity to the diagnostic process. The patient’s presentation included symptoms such as intermittent fever, fatigue, oral sicca, weight loss, breathlessness, and joint stiffness, along with laboratory findings of pancytopenia and elevated serum protein levels. Initial investigations revealed positive findings for various autoantibodies, including anti-nuclear antibodies (ANA) and specific autoantigens associated with CTDs. Despite extensive testing and evaluation, reaching a definitive diagnosis proved challenging. Differential diagnoses considered included monoclonal gammopathy, late-onset [SLE](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/), [Sjogren’s syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sjogrens-syndrome/), and [MCTD](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/mixed-connective-tissue-disease/). Ultimately, the patient was diagnosed with late-onset SLE based on clinical features and laboratory findings. > **The report underscores the importance of ongoing monitoring and long-term follow-up for people with autoimmune diseases, as signs, symptoms, and diagnoses may evolve over time.** It also emphasizes the need for awareness of diagnostic dilemmas and the challenges posed by overlapping symptoms and laboratory findings in autoimmune disorders. Citation Tripathi P, Bhushan D, Banerjee A, et al. (April 08, 2024) **[The Kaleidoscope of Polyautoimmunity: An Odyssey of Diagnostic Dilemmas](https://www.cureus.com/articles/211162-the-kaleidoscope-of-polyautoimmunity-an-odyssey-of-diagnostic-dilemmas?score_article=true#!/)**. Cureus 16(4): e57799. doi:10.7759/cureus.57799 **Category:** Autoimmune Diseases, Case Studies, Lupus, Rheumatoid Arthritis, Sjögren disease --- ### [Key Takeaways from the Autoimmune Disease and Women's Health Symposium](https://www.autoimmuneinstitute.org/research_updates/unlocking-advances-in-womens-health-key-insights-from-the-autoimmune-disease-symposium/) **Published:** May 10, 2024 **Author:** Carolyn Serraino **Excerpt:** The event highlighted the disproportionate impact of autoimmune diseases on women, noting that over 80% of the 23.5 million individuals in the U.S. affected are women. Various key speakers and panelists contributed to the discussion. **Content:** May 10, 2024 The symposium, “[**Emerging Topics in Women’s Health: Autoimmune Disease Challenge**](https://swhr.org/event/vcu-health-of-women-2024-emerging-topics-in-womens-health-autoimmune-disease-challenge/),” held virtually on May 9th, focused on key areas of autoimmune disease research and care, with a special emphasis on women’s health across the lifespan. The event highlighted the disproportionate impact of autoimmune diseases on women, noting that over 80% of the 23.5 million individuals in the U.S. affected are women. Various key speakers and panelists contributed to the discussion. ### Key moments and comments include: #### [**Dr. Irene Aninye’s Overview**](https://swhr.org/team/irene-aninye/): Dr. Aninye emphasized the importance of considering women’s health across different stages of life, touching on pregnancy, maternal health, and the menopause transition. #### [**Dr. Stacy Bell’s Presentation on Pregnancy Challenges**](https://swhr.org/team/stacie-bell-phd/): - Dr. Bell discussed the underrepresentation of pregnant women in clinical trials, its consequences for drug safety and efficacy data, and its broader implications for maternal health care. - She emphasized the need for targeted research to improve treatment protocols during pregnancy and the importance of developing safer, more effective healthcare options for pregnant women with autoimmune conditions. #### [**Estela Mata-Carcamo’s Caregiving Insights**](https://swhr.org/team/maria-estela-mata-carcamo/): - Estela highlighted the emotional and logistical challenges faced by caregivers of individuals with autoimmune diseases. - She shared personal stories to illustrate the impact of these diseases on families and discussed strategies to support caregivers, including education, advocacy, and community support. - Estela emphasized the need for policy changes to better support caregivers, including financial aid and healthcare services. #### [**Dr. JoAnn Pinkerton on Menopause and Autoimmune Diseases**](https://swhr.org/team/joann-v-pinkerton-md/): - Dr. Pinkerton discussed how menopause can exacerbate autoimmune conditions, complicating the management of these diseases. She explained the mixed effects of hormone therapy, with some conditions potentially worsening with treatment. - Dr. Pinkerton called for more research into the interactions between menopause, autoimmune diseases, and hormone treatments to develop better management strategies for affected women. #### [**Lindsey Miltenberger’s Policy Discussion**](https://swhr.org/team/lindsey-miltenberger/): - Lindsey outlined the critical role of policy in shaping research and care for autoimmune diseases. She discussed legislative efforts and policy initiatives aimed at improving research funding, clinical trial diversity, and access to care. - Lindsey encouraged symposium attendees to engage with policymakers and participate in advocacy efforts to ensure that the needs of women with autoimmune diseases are met. ### Q&A Session The symposium concluded with a Q&A session, during which panelists responded to questions about improving autoimmune disease outcomes for women, stressing the importance of collaborative efforts among research, clinical care, and policy stakeholders. #### **How can healthcare providers better support women with autoimmune diseases during the transition to menopause?** Answer: Panelists discussed the need for integrated care approaches that involve rheumatologists, endocrinologists, and gynecologists. They emphasized the importance of personalized treatment plans that consider the hormonal changes during menopause and their impact on autoimmune conditions. #### **What are some emerging therapies in the pipeline for autoimmune diseases that could specifically benefit women?** Answer: Researchers on the panel highlighted new biologic treatments and personalized medicine approaches that target specific pathways involved in autoimmune responses. They also mentioned ongoing clinical trials aimed at evaluating the efficacy and safety of these new therapies in women. #### **How can we improve the inclusion of diverse populations in autoimmune disease research?** Answer: Panelists suggested enhancing outreach and education efforts in underrepresented communities to raise awareness about the importance of clinical trial participation. They also called for regulatory changes to require more diverse clinical trial enrollment and for funding to support research focused on diverse populations. **Watch the whole symposium here:** **Category:** Autoimmune Diseases, Events, Research Studies --- ### [NIH Releases Autoimmune Disease and Women's Health Fact Sheet](https://www.autoimmuneinstitute.org/research_updates/fact-sheet-on-autoimmune-disease-and-womens-health/) **Published:** May 24, 2024 **Author:** Elevation **Excerpt:** The National Institutes of Health (NIH) recently released NIH Fact Sheets On Women’s Health Research. The section on Autoimmune Diseases and Women’s Health (pages 4-5) states that autoimmune diseases affect an estimated 25-31 million Americans, making them the third most common category of diseases in the U.S., after cancer and cardiovascular disease. **Content:** The National Institutes of Health (NIH) recently released [NIH Fact Sheets On Women’s Health Research](https://orwh.od.nih.gov/sites/orwh/files/docs/NIH%20Fact%20Sheets%20on%20Womens%20Health%20Research_050924_508c.pdf "NIH Fact Sheets on Women's Health Research"). The section on Autoimmune Diseases and Women’s Health (pages 4-5) states that autoimmune diseases affect an estimated 25-31 million Americans, making them the third most common category of diseases in the U.S., after cancer and cardiovascular disease. Notably, 80% of those diagnosed with autoimmune diseases are women. The reasons for this gender disparity are not fully understood, but hormonal and physiological changes related to puberty, [pregnancy](https://www.autoimmuneinstitute.org/articles/how-autoimmune-disease-affects-fertility "How Autoimmune Disease Affects Fertility"), and menopause are believed to increase the risk and severity of these conditions in women. [Pregnancy](https://www.autoimmuneinstitute.org/articles/pregnancy-with-an-autoimmune-disease "Pregnancy with an Autoimmune Disease"), in particular, represents a unique immunologic state that can exacerbate or alleviate symptoms depending on the specific disease, such as [RA](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid arthritis") improving and [SLE](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/) worsening during pregnancy. Research indicates that sex differences in immune cell responses and the mosaicism of the female X chromosome, where immune-related genes are located, may also contribute to higher rates of autoimmune diseases in women. Environmental and occupational exposures, varying by gender, and experiences of vicarious racism have been identified as factors influencing disease activity and contributing to racial disparities in conditions like SLE. Significant gaps remain in understanding autoimmune diseases, particularly in diagnostics, therapeutics, and outcomes. The NIH is actively working to address these gaps through extensive research funding and collaborative initiatives. In Fiscal Year 2023, NIH allocated $241 million to autoimmune disease and women’s health research, supporting various programs and initiatives aimed at improving treatment strategies and understanding the underlying mechanisms of autoimmune diseases. The recently established Office of Autoimmune Disease Research (OADR) within the Office of Research on Women’s Health (ORWH) is spearheading efforts to foster collaboration and innovation in this field, developing a strategic plan to enhance autoimmune disease research through multi-institute partnerships. #### **[Read the Full Report Here](https://orwh.od.nih.gov/sites/orwh/files/docs/NIH%20Fact%20Sheets%20on%20Womens%20Health%20Research_050924_508c.pdf)** **Category:** Autoimmune Diseases, Lupus, OADR (NIH Office of Autoimmune Disease Research), Research Studies --- ### [Lolamicin May Protect the Gut Microbiome While Fighting Infection](https://www.autoimmuneinstitute.org/research_updates/revolutionary-antibiotic-lolamicin-spares-gut-microbiome/) **Published:** May 30, 2024 **Author:** Carolyn Serraino **Excerpt:** Lolamicin, a Gram-negative antibiotic that targets harmful bacteria while preserving the gut microbiome is a novel treatment that may reduce the risk of autoimmune disease development and combat multidrug-resistant infections, offering a promising solution for safer antibiotic therapy. **Content:** May 30, 2024 A groundbreaking new [study](https://www.nature.com/articles/s41586-024-07502-0.epdf?sharing_token=t4lMTeddKZFW5v1UIMJbctRgN0jAjWel9jnR3ZoTv0Ml6ru1E8G45f9rPVxrmF2oKChPl9O28tbP9dTRcCtfUgueZoyVC2EkFjxuYL8tXr0PKM9ktnLwtLJZGoOg49SGWxD3buHpPJ5PgVusE38RaXw9V--s2C2u_rsPJ8FCcXs%3D) discusses the antibiotic lolamicin, designed to selectively target Gram-negative pathogens while preserving the gut microbiome, offering a promising solution to minimize the risk of developing autoimmune disease. ### Key Points #### **What is the problem with current antibiotics, and why is there a n**eed for selective antibiotics**?** - Gram-negative infections are increasing and are typically treated with broad-spectrum antibiotics. - Broad-spectrum antibiotics disrupt the gut microbiome, leading to secondary infections like Clostridioides difficile (*C. difficile)*, and can cause gastrointestinal, renal, and hematological issues. - There is a critical need for antibiotics that selectively target Gram-negative pathogens while sparing commensal (beneficial) bacteria in the gut in order to reduce gut dysbiosis and its associated risks. #### **What is Lolamicin?** - Lolamicin is a newly discovered antibiotic targeting the Lol lipoprotein transport system (Lol system), specific to Gram-negative bacteria. - It is effective against over 130 multidrug-resistant clinical isolates and shows efficacy in mouse models of pneumonia and septicemia. - Crucially, lolamicin spares the gut microbiome, preventing *C. difficile* infections. - Lolamicin demonstrated significant efficacy in reducing bacterial burden and increasing survival rates in mouse models of infection. - Oral administration of lolamicin showed substantial bioavailability and was well-tolerated by mice. #### **How does antibiotic selectivity work?** - The selective killing is due to low sequence homology between the target in pathogenic bacteria and commensals. - Lolamicin targets the Lol system, which is essential for lipoprotein transport in Gram-negative bacteria but is absent in Gram-positive bacteria. #### **What impact does lolamicin have on the gut microbiome?** - Studies on mice showed that lolamicin did not cause significant changes in the gut microbiome composition or diversity. - Unlike broad-spectrum antibiotics, lolamicin treatment allowed mice to clear *C. difficile* colonization effectively. #### **How does this discovery relate to autoimmune disease?** - The gut microbiome plays a critical role in regulating the immune system. Disruption of this microbiome can contribute to the development of autoimmune diseases. - By sparing the gut microbiome, lolamicin potentially lowers the risk of autoimmune diseases linked to antibiotic-induced dysbiosis. ##### **Citation** Muñoz, K.A., Ulrich, R.J., Vasan, A.K. *et al.* A Gram-negative-selective antibiotic that spares the gut microbiome. *Nature* (2024). <https://doi.org/10.1038/s41586-024-07502-0> **Category:** Autoimmune Diseases, Microbiome, Research Studies --- ### [Global Autoimmune Institute Supports Future Physicians at AMSA 2024](https://www.autoimmuneinstitute.org/research_updates/global-autoimmune-institute-sponsors-amsa-annual-conference/) **Published:** June 5, 2024 **Author:** Carolyn Serraino **Excerpt:** GAI was delighted to present a new award in Autoimmune Disease at the 2024 American Medical Student Association (AMSA) conference. **Content:** June 5, 2024 The Global Autoimmune Institute (GAI) was delighted to present a new award in Autoimmune Disease at the 2024 American Medical Student Association (AMSA) conference, “[DARE: Future Physicians for Change](https://fp4change.org/).” The award for the poster session category was given to Elizabeth Cole for her outstanding poster titled *Effect of Sjögren’s Disease on Pregnancy and Neonatal Outcomes: A Systematic Review, Meta-Analysis, & Summary of Current Recommendations*. GAI enlisted the judging expertise of Dr. Linda Spatz, who has made [significant contributions to autoimmune disease research](https://www.sciencedirect.com/science/article/abs/pii/S0161589021000213?via%3Dihub), including a recent paper supported in part by GAI, and Dr. Anne Davidson. Our Executive Director, Sandy Boek Werness, delivered a keynote speech at the awards dinner, emphasizing the necessity for future physicians to be well-versed in autoimmune diseases, their commonalities, and their coexistence with neurological disorders. Sandy highlighted that understanding autoimmune diseases is crucial across all medical specialties, a message that resonates with GAI’s mission to advance awareness and education in this field. GAI is committed to nurturing the next generation of medical professionals by improving the diagnosis, treatment, and pursuit of cures for autoimmune diseases. Our sponsorship at the AMSA conference included not only the new Autoimmune Disease poster prize but also contributions to AMSA’s new research directory and support for the awards dinner. Additionally, GAI proudly co-sponsored AMSA’s Simulation Case Challenge ([SimChallenge](https://fp4change.org/sim-challenge-2024/)), providing a valuable opportunity for students to tackle complex scenarios related to autoimmune disorders. This initiative empowers medical students to enhance their problem-solving skills and deepen their understanding of autoimmune conditions, thereby fostering advancements in research and patient care. **Category:** Events --- ### [Study Examines the Link Between Endometriosis and Autoimmune Disease](https://www.autoimmuneinstitute.org/research_updates/is-there-a-connection-between-endometriosis-and-autoimmune-diseases/) **Published:** June 13, 2024 **Author:** Carolyn Serraino **Excerpt:** Explore the potential link between endometriosis and autoimmune disease and its implications for patient care and future research in this comprehensive review. **Content:** Endometriosis is a chronic gynecological condition in which tissue similar to the lining of the uterus grows outside the uterus, affecting an estimated 2–10% of women of reproductive age. Although endometriosis is not classified as an autoimmune disease, researchers have long suspected that immune system abnormalities may contribute to its development and progression. This has led scientists to investigate whether people with endometriosis are more likely to develop autoimmune diseases. A 2019 systematic review and meta-analysis published in *Human Reproduction Update* evaluated 26 population-based studies examining the relationship between endometriosis and autoimmune diseases. Overall, the review found evidence that endometriosis is associated with an increased likelihood of several autoimmune diseases, including [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus (SLE)") (SLE), [Sjögren disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sjogren-syndrome/ "Sjögren disease (SjD)"), [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid arthritis"), [autoimmune thyroid disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/hashimotos-thyroiditis/ "Hashimoto’s thyroiditis (autoimmune thyroiditis)"), [celiac disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/celiac-disease/ "celiac disease"), [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/ "Multiple sclerosis"), inflammatory bowel disease ([Crohn’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crohns-disease/ "Crohn’s disease") and [ulcerative colitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ulcerative-colitis/ "Ulcerative colitis")), and [Addison’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-addisons-disease/ "Addison’s disease"). However, the authors also emphasized that much of the available evidence was of low quality because many studies were small, retrospective, or had a high risk of bias. Only a handful of large, well-designed studies provided strong evidence supporting these associations. As a result, the review could not determine whether endometriosis increases the risk of autoimmune disease, whether autoimmune diseases increase the risk of endometriosis, or whether the conditions share common biological mechanisms. Researchers suggest that immune dysregulation may help explain the observed overlap. Studies have identified abnormalities in immune cells, chronic inflammation, altered immune surveillance, and changes in inflammatory signaling in people with endometriosis. These findings raise the possibility that some of the same immune pathways involved in autoimmune diseases may also contribute to endometriosis, although more research is needed to better understand these relationships. This review highlights the importance of considering autoimmune diseases in people with endometriosis and vice versa, while emphasizing the need for larger prospective studies to determine whether these associations are causal and to identify the underlying biological mechanisms. ##### Citation Nina Shigesi, Marina Kvaskoff, Shona Kirtley, Qian Feng, Hai Fang, Julian C Knight, Stacey A Missmer, Nilufer Rahmioglu, Krina T Zondervan, Christian M Becker, **The association between endometriosis and autoimmune diseases: a systematic review and meta-analysis**, *Human Reproduction Update*, Volume 25, Issue 4, July-August 2019, Pages 486–503, <https://doi.org/10.1093/humupd/dmz014> **Category:** Autoimmune Diseases, Research Studies --- ### [Controversies in Rheumatology and Autoimmunity Conference](https://www.autoimmuneinstitute.org/research_updates/controversies-in-rheumatology-autoimmunity-conference/) **Published:** March 16, 2019 **Author:** Carolyn Serraino **Excerpt:** At the March 2019 CORA Conference in Florence, Italy, leading scientists gave lectures and presented their cases for and against the existence of effective treatments for scleroderma, the risk of cardiovascular disease in SLE, weaning patients off drugs, and a host of other controversies. **Category:** Events, Lupus, Research Studies, Rheumatoid Arthritis --- ### [Clarity in Sight: AI Innovates Uveitis Diagnosis Criteria](https://www.autoimmuneinstitute.org/research_updates/clarity-in-sight-ai-innovates-uveitis-diagnosis-criteria/) **Published:** August 13, 2021 **Author:** Elevation **Excerpt:** More than 30 different diseases can cause inflammation inside the eye, a condition known as uveitis. Research into causes and potential therapies for some of these leading causes of blindness have been limited by a lack of widely used set of diagnostic criteria. **Content:** More than 30 different diseases can cause inflammation inside the eye, a condition known as [uveitis](https://www.autoimmuneinstitute.org/autoimmunity-and-the-eyes-a-spotlight-on-uveitis/). Research into causes and potential therapies for some of these leading causes of blindness have been limited by a lack of widely used set of diagnostic criteria. Using [artificial intelligence](https://www.autoimmuneinstitute.org/articles/the-promise-of-ai-in-autoimmune-disease-from-early-detection-to-personalized-care "The Promise of Artificial Intelligence in Autoimmune Disease Healthcare"), the Standardization of Uveitis Nomenclature (SUN) Working Group (a collection of over 100 experts from 60 clinical centers in 20 countries) developed just a set of criteria for 25 of the most common types of uveitis. The work, [published in the American Journal of Ophthalmology](https://www.sciencedirect.com/science/article/abs/pii/S0002939421001860), was funded by the National Eye Institute. Historically, uveitis had been classified by its location within the eye, such as the anterior chamber, vitreous, choroid, retina, or all of the above. But uveitis affecting the same parts of the eye can have very different causes, as well as treatments and prognosis. The Working Group entered information from 5,766 cases (averaging 100-250 cases for each uveitis type) into a database and then used machine learning to identify similarities between cases of uveitis. The resulting criteria were then approved by the full committee. ##### **Citation** Standardization of Uveitis Nomenclature (SUN) Working Group (2021). Development of Classification Criteria for the Uveitides. *American journal of ophthalmology*, *228*, 96–105. <https://doi.org/10.1016/j.ajo.2021.03.061> **Category:** Autoimmune Diseases, Eye Disease --- ### [Colistin Resistance May Strengthen Bacteria Against the Immune System](https://www.autoimmuneinstitute.org/research_updates/colistin-resistance-evolution-boosts-bacterial-virulence-and-amp-resistance/) **Published:** May 2, 2023 **Author:** Carolyn Serraino **Excerpt:** The research reveals that colistin resistance not only enhances bacterial defenses against AMPs but also boosts the expression of virulence genes, making infections more challenging to treat. These findings underscore the urgent need for innovative approaches to combat antibiotic resistance and manage bacterial infections effectively. **Content:** The evolution of resistance to colistin, a last-resort antibiotic, has become a serious concern for public health, as it can lead to the emergence of untreatable bacterial infections. A recent study, titled ‘[The evolution of colistin resistance increases bacterial resistance to host antimicrobial peptides and virulence](https://pubmed.ncbi.nlm.nih.gov/37094804/)‘ published in *eLife* investigated how the evolution of colistin resistance can impact bacterial resistance to host antimicrobial peptides (AMPs) and virulence. The researchers used a model system of Pseudomonas aeruginosa, a bacterial pathogen that commonly infects patients in hospitals, to evolve resistance to colistin. **They found that the evolution of colistin resistance increased the bacterial resistance to host AMPs, which are part of the innate immune system and play a crucial role in controlling bacterial infections**. The study also showed that the evolution of colistin resistance led to increased *bacterial virulence*, which is the ability of bacteria to cause disease in the host. The researchers further investigated the mechanism behind these observations and found that **the evolution of colistin resistance altered the bacterial membrane composition, making it more resistant to both colistin and AMPs**. Additionally, the study showed that the evolution of colistin resistance increased the expression of certain virulence genes in the bacteria. The findings of this study have important implications for the management of bacterial infections. **The evolution of resistance to last-resort antibiotics such as colistin can not only render antibiotics ineffective, but it can also increase the virulence of bacteria and make them more resistant to the host’s immune system**. This highlights the urgent need to develop alternative approaches to treat bacterial infections and prevent the evolution of resistance to antibiotics. ##### **Citation** Jangir, P. K., Ogunlana, L., Szili, P., Czikkely, M., Shaw, L. P., Stevens, E. J., Yu, Y., Yang, Q., Wang, Y., Pál, C., Walsh, T. R., & MacLean, C. R. (2023). The evolution of colistin resistance increases bacterial resistance to host antimicrobial peptides and virulence. *eLife*, *12*, e84395. [https://doi.org/10.7554/eLife.84395.](https://doi.org/10.7554/eLife.84395) **Category:** Research Studies, Risk Factors --- ### [Childhood Mono Linked to Higher Risk of Multiple Sclerosis](https://www.autoimmuneinstitute.org/research_updates/childhood-mono-linked-to-higher-risk-of-multiple-sclerosis/) **Published:** October 12, 2021 **Author:** Carolyn Serraino **Excerpt:** Researchers aimed to explore whether contracting mononucleosis in childhood (birth to 10 years) or adolescence (11-19 years) increases the risk of developing MS later in life. **Content:** Infectious mononucleosis, caused primarily by the Epstein-Barr virus (EBV), has been linked to [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/) (MS). [Researchers](https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2784780?resultClick=1) aimed to explore whether contracting mononucleosis in childhood (birth to 10 years) or adolescence (11-19 years) increases the risk of developing MS later in life. Analyzing data from nearly 2.5 million individuals in Sweden, they found that hospital-diagnosed mononucleosis during these periods, especially adolescence, heightened the risk of developing MS. To account for genetic and environmental factors, the study included within-sibling comparisons, confirming the association regardless of shared genetics and upbringing. The researchers speculated that the similarity between some EBV proteins and myelin components might trigger the immune system to attack myelin, leading to MS. This study underscores the potential long-term impacts of EBV infections in childhood and adolescence. ##### **Citation** Xu, Y., Hiyoshi, A., Smith, K. A., Piehl, F., Olsson, T., Fall, K., & Montgomery, S. (2021). **Association of Infectious Mononucleosis in Childhood and Adolescence With Risk for a Subsequent Multiple Sclerosis Diagnosis Among Siblings**. *JAMA network open*, *4*(10), e2124932. <https://doi.org/10.1001/jamanetworkopen.2021.24932> **Category:** Autoimmune Diseases, Multiple Sclerosis, Research Studies, Risk Factors --- ### [Targeting Autoimmunity in Type 1 Diabetes with Teplizumab](https://www.autoimmuneinstitute.org/research_updates/targeting-autoimmunity-in-type-1-diabetes-with-teplizumab/) **Published:** June 22, 2026 **Author:** Carolyn Serraino **Content:** For decades, treatment for **[type 1 diabetes](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/type-1-diabetes-insulin-dependent-diabetes/ "Type 1 diabetes (T1D)")** has focused on replacing insulin after the immune system destroys the pancreas’s insulin-producing beta cells. While insulin remains lifesaving, it does not address the underlying autoimmune process that causes the disease. In June 2026, the U.S. Food and Drug Administration (FDA) approved a new indication for **teplizumab (Tzield)** for children and adolescents ages 8 to 17 who have been recently diagnosed with Stage 3 Type 1 diabetes. The approval marks the first time a disease-modifying therapy has been approved for newly diagnosed Stage 3 disease, reflecting **a growing shift toward treatments designed to slow autoimmune damage rather than simply manage its consequences**. ## **Targeting the Autoimmune Process** Type 1 diabetes develops when the immune system mistakenly attacks the insulin-producing beta cells of the pancreas. Teplizumab is a humanized anti-CD3 monoclonal antibody that targets this autoimmune process, helping delay the decline of the body’s remaining insulin production after diagnosis. Unlike therapies that require continuous immune suppression, teplizumab is administered in two 12-day treatment courses. Researchers believe it works by modifying immune activity involved in the autoimmune attack while helping preserve the body’s remaining beta-cell function. More broadly, this reflects an increasing focus in autoimmune research on **[restoring immune tolerance ](https://www.autoimmuneinstitute.org/articles/restoring-immune-tolerance-in-autoimmune-disease "Restoring Immune Tolerance in Autoimmune Disease")**(the immune system’s ability to distinguish healthy tissue from harmful threats) rather than broadly suppressing immune function. ### 💡 Did You Know? **Type 1 diabetes develops in stages before symptoms appear.** - **Stage 1:** Diabetes-related autoantibodies are present, but blood sugar remains normal and there are no symptoms. - **Stage 2:** Autoantibodies remain present, and blood sugar begins to rise, but symptoms have not yet developed. - **Stage 3:** Symptoms develop because the immune system has destroyed enough insulin-producing beta cells that the body can no longer make sufficient insulin. Insulin therapy becomes necessary. **Why this matters:** Teplizumab was first approved in 2022 to delay progression from **Stage 2** to **Stage 3** Type 1 diabetes. The new FDA approval expands its use to children and adolescents who have already reached **Stage 3**, helping delay the decline of their remaining insulin production after diagnosis. ## **Evidence from the PROTECT Trial** The approval was supported by results from the Phase 3 PROTECT clinical trial, which enrolled **328 children and adolescents** within six weeks of a Stage 3 Type 1 diabetes diagnosis. Participants received two 12-day courses of teplizumab, administered 26 weeks apart, in addition to standard diabetes care. After 78 weeks, participants receiving teplizumab maintained significantly greater insulin-producing capacity than those receiving placebo, as measured by stimulated C-peptide, a marker of the body’s natural insulin production. #### Nearly 95% of treated participants maintained clinically meaningful C-peptide levels, compared with about 79% of those receiving placebo.   The study did not find statistically significant differences in several secondary clinical outcomes, including HbA1c, insulin dose, or time spent within the target glucose range. However, because preserving insulin production is considered reasonably likely to predict long-term clinical benefit, the FDA granted accelerated approval while additional studies continue. ## **Looking Ahead** Teplizumab is not a cure for Type 1 diabetes, and insulin therapy remains essential. However, this approval represents an important milestone in autoimmune medicine. It expands the role of disease-modifying therapy beyond delaying the onset of clinical disease and into preserving remaining pancreatic function after diagnosis. As researchers continue to develop therapies that target the immune mechanisms driving autoimmune diseases, approaches like teplizumab may help shift treatment toward preserving healthy tissue and slowing disease progression rather than only replacing what has already been lost. #### Citations FDA Approves New Indication for Tzield (teplizumab) for Certain Pediatric Patients with Recently Diagnosed Stage 3 Type 1 Diabetes. Updated 06/15/2026. <https://www.fda.gov/news-events/press-announcements/fda-approves-new-indication-tzield-teplizumab-certain-pediatric-patients-recently-diagnosed-stage-3> Lledó-Delgado, A., Preston-Hurlburt, P., Currie, S., Clark, P., Linsley, P. S., Long, S. A., Liu, C., Koroleva, G., Martins, A. J., Tsang, J. S., & Herold, K. C. (2024). Teplizumab induces persistent changes in the antigen-specific repertoire in individuals at risk for type 1 diabetes. *The Journal of clinical investigation*, *134*(18), e177492. <https://doi.org/10.1172/JCI177492> Ramos, E. L., Dayan, C. M., Chatenoud, L., Sumnik, Z., Simmons, K. M., Szypowska, A., Gitelman, S. E., Knecht, L. A., Niemoeller, E., Tian, W., Herold, K. C., & PROTECT Study Investigators (2023). Teplizumab and β-Cell Function in Newly Diagnosed Type 1 Diabetes. *The New England journal of medicine*, *389*(23), 2151–2161. <https://doi.org/10.1056/NEJMoa2308743> **Category:** Clinical Trials, Research Studies, Therapies, Type 1 Diabetes --- ### [Why Are Females More Likely to Develop Autoimmune Disease?](https://www.autoimmuneinstitute.org/research_updates/why-are-females-more-likely-to-develop-autoimmune-disease-than-males/) **Published:** August 1, 2024 **Author:** GAI-assistant **Content:** A review called [Gender differences in autoimmune disease](https://www.sciencedirect.com/science/article/pii/S0091302214000466?via%3Dihub) published in the journal *Frontiers in Neuroendocrinology* discusses the higher prevalence of autoimmune diseases in [females](https://www.autoimmuneinstitute.org/research_updates/fact-sheet-on-autoimmune-disease-and-womens-health/) compared to males and evaluates sex-specific mechanisms that might explain this phenomenon. Autoimmune diseases, such as [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/) (MS), [type I diabetes](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/diabetes-type-1/ "Diabetes, Type 1 (T1D)") (T1D), and inflammatory bowel disease (IBD), are thought to develop as a result of a combination of genetic and environmental factors; however, the presence or lack of a Y chromosome is often overlooked as an important risk factor. For example, data from the USA, England, France, Denmark, Japan, China, India, and Australia indicate a strong bias toward biological females in the prevalence of systemic, neurological, endocrine, rheumatological, and gastrointestinal autoimmune conditions; in fact, there is a 9:1 specific bias toward females for systemic autoimmune diseases. The bias toward females in autoimmune disease prevalence may in part be explained by differences in the immune system, as females tend to exhibit stronger immune responses following infection or vaccination than males. These differences may be attributed to the activity of immune cells, including B cells and T cells, which are greatly affected by hormonal cycles, as estrogen, progesterone, androgen, and prolactin levels vary through the female lifespan. The onset of autoimmune diseases may also be impacted by puberty and pregnancy, as well as menopause. Differences in environmental exposure can also play a role in sex dimorphism in autoimmunity, as males tend to get more sunlight and thus have higher levels of Vitamin D. Autoimmunity is complex and disease risk is impacted by a variety of factors, many of which are still under investigation. In fact, a recent study identified a [genetic risk factor](https://www.autoimmuneinstitute.org/research_updates/new-theory-explaining-higher-prevalancy-of-autoimmunity-in-females/) on X chromosomes (XIST) that may contribute to the development of autoimmune disease in females. The bias toward females is an important area of research that could provide further insights on understanding the immune system as a whole and providing better care to both females and males with autoimmune disease. ##### Citation: Ngo, S. T., Steyn, F. J., & McCombe, P. A. (2014). Gender differences in autoimmune disease. *Frontiers in neuroendocrinology*, *35*(3), 347–369. <https://doi.org/10.1016/j.yfrne.2014.04.004> **Category:** Genetics, IBD (Crohn's and UC), Multiple Sclerosis, Risk Factors, Type 1 Diabetes --- ### [ScienceTALKS Recap: Viral Triggers of Autoimmune Disease](https://www.autoimmuneinstitute.org/research_updates/sciencetalks-recap-viral-triggers-of-autoimmune-disease/) **Published:** August 27, 2024 **Author:** Elevation **Excerpt:** This 'Going Viral" presentation discussed viral exposures as a driver of autoimmune disease, the Epstein-Barr virus and multiple sclerosis connection, and the TEDDY study which investigates viral triggers of type 1 diabetes and celiac disease. **Content:** #### The ‘Going Viral’ ScienceTALKS, held on August 27, 2024 and hosted by the OADR, covered: - Viral Exposures as a Driver of Autoimmune Disease – [Judith A. James, M.D., Ph.D.](https://omrf.org/research-faculty/scientists/james-judith-a/) - Epstein-Barr Virus and Multiple Sclerosis – [William H. Robinson, M.D., Ph.D](https://pubmed.ncbi.nlm.nih.gov/35025606/ "William H. Robinson, M.D., Ph.D"). - TEDDY Study: Viral Triggers or Drivers of Type 1 Diabetes and Celiac Disease? – [Marian Rewers, M.D., Ph.D.](https://diabetes.org/newsroom/latest-TEDDY-report-outlines-research-on-t1d-and-celiac-disease) [WATCH HERE:](https://videocast.nih.gov/watch=54970) [![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/09/Screenshot-2024-09-30-at-12.20.04 PM-1024x490.png)](https://videocast.nih.gov/watch=54970) **Category:** Events, OADR (NIH Office of Autoimmune Disease Research), Research Studies, Risk Factors --- ### [Does Sjögren’s Syndrome Increase Cardiovascular Disease Risk?](https://www.autoimmuneinstitute.org/research_updates/sjogrens-syndrome-and-cardiovascular-disease-risk/) **Published:** September 1, 2024 **Author:** GAI-assistant **Content:** Results from a study called [*Cardiovascular Risk in Patients with Sjogren’s Syndrome*](https://ard.bmj.com/content/74/Suppl_2/1082.3) were presented at the 2015 Annual European Congress of Rheumatology, and the abstract was published in the *Annals of the Rheumatic Diseases*. This study evaluated the risk of cardiovascular disease in patients with [Sjögren’s Syndrome](https://www.ncbi.nlm.nih.gov/books/NBK431049/), a chronic inflammatory autoimmune disease with a female predominance. Patients with Sjögren’s Syndrome experience dryness of the eyes and mouth, and the disease can also impact additional organs, including the joints, lungs, and gastrointestinal system. Sjögren’s Syndrome is also accompanied by other autoimmune conditions such as rheumatoid arthritis and systemic lupus erythematosus. Some [studies](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9134348/) have shown that patients with Sjogren’s Syndrome may also be at higher risk of developing other conditions such as cardiovascular disease. At the 2015 Annual European Congress of Rheumatology, Garcia et al. presented results from their analysis on the relationship between cardiovascular disease and Sjogren’s syndrome in 49 patients. They evaluated cardiovascular risk factors using several measures, including the Framingham score, exercise capacity, and cardiac ultrasound (imaging), among others. The [Framingham score](https://www.framinghamheartstudy.org/fhs-risk-functions/hard-coronary-heart-disease-10-year-risk/) is used to predict the risk of developing heart disease over 10 years, and was developed as part of a very large study on cardiovascular disease; these risk [factors](https://www.framinghamheartstudy.org/fhs-risk-functions/hard-coronary-heart-disease-10-year-risk/) include age, cholesterol, blood pressure, hypertension treatment, and smoking status. They also evaluated disease activity using the EULAR Sjögren’s Syndrome disease activity index, or ESSDAI. The researchers found a positive relationship between Framingham and ESSDAI scores, indicating that patients with Sjögren’s Syndrome with high disease activity are at greater risk of developing cardiovascular disease. While these results must be confirmed in larger studies, clinicians treating patients with Sjögren’s Syndrome should be aware of their potential risk of developing cardiovascular disease and manage them appropriately. ##### Citation: Garcia A, Trevisani V, Dardin L*, et al*. **[AB0547 Cardiovascular Risk in Patients with Sjogren’s Syndrome](https://ard.bmj.com/content/74/Suppl_2/1082.3)**. *Annals of the Rheumatic Diseases* 2015;**74:**1082-1083. **Category:** Research Studies, Risk Factors, Sjögren disease --- ### [Reproductive Factors Linked to Increased SLE Risk in Black Women](https://www.autoimmuneinstitute.org/research_updates/reproductive-factors-linked-to-increased-sle-risk-in-black-women-2/) **Published:** October 2, 2024 **Author:** GAI-assistant **Content:** A recent study titled “[A prospective study of reproductive factors in relation to the risk of systemic lupus erythematosus among black women](https://pubmed.ncbi.nlm.nih.gov/33231506/#:~:text=Conclusion%3A%20Our%20results%20suggest%20that,potential%20associations%20should%20be%20pursued.)” sheds light on unique factors affecting Black women with [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/diseases_list/systemic-lupus-erythematosus/) (SLE). SLE, an autoimmune disorder that leads to widespread inflammation, typically appears during the reproductive years (ages 15 to 40). Conducted by a multi-site research group, this study identifies key reproductive factors that may influence the higher prevalence and severity of SLE in Black women, who are more affected by SLE than any other racial or ethnic group. #### **Key Findings**  The study identified 125 cases of SLE from surveys of over 58,000 participants of the Black Women’s Health Study. The surveys covered various reproductive factors, including: - Age at first period - Breastfeeding status and duration - Age at first birth - Menopausal status - Hysterectomy history - History of endometriosis #### **Factors linked to an increased SLE risk** - **Late Menarche:** Women who had their first period after age 15 had a higher risk of developing SLE compared to those who started at age 12. - **Extended Breastfeeding:** Breastfeeding for longer than six months was associated with an increased risk of SLE compared to not breastfeeding at all. #### **What’s the next step?** This study offers important insights into how SLE uniquely affects Black women. However, the authors note that these findings are preliminary and differ from previous studies involving other racial and ethnic groups. The relatively small number of SLE cases limits the conclusions, underscoring the need for larger, more comprehensive studies. Further research is essential to understand the biological mechanisms underlying these associations and to improve the diagnosis and management of SLE in Black women. ##### Citation: Cozier, Y. C., et al. (2021). A prospective study of reproductive factors in relation to risk of systemic lupus erythematosus among black women. *Lupus*, *30*(2), 204–210. <https://doi.org/10.1177/0961203320973074> **Category:** Lupus, Research Studies, Risk Factors --- ### [Partnership to Develop mRNA Therapies for Autoimmune Diseases](https://www.autoimmuneinstitute.org/research_updates/partnership-to-develop-mrna-therapies-for-autoimmune-diseases/) **Published:** March 6, 2025 **Author:** Carolyn Serraino **Content:** The Walter and Eliza Hall Institute of Medical Research (WEHI) and biotechnology company Moderna have [formed an exclusive partnership](https://www.wehi.edu.au/news/australian-first-partnership-to-develop-mrna-medicines-for-autoimmune-diseases/) to develop messenger RNA [(mRNA)-based therapies for autoimmune diseases](https://www.autoimmuneinstitute.org/research_updates/mrna-treatment-multiple-sclerosis/ "Potential mRNA Treatment for Autoimmune Disease"). The collaboration includes the launch of MATE (mRNA for Autoimmune Therapeutics of Excellence)**,** a first-of-its-kind pilot program in Australia dedicated to advancing mRNA treatments for conditions such as lupus, Graves’ disease, and coeliac disease. Through this initiative, WEHI researchers will gain access to Moderna’s cutting-edge mRNA technology, enabling the development of more precise treatments. Unlike traditional immunosuppressants, which broadly dampen immune activity, mRNA-based therapies have the potential to fine-tune immune responses, reducing harmful autoimmune activity while preserving overall immune function. As the only research institution in Australia participating in this exclusive program, WEHI is at the forefront of exploring how mRNA medicine could transform the treatment of autoimmune diseases. By combining WEHI’s expertise in immunology with Moderna’s advancements in RNA therapeutics, the MATE program aims to address a significant unmet need in autoimmune disease management. **Category:** Autoimmune Diseases, Research Studies, Therapies --- ### [Vaccine-Preventable Infections Can Have Lifelong Consequences](https://www.autoimmuneinstitute.org/research_updates/vaccine-preventable-infections-can-have-lifelong-consequences/) **Published:** April 7, 2025 **Author:** Carolyn Serraino **Content:** Some viral infections can have effects that extend far beyond the initial illness. Measles, for example, can lead to subacute sclerosing panencephalitis (SSPE), a rare but fatal neurological disease that develops years after the original infection. Although a child may appear to have fully recovered, the virus can remain in the brain and later trigger progressive neurological damage. Measles can also weaken the immune system after infection, increasing vulnerability to pneumonia, bacterial infections, and other serious complications. Preventing infection helps reduce the risk of both immediate illness and long-term health consequences. Vaccination remains one of the most effective ways to protect against complications that may not emerge until months or even years later. #### **Vaccines don’t just prevent illness; they protect the immune system from long-term damage.** ### Related Insight **Long COVID Isn’t New—It Follows a Pattern of Post-Viral Illness** Conditions like ME/CFS, Gulf War Illness, and fibromyalgia have shown us what happens when post-viral diseases are dismissed or underfunded. [ 👉 Learn More ](https://www.autoimmuneinstitute.org/covid_timeline/long-covid-follows-a-pattern-of-post-viral-illness/) **Category:** Risk Factors --- ### [Rising Investment in Autoimmune Disease Diagnosis](https://www.autoimmuneinstitute.org/research_updates/rising-investment-in-autoimmune-disease-diagnosis/) **Published:** December 10, 2025 **Author:** Carolyn Serraino **Content:** A new global market analysis projects rapid growth in autoimmune disease diagnostic testing over the next several years, driven by rising rates of autoimmune conditions and increased emphasis on earlier detection. While market reports typically focus on industry trends, this growth may have meaningful implications for people living with autoimmune disease. [![](https://www.researchandmarkets.com/content-images/2384/2384457/2/autoimmunity-diagnostics-market.png)](https://www.researchandmarkets.com/content-images/2384/2384457/2/autoimmunity-diagnostics-market.png) Systemic autoimmune diseases, such as [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid arthritis"), [lupus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus"), [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/ "Multiple sclerosis"), and inflammatory bowel disease ([Crohn’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crohns-disease/ "Crohn’s disease") and [ulcerative colitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ulcerative-colitis/ "Ulcerative colitis")), account for the largest share of diagnostic testing. These conditions often affect multiple organs and can be challenging to diagnose, requiring repeated blood tests, antibody panels, and long-term monitoring. Increased investment in this area reflects growing recognition of the complexity of these diagnoses. #### The report highlights expanded use of advanced laboratory technologies that allow multiple immune markers to be measured at once and processed more efficiently. For those on their autoimmune/chronic illness journey, this may translate into faster test results, more comprehensive immune profiling, and improved ability to track disease activity over time. It may also support earlier diagnosis for people whose symptoms are initially dismissed or difficult to explain. However, the report also underscores ongoing challenges. Most advanced testing is still concentrated in large clinical laboratories, which can affect access depending on location, insurance coverage, and referral pathways. Better tests do not automatically guarantee clear answers, and results still require careful interpretation by experienced clinicians. Overall, the growing focus on autoimmune diagnostics signals progress, but also highlights the continued need for patient-centered care, clinical expertise, and equitable access to testing as the science advances. ##### Citation [Autoimmunity Diagnostics Market](https://www.researchandmarkets.com/reports/6163843/autoimmunity-diagnostics-market-product) by Product (Consumables, Instruments), Test Type (Routine, Autoantibody, Inflammatory, Urinalysis Tests), Disease (RA, SLE, MS, IBD), End User (Clinical Laboratories, Hospitals & Clinics) – Global Forecast to 2031 **Category:** Autoimmune Diseases, Diagnostic Testing, IBD (Crohn's and UC), Lupus, Multiple Sclerosis, Rheumatoid Arthritis --- ### [Krista Halvorson & the Reality of Sudden Autoimmune Disease](https://www.autoimmuneinstitute.org/research_updates/krista-halvorson-the-reality-of-sudden-autoimmune-disease/) **Published:** January 1, 2026 **Author:** Carolyn Serraino **Content:** Krista Halvorson’s life and legacy offer a powerful reminder of one of the most brutal truths about autoimmune disease: **it can affect anyone, at any time**. There is no age requirement, no warning sign, no protected group. #### Autoimmune disease is one of the few communities that anyone can suddenly, and without choice, become part of. Krista was a vibrant, fun-loving young woman when she woke up one morning feeling unwell. Within 24 hours, she was paralyzed from the chest down and diagnosed with [transverse myelitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/transverse-myelitis/ "Transverse Myelitis"), a rare autoimmune neurological disease caused by inflammation of the spinal cord. Years later, she was also diagnosed with [chronic inflammatory demyelinating polyneuropathy](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/chronic-inflammatory-demyelinating-polyneuropathy/ "Chronic inflammatory demyelinating polyneuropathy") (CIDP), another rare autoimmune condition that brought severe, chronic pain. #### Despite profound physical disability and ongoing illness, Krista refused to let autoimmune disease define the boundaries of her life. She graduated from college, worked full-time, and was known for her positivity and determination. Those closest to her describe someone who smiled through hardship and focused on living fully, even while carrying an extraordinary physical burden. Knowing her life might be shortened, Krista made a deliberate decision early on to be an organ donor. At age 47, she died following a sudden brain hemorrhage. In her death, Krista saved lives—her heart, liver, kidneys, and lungs were donated through Mid-America Transplant, giving multiple people a future they might not otherwise have had. #### Krista is remembered not for her diagnoses, but for the kindness, determination, and love she brought into the lives of those around her. Her legacy reminds us that autoimmune disease does not discriminate and that even in the face of devastating illness, individuals can leave behind extraordinary, life-changing good. **Category:** Autoimmune Stories --- ### [How Should Physicians Respond to Medical Misinformation?](https://www.autoimmuneinstitute.org/research_updates/how-should-physicians-respond-to-medical-misinformation/) **Published:** February 25, 2026 **Author:** Carolyn Serraino **Content:** > *“you can’t have science without emotionally connecting with the person across from you” – Dr. Mike* In a [MedPage Today conversation](https://www.medpagetoday.com/opinion/faustfiles/120047) moderated by Dr. Jeremy Faust, Dr. Paul Offit, and Dr. Mike Varshavski discussed how physicians can respond to the growing spread of medical misinformation. #### The discussion began with a practical question: with misinformation widespread and amplified in high-profile spaces, what is the most effective way for physicians to respond? Dr. Varshavski emphasized the importance of engagement, particularly on social media platforms where health information circulates widely. He argued that physicians need to participate in these spaces to ensure accurate information is represented and to reach individuals who are uncertain or vaccine-hesitant. In his view, the setting, format, and communicator matter. Engagement requires preparation, emotional intelligence, and an understanding of how audiences consume information. Dr. Offit focused on the structure of scientific debate. He cautioned that live debates with professional anti-vaccine advocates can create misleading equivalence, especially when rapid claims are presented without proper context. He emphasized that scientific disagreements are best resolved through peer review, reproducibility, and transparent evidence rather than rhetorical exchange. Both physicians acknowledged the personal toll of public engagement, including harassment and threats. They also agreed that scientists and physicians are not formally trained in public communication, yet public trust increasingly depends on it. Clear explanation of evidence, transparency about uncertainty, and acknowledgment of past missteps were identified as essential components of maintaining credibility. The conversation underscored that protecting scientific integrity requires both rigorous evidence and thoughtful communication tailored to the audience, format, and purpose. **Category:** Events --- ### [Real-World Data in Autoimmune Disease Research](https://www.autoimmuneinstitute.org/research_updates/real-world-data-in-autoimmune-disease-research/) **Published:** February 26, 2026 **Author:** Carolyn Serraino **Content:** OneMedNet [recently announced](https://www.onemednet.com/news/onemednet-partners-with-viuhealth-to-enhance-autoimmune-dataset-scale-accelerating-recurring-revenue-from-life-sciences-and-ai-customers/) a partnership with ViuHealth to expand the amount of longitudinal autoimmune disease data available through its real-world data platform. #### The collaboration is expected to capture ongoing patient information, including symptom patterns, flare activity, treatment use, and outcomes. The companies state that the expanded dataset may be used by life sciences and [artificial intelligence (AI)](https://www.autoimmuneinstitute.org/articles/the-promise-of-ai-in-autoimmune-disease-from-early-detection-to-personalized-care "The Promise of Artificial Intelligence in Autoimmune Disease Healthcare") groups to analyze treatment patterns, identify patient subgroups, and generate real-world evidence. #### This reflects a broader shift in autoimmune research toward combining traditional clinical trials with real-world data collected from routine care. Clinical trials remain essential for evaluating safety and effectiveness under structured protocols. Real-world data, however, may provide longer-term insight into how chronic autoimmune conditions fluctuate and how patients respond to therapy outside tightly defined study criteria. #### As datasets grow, AI tools are increasingly used to analyze large volumes of health data to detect patterns that might not be visible in smaller studies. In a recent review published in the *[Journal of Investigative Dermatology](https://www.jidonline.org/article/S0022-202X(25)03518-3/fulltext)*, researchers describe how machine learning is already being applied to inflammatory and autoimmune-related skin diseases, including [atopic dermatitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/eczema/ "Eczema / atopic dermatitis"), [psoriasis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/psoriasis/ "Psoriasis"), [lupus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus"), and [scleroderma](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/scleroderma/ "Scleroderma / systemic sclerosis"). Models trained on clinical images, pathology slides, gene expression data, and electronic health records are being explored to improve disease classification, identify molecular subtypes, and guide more personalized treatment strategies\*. Computational approaches are also being used to prioritize drug targets and evaluate potential therapy repurposing. *\*However, the authors note important limitations, including small or nonrepresentative training datasets, bias in underrepresented populations, inconsistent external validation, and challenges integrating predictive tools into routine care.* #### Expanded use of real-world patient data and AI analytics underscores the need for strong privacy protections, transparent governance, and ethical oversight as these tools continue to evolve. ##### Citations *OneMedNet Corporation*. (2026, February 26). **OneMedNet partners with ViuHealth to enhance autoimmune dataset scale, accelerating recurring revenue from life sciences and AI customers**. <https://www.onemednet.com/news/onemednet-partners-with-viuhealth-to-enhance-autoimmune-dataset-scale-accelerating-recurring-revenue-from-life-sciences-and-ai-customers/> Tang, A. S., Wei, M. L., Haemel, A., La, C., Sirota, M., & Lee, E. Y. (2026). **Artificial intelligence-enabled precision medicine for inflammatory skin diseases**. *The Journal of investigative dermatology*, S0022-202X(25)03518-3. Advance online publication. <https://doi.org/10.1016/j.jid.2025.10.596> **Category:** Research Studies, Resources --- ### [What to Expect After a Celiac Disease Diagnosis](https://www.autoimmuneinstitute.org/research_updates/what-to-expect-after-a-celiac-disease-diagnosis/) **Published:** April 23, 2026 **Author:** Carolyn Serraino **Content:** *A new virtual education series, [**Foundations of Celiac Disease**](https://celiac.org/nutrition-education/), is working to address a major gap in care: **many individuals diagnosed with [celiac disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/celiac-disease/ "Celiac disease") receive little to no formal nutrition guidance after diagnosis**.* *Developed by the Celiac Disease Foundation Dietitian Advisory Council, the free, multi-session program provides evidence-based education on how to manage a gluten-free diet and navigate long-term care. It is especially designed for those who lack access to specialized celiac centers or nutrition counseling.* ![](https://celiac.org/wp-content/uploads/2025/12/Chosen-2048x686.png) **Today’s session focused on what those with celiac disease can expect after diagnosis and how to manage ongoing symptoms.** #### One of the main takeaways was that healing after starting a gluten-free diet takes time. Symptoms such as fatigue, bloating, abdominal pain, and irregular bowel movements may continue for months while the intestine heals. Blood markers can also remain elevated early on, which does not necessarily indicate poor disease control. #### The speakers emphasized that not all symptoms are caused by gluten exposure. Conditions like lactose intolerance, irritable bowel syndrome (IBS), [nutrient deficiencies](https://www.autoimmuneinstitute.org/gai-library/#ad-food), and [stress](https://www.autoimmuneinstitute.org/articles/stress-autoimmune-disease-navigating-the-complex-relationship "Stress & Autoimmune Disease: Navigating the Complex Relationship") can produce similar symptoms. [Tracking food intake and symptoms](https://www.autoimmuneinstitute.org/autoimmune-chronic-illness-toolkit/ "Autoimmune & Chronic Illness Toolkit") can help identify patterns and guide follow-up care. #### Another important point was that symptoms do not always reflect disease activity. Some individuals may have little or no noticeable symptoms after gluten exposure, but intestinal damage can still occur. Over time, repeated exposure may increase the risk of complications such as malnutrition and bone loss. #### While occasional exposure may happen, consistent exposure over time is the greater concern.  Unintentional gluten exposure remains common, even for those carefully following the diet. Cross-contact, hidden ingredients, and miscommunication in food preparation are frequent sources. For symptom management, the guidance focused on supportive care rather than quick fixes. Hydration, rest, and gentle foods (such as soft-cooked vegetables, soups, and smoothies) were recommended. Small, practical strategies such as sipping fluids rather than drinking large amounts at once, or choosing electrolyte drinks with sugar for better absorption, were also discussed. The session also cautioned against common misconceptions. #### Detoxes, fasting, activated charcoal, and “gluten-digesting” enzyme supplements were not supported by evidence and may create a false sense of protection. Finally, speakers emphasized the importance of ongoing follow-up care, including regular blood work to monitor nutrient levels (such as iron, B vitamins, and vitamin D), screening for related conditions like thyroid disease, and working with a healthcare team when possible. ### **Key Questions from Attendees** **Is there such a thing as “mild” celiac disease?** Speakers clarified that celiac disease is not classified as mild or severe. A diagnosis is considered definitive regardless of symptom severity, and even individuals with minimal symptoms can have significant intestinal damage. **What conditions should people with celiac disease be monitored for?** Common areas of follow-up include nutrient deficiencies (such as iron, B vitamins, and vitamin D), thyroid disease, bone density issues, and other autoimmune conditions. Routine blood work and, in some cases, bone density scans may be recommended. **Who should be part of a care team for celiac disease?** Core providers typically include a primary care physician, a gastroenterologist, and a dietitian, with additional specialists involved depending on symptoms (e.g., dermatology, neurology, or mental health support). **Are over-the-counter medications safe after gluten exposure?** Standard symptom-relief medications (such as those for pain, nausea, or diarrhea) are generally considered appropriate, but patients are encouraged to confirm options with their healthcare provider. In contrast, supplements marketed to “neutralize” gluten are not supported by evidence. **Do medications need to be gluten-free?** Most medications are gluten-free, and gluten-containing medications are considered extremely rare. Patients are advised to communicate their diagnosis to providers but do not need to assume medications are a common source of exposure. **What if someone with celiac disease cannot afford a dietitian?** Speakers pointed to free resources, including webinars, nonprofit organizations, and even grocery store dietitians, as alternative ways to access reliable guidance. ### Explore More Celiac Disease Resources Access additional webinar sessions, educational materials, and practical guidance from the Celiac Disease Foundation’s nutrition education program. [ View Nutrition Education Program ](https://celiac.org/nutrition-education/) **Category:** Celiac Disease, Events, Research Studies, Resources --- ### [Vivian Pinn Symposium Panel 2: Clinical Research in Women’s Chronic Disease](https://www.autoimmuneinstitute.org/research_updates/vivian-pinn-symposium-panel-2-clinical-research-in-womens-chronic-disease/) **Published:** May 11, 2026 **Author:** Carolyn Serraino **Excerpt:** “The issue isn’t that the symptoms are vague; it’s that the framework for recognizing them is too narrow.” That observation from Jonna Morris, PhD, RN, during her presentation on obstructive sleep apnea in women, became one of the defining themes of the panel. Following the symposium’s first panel on translational autoimmune and chronic disease research, Panel 2 focused on another major challenge in women’s health: delayed, missed, and underestimated diagnoses. **Content:** *May 11, 2026* Following the symposium’s [ first panel on translational autoimmune and chronic disease research ](https://www.autoimmuneinstitute.org/research_updates/vivian-pinn-symposium-panel-1-translational-autoimmune-research/), Panel 2 focused on another major challenge in women’s health: delayed, missed, and underestimated diagnoses. #### “The issue isn’t that the symptoms are vague; it’s that the framework for recognizing them is too narrow.” – Jonna L. Morris, PhD, RN This observation emerged as a central theme throughout the panel discussions. Across presentations on gynecologic cancers, [endometriosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/endometriosis/ "Endometriosis"), and sleep apnea, speakers repeatedly emphasized that many chronic conditions affecting women remain underdiagnosed, not because symptoms go unreported, but because diagnostic frameworks, screening tools, and long-standing clinical assumptions have historically failed to fully capture how disease presents across different populations and [life stages](https://www.autoimmuneinstitute.org/articles/the-stages-of-autoimmunity "The Stages of Autoimmunity"). The panel discussed how these gaps can contribute to [years-long diagnostic delays](https://www.autoimmuneinstitute.org/articles/misdiagnosed-undiagnosed-expert-insights-on-the-autoimmune-diagnosis-process "Misdiagnosed and Undiagnosed: Expert Insights on the Autoimmune Diagnosis Process"), [worsening chronic disease outcomes](https://www.autoimmuneinstitute.org/articles/outbursts-in-autoimmunity-disease-flare-ups "Outbursts in Autoimmunity: Disease Flare-ups"), [barriers to treatment](https://www.autoimmuneinstitute.org/articles/navigating-autoimmune-care-with-limited-resources "Navigating Autoimmune Care With Limited Resources"), and [persistent disparities in care](https://www.autoimmuneinstitute.org/articles/when-youve-lost-trust-in-doctors "When You’ve Lost Trust in Doctors…"), particularly for women with non-classic symptoms or historically underserved backgrounds. ### Endometrial Cancer Diagnostic Advancements **Rebecca Arend, MD, MPH**, discussed efforts to improve earlier and more accessible detection of endometrial cancer, particularly among populations disproportionately affected by delayed diagnosis and poor outcomes. She highlighted rising rates of aggressive endometrial cancer subtypes, especially among non-Hispanic Black women and women under age 50. Dr. Arend outlined persistent diagnostic challenges, including barriers affecting premenopausal women, and discussed how [symptom dismissal](https://www.autoimmuneinstitute.org/research_updates/youre-not-imagining-it-when-symptoms-are-dismissed/ "You’re Not Imagining It: When Symptoms Are Dismissed"), [insurance limitations](https://www.autoimmuneinstitute.org/articles/navigating-health-insurance-for-autoimmune-disease-patients-expert-tips-and-resources "Navigating Health Insurance with Autoimmune Disease"), and [unequal access to care](https://www.autoimmuneinstitute.org/articles/navigating-autoimmune-care-with-limited-resources "Navigating Autoimmune Care With Limited Resources") can contribute to delayed detection and worse outcomes. She also presented research from the DETECT trial, which is evaluating whether self-collected vaginal tampon samples could support minimally invasive molecular testing for endometrial cancer detection and potentially provide a more accessible tool for earlier diagnosis and prevention. ### Rethinking Sleep Apnea in Women **Jonna Morris, PhD, RN**, discussed how obstructive sleep apnea is frequently underdiagnosed in women because symptoms often differ from the “classic” presentation historically associated with the condition. The presentation explored how women may be more likely to report fatigue, insomnia, [anxiety](https://www.autoimmuneinstitute.org/articles/stress-autoimmune-disease-navigating-the-complex-relationship "Stress & Autoimmune Disease: Navigating the Complex Relationship"), depression, or disturbed sleep rather than the stereotypical symptoms emphasized in many screening tools. Morris also discussed how **current diagnostic criteria and insurance guidelines may miss women with milder or different disease presentations, despite significant long-term health impacts**. Dr. Morris emphasized the need for more sex-specific screening approaches and diagnostic frameworks that better reflect how chronic disease can present differently in women. ### Endometriosis: Phenotype Matters > “***Currently, we lack a reliable biomarker for diagnosis. There is no cure, only symptom management**.*“ **Karen Schliep, PhD, MSPH**, discussed the complexity of endometriosis and the long diagnostic delays many women experience before receiving care. She noted that symptoms often begin during adolescence, yet diagnosis still takes an average of seven years, with underserved populations frequently experiencing even longer delays. The presentation emphasized that “phenotype matters,” with different forms of endometriosis carrying different risks related to [infertility](https://www.autoimmuneinstitute.org/articles/how-autoimmune-disease-affects-fertility "How Autoimmune Disease Affects Fertility"), miscarriage, ovarian cancer, and cardiometabolic disease. Dr. Schliep explained that newer research suggests the **location and depth of endometriosis lesions may provide more meaningful clinical information than older severity classifications** (which labeled disease as minimal, mild, moderate, or severe), particularly when evaluating long-term health risks and reproductive outcomes. Dr. Schliep highlighted ongoing efforts to develop clinical prediction tools and electronic health record–based symptom flagging systems to help identify endometriosis earlier and reduce downstream chronic disease risks. Continue to [ Panel 3: Social and Behavioral Sciences Research ](https://www.autoimmuneinstitute.org/research_updates/vivian-pinn-symposium-panel-3-social-and-behavioral-sciences-research/), featuring discussions on reproductive healthcare gaps in rheumatology, cardiovascular disease in women, and barriers affecting chronic disease care. **Category:** Diagnostic Testing, Events, OADR (NIH Office of Autoimmune Disease Research), Risk Factors --- ### [Why Europe & North America Still Disagree on Diagnosing Celiac Disease](https://www.autoimmuneinstitute.org/research_updates/why-europe-north-america-still-disagree-on-diagnosing-celiac-disease/) **Published:** June 10, 2026 **Author:** Carolyn Serraino **Content:** For decades, an intestinal biopsy has been considered the gold standard for diagnosing [celiac disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/celiac-disease/ "Celiac disease"). Yet today, leading medical organizations on either side of the Atlantic continue to disagree on whether some children can be diagnosed without one. At the center of the debate are two leading pediatric gastroenterology organizations. The European Society for Paediatric Gastroenterology, Hepatology and Nutrition ([ESPGHAN](https://www.espghan.org/)) supports a biopsy-free pathway for some children who meet specific criteria, while the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition ([NASPGHAN](https://naspghan.org/)) has historically taken a more cautious approach. European and North American experts continue to differ on how much evidence is needed before a child can be diagnosed with celiac disease and begin a lifelong gluten-free diet. Traditionally, diagnosis has relied on a combination of blood tests and an upper endoscopy with biopsy to identify characteristic damage in the small intestine. While that approach remains standard in much of North America, European guidelines have increasingly embraced the idea that some children can be diagnosed accurately without an invasive procedure. The disagreement is more than academic. Whether a biopsy is required can affect how quickly a diagnosis is made, whether a child must undergo anesthesia and endoscopy, and how healthcare resources are used. ### Europe’s Shift Toward Biopsy-Free Diagnosis In 2012, ESPGHAN introduced criteria allowing some symptomatic children to receive a celiac disease diagnosis without undergoing biopsy. The pathway required tissue transglutaminase IgA (tTG-IgA) levels greater than 10 times the upper limit of normal, confirmation with endomysial antibody (EMA) testing, compatible genetic markers, and symptoms consistent with celiac disease. The guidelines were updated in 2020 after additional research demonstrated that genetic testing did not substantially improve diagnostic accuracy in children who already met the other criteria. The revised recommendations removed the requirement for HLA testing and expanded the biopsy-free pathway to include certain asymptomatic children with strongly positive serology. As a result, biopsy-sparing diagnosis has become an increasingly accepted part of pediatric celiac disease care across Europe. ### Why North America Has Been More Cautious NASPGHAN has cited several reasons for its more cautious approach. One concern involves variability between laboratory assays used to measure tTG antibodies. Because different tests may perform differently, some experts have questioned whether a single antibody threshold can be applied consistently across healthcare systems. Another concern is that endoscopy can occasionally identify additional conditions beyond celiac disease, including eosinophilic gastrointestinal disorders or Helicobacter pylori infection. Forgoing biopsy could mean missing information that might otherwise influence a patient’s care. There are also concerns about implementation. Because a diagnosis of celiac disease typically leads to lifelong dietary restrictions and medical follow-up, some experts argue that a biopsy provides an additional layer of diagnostic certainty before recommending permanent changes. NASPGHAN acknowledged the European approach in its 2016 clinical report but did not endorse it for routine use. More recently, the [American College of Gastroenterology’s 2023 guideline](https://socgastro.org.br/novo/wp-content/uploads/2023/01/American_College_of_Gastroenterology_Guidelines.17.pdf) suggested that a biopsy-free diagnosis may be appropriate for carefully selected children with strongly positive serology, while continuing to recommend endoscopy with duodenal biopsy as the standard diagnostic approach. ### Could New Diagnostic Tools Change the Debate? Researchers are also exploring new diagnostic tools that could reduce the need for both biopsies and prolonged gluten challenges. This is particularly important for people who have already started a gluten-free diet before being formally evaluated for celiac disease. Current recommendations often require these individuals to reintroduce gluten for several months before blood tests and biopsies can reliably detect an active immune response. For many patients, that process can be physically uncomfortable and psychologically difficult. One promising area of research focuses on [measuring rapid immune responses to gluten](https://www.autoimmuneinstitute.org/research_updates/blood-test-shows-promise-for-diagnosing-celiac-disease-on-a-gf-diet/ "Blood Test Shows Promise for Diagnosing Celiac Disease on a GF Diet"). Levels of the immune signaling molecule interleukin-2 (IL-2) can rise within hours when gluten-reactive immune cells become activated, raising the possibility of diagnostic approaches that require far less gluten exposure than current protocols. Researchers are also investigating whether those same immune responses can be measured entirely outside the body. Rather than requiring patients to consume gluten, scientists can expose a blood sample to gluten peptides in a laboratory and measure whether gluten-reactive immune cells respond. If validated in larger studies, such approaches could potentially help diagnose celiac disease in people who are already following a gluten-free diet without requiring a lengthy gluten challenge. ### A Debate That Is Still Evolving Despite growing interest in biopsy-free diagnosis, there is currently no global consensus on the best approach. For now, the Atlantic Ocean still marks a meaningful divide in how celiac disease is diagnosed. But as new biomarkers and blood-based immune tests move closer to clinical practice, the question may eventually shift from whether a biopsy is necessary to whether either side’s current approach remains the best option. Until then, children with similar test results may continue to face different diagnostic pathways depending on which guidelines their healthcare team follows. **Category:** Celiac Disease, Research Studies --- ### [What Senescent Cells Could Teach Us About Autoimmune Disease and Aging](https://www.autoimmuneinstitute.org/research_updates/what-senescent-cells-could-teach-us-about-autoimmune-disease-and-aging/) **Published:** June 15, 2026 **Author:** Carolyn Serraino **Excerpt:** A new NIH-funded research effort is providing a closer look at one of the biological processes thought to help drive those changes: cellular senescence. Researchers have reported major progress toward building the first comprehensive atlas of human senescent cells, a resource that could help scientists better understand aging, immune function, chronic inflammation, and age-related disease. **Content:** **Quick Reference Guide** **Cellular senescence:** A state in which cells stop dividing but remain active in the body. **Senescent cells:** Aging or stressed cells that no longer divide and may release inflammatory signals. **Senotypes:** Different forms of senescence that vary depending on the tissue, cell type, and surrounding environment. **Immunosenescence:** Age-related remodeling of the immune system that can affect immune function and inflammation. **Senolytics:** Experimental treatments designed to selectively remove harmful senescent cells. In our recent *[**How Autoimmunity Changes Over Time**](https://www.autoimmuneinstitute.org/gai-library/#disease-progression)* series, we explored how aging reshapes the immune system, contributes to chronic inflammation, and may increase the risk of autoimmune disease. Now, a new NIH-funded research effort is providing a closer look at one of the biological processes thought to help drive those changes: **cellular senescence**. Researchers have reported major progress toward building the first comprehensive atlas of human senescent cells, a resource that could help scientists better understand aging, immune function, chronic inflammation, and age-related disease (1). Published in *Cell*, the work comes from the National Institutes of Health’s Cellular Senescence Network (SenNet), a collaborative initiative launched in 2021 to identify and characterize senescent cells throughout the human body (2). Notably, SenNet researcher Paul Robbins, who shared his expertise in GAI’s recent *[**Aging and Autoimmune Disease**](https://www.autoimmuneinstitute.org/articles/aging-and-autoimmune-disease/)* article, is among the authors of the new publication. **Senescent cells** are aging cells that have stopped dividing but do not die off. Some help with wound healing and other normal processes, but as they accumulate with age, they can release inflammatory molecules that may contribute to chronic disease. A new collection of studies from the SenNet consortium suggests that senescence may be far more complex than researchers once believed. Rather than behaving as a single type of cell, senescent cells appear to exist in many different forms depending on where they are found in the body and what caused them to become senescent in the first place. To describe these differences, researchers introduced a new concept called **“senotypes.”** The consortium has mapped senescent cells in multiple tissues, including the brain, lungs, liver, skin, and lymph nodes, to explore these different senotypes. One finding that may be particularly relevant to immune health came from a detailed study of human lymph nodes. Researchers examined lymph nodes from people aged 5 to 86 and found age-related changes throughout the tissue, including the gradual accumulation of senescent germinal center B cells, a type of immune cell involved in antibody production. The findings contribute to a growing understanding of [**immunosenescence**](https://www.autoimmuneinstitute.org/articles/aging-and-autoimmune-disease "Aging and Autoimmune Disease"), the age-related remodeling of the immune system. By mapping age-related changes in immune tissues such as lymph nodes, researchers hope to better understand how aging influences inflammation, immune function, and disease risk over time. The researchers also developed new tools to identify biological markers of senescence in blood samples. These markers were associated with conditions such as frailty, kidney disease, and diabetes, raising the possibility that blood tests may one day help identify people at increased risk of age-related health problems. Ultimately, researchers hope the atlas will help them better distinguish “beneficial” senescent cells from “harmful” ones. That knowledge could support the development of new treatments known as **senolytics**, which are designed to selectively remove damaging senescent cells while leaving helpful ones intact. **Worth a Look:** The NIH press release includes a beautiful illustration by artist Lettie Margaret McGuire, EdM, showing cells transitioning through the lifespan within an hourglass. The artwork was created to visualize the SenNet project’s effort to map cellular senescence across the human body. [View the artwork here.](https://www.nih.gov/sites/default/files/2026-06/20260611-sennet-illustration.jpg) ##### Citations 1. National Institutes of Health. (2026, June 11). *NIH research establishes new framework for the role of senescence in aging*. U.S. Department of Health and Human Services. <https://www.nih.gov/news-events/news-releases/nih-research-establishes-new-framework-role-senescence-aging> 2. Suryadevara, V., Farzad, N., Yang, M., Xu, K., Tsankov, A., Thompson, R. C., Sloan, N., Phatnani, H., Olinger, B., Mares, J. A., Lund, A. N., Li, D., Gorospe, M., Ding, L., Beckmann, N., Basisty, N., Anerillas, C., NIH SenNet consortium, Robbins, P., & Fan, R. (2026). Charting human cellular senescence in aging and disease. *Cell*, *189*(12), 3501–3505. <https://doi.org/10.1016/j.cell.2026.05.028> **Category:** Policy & Health Decisions, Research Studies --- ### [Is Ehlers-Danlos an Autoimmune Disease?](https://www.autoimmuneinstitute.org/research_updates/is-ehlers-danlos-an-autoimmune-disease/) **Published:** December 18, 2024 **Author:** Elevation **Content:** ## What is Ehlers-Danlos? Ehlers-Danlos syndrome can take one of several forms, but essentially, it means the body has a problem producing collagen, making your connective tissues weaker than they should be. Different types of Ehlers-Danlos syndrome are associated with a variety of genetic causes, some of which are inherited and passed on from parent to child. ## How Many Types of Ehlers-Danlos are There? Currently, there are 14 formally recognized subtypes, and the Ehlers-Danlos Society has great resources for each: - [Arthrochalasia EDS (aEDS)](https://www.ehlers-danlos.com/what-is-eds/arthrochalasia-ehlers-danlos-syndrome/) - [Brittle Cornea Syndrome (BCS)](https://www.ehlers-danlos.com/what-is-eds/brittle-cornea-syndrome-bcs/) - [Cardiac-valvular EDS (cvEDS)](https://www.ehlers-danlos.com/what-is-eds/cardiac-valvular-ehlers-danlos-syndrome/) - [Classical EDS](https://www.ehlers-danlos.com/ceds/) [(cEDS)](https://www.ehlers-danlos.com/ceds/) - [Classical-like EDS](https://www.ehlers-danlos.com/what-is-eds/classical-like-ehlers-danlos-syndrome/) [(clEDS)](https://www.ehlers-danlos.com/what-is-eds/classical-like-ehlers-danlos-syndrome/) - [Dermatosparaxis EDS](https://www.ehlers-danlos.com/what-is-eds/dermatosparaxis-ehlers-danlos-syndrome/) [(dEDS)](https://www.ehlers-danlos.com/what-is-eds/dermatosparaxis-ehlers-danlos-syndrome/) - [Hypermobile EDS](https://www.ehlers-danlos.com/heds/) [(hEDS)](https://www.ehlers-danlos.com/heds/) - [Hypermobility Spectrum Disorders (HSD)](https://www.ehlers-danlos.com/hsd/) - [Kyphoscoliotic EDS](https://www.ehlers-danlos.com/keds/) [(kEDS)](https://www.ehlers-danlos.com/keds/) - [Musculocontractural EDS (mcEDS)](https://www.ehlers-danlos.com/what-is-eds/musculocontractural-ehlers-danlos-syndrome/) - [Myopathic EDS](https://www.ehlers-danlos.com/what-is-eds/myopathic-ehlers-danlos-syndrome-meds/) [(mEDS)](https://www.ehlers-danlos.com/what-is-eds/myopathic-ehlers-danlos-syndrome-meds/) - [Periodontal EDS](https://www.ehlers-danlos.com/what-is-eds/periodontal-ehlers-danlos-syndrome/) [(pEDS)](https://www.ehlers-danlos.com/what-is-eds/periodontal-ehlers-danlos-syndrome/) - [Spondylodysplastic EDS (spEDS)](https://www.ehlers-danlos.com/what-is-eds/spondylodysplastic-ehlers-danlos-syndrome/) - [Vascular EDS](https://www.ehlers-danlos.com/veds/) [(vEDS)](https://www.ehlers-danlos.com/veds/) ## Is Ehlers-Danlos an Autoimmune Disease? Ehlers-Danlos syndrome is not classified as an autoimmune disease because it is primarily a genetic condition caused by a mutation that affects collagen production, a key component of connective tissue, unlike autoimmune disease, where the immune system attacks the body’s tissues. A contrasting example is [mixed connective tissue disease,](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/mixed-connective-tissue-disease/) an autoimmune disease where antibodies attack the body’s connective tissues. [Recent research](https://www.ehlers-danlos.com/wp-content/uploads/2022/02/Allergy_Summit_Series_Clair_Francomano_Autoimmune_Rheumatic.pdf) shows that there is evidence of an autoimmune process associated with Ehlers-Danlos syndrome in specific organs. ![Organs in which there is at least preliminary evidence of an autoimmune process associated with Ehlers-Danlos syndrome](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/12/Screenshot-2024-12-18-at-4.10.27 PM.png) [Image Source](https://www.ehlers-danlos.com/wp-content/uploads/2022/02/Allergy_Summit_Series_Clair_Francomano_Autoimmune_Rheumatic.pdf) ## **Recommended Resource**s: [![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/03/Icon-33.png)](https://www.ehlers-danlos.com/healthcare-professionals-directory/) ### [Healthcare Professionals Directory](https://www.ehlers-danlos.com/healthcare-professionals-directory/) The **Ehlers-Danlos Society** recognizes the challenges in finding knowledgeable healthcare professionals for EDS and HSD. To improve access to care, they offer a **global directory of providers**. [![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/03/Icon-26.png)](https://www.statnews.com/2022/12/12/ehlers-danlos-syndrome-patients-turned-researchers/) ### [Revenge of the Gaslit Patients](https://www.statnews.com/2022/12/12/ehlers-danlos-syndrome-patients-turned-researchers/) This [article](https://www.statnews.com/2022/12/12/ehlers-danlos-syndrome-patients-turned-researchers/) sheds light on the powerful role of patient-researchers with hypermobile Ehlers-Danlos syndrome (hEDS), who channel their lived experiences into advancing research on a misunderstood condition. **Often gaslit and dismissed by medical professionals, these individuals are challenging outdated diagnostic tools, uncovering genetic clues, and pushing for the recognition and understanding hEDS patients deserve.** Their work highlights the urgent need for further research and the importance of the human element in science to address systemic barriers and improve care for those with hEDS. --- ### [Understanding HLA Genetic Testing in Celiac Disease](https://www.autoimmuneinstitute.org/research_updates/understanding-hla-genetic-testing-in-celiac-disease/) **Published:** June 12, 2026 **Author:** Carolyn Serraino **Excerpt:** Genetic testing is becoming an increasingly important topic in celiac disease, especially as researchers explore new diagnostic tools and potential therapies that may depend on a person's genetic profile. During the Celiac Disease National Policy Symposium, From Diagnosis to Coverage: Aligning Policy for Celiac Disease Therapeutics, organized by the Celiac Disease Foundation and the Society for the Study of Celiac Disease, researchers, clinicians, and genetics experts examined the current and future role of HLA genetic testing in celiac disease. **Content:** *June 12, 2026* Genetic testing is becoming an increasingly important topic in [celiac disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/celiac-disease/ "celiac disease"), especially as researchers explore [new diagnostic tools](https://www.autoimmuneinstitute.org/research_updates/blood-test-shows-promise-for-diagnosing-celiac-disease-on-a-gf-diet/ "Blood Test Shows Promise for Diagnosing Celiac Disease on a GF Diet") and [potential therapies](https://www.autoimmuneinstitute.org/research_updates/a-new-clue-to-why-celiac-disease-develops-inc13/ "A New Clue to Why Celiac Disease Develops: lnc13") that may depend on a person’s genetic profile. During the *Celiac Disease National Policy Symposium*, **[From Diagnosis to Coverage: Aligning Policy for Celiac Disease Therapeutics](https://celiac.org/event/from-diagnosis-to-coverage-aligning-policy-for-celiac-disease-therapeutics/)**, organized by the [Celiac Disease Foundation](https://celiac.org/) and the [Society for the Study of Celiac Disease](https://theceliacsociety.org/ "Society for the Study of Celiac Disease"), researchers, clinicians, and genetics experts examined the current and future role of HLA genetic testing in celiac disease. While HLA testing is often used today to help rule out celiac disease in complex cases, speakers discussed how it may soon play a larger role in clinical trials, treatment eligibility, risk assessment, and personalized approaches to care. They also highlighted ongoing challenges, including inconsistent test reporting, limited genetic counseling resources, and the need for better education for both healthcare providers and patients. **Questions addressed included:** ### What Is HLA Testing? HLA testing looks for specific genetic markers associated with celiac disease, most commonly HLA-DQ2 and HLA-DQ8. Nearly all people with celiac disease carry one of these genetic markers, but many people who carry them never develop the disease. Experts described these genes as being necessary for most cases of celiac disease, but not sufficient on their own to cause it. ### Can HLA Testing Alone Diagnose Celiac Disease? No. Experts emphasized that HLA testing alone cannot diagnose celiac disease. While most people with celiac disease carry HLA-DQ2 or HLA-DQ8, many people with these genes never develop the condition. Today, HLA testing is used primarily as an exclusionary tool rather than a diagnostic tool. A diagnosis of celiac disease still relies on the broader clinical picture, including serologic testing, biopsies, symptoms, and medical history. ### When Is HLA Testing Most Useful in Celiac Disease? According to the speakers, HLA testing is often most useful when the diagnosis is unclear. Examples include people who started a gluten-free diet before being tested, individuals with incomplete medical records, or patients whose symptoms, blood tests, and biopsy findings do not tell a clear story. In these situations, HLA testing can help determine whether celiac disease remains a realistic possibility. Experts also noted that family members of people with celiac disease sometimes use HLA testing to better understand whether ongoing screening may be needed. ### If My HLA Test Is Positive, Does That Mean I Have Celiac Disease? No. A positive HLA test means that you carry genetic markers associated with celiac disease. It does not mean that you currently have the disease or that you will definitely develop it in the future. Experts noted that approximately 40% of the general population carries HLA-DQ2 or HLA-DQ8, yet only a small percentage ultimately develop celiac disease. Risk depends on many factors beyond genetics alone. ### If My HLA Test Is Negative, Can I Rule Out Celiac Disease? A negative HLA test makes celiac disease extremely unlikely, which is why experts described HLA testing as having a high negative predictive value. However, speakers cautioned against relying on any single test in isolation. HLA results should always be interpreted alongside symptoms, blood tests, biopsy findings, and clinical judgment. ### Why Don’t Doctors Routinely Order HLA Testing for Everyone Being Evaluated for Celiac Disease? Speakers explained that HLA testing is best at identifying who is unlikely to have or develop celiac disease rather than confirming who has it. Most gastroenterologists see patients after symptoms or positive antibody tests have already raised suspicion for celiac disease, making other diagnostic tests more immediately relevant. Experts also noted that cost and practicality would be important considerations if HLA testing were ever used as a population-wide screening tool. ### Are Direct-to-Consumer Genetic Tests Enough for Celiac Disease Decision-Making? Not always. Speakers noted that consumer-directed testing can provide useful information, but the amount of genetic detail reported may differ from testing performed through clinical laboratories. Some consumer tests may not report all potentially relevant celiac-associated variants or provide the level of detail that could become important for future diagnostic methods or therapies. Several experts suggested that clinical confirmation may still be needed in situations where treatment eligibility or clinical decision-making depends on precise genetic information. ### Why Can Two HLA Test Reports Look Different Even When They Are Testing for the Same Thing? One of the major concerns raised during the session was the lack of standardization in HLA reporting. Different laboratories and testing companies may use different testing methods, report results using different formats, or include different levels of genetic detail. Some reports may include less common variants such as DQ2.2 or DQ7.5, while others may not. Experts warned that these differences can create confusion for both patients and healthcare providers. ### Why Can a Positive HLA Test Cause Unnecessary Anxiety? Several speakers cautioned that people often misunderstand what a positive HLA result means. Because HLA-DQ2 and HLA-DQ8 are associated with celiac disease, some individuals assume that carrying one of these genes means they will inevitably develop the condition. Experts stressed that a positive HLA test indicates genetic susceptibility, not a diagnosis or certainty that celiac disease will develop. They noted that proper counseling can help patients understand their actual level of risk, avoid unnecessary worry, and make informed decisions about screening and follow-up care. Panelists also pointed out that access to genetic counseling is already limited in many areas. ### Why Do Experts Believe More Education About HLA Testing Is Needed for Healthcare Providers? Several speakers noted that HLA testing is not widely used in routine celiac disease care and that many healthcare providers receive limited training in how to interpret genetic test results. Panelists discussed how differences in laboratory reports, testing methods, and genetic terminology can create confusion even among specialists. Experts emphasized that clinicians need clear, standardized reporting and educational resources to help them accurately interpret HLA results, explain them to patients, and incorporate them into clinical decision-making as genetic testing becomes more common in research and potentially future treatment selection. ### Why Are Many Celiac Disease Clinical Trials Now Collecting HLA Information? The speakers explained that HLA testing can help investigators better understand who is participating in a study, how certain biomarkers behave in different genetic groups, and whether a treatment works differently depending on a person’s genotype. In some studies, HLA information is collected for analysis purposes, while in others it is used to determine eligibility for enrollment. Several ongoing clinical trials already include HLA testing as part of their screening process. ### Could My HLA Type Affect Which Celiac Disease Treatments I May Be Eligible for in the Future? Possibly. The speakers described several investigational therapies that specifically target immune pathways involving HLA-DQ molecules. Some clinical trials already limit enrollment to participants with particular HLA types, especially HLA-DQ2.5. Evidence suggesting that HLA type may influence how some experimental therapies perform and whether a person may be eligible to receive certain treatments if they eventually become available was also discussed. While no HLA-directed therapies are currently approved, genetic testing may become increasingly important if these therapies prove successful and move into clinical practice. **Category:** Celiac Disease, Diagnostic Testing, Events, Genetics, Research Studies, Risk Factors --- ### [Advancing Towards an Epstein-Barr Virus Vaccine](https://www.autoimmuneinstitute.org/research_updates/advancing-towards-an-epstein-barr-virus-vaccine/) **Published:** May 9, 2022 **Author:** GAI-assistant **Excerpt:** The Epstein-Barr Virus (EBV) causes the infectious disease mononucleosis and has been linked to the onset of cancer and autoimmune disorders like multiple sclerosis. Despite its significance, no vaccine against it currently exists. However, in 2022, the National Institute of Health (NIH) initiated a phase 1 vaccine trial, announced in a press release titled, “NIH launches clinical trial of Epstein-Barr virus vaccine”. **Content:** May 9, 2022 The Epstein-Barr Virus (EBV) causes the infectious disease mononucleosis and has been linked to the onset of cancer and autoimmune disorders like multiple sclerosis. Despite its significance, no vaccine against it currently exists. However, in 2022, the National Institute of Health (NIH) initiated a phase 1 vaccine trial, announced in a press release titled, “[NIH launches clinical trial of Epstein-Barr virus vaccine](https://www.nih.gov/news-events/news-releases/nih-launches-clinical-trial-epstein-barr-virus-vaccine)”. The primary goal of this phase 1 trial is to assess the safety and immune response generated by the vaccine. The trial involved two groups of participants: twenty individuals who showed prior evidence of EBV infection and twenty who had not been infected with EBV. Each group received three vaccine doses spread out over a six-month period, followed by a four-year monitoring period. As of now, the trial is still ongoing, with the potential to progress to phase 2 if successful. The development of an EBV vaccine holds immense promise in mitigating one potential factor contributing to cancer and autoimmune diseases in the future. **Category:** Clinical Trials, Multiple Sclerosis, Research Studies, Risk Factors --- ### [Rethinking Obesity, Inflammation, and Disease Risk](https://www.autoimmuneinstitute.org/research_updates/rethinking-obesity-inflammation-and-disease-risk/) **Published:** May 1, 2026 **Author:** Carolyn Serraino **Content:** Body mass index (BMI) has long been used to assess whether a person falls within a healthy weight range, but growing evidence suggests that BMI alone may not fully capture an individual’s health risks. A new study published in *Nature Medicine* highlights just how different those risks can be. Researchers analyzed health data from nearly 200,000 adults with overweight or obesity and developed a risk prediction tool called OBSCORE designed to estimate an individual’s likelihood of developing 18 obesity-related complications, including type 2 diabetes, cardiovascular disease, chronic kidney disease, and sleep apnea (1). #### The researchers found that people with similar BMIs often had dramatically different future health risks. In some cases, individuals classified within the same BMI category fell into entirely different risk groups, suggesting that body weight alone may overlook important biological and clinical differences that influence long-term health outcomes. One of the study’s most striking findings was the degree of variation observed within BMI categories. The highest-risk group identified by OBSCORE had a 47-fold greater risk of cardiovascular death than the lowest-risk group, despite all participants already meeting criteria for overweight or obesity. #### While obesity is often discussed in terms of body weight, scientists increasingly recognize it as a condition that can influence immune function throughout the body. Adipose tissue, commonly known as body fat, is now understood to be an active endocrine and immune organ that produces signaling molecules that influence inflammation and metabolism (3). As obesity develops, immune cell populations within adipose tissue shift toward a more inflammatory state, with increased numbers of macrophages, Th1 cells, and Th17 cells and reduced activity of regulatory immune pathways that normally help maintain immune balance (2,3). Researchers have proposed that these immune changes may help explain why obesity has been linked to a variety of chronic inflammatory conditions (2,3). ### The Growing Link Between Obesity and Autoimmune Disease Interest in the connection between obesity and autoimmunity has grown substantially over the past two decades. Several biological mechanisms may contribute to this relationship. Obesity is associated with increased production of inflammatory molecules such as TNF-α and IL-6 as well as altered levels of hormones known as adipokines, which help regulate interactions between metabolism and the immune system (3). One adipokine, leptin, has attracted particular attention because it promotes inflammatory T-cell responses while suppressing regulatory T cells that normally help prevent excessive immune activation (3). A recent systematic review and meta-analysis published in *Obesity* analyzed data from 26 studies involving more than 1.9 million participants and found that obesity was associated with a significantly increased risk of developing autoimmune diseases overall (4). Compared with individuals in the BMI category traditionally classified as normal weight, people with obesity had a 30% higher risk of developing [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid arthritis"), a 49% higher risk of [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/ "Multiple sclerosis"), a 35% higher risk of [Crohn’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crohns-disease/ "Crohn’s disease"), and an 18% higher risk of [psoriasis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/psoriasis/ "Psoriasis"). #### When researchers combined data across autoimmune diseases, obesity was associated with a 41% increased risk of developing an autoimmune condition overall (4). Researchers have also observed high rates of overweight and obesity among children and adolescents with [chronic autoimmune thyroiditis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/hashimotos-thyroiditis/ "Hashimoto’s thyroiditis (autoimmune thyroiditis)"), further highlighting growing interest in the relationship between metabolic health and autoimmunity (5). Obesity has also been associated with worse outcomes in some autoimmune conditions after diagnosis. In [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid arthritis"), studies have linked obesity to greater symptom burden, higher levels of disability, elevated inflammatory markers, and lower rates of remission (6). ### Looking Beyond BMI Toward More Personalized Risk Assessment Despite these associations, not every person with obesity develops metabolic disease, cardiovascular disease, or autoimmune conditions. Likewise, some individuals with relatively modest increases in body weight experience significant health complications. The OBSCORE model was designed to help explain these differences by incorporating a broader range of clinical and biological information than BMI alone (1). #### Rather than treating everyone within a BMI category as having similar risks, the model attempts to identify which individuals are most likely to develop serious complications in the future. These findings suggest that BMI may be useful as a screening tool but may not fully capture the biological complexity underlying disease risk, reflecting a broader shift toward [precision medicine](https://www.autoimmuneinstitute.org/articles/tailoring-autoimmune-treatment-with-precision-medicine "Tailoring Autoimmune Treatment with Precision Medicine"), an approach that seeks to move beyond one-size-fits-all measures and better account for individual differences in biology and health. ##### Citations 1. Demircan, K., Carrasco-Zanini, J., Williamson, A. *et al.* Data-driven prioritization of high-risk individuals for weight loss interventions. *Nat Med* (2026). <https://doi.org/10.1038/s41591-026-04353-2> 2. Endo, Y., Yokote, K., & Nakayama, T. (2017). The obesity-related pathology and Th17 cells. *Cellular and molecular life sciences : CMLS*, *74*(7), 1231–1245. <https://doi.org/10.1007/s00018-016-2399-3> 3. Taylor E. B. (2021). The complex role of adipokines in obesity, inflammation, and autoimmunity. *Clinical science (London, England : 1979)*, *135*(6), 731–752. <https://doi.org/10.1042/CS20200895> 4. Spatocco, I., Mele, G., De Rosa, G., Fusco, C., Ruggiero, K., Pellegrini, V., Carreras, F., La Grotta, R., Ceriello, A., Procaccini, C., Matarese, G., Prattichizzo, F., & de Candia, P. (2026). Obesity as a Risk Factor for Autoimmune Diseases: A Systematic Review and Meta-Analysis. *Obesity (Silver Spring, Md.)*, *34*(1), 36–50. <https://doi.org/10.1002/oby.70044> 5. González-Mereles, A. P., Arguinzoniz-Valenzuela, S. L., López-López, A. P., Maqueda-Tenorio, S. E., & González-Baqué, I. (2021). Overweight and obesity in children and adolescents with chronic autoimmune thyroiditis. Sobrepeso y obesidad en niños y adolescentes con tiroiditis crónica autoinmunitaria. *Boletin medico del Hospital Infantil de Mexico*, *78*(5), 424–431. <https://doi.org/10.24875/BMHIM.20000292> 6. Poudel, D., George, M. D., & Baker, J. F. (2020). The Impact of Obesity on Disease Activity and Treatment Response in Rheumatoid Arthritis. *Current rheumatology reports*, *22*(9), 56. <https://doi.org/10.1007/s11926-020-00933-4> **Category:** Research Studies, Rheumatoid Arthritis, Risk Factors, Thyroid Disease --- ### [A New Clue to Why Celiac Disease Develops: lnc13](https://www.autoimmuneinstitute.org/research_updates/a-new-clue-to-why-celiac-disease-develops-inc13/) **Published:** May 28, 2026 **Author:** Carolyn Serraino **Content:** ### Why do most people tolerate gluten while others develop celiac disease? A new study published in *Nature Immunology* points to a possible answer. Researchers found that a long noncoding RNA called **lnc13** helps keep inflammatory immune responses to gluten in check, and that loss of this protective mechanism can trigger celiac disease-like changes in genetically susceptible mice. [Celiac disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/celiac-disease/ "Celiac disease") develops when the immune system mounts an inappropriate response to gluten, leading to inflammation and damage in the small intestine. Although scientists have identified many of the genetic and immune factors involved, the mechanisms that normally maintain tolerance to gluten remain incompletely understood. To investigate this question, researchers focused on lnc13, a molecule previously linked to celiac disease risk that helps regulate the activity of other genes. Using genetically modified mice carrying the human HLA-DQ8 risk gene, researchers found that animals lacking lnc13 developed many features that resemble celiac disease after exposure to gluten. These included increased inflammatory immune activity, expansion of cytotoxic immune cells in the intestine, production of celiac-associated antibodies, and structural changes in the small intestine consistent with early disease. Importantly, many of these changes improved when gluten was removed from the diet. The study also identified a possible mechanism behind these effects. The researchers found that lnc13 helps limit the activity of **IL-15**, an immune signaling molecule long recognized as an important driver of celiac disease. Without lnc13, immune cells became more responsive to IL-15 and were more likely to develop into inflammatory, tissue-damaging cells. Because celiac disease is one of the few autoimmune diseases with a known environmental trigger, researchers believe it offers a valuable model for understanding how [immune tolerance](https://www.autoimmuneinstitute.org/articles/restoring-immune-tolerance-in-autoimmune-disease "Restoring Immune Tolerance in Autoimmune Disease") breaks down. While additional studies will be needed to determine whether lnc13 could eventually become a therapeutic target, the findings provide new insight into the molecular mechanisms that normally help prevent harmful immune responses to food. **Related:** In March 2026, co-author Dr. Arnold Han discussed how advances in immune profiling technologies are helping researchers better understand the cellular events that drive celiac disease and how those discoveries may inform research into autoimmune diseases more broadly during the 100th episode of Beyond Celiac’s *Celiac Straight Talk* podcast: **Unlocking Autoimmunity Through Celiac Research**. [Podcast Episode](https://podcasts.apple.com/us/podcast/celiac-straight-talk/id1223772536?i=1000757661872) ##### Citation Yang-Fischer, R., Shearer, A., Leão, F.B. *et al.* The long noncoding RNA lnc13 restrains inflammatory responses to maintain oral tolerance to gluten. *Nat Immunol* **27**, 1145–1158 (2026). <https://doi.org/10.1038/s41590-026-02506-6> **Category:** Celiac Disease, Genetics, Research Studies, Risk Factors --- ### [Blood Test Shows Promise for Diagnosing Celiac Disease on a GF Diet](https://www.autoimmuneinstitute.org/research_updates/blood-test-shows-promise-for-diagnosing-celiac-disease-on-a-gf-diet/) **Published:** June 5, 2026 **Author:** Carolyn Serraino **Excerpt:** Researchers evaluated a blood test that measures gluten-reactive immune cells and may help diagnose celiac disease on a gluten-free diet. Diagnosing celiac disease can be difficult for people who have already stopped eating gluten. Standard blood tests and intestinal biopsies typically rely on evidence of an active immune response to gluten, meaning some individuals must undergo a gluten challenge before testing can be performed accurately. **Content:** Diagnosing [celiac disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/celiac-disease/) can be difficult for people who have already stopped eating gluten. Standard blood tests and intestinal biopsies typically rely on evidence of an active immune response to gluten, meaning some individuals must undergo a gluten challenge before testing can be performed accurately. #### In a study published in *Gastroenterology*, researchers evaluated a blood test designed to measure the activity of gluten-reactive immune cells. The test focuses on interleukin-2 (IL-2), an immune signaling molecule released when certain T cells become activated (1). In celiac disease, these T cells mistakenly react to gluten and help drive the immune response that damages the small intestine. The study included 181 adults, including people with active celiac disease, individuals following a gluten-free diet, healthy controls, and participants with non-celiac gluten sensitivity. Researchers exposed blood samples to gluten-derived peptides and measured the resulting IL-2 response. #### The test performed particularly well in people carrying HLA-DQ2.5, the genetic variant most commonly associated with celiac disease. In that group, it correctly identified about 90% of people with the disease and correctly ruled it out in about 95% of people without it. Performance was lower in participants carrying certain less common genetic variants, highlighting the need for additional research. To better understand what the test was detecting, the researchers compared it with specialized laboratory methods used to directly identify gluten-reactive T cells. #### People with stronger IL-2 responses tended to have higher numbers of these disease-associated immune cells, suggesting the assay was capturing a biologically meaningful immune response rather than simply measuring general inflammation.  The researchers also found that participants with stronger immune responses were more likely to experience severe symptoms during a gluten challenge. Those who developed vomiting after gluten exposure had substantially higher IL-2 responses and greater numbers of gluten-reactive T cells than those who did not. Beyond its potential diagnostic value, the study offers additional insight into the immune mechanisms underlying celiac disease. Rather than measuring intestinal damage or antibodies that appear after gluten exposure, the test focuses on the activity of the T cells that help drive the disease itself. The researchers suggest that similar approaches could eventually be explored for other conditions involving disease-specific T-cell responses. #### The findings also build on recent research from the same group examining how T cells function in celiac disease. In that earlier study, researchers reported that CD4 helper T cells from people with celiac disease showed weaker signaling, slower activation, and reduced survival, challenging the idea that autoimmune disease is simply the result of an overactive immune response (2). Those differences were observed even in people following a gluten-free diet, suggesting they may reflect underlying features of immune function rather than the effects of ongoing disease activity. Together, the studies point to IL-2 signaling and T-cell behavior as important areas of investigation in celiac disease. The researchers hope that combining genetic information with functional measurements of immune cell activity may eventually help identify disease risk earlier and improve understanding of how autoimmune diseases develop. While additional validation studies will be needed before the test could become part of routine clinical practice, the findings highlight a growing effort to develop diagnostic tools that directly measure the immune cells involved in autoimmune disease. For people who have already eliminated gluten from their diets, approaches like this may eventually offer a more practical way. ##### Citations 1. Farchione, A. J., Cheon, H., Vremec, D., Neumann, J., Verstappen, G. M., Hardy, M. Y., Margetts, M. B., Howson, L. J., Henneken, L. M., Forde, M., Tye-Din, J. A., Heinzel, S., Hodgkin, P. D., & Bryant, V. L. (2026). Functional immune profiling reveals CD4+ T cell dysregulation in coeliac disease. *Immunology and cell biology*, 10.1111/imcb.70132. Advance online publication. <https://doi.org/10.1111/imcb.70132> 2. Moscatelli, O. G., Russell, A. K., Henneken, L. M., Fothergill, L., Motyer, A., Reid, H., Rossjohn, J., Bryant, V., Anderson, R. P., Hardy, M. Y., & Tye-Din, J. A. (2025). Blood-Based T-Cell Diagnosis of Celiac Disease. *Gastroenterology*, *169*(6), 1253–1267.e5. <https://doi.org/10.1053/j.gastro.2025.05.022> **Category:** Celiac Disease, Diagnostic Testing, Research Studies --- ### [Texas Court Ruling and Autoimmune Disease Accommodations](https://www.autoimmuneinstitute.org/research_updates/texas-court-ruling-and-autoimmune-disease/) **Published:** June 1, 2026 **Author:** Carolyn Serraino **Excerpt:** A judge's rare autoimmune disease sparked a courtroom masking dispute, raising broader questions about accommodations and accessibility for chronically ill individuals. **Content:** *June 1, 2026* A recent Texas Supreme Court ruling involving Dallas County [**Judge D’Metria Benson**](https://www.judgebenson.com/) has brought renewed attention to a challenge many people with autoimmune diseases and other chronic health conditions face every day: [how to safely continue working and participating in public life](https://www.autoimmuneinstitute.org/articles/finding-purpose-and-fulfillment-with-autoimmune-and-chronic-disease "Finding Purpose & Fulfillment with Autoimmune and Chronic Disease") while managing serious health risks. #### Judge Benson had required most people in her courtroom to wear masks during court proceedings, explaining that she has a rare autoimmune disease that leaves her highly vulnerable to infections. According to the judge, her physicians advised strict precautions, and she described multiple severe infections and lengthy hospitalizations in 2025 that reinforced those concerns. Judge Benson is not alone. Many [medications](https://www.autoimmuneinstitute.org/articles/biologics-for-autoimmune-disease-what-you-should-know "Biologics for Autoimmune Disease: What You Should Know") used to treat conditions such as [lupus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus (SLE)"), [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid arthritis"), [inflammatory bowel disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crohns-disease/ "Crohn’s disease"), and other autoimmune disorders can suppress immune function, increasing the risk of serious infections. As a result, precautions such as masking, improved ventilation, remote participation, or [telehealth appointments](https://www.autoimmuneinstitute.org/articles/navigating-healthcare-through-the-practical-lens-of-telehealth "Navigating Healthcare Through the Practical Lens of Telehealth") become part of managing that risk. Many don’t see the [mental and emotional toll](https://www.autoimmuneinstitute.org/articles/managing-mental-health-with-an-autoimmune-disease "Managing Mental Health with an Autoimmune Disease") of constantly weighing those risks, deciding which activities feel safe enough to participate in, and how that can lead to [feeling isolated from others](https://www.autoimmuneinstitute.org/articles/chronic-illness-when-you-feel-like-giving-up "Chronic Illness: When You Feel Like Giving Up"). Nevertheless, after an attorney challenged her masking policy, the Texas Supreme Court ordered it withdrawn. **While expressing sympathy for Benson’s health challenges, the Court concluded that requiring masks in a courtroom placed an unfair burden on courtroom participants and was not an appropriate accommodation**. #### If the accommodation that helps protect your health is unavailable, what alternatives remain? The ruling may settle this particular dispute, but it leaves a larger question unanswered. Similar situations arise every day in workplaces, schools, healthcare settings, and public spaces. Most involve ordinary people quietly trying to navigate chronic illness without the resources or public platform that come with a high-profile legal case. How do you continue doing the things you love, fulfilling your responsibilities, accessing the services you need, and participating fully in your community when the precautions that help keep you safe are no longer available? #### What can you do when your body imposes limits you never asked for, but the world expects you to function as though those limits don’t exist? Judge Benson had already implemented other protective measures, including air filtration and modified courtroom procedures, before the masking policy became the subject of legal challenge, and has since indicated that she is exploring additional solutions while temporarily moving proceedings online. The reality of chronic illness is that the need to adapt rarely ends and sometimes resilience looks less like overcoming obstacles and more like finding another way forward. At the same time, we have hope that advances in medicine, accessibility, and public understanding will make it easier for people with autoimmune diseases and other complex health conditions to participate fully in the world around them without having to choose between their health and the lives they want to live. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/06/Callout-Block-2.jpg) GAI explores these challenges in greater detail in *[**A Guide for Immunocompromised Individuals in a Post-Pandemic World**](https://www.autoimmuneinstitute.org/articles/a-guide-for-immunocompromised-individuals-in-a-post-pandemic-world "A Guide for Immunocompromised Individuals in a Post-Pandemic World")*, which covers practical strategies for reducing infection risk, communicating accommodation needs, understanding legal protections, navigating healthcare settings, and balancing physical and mental well-being in a world where most public precautions have disappeared. [Learn More](https://www.autoimmuneinstitute.org/articles/a-guide-for-immunocompromised-individuals-in-a-post-pandemic-world) ![Loader](https://www.autoimmuneinstitute.org/wp-content/plugins/embed-any-document/images/loading.svg) Loading… ![EAD Logo](https://www.autoimmuneinstitute.org/wp-content/plugins/embed-any-document/images/EAD-logo.svg) Taking too long? ![Reload](https://www.autoimmuneinstitute.org/wp-content/plugins/embed-any-document/images/reload.svg) Reload document \| [ ![Open](https://www.autoimmuneinstitute.org/wp-content/plugins/embed-any-document/images/open.svg) Open in new tab ](https://www.abajournal.com/files/Second_Letter_Response_from_Judge_Benson.pdf) ![Loader](https://www.autoimmuneinstitute.org/wp-content/plugins/embed-any-document/images/loading.svg) Loading… ![EAD Logo](https://www.autoimmuneinstitute.org/wp-content/plugins/embed-any-document/images/EAD-logo.svg) Taking too long? ![Reload](https://www.autoimmuneinstitute.org/wp-content/plugins/embed-any-document/images/reload.svg) Reload document \| [ ![Open](https://www.autoimmuneinstitute.org/wp-content/plugins/embed-any-document/images/open.svg) Open in new tab ](https://www.abajournal.com/files/STATEMENT_FROM_JUDGE_D_Metria_Benson.pdf) **Category:** Autoimmune Diseases, Risk Factors --- ### [Could Somatic Mutations Help Drive Autoimmune Disease?](https://www.autoimmuneinstitute.org/research_updates/could-somatic-mutations-help-drive-autoimmune-disease/) **Published:** May 25, 2026 **Author:** Carolyn Serraino **Content:** ### Scientists Revisit Decades-Old Autoimmune Theory With New DNA Technology Researchers are uncovering new evidence that **acquired mutations** in immune cells may play a role in autoimmune disease, reviving a decades-old theory about how the immune system loses tolerance to the body’s own tissues. In a new study published in Nature, researchers used an advanced ultra-sensitive DNA sequencing method called NanoSeq to analyze thyroid tissue from patients with autoimmune thyroid disease, including [Hashimoto’s thyroiditis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/hashimotos-thyroiditis/ "Hashimoto’s thyroiditis (autoimmune thyroiditis)") and [Graves’ disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/graves-disease/ "Graves’ disease") (1). #### The team discovered large numbers of B-cell clones carrying **somatic mutations**, non-inherited genetic changes acquired over a person’s lifetime, in key immune checkpoint genes such as TNFRSF14 (HVEM) and CD274 (PD-L1). Immune checkpoints normally help prevent excessive immune activation and autoimmunity. The researchers suggest that when self-reactive B cells acquire mutations that disable these checkpoints, the cells may gain a survival advantage and become more capable of evading normal immune suppression (2). The findings support a long-standing **“forbidden clone” hypothesis**, first proposed in the 1950s, which suggested that autoimmune disease could arise when self-reactive immune cells acquire mutations that allow them to bypass [tolerance mechanisms](https://www.autoimmuneinstitute.org/articles/restoring-immune-tolerance-in-autoimmune-disease "Restoring Immune Tolerance in Autoimmune Disease"). The newer model described in the paper proposes that autoimmune disease may develop through a gradual, multi-step process in which multiple self-reactive immune cell clones independently accumulate mutations over time. #### Importantly, the study did not identify a single dominant clone, as is often seen in [cancer](https://www.autoimmuneinstitute.org/gai-library/#immune-spectrum). Instead, researchers found hundreds of separate mutated B-cell populations within inflamed thyroid tissue, with many converging on the same immune checkpoint pathways. While each clone represented only a small percentage of cells individually, together they made up a substantial portion of the infiltrating B cells. This finding supports the idea that autoimmune disease may involve widespread, polyclonal immune dysregulation rather than a single dominant abnormal clone. The study also linked some of these mutated B cells directly to thyroid [autoantibodies](https://www.autoimmuneinstitute.org/articles/decoding-the-role-of-autoantibodies-in-autoimmunity "Decoding the Role of Autoantibodies in Autoimmunity"). Researchers synthesized antibodies predicted to be produced by certain mutated cells and found that several reacted to thyroid-associated antigens, including thyroid peroxidase and thyroglobulin. These findings suggest that some of the mutated B cells were not merely present in inflamed tissue but may have been directly involved in producing autoimmune responses. The findings may also help explain why immune checkpoint inhibitor [drugs used in cancer treatment can sometimes trigger thyroid inflammation](https://www.autoimmuneinstitute.org/articles/the-immune-balancing-act-cancer-and-autoimmunity "The Immune Balancing Act: Cancer and Autoimmunity") and autoimmune complications. #### Although the research does not prove that these mutations directly cause autoimmune disease, experts described the findings as some of the strongest evidence yet supporting a role for somatic evolution in common autoimmune disorders. Future studies will be needed to determine whether similar mutation patterns occur across other autoimmune diseases and whether these processes could eventually become targets for diagnosis or treatment. ##### Citations 1. Nicola, P.A., Lawson, A.R.J., Tidd, A. *et al.* **[Polyclonal selection of immune checkpoint mutations in thyroid autoimmunity](https://rdcu.be/fk2V4)**. *Nature* (2026). https://doi.org/10.1038/s41586-026-10493-9 2. Koralov, S. B., & Borbet, T. C. (2026). **[Hard-to-detect mutations explain how common autoimmune diseases arise](https://www.nature.com/articles/d41586-026-01415-w)**. *Nature*, 10.1038/d41586-026-01415-w. Advance online publication. https://doi.org/10.1038/d41586-026-01415-w **Category:** Genetics, Research Studies, Risk Factors, Thyroid Disease --- ### [A Fresh Look at Viruses: What Survivors Can Teach Us About Immunity](https://www.autoimmuneinstitute.org/research_updates/a-fresh-look-at-viruses-what-survivors-can-teach-us-about-immunity/) **Published:** May 20, 2026 **Author:** Carolyn Serraino **Excerpt:** Researchers at LJI studied Ebola and Lassa survivors to identify rare antibodies that could guide future vaccines, therapies, and outbreak preparedness. **Content:** **May 20, 2026 \| LJI Live from the Lab Webinar** **[La Jolla Institute for Immunology](https://www.autoimmuneinstitute.org/gai-and-la-jolla-institute-for-immunology/ "GAI and La Jolla Institute for Immunology") (LJI)**‘s latest [Live from the Lab](https://www.lji.org/events/live-from-the-lab/) webinar, ***A Fresh Look at Viruses***, featured graduate researchers **Onyeka Chukwudozie** and **Kelly Schaefer** and was moderated by **LJI President and CEO Erica Ollmann Saphire, PhD, MBA**. #### The discussion explored how studying survivors of Lassa fever, Ebola, and related viral infections may help researchers uncover immune responses that could inform future vaccines and antibody-based therapies. Opening the event, Saphire reflected on her own decades of research studying Ebola, Lassa virus, and other emerging viral threats. She described work that has taken her from high-containment laboratories to outbreak regions around the world and emphasized that preparedness begins long before a disease reaches international headlines. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/05/GAI-LJI-Live-from-the-Lab-A-Fresh-Look-at-Viruses-1024x768.png) ## New Insights Into Lassa Virus Immunity Chukwudozie focused on Lassa fever, a rodent-borne viral hemorrhagic disease that is endemic throughout parts of West Africa. #### Despite causing hundreds of thousands of infections each year and severe complications ranging from hearing loss to pregnancy-related mortality, there are currently no approved vaccines or antibody therapies for Lassa fever. One challenge is that several distinct viral lineages circulate across West Africa, making it difficult to develop broadly effective interventions. Working with collaborators in Nigeria, Chukwudozie analyzed blood samples from Lassa survivors and exposed individuals to better understand how the immune system responds to different forms of the virus. He reported that many survivors produced antibodies capable of recognizing multiple Lassa lineages, and a small number demonstrated broadly neutralizing responses against all tested lineages. The findings suggest that at least some people can develop immune responses that recognize diverse forms of the virus, providing important clues for future vaccine and therapeutic research. One particularly striking example involved a 50-year-old survivor from southwestern Nigeria. Chukwudozie showed that her antibodies targeted multiple distinct regions of the virus’s surface glycoprotein, including the top, apex, side, base, and an additional region near the extreme base of the structure. #### Rather than focusing on a single vulnerable site, her immune system generated antibodies against several different parts of the viral protein, illustrating the complexity and breadth of immune responses that can develop following infection. Chukwudozie also described the extensive fieldwork behind the study, including traveling to outbreak regions, working directly with Nigerian hospitals and laboratories, and partnering with local scientists to collect and process samples. He emphasized that understanding diseases such as Lassa fever requires close collaboration with the communities most affected by them. ## Searching for Broadly Protective Ebola Antibodies Schaefer’s presentation focused on filoviruses, the family of viruses that includes Ebola and Marburg viruses. #### While effective antibody therapies exist for some Ebola virus species, most current treatments are highly specific and do not work broadly across the entire filovirus family. This creates challenges during outbreaks, particularly when laboratory confirmation is delayed or when multiple related viruses circulate in the same region. To search for broader immune protection, Schaefer and her collaborators studied blood samples from individuals in the Democratic Republic of the Congo who were likely exposed to multiple filoviruses over their lifetimes. The project required years of collaboration, fieldwork, and sample collection in remote regions where outbreaks have repeatedly occurred. Using specialized single-cell screening technology, the researchers examined millions of immune cells in search of rare antibodies with unusually broad activity. Their search led to the discovery of a single antibody-producing cell that generated an antibody capable of recognizing all mammalian filoviruses tested in the study. The antibody also showed neutralizing activity and targeted a region of the viral glycoprotein that appears to be conserved across the filovirus family. Because only one cell among millions carried this antibody sequence, Schaefer noted just how rare the response appears to be. #### Reflecting on the moment the signal first appeared on the screening instrument, she described it as “the most exciting day of my scientific career so far” and said it was “so incredibly fulfilling to finally see this.” Additional laboratory testing will be needed to determine whether the antibody can eventually be developed into a therapeutic candidate. However, the discovery offers a potential path toward treatments that could work against multiple Ebola and Marburg viruses rather than a single species. Both presentations highlighted a common theme: survivors’ immune systems may hold important clues for fighting future outbreaks. By studying the antibodies generated during natural infection, researchers hope to better understand what effective protection looks like and use those insights to guide the next generation of vaccines, therapies, and diagnostic tools. Saphire closed by emphasizing that progress depends on sustained investment in immunology research, surveillance, antibody discovery, and collaborations with scientists and healthcare teams in the regions where outbreaks occur. **Category:** Events, Research Studies, Risk Factors --- ### [Scientists Receive Funding to Watch Inflammation in Real Time](https://www.autoimmuneinstitute.org/research_updates/scientists-receive-funding-to-watch-inflammation-in-real-time/) **Published:** May 18, 2026 **Author:** Carolyn Serraino **Content:** Biologists have made incredible discoveries using dead tissues – those that have been extracted from a live biological system, frozen, or fixed with harsh chemicals. While useful, this model doesn’t quite represent living beings and only gives scientists glimpses of biology at one time. Scientists can take multiple samples over a period of time, but this practice can potentially miss out on important phenomena that can’t be captured at a low temporal resolution. Recently, [Biohub announced that it is funding 15 teams](https://biohub.org/blog/biologys-blind-spot/) to better understand how [inflammation](https://www.autoimmuneinstitute.org/articles/inflammation-a-driving-force-of-autoimmune-disease "Inflammation: A Driving Force of Autoimmune Disease") and other biological processes happen in real time and across an entire tissue. This spatiotemporal omics approach will help scientists understand what genes, proteins, and metabolites are present and how they change in the course of inflammation or autoimmune disease. Projects funded include those meant to understand the fundamentals of inflammation and immune regulation while others focus on a specific autoimmune disease. ### What is spatiotemporal omics?+ Omics is the study of the totality of a particular molecule found in a biological sample. These molecules could include all the DNA, all the genes, all the proteins, or all the metabolites found in a sample. A sample could be a cell type, a tissue, or an entire organism. Spatiotemporal means in space and across time. Essentially, spatiotemporal omics is the study of the totality of a type of molecule over time in space in a sample. ##### **Citation** (2026, May 18). Watching inflammation in real time. Biohub. <https://biohub.org/blog/biologys-blind-spot/> **Category:** Research Studies --- ### [Vivian Pinn Symposium Highlights Data and Women’s Health](https://www.autoimmuneinstitute.org/research_updates/vivian-pinn-symposium-highlights-data-and-womens-health/) **Published:** May 15, 2025 **Author:** Carolyn Serraino **Content:** *May 15, 2025* Today, the **NIH Office of Research on Women’s Health (ORWH) held its 9th Annual Vivian W. Pinn Symposium**, bringing together experts in data science, women’s health, bioethics, [artificial intelligence (AI)](https://www.autoimmuneinstitute.org/articles/the-promise-of-ai-in-autoimmune-disease-from-early-detection-to-personalized-care "The Promise of Artificial Intelligence in Autoimmune Disease Healthcare"), and health equity. While the symposium covered a broad range of topics, many discussions were highly relevant to autoimmune disease, particularly the ongoing need for more representative health data, better inclusion of women in research, and more [personalized approaches to care](https://www.autoimmuneinstitute.org/articles/personalized-medicine-for-autoimmune-diseases "Personalized Medicine for Autoimmune Diseases"). [Watch Here](https://videocast.nih.gov/watch/d70b6286-d5db-11f0-9cf9-12c45c580ad9) ORWH Director Janine Clayton, M.D., FARVO, emphasized the importance of considering biological, social, and structural determinants of health when studying disease and designing care. Speakers repeatedly highlighted that health outcomes are shaped not only by [genetics](https://www.autoimmuneinstitute.org/articles/how-sex-genetics-influence-autoimmunity "How Sex & Genetics Influence Autoimmunity"), but also by factors such as geography, socioeconomic status, access to care, and systemic inequities. These themes are especially relevant to autoimmune disease, which disproportionately affects women and is often influenced by complex interactions between immune function, [environmental exposures](https://www.autoimmuneinstitute.org/articles/autoimmunity-on-the-rise "Autoimmunity on the Rise"), [stress](https://www.autoimmuneinstitute.org/articles/stress-autoimmune-disease-navigating-the-complex-relationship "Stress & Autoimmune Disease: Navigating the Complex Relationship"), infection, [access to care](https://www.autoimmuneinstitute.org/articles/navigating-autoimmune-care-with-limited-resources "Navigating Autoimmune Care With Limited Resources"), and social determinants of health. Delayed diagnosis, underrepresentation in research, fragmented care, and disparities in outcomes remain major challenges across many autoimmune diseases. The symposium’s capstone speaker, Raquel Hill, Ph.D., discussed how ZIP codes and lived environments can strongly predict health outcomes and life expectancy, arguing that biomedical research must better integrate environmental and socioeconomic data into electronic health records and research systems. She also addressed challenges involving privacy, underrepresentation, and data sharing for smaller populations. Several presentations focused on improving representation in health research. Melissa Buffalo, M.S., CEO of the American Indian Cancer Foundation, discussed how small sample sizes and historical exclusion can make some communities effectively “invisible” in datasets, limiting meaningful analysis and contributing to health disparities. These concerns parallel longstanding issues in autoimmune disease research, where women, minority populations, and people with poorly understood or overlapping conditions are often underrepresented. Other speakers explored how AI, longitudinal health data, [microbiome research](https://www.autoimmuneinstitute.org/gai-library/#microbiome), and computational biology may help advance more individualized care. Liat Shenhav, Ph.D., presented research examining interactions between human milk, the infant microbiome, and immune-related outcomes such as asthma. Although not specifically focused on autoimmune disease, microbiome and early immune development research are increasingly being explored for their potential role in immune dysregulation and autoimmune risk. Throughout the symposium, speakers also emphasized ethical data stewardship, patient trust, privacy protections, and the importance of including communities directly in research and decision-making processes. Vivian W. Pinn, M.D., closed the symposium by reiterating the importance of considering women’s health in trial design and ensuring that research findings are meaningfully shared with participating communities. **Category:** Events, OADR (NIH Office of Autoimmune Disease Research) --- ### [Vivian W. Pinn Symposium: Innovations in Autoimmune Disease Research and Care](https://www.autoimmuneinstitute.org/research_updates/vivian-w-pinn-symposium-innovations-in-autoimmune-disease-research-and-care/) **Published:** May 20, 2024 **Author:** Elevation **Excerpt:** Held on May 15, 2024, the 8th Annual Vivian W. Pinn Symposium brought together leading researchers and healthcare professionals to discuss the latest innovations in autoimmune disease research and care, emphasizing the importance of collaboration and interdisciplinary approaches. The event focused on autoimmune diseases, which disproportionately affect women, and explored how new discoveries are improving understanding, diagnosis, and treatment of these conditions. **Content:** Held on May 15, 2024, the 8th Annual Vivian W. Pinn Symposium brought together leading researchers and healthcare professionals to discuss the latest innovations in autoimmune disease research and care, emphasizing the importance of collaboration and interdisciplinary approaches. The event focused on autoimmune diseases, which disproportionately affect women, and explored how new discoveries are improving understanding, diagnosis, and treatment of these conditions. [Watch Here](https://videocast.nih.gov/watch/d1ac6df3-d5db-11f0-9cf9-12c45c580ad9) #### Introduction and Welcome Dr. Janine Austin Clayton, Director of the Office of Research on Women’s Health (ORWH), opened the symposium by underscoring NIH’s commitment to autoimmune disease research. She noted that NIH has funded over 1,400 grants related to autoimmune disease in recent years, and the newly established Office of Autoimmune Disease Research (OADR) aims to coordinate efforts across multiple institutes and centers. OADR also focuses on advancing research, fostering collaboration, and developing a central autoimmune disease research repository. #### Keynote: Understanding the Immunome – Past, Present, and Future Dr. Jane Buckner, President of the Benaroya Research Institute, discussed the immune system’s role in autoimmune diseases like type 1 diabetes (T1D), rheumatoid arthritis, and psoriasis. T cells, which normally protect the body from infections, mistakenly attack healthy tissues in autoimmune diseases. Dr. Buckner highlighted the role of genetic factors like PTPN2, which impairs regulatory T cells (Tregs) in individuals with T1D. While Treg-based therapies show promise, challenges remain in restoring balance to the immune system. Gene-editing technologies such as CRISPR are being explored to develop antigen-specific Tregs that could provide more targeted therapies for autoimmune diseases. #### Genetics of Childhood-Onset Systemic Lupus Erythematosus (cSLE) Dr. Laura Lewandowski highlighted childhood-onset systemic lupus erythematosus (cSLE), which affects about 20% of lupus patients but is far more severe than the adult-onset form. She discussed the need for more research into cSLE, especially in low-resource regions like sub-Saharan Africa and Southeast Asia, where lupus is more severe, leading to higher mortality rates. Genetic studies on cSLE have revealed a higher genetic load, and ongoing research aims to uncover both common and rare genetic variants that contribute to the disease. Dr. Lewandowski emphasized the importance of studying diverse populations to ensure a comprehensive understanding of lupus globally. #### Anticytokine Autoantibodies Dr. Steven Holland discussed a distinct syndrome prevalent among Southeast Asian immigrants, which involves the presence of anticytokine autoantibodies. These autoantibodies interfere with the immune system’s ability to combat infections like nontuberculous mycobacteria (NTM). His research suggests that exposure to the fungus Aspergillus may trigger autoimmune responses in genetically predisposed individuals. The syndrome primarily affects women and poses a severe risk of opportunistic infections. Advances in treatment, including therapies like rituximab that target B cells producing autoantibodies, have shown promise in managing the condition. #### Genetic and Environmental Risk Factors of Autoimmune Diseases Dr. Alison Motsinger-Reif presented findings from the Personalized Environment and Genes Study (PEGS), a large cohort study aimed at investigating the interplay between genetics, environmental exposures, and autoimmune diseases. PEGS has revealed strong associations between lifestyle factors like smoking and occupational exposures with autoimmune diseases. Dr. Motsinger-Reif highlighted the importance of studying environmental factors to understand disease triggers better and develop personalized healthcare interventions. The PEGS Explorer web tool was introduced to allow researchers to explore these complex associations further. #### Fireside Chat: Turning Hope into Action – Empowering Communities to Advance Science Dr. David Fajgenbaum shared his personal journey with idiopathic multicentric Castleman disease (iMCD), a rare autoimmune disorder. Dr. Fajgenbaum recounted his experience as a patient and how it drove him to co-found the Castleman Disease Collaborative Network (CDCN) to advance research on iMCD. His innovative approach includes repurposing FDA-approved drugs for rare diseases and using artificial intelligence to identify potential treatments. His efforts led to breakthroughs in iMCD treatment and contributed to 15 other potential treatment approaches. Dr. Fajgenbaum also co-founded Every Cure, a nonprofit organization aimed at finding new uses for existing drugs to treat diseases beyond their original purpose. #### Inside Innovation: Intramural Impact at NIH The symposium showcased groundbreaking research efforts within NIH, particularly those focused on the genetics of autoimmune diseases. These studies are crucial for understanding the genetic underpinnings of conditions like childhood-onset systemic lupus erythematosus and T1D. Genetic insights are helping researchers develop more targeted treatments for autoimmune diseases, while NIH initiatives like the Accelerating Medicines Partnership® (AMP® AIM) and the Team Science Leadership Scholars Program foster collaboration across institutes and disciplines. #### Closing Capstone: Making a Difference Dr. Gail Kerr, Professor of Medicine and Chief of Rheumatology at the Washington, D.C. Veterans Affairs Medical Center, discussed her work with veterans suffering from autoimmune diseases like rheumatoid arthritis. Dr. Kerr’s initiatives include the creation of the VA Rheumatoid Arthritis Registry, a national biorepository that collects data to improve patient care for veterans. She also emphasized the need for greater diversity in clinical trials and the medical workforce, highlighting the importance of addressing healthcare disparities among ethnic minorities. #### Concluding Remarks Dr. Vivian Pinn, the symposium’s namesake, delivered the closing remarks, celebrating the progress made in autoimmune disease research. She praised the establishment of the Office of Autoimmune Disease Research as a major step forward in addressing autoimmune conditions that disproportionately affect women. Dr. Pinn emphasized the importance of continued collaboration among researchers, clinicians, and advocacy groups to drive scientific breakthroughs that will improve outcomes for patients with autoimmune diseases. The symposium concluded with a strong message of hope, underlining the critical role that synergy in science plays in advancing understanding, diagnosis, and treatment of autoimmune diseases, while ensuring that the unique health needs of women are addressed through dedicated research and collaborative efforts. [Detailed Meeting Summary](https://orwh.od.nih.gov/sites/orwh/files/docs/2024_8th%20Annual%20Vivian%20W.%20Pinn%20Symposium_Summary_F_508c.pdf) **Category:** Autoimmune Diseases, Events, OADR (NIH Office of Autoimmune Disease Research), Research Studies, Risk Factors --- ### [Vivian Pinn Symposium Panel 1: Translational Autoimmune Research](https://www.autoimmuneinstitute.org/research_updates/vivian-pinn-symposium-panel-1-translational-autoimmune-research/) **Published:** May 11, 2026 **Author:** Carolyn Serraino **Excerpt:** Today, the 10th Anniversary Vivian W. Pinn Symposium, hosted by the NIH Office of Research on Women’s Health (ORWH), is bringing together researchers, clinicians, and public health leaders to discuss advances in women’s chronic disease research across basic science, clinical care, implementation science, and federal partnerships. **Content:** *May 11, 2026* Today, the [10th Anniversary Vivian W. Pinn Symposium](https://orwh.od.nih.gov/events/10th-anniversary-vivian-w-pinn-symposium#event--agenda), hosted by the NIH Office of Research on Women’s Health ([ORWH](https://orwh.od.nih.gov/events/10th-anniversary-vivian-w-pinn-symposium)), is bringing together researchers, clinicians, and public health leaders to discuss advances in women’s chronic disease research across basic science, clinical care, implementation science, and federal partnerships. This year’s symposium, titled ***From Gaps to Gateways: Advancing Research on Chronic Conditions in Women***, focuses on improving understanding of conditions that disproportionately affect women and strengthening the connection between research, policy, and patient outcomes. Throughout the day, speakers are discussing topics ranging from autoimmune disease and cardiovascular health to reproductive care, diagnostics, implementation science, and public-private research partnerships. As the symposium continues, we’ll be sharing some of the talks, discussions, and research highlights that stand out most to us, especially those relevant to autoimmune disease, immune-mediated conditions, and women’s health research. #### Panel 1: Basic & Translational Research – emerging discoveries related to autoimmune disease, cardiovascular risk, obesity, and lymphatic disorders in women. One major topic focused on why women are disproportionately affected by autoimmune diseases such as [lupus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus"). **Montserrat C. Anguera, PhD**, presented research exploring how the X chromosome may shape immune system activity differently in [women and men](https://www.autoimmuneinstitute.org/articles/how-sex-genetics-influence-autoimmunity "How Sex & Genetics Influence Autoimmunity"). Her presentation highlighted that women carry two X chromosomes and that many important immune-related genes are located on the X chromosome itself. Normally, one X chromosome is largely “silenced” through a process called [X-chromosome inactivation](https://www.autoimmuneinstitute.org/research_updates/improper-x-chromosome-inactivation-and-hormonal-fluctuations-linked-to-autoimmunity/ "Improper X Chromosome Inactivation and Hormonal Fluctuations Linked to Autoimmunity"), helping maintain balance in gene expression. The presentation focused on abnormalities involving XIST RNA, a molecule responsible for helping organize and maintain that silencing process. In immune cells from lupus patients, researchers observed abnormal XIST RNA localization patterns alongside altered expression of X-linked immune genes. The findings raise questions about whether disruptions in normal X-chromosome regulation could contribute to the [increased risk of lupus](https://www.autoimmuneinstitute.org/research_updates/why-ms-progression-differs-between-men-and-women/ "Why MS Progression Differs Between Men and Women") and other autoimmune diseases in women. Researchers also discussed how these XIST-related abnormalities appear even during periods of disease remission, suggesting they may reflect deeper underlying immune dysregulation rather than inflammation alone. The work highlights a growing area of autoimmune research focused on understanding how sex-based biological differences may influence immune function, disease susceptibility, and potentially future diagnostic approaches. The panel also examined sex-specific cardiovascular mechanisms linked to obesity and hypertension. **Eric Belin de Chantemèle, DSc**, presented research exploring why obesity may have unique cardiovascular effects in women. The presentation discussed how obesity-related changes in [hormones](https://www.autoimmuneinstitute.org/research_updates/the-role-of-hormones-and-sex-chromosomes-in-autoimmune-disease/ "The Role of Hormones and Sex Chromosomes in Autoimmune Disease") and vascular signaling pathways, including leptin, aldosterone, and mineralocorticoid receptor activity, may contribute to endothelial dysfunction and elevated blood pressure. Researchers also explored the possibility that obesity and [aging](https://www.autoimmuneinstitute.org/articles/aging-and-autoimmune-disease "Aging and Autoimmune Disease"), particularly after menopause, may diminish some of the cardiovascular protection typically associated with the female sex. The work highlighted how sex-specific biology may influence not only disease risk, but also how women respond to potential treatments targeting these pathways. **Rachelle Crescenzi, PhD**, presented translational imaging research involving SALT MRI technology, which is designed to visualize sodium accumulation, adipose tissue, and lymphatic dysfunction in conditions such as lymphedema and lipedema. Researchers explained that improved imaging tools may help distinguish lymphatic disease from obesity and could eventually support future clinical trials and the development of treatments for conditions that currently have limited therapeutic options. One particularly powerful aspect of Dr. Crescenzi’s presentation was a direct imaging comparison between a patient with lymphatic disease and a matched control individual. The scans highlighted differences in adipose tissue composition and tissue characteristics despite otherwise similar measurements, reinforcing that these conditions involve measurable biological differences rather than simply body size or weight alone. #### The example underscored how advanced imaging tools can help validate patient experiences while advancing diagnosis and treatment research by revealing biological variations that might otherwise go unrecognized. Together, the panel highlighted how translational research is increasingly uncovering biological differences that may influence disease risk, diagnosis, and treatment outcomes in women across autoimmune, cardiovascular, and chronic inflammatory conditions. Continue to [ Panel 2: Clinical Research in Women’s Chronic Disease ](https://www.autoimmuneinstitute.org/research_updates/vivian-pinn-symposium-panel-2-clinical-research-in-womens-chronic-disease/), which explores diagnostic delays, endometriosis, sleep apnea in women, and emerging approaches to earlier detection and care. Then continue to [ Panel 3: Social and Behavioral Sciences Research ](https://www.autoimmuneinstitute.org/research_updates/vivian-pinn-symposium-panel-3-social-and-behavioral-sciences-research/), featuring discussions on reproductive healthcare gaps in rheumatology, cardiovascular disease in women, and barriers affecting chronic disease care. **Category:** Events, OADR (NIH Office of Autoimmune Disease Research), Research Studies, Risk Factors --- ### [Vivian Pinn Symposium Panel 3: Social and Behavioral Sciences Research](https://www.autoimmuneinstitute.org/research_updates/vivian-pinn-symposium-panel-3-social-and-behavioral-sciences-research/) **Published:** May 11, 2026 **Author:** Carolyn Serraino **Excerpt:** Following the symposium’s earlier panels on translational and clinical research, Panel 3 focused on “Social and Behavioral Sciences Research” and explored reproductive healthcare gaps in rheumatology, cardiovascular disease in women, and barriers affecting chronic disease care. **Content:** *May 11, 2026* #### “We as rheumatologists have to start screening routinely for reproductive goals at the time of diagnosis, annually, and always when we prescribe a teratogen as the minimum standard of care” – Mehret Birru Talabi, MD, PhD Following the symposium’s earlier panels on translational and clinical research, **Panel 3 focused on “Social and Behavioral Sciences Research”** and the broader [real-world challenges](https://www.autoimmuneinstitute.org/gai-library/#real-life) women face [navigating chronic disease](https://www.autoimmuneinstitute.org/gai-library/#living-with-chronic-illness), healthcare systems, and long-term care disparities. The panel opened with **Holly J. Jones, PhD, RN, MSN, APRN-CNP, FAHA**, who discussed cardiovascular disease in women and the importance of recognizing sex-specific differences in cardiovascular risk, presentation, and outcomes. The presentation emphasized that women’s cardiovascular symptoms and risk factors are not always reflected in traditional clinical models, contributing to underrecognition and delayed care. **Mehret Birru Talabi, MD, PhD**, then presented on reproductive healthcare gaps in rheumatology. Women with rheumatic diseases often navigate complex decisions surrounding fertility, pregnancy, contraception, breastfeeding, medication safety, and disease management, frequently while receiving fragmented or inconsistent guidance. Dr. Talabi discussed how reproductive health conversations are often overlooked in chronic disease care despite the fact that many autoimmune diseases disproportionately affect women during their reproductive years. [ Explore Our Pregnancy and Autoimmune Disease Series ](https://www.autoimmuneinstitute.org/gai-library/#pregnancy) The discussion also highlighted how uncertainty surrounding [medication risks](https://www.autoimmuneinstitute.org/articles/biologics-for-autoimmune-disease-what-you-should-know "Biologics for Autoimmune Disease: What You Should Know"), [pregnancy outcomes](https://www.autoimmuneinstitute.org/articles/how-autoimmune-disease-affects-fertility "How Autoimmune Disease Affects Fertility"), and [disease activity](https://www.autoimmuneinstitute.org/articles/outbursts-in-autoimmunity-disease-flare-ups "Outbursts in Autoimmunity: Disease Flare-ups") can create significant emotional and medical burdens for patients. Researchers emphasized the importance of coordinated care between rheumatologists, obstetric specialists, and patients themselves, as well as the need for healthcare systems that proactively address reproductive goals rather than treating them as secondary concerns. The panel concluded with **Kamila Alexander, PhD, RN, MSN/MPH**, whose presentation focused on intimate partner violence, healthcare access, and safety strategies among Black women living with HIV. Across the session, speakers highlighted how women’s chronic disease experiences are influenced not only by biology, but also by healthcare access, communication gaps, social determinants of health, and systems that have historically overlooked sex-specific needs and lived experiences. Continue exploring the Vivian Pinn Symposium discussions with [ Panel 1: Translational Autoimmune Research ](https://www.autoimmuneinstitute.org/research_updates/vivian-pinn-symposium-panel-1-translational-autoimmune-research/) and [ Panel 2: Clinical Research in Women’s Chronic Disease ](https://www.autoimmuneinstitute.org/research_updates/vivian-pinn-symposium-panel-2-clinical-research-in-womens-chronic-disease/). **Category:** Events, OADR (NIH Office of Autoimmune Disease Research), Research Studies, Rheumatoid Arthritis, Risk Factors --- ### [LJI Webinar to Highlight Global Virus Research Efforts](https://www.autoimmuneinstitute.org/research_updates/lji-webinar-to-highlight-global-virus-research-efforts/) **Published:** May 6, 2026 **Author:** Carolyn Serraino **Content:** [La Jolla Institute for Immunology](https://www.autoimmuneinstitute.org/gai-and-la-jolla-institute-for-immunology/ "GAI and La Jolla Institute for Immunology") (LJI) announced an upcoming installment of its *Live from the Lab* webinar series focused on emerging virus research and global infectious disease efforts. The virtual event, titled ***A Fresh Look at Viruses, is scheduled for May 20, 2026,*** and will feature discussions on Ebola and Lassa virus research taking place in African countries. The webinar will be moderated by virologist and immunologist Erica Ollmann Saphire, Ph.D., MBA, President and CEO of LJI, and will feature researchers Kelly Shaffer and Onyeka Chukwudozie, Ph.D. The discussion will provide a behind-the-scenes look at how fieldwork in remote regions is contributing to discoveries about dangerous viral diseases such as Ebola and Lassa fever. While the webinar is centered on infectious disease research, the broader themes are also relevant to autoimmune disease and immune-mediated conditions. Viral infections have long been studied as potential triggers or contributors to immune dysregulation, chronic inflammation, and post-viral complications. Understanding how the immune system responds to high-risk viral infections may help researchers better understand immune activation more broadly, including mechanisms involved in autoimmune disease. LJI also emphasized its broader mission of applying immunology research to cancer, autoimmune, infectious, and neurodegenerative diseases to make disease prevention, diagnosis, and treatment more precise and effective. [Click to Register](https://lji-org.zoom.us/webinar/register/WN_t_7WYVxnSJG5EOn4Q460AQ#/registration) **Category:** Events --- ### [NIH ADCC Merges into New Office of Autoimmune Disease Research](https://www.autoimmuneinstitute.org/research_updates/nih-adcc-merges-into-new-office-of-autoimmune-disease-research/) **Published:** April 14, 2023 **Author:** Elevation **Excerpt:** The NIH's Autoimmune Diseases Coordinating Committee (ADCC), was absorbed into the newly formed Office of Autoimmune Disease Research (OADR) within the Office of Research on Women’s Health (ORWH). **Content:** In December 2022, the National Institute of Health’s (NIH) Autoimmune Diseases Coordinating Committee (ADCC), initially established in 1998, was absorbed into the newly formed [Office of Autoimmune Disease Research](https://orwh.od.nih.gov/OADR-ORWH) (OADR) within the [Office of Research on Women’s Health](https://orwh.od.nih.gov/) (ORWH). The ADCC, which facilitated collaboration across NIH, federal agencies, and advocacy organizations, held its [final meeting](https://www.niaid.nih.gov/sites/default/files/adcc-fatigue-agenda-13dec2022.pdf) in December 2022. The creation of OADR consolidates the functions of ADCC and shifts autoimmune disease research coordination under ORWH, reflecting the significant burden of autoimmune diseases, which [disproportionately affect women](https://www.autoimmuneinstitute.org/articles/how-sex-genetics-influence-autoimmunity "How Sex & Genetics Influence Autoimmunity"). This transition aligns with recommendations from the National Academies of Sciences, Engineering, and Medicine (NASEM), aiming to enhance collaboration across NIH’s institutes, centers, and offices (ICOs). #### The NIH [press release](https://content.govdelivery.com/accounts/USNIHORWH/bulletins/3581a39) about the switchover stated: #### ORWH Announces Formation of New Office of Autoimmune Disease Research On April 12, 2023, ORWH Director Janine A. Clayton, M.D., FARVO, announced the establishment of the NIH Office of Autoimmune Disease Research (OADR) during the [58th Meeting of the Advisory Committee on Research on Women’s Health](https://orwh.od.nih.gov/about/newsroom/events/58th-meeting-of-nih-advisory-committee-on-research-on-womens-health). The creation of this office within ORWH was mandated by Congress in the [Consolidated Appropriations Act, 2023](https://www.congress.gov/bill/117th-congress/house-bill/2617/text) (Public Law 117–328), stemming from recommendations in the National Academies of Sciences, Engineering, and Medicine’s 2022 report titled [Enhancing NIH Research on Autoimmune Disease](https://nap.nationalacademies.org/read/26554/chapter/1), which highlighted the need for greater coordination across NIH regarding autoimmune disease efforts. “The congressional charge for ORWH to establish the Office of Autoimmune Disease Research is a cross-cutting effort,” Dr. Clayton notes. “ORWH is enthusiastic about the opportunity to lead the next chapter of autoimmune disease research at NIH, leveraging our ORWH perspective to complement, synergize with, and catalyze NIH Institute, Center, and Office (ICO) investments through integrative research approaches to accelerate progress in support of patients.” Autoimmune diseases occur when the body’s immune system malfunctions and mistakenly attacks healthy cells, tissues, and organs. These diseases can be acute or chronic and are often disabling, and they can affect specific organs or multiple organ systems. Many autoimmune diseases are understudied and have limited treatment options, and some have unknown causes or origins. Approximately 8% of the U.S. population is living with an autoimmune disease, and women constitute nearly 80% of this group. The disproportionate burden of autoimmune disease borne by women underscores the importance of understanding the influences of sex and gender in health and disease, a critical part of ORWH’s mission. OADR-ORWH is working with NIH leadership, other ICOs, researchers, clinicians, patient advocacy groups, and the public to ensure that plans for the new office synergize with other NIH efforts, observe congressional directives, address research gaps, and serve patients with autoimmune disorders. OADR-ORWH is also establishing the Coordinating Committee on Autoimmune Disease Research, which will provide a structured forum to collaborate and leverage autoimmune expertise across ICOs. This committee will support strategic decisions and engagement with community stakeholders. Additionally, OADR-ORWH has developed principles to guide decisions about funding for research on autoimmune diseases. These principles are broadly reflective of the [*2019–2023 Trans-NIH Strategic Plan for Women’s Health Research*](https://orwh.od.nih.gov/about/trans-nih-strategic-plan-womens-health-research), which was developed by a collaborative group of leaders from the ICOs, external stakeholders, and the public. OADR-ORWH is excited to share current open funding opportunities for research on autoimmune diseases: - [NOT-OD-23-112: Notice of Special Interest (NOSI): EXposome in Autoimmune Disease Collaborating Teams PLANning Awards (EXACT-PLAN) (Clinical Trials Not Allowed) ](https://grants.nih.gov/grants/guide/notice-files/NOT-OD-23-112.html)(fiscal year \[FY\] 2023) - [RFA-OD-23-013: Understanding Chronic Conditions Understudied Among Women (R21 Clinical Trial Optional)](https://grants.nih.gov/grants/guide/rfa-files/RFA-OD-23-013.html) (FY 2024) - [RFA-OD-23-014: Understanding Chronic Conditions Understudied Among Women (R01 Clinical Trial Optional)](https://grants.nih.gov/grants/guide/rfa-files/RFA-OD-23-014.html) (FY 2024) **Category:** Clinical Trials, OADR (NIH Office of Autoimmune Disease Research), Research Studies --- ### [Key Goals of NIH’s Office of Autoimmune Disease Research](https://www.autoimmuneinstitute.org/research_updates/key-goals-of-nihs-office-of-autoimmune-disease-research/) **Published:** June 5, 2023 **Author:** Elevation **Excerpt:** Congress directed the NIH in 2022 to create the Office of Autoimmune Disease Research (OADR) within the Office of Research on Women’s Health (ORWH). The OADR focuses on coordinating research efforts across multiple NIH institutes, fostering innovation, and promoting collaboration. **Content:** According to the NIH, autoimmune diseases affect around 8% of the U.S. population, with nearly [80% of those affected being women](https://www.autoimmuneinstitute.org/articles/how-sex-genetics-influence-autoimmunity "How Sex & Genetics Influence Autoimmunity"). Despite the large burden of these conditions, many autoimmune diseases remain understudied, and treatment options are limited. **To address this, Congress [directed the NIH in 2022](https://www.autoimmuneinstitute.org/research_updates/nih-adcc-merges-into-new-office-of-autoimmune-disease-research/ "NIH ADCC Merges into New Office of Autoimmune Disease Research") to create the [Office of Autoimmune Disease Research](https://orwh.od.nih.gov/OADR-ORWH) (OADR) within the Office of Research on Women’s Health (ORWH).** The OADR focuses on coordinating research efforts across multiple NIH institutes, fostering innovation, and promoting collaboration. It also evaluates NIH’s autoimmune disease research portfolio and supports planning and resource sharing to advance the field. By bringing together expertise from across NIH, OADR aims to drive progress in autoimmune disease research and improve treatment outcomes for the millions affected. #### Key goals include: - Coordinating the development of a strategic research plan across multiple NIH institutes and centers. - Identifying emerging areas of innovation and research opportunities in autoimmune diseases. - Fostering collaborative research across NIH institutes, centers, and offices (ICOs). - Annually evaluating NIH’s autoimmune disease research (ADR) portfolio. - Providing resources to support research planning, collaboration, and innovation. - Developing a publicly accessible central repository for autoimmune disease research. **Category:** Clinical Trials, OADR (NIH Office of Autoimmune Disease Research), Research Studies --- ### [February 2024 OADR Meeting: Key Updates on Autoimmune Disease Research](https://www.autoimmuneinstitute.org/research_updates/february-2024-oadr-meeting-key-updates-on-autoimmune-disease-research/) **Published:** February 23, 2024 **Author:** Elevation **Excerpt:** This meeting of the Office of Autoimmune Disease Research (OADR) under the Office of Research on Women's Health (ORWH) at the National Institutes of Health (NIH) featured updates from Dr. Vicki Shanmugam. The meeting opened with an overview of OADR's establishment, which was mandated by Public Law 117-328 and the 2023 Consolidated Appropriations Act. **Content:** ##### *Meeting held virtually on February 23, 2024* This meeting of the Office of Autoimmune Disease Research (OADR) under the Office of Research on Women’s Health (ORWH) at the National Institutes of Health (NIH) featured updates from Dr. Vicki Shanmugam. The meeting opened with an overview of OADR’s establishment, which was mandated by [Public Law 117-328](https://www.appropriations.senate.gov/imo/media/doc/Division%20H%20-%20LHHS%20Statement%20FY23.pdf#page=83) and the 2023 Consolidated Appropriations Act. This law tasked OADR with coordinating a multi-institute research plan, identifying emerging research areas, fostering collaboration, evaluating the autoimmune disease research portfolio, and creating a central repository for autoimmune disease research. OADR-ORWH has developed an initial research portfolio encompassing 144 autoimmune diseases categorized into 15 research areas, which are being evaluated as part of the NIH’s autoimmune research analysis. Meeting participants were enthusiastic about the concept of a centralized autoimmune disease research repository, with researchers proposing the following: a biofluid repository; a database with photographic representation of disease manifestation; and an integrated database with immune repertoire, genetic, clinical, and phenotypic data, and environmental and pathogen exposure data. Participants noted expected challenges, including the enormity of project scope, patient confidentiality, patient engagement, and data curation and management. Ensuring diversity and representation from all populations was also emphasized. The need for phenotyping technologies, guidelines for sharing phenotyping, and the development of prediction models was agreed on by several researchers.  In fiscal year 2023, OADR-ORWH supported a total of 41 awards across 12 separate NIH institutes and centers. This included 15 extramural co-funding awards, 3 R56 bridge funding awards, 2 Accelerating Medicines Partnership® Autoimmune and Immune-Mediated Diseases ([AMP® AIM](https://www.nih.gov/research-training/accelerating-medicines-partnership-amp/autoimmune-immune-mediated-diseases)) awards, 10 intramural co-funding awards, 5 intramural scientific fellowships, and 6 [EXACT-PLAN](https://grants.nih.gov/grants/guide/notice-files/NOT-OD-23-112.html) (EXposome in Autoimmune Disease Collaborating Teams PLANning) awards. The EXACT-PLAN Awards were developed by OADR-ORWH with the [National Institute of Arthritis and Musculoskeletal and Skin Diseases](https://www.niams.nih.gov/), the [National Institute of Environmental Health Sciences](https://www.niehs.nih.gov/), and additional NIH institute, center, and office (ICO) partners to support the design, development, and implementation of a future, national, interdisciplinary, collaborative, team science research network that will advance the study of the exposome in autoimmune disease. These awards spanned basic to translational, clinical, and public health research focused on autoimmune diseases. Additionally, OADR has an active [Request for Information](https://grants.nih.gov/grants/guide/notice-files/NOT-OD-24-049.html) (RFI) seeking input for the NIH-wide Strategic Plan for Autoimmune Disease Research, with comments being accepted until March 1, 2024. Responses will guide OADR’s strategic planning process. Other study topics raised by participants included investigation into commonly utilized non-medical approaches to disease management, inflammatory responses as a driver of neurodegenerative diseases, development of biomarkers, and better approaches to medication termination. **Category:** Autoimmune Diseases, Events, OADR (NIH Office of Autoimmune Disease Research), Research Studies --- ### [ScienceTALKS Recap: Why Autoimmune Diseases Are More Common in Women](https://www.autoimmuneinstitute.org/research_updates/sciencetalks-recap-why-autoimmune-diseases-are-more-common-in-women/) **Published:** April 23, 2024 **Author:** Elevation **Excerpt:** The April 23, 2024, OADR-ORWH ScienceTALKS webinar explored why autoimmune diseases are more prevalent in women, with insights into the role of X-chromosome inactivation. The event featured prominent researchers, including Dr. Montserrat Anguera, Dr. Diana Dou, and Dr. Brendan Antiochos, who presented their findings on the genetic and epigenetic mechanisms that influence autoimmune diseases, such as lupus. **Content:** The [April 23, 2024, OADR-ORWH ScienceTALKS webinar](https://orwh.od.nih.gov/about/newsroom/events/oadr-orwh-sciencetalks-0 "April 23, 2024, OADR-ORWH ScienceTALKS webinar") explored why autoimmune diseases are [more prevalent in women](https://www.autoimmuneinstitute.org/articles/how-sex-genetics-influence-autoimmunity "How Sex & Genetics Influence Autoimmunity"), with insights into the role of X-chromosome inactivation. The event featured prominent researchers, including Dr. Montserrat Anguera, Dr. Diana Dou, and Dr. Brendan Antiochos, who presented their findings on the genetic and epigenetic mechanisms that influence autoimmune diseases, such as lupus. #### **Dr. Montserrat Anguera’s Study on X-Chromosome Inactivation Mechanisms in Immune Cells**: - Investigated how the X chromosome is inactivated in immune cells. - Found that in autoimmune diseases like lupus, XIST RNA fails to properly silence the X chromosome in B cells, leading to overactive immune responses. - Developed a mouse model where the Xist gene was deleted, showing that improper X-chromosome inactivation contributes to autoimmune conditions. #### **Dr. Diana Dou’s Study on** Xist Ribonucleoproteins Promote Increased Prevalence for Autoimmunity in Females: - Focused on how XIST RNPs interact with proteins targeted by the immune system in autoimmune diseases. - Demonstrated that these interactions prolong immune activation, leading to chronic inflammation. - Used a mouse model to show that XIST upregulation is linked to increased autoimmune activity, particularly in female subjects. #### **Dr. Brendan Antiochos’ Study on XIST lncRNA as a Sex-Specific Reservoir of TLR7 Ligands in Lupus**: - Explored the role of XIST as a ligand for toll-like receptor 7 (TLR7), which senses RNA in immune cells. - Found that XIST activates TLR7, contributing to immune system overactivity in autoimmune diseases. - Showed that XIST is overexpressed in women with lupus and correlates with increased disease activity. The panel concluded with discussions on the future of XIST research, emphasizing the importance of interdisciplinary collaboration, the need for more male participant data in autoimmune studies, and the potential for new diagnostics and treatments based on these discoveries. The ScienceTALKS session provided critical insights into how genetic and epigenetic factors contribute to the gender disparity in autoimmune disease prevalence, with promising implications for future research and therapies. [Detailed Meeting Summary](https://orwh.od.nih.gov/sites/orwh/files/docs/ScienceTALKS_Xist%20Event%20Summary_Speakers-508c.pdf) **Category:** Autoimmune Diseases, Events, OADR (NIH Office of Autoimmune Disease Research), Research Studies, Risk Factors --- ### [July 2024 OADR Meeting: Key Updates on Autoimmune Disease Research](https://www.autoimmuneinstitute.org/research_updates/july-2024-oadr-meeting-key-updates-on-autoimmune-disease-research/) **Published:** July 25, 2024 **Author:** Elevation **Excerpt:** The meeting held on July 25, 2024, by the Office of Autoimmune Disease Research (OADR) under the Office of Research on Women’s Health (ORWH) highlighted significant updates in autoimmune disease research. A key update was the establishment of the OADR in alignment with Public Law 117-328, which mandates developing a multi-institute strategic research plan and creating a central autoimmune disease research repository. **Content:** ##### *Meeting held virtually on July 25, 2024* The [meeting](https://orwh.od.nih.gov/about/newsroom/events/updates-on-oadr-orwh-session-4 "meeting"), held by the Office of Autoimmune Disease Research (OADR) under the Office of Research on Women’s Health (ORWH), was opened by Dr. Vicki Shanmugam, who highlighted significant updates in autoimmune disease research. Dr. Shanmugam reflected on artwork by [Shelley Lowenstein](https://shelleylowenstein.com/home.html), inspired by her daughter’s [type 1 diabetes](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/diabetes-type-1/ "Diabetes, Type 1 (T1D)") diagnosis, and provided a background on the autoimmune disease research landscape. A key update was the establishment of the OADR in alignment with [Public Law 117-328](https://www.appropriations.senate.gov/imo/media/doc/Division%20H%20-%20LHHS%20Statement%20FY23.pdf#page=83), which mandates developing a multi-institute strategic research plan and creating a central autoimmune disease research repository. Additionally, Dr. Shanmugam presented the publication of a [Notice of Special Interest](https://grants.nih.gov/grants/guide/notice-files/NOT-OD-24-145.html) (NOSI) to advance autoimmune disease research through common data elements. Dr. Shanmugam shared an overview of the [autoimmune disease research portfolio](https://orwh.od.nih.gov/OADR-ORWH/ADR-Across-NIH), which consists of 144 diseases, and a timeline of OADR-ORWH activities. In April and May 2024, OADR-ORWH published an [article](https://acrjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/art.42837) in *Arthritis and Rheumatology* spotlighting the establishment of the office and hosted the inaugural [ScienceTALKS](https://orwh.od.nih.gov/about/newsroom/events/oadr-orwh-sciencetalks-0) and the [8th Annual Vivian W. Pinn Symposium](https://orwh.od.nih.gov/about/newsroom/events/8th-annual-vivian-w-pinn-symposium). Dr. Shanmugam also shared progress on the Exposome in Autoimmune Disease Collaborating Teams PLANning Awards ([EXACT-PLAN](https://orwh.od.nih.gov/in-the-spotlight/all-articles/meet-2023-exact-plan-award-recipients)), which aims to uncover the environmental exposures influencing autoimmune diseases. The team’s recent summit in Seattle fostered collaborative discussions on research advancements in this area. Dr. Shanmugam [spotlighted](https://orwh.od.nih.gov/in-the-spotlight/all-articles/coordination-and-collaboration-to-support-exposome-research-in-autoimmune-diseases) ongoing strategic planning efforts and NIH’s editorial contribution to *Arthritis Care & Research*, which emphasized the role of environmental factors in autoimmune disease research. Further, she highlighted funding opportunities for career reintegration and women’s health research. The meeting concluded with a roundtable discussion where participants, including advocacy groups, raised concerns about viral triggers of autoimmune diseases and the inclusion of specific populations in research. Upcoming events, such as the [August ScienceTALKS webinar](https://orwh.od.nih.gov/about/newsroom/events/oadr-orwh-sciencetalks), were also announced. **Category:** Autoimmune Diseases, Events, OADR (NIH Office of Autoimmune Disease Research), Research Studies, Type 1 Diabetes --- ### [Autoimmune Disease Research at Risk Amid Federal Cuts](https://www.autoimmuneinstitute.org/research_updates/autoimmune-disease-research-federal-cuts/) **Published:** March 26, 2025 **Author:** Carolyn Serraino **Excerpt:** *Updated March 28, 2025* Following public outcry and advocacy efforts, the NIH has reversed its decision to cancel up to 45 RECOVER research grants focused on Long COVID. Who is advocating for autoimmune disease within the federal system right now? What research priorities might be delayed or dropped? When will open communication with the public resume? **Content:** #### Updated March 28, 2025 **Following public outcry and advocacy efforts, the NIH has reversed its decision to cancel up to 45 RECOVER research grants focused on Long COVID.** These grants, originally rescinded earlier in the week, included critical studies on pediatric Long COVID, post-exertional malaise, vascular dysfunction, persistent viral reservoirs, and the link between SARS-CoV-2 and diabetes. Patient advocates, including RECOVER representatives, confirmed the reinstatement. Researchers noted that some studies were nearing completion and that this restoration prevents years of work from being lost. The move is seen as a rare win for the chronic illness community amid broader federal cuts, including the expected closure of the Office of Long COVID Research and Practice. *We’ve preserved the original update below for full context.* *March 26, 2025* #### **How Federal Disruptions Are Affecting the Autoimmune Community** If you live with autoimmune disease or care for someone who does, you may have noticed that the Office of Autoimmune Disease Research ([OADR-ORWH](https://orwh.od.nih.gov/OADR-ORWH)) has gone quiet. This office, part of the National Institutes of Health ([NIH](https://www.nih.gov/)), plays a central role in autoimmune disease research coordination. It helps align work across NIH institutes, reports progress to Congress, and creates opportunities for public education and engagement. That lack of communication is concerning. When communication stops, clarity fades. It becomes harder to follow research progress, track funding priorities, or see how agencies are working together. And for people living with these complex, often invisible illnesses, it can feel like being pushed even further to the margins. ##### Whether you’re a patient, caregiver, clinician, or researcher, this moment raises urgent questions: **Who is advocating for autoimmune disease within the federal system right now? What research priorities might be delayed or dropped? When will open communication with the public resume?** #### ****OADR Quiet as NIH Faces Major Federal Cuts**** Since January, OADR-ORWH has canceled multiple public-facing events, [removed and later restored its 2023–2024 report without explanation](https://www.autoimmuneinstitute.org/research_updates/the-disappearance-of-the-oadr-orwh-report/ "The Disappearance of the OADR-ORWH Report"), and [abruptly canceled its March 4 *ScienceTALKS* session](https://www.autoimmuneinstitute.org/research_updates/another-canceled-oadr-event-and-still-no-clear-answers/ "Another Canceled OADR Event—and Still No Clear Answers") on emerging cell therapies. OADR-ORWH has offered no explanation for the cancellations or when normal operations might resume. These disruptions appear to align with a [sweeping federal directive issued in February 2025](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/03/federal-rif-guidance-doge-initiative-2025.pdf). Under the “Department of Government Efficiency” initiative, agencies were ordered to submit plans for workforce reductions and reorganization by March 13. The guidance instructed agency heads to eliminate functions “not statutorily mandated,” reduce staff, and consolidate operations often at the Department of Health and Human Services (HHS) level, where sub-agency leaders may have limited input. NIH could lose up to 5,000 staff members. Though OADR-ORWH hasn’t been specifically named, the timing and silence surrounding its activities are hard to ignore. #### **Risks to Chronic Illness Research as Long COVID Office Closes** The federal Office of Long COVID Research and Practice is also [expected to shut down](https://www.autoimmuneinstitute.org/covid_timeline/office-of-long-covid-research-and-practice-closure/ "The Federal Long COVID Office Is Closing—Here’s What We Know"), according to recent internal communications. While no formal public announcement has been made and no official closure date has been set, the office is reportedly preparing to wind down operations as part of broader agency restructuring. At the same time, *[Nature](https://www.nature.com/articles/d41586-025-00954-y)* reports that the NIH and CDC have begun terminating nearly $850 million in active COVID-19 research grants, amounting to about 2% of NIH’s total budget. Projects being cut include research on vaccine hesitancy, diversity in science, and post-viral illness. A $577 million antiviral development program has also been eliminated. The CDC is expected to cancel an additional $11.4 billion in pandemic response funding. Like autoimmune conditions, Long COVID represents a [complex, often misunderstood chronic illness](https://www.autoimmuneinstitute.org/covid_timeline/long-covid-follows-a-pattern-of-post-viral-illness/ "Long COVID Isn’t New—It Follows a Pattern of Post-Viral Illness") that has long struggled for recognition and sustained investment. ###### **The Long Covid office is one of the few centralized federal efforts to address post-viral illness. Its possible closure—alongside large-scale research terminations—raises serious concerns that chronic, immune-related conditions are being deprioritized at the federal level.** We don’t yet have all the answers, but we know that transparency, communication, and coordination are essential for the autoimmune disease and chronic illness community. We will continue to monitor developments and advocate for clarity and the resources and representation this community deserves. **Category:** OADR (NIH Office of Autoimmune Disease Research), Policy & Health Decisions --- ### [January 2026 OADR Meeting: Key Updates on Autoimmune Disease Research](https://www.autoimmuneinstitute.org/research_updates/january-2026-oadr-meeting-key-updates-on-autoimmune-disease-research/) **Published:** January 29, 2026 **Author:** Carolyn Serraino **Excerpt:** A brief summary of the January 29, 2026 NIH Office of Autoimmune Disease Research (OADR) virtual meeting, highlighting updates on strategic planning, research infrastructure, funding policy, and ongoing programs. **Content:** ##### *Meeting held virtually on January 29, 2026* The NIH Office of Autoimmune Disease Research (OADR), within the Office of Research on Women’s Health (ORWH), hosted its quarterly “[**Updates on OADR–ORWH**](https://orwh.od.nih.gov/events/updates-on-oadr-orwh-january-29-2026)” virtual session. The discussion, led by Vicki Shanmugam, MBBS, FRCP, FACR, CCD, provided an overview of current priorities, initiatives, and coordination efforts related to autoimmune disease research across the NIH. Key highlights are summarized below. The session referenced the recently launched [**NIH-Wide Strategic Plan for Autoimmune Disease Research (FY26–2030)**](https://www.autoimmuneinstitute.org/research_updates/nih-wide-strategic-plan-for-autoimmune-disease-research/ "NIH Strategic Plan for Autoimmune Disease Research 2026-2030"), which outlines shared priorities across NIH Institutes, Centers, and Offices. The plan is intended to strengthen coordination, accelerate discovery and translation, and improve alignment across autoimmune disease research efforts. Updates were shared on the [**Autoimmune Disease Analysis Platform Testing Space (ADAPTS)**](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/02/Congressional-Directive-6-ADAPTS-OADR-GAI.png "Congressional Directive 6 ADAPTS OADR GAI January 2026"), developed in response to Congressional Directive 6 calling for a repository to support autoimmune disease research. ADAPTS was described as a federated data platform designed to provide a unified view across multiple distributed datasets, allowing data to function as a virtual database without requiring data transfer, reducing reliance on complex extract, transform, and load pipelines, and maintaining governance, privacy, and security while enabling real-time access and data steward control. The session briefly referenced recent [**NIH funding policy updates**](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/02/NIH-Funding-Policy-Updates-OADR-GAI-January-2026.png "NIH Funding Policy Updates OADR GAI January 2026"), including a new framework effective with the [January 2026 Council round](https://grants.nih.gov/news-events/nih-extramural-nexus-news/2025/11/implementing-a-unified-nih-funding-strategy-to-guide-consistent-and-clearer-award-decisions) to guide how funding strategies are developed, implemented, and evaluated across NIH. Additional updates included the use of “Highlighted Topics” in place of some Notices of Special Interest, consolidation of funding opportunities through grants.gov, and references to recent policy notices addressing letters of intent requirements, standardized application forms, and the reopening of extramural activities following the [October 2025 lapse in appropriations](https://www.autoimmuneinstitute.org/research_updates/another-canceled-oadr-event-and-still-no-clear-answers/ "Another Canceled OADR Event—and Still No Clear Answers"). Information was also shared about [**NIH Rare Diseases Day 2026**](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/02/NIH-Rare-Diseases-Day-2026-OADR-GAI-January-2026.png "NIH Rare Diseases Day 2026 OADR GAI January 2026"), scheduled for February 27, 2026, at the Natcher Conference Center on the NIH main campus, with live-stream access available. The event is intended to convene researchers, clinicians, patients, advocates, and other stakeholders across rare and autoimmune disease communities. The session also included a brief update on the [**Nourish Challenge**](https://www.autoimmuneinstitute.org/research_updates/nutrition-and-autoimmunity-nih-nourish-challenge/ "Nutrition and Autoimmunity: NIH NOURISH Challenge"), noting that submissions are under review and winners are being selected. **Category:** Autoimmune Diseases, Events, OADR (NIH Office of Autoimmune Disease Research), Research Studies --- ### [NIH Highlights Autoimmune Research Priority](https://www.autoimmuneinstitute.org/research_updates/nih-highlights-autoimmune-research-priority/) **Published:** February 20, 2026 **Author:** Carolyn Serraino **Excerpt:** The NIH is signaling strong interest in new autoimmune disease research, particularly studies focused on early detection, biomarkers, and the interaction between genetic and environmental risk factors. **Content:** On February 12, 2026, the National Institutes of Health (NIH) identified autoimmune disease research as a current “[Highlighted Topic](https://grants.nih.gov/funding/find-a-fit-for-your-research/highlighted-topics/43),” signaling strong interest in new grant applications in this area. **This is not a new funding program, but rather a notice that the NIH is encouraging researchers to submit proposals that advance understanding of autoimmune diseases.** ### What Is the NIH Looking For? **The NIH is particularly interested in research that:** - Examines how **[genetics](https://www.autoimmuneinstitute.org/articles/how-sex-genetics-influence-autoimmunity "How Sex & Genetics Influence Autoimmunity"), environmental exposures, and immune system changes** work together to trigger autoimmune disease - Identifies **early warning signs or biomarkers** that could improve [diagnosis](https://www.autoimmuneinstitute.org/articles/misdiagnosed-undiagnosed-expert-insights-on-the-autoimmune-diagnosis-process "Misdiagnosed & Undiagnosed: Expert Insights on the Autoimmune Diagnosis Process") - Develops **better tools for monitoring disease**, including imaging, wearable devices, and point-of-care tests - Studies autoimmune disease **across the lifespan**, including [sex differences](https://www.autoimmuneinstitute.org/articles/how-sex-genetics-influence-autoimmunity "How Sex & Genetics Influence Autoimmunity") and [aging](https://www.autoimmuneinstitute.org/articles/aging-and-autoimmune-disease "Aging and Autoimmune Disease") - Explores **shared biological mechanisms** across different autoimmune conditions The goal is to improve early detection, prediction, and treatment strategies. Autoimmune diseases are complex and often develop gradually. By encouraging research that integrates genetic risk, environmental exposures, and immune profiling, the NIH is emphasizing a more comprehensive approach to understanding disease development. #### Multiple NIH Institutes and Centers are participating, including those focused on allergy and infectious disease, arthritis and skin disease, aging, women’s health, genomics, environmental health, and biomedical engineering. ##### Citation National Institutes of Health. (2026, February 12). *Advancing autoimmune disease research: Integrating genetic, environmental, and immunological factors to improve diagnosis and treatment*. NIH Grants & Funding. <https://grants.nih.gov/funding/find-a-fit-for-your-research/highlighted-topics/43> **Category:** Policy & Health Decisions, Research Studies --- ### [NIH Clinical Trial Cuts Widen Gaps in Autoimmune Research](https://www.autoimmuneinstitute.org/research_updates/nih-clinical-trial-cuts-widen-gaps-in-autoimmune-research/) **Published:** November 24, 2025 **Author:** Carolyn Serraino **Content:** A new Research Letter published in *JAMA Internal Medicine* reports that 383 NIH-funded clinical trials lost grant support in the first half of 2025, disrupting studies involving more than 74,000 participants. Although the authors do not specify autoimmune-related trials, several disproportionately affected categories (such as prevention of disease onset trials, behavioral intervention type trials, and infectious disease trials) overlap with areas that help inform autoimmune risk factors, immune triggers, and long-term disease management for people with autoimmune and immune-mediated conditions. Clinical trials in these categories often include approaches relevant to the lived experience of autoimmunity and chronic illness, such as chronic pain, fatigue, sleep disturbances, exercise intolerance, or post-viral immune dysfunction. These areas of research already have limited pharmaceutical options and rely heavily on NIH funding to move forward. An accompanying Editor’s Note underscores the ethical concerns raised by these funding disruptions. The authors write that terminating clinical trial grants “for reasons other than safety or efficacy” leads to “the violation of foundational ethical principles of human participant research,” raising serious and important questions about the obligations owed to individuals who volunteer their time, health information, and risk tolerance to advance medical research. “Clinical trial participation often requires individuals to travel and attend dedicated study visits and undergo additional testing and procedures.” “First and foremost, it is betrayal of the fundamental principles of informed consent for research. Participants have agreed to give of their time and effort and expose themselves to potential risks for the sake of advancing knowledge.” “Moreover, participants who have been exposed to an intervention in the context of a trial may be harmed by its premature withdrawal or inadequate follow-up and monitoring for adverse effects.” Although some terminated grants were eventually restored, the authors stress that these reversals “can be expected to, at best, mitigate the harms,” as the scientific opportunity, participants’ trust, and irreplaceable data collection have already been compromised. For people with autoimmune and chronic illnesses in particular, who depend on consistent research progress to clarify disease mechanisms, improve symptom management, and expand treatment options, these disruptions widen existing gaps between urgent scientific need and actual progress. They also influence which patient communities remain understudied and how confident individuals can feel when participating in clinical research. ##### Citations Patel, V. R., Liu, M., & Jena, A. B. (2025). Clinical Trials Affected by Research Grant Terminations at the National Institutes of Health. *JAMA internal medicine*, e256088. Advance online publication. <https://doi.org/10.1001/jamainternmed.2025.6088> Brender, T. D., & Gross, C. P. (2025). Consequences of Grant Termination in Clinical Trials. *JAMA internal medicine*, 10.1001/jamainternmed.2025.6093. Advance online publication. <https://doi.org/10.1001/jamainternmed.2025.6093> **Category:** Autoimmune Diseases, Clinical Trials, OADR (NIH Office of Autoimmune Disease Research), Policy & Health Decisions, Risk Factors, Therapies --- ### [Targeting a Bacterial Toxin To Help Treat Lupus Nephritis](https://www.autoimmuneinstitute.org/research_updates/targeting-a-bacterial-toxin-to-help-treat-lupus-nephritis/) **Published:** April 28, 2026 **Author:** Carolyn Serraino **Content:** [Lupus nephritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/lupus-nephritis/), a serious inflammation of the kidneys, affects half of [SLE](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus") patients. #### In previous studies, lupus nephritis flares have been [linked to the bacteria *Ruminococcus gnavus*](https://ard.bmj.com/content/78/7/947) and a toxin it produces. This bacteria is also found in the guts of people without lupus, where it is found at low levels and doesn’t cause an immune response. A [recent study](https://pubmed.ncbi.nlm.nih.gov/42031645/) finds that targeting the bacteria or an immune cell receptor it activates may help treat lupus nephritis. Half of the lupus nephritis patients in this study had increased growth of this bacterium and these patients also had signs of increased inflammation and antibodies against the bacterium’s toxin. In preclinical models, the researchers found that exposure of this bacteria to the guts of mice with lupus triggered inflammation and renal damage. #### Blocking the receptor on the immune cells reduced the amount of inflammation. “**Our findings also set the stage for using selective antibiotic drugs to block these bacterial growths, or other inhibiting drugs to block the toll-like receptor 2 toxins produced by these bacterial blooms, to treat lupus nephritis**,” [said Gregg Silverman](https://www.eurekalert.org/news-releases/1124731), a professor at NYU Grossman School of Medicine and lead author on the study. #### This work adds to the large body of work that shows a connection between [autoimmune diseases and the gut microbiome](https://www.autoimmuneinstitute.org/gai-library/#microbiome). ##### **Citation**s Azzouz, D., Omarbekova, A., Heguy, A., Schwudke, D., Gisch, N., Rovin, B. H., Caricchio, R., Buyon, J. P., Alekseyenko, A. V., & Silverman, G. J. (2019). Lupus nephritis is linked to disease-activity associated expansions and immunity to a gut commensal. *Annals of the rheumatic diseases*, *78*(7), 947–956. <https://doi.org/10.1136/annrheumdis-2018-214856> Amarnani, A., Rivera, C. F., Cornwell, M., Weinstein, T., Azad, Z., Gottesman, S. R. S., Loomis, C., Lee, A., Ullah, N., Prasad, J., Yi, M., Cooney, L., Barnes, B. J., Gisch, N., Ruggles, K. V., Ramkhelawon, B., & Silverman, G. J. (2027). A pathogenic gut lipoglycan drives systemic thromboinflammation in lupus nephritis. *Annals of the rheumatic diseases*, S0003-4967(26)00146-9. Advance online publication. <https://doi.org/10.1016/j.ard.2026.03.002> **Category:** Autoimmune Diseases, Lupus, Microbiome, Research Studies, Therapies --- ### [Autoimmune Disease May Involve Hidden Mutations](https://www.autoimmuneinstitute.org/research_updates/autoimmune-disease-may-involve-hidden-mutations/) **Published:** April 21, 2026 **Author:** Carolyn Serraino **Content:** New research is shedding light on a previously hidden factor in autoimmune disease: **mutations that develop in immune cells over time**. In a recent study focused on thyroid autoimmune conditions such as [Hashimoto’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/hashimotos-thyroiditis/ "Hashimoto’s thyroiditis / autoimmune thyroiditis") and [Graves’ disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/graves-disease/ "Graves’ disease"), researchers identified somatic mutations (DNA changes acquired over the course of life) in B cells, a type of immune cell involved in antibody production. These mutations were found in genes that normally help regulate immune responses, including key pathways that act as brakes on immune activity. When these regulatory systems are disrupted, immune cells may become overactive, potentially contributing to immune attacks on the body’s own tissues. Notably, multiple independent groups of mutated B cells were identified within individual patients. This suggests that these changes can accumulate gradually over many years, potentially before disease becomes clinically apparent. Advances in technologies such as single-cell DNA sequencing have made it possible to detect rare mutations that were previously invisible, helping researchers uncover these changes in the context of autoimmune disease. These findings reflect a shift in research focus. Rather than examining autoimmune disease primarily through inherited genetics and environmental triggers, scientists are increasingly investigating the role of somatic mutations that accumulate within immune cells over time. It remains unclear whether these mutations initiate disease or contribute to its progression. This emerging area of research reflects a broader shift in how scientists understand disease risk beyond inherited DNA, including themes explored in *Beyond Inheritance* by Roxanne Khamsi, published today. In a [recent discussion](https://substack.com/@erictopol?utm_campaign=profile&utm_medium=profile-page), physician-scientist Eric Topol and Khamsi highlighted how ongoing mutations within the body may shape health and disease over time. As research continues, these insights may help guide more [precise approaches](https://www.autoimmuneinstitute.org/articles/tailoring-autoimmune-treatment-with-precision-medicine "Tailoring Autoimmune Treatment with Precision Medicine") to [diagnosis](https://www.autoimmuneinstitute.org/category/diagnosis-treatment/ "Diagnosis & Treatment") and [treatment](https://www.autoimmuneinstitute.org/articles/personalized-medicine-for-autoimmune-diseases "Personalized Medicine for Autoimmune Diseases"). ##### Citations P. Nicola, A. Lawson, et al. (2026) ‘Polyclonal selection of immune checkpoint mutations in thyroid autoimmunity’. Nature. DOI: [10.1038/s41586-026-10493-9.](https://www.nature.com/articles/s41586-026-10493-9) Khamsi, R. (2026). *Beyond inheritance: Our ever-mutating cells and a new understanding of health*. Riverhead Books. --- ### [You’re Not Imagining It: When Symptoms Are Dismissed](https://www.autoimmuneinstitute.org/research_updates/youre-not-imagining-it-when-symptoms-are-dismissed/) **Published:** April 10, 2026 **Author:** Carolyn Serraino **Excerpt:** Endometriosis reveals the cost of dismissed symptoms and the impact of a doctor who listens, investigates, and uses advanced care to find real answers. **Content:** > *“I believe you.”* Endometriosis is not formally classified as an autoimmune disease, but it shares many features with immune-related and chronic conditions, particularly in how it is experienced and diagnosed. #### Many individuals with endometriosis live with severe, disruptive symptoms for years before receiving answers. Pain, fatigue, and changes in bladder or bowel function can interfere with daily life, yet standard tests often come back normal, leading to confusion, misdiagnosis, or dismissal. This experience is not unique to endometriosis. #### Across many chronic and autoimmune-related conditions, patients report being told their symptoms are “normal,” unrelated, or difficult to explain. Symptoms that do not fit neatly into expected categories are more likely to be dismissed, even when they significantly affect quality of life. As a result, [diagnosis can take years](https://www.autoimmuneinstitute.org/articles/misdiagnosed-undiagnosed-expert-insights-on-the-autoimmune-diagnosis-process "Misdiagnosed & Undiagnosed: Expert Insights on the Autoimmune Diagnosis Process"), [delaying appropriate care](https://www.autoimmuneinstitute.org/articles/experts-discuss-the-complex-path-to-an-autoimmune-diagnosis "Experts Discuss the Complex Path to an Autoimmune Diagnosis") and adding [emotional strain](https://www.autoimmuneinstitute.org/articles/when-youve-lost-trust-in-doctors "When You’ve Lost Trust in Doctors…"). #### Outcomes dramatically change when people are finally connected with specialists who listen, investigate, and have the expertise to find answers. In one case, after being dismissed by multiple providers, a young woman was eventually evaluated by a specialist at MUSC Women’s Health who took her symptoms seriously. **Dr. Courtney Poston, a specialist in minimally invasive gynecologic surgery, confirmed the diagnosis of endometriosis.** After years of uncertainty, the patient was finally believed and able to move forward with appropriate treatment. #### Using laparoscopic and robotic techniques, specialists can more accurately diagnose and treat endometriosis, often with smaller incisions and shorter recovery times. Ultimately, endometriosis highlights a broader issue across chronic illness: when symptoms are not immediately explained, they are often minimized rather than investigated. Improving care requires not only better tools, but a shift toward listening to patient experiences and recognizing patterns that may not be obvious at first. [Read the full story from MUSC Women’s Health](https://www.musc.edu/content-hub/News/2026/04/09/endometriosis) This patient was fortunate to find the care she needed, but many people facing similar symptoms are not as quickly connected with the right expertise. #### Some travel long distances, see multiple specialists, and spend significant time, money, and energy just trying to be heard. Even Dr. Zeest Khan, a physician living with Long COVID, [has described](https://substack.com/@longcovidmd/note/c-241266728?r=5hi0h5&utm_source=notes-share-action&utm_medium=web) traveling hundreds of miles and seeing multiple doctors in a matter of days in search of appropriate care. [She plans to](https://substack.com/@longcovidmd/note/p-193819756?r=5hi0h5&utm_source=notes-share-action&utm_medium=web) discuss how to decide what appointments are worthwhile and when, highlighting the complex decisions many people face when [navigating care](https://www.autoimmuneinstitute.org/category/autoimmune-care-and-support/ "Navigating Autoimmune Care With Limited Resources"). **Category:** Case Studies, Diagnostic Testing --- ### [Celiac Disease: Can You Kiss Someone After They've Eaten Gluten?](https://www.autoimmuneinstitute.org/research_updates/celiac-disease-can-you-kiss-someone-after-theyve-eaten-gluten/) **Published:** April 9, 2026 **Author:** Carolyn Serraino **Content:** A new study set out to answer this very question. In a small 2026 study, researchers examined whether gluten could be transferred through kissing between partners where one person has [celiac disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/celiac-disease/ "Celiac disease"). #### They found that while gluten transfer can occur, the amounts were typically very low and generally remained within levels considered safe. **In most cases, no symptoms were reported**. Notably, when the non-celiac partner drank water before kissing, gluten levels dropped even further and were often undetectable. At face value, these findings are reassuring. #### But they also highlight something less visible: the constant, often exhausting mental calculations that come with living with celiac disease. **Previous survey data showed that 39% of people with celiac disease hesitate to kiss their partner due to fear of gluten exposure, and nearly 68% say the condition impacts their dating life**. These concerns are not unfounded. Even small exposures can lead to symptoms that last for days, and in some cases longer. This study does more than answer a scientific question. It brings attention to a reality many people never have to consider. For those living with autoimmune disease, everyday moments like sharing a meal or a kiss can carry [uncertainty, risk, and anxiety](https://www.autoimmuneinstitute.org/articles/managing-mental-health-with-an-autoimmune-disease "Managing Mental Health with an Autoimmune Disease"). Understanding that burden is just as important as understanding the biology. ##### Citations Lee, A. R., Chen, Z., Jossen, J., Lebovits, J., Lebwohl, B., Lewis, S. K., Krishnareddy, S., Wolf, R. L., Emerson, L., & Green, P. H. R. (2026). A Prospective Study of Gluten Transfer Through Kissing in Celiac-Discordant Couples. *Gastroenterology*, S0016-5085(26)00091-0. Advance online publication. <https://doi.org/10.1053/j.gastro.2026.01.024> Lebovits, J., Lee, A. R., Ciaccio, E. J., Wolf, R. L., Davies, R. H., Cerino, C., Lebwohl, B., & Green, P. H. R. (2022). Impact of Celiac Disease on Dating. *Digestive diseases and sciences*, *67*(11), 5158–5167. <https://doi.org/10.1007/s10620-022-07548-y> **Category:** Celiac Disease, Research Studies, Risk Factors --- ### [New Lyme Disease Vaccine: What We Know](https://www.autoimmuneinstitute.org/research_updates/new-lyme-disease-vaccine-what-we-know/) **Published:** March 23, 2026 **Author:** Carolyn Serraino **Content:** A new [Lyme disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/lyme-disease/ "Lyme disease") vaccine could help prevent not just infection, but some of the longer-term health effects that can follow. In a large Phase 3 clinical trial, the vaccine developed by Pfizer and Valneva reduced Lyme disease cases by more than 70% in people ages 5 and older. The vaccine, known as VLA15 (PF-07307405), works by training the immune system to recognize a protein on the surface of the Lyme-causing bacteria. #### When a tick bites a vaccinated person, these antibodies are taken up by the tick and can block the bacteria before it is transmitted into the body. The study followed more than 12,000 participants across North America and Europe and used a series of doses timed before peak tick season. So far, the vaccine appears to be well tolerated, with no major safety concerns reported. You may have heard that Lyme disease can be hard to test for, especially early on, and that’s true in everyday medical care. To make the results more reliable, researchers didn’t rely on a single test. Instead, they looked at a combination of symptoms (such as the well-known bullseye rash or flu-like illness), lab results, and close follow-up over time. This allowed them to more accurately identify true cases of Lyme disease in both the vaccinated and placebo groups. Infections like Lyme disease don’t just cause short-term illness; they can activate the immune system in ways that sometimes linger, affecting joints, the nervous system, or other parts of the body. #### This is part of a larger pattern researchers are continuing to study: how infections can act as one piece of the puzzle in long-term immune system disruption. A vaccine like this does not treat autoimmune disease, but it may help reduce one of the triggers that can set these processes in motion. ##### Citations Pfizer Inc., & Valneva SE. (2026, March 23). *Pfizer and Valneva announce Lyme disease vaccine candidate demonstrates strong efficacy in Phase 3 VALOR trial*. <https://www.pfizer.com/news/press-release/press-release-detail/pfizer-and-valneva-announce-lyme-disease-vaccine-candidate> ClinicalTrials.gov. (2022). *A Phase 3 trial to evaluate a Lyme disease vaccine (VLA15) (NCT05477524)*. U.S. National Library of Medicine. <https://clinicaltrials.gov/study/NCT05477524> **Category:** Clinical Trials, Research Studies --- ### [Why MS Progression Differs Between Men and Women](https://www.autoimmuneinstitute.org/research_updates/why-ms-progression-differs-between-men-and-women/) **Published:** October 14, 2025 **Author:** Carolyn Serraino **Content:** A recent review published in *Biological Research for Nursing* explores why [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/ "Multiple sclerosis") (MS) develops and progresses differently in males and females. #### Key Takeaways: - MS is two diseases happening at once, but these processes don’t always occur equally - **Inflammation:** Immune system attacks myelin - **Neurodegeneration:** Long-term nerve damage and brain atrophy - **MS in Females:** More immune-driven [inflammation](https://www.autoimmuneinstitute.org/articles/inflammation-a-driving-force-of-autoimmune-disease "Inflammation: A Driving Force of Autoimmune Disease") (16% higher relapse rates in females) - **MS in Males:** Faster [neurodegeneration](https://www.autoimmuneinstitute.org/articles/autoimmune-aspects-of-neurodegenerative-diseases "Autoimmune Aspects of Neurodegenerative Diseases") (greater brain atrophy and structural damage seen in males) While MS affects both sexes, females are more likely to develop the disease and tend to experience higher levels of inflammatory activity, including more frequent relapses. In contrast, males often experience faster neurodegeneration, leading to greater long-term disability. The researchers highlight several factors that may contribute to these differences, including sex hormones, genetics, and environmental exposures. Estrogen appears to play a complex role, with both pro- and anti-inflammatory effects depending on its levels, while testosterone may help reduce inflammation and support nerve protection. Differences in [sex chromosomes](https://www.autoimmuneinstitute.org/articles/how-sex-genetics-influence-autoimmunity "How Sex & Genetics Influence Autoimmunity"), particularly the immune-related genes on the X chromosome, may also increase susceptibility to autoimmune activity in females. The review also emphasizes the role of [epigenetic](https://www.autoimmuneinstitute.org/articles/the-role-of-epigenetics-in-autoimmune-disease "The Role of Epigenetics in Autoimmune Disease") mechanisms, especially microRNAs, which help regulate gene expression and may influence whether inflammation or neurodegeneration becomes more prominent. Environmental factors such as Epstein-Barr virus infection and vitamin D deficiency may further interact with these biological pathways in sex-specific ways. Importantly, current MS treatments are more effective at reducing inflammation than slowing neurodegeneration, highlighting a critical gap in care. Understanding these sex-based differences may help guide more personalized treatment strategies and improve long-term outcomes for people with MS. ##### Citation Buxhoeveden, S., Swift-Scanlan, T., Goldman, M. D., Canissario, R., & Oh, U. (2026). Exploring Sex-Based Mechanisms of Inflammation and Neurodegeneration in Multiple Sclerosis. *Biological research for nursing*, *28*(2), 283–295. <https://doi.org/10.1177/10998004251387318> **Category:** Multiple Sclerosis, Research Studies, Risk Factors --- ### [ACIP Meeting Status Unclear Following Federal Court Decision](https://www.autoimmuneinstitute.org/research_updates/acip-meeting-raises-questions-on-public-access-and-clarity/) **Published:** March 18, 2026 **Author:** Carolyn Serraino **Content:** > The Advisory Committee on Immunization Practices (ACIP), which advises the Centers for Disease Control and Prevention on vaccine policy, was scheduled to meet March 18–19, 2026. ![Federal Register notice for the ACIP March 2026 meeting showing inconsistent dates for the second day of the meeting and public access statement.](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/03/acip-meeting-federal-register-date-inconsistency-public-access-statement-1024x669.png) ![CDC ACIP meetings page stating that meetings are open to the public via live webcast](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/03/cdc-acip-meeting-webcast-public-access-statement-1024x532.png) #### Both the official [Federal Register notice](https://www.federalregister.gov/documents/2026/02/26/2026-03877/meeting-of-the-advisory-committee-on-immunization-practices) and the [CDC’s ACIP meetings page](https://www.cdc.gov/acip/meetings/index.html) state that the meeting is open to the public via live webcast. However, the [CDC-hosted YouTube stream](https://www.youtube.com/watch?v=_H-Va1Q2H4Q) remained in a “waiting” state well beyond the scheduled start time of 8:00 AM EST, with no visible indication that the meeting had begun or that an alternative viewing option was available. No real-time updates or clarifications were visible across the CDC’s website or social media. ![YouTube livestream page for the CDC ACIP meeting on March 18, 2026 showing a “waiting” status at the scheduled start time](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/03/acip-meeting-march-18-2026-youtube-waiting-screen-1024x768.png) ![YouTube livestream page for the CDC ACIP meeting on March 18, 2026 showing a “waiting” status at the scheduled start time and comments disabled](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/03/no-comments-acip-meeting-march-18-2026-youtube-waiting-1024x732.png) The Federal Register notice announcing the meeting also contains an apparent inconsistency, listing the second day of the meeting as March 19, 2025 instead of 2026. While likely a typographical error, discrepancies in official documentation may contribute to confusion about scheduling and access. ACIP meetings play an important role in shaping vaccine recommendations in the United States. #### Clear communication and reliable public access are key components of transparency in these processes. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/GAI-Logo-Image-e1707845715517.png) ### \*Update: “ACIP as currently constituted cannot meet” Still, there is no clear public-facing update from the CDC explaining the status of the scheduled ACIP meeting or its accessibility. This creates a clear disconnect between what was communicated and what is actually happening, leaving people without a reliable, centralized source of information about a meeting that directly informs public health guidance. #### However, upon further investigation, it appears that a federal court decision issued March 16, 2026, may explain the change. According to a press release from organizations involved in American Academy of Pediatrics et al. v. Kennedy et al., a U.S. District Court judge temporarily stayed actions affecting the current composition of the Advisory Committee on Immunization Practices (ACIP), stating that the committee “cannot meet” as currently constituted. ##### Citations **Centers for Disease Control and Prevention.** (2026). *Advisory Committee on Immunization Practices (ACIP) meetings*. <https://www.cdc.gov/acip/meetings/index.html> **Office of the Federal Register.** (2026, February 26). *Meeting of the Advisory Committee on Immunization Practices*. <https://www.federalregister.gov/documents/2026/02/26/2026-03877/meeting-of-the-advisory-committee-on-immunization-practices> Schnirring, L. (2026, March 17). ***Federal judge halts HHS, ACIP vaccine decisions: What to know.*** *Association of Health Care Journalists*. <https://healthjournalism.org/blog/2026/03/federal-judge-halts-hhs-acip-vaccine-decisions-what-to-know/> American Academy of Pediatrics, Infectious Diseases Society of America, Massachusetts Public Health Alliance, American Public Health Association, American College of Physicians, & Society for Maternal-Fetal Medicine (2026, March 16). **Federal judge blocks immunization schedule changes, stays ACIP member appointments** \[Press release\]. *PR Newswire*. <https://www.prnewswire.com/news-releases/federal-judge-blocks-immunization-schedule-changes-stays-acip-member-appointments-302715182.html> **Category:** Policy & Health Decisions --- ### [Human-Based Models May Transform Autoimmune Research](https://www.autoimmuneinstitute.org/research_updates/human-based-models-may-transform-autoimmune-research/) **Published:** March 18, 2026 **Author:** Carolyn Serraino **Content:** Autoimmune diseases are notoriously difficult to model in animals, as they involve complex, human-specific immune interactions. As a result, many therapies that appear promising in animal studies fail in human trials. #### The National Institutes of Health (NIH) has announced a $150 million investment in new research approaches designed to better replicate human biology and reduce reliance on animal models. Human-based models could help address this gap by more accurately reflecting how the immune system behaves in people. This may improve how researchers study immune tolerance, chronic inflammation, and autoimmune disease progression. By shifting toward models that more closely mimic human biology, this approach could: - Improve the accuracy of preclinical research - Reduce the number of failed [clinical trials](https://www.autoimmuneinstitute.org/articles/the-importance-of-clinical-trials-for-autoimmunity "The Importance of Clinical Trials for Autoimmunity") - Support the development of more [targeted therapies](https://www.autoimmuneinstitute.org/articles/tailoring-autoimmune-treatment-with-precision-medicine "Stem Cell Therapy for Autoimmune Disease") - Enable more [personalized approaches](https://www.autoimmuneinstitute.org/articles/personalized-medicine-for-autoimmune-diseases "Personalized Medicine for Autoimmune Diseases") using [patient-derived cells](https://www.autoimmuneinstitute.org/articles/stem-cell-therapy-for-autoimmune-disease "Stem Cell Therapy for Autoimmune Disease") The funding supports the Complement-ARIE program, which focuses on advancing “new approach methodologies” (NAMs), including lab-grown tissues, organ-on-chip systems, and computational models. The initiative will establish technology development centers, a centralized data hub, and a validation network to ensure these tools are reliable and ready for broader scientific and regulatory use. Early pilot projects will focus on developmental health, toxicity testing, and neurological conditions. ##### Citation National Institutes of Health. (2026, March 18). *NIH invests $150 million in human-based research to reduce use of animal models*. <https://www.nih.gov/news-events/news-releases/nih-invests-150-million-human-based-research-reduce-use-animal-models> **Category:** Clinical Trials, Policy & Health Decisions, Research Studies, Risk Factors, Therapies --- ### [Hormones and MS: Pregnancy, Periods, Menopause](https://www.autoimmuneinstitute.org/research_updates/hormones-and-ms-pregnancy-periods-menopause/) **Published:** March 16, 2026 **Author:** Carolyn Serraino **Content:** New insights from experts at the University of Colorado Anschutz Medical Campus highlight how hormonal changes across a woman’s life, from menstruation to pregnancy and menopause, can influence disease activity in [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/ "Multiple sclerosis") (MS), while also emphasizing that modern treatment strategies are improving outcomes. MS is diagnosed up to three times more often in women, particularly during their reproductive years. This pattern suggests a strong connection between sex hormones and immune system behavior, though the exact mechanisms are still being studied. [Learn More About Reproductive Health and Autoimmune Disease](https://www.autoimmuneinstitute.org/articles/pregnancy-with-an-autoimmune-disease) One of the most important findings is that **pregnancy appears to reduce MS disease activity**, with relapse rates decreasing significantly, especially in the third trimester. However, this protective effect reverses after childbirth, when the risk of relapse can rise sharply. Emerging treatment strategies, including carefully timed therapies before conception, may help reduce this postpartum risk. Hormonal shifts during menstruation and menopause may also influence symptoms. While menstrual cycles can temporarily worsen existing symptoms (often referred to as “pseudo-relapses”), menopause may amplify fatigue, brain fog, and sleep disturbances overlapping with core MS symptoms. Overall, advances in treatment and disease management are helping women with MS navigate reproductive decisions with greater confidence and support. Full expert Q&A and detailed guidance from CU Anschutz **Category:** Multiple Sclerosis, Research Studies, Risk Factors --- ### [How Food Proteins Help Train Immune Tolerance](https://www.autoimmuneinstitute.org/research_updates/how-food-proteins-help-train-immune-tolerance/) **Published:** March 10, 2026 **Author:** Carolyn Serraino **Content:** Scientists have long known that the immune system learns to tolerate harmless substances (such as food) through specialized immune cells called **regulatory T cells (Tregs)**. However, the specific dietary molecules that help train this tolerance have remained largely unknown. A study published in *Science Immunology* identified several food-derived proteins that appear to play a key role in this process. Researchers found that seed storage proteins, commonly found in foods such as corn, soy, and wheat, can activate regulatory T cells in the gut, helping the immune system recognize these proteins as harmless rather than triggering an inflammatory response. In experiments using mice, the team discovered that a peptide from a corn protein known as **α-zein** triggered a particularly strong regulatory T cell response. In fact, a significant proportion of regulatory T cells in the animals’ immune systems were found to recognize this single food-derived epitope. These cells developed during early life, particularly around the time when animals began consuming solid food. The findings suggest that certain dietary proteins may help establish **oral immune tolerance**, a process that allows the immune system to safely coexist with the many harmless substances encountered through diet. The researchers also observed that this tolerance was influenced by the [gut environment](https://www.autoimmuneinstitute.org/articles/the-relationship-between-autoimmune-disease-and-the-gut-microbiome "The Relationship Between Autoimmune Disease and the Gut Microbiome"), including interactions with the [microbiome](https://www.autoimmuneinstitute.org/articles/what-is-the-microbiome-and-why-is-it-important "What is the Microbiome and Why is it Important?"). #### Understanding how dietary antigens shape immune tolerance could help researchers better understand why immune tolerance sometimes fails, which is a hallmark of autoimmune disease and allergic conditions. Insights into these mechanisms may eventually support the development of therapies that promote antigen-specific immune tolerance rather than broadly suppressing the immune system. This research also reinforces a broader concept in immunology: the immune system is constantly learning from the environments it encounters. Food proteins, gut microbes, and even microbes in the mouth can shape immune responses and influence tolerance. Our article, **[Is Your Oral Microbiome Fueling Autoimmune Disease?](https://www.autoimmuneinstitute.org/articles/is-your-oral-microbiome-fueling-autoimmune-disease "Is Your Oral Microbiome Fueling Autoimmune Disease?")** explores how microbial changes in the oral cavity may contribute to immune imbalance in autoimmune disease. In some cases, similarities between food proteins and human tissues may also influence immune activity through mechanisms such as molecular mimicry, as discussed in our article, [How Food Can Influence Autoimmune Disease](https://www.autoimmuneinstitute.org/articles/what-does-organic-really-mean-part-two "How Food Can Influence Autoimmune Disease"). ##### Citation Jamie E. Blum et al., **Identification and characterization of dietary antigens in oral tolerance**. *Sci. Immunol.* **11**, eaeb4684(2026). DOI:[10.1126/sciimmunol.aeb4684](https://doi.org/10.1126/sciimmunol.aeb4684) **Category:** Microbiome, Research Studies, Risk Factors --- ### [NIAID Workshop: Infections and Autoimmune Diseases](https://www.autoimmuneinstitute.org/research_updates/niaid-workshop-infections-and-autoimmune-diseases/) **Published:** February 4, 2025 **Author:** Elevation **Content:** #### There is mounting evidence of the connections between autoimmunity and infectious disease. - Geographic differences in the prevalence of autoimmune diseases that can’t be explained by genetics - Seasonality that affects the onset and severity of autoimmune diseases - Associations between neonatal and postnatal infections and autoimmune diseases To explore the connections between autoimmune diseases and infections, scientists and physicians met at an **NIAID workshop held on September 11-12, 2024,** to discuss. #### **The meeting report documents key areas, including:** - **Epstein-Barr virus (EBV) and autoimmune diseases:** EBV has been associated with many autoimmune diseases including [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus"), [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/ "multiple sclerosis"), [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid arthritis"), and [Sjogren’s syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sjogren-syndrome/ "Sjögren’s syndrome"). Researchers propose that this happens because of molecular mimicry where molecules from the virus appear similar to molecules from the body. Then, the immune system mistakenly targets self. - **Connections between autoimmune diseases and other infections:** Many other infections – either bacterial or viral – have been associated with autoimmune diseases including autoimmune gastritis, spondyloarthropathies, rheumatic heart disease - **How the microbiome affects autoimmunity:** Scientists have found that specific microbes that tend to be in the gut microbiome of rheumatoid arthritis patients, that antibiotics treatment exacerbates autoimmune diseases in preclinical models, and that enteroviral infections may be related to celiac disease. Oral microbes also have a connection to rheumatoid arthritis. The workshop also discussed whether any causation can be established (ex: does infection cause autoimmune disease vs. does autoimmune disease and infections coincide because of another reason). While many infections seem involved in autoimmune diseases, these infections also happen to people that don’t develop autoimmune diseases. Another challenge is that symptoms of autoimmune diseases often don’t appear until later in life. In the future, it’s possible that advances in fields such as AI could help researchers better understand the relationship between autoimmune disease and infections. ##### Citation: Ferguson, S.E., et al. (2025). **NIAID workshop on infections and autoimmune diseases**. *Nature immunology*. <https://doi.org/10.1038/s41590-024-02066-7> **Category:** Autoimmune Diseases, Events, Lupus, Multiple Sclerosis, Research Studies, Rheumatoid Arthritis, Risk Factors, Sjögren disease --- ### [Tracking T Cells Could Help Decode Autoimmune Disease](https://www.autoimmuneinstitute.org/research_updates/tracking-t-cells-could-help-decode-autoimmune-disease/) **Published:** March 6, 2026 **Author:** Carolyn Serraino **Content:** Researchers have developed a new method that allows scientists to track recently activated T cells across different organs, revealing how the body organizes immune responses during infection. The system, called TRACK (Tracking Recently Activated Cell Kinetics), uses a fluorescent marker to permanently label T cells shortly after they encounter a pathogen, allowing researchers to follow how those cells move and change over time. In experiments using a mouse model of influenza infection, scientists tracked CD4⁺ T cells across the lungs, lymph nodes, and spleen. ##### Each location appeared to shape T cell behavior differently. T cells in the lungs specialized in directly fighting infected cells, while those in lymph nodes focused on helping B cells produce antibodies. T cells in the spleen acted more like mobile reserves that could circulate to other tissues. Over time, these specialized populations gradually redistributed and formed long-term immune memory, helping the body respond more quickly to future infections. ##### Although the study focused on viral infection, the researchers say the same tracking approach could help scientists study immune responses in other diseases, including cancer and autoimmune disorders such as [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/ "Multiple sclerosis"). Understanding how immune cells are programmed by different tissues may eventually help researchers design therapies that redirect harmful immune activity or restore immune balance in autoimmune disease. ###### Citation Parsa, R., Assis, H.C., de Castro, T.B.R. *et al.* Tissue-specific clonal selection and differentiation of CD4⁺ T cells during infection. *Nat Immunol* (2026). <https://doi.org/10.1038/s41590-026-02451-4> **Category:** Multiple Sclerosis, Research Studies, Risk Factors --- ### [NIH Grant Funds Study of Protein That May Drive Lupus](https://www.autoimmuneinstitute.org/research_updates/nih-grant-funds-study-of-protein-that-may-drive-lupus/) **Published:** March 3, 2026 **Author:** Carolyn Serraino **Content:** A new $1.7 million National Institutes of Health (NIH) grant will support research into a protein that may help explain why [systemic lupus erythematosus (SLE)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus") develops and how it might be treated more precisely. [The project, led by Carol Webb](https://ou.edu/news/articles/2026/march/new-nih-grant-advances-lupus-protein-research), Ph.D., at the University of Oklahoma College of Medicine, focuses on a protein called **ARID3a**, which appears in higher numbers in the B cells of people with lupus. B cells are immune cells that produce antibodies, including the harmful autoantibodies that attack the body’s own tissues in lupus. Webb’s research suggests that ARID3a may disrupt an important “safety check” during early B cell development. Normally, immature B cells that recognize the body’s own tissues are removed before they can cause harm. In people with lupus, however, some of these cells appear to escape this process, potentially allowing autoantibodies to form. The newly funded project will investigate the genes controlled by ARID3a, examine how it alters B-cell development, and test whether blocking the protein can reduce lupus symptoms in animal models. Understanding how these harmful antibodies arise is a major focus of lupus research. For example, [research supported by GAI](https://www.autoimmuneinstitute.org/past-grants-collaborations/ "Past Grants & Collaborations") has explored how antibodies triggered by [Epstein–Barr virus](https://www.autoimmuneinstitute.org/research_updates/the-puzzling-link-between-ebv-and-ms/ "The Puzzling Link Between EBV and MS") (EBV) may cross-react with human DNA through a process called **molecular mimicry**, potentially contributing to lupus development. Together, studies like these aim to uncover both the triggers and the immune system changes that allow autoimmune responses to take hold. By identifying specific pathways involved in lupus, researchers hope to move toward more targeted therapies that address the root causes of the disease rather than broadly suppressing the immune system. **Category:** Lupus, Research Studies --- ### [Rare Disease Day 2026 at NIH](https://www.autoimmuneinstitute.org/research_updates/rare-disease-day-2026-at-nih/) **Published:** March 2, 2026 **Author:** Carolyn Serraino **Excerpt:** Rare Disease Day 2026 highlighted CAR T therapy, innovative trial design, and gene editing advances with implications for autoimmune disease. **Content:** **February 27, 2026** \| **National Center for Advancing Translational Sciences (NCATS)** Rare Disease Day 2026 brought together researchers, clinicians, patient advocates, and families to discuss how rare disease research is moving forward. [Sessions](https://ncats.nih.gov/sites/default/files/2026-02/Final-Agenda-RDD2026-2-23-2026-508.pdf) throughout the day explored innovative clinical trial design, artificial intelligence applications, gene therapy advances, and patient advocacy, among other topics. Many of the themes shared are directly relevant to people living with autoimmune and immune-mediated conditions. ### New Ways to Run Clinical Trials One session focused on improving how [clinical trials](https://www.autoimmuneinstitute.org/articles/the-importance-of-clinical-trials-for-autoimmunity "The Importance of Clinical Trials for Autoimmunity") are designed for rare diseases. Traditional drug trials often require large numbers of participants, which is difficult when a condition affects only a small population. Researchers discussed trial models that allow multiple treatments to be tested under a single framework, use shared comparison groups, and enroll patients based on measurable biological signals. These approaches can make studies more efficient and reduce the burden on patients. For rare autoimmune diseases, where patient numbers are limited and disease presentations can vary widely, these newer trial designs may help speed up access to potential therapies. ### CAR T Therapy for Juvenile Myositis A featured session highlighted the development of [CAR T cell therapy](https://www.autoimmuneinstitute.org/articles/car-t-cell-therapy-for-autoimmune-disease "CAR T-Cell Therapy For Autoimmune Disease") for [juvenile myositis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/juvenile-myositis/ "Juvenile myositis"). CAR T therapy was first developed for certain blood cancers. In cancer, it works by engineering a patient’s own T cells to target and destroy malignant cells. In autoimmune disease, researchers are adapting the approach to target B cells that produce harmful autoantibodies. Early reports from Europe in severe autoimmune diseases have shown significant symptom improvement and sustained remission in some patients. U.S. trials are now enrolling children and adults with severe disease. This approach is sometimes described as an immune reset. Researchers emphasized that long-term safety and durability still need to be studied, but the shift from cancer treatment to autoimmune application represents an important development. ### Advances in Gene Editing Speakers also discussed progress in [CRISPR-based gene editing](https://www.autoimmuneinstitute.org/articles/crispr-cas9-gene-editing-revolutionizing-autoimmune-disease-treatment "CRISPR/Cas9 Gene Editing: Revolutionizing Autoimmune Disease Treatment") for rare inherited disorders. In preclinical models of connective tissue disease, correcting a single mutation prevented downstream tissue damage. Delivery remains a challenge. Current gene editing tools are most reliable in organs such as the liver, and safely reaching other tissues is an area of active research. While most autoimmune diseases are not caused by a single gene mutation, some rare immune dysregulation syndromes are. The expansion of gene editing platforms may eventually provide options for those patients. ### Personalized Gene Therapy Another session reviewed the development of a [personalized](https://www.autoimmuneinstitute.org/articles/personalized-medicine-for-autoimmune-diseases "Personalized Medicine for Autoimmune Diseases") CRISPR therapy for a newborn with a life-threatening metabolic condition. Researchers identified the specific mutation, designed a targeted therapy, and obtained regulatory clearance within months. Beyond the individual case, the broader impact lies in creating a regulatory and manufacturing pathway that could be used again for other ultra-rare conditions. ## Importance of Rare Disease Day for Autoimmune Disease Many autoimmune diseases are rare, and even common conditions often have rare, severe subtypes. This year’s discussions highlighted: - More efficient clinical trial designs - Immune cell reprogramming approaches - Platform-based gene editing strategies - Increased collaboration between researchers, regulators, and patient communities The tools being built in rare disease research are increasingly relevant to autoimmune disease. Several are already moving into clinical trials, particularly for severe or treatment-resistant cases. #### As new trial designs, gene therapies, and immune-targeted treatments mature, the lessons learned in rare conditions may help shape broader autoimmune care in the years ahead. **Category:** Clinical Trials, Events, Research Studies, Risk Factors, Therapies --- ### [Risk Factors for Type 1 Diabetes Can Be Found at Birth](https://www.autoimmuneinstitute.org/research_updates/risk-factors-for-type-1-diabetes-can-be-found-at-birth/) **Published:** February 2, 2026 **Author:** Carolyn Serraino **Content:** A new study from the University of Florida and Linköping University identified early-life risk factors of [type 1 diabetes](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/type-1-diabetes-insulin-dependent-diabetes/ "Type 1 diabetes / insulin-dependent diabetes") in umbilical cord blood. This study looked at 16,683 babies in Sweden born between 1997 and 1999 as part of the All Babies in Southeast Sweden study and included those that went on to develop type 1 diabetes and those that did not. They analyzed proteins from umbilical cord blood and used machine learning techniques to identify the proteins that could lead to a higher risk of developing type 1 diabetes in the future. They found that those with type 1 diabetes had differences in inflammatory signals in their cord blood, with increased abundance for proteins involved in neutrophil migration, cytotoxicity, extracellular matrix remodeling, and immune regulation. Environmental exposures to compounds such as perfluorodecylethanoic acid and perfluorooctane sulfonate contribute to an increased risk. Using machine learning, they could predict type 1 diabetes with high accuracy based on the levels of the proteins. This risk was calculated independent of HLA, a gene that has been previously linked to autoimmunity. The fact that blood at birth could hold clues into future disease makes it useful as a potential screening tool. “It would be useful if markers in the umbilical cord blood could give doctors a heads-up — as current screening is genetically based or requires antibodies to the self, at which point the disease has already progressed significantly,” said the study’s lead author Angelica Ahrens, an assistant research scientist at the University of Florida. #### **Citation** Ahrens, A.P., Dias, R., Hyötyläinen, T. et al. The inflammatory path toward type 1 diabetes begins during pregnancy. Nat Commun 17, 979 (2026). <https://doi.org/10.1038/s41467-025-67712-6> **Category:** Diagnostic Testing, Genetics, Research Studies, Risk Factors, Type 1 Diabetes --- ### [Brain Fog and Memory Problems in Autoimmune Disease](https://www.autoimmuneinstitute.org/research_updates/brain-fog-and-memory-problems-in-autoimmune-disease/) **Published:** September 5, 2025 **Author:** Carolyn Serraino **Content:** A new review highlights how “brain fog” and other thinking problems are common yet often overlooked in systemic autoimmune diseases beyond [lupus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus"). The authors examined evidence on the reported prevalence of cognitive impairment in several conditions: [ANCA-associated vasculitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/microscopic-polyangiitis-anca-associated-vasculitis/ "Microscopic polyangiitis / ANCA-associated vasculitis") (≈30%), [sarcoidosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sarcoidosis/ "Sarcoidosis") (0–35%, higher in neurosarcoidosis), [Sjögren disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sjogren-syndrome/ "Sjögren disease (SjD)") (10–80%), [systemic sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/scleroderma/ "Scleroderma / systemic sclerosis") (8–65%), and [Behçet’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/behcets/ "Behçet’s disease") (30–100%). Across these studies, difficulties with attention, planning, and mental flexibility (executive function) appear most consistent. The causes are likely complex. Inflammatory molecules such as IL-6 and TNF-α may directly disrupt brain function, while small-vessel damage and reduced blood flow can harm white-matter pathways. #### Some patients show abnormalities on advanced brain imaging even when standard MRI scans appear normal. Symptoms such as fatigue, [chronic pain](https://www.autoimmuneinstitute.org/articles/facts-about-chronic-pain "Facts about Chronic Pain"), [depression](https://www.autoimmuneinstitute.org/articles/managing-mental-health-with-an-autoimmune-disease "Managing Mental Health with an Autoimmune Disease"), and small-fiber neuropathy can contribute to or be mistaken for cognitive impairment, making careful assessment essential. The review emphasizes that brief tools, such as the Montreal Cognitive Assessment (MoCA), commonly used for quick screening, may overlook subtler deficits in these populations. More systematic, disease-specific assessments and multidisciplinary care are needed so that problems with memory and focus are recognized early, managed appropriately, and factored into treatment decisions to improve quality of life. ###### Citation Camard, M., Urbain, F., & Noel, N. (2025). Cognitive impairment in systemic autoimmune and inflammatory diseases: **A narrative review focused on ANCA-associated vasculitis, sarcoidosis, Sjögren’s syndrome, systemic sclerosis, and Behçet’s disease**. *Autoimmunity reviews*, *24*(11), 103899. Advance online publication. <https://doi.org/10.1016/j.autrev.2025.103899> **Category:** Autoimmune Brain Inflammation, Autoimmune Diseases, Neurological Disorders, Research Studies, Sjögren disease --- ### [Clinical Trial Finds Intermittent Fasting Benefits for Crohn’s Disease](https://www.autoimmuneinstitute.org/research_updates/clinical-trial-finds-intermittent-fasting-benefits-for-crohns-disease/) **Published:** February 9, 2026 **Author:** Carolyn Serraino **Excerpt:** A new randomized controlled trial published in Gastroenterology examined whether intermittent fasting could improve symptoms in adults with Crohn’s disease. Intermittent fasting, also called time-restricted feeding, typically involves fasting for 16 hours and eating within an 8-hour window. In this 12-week study, participants with Crohn’s disease were randomly assigned to either follow a 16-hour daily fast (six days per week) or continue their usual eating pattern. **Content:** Intermittent fasting is a diet pattern alternating between a 16 hour fast and an 8 hour period of eating. The idea is that it can help improve health and weight management. But besides these goals, intermittent fasting can help in other ways. ## What Are the Benefits of Intermittent Fasting? In the general population, intermittent fasting has been shown to: - Have anti-inflammatory effects - Reduce insulin resistance - Reduce circulating cytokines - Reduce visceral fat ## Intermittent Fasting Shows Benefits in Crohn’s Disease For people with [Crohn’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crohns-disease/ "Crohn’s disease"), a [new study](https://www.gastrojournal.org/article/S0016-5085(25)06485-6/fulltext) shows that intermittent fasting can reduce their symptoms of disease. This study randomized participants into two groups: one that did intermittent fasting for 12 weeks and one that did not. The intermittent fasting group fasted for 16 consecutive hours per day for six days of the week. The researchers collected stool samples and blood samples as well as weight and height measurements at the beginning and the end of the study. They found that intermittent fasting reduced Crohn’s disease activity by 40% and abdominal discomfort by 50% at the end of the study. Those that fasted had reduced levels of blood markers of inflammation and a more diverse microbiota. This microbiome was also enriched in bacteria known to produce short chain fatty acids, which have anti-inflammatory and metabolic benefits. This study involved only 35 participants, and a larger trial in the future would help confirm their findings. “Time-restricted feeding is showing real promise as a new way to help people with Crohn’s disease manage not only their symptoms but also their overall health,” [said Andres Lorenzo Hurtado](https://www.eurekalert.org/news-releases/1114988), Senior Vice President at the Crohn’s & Colitis Foundation, which provided funding for the study. “We are excited to support studies like this that put patients at the center of new solutions and encourage more research to make these benefits last for everyone living with IBD.” ##### **Citation** Haskey, N., Ye, J., Lewis, A., *et al.* **Time-Restricted Feeding Reduces Body Mass Index, Visceral Adiposity, Systemic Inflammation, and Clinical Disease Activity in Adults With Crohn’s Disease: A Randomized Controlled Study**. *Gastroenterology* (2026). <https://doi.org/10.1053/j.gastro.2025.11.008> **Category:** Clinical Trials, IBD (Crohn's and UC), Research Studies, Therapies --- ### [Honoring Research That Shapes Autoimmune Insight](https://www.autoimmuneinstitute.org/research_updates/honoring-research-that-shapes-autoimmune-insight/) **Published:** February 24, 2026 **Author:** Carolyn Serraino **Content:** [Dr. Mitchell Kronenberg](https://www.lji.org/labs/kronenberg-lab/), President and Chief Scientific Officer at [La Jolla Institute for Immunology](https://www.autoimmuneinstitute.org/gai-and-la-jolla-institute-for-immunology/ "GAI and La Jolla Institute for Immunology") (LJI), has been [elected a Fellow of the American Academy of Microbiology](https://www.lji.org/news-events/news/post/kronenberg-aam-microbiology-fellow/). While this honor recognizes excellence in microbiology, his work has direct implications for autoimmune disease. Kronenberg is best known for advancing our understanding of natural killer T (NKT) cells and other innate-like T cells. These cells respond quickly to lipid antigens presented by CD1 molecules, helping shape early immune responses. That early signaling matters. In autoimmune disease, inappropriate activation or dysregulation of these pathways can contribute to [chronic inflammation](https://www.autoimmuneinstitute.org/articles/inflammation-a-driving-force-of-autoimmune-disease "Inflammation: A Driving Force of Autoimmune Disease") and tissue damage. Research into lipid antigen presentation and unconventional T cell biology has expanded our understanding of how the immune system distinguishes self from non-self. When that discrimination fails, immune cells may attack the body’s own tissues. Insights from Kronenberg’s work help researchers map the checkpoints that normally prevent this from happening. For autoimmune conditions, this kind of foundational immunology is critical. It informs how immune tolerance breaks down, why certain tissues become targets, and how future therapies might recalibrate immune responses without broadly suppressing immunity. The honor is a fitting acknowledgment of scientific work that continues to shape our understanding of the immune system in health and disease. **Category:** Events, Research Studies --- ### [ECCO 2026: New Insights Into IBD Risk & Care](https://www.autoimmuneinstitute.org/research_updates/ecco-2026-new-insights-into-ibd-risk-care/) **Published:** February 23, 2026 **Author:** Carolyn Serraino **Excerpt:** Research presented at the 21st Congress of ECCO explores how workplace exposures and severe infections may influence IBD risk, and how early treatment strategies could reduce long-term complications in Crohn’s disease. **Content:** ##### ***February 18–21, 2026 \| Stockholm, Sweden*** At the [**21st Congress of the European Crohn’s and Colitis Organisation**](https://ecco-congress.meta-dcr.com/) ([ECCO](https://ecco-ibd.eu/)), researchers presented new findings that deepen our understanding of both inflammatory bowel disease (IBD) risk and long-term disease course. ## Work Environment as a Possible Risk Modifier One large multicohort study examined whether occupations and the exposures embedded within them influence IBD risk. Researchers analyzed 120,290 participants in the UK Biobank and confirmed key findings in an independent Chinese medical insurance database. They identified higher IBD risk in certain skilled trades and occupations with higher levels of pollutant exposure. ##### High exposure to diesel exhaust was associated with a 56% increased risk of IBD, and exposure to mists and aerosols was associated with a 31% increased risk (1). Lifelong high levels of work-related physical activity were also associated with elevated risk, whereas occupations associated with greater socioeconomic advantage were linked to lower IBD risk. ## Severe Infection as a Long-Term Immune Stressor A second large prospective study examined whether serious infections requiring hospital treatment were linked to later development of inflammatory bowel disease. Researchers followed more than 359,000 UK Biobank participants for an average of 12 years after their first hospital-treated infection (2). ##### People who experienced a hospital-treated infection had a little more than three times the risk of developing IBD compared with those who did not. The increased risk was seen across different types of infections – including bacterial, viral, fungal, and parasitic – and across multiple organ systems. The researchers also found that genetics influenced how strongly infection was associated with IBD risk. Variants in immune-related genes modified susceptibility, and the team developed an “Infection IBD Score” to help identify individuals who may be more vulnerable following severe infection. The findings support a multi-hit model in which severe infection may act as an immune stressor in people who are already genetically susceptible. ## Early Treatment Strategy and Long-Term Crohn’s Outcomes Follow-up data from the PROFILE randomized trial examined whether starting combination biologic therapy at diagnosis changes the long-term course of [Crohn’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crohns-disease/ "Crohn’s disease") (3). In the study, patients were assigned to one of two strategies: - A **“top-down” approach**, meaning they received combination biologic therapy (infliximab plus an immunomodulator) immediately after diagnosis. - A **“step-up” approach**, meaning they began with conventional therapies such as steroids or immunomodulators and escalated to biologic treatment later if needed. Over a median follow-up of about 4.5 years from diagnosis, patients initially treated with the step-up strategy were significantly more likely to experience serious disease complications. From diagnosis onward, **27 abdominal surgeries occurred in the step-up group compared with 6 in the top-down group**. Overall, patients who began with step-up treatment had about **five times the odds of requiring Crohn’s-related abdominal surgery**. Progression to more severe forms of disease (stricturing or penetrating Crohn’s) was also more common in the step-up group. ##### Hospital admissions related to Crohn’s disease were nearly four times higher among patients who started with step-up treatment. Because this analysis reflects longer-term follow-up after the initial trial period, treatment decisions beyond the first year varied. However, the findings suggest that early and effective control of inflammation may reduce long-term complications rather than simply managing short-term symptoms. ##### Citations 1. Y Zhou, L Dan, X Ruan, M Deng, J Chen, X Wang, **OP01 The Occupational Landscape of Inflammatory Bowel Disease Susceptibility and Modulating Roles of Pollutant Exposure, Work Behaviors, and Socioeconomic Status: A Multicohort Cross-Population Study**, *Journal of Crohn’s and Colitis*, Volume 20, Issue Supplement\_1, January 2026, jjaf231.001, <https://doi.org/10.1093/ecco-jcc/jjaf231.001> 2. H Zhuang, L Dan, X Xiang, X Ruan, S Yuan, J Yao, J Geng, L Jonas, T Fu, C M Ferreira de Abreu, L Peyrin-Biroulet, X Li, F Magro, X Wang, J Sun, J Chen, **OP14 Risk of Inflammatory Bowel Disease Following Hospital-Treated Infections and Modulatory Role of Host Genetics to support a multi-hit pathogenesis model**, *Journal of Crohn’s and Colitis*, Volume 20, Issue Supplement\_1, January 2026, jjaf231.014, <https://doi.org/10.1093/ecco-jcc/jjaf231.014> 3. N Noor, H Zheng, M T Sharip, J Lee, D Robertson, M Parkes, PROFILE Study Group, **OP05 PROFILE 4-year follow-up shows that early effective “top-down” therapy is associated with reduced long-term Crohn’s disease complications**, *Journal of Crohn’s and Colitis*, Volume 20, Issue Supplement\_1, January 2026, jjaf231.005, <https://doi.org/10.1093/ecco-jcc/jjaf231.005> **Category:** Events, IBD (Crohn's and UC), Research Studies, Risk Factors --- ### [Blood Viral Patterns May Signal Crohn’s Disease](https://www.autoimmuneinstitute.org/research_updates/blood-viral-patterns-may-signal-crohns-disease/) **Published:** January 5, 2026 **Author:** Carolyn Serraino **Content:** Researchers have identified differences in the viruses circulating in the blood of people with [Crohn’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crohns-disease/ "Crohn’s disease"), suggesting that the “blood virome” could serve as a disease signature. Crohn’s disease has long been linked to changes in the [gut microbiome](https://www.autoimmuneinstitute.org/articles/the-relationship-between-autoimmune-disease-and-the-gut-microbiome "The Relationship Between Autoimmune Disease and the Gut Microbiome"). However, the gut virome is highly variable between individuals, making it difficult to use as a consistent marker of disease. #### In this study, researchers analyzed blood and stool samples from 15 patients with Crohn’s disease and 14 healthy individuals using metagenomic sequencing. They confirmed that blood is not sterile. Both healthy individuals and patients with Crohn’s disease had detectable viruses in their blood, primarily bacteriophages, which are viruses that infect bacteria. The total number of viral particles in blood was similar between groups, and overall diversity was also similar. The key difference was in composition. #### While fecal viral communities did not clearly separate patients from healthy controls, the blood viral communities did. Statistical analysis showed a significant difference in blood virome composition between the two groups, in particular: - Phages targeting Acinetobacter were more abundant in healthy individuals. - A distinct set of phages, including some predicted to infect intestinal bacteria, were enriched in Crohn’s disease. #### The authors suggest that increased intestinal barrier dysfunction in Crohn’s disease may allow viral particles to move from the gut into the bloodstream. If validated in larger studies, blood viral patterns could serve as biomarkers for Crohn’s disease. Notably, the blood virome appeared more discriminatory than the gut virome in this small cohort. However, this proposed mechanism is based on metagenomic data and requires further confirmation, and the study has important limitations: - Small sample size - Mixed disease states (remission and flare) - Mechanistic conclusions not yet confirmed For now, these findings represent an early research signal rather than a clinical tool. ### Living With Crohn’s Disease While researchers continue working to better understand the biological signatures of Crohn’s disease, people living with the condition navigate its realities every day. At GAI, members of our community have shared powerful personal stories about diagnosis delays, stigma, coexisting conditions, and learning to advocate for themselves: - **Daanya’s Story: [Breaking the Stigma of Crohn’s Disease](https://www.autoimmuneinstitute.org/autoimmune_stories/daanyas-story-breaking-the-stigma-of-crohns-disease/ "Daanya’s Story: Breaking the Stigma of Crohn’s Disease")** - **Claire’s Story: [Gender Bias and the Long Road to Diagnosis](https://www.autoimmuneinstitute.org/autoimmune_stories/claires-story-gender-bias-the-long-road-to-diagnosis/ "Claire’s Story: Gender Bias & the Long Road to Diagnosis")** - **Hannah’s Story: [Celebrating Progress While Battling Crohn’s Disease](https://www.autoimmuneinstitute.org/autoimmune_stories/hannahs-story-celebrating-progress-while-battling-crohns-disease/ "Hannah’s Story: Celebrating Progress While Battling Crohn’s Disease")** - **Morgan’s Story: [Getting Help With Crohn’s Disease](https://www.autoimmuneinstitute.org/autoimmune_stories/morgans-story-getting-help-with-crohns-disease/ "Morgan’s Story: Getting Help with Crohn’s Disease")** - **Morgan’s Update: [Keeping Dreams in View While Having Multiple Illnesses](https://www.autoimmuneinstitute.org/autoimmune_stories/morgans-update-keeping-dreams-in-view-while-having-multiple-illnesses/ "Morgan’s Update: Keeping Dreams in View While Having Multiple Illnesses")** Their experiences highlight what research alone cannot capture: the complexity of living with inflammatory bowel disease and the importance of early recognition, support, and compassionate care. You can explore these and other stories in our [Autoimmune Stories](https://www.autoimmuneinstitute.org/autoimmune-stories/ "Autoimmune Stories") collection. ##### Citation Lamy-Besnier, Q., Theodorou, I., Sokol, H., De Paepe, M., Petit, M. A., De Sordi, L., & Blood Virome Working Group (2025). The Human Blood Virome Differs in Crohn’s Disease. *Gastroenterology*, S0016-5085(25)06122-0. Advance online publication. <https://doi.org/10.1053/j.gastro.2025.10.007> **Category:** Diagnostic Testing, IBD (Crohn's and UC), Research Studies --- ### [The New Flu Shot Isn’t Dead After All](https://www.autoimmuneinstitute.org/research_updates/the-new-flu-shot-isnt-dead-after-all/) **Published:** February 18, 2026 **Author:** Carolyn Serraino **Excerpt:** After initially declining to review a new mRNA influenza vaccine, the FDA has reversed course and will now evaluate Moderna’s application. Frequent changes in vaccine availability or recommendations can negatively affect well-being. Many people with autoimmune disease plan treatments, social activities, and exposure precautions around anticipated infection risk. **Content:** *Wednesday, February 18, 2026* After [initially declining to review a new mRNA influenza vaccine](https://www.autoimmuneinstitute.org/research_updates/autoimmune-disease-and-vaccine-preventable-disease-outbreaks/ "Autoimmune Disease and Vaccine-Preventable Disease Outbreaks"), the U.S. Food and Drug Administration (FDA) has reversed course and will now evaluate Moderna’s application. The vaccine, designed for adults age 50 and older, previously completed a 40,000-person clinical trial showing higher effectiveness in older adults compared with a commonly used flu shot. Regulators did not identify safety concerns. The [earlier refusal](https://www.autoimmuneinstitute.org/research_updates/autoimmune-disease-and-vaccine-preventable-disease-outbreaks/ "Autoimmune Disease and Vaccine-Preventable Disease Outbreaks") stemmed from a dispute over the comparison standard: the trial used a standard-dose flu shot rather than the high-dose vaccine typically recommended for adults over 65. However, the FDA had previously approved the study design and did not identify any safety or efficacy concerns. Moderna has now proposed a revised approval pathway: full approval for adults 50–64 and accelerated approval for those 65 and older with an additional post-market study. The FDA has accepted the application and is expected to issue a decision by August 5, 2026. The change restores the possibility that the vaccine could become available later this year. For individuals with autoimmune disease and others at elevated infection risk, the significance is practical: vaccine availability determines the number of circulating respiratory infections and therefore the baseline exposure risk in daily life. In Virginia, health officials reported 10 measles cases in early 2026, *twice the total for all of 2025*,  underscoring how quickly [vaccine-preventable diseases](https://www.autoimmuneinstitute.org/research_updates/autoimmune-disease-and-vaccine-preventable-disease-outbreaks/ "Autoimmune Disease and Vaccine-Preventable Disease Outbreaks") can resurge when immunity gaps occur. [Virginia state health recommendations](https://content.govdelivery.com/accounts/VAVDHORCE/bulletins/40a8fe0) continue to emphasize adherence to the 2026 childhood immunization schedule, and school vaccination requirements remain unchanged. Frequent changes in vaccine availability or recommendations can negatively affect well-being. Many people with autoimmune disease plan treatments, social activities, and exposure precautions around anticipated infection risk. When those expectations change, medical decisions may need to be revisited repeatedly. [ Related Read To learn more about navigating infection risk while immunocompromised, read *A Guide for Immunocompromised Individuals in a Post-Pandemic World*. ](https://www.autoimmuneinstitute.org/articles/a-guide-for-immunocompromised-individuals-in-a-post-pandemic-world/) **Category:** Policy & Health Decisions, Risk Factors --- ### [Infections May Influence Where Autoimmune Disease Develops](https://www.autoimmuneinstitute.org/research_updates/infections-may-influence-where-autoimmune-disease-develops/) **Published:** February 16, 2026 **Author:** Carolyn Serraino **Excerpt:** A new case-control study published in JAMA Ophthalmology examined whether prior infection with human papillomavirus (HPV) might be associated with thyroid eye disease (TED), a complication of autoimmune hyperthyroidism. **Content:** ## Study Suggests HPV May Be Linked to Thyroid Eye Disease A new case-control study published in *JAMA Ophthalmology* examined whether prior infection with human papillomavirus (HPV) might be associated with [thyroid eye disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/thyroid-eye-disease-graves-ophthalmopathy-thyroid-associated-orbitopathy/ "Thyroid eye disease / Graves’ ophthalmopathy / thyroid-associated orbitopathy") (TED), a complication of [autoimmune hyperthyroidism](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/graves-disease/ "Graves’ disease"). Using a large electronic health record database of approximately 150 million patients, researchers compared individuals with autoimmune hyperthyroidism who developed TED to matched patients with autoimmune hyperthyroidism alone. ### What They Found - **Low-risk HPV was uncommon overall but slightly more frequent in patients with TED.** - 0.46% of patients with TED had a prior low-risk HPV diagnosis - 0.30% of matched controls had a prior low-risk HPV diagnosis - That difference equals about **16 additional cases per 10,000 people**. - **High-risk HPV was not associated with TED.** Rates were similar between groups. - **New HPV infections after hyperthyroidism diagnosis were also similar** between those who did and did not develop TED. - Among patients who already had TED: - 13.43% of those with low-risk HPV underwent orbital decompression surgery - 5.47% of those without HPV underwent surgery - That equals roughly **8 additional surgeries per 100 patients**. - There were **no differences** in steroid use, vision loss, eyelid retraction, or strabismus between groups The authors suggest that molecular mimicry could potentially play a role in disease development. However, this study does not prove that HPV causes thyroid eye disease. It identifies an association based on medical record data, which can contain inconsistencies and incomplete documentation. More research is needed to determine whether HPV contributes directly to disease mechanisms or whether the association reflects shared risk factors. ##### Citation Weber, M. I., Karanfilian, T., Gupta, L., & Barmettler, A. (2026). Thyroid Eye Disease and the Prevalence of Human Papillomavirus. *JAMA ophthalmology*, e256244. Advance online publication. <https://doi.org/10.1001/jamaophthalmol.2025.6244> **Category:** Autoimmune Diseases, Case Studies, Eye Disease, Research Studies, Risk Factors, Thyroid Disease --- ### [Autoimmune Disease and Vaccine-Preventable Disease Outbreaks](https://www.autoimmuneinstitute.org/research_updates/autoimmune-disease-and-vaccine-preventable-disease-outbreaks/) **Published:** February 13, 2026 **Author:** Carolyn Serraino **Excerpt:** Infectious disease outbreaks do not affect everyone equally. Those with autoimmune disease and immunosuppression face unique risks. Learn how infections can trigger disease activity and why community infection levels influence treatment safety and daily life. **Content:** #### In 2026, vaccines are back in the headlines worldwide. Infectious diseases do not disappear all at once. They fade when enough people remain protected, and they return when protection drops. Several recent events show this process happening in real time. In Malawi, health workers began vaccinating more than a million children after polio was detected again. The virus is close to global eradication, but it can reappear when immunity gaps develop. The World Health Organization (WHO) recently approved a newer oral polio vaccine designed to stop outbreaks more quickly and raised concerns about a proposed study that would delay a proven hepatitis B birth-dose vaccine for some newborns, noting that the vaccine prevents serious liver disease later in life. In the United States, some policymakers seek to repeal school vaccination mandates originally implemented to limit the community spread of contagious diseases. At the same time, federal regulators recently [declined to review an application for a new mRNA influenza vaccine](https://www.accessnewswire.com/newsroom/en/healthcare-and-pharmaceutical/moderna-receives-refusal-to-file-letter-from-the-u.s.-food-and-drug-a-1135749) despite completed trials and no identified safety or efficacy concerns, raising questions about future vaccine availability.\* *\*update available about this decision, [read more here](https://www.autoimmuneinstitute.org/research_updates/the-new-flu-shot-isnt-dead-after-all/ "The New Flu Shot Isn’t Dead After All")* These events are often discussed in terms of policy decisions or public debate. Medically, they describe something simpler: how much virus is likely to circulate in daily life. For many people, that changes little. For others, it determines whether vaccination is effective, whether treatment can continue safely, and whether routine activities pose an infection risk. #### Not everyone relies on vaccines in the same way. People living with autoimmune disease and other immune-related chronic illnesses are part of this second group. Their safety depends not only on their own immune system, but also on how much infection is circulating around them. The effects appear in several predictable ways. [ Related Read To learn more about navigating infection risk while immunocompromised, read *A Guide for Immunocompromised Individuals in a Post-Pandemic World*. ](https://www.autoimmuneinstitute.org/articles/a-guide-for-immunocompromised-individuals-in-a-post-pandemic-world/) ### Infections Can Trigger Autoimmune Activity Immune responses meant to eliminate pathogens can also activate pathways involved in autoimmune disease. Researchers have identified several mechanisms, including molecular mimicry, bystander activation, epitope spreading, and interferon signaling. After outbreaks, clinicians often observe increases in: - worsening inflammatory arthritis - [lupus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus") and vasculitis [flares](https://www.autoimmuneinstitute.org/articles/outbursts-in-autoimmunity-disease-flare-ups "Outbursts in Autoimmunity: Disease Flare-ups") - autoimmune blood disorders - neurologic immune complications - post-viral fatigue and dysautonomia Outbreaks may therefore affect both people already diagnosed and those who have not yet developed symptoms. ### Outbreaks Can Change Treatment Decisions When highly contagious infections are spreading locally, physicians may delay initiation or intensification of immunosuppressive therapy. Medications such as rituximab or cyclophosphamide may be postponed to avoid leaving a patient severely immunocompromised during exposure risk. As a result, outbreaks can influence disease management and sometimes prolong active disease. ### Measles Can Weaken Existing Immune Protection Measles is unusual among respiratory viruses because it affects immune memory. The virus infects memory B cells and T cells, which store protection from past infections and vaccines. After recovery, the immune system may lose part of this stored protection, a process sometimes called immune amnesia. #### This can increase susceptibility to other infections for months after the initial illness. For individuals with altered immune regulation, consequences may include: - higher rates of secondary infections - reactivation of dormant infections - prolonged recovery periods - increased need for hospitalization after the acute illness ### Some Cannot Receive Live Vaccines The measles, mumps, and rubella vaccine is a live attenuated vaccine. While safe for healthy individuals, it may not be recommended during significant immunosuppression. These patients rely primarily on low levels of circulating virus in the community for protection. When outbreaks occur, that layer of protection is reduced. ### Infection Risk Can Remain High Even After Vaccination Many autoimmune conditions are treated with [medications](https://www.autoimmuneinstitute.org/articles/biologics-for-autoimmune-disease-what-you-should-know "Biologics for Autoimmune Disease: What You Should Know") that suppress immune activity to prevent tissue damage. These include corticosteroids, methotrexate, azathioprine, mycophenolate, biologic therapies, JAK inhibitors, and B-cell–depleting medications such as rituximab. Because these therapies affect immune cells responsible for establishing long-term protection, vaccination does not always elicit the same level of immunity observed in healthy individuals. Patients may: - produce fewer protective antibodies - lose protection sooner than expected - remain only partially protected - be unable to safely receive certain vaccines During outbreaks, this creates an important difference. A vaccinated healthy person is usually well protected, while a vaccinated immunosuppressed person may still be vulnerable to infection. For this group, community immunity functions as an additional layer of medical protection. #### For many people, infectious disease prevention is not just precaution, it is required for their medical safety. **Category:** Policy & Health Decisions, Risk Factors --- ### [Microbiome: Therapeutic Implications, Killarney Conference](https://www.autoimmuneinstitute.org/research_updates/microbiome-therapeutic-implications-conference/) **Published:** October 11, 2019 **Author:** Elevation **Excerpt:** An interdisciplinary group of scientists and physicians presented largely unpublished microbiome research at the 2019 Keystone Symposium in an effort to share, inspire, and provoke new ways of thinking. Certain autoimmune diseases, such as ulcerative colitis and type 1 diabetes, exhibit microbiomes that differ from those of healthy individuals. **Content:** **Category:** Events, IBD (Crohn's and UC), Microbiome, Therapies, Type 1 Diabetes --- ### [Nasal Swabs May Transform Lupus Research](https://www.autoimmuneinstitute.org/research_updates/nasal-swabs-may-transform-lupus-research/) **Published:** November 19, 2025 **Author:** Carolyn Serraino **Content:** At the [La Jolla Institute for Immunolog](https://www.autoimmuneinstitute.org/gai-and-la-jolla-institute-for-immunology/ "GAI and La Jolla Institute for Immunology")y, LJI Instructor Carolyn Moderbacher, Ph.D., is leading an innovative effort to better understand lupus using a simple but powerful tool: a nasal swab. Unlike many autoimmune diseases that target a single organ, [lupus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus") is systemic and can affect the joints, kidneys, skin, brain, and reproductive organs. This widespread immune involvement makes the disease difficult to study, especially because the immune cells responsible for driving lupus are often not easily detected in the blood. Working in the lab of Shane Crotty, Moderbacher adapted a technique originally developed to study SARS-CoV-2 vaccine responses. Her team collects immune cells from lymphoid tissue deep within the nasal passages, an area rich in B and T cells. This minimally invasive method allows researchers to repeatedly sample tissue over time, offering a window into immune activity that traditional blood tests may miss. To date, 10 lupus patients have participated in monthly sampling over the course of a year. Early findings show clear differences between immune cells found in nasal tissue and those circulating in the blood. Researchers have also observed changes in nasal immune cell populations following B cell depleting therapy, suggesting the approach could help monitor treatment response or anticipate disease flares. The project recently received nearly $450,000 in funding from the [Lupus Research Alliance](https://www.lupusresearch.org/for-researchers/funded-research/grant/probing-autoreactive-t-cells-across-tissues-in-sle/). If validated in larger studies, this nasal swab technique could improve how researchers track lupus progression and identify new therapeutic targets. **To learn more about this promising research, read the full feature from LJI here: <https://mag.lji.org/fall2025/what-the-nose-knows/>** **Category:** Lupus, Research Studies --- ### [Targeting TRM Cells for Cancer and Autoimmunity](https://www.autoimmuneinstitute.org/research_updates/targeting-trm-cells-for-cancer-and-autoimmunity/) **Published:** November 25, 2025 **Author:** Carolyn Serraino **Content:** Scientists at [La Jolla Institute for Immunology](https://www.autoimmuneinstitute.org/gai-and-la-jolla-institute-for-immunology/ "GAI and La Jolla Institute for Immunology") (LJI) have identified a key molecular driver that helps certain immune cells take up long-term residence in organs such as the lungs and liver. These cells, known as tissue-resident memory T cells (TRM cells), act as first responders against infections and tumors. Rather than circulating in the bloodstream, TRM cells stay within specific tissues, where they can rapidly respond to threats. Higher densities of these cells have previously been associated with improved survival in some cancers, including lung cancer. In a study published in *Science Immunology*, researchers discovered that a receptor called GPR25 plays a critical role in TRM cell development. The team found that GPR25 is induced by TGF-β, a signaling molecule that guides immune cell differentiation. In genetically engineered mice lacking GPR25, TRM cells could not properly maintain TGF-β signaling and failed to form functional tissue-resident populations. Because GPR25 belongs to the G protein–coupled receptor (GPCR) family — a class of molecules already targeted by many FDA-approved drugs — it may represent a promising therapeutic target. Enhancing GPR25 activity could strengthen immune defenses against infections or cancer. #### Conversely, suppressing it might reduce harmful inflammation in autoimmune diseases where TRM cells contribute to tissue damage. This discovery offers a potential new pathway for precision immune modulation. ##### Citation Feng, H., Park, S., Shin, J. W., Castañeda-Castro, F. E., Hernandez, J. R., Schmiedel, B. J., Liu, C., Jackson, M. R., Ottensmeier, C. H., & Vijayanand, P. (2025). GPR25 promotes the formation of lung and liver tissue-resident memory CD8 T cells. *Science immunology*, *10*(113), eadu2089. <https://doi.org/10.1126/sciimmunol.adu2089> **Category:** Research Studies, Therapies --- ### [Immune Cleanup Failure May Worsen Lupus Gut Inflammation](https://www.autoimmuneinstitute.org/research_updates/immune-cleanup-failure-may-worsen-lupus-gut-inflammation/) **Published:** February 11, 2026 **Author:** Carolyn Serraino **Content:** A new study in *Scientific Reports* examined what happens when the immune system cannot properly “clean up” dying cells and how that may affect lupus. #### Researchers studied mice lacking a receptor called SCARF1. This receptor helps immune cells remove dead or dying cells before they trigger [inflammation](https://www.autoimmuneinstitute.org/articles/inflammation-a-driving-force-of-autoimmune-disease "Inflammation: A Driving Force of Autoimmune Disease"). Without SCARF1, cellular debris built up in tissues. These mice developed lupus-like disease and showed clear signs of [gut inflammation](https://www.autoimmuneinstitute.org/articles/the-relationship-between-autoimmune-disease-and-the-gut-microbiome "The Relationship Between Autoimmune Disease and the Gut Microbiome"). The gut bacteria were also different. The lupus-prone mice had less bacterial diversity, which is often considered a sign of imbalance. They were missing helpful bacteria such as *Akkermansia muciniphila*, a species known to support the gut lining and regulate inflammation. At the same time, bacteria associated with inflammatory conditions were more abundant. #### The severity of lupus symptoms in the mice tracked with these bacterial shifts. The findings suggest that when the immune system fails to clear dying cells effectively, it may disrupt the gut bacteria, potentially exacerbating inflammation and autoimmune disease. Although this study was conducted in mice, it contributes to growing evidence that immune function and the [gut microbiome](https://www.autoimmuneinstitute.org/articles/what-is-the-microbiome-and-why-is-it-important "What is the Microbiome and Why is it Important?") are closely linked in [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus") (SLE). ##### Citation Shepard, D.M., Hahn, S., Chitre, M. *et al.* SCARF1 deficiency exacerbates gut inflammation and autoimmune pathology. *Sci Rep* (2026). <https://doi.org/10.1038/s41598-026-39378-7> **Category:** Lupus, Microbiome, Research Studies, Risk Factors --- ### [Vagus Nerve Research: Implications for Autoimmune Disease](https://www.autoimmuneinstitute.org/research_updates/vagus-nerve-research-implications-for-autoimmune-disease/) **Published:** January 28, 2026 **Author:** Carolyn Serraino **Excerpt:** A live discussion with Kevin J. Tracey and Eric Topol highlights how vagus nerve research is shaping autoimmune disease science. **Content:** On January 28, 2026 neurosurgeon and bioelectronic medicine pioneer **Kevin J. Tracey** joined cardiologist and science communicator **Eric Topol** for a [live Substack conversation](https://substack.com/@erictopol/note/c-208424475?utm_source=notes-share-action&r=1m6mb9) centered on Tracey’s book *The Great Nerve: The New Science of the Vagus Nerve and How to Harness Its Healing Reflexes*. #### Tracey’s work has been instrumental in defining how the vagus nerve regulates immune responses via the “inflammatory reflex”, a neural circuit that can turn off [excessive inflammation](https://www.autoimmuneinstitute.org/articles/inflammation-a-driving-force-of-autoimmune-disease "Inflammation: A Driving Force of Autoimmune Disease"). This concept forms the scientific foundation for bioelectronic medicine, therapies that modulate nerve activity to treat [inflammatory](https://www.autoimmuneinstitute.org/articles/autoimmune-vs-autoinflammatory-disease "Autoimmune vs Autoinflammatory Disease") and autoimmune diseases. Multiple [clinical trials](https://clinicaltrials.gov/expert-search?term=vagus%20nerve%20stimulations%20autoimmune%20disease&sort=@relevance&limit=100&page=1) of vagus nerve stimulation for [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid arthritis"), [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus") (SLE), [postural orthostatic tachycardia syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/postural-orthostatic-tachycardia-syndrome/ "Postural orthostatic tachycardia syndrome") (POTS), [Crohn’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crohns-disease/ "Crohn’s disease"), [ulcerative colitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ulcerative-colitis/ "Ulcerative colitis"), [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/ "Multiple sclerosis"), [Sjögren’s syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sjogren-syndrome/ "Sjögren disease (SjD)"), [juvenile idiopathic arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/juvenile-idiopathic-arthritis-stills/ "Juvenile idiopathic arthritis / adult-onset Still’s disease"), and [chronic inflammatory demyelinating polyneuropathy](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/chronic-inflammatory-demyelinating-polyneuropathy/ "Chronic inflammatory demyelinating polyneuropathy") are completed, ongoing, or currently recruiting, reflecting sustained scientific interest in this technology. The discussion underscored growing scientific interest in the [neuro-immune](https://www.autoimmuneinstitute.org/articles/autoimmune-aspects-of-neurodegenerative-diseases "Autoimmune Aspects of Neurodegenerative Diseases") interface, where vagus nerve pathways are being explored as a means to alter immune activity without conventional drugs. [Recent research](https://www.autoimmuneinstitute.org/research_updates/vagus-nerve-device-approved-for-rheumatoid-arthritis/ "Vagus Nerve Device Approved for Rheumatoid Arthritis"), including trials of implantable vagus nerve stimulators in those with rheumatoid arthritis, suggests that daily stimulation can produce measurable improvements in disease activity scores compared with sham controls, highlighting the potential for non-pharmacologic autoimmune therapies. Topol also connected Tracey’s work to a broader shift in how scientists think about the body. Rather than viewing the brain, immune system, and organs as separate systems, researchers now understand them as closely linked and constantly communicating. In this view, chronic inflammation and autoimmune disease are shaped not only by immune cells, but also by signals traveling through nerves. Studies show that changes in activity within specific nerve pathways can influence levels of inflammatory molecules in the body, helping to explain how the nervous system can modulate inflammation. ##### Citations [Eric Topol Substack](https://substack.com/@erictopol?) Koopman, F. A., Chavan, S. S., Miljko, S., Grazio, S., Sokolovic, S., Schuurman, P. R., Mehta, A. D., Levine, Y. A., Faltys, M., Zitnik, R., Tracey, K. J., & Tak, P. P. (2016). Vagus nerve stimulation inhibits cytokine production and attenuates disease severity in rheumatoid arthritis. *Proceedings of the National Academy of Sciences of the United States of America*, *113*(29), 8284–8289. <https://doi.org/10.1073/pnas.1605635113> Pavlov, V. A., & Tracey, K. J. (2012). The vagus nerve and the inflammatory reflex–linking immunity and metabolism. *Nature reviews. Endocrinology*, *8*(12), 743–754. <https://doi.org/10.1038/nrendo.2012.189> Olofsson, P. S., & Tracey, K. J. (2017). Bioelectronic medicine: technology targeting molecular mechanisms for therapy. *Journal of internal medicine*, *282*(1), 3–4. <https://doi.org/10.1111/joim.12624> **Category:** Autoimmune Brain Inflammation, Autoimmune Diseases, Clinical Trials, IBD (Crohn's and UC), Lupus, Multiple Sclerosis, Neurological Disorders, Research Studies, Rheumatoid Arthritis, Sjögren disease, Therapies --- ### [Addressing Economic Stress Improves Lupus Health Outcomes](https://www.autoimmuneinstitute.org/research_updates/addressing-economic-stress-improves-lupus-health-outcomes/) **Published:** January 23, 2026 **Author:** Carolyn Serraino **Content:** A new study published in *Arthritis Care & Research* highlights how economic stressors, such as food insecurity, housing instability, transportation barriers, and financial strain, can significantly worsen health outcomes for people living with [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus") (SLE or lupus). Researchers analyzed data from more than 220 adults receiving care at multidisciplinary lupus clinics in the Midwest. #### About one in six patients reported at least one form of economic insecurity. Each additional economic challenge was associated with poorer patient-reported physical health and social functioning, even after accounting for disease activity, medication use, and other clinical factors. Importantly, the study also examined what happens when these barriers are addressed. Patients who screened positive for economic insecurity met with a clinic-based social worker who helped connect them to resources such as transportation assistance, food support programs, or financial aid. After 3 to 6 months, patients whose economic barriers were addressed reported meaningful improvements in physical health and social functioning. #### The findings reinforce that autoimmune disease outcomes are shaped not only by biology but also by everyday access to resources. Integrating routine screening for economic stressors and providing social support within clinical care may represent a practical, scalable way to improve quality of life for people living with lupus and potentially other autoimmune diseases. ##### Citation Patel, J., Singh, T., Ingersoll, M., Gomez, S., Weber, A., Panzer, S. E., Ferguson, S., Bartels, C. M., & Garg, S. (2026). Addressing Economic Insecurities Can Improve Patient-Reported Outcomes in Lupus. *Arthritis care & research*, 10.1002/acr.80000. Advance online publication. [https://doi.org/10.1002/acr.80000](https://acrjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/acr.80000) **Category:** Lupus, Research Studies, Resources --- ### [Congressional Briefing on Women’s Inclusion in Clinical Research](https://www.autoimmuneinstitute.org/research_updates/congressional-briefing-on-womens-inclusion-in-clinical-research/) **Published:** January 20, 2026 **Author:** Carolyn Serraino **Content:** #### On January 20, 2026, the **[Society for Women’s Health Research (SWHR)](https://swhr.org/event/overcoming-barriers-to-womens-participation-in-clinical-research/)** hosted a congressional briefing on the persistent barriers that limit women’s participation in [clinical research](https://www.autoimmuneinstitute.org/articles/the-importance-of-clinical-trials-for-autoimmunity "The Importance of Clinical Trials for Autoimmunity"). Despite decades of progress, women remain underrepresented in clinical trials, resulting in critical gaps in understanding disease progression, diagnostics, and treatment effectiveness across the lifespan. This widely attended, in-person forum, held in recognition of Women’s Health Research Day, brought together leaders from research, federal agencies, and patient advocacy to examine the regulatory, socioeconomic, and systemic challenges that continue to restrict equitable participation. Panelists shared expert insights and lived perspectives while outlining actionable strategies to improve inclusion, strengthen trial design, and ensure that medical innovation reflects the needs of all populations. The discussion emphasized policy-driven solutions and cross-sector collaboration as essential tools for advancing women’s health research. This event underscored the importance of inclusive research practices in shaping evidence-based care and improving health outcomes for women nationwide. **Featured panelists included:** - Katie Baca Motes, MBA, CEO, GSD Health Research - Aaron Pawlyk, PhD, NICHD (NIH) - Olga Lucia Torres, MS, JD, Columbia University & Lupus Foundation of America #### Watch it here: **Category:** Clinical Trials, Events, Policy & Health Decisions --- ### [USPSTF Delays Raise Concerns for Autoimmune Diagnosis & Care](https://www.autoimmuneinstitute.org/research_updates/uspstf-delays-raise-concerns-for-autoimmune-diagnosis-care/) **Published:** January 9, 2026 **Author:** Carolyn Serraino **Content:** Experts are raising concerns that disruptions at the **[U.S. Preventive Services Task Force](https://www.uspreventiveservicestaskforce.org/uspstf/)** could have serious downstream effects for people navigating autoimmune disease, including those who are symptomatic but remain undiagnosed or are still waiting for answers. Despite [recent advancements](https://www.autoimmuneinstitute.org/articles/innovative-diagnostic-techniques-for-detecting-autoimmune-diseases "Innovative Diagnostic Techniques for Detecting Autoimmune Diseases"), autoimmune diseases are still frequently difficult to identify in their early stages. Many patients experience years of unexplained symptoms, delayed referrals, and inconclusive testing [before receiving a diagnosis](https://www.autoimmuneinstitute.org/articles/experts-discuss-the-complex-path-to-an-autoimmune-diagnosis "Experts Discuss the Complex Path to an Autoimmune Diagnosis"). #### During this period, preventive care frequently becomes one of the few consistent points of medical contact. Screenings, counseling, and early interventions can uncover warning signs, prompt further evaluation, or help prevent complications while patients remain in [diagnostic limbo](https://www.autoimmuneinstitute.org/articles/misdiagnosed-undiagnosed-expert-insights-on-the-autoimmune-diagnosis-process "Misdiagnosed & Undiagnosed: Expert Insights on the Autoimmune Diagnosis Process"). The USPSTF plays a unique role because its A and B graded recommendations are directly tied to [insurance coverage](https://www.autoimmuneinstitute.org/articles/navigating-health-insurance-for-autoimmune-disease-patients-expert-tips-and-resources "Navigating Health Insurance with Autoimmune Disease") under the Affordable Care Act, which requires most private insurers to cover these services without cost-sharing. #### When the task force’s work slows, updates to preventive guidance may stall, creating uncertainty about access to covered care. Recent reporting describes canceled or postponed meetings, expired task force member terms without announced replacements, and delayed guideline finalization. In addition, the USPSTF has not yet posted its required 2025 [Report to Congress](https://www.uspreventiveservicestaskforce.org/uspstf/about-uspstf/reports-congress), which summarizes activities, recommendations, and progress over the past year. For people already diagnosed with autoimmune disease, these delays may affect monitoring for medication-related risks and long-term complications. For those still undiagnosed, the impact may be even greater. Gaps in preventive guidance risk prolonging diagnostic delays, increasing out-of-pocket costs, and allowing preventable problems to worsen before they are identified. **Category:** Diagnostic Testing, Policy & Health Decisions, Risk Factors --- ### [Study Finds Gluten Transfer From Some Biodegradable Plates](https://www.autoimmuneinstitute.org/research_updates/study-finds-gluten-transfer-from-some-biodegradable-plates/) **Published:** October 30, 2025 **Author:** Carolyn Serraino **Content:** Researchers at the University of Seville published a [study](https://pubs.acs.org/doi/pdf/10.1021/acs.jafc.5c07516?ref=article_openPDF "study") examining whether biodegradable tableware can contaminate gluten-free foods, an issue of growing concern as compostable plates and utensils become more widely used. The team tested eight biodegradable dishes, cups, and straws made from materials such as wheat, wheat pulp, palm leaf, and sugarcane. They measured both the gluten content of the tableware and whether gluten could transfer into gluten-free foods under realistic conditions. Only one product, a wheat-based plate marketed as “eatable,” contained very high levels of gluten and transferred gluten into food at levels well above the gluten-free safety threshold. #### Gluten transfer varied by food type and conditions. Liquid and emulsified foods, such as milk and vegetable cream, absorbed far more gluten than solid foods like rice or omelets. Heat and longer contact times increased contamination risk, and the eatable wheat-based plate softened and partially broke down when exposed to hot or liquid foods. All other biodegradable items tested, including non-eatable products made from wheat by-products, showed no detectable gluten transfer. #### However, the study highlights a major regulatory gap, as food-contact materials are not required to label allergens. The findings support clear guidance for people with [celiac disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/celiac-disease/ "Celiac disease"): avoid wheat-based tableware marketed as eatable and choose clearly gluten-free alternatives when serving gluten-free foods. ##### Citation Sousa, C., Heredia, A., de Arcos, L., Segura, V., Ruiz-Carnicer, Á., & Comino, I. (2025). Potential Transfer of Toxic Gluten from Biodegradable Tableware to Gluten-Free Foods: Implications for Individuals with Gluten-Related Disorders. *Journal of agricultural and food chemistry*, *73*(44), 28386–28394. <https://doi.org/10.1021/acs.jafc.5c07516> **Category:** Celiac Disease, Research Studies, Risk Factors --- ### [Genetic Risk Score Predicts Type 1 Diabetes Risk](https://www.autoimmuneinstitute.org/research_updates/genetic-risk-score-predicts-type-1-diabetes-risk/) **Published:** January 7, 2026 **Author:** Carolyn Serraino **Content:** In 2022, the FDA [approved a drug](https://pmc.ncbi.nlm.nih.gov/articles/PMC10545553/) that can slow down early progression of [type 1 diabetes](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/type-1-diabetes-insulin-dependent-diabetes/ "Type 1 diabetes / insulin-dependent diabetes") in children and adults. This drug, which can delay clinical diagnosis by three years, only works before symptoms develop. However, identifying those at risk for the disease, and who would benefit from the drug, is challenging. Only 10-15% of type 1 diabetes cases are linked to family history. To aid efforts in predicting who is at risk for type 1 diabetes, researchers developed a way to use genetic information. This test looks for single genetic variations within a person’s DNA that could give signs of impending disease. This genetic risk score could be combined with other information like family history, age, and blood tests to better assess risk. Those with the highest risk could then be offered an autoantibody blood test to determine if they are in the early stage of disease. In a study with 10,000 adults, the team found that people with the highest scores had a higher risk of being in the early stages of type 1 diabetes. This work is an early finding and the researchers will use larger scale studies like the [ELSA Study](https://www.elsadiabetes.nhs.uk/) for children and the [T1DRA](https://t1dra.bristol.ac.uk/) for adults, which are currently recruiting. ##### **Citation**s Herold, K. C., Gitelman, S. E., Gottlieb, P. A., Knecht, L. A., Raymond, R., & Ramos, E. L. (2023). Teplizumab: A Disease-Modifying Therapy for Type 1 Diabetes That Preserves β-Cell Function. Diabetes care, 46(10), 1848–1856. <https://doi.org/10.2337/dc23-0675> Thomas, N. J., Long, A., Gillespie, K., Fraser, D. P., Hill, A., Ferrat, L., Evans-Molina, C., McDonald, T., Nice, R., Jones, A., Hattersley, A. T., Hagopian, W. A., & Oram, R. A. (2026). Genetic risk-targeted islet autoantibody screening for presymptomatic type 1 diabetes in adults. *Lancet Diabetes Endocrinol*, 14(1), 11–13. <https://doi.org/10.1016/S2213-8587(25)00318-3> **Category:** Clinical Trials, Diagnostic Testing, Genetics, Risk Factors, Therapies, Type 1 Diabetes --- ### [Autoimmune Target Identified in ALS](https://www.autoimmuneinstitute.org/research_updates/autoimmune-target-identified-in-als/) **Published:** October 15, 2025 **Author:** Carolyn Serraino **Content:** Researchers at [the La Jolla Institute for Immunology](https://www.autoimmuneinstitute.org/gai-and-la-jolla-institute-for-immunology/) (LJI), collaborating with colleagues at Columbia University, identified a specific immune target implicated in amyotrophic lateral sclerosis (ALS). ALS has long been linked to inflammation in the brain and spinal cord, but this research helped clarify what exactly the immune system may be reacting to. The study found that immune cells called CD4 T cells mistakenly recognize a normal nervous-system protein, **C9orf72**, as a threat. This type of “self-attack” is a defining feature of autoimmune disease and provides direct evidence that autoimmune mechanisms may contribute to ALS. #### People with ALS who carry genetic changes in the C9orf72 gene showed much stronger immune reactions to the protein. This connects a known genetic risk factor for ALS with abnormal immune activity, demonstrating how genetics and the immune system may work together to influence disease progression. The researchers also observed important differences in immune responses between patients. Some immune cells produced inflammatory signals, while others produced signals that help calm inflammation. People with higher levels of these calming immune responses were predicted to live longer, suggesting that certain immune activity may help slow disease progression. Overall, the findings support a growing view in [neuroimmunology](https://www.autoimmuneinstitute.org/articles/autoimmune-aspects-of-neurodegenerative-diseases "Autoimmune Aspects of Neurodegenerative Diseases") that ALS may involve both harmful and protective immune responses, and that future treatments could focus on reducing damaging inflammation while strengthening the immune system’s regulatory and protective roles. ##### Citation Michaelis, T., Lindestam Arlehamn, C. S., Johansson, E., Frazier, A., Berry, J. D., Cudkowicz, M., Goyal, N. A., Fournier, C., Snyder, A., Kwan, J. Y., Crook, J., Phillips, E. J., Mallal, S. A., Ravits, J., Marder, K. S., Sidney, J., Sulzer, D., & Sette, A. (2025). Autoimmune response to C9orf72 protein in amyotrophic lateral sclerosis. *Nature*, *647*(8091), 970–978. <https://doi.org/10.1038/s41586-025-09588-6> **Category:** Genetics, Research Studies, Risk Factors --- ### [Teen Invents Free App That Could Help Those With Autoimmune Disease](https://www.autoimmuneinstitute.org/research_updates/teen-invents-free-app-that-could-help-those-with-autoimmune-disease/) **Published:** July 10, 2025 **Author:** Carolyn Serraino **Content:** A Virginia high school student is gaining national recognition for developing [*Swype AI*,](https://swypeai.tech/) a free assistive app that enables users with motor impairments to control their computers using hand gestures or voice commands. Sixteen-year-old [Dhanvin Ganeshkumar](https://www.linkedin.com/in/dhanvin-ganeshkumar/) was inspired by his own family’s struggles with tremors and launched the app to make everyday tech more accessible. ##### Though initially focused on conditions like Parkinson’s and ALS, *Swype* is now being tested by individuals with [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid arthritis"), [myositis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/inclusion-body-myositis/ "Inclusion body myositis"), [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/ "Multiple sclerosis"), [lupus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus"), and other conditions that affect motor control. These diseases often cause tremors, weakness, or joint pain, making traditional input devices difficult or painful to use. Swype utilizes motion tracking and voice recognition to translate hand gestures into smooth, real-time computer control. The app has been fine-tuned to minimize lag and enhance accuracy, making it easier for users with tremors or motor challenges to navigate digital tasks. Ganeshkumar has partnered with the Virginia Assistive Technology Department for user testing and plans to relaunch Swype’s beta version in September, with a **full release expected in November**. He’ll also be presenting the app at the [2024 Myositis Association International Patient Conference](https://www.myositis.org/calendar/events/2024-international-annual-patient-conference/) and contributing to *[The Chronicle](https://www.acpanow.com/chronicle.html#/)*, the quarterly publication of the American Chronic Pain Association. ##### His long-term goal is to keep the core features free, serving underserved and low-income communities, ensuring that assistive technology remains accessible. **Category:** Autoimmune Stories, Lupus, Multiple Sclerosis, Rheumatoid Arthritis --- ### [Sleep’s Important Role in MS Care](https://www.autoimmuneinstitute.org/research_updates/sleeps-important-role-in-ms-care/) **Published:** August 18, 2025 **Author:** Carolyn Serraino **Excerpt:** A 2025 review pulls together what we know about how sleep and multiple sclerosis (MS) influence each other and why sleep care should be part of MS treatment. Poor or fragmented sleep can tilt the immune system toward inflammation (via cytokines like IL-1, IL-6, and TNF-α), potentially worsening MS activity. Conversely, MS symptoms and treatments often disrupt sleep, creating a vicious cycle. Primary sleep disorders are especially common in MS: nearly half of patients report moderate to severe problems, with high rates of insomnia, restless legs syndrome (RLS), and obstructive sleep apnea (OSA). Objective sleep studies link lower sleep efficiency with more fatigue and reduced quality of life. **Content:** ### **Key Highlights** - Poor sleep fuels inflammation and may worsen MS activity. - Nearly half of MS patients experience sleep disorders such as insomnia, RLS, or OSA. - Sleep quality directly impacts fatigue and quality of life. - Biological links include neuroinflammation, oxidative stress, and the glymphatic system. - Treating sleep disorders could improve symptoms and possibly alter disease course. --- A [2025 review](https://www.sciencedirect.com/science/article/pii/S1568997225001636?via%3Dihub) pulls together what we know about how sleep and [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/ "Multiple sclerosis") (MS) influence each other and why sleep care should be part of MS treatment. Poor or fragmented sleep can tilt the immune system toward inflammation (via cytokines like IL-1, IL-6, and TNF-α), potentially worsening MS activity. Conversely, MS symptoms and treatments often disrupt sleep, creating a vicious cycle. Primary sleep disorders are especially common in MS: nearly half of patients report moderate to severe problems, with high rates of insomnia, restless legs syndrome (RLS), and obstructive sleep apnea (OSA). Objective sleep studies link lower sleep efficiency with more fatigue and reduced quality of life. On a biological level, sleep affects many of the same processes involved in MS. Poor sleep can worsen brain inflammation, increase stress on cells, and interfere with how the brain clears out waste during the night. Treating sleep problems like sleep apnea, restless legs, or insomnia may help lower inflammation, ease fatigue, and possibly even slow the disease. Some early studies also suggest that supplements such as melatonin or vitamin D could play a supportive role, though more research is needed. ##### Citation Cordone, S., Alfonsi, V., & De Gennaro, L. (2025). The role of sleep in multiple sclerosis. *Autoimmunity reviews*, *24*(11), 103902. Advance online publication. <https://doi.org/10.1016/j.autrev.2025.103902> **Category:** Multiple Sclerosis, Research Studies --- ### [Pathogenic Antibodies Identified in Rare Autoimmune Brain Disease](https://www.autoimmuneinstitute.org/research_updates/pathogenic-antibodies-identified-in-rare-autoimmune-brain-disease/) **Published:** December 19, 2025 **Author:** Carolyn Serraino **Content:** Researchers have provided direct evidence that patient-derived antibodies can actively damage nervous system cells in [myelin oligodendrocyte glycoprotein antibody–associated disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/myelin-oligodendrocyte-glycoprotein-antibody-disease-mogad/ "Myelin Oligodendrocyte Glycoprotein Antibody Disease (MOGAD)") (MOGAD), a rare and recently defined CNS demyelinating disease affecting the brain, optic nerves, and spinal cord. In this study, scientists isolated individual MOG-reactive B cells from people with MOGAD and used them to generate monoclonal anti-MOG antibodies in the laboratory. #### This allowed the team to study the behavior of single antibodies rather than mixed antibody pools found in patient blood. The researchers found that these patient-derived antibodies could trigger multiple immune attack mechanisms, including antibody-dependent phagocytosis, antibody-dependent cellular cytotoxicity, and complement-mediated cell death. In laboratory models, these immune responses led to damage and death of MOG-expressing cells, supporting a direct pathogenic role for anti-MOG antibodies in MOGAD. #### Importantly, the antibodies varied in how strongly they bound to MOG and how effectively they activated immune damage. Some antibodies showed evidence of affinity maturation, suggesting that ongoing immune activity may contribute to relapsing disease in some patients. Others appeared to originate from naïve B cells, pointing to a breakdown in immune tolerance. The findings also reinforce that MOGAD is biologically distinct from [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/ "Multiple sclerosis"), with different immune mechanisms involved. Researchers say this detailed antibody mapping may help improve diagnostic testing and guide the development of targeted therapies that focus on specific B-cell populations or antibody functions rather than broad immune suppression. This study strengthens the evidence that autoantibodies are not just markers of disease but active drivers of tissue damage in MOGAD. Understanding how specific antibodies harm myelin may lead to more precise treatments and avoid therapies that are ineffective or inappropriate for this distinct autoimmune condition. ##### Citation Wetzel, N. S., Kulsvehagen, L., Lecourt, A. C., Filipek, B., Lipps, P., Rieder, L., Berve, K., Krishnamoorthy, G., ‘t Hart, B. A., Schirmer, L., Yandamuri, S. S., O’Connor, K. C., & Pröbstel, A. K. (2026). Patient-Derived Monoclonal Myelin Oligodendrocyte Glycoprotein Autoantibodies Mediate Cytotoxicity. *Neurology(R) neuroimmunology & neuroinflammation*, *13*(1), e200520. <https://doi.org/10.1212/NXI.0000000000200520> **Category:** Autoimmune Brain Inflammation, Autoimmune Diseases, Research Studies, Therapies --- ### [Fine Particulate Matter in Air Pollution & Autoimmune Disease](https://www.autoimmuneinstitute.org/research_updates/fine-particulate-matter-in-air-pollution-autoimmune-disease/) **Published:** October 23, 2025 **Author:** Carolyn Serraino **Content:** While air pollution has been linked to systemic autoimmune rheumatic diseases, scientists know less about the impacts of [fine particulate matter](https://www.epa.gov/pm-pollution/particulate-matter-pm-basics), particles that are less than 2.5 micrometers in diameter, that is in air pollution. To explore this, researchers used serum samples from over 3,500 participants in the [Ontario Health Study](https://pmc.ncbi.nlm.nih.gov/articles/PMC10321700/) general population cohort. The Ontario Health Study is a broad population study that looks at how lifestyle, the environment, and genetics affect health. For each sample, the scientists looked at the levels of [antinuclear antibodies](https://www.autoimmuneinstitute.org/articles/autoimmunity-on-the-rise/) (ANA), a biomarker linked with autoimmune disease. They correlated ANA levels to fine particulate matter levels based on the participant’s zip code. The researchers found that fine particulate matter exposure was [associated with high levels of ANA](https://academic.oup.com/rheumatology/advance-article/doi/10.1093/rheumatology/keaf545/8300554) and think that it’s possible that fine particulate matter can change systemic immunity. This research adds to the growing body of evidence that air pollution affects the body beyond just the heart and the lungs. ##### **Citations** Zhao, N., Smargiassi, A., Chen, H., Choi, M. Y., Fritzler, M. J., Touma, Z., Antonio Aviña-Zubieta, J., & Bernatsky, S. (2025). Fine particulate matter air pollution and anti-nuclear antibodies. Rheumatology (Oxford, England), keaf545. Advance online publication. <https://doi.org/10.1093/rheumatology/keaf545> Kirsh, V. A., Skead, K., McDonald, K., Kreiger, N., Little, J., Menard, K., McLaughlin, J., Mukherjee, S., Palmer, L. J., Goel, V., Purdue, M. P., & Awadalla, P. (2023). Cohort Profile: The Ontario Health Study (OHS). International journal of epidemiology, 52(2), e137–e151. [https://doi.org/10.10](https://doi.org/10.1093/ije/dyac156)[9](https://doi.org/10.1093/ije/dyac156)[3/ije/dyac156](https://doi.org/10.1093/ije/dyac156) **Category:** Autoimmune Diseases, Research Studies, Risk Factors --- ### [What We Know Now About Inverse Vaccines](https://www.autoimmuneinstitute.org/research_updates/what-we-know-now-about-inverse-vaccines/) **Published:** December 12, 2025 **Author:** Carolyn Serraino **Content:** Since [inverse vaccines](https://www.autoimmuneinstitute.org/research_updates/revolutionary-inverse-vaccine-offers-hope-for-autoimmune-disease-treatment/ "Revolutionary ‘Inverse Vaccine’ Offers Hope for Autoimmune Disease Treatment") were first proposed as a potential means of retraining the immune system in autoimmune disease, new research has clarified how immune tolerance is actively enforced at the cellular level and why certain delivery strategies may be more effective than others. A recent study published in *Nature* sheds light on the role of a specialized group of immune cells, known as **type 1 conventional dendritic cells (cDC1s)**, in determining whether an immune response becomes inflammatory or tolerant. The researchers identified a molecular switch on these cells, the **erythropoietin receptor (EPOR)**, that helps guide immune responses toward tolerance rather than attack. When this pathway is engaged, cDC1s are more likely to promote the development of regulatory T cells. Regulatory T cells play a central role in preventing autoimmune disease by keeping self-reactive immune cells in check, and their dysfunction has been linked to conditions such as [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/ "Multiple sclerosis"), [celiac disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/celiac-disease/ "Celiac disease"), and [type 1 diabetes](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/type-1-diabetes-insulin-dependent-diabetes/ "Type 1 diabetes / insulin-dependent diabetes"). #### This process appears to preserve the immune system’s ability to respond to infections and cancer, while selectively dampening responses to specific antigens. These findings help explain why inverse vaccine strategies that leverage natural tolerance-promoting environments such as the liver have shown promise in preclinical models and early human studies. By presenting disease-related antigens in a context the immune system recognizes as “safe,” researchers aim to silence harmful immune reactions without broad immunosuppression. At the same time, the study underscores why inverse vaccines are unlikely to be universal or straightforward solutions. Immune tolerance depends on precise cellular programming, timing, and antigen specificity. Disrupting these pathways can have opposite effects, such as enhancing immune responses in cancer, highlighting the need for careful clinical translation. Together, these insights reinforce the idea that inverse vaccines represent precision immune reprogramming, not immune shutdown, and that understanding the biology of tolerance is essential before this approach can be widely applied in autoimmune disease. ##### Citation Zhang, X., McGinnis, C.S., Yu, G. *et al.* Erythropoietin receptor on cDC1s dictates immune tolerance. *Nature* (2025). <https://doi.org/10.1038/s41586-025-09824-z> **Category:** Research Studies, Therapies --- ### [Revolutionary ‘Inverse Vaccine’ Offers Hope for Autoimmune Disease Treatment](https://www.autoimmuneinstitute.org/research_updates/revolutionary-inverse-vaccine-offers-hope-for-autoimmune-disease-treatment/) **Published:** September 13, 2023 **Author:** Elevation **Excerpt:** A research team has developed an innovative "inverse vaccine" that could potentially treat autoimmune diseases, including multiple sclerosis (MS), type 1 diabetes, rheumatoid arthritis, and Crohn's disease. This groundbreaking approach could offer more specificity in treatment, minimizing side effects and enhancing patient safety compared to current treatments that broadly suppress the immune system. **Content:** A research team has developed an innovative “inverse vaccine” that could potentially treat autoimmune diseases, including [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/multiple-sclerosis/), [type 1 diabetes](https://www.autoimmuneinstitute.org/autoimmune-resources/diabetes-type-1/), [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/rheumatoid-arthritis/), and [Crohn’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/crohns-disease/). The researchers at the University of Chicago’s Pritzker School of Molecular Engineering published their findings in *Nature Biomedical Engineering* earlier this month. Traditional vaccines teach the immune system to recognize and attack specific pathogens, but this new approach aims to do the opposite by essentially marking cells to be *ignored* rather than targeted. #### The inverse vaccine utilizes the liver’s natural mechanism (peripheral immune tolerance) to tag molecules with degraded cells, preventing autoimmune reactions against these molecules. This technique is desirable in the context of autoimmune diseases because normal tissue is mistakenly recognized as foreign or harmful and is attacked by immune cells. By combining an antigen with a molecule resembling a fragment of an aging cell, the researchers demonstrated that the vaccine could halt autoimmune responses, particularly in an MS-like disease, **even when inflammation was already ongoing**. #### This groundbreaking approach could offer more specificity in treatment, minimizing side effects and enhancing patient safety compared to current treatments that broadly suppress the immune system. Safety trials have already begun, with the hope of advancing this promising technology toward clinical use. ##### Citation Tremain, A.C., Wallace, R.P., Lorentz, K.M. *et al.* Synthetically glycosylated antigens for the antigen-specific suppression of established immune responses. *Nat. Biomed. Eng* **7**, 1142–1155 (2023). <https://doi.org/10.1038/s41551-023-01086-2> **Category:** Autoimmune Diseases, IBD (Crohn's and UC), Multiple Sclerosis, Research Studies, Rheumatoid Arthritis, Therapies, Type 1 Diabetes --- ### [Promising Phase III Trial for Immune Thrombocytopenia Treatment](https://www.autoimmuneinstitute.org/research_updates/promising-phase-iii-trial-for-immune-thrombocytopenia-treatment/) **Published:** December 15, 2025 **Author:** Carolyn Serraino **Content:** [Immune thrombocytopenia](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/immune-thrombocytopenia/) (ITP) is an autoimmune disease where the immune system attacks platelets in the blood, resulting in a low platelet count. Because platelets normally help the blood clot, low platelet counts can lead to significant bruising or bleeding. Patients with ITP can be treated with steroids, but those that don’t respond to this require a different type of medication. Medications, such as eltrombopag, can help increase platelet counts but often require daily or weekly dosing. Novartis recently published the results of a Phase III clinical trial showing that treatment with the monoclonal antibody ianalumab alongside eltrombopag can help extend the “time to treatment failure” compared to eltrombopag alone. The “time to treatment failure” data point can indicate how long a treatment lasts, with longer times indicating that a therapy holds up better. Those treated with both drugs had a time to treatment failure of over one year while those on eltrombopaq had a time to treatment failure of 4.7 months. If approved, this drug can give patients the possibility of reducing the need for chronic treatment. Treatment with ianalumab decreases the autoreactive B cells that cause ITP and this drug has also been explored to treat other autoimmune diseases. ##### **Citation** Cuker, A., Stauch, T., Cooper, N., Al-Samkari, H., Michel, M., Ghanima, W., Urban, P., Fronczek, J., Foster, M., Weill, M., Zhang, L., Hou, M., Zander, T., Sharif, A., Sun, J., Nath, U. K., Schutgens, R., Rossi, E., Deleu, L., Červinek, L., … VAYHIT2 Investigators (2025). Ianalumab plus Eltrombopag in Immune Thrombocytopenia. *The New England Journal of Medicine*, 10.1056/NEJMoa2515168. Advance online publication. <https://doi.org/10.1056/NEJMoa2515168> **Category:** Autoimmune Diseases, Clinical Trials, Therapies --- ### [Could AI Help Personalize Stem Cell Therapy for Lupus?](https://www.autoimmuneinstitute.org/research_updates/could-ai-help-personalize-stem-cell-therapy-for-lupus/) **Published:** November 27, 2025 **Author:** Carolyn Serraino **Content:** Researchers are exploring how [artificial intelligence](https://www.autoimmuneinstitute.org/articles/the-promise-of-ai-in-autoimmune-disease-from-early-detection-to-personalized-care "The Promise of Artificial Intelligence in Autoimmune Disease Healthcare") could help improve mesenchymal [stem cell](https://www.autoimmuneinstitute.org/articles/stem-cell-therapy-for-autoimmune-disease "Stem Cell Therapy for Autoimmune Disease") (MSC) therapies for [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus") by making treatments more consistent and [personalized](https://www.autoimmuneinstitute.org/articles/personalized-medicine-for-autoimmune-diseases "Personalized Medicine for Autoimmune Diseases"). MSC therapy has shown promise in lupus because these cells can help calm immune overactivity while also supporting tissue repair. However, results across studies have been mixed. Differences in cell sources, culture conditions, dosing strategies, patient immune profiles, and concurrent medications all influence how well MSC therapy works, making outcomes difficult to predict. #### This new review outlines how AI and machine learning tools could help address these challenges by analyzing large and complex datasets. Potential applications include predicting how stem cells will behave under different culture or priming conditions, identifying molecular features linked to stronger immunomodulatory effects, and tailoring dosing strategies to individual patients. AI-based approaches may also help optimize how stem cell therapies are combined with existing lupus treatments. While these strategies are still largely at the research and development stage, the authors argue that AI-guided personalization could move stem cell therapy away from a one-size-fits-all approach. For a disease as biologically diverse as lupus, this type of precision could be key to improving reliability, safety, and long-term effectiveness. ##### Citation Rajeev Kumar, S., Kai He, K., Lokanathan, Y., Gaurav, A., Yusoff, K., Macedo, M. F., & Bhassu, S. (2025). How artificial intelligence can enable personalized mesenchymal stem cell-based therapeutic strategies in systemic lupus erythematosus. *Frontiers in immunology*, *16*, 1654117. <https://doi.org/10.3389/fimmu.2025.1654117> **Category:** Lupus, Research Studies, Therapies --- ### [c-Maf: The Immune “Brake” Shaping Autoimmune Disease](https://www.autoimmuneinstitute.org/research_updates/c-maf-the-immune-brake-shaping-autoimmune-disease/) **Published:** November 26, 2025 **Author:** Carolyn Serraino **Excerpt:** The transcription factor c-Maf acts like an immune-system “programmer,” helping to decide when immune cells ramp up inflammation versus applying the brakes. However, rather than acting as simply an on/off switch, c-Maf functions more like a dimmer, shaping how immune cells develop and how much inflammation they produce. This new review explains how c-Maf functions as an immune checkpoint, shaping the development and behavior of many immune cell types, including T cells, B cells, innate lymphoid cells, and macrophages, and why that matters for autoimmune disease. **Content:** What Is a Transcription Factor? A **transcription factor** is a type of protein that helps control how cells behave by deciding which genes are turned on or off. Every cell contains the same DNA, but not every gene is active at the same time. Transcription factors bind to DNA and guide the cell on when to make specific proteins. Those proteins then influence how a cell grows, responds to stress, or communicates with other cells. In the immune system, transcription factors help determine what type of immune cell develops, how strongly it responds to a trigger, and when an immune response should slow down or stop. Because of this role, changes in transcription factor activity can strongly shape inflammation, immune tolerance, and the risk of autoimmune disease. The transcription factor c-Maf acts like an immune-system “programmer,” helping to decide when immune cells ramp up inflammation versus applying the brakes. However, rather than acting as simply an on/off switch, c-Maf functions more like a dimmer, shaping how immune cells develop and how much inflammation they produce. This new review explains how c-Maf functions as an immune checkpoint, shaping the development and behavior of many immune cell types, including T cells, B cells, innate lymphoid cells, and macrophages, and why that matters for autoimmune disease. A key role of c-Maf is promoting IL-10, an anti-inflammatory signaling protein that helps calm immune responses once a threat has passed. Through this pathway, c-Maf supports immune tolerance and helps prevent excessive or chronic inflammation. The review also explains how c-Maf influences specific immune cell subsets such as regulatory T cells and follicular helper T cells that play important roles in antibody production and immune regulation. Disruptions in c-Maf-controlled pathways have been linked to several autoimmune diseases, including inflammatory bowel disease ([Crohn’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crohns-disease/ "Crohn’s disease") and [ulcerative colitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ulcerative-colitis/ "Ulcerative colitis")), [type 1 diabetes](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/type-1-diabetes-insulin-dependent-diabetes/ "Type 1 diabetes / insulin-dependent diabetes"), [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus"), [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/ "Multiple sclerosis"), and [immune thrombocytopenia](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/immune-thrombocytopenia/ "Immune thrombocytopenia / autoimmune thrombocytopenia purpura") (ITP). When c-Maf signaling is altered, the immune system may produce excessive inflammation or fail to properly regulate antibody-driven immune responses. The authors note that while c-Maf represents a promising target for future therapies, transcription factors are difficult to target directly. In addition, c-Maf can play different roles depending on the disease and immune context, meaning any future treatments would need to be carefully tailored rather than broadly applied. ##### Citation Liu, N., Zhang, J., Wang, P., Jin, S., Yang, C., Yan, X., Xu, J., Wang, H., Sun, W., & Xu, D. (2025). Transcription factor c-Maf: a checkpoint that programs autoimmunity. *Frontiers in immunology*, *16*, 1682098. <https://doi.org/10.3389/fimmu.2025.1682098> **Category:** Autoimmune Diseases, IBD (Crohn's and UC), Lupus, Multiple Sclerosis, Research Studies, Therapies, Type 1 Diabetes --- ### [CD226+ B-Cells Linked to Sjögren’s Syndrome Severity](https://www.autoimmuneinstitute.org/research_updates/cd226-b-cells-linked-to-sjogrens-syndrome-severity/) **Published:** July 28, 2025 **Author:** Carolyn Serraino **Content:** A new study has found that a type of immune cell, known as a B-cell, expressing the protein CD226 may play a crucial role in [primary Sjögren’s syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sjogren-syndrome/ "Sjögren disease (SjD)") (pSS). People with this condition had more CD226-positive B-cells in their blood than healthy individuals, and the higher their levels, the worse their symptoms and disease activity. Sjögren’s syndrome occurs when the immune system mistakenly attacks the glands that produce tears and saliva, resulting in dry eyes and a dry mouth. #### In this study, CD226+ B-cells were associated not only with these hallmark symptoms but also with fatigue, joint pain, and lung involvement. These cells also produced more inflammatory signals and antibodies than other B-cells, suggesting they may drive ongoing immune system attacks. Importantly, researchers found that CD226+ B-cells were also present in the salivary glands of individuals with Sjögren disease, and in laboratory models, they demonstrated activity in pathways known to fuel autoimmune disease. #### The results suggest these cells could serve as a biomarker (a measurable indicator of disease activity) and a potential target for new treatments. More research is needed, but this discovery could open new paths toward therapies that modify the disease rather than just treat symptoms. ###### Citation Zhao, P., Song, S., Zhang, S., Peng, C., Cheng, W., Chang, X., Xie, C., Hu, Z., & Liu, C. (2025). CD226+ B cells in primary Sjögren’s syndrome: a key player in clinical manifestations and disease pathogenesis. *Frontiers in immunology*, *16*, 1623774. <https://doi.org/10.3389/fimmu.2025.1623774> **Category:** Research Studies, Risk Factors, Sjögren disease --- ### [New EBV Receptors Reveal Targets for Therapies](https://www.autoimmuneinstitute.org/research_updates/new-ebv-receptors-reveal-targets-for-therapies/) **Published:** September 30, 2025 **Author:** Carolyn Serraino **Content:** Infection with Epstein-Barr virus (EBV) [has been linked to](https://www.autoimmuneinstitute.org/research_updates/how-interactions-between-genetic-variants-and-epstein-barr-virus-infection-contribute-to-multiple-sclerosis/) the development of [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/ "Multiple sclerosis") and other autoimmune disorders. Research in the past has identified a number of receptors involved in how the virus enters human cells, including a glycoprotein complex that has a central role in EBV infection. Now, three new research studies identified additional receptors involved in this process: - Desmocollin 2: Two of these studies identified desmocollin 2 as a main receptor for the glycoprotein complex. Even in the presence of other receptors, if desmocollin 2 wasn’t missing, EBV couldn’t infect. - R9AP:  This receptor is expressed on both epithelial and B cells, two cell types that EBV infects. **Why does this research matter?** Discovering new receptors involved in EBV infection means that drug developers have additional targets to block viral entry and infection. This can help develop therapeutics that could prevent initial infection or limit reactivation of the virus. ##### Citation Liu, S., & Hahn, A.S. (2025). Identified receptors shed light on Epstein–Barr virus infection. *Nature Microbiology*. <https://doi.org/10.1038/s41564-025-02123-3> **Category:** Multiple Sclerosis, Research Studies, Therapies --- ### [How EBV Reprograms B Cells to Trigger Lupus](https://www.autoimmuneinstitute.org/research_updates/how-ebv-reprograms-b-cells-to-trigger-lupus/) **Published:** November 14, 2025 **Author:** Carolyn Serraino **Content:** Most people in the world become infected with [Epstein-Barr virus](https://www.cdc.gov/epstein-barr/about/index.html) (EBV). Yet, this infection is often not symptomatic or can be mistaken for other childhood illnesses. Scientists have long linked this virus to autoimmune diseases, such as [lupus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus"), and [long COVID](https://www.autoimmuneinstitute.org/category/covid-19-and-long-covid/ "COVID-19 and Long Covid"), but the mechanisms behind this connection have remained unclear. What is clear though is that not everyone infected with EBV develops these illnesses, but just about everyone with lupus has been infected by EBV. Now, a new study looks at what happens to B cells infected by EBV. Normally these B cells act as “antigen-presenting cells” where they process pieces of invading microbes, display them on their surfaces, and prompt other immune cells to mount an attack on pathogens. A subset of these B cells target antigens that are present from our own bodies called self-antigens, but these cells remain in a dormant state. This new study finds that in lupus patients, nearly 1 in 400 B cells are infected by EBV (in contrast, just 1 in 10,000 B cells are infected in healthy people). In these cells, the virus produces a protein that activates a cascade of gene expression within the B cell that leads the cell to become inflammatory. These inflammatory B cells also activate self-reactive T cells, which stimulate the immune response against components of the cell nucleus. The result: lupus. This study is broadly important because it’s possible that EBV reprograms autoreactive B cells in other autoimmune diseases. Understanding how this process works in a variety of diseases could help researchers get closer to therapeutics to block this cascade of events after EBV infection. ##### **Citation** Younis, S., et al. (2025). Epstein-Barr virus reprograms autoreactive B cells as antigen-presenting cells in systemic lupus erythematosus. *Science Translational Medicine*, 17(824), eady0210. <https://doi.org/10.1126/scitranslmed.ady0210> **Category:** Genetics, Lupus, Research Studies, Risk Factors --- ### [How Oral Lichen Planus Connects to Systemic Autoimmune Disease](https://www.autoimmuneinstitute.org/research_updates/how-oral-lichen-planus-connects-to-systemic-autoimmune-disease/) **Published:** December 2, 2025 **Author:** Carolyn Serraino **Content:** A literature review recently published in the *Journal of Dental Research* examined current evidence on the relationship between systemic diseases and oral [lichen planus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/lichen-planus/ "Lichen planus") (OLP), an autoimmune disorder in which CD8+ T cells target basal keratinocytes in the oral mucosa. OLP affects about 1% of the population and may also involve other mucosal sites, including the esophagus and genital mucosa. Clinically, it is defined by characteristic lace-like white lesions, supported by histopathologic findings such as basal-layer degeneration and a bandlike lymphocytic infiltrate. ### **OLP and Diabetes** Current literature on the relationship between OLP and diabetes is conflicting. While over 100 studies have shown a significantly higher risk of developing Type 2 diabetes, there are few studies (only five primary studies) currently available with a focus on [Type 1 diabetes](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/type-1-diabetes-insulin-dependent-diabetes/ "Type 1 diabetes / insulin-dependent diabetes") (T1D), which is also an autoimmune disease. The authors noted that a T1D prevalence of 1.62% was determined in OLP patients. T1D patients often present a “state of systemic autoimmunity, with a predisposition to develop multiple autoimmune diseases simultaneously; therefore, it can be suggested that the association between OLP and diabetes mellitus, especially Type 2, may be bidirectional. ### **OLP and Thyroid Disease** Patients with OLP have a significantly higher risk of developing thyroid disease than the general population, with meta-analysis results showing [Hashimoto’s](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/hashimotos-thyroiditis/ "Hashimoto’s thyroiditis / autoimmune thyroiditis") being the most prevalent form in patients with OLP. In fact, the risk of developing Hashimoto’s with OLP is 2.2x higher than in the general population. The prevalence of Graves’ disease (the result of an overactive thyroid gland) is inconclusive from current literature. The link between Hashimoto’s and OLP may come from cross-immunity. The authors note that some studies suggest that certain thyroid proteins resemble proteins in the oral tissues, which could confuse the immune system and trigger both conditions. Another possibility is that thyroid receptor (TSHR) expression is more common in the mouth lesions of people with thyroid disease, suggesting a shared biological pathway. While larger-scale studies show that OLP and thyroid disorders frequently occur together, it still remains unclear which one comes first, or if they share an underlying autoimmune pathogenesis. ### **OLP and Celiac Disease** The last autoimmune disease covered in this literature review is [celiac disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/celiac-disease/ "Celiac disease"). “Patients with OLP suffer from celiac disease in 8.66% of cases, with a risk 18.44 times higher than the general population”. In contrast, the prevalence of celiac disease in the general population is around 1.4%. Cross-autoimmunity has been hypothesized for this phenomenon. A target enzyme in celiac disease may share the same structure homology with proteins of the mouth’s oral lining, allowing T lymphocytes activated by gluten to contribute to the pathogenesis of OLP. It has also been reported that the immune response to gluten may also attack oral mucosa, causing epithelial disruption and compromising the mucosal barrier. This process may also lead to the development of OLP, but evidence remains limited for both. ##### Citation Warnakulasuriya, S., Ramos-García, P., & González-Moles, M.Á. (2025, November 18). *Oral Lichen Planus and Systemic Diseases.* *Journal of Dental Research.* Advance online publication. <https://doi.org/10.1177/00220345251385966> **Category:** Autoimmune Diseases, Celiac Disease, Research Studies, Risk Factors, Thyroid Disease, Type 1 Diabetes --- ### [Brain Waste-Clearance Impairments Tied to ME/CFS](https://www.autoimmuneinstitute.org/research_updates/brain-waste-clearance-impairments-tied-to-me-cfs/) **Published:** November 28, 2025 **Author:** Carolyn Serraino **Content:** A new perspective article from Stanford researchers proposes that dysfunction of the glymphatic system, the brain’s waste-clearance network, may be a central contributor to the neurological symptoms of [Myalgic Encephalomyelitis/Chronic Fatigue Syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/me-cfs/ "Myalgic encephalomyelitis / chronic fatigue syndrome") (ME/CFS). The glymphatic system typically removes metabolic byproducts such as lactate, glutamate, tau, and beta-amyloid, especially during deep sleep. #### When this system is impaired, these metabolites can accumulate, triggering oxidative stress, neuroinflammation, and impaired neuronal signaling. The authors outline multiple biological pathways in ME/CFS that may converge on glymphatic failure, including blood–brain barrier disruption, chronic neuroinflammation, mitochondrial dysfunction, impaired cerebral blood flow, sleep instability, dysautonomia, and viral reactivation. They highlight AQP4, a water-channel protein in astrocytes essential for glymphatic flow, as a possible mechanistic link: oxidative stress, autoantibody activity, or membrane disruption may mislocalize or reduce AQP4, compromising waste clearance. #### These disruptions may help explain hallmark symptoms such as post-exertional malaise, brain fog, unrefreshing sleep, and orthostatic intolerance. The paper also discusses emerging therapeutic strategies targeting glymphatic function, including sleep-based interventions, neuromodulation, and agents that modulate AQP4 regulation. While not a clinical study, the article provides a cohesive model that unifies many ME/CFS abnormalities within a glymphatic-centered framework, offering new directions for diagnostics and future treatment research. The findings add to a growing body of evidence confirming that the cognitive and neurological challenges described by ME/CFS patients are rooted in identifiable biological dysfunction, directly countering the long-held misconception that these symptoms were imagined. ##### Citation Nemat-Gorgani, M., Jensen, M. A., & Davis, R. W. (2025). Glymphatic System Dysregulation as a Key Contributor to Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. *International Journal of Molecular Sciences*, *26*(23), 11524. <https://doi.org/10.3390/ijms262311524> **Category:** ME/CFS, Research Studies --- ### [NASPGHAN 2025 Marks Major Shift in Celiac Disease Care & Research](https://www.autoimmuneinstitute.org/research_updates/naspghan-2025-marks-major-shift-in-celiac-disease-care-research/) **Published:** November 7, 2025 **Author:** Carolyn Serraino **Content:** For the first time, the [North American Society for Pediatric Gastroenterology, Hepatology & Nutrition (NASPGHAN)](https://celiac.org/2025/11/07/clearing-the-crumbs-at-naspghan-2025/) dedicated an entire Single Topic Symposium to [celiac disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/celiac-disease/ "Celiac disease"), an autoimmune condition that affects roughly 1 in 100 children but remains frequently missed or diagnosed late. More than 350 clinicians, researchers, dietitians, and mental health professionals attended, reflecting growing recognition that celiac disease requires earlier detection, better follow-up care, and broader clinical expertise beyond specialty centers. Speakers highlighted several key problems driving underdiagnosis, including persistent disparities in testing among children from lower-income and minority communities. Experts emphasized that screening is especially critical in children with related autoimmune conditions such as [Type 1 diabetes](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/type-1-diabetes-insulin-dependent-diabetes/ "Type 1 diabetes / insulin-dependent diabetes") and [autoimmune thyroid disease](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/hashimotos/ "Hashimoto's Thyroiditis/Autoimmune Thyroiditis"), where risk is significantly higher. Sessions also covered practical challenges pediatricians face when evaluating symptoms, deciding when to perform a gluten challenge, and interpreting inconsistent biopsy or antibody results. The symposium underscored that accurate diagnosis is central to preventing years of uncertainty and avoiding unnecessary dietary restriction. Emerging research presented at the meeting pointed to major changes ahead: microbiome-targeted therapies, immune-modulating drugs, AI-supported diagnostics, and new clinical trial designs centered on quality of life. For families, these advances signal a future in which celiac disease may be easier to identify, treat, and manage, and one where strict lifelong gluten avoidance may no longer be the only option. **Category:** Celiac Disease, Events, Microbiome, Research Studies, Risk Factors, Therapies, Thyroid Disease, Type 1 Diabetes --- ### [Biologic-Induced Lichen Planus](https://www.autoimmuneinstitute.org/research_updates/biologic-induced-lichen-planus/) **Published:** October 27, 2025 **Author:** Carolyn Serraino **Content:** [Lichen planus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/lichen-planus/ "Lichen planus") (LP) is a chronic inflammatory immune-mediated disorder of the skin and mucous membranes, also affecting hair and nails, and is typically triggered by viral infections as well as pharmacological agents. With the increased use of biologics, lichen planus has gained recognition as a drug-induced adverse event. Recently, a literature review was published in the *Journal of Inflammation Research* exploring how modern biologic therapies can trigger lichen planus. This is considered a paradox as biologics are designed to suppress inflammation. Lichen planus has a hyper-inflammatory effect driven by a cytotoxic immune response that induces the cellular death of skin stem cells at the lowest layer of the epidermis. The authors analyzed 145 publications describing 157 cases of lichen planus or lichenoid eruptions associated with biologic agents, aiming to uncover correlations and a more well-rounded understanding of the possible immune mechanisms driving these reactions. Drug-induced lichen planus presents in a wide range of forms: classic cutaneous LP, oral LP, lichen planus pemphigoides, nail LP, and lichen planopilaris (from most to least commonly referred to in the literature, respectively). The biologic classes most frequently implicated were immune checkpoint inhibitors (anti-PD-1/PD-L1), tumor necrosis factor-alpha (TNF-α) inhibitors, and inhibitors of IL-17 and IL-23. Several overlapping immune pathways may explain how LP develops in a state of immunosuppression. “They appear to result from disruptions to immune homeostasis that ultimately favor cytotoxic T cell-mediated injury at the dermoepidermal junction… \[these include\] cytokine imbalance, immune pathway redirection, unmasking of antigens and epitope spreading, dysregulation of keratinocyte apoptosis pathways, and potential genetic or host susceptibility factors.” Most cases improved after discontinuation of the biologic and standard lichen planus therapies (which include steroid-sparing agents), but the unpredictable onset and variety of presentations highlight the need for clinician awareness. Authors also emphasize that the findings compiled in the review are largely observational, primarily based on case reports. Furthermore, future research focusing on identifying biomarkers, as well as genetic and cytokine profiles, that predict susceptibility may lead to a safer use of biologics in patients with autoimmune predispositions. ##### Citation Podolsky, A. S., & Lipner, S. R. (2025). Mechanisms Underlying Lichen Planus in Association with Biologic Therapy. *Journal of inflammation research*, *18*, 14961–14970. <https://doi.org/10.2147/JIR.S554375> **Category:** Autoimmune Diseases, Research Studies, Risk Factors, Therapies --- ### [TPO Antibodies Predict Thyroid Disease in Type 1 Diabetes](https://www.autoimmuneinstitute.org/research_updates/tpo-antibodies-predict-thyroid-disease-in-type-1-diabetes/) **Published:** November 21, 2025 **Author:** Carolyn Serraino **Content:** A retrospective, 30-year longitudinal study published in *Frontiers in Endocrinology* examined whether thyroid peroxidase antibodies (TPO-Abs) present at the onset of [type 1 diabetes](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/type-1-diabetes-insulin-dependent-diabetes/ "Type 1 diabetes / insulin-dependent diabetes") (T1D) predict later thyroid dysfunction, including autoimmune thyroid disease. The study followed 160 individuals diagnosed with T1D between 1987 and 1994, with an average follow-up time of 30.6 years. At diabetes onset, 21.9% of participants tested positive for TPO-Abs. Over the subsequent decades, 84% of those who were antibody-positive developed thyroid dysfunction, including 20 cases of hypothyroidism and one case of Graves’ disease. The authors also documented seroconversion: 18 participants who were initially TPO-Ab negative developed detectable antibodies after an average of 17.3 years. Of these, 72% later developed thyroid dysfunction (11 hypothyroidism, 2 [Graves’ disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/graves-disease/ "Graves’ disease")), often emerging around the same time as antibody conversion. Only one participant who remained antibody-negative throughout the entire follow-up period developed subclinical hypothyroidism. Age at diabetes onset significantly modified risk. In adults diagnosed with T1D, TPO-Ab positivity at the time of diagnosis was a strong predictor of future thyroid dysfunction. In those diagnosed before age 18, the risk was lower at diagnosis, but many thyroid disorders in this group arose from later seroconversion rather than antibody status at onset. #### TPO-Ab positivity remained an independent predictor of thyroid dysfunction even after adjusting for sex and other variables. Based on these findings, the authors propose an age-tailored screening strategy. They recommend measuring TPO-Abs and thyroid-stimulating hormone (TSH) at the time of T1D diagnosis. For antibody-positive individuals, annual TSH testing is advised. For antibody-negative adolescents, repeating TPO-Abs and TSH every two years, especially after puberty, may help identify seroconversion early. For asymptomatic, antibody-negative adults, routine repeat screening may not be necessary, as most remained euthyroid over the 30-year period. The authors note two limitations: the baseline TPO-Ab assay was less sensitive than current methods, and thyroid testing intervals varied over time. ##### Citation Carreras, G., Mendoza, L. C., Colom, C., Tirado-Capistros, M., Sardà, H., Sánchez-Quesada, J. L., & Pérez, A. (2025). Thyroid autoimmunity at onset of type 1 diabetes as a predictor of thyroid dysfunction: A thirty-years retrospective longitudinal study. *Frontiers in Endocrinology, 16*, 1699111. <https://doi.org/10.3389/fendo.2025.1699111> **Category:** Autoimmune Diseases, Diagnostic Testing, Research Studies, Thyroid Disease, Type 1 Diabetes --- ### [How NETs Drive Autoimmune Disease and New Treatment Targets](https://www.autoimmuneinstitute.org/research_updates/how-nets-drive-autoimmune-disease-and-new-treatment-targets/) **Published:** November 17, 2025 **Author:** Carolyn Serraino **Content:** A study published in *Frontiers in Immunology* reviewed the emerging role of neutrophil extracellular traps (NETs) in the development and progression of autoimmune diseases. The authors argue that NETs are central players in autoimmune pathology because they bridge innate and adaptive immunity, serve as sources of autoantigens, and directly damage tissues. NETs are web-like DNA–protein structures released by neutrophils in response to stimuli such as cytokines, pathogens, or chemical triggers. Although NETs play a protective role in antimicrobial defense, excessive formation or impaired clearance contributes to autoimmune disease. Under normal conditions, neutrophils kill pathogens through phagocytosis and enzyme release. When confronted by large organisms that cannot be engulfed, they expel DNA, histones, and proteins like neutrophil elastase (NE) and myeloperoxidase (MPO) to form NETs, which immobilize and degrade pathogens extracellularly. NETs promote inflammation by releasing DAMPs, histones, and proteases, further activating immune pathways and potentially supplying autoantigens that can bind autoantibodies. The authors detail how dysregulated NETs contribute to several autoimmune diseases, including [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus") (SLE), [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid arthritis") (RA), [antiphospholipid syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/antiphospholipid-syndrome/ "Antiphospholipid syndrome") (APS), and [type 1 diabetes](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/type-1-diabetes-insulin-dependent-diabetes/ "Type 1 diabetes / insulin-dependent diabetes") (T1D). NET accumulation and impaired clearance are also well-documented in [ANCA-associated vasculitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/microscopic-polyangiitis-anca-associated-vasculitis/ "Microscopic polyangiitis / ANCA-associated vasculitis") (AAV) and psoriasis. In RA, NETs form readily in the synovial fluid. Citrullinated histones within NETs can drive ACPA production, while NET-derived enzymes and cytokines contribute to cartilage damage. In SLE, NETs persist due to impaired degradation and contain enriched citrullinated histones and oxidized mitochondrial DNA, potent autoantigens that amplify interferon-driven inflammation and form a self-sustaining inflammatory loop. In T1D, elevated NET markers appear early after disease onset. Neutrophils infiltrate the pancreas and release NETs that damage beta cells and activate innate and adaptive immune pathways. In APS, antiphospholipid antibodies can trigger NET release through β2-glycoprotein I–dependent mechanisms, and anti-NET antibodies may further impair NET clearance. The authors also highlight therapeutic strategies targeting NETs, including inhibitors of ROS, PAD4, NE, and MPO that prevent NET formation. (ROS, NE, MPO, and PAD4 are all essential components of NETosis.) Additional approaches include enhancing NET clearance with DNase-based therapies and using biologics that modulate type I interferon signaling, since NETs strongly activate IFN pathways. ##### Citation Tang, R., Yin, J., Qin, Z., Zhang, M., & Jia, X. (2025). NETs: a new target for autoimmune disease. *Frontiers in immunology*, *16*, 1646527. <https://doi.org/10.3389/fimmu.2025.1646527> **Category:** Autoimmune Diseases, Lupus, Psoriasis, Research Studies, Rheumatoid Arthritis, Type 1 Diabetes --- ### [Sjögren’s and Lupus: New Insights on Remission](https://www.autoimmuneinstitute.org/research_updates/sjogrens-and-lupus-new-insights-on-remission/) **Published:** October 13, 2025 **Author:** Carolyn Serraino **Content:** A recent study published in *Frontiers in Immunology* examined how [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus") (SLE) overlapping with [Sjögren’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sjogren-syndrome/ "Sjögren disease (SjD)") affects long-term outcomes, especially the likelihood of reaching low disease activity or remission. Sjögren’s disease is the most common connective tissue disease to co-occur with SLE, appearing in roughly 6.5% to 14.5% of patients (as noted by the authors). Using data from 626 adults in the Peking University First Hospital SLE cohort, followed for a median of 4.3 years, researchers found that 12.3% (77 patients) also had Sjögren’s disease. These patients were further categorized by immunological profile: anti-SSA positivity alone, combined anti-SSA/SSB positivity (“double-positive” Sjögren’s), and baseline hypergammaglobulinemia. Hypergammaglobulinemia refers to elevated IgG levels and often reflects high B-cell activity in autoimmune disease. To fairly compare outcomes with SLE-only patients, the researchers used propensity score matching to adjust for key confounders, including age of onset, disease duration, organ involvement, serology, and baseline treatment. They then applied time-to-event modeling to assess how each Sjögren’s subtype influenced the likelihood of achieving lupus low disease activity state (LLDAS) or remission on treatment (RONT). Overall, overlapping Sjögren’s disease was associated with a 24% higher likelihood of achieving LLDAS, meaning these patients were somewhat more likely to reach a stable low-activity state. However, it also significantly reduced the probability of achieving remission by 29% for clinical remission and 38% for complete remission, depending on the definition. This pattern was driven largely by challenges achieving normal serology (anti-dsDNA and complement), which is required for complete remission and was consistently harder for patients with overlap. Subtype analysis revealed important differences. Patients with anti-SSA/SSB double positivity had the *poorest* remission outcomes, with up to a 50% reduction in the chance of achieving remission and a 35–36% reduction in achieving normal serology. Meanwhile, patients with baseline hypergammaglobulinemia showed a protective association: they were more likely to reach LLDAS and, in some analyses, more likely to reach clinical or complete remission. Anti-SSA single-positive Sjögren’s disease did not have a clear independent effect. These findings reinforce that SLE patients with overlapping Sjögren’s disease are not a uniform group. Their immunological profiles meaningfully shape treatment trajectories. For clinicians, the authors note that double-positive (SSA/SSB) patients may require closer monitoring and potentially more intensive therapy. Conversely, patients with elevated IgG levels may respond more readily to treat-to-target strategies, though the biological reasons for this pattern require further study. ##### Citation Zhang, H., Zhang, H., Gao, D., Ji, L., Hao, Y., & Zhang, Z. (2025). Impact of Sjögren’s disease and its immunological characteristics on reaching remission or low disease activity state in systemic lupus erythematosus patients: a propensity score-matched longitudinal study. *Frontiers in immunology*, *16*, 1639252. <https://doi.org/10.3389/fimmu.2025.1639252> **Category:** Autoimmune Diseases, Lupus, Research Studies, Risk Factors, Sjögren disease --- ### [Record Growth in Autoimmune Treatment Pipeline, but Access Lags](https://www.autoimmuneinstitute.org/research_updates/record-growth-in-autoimmune-treatment-pipeline-but-access-lags/) **Published:** November 12, 2025 **Author:** Carolyn Serraino **Content:** The autoimmune treatment landscape is undergoing a significant transition. Across [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid arthritis"), [IBD](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crohns-disease/ "Crohn’s disease"), [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/ "Multiple sclerosis"), [psoriasis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/psoriasis/ "Psoriasis"), and rare immune-mediated conditions, researchers are advancing one of the largest and most diverse pipelines to date. New therapeutic approaches, including next-generation biologics, JAK inhibitors, cytokine-targeting agents, and early-stage immune-resetting modalities, are accelerating the pace of discovery and expanding potential options for patients. However, while innovation continues to climb, real-world access has not kept pace. Insurance plans are increasingly relying on step-therapy requirements, prior authorization hurdles, and narrow coverage criteria, leaving patients with inconsistent access to newer therapies. At the same time, many drugs now enter crowded treatment classes with similar efficacy, making it harder for clinicians and insurers to differentiate between options and build clear treatment pathways. Taken together, these trends reflect a growing gap between scientific progress and patient experience. Even as more treatments enter development, achieving timely, equitable access remains a challenge for many people living with autoimmune disease. ### Related Reads - [ Navigating Health Insurance with Autoimmune Disease ](https://www.autoimmuneinstitute.org/articles/navigating-health-insurance-for-autoimmune-disease-patients-expert-tips-and-resources) - [ Effective Communication Strategies for Those with Autoimmune Disease ](https://www.autoimmuneinstitute.org/articles/effective-communication-strategies-for-patients-with-autoimmune-diseases) - [ The Spectrum of Autoimmune Disease Treatments ](https://www.autoimmuneinstitute.org/the-spectrum-of-autoimmune-disease-treatments/) - [ Biologics for Autoimmune Disease: What You Should Know ](https://www.autoimmuneinstitute.org/articles/biologics-for-autoimmune-disease-what-you-should-know) - [ CAR T-Cell Therapy for Autoimmune Disease ](https://www.autoimmuneinstitute.org/articles/car-t-cell-therapy-for-autoimmune-disease) - [ Personalized Medicine for Autoimmune Diseases ](https://www.autoimmuneinstitute.org/articles/personalized-medicine-for-autoimmune-diseases) - [ CRISPR/Cas9 Gene Editing: Revolutionizing Autoimmune Disease Treatment ](https://www.autoimmuneinstitute.org/articles/crispr-cas9-gene-editing-revolutionizing-autoimmune-disease-treatment) **Category:** Autoimmune Diseases, Clinical Trials, Therapies --- ### [Breakthrough Autoimmune Findings at ACR 2025](https://www.autoimmuneinstitute.org/research_updates/breakthrough-autoimmune-findings-at-acr-2025/) **Published:** November 3, 2025 **Author:** Carolyn Serraino **Content:** The American College of Rheumatology’s annual meeting, [ACR Convergence 2025](https://eppro02.ativ.me/web/planner.php?id=ACR25), took place from October 24 to 29 in Chicago and featured significant advances that could transform the treatment and understanding of autoimmune diseases. For **[rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid arthritis")**, researchers reported encouraging results from an experimental therapy called rosnilimab. The drug works by removing overactive immune cells known as T cells, which attack the body’s own tissues in autoimmune diseases. In this study, patients experienced meaningful improvement in joint pain and swelling, with a strong safety profile. This approach could one day offer a new option for people who do not respond to existing medications. In **[psoriatic arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/psoriatic-arthritis/ "Psoriatic arthritis")**, the oral medication deucravacitinib continued to show benefit through a full year of treatment. It blocks a signaling pathway called TYK2 that drives inflammation in multiple autoimmune conditions. Related studies suggest this same pathway may also play a role in diseases such as inflammatory bowel disease and lupus. For **[Sjögren disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sjogren-syndrome/ "Sjögren disease (SjD)")**, researchers announced progress on a long-awaited treatment. The B-cell-targeting drug ianalumab significantly reduced disease activity in two large phase III trials, NEPTUNUS-1 and NEPTUNUS-2, presented by Grader-Beck. Earlier research helped establish how overactive B cells contribute to dryness, fatigue, and organ involvement in Sjögren’s. New findings in **[systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus")** (SLE) revealed how severely this disease can affect the heart. A nationwide case-control study and new autopsy analyses showed that people with SLE face a much higher risk of cardiovascular disease and heart tissue damage than the general population. These results emphasize the importance of regular heart health monitoring for anyone living with lupus. Together, these studies point toward a future of [more precise](https://www.autoimmuneinstitute.org/articles/tailoring-autoimmune-treatment-with-precision-medicine "Tailoring Autoimmune Treatment with Precision Medicine"), [immune-targeted therapies](https://www.autoimmuneinstitute.org/articles/immunotherapy-for-those-with-autoimmune-disease "Immunotherapy for Those with Autoimmune Disease") that aim not only to manage symptoms but to correct the underlying causes of autoimmunity. ##### Sources Presented at ACR Convergence 2025, American College of Rheumatology. 1. **Emery P, et al.** *“Rosnilimab, a selective and potent depleter of pathogenic T cells, demonstrates efficacy, safety, and translational proof of mechanism in a rheumatoid arthritis phase 2b trial”* *ACR 2025*; Abstract LB19. 2. **Van der Heijde D, et al.** *“Efficacy and safety of deucravacitinib up to week 52: a multicenter, randomized, double-blind, placebo-controlled, phase 3 study in patients with active psoriatic arthritis who are naive to biologic disease-modifying antirheumatic drugs”* *ACR 2025*; Abstract LB20. 3. **Grader-Beck T, et al.** *“Ianalumab demonstrates significant reduction in disease activity in patients with Sjögren’s disease: Efficacy and safety results from two global phase 3, randomized, placebo-controlled double-blind studies (NEPTUNUS-1 and NEPTUNUS-2)”* *ACR 2025*; Abstract LB24. 4. **Ross L, et al.** *“The frequency and impact of cardiovascular disease in systemic lupus erythematosus: a nationwide, matched case-control study”* *ACR 2025*; Abstract 1716. **Category:** Clinical Trials, Events, Lupus, Research Studies, Rheumatoid Arthritis, Sjögren disease, Therapies --- ### [Saphnelo and Benlysta Differ in Lupus Side-Effect Reports](https://www.autoimmuneinstitute.org/research_updates/saphnelo-and-benlysta-differ-in-lupus-side-effect-reports/) **Published:** October 20, 2025 **Author:** Carolyn Serraino **Excerpt:** A new analysis of the FDA’s Adverse Event Reporting System (FAERS) compared the lupus medications Saphnelo (anifrolumab) and Benlysta (belimumab), revealing distinct side-effect patterns for each. Researchers reviewed more than 21,000 reports submitted to FAERS between 2011 and 2024. **Content:** **Key Takeaway**: A new analysis of the FDA’s Adverse Event Reporting System (FAERS) compared the lupus medications Saphnelo (anifrolumab) and Benlysta (belimumab), revealing distinct side-effect patterns for each. #### Researchers reviewed more than 21,000 reports submitted to FAERS between 2011 and 2024. For **Saphnelo**, the most common safety signals were **shingles (herpes zoster)**, **headache**, **rash**, and **pericarditis**, a type of heart inflammation. Saphnelo blocks the **type I interferon pathway**, a key part of the body’s antiviral defense, which may increase vulnerability to viral infections such as shingles. For **Benlysta**, side effects were more often linked to **injection or administration issues**, such as pain or bleeding at the injection site, dosing mistakes, or problems using the delivery device. Benlysta, by contrast, targets **B-cell activity and antibody production**, which affects how the immune system responds over time but does not typically heighten viral risk. #### Differences likely stem from how each medication affects the immune system and how it is administered, with Saphnelo by infusion and Benlysta often by self-injection, which may also influence the types of reported side effects. Both drugs occasionally showed reports of urinary tract infections, but these tended to appear sooner with Saphnelo (about 18 days after starting treatment) than with Benlysta (around 29 days). The authors caution that FAERS data come from voluntary reports, so they do not show how often these events actually occur—only that they have been reported more than expected. #### Understanding these differences can help personalize care and guide clinicians in monitoring for early warning signs and managing risk, for example, by discussing **shingles vaccination** before starting Saphnelo. ###### Citation Ren, N., Tian, X., & Chen, L. (2025). **Comparing adverse events of Saphnelo and Benlysta: A real-world observational study based on the FDA adverse event reporting system (FAERS) following STROBE guidelines**. *Medicine*, *104*(41), e44960. <https://doi.org/10.1097/MD.0000000000044960> **Category:** Lupus, Research Studies, Risk Factors, Therapies --- ### [Breakthrough Compound Reverses Myelin Loss](https://www.autoimmuneinstitute.org/research_updates/breakthrough-compound-reverses-myelin-loss/) **Published:** October 8, 2025 **Author:** Carolyn Serraino **Excerpt:** Researchers identified a compound that helps the brain repair the nerve coating damaged by multiple sclerosis, restoring both myelin and vision in animal models. Unlike older estrogen-based treatments, these compounds don’t cause hormonal side effects and were optimized to remain active longer and reach the brain more effectively. **Content:** ### Key Takeaways Researchers identified a compound that helps the brain repair the nerve coating damaged by multiple sclerosis, restoring both myelin and vision in animal models. Unlike older estrogen-based treatments, these compounds don’t cause hormonal side effects and were optimized to remain active longer and reach the brain more effectively. #### A next-generation therapy that helps the brain repair itself. Scientists built on earlier discoveries showing that estrogen receptor beta (ERβ) supports the survival and repair of myelin-producing cells. Using that foundation, they engineered a new class of chloroindazole-based molecules that selectively activate ERβ without triggering estrogen receptor alpha (ERα), the pathway associated with hormonal side effects seen in some [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/ "Multiple sclerosis") treatments. #### The treatment restored both structure and function. In mouse models of autoimmune demyelination, treatment with these ERβ ligands repaired the protective myelin sheath around optic nerve fibers and restored visual responses, demonstrating that the regenerated tissue functioned as it should, which is rare in neurological repair. Pharmacokinetic studies showed that the optimized ERβ ligands were chemically stable, sustained active levels in circulation, and effectively crossed the blood–brain barrier to reach the central nervous system. ##### Citation Feri, M., et al. (2025). Chloroindazole based estrogen receptor β ligands with favorable pharmacokinetics promote functional remyelination and visual recovery. *Scientific reports*, *15*(1), 35056. <https://doi.org/10.1038/s41598-025-20254-9> **Category:** Multiple Sclerosis, Research Studies, Therapies --- ### [JAMA+ Launches Women’s Health Channel](https://www.autoimmuneinstitute.org/research_updates/jama-launches-womens-health-channel/) **Published:** October 10, 2025 **Author:** Carolyn Serraino **Content:** The JAMA Network has launched **[JAMA+ Women’s Health](https://jamanetwork.com/channels/womens-health)**, a centralized platform showcasing evidence-based research, policies, and commentary across all areas of women’s health. Editor-in-Chief Linda Brubaker, MD, MS, emphasizes that women’s health extends far beyond reproduction and menopause, encompassing every specialty where sex-based biological and clinical differences shape outcomes. #### Historically, most clinical research excluded or underrepresented women, limiting the accuracy of medical guidance. Now, with more rigorous inclusion of women in clinical trials, a clearer understanding of [sex-specific physiology](https://www.autoimmuneinstitute.org/articles/how-sex-genetics-influence-autoimmunity "How Sex & Genetics Influence Autoimmunity") and disease expression is emerging. The new JAMA+ Women’s Health channel aims to improve visibility, discoverability, and access to this growing body of evidence, supporting clinicians in providing more precise, equitable care. #### For autoimmune disease, which [disproportionately affects women](https://www.autoimmuneinstitute.org/research_updates/sciencetalks-recap-why-autoimmune-diseases-are-more-common-in-women/ "ScienceTALKS Recap: Why Autoimmune Diseases Are More Common in Women"), this effort marks an important shift toward recognizing how immune responses, hormones, and genetics differ between sexes. By consolidating research across JAMA’s 12 journals, we hope this initiative accelerates insights into why autoimmune diseases are more prevalent in women and how treatment approaches can be tailored accordingly. **Category:** Genetics, Research Studies, Risk Factors --- ### [How the Brain Regulates Inflammation](https://www.autoimmuneinstitute.org/research_updates/how-the-brain-regulates-inflammation/) **Published:** May 15, 2024 **Author:** Carolyn Serraino **Content:** A study in *Nature* has uncovered a direct connection between the brain and the body’s inflammatory responses, revealing that the nervous system can actively regulate immune activity. #### Researchers identified a population of neurons in the brainstem that function as a central control switch capable of turning inflammation up or down throughout the body. Using a mouse model, the team traced how sensory neurons in the vagus nerve detect signals from inflamed tissues and relay that information to the caudal nucleus of the solitary tract (cNST) in the brainstem. Within this region, a small set of neurons integrates these signals and sends feedback to peripheral immune organs. Stimulating this circuit suppressed inflammation, whereas silencing it caused an exaggerated immune response, resulting in tissue damage and systemic inflammation. This shows that the brain plays a direct, dynamic role in maintaining immune balance. #### Researchers believe that identifying how this “inflammation dial” operates could open new therapeutic pathways for autoimmune and inflammatory diseases. The work contributes to the growing field of neuroimmunology, which explores how the brain and immune system communicate to maintain homeostasis. Future studies will examine whether similar circuits exist in humans and how they might be targeted to restore immune regulation without broadly suppressing immune function. ###### Citation Jin, H., Li, M., Jeong, E. *et al.* A body–brain circuit that regulates body inflammatory responses. *Nature* **630**, 695–703 (2024). <https://doi.org/10.1038/s41586-024-07469-y> **Category:** Autoimmune Brain Inflammation, Neurological Disorders, Research Studies, Therapies --- ### [What is the Autoimmune Prodrome?](https://www.autoimmuneinstitute.org/research_updates/what-is-the-autoimmune-prodome/) **Published:** October 3, 2025 **Author:** Carolyn Serraino **Excerpt:** Most autoimmune diseases do not appear overnight. Instead, many begin with a prolonged "silent" phase, often referred to as the autoimmune prodrome. During this stage, which can last for several years, the immune system begins to exhibit early signs of malfunction. People may notice vague symptoms, such as fatigue, brain fog, stomach or skin problems, or mild joint pain, but nothing that clearly points to a single disease. Doctors sometimes detect early warning signals in bloodwork, such as inflammation or antibodies that target the body, but these are not enough to make a diagnosis on their own. **Content:** Most autoimmune diseases do not appear overnight. Instead, many begin with a prolonged “silent” phase, often referred to as the **autoimmune prodrome**. During this stage, which can last for several years, the immune system begins to exhibit early signs of malfunction. People may notice vague symptoms, such as fatigue, [brain fog](https://www.autoimmuneinstitute.org/covid_timeline/brain-fog-likely-caused-by-brain-inflammation-its-not-just-all-in-their-head/ "Brain Fog Likely Caused by Brain Inflammation – It’s Not Just "All in Their Head""), stomach or skin problems, or mild joint pain, but nothing that clearly points to a single disease. Doctors sometimes detect early warning signals in bloodwork, such as [inflammation](https://www.autoimmuneinstitute.org/articles/inflammation-a-driving-force-of-autoimmune-disease "Inflammation: A Driving Force of Autoimmune Disease") or [antibodies that target the body](https://www.autoimmuneinstitute.org/articles/decoding-the-role-of-autoantibodies-in-autoimmunity "Decoding the Role of Autoantibodies in Autoimmunity"), but these are not enough to make a diagnosis on their own. [![autoimmune prodrome Figure 1 Phases of Autoimmunity. The majority of the healthy population has no evidence of cellular or humoral autoimmunity. However, a substantial fraction develops autoantibodies or self-reactive T cells while remaining asymptomatic (1). These individuals typically do not seek medical care unless it is to explain serological findings. After a period of years, characterized by expanding serological autoimmunity and up-regulation of inflammatory cytokines and chemokines, early symptoms develop in a sub-set of people with asymptomatic autoimmunity (2). With the accumulation of sufficient clinical signs and symptoms, patients are classified with definite autoimmune conditions (3). If possible, the prevention of autoimmunity will take place in the earliest phases before there are significant health concerns present. Later clinical treatments will address organ damage and dysfunction but are less likely to halt disease progression over time.](https://www.frontiersin.org/files/Articles/983310/fimmu-13-983310-HTML-r1/image_m/fimmu-13-983310-g001.jpg)](https://www.frontiersin.org/research-topics/18412/understanding-the-concept-of-pre-clinical-autoimmunity/magazine)F*igure 1. **Phases of Autoimmunity**. From “Olsen, N. J., Okuda, D. T., Holers, V. M., & Karp, D. R. (2022). Editorial: Understanding the concept of pre-clinical autoimmunity. Frontiers in immunology, 13, 983310. <https://doi.org/10.3389/fimmu.2022.983310>. [CC BY 4.0](https://creativecommons.org/licenses/by/4.0/).* **Note:** In this figure, the autoimmune prodrome corresponds to Stages 1 and 2, during which autoantibodies or autoreactive T cells are detectable, often accompanied by vague early symptoms, but before the accumulation of sufficient signs and symptoms for a clinical diagnosis. Scientists have found this pre-disease phase in conditions like [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid arthritis"), [lupus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus"), [Sjögren disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sjogren-syndrome/ "Sjögren disease (SjD)"), [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/ "Multiple sclerosis"), and inflammatory bowel disease ([Crohn’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crohns-disease/ "Crohn’s disease") and [ulcerative colitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ulcerative-colitis/ "Ulcerative colitis")). Detecting autoimmunity this early is challenging, as many tests are still too general or too limited; however, new research is working to change that. For example, by examining patterns of autoantibodies in blood samples, it is possible to identify individuals who are most likely to develop one or more autoimmune conditions. [![autoimmune prodrome Figure 2. Frazzei, G., et al. (2022). Preclinical Autoimmune Disease: a Comparison of Rheumatoid Arthritis, Systemic Lupus Erythematosus, Multiple Sclerosis and Type 1 Diabetes. Frontiers in immunology, 13, 899372. https://doi.org/10.3389/fimmu.2022.899372. CC BY 4.0.](https://www.frontiersin.org/files/Articles/899372/fimmu-13-899372-HTML-r1/image_m/fimmu-13-899372-g002.jpg)](https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2022.899372/full)*Figure 2. Frazzei, G., et al. (2022). **Preclinical Autoimmune Disease: a Comparison of Rheumatoid Arthritis, Systemic Lupus Erythematosus, Multiple Sclerosis and Type 1 Diabetes.** *Frontiers in immunology*, *13*, 899372. <https://doi.org/10.3389/fimmu.2022.899372>. [CC BY 4.0](https://creativecommons.org/licenses/by/4.0/).* **Note:** This figure illustrates how several autoimmune diseases share a prodromal window: an asymptomatic stage marked by autoantibodies, followed by vague or nonspecific symptoms (such as fatigue, joint pain, or depression) before diagnosable disease emerges. While the details differ for rheumatoid arthritis, lupus, multiple sclerosis, and [type 1 diabetes](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/type-1-diabetes-insulin-dependent-diabetes/ "Type 1 diabetes / insulin-dependent diabetes"), each shows evidence of a preclinical phase that aligns with the concept of an autoimmune prodrome. #### Understanding the autoimmune prodrome could transform care. If doctors can reliably identify people in this early stage, it may one day be possible to intervene before irreversible damage occurs. Research is already exploring ways to “rebalance” the immune system during this phase, from boosting protective cells that keep autoimmunity in check to fine-tuning how immune cells are trained not to attack the body. These approaches are still experimental, but they point to a future where autoimmune disease might be detected earlier, monitored more closely, and potentially even prevented. **Related Reading** [ Examining Pre-Autoimmunity: Can Autoimmune Disease Be Prevented? ](https://www.autoimmuneinstitute.org/articles/examining-pre-autoimmunity-can-autoimmune-disease-be-prevented/) Overview of the “pre-clinical” phase of autoimmunity, how it can be detected, and what research suggests about prevention. ###### Citations Makhani, N., & Tremlett, H. (2021). The multiple sclerosis prodrome. *Nature reviews. Neurology*, *17*(8), 515–521. <https://doi.org/10.1038/s41582-021-00519-3> Olsen, N. J., Okuda, D. T., Holers, V. M., & Karp, D. R. (2022). Editorial: Understanding the concept of pre-clinical autoimmunity. *Frontiers in immunology*, *13*, 983310. <https://doi.org/10.3389/fimmu.2022.983310> Frazzei, G., van Vollenhoven, R. F., de Jong, B. A., Siegelaar, S. E., & van Schaardenburg, D. (2022). Preclinical Autoimmune Disease: a Comparison of Rheumatoid Arthritis, Systemic Lupus Erythematosus, Multiple Sclerosis and Type 1 Diabetes. *Frontiers in immunology*, *13*, 899372. <https://doi.org/10.3389/fimmu.2022.899372> **Category:** Autoimmune Diseases, Diagnostic Testing, IBD (Crohn's and UC), Lupus, Multiple Sclerosis, Rheumatoid Arthritis, Risk Factors, Sjögren disease --- ### [Nobel Prize: Discoveries That Prevent Autoimmunity](https://www.autoimmuneinstitute.org/research_updates/nobel-prize-discoveries-that-prevent-autoimmunity/) **Published:** October 6, 2025 **Author:** Carolyn Serraino **Content:** **The 2025 Nobel Prize in Physiology or Medicine** has been awarded to **Mary Brunkow**, **Fred Ramsdell**, and **Shimon Sakaguchi** for their discovery of a class of immune cells that help to prevent the body from attacking its own tissues. #### Their landmark discoveries of regulatory T cells (Tregs) and the FOXP3 gene transformed understanding of immune tolerance and opened the door to new treatments for autoimmune disease. In 1995, Sakaguchi identified **regulatory T cells**, a rare subset of T cells that act as the immune system’s “brakes,” shutting down excessive inflammation and maintaining balance. Without them, autoimmune diseases such as [type 1 diabetes](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/type-1-diabetes-insulin-dependent-diabetes/ "Type 1 diabetes / insulin-dependent diabetes"), [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/ "Multiple sclerosis"), and [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid arthritis") can develop. **Brunkow and Ramsdell later discovered that [mutations in the FOXP3 gene lead to fatal autoimmune diseases](https://www.autoimmuneinstitute.org/research_updates/mechanisms-behind-regulatory-t-cell-dysfunction/ "Mechanisms Behind Regulatory T Cell Dysfunction") in mice and humans, demonstrating that FOXP3 is crucial for Treg development and function.** #### These discoveries have since spurred hundreds of studies and more than 200 ongoing clinical trials exploring how to harness Tregs to treat autoimmune and inflammatory disorders. Companies including Eli Lilly, Celgene, and Sonoma Biotherapeutics are now developing therapies that stimulate or expand Tregs to restore immune tolerance in diseases such as [lupus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus"), [autoimmune hepatitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-hepatitis/ "Autoimmune hepatitis"), and rheumatoid arthritis. **Experts describe the Nobel-winning work as a foundation for a new generation of “immune-calming” treatments that could one day prevent or even cure autoimmunity**. During a press conference, Sakaguchi shared an encouraging message for young researchers: #### “Keep going, find your path, and continue doing what you love.” ###### Citations Conrad, N., Misra, S., Verbakel, J. Y., Verbeke, G., Molenberghs, G., Taylor, P. N., Mason, J., Sattar, N., McMurray, J. J. V., McInnes, I. B., Khunti, K., & Cambridge, G. (2023). **Incidence, prevalence, and co-occurrence of autoimmune disorders over time and by age, sex, and socioeconomic status: a population-based cohort study of 22 million individuals in the UK**. *Lancet (London, England)*, *401*(10391), 1878–1890. <https://doi.org/10.1016/S0140-6736(23)00457-9> Sakaguchi, S., Sakaguchi, N., Asano, M., Itoh, M., & Toda, M. (1995). Immunologic self-tolerance maintained by activated T cells expressing IL-2 receptor alpha-chains (CD25). [**Breakdown of a single mechanism of self-tolerance causes various autoimmune diseases**](https://pubmed.ncbi.nlm.nih.gov/7636184/). *Journal of immunology (Baltimore, Md. : 1950)*, *155*(3), 1151–1164. Brunkow, M. E., Jeffery, E. W., Hjerrild, K. A., Paeper, B., Clark, L. B., Yasayko, S. A., Wilkinson, J. E., Galas, D., Ziegler, S. F., & Ramsdell, F. (2001). **Disruption of a new forkhead/winged-helix protein, scurfin, results in the fatal lymphoproliferative disorder of the scurfy mouse**. *Nature genetics*, *27*(1), 68–73. <https://doi.org/10.1038/83784> Wildin, R. S., Ramsdell, F., Peake, J., Faravelli, F., Casanova, J. L., Buist, N., Levy-Lahad, E., Mazzella, M., Goulet, O., Perroni, L., Bricarelli, F. D., Byrne, G., McEuen, M., Proll, S., Appleby, M., & Brunkow, M. E. (2001). **X-linked neonatal diabetes mellitus, enteropathy and endocrinopathy syndrome is the human equivalent of mouse scurfy**. *Nature genetics*, *27*(1), 18–20. <https://doi.org/10.1038/83707> Hori, S., Nomura, T., & Sakaguchi, S. (2003). **Control of regulatory T cell development by the transcription factor Foxp3**. *Science (New York, N.Y.)*, *299*(5609), 1057–1061. <https://doi.org/10.1126/science.1079490> **Category:** Autoimmune Diseases, Clinical Trials, Events, Lupus, Multiple Sclerosis, Research Studies, Rheumatoid Arthritis, Therapies, Type 1 Diabetes --- ### [MS Drug May Delay Symptom Onset](https://www.autoimmuneinstitute.org/research_updates/can-an-approved-treatment-delay-the-onset-of-ms-symptoms/) **Published:** January 4, 2023 **Author:** GAI-assistant **Content:** A study called[Dimethyl Fumarate Delays Multiple Sclerosis in Radiologically Isolated Syndrome](https://pubmed.ncbi.nlm.nih.gov/36401339/)[,](https://www.neurology.org/doi/10.1212/WNL.0000000000200970) published in *Annals of Neurology,* investigated whether an approved treatment could prevent the first clinical symptoms of multiple sclerosis (MS). While numerous MS treatment options are available for patients–including [Tecfidera™ (dimethyl fumarate)](https://www.accessdata.fda.gov/drugsatfda_docs/label/2013/204063lbl.pdf)–it is critical to begin therapy as early as possible to slow disease progress and improve outcomes. Researchers conducted a multi-center, randomized, double-blinded, placebo-controlled study (called the [ARISE trial](https://clinicaltrials.gov/study/NCT02739542)) in patients with radiologically isolated syndrome (RIS); patients with RIS have indications of MS-related brain changes (as revealed by imaging) but no clinical symptoms of MS. These patients are at a higher risk of later being diagnosed with MS, so RIS may represent an early preclinical stage of MS. Results from this clinical trial, which is the first of its kind, found that patients with RIS taking Tecfidera (n=44) had a significantly lower risk of experiencing a clinical event associated with MS after 96 weeks of treatment compared to patients with RIS taking placebo, an inactive substance (n=43). Treatment was well tolerated, and severe adverse events were similar in both groups. These data, which were first presented at the [European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) 2022 meeting](https://journals.sagepub.com/doi/epub/10.1177/13524585221126908), suggest that patients with RIS may benefit from treatment early on to potentially delay the onset of MS symptoms. ##### Citation Okuda, D. T., et al. (2023). Dimethyl Fumarate Delays Multiple Sclerosis in Radiologically Isolated Syndrome. *Annals of neurology*, *93*(3), 604–614. <https://doi.org/10.1002/ana.26555> **Category:** Clinical Trials, Multiple Sclerosis, Therapies --- ### [Building the Body’s Immune Clock](https://www.autoimmuneinstitute.org/research_updates/building-the-bodys-immune-clock/) **Published:** July 13, 2021 **Author:** Elevation **Excerpt:** Researchers used machine learning to analyze the immunome of 1,001 people aged 8-96 years and created an inflammatory clock of aging (iAge). **Content:** The immune system protects us from pathogens, and scientists now know that chronic inflammation is involved in the aging process. However, researchers lacked biomarkers and models to describe chronic inflammation. In a [new study](https://www.nature.com/articles/s43587-021-00082-y) published in *Nature Aging*, researchers used machine learning to analyze the immunome of 1,001 people aged 8-96 years and created an inflammatory clock of aging (iAge). The iAge closely tracked several major aspects of aging, including the development of multiple chronic health conditions, immune system decline, and frailty. An in-depth analysis of iAge revealed that the strongest contributor to immune age is a signaling protein called CXCL9. This chemokine is known to play a role in inflammation and white blood cell development. Scientists found that increased CXCL9 production by endothelial cells is linked to cellular dysfunctions associated with aging. Blocking CXCL9 activity in endothelial cells derived from induced pluripotent stem cells eliminated age-related dysfunction. Additional experiments showed that CXCL9 reduces blood vessel functioning and increases arterial stiffness, two hallmarks of aging. Researchers concluded that the age-related increase in CXCL9 plays a major role in the aging process. ##### **Citation** Sayed, N., Huang, Y., Nguyen, K. *et al.* **An inflammatory aging clock (iAge) based on deep learning tracks multimorbidity, immunosenescence, frailty and cardiovascular aging**. *Nat Aging* **1**, 598–615 (2021). <https://doi.org/10.1038/s43587-021-00082-y> **Category:** Autoimmune Diseases, Research Studies --- ### [Gene Therapy Restores Immune Function in ADA-SCID](https://www.autoimmuneinstitute.org/research_updates/breakthrough-gene-therapy-restores-immune-function-in-children-with-ada-scid/) **Published:** May 12, 2021 **Author:** Elevation **Excerpt:** Severe combined immunodeficiency due to adenosine deaminase deficiency (ADA-SCID) is a rare, inherited condition that causes a complete loss of functional disease-fighting B and T lymphocytes. **Content:** Severe combined immunodeficiency due to adenosine deaminase deficiency (ADA-SCID) is a rare, inherited condition that results in the complete loss of functional disease-fighting B and T lymphocytes. **Without treatment, most children with ADA-SCID die within the first few years of life**. A [study](https://www.nejm.org/doi/10.1056/NEJMoa2027675) published in the *New England Journal of Medicine* reports that 48 out of 50 children with ADA-SCID treated with an experimental lentiviral gene therapy continued to show normal immune function 2-3 years after treatment. Previously, therapies for ADA-SCID, such as enzyme replacement therapies and stem cell transplants, had significant risks and drawbacks. In this study, scientists used a lentivirus to insert a correct version of the ADA gene into lab-grown cells. These modified cells were then infused back into patients aged 4 months to 16 years. **After several years of follow-up, 96.7% of children treated in the U.S. and 95% of those in the U.K. stopped all other therapies and continued to show strong immune functioning**. ##### **Citation** Kohn, D. B., et al. (2021). **Autologous Ex Vivo Lentiviral Gene Therapy for Adenosine Deaminase Deficiency**. *The New England journal of medicine*, *384*(21), 2002–2013. <https://doi.org/10.1056/NEJMoa2027675> **Category:** Autoimmune Diseases, Clinical Trials, Therapies --- ### [Rheumatoid Arthritis May Raise Parkinson’s Risk](https://www.autoimmuneinstitute.org/research_updates/are-rheumatoid-arthritis-and-parkinsons-disease-linked/) **Published:** June 13, 2023 **Author:** GAI-assistant **Content:** A retrospective cohort study called [Rheumatoid arthritis and risk of Parkinson disease in Korea,](https://jamanetwork.com/journals/jamaneurology/article-abstract/2804530) published in *JAMA Neurology,* investigated the association between [rheumatoid arthriti](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid arthritis")s (RA) and Parkinson’s disease (PD) in over 328,000 participants in Korea. While on the surface, RA, an autoimmune disease, and PD, a neurodegenerative disorder, do not seem to have much in common, chronic inflammation may lie at the root of both of these conditions. A few studies have in fact noted that the incidence of RA and PD may be related, but these results have been conflicting and not entirely conclusive. Researchers utilized data from the National Health Insurance Service (NHIS), a universal social insurance program that covers nearly the entire Korean population, to explore the link between RA and PD incidence. Within this cohort, 39,010 had seropositive RA (SPRA) and 15,670 had seronegative RA (SNRA); 273,400 matched controls did not have RA. The majority of participants were female with a mean age of 58.6 years. After a mean follow up of 4.52 years, 290 participants diagnosed with RA had developed PD, while 803 of the matched controls developed PD, corresponding to a 1.74-fold higher risk for PD in the RA group. Furthermore, participants who had SPRA had a higher risk of PD than participants who had SNRA. Premenopausal women and those who did not use biological disease-modifying antirheumatic drugs also had an increased risk of developing PD. Researchers recommend that clinicians should be aware of the association between RA and PD and should refer patients with RA presenting with early signs of PD without synovitis to a neurologist. It’s important to note that, in this study, disease activity was not taken into account and therefore it is unknown whether the risk of PD is affected by RA disease severity. Additional variables such as genetic contributors and environmental exposure were also not taken into account. As disease prevalence differs across various geographic regions, additional studies should be conducted in other populations to confirm these results. ##### Citation: Kang, J., et al. (2023). Rheumatoid Arthritis and Risk of Parkinson Disease in Korea. *JAMA neurology*, *80*(6), 634–641. <https://doi.org/10.1001/jamaneurol.2023.0932> **Category:** Research Studies, Rheumatoid Arthritis, Risk Factors --- ### [Live From the Lab: The Autoimmune Framework](https://www.autoimmuneinstitute.org/research_updates/live-from-the-lab-the-autoimmune-framework/) **Published:** March 25, 2025 **Author:** Carolyn Serraino **Content:** ### ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/04/Untitled-design-62.png) ## Key Topics and Q&A #### **[Hosted by LJI and GAI](https://www.autoimmuneinstitute.org/gai-and-la-jolla-institute-for-immunology/ "GAI and La Jolla Institute for Immunology")** 📆 Wednesday, March 19, 2025 #### **Featured Speaker:** **Dr. Sonia Sharma** *Associate Professor at LJI & Director of the [Center for Sex-based Differences in the Immune System](https://www.lji.org/research/research-centers/center-for-sex-based-differences-in-the-immune-system/)* #### Opening Remarks Dr. Erica Ollmann Saphire, CEO of LJI, opened the event with gratitude to the Global Autoimmune Institute for their partnership and vision. She highlighted GAI’s role in transforming how autoimmune disease research connects to real-world impact. #### ***“GAI is redefining what it means to drive and fund research in autoimmune disease…They are a powerhouse in the autoimmune disease space.”*** She introduced Dr. Sonia Sharma as a leading immunologist whose work is reshaping the understanding of immune signaling, inflammation, and sex-based differences in disease. --- #### The Autoimmune Landscape Dr. Sharma described autoimmune disease as a condition where the immune system attacks healthy tissue. Over 100 distinct autoimmune diseases exist, many of which affect multiple organ systems. Collectively, they impact at least 20% of Americans—and that number is rising. #### ***“Each disease is often considered rare on its own, but collectively they are not rare.”*** > She emphasized the complexity of autoimmune disease, which arises from a combination of genetic, environmental, and immune regulatory factors. --- #### Innate Immunity and Early Immune Triggers Most research has focused on late-stage immune activity, particularly the production of autoantibodies. Dr. Sharma highlighted a shift in focus: to the innate immune system and its early signals—especially neutrophils. #### ***“Autoantibodies are just one piece of the immune system puzzle.”*** > Neutrophils, the most abundant immune cells in blood, respond early to infection and inflammation. Her lab’s research suggests they play a much larger role in the development of autoimmunity than previously recognized. --- #### Discovering a Metabolic Signal: Lysophosphatidylcholine (LPC) Through advanced metabolomics, Dr. Sharma’s team identified a naturally occurring fat in the blood—lysophosphatidylcholine (LPC)—as a key signal involved in immune regulation. #### ******“We uncovered a specific metabolite called LPC that was uniquely reduced in every patient who developed a severe autoimmune disease.”****** > LPC levels dropped significantly in patients who developed immune-related complications from cancer immunotherapy, suggesting a strong link between LPC depletion and autoimmune flare-ups. Low LPC was also associated with elevated neutrophil levels, a hallmark of inflammation. --- #### Cancer Immunotherapy as a Window Into Autoimmunity Checkpoint inhibitors used in cancer therapy often cause autoimmune-like side effects. Because these responses are predictable and closely monitored, they provided a valuable model for tracking immune changes in real time. #### ******“This was the only metabolite consistently reduced in every patient with a severe autoimmune event.”****** > This connection allowed Dr. Sharma’s lab to study the precise timing and metabolite shifts that occur before, during, and after a flare. --- #### Restoring Balance: LPC Supplementation in Mouse Models In experimental models of [ulcerative colitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ulcerative-colitis/ "Ulcerative colitis"), supplementing LPC led to a reduction in inflammation and preservation of colon tissue. #### ******“It’s not a broadscale immunosuppressant… It’s a natural anti-inflammatory turning down the flame on that autoimmunity.”****** > These findings suggest that LPC may offer a safer, more targeted way to manage autoimmune flares—without compromising the immune system’s ability to fight infection or cancer. --- #### Therapeutic Development: Toward a Topical LPC Treatment Dr. Sharma’s team is now working with a biotech partner to develop a transdermal LPC therapy that can be applied to the skin during flare-ups. #### ******“We think during a flare, the patient might need a little more of a hit—and this transdermal method minimizes delay and degradation.”****** > Topical delivery is designed to bypass the digestive system and ensure rapid, localized absorption. --- ### **Audience Q&A Highlights** **Do you think LPC could help with autoimmune diseases beyond those caused by cancer therapy?** “We absolutely do. Innate immunity is upstream of the adaptive immune response and by virtue of that—of all immune responses.” **Why are autoimmune diseases more common in women?** “Estrogen is immune-stimulatory. Testosterone is immune-suppressive. And women have two X chromosomes packed with immune genes—that’s extra immunological hardware.” **What role do hormones and epigenetics play?** “We’ve only scratched the surface. But estrogen definitely regulates immune proteins. The next step is linking those hormonal signals to genetic changes at the molecular level.” **Why develop a topical LPC therapy instead of an oral supplement?** “Oral LPC can degrade in the gut. It’s also slower. Topical application minimizes delay and preserves the molecule’s effectiveness.” **Are clinical trials available for LPC?** “Not yet—but we’re working very hard to finalize the formulation and launch a Phase 1 trial. Stay tuned.” **How does this relate to IBD or IBS?** “IBD is a neutrophilic disease. We’ve already seen that LPC supplementation reduced inflammation in colitis mouse models.” **Why do some people develop chronic disease while others recover?** “It’s the interplay of genetics, environment, and immune regulation—and those are all complex. But with more profiling, we may identify biomarkers to predict individual risk.” --- This presentation offers a new lens on autoimmunity: instead of waiting for symptoms to appear, we might prevent them by understanding—and gently correcting—the earliest signals. For patients, this could mean fewer flares, less reliance on harsh immunosuppressants, and a future where treatments are precisely targeted and better tolerated. **Category:** Events --- ### [NIH Webinar on NOURISH Autoimmunity Challenge](https://www.autoimmuneinstitute.org/research_updates/nih-webinar-on-nourish-autoimmunity-challenge/) **Published:** September 30, 2025 **Author:** Carolyn Serraino **Content:** September 30, 2025 The National Institutes of Health (NIH) hosted a public webinar to provide guidance on the **NOURISH (Nutrition for OUR Immune System Health): Autoimmunity Challenge**, a competition seeking innovative ideas to enhance the integration of diet and nutrition into autoimmune disease research. During the webinar, NIH officials and partners from Ensemble and the NASA Tournament Lab explained the motivation for the initiative. Previous NIH workshops identified major gaps in knowledge, including the need to connect scientific findings with patient experience and to strengthen interdisciplinary collaboration that incorporates patient-centered outcomes. #### The goals of the NOURISH Challenge include: - Develop innovative ideas linking diet and autoimmunity - Engage diverse communities, from patients and caregivers to scientists and clinicians - Identify dietary or nutritional strategies that could be tested scientifically - Highlight scalable, transformative, and impactful approaches across autoimmune diseases The competition is open to everyone, including people with autoimmune disease, advocacy groups, caregivers, organizations, healthcare professionals, dietitians, and scientists! #### Submissions are evaluated equally on five criteria: 1. Scientific Rationale – clarity and rigor of the idea 2. Engagement – inclusion of patients, advocacy groups, and interdisciplinary expertise 3. Impact – potential benefit for people living with autoimmune disease 4. Feasibility – whether the idea can be developed and scaled 5. Innovation – novelty and broad applicability #### Key Dates for NOURISH Challenge **Submissions opened:** September 23, 2025 **First webinar:** September 30, 2025 **Second webinar:** October 2025 **Challenge closes:** December 4, 2025 **Judging:** January–February 2026 **Winners announced:** March 2026 #### 👉 **For a curated set of resources, background readings, and scientific articles to inspire submissions, see GAI’s companion update: [Nutrition and Autoimmunity: NIH NOURISH Challenge](https://www.autoimmuneinstitute.org/research_updates/nutrition-and-autoimmunity-nih-nourish-challenge/)** **Category:** Events, Policy & Health Decisions, Risk Factors --- ### [Mast Cell Activation Syndrome and Autoimmune Disease](https://www.autoimmuneinstitute.org/research_updates/mast-cell-activation-syndrome-and-autoimmune-disease/) **Published:** October 1, 2025 **Author:** Carolyn Serraino **Content:** Flushing, hives, stomach pain, diarrhea, fatigue, brain fog, and a racing heartbeat are all symptoms that can point in many directions. For some people, they appear during the search for an autoimmune diagnosis. However, in other cases, another condition known as mast cell activation syndrome (MCAS) may be involved. #### In MCAS, mast cells, immune cells that normally help defend the body, become overly reactive. They release histamine and other chemical messengers too often, or in response to harmless triggers like food, chemicals, or temperature changes. #### This overreaction can look very similar to autoimmune disease, which is why MCAS often comes up while doctors are ruling out other causes. **The difference is important:** - In autoimmune disease, the immune system mistakes the body’s own tissues for an enemy and attacks them, leading to lasting tissue damage. - In MCAS, the body isn’t attacking itself; it’s overreacting to things that shouldn’t be a threat. **Where they connect:** - People with autoimmune disease may still have mast cell overactivity, which can intensify inflammation or make flares feel worse. - Research shows that mast cells themselves can take part in autoimmune pathways. For example, in chronic spontaneous [urticaria](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/chronic-urticaria/ "Chronic autoimmune urticaria") (a condition marked by recurring hives), **autoantibodies can activate mast cells and drive symptoms**, illustrating the fine line between mast cell overactivity on its own (MCAS) and mast cell involvement in autoimmunity. - People with MCAS may also develop autoimmune conditions. This doesn’t mean one causes the other, but it shows how immune system problems can overlap. #### Diagnosing MCAS is complex.  Because mast cells are found throughout the body, in the skin, lungs, gut, and bone marrow, symptoms often affect multiple systems simultaneously. Doctors typically look for: - Symptoms in at least two organ systems (for example, skin and digestive tract) - Evidence of mast cell chemicals in blood or urine - Improvement with treatments that block or stabilize mast cells MCAS is also part of a broader category called mast cell activation diseases (MCAD), which includes mastocytosis (where the body makes too many mast cells). Research shows MCAS can overlap with primary immunodeficiency, connective tissue disorders like Ehlers-Danlos, thyroid disease, and sometimes autoimmune disease, making the diagnostic process even more challenging. #### Recognizing the differences between MCAS and autoimmune disease and how they occasionally overlap can help patients and doctors develop a clearer diagnosis and treatment plan. ###### Citations Xu, Y., & Chen, G. (2015). Mast cell and autoimmune diseases. *Mediators of inflammation*, *2015*, 246126. https://doi.org/10.1155/2015/246126 Koren, A., Dejanović, L., Rijavec, M., Kopač, P., Bizjak, M., Zidarn, M., Košnik, M., & Korošec, P. (2024). Autoimmune Mast Cell Activation Test as a Diagnostic Tool in Chronic Spontaneous Urticaria. *International journal of molecular sciences*, *25*(17), 9281. https://doi.org/10.3390/ijms25179281 **Category:** Research Studies --- ### [Nutrition and Autoimmunity: NIH NOURISH Challenge](https://www.autoimmuneinstitute.org/research_updates/nutrition-and-autoimmunity-nih-nourish-challenge/) **Published:** September 25, 2025 **Author:** Carolyn Serraino **Content:** The National Institutes of Health (NIH) has launched the **[NOURISH (Nutrition for OUR Immune System Health): Autoimmunity Challenge](https://www.challenge.gov/?challenge=nourish-autoimmunity-challenge)**, a crowdsourcing competition offering up to $150,000 in prizes. The challenge is open through **December 4, 2025**, and aims to gather innovative, community-driven ideas about how diet and nutrition can be better studied in autoimmune disease research. #### The challenge focuses on three big questions: - How diet contributes to autoimmune onset and prodrome - How nutrition influences disease progression and flares - The role of diet in symptom management At GAI, we’ve published extensively on diet, nutrition, and immune health. Below is a collection of our articles and research updates, grouped to match the challenge’s themes. These can serve as background or inspiration for anyone considering a submission. ### Diet and Autoimmune Onset Risk ##### Challenge question: What role does diet play in the early phases of autoimmunity, before a disease is fully established? - [**How Diet Impacts Autoimmunity**](https://www.autoimmuneinstitute.org/research_updates/how-diet-impacts-autoimmunity/) – Explores how nutrients and dietary patterns, like the Mediterranean diet, influence immune signaling, inflammation, and thyroid health. Highlights links between iodine intake and thyroid autoimmunity, and early research into compounds like yerba mate in multiple sclerosis. - [**Beyond Genes and Smoking: 5 More Triggers**](https://www.autoimmuneinstitute.org/articles/beyond-genes-and-smoking-5-more-triggers-that-heighten-autoimmune-disease-risk) – Identifies diet as one of several interacting risk factors alongside pathogens, dysbiosis, toxins, and stress. Explains mechanisms such as molecular mimicry and how processed foods can increase intestinal inflammation. - [**What Is the Microbiome and Why Is It Important?**](https://www.autoimmuneinstitute.org/articles/what-is-the-microbiome-and-why-is-it-important) – Provides an introduction to the human microbiome and its role in immune regulation, digestion, and disease susceptibility. Reviews evidence of reduced microbial diversity in autoimmune conditions like Crohn’s and ulcerative colitis. - [**Pesticide Use & the Gut Microbiome**](https://www.autoimmuneinstitute.org/articles/pesticide-use-the-gut-microbiome) – Examines how agricultural chemicals disrupt microbial balance, increasing autoimmune risk. Reviews evidence linking pesticides to lupus, rheumatoid arthritis, systemic sclerosis, and thyroid disease. Offers dietary strategies like fiber and fermented foods to support gut resilience. - [**What Does “Organic” Really Mean?**](https://www.autoimmuneinstitute.org/articles/what-does-organic-really-mean-part-one) – Explains the USDA certification process, the history of organics, and the limits of the label. Clarifies how organic farming differs from conventional methods in pesticide use, soil health, and sustainability. - [**Is Organic Food Better for Autoimmune Health?**](https://www.autoimmuneinstitute.org/articles/what-does-organic-really-mean-part-two) – Explores whether eating organic lowers autoimmune risk. Highlights research on molecular mimicry in food proteins, the role of chemical additives, and evidence that lower toxic exposures may reduce immune activation. ### Dietary Contributors to Autoimmunity & Flares ##### Challenge question: How do diet and nutrition contribute to worsening disease activity or triggering flares? - [**How Diet Impacts Gut Immunity and Autoimmune Disease Risk**](https://www.autoimmuneinstitute.org/research_updates/how-diet-impacts-gut-immunity-and-autoimmune-disease-risk/) – Summarizes findings from the NIH workshop on diet and mucosal immunity. Emphasizes how early dietary exposures and metabolites shape immune responses, and why standardized diet definitions are crucial for research. - [**Can Diet Repair Gut Damage from Antibiotics?**](https://www.autoimmuneinstitute.org/research_updates/can-diet-repair-gut-damage-from-antibiotics/) – Explains how high-fiber diets help the gut microbiome recover after antibiotic use, reducing risks of prolonged dysbiosis linked to autoimmune flare susceptibility. - [**Is Your Oral Microbiome Fueling Autoimmune Disease?**](https://www.autoimmuneinstitute.org/articles/is-your-oral-microbiome-fueling-autoimmune-disease) – Investigates the role of oral dysbiosis in systemic autoimmunity. Details mechanisms like microbial translocation, molecular mimicry, and citrullination (linked to rheumatoid arthritis). - [**Gut-Skin Connection: How Your Microbiome Impacts Autoimmune Skin Diseases**](https://www.autoimmuneinstitute.org/articles/gut-skin-connection-how-your-microbiome-impacts-autoimmune-skin-diseases) – Reviews evidence for the gut-skin axis in diseases like psoriasis, lupus, atopic dermatitis, and vitiligo. Highlights how diet shapes microbial metabolites that may trigger skin inflammation. ### Dietary Strategies for Autoimmune Disease Management ##### Challenge question: Can dietary strategies help patients manage symptoms and improve quality of life? - [**Elimination Diets: What You Need to Know**](https://www.autoimmuneinstitute.org/articles/elimination-diets-what-you-need-to-know) – Provides a practical guide to elimination diets, describing how they can uncover food triggers in autoimmune conditions, their benefits, risks, and common protocols like AIP, SCD, and low-FODMAP. - [**What Is Processed Food?**](https://www.autoimmuneinstitute.org/articles/what-is-processed-food) – Defines levels of food processing, reviews evidence linking ultra-processed foods to inflammation and microbiome disruption, and offers tips for making healthier choices. - [**Culinary Medicine, Autoimmunity, and Healthful Eating**](https://www.autoimmuneinstitute.org/articles/culinary-medicine-autoimmunity-and-healthful-eating) – Explains how practical cooking approaches, including Mediterranean and AIP diets, can reduce inflammation, ease symptoms, and make nutrition changes sustainable. - [**Probiotics, Prebiotics, and Autoimmune Disease**](https://www.autoimmuneinstitute.org/articles/probiotics-prebiotics-and-autoimmune-disease) – Reviews the scientific evidence for microbial therapies across autoimmune diseases, including RA, IBD, MS, and lupus. Highlights both promise and limitations of probiotic and prebiotic use. - [**The Relationship Between Autoimmune Disease and the Gut Microbiome**](https://www.autoimmuneinstitute.org/articles/the-relationship-between-autoimmune-disease-and-the-gut-microbiome) – Explores how dysbiosis links to lupus, IBD, type 1 diabetes, MS, and RA. Discusses whether restoring balance through diet or other interventions could reduce symptoms. The NOURISH Challenge is about ideas, not clinical trials, but the right ideas could shape the next decade of NIH research. These resources offer science-based insights for anyone looking to think creatively about the role of diet in autoimmunity. **Category:** Events, Policy & Health Decisions --- ### [Exercise Triggers Immune and Energy Strain in ME/CFS](https://www.autoimmuneinstitute.org/research_updates/exercise-triggers-immune-and-energy-strain-in-me-cfs/) **Published:** September 23, 2025 **Author:** Carolyn Serraino **Content:** #### A new study shows that people with [myalgic encephalomyelitis/chronic fatigue syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/me-cfs/ "Myalgic encephalomyelitis / chronic fatigue syndrome") (ME/CFS) experience unusually strong immune reactions and energy strain after exercise, helping to explain post-exertional malaise (PEM). Study participants with ME/CFS were compared to healthy controls before and after exercise. The researchers found that the immune system became unusually reactive, with stronger signals of inflammation and complement activity. At the same time, the body’s energy systems exhibited stress, including difficulty utilizing fats for fuel, signs of blocked energy pathways, and markers of mitochondrial strain. Participants also had higher levels of fats in their blood that can drive inflammation, as well as shifts in gut-related molecules, suggesting a weakened barrier and changes in the microbiome. #### Pathways tied to **tryptophan metabolism**, which affects brain function, were altered after exercise and may help explain symptoms such as “brain fog.” Many of these biological changes were associated with increased fatigue and reduced daily activity. The authors suggest that future treatments might focus on calming the overactive immune response, supporting energy production, or enhancing gut health. ###### Citation Che, X., Ranjan, A., Guo, C., Zhang, K., Goldsmith, R., Levine, S., Moneghetti, K. J., Zhai, Y., Ge, L., Mishra, N., Hornig, M., Bateman, L., Klimas, N. G., Montoya, J. G., Peterson, D. L., Klein, S. L., Fiehn, O., Komaroff, A. L., & Lipkin, W. I. (2025). **Heightened innate immunity may trigger chronic inflammation, fatigue and post-exertional malaise in ME/CFS**. *npj metabolic health and disease*, *3*(1), 34. <https://doi.org/10.1038/s44324-025-00079-w> **Category:** ME/CFS, Microbiome, Research Studies --- ### [How Diet Impacts Gut Immunity and Autoimmune Disease Risk](https://www.autoimmuneinstitute.org/research_updates/how-diet-impacts-gut-immunity-and-autoimmune-disease-risk/) **Published:** August 23, 2024 **Author:** Elevation **Content:** On August 21–22, 2024, the **NIH Workshop on the Impact of Diet on Mucosal Immunity and Immune-Mediated Digestive Diseases** brought together scientists, clinicians, and patient advocates to examine how nutrition influences immune health and disease risk. Hosted by the NIH Office of Nutrition Research and the National Institute of Allergy and Infectious Diseases, the event emphasized the role of diet in gut microbiome interactions, immune system function, and the development of autoimmune diseases. Key discussions included how early dietary exposures shape immune development, the influence of diet-derived metabolites, and the impact of different diets, such as high-fat Western diets, on immune responses. Experts stressed the need for further research on diet-gut interactions, particularly how dietary changes can rapidly alter the microbiome and trigger immune-mediated conditions. The workshop also called for standardized dietary definitions in clinical research and greater integration of dietitians into patient care teams. Precision nutrition was highlighted as a promising tool for managing or even preventing autoimmune diseases. With immune-related conditions on the rise, these findings reinforce the importance of interdisciplinary collaboration to advance nutrition science and improve patient outcomes. ##### **If you would like to view the meeting recording, please use the links below:** Day 1: [https://videocast.nih.gov/watch=54967](https://nam10.safelinks.protection.outlook.com/?url=https%3A%2F%2Fvideocast.nih.gov%2Fwatch%3D54967&data=05%7C02%7Cheather.leonard%40luminacorps.com%7C67e19cdccb8f4f42859608dcbd58b2b1%7C614692ec487445578f7707ec51d386fc%7C1%7C0%7C638593435910575718%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C0%7C%7C%7C&sdata=B%2BhPQJIFttm8E1kejURX8pr7x2cNb1sPSxufWVd8qjs%3D&reserved=0) Day 2: [https://videocast.nih.gov/watch=54969](https://nam10.safelinks.protection.outlook.com/?url=https%3A%2F%2Fvideocast.nih.gov%2Fwatch%3D54969&data=05%7C02%7Cheather.leonard%40luminacorps.com%7C67e19cdccb8f4f42859608dcbd58b2b1%7C614692ec487445578f7707ec51d386fc%7C1%7C0%7C638593435910593704%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C0%7C%7C%7C&sdata=ITilCdNVcVUAc7LkIZKr449TFOUiwywo2tshiT0wRFk%3D&reserved=0) **Category:** Events, Microbiome, Risk Factors --- ### [MAHA Report: Autoimmune Disease Claims - IBD trends](https://www.autoimmuneinstitute.org/research_updates/maha-report-autoimmune-disease-claims-ibd-trends/) **Published:** September 19, 2025 **Author:** Carolyn Serraino **Content:** A May 2025 report from the White House, ***Make Our Children Healthy Again: Assessment***, highlights concerning trends in childhood chronic illness, including an increase in autoimmune diseases. ##### **The report points to rising diagnoses of:** ###### [celiac disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/celiac-disease/ "Celiac disease") ###### inflammatory bowel disease ([Crohn’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crohns-disease/ "Crohn’s disease") and [ulcerative colitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ulcerative-colitis/ "Ulcerative colitis")), ###### and [type 1 diabetes](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/type-1-diabetes-insulin-dependent-diabetes/ "Type 1 diabetes / insulin-dependent diabetes") among U.S. children and explores possible contributing factors related to diet, chemical exposure, gut health, and early antibiotic use. While the report cites peer-reviewed research to support its claims, many of the referenced studies are behind paywalls, limiting public access. This lack of transparency raises concerns, especially given that the report itself states its purpose is to *“inform the American people regarding the childhood chronic disease crisis, using transparent and clear facts”* (*MAHA Report*, p. 2). In several cases, statements made in the report were not fully supported by the sources cited. **This doesn’t mean the overall concerns raised are unfounded, but when it comes to research and medical topics, accuracy and clarity matter.** Even well-intentioned messages can lose credibility if the supporting details aren’t carefully conveyed. This makes it even more important for readers to have the ability to verify the original evidence for themselves. #### Building public trust requires public access to the raw evidence backing the claims being made. Of the five sources cited in the autoimmune-related sections, only one was freely available; purchasing the remaining four would cost around $160. Nonetheless, the Global Autoimmune Institute has independently reviewed each cited study to evaluate the strength and validity of the claims presented. #### Related Update Looking for the analysis of celiac disease trends in the MAHA report? [ Read our Claim 1 update on pediatric celiac disease prevalence ](https://www.autoimmuneinstitute.org/research_updates/maha-report-autoimmune-disease-claims-celiac-disease-trends/) ## Claim 2: Inflammatory Bowel Disease Trends **The MAHA report states on page 15:** ##### “Rates of Inflammatory Bowel Disease (IBD), including Crohn’s, have increased by 25% over the last decade.” To support this, the report cites: ‘**Prevalence of pediatric inflammatory bowel disease in the United States: Pooled estimates from three administrative claims data sources**‘, published in *Gastroenterology* by Kappelman et al in 2025. #### What the Research Says The study pooled insurance claims from more than 2.7 million U.S. children and teens under age 20. Among them, about 100,000 youth were estimated to be living with IBD (58,733 with Crohn’s disease and 36,270 with ulcerative colitis). The researchers also examined trends in the commercially insured population, which had data across multiple years. The 2020 standardized national prevalence was: - 122 per 100,000 for IBD - 71 per 100,000 for Crohn’s disease - 44 per 100,000 for ulcerative colitis For total pediatric IBD (Crohn’s and UC combined), prevalence rose from: - 2011: 110 per 100,000 - 2014: 119 per 100,000 - 2017: 126 per 100,000 - 2020: 125 per 100,000 ###### **This represents an increase of ~14% from 2011 to 2020, not the 25% cited in the MAHA report.** #### **How Reliable Are These Numbers?** Because the U.S. has no national registry for IBD, prevalence estimates depend on insurance claims. Misclassification is a risk, but Kappelman’s team built on prior validation work (Dawwas et al., 2023), which showed that requiring multiple diagnosis codes plus supporting procedures or prescriptions yields a positive predictive value of ~91–94%. The numbers are robust, though not exact. #### **Placing U.S. Pediatric IBD in Context** - **National burden**: A related study (Lewis et al., 2023) found that about 0.7% of the *entire* U.S. population (children + adults) lives with IBD. Pediatric cases are part of this broader, rising burden. - **Disparities**: Barnes et al. (2022) reported lower diagnosis rates among Black and Hispanic children compared to White children, which may reflect both real differences in risk and inequities in access to gastroenterology care. - **Global perspective**: Kuenzig et al. (2022) documented rising pediatric IBD worldwide, with the steepest increases in North America and Europe, and growing incidence in Asia, the Middle East, and South America. #### **Bottom Line** The MAHA report is correct that pediatric IBD prevalence has risen, but its claim of a “25% increase over the last decade” is not supported by the cited study. The actual increase documented between 2011 and 2020 is closer to 14–15%. If the report intended “the last decade” to mean 2015–2025, the cited study still does not substantiate that interpretation. Scientific publications typically state timeframes explicitly, and the report would have been more precise and more accurate had it followed that standard. ## What Can Be Done? Recognizing the burden of pediatric IBD is an essential first step. But beyond simply reporting numbers, action is needed to support children and families affected by Crohn’s disease and ulcerative colitis. Policymakers could: - **Fund pediatric gastroenterology clinics and research centers**, ensuring timely access to specialists trained in childhood-onset IBD. - **Expand insurance coverage** for essential diagnostic tests, medications, and nutrition therapy to reduce financial barriers. - **Support school accommodations**, including training for school nurses, teachers, and cafeteria staff on IBD-related needs. - **Promote diverse representation in IBD research** to close gaps in understanding of racial and ethnic disparities. - **Invest in public awareness campaigns** that help families recognize symptoms early, reducing diagnostic delays. #### The data is already here. What we need now is action. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/GAI-Logo-Image-e1707845715517.png) ###### Citations [MAHA Report](https://www.whitehouse.gov/wp-content/uploads/2025/05/MAHA-Report-The-White-House.pdf) (May 2025). *[The White House](http://www.whitehouse.gov/maha)*. Kappelman, M. D., Brensinger, C., Parlett, L. E., Hurtado-Lorenzo, A., & Lewis, J. D. (2025). Prevalence of Pediatric Inflammatory Bowel Disease in the United States: Pooled Estimates From Three Administrative Claims Data Sources. *Gastroenterology*, *168*(5), 980–982.e2. <https://doi.org/10.1053/j.gastro.2024.11.004> Molodecky, N. A., et al. (2012). Increasing incidence and prevalence of the inflammatory bowel diseases with time, based on systematic review. *Gastroenterology*, *142*(1), 46–e30. <https://doi.org/10.1053/j.gastro.2011.10.001> Ng, S. C., et al. (2017). Worldwide incidence and prevalence of inflammatory bowel disease in the 21st century: a systematic review of population-based studies. *Lancet (London, England)*, *390*(10114), 2769–2778. <https://doi.org/10.1016/S0140-6736(17)32448-0> Kuenzig, M. E., et al. (2022). Twenty-first Century Trends in the Global Epidemiology of Pediatric-Onset Inflammatory Bowel Disease: Systematic Review. *Gastroenterology*, *162*(4), 1147–1159.e4. <https://doi.org/10.1053/j.gastro.2021.12.282> Barnes, E. L., et al. (2022). Racial and Ethnic Distribution of Inflammatory Bowel Disease in the United States. *Inflammatory bowel diseases*, *28*(7), 983–987. <https://doi.org/10.1093/ibd/izab219> Lewis, J. D., et al. (2023). Incidence, Prevalence, and Racial and Ethnic Distribution of Inflammatory Bowel Disease in the United States. *Gastroenterology*, *165*(5), 1197–1205.e2. <https://doi.org/10.1053/j.gastro.2023.07.003> Dawwas, G. K., et al. (2023). Development and Validation of Claims-Based Definitions to Identify Incident and Prevalent Inflammatory Bowel Disease in Administrative Healthcare Databases. *Inflammatory bowel diseases*, *29*(12), 1993–1996. <https://doi.org/10.1093/ibd/izad053> Kappelman, M. D., Moore, K. R., Allen, J. K., & Cook, S. F. (2013). Recent trends in the prevalence of Crohn’s disease and ulcerative colitis in a commercially insured US population. *Digestive diseases and sciences*, *58*(2), 519–525. <https://doi.org/10.1007/s10620-012-2371-5> Dhaliwal, J., et al. (2020). Phenotypic Variation in Paediatric Inflammatory Bowel Disease by Age: A Multicentre Prospective Inception Cohort Study of the Canadian Children IBD Network. *Journal of Crohn’s & colitis*, *14*(4), 445–454. <https://doi.org/10.1093/ecco-jcc/jjz106> Tolbert J, et al. KFF. The Uninsured Population and Health Coverage. <https://www.kff.org/health-policy-101-the-uninsured-population-and-health-coverage/>. Published May 28, 2024. Nead, K. T., Hinkston, C. L., & Wehner, M. R. (2022). Cautions When Using Race and Ethnicity in Administrative Claims Data Sets. *JAMA health forum*, *3*(7), e221812. <https://doi.org/10.1001/jamahealthforum.2022.1812> **Category:** IBD (Crohn's and UC), Policy & Health Decisions, Research Studies --- ### [MAHA Report: Autoimmune Disease Claims - Celiac Disease Trends](https://www.autoimmuneinstitute.org/research_updates/maha-report-autoimmune-disease-claims-celiac-disease-trends/) **Published:** May 30, 2025 **Author:** Carolyn Serraino **Content:** A May 2025 report from the White House, ***Make Our Children Healthy Again: Assessment***, highlights concerning trends in childhood chronic illness, including an increase in autoimmune diseases. ##### **The report points to rising diagnoses of:** ###### [celiac disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/celiac-disease/ "Celiac disease") ###### inflammatory bowel disease ([Crohn’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crohns-disease/ "Crohn’s disease") and [ulcerative colitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ulcerative-colitis/ "Ulcerative colitis")), ###### and [type 1 diabetes](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/type-1-diabetes-insulin-dependent-diabetes/ "Type 1 diabetes / insulin-dependent diabetes") among U.S. children and explores possible contributing factors related to diet, chemical exposure, gut health, and early antibiotic use. While the report cites peer-reviewed research to support its claims, many of the referenced studies are behind paywalls, limiting public access. This lack of transparency raises concerns, especially given that the report itself states its purpose is to *“inform the American people regarding the childhood chronic disease crisis, using transparent and clear facts”* (*MAHA Report*, p. 2). In several cases, statements made in the report were not fully supported by the sources cited. **This doesn’t mean the overall concerns raised are unfounded, but when it comes to research and medical topics, accuracy and clarity matter.** Even well-intentioned messages can lose credibility if the supporting details aren’t carefully conveyed. This makes it even more important for readers to have the ability to verify the original evidence for themselves. #### Building public trust requires public access to the raw evidence backing the claims being made. Of the five sources cited in the autoimmune-related sections, only one was freely available; purchasing the remaining four would cost around $160. Nonetheless, the Global Autoimmune Institute has independently reviewed each cited study to evaluate the strength and validity of the claims presented. #### Related Update Looking for the analysis of inflammatory bowel disease trends in the MAHA report? [ Read our Claim 2 update on pediatric IBD prevalence ](https://www.autoimmuneinstitute.org/research_updates/maha-report-autoimmune-disease-claims-ibd-trends/) ## Claim 1: Celiac Disease Trends **The MAHA report states on page 15:** ##### “Celiac disease rates have increased 5-fold in American children since the 1980s” To support this, the report cites two studies: 1. ‘**The new epidemiology of celiac disease**‘, published in the *Journal of Pediatric Gastroenterology and Nutrition* by Catassi et al in 2014 2. ‘**The changing face of childhood celiac disease in North America: impact of serological testing**‘, published in *Pediatrics* by McGowan et al in 2009. However, neither study provides evidence for a 5-fold increase in American children. #### What the Research Says *“A recent US study showed that CD prevalence was only 0.2% in the year 1975, and increased fivefold during the following 25 years (5).”* — *Catassi et al., 2014* That statistic originates from a 2010 study of **U.S. adults, not children**, by the same lead author: *“During the last 30 years the prevalence of CD among adults in the US increased 5-fold, doubling approximately every 15 years.”* — *Catassi et al., 2010* That finding was based on serological testing of 3,511 adults from a U.S. cohort followed from 1974 to 1989, with a third data point in 2001 from a separate group of 2,845 adults. It does not reflect trends in children. The second cited source—*McGowan et al., 2009*—does look at pediatric data, but **from Canada, not the U.S.** It reported: *“The incidence of celiac disease increased from 2.0 cases per 100,000 children… to 7.3 cases per 100,000 children.”* — *McGowan et al., 2009* That’s a 3.7-fold increase in childhood incidence between 1990–1996 and 2000–2006 in Calgary, Alberta. The McGowan study found that most of the new diagnoses came from children who didn’t have classic digestive symptoms. Over time, classic cases (those with signs like chronic diarrhea, weight loss, and malnutrition) made up a smaller share of diagnoses, dropping from 67% to 19%. But because the total number of children diagnosed increased so much, the actual number of classic cases rose slightly as well: from 0.8 to 1.6 per 100,000 children. In other words, classic celiac became less common as a percentage, but not necessarily less common overall. This pattern suggests that **better screening and broader awareness played a major role** in the rising diagnosis rates. The shift from mostly classic to more atypical and silent presentations aligns with the increased use of antibody-based tests during the study period. **This data shows that how we diagnose the disease has changed significantly and that alone can impact reported trends and help children get the care they need sooner.** ##### We are not suggesting that celiac disease isn’t a growing concern. Like many autoimmune conditions, its true incidence *is* increasing. But the MAHA report’s claim of a 5-fold rise in American children is not supported by the studies it cites. And that’s exactly why getting the numbers right matters. Clear, well-sourced communication is essential, especially when the goal is to build public trust around complex health issues. #### Why are Celiac Disease Rates Increasing in Children? The studies cited in the MAHA report suggest several possible contributors to rising diagnosis rates: ###### Improved Testing and Awareness The introduction of antibody-based screening has significantly expanded diagnosis rates: > *“Antibody testing for celiac disease tripled the incidence of celiac disease and quadrupled the median age at diagnosis.”* > — *McGowan et al., 2009, p. 1576* This has led to increased detection of both typical and atypical forms of the disease, particularly in older children. ###### Changes in Infant Feeding Practices Population-level trends suggest that early nutrition may also play a role: > *“Variation in the pattern of infant nutrition could influence the prevalence of CD at the population level, as suggested by the analysis of an epidemic of early-onset CD observed in Sweden.”* > — *Catassi et al., 2014, p. 1* Although not the primary focus of either study, shifts in breastfeeding, timing of gluten introduction, and dietary patterns are under investigation as contributing factors. #### What Can Be Done? It’s encouraging to see a White House report acknowledge what the autoimmune disease community has known for years: more children are being diagnosed with conditions like celiac disease. But recognition isn’t enough. **Instead of spending more time and resources generating reports, the government could act by:** - covering the cost of diagnostic testing, especially for families who can’t afford it - funding [pediatric celiac disease programs in schools](https://www.childrensnational.org/get-care/departments/celiac-disease-program/family-resources/gluten-free-at-school) nationwide, like [the initiative GAI helped support](https://www.autoimmuneinstitute.org/past-grants-collaborations/) to develop national recommendations for managing celiac disease in learning environments - investing in accessible educational tools like GAI’s [*Gluten Free* podcast, *Raising Celiac* podcast](https://www.autoimmuneinstitute.org/essential-podcasts/ "Gluten Free podcast, Raising Celiac podcast"), and [*Gluten Free* app](http://autoimmuneinstitute.org/helpful-apps/) to empower families navigating this lifelong condition - mandating gluten-free meal options in public schools, with clear labeling and safe preparation practices - training school nurses and cafeteria staff on celiac disease management and cross-contact risks - funding continuing medical education (CME) for pediatricians and primary care providers on how to recognize and test for autoimmune conditions like celiac disease - creating public awareness campaigns to help families recognize symptoms and understand when to seek testing - including celiac disease and autoimmune disorders in national nutrition and chronic disease prevention strategies (e.g., [Healthy People 2030](https://odphp.health.gov/healthypeople)) #### The data is already here. What we need now is action. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/GAI-Logo-Image-e1707845715517.png) ###### Citations [MAHA Report](https://www.whitehouse.gov/wp-content/uploads/2025/05/MAHA-Report-The-White-House.pdf) (May 2025). *[The White House](http://www.whitehouse.gov/maha)*. Catassi, C., et al. (2014). [The new epidemiology of celiac disease](https://pubmed.ncbi.nlm.nih.gov/24979197/). *Journal of pediatric gastroenterology and nutrition*, 59, S7-S9. Catassi, C., et al. (2010). [Natural history of celiac disease autoimmunity in a USA cohort followed since 1974](https://doi.org/10.3109/07853890.2010.514285). *Annals of medicine*, *42*(7), 530–538. McGowan, K. E., et al. (2009). [The changing face of childhood celiac disease in North America: impact of serological testing](https://pubmed.ncbi.nlm.nih.gov/19948628/). *Pediatrics*, 124(6), 1572-1578. **Category:** Celiac Disease, Policy & Health Decisions, Research Studies --- ### [The Relationship Between Blood Glucose and Autoantibodies](https://www.autoimmuneinstitute.org/research_updates/the-relationship-between-blood-glucose-and-autoantibodies/) **Published:** October 18, 2022 **Author:** GAI-assistant **Content:** [Type 1 diabetes](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/type-1-diabetes-insulin-dependent-diabetes/ "Type 1 diabetes / insulin-dependent diabetes") (T1D) develops when the immune system attacks the pancreas’s insulin-producing beta cells, raising blood glucose levels and eventually requiring insulin treatment. While the disease is usually diagnosed in childhood, researchers are still uncovering how and when the disease process begins. A study published in *The Journal of Clinical Investigation* tracked 1,050 infants at genetic risk for type 1 diabetes from 4 months to 3.5 years of age. Researchers measured blood glucose alongside autoantibodies targeting beta cells. #### Some children later developed T1D, but the key discovery was that blood glucose began rising after meals even before autoantibodies were detectable. This suggests there may be an early trigger that impairs beta cells first, followed by the immune system’s autoantibody response. As autoantibody levels rose, blood glucose also increased, pointing to progressive immune-mediated beta-cell damage. These findings mark an important step toward earlier detection of type 1 diabetes. In the future, they may help identify at-risk children sooner and open the door to strategies aimed at stopping beta-cell destruction before insulin therapy becomes necessary. ##### Citation: Warncke, K., et al. (2022). Elevations in blood glucose before and after the appearance of islet autoantibodies in children. *The Journal of clinical investigation*, *132*(20), e162123. <https://doi.org/10.1172/JCI162123> **Category:** Diagnostic Testing, Research Studies, Type 1 Diabetes --- ### [The Repertoire of Autoantibodies in Celiac Disease: Any New One?](https://www.autoimmuneinstitute.org/research_updates/the-repertoire-of-autoantibodies-in-celiac-disease/) **Published:** June 22, 2022 **Author:** Elevation **Excerpt:** The current standard of classical serological markers for the diagnosis of CD has its limitations. Therefore, a new generation of markers should be considered and developed. **Content:** ### *Presented at the 13th International Congress on Autoimmunity in Athens, Greece* #### *Speaker: [Aaron Lerner](https://orcid.org/0000-0002-6779-4090)* #### Key Takeaways: - Current [celiac disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/celiac-disease/ "Celiac disease") (CD) guidelines recommend blood-based antibody tests for screening and diagnosis. - Standard serologic tests include: - **tTG-IgA and tTG-IgG** – tTG-IgA is considered the “gold standard,” but normal ranges are not well defined, cutoff levels vary by manufacturer, and test standardization is lacking. - **EMA-IgA** – highly accurate, but results depend on the observer, making it subjective, plus it is costly and time-intensive. - **DGP-IgA and DGP-IgG** – used less often due to poor predictive value in children and limited ability to distinguish CD from non-CD. - These limitations highlight the need for new diagnostic tools. ##### The current standard of classical serological markers for diagnosing CD has its limitations. Therefore, a new generation of markers should be considered and developed. 83% of Americans who have CD are undiagnosed or misdiagnosed with other conditions. Late diagnosis has long-term complications: short stature, osteoporosis, enamel defects, nutritional deficiencies, cancer predisposition, and susceptibility to other autoimmune diseases. ##### **Lerner [proposed](https://pubmed.ncbi.nlm.nih.gov/31663117/) that the tTG neo-epitope should be considered as a new diagnostic marker for CD**. #### Proposed New Marker: tTG neo-epitope - Shows **higher sensitivity and specificity**, especially in children - Strong correlation with **Marsh criteria** (grading of intestinal damage) - Effective as an **early marker** for silent or latent CD - Potential to serve as a **superior screening assay** ###### Citation Agardh, D., Matthias, T., Wusterhausen, P., Neidhöfer, S., Heller, A., & Lerner, A. (2020). Antibodies against neo-epitope of microbial and human transglutaminase complexes as biomarkers of childhood celiac disease. *Clinical and experimental immunology*, *199*(3), 294–302. <https://doi.org/10.1111/cei.13394> **Category:** Celiac Disease, Diagnostic Testing, Events, Research Studies --- ### [Trusted Sources for Reliable Health Information](https://www.autoimmuneinstitute.org/research_updates/trusted-sources-for-reliable-health-information/) **Published:** May 5, 2025 **Author:** Carolyn Serraino **Content:** The *New York Times* recently reported that changes to federal health websites have raised concerns about whether they can still be trusted as the most reliable sources of health information. Sections on topics like health equity and teen pregnancy were deleted, and public trust in the CDC and FDA is declining. Experts worry that this loss of confidence may drive more people to rely on social media, where misinformation spreads quickly. ##### The article highlights five independent, evidence-based resources you can turn to for accurate, clear health information: 1. **[Vaccine Education Center ](https://www.chop.edu/vaccine-education-center/about-vec)(Children’s Hospital of Philadelphia)** – Provides vaccine schedules, safety explanations, and myth-busting, with all content verified by physicians. 2. **[American College of Obstetricians and Gynecologists](https://www.acog.org/womens-health) (ACOG)** – Offers reliable information on women’s health topics, including reproductive care, with regular expert review and updates. 3. **[Cleveland Clinic Health Library](https://my.clevelandclinic.org/health)** – A searchable resource that addresses popular health questions, TikTok trends, supplements, and medical procedures, written and reviewed by medical experts. 4. **[HealthyChildren.org](https://www.healthychildren.org/) (American Academy of Pediatrics)** – Covers health topics from infancy to young adulthood, with interactive tools like a symptom checker, and content available in Spanish. 5. **[The Tracking Report](https://mailchi.mp/brown/tracking-report-subscription) (Brown University Pandemic Center)** – A free newsletter offering weekly updates on infectious disease outbreaks using data from journals, health agencies, and local departments. Experts also point to the **[National Foundation for Infectious Diseases](https://www.nfid.org/infectious-diseases/)** as a reliable source for information on conditions like flu and COVID-19. At GAI, we also strive to be a trusted resource by providing simple, accurate, and science-based content tailored to the autoimmune community. Our goal is to help people cut through confusion, avoid misinformation, and make informed decisions about their health. ###### Citation Rosenbluth, T. (2025, April 28). **5 places to turn for accurate health information.** *The New York Times*.<https://www.nytimes.com/2025/04/28/well/health-information-accurate-online.html> **Category:** Policy & Health Decisions, Resources --- ### [Dermatitis Herpetiformis: A Form of Celiac Disease](https://www.autoimmuneinstitute.org/research_updates/dermatitis-herpetiformis-a-form-of-celiac-disease/) **Published:** September 10, 2025 **Author:** Carolyn Serraino **Excerpt:** For many years DH was described as a skin condition that often co-occurred with celiac disease. Because most patients did not experience digestive symptoms, DH was often treated as a related but separate disorder. Research has since shown otherwise. The majority of individuals with DH show intestinal changes indicative of celiac disease, even if they do not experience gastrointestinal symptoms. **Content:** ### Celiac Symposium 2025 Highlight This discovery is part of the conversation at the [Tampere Celiac Disease Symposium](https://events.tuni.fi/tcds2025/), where international experts are exploring advances in celiac disease and autoimmune research. GAI is proud to support the symposium as both a sponsor and an active participant in the exchange of ideas. - [Learn More About the Symposium](https://www.autoimmuneinstitute.org/research_updates/advancing-patient-care-tampere-celiac-disease-symposium-2025/) For many years, [dermatitis herpetiformis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/dermatitis-herpetiformis/ "Dermatitis herpetiformis") (DH) was described as a rare, blistering skin condition that often co-occurred with [celiac disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/celiac-disease/ "Celiac disease"). #### Because most patients did not experience digestive symptoms, DH was often treated as a related but separate disorder. Research has since shown otherwise. The majority of individuals with DH show intestinal changes indicative of celiac disease, even if they do not experience gastrointestinal symptoms. Gluten exposure triggers the immune system to make IgA antibodies that mistakenly target transglutaminase-3 in the skin, causing the intensely itchy rash. #### These findings established DH as a cutaneous form of celiac disease, not just an association. This reframing highlights a broader trend in autoimmune research: recognizing common immune pathways across conditions once considered distinct. As investigators also explore connections between celiac disease and type 1 diabetes, DH serves as a clear example of how refining disease categories can reshape understanding and improve patient care. ###### Citations Kotze, L. M. D. S., et al. (2025). CLINICAL AND HISTOLOGICAL COMPARISON OF CELIAC DISEASE AND DERMATITIS HERPETIFORMIS IN MALE PATIENTS: A TEN-YEAR RETROSPECTIVE STUDY. *Arquivos de gastroenterologia*, *62*, e25016. <https://doi.org/10.1590/S0004-2803.24612025-016> Didona, D., Maglie, R., & Solimani, F. (2025). Gluten-related skin disorders: clinical presentation, diagnostic and treatments. *Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG*, *23*(7), 857–867. <https://doi.org/10.1111/ddg.15704> Akhondi, H., & Ross, A. B. (2025). [Gluten-Associated Medical Problems](https://pubmed.ncbi.nlm.nih.gov/30860740/). In *StatPearls*. StatPearls Publishing. Bajor, J., et al. (2025). Associations of Clinical Presentation of Coeliac Disease with Comorbidities and Complications: A Retrospective Single-Centre Analysis. *Journal of personalized medicine*, *15*(2), 55. <https://doi.org/10.3390/jpm15020055> **Category:** Celiac Disease, Research Studies --- ### [When Immune Youth Fuels Autoimmunity in Aging](https://www.autoimmuneinstitute.org/research_updates/when-immune-youth-fuels-autoimmunity-in-aging/) **Published:** September 1, 2025 **Author:** Carolyn Serraino **Content:** A recently published *Nature Aging* review challenges the assumption that age-related immune decline is purely harmful. While older adults often lose defenses against infection and cancer, this decline may actually protect against autoimmunity. The authors argue that when the immune system retains too much “youthfulness,” it can backfire and fuel autoimmune disease in later life. The authors use [giant cell arteritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/giant-cell-arteritis-temporal-arteritis-hortons-disease/ "Giant cell arteritis / temporal arteritis / Horton’s disease") (GCA), an autoimmune vasculitis that only develops after age 50, as a model. #### Mechanism at a Glance: How GCA Defies Normal Immune Aging - **TSCM cells** (stem-like memory CD4+ T cells) stay unusually youthful → continually generate effector T cells that attack blood vessels. - **APCs** (antigen-presenting cells) fail to deliver inhibitory “stop signals” → the brakes on the immune system are missing. - **Neoantigens** build up in all aging tissues → in GCA, an overly “youthful” immune system attacks them as if they were foreign. *Result: immune system remains in attack mode in GCA.* ### Immune aging in most older adults vs. giant cell arteritis (GCA) ##### **In most older adults:** - T cells age and slow down → fewer new effector T cells are made. - APCs add brakes → inhibitory signals help keep immune responses in check. - Neoantigens → the slowed-down immune system largely ignores them. - **Result:** immune decline leaves people more vulnerable to infections, but it also reduces the chance of autoimmunity. ##### **In giant cell arteritis (GCA):** - TSCM cells stay unusually youthful → they keep producing aggressive effector T cells. - APCs fail to provide brakes → inhibitory “stop signals” are missing. - Neoantigens become targets → a “too young” immune system mistakes them for foreign invaders. - **Result:** an overactive immune system attacks blood vessels, driving autoimmunity in older adults. The broader takeaway is that immune aging may be an adaptive safeguard. Efforts to “rejuvenate” immunity in older adults could improve defenses against infection and cancer, but may also carry the unintended cost of increasing autoimmune disease risk. ###### Citation Weyand, C. M., & Goronzy, J. J. (2025). Sustained immune youth risks autoimmune disease in the aging host. *Nature aging*, *5*(8), 1404–1414. <https://doi.org/10.1038/s43587-025-00919-w> ### Related Reading: Autoimmunity & Aging - [Age-Related Variations in Giant Cell Arteritis](https://www.autoimmuneinstitute.org/research_updates/age-related-variations-in-giant-cell-arteritis/) - [Age, Ethnicity, and Unexpected Connections in Autoimmune Risk Factors](https://www.autoimmuneinstitute.org/articles/age-ethnicity-and-unexpected-connections-in-autoimmune-risk-factors/) - [How Aging Exacerbates Autoimmune Disease](https://www.autoimmuneinstitute.org/research_updates/how-aging-exacerbates-autoimmune-disease/) **Category:** Autoimmune Diseases, Research Studies --- ### [Updated Guidance: Autoimmune Drug Safety in Pregnancy and Breastfeeding](https://www.autoimmuneinstitute.org/research_updates/updated-guidance-autoimmune-drug-safety-in-pregnancy-and-breastfeeding/) **Published:** April 29, 2025 **Author:** Carolyn Serraino **Content:** Women are more likely than men to develop autoimmune diseases, and many are diagnosed during their reproductive years. Managing disease during pregnancy and breastfeeding requires careful balancing of maternal and fetal health. The [2024 update](https://www.sciencedirect.com/science/article/pii/S0003496725008180) from the European Alliance of Associations for Rheumatology (EULAR) provides much-needed clarity: most standard treatments for autoimmune rheumatologic conditions are safe to use while trying to conceive, during pregnancy, and while breastfeeding. Commonly used treatments like hydroxychloroquine, azathioprine, sulfasalazine, and TNF inhibitors (such as adalimumab and etanercept) can generally be continued safely. Most biologic therapies are also considered compatible with breastfeeding due to minimal transfer into breast milk. However, certain medications should be avoided, including methotrexate, mycophenolate, and cyclophosphamide, as well as many newer oral treatments like JAK inhibitors (tofacitinib, upadacitinib) and apremilast, which either pose known risks or lack sufficient safety data. NSAIDs should be used sparingly and stopped after 28 weeks of pregnancy. These recommendations apply to a wide range of autoimmune rheumatic diseases, including lupus, rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, and systemic vasculitis. ##### Active autoimmune disease itself can harm pregnancy outcomes, so treatment plans should aim for remission or low disease activity throughout. EULAR emphasizes shared decision-making and early, regular counseling to support both parent and child through every stage of reproductive health. ###### Citation Rüegg, L., et al. (2025). *EULAR recommendations for use of antirheumatic drugs in reproduction, pregnancy, and lactation: 2024 update*. Annals of the Rheumatic Diseases. Advance online publication. <https://doi.org/10.1016/j.ard.2025.02.023> ### Related Reading: Autoimmunity & Pregnancy - [Pregnancy with an Autoimmune Disease](https://www.autoimmuneinstitute.org/articles/pregnancy-with-an-autoimmune-disease/) - [Why Autoimmunity Emerges Postpartum and How to Recognize It](https://www.autoimmuneinstitute.org/articles/why-autoimmunity-emerges-postpartum-and-how-to-recognize-it/) - [Is it Safe to Take a Biologic During Pregnancy?](https://www.autoimmuneinstitute.org/research_updates/is-it-safe-to-take-a-biologic-during-pregnancy/) - [Veterans With Lupus and RA Have Higher Pregnancy Risks](https://www.autoimmuneinstitute.org/research_updates/veterans-with-lupus-and-ra-have-higher-pregnancy-risks/) **Category:** Autoimmune Diseases, Lupus, Rheumatoid Arthritis, Therapies --- ### [Is it Safe to Take a Biologic During Pregnancy?](https://www.autoimmuneinstitute.org/research_updates/is-it-safe-to-take-a-biologic-during-pregnancy/) **Published:** July 25, 2025 **Author:** Carolyn Serraino **Content:** [Biologics](https://www.autoimmuneinstitute.org/articles/biologics-for-autoimmune-disease-what-you-should-know/) are becoming more commonly used to treat autoimmune diseases, but because these therapies are relatively new, there have been fewer studies on how they affect pregnancy and birth outcomes. While some drugs like methotrexate are known to adversely affect pregnancy, uncontrolled autoimmune disease is a risk factor for adverse pregnancy outcomes. The key is to choose a medication that best controls disease that has minimal negative impacts on pregnancy. A recent study combed through 40 studies involving 11,712 autoimmune rheumatic disease patients to analyze any potential adverse pregnancy outcomes – such as pre-term birth, low birth weight, preeclampsia, and miscarriages — associated with biologic exposure. #### **Overall, the study did not find that biologics led to a higher prevalence of adverse pregnancy outcomes in people with autoimmune rheumatic disease.**  The study emphasizes that TNF inhibitors are associated with reduced prevalence of some adverse pregnancy outcomes, while other biologics may have a higher risk. Data also shows that while biologics can cross the placenta, they have a limited impact on embryonic or fetal development. Future studies such as this one can help inform biologic choice during pregnancy to maximize the health of the pregnancy and offspring while keeping symptoms of autoimmune disease under control. ##### Citation Li, S., et al. (2025). Safety of biologics in patients with autoimmune rheumatic diseases during pregnancy: Systematic review and meta-analysis. *Autoimmunity Reviews*, 24(8):103827. <https://doi.org/10.1016/j.autrev.2025.103827> ### Related Reading: Autoimmunity & Pregnancy - [Pregnancy with an Autoimmune Disease](https://www.autoimmuneinstitute.org/articles/pregnancy-with-an-autoimmune-disease/) - [Why Autoimmunity Emerges Postpartum and How to Recognize It](https://www.autoimmuneinstitute.org/articles/why-autoimmunity-emerges-postpartum-and-how-to-recognize-it/) - [Veterans With Lupus and RA Have Higher Pregnancy Risks](https://www.autoimmuneinstitute.org/research_updates/veterans-with-lupus-and-ra-have-higher-pregnancy-risks/) - [Updated Guidance: Autoimmune Drug Safety in Pregnancy and Breastfeeding](https://www.autoimmuneinstitute.org/research_updates/updated-guidance-autoimmune-drug-safety-in-pregnancy-and-breastfeeding/) **Category:** Autoimmune Diseases, Research Studies --- ### [Veterans With Lupus and RA Have Higher Pregnancy Risks](https://www.autoimmuneinstitute.org/research_updates/veterans-with-lupus-and-ra-have-higher-pregnancy-risks/) **Published:** September 3, 2025 **Author:** Carolyn Serraino **Content:** A new study in *ACR Open Rheumatology* reveals that female veterans with [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus") (SLE) or [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid arthritis") (RA) face substantially higher risks of pregnancy loss and severe maternal morbidity compared to other veterans. Analyzing [Department of Veterans Affairs (VA) health records](https://www.data.va.gov/stories/s/VetPop2023-Data-Story/yr7p-v5my/) from 2009–2019, researchers identified 29,713 pregnancies, including 113 in women with SLE and 92 with RA. #### Among these, 36% of SLE pregnancies and 30% of RA pregnancies ended in nonlive births (stillbirth, ectopic pregnancy, or miscarriage), compared to 25% in other veterans. Rates of life-threatening maternal complications, such as renal failure, sepsis, and need for transfusion, were also elevated. #### 9.7% of veterans with SLE and 4.3% of those with RA, versus 3.2% in the comparison group, had life-threatening maternal complications. Comorbid conditions were strikingly common: **nearly one in five veterans with SLE had end-stage kidney disease, and over one-third had pulmonary hypertension, both major contributors to poor pregnancy outcomes**. Half of the women with lupus were Black, echoing [known racial disparities in maternal health](https://www.autoimmuneinstitute.org/research_updates/reproductive-factors-linked-to-increased-sle-risk-in-black-women-2/ "Reproductive Factors Linked to Increased SLE Risk in Black Women"). The authors conclude that VA maternity care models must better integrate rheumatology expertise to support those with autoimmune conditions. They also stress the need for tailored strategies that address overlapping medical, mental health, and social risks. ###### Citation Quinn, D. A., et al. (2025). **Severe Maternal Morbidity During and After Pregnancy Among Veterans With Systemic Lupus Erythematosus or Rheumatoid Arthritis**. *ACR open rheumatology*, *7*(9), e70100. [https://doi.org/10.1002/acr2.70100](https://acrjournals.onlinelibrary.wiley.com/doi/10.1002/acr2.70100) ### Related Reading: Autoimmunity & Pregnancy - [Pregnancy with an Autoimmune Disease](https://www.autoimmuneinstitute.org/articles/pregnancy-with-an-autoimmune-disease/) - [Why Autoimmunity Emerges Postpartum and How to Recognize It](https://www.autoimmuneinstitute.org/articles/why-autoimmunity-emerges-postpartum-and-how-to-recognize-it/) - [Is it Safe to Take a Biologic During Pregnancy?](https://www.autoimmuneinstitute.org/research_updates/is-it-safe-to-take-a-biologic-during-pregnancy/) - [Updated Guidance: Autoimmune Drug Safety in Pregnancy and Breastfeeding](https://www.autoimmuneinstitute.org/research_updates/updated-guidance-autoimmune-drug-safety-in-pregnancy-and-breastfeeding/) **Category:** Lupus, Research Studies, Rheumatoid Arthritis, Risk Factors --- ### [Global Consensus on Sjögren Disease](https://www.autoimmuneinstitute.org/research_updates/global-consensus-on-sjogren-disease/) **Published:** July 23, 2025 **Author:** Carolyn Serraino **Excerpt:** An international task force of 79 experts and 1,431 patients from 34 countries published new recommendations in Nature Reviews Rheumatology (2025) officially renaming Sjögren’s syndrome as Sjögren disease (SjD). The group also advised replacing the term secondary with associated when the condition occurs alongside another autoimmune disease. **Content:** *As of 2025, GAI has officially updated our [A–Z List](https://www.autoimmuneinstitute.org/resources/autoimmune-diseases-list/ "A-Z Disease List") to reflect the new international consensus on nomenclature.* --- An international task force of 79 experts and 1,431 patients from 34 countries has issued new consensus recommendations on the nomenclature of Sjögren’s, published in *Nature Reviews Rheumatology*. #### The group concluded that the term “Sjögren syndrome” should be replaced with “[Sjögren disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sjogren-syndrome/ "Sjögren disease (SjD)") (SjD)”. The change is intended to correct the misconception that Sjögren is simply a vague collection of symptoms. Instead, it is a distinct autoimmune disease with well-defined autoantibodies, glandular pathology, and systemic manifestations. Patients strongly supported the change, expressing that the word “syndrome” undermines the seriousness of the condition. The consensus also recommends replacing the term “secondary Sjögren” with “associated Sjögren disease” when the condition coexists with another systemic autoimmune disease, such as [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid arthritis") or [lupus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus"). For routine clinical use, experts suggest dropping the primary/secondary distinction altogether, though researchers may still use these categories in trials to maintain study consistency. This shift aligns Sjögren with other autoimmune diseases that no longer use outdated or confusing terminology (e.g., “primary biliary cirrhosis” → “[primary biliary cholangitis](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/primary-biliary-cholangitis/ "Primary Biliary Cholangitis")”). For patients, researchers, and clinicians, the updated nomenclature brings greater clarity and may also improve awareness, funding, and advocacy for a condition that often remains underdiagnosed and misunderstood. ###### Citation International Task Force on Nomenclature of Sjögren Disease, et al. (2025). 2023 International Rome consensus for the nomenclature of Sjögren disease. *Nature reviews. Rheumatology*, *21*(7), 426–437. <https://doi.org/10.1038/s41584-025-01268-z> **Category:** Sjögren disease --- ### [Breakthrough Insights on Rheumatoid Arthritis Flares & Pain](https://www.autoimmuneinstitute.org/research_updates/breakthrough-insights-on-rheumatoid-arthritis-flares-pain/) **Published:** August 28, 2025 **Author:** Carolyn Serraino **Content:** [Rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid arthritis") (RA) affects more than 1.5 million Americans and often limits patients’ ability to travel for care or research. To overcome this challenge, researchers at Rockefeller University, led by Dr. Dana Orange, developed an at-home finger-prick RNA sequencing test that enables patients to contribute samples without leaving home. This innovation has generated striking discoveries. ### PRIME Cells Predict RA Flares The team identified hundreds of gene expression changes that appear one to two weeks before a flare, including rare “pre-inflammatory mesenchymal” (PRIME) cells that migrate into joints and drive inflammation. These cells have also been detected in patients with [psoriatic arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/psoriatic-arthritis/ "Psoriatic arthritis"), inflammatory bowel disease ([Crohn’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crohns-disease/ "Crohn’s disease") and [ulcerative colitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ulcerative-colitis/ "Ulcerative colitis")), [lupus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus"), and [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/ "Multiple sclerosis"), suggesting a broader autoimmune relevance. ### Oral Bacteria from Gum Disease Fuel RA The researchers also uncovered a surprising connection between RA and gum disease. When patients brushed their teeth before giving blood samples, oral bacteria sometimes entered the bloodstream. These bacteria carry proteins that closely resemble proteins in joint tissue, essentially tricking the immune system into repeated attacks. This constant bacterial “fuel” may explain why RA patients with gum disease often respond less effectively to standard treatments, even while on powerful medications. ### Nerve-driven Pain Explains RA Drug Resistance in Some Another breakthrough revealed why approximately one in five RA patients don’t experience relief from anti-inflammatory drugs. Unlike most patients, their pain isn’t driven by inflammation at all. Instead, joint cells stimulate the growth of new pain-sensing nerves. Because their pain stems from nerve overgrowth rather than inflammation, anti-inflammatory medications are ineffective, meaning these patients may require entirely different treatment approaches. This work opens the door to more precise therapies, from nerve-targeting strategies to interventions that anticipate flares before symptoms begin. ###### Citations Smith, M. H., et al. (2025). **Characterizing molecular targets in difficult-to-treat rheumatoid arthritis**. *Seminars in arthritis and rheumatism*, *70S*, 152588. <https://doi.org/10.1016/j.semarthrit.2024.152588> Stephenson, W., et al. (2018). **Single-cell RNA-seq of rheumatoid arthritis synovial tissue using low-cost microfluidic instrumentation**. *Nature communications*, *9*(1), 791. <https://doi.org/10.1038/s41467-017-02659-x> Orange, D. E., et al. (2018). **Identification of Three Rheumatoid Arthritis Disease Subtypes by Machine Learning Integration of Synovial Histologic Features and RNA Sequencing Data**. *Arthritis & rheumatology (Hoboken, N.J.)*, *70*(5), 690–701. <https://doi.org/10.1002/art.40428> Rockefeller University. (2025, August 27). **These genetic insights into rheumatoid arthritis could help design better treatments**. *The Rockefeller University*. [https://www.rockefeller.edu/news/38188-these-genetic-insights-into-rheumatoid-arthritis-could-help-design-better-treatments/](https://www.rockefeller.edu/news/38188-these-genetic-insights-into-rheumatoid-arthritis-could-help-design-better-treatments/?utm_source=chatgpt.com) **Category:** Autoimmune Diseases, Genetics, Research Studies, Rheumatoid Arthritis, Risk Factors, Therapies --- ### [Antibiotics in Pregnancy and Infancy Not Linked to Autoimmune Risk](https://www.autoimmuneinstitute.org/research_updates/antibiotics-in-pregnancy-and-infancy-not-linked-to-autoimmune-risk/) **Published:** August 26, 2025 **Author:** Carolyn Serraino **Content:** A nationwide Korean cohort study published in *PLOS Medicine* followed more than 5 million children to test whether antibiotics given during pregnancy or in the first six months of life raise the risk of autoimmune disease. The autoimmune diseases of interest were [type 1 diabetes](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/type-1-diabetes-insulin-dependent-diabetes/ "Type 1 diabetes / insulin-dependent diabetes"), [juvenile idiopathic arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/juvenile-idiopathic-arthritis-stills/ "Juvenile idiopathic arthritis / adult-onset Still’s disease"), [Crohn’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crohns-disease/ "Crohn’s disease"), [ulcerative colitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ulcerative-colitis/ "Ulcerative colitis"), [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus"), and [Hashimoto’s thyroiditis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/hashimotos-thyroiditis/ "Hashimoto’s thyroiditis / autoimmune thyroiditis"). #### The researchers found no overall association between antibiotic exposure during pregnancy or early infancy and the development of autoimmune disease. To reduce bias from infections and family factors, they applied inverse probability weighting and sibling-matched analyses, both of which “showed null association between antibiotic exposure and autoimmune diseases in children.” #### Some Subgroups Showed Modest Autoimmune Risk Increases - **Crohn’s disease:** “*maternal use of cephalosporins or antibiotics during first or second trimester was associated with a small increased risk of Crohn’s disease in pregnancy analysis*” – Choi et al., 2025 - **Autoimmune thyroiditis:** “*antibiotic exposure in males or during the first two months of life was associated with a modestly increased risk of autoimmune thyroiditis in infancy analysis.*” – Choi et al., 2025 Overall, the findings are reassuring for families and clinicians: when antibiotics are prescribed for real infections in pregnancy or infancy, they do not appear to raise children’s long-term risk of autoimmune disease. ###### Citation Choi, E.-Y., et al. (2025) Exposure to antibiotics during pregnancy or early infancy and the risk of autoimmune disease in children: A nationwide cohort study in Korea. *PLoS Medicine*, 22(8). DOI: 10.1371/journal.pmed.1004677. <https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1004677> **Category:** Autoimmune Diseases, IBD (Crohn's and UC), Lupus, Research Studies, Risk Factors, Thyroid Disease, Type 1 Diabetes --- ### [Largest Genetic Study of ME/CFS Identifies Risk Genes](https://www.autoimmuneinstitute.org/research_updates/largest-genetic-study-identifies-me-cfs-risk-genes/) **Published:** August 21, 2025 **Author:** Carolyn Serraino **Content:** A landmark [study](https://www.medrxiv.org/content/10.1101/2025.08.06.25333109v1), DecodeME, has provided the first robust genetic evidence for myalgic encephalomyelitis/chronic fatigue syndrome ([ME/CFS](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/me-cfs/ "Myalgic encephalomyelitis / chronic fatigue syndrome")), a disabling illness marked by post-exertional malaise, chronic pain, and overwhelming fatigue. The genome-wide association study (GWAS) analyzed DNA from 15,579 people with ME/CFS and 259,909 population controls of European ancestry. Researchers identified eight genome-wide significant genetic loci, including regions near *RABGAP1L, BTN2A2, FBXL4, OLFM4, CA10,* and *ARFGEF2/CSE1L*. #### These genes are involved in infection response, mitochondrial function, immune regulation, and pain pathways. One signal (near *CA10*) overlaps with genetic risk for chronic multi-site pain, while others (*BTN2A2, OLFM4, RABGAP1L*) are linked to immune responses against viruses and bacteria. Interestingly, no overlap was found with depression or anxiety, countering a long history of misdiagnosis. #### These findings underscore that ME/CFS has both immunological and neurological roots, validating patients’ experiences after decades of dismissal. While no diagnostic test or treatment exists yet, this study offers new biological targets for future therapies. Funded by the UK’s Medical Research Council (MRC) and National Institute for Health and Care Research (NIHR), DecodeME is now the world’s largest ME/CFS genetic study and a turning point for research. ###### Citation \[pre-print\] Genetics Delivery Team, et al. (2025). Initial findings from the DECODEME genome-wide association study of Myalgic Encephalomyelitis/chronic fatigue syndrome. *medRxiv*. [https://doi.org/10.1101/2025.08.06.25333109](https://www.medrxiv.org/content/10.1101/2025.08.06.25333109v1) **Category:** Genetics, ME/CFS, Research Studies, Risk Factors --- ### [Firefighter Study Links PFAS to Immune Dysfunction](https://www.autoimmuneinstitute.org/research_updates/firefighter-study-links-pfas-to-immune-dysfunction/) **Published:** August 20, 2025 **Author:** Carolyn Serraino **Content:** A new study of U.S. firefighters shows that exposure to PFAS, often called “forever chemicals,” can alter how genes are switched on and off in ways that may increase risk for autoimmune disease. #### Researchers analyzed blood samples from more than 300 firefighters and found that PFAS exposure changed microRNA activity. MicroRNAs are small molecules that regulate gene expression, essentially controlling whether genes are turned on or off. Several of the disrupted pathways were tied to immune system balance, including genes involved in [lupus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus"), [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid arthritis"), asthma, and other autoimmune or inflammatory conditions. These findings add a crucial layer of evidence to decades of epidemiology showing higher autoimmune disease risk in people exposed to PFAS. By linking exposure to specific genetic mechanisms, the study helps explain why PFAS may drive immune dysfunction. This also opens the door to future treatments aimed at restoring normal gene regulation before disease develops. Because PFAS accumulate in the body and resist natural breakdown, exposure through firefighting foam, water, food packaging, and household products could have long-lasting effects. Understanding how PFAS interfere with immune regulation is especially important for communities already affected by rising autoimmune disease rates. ##### Citation Furlong, M. A., et al. (2025). **Per- and polyfluoroalkyl substances (PFAS) and microRNA: An epigenome-wide association study in firefighters**. *Environmental research*, *279*(Pt 2), 121766. <https://doi.org/10.1016/j.envres.2025.121766> **Category:** Genetics, Lupus, Research Studies, Rheumatoid Arthritis, Risk Factors --- ### [Chikungunya Surge May Complicate Autoimmune Diagnoses](https://www.autoimmuneinstitute.org/research_updates/chikungunya-surge-may-complicate-autoimmune-diagnoses/) **Published:** August 19, 2025 **Author:** Carolyn Serraino **Content:** Chikungunya virus, spread by mosquitoes, is surging worldwide as climate change expands its reach. Recent cases in the Americas and even the U.S. highlight how quickly this once “tropical” virus is moving into new territory. While most people recover after a week, many are left with long-lasting arthritis pain and stiffness that can resemble autoimmune diseases like [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid arthritis"). That similarity may become a growing challenge. #### New research shows that after chikungunya infection, the immune system often stays “stuck in overdrive.” T cells keep firing off inflammation signals, and some patients develop autoantibodies that resemble those found in autoimmune disease. The result is joint pain and disability that looks nearly identical to autoimmune arthritis, even though the underlying biology is different. #### As chikungunya spreads, more patients could show up with arthritis that blurs the line between post-viral illness and classic autoimmune disease. This raises the risk of delayed or missed diagnoses, unnecessary treatments, and new burdens on healthcare systems already stretched by rising autoimmune disease rates. Scientists say the findings underscore the urgent need for better diagnostic tools that can distinguish viral aftereffects from autoimmune disease, as well as treatments that calm runaway inflammation. Beyond chikungunya, these studies also raise bigger questions about how infections may shape immune health in the decades ahead. ##### Citation Ansah-Dico S, et al (2025). **[The role of autoantibodies in post-chikungunya viral arthritis disease severity](https://journals.asm.org/doi/10.1128/spectrum.02656-24)**. Microbiol Spectr 13:e02656-24. Agarwal, R., et al. (2025). **[Chikungunya virus-specific CD4+ T cells are associated with chronic chikungunya viral arthritic disease in humans](https://doi.org/10.1016/j.xcrm.2025.102134).** *Cell reports. Medicine*, *6*(5), 102134. **Category:** Research Studies, Rheumatoid Arthritis, Risk Factors --- ### [Infection-Associated Chronic Illness Provider Manual](https://www.autoimmuneinstitute.org/research_updates/infection-associated-chronic-illness-provider-manual/) **Published:** August 15, 2025 **Author:** Carolyn Serraino **Content:** ### First of Its Kind from Mount Sinai Mount Sinai’s Cohen Center for Recovery from Complex Chronic Illness (CoRE) has released a first-of-its-kind **[Infection-Associated Chronic Illness (IACI) Provider Manual](https://www.mountsinai.org/about/newsroom/2025/mount-sinai-creates-first-manual-for-treating-infection-associated-chronic-illness-for-clinicians)**, a comprehensive, evidence-based guide for clinicians treating patients with conditions linked to infections. These include **long COVID, [myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/me-cfs/ "Myalgic encephalomyelitis / chronic fatigue syndrome"), and chronic tick- and vector-borne illnesses** such as post-treatment [Lyme disease syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/lyme-disease/ "Lyme disease"). The manual, described as a living document that will be updated every 6 months, aims to fill a significant gap in medical education and clinical resources. #### Although millions of people worldwide live with these often-debilitating conditions, most healthcare providers receive little to no formal training in their recognition and management. Without clear, research-based guidance, patients can face years of delayed diagnoses, ineffective treatments, and unnecessary suffering. Developed by a multidisciplinary team at the Icahn School of Medicine at Mount Sinai, the manual provides practical recommendations across the entire care spectrum—from initial assessment and diagnosis to long-term management strategies and referrals to appropriate specialists. It emphasizes a patient-centered approach, balancing evidence-based treatments with supportive care that addresses quality of life. #### The resource is available free of charge to clinicians worldwide. To access it, providers complete a brief form; responses help the CoRE team understand who is using the manual and guide future updates. Once submitted, the manual is available for immediate download, and users can also explore upcoming CME-accredited courses and other educational opportunities from Mount Sinai. #### For the autoimmune and chronic illness community, this manual represents a significant step toward improving care, expanding provider knowledge, and reducing the widespread gaps in treatment that so many patients face. [**Download the Provider Manual**](https://icahn.mssm.edu/research/cohen/resources?pk_vid=4849e54d7e92367d175526898207ce1d) **Category:** Autoimmune Diseases, ME/CFS, Resources --- ### [Transcription Factors Mapping Uncovers Autoimmune Clues in B Cells](https://www.autoimmuneinstitute.org/research_updates/transcription-factors-autoimmune-bcells/) **Published:** August 24, 2023 **Author:** Carolyn Serraino **Content:** B lymphocytes, also called B cells, are white blood cells that make antibodies, helping the immune system recognize and fight infections. Their development is carefully guided by “control hubs” made up of transcription factors (TFs), proteins that switch genes on and off at the appropriate times. In healthy development, these TF networks act like air traffic controllers, making sure B cells mature properly and stay on course. A [2023 study](https://pmc.ncbi.nlm.nih.gov/articles/PMC10546977/) mapped these networks in detail and compared them to B cells from patients with leukemia, a cancer of the blood-forming tissues. The results showed that in leukemia, the TF hubs are rewired. This miswiring changes how DNA is packaged (chromatin accessibility) and alters entire gene programs, pushing B cells to multiply uncontrollably instead of maturing normally. Interestingly, some transcription factors that typically protect healthy B cell identity are hijacked by leukemia cells to support their survival. How is this relevant to autoimmune disease? Many autoimmune diseases, including [lupus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus"), [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid arthritis"), and [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/ "Multiple sclerosis"), involve overactive or misdirected B cells. The same TF pathways that go wrong in leukemia can also influence autoimmune B cell activity, leading to the production of harmful autoantibodies. By mapping exactly how these TF networks work and how they’re corrupted, researchers may be able to design therapies that selectively “reset” misbehaving B cells. Such treatments could, in theory, target disease-driving cells without wiping out the entire immune system. This network-level insight marks a step toward precision medicine for both cancer and autoimmunity, turning basic cell biology into a blueprint for future therapies. ##### Citation Sigvardsson M. (2023). Transcription factor networks link B-lymphocyte development and malignant transformation in leukemia. *Genes & development*, *37*(15-16), 703–723.[ https://doi.org/10.1101/gad.349879.122](https://doi.org/10.1101/gad.349879.122) **Category:** Research Studies --- ### [Genetic Guillain-Barré Look-Alike Behind Deadly Cases in Children](https://www.autoimmuneinstitute.org/research_updates/genetic-guillain-barre-look-alike-behind-deadly-cases-in-children/) **Published:** August 13, 2025 **Author:** Carolyn Serraino **Content:** A rare, life-threatening condition in children has been discovered that looks just like [Guillain-Barré syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/guillain-barre-syndrome/ "Guillain-Barrè syndrome") (GBS) but isn’t. GBS is an autoimmune disease where the body’s immune system mistakenly attacks the nerves after an infection. The new illness, found in 24 children from 12 families, causes similar symptoms: sudden muscle weakness, loss of reflexes, and breathing problems that often require intensive care. But unlike GBS, this disorder is caused by a genetic mutation in a gene called *RCC1* and does not respond to typical autoimmune treatments. This type of disease is called a “GBS mimic” because it looks like GBS but has an entirely different cause. Tragically, 15 of the 24 children died. Many were initially misdiagnosed and treated for autoimmune disease, which didn’t help because the root problem was genetic. #### Researchers have found that the RCC1 mutation makes nerve cells extremely vulnerable to stress following infections, such as colds or fevers. Some children also showed signs of brain damage over time. This discovery is significant for the autoimmune disease community. It shows that not all sudden, post-infection nerve problems are autoimmune, and misdiagnosis can be deadly. It also raises questions about how infections can trigger both autoimmune and non-autoimmune diseases, depending on an individual’s genetic makeup. Doctors are now urged to consider genetic testing for *RCC1* in children who don’t recover as expected from GBS or who have affected siblings. Early and accurate diagnosis could help families avoid repeated tragedy and guide future treatments. ##### Citation Harkness, J. R., et al. (2025). Acute-onset axonal neuropathy following infection in children with biallelic RCC1 variants: a case series. *The Lancet. Neurology*, *24*(8), 667–680. <https://doi.org/10.1016/S1474-4422(25)00198-X> **Category:** Case Studies, Genetics, Risk Factors --- ### [Adipokines Offer Clues for MS Diagnosis and Treatment](https://www.autoimmuneinstitute.org/research_updates/adipokines-offer-clues-for-ms-diagnosis-and-treatment/) **Published:** August 6, 2025 **Author:** Carolyn Serraino **Content:** In [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/ "Multiple sclerosis"), the immune system attacks the central nervous system, which consists of the brain and spinal cord. While multiple sclerosis is known as a central nervous system disease, it actually involves the effect of immunometabolic influences beyond the central nervous system. One type of these molecules is the adipokines. **What are adipokines?** Adipokines are bioactive molecules secreted by adipose tissue (body fat). These molecules have roles in regulating immune and metabolic pathways and have implications in multiple sclerosis. Some examples include: - **Resistin, leptin, and chemerin**, which are pro-inflammatory - **Adiponectin**, which is anti-inflammatory and has neuroprotective effects ## Potential for Future Biomarkers and Treatment In multiple sclerosis, these adipokines become dysregulated. Therefore, adipokines can be biomarkers for multiple sclerosis – possibly aiding in diagnosis and monitoring disease or assessing the effectiveness of therapies. Work in this area is ongoing and would require more validation to become widely adopted clinically. It’s also feasible that in the future, treating multiple sclerosis could involve modulating the activity or levels of adipokines. For example, this could be done by blocking pro-inflammatory adipokines or increasing adiponectin’s anti-inflammatory activity. It’s also possible that lifestyle modifications can help regulate adipokine secretion without the use of medication. For example, a [Mediterranean diet](https://www.autoimmuneinstitute.org/research_updates/how-diet-impacts-autoimmunity/ "How Diet Impacts Autoimmunity") can lower pro-inflammatory adipokines while increasing adiponectin. [![](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/08/ijms-22-10845-g001-scaled.png)](https://www.mdpi.com/ijms/ijms-22-10845/article_deploy/html/images/ijms-22-10845-g001-550.jpg)*[**Figure 1**](https://www.mdpi.com/ijms/ijms-22-10845/article_deploy/html/images/ijms-22-10845-g001-550.jpg). Proposed hypothesis: Obesity and MS can lead to altered adipokine release from white adipose tissue (WAT) into circulation. This results in the activation of inflammatory pathways and increased infiltration of immune cells in the CNS. On the other hand, increased levels of pro-inflammatory cytokines in MS such as tumor necrosis factor α (TNF-α), interleukin 6 (IL-6), and interferon γ (IFN-γ) further stimulate the release of pro-inflammatory adipokines from the WAT and disrupt adipokine signaling, creating a detrimental positive feedback loop. MS, multiple sclerosis; BBB, blood–brain barrier. Rijnsburger, M., et al. (2021). **Adipokines as Immune Cell Modulators in Multiple Sclerosis**. International journal of molecular sciences, 22(19), 10845. https://doi.org/10.3390/ijms221910845* ###### **Citation**s Ghaffary EM, Bjørklund G, Bhat RS, Mirmosayyeb O. **[Adipokines in multiple sclerosis: Immune dysregulation, neuroinflammation, and therapeutic opportunities](https://pubmed.ncbi.nlm.nih.gov/40311722/)**. *Autoimmun Rev*. 2025;24(8):103825. doi:10.1016/j.autrev.2025.103825 Rijnsburger, M., Djuric, N., Mulder, I. A., & de Vries, H. E. (2021). **[Adipokines as Immune Cell Modulators in Multiple Sclerosis](https://www.mdpi.com/1422-0067/22/19/10845# "Adipokines as Immune Cell Modulators in Multiple Sclerosis")**. *International journal of molecular sciences*, *22*(19), 10845. https://doi.org/10.3390/ijms221910845 **Category:** Multiple Sclerosis --- ### [Genetic and Immune Drivers of Vitiligo](https://www.autoimmuneinstitute.org/research_updates/genetic-and-immune-drivers-of-vitiligo/) **Published:** August 11, 2025 **Author:** Carolyn Serraino **Content:** [Vitiligo](https://www.autoimmuneinstitute.org/articles/vitiligo-what-we-know-and-what-we-dont-know/) is an autoimmune condition where the immune system attacks the cells that produce melanin, which gives skin, hair, and eyes their color. Behind this disease is a complex network of genetic, epigenetic, and environmental factors. An understanding of the mechanisms behind this disease has helped researchers develop more precise therapies in contrast to broadly suppressing the immune system. #### Key developments in the understanding of vitiligo include: - The identification of over 50 vitiligo susceptibility genes related to immune regulation, melanocytes, and oxidative stress - Research into the role of immune cells called cytotoxic T cells and the activation of their signaling molecules - Progress towards targeted therapies including cytokine-targeted therapies, JAK signaling inhibitors, and Wnt signaling agonists As scientists understand more about the underpinnings of vitiligo, treatment options can become more personalized towards the individual. ##### **Citation** Upadhya S, Andrade MJ, Shukla V, Rao R, Satyamoorthy K. Genetic and immune dysregulation in vitiligo: Insights into autoimmune mechanisms and disease pathogenesis. Autoimmun Rev. 2025;24(8):103841. [doi:10.1016/j.autrev.2025.103841](https://www.sciencedirect.com/science/article/pii/S1568997225001016?via%3Dihub "doi:10.1016/j.autrev.2025.103841") **Category:** Autoimmune Diseases, Genetics, Research Studies --- ### [Gut–Kidney Connection: Microbiome’s Role in IgA Nephropathy](https://www.autoimmuneinstitute.org/research_updates/gut-kidney-connection-microbiomes-role-in-iga-nephropathy/) **Published:** August 4, 2025 **Author:** Carolyn Serraino **Content:** [IgA nephropathy](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/iga-nephropathy/), or Berger disease, is an autoimmune disease that occurs when IgA antibodies are deposited in the kidney. This causes inflammation and damage to the kidneys. However, the complete process of how the disease develops is unclear and the disease currently lacks effective early diagnosis and treatment strategies. **What is IgA?** IgA is an antibody that’s part of the immune system and is typically found in the mucous membranes and body fluids. It accounts for about 15% of the total antibodies produced in the body—and remarkably, around three grams of IgA are secreted into the intestines every day. ## How are Gut Microbes Involved in IgA Nephropathy? While the exact development of IgA nephropathy has not been completely deciphered, it’s known that the gut microbiome plays a role. The composition of the gut microbiome can influence aspects of immunity such as stimulating B cells and IgA production in the gut. This relationship goes both ways where the IgA response shapes the gut microbiome as well. ## Therapies Targeting the Microbiome-B cell-IgA axis New therapies have emerged to treat IgA nephropathy that target the microbiome-B cell-IgA axis and include those that are approved or currently undergoing clinical trials. These therapies include those that target hyperactive B cells, deplete B cells, or break down IgA. More precise methods, such as those that modulate the microbiome or more targeted depleting of specific B cells, are still emerging and pose an exciting opportunity for the field. ###### **Citation** Dang, S., Zhang, X., Zhang, Y., & Zhang, H. (2025). New thoughts on the intestinal microbiome-B cell-IgA axis and therapies in IgA nephropathy. Autoimmunity reviews, 24(8), 103835. <https://doi.org/10.1016/j.autrev.2025.103835> **Category:** Microbiome, Research Studies, Therapies --- ### [Advancing Imaging Techniques to Diagnose Psoriatic Disease](https://www.autoimmuneinstitute.org/research_updates/advancing-imaging-techniques-to-diagnose-psoriatic-disease/) **Published:** July 31, 2025 **Author:** Carolyn Serraino **Content:** In psoriatic diseases, symptoms first appear in the skin before the disease begins affecting the musculoskeletal system. In most cases, this progression from cutaneous psoriasis to [psoriatic arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/psoriatic-arthritis/ "Psoriatic arthritis") is slow. However, non-specific symptoms or symptoms that aren’t severe enough to meet diagnostic criteria can delay diagnosis and treatment. This makes it difficult to detect and treat disease early. However, advances in imaging techniques can help overcome these challenges. Such techniques include: - **Fluorescence optical imaging:** Inflamed tissues accumulate fluorescent contrast agents more easily than healthy tissues so this technique can identify inflamed areas including joints. - **High-resolution peripheral quantitative computed tomography:** This technique can help identify lesions at points where tendons and ligaments attach to the bone. These lesions are predictive of psoriasis patients at risk of developing psoriatic arthritis. - **Multispectral optoacoustic tomography:**  This method combines ultrasound and optoacoustic imaging to measure molecules involved in inflammation such as levels of hemoglobin, oxygen saturation, collagen, and lipids. - **Artificial intelligence:** AI can help quantify structural damage to predict disease outcome. However, most studies involving AI are in their early stages. Early diagnosis of these diseases can help stop disease progression and avoid irreversible joint damage. Imaging techniques can be used as part of a precision medicine approach to tailor treatments on an individual basis. ##### **Citation** Witte, T.,  et al. (2025). Advances in precision medicine in imaging and therapeutic strategies for psoriatic disease. *Autoimmunity reviews*, 24(8), 103839. <https://doi.org/10.1016/j.autrev.2025.103839> **Category:** Diagnostic Testing, Psoriasis --- ### [Vagus Nerve Device Approved for Rheumatoid Arthritis](https://www.autoimmuneinstitute.org/research_updates/vagus-nerve-device-approved-for-rheumatoid-arthritis/) **Published:** August 1, 2025 **Author:** Carolyn Serraino **Content:** The FDA has approved the first electrical implant therapy for [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid arthritis") (RA), offering new hope for patients who don’t respond to medications like biologics or JAK inhibitors. ##### The device uses vagus nerve stimulation to calm the body’s inflammatory response, a process scientists call the “neuroimmune reflex.” This tiny implant, called the SetPoint System, developed by SetPoint Medical, is placed under the skin in the neck to deliver a low-voltage signal to the vagus nerve for just 60 seconds a day. **It’s designed to activate a natural reflex that helps the nervous system detect and reduce inflammation**. In a [major clinical trial](https://setpointmedical.com/setpoint-medical-announces-late-breaking-data-from-reset-ra-study-at-acr-convergence-2024/), more than half of participants saw significant symptom improvement within 24 weeks. ##### After a year, three-quarters of patients were able to stop taking biologic or targeted synthetic drugs altogether. The procedure was well-tolerated, with a very low rate of serious side effects (1.7%), and no major infections, cancers, or cardiac events linked to the therapy. SetPoint plans to roll out the therapy in select U.S. cities later this year, with nationwide expansion in 2026. **The company is also [exploring the same technology](https://setpointmedical.com/fda-ide-approval-us-pilot-study-neuroimmune-modulation-platform-multiple-sclerosis/) for treating [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/ "Multiple sclerosis") and [Crohn’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crohns-disease/ "Crohn’s disease"), potentially opening a new frontier in autoimmune treatment.** ###### Citations SetPoint Medical. (2024, November 18). *[SetPoint Medical announces late‑breaking data from RESET‑RA study at ACR Convergence 2024](https://setpointmedical.com/setpoint-medical-announces-late-breaking-data-from-reset-ra-study-at-acr-convergence-2024/)* \[Press release\]. SetPoint Medical. SetPoint Medical. (2024, October 2). *[FDA’s IDE approval for U.S. pilot study of neuroimmune modulation platform in adults with relapsing‑remitting multiple sclerosis](http://setpointmedical.com/fda-ide-approval-us-pilot-study-neuroimmune-modulation-platform-multiple-sclerosis/↗ "FDA’s IDE approval for U.S. pilot study of neuroimmune modulation platform in adults with relapsing‑remitting multiple sclerosis")* \[Press release\]. SetPoint Medical. SetPoint Medical Corporation. (2025, January 10). *[Vagus nerve stimulation for moderate to severe rheumatoid arthritis](https://clinicaltrials.gov/study/NCT04539964)* (Clinical trial registration NCT04539964). ClinicalTrials.gov. **Category:** Clinical Trials, Rheumatoid Arthritis, Therapies --- ### [New Hope for Pediatric-onset Multiple Sclerosis](https://www.autoimmuneinstitute.org/research_updates/new-hope-for-pediatric-onset-multiple-sclerosis/) **Published:** June 23, 2025 **Author:** Carolyn Serraino **Content:** Multiple sclerosis diagnoses often occur between 20 and 40 years old. Early-onset multiple sclerosis, which occurs during childhood or adolescence accounts for less than 5% of all cases. Pediatric cases seem to be more inflammatory and aggressive than adult-onset [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/) and have a high relapse rate. Therefore, an important aspect of treating pediatric cases is to slow down disease progression as much as possible and prevent irreversible damage. #### An increasing understanding of B cells in this disease as well as therapies that target B cells are giving hope in treating pediatric-onset multiple sclerosis.  **B cell depletion therapies** are one growing area of study that use antibodies to target B cells and eliminate them from the body. While some of these therapies are in clinical trials, many have not reached pediatric clinical trials yet. Other emerging therapies include those that target specific B cell signaling pathways. **BAFF targeting therapy** interferes with B cell activation and is widely used for other autoimmune diseases. However, these therapies seemed to increase inflammatory activity in a clinical trial, which was subsequently terminated. **Bruton’s tyrosine kinase inhibitors**, which interfere with B cell activation and maturation, are currently undergoing multiple clinical trials. ###### Citation Skarlis, C., Kotsari, M., & Anagnostouli, M. (2025). Advancing Treatment in Pediatric Multiple Sclerosis: The Promise of B-Cell-Targeting Therapies. International Journal of Molecular Sciences, 26(13), 5989. <https://doi.org/10.3390/ijms26135989> **Category:** Multiple Sclerosis, Research Studies, Therapies --- ### [New Clues to Immune Dysfunction in Sjögren’s](https://www.autoimmuneinstitute.org/research_updates/new-clues-to-immune-dysfunction-in-sjogrens/) **Published:** December 23, 2024 **Author:** Carolyn Serraino **Content:** Sjögren’s disease is an autoimmune disease where the immune system attacks the salivary and lacrimal glands. The result is impaired saliva and tear production, leading to dry mouth and eyes. While this disease is associated with self-reactive immune cells, there are still many unknown mechanisms that contribute to disease progression. [New research](https://www.science.org/doi/10.1126/scitranslmed.ado4856) deciphers some additional pathways involved in [Sjögren’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sjogren-syndrome/) and finds that an immunomodulatory drug currently used to treat [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid arthritis") called baricitinib could have some positive effects in Sjögren’s disease. For the study, they used mice that lacked two genes involved in calcium signaling. When they deleted these genes from regulatory T cells in the mice, they found the mice had symptoms associated with Sjögren’s disease such as dry eyes and month, autoantibodies, immune cells in the salivary glands, and lung inflammation. One thing that the researchers noticed was that because regulatory T cells normally inhibit immune cells, impaired calcium signaling in these cells meant they could not inhibit other immune cells as well. This includes immune cells that produce the pro-inflammatory cytokine interferon gamma. When the researchers deleted the gene for interferon gamma, they found that it improved the function of the salivary gland. Inhibiting interferon gamma signaling with the drug baricitinib suppressed inflammation in the salivary gland, hinting that the drug could be a potential candidate to treat Sjögren’s disease. ##### Citation Wang YH, Li W, McDermott M, et al. IFN-γ-producing TH1 cells and dysfunctional regulatory T cells contribute to the pathogenesis of Sjögren’s disease. Sci Transl Med. 2024;16(778):eado4856. [doi:10.1126/scitranslmed.ado4856](https://www.science.org/doi/10.1126/scitranslmed.ado4856) **Category:** Research Studies, Sjögren disease --- ### [Autoimmune Encephalitis Tests Miss the Mark 72% of the Time](https://www.autoimmuneinstitute.org/research_updates/autoimmune-encephalitis-tests-miss-the-mark-72-of-the-time/) **Published:** July 29, 2025 **Author:** Carolyn Serraino **Content:** With the increasing use of commercial [autoimmune encephalitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/acute-disseminated-encephalomyelitis/ "Autoimmune encephalitis / acute disseminated encephalomyelitis (ADEM)") autoantibody test kits, a [recent study](https://pmc.ncbi.nlm.nih.gov/articles/PMC12240144/) found a high number of false-positive results leading to misdiagnoses and improper treatment. While autoantibody tests are informative, considering the tests alone without other clinical context can lead to false positive results. The [clinical criteria](https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(15)00401-9/fulltext) for diagnosis autoimmune encephalitis published in 2016 include: - Rapid onset of short-term memory loss, altered mental state, or psychiatric symptoms - One or more of the following: unexplained seizures, new problems with nerve, spinal cord, or brain functions that affect a specific part of the body, increased number of white blood cells in the cerebrospinal fluid, or MRI features indicating encephalitis - Exclusion of other causes This study examined hospital records and identified 67 patients that had a positive autoimmune encephalitis autoantibody panel result. ##### However, only 19 of these patients (28%) met the criteria for autoimmune encephalitis as described above, making the false positive rate 72%. Of those within the false positive group, the most common clinical diagnoses were epilepsy, primary psychiatric disorders, and dementia. These results highlight the risk of relying on test results alone without also looking at the person’s symptoms, medical history, and other clues. But in reality, many people can’t access a specialist without some form of “confirmed results”. ##### No diagnosis without a specialist. No specialist without a test result. That’s the autoimmune catch-22. The study doesn’t address this, but it’s a common experience for those navigating unclear symptoms or suspected autoimmune conditions. ###### Citation Al-Qassabi, A., et al. (2025). Clinical and Autoimmune Profiles of Omani Patients with True Versus False Positive Autoimmune Encephalitis Antibodies Panels. Sultan Qaboos University medical journal, 25(1), 242–250. <https://doi.org/10.18295/squmj.7.2024.046> **Category:** Autoimmune Brain Inflammation, Diagnostic Testing, Research Studies --- ### [Is Saliva Loss Always Autoimmune? What Mouse Studies Reveal](https://www.autoimmuneinstitute.org/research_updates/is-saliva-loss-always-autoimmune-what-mouse-studies-reveal/) **Published:** November 22, 2024 **Author:** Carolyn Serraino **Content:** Calcium is known for its role in building and maintaining strong bones. But beyond this important role, calcium is an essential player in muscle movement, neuron function, hormone regulation, and saliva production. New research identifies two genes involved in calcium signaling in saliva production. While reduced saliva and tear production are symptoms of [Sjögren’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sjogren-syndrome/), it’s currently unclear why saliva loss occurs in this disease. This study found that mice lacking these genes – called Stim1 and Stim2 – in the salivary glands had reduced calcium levels and decreased saliva production. The loss of these genes affected the function of a calcium channel needed for saliva secretion. However, despite the decreased saliva production, these mice didn’t show signs of autoimmune disease, such as an accumulation of immune cells in the area or autoantibodies typically found in Sjögren’s disease. While this work did not show that mice lacking Stim1 and Stim2 had signs of autoimmunity, it highlights the fact that decreased saliva production can occur independently of autoimmunity. ###### **Citation** Son, G. Y., et al. (2025). Loss of STIM1 and STIM2 in Salivary Glands Disrupts ANO1 Function but Does Not Induce Sjogren’s Disease. *Function (Oxford, England)*, 6(1), zqae047. <https://doi.org/10.1093/function/zqae047> **Category:** Research Studies, Sjögren disease --- ### [How Diet Impacts Autoimmunity](https://www.autoimmuneinstitute.org/research_updates/how-diet-impacts-autoimmunity/) **Published:** July 15, 2025 **Author:** Carolyn Serraino **Content:** Nutrition and the immune system are intimately linked, as nutrition can affect how immune cells respond to invading pathogens, how immune cells distinguish self from non-self, and the overall “health” of our immune system. This connection goes both ways: what we eat influences the immune system, and the immune system influences our metabolism, appetite, and nutrient absorption. More and more research is being done to see how dietary changes can impact the management of autoimmune diseases, with many proponents advocating for the benefits of an anti-inflammatory or Mediterranean diet. The Mediterranean diet is an [anti-inflammatory diet](https://www.autoimmuneinstitute.org/articles/culinary-medicine-autoimmunity-and-healthful-eating "Elimination Diets: What You Need to Know") containing olive oil, fish, fruits, vegetables, and whole grains. Research has found that: - The Mediterranean diet reduces systemic inflammation and boosts thyroid health. - Diets with high antioxidant content protect against autoimmune thyroid diseases. - Mediterranean diets can help improve management of autoimmune diseases that are systemic and organ-specific. - The Mediterranean diet slightly improved outcomes with [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/ "Multiple sclerosis") (though not statistically significant). Beyond the Mediterranean diet, other researchers have found interesting links between nutrition and immunity. This includes studies that found that iodine intake influenced thyroid autoimmunity in certain populations and that yerba mate reduced multiple sclerosis symptoms in mice. Although genetics and other environmental factors impact the development of autoimmunity, [dietary changes are highly actionable to help manage autoimmunity](https://www.autoimmuneinstitute.org/articles/elimination-diets-what-you-need-to-know "Elimination Diets: What You Need to Know"). ###### Citation Ruggeri, R. M., Hrelia, S., & Barbalace, M. C. (2025). Nutrition and Autoimmune Diseases. Nutrients, 17(13), 2176. <https://doi.org/10.3390/nu17132176> **Category:** Autoimmune Diseases, Multiple Sclerosis, Research Studies, Thyroid Disease --- ### [MS Brain Damage Driven by Mitochondria Malfunction](https://www.autoimmuneinstitute.org/research_updates/ms-brain-damage-driven-by-mitochondria-malfunction/) **Published:** July 2, 2025 **Author:** Carolyn Serraino **Content:** [Multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/ "Multiple sclerosis") (MS) is characterized by damage to the material that surrounds nerve cells called myelin. This can lead to communication problems between the cells of the brain and the rest of the body and cause trouble with balance, muscle weakness, and paralysis, among others. New research from the University of California, Riverside reveals a mechanism behind the motor impairment seen in MS. The key players in their study are: - **Mitochondria:** Mitochondria are the parts of a cell responsible for generating energy. They’re often known as the “powerhouse” of the cell. - **Purkinje cells:** These cells are neurons within the cerebellum of the brain. The cerebellum, which sits at the back of the head, is responsible for movement, balance, and muscle tone. Purkinje cells help coordinate these functions. The researchers noticed that brains from multiple sclerosis patients often have problems in Purkinje cells, including problems with their mitochondria. The neurons weren’t getting enough energy. In a mouse model of experimental autoimmune encephalomyelitis where mice develop symptoms similar to MS, the researchers found that the mice lost Purkinje cells over time. This is similar to what happens in people with MS. While the Purkinje cells do eventually die, the problems due to energy and myelin loss start before the neurons actually die. In the future, it’s possible that targeting and trying to correct mitochondrial problems could help prevent or slow the progression of multiple sclerosis. ##### Citation Atkinson, K., et al. (2025). **Decreased mitochondrial activity in the demyelinating cerebellum of progressive multiple sclerosis and chronic EAE contributes to Purkinje cell loss**. *Proc. Natl. Acad. Sci. U.S.A.* 122 (25) e2421806122, <https://doi.org/10.1073/pnas.2421806122> **Category:** Multiple Sclerosis, Research Studies --- ### [CAR-T Cell Therapy Enters Autoimmune Arena With Promising Results](https://www.autoimmuneinstitute.org/research_updates/car-t-cell-therapy-enters-autoimmune-arena-with-promising-results/) **Published:** June 26, 2025 **Author:** Carolyn Serraino **Content:** Cell therapies, once reserved for cancer, are now breaking new ground in autoimmune disease (AD) treatment. A [recent review](https://pubmed.ncbi.nlm.nih.gov/40562292/) in *Seminars in Cancer Biology* examines how chimeric antigen receptor (CAR) technologies are being adapted to target immune cells that contribute to chronic inflammation and autoimmunity. One of the most promising developments involves CD19-directed CAR-T therapy, which targets and eliminates B cells that drive diseases such as [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus"). ##### **In early trials, patients with severe, treatment-resistant SLE have achieved lasting drug-free remission after just one infusion.** Researchers are also exploring newer approaches, such as CAR-Tregs and BAR-Tregs—engineered regulatory T cells that could **selectively shut down overactive immune responses without weakening the entire immune system**. ##### **Preclinical studies show success across a range of diseases, including [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/ "Multiple sclerosis"), [myasthenia gravis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/myasthenia-gravis/ "Myasthenia gravis"), [autoimmune hemolytic anemia](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-hemolytic-anemia/ "Autoimmune hemolytic anemia"), [pemphigus vulgaris](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/pemphigus-vulgaris/ "Pemphigus vulgaris"), [type 1 diabetes](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/type-1-diabetes-insulin-dependent-diabetes/ "Type 1 diabetes / insulin-dependent diabetes"), and IBD ([Crohn’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crohns-disease/ "Crohn’s disease") and [ulcerative colitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ulcerative-colitis/ "Ulcerative colitis")).** The review also discusses the growing number of clinical trials testing **“universal” off-the-shelf CAR therapies for autoimmune disorders**. ### What Is “Universal” CAR Therapy? #### Traditional CAR-T cell Therapy: - T cells are taken from the patient (autologous), - Engineered in a lab to express a chimeric antigen receptor (CAR), - Then infused back into the same patient. This custom process is time-consuming, expensive, and not always feasible for severely ill or immunocompromised patients. #### “Universal” or “Off-the-Shelf” CAR Therapies: - Use pre-made CAR-T or CAR-Treg cells derived from healthy donors (*allogeneic*), - Engineered in advance and stored for rapid use, - Often gene-edited to reduce the risk of graft-versus-host disease (GVHD) or immune rejection. For people with autoimmune diseases, many of whom have impaired T or B cells or need urgent treatment during disease flares, universal CAR therapies offer significant promise. They have the potential to significantly increase access, reduce costs, and enable quicker intervention, particularly in emergency or early-stage treatment settings. While these therapies are still in early stages, they could mark a turning point for patients who currently face lifelong immunosuppression or disease flares. As the authors emphasize, understanding which AD patients are most likely to benefit and when to intervene will be key to maximizing success while minimizing risk. **🔬 Want to learn more about CAR T Cell research in autoimmune disease?** Visit our [LEAD Day page](https://www.autoimmuneinstitute.org/lead-day/) to explore highlights from our inaugural research event. We honored **Dr. Georg Schett**, a pioneer in the CAR T field, with the *Walter and Jean Boek Leadership in Research Award* for his groundbreaking contributions to autoimmune disease treatment. #### Citation Wen, R., et al. (2025). **Chimeric antigen receptor cell therapy: A revolutionary approach transforming cancer treatment to autoimmune disease therapy**. *Autoimmunity reviews*, *24*(9), 103859. Advance online publication. <https://doi.org/10.1016/j.autrev.2025.103859> **Category:** Clinical Trials, IBD (Crohn's and UC), Lupus, Multiple Sclerosis, Therapies, Type 1 Diabetes --- ### [Omics Tech Unlocks New Insights Into Rheumatoid Arthritis](https://www.autoimmuneinstitute.org/research_updates/omics-tech-unlocks-new-insights-into-rheumatoid-arthritis/) **Published:** June 20, 2025 **Author:** Carolyn Serraino **Content:** In recent years, scientific research has made great strides in the development of “omics” techniques. Omics studies examine all of the genes, proteins, and metabolites from a sample at once and have added tremendous value in our understanding of musculoskeletal tissues and associated diseases such as [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/) and [juvenile idiopathic arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/juvenile-idiopathic-arthritis-stills/). ## What are omics techniques? Omics refers to the large-scale study of biological material within a sample. As explained above, this has been done in bulk – looking at the entire sample as a whole. Types of omics techniques include: - Genomics: Study of all DNA in a sample - Transcriptomics: Study of all genes expressed in a sample - Proteomics: Study of all proteins in a sample - Metabolomics: Study of all small molecules in a sample By examining all of the contents within a sample, these studies can give scientists a comprehensive view of the sample as a whole. However, these studies mask cellular heterogeneity within the sample because they only show the averages across all cells in the population. These omic studies also don’t reveal spatial patterns within tissues. ## Single-cell and spatial omics Newer, more precise methods, within the “omics” technologies look at individual cells instead of the entire population. When combined with spatial methods, this allows scientists to understand the arrangement of these cells and what they’re doing within a larger sample. These types of studies have allowed rheumatoid arthritis researchers to identify new cell types involved in disease, show how immune cells interact with cartilage and bone cells, and potentially identify new pathways that can be used as drug targets. ##### Citation:  Li, X., Fang, L., Zhou, R. et al. Current cutting-edge omics techniques on musculoskeletal tissues and diseases. Bone Res 13, 59 (2025). <https://doi.org/10.1038/s41413-025-00442-z> **Category:** Research Studies, Rheumatoid Arthritis, Therapies --- ### [Declining ACIP Activity Raises Concerns for High-Risk Groups](https://www.autoimmuneinstitute.org/research_updates/declining-acip-activity-raises-concerns-for-high-risk-groups/) **Published:** June 1, 2025 **Author:** Carolyn Serraino **Content:** Since the start of the COVID-19 pandemic, the [Advisory Committee on Immunization Practices (ACIP)](https://www.cdc.gov/acip/meetings/index.html) has seen significant changes in both activity level and areas of focus. In **2020**, ACIP held nine meetings, many of them emergency sessions or short virtual gatherings focused on COVID-19 vaccine authorizations and prioritization phases. That year, it published 178 documents. By **2021**, ACIP was operating at peak intensity. The committee held eight meetings and published 297 documents, including emergency guidance, vaccine schedule updates, and clinical recommendations. Discussions focused on mRNA vaccines, boosters, pediatric use, and risk-based strategies. In **2022**, activity began to decline. ACIP held five meetings and issued 245 publications, reflecting a shift from rapid pandemic response to more structured, long-term planning. In **2023**, the number of publications dropped to 134, while the number of meetings rose to eight. ACIP concentrated on routine updates such as RSV and mpox guidance and began efforts to rebuild confidence in the childhood immunization schedule amid growing vaccine hesitancy. By **2024**, activity had slowed further. Only three meetings were held, and just 93 publications were released for the entire year. Key focus areas in 2024 included: - RSV vaccination policy for older adults and infants - MenABCWY combination meningococcal vaccines - Routine immunization catch-up efforts following the pandemic - Discussion of post-viral illness and long COVID vaccine relevance So far in **2025**, only one meeting has taken place. While this decline in activity may reflect a return to non-emergency operations, GAI and other public health experts have expressed concern that reduced meeting frequency and delayed policy updates could leave high-risk groups, particularly those who are immunocompromised or living with autoimmune disease, without timely guidance or protection. **Category:** Policy & Health Decisions, Risk Factors --- ### [April 2025 ACIP Day 2: Meningococcal, RSV & Chikungunya Updates](https://www.autoimmuneinstitute.org/research_updates/april-2025-acip-day-2-meningococcal-rsv-chikungunya-updates/) **Published:** April 16, 2025 **Author:** Carolyn Serraino **Content:** On Day 2 of the April 2025 ACIP meeting, discussions centered around meningococcal, RSV, and chikungunya vaccines. Several updates and proposals are relevant for individuals with autoimmune or immune-compromising conditions, including those living with chronic illness, immunosuppressive treatment, or impaired antibody transfer during pregnancy. **Day 1 Summary:** > [April 2025 ACIP Meeting: Autoimmune and Immunocompromised Key Updates](https://www.autoimmuneinstitute.org/research_updates/april-2025-acip-meeting-autoimmune-and-immunocompromised-key-updates/) --- #### **Meningococcal Vaccine: [Expanded Protection for High-Risk Groups](https://www.cdc.gov/acip/downloads/slides-2025-04-15-16/01-Loehr-mening-508.pdf)** ACIP reviewed data on MenABCWY combination vaccines (Pfizer’s *Penbraya* and GSK’s *Penmenvy*). These pentavalent vaccines combine protection against serogroups A, B, C, W, and Y. The committee voted to recommend the use of *Penmenvy* only when both MenACWY and MenB vaccines are indicated at the same visit. This applies to people with: - Complement deficiencies or use of complement inhibitors - Functional or anatomic asplenia - HIV infection - Certain autoimmune diseases associated with increased meningococcal risk --- #### **RSV in Adults: [Ongoing Risk for Chronic and Immune Conditions](https://www.cdc.gov/acip/downloads/slides-2025-04-15-16/01-Shaw-Adult-RSV-508.pdf)** Multiple presentations addressed RSV hospitalization risk and vaccine effectiveness in adults under 60 who have chronic or immunocompromising conditions. Risk groups included: - COPD, asthma, coronary artery disease, diabetes, obesity (BMI ≥40) - Cancer patients, transplant recipients, and people on immunosuppressants - Patients with renal, liver, or heart failure CDC models showed that RSV hospitalization rates among adults aged 50–59 with ≥1 chronic or immune-related condition were up to 3.5 times higher than in the general population. Discussions are ongoing about whether to recommend RSV vaccination for high-risk adults under 60 formally. --- #### **Infants Born to Mothers With Immune Challenges: [RSV Antibody Guidance](https://www.cdc.gov/acip/downloads/slides-2025-04-15-16/03-Jones-maternal-peds-RSV-508.pdf)** A new long-acting RSV monoclonal antibody (Clesrovimab) is under review as an alternative to Nirsevimab. If approved, either may be used in infants during their first RSV season. Importantly, infants born to mothers with immune impairments (e.g., those with autoimmune diseases or HIV) may not receive enough protection via maternal vaccination. In these cases, direct antibody administration to the infant is recommended, even if the mother was vaccinated. --- #### **Chikungunya Vaccine: [Guidance Includes Autoimmune-Adjacent Risks](https://www.cdc.gov/acip/downloads/slides-2025-04-15-16/01-Asturias-chikungunya-508.pdf)** ACIP reviewed updated guidance for two licensed chikungunya vaccines: - Live attenuated vaccine (CHIK-LA) — approved in 2023 - Virus-like particle vaccine (CHIK-VLP/VIMKUNYA) — approved in 2025 **Notably:** - Older adults (≥65) with underlying conditions may receive CHIK-VLP if traveling to high-risk areas. However, CHIK-LA is cautioned in this age group due to increased rates of adverse events, including rare hospitalizations for severe myalgia and atrial fibrillation. - A reported serious adverse event occurred in a 58-year-old woman with fibromyalgia, raising questions about reactogenicity in individuals with chronic immune-related pain syndromes. **Watch the whole day 2 meeting here:** **Category:** Clinical Trials, Policy & Health Decisions, Research Studies, Risk Factors --- ### [April 2025 ACIP Meeting: Autoimmune and Immunocompromised Key Updates](https://www.autoimmuneinstitute.org/research_updates/april-2025-acip-meeting-autoimmune-and-immunocompromised-key-updates/) **Published:** April 15, 2025 **Author:** Carolyn Serraino **Content:** The [Advisory Committee on Immunization Practices (ACIP)](https://www.cdc.gov/acip/meetings/index.html) met on April 15–16, 2025, to review new data and discuss potential changes to U.S. vaccine policy. This summary covers the presentations from day 1 (April 15) and includes updates most relevant to people with autoimmune conditions or compromised immune systems. **Day 2 Summary:** > [April 2025 ACIP Day 2: Meningococcal, RSV & Chikungunya Updates](https://www.autoimmuneinstitute.org/research_updates/april-2025-acip-day-2-meningococcal-rsv-chikungunya-updates/) --- #### **Lyme Disease: [Planning for a Future Vaccine](https://www.cdc.gov/acip/downloads/slides-2025-04-15-16/01-Marx-Lyme-508.pdf)** A new ACIP workgroup has been announced to prepare for a Lyme disease vaccine, which is [currently in late-stage trials](https://clinicaltrials.gov/search?cond=lyme%20disease%20vaccine&sort=StudyFirstPostDate). This workgroup plans to present at the June 2025 ACIP meeting. While [Lyme disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/lyme-disease/) is not formally classified as an autoimmune disease, it can trigger autoimmune responses and mimic autoimmune conditions, and is the most common vector-borne disease in the U.S., with an estimated 476,000 people in the U.S. diagnosed and treated for Lyme disease each year. ##### **ACIP Lyme Disease Vaccines Work Group Objectives** - Review epidemiology and burden of Lyme disease - Review data about risk for Lyme disease - Review safety, immunogenicity, and efficacy data for Lyme disease vaccine candidates - Review economic analyses related to Lyme disease vaccination - Develop Lyme disease vaccination policy options - Identify areas where additional data are needed --- #### **COVID-19: [Risk-Based Guidance May Be Coming](https://www.cdc.gov/acip/downloads/slides-2025-04-15-16/05-Panagiotakopoulos-COVID-508.pdf)** Find a detailed summary on the [Epidemiology and risk factors for COVID-19 hospitalizations](https://www.cdc.gov/acip/downloads/slides-2025-04-15-16/03-Havers-COVID-508.pdf) presentation **[here](https://www.autoimmuneinstitute.org/covid_timeline/acip-update-covid-still-dangerous-for-people-with-chronic-conditions/)**: > [ACIP Update: COVID Still Dangerous for People with Chronic Conditions](https://www.autoimmuneinstitute.org/covid_timeline/acip-update-covid-still-dangerous-for-people-with-chronic-conditions/) ACIP discussed possible changes to the COVID-19 vaccine schedule for the 2025–2026 season. A shift toward risk-based recommendations, rather than universal annual boosters, is being considered. **Proposed guidance includes:** - Immunocompromised individuals would still be recommended to receive multiple doses per year. - Patients with autoimmune conditions (e.g., lupus, MS, autoimmune hepatitis) are explicitly listed among the groups at higher risk of severe COVID-19 and eligible for continued protection. A formal vote is expected at a future meeting. --- #### **Pneumococcal Vaccine: [Guidance Under Review for Special Populations](https://www.cdc.gov/acip/downloads/slides-2025-04-15-16/01-Kobayashi-Pneumococcal-508.pdf)** The ACIP’s pneumococcal vaccine workgroup is reviewing data to update guidance for hematopoietic stem cell transplant (HSCT) recipients — a group that significantly overlaps with autoimmune and immunodeficient patients. --- #### **FluMist: [Easier Access for Caregivers](https://www.cdc.gov/acip/downloads/slides-2025-04-15-16/04-bandell-influenza-508.pdf)** The nasal spray flu vaccine, FluMist, is now approved for self-administration in adults and caregiver administration to children. This may improve vaccination access in households managing chronic illness or mobility challenges. --- #### **Mpox: [Adolescent Vaccine Recommendation in Progress](https://www.cdc.gov/acip/downloads/slides-2025-04-15-16/02-Creech-Mpox-508.pdf)** ACIP previewed a possible new recommendation for routine mpox vaccination in adolescents at increased risk, such as those with immune deficiencies or underlying conditions. Early data indicate that the JYNNEOS vaccine is safe and elicits robust immune responses in this age group. A vote is expected in June. --- #### **CMV: [A Promising Vaccine in Development](https://www.cdc.gov/acip/downloads/slides-2025-04-15-16/03-paris-CMV-508.pdf)** Moderna’s mRNA-1647 vaccine for cytomegalovirus (CMV) is now in a Phase 3 trial targeting non-pregnant women ages 16–40. CMV can cause life-threatening disease in immunocompromised individuals and birth defects in newborns. Though current trials focus on maternal protection, future studies may explore uses for transplant recipients and other high-risk populations. --- #### **Measles: [Resurgence Highlights Need for Community Protection](https://www.cdc.gov/acip/downloads/slides-2025-04-15-16/01-Sugerman-measles-508.pdf)** The CDC reported a significant spike in U.S. measles cases—712 as of April 10, including a large outbreak in Texas. Nearly all cases were among unvaccinated individuals. Hospitalization and severe complications remain a concern, especially for immunocompromised individuals. ACIP emphasized the importance of maintaining high MMR coverage to protect those who cannot rely on their own immune response. --- **Watch the whole day one meeting here:** **Category:** Clinical Trials, Policy & Health Decisions, Risk Factors --- ### [Kennedy’s Vaccine Panel Firings May Undermine Autoimmune Safety](https://www.autoimmuneinstitute.org/research_updates/kennedys-vaccine-panel-firings-may-undermine-autoimmune-safety/) **Published:** June 11, 2025 **Author:** Carolyn Serraino **Content:** This week, Health Secretary [Robert F. Kennedy Jr.](https://x.com/SecKennedy/status/1932580198198964241) [removed all 17 members of the CDC’s vaccine advisory panel](https://www.hhs.gov/press-room/hhs-restore-public-trust-vaccines-acip.html), known as the [Advisory Committee on Immunization Practices (ACIP)](https://www.cdc.gov/acip/). This group helps decide which vaccines are recommended, who should get them, and when. Their decisions also determine which vaccines insurance companies are required to cover. **The committee last met in [April 2025](https://www.autoimmuneinstitute.org/research_updates/april-2025-acip-meeting-autoimmune-and-immunocompromised-key-updates/ "April 2025 ACIP Meeting: Autoimmune and Immunocompromised Key Updates"), and no new members have been publicly named ahead of its next scheduled meeting on June 25.** For individuals with autoimmune or immune-related conditions, these recommendations are critical. Vaccines don’t just protect the general public; they create a safety net for those at higher risk of infection or serious illness. **If ACIP stops recommending certain shots, it could make them more challenging to access, more expensive, and create confusion about whether they’re still needed.** Kennedy has stated that the firings were necessary to address conflicts of interest; however, no documented evidence of ethical violations or misconduct by ACIP members has been presented. **Why does this matter?** Without a strong, science-based process, vaccine guidance could become less consistent and less trusted. That affects everyone, but especially those who are immunocompromised and depend on high vaccination rates among those around them to stay safe. **For many living with autoimmune disease, fewer people getting vaccinated isn’t just a public health concern; it’s a threat to daily safety. It increases both the risk of immediate infection and the risk of long-term complications, such as [post-viral illness.](https://www.autoimmuneinstitute.org/covid_timeline/long-covid-follows-a-pattern-of-post-viral-illness/ "Long COVID Isn’t New—It Follows a Pattern of Post-Viral Illness")** ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/01/Navigating-Mask-Wearing-e1749652601982.png) Read more: [A Guide for Immunocompromised Individuals in a Post-Pandemic World](https://www.autoimmuneinstitute.org/articles/a-guide-for-immunocompromised-individuals-in-a-post-pandemic-world) **Category:** Policy & Health Decisions --- ### [CAR T-Cell Therapy Side Effects in Autoimmune Disease](https://www.autoimmuneinstitute.org/research_updates/car-t-cell-therapy-side-effects-in-autoimmune-disease/) **Published:** June 6, 2025 **Author:** Carolyn Serraino **Content:** [Chimeric antigen receptor (CAR) T-cell therapy](https://www.autoimmuneinstitute.org/articles/car-t-cell-therapy-for-autoimmune-disease/), which was pioneered in the cancer field, has been applied to treat severe autoimmune diseases. In CAR T-cell therapy, engineered T-cells target and eliminate B cells, including those that can cause autoimmune reactions. Due to its relatively short history in treating autoimmune diseases, the side effects of CAR T-cell therapy in this context are still being understood. In a new study published in *The Lancet Rheumatology*, researchers examined local organ-specific reactions after CAR T-cell therapy and identified a previously unreported side effect, which they termed local immune effector cell-associated toxicity syndrome (LICATS). The study involved patients with [SLE](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus"), idiopathic inflammatory myopathy, and systemic sclerosis. Of the 39 patients, 77% experienced a total of 54 LICATS events. These mild, self-limited inflammatory reactions resembled symptoms of the patients’ original disease but resolved on their own. Biopsies confirmed there were no signs of autoimmune reactivation. The most affected organs included the skin (rashes) and kidneys (proteinuria), and symptoms appeared a median of 10 days after CAR T-cell infusion and lasted around 11 days. LICATS is different from other serious side effects like cytokine release syndrome, and it’s also not a sign that the autoimmune disease is coming back. Instead, researchers believe these mild symptoms may occur because the body is clearing out leftover dead B cells and debris from the tissues affected by the disease. Because LICATS goes away on its own and isn’t caused by active autoimmunity, it usually doesn’t need treatment with immunosuppressing drugs. Understanding LICATS as its own, mostly harmless reaction helps doctors know what to expect and how to care for patients during future CAR T-cell trials for autoimmune disease. CAR T-cell therapy has shown promise in treating autoimmune diseases, though its use is still considered experimental as long-term studies are necessary to evaluate its safety, durability, and impact on disease relapse. This new observational study aims to clarify the short-term inflammatory effects patients may experience and how these effects differ from more severe autoimmune complications. #### Citation Hagen et al. [Local immune effector cell-associated toxicity syndrome in CAR T-cell treated patients with autoimmune disease: an observational study](https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(25)00091-8/fulltext). *The Lancel Rheumatology* **7**(6): E424-E433. DOI: https://doi.org/10.1016/S2665-9913(25)00091-8 **Category:** Clinical Trials, Lupus, Research Studies, Risk Factors, Therapies --- ### [Protecting the Immunocompromised: New Bill Moves to Ban Mask Bans](https://www.autoimmuneinstitute.org/research_updates/protecting-the-immunocompromised-new-bill-moves-to-ban-mask-bans/) **Published:** May 27, 2025 **Author:** Carolyn Serraino **Content:** Illinois may soon become a leader in public health and disability rights with a [groundbreaking bill](https://www.ilga.gov/legislation/billstatus.asp?DocNum=3853&GAID=18&GA=104&DocTypeID=HB&LegID=162745&SessionID=114) that would prohibit statewide bans on mask-wearing. ##### Co-written by Megan E. Doherty and a coalition of disability advocates—many of whom live with chronic illness and autoimmune disease—the bill affirms that wearing a mask is a necessary, life-protecting choice, not a [threat](https://chicago.councilmatic.org/legislation/o2024-0009463/). Specifically, the Protective Medical Equipment Freedom Act (HB3853) outlines the following protections: 1. It will prevent discrimination against individuals who choose to wear protective medical equipment, ensuring that no one is denied service, employment, or access to public spaces because of health precautions taken for themselves, their families, or their communities. 2. Neither operators of places of public accommodation nor public officials can infringe on this right, which includes protection from any pressure to remove their mask or not wear it in public. 3. The only person who can remove the mask is the person wearing it. 4. People can’t be forced to disclose their health status or other protective information. 5. With oversight from the Illinois Attorney General, this bill includes clear protections against discrimination, retaliation, and harassment, ensuring compliance and accountability through meaningful penalties. The Attorney General would be responsible for creating reporting mechanisms while investigating violations. People with autoimmune diseases like [lupus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus"), [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid arthritis"), and [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/ "Multiple sclerosis") are often immunocompromised, whether due to the disease itself or the medications they rely on. This bill directly protects their right to safely access public spaces without fear of stigma or criminalization. It also covers those still in the lengthy process of being formally diagnosed, which is very common with autoimmune disease, who would likely be excluded from narrow “[health exemptions](https://www.jewsformaskrights.com/resources/health-exemptions-wont-work-why-mask-bans-are-fundamentally-flawed)” in anti-mask legislation. Doherty and her co-authors argue that masking is a disability rights issue, a public health tool, and a matter of dignity and bodily autonomy. The bill builds on Illinois’s 2023 success in banning book bans, offering a blueprint for other states to take proactive steps in future-proofing the right to mask, especially important as the risk of Long COVID and other post-viral complications remains high. For autoimmune patients and allies nationwide, this is a moment of collective power and visibility. **Category:** Policy & Health Decisions, Risk Factors --- ### [What If Alzheimer’s Begins With the Immune System?](https://www.autoimmuneinstitute.org/research_updates/what-if-alzheimers-begins-with-the-immune-system/) **Published:** May 19, 2025 **Author:** Carolyn Serraino **Excerpt:** Alzheimer’s disease is usually seen as a brain disorder that causes memory loss, but what if the immune system plays a much bigger role than we thought? Scientists are now looking at Alzheimer’s from new angles. In addition to classic signs of disease like sticky amyloid plaques and twisted tau tangles, researchers are studying how chronic inflammation and immune dysfunction might contribute to neurodegeneration. **Content:** #### Webinar Overview: **Title:** Alzheimer’s Disease: Are We Missing a Key Piece of the Puzzle? **Date:** May 19, 2025 **Hosted by:** ADPD™ Education & Mosaic of Autoimmunity This expert-led webinar explored the complexity of Alzheimer’s disease through the lens of neurology, immunology, and autoimmunity. Topics included core pathological features (like amyloid plaques and tau tangles), motor symptoms, immune dysfunction, and a novel theory connecting polyamine metabolism and nucleolar stress to neurodegeneration. #### **Key Takeaways:** - **Motor symptoms** like slowed movement or grip weakness may show up early in Alzheimer’s and could help with earlier detection. - **Inflammation and immune system activity** may play a bigger role in Alzheimer’s than previously thought. - Researchers are exploring links between Alzheimer’s and autoimmune disease, including a new theory involving **cell metabolism and stress**. - Tools like **brain organoids and gene-mapping techniques** are opening up new ways to study the disease and test treatments. - **Collaboration** across neurology, immunology, and related fields is essential to uncover what’s really driving Alzheimer’s. --- #### Alzheimer’s disease is usually seen as a brain disorder that causes memory loss, but what if the immune system plays a much bigger role than we thought? Scientists are now looking at Alzheimer’s from new angles. In addition to classic signs of disease like sticky amyloid plaques and twisted tau tangles, researchers are studying how chronic [inflammation](https://www.autoimmuneinstitute.org/articles/inflammation-a-driving-force-of-autoimmune-disease "Inflammation: A Driving Force of Autoimmune Disease") and [immune dysfunction](https://www.autoimmuneinstitute.org/articles/autoimmune-vs-autoinflammatory-disease "Autoimmune vs Autoinflammatory Disease") might contribute to neurodegeneration. They’re also uncovering that Alzheimer’s may not be purely cognitive. People with the disease often show subtle motor symptoms, like slower walking, weaker grip, or finger tapping difficulties. These can appear early and may even correlate with brain biomarkers, pointing to new ways of detecting the disease before memory loss sets in. One of the most intriguing parts of the webinar was a new theory presented by [Dr. Wesley Brooks](https://www.researchgate.net/profile/Wesley-Brooks-2). He proposed that polyamines—molecules that help cells manage RNA and build proteins—can become dysregulated and damage the nucleolus (a key part of the cell’s control center). This disruption may trigger immune system overactivity and neurodegeneration. He connected this to both Alzheimer’s and autoimmune diseases like lupus, suggesting that stress from things like trauma or viral infections might start the whole process. Other topics included emerging diagnostic tools, ethical questions about diagnosing Alzheimer’s before symptoms arise, and the need for interdisciplinary collaboration. Experts emphasized using brain organoids (lab-grown mini-brains) and spatial transcriptomics (which map where genes are active in brain tissue) to test new therapies and deepen understanding. *Source: [Joint AD/PD™ and Mosaic of Autoimmunity Webinar](https://unlok-education.com/joint-ad-pd-and-the-mosaic-of-autoimmunity-webinar/)* #### Curious about the molecular theory behind the immune connection? Dr. Wesley Brooks expands on the ideas shared in the webinar with a groundbreaking publication exploring how immune stress, chromatin disruption, and polyamine imbalances may drive Alzheimer’s pathology—linking it to broader autoimmune disease mechanisms. 👉 [Read our summary of the research and what it could mean for Alzheimer’s and autoimmunity.](https://www.autoimmuneinstitute.org/research_updates/can-cell-and-immune-stress-trigger-alzheimers/) **Category:** Autoimmune Diseases, Events --- ### [Severe ME/CFS Isn’t Hopeless and Patients Deserve More](https://www.autoimmuneinstitute.org/research_updates/severe-me-cfs-isnt-hopeless-and-patients-deserve-more/) **Published:** May 16, 2025 **Author:** Carolyn Serraino **Content:** Those with severe myalgic encephalomyelitis/chronic fatigue syndrome ([ME/CFS](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/me-cfs/ "Myalgic encephalomyelitis / chronic fatigue syndrome")) are often told there’s nothing that can be done, but that story is wrong. A new [*BMJ* opinion piece](https://www.bmj.com/content/389/bmj.r977) calls out the urgent need for expert, compassionate, and holistic care for those living with the most debilitating forms of ME/CFS. ME/CFS can leave patients completely bedridden, unable to tolerate light, sound, or touch. A hallmark symptom, post-exertional malaise (PEM), is especially cruel because even minimal activity can trigger days or weeks of crushing fatigue and worsening symptoms. Yet PEM is still misunderstood, and many treatment settings overlook it entirely. The [Leeds National Inpatient Centre for Psychological Medicine](https://www.leedsandyorkpft.nhs.uk/our-services/me-cfs-service/ "Leeds National Inpatient Centre for Psychological Medicine") is changing that. Their approach? #### A multidisciplinary care team offering individualized rehabilitation, emotional support, and a new understanding of how the brain and body interact in chronic illness. In nine of the past ten years, every patient discharged showed improvement, and over half reported significant progress. This model rejects the harmful narrative that ME/CFS is hopeless and challenges outdated divisions between “mental” and “physical” illness, instead recognizing the complexity of brain-body dysregulation. #### The authors argue that gradual activity, tailored rehabilitation, and belief in recovery, not endless isolation and sensory deprivation, can help restore health and agency. No one should be left to deteriorate in silence. Severe ME/CFS is not the end of the road, and people living with it deserve care that reflects that truth. ###### Citation Miller A, Symington F, Garner P, Pedersen M. **[Patients with severe ME/CFS need hope and expert multidisciplinary care](https://www.bmj.com/content/bmj/389/bmj.r977.full.pdf)** *BMJ* 2025; 389 :r977 doi:10.1136/bmj.r977 **Category:** ME/CFS, Policy & Health Decisions, Therapies --- ### [Can Cell and Immune Stress Trigger Alzheimer's?](https://www.autoimmuneinstitute.org/research_updates/can-cell-and-immune-stress-trigger-alzheimers/) **Published:** April 12, 2024 **Author:** Carolyn Serraino **Content:** A provocative [publication](https://journals.sagepub.com/doi/epub/10.3233/JAD-231184) by Dr. Wesley Brooks presents a systems biology theory that [connects Alzheimer’s disease to autoimmune processes](https://www.autoimmuneinstitute.org/research_updates/is-alzheimers-disease-an-autoimmune-disease/ "Is Alzheimer’s Disease an Autoimmune Disease?") through immune stress, chromatin disruption, and polyamine imbalance. The paper proposes that Alzheimer’s may not simply be a brain disorder—it may begin with cellular mechanisms that overlap with autoimmune disease pathways. Polyamines are small, positively charged molecules that help cells fold RNA and build proteins. Brooks suggests that when these molecules become dysregulated, due to viral infections, trauma, or environmental stress, they can disrupt the nucleolus (a key part of the cell that manages gene expression and repair). This disturbance may reactivate silenced genetic elements (like ALU sequences and LINE-1 retrotransposons), triggering inflammation, RNA misfolding, and ultimately, neurodegeneration. The theory also highlights the inactive [X chromosome](https://www.autoimmuneinstitute.org/research_updates/why-are-females-more-likely-to-develop-autoimmune-disease-than-males/ "Why Are Females More Likely to Develop Autoimmune Disease Than Males?") as a point of vulnerability—especially in females—adding a new layer of explanation for Alzheimer’s sex bias and its overlap with autoimmune diseases like [lupus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus"). If proven, this hypothesis could reshape how researchers approach diagnostics and therapy, suggesting new molecular targets for early intervention. While still theoretical, this model encourages a broader view of Alzheimer’s that incorporates immunology, epigenetics, and higher-order chromatin structure—areas that are often siloed in research. It also underscores the potential value of human brain organoids and computational drug screening tools in testing these complex interactions. #### Citation Brooks WH. Polyamine Dysregulation and Nucleolar Disruption in Alzheimer’s Disease. *Journal of Alzheimer’s Disease*. 2024;98(3):837-857. doi:[10.3233/JAD-231184](https://doi.org/10.3233/JAD-231184) **Category:** Autoimmune Diseases, Genetics --- ### [Is Alzheimer’s Disease an Autoimmune Disease?](https://www.autoimmuneinstitute.org/research_updates/is-alzheimers-disease-an-autoimmune-disease/) **Published:** September 27, 2022 **Author:** Elevation **Content:** While Alzheimer’s disease has been known as a neurodegenerative disease, a new model mentioned in a piece titled [**Alzheimer’s disease as an innate autoimmune disease (AD2): A new molecular paradigm**](https://alz-journals.onlinelibrary.wiley.com/doi/10.1002/alz.12789) proposes that Alzheimer’s disease is an autoimmune disease within the brain. This model was born from a comprehensive analysis of existing journals and patent literature. In this model, immune-stimulating events such as infection or trauma spur the release of a protein called amyloid beta. Amyloid beta’s antimicrobial activity helps our bodies fight infections. Amyloid beta also launches a cascade of immune responses. However, problems arise when amyloid beta can’t distinguish between a bacterium and a brain cell and begins attacking brain cells. Most approaches to Alzheimer’s disease as a neurodegenerative disease view the disease as caused in part by an accumulation and clumping of amyloid beta in the brain, killing brain cells along the way. **Citation:** Weaver D. F. (2022). Alzheimer’s disease as an innate autoimmune disease (AD2 ): A new molecular paradigm. *Alzheimer’s & dementia : the journal of the Alzheimer’s Association*, 10.1002/alz.12789. Advance online publication. <https://doi.org/10.1002/alz.12789> **Category:** Autoimmune Diseases, Research Studies --- ### [Co-Occurrence of ME/CFS and Chronic Pain Conditions](https://www.autoimmuneinstitute.org/research_updates/co-occurrence-of-me-cfs-and-chronic-pain-conditions/) **Published:** October 28, 2024 **Author:** Lukshmi Solos **Content:** Myalgic encephalomyelitis/chronic fatigue syndrome ([ME/CFS](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/me-cfs/ "Myalgic encephalomyelitis / chronic fatigue syndrome")) is a chronic disease characterized by a significantly reduced ability to perform daily activities and intense fatigue that lasts for six months or more. Patients with ME/CFS also experience post-exertional, where symptoms worsen following physical, mental or emotional effort. The effects of ME/CFS are wide ranging and debilitating. Many patients also develop other conditions that cause pain, known as chronic overlapping pain conditions (COPC). Details regarding the prevalence and impact of ME/CFS and COPC occurring together has been difficult to find. However, a[ recent study ](https://pmc.ncbi.nlm.nih.gov/articles/PMC11488184/#Sec8)examined 923 individuals with either ME/CFS or a healthy control group (HC). Compared to HCs, those with ME/CFS tended to be older, female, white, non-hispanic and not currently employed. Many reported sudden onset of illness that lasted 13 years or more.  Among  ME/CFS patients, 76% had at least one COPC, compared to 17% of controls. The most common COPC impacting ME/CFS patients in this study were chronic migraines/headaches, fibromyalgia, chronic low back pain and irritable bowel syndrome. Patients experiencing both ME/CFS and COPCs reported more severe symptoms and greater impacts on their ability to function. This study is valuable because it is the largest dataset currently available on the occurrence of ME/CFS with COPC and their combined impact on patients. More research is needed to understand the association and to develop treatments for these patients. ##### Citation: Fall, E. et al. (2024). Chronic overlapping pain conditions in people with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS): A sample from the multi-site clinical assessment of ME/CFS (MCAM) study. *BMC Neurology*, *24*(1). [https://doi.org/10.1186/s12883-024-03872-0 ](https://doi.org/10.1186/s12883-024-03872-0) **Category:** ME/CFS, Research Studies, Therapies --- ### [ME/CFS Awareness Day: Join the #MillionsMissing Movement](https://www.autoimmuneinstitute.org/research_updates/me-cfs-awareness-day-join-the-millionsmissing-movement/) **Published:** May 12, 2025 **Author:** Carolyn Serraino **Content:** Today and every day, GAI stands in solidarity with the millions of people living with Myalgic Encephalomyelitis (ME), also known as [ME/CFS](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/me-cfs/ "Myalgic encephalomyelitis / chronic fatigue syndrome"). This disabling neuroimmune disease continues to be underfunded, misunderstood, and overlooked by the medical system. May 12 marks ME Awareness Day and the global **\#MillionsMissing** campaign—a movement demanding recognition, biomedical research, and equitable clinical care for people with ME. Though many cannot march or protest in person due to the severity of their illness, you can still *show up from home* to make a difference. **Ways to Take Action:** - [Show Up From Home Toolkit](https://docs.google.com/document/d/1_f2UQET_AQD4Rq0H9iOwEbWdSIUC4ROME90gd9G1XeY/edit) - **Sign the petition urging NIH to create a research roadmap for ME:** [Sign here](https://www.meactions.org/research-roadmap-petition) - **Call your members of Congress:** [Call script and info](https://docs.google.com/document/d/1pTwIjrfLKngFUQXfQFerkw8vwmZKaT9JDAl6DVUOiSE/edit) This day is especially important for those in the autoimmune and chronic illness communities, as ME/CFS often overlaps with other diseases and remains an example of how long-neglected conditions can be made visible through collective action. #### Learn more at [MEAction.net](https://www.meactions.org/millionsmissing25)! **Category:** Autoimmune Diseases, ME/CFS, Policy & Health Decisions --- ### [Is CAR T-Cell Therapy Safe for Autoimmune Patients?](https://www.autoimmuneinstitute.org/research_updates/is-car-t-cell-therapy-safe-for-autoimmune-patients/) **Published:** May 2, 2025 **Author:** Carolyn Serraino **Content:** A new study published in *The Lancet Rheumatology* provides encouraging news for individuals with autoimmune or inflammatory diseases who also face cancer. Researchers at Dana-Farber Cancer Institute reviewed over 600 cases of patients receiving [CAR T-cell therapy](https://www.autoimmuneinstitute.org/articles/car-t-cell-therapy-for-autoimmune-disease "CAR T-Cell Therapy For Autoimmune Disease") for lymphoma or multiple myeloma—53 of whom had pre-existing autoimmune or inflammatory diseases, including [lupus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus"), [psoriasis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/psoriasis/ "Psoriasis"), and [thyroid disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/hashimotos-thyroiditis/ "Hashimoto’s thyroiditis / autoimmune thyroiditis"). The results showed **no increase in severe side effects**, including cytokine release syndrome or immune-effector cell-associated neurotoxicity syndrome (ICANS), among autoimmune patients compared to those without these conditions. Importantly, **no patients with autoimmune disease experienced severe cytokine storms**, and only one mild flare (of psoriasis) was reported after treatment. In fact, many patients showed *lower disease activity* and required *less immunosuppressive medication* after therapy. These findings suggest that CAR T-cell therapy—a powerful cancer immunotherapy—may be **safer than previously thought** for patients with underlying autoimmune diseases. While more data are needed, the study offers hope that life-saving cancer treatments won’t have to be withheld due to autoimmunity. ##### Citation Vanni, K. et al. (2025). Safety of CAR T-cell therapy for cancer in pre-existing autoimmune or inflammatory disease: a retrospective comparative cohort study. *The Lancet. Rheumatology*, *7*(4), e226–e229. <https://doi.org/10.1016/S2665-9913(24)00402-8> **Category:** Autoimmune Diseases, Clinical Trials, Research Studies, Risk Factors, Therapies --- ### [Why Some Autoimmune Diseases Are Hard to Treat](https://www.autoimmuneinstitute.org/research_updates/why-some-autoimmune-diseases-are-hard-to-treat/) **Published:** April 18, 2025 **Author:** Carolyn Serraino **Content:** A [review](https://pubmed.ncbi.nlm.nih.gov/39848270/) published in *The Lancet Rheumatology* proposes a broader and more empathetic framework for managing [autoimmune diseases](https://www.autoimmuneinstitute.org/resources/autoimmune-diseases-list/ "A-Z Disease List") that don’t respond to standard treatments. Known as “difficult-to-treat” conditions, these cases include not only biologically refractory disease but also challenges like [misdiagnosis](https://www.autoimmuneinstitute.org/articles/misdiagnosed-undiagnosed-expert-insights-on-the-autoimmune-diagnosis-process "Misdiagnosed & Undiagnosed: Expert Insights on the Autoimmune Diagnosis Process"), [medication side effects](https://www.autoimmuneinstitute.org/articles/biologics-for-autoimmune-disease-what-you-should-know "Biologics for Autoimmune Disease: What You Should Know"), [comorbidities](https://www.autoimmuneinstitute.org/articles/comorbidities-in-autoimmune-disease-multiple-autoimmune-syndrome "Comorbidities in Autoimmune Disease & Multiple Autoimmune Syndrome"), and [psychosocial barriers](https://www.autoimmuneinstitute.org/articles/managing-mental-health-with-an-autoimmune-disease "Managing Mental Health with an Autoimmune Disease") to care. The article traces how “treat-to-target” strategies have improved outcomes in diseases like rheumatoid arthritis but notes that many patients still struggle despite appropriate therapy. Definitions of difficult-to-treat disease now exist for several autoimmune conditions—including lupus, psoriatic arthritis, and inflammatory bowel disease—with others in development. By emphasizing shared decision-making, personalized treatment targets, and a multidisciplinary approach, the authors argue for shifting away from a one-size-fits-all mindset. For patients with autoimmune conditions, this could mean more inclusive research designs, expanded treatment pathways, and a clinical model that better reflects the complex nature of their diseases. ##### Citation Nagy, G., et al. (2025). The concept of difficult-to-treat disease in rheumatology: where next?. *The Lancet. Rheumatology*, *7*(4), e274–e289. <https://doi.org/10.1016/S2665-9913(24)00340-0> **Category:** Autoimmune Diseases, Therapies --- ### [Piperacillin as a Targeted Lyme Disease Treatment](https://www.autoimmuneinstitute.org/research_updates/piperacillin-as-a-targeted-lyme-disease-treatment/) **Published:** April 25, 2025 **Author:** Carolyn Serraino **Content:** A new [study](https://pubmed.ncbi.nlm.nih.gov/40267215/) published in *Science Translational Medicine* reveals that the antibiotic piperacillin may offer a safer and more targeted way to treat [Lyme disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/lyme-disease/ "Lyme disease"). Unlike doxycycline—the current first-line treatment—piperacillin works at much lower doses and avoids the broad-spectrum side effects that disrupt the [gut microbiome](https://www.autoimmuneinstitute.org/articles/the-relationship-between-autoimmune-disease-and-the-gut-microbiome "The Relationship Between Autoimmune Disease and the Gut Microbiome") or harm human cells. Researchers screened nearly 500 FDA-approved drugs and found that piperacillin uniquely interferes with how Borrelia burgdorferi, the bacteria that cause Lyme disease, builds its cell wall. #### In mice, piperacillin was just as effective as doxycycline but spared the microbiome and worked at a 100-fold lower dose. **This is especially important for individuals with autoimmune diseases or post-treatment Lyme symptoms, where antibiotic side effects can worsen underlying inflammation.** While more research is needed in humans, this breakthrough suggests we may be closer to a precision therapy for Lyme disease, an infection increasingly recognized as a potential trigger or confounder in autoimmune conditions. ##### Citation Gabby, M. E., et al. (2025). **A high-resolution screen identifies a preexisting beta-lactam that specifically treats Lyme disease in mice**. *Science translational medicine*, *17*(795), eadr9091. <https://doi.org/10.1126/scitranslmed.adr9091> **Category:** Microbiome, Research Studies, Therapies --- ### [Can Diet Repair Gut Damage from Antibiotics?](https://www.autoimmuneinstitute.org/research_updates/can-diet-repair-gut-damage-from-antibiotics/) **Published:** May 8, 2025 **Author:** Carolyn Serraino **Content:** Taking antibiotics helps clear our body of bacterial infections, but they also kill off members of our gut microbiota as collateral damage. This leaves the gut microbiota in a state of dysbiosis. Microbial dysbiosis has many risks for our health, including effects on our immune system. Research has shown that an altered gut microbiome is linked to multiple autoimmune diseases, including [ulcerative colitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ulcerative-colitis/ "Ulcerative colitis"), [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/), and [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/). Research published in [Nature](https://doi.org/10.1038/s41586-025-08937-9) found that diet greatly influences how our microbiome recovers after antibiotic treatment. This study treated mice with antibiotics and then fed them either a low-fat, high-fiber diet or a Western diet high in fat and low in fiber. They found that only mice on the low-fat, high-fiber diet had a rapid recovery in their microbiome after antibiotics. Mice on the Western diet had an extended period of gut dysbiosis, making them susceptible to intestinal infections. With growing support for fecal microbiota transplants to treat dysbiosis, this research finds that diet may be a more effective and less invasive strategy. ##### **Citation:** Kennedy, L., et al. (2025). **Diet outperforms microbial transplant to drive microbiome recovery in mice**. *Nature*. <https://doi.org/10.1038/s41586-025-08937-9> **Category:** Microbiome, Research Studies, Risk Factors --- ### [Infections and Pathogens as Triggers of Autoimmune Disease](https://www.autoimmuneinstitute.org/research_updates/infections-and-pathogens-as-triggers-of-autoimmune-disease/) **Published:** April 19, 2022 **Author:** Carolyn Serraino **Content:** One of the most powerful and well-supported environmental contributors to autoimmune disease is [infection](https://www.autoimmuneinstitute.org/covid_timeline/long-covid-follows-a-pattern-of-post-viral-illness/ "Long COVID Isn’t New—It Follows a Pattern of Post-Viral Illness"). In their [2022 publication in *Pathophysiology*](https://www.mdpi.com/1873-149X/29/2/20), Aristo Vojdani and colleagues [detailed](https://www.autoimmuneinstitute.org/research_updates/the-role-of-exposomes-toxic-chemicals-food-and-pathogens-in-the-pathophysiology-of-ads/ "The Role of Exposomes in the Pathophysiology of Autoimmunity") the complex relationship between infectious agents and the immune system, explaining how pathogens can serve as potent triggers for autoimmune reactions, especially in [genetically susceptible](https://www.autoimmuneinstitute.org/articles/how-sex-genetics-influence-autoimmunity "How Sex & Genetics Influence Autoimmunity") individuals. The paper outlines several mechanisms by which infections can contribute to immune dysregulation, as well as [specific pathogens](#pathogens) most frequently associated with autoimmune disease. ### How Infections Can Trigger Autoimmunity Multiple immune mechanisms may be set into motion when the body encounters an infection: #### **Molecular mimicry** Structural similarities between microbial and self-proteins can mislead the immune system, causing it to attack the body’s own tissues. #### **Epitope spreading** Initial tissue damage from infection can expose hidden self-antigens, broadening the autoimmune response. #### **Viral persistence** Chronic or latent infections can keep the immune system in a constant state of low-level activation. #### **Bystander activation** Nearby immune cells may become activated in response to inflammation, even if they are not specific to the pathogen. #### **Polyclonal activation** Some infections trigger widespread immune cell activation, increasing the likelihood of autoreactive cells becoming active. #### **Innate immune activation** Infections can overstimulate pattern recognition receptors like Toll-like receptors (TLRs), driving prolonged inflammation. #### **Dysregulation of immune homeostasis** Repeated or chronic immune stimulation may erode the body’s normal checks and balances, tipping the immune system into self-reactivity. ### **Key Pathogen Groups Linked to Autoimmunity** #### **Oral Pathogens** Oral bacteria such as *Porphyromonas gingivalis*—often involved in periodontal disease—have been shown to: - Translocate from the mouth to the gut, disrupting the [gut microbiome](https://www.autoimmuneinstitute.org/articles/the-relationship-between-autoimmune-disease-and-the-gut-microbiome "The Relationship Between Autoimmune Disease and the Gut Microbiome"). - Increase intestinal permeability (also known as “leaky gut”). - Contribute to systemic inflammation and autoantigen formation. These disturbances can drive the immune system to produce autoantibodies and fuel systemic autoimmunity. Oral pathogens have been implicated in diseases such as rheumatoid arthritis, systemic lupus erythematosus, and inflammatory bowel disease. #### **SARS-CoV-2** The virus that causes COVID-19 has earned the nickname “the autoimmune virus” due to its extensive and well-documented connections to immune dysregulation: - **Molecular mimicry**: The virus’s spike and nucleocapsid proteins share similarities with human proteins, leading to cross-reactivity. - **Antibody cross-reactions**: Studies show that antibodies against SARS-CoV-2 can bind to human autoantigens, and vice versa. - **Autoantibody development**: Elevated levels of autoantibodies have been found in people infected with COVID-19—even in those without prior autoimmune disease. - **Immune profile overlap**: The lymphocyte subpopulation patterns seen in COVID-19 mirror those found in certain autoimmune conditions. This may explain the post-COVID development or worsening of diseases like lupus, type 1 diabetes, autoimmune encephalitis, and antiphospholipid syndrome. #### **Herpesviruses** The human herpesvirus (HHV) family includes Epstein-Barr virus (EBV), cytomegalovirus (CMV), herpes simplex virus (HSV), and others. These viruses are known for their ability to establish lifelong latency and reactivate periodically, presenting a unique challenge to the immune system. ##### **Epstein-Barr virus** **EBV** has been linked to numerous autoimmune diseases, including: - Multiple sclerosis (MS) - Systemic lupus erythematosus (SLE) - Rheumatoid arthritis (RA) - Sjögren’s syndrome - Type 1 diabetes - Autoimmune thyroid disease - Celiac disease **HHV-6** and related viruses have been associated with: - MS and ME/CFS - Guillain-Barré syndrome - Encephalitis and epilepsy - Neurodegenerative diseases like Parkinson’s and Alzheimer’s - Collagen vascular diseases These viruses may contribute to autoimmunity by integrating into host genomes, modifying immune signaling, and triggering recurrent inflammatory episodes. ### Implications for Autoimmune Disease Prevention and Management The exposome model proposed by Vojdani reframes autoimmune disease as the result of cumulative lifetime exposures, with infections representing one of the most prominent and modifiable risk factors. Understanding the link between pathogens and autoimmunity may help: - Identify at-risk individuals after infection - Improve post-infection monitoring for autoimmune activity - Inform treatment decisions for those with lingering inflammatory symptoms - Guide future vaccine development with attention to immune cross-reactivity By recognizing infectious agents as central to immune dysfunction in autoimmunity, clinicians and researchers can move toward more precise, preventive, and personalized approaches to autoimmune care. ###### Citation Vojdani, A.; Vojdani, E.; Rosenberg, A.Z.; Shoenfeld, Y. **The Role of Exposomes in the Pathophysiology of Autoimmune Diseases II: Pathogens**. *Pathophysiology***2022**, *29*, 243-280. [https://doi.org/10.3390/pathophysiology29020020](https://www.mdpi.com/1873-149X/29/2/20/htm) **Category:** Autoimmune Diseases, Research Studies, Risk Factors --- ### [EBV is Likely the Leading Cause of Multiple Sclerosis (MS)](https://www.autoimmuneinstitute.org/research_updates/ebv-is-likely-the-leading-cause-of-multiple-sclerosis-ms/) **Published:** January 17, 2022 **Author:** Carolyn Serraino **Content:** A [major study](https://www.science.org/doi/10.1126/science.abj8222?t "major study") published in *Science* followed more than 10 million U.S. military personnel and found compelling evidence that **infection with the Epstein-Barr virus (EBV) is the trigger for most cases of [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/ "Multiple sclerosis") (MS)**. **Of the 801 individuals who developed MS during the study,** **all but one had tested positive for EBV before their MS symptoms began**. This makes EBV the strongest known risk factor for MS, raising the chances of developing the disease by 32 times after infection. 📌 *“Only one of the 801 MS cases occurred in an individual who was EBV-negative in the last sample… The HR for MS comparing EBV seroconversion versus persistent EBV seronegativity was 32.4.”* — Bjornevik et al., Science, 2022 ***HR** stands for hazard ratio, a statistical measure used to show how much the risk of something (like developing MS) increases or decreases over time between two groups.* ***Seroconversion** means the moment your body first starts producing detectable antibodies to a virus, in this case, EBV. It’s how scientists know when someone first became infected and transitioned from seronegative to seropositive.* ***Seronegativity** means that a person does not have detectable antibodies to a particular virus in their blood, indicating they have not yet been infected.* Researchers examined blood samples collected over several years and discovered that nerve damage—a hallmark of MS—only appeared after EBV infection, not before. Other viruses, like cytomegalovirus, did not show the same link. 📌 *“sNfL levels… increased after EBV infection. Thus, there were no signs of neuroaxonal degeneration before EBV seroconversion.”* — Bjornevik et al., Science, 2022 ***sNfL** stands for serum neurofilament light chain, a biomarker of nerve damage. Higher levels in the blood suggest that neurons (nerve cells) are breaking down—something that happens in MS.* They also ruled out other possible explanations, such as general immune problems or random chance, but only EBV stood out. 📌 *“The overall antibody response to viral peptides was similar in cases and controls at both time points, except for EBV… arguing against a second hit from another virus playing a major role.”* — Bjornevik et al., Science, 2022 *The researchers used a tool called VirScan to scan each person’s blood for antibodies to hundreds of viruses, not just EBV.* *They did this both before and after the person’s MS symptoms began.* *They found* *no big differences in antibody responses to other viruses between people who developed MS and those who didn’t.* *Except for EBV, which had a much stronger antibody response in the people who developed MS.* *This suggests that people with MS weren’t more vulnerable to viruses in general, just to EBV specifically.* ##### This research suggests that EBV may be the leading cause of MS**,** and that a vaccine or treatment targeting this virus could one day help prevent the disease entirely. ###### Citation Kjetil Bjornevik *et al.*, Longitudinal analysis reveals high prevalence of Epstein-Barr virus associated with multiple sclerosis. *Science* **375**,296-301(2022). DOI:[10.1126/science.abj8222](https://doi.org/10.1126/science.abj8222) **Category:** Multiple Sclerosis, Research Studies, Risk Factors --- ### [What Minnesota HF 3219 Says—and What the Science Says](https://www.autoimmuneinstitute.org/research_updates/mrna-bill-proposed/) **Published:** April 30, 2025 **Author:** Carolyn Serraino **Content:** **Minnesota House File 3219**, a bill introduced in April 2025, proposes criminal penalties for the development and distribution of mRNA-based vaccines and therapeutics. Although the bill is not expected to advance, its content and sponsorship raise essential questions about the role of scientific accuracy in legislation. **Why this matters for autoimmune disease:** Researchers are actively exploring how mRNA-based therapies could help treat or prevent autoimmune conditions by targeting overactive immune responses or promoting immune tolerance. These therapies hold promise for reducing reliance on broad immunosuppressants and personalizing care. Legislation that misrepresents mRNA technology could hinder progress, discourage innovation, or create public confusion—potentially delaying future treatments for autoimmune patients. ### **Model Legislation Circulates** - **Early 2025**: A bill template proposing legal restrictions on mRNA vaccine technology begins circulating in multiple U.S. states. - The draft includes references to “nanotechnology,” “gene alteration,” and “biosynthetic cell replication,” but **does not cite peer-reviewed studies or established scientific authorities**. ### **Minnesota Legislators Introduce HF 3219** - **Mid-April 2025**: Eight members of the Minnesota House of Representatives formally introduced House File 3219, titled the *[mRNA Bioweapons Prohibition Act](https://www.revisor.mn.gov/bills/bill.php?b=House&f=HF3219&ssn=0&y=2025)*. - The bill calls for criminal penalties for administering or distributing mRNA-based vaccines and therapeutics in the state. - It defines such technologies as “bioweapons” and includes descriptions of genetic alteration that are not consistent with current scientific understanding of mRNA function. ##### The fact that eight elected officials endorsed this bill highlights a deeper problem: when science is misunderstood at the policy level, it can lead to laws that ignore evidence, mislead the public, and hinder medical progress. ### **Scientific Experts Respond** - **Late April 2025**: Medical professionals respond publicly to clarify the science behind mRNA vaccines: - According to Dr. David Cennimo, an infectious disease specialist at Rutgers New Jersey Medical School, **mRNA vaccines operate outside the cell nucleus and do not interact with or modify human DNA.** - Nanoparticles used in vaccine delivery are a standard biomedical tool designed to improve stability and effectiveness. - A [2021 article](https://www.sciencedirect.com/science/article/pii/S1748013221000670?via%3Dihub) published in *Nano Today* explains the role of nanotechnology in supporting the delivery and immune activation of mRNA vaccines. While HF 3219 is unlikely to move forward, its introduction reflects a troubling disconnect between emerging medical science and the laws being written about it. For individuals living with autoimmune disease, every new advance in treatment can offer hope, especially as researchers explore mRNA-based approaches to reduce flares, improve precision, and avoid long-term immune suppression. It may be easy for lawmakers to lose sight of that human reality in the abstract language of policy. But they shouldn’t. ##### The responsibility of public office includes making the effort to understand complex scientific issues—because those decisions affect real people, often in the most vulnerable moments of their lives. **Category:** Policy & Health Decisions --- ### [New Clues to Preventing Rheumatoid Arthritis](https://www.autoimmuneinstitute.org/research_updates/new-clues-to-preventing-rheumatoid-arthritis/) **Published:** April 1, 2025 **Author:** Carolyn Serraino **Content:** People who develop [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/) show signs of disease years before symptoms arise. Studies in the past have found that certain biomarkers or changes in immune cell populations are linked to rheumatoid arthritis risk. New research from the University of Colorado takes this work one step further by using a comprehensive, unbiased approach to assess the immune cells in blood from individuals at-risk for rheumatoid arthritis. They compared immune cells from three different groups in their study: at-risk individuals due to a first-degree relative having rheumatoid arthritis, at-risk individuals with autoantibodies commonly seen in rheumatoid arthritis, and healthy controls. What they found was that several immune cell types were expanded in at-risk individuals. With advances in [artificial intelligence](https://www.autoimmuneinstitute.org/articles/the-promise-of-ai-in-autoimmune-disease-from-early-detection-to-personalized-care/), it becomes more and more possible that doctors and researchers can perform larger studies to help precisely recognize abnormalities that could lead to rheumatoid arthritis and other autoimmune diseases in the future. ###### **Citation:**  Inamo, J. et al. (2025). Deep immunophenotyping reveals circulating activated lymphocytes in individuals at risk for rheumatoid arthritis. *J Clin Invest*, 135(6):e185217. <https://doi.org/10.1172/jci185217> **Category:** Research Studies, Rheumatoid Arthritis, Risk Factors --- ### [How Regulatory T Cells Keep The Body From Attacking Itself](https://www.autoimmuneinstitute.org/research_updates/how-regulatory-t-cells-keep-the-body-from-attacking-itself/) **Published:** April 14, 2025 **Author:** Carolyn Serraino **Content:** The ideal immune system targets invading bacteria and viruses but does not attack our own cells. The ability for the immune system to differentiate our body’s cells from invaders is called “self-nonself discrimination.” During an immune response, cells called dendritic cells take proteins from invading cells and turn them into small fragments called antigens. These cells add the antigens on their cell surface where they can be recognized by a type of immune cells called T cells. If the antigens belong to invading cells, helper T cells become activated to target the invaders. However, if the dendritic cell displays a self-antigen, the helper T cells shouldn’t respond. Immune cells called regulatory T cells are a critical player in preventing self-attack, but it’s been unclear how regulatory T cells know when to prevent the immune system from responding. In a study from the University of Chicago, researchers examined how this happens by looking at regulatory T cells that recognize the same self-antigen that helper T cells do. These T cells are called “matched.” They designed a study where they deleted regulatory T cells that recognize a self-peptide in the prostate. Without bacterial infection, there was no autoimmunity. When the researchers infected mice with a bacterium that possessed a prostate self-peptide, they saw that the bacteria triggered an autoimmune response to the prostate because there weren’t any prostate-specific regulatory T cells to stop it. Because the bacterium also expresses other peptides, it can still trigger an immune response against the bacteria via bacteria-specific peptides. This research presents a complementary mechanism of self-tolerance beyond the traditional view that autoimmunity is prevented solely by inactivating self-reactive helper T cells. ###### **Citation:**  Klawon, D.J., et al. (2025). Regulatory T cells constrain T cells of shared specificity to enforce tolerance during infection. *Science*, 387(6740):eadk3248. <https://doi.org/10.1126/science.adk3248> **Category:** Research Studies, Risk Factors --- ### [Could a Healthy Fat Help Calm Autoimmune Flares?](https://www.autoimmuneinstitute.org/research_updates/could-a-healthy-fat-help-calm-autoimmune-flares/) **Published:** March 28, 2025 **Author:** Carolyn Serraino **Content:** For people living with autoimmune disease, treatment often means trade-offs: immunosuppressants that quiet inflammation but leave the body vulnerable to infections, side effects, and long-term risks. But what if there was a gentler option—one that worked with your body instead of shutting it down? In a powerful *[Live from the Lab](https://www.youtube.com/watch?v=_cPbfxKuRMs&t=4s)* presentation, Dr. Sonia Sharma of the [La Jolla Institute for Immunology](https://www.autoimmuneinstitute.org/gai-and-la-jolla-institute-for-immunology/) introduced a lesser-known molecule called **lysophosphatidylcholine (LPC)**—a natural fat found in the blood that may play a surprising role in how autoimmune flares begin and end. “We observed that a specific type of LPC was **uniquely reduced** in patients who developed autoimmune complications,” said Dr. Sharma. Her lab discovered that when LPC levels drop, **inflammatory immune cells like neutrophils spike**, triggering the kind of damage seen in diseases like lupus, rheumatoid arthritis, and inflammatory bowel disease. But when LPC was added back in lab models, it helped restore balance—reducing inflammation without wiping out the immune system. Unlike traditional treatments, “this is not a broadscale immunosuppressant,” Sharma emphasized. ##### **“It’s a natural anti-inflammatory… turning down the flame on that autoimmunity.”** Dr. Sharma and her team are now working on a **topical version of LPC** designed to be used during flares, offering a faster-acting, lower-risk way to help manage symptoms and protect long-term health. Whether you’re newly diagnosed or searching for safer ways to manage chronic inflammation, this talk offers something rare: a glimpse at where autoimmune treatment may be headed—and why early immune signals matter more than we thought. **Category:** Events, Research Studies, Therapies --- ### [The Role of Exposomes in the Pathophysiology of Autoimmunity](https://www.autoimmuneinstitute.org/research_updates/the-role-of-exposomes-toxic-chemicals-food-and-pathogens-in-the-pathophysiology-of-ads/) **Published:** June 22, 2022 **Author:** Elevation **Excerpt:** What if autoimmune disease wasn’t caused by one thing—but by many exposures building over time? The exposome is the total environmental and lifestyle exposures that interact with our genetics to drive immune dysfunction. Learn how chemicals, pathogens, and ultra-processed food may contribute to the development of autoimmune diseases. **Content:** ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2022/06/Autoimmunity-2022-1200x628px-1024x536.jpg) ## Presented at the 13th International Congress on Autoimmunity in Athens, Greece ### *Speaker:[ Aristo Vojdani](https://immunoscienceslab.com/aristo-vojdani-phd-msc/)* ##### *Publications:* Vojdani, A.; Vojdani, E. **The Role of Exposomes in the Pathophysiology of Autoimmune Diseases I: Toxic Chemicals and Food**. *Pathophysiology* **2021**, 28, 513-543. [https://doi.org/10.3390/pathophysiology28040034](https://www.mdpi.com/1873-149X/28/4/34/htm) Vojdani, A.; Vojdani, E.; Rosenberg, A.Z.; Shoenfeld, Y. **The Role of Exposomes in the Pathophysiology of Autoimmune Diseases II: Pathogens**. *Pathophysiology***2022**, *29*, 243-280. [https://doi.org/10.3390/pathophysiology29020020](https://www.mdpi.com/1873-149X/29/2/20/htm) ### Key Takeaways: - It is now known that genetics play a relatively small part in the pathophysiology of autoimmune disorders in general, and that environmental factors have a greater role. - The role of the exposome, an individual’s lifetime exposure to external and internal factors, is a key component in the pathophysiology of autoimmune diseases. - The most common environmental factors are toxic chemicals, food/diet, and pathogens/infections. - The solution is to detect the trigger, remove it from the environment or diet, then repair the damage to the individual’s body and health. #### Gene plus exposome factors that contribute to autoimmune diseases [![](https://www.autoimmuneinstitute.org/wp-content/uploads/2022/06/https-www.mdpi_.com1873-149X28434-1024x1007.jpg)](https://www.mdpi.com/1873-149X/28/4/34)*Vojdani, A.; Vojdani, E. The Role of Exposomes in the Pathophysiology of Autoimmune Diseases I: Toxic Chemicals and Food. Pathophysiology 2021, 28, 513-543. <https://doi.org/10.3390/pathophysiology28040034>* #### The exposome is an individual’s lifetime exposure to a variety of external and internal factors ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2022/06/https-www.mdpi_.compathophysiologypathophysiology-28-00034article_deployhtmlimagespathophysiology-28-00034-g001-1024x434.jpg)*Vojdani, A.; Vojdani, E. The Role of Exposomes in the Pathophysiology of Autoimmune Diseases I: Toxic Chemicals and Food. Pathophysiology 2021, 28, 513-543. <https://doi.org/10.3390/pathophysiology28040034>* ## Environmental triggers of autoimmunity: ### **Toxic Chemicals** #### **Mercury** - Exposure to mercury can occur through external pathways, such as environmental pollution, occupation, and the handling of items or products containing it; or through internal pathways, such as preservatives/adjuvants in drugs and vaccines, contaminated food, or dental amalgams. - Even chronic low mercury exposure can trigger local and systemic inflammation in susceptible individuals, exacerbating the already ongoing autoimmune response in those suffering from autoimmunity. - Exposure can cause dysregulation of autoimmune responses and aggravation of the immunotoxic effects associated with elevated titers of autoantibodies detected in serum #### **Occupational exposure to crystalline silica** - Has been linked to [rheumatoid arthritis](https://www.autoimmuneinstitute.org/rheumatoid-arthritis/) (RA), [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/systemic-lupus-erythematosus/) (SLE), systemic sclerosis (SSc), and antineutrophil cytoplasmic antibody (ANCA)-related diseases #### **Smoking** - Has been linked to RA, SLE, [multiple sclerosis](https://www.autoimmuneinstitute.org/multiple-sclerosis/) (MS), thyroid autoimmunity, and [Crohn’s disease](https://www.autoimmuneinstitute.org/crohns-disease/) #### **Solvents or chemicals with similar structures** - Examples include vinyl chloride, perchloroethylene, trichloroethylene (TCE), or mixed solvents - Has been linked to SSc and MS #### **Certain cosmetic chemicals** - Has been linked to RA, SLE, and [primary biliary cholangitis](https://www.autoimmuneinstitute.org/primary-biliary-cirrhosis/) (PBC) #### **Infections/Pathogens** Infectious agents can induce autoimmune disorders through the following [mechanisms](https://www.ncbi.nlm.nih.gov/pubmed/19643667): - Molecular mimicry - Epitope spreading - Viral persistence - Bystander activation - Polyclonal activation - Autoinflammatory activation of innate immunity - Dysregulation of immune homeostasis ##### The three best examples of autoimmune-inducing infectious agents are: **oral pathogens, SARS-CoV-2, and the herpesvirus** - Oral pathogens reach the gut, disturb the microbiota, increase gut permeability, cause local inflammation, and generate autoantigens, leading to systemic inflammation, multiple autoimmune reactivities, and systemic autoimmunity. - [SARS-CoV-2 has been called the autoimmune virus](https://www.autoimmuneinstitute.org/molecular-and-immunological-evidence-for-sars-cov-2-being-the-autoimmune-virus/), and the following key points support this appellation: - Similarities in lymphocyte map or lymphocyte subpopulation patterns between COVID-19 and autoimmune diseases - Molecular mimicry between SARS-CoV-2 spike proteins, nucleoproteins and human autoantigens that contribute to autoimmune diseases - Reaction of both animal and human monoclonal antibodies made against SARS-CoV-2 spike proteins and nucleoproteins with human autoantigens - Reaction of antibodies made against human autoantigens with SARS-CoV-2 spike proteins and nucleoproteins - Detection of autoantibodies made against human autoantigens known to cross-react with SARS-CoV-2 in the sera of patients with COVID-19 - The human herpesvirus family includes human herpesvirus 1 (HSV-1 or HHV-1); herpes simplex virus type 2 (HSV-2 or HHV-2); the *Varicella zoster*virus (VZV or HHV-3); EBV or HHV-4; cytomegalovirus (CMV or HHV-5); human herpesvirus type 6 (HHV-6); and measles (rubeola) - EBV has been linked to [Celiac Disease](https://www.autoimmuneinstitute.org/celiac-disease/), Autoimmune Liver Disease, Inflammatory Bowel Disease, [SLE](https://www.autoimmuneinstitute.org/systemic-lupus-erythematosus/). [RA](https://www.autoimmuneinstitute.org/rheumatoid-arthritis/), [Sjogren’s Syndrome](https://www.autoimmuneinstitute.org/sjogrens-syndrome/), [MS](https://www.autoimmuneinstitute.org/multiple-sclerosis/), [Type 1 Diabetes](https://www.autoimmuneinstitute.org/diabetes-type-1/), Polyneuropathy, and Thyroid Autoimmunity - HHV has been linked to MS, [Guillain-Barre’ Syndrome](https://www.autoimmuneinstitute.org/guillain-barre-syndrome/), Thyroid Autoimmunity, Sjogren’s, SLE, [Myalgic Encephalomyelitis (ME/CFS)](https://www.autoimmuneinstitute.org/me-cfs/), Parkinson’s Disease, Alzheimer’s Disease, Epilepsy, Encephalitis, and Collagen Vascular Disease ### **Food/Diet** #### **Aluminum ingestion and absorption from the GI tract** - May contribute to Crohn’s disease, celiac disease, and Alzheimer’s disease - See: Vojdani A. **[Elevated IgG Antibody to Aluminum Bound to Human Serum Albumin in Patients with Crohn’s, Celiac and Alzheimer’s Disease](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8473134/)**. *Toxics*. 2021 Sep 4;9(9):212. doi: 10.3390/toxics9090212. #### **Industrial food additives** - Includes colorants, preservatives, emulsifiers, food glue, gluten, sugar, salt, gums, pesticides, and nanoparticles - See: Lerner A, Matthias T. [**Changes in intestinal tight junction permeability associated with industrial food additives explain the rising incidence of autoimmune disease**](https://pubmed.ncbi.nlm.nih.gov/25676324/). *Autoimmun Rev*. 2015 Jun;14(6):479-89. doi: 10.1016/j.autrev.2015.01.009. #### **Plant aquaporins (in corn and soy especially)** - A subclass of patients with relapsing-remitting MS reacted to both plant and human AQP4 peptides. This immune reaction against different plant aquaporins may help in the development of dietary modifications for patients with MS and other neuroimmune disorders. - See: Vojdani, Aristo & Mukherjee, Partha Sarathi & Berookhim, Joshua & Kharrazian, Datis. (2015). **[Detection of Antibodies against Human and Plant Aquaporins in Patients with Multiple Sclerosis](https://www.hindawi.com/journals/ad/2015/905208/)**. *Autoimmune Diseases*. 2015. doi: 10.1155/2015/905208. #### **Anti-lectin antibodies (in beans especially)** - The reaction of anti-lectin antibodies with human tissue components and their detection in RF-positive samples may describe mechanisms by which the production of antibodies against undigested lectins may contribute to the pathogenesis of some ADs. - See: Vojdani A, Afar D, Vojdani E. **[Reaction of Lectin-Specific Antibody with Human Tissue: Possible Contributions to Autoimmunity](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7036108/)**. *J Immunol Res.* 2020 Feb 11;2020:1438957. doi: 10.1155/2020/1438957. #### **Wheat and milk are associated with a spectrum of autoimmune diseases** - A high percentage of MS patients harbored antibodies to bovine casein. The antibody cross-reactivity between cow’s milk and CNS antigens can also exacerbate demyelination. - See: Chunder R, et al. **[Antibody cross-reactivity between casein and myelin-associated glycoprotein results in central nervous system demyelination](https://pubmed.ncbi.nlm.nih.gov/35235454/)**. *Proc Natl Acad Sci U S A.* 2022 Mar 8;119(10):e2117034119. doi: 10.1073/pnas.2117034119. #### Spectrum of autoimmune disorders associated with wheat proteomes ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2022/06/https-www.mdpi_.compathophysiologypathophysiology-28-00034article_deployhtmlimagespathophysiology-28-00034-g011-1024x1009.jpg)Vojdani, A.; Vojdani, E. The Role of Exposomes in the Pathophysiology of Autoimmune Diseases I: Toxic Chemicals and Food. Pathophysiology 2021, 28, 513-543. <https://doi.org/10.3390/pathophysiology28040034> #### Spectrum of autoimmune disorders associated with milk proteomes ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2022/06/https-www.mdpi_.compathophysiologypathophysiology-28-00034article_deployhtmlimagespathophysiology-28-00034-g012-982x1024.jpg)Vojdani, A.; Vojdani, E. The Role of Exposomes in the Pathophysiology of Autoimmune Diseases I: Toxic Chemicals and Food. Pathophysiology 2021, 28, 513-543. <https://doi.org/10.3390/pathophysiology28040034> **Category:** Autoimmune Diseases, Events, Microbiome, Research Studies, Risk Factors --- ### [FDA Clears Trial of Controllable CAR-T Therapy for Autoimmune Disease](https://www.autoimmuneinstitute.org/research_updates/fda-clears-trial-of-controllable-car-t-therapy-for-autoimmune-disease/) **Published:** April 10, 2025 **Author:** Carolyn Serraino **Content:** The FDA has cleared a first-in-human clinical trial for CI-SP19, a new [CAR-T cell therapy](https://www.autoimmuneinstitute.org/articles/car-t-cell-therapy-for-autoimmune-disease "CAR T-Cell Therapy For Autoimmune Disease") designed to treat autoimmune disease more safely and precisely. The therapy will be tested in people with [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus") and works by targeting and removing immune cells that mistakenly attack the body—while avoiding broad immune suppression. CI-SP19 is unique because it’s controllable: doctors can use a separate drug to activate or deactivate the CAR-T cells as needed. This “switchable” feature adds a layer of safety, allowing treatment to be paused or fine-tuned if needed—something traditional CAR-T therapies can’t do. The underlying technology was developed by Calibr, the drug discovery division of Scripps Research, and is being used under license by CoImmune, which is running the clinical trial. CI-SP19 is the first version of this technology to move into human testing. If successful, this trial could open the door to a new kind of precision therapy for autoimmune disease—one that rebalances the immune system by targeting only the harmful cells, while preserving the body’s ability to fight infection and maintain long-term health. ##### Citation *[FDA clears IND for clinical trial testing switchable CAR-T therapy in patients with autoimmune diseases, without chemotherapy](https://www.scripps.edu/news-and-events/press-room/2025/20250408-calibr-scar-t.html)*. Scripps Research. **Category:** Clinical Trials, Lupus, Therapies --- ### [New Celiac Screening Test Approved by FDA for At-Home Use](https://www.autoimmuneinstitute.org/research_updates/glutenid-cleared-by-fda/) **Published:** February 20, 2025 **Author:** Carolyn Serraino **Content:** In a step forward for autoimmune disease awareness and early detection, the FDA has approved **GlutenID**, the first at-home genetic screening test for [celiac disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/celiac-disease/ "Celiac disease") risk that can be purchased without a prescription. Developed by Targeted Genomics, the test uses saliva samples and next-generation sequencing to identify HLA gene variants (DQ2, DQ8, DQ2.2, DQ7) linked to celiac disease. Celiac disease is the most common intestinal autoimmune condition worldwide, and early identification of genetic risk may help individuals—**especially those with a family history of autoimmune disease**—make informed health decisions. However, experts stress that GlutenID is not a diagnostic tool because serology and not genetics is currently the preferred screening test for celiac disease in individuals regularly eating gluten. ##### Traditional screening and diagnosis still rely on antibody tests and intestinal biopsy. Genetic testing may be helpful in specific situations, such as when someone is already eating gluten-free or when screening first-degree relatives. Despite recommendations, recent data presented at NASPGHAN 2024 revealed that only 10% of over 223,000 eligible children were screened for celiac disease—highlighting major gaps and disparities in current testing practices. As access to direct-to-consumer tools like GlutenID expands, we hope to see more at-risk individuals empowered to seek clinical evaluation and receive earlier diagnoses. ###### Citations *[FDA approves glutenid: What it means for celiac disease screening](https://celiac.org/2025/03/07/fda-approves-glutenid-what-it-means-for-celiac-disease-screening/?eType=EmailBlastContent&eId=5ce3a493-6cc2-42b8-84d3-e8e34ee998e3)*. *Celiac Disease Foundation*. (2025, March 25). [Targeted Genomics Receives FDA Clearance for First Direct-to-Consumer Celiac Disease Genetic Health Risk Test](https://www.globenewswire.com/news-release/2025/02/17/3027239/0/en/Targeted-Genomics-Receives-FDA-Clearance-for-First-Direct-to-Consumer-Celiac-Disease-Genetic-Health-Risk-Test.html). News release. *Targeted Genomics*. February 17, 2025. Miller, E, Avery, K, Ratner, A. Insufficient Adherence to Celiac Disease Screening Recommendations With Disparities By Race, Age, And Presenting Condition. Presented at [NASPHGAN 2024](https://www.hcplive.com/conference/naspghan) in Hollywood, Florida, from November 7 – November 9, 2024. **Category:** Celiac Disease, Diagnostic Testing, Risk Factors --- ### [White House Vows to Tackle Autoimmune and Chronic Illness](https://www.autoimmuneinstitute.org/research_updates/white-house-vows-to-tackle-autoimmune-and-chronic-illness/) **Published:** February 14, 2025 **Author:** Carolyn Serraino **Content:** Autoimmune disease research policy is once again a national talking point. On February 13, 2025, the White House announced the formation of the President’s [Make America Healthy Again Commission](https://www.whitehouse.gov/presidential-actions/2025/02/establishing-the-presidents-make-america-healthy-again-commission/ "Make America Healthy Again Commission")—a new federal initiative aimed at reversing worsening health trends in the U.S., particularly the rise in chronic diseases among children. The executive order specifically calls out autoimmune diseases such as inflammatory bowel disease ([Crohn’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crohns-disease/ "Crohn’s disease") and [ulcerative colitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ulcerative-colitis/ "Ulcerative colitis")), [psoriasis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/psoriasis/ "Psoriasis"), and [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/ "multiple sclerosis") as increasingly common in high-income countries like the United States. The commission, chaired by the Secretary of Health and Human Services, is tasked with examining potential causes of childhood chronic illness—including diet, environmental exposures, medications, lifestyle factors, and government policy—and recommending solutions. Autoimmune disease is included as part of the broader chronic disease crisis, with nearly 41% of U.S. children reported to have at least one health condition in 2022. While the initiative acknowledges troubling trends long raised by researchers and patient advocates, many in the autoimmune community are responding with cautious optimism. Federal promises to address autoimmune diseases have been made before—often with little follow-through or long-term investment in research, prevention, and care. ##### **The autoimmune disease and chronic illness communities have seen commissions, task forces, and strategic plans come and go**. **This initiative will be judged by what it delivers, not what it announces.** The commission is required to submit a full assessment within 100 days, followed by a national strategy within 180 days. These reports will evaluate existing federal efforts, identify gaps, and propose new approaches to chronic disease prevention—emphasizing data transparency, reduced industry influence, and lifestyle-based risk factor mitigation. Whether these efforts lead to meaningful, sustained progress for autoimmune disease patients remains to be seen. **Category:** Autoimmune Diseases, IBD (Crohn's and UC), Multiple Sclerosis, Policy & Health Decisions, Psoriasis, Research Studies --- ### [Uncovering Common Genetic Factors Among Autoimmune Diseases](https://www.autoimmuneinstitute.org/research_updates/uncovering-common-genetic-factors-among-autoimmune-diseases/) **Published:** May 6, 2023 **Author:** Elevation **Excerpt:** Harroud and Hafler explore the genetic factors contributing to autoimmune diseases, highlighting shared genetic mechanisms, particularly within the major histocompatibility complex region, revealing variants linked to multiple autoimmune diseases like rheumatoid arthritis, multiple sclerosis, type 1 diabetes, and systemic lupus erythematosus. **Content:** In the article “[Common genetic factors among autoimmune diseases](https://www.science.org/doi/10.1126/science.adg2992),” published in *Science*, Harroud and Hafler explore the genetic factors that contribute to autoimmune diseases. The authors argue that while autoimmune diseases have traditionally been considered separate conditions, recent research has highlighted common genetic factors that contribute to the development of multiple autoimmune diseases. Autoimmune diseases are known to cluster within families, indicating a strong genetic component and recent advances in genomics have allowed researchers to identify specific genes associated with autoimmune diseases. In particular, the authors focus on the major histocompatibility complex (MHC) region, which contains a large number of genes that play a critical role in the immune system. The MHC has been implicated in a wide range of autoimmune diseases, suggesting that there may be common genetic factors that contribute to the development of these conditions. The authors review several studies that have identified specific genetic variants within the MHC that are associated with multiple autoimmune diseases. For example, a variant in the HLA-DRB1 gene has been associated with both rheumatoid arthritis and multiple sclerosis, while a variant in the PTPN22 gene has been linked to several autoimmune diseases, including type 1 diabetes, rheumatoid arthritis, and systemic lupus erythematosus. The authors argue that these findings suggest that there may be shared genetic mechanisms that underlie the development of autoimmune diseases and that these mechanisms may involve dysregulation of immune cells, such as T cells and B cells, which play a critical role in the immune response. Dysregulation of these cells may lead to the production of autoantibodies, which target the body’s own tissues and contribute to the development of autoimmune disease. A better understanding of the genetic factors that contribute to autoimmune diseases may lead to new treatments, therapies, and diagnostic tools. By identifying common genetic mechanisms, researchers may be able to develop treatments that target multiple autoimmune diseases at once, rather than treating each condition separately, and new diagnostic tools which could improve early detection and treatment of these conditions. **Citation for report:** Harroud, A., & Hafler, D. A. (2023). Common genetic factors among autoimmune diseases. *Science (New York, N.Y.)*, *380*(6644), 485–490. <https://doi.org/10.1126/science.adg2992> **Category:** Autoimmune Diseases, Genetics, Lupus, Multiple Sclerosis, Research Studies, Rheumatoid Arthritis, Type 1 Diabetes --- ### [Children’s National Hosts 35th Annual Pediatric Neurology Update](https://www.autoimmuneinstitute.org/research_updates/childrens-national-hosts-35th-annual-pediatric-neurology-update/) **Published:** March 25, 2025 **Author:** Carolyn Serraino **Content:** Join top experts in neuroscience for the 35th Annual Pediatric Neurology Update, hosted by Children’s National Hospital on April 10, 2025. This full-day, CME-accredited event brings together pediatricians, neurologists, and neurosurgeons to explore cutting-edge advances in epilepsy care, vascular neurosurgery, and mental health in neurological conditions. The hybrid event will be held at the Children’s National Research & Innovation Campus in Washington, D.C., and will also offer free virtual registration. It will feature esteemed speakers, including Dr. Annapurna Poduri from the [National Institute of Neurological Disorders and Stroke](https://www.ninds.nih.gov/) (NINDS), Dr. Emily Freilich from the [U.S. Food and Drug Administration](https://www.fda.gov/) (FDA), and Dr. Conor Mallucci from the [Alder Hey Children’s Hospital](https://www.alderhey.nhs.uk/) in the UK. While not limited to autoimmune disease, the sessions may hold valuable insights for clinicians treating pediatric patients with autoimmune neurological conditions such as autoimmune encephalitis, pediatric multiple sclerosis, and neuropsychiatric lupus. **Register and learn more:** [ChildrensNational.org/NeurologyUpdate](https://childrensnational.org/NeurologyUpdate) **Category:** Events, Neurological Disorders, Research Studies --- ### [Do Vaccines Increase Rheumatoid Arthritis Risk?](https://www.autoimmuneinstitute.org/research_updates/do-vaccines-increase-rheumatoid-arthritis-risk/) **Published:** March 19, 2025 **Author:** Carolyn Serraino **Content:** [Rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid arthritis") (RA) is a chronic autoimmune disease that affects about 1% of adults, and its rates have steadily increased in recent decades. A newly published study examined whether vaccines might play a role in causing RA or triggering flare-ups in people who already have it. Researchers reviewed 16 studies conducted between 2008 and 2024 involving nearly 26 million people from Europe, North America, and Asia. These studies looked at common vaccines, including those for influenza, COVID-19, HPV (human papillomavirus), hepatitis B, tetanus, anthrax, and shingles (herpes zoster), in people ranging in age from children to older adults. The researchers found no overall link between getting vaccinated and an increased risk of developing or relapsing RA. In fact, in studies that followed people for less than one year, vaccination—especially with the HPV or COVID-19 vaccines—appeared to have a mild protective effect, possibly by strengthening the immune system in a way that temporarily prevents inflammation. This protective effect was not seen in longer-term follow-ups, suggesting that it may fade over time. Most vaccines showed no harmful association with RA. However, one exception was the shingles (herpes zoster) vaccine, which did show a possible connection to increased RA risk. The anthrax vaccine also showed a similar trend, but the evidence was not strong enough to draw firm conclusions. Overall, the study supports the safety of vaccines in relation to RA and even hints at possible short-term benefits. However, researchers emphasize that more high-quality studies are needed to better understand how different vaccines might affect people at risk for RA or those already diagnosed. ##### Citation Pan, H., Yu, Y., Li, X. *et al.* Vaccination and rheumatoid arthritis: an updated systematic review and meta-analysis of data from 25,949,597 participants. *BMC Public Health* **25**, 933 (2025). <https://doi.org/10.1186/s12889-025-22093-9> **Category:** Research Studies, Rheumatoid Arthritis, Risk Factors --- ### [How Aging Exacerbates Autoimmune Disease](https://www.autoimmuneinstitute.org/research_updates/how-aging-exacerbates-autoimmune-disease/) **Published:** March 24, 2025 **Author:** Carolyn Serraino **Content:** **Immunosenescence** (*noun*): The gradual deterioration of the immune system, brought on by natural age advancement and marked by reduced immune cell function, increased inflammation, and impaired tolerance to the body’s own tissues. As people age, their immune systems undergo a gradual decline known as **immunosenescence**. This age-related immune shift may raise the risk of developing autoimmune disease (AD). A new [review](https://www.sciencedirect.com/science/article/abs/pii/S1568997225000655?via%3Dihub) in *Autoimmunity Reviews* explores how immunosenescence contributes to the onset, progression, and severity of ADs such as [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid arthritis"), [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus"), [Sjögren’s syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sjogren-syndrome/ "Sjögren’s syndrome"), and [type 1 diabetes](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/diabetes-type-1/ "Type 1 diabetes / insulin-dependent diabetes"). Aging alters how immune cells recognize self-antigens, impairs the removal of dying cells, and leads to the accumulation of pro-inflammatory, senescent immune cells that drive tissue damage. The review also highlights how mitochondrial dysfunction and chronic inflammation—common features of aging—create a feedback loop that promotes further immune system decline. These age-associated changes not only increase the risk of autoimmunity but may also reduce the effectiveness of existing treatments. Promising new therapies aim to target immunosenescence directly. These include senolytics (which clear senescent cells), senomorphics (which reduce harmful secretions), and approaches that may rejuvenate immune cells. Though still in early stages, such strategies could offer a novel way to manage or even prevent ADs in older adults. As the global population ages, addressing immunosenescence may be key to reducing the growing burden of autoimmune disease. ##### Citation Huifang Hu, et al (2025). Immunosenescence in autoimmune diseases, *Autoimmunity Reviews*, 103805, ISSN 1568-9972, <https://doi.org/10.1016/j.autrev.2025.103805>. **Category:** Lupus, Research Studies, Rheumatoid Arthritis, Risk Factors, Sjögren disease, Therapies, Type 1 Diabetes --- ### [Join Us for Live from the Lab: Decoding Early Immune Signals](https://www.autoimmuneinstitute.org/research_updates/join-us-for-live-from-the-lab-decoding-early-immune-signals/) **Published:** March 14, 2025 **Author:** Carolyn Serraino **Content:** Mark your calendar for **Wednesday, March 19, 2025, from 3:00-4:00** **p.m. (ET) / 12:00-1:00 p.m. (PT)** as Dr. Sonia Sharma, Associate Professor at La Jolla Institute for Immunology, explores the critical role of innate immunity in autoimmune disease and inflammation. In this ***Live from the Lab*** webinar, Dr. Sharma will uncover how non-immune cells—like those in the skin and blood vessels—act as first responders, setting the stage for autoimmune reactions. Using advanced techniques like CRISPR/Cas9 and mass spectrometry metabolomics, she will explain how early immune signals influence disease outcomes. This session—underwritten by the Global Autoimmune Institute—offers valuable insights for anyone interested in autoimmune and inflammatory conditions. #### **[Register now](https://lji-org.zoom.us/webinar/register/WN_0traZ65CTsa5JPgrlIPGSQ#/registration) and share with others who may benefit!** **Category:** Autoimmune Diseases, Events, Research Studies, Risk Factors --- ### [Genetic and Lifestyle Factors Linked to Sarcoidosis Risk](https://www.autoimmuneinstitute.org/research_updates/genetic-and-lifestyle-factors-linked-to-sarcoidosis-risk/) **Published:** March 13, 2025 **Author:** Carolyn Serraino **Content:** **A new genome-wide association study (GWAS) identifies 28 genetic loci, modifiable risk factors, and circulating biomarkers associated with [sarcoidosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sarcoidosis/ "Sarcoidosis").** A large-scale GWAS involving 9,755 sarcoidosis cases and over 1.5 million controls has pinpointed key genetic risk factors for the disease. The strongest association was found at the C1orf141-IL23R locus, with additional risk loci linked to immune system genes such as TYK2, ANXA11, CCDC88B, and IL23R. Gene expression studies highlighted sarcoidosis-related activity in the spleen, whole blood, and lungs, with key pathways involving T cell activation, leukocyte adhesion, and cytokine signaling. Mendelian randomization analysis also revealed modifiable risk factors. Higher body mass index (BMI) was associated with increased sarcoidosis risk, while moderate-to-vigorous physical activity (MVPA) was linked to a lower risk. Notably, circulating levels of interleukin-23 receptor (IL23R) and eight inflammatory proteins were significantly correlated with disease susceptibility. These findings reinforce sarcoidosis’ genetic and immune-mediated nature and suggest potential therapeutic targets, particularly IL23R and TYK2, which are already under investigation for other autoimmune conditions. ##### Citation Yuan, S., Chen, J., Geng, J. *et al.* **GWAS identifies genetic loci, lifestyle factors and circulating biomarkers that are risk factors for sarcoidosis**. *Nat Commun* **16**, 2481 (2025). <https://doi.org/10.1038/s41467-025-57829-z> **Category:** Autoimmune Diseases, Genetics, Research Studies, Risk Factors --- ### [Multiple Sclerosis Lesions Detected Earlier with New 4D Brain Map](https://www.autoimmuneinstitute.org/research_updates/multiple-sclerosis-lesions-detected-earlier-with-new-4d-brain-map/) **Published:** February 27, 2025 **Author:** Carolyn Serraino **Content:** #### **NIH Study Identifies Key Markers of Lesion Development and Repair** A groundbreaking [study](https://www.science.org/doi/10.1126/science.adp6325) by the National Institutes of Health (NIH) has developed a four-dimensional brain map that uncovers early warning signs of [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/ "multiple sclerosis") (MS). Using advanced MRI imaging in a marmoset model, researchers identified brain regions at risk of damage **weeks before lesions appear**, providing a potential new tool for early diagnosis and intervention. The study, published in *Science*, highlights the role of **SERPINE1+ astrocytes**, a specialized subset of astrocytes, which are support cells in the brain. These cells accumulate at lesion borders **before visible damage occurs** and may play a role in both triggering inflammation and aiding in tissue repair. Their presence makes them a promising target for future MS treatments. Researchers also discovered a unique MRI biomarker, a **proton density-to-T1 ratio**, which measures changes in brain tissue composition. This ratio was found to increase in areas of the brain weeks before visible MS lesions form, signaling early cellular activity linked to inflammation and potential myelin damage. The team is now expanding their studies to aged animals to better understand **progressive MS**, a critical area of unmet medical need. This research could transform how **MS and other neurological conditions** are diagnosed and treated, paving the way for earlier and more effective interventions. ##### Citation Jing-Ping Lin *et al.*, **4D marmoset brain map reveals MRI and molecular signatures for onset of multiple sclerosis–like lesions**. *Science* **387**, eadp6325 (2025). DOI:[10.1126/science.adp6325](https://doi.org/10.1126/science.adp6325) **Category:** Autoimmune Diseases, Diagnostic Testing, Multiple Sclerosis, Research Studies, Therapies --- ### [How the Immune System Attacks the Brain in Neuromyelitis Optica](https://www.autoimmuneinstitute.org/research_updates/how-the-immune-system-attacks-the-brain-in-neuromyelitis-optica/) **Published:** February 24, 2025 **Author:** Elevation **Content:** A new [study](https://www.science.org/doi/epdf/10.1126/sciadv.adq7560) reveals how [neuromyelitis optica](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/neuromyelitis-optica/ "Neuromyelitis optica / Devic’s disease") (NMO), a rare autoimmune disease, damages the brain and spinal cord. Scientists used advanced imaging to see how harmful antibodies in NMO attack aquaporin-4 (AQP4), a protein that helps move water in the brain. #### **What happens in NMO?** The immune system mistakenly targets AQP4, damaging brain support cells (astrocytes) and causing nerve damage, vision loss, and muscle weakness. #### **How does the attack work?** Harmful antibodies in NMO attach to three key areas on the AQP4 protein, triggering inflammation and destroying nerve cells. #### **Why does this matter?** Understanding how these antibodies bind to AQP4 could lead to better treatments that block the attack before it happens. Current NMO treatments suppress the immune system, which can cause side effects. This research could lead to targeted therapies that stop the disease without weakening the entire immune system. ##### Citation Gupta, M., et al. (2025). Structural basis of aquaporin-4 autoantibody binding in neuromyelitis optica. *Science advances*, *11*(8), eadq7560. <https://doi.org/10.1126/sciadv.adq7560> **Category:** Autoimmune Diseases, Research Studies --- ### [NIH Funds Conferences to Standardize Autoimmune Research Data](https://www.autoimmuneinstitute.org/research_updates/nih-funds-conferences-to-standardize-autoimmune-research-data/) **Published:** June 18, 2024 **Author:** Elevation **Content:** The National Institutes of Health (NIH) has announced a new funding opportunity aimed at advancing autoimmune disease research through the development of **Common Data Elements (CDEs)**. This initiative will support scientific conferences and workshops that bring together experts to refine and standardize research data collection, ultimately improving study comparability and accelerating discoveries in autoimmune diseases. CDEs are essential for ensuring that data from different studies can be easily compared and integrated, which enhances collaboration and the effectiveness of research efforts. While many autoimmune disease studies use CDEs, very few have received formal endorsement from the NIH’s National Library of Medicine (NLM). By funding conferences dedicated to CDE development, the NIH aims to establish widely accepted standards, making it easier to share and analyze data across different research projects. This effort aligns with the **2023 NIH Data Management and Sharing Policy**, which prioritizes data harmonization. It is also part of a broader NIH strategy to improve autoimmune disease research coordination, as outlined in the 2022 National Academies of Sciences, Engineering, and Medicine report. For the autoimmune disease community, this initiative promises **faster, more reliable research outcomes, better collaboration among scientists, and potentially quicker advancements in treatments and diagnostics**. By standardizing data collection, researchers can more effectively identify patterns, evaluate therapies, and ultimately improve patient care. ##### Citation National Institutes of Health**.** (2024, June 17). ***Notice of Special Interest: R13 support for conferences and scientific meetings to support consensus building for autoimmune disease research related common data elements (NOT-OD-24-145)**.* *NIH Grants & Funding*. <https://grants.nih.gov/grants/guide/notice-files/NOT-OD-24-145.html> **Category:** Autoimmune Diseases, Events, Research Studies --- ### [Flu-Linked Acute Necrotizing Encephalopathy in Children](https://www.autoimmuneinstitute.org/research_updates/flu-linked-acute-necrotizing-encephalopathy-in-children/) **Published:** February 14, 2025 **Author:** Elevation **Content:** Public health officials are investigating a possible increase in flu-associated acute necrotizing encephalopathy (ANE) cases in children. ANE is a rare but severe neurologic complication linked to immune system overactivation, leading to rapid brain swelling and, in some cases, fatal outcomes. Dr. Adrienne Randolph of Boston Children’s Hospital has reported 12 potential cases to the CDC’s National Center for Immunization and Respiratory Diseases (NCIRD). Experts emphasize the need for careful evaluation, as ANE diagnosis requires specific clinical and imaging findings. This potential rise coincides with an exceptionally active flu season, with [CDC data](https://www.cdc.gov/fluview/surveillance/2025-week-05.html) showing record-high influenza-like illness rates. Factors such as lower vaccination rates and reduced flu immunity from the COVID-19 pandemic may contribute to increased complications. Increased awareness may help with early identification and improved outcomes. ###### Citation Centers for Disease Control and Prevention. (2025, February 7). *Weekly US Influenza Surveillance Report: Key Updates for Week 5, ending February 1, 2025*. Centers for Disease Control and Prevention. <https://www.cdc.gov/fluview/surveillance/2025-week-05.html> **Category:** Autoimmune Brain Inflammation, Case Studies, Neurological Disorders, Research Studies, Risk Factors --- ### [Toxic Exposure and Autoimmune Disease: Superfund Sites](https://www.autoimmuneinstitute.org/research_updates/toxic-exposure-and-autoimmune-disease-superfund-sites/) **Published:** February 13, 2025 **Author:** Elevation **Content:** Environmental pollutants, such as industrial chemicals, heavy metals, and solvents, are increasingly recognized as [potential triggers for autoimmune diseases](https://www.autoimmuneinstitute.org/research_updates/experts-report-environmental-contributors-to-autoimmune-disease/ "Experts Report Environmental Contributors to Autoimmune Disease"). [**Superfund sites**](https://www.epa.gov/superfund)—highly contaminated locations designated by the Environmental Protection Agency (EPA) for cleanup—contain hazardous chemicals such as trichloroethylene (TCE), dioxins, PCBs, and heavy metals that may disrupt immune function. These chemicals have been shown to promote chronic inflammation and immune system dysregulation through oxidative stress, immune suppression, or endocrine disruption, increasing susceptibility to autoimmunity. #### Research shows that living near Superfund sites increases the risk of autoimmune disease. Studies have found that communities near Superfund sites experience higher rates of [lupus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus"), [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid arthritis"), [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/ "multiple sclerosis"), and thyroid disorders ([1](https://doi.org/10.1289/ehp.8946)). A study published in *Environmental Research* linked TCE exposure to a 40% increased risk of autoimmune diseases, particularly systemic lupus erythematosus ([2](https://www.niehs.nih.gov/research/supported/centers/srp/science_digest/2020/6/features)). Similarly, The Buffalo Lupus Project found a higher prevalence of lupus among residents near Love Canal, a notorious Superfund site ([3](https://www.emerald.com/insight/content/doi/10.1108/s1479-358x(2012)0000009011/full/html)) ([4](https://scholarcommons.sc.edu/cgi/viewcontent.cgi?article=1004&context=sph_epidemiology_biostatistics_facpub)). While cleanup efforts are ongoing, millions still live near these [hazardous locations](https://www.epa.gov/superfund/search-superfund-sites-where-you-live). Experts urge better regulation of industrial pollutants and more research on environmental factors in autoimmune disease, yet progress remains slow. ###### Citations (1) Williamson, D. M., et al. (2006). **Evaluation of serum immunoglobulins among individuals living near six Superfund sites**. *Environmental health perspectives*, *114*(7), 1065–1071. <https://doi.org/10.1289/ehp.8946> (2) *National Institute of Environmental Health Sciences***.** (2020, June). **Superfund Research Program Science Digest: Features**. *National Institutes of Health*. Retrieved from <https://www.niehs.nih.gov/research/supported/centers/srp/science_digest/2020/6/features> (3) Williams, E.M., et al. (2012). **The Buffalo Lupus Project: A Community-Based Participatory Research Investigation of Toxic Waste Exposure and Lupus**. *Health Disparities Among Under-served Populations: Implications for Research, Policy and Praxis* (*Advances in Education in Diverse Communities, Vol. 9*), Emerald Group Publishing Limited, Leeds, pp. 159-175. <https://doi.org/10.1108/S1479-358X(2012)0000009011> (4) Williams, E. M., et al. (2011). **[A geographic information assessment of exposure to a toxic waste site and development of systemic lupus erythematosus (SLE): Findings from the Buffalo Lupus Project](https://scholarcommons.sc.edu/cgi/viewcontent.cgi?article=1004&context=sph_epidemiology_biostatistics_facpub)**. *Journal of Toxicology and Environmental Health Sciences*, 3(3), 52–64. **Category:** Autoimmune Diseases, Lupus, Multiple Sclerosis, Research Studies, Rheumatoid Arthritis, Risk Factors --- ### [Microplastics, Immunity & Brain Health: Findings from a New Study](https://www.autoimmuneinstitute.org/research_updates/microplastics-immunity-brain-health-findings-from-a-new-study/) **Published:** February 6, 2025 **Author:** Elevation **Content:** ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/02/Microplastics-in-the-brain-article-banner-1024x585.jpg) A recent study published in *Nature Medicine*, titled **“[Bioaccumulation of Microplastics in Decedent Human Brains](https://www.nature.com/articles/s41591-024-03453-1)**,” presents evidence that microplastics (MNPs) accumulate in human organs, including the **brain, liver, and kidneys**, with significant implications for **immune system function** and potential links to **autoimmune disease**. ### **Microplastics and the Immune System** - Microplastics were found in immune cells within the brain, suggesting the body recognizes them as foreign invaders. - Brain samples from individuals with dementia showed even greater microplastic accumulation, particularly in cerebrovascular walls and immune cells—raising concerns about neuroinflammation. - These findings align with existing research suggesting that chronic inflammation and immune activation contribute to neurodegenerative and autoimmune diseases. ###### *“…even greater accumulation of MNPs was observed in a cohort of decedent brains with documented dementia diagnosis, with notable deposition in cerebrovascular walls and immune cells.”* ### **The Body’s Response to Microplastics** - Immune cells in the brain, particularly microglia, are known to trigger inflammation in response to foreign particles. The presence of microplastics could lead to chronic immune activation and impaired clearance mechanisms over time. - Previous studies have linked microplastic exposure to increased inflammatory markers, which are also elevated in many autoimmune disorders such as [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/ "multiple sclerosis") (MS), lupus, and [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "rheumatoid arthritis") (RA). ### **Increase in Microplastics** - Brain and liver samples from **2024 contained significantly more microplastics** **than those from 2016**, suggesting that exposure is increasing over time. - If microplastics persist in human tissues without effective clearance mechanisms, this could contribute to long-term immune dysregulation. ### **Potential Links to Autoimmune Disease** - Disruptions to the blood-brain barrier (BBB) due to chronic microplastic exposure could allow immune cells to attack brain tissue, a hallmark of neuroinflammatory and autoimmune disorders like MS. - The study raises concerns about whether the immune system’s inability to clear microplastics could contribute to the development or worsening of autoimmune diseases. ### **Methodology and Confirmation of Microplastics in Human Tissues** The study used multiple advanced techniques to detect and confirm microplastics in immune cells and brain tissues, including: - Pyrolysis gas chromatography-mass spectrometry (Py-GC/MS) - Fourier transform infrared spectroscopy (FTIR) - Electron microscopy ### **What This Means for Immune and Neurological Health** While no causal link between microplastics and autoimmune disease has been established, these findings underscore the need for further research on: - The mechanism by which microplastics trigger chronic immune activation - The role of microplastics in inflammation-related conditions, including neurodegenerative and autoimmune diseases - Whether microplastics impair the body’s ability to regulate immune responses, leading to an increased risk of autoimmunity ###### **“These results highlight a critical need to better understand the routes of exposure, uptake and clearance pathways and potential health consequences of plastics in human tissues, particularly in the brain.”*​* ### **Key Takeaway** Microplastics not only accumulate in the brain but also infiltrate immune cells, raising serious concerns about long-term immune system effects, inflammation, and autoimmune risk. As microplastic exposure continues to rise, understanding its impacts on human immunity and disease will be critical for public health. ##### Citation Nihart, A.J., Garcia, M.A., El Hayek, E. *et al.* **Bioaccumulation of microplastics in decedent human brains**. *Nat Med* (2025). <https://doi.org/10.1038/s41591-024-03453-1> **Category:** Research Studies, Risk Factors --- ### [Link Between Alzheimer’s Disease Pathologies and Herpes Virus](https://www.autoimmuneinstitute.org/research_updates/link-between-alzheimers-disease-pathologies-and-herpes-virus/) **Published:** January 31, 2025 **Author:** Elevation **Content:** The tau protein is well known for its role in Alzheimer’s disease, where these proteins undergo modifications and accumulate inside neurons. This causes toxic effects inside the cell, leading to neuronal death and cognitive decline. However, tau proteins are actually a normal part of the brain and can protect the brain from invading viruses. Normally, they bind the virus and inhibit them. A [recent study](https://doi.org/10.1016/j.celrep.2024.115109) finds that this is what happens in herpes simplex virus infection and explores how this may relate to Alzheimer’s disease. #### This study found that proteins from the herpes virus could be found in the brain in all stages of Alzheimer’s disease. The presence of these proteins correlated with the presence of a highly modified version of tau and with Alzheimer’s severity. In organoid models (i.e. mini models of human brains), the study found that the herpes virus could affect the levels of modifications on the tau protein. These modified tau proteins reduced herpes virus protein levels and decreased post-infection neuronal death. It’s possible these modified tau proteins act as an innate immune response in Alzheimer’s disease. This study highlights the complicated and interconnected nature of infections, immune responses, and neurodegeneration. ##### Citation: Hyde et al. (2025). **Anti-herpetic tau preserves neurons via the cGAS-STING-TBK1 pathway in Alzheimer’s disease**. *Cell Reports*. <https://doi.org/10.1016/j.celrep.2024.115109> **Category:** Research Studies, Risk Factors --- ### [Autoimmune Disease and Pregnancy](https://www.autoimmuneinstitute.org/research_updates/autoimmune-diseases-and-pregnancy-a-complex-relationship/) **Published:** October 4, 2024 **Author:** GAI-assistant **Content:** Autoimmune diseases disproportionately affect women, often during their prime reproductive years. Consequently, understanding their interplay with pregnancy is crucial for optimizing maternal and fetal health. A recent study, “[Autoimmunity in obstetrics and autoimmune diseases in pregnancy](https://pubmed.ncbi.nlm.nih.gov/31133364/),” delves into this complex relationship. Here’s what the article found: [**Systemic Lupus Erythematosus (SLE)**](https://www.autoimmuneinstitute.org/diseases_list/systemic-lupus-erythematosus/)[,](https://www.autoimmuneinstitute.org/diseases_list/antiphospholipid-syndrome/) a systemic autoimmune disorder, poses significant pregnancy risks. Pre-pregnancy planning is essential for mitigating complications, especially for women with recent disease activity or specific SLE subtypes. Treatment strategies vary based on disease severity and pregnancy trimester. Potential adverse outcomes: - miscarriage - growth restrictions - preterm birth - hypertensive disorders - fetal loss - neonatal lupus [**Antiphospholipid Syndrome (APS)**,](https://www.autoimmuneinstitute.org/diseases_list/antiphospholipid-syndrome/) characterized by abnormal blood clotting, heightens the risk of miscarriage. The presence of specific antibodies can be a marker for poor pregnancy outcomes. Preconception care is vital to support placental health and reduce pregnancy complications. Predictors of complications: - presence of SLE or another autoimmune disease - previous pregnancy loss - specific autoantibodies - blood clotting abnormalities Low-dose immunotherapy and anticoagulants, combined with Doppler ultrasound monitoring, are essential during pregnancy. **[Sjögren’s Syndrome (SS)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sjogren-syndrome/ "Sjögren’s Syndrome")**, an autoimmune disorder that targets moisture-producing glands, is increasingly prevalent among pregnant women. The most severe pregnancy-related complication is congenital heart block (CHB), caused by maternal autoantibodies attacking the fetal heart. Risk factors of CHB include maternal autoantibodies, family history, and female fetus. Fetal echocardiograms and specific medications can manage CHB, but many affected children will require pacemakers. The overall impact of SS on pregnancy remains unclear and requires further research. [**Rheumatoid Arthritis (RA)**](https://www.autoimmuneinstitute.org/diseases_list/rheumatoid-arthritis/), an inflammatory joint disease, improves in 60% of pregnancies. However, flares can occur postpartum. Medication adjustments are necessary throughout pregnancy due to drug contraindications. Preconception planning is crucial for optimal management. **Systemic Sclerosis (SSc)**, a multi-organ targeting autoimmune disease, is less understood in pregnancy. While previously discouraged, recent evidence suggests more favorable outcomes for pregnant women with SSc. However, research is needed to clarify pregnancy complications and outcomes in this population. Autoimmune diseases present unique challenges during pregnancy. Early and comprehensive care, including preconception planning, is vital for optimizing maternal and fetal well-being. Further research is necessary to deepen our understanding of these complex interactions and develop targeted interventions. ##### Citation: De Carolis, S., at al. (2019). Autoimmunity in obstetrics and autoimmune diseases in pregnancy. *Best practice & research. Clinical obstetrics & gynaecology*, *60*, 66–76. <https://doi.org/10.1016/j.bpobgyn.2019.03.003> **Category:** Lupus, Research Studies, Rheumatoid Arthritis, Risk Factors, Sjögren disease --- ### [Assessing Chagas Disease Risk With Kissing Bug Surveillance](https://www.autoimmuneinstitute.org/research_updates/assessing-chagas-disease-risk-with-kissing-bug-surveillance/) **Published:** November 25, 2022 **Author:** Elevation **Excerpt:** How prevalent are kissing bugs?  How often do they carry the parasite T. cruzi? What hosts do they feed for blood meals? **Content:** November 25, 2022 Scientists at the University of Florida reported the results of a large state-wide assessment of kissing bugs in a presentation titled [Florida Kissing Bugs (Hemiptera, Reduviidae, Triatominae) Invade Homes, Feed on Diverse Hosts, and Harbor *Trypanosoma cruzi*](https://www.researchgate.net/publication/365126553_Florida_Kissing_Bugs_Hemiptera_Reduviidae_Triatominae_Invade_Homes_Feed_on_Diverse_Hosts_and_Harbor_Trypanosoma_cruzi?channel=doi&linkId=636553f7431b1f53006d6e86&showFulltext=true). Their research, which used the help of community members to collect kissing bugs across the state, aimed to answer questions such as: - How prevalent are kissing bugs? - How often do they carry the parasite *T*. *cruzi*? - What hosts do they feed for blood meals? **From a total of 309 bugs analyzed, they found that 29.5% of the bugs contained the parasite. *T*. *cruzi*, which causes** [**Chagas disease**](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/chagas-disease/), can persist long-term in humans and lead to cardiac and gastrointestinal complications. The researchers found that the bugs fed from a variety of hosts – humans, cockroaches, wild and domestic mammals, reptiles, and amphibians. Since the bug feeds off of humans and natural hosts of *T*. *cruzi*, understanding the prevalence of the bugs is important to monitor and control disease spread from the parasite. There is some evidence that chronic Chagas cardiomyopathy, which develops from persistent infection with *T*. *cruzi*, has [characteristics of autoimmunity](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6088212/). **Category:** Autoimmune Diseases, Research Studies, Risk Factors --- ### [Arthritis Activity Suppressing Protein Discovery](https://www.autoimmuneinstitute.org/research_updates/arthritis-activity-suppressing-protein-discovery/) **Published:** August 18, 2021 **Author:** Elevation **Excerpt:** A team discovered that the protein 14-3-3ζ suppresses inflammatory arthritis in rats, offering new therapeutic insights. Rats lacking 14-3-3ζ developed severe arthritis, but a preventive vaccine using 14-3-3ζ reduced symptoms, suggesting this protein plays a key role in protecting against autoimmunity. **Content:** August 18, 2021 Researchers have gained a detailed understanding of the events that trigger inflammation in [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/) (also called inflammatory arthritis in this study). They know less about why the body loses its normal protections against autoimmunity. A team of scientists from the Universities of Michigan and Toledo showed that a protein called 14-3-3ζ [suppresses inflammatory arthritis in rats](https://www.pnas.org/doi/10.1073/pnas.2025257118). These results, they say, point to potential clues for therapies. Previous studies had identified 14-3-3ζ and showed that the protein plays a role in cancer and sepsis, as well as autoimmunity. Rats that were genetically engineered to lack 14-3-3ζ developed severe, early-onset arthritis in two different models of inflammatory arthritis. The onset of arthritis occurred at the same time as the body stopped making antibodies against 14-3-3ζ to prevent the body from attacking itself. A preventive vaccine using 14-3-3ζ helped reduce symptoms of inflammatory arthritis in rats. Taken together, the researchers conclude that 14-3-3ζ protects the body from the development of inflammatory arthritis. **Citation for report:** Kim, J., Chun, K., McGowan, J., Zhang, Y., Czernik, P. J., Mell, B., Joe, B., Chattopadhyay, S., Holoshitz, J., & Chakravarti, R. (2021). 14-3-3ζ: A suppressor of inflammatory arthritis. *Proceedings of the National Academy of Sciences of the United States of America*, *118*(34), e2025257118. <https://doi.org/10.1073/pnas.2025257118> **Category:** Autoimmune Diseases, Research Studies, Rheumatoid Arthritis --- ### [Are Immunosuppressants Neuroprotective in Autoimmune Disease?](https://www.autoimmuneinstitute.org/research_updates/are-immunosuppressants-neuroprotective-in-autoimmune-disease/) **Published:** January 1, 2020 **Author:** GAI-assistant **Content:** A preclinical study called [Immunosuppression prevents neuronal atrophy in lupus-prone mice: evidence for brain damage induced by autoimmune disease?](https://www.sciencedirect.com/science/article/pii/S0165572800003647#aep-section-id28) published in the *Journal of Neuroimmunology* evaluated the effects of chronic autoimmune disease on neural activity in a mouse model. Systemic lupus erythematosus (SLE), or lupus, is an autoimmune disorder characterized by [widespread inflammation](https://www.scirp.org/journal/paperinformation?paperid=111950) that impacts multiple organ systems, resulting in extreme fatigue, joint pain, and skin symptoms. Less commonly recognized is the impact of the disease on neurological function and neurodevelopment. Researchers utilized a genetic model of “lupus-like disease” that exhibits the general characteristics of autoimmune disease and neurological signs of lupus. Transgenic mice were treated with the immunosuppressive drug cyclophosphamide (CY) or saline over 8 weeks. Measurements of ANA levels, antibodies that can be elevated in people with autoimmune disease, indicated that CY treatment effectively lowered immune activity. Analyses of specific brain regions revealed increased neural activity within the hippocampus, which is responsible for memory function, in mice treated with CY; similar results were found in the parietal region, which is important for sensory functioning. Further analyses showed that ANA levels were correlated with measures of neuronal activity, indicating that CY treatment may be neuroprotective. While these results could have implications for patients with autoimmune diseases like lupus, studies in preclinical models must be interpreted carefully. Despite shared biology, results from mouse studies often cannot be replicated in humans. Therefore, the effects of CY treatment on neurological function must be confirmed in humans. ##### Citation: Sakic, B., et al. (2000). Immunosuppression prevents neuronal atrophy in lupus-prone mice: evidence for brain damage induced by autoimmune disease?. *Journal of neuroimmunology*, *111*(1-2), 93–101. <https://doi.org/10.1016/s0165-5728(00)00364-7> **Category:** Autoimmune Brain Inflammation, Lupus, Research Studies, Therapies --- ### [Air Pollution Increases Autoimmunity Risk](https://www.autoimmuneinstitute.org/research_updates/air-pollution-increases-autoimmunity-risk/) **Published:** February 15, 2022 **Author:** GAI-assistant **Excerpt:** In this study, scientists analyzed medical data from 81,636 individuals in Italy, along with air pollution data from the Italian Institute of Environmental Protection and Research. Their aim was to investigate the potential correlation between air pollution levels and the incidence of autoimmune diseases. **Content:** It remains unclear why some individuals develop autoimmune diseases while others do not. Current data suggests that it is likely a combination of genetics and environmental factors. A study titled “[Association between long-term exposure to air pollution and immune-mediated diseases: a population-based cohort study](https://rmdopen.bmj.com/content/8/1/e002055),” published in the *Journal of Rheumatic and Musculoskeletal Diseases*, proposes that air pollution is one possible environmental contributor. In this study, scientists analyzed medical data from 81,636 individuals in Italy, along with air pollution data from the Italian Institute of Environmental Protection and Research. Their aim was to investigate the potential correlation between air pollution levels and the incidence of autoimmune diseases. Their findings suggest a significant link between air pollution and autoimmunity, indicating that higher levels of air pollution correspond to an increased risk of developing autoimmune diseases. More data is needed to understand this association and the mechanism through which air pollution may contribute to autoimmunity. ##### Citation: Adami, G., et al. (2022). **Association between long-term exposure to air pollution and immune-mediated diseases: a population-based cohort study**. *RMD open*, *8*(1), e002055. <https://doi.org/10.1136/rmdopen-2021-002055> **Category:** Research Studies, Risk Factors --- ### [Age-Related Variations in Giant Cell Arteritis](https://www.autoimmuneinstitute.org/research_updates/age-related-variations-in-giant-cell-arteritis/) **Published:** August 24, 2023 **Author:** GAI-assistant **Content:** [Giant cell arteritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/giant-cell-arteritis-temporal-arteritis-hortons-disease/ "Giant cell arteritis/temporal arteritis/Horton’s disease") (GCA) is an inflammatory disease affecting blood vessels in the scalp, neck, and arms, primarily affecting individuals over 50, with prevalence increasing with age. However, the specific impact of age on symptom presentation and severity has remained unclear. A recent study published in the journal Vasculitis titled, “[Age at diagnosis influences the clinical phenotype, treatment strategies and outcomes in patients with giant cell arteritis: results from the observational GCAGE study on a large cohort of 1004 patients](https://ard.bmj.com/content/82/8/1098?with-ds=yes)” sought to answer this question. The study enrolled 1,004 patients diagnosed with GCA from Italy and categorized them into three age groups: over 80, 65-69, and under 65. The researchers then compared symptoms and severity across these groups. Their findings revealed age-related variations in symptoms. Younger patients tended to exhibit large-vessel GCA and systemic symptom onset and were more frequently treated with high-dose corticosteroids compared to their older counterparts. Conversely, older patients exhibited higher mortality rates and a greater overall symptom burden, particularly related to complications such as blindness. Some aspects, such as the number of relapses and time to first relapse, were consistent across age groups. This study underscores the heightened risk of complications among older individuals with GCA. Armed with this knowledge, healthcare providers can enhance monitoring and interventions to improve the quality of life for these patients. ##### Citation: Monti, S., et al. Italian Society of Rheumatology Vasculitis Study Group (2023). **Age at diagnosis influences the clinical phenotype, treatment strategies and outcomes in patients with giant cell arteritis: results from the observational GCAGE study on a large cohort of 1004 patients**. *Annals of the rheumatic diseases*, *82*(8), 1098–1106. <https://doi.org/10.1136/ard-2023-223895> **Category:** Research Studies, Risk Factors --- ### [Advancing Women's Health: Insights into Autoimmune Diseases efforts at NIH](https://www.autoimmuneinstitute.org/research_updates/advancing-womens-health-insights-into-autoimmune-diseases-efforts-at-nih/) **Published:** June 28, 2024 **Author:** Elevation **Excerpt:** The NIH has compiled fact sheets outlining the current state of science on specific health topics. In the section titled "Autoimmune Diseases and Women’s Health," the focus is specifically on autoimmune disease, highlighting several important points. **Content:** Efforts are increasingly directed towards funding and understanding the issues affecting women’s health. To facilitate the gathering of information, the NIH has compiled fact sheets outlining the current state of science on specific health topics. In the section titled “[Autoimmune Diseases and Women’s Health](https://orwh.od.nih.gov/sites/orwh/files/docs/NIH%20Fact%20Sheets%20on%20Womens%20Health%20Research_050924_508c.pdf),” the focus is specifically on autoimmune disease, highlighting several important points. Here’s an overview. #### **Statistics and Current State of Research** The report notes that autoimmune diseases impact an estimated 25-31 million Americans, making it the third most common category of disease, with 80% of affected individuals being women. However, the exact cause of this increased prevalence in women is still not fully understood and is an area undergoing active investigation. Some theories being studied include hormonal differences, genes on the X chromosome, environmental exposures, and stressors such as the increased racism faced by Black, Latina, and other marginalized women. Efforts are also underway to understand factors contributing to autoimmunity beyond these. Other gaps in autoimmune research include improving diagnostics, enhancing therapeutics, and interventions to reduce disparities in care. #### **Funding and Research Initiatives:** NIH’s spending on autoimmune disease totaled $241 million in fiscal year 2023. Most of this support went to research funded by the following NIH institutes: The National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institute of Allergy and Infectious Diseases, and National Institute of Dental and Craniofacial Research. Additionally, NIH has recently established an office of autoimmune disease research, which is part of the Office of Research on Women’s Health, focusing on emerging innovation and fostering collaborations among key autoimmune disease researchers. This office specifically awarded 41 grants related to this mission in FY23. Combined, this report outlines the importance of autoimmune research and the efforts being done in this area. Citation: *National Institutes of Health, Office of Research on Women’s Health*. **NIH fact sheets on women’s health research**. **Category:** Autoimmune Diseases, Research Studies, Risk Factors --- ### [A New Role for Chemokines in Inducing Inflammation](https://www.autoimmuneinstitute.org/research_updates/a-new-role-for-chemokines-in-inducing-inflammation/) **Published:** June 1, 2022 **Author:** Elevation **Excerpt:** Chemokines are proteins made by cells of the immune system that normally function to alert and guide immune cells to an infection site. The paper titled Chemokines form nanoparticles with DNA and can superinduce TLR-driven immune inflammation, published in The Journal of Experimental Medicine, uncovers a new role of chemokines potentially linked to autoimmune disease. **Content:** Chemokines are proteins made by cells of the immune system that normally function to alert and guide immune cells to an infection site. The paper titled [Chemokines form nanoparticles with DNA and can superinduce TLR-driven immune inflammation](https://rupress.org/jem/article/219/7/e20212142/213252/Chemokines-form-nanoparticles-with-DNA-and-can), published in *The Journal of Experimental Medicine*, uncovers a new role of chemokines potentially linked to autoimmune disease. In this study, researchers focused on the chemokine CXCL4, which is implicated in autoimmune diseases such as [scleroderma](https://www.science.org/doi/10.1126/scitranslmed.aam8458) and [rheumatoid arthritis](https://ard.bmj.com/content/75/4/763). Using mouse models of skin inflammation, scientists discovered that CXCL4 can form complexes with DNA, termed nanoparticles, capable of activating Toll-like receptors (TLRs). TLRs play a crucial role in detecting pathogens upon entry, subsequently initiating the production of interferons—proteins that activate immune cells and trigger inflammation. These researchers found that in their mouse models, the chemokine-DNA nanoparticles enter cells, trigger TLRs, and induce the production of interferons (signaling proteins made and released in response to the presence of several viruses) in the absence of a pathogen, leading to an immune response against the body itself. Their results also suggest that other chemokines, like CXCL10, may also do this and that the specific chemokines involved may vary depending on the autoimmune disease under investigation. Overall, this finding is groundbreaking, as it reveals a new role for chemokines in autoimmunity. Further research is necessary to validate these results in humans, but this work holds the potential to pave the way for new therapeutic approaches. ##### Citation Yong Du, Marie Dominique Ah Kioon, Paoline Laurent, Vidyanath Chaudhary, Michael Pierides, Chao Yang, David Oliver, Lionel B. Ivashkiv, Franck J. Barrat; Chemokines form nanoparticles with DNA and can superinduce TLR-driven immune inflammation. **J Exp Med** 4 July 2022; 219 (7): e20212142. doi: <https://doi.org/10.1084/jem.20212142> **Category:** Research Studies, Risk Factors --- ### [1.3% of U.S. adults documented to have ME/CFS in 2021-2022](https://www.autoimmuneinstitute.org/research_updates/1-3-of-u-s-adults-documented-to-have-me-cfs-in-2021-2022/) **Published:** December 8, 2023 **Author:** Elevation **Excerpt:** The NCHS Data Brief No. 488, released this month by the U.S. Department of Health and Human Services, presents key findings on Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) in U.S. adults based on the 2021–2022 National Health Interview Survey. **Content:** December 8, 2023 The [NCHS Data Brief No. 488](https://www.cdc.gov/nchs/data/databriefs/db488.pdf), released this month by the U.S. Department of Health and Human Services, presents key findings on [Myalgic Encephalomyelitis/Chronic Fatigue Syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/me-cfs/) (ME/CFS) in U.S. adults based on the 2021–2022 National Health Interview Survey. The Centers for Disease Control and Prevention (CDC) defines ME/CFS as a “complex, multisystem illness characterized by activity-limiting fatigue, worsening of symptoms after activity, and other symptoms ([1](https://pubmed.ncbi.nlm.nih.gov/25695122/)). It affects all age, sex, and racial and ethnic groups and costs the U.S. economy about $18–$51 billion annually ([2](https://pubmed.ncbi.nlm.nih.gov/10527290/),[3](https://pubmed.ncbi.nlm.nih.gov/12860574/),[4](https://pubmed.ncbi.nlm.nih.gov/21251294/),[5](https://doi.org/10.3389%2Ffped.2019.00185)).” The report reveals that **1.3% of adults had ME/CFS, with a higher prevalence among women**. The likelihood of having ME/CFS increased with age up to 60–69 years, declining in those aged 70 and older. **White non-Hispanic adults exhibited a higher prevalence** (1.5%) compared to Hispanic (0.8%) and Asian non-Hispanic (0.7%) adults. Individuals with a family income less than 100% of the federal poverty level had a higher percentage of ME/CFS (2.0%), and prevalence increased with greater rurality of residence. The report emphasizes the impact of demographic and geographic factors on ME/CFS prevalence, noting limitations in the analysis based on diagnosed cases and potential underestimation due to undiagnosed individuals. **Citation for report:** Vahratian A, Lin JS, Bertolli J, Unger ER. Myalgic encephalomyelitis/chronic fatigue syndrome in adults: United States, 2021–2022. NCHS Data Brief, no 488. Hyattsville, MD: National Center for Health Statistics. 2023. DOI: <https://dx.doi.org/10.15620/cdc:134504>. **Category:** Autoimmune Diseases, Research Studies --- ### [Trained Immunity: Gut Bacteria & Bone Marrow Connection](https://www.autoimmuneinstitute.org/research_updates/trained-immunity-gut-bacteria-bone-marrow-connection/) **Published:** January 24, 2025 **Author:** Elevation **Content:** A recently published [study](https://pubmed.ncbi.nlm.nih.gov/39848243/) explores the impact of gut microbiota translocation, particularly *Enterococcus faecalis*, on inducing trained immunity (TI) in myeloid progenitors within the bone marrow. Key findings include: #### **Gut Barrier Disruption and Trained Immunity** - Dextran sulfate sodium (DSS) treatment in mice leads to gut barrier disruption, allowing *E. faecalis* to translocate to the bone marrow. - This translocation triggers Mincle-mediated trained immunity in bone marrow progenitors, enhancing inflammatory responses. #### **Mincle Receptor’s Role** - The C-type lectin receptor Mincle (Clec4e) is critical for sensing *E. faecalis* and driving trained immunity. - Mincle-deficient mice showed impaired trained immunity and reduced inflammation upon DSS treatment. #### **Protective vs. Detrimental Effects** - While trained immunity provides protection against secondary infections, it may exacerbate inflammation-related diseases such as colitis. - Mincle activation can promote both beneficial immune responses and pathological inflammation. #### **Experimental Findings** - DSS-treated mice exhibited increased tumor necrosis factor (TNF) and interleukin-6 (IL-6) production upon pathogen challenge. - Bone marrow progenitors showed metabolic and epigenetic reprogramming indicative of long-term immune adaptation. #### **Human Relevance** - *E. faecalis* also induced trained immunity features in human monocytes, suggesting potential clinical implications. - The study highlights the complex interplay between gut microbiota translocation and systemic immune responses, with implications for inflammatory diseases and potential therapeutic interventions. ##### Citation: Robles-Vera, I., et al. (2025). **Microbiota translocation following intestinal barrier disruption promotes Mincle-mediated training of myeloid progenitors in the bone marrow**. *Immunity*, S1074-7613(24)00577-6. Advance online publication. <https://doi.org/10.1016/j.immuni.2024.12.01>2 **Category:** IBD (Crohn's and UC), Microbiome, Research Studies, Risk Factors --- ### [Guillain-Barré Syndrome (GBS) Warning Added to RSV Vaccines](https://www.autoimmuneinstitute.org/research_updates/guillain-barre-syndrome-gbs-warning-added-to-rsv-vaccines/) **Published:** January 8, 2025 **Author:** Elevation **Content:** The US Food and Drug Administration (FDA) has [required safety updates](https://www.fda.gov/safety/medical-product-safety-information/fda-requires-guillain-barre-syndrome-gbs-warning-prescribing-information-rsv-vaccines-abrysvo-and) to the prescribing information for the RSV vaccines Abrysvo (by Pfizer) and Arexvy (by GSK). A new warning has been added to inform healthcare providers and patients about a potential increased risk of [Guillain-Barré syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/guillain-barre-syndrome/ "Guillain-Barrè syndrome") (GBS) within 42 days after vaccination. GBS is a rare condition where the immune system attacks the nerves, causing muscle weakness and, in some cases, paralysis. ### Postmarketing Observational Study Suggesting Increased GBS Risk Following RSV Vaccination The [**FDA self-controlled case series GBS update**](https://www.cdc.gov/acip/downloads/slides-2024-10-23-24/05-RSV-Adult-Lloyd-508.pdf), presented at the October 2024 meeting of the Advisory Committee on Immunization Practices, reported the following conclusions: - Our findings suggest an increased GBS risk following RSVPreF3+AS01 \[GSK – AREXVY\] and RSVPreF \[Pfizer – ABRYSVO\] **among adults aged 65 years and older** - These results are **consistent with pre-licensure clinical trials and surveillance systems** such as VAERS - End-of-season SCCS analyses results are largely chart-confirmed from MRR and include approximately three times more vaccine doses and GBS cases compared to the early season SCCS results - This means that by the end of the RSV season, the analysis had more data available, and the end-of-season analysis included about three times more individuals who received the vaccine **and** three times more GBS cases, making the findings more robust and reliable compared to the preliminary, early-season results. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/01/Screenshot-2025-01-24-at-3.27.22 PM-1024x573.png) - **GBS risk following vaccination with RSVPreF3+AS01 and RSVPreF is rare, with less than 10 cases per 1 million vaccinations** - There is no difference in GBS risk among persons with and without **same day concomitant vaccination** with RSV vaccines - This finding indicates that receiving an RSV vaccine alongside other vaccines (such as flu or COVID-19 vaccines) on the same day does **not** increase or decrease the risk of developing GBS compared to receiving the RSV vaccine alone. ## ABRYSVO **Abrysvo** was initially approved for individuals 60 and older but is now also authorized for younger at-risk adults and pregnant individuals to protect infants from RSV-related illness. **The January 6, 2025, FDA [approval letter](https://www.fda.gov/media/184945/download?attachment) for ABRYSVO stated the following:** “Since ABRYSVO was approved in 2023, we have become aware of data from a postmarketing observational study conducted among Medicare beneficiaries 65 years of age and older that suggest an increased risk of Guillain-Barré syndrome (GBS) following vaccination with ABRYSVO; please see [FDA self-controlled case series GBS update](https://www.cdc.gov/acip/downloads/slides-2024-10-23-24/05-RSV-Adult-Lloyd-508.pdf), presented at the October 24, 2024 meeting of the Advisory Committee on Immunization Practices. Therefore, we consider this information to be “new safety information” as defined in section 505-1(b)(3) of the FDCA. We have determined that an analysis of spontaneous postmarketing adverse events reported under section 505(k)(1) of the FDCA will not be sufficient to assess a serious risk of Guillain-Barré Syndrome following administration of ABRYSVO in pregnant individuals. Furthermore, the pharmacovigilance system that FDA is required to maintain under section 505(k)(3) of the FDCA is not sufficient to assess this serious risk. Therefore, based on appropriate scientific data, we have determined that you are required to conduct the following studies: Study titled, “[A Rapid Surveillance and Cohort Post-Marketing Safety Study to Evaluate the Safety of Respiratory Syncytial Virus Vaccine (ABRYSVO) Exposure During Pregnancy in the United States](https://catalogues.ema.europa.eu/node/4016/administrative-details)” (Protocol C3671027). This postmarketing database study will utilize Sentinel System claims data, including Medicaid claims data, to conduct near real-time monitoring and evaluate Guillain Barré syndrome (GBS) among pregnant women vaccinated with ABRYSVO in the United States.” ## AREXVY **Arexvy** was initially approved for those 60 and older and is now available for at-risk individuals aged 50-59. **The January 6, 2025, FDA [approval letter](https://www.fda.gov/media/184953/download?attachment) for AREXVY stated the following:** We have approved your request received on November 22, 2024, to supplement your Biologics License Application (BLA) submitted under section 351(a) of the Public Health Service Act for Respiratory Syncytial Virus Vaccine, Adjuvanted (AREXVY) manufactured at your facility in Wavre, Belgium to update the “Warnings and Precautions” and “Adverse Reactions” sections of the Package Insert to include new safety information on the risk of Guillain-Barré syndrome (GBS) following vaccination with AREXVY. The review of this supplement was associated with our October 25, 2024, SAFETY LABELING CHANGE NOTIFICATION LETTER, notifying you, under Section 505(o)(4) of the Federal Food, Drug, and Cosmetic Act (FDCA), of new safety information that we believe should be included in the labeling for AREXVY. This information pertains to data from a postmarketing observational study that suggest an increased risk of GBS during the 42 days following vaccination with AREXVY. **Healthcare providers and patients are encouraged to report any suspected side effects to the [Vaccine Adverse Event Reporting System (VAERS)](https://vaers.hhs.gov/reportevent.html?utm_medium=email&utm_source=govdelivery).** ##### Citations: *FDA***. The FDA Safety Information and Adverse Event Reporting Program. Retrieved from:** <https://www.fda.gov/safety/medical-product-safety-information/fda-requires-guillain-barre-syndrome-gbs-warning-prescribing-information-rsv-vaccines-abrysvo-and> *Meeting of the Advisory Committee on Immunization Practices (ACIP)*: **Respiratory Syncytial Virus (RSV) Vaccine, Adults**. October 23-24, 2024. Retrieved from: [https://www.cdc.gov/acip/downloads/slides-2024-10-23-24/05-RSV-Adult-Lloyd-508.pdf](https://www.cdc.gov/acip/meetings/presentation-slides-october-23-24-2024.html) **Respiratory Syncytial Virus Vaccine Recombinant, Adjuvanted (Arexvy)**. *Vaccines and Related Biological Products Advisory Committee Meeting*. FDA Briefing Document. March 1, 2023. <https://www.fda.gov/media/165622/download> **Respiratory Syncytial Virus Stabilized Bivalent Prefusion F Subunit Vaccine (Abrysvo)**. *Vaccines and Related Biological Products Advisory Committee Meeting*. FDA Briefing Document. March 1, 2023. <https://www.fda.gov/media/165625/download> Hause AM, et al. **Early Safety Findings Among Persons Aged ≥60 Years Who Received a Respiratory Syncytial Virus Vaccine — United States, May 3, 2023–April 14, 2024**. *MMWR Morb Mortal Wkly Rep* 2024;73:489–494. DOI: <http://dx.doi.org/10.15585/mmwr.mm7321a3> Petersen I, Douglas I, Whitaker H. [**Self controlled case series methods: an alternative to standard epidemiological study designs**](https://www.bmj.com/content/354/bmj.i4515). 2016;354:i4515. **Evaluation of Multiple Safety Outcomes following Respiratory Syncytial Virus (RSV) Vaccination in Adults 60 Years and Older**. BEST Initiative. Center for Biologics Evaluation and Research (CBER). United States Food and Drug Administration (U.S. FDA). <https://bestinitiative.org/wp-content/uploads/2024/01/BEST_RSV_Safety_Older_Adults_2023-2024.pdf> Sejvar JJ, Kohl KS, et al, **Guillain–Barré syndrome and Fisher syndrome: Case definitions and guidelines for collection, analysis, and presentation of immunization safety data**, *Vaccine*, Volume 29, Issue 3, 2011. <https://doi.org/10.1016/j.vaccine.2010.06.003.> Farrington, C. P., et al. (2011). **Self-Controlled Case Series Analysis With Event-Dependent Observation Periods**. *Journal of the American Statistical Association*, 106(494), 417–426. <https://doi.org/10.1198/jasa.2011.ap10108> Arya, D.P., et al. **[Surveillance for Guillain-Barré syndrome after 2015-2016 and 2016-2017 influenza vaccination of Medicare beneficiaries](https://pubmed.ncbi.nlm.nih.gov/31515146/)**. *Vaccine*, 2019. 37(43): p. 6543-6549. 2. **Category:** Autoimmune Diseases, Risk Factors --- ### [Protein that Determines When T Cells Rest or Awaken Identified](https://www.autoimmuneinstitute.org/research_updates/protein-that-determines-when-t-cells-rest-or-awaken-identified/) **Published:** December 16, 2024 **Author:** Elevation **Content:** Our immune system helps protect us from disease, but this doesn’t mean they’re always combating threats like bacteria or viruses. Sometimes, there aren’t any threats to respond to. In those cases, the immune system waits for the right signals to “awaken.” In a recent study, scientists identified a protein called [MED12](https://www.nature.com/articles/s41586-024-08314-y) that is the mastermind behind when T cells rest or awaken. The researchers found that MED12 binds to different locations in the genome to control which genes are turned on. These genes can help shuttle T cells towards states of rest or activation. If MED12 is removed from T cells, T cells never become fully activated nor do they fully rest. Understanding this process could have significance for diseases such as cancer or autoimmune diseases where malfunctions in the T cell response plays a role. ##### Citation:  Arce, M., et al. (2024). [Central control of dynamic gene circuits governs T cell rest and activation](https://www.nature.com/articles/s41586-024-08314-y). *Nature.*  https://doi.org/10.1038/s41586-024-08314-y **Category:** Research Studies --- ### [Repurposing A Diuretic Drug to Treat Skin Inflammation](https://www.autoimmuneinstitute.org/research_updates/repurposing-a-diuretic-drug-to-treat-skin-inflammation/) **Published:** December 13, 2024 **Author:** Elevation **Content:** Immunosuppressive drugs are often used to treat autoimmune diseases, but come with some disadvantages: they can be expensive, difficult to administer, and leave patients prone to infections. [New research](https://www.science.org/doi/10.1126/scitranslmed.ade5915) finds a possible therapy for [psoriasis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/psoriasis/ "Psoriasis") that avoids using immunosuppressive drugs altogether. In this work, scientists tested drug compounds on their effects on inflammatory signals. They identify that benzamil, a derivative of the diuretic drug amiloride, reverses inflammatory signaling in skin cells. In live-animal studies, they found that topical and systemic versions of the drug inhibited skin inflammation. Amiloride, a sodium channel inhibitor, was approved to treat high blood pressure by reducing the amount of water in the body. While its derivative benzamil is not yet approved, it is an attractive drug candidate to treat psoriasis without using immunosuppressive drugs. ##### Citation: Winge, M. C. G., et al. (2024). Repurposing an epithelial sodium channel inhibitor as a therapy for murine and human skin inflammation. *Science translational medicine*, 16(777), eade5915. <https://doi.org/10.1126/scitranslmed.ade5915> **Category:** Autoimmune Diseases, Psoriasis, Research Studies, Therapies --- ### [New Mutations Identified Linked to Rare Autoimmune Disease](https://www.autoimmuneinstitute.org/research_updates/new-mutations-identified-linked-to-rare-autoimmune-disease/) **Published:** October 14, 2024 **Author:** Elevation **Content:** Autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED) is a rare autoimmune disorder. The disease has a genetic basis where mutations in both copies of the autoimmune regulator gene (*AIRE*) cause disease. This regulator is normally responsible for eliminating self-reactive T cells, but when mutated, has the potential to cause autoimmune disease. While there are *AIRE* variants known to cause APECED, not all people with APECED have the expected genetic variants. Now, a recent study titled [Autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED) Autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED)](https://www.science.org/doi/10.1126/scitranslmed.adk0845) identifies a new mutation in non-coding regions of the *AIRE* gene that can explain these cases of APECED. This study examined the DNA sequences from 104 individuals with APECED. Of these 104, 17 had no hallmark AIRE mutations typically associated with APECED. The mutation the study identified leads to the inclusion of sequences in the AIRE protein that aren’t normally included, leading to the dysfunction. This finding can help develop new genetic screenings and treatments for APECED. ##### **Citation:** Ochoa, S., et al. (2024). A deep intronic splice–altering AIRE variant causes APECED syndrome through antisense oligonucleotide-targetable pseudoexon inclusion. *Science Translational Medicine*, 16(765), <https://doi.org/10.1126/scitranslmed.adk0845> **Category:** Autoimmune Diseases, Diagnostic Testing, Genetics, Research Studies, Therapies --- ### [Plant Autoimmunity and Microbiota: Implications for Human Health](https://www.autoimmuneinstitute.org/research_updates/plant-autoimmunity-and-microbiota-implications-for-human-health/) **Published:** December 9, 2024 **Author:** Elevation **Content:** Although most studies of autoimmunity focus on human health, there’s a lot we can learn about autoimmunity from studying other organisms such as plants. Scientists from Duke University recently identified a gene that helps arabidopsis plants maintain a healthy gut microbiome. Their work, titled [Roles of microbiota in autoimmunity in Arabidopsis leaves](https://www.nature.com/articles/s41477-024-01779-9), has implications for agriculture, gut health, and autoimmunity in humans. This gene, when mutated in arabidopsis, gives the plant features of autoimmunity often seen in plants – they’re short, they have lesions on their leaves, and they express a high level of defense genes. The root cause of these characteristics is the abnormal leaf microbiome that results from the gene deletion. These characteristics highlight similarities between the plant and human microbiome, where human autoimmunity can be characterized by gut dysbiosis, lesions in the tissue, and altered immune responses. Because a plant’s microbiome can be transferred into our gut when we eat fruits and vegetables, understanding plant health and their microbiome can have implications for human health. ##### Citation: Cheng, Y.T., et al. (2024). Roles of microbiota in autoimmunity in Arabidopsis leaves. *Nature plants*. **10**, 1363–1376. <https://doi.org/10.1038/s41477-024-01779-9> **Category:** Autoimmune Diseases, Genetics, Microbiome, Sjögren disease --- ### [How Interactions between Genetic Variants and Epstein-Barr Virus Infection Contribute to Multiple Sclerosis](https://www.autoimmuneinstitute.org/research_updates/how-interactions-between-genetic-variants-and-epstein-barr-virus-infection-contribute-to-multiple-sclerosis/) **Published:** December 30, 2024 **Author:** Elevation **Content:** Epstein-Barr virus (EBV) infection has been associated with [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/) (MS) for [nearly 40 years](https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2024.1466339/full) and nearly all MS patients have a history of EBV infections. However, the mechanisms behind this association have been difficult to understand. Moreover, 95% of healthy adults have had a prior EBV infection but only 0.1-0.5% of adults have MS So what other factors are at play? A recent study titled [Gene–environment interactions: Epstein–Barr virus infection and risk of pediatric-onset multiple sclerosis](https://pmc.ncbi.nlm.nih.gov/articles/PMC11093131/) examined the connections between EBV infection and genetic variations to determine if there are any synergistic interactions that spur the development of pediatric-onset MS. In the study, they looked for genetic variants in the human leukocyte antigen (*HLA*) genes, which have been associated with several autoimmune diseases including MS, as well as other genetic risk factors beyond *HLA*. They found that a specific *HLA* variant called *HLA-DRB1\*15* and a variant in the CD86 gene, which produces a protein expressed on many immune cells, are linked to pediatric-onset MS risk. **Significance of this study:** This study finds that EBV infection during childhood leads to a higher risk for developing pediatric-onset MS in those that have these specific genetic variants. ##### **Citation:** Ziaei, A., *et al*. (2024). Gene-environment interactions: Epstein-Barr virus infection and risk of pediatric-onset multiple sclerosis. *Multiple Sclerosis*, 30(3), 308–315. <https://doi.org/10.1177/13524585231224685> **Category:** Multiple Sclerosis, Research Studies, Risk Factors --- ### [Advancing Autoimmune Research with Sex-Based Insights](https://www.autoimmuneinstitute.org/research_updates/advancing-autoimmune-research-with-sex-based-insights/) **Published:** December 5, 2024 **Author:** Elevation **Content:** The NIH’s Office of Research on Women’s Health (ORWH) engaged with the Japan Science and Technology Agency to [share insights](https://orwh.od.nih.gov/in-the-spotlight/all-articles/orwh-shares-insights-on-sex-and-gender-research-with-japanese-research-agency) on fostering gendered innovations and integrating “sex as a biological variable” (SABV) in research. ### **Why is “Sex As a Biological Variable” Research Necessary?** - Both Drs. Hunter and Douthard expressed how “the inclusion of both sexes in research is crucial for obtaining accurate results and that the exclusion of one sex can lead to an incomplete understanding of the results.” - “Personalized medicine and effective disease treatment require a complete body of knowledge about both men and women and that the inclusion of women in research benefits the health of all.” - Dr. Regine Douthard emphasized the importance of studying sex differences in autoimmune diseases, as these conditions often show significant sex-specific variations in prevalence, symptoms, and responses to treatment. ### **Recommendations for Promoting SABV Research:** - Provide investigators with supplemental funding to add sex and gender components to research. - Train future investigators in SABV principles. - Build large study cohorts and emphasize SABV in publications and educational efforts. - Engage community organizations to spread awareness about SABV research. - Identify champions within the scientific community to promote SABV initiatives. **Category:** Events, Genetics, Research Studies --- ### [A Type of Immune Cell Behaves Differently in SLE Patients](https://www.autoimmuneinstitute.org/research_updates/a-type-of-immune-cell-behaves-differently-in-sle-patients/) **Published:** March 15, 2024 **Author:** Elevation **Content:** Neutrophils are a type of immune cell thought to be the “first line of defense” against microbial invaders. These cells expel web-like traps that bind and immobilize microbes. Many studies have found connections between neutrophil dysregulation and [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/). A pro-inflammatory subtype of neutrophils has been extensively studied in the context of SLE, but less is known about the traditional subtype of neutrophils. A new study titled [Neutrophils isolated from systemic lupus erythematosus patients exhibit a distinct functional phenotype](https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2024.1339250/full) examines the changes in traditional neutrophils during SLE by comparing the functions of these neutrophils in SLE patients vs. healthy controls. Because neutrophils also exist in two states (ex: resting, when they’re unstimulated, and activated, when they’ve been stimulated by microbes), the researchers looked at how these states were different in SLE neutrophils compared to healthy controls. **They found that:** - Resting SLE neutrophils secreted fewer proinflammatory cytokines compared to controls. - SLE neutrophils produced fewer traps and cytokines when stimulated. - SLE neutrophils had different expression of miRNA and mRNA involved in neutrophil development. The researchers of the study concluded that traditional neutrophils in SLE behave differently than neutrophils from healthy individuals. The study highlights the importance of considering the functions of specific subtypes of a cell population and how these subtypes may contribute to disease. ##### Citation:  Jog, N.R., et al. (2024). Neutrophils isolated from systemic lupus erythematosus patients exhibit a distinct functional phenotype. *Front Immunol*, 15:1339250. <https://doi.org/10.3389/fimmu.2024.1339250> **Category:** Lupus, Research Studies, Risk Factors --- ### [Autoimmune Disease Researchers Receive EXACT-PLAN Awards](https://www.autoimmuneinstitute.org/research_updates/autoimmune-disease-researchers-receive-exact-plan-awards/) **Published:** November 6, 2024 **Author:** Elevation **Content:** The Office of Autoimmune Disease Research and the National Institute of Arthritis and Musculoskeletal and Skin Diseases announced the recipients of the EXACT-PLAN awards. The awards are intended to build infrastructure, partnerships, and capabilities needed for research into how environmental exposures influence the development of autoimmune diseases. #### Award recipients include: - **Jane Buckner**, president of the Benaroya Research Institute: - **Wilson Liao**, professor at the University of California San Francisco - **Marc Natter**, pediatric rheumatologist at Boston Children’s Hospital - **Jill Norris**, professor at the Colorado School of Public Health - **John Pearce**, environmental health scientist at Medical University of South Carolina - **Brigitte Frohnert**, associate professor at the University of Colorado School of Medicine ##### Learn more about the award and the recipients here: [*Meet the 2023 EXACT-PLAN Award Recipients*](https://orwh.od.nih.gov/in-the-spotlight/all-articles/meet-2023-exact-plan-award-recipients). (2024, November 5). **Category:** Events --- ### [New Biomarkers of Lupus Nephritis May Help Predict Treatment Response](https://www.autoimmuneinstitute.org/research_updates/new-biomarkers-of-lupus-nephritis-may-help-predict-treatment-response/) **Published:** July 8, 2024 **Author:** Lukshmi Solos **Content:** A recent study called [Association of autoantibody concentrations and trajectories with lupus nephritis histologic features and treatment response](https://acrjournals.onlinelibrary.wiley.com/doi/10.1002/art.42941) published in *Arthritis & Rheumatology* identified autoantibodies in people with [lupus nephritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/lupus-nephritis/ "Lupus Nephritis") (LN) that may predict treatment response and thus represent potential biomarkers of the disease. LN is a common manifestation of [systemic lupus erythematosus (SLE](https://www.ncbi.nlm.nih.gov/books/NBK499817/)[)](https://www.ncbi.nlm.nih.gov/books/NBK499817/), a chronic, inflammatory autoimmune condition. While SLE can impact several major organ systems, LN specifically affects kidney function. People with LN may present with rash, photosensitivity, oral ulcers, seizures, or hematologic disorders, among other symptoms. Kidney biopsies are performed to confirm a diagnosis of LN, and disease types are determined by histological features (tissue structure) of the kidney. For example, proliferative LN is characterized by the presence of increased cells in the kidney and an accumulation of immune complexes (formed by antibodies and antigens). Despite treatment, many people with LN will eventually progress to end-stage renal disease. Identifying biomarkers for LN could help clinicians predict treatment response at the time of diagnosis and potentially improve clinical outcomes. In this study, researchers screened blood samples from 268 people with proliferative LN from 5 clinical sites as part of an Accelerating Medicines Partnership LN longitudinal cohort study. Samples were tested for the presence of 13 autoantibodies at the time of kidney biopsy and 3, 6, and 12 months after biopsy. This study identified two autoantibodies–anti-C1q and anti-dsDNA–associated with treatment response. Higher baseline concentration of these autoantibodies predicted complete response to treatment at 12 months. Histological features of the kidney in LN, which are evaluated prior to starting treatment, can change over time, and are not always associated with treatment response. Identification of biomarkers of LN may allow clinicians to better predict and help monitor response over time in a noninvasive way. Further data are required to better understand these biomarkers, especially since this study did not look at the associations between anti-C1q and anti-dsDNA and response to specific types of LN treatments. ##### Citation: Fava, A., et al. (2024). Association of autoantibody concentrations and trajectories with lupus nephritis histologic features and treatment response. Arthritis & Rheumatology (Hoboken, N.J.), 10.1002/art.42941. Advance online publication. [https://doi.org/10.1002/art.42941 ](https://doi.org/10.1002/art.42941) **Category:** Autoimmune Diseases, Diagnostic Testing, Lupus, Research Studies, Risk Factors, Therapies --- ### [Do Gut Microbes Predict Multiple Sclerosis Severity?](https://www.autoimmuneinstitute.org/research_updates/do-gut-microbes-predict-multiple-sclerosis-severity/) **Published:** August 5, 2024 **Author:** Lukshmi Solos **Content:** In a study titled [Gut microbial factors predict disease severity in a mouse model of multiple sclerosis](https://www.nature.com/articles/s41564-024-01761-3), researchers use a preclinical mouse model of multiple sclerosis to pinpoint microbial factors in the pre-disease gut microbiome that could be linked to disease outcome. Finding microbial predictors of this disease is difficult in human cohort studies, as you cannot determine whether alterations in the microbiome are a result or cause of disease. Most of these types of studies include participants who are already diagnosed with the disease or do not have the disease. It’s rare for such studies to include individuals who develop disease during the course of the research. In contrast, a mouse model of multiple sclerosis can capture pre-disease and post-disease states in individual mice. In this study, the researchers found that *Akkermansia* bacteria, which are commonly associated with multiple sclerosis, have variable associations with disease in their model. This association depended on what other microbes were the microbiome. Even in mice with the same microbial composition, they found variability in disease between individual mice. This study demonstrates that connections between microbiome and disease outcomes need to consider the bi-directional interaction between host and the microbiome. The researchers found that the immunoglobulin A (IgA) coating of certain bacteria before disease is the best predictor of disease development as opposed to the abundance of specific bacteria in the gut microbiota. ##### Citation: Steimle, A., et al. Gut microbial factors predict disease severity in a mouse model of multiple sclerosis. Nature microbiology, 9, 2244-2261 (2024) <https://doi.org/10.1038/s41564-024-01761-3> **Category:** Autoimmune Diseases, Microbiome, Multiple Sclerosis, Research Studies, Risk Factors --- ### [Mechanisms Behind Regulatory T Cell Dysfunction](https://www.autoimmuneinstitute.org/research_updates/mechanisms-behind-regulatory-t-cell-dysfunction/) **Published:** September 20, 2024 **Author:** Lukshmi Solos **Content:** New research from Yale University unravels the mechanism behind regulatory T cell dysfunction in multiple sclerosis. Their study titled [An autoimmune transcriptional circuit drives FOXP3+ regulatory T cell dysfunction](https://www.science.org/doi/10.1126/scitranslmed.adp1720) found that people with multiple sclerosis have elevated expression of a protein called *PRDM1-S*. This protein induces the expression of a salt-sensing enzyme that affects regulatory T cell function. In combination with previous research from the team that found that [high salt levels](https://news.yale.edu/2018/10/29/how-salt-can-trigger-inflammation-multiple-sclerosis) can trigger inflammation found in multiple sclerosis, this new work shows a connection between the genetic and environmental influences behind autoimmunity. *PRDM1-S* is also upregulated in other autoimmune diseases and hints at a common mechanism of regulatory T cell dysfunction between autoimmune diseases. ##### Citation: Sumida, T. S., et al. An autoimmune transcriptional circuit drives FOXP3+ regulatory T cell dysfunction. Science translational medicine, 16(762), eadp1720. (2024) <https://doi.org/10.1126/scitranslmed.adp1720> **Category:** Autoimmune Diseases, Genetics, Multiple Sclerosis, Research Studies, Risk Factors --- ### [New Protein Mutation Behind Autoimmune Disease Identified](https://www.autoimmuneinstitute.org/research_updates/new-protein-mutation-behind-autoimmune-disease-identified/) **Published:** August 1, 2024 **Author:** Lukshmi Solos **Content:** In a recent publication titled [A TNIP1-driven systemic autoimmune disorder with elevated IgG4](https://www.nature.com/articles/s41590-024-01902-0), researchers identify a protein mutation associated with autoimmune diseases. This protein, TNIP1, has roles in protein metabolism to remove old proteins and mitochondria, which generates the energy source to power the cell. TNIP1 usually brings these damaged mitochondria to compartments in the cell where they can be taken apart and repurposed. Mutated TNIP1 have defects in this process meaning that damaged mitochondria build up in the cell, potentially triggering the immune system and leading to immunity. The researchers identified the exact same TNIP1 mutation in two unrelated patients. When they introduced the exact same mutation in mice, they developed symptoms similar to those in Sjögren’s Syndrome. Both patients had high levels of IgG4 antibody found in the blood, indicating that elevated IgG4 levels is a possible biomarker of autoimmune disease caused by TNIP1 mutations. This is the first time that cases of autoimmunity have been attributed to TNIP1 variants. ##### Citation: Medhavy A, et al. A TNIP1-driven systemic autoimmune disorder with elevated IgG4. *Nature Immunology*, 25, 1678–1691 (2024). <https://doi.org/10.1038/s41590-024-01902-0> **Category:** Autoimmune Diseases, Genetics, Research Studies, Risk Factors, Sjögren disease --- ### [Whole-Person Approach to Women's Health Research](https://www.autoimmuneinstitute.org/research_updates/whole-person-approach-to-womens-health-research/) **Published:** November 13, 2024 **Author:** Elevation **Content:** The National Institutes of Health (NIH) has led significant advancements in women’s health research, addressing issues like cervical cancer prevention through the HPV vaccine and heart disease mitigation with statins. Despite these achievements, more work is needed in areas such as autoimmune diseases, chronic pain, and postpartum depression. A [recent White House workshop](https://directorsblog.nih.gov/2024/11/12/advancing-a-whole-person-approach-to-womens-health-research/) convened NIH experts to discuss a “whole-person” approach to women’s health, emphasizing the role of biological, social, and structural factors across a woman’s lifespan. Historically, women were excluded from clinical trials until a 1993 law mandated their inclusion; today, NIH research actively explores biological sex differences to better understand conditions that disproportionately affect women, such as autoimmune diseases. In 2025, NIH will invest $200 million in interdisciplinary women’s health research, focusing on critical life stages, including menarche, pregnancy, and menopause, as well as conditions unique to or more prevalent among women. This renewed commitment, spurred by the White House Initiative on Women’s Health Research, aims to address disparities in maternal health, particularly among Black women, and to ensure comprehensive, equitable health outcomes. NIH’s strategy integrates a whole-person perspective into every stage of research, from question formulation to treatment development, to meet the unique needs of women throughout their lives. **Category:** Events, Research Studies --- ### [Influence of Epigenetics on Autoimmunity](https://www.autoimmuneinstitute.org/research_updates/influence-of-epigenetics-on-autoimmunity/) **Published:** July 5, 2024 **Author:** Lukshmi Solos **Content:** Autoimmune diseases are highly complex diseases with a known genetic component. But, genetics isn’t the only factor that influences the development of autoimmune diseases. Another important player: epigenetic modifications. Epigenetic modifications describe a layer of changes that can happen to DNA without altering the DNA sequence itself. These changes can have profound effects on immunity when they alter the expression of immune-related genes. A recent publication in *Autoimmunity Reviews* titled “[Exposome: Epigenetics and autoimmune diseases](https://doi.org/10.1016/j.autrev.2024.103584)” highlights the various types of epigenetic modifications and how they impact diseases such as [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/diseases_list/systemic-lupus-erythematosus/), Idiopathic Inflammatory Myopathies, [ANCA-associated vasculitis](https://www.autoimmuneinstitute.org/diseases_list/microscopic-polyangiitis-anca-associated-vasculitis/), and [rheumatoid arthritis](https://www.autoimmuneinstitute.org/diseases_list/rheumatoid-arthritis/). These modifications are now being studied as therapeutic targets. ##### Citation: Danieli, M., et al. (2024). Exposome: Epigenetics and autoimmune diseases. *Autoimmunity Reviews*, 103584. <https://doi.org/10.1016/j.autrev.2024.103584> **Category:** Autoimmune Diseases, Genetics, Lupus, Research Studies, Rheumatoid Arthritis, Therapies --- ### [Studies Link Systemic Inflammation to Worsening Multiple Sclerosis](https://www.autoimmuneinstitute.org/research_updates/studies-link-systemic-inflammation-to-worsening-multiple-sclerosis/) **Published:** June 1, 2024 **Author:** Lukshmi Solos **Content:** New research from the University of Southampton and University Hospital Southampton finds that inflammation outside of the brain leads to the progression of [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/). They found that common illnesses (ex: flu and urinary tract infections) are linked to loss of nerve cells in the spinal cord. In their study titled [Systemic inflammation associates with and precedes cord atrophy in progressive multiple sclerosis](https://academic.oup.com/braincomms/article/6/3/fcae143/7655554?login=false), they tracked 50 people living with multiple sclerosis for 2.5 years. Participants collected weekly urine samples and the researchers took MRIs at the beginning and end of the study. The ratio of specific compounds in the urine hold signs of systemic inflammation and MRIs can reveal changes in spinal cord and brain atrophy. In a subsequent study titled [Mild Systemic Inflammation Increases Erythrocyte Fragility](https://pubmed.ncbi.nlm.nih.gov/39000133/) the researchers found that mild systemic inflammation can contribute to the destruction of red blood cells. Red blood cells contain large amounts of the iron-containing protein hemoglobin, which is toxic when unbound by blood cells. While the body has mechanisms to neutralize hemoglobin toxicity, it’s possible for these systems to become overwhelmed. Unbound hemoglobin is pro-inflammatory and has been linked to brain atrophy in multiple sclerosis. ##### Citations: Stuart, C. M., et al. (2024). Systemic inflammation associates with and precedes cord atrophy in progressive multiple sclerosis. *Brain communications*, 6(3), fcae143. <https://doi.org/10.1093/braincomms/fcae143> Stuart, C. M., et al. (2024). Mild Systemic Inflammation Increases Erythrocyte Fragility. *International journal of molecular sciences*, 25(13), 7027. <https://doi.org/10.3390/ijms25137027> **Category:** Autoimmune Diseases, Multiple Sclerosis, Research Studies, Risk Factors --- ### [Potential Oral Therapy to Treat ALS Showing Promise](https://www.autoimmuneinstitute.org/research_updates/potential-oral-therapy-to-treat-als-showing-promise/) **Published:** July 26, 2024 **Author:** Lukshmi Solos **Content:** Io Therapeutics plans to launch a Phase 2 trial for IRX4204, its investigational oral therapy, to treat amyotrophic lateral sclerosis (ALS). IRX4204 is a “RXR agonist compound” that activates retinoid X receptors which regulate expression of genes associated with inflammation and metabolism. It promotes the growth of immunosuppressive T regulatory cells that keep the immune system in check, while preventing the growth of pro-inflammatory Th17 cells and the production of proinflammatory signaling proteins. These activities counteract the increase in proinflammatory cells and the decrease in immunosuppressive cells characteristic of ALS. While the trial is designed for ALS, IRX4204 has potential applications in treating the autoimmune disease [multiple sclerosis](https://www.autoimmuneinstitute.org/diseases_list/multiple-sclerosis/) and [autoimmune encephalomyelitis](https://www.autoimmuneinstitute.org/diseases_list/autoimmune-encephalitis/). Through phase I and II clinical trials in cancer and Parkinson’s disease patients, they showed that IRX4202 is safe and well tolerated in these populations. Vidyasagar Vuligonda, Chief Science Officer at Io Therapeutics, stated in a [press release](https://www.globenewswire.com/en/news-release/2024/07/16/2913870/0/en/Io-Therapeutics-Inc-presented-today-results-from-studies-of-IRX4204-the-company-s-phase-II-clinical-development-stage-highly-selective-RXR-nuclear-receptor-agonist-compound-support.html), “Our results identify a new approach to potentially treating ALS by inhibiting multiple pathophysiologic processes with IRX4204, including autoimmune neuroinflammation, demyelination, and neuronal death.” [Learn more about IRX4204 here](https://www.globenewswire.com/news-release/2024/07/16/2913870/0/en/Io-Therapeutics-Inc-presented-today-results-from-studies-of-IRX4204-the-company-s-phase-II-clinical-development-stage-highly-selective-RXR-nuclear-receptor-agonist-compound-support.html#). ##### Citation: Steve Bryson, P. (2024, July 23). Phase 2 trial goal for IRX4204, targeting neuroinflammation in ALS. ALS News Today.[ https://alsnewstoday.com/news/phas-2-trial-planned-irx4204-targets-neuroinflammation-als/ ](https://alsnewstoday.com/news/phas-2-trial-planned-irx4204-targets-neuroinflammation-als/) **Category:** Autoimmune Diseases, Clinical Trials, Multiple Sclerosis, Neurological Disorders, Therapies --- ### [Nightmares and Daymares - What’s Their Connection to Lupus?](https://www.autoimmuneinstitute.org/research_updates/nightmares-and-daymares-whats-their-connection-to-lupus/) **Published:** August 8, 2024 **Author:** Lukshmi Solos **Content:** Researchers report that nightmares and daymares can act as an indicator of the onset or flares of lupus in an article titled [Neuropsychiatric prodromes and symptom timings in relation to disease onset and/or flares in SLE: results from the mixed methods international INSPIRE study](https://pubmed.ncbi.nlm.nih.gov/39429812/). Through a series of interviews and surveys with people living with lupus as well as clinician surveys, the researchers investigated the correlation between neuropsychiatric symptoms during initial disease onset and flares. Some interesting insights they found include: - >50% of lupus patients reported new hallucinations, delusions, or paranoia more than one year after disease onset - 1/5 to 1/3 of the participants in the study had neuropsychiatric symptoms for the first time within one year of disease onset - During flares, symptom progression varied greatly among patients, but symptoms progressed similarly across flare-ups in the same patient Understanding how these symptoms precede flares could help doctors modulate immunosuppressive treatment dosing during anticipated flare-ups. ##### Citation: Sloan, M., et al. (2024). Neuropsychiatric prodromes and symptom timings in relation to disease onset and/or flares in SLE: Results from the Mixed Methods International Inspire Study. *eClinicalMedicine*, *73*, 102634. <https://doi.org/10.1016/j.eclinm.2024.102634> **Category:** Autoimmune Diseases, Lupus, Research Studies, Therapies --- ### [Sex Differences in Immune Responses](https://www.autoimmuneinstitute.org/research_updates/sex-differences-in-immune-responses/) **Published:** June 9, 2020 **Author:** Lukshmi Solos **Content:** A review article published in Nature Reviews Immunology titled [Sex differences in immune responses](https://www.nature.com/articles/nri.2016.90) highlights several key areas of how sex differences impact the immune response. This includes: - How age and reproductive state influence the immune response - How sex hormones contribute to differences in immune regulation between males and females - How environmental factors, such as nutrition and the microbiome, differentially affect the immune system in males and females - How sex chromosomes impact the development of immune-related diseases Such differences influence the innate and adaptive immune responses and result in the varying rates of autoimmune diseases in males and females where 80% of autoimmune diseases occur in females. Understanding the biology behind these differences can help scientists develop more personalized treatments for immune-related diseases. Learn more in our article [How Sex & Genetics Influence Autoimmunity](https://www.autoimmuneinstitute.org/articles/how-sex-genetics-influence-autoimmunity/). ##### Citation: Klein, S. L., & Flanagan, K. L. (2016). Sex differences in immune responses. Nature Reviews Immunology, 16(10), 626–638. [https://doi.org/10.1038/nri.2016.90 ](https://doi.org/10.1038/nri.2016.90) **Category:** Autoimmune Diseases, Genetics, Microbiome, Research Studies, Risk Factors --- ### [Impact of Endocrine Transitions on Autoimmunity in Women](https://www.autoimmuneinstitute.org/research_updates/impact-of-endocrine-transitions-on-autoimmunity-in-women/) **Published:** September 9, 2020 **Author:** Lukshmi Solos **Content:** Approximately 80% of autoimmune disease patients are women. One reason behind this striking statistic is the endocrinological changes during puberty, pregnancy, and menopause, according to the review article titled [Autoimmune Disease in Women: Endocrine Transition and Risk Across the Lifespan](https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2019.00265/full). These changes affect the innate and adaptive immune system as well as cytokine expression. Endocrine changes have been linked to the development of autoimmune diseases such as: - [Multiple sclerosis](https://www.autoimmuneinstitute.org/diseases_list/multiple-sclerosis/) - [Systemic lupus erythematosus](https://www.autoimmuneinstitute.org/diseases_list/systemic-lupus-erythematosus/) - [Type 1 diabetes](https://www.autoimmuneinstitute.org/diseases_list/diabetes-type-1/) - [Rheumatoid arthritis](https://www.autoimmuneinstitute.org/diseases_list/rheumatoid-arthritis/) - [Psoriasis](https://www.autoimmuneinstitute.org/diseases_list/psoriasis/). However, hormonal changes themselves don’t lead to autoimmunity, as only a small percentage of women are affected. The interplay between hormonal changes, genetic susceptibility, and specific environmental conditions impacts autoimmunity. To further understand autoimmunity in women, scientists are studying: - The changes that occur in the immune system during endocrine transitions - The genetic and epigenetic characteristics in women who develop autoimmune diseases ##### Citation: Desai, M. K., & Brinton, R. D. (2019). Autoimmune disease in women: Endocrine transition and risk across the lifespan. *Frontiers in Endocrinology*, *10*. <https://doi.org/10.3389/fendo.2019.00265> **Category:** Autoimmune Diseases, Genetics, Lupus, Multiple Sclerosis, Psoriasis, Research Studies, Rheumatoid Arthritis, Risk Factors, Type 1 Diabetes --- ### [Experts Report Environmental Contributors to Autoimmune Disease](https://www.autoimmuneinstitute.org/research_updates/experts-report-environmental-contributors-to-autoimmune-disease/) **Published:** July 13, 2020 **Author:** Lukshmi Solos **Content:** An article called [Epidemiology of environmental exposures and human autoimmune diseases: Findings from a National Institute of Environmental Health Sciences Expert Panel Workshop](https://www.sciencedirect.com/science/article/pii/S0896841112000595?via%3Dihub) summarizes research findings from 1982 to 2012 on the impact of environmental factors in autoimmunity. Their work evaluates the connections between chemical agents (ex: asbestos, pesticides, solvents, smoking, and cosmetics), physical factors, (ex: ionizing radiation, sunlight, and electromagnetic fields), and biological agents (ex: infectious disease, contaminants in food, mold, and toxins) and autoimmunity as well as the likelihood of their contributes to autoimmunity. Many studies suggest autoimmune diseases are largely affected by factors beyond genetics, and there have been many animal and *in vitro* studies, and case reports of onset of autoimmunity after various environmental exposures. The curation of these findings into one report can help prioritize areas of future study. ##### Citation: Miller, F. W., et al. (2012). Epidemiology of environmental exposures and human autoimmune diseases Findings from a National Institute of Environmental Health Sciences Expert Panel Workshop. Journal of Autoimmunity, 39(4), 259–271. [https://doi.org/10.1016/j.jaut.2012.05.002 ](https://doi.org/10.1016/j.jaut.2012.05.002) **Category:** Autoimmune Diseases, Genetics, Research Studies, Risk Factors --- ### [Addressing the Rapid Rise in Autoimmunity](https://www.autoimmuneinstitute.org/research_updates/addressing-the-rapid-rise-in-autoimmunity/) **Published:** March 1, 2023 **Author:** Lukshmi Solos **Content:** A new review article titled [The increasing prevalence of autoimmunity and autoimmune diseases: an urgent call to action for improved understanding, diagnosis, treatment, and prevention](https://www.sciencedirect.com/science/article/abs/pii/S0952791522001133?via%3Dihub) describes the increase in autoimmunity in recent years and how changes in our environmental exposures contribute to the increased prevalence of autoimmunity. Recent investigations have found that [autoantibody](https://www.autoimmuneinstitute.org/articles/autoimmune-terminology-to-know-for-your-next-doctors-appointment/) frequencies are rising, with 32% of adults over 60 possessing autoantibodies associated with rheumatoid arthritis, autoimmune thyroid disease, or gluten-sensitive enteropathies. A striking example of the increase in autoimmune disease can also be found for type 1 diabetes, where scientists have identified an annual increase of 3-4% in incidences across the last few decades. Frederick Miller, Scientist Emeritus at the National Institute of Environmental Health Sciences and author of the review article, posits that the rapidly changing environment could account for these increases. #### **Environmental exposures that contribute to the rise in autoimmune diseases could include:** (1) changes in diet, which changes the composition of our microbiome (2) chemicals found in our bodies derived from external sources (ex: pharmaceuticals, environmental pollutants, etc.) (3) lifestyle changes (4) stress (5) sleep deprivation (6) air pollution Addressing the rise in autoimmunity requires global efforts across scientific research, public health, regulatory, funding, and drug development. “The costs of inaction will be profound, and only by dedicating additional resources now can we decrease the future frequency, morbidity, mortality, and costs of these conditions,” Miller wrote in the article. ##### Citation: Miller, F. W. (2023). The increasing prevalence of autoimmunity and autoimmune diseases: An urgent call to action for improved understanding, diagnosis, treatment, and prevention. *Current Opinion in Immunology*, *80*, 102266. <https://doi.org/10.1016/j.coi.2022.102266> **Category:** Autoimmune Diseases, Diagnostic Testing, Genetics, Microbiome, Rheumatoid Arthritis, Risk Factors, Thyroid Disease, Type 1 Diabetes --- ### [Abatacept as a Potential Preventative for Rheumatoid Arthritis](https://www.autoimmuneinstitute.org/research_updates/abatacept-as-a-potential-preventative-for-rheumatoid-arthritis/) **Published:** March 8, 2024 **Author:** GAI-assistant **Content:** Abatacept, FDA-approved for treating [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid Arthritis") (RA), may soon serve as a preventative measure for those at high risk of developing RA. A recent Lancet publication titled, “[Abatacept in individuals at high risk of rheumatoid arthritis (APIPPRA): a randomised, double-blind, multicentre, parallel, placebo-controlled, phase 2b clinical trial](https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)02649-1/fulltext)[,](https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)02649-1/fulltext)” reports these trial results. The trial enrolled individuals displaying markers indicating susceptibility to RA, such as serum antibodies for citrullinated protein antigens, rheumatoid factor, and inflammatory joint pain. Participants were randomly assigned to receive either a placebo or Abatacept, with weekly injections administered over 12 months, followed by a 12-month follow-up period. Researchers tracked the time taken to develop clinical joint inflammation in three or more joints or to meet the rheumatology 2010 diagnostic criteria. Results were encouraging: the Abatacept group exhibited fewer cases of progression to rheumatoid arthritis compared to the placebo group at both 12 and 24 months. Additionally, Abatacept was associated with improved pain scores, functional well-being, and quality of life measures. However, most of these benefits weren’t sustained at the 24 month time period, which was 12 months after treatment ended. Importantly, no new or unexpected safety concerns arose, reinforcing Abatacept’s existing safety as an FDA approved drug for RA. These findings suggest that early intervention with Abatacept in individuals high-risk for RA may enhance outcomes and slow disease progression. However, further research is necessary to determine the long-term benefits and whether treatment durations exceeding 12 months are necessary for sustained benefit. ##### Citation: Cope, A. P., et al. APIPPRA study investigators (2024). **Abatacept in individuals at high risk of rheumatoid arthritis (APIPPRA): a randomised, double-blind, multicentre, parallel, placebo-controlled, phase 2b clinical trial**. *Lancet (London, England)*, *403*(10429), 838–849. <https://doi.org/10.1016/S0140-6736(23)02649-1> **Category:** Clinical Trials, Rheumatoid Arthritis, Risk Factors, Therapies --- ### [New Hope for Ulcerative Colitis Patients: FDA Greenlights Omvoh](https://www.autoimmuneinstitute.org/research_updates/new-hope-for-ulcerative-colitis-patients-fda-greenlights-omvoh/) **Published:** October 27, 2023 **Author:** GAI-assistant **Content:** Ulcerative Colitis (UC) presents a significant challenge as an inflammatory bowel disease. Fortunately, there is encouraging news with the FDA’s recent approval of a new medication from Lilly designed for adults with moderate to severe UC. The announcement of this FDA approval came through a press release on Lilly’s website titled “[FDA ](https://investor.lilly.com/news-releases/news-release-details/fda-approves-lillys-omvohtm-mirikizumab-mrkz-first-class)[Approves Lilly’s Omvoh™ (mirikizumab-mrkz), A First-in-Class Treatment for Adults with Moderately to Severely Active Ulcerative Colitis.](https://investor.lilly.com/news-releases/news-release-details/fda-approves-lillys-omvohtm-mirikizumab-mrkz-first-class)” Omvoh targets and inhibits a molecule called Interleukin-23, which is associated with disease activity in UC patients. The FDA approval was supported by data from two randomized, double-blind, placebo-controlled Phase 3 clinical trials. One trial spanned 12 weeks during initial treatment, while the second focused on a 40-week maintenance study. The results from these trials were highly promising. In the 12-week study, 65% of patients experienced improvement in clinical symptoms, and 24% achieved clinical remission. In the 40-week study, 51% reported clinical remission, compared to 27% in the placebo group. Notably, patients reported improvements as early as three weeks after starting treatment. Side effects were minimal, with the most commonly reported ones being upper respiratory infection, injection site reactions, and joint stiffness. Overall, these findings are promising, leading to the FDA’s approval of Omvoh, which is now available via prescription for UC patients. **Category:** IBD (Crohn's and UC), Therapies --- ### [Microbiome Composition Predicts Onset of Crohn's Disease](https://www.autoimmuneinstitute.org/research_updates/microbiome-composition-predicts-onset-of-crohns-disease/) **Published:** October 2, 2023 **Author:** GAI-assistant **Content:** All individuals harbor a diverse array of microbes within their gastrointestinal (GI) system, collectively known as the gut microbiome. Each person possesses a unique combination of microbes shaping this microbiome. For quite some time, researchers have hypothesized that the composition of the gut microbiome may play a crucial role in the development and/or progression of inflammatory GI diseases, such as [Crohn’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crohns-disease/ "Crohn’s disease"). A recent study, published in Gastroenterology, titled “[Gut Microbiome Composition Is Associated With Future Onset of Crohn’s Disease in Healthy First-Degree Relatives](https://www.sciencedirect.com/science/article/abs/pii/S0016508523008053)” sheds further light on this topic. In this study, researchers tracked 3,483 healthy first-degree relatives of individuals with Crohn’s disease. They characterized the composition of their gut microbiome and followed them to determine if they developed Crohn’s disease. Using the collected data, they developed a microbiome risk score. They then used this microbiome risk score to evaluate Crohn’s disease development on an independent cohort of individuals. They found that this score was able to predict the development of Crohn’s disease up to five years before the onset of the disease. While these findings require additional validation, this research opens avenues for therapies targeting these microbiome changes or aiding in earlier diagnosis and intervention. ##### Citation: Raygoza Garay, J. A., et al. (2023). **Gut Microbiome Composition Is Associated With Future Onset of Crohn’s Disease in Healthy First-Degree Relatives**. *Gastroenterology*, 165(3), 670–681. <https://doi.org/10.1053/j.gastro.2023.05.032> **Category:** IBD (Crohn's and UC), Microbiome, Research Studies, Risk Factors --- ### [Improper X Chromosome Inactivation and Hormonal Fluctuations Linked to Autoimmunity](https://www.autoimmuneinstitute.org/research_updates/improper-x-chromosome-inactivation-and-hormonal-fluctuations-linked-to-autoimmunity/) **Published:** June 4, 2020 **Author:** Lukshmi Solos **Content:** Approximately 80% of autoimmune disease patients are women. A review article titled [The Prevalence of Autoimmune Disorders in Women: A Narrative Review](https://doi.org/10.7759/cureus.8094) explores several possible reasons why women are more susceptible than men to autoimmune diseases including: - **Improper X chromosome inactivation:** During embryonic development, one of the two X chromosomes in women becomes inactivated to prevent overexpression of genes. If X inactivation doesn’t occur properly, it can lead to the overexpression of immune-associated genes. This is a hypothesis behind why eight out of every nine people with [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/diseases_list/systemic-lupus-erythematosus/) are women. - **Hormonal changes:** It’s possible that [rheumatoid arthritis](https://www.autoimmuneinstitute.org/diseases_list/rheumatoid-arthritis/), [Sjogren’s syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sjogren-syndrome/ "Sjögren’s Syndrome"), and [psoriasis](https://www.autoimmuneinstitute.org/diseases_list/psoriasis/) occur more in women because they typically experience more hormonal changes than men. Estrogen, which can decrease inflammation, is thought to protect against rheumatoid arthritis and Sjogren’s syndrome. These two diseases have been associated with decreased estrogen levels during menopause. Hormonal changes during pregnancy and puberty have also been linked to autoimmune disease onset. [Learn More About Sex, Genetics & Autoimmunity](https://www.autoimmuneinstitute.org/articles/how-sex-genetics-influence-autoimmunity) ##### Citation: Angum, F., Khan, T., Kaler, J., Siddiqui, L., & Hussain, A. (2020). The prevalence of autoimmune disorders in women: A narrative review. Cureus. [https://doi.org/10.7759/cureus.8094 ](https://doi.org/10.7759/cureus.8094) **Category:** Autoimmune Diseases, Genetics, Lupus, Psoriasis, Research Studies, Rheumatoid Arthritis, Risk Factors, Sjögren disease --- ### [Antibodies Against Immune Signaling Molecules Lead to Immune Deficiencies](https://www.autoimmuneinstitute.org/research_updates/antibodies-against-immune-signaling-molecules-lead-to-immune-deficiencies/) **Published:** April 25, 2024 **Author:** Lukshmi Solos **Content:** Patients with thymomas, or tumors found in the thymus, often produce antibodies against signaling molecules that modulate the immune system. Antibodies against one such molecule, interleukin-23 (IL-23), could contribute to adult-onset immunodeficiency that lead to opportunistic infections. This finding was reported in a recent publication titled [Anti–Interleukin-23 Autoantibodies in Adult-Onset Immunodeficiency](https://www.nejm.org/doi/full/10.1056/NEJMoa2210665). It’s common for patients with thymomas to produce autoantibodies against IL-12, a signaling molecule that shares some similarities with IL-23. This study found that half of the patients with autoantibodies against IL-12 also produce autoantibodies against IL-23. Antibodies against IL-12 were not associated with opportunistic infections. When the researchers examined thymoma patients with “disseminated, cerebral, or pulmonary infections,” 83% of them had antibodies against IL-23, further underscoring the link between IL-23 antibodies and opportunistic infections. ##### Citation: Cheng, A., et al. (2024). Anti–interleukin-23 autoantibodies in adult-onset immunodeficiency. New England Journal of Medicine, 390(12), 1105–1117. [https://doi.org/10.1056/nejmoa2210665 ](https://doi.org/10.1056/nejmoa2210665) **Category:** Autoimmune Diseases, Genetics, Research Studies, Risk Factors --- ### [Tailored Autoimmune Disease Medications Thanks to “Digital Twins”](https://www.autoimmuneinstitute.org/research_updates/tailored-autoimmune-disease-medications-thanks-to-digital-twins/) **Published:** April 18, 2024 **Author:** Lukshmi Solos **Content:** What if you could test thousands of drugs before choosing the best one for a patient? This is now possible thanks to “digital twins” that model the activity of thousands of genes in different cell types during inflammatory diseases and drug treatment.This work was published in BMC Genome Medicine in a paper called [scDrugPrio: a framework for the analysis of single-cell transcriptomics to address multiple problems in precision medicine in immune-mediated inflammatory diseases](https://genomemedicine.biomedcentral.com/articles/10.1186/s13073-024-01314-7). This computational framework was developed using a mouse model of arthritis and applied to other autoimmune diseases including [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/ "multiple sclerosis"), [Crohn’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crohns-disease/ "Crohn’s disease"), and [psoriatic arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/psoriatic-arthritis/ "Psoriatic Arthritis"). It uses: (1) an individual’s sample input (ex: cerebrospinal fluid from multiple sclerosis patients or biopsies from Crohn’s disease patients) to access gene expression patterns (2) existing drug data to produce drug prioritizations for individuals. The researchers found vast differences in gene activities between patients with the same diagnosis, suggesting the need to individualize treatment. When patients received medication suggested by their digital twins, the researchers found that the model accurately predicted the results of drug treatment. The researchers hope that using digital twins can lead to better, more personalized treatments as currently, a large number of patients do not respond to existing treatments. ##### Citation: Schäfer, S., et al. (2024). ScDrugPrio: A framework for the analysis of single-cell transcriptomics to address multiple problems in precision medicine in immune-mediated inflammatory diseases. *Genome Medicine*, *16*(1). <https://doi.org/10.1186/s13073-024-01314-7> **Category:** Autoimmune Diseases, Genetics, IBD (Crohn's and UC), Multiple Sclerosis, Psoriasis, Research Studies, Therapies --- ### [New Lupus Drug, RSLV-132 Shows Mixed Results](https://www.autoimmuneinstitute.org/research_updates/new-lupus-drug-rslv-132-shows-mixed-results/) **Published:** February 1, 2024 **Author:** Lukshmi Solos **Content:** Results from a clinical trial of a new lupus drug, RSLV-132, were recently reported in a publication, [Evaluation of RNase therapy in systemic lupus erythematosus: a randomised phase 2a clinical trial of RSLV-132](https://lupus.bmj.com/content/11/1/e001113). Sixty-four patients, who had moderate to severe forms of [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic Lupus Erythematosus"), were given RSLV-132 for six months and evaluated using the [CLASI (Cutaneous Lupus Erythematosus Disease Area and Severity Index)](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3928016/). The good news: RSLV-132 seemed to help patients with more active disease. The bad news: when considering all patients in the trial, treatment with RSLV-132 did not improve symptoms based on the CLASI scores compared to the placebo group. The researchers hope to further investigate the effect of RSLV-132 in patients with active systemic disease in a larger study. This drug developed by Resolve Therapeutics is designed to digest and destroy circulating RNA that triggers type I interferon release. Type I interferon is one of the primary drivers of systemic lupus erythematosus (SLE). ##### Citation: Burge, D. J., et al. (2024). Evaluation of RNase therapy in systemic lupus erythematosus: A randomised phase 2a clinical trial of RSLV-132. Lupus Science & Medicine, 11(1). [https://doi.org/10.1136/lupus-2023-001113 ](https://doi.org/10.1136/lupus-2023-001113) **Category:** Autoimmune Diseases, Clinical Trials, Lupus, Therapies --- ### [Sinus Infections and Autoimmune Disease. What’s the Connection?](https://www.autoimmuneinstitute.org/research_updates/sinus-infections-and-autoimmune-disease-whats-the-connection/) **Published:** February 19, 2024 **Author:** Lukshmi Solos **Content:** Scientists from the Mayo Clinic report the link between sinusitis and rheumatic diseases in a recent publication titled “[Association between sinusitis and incident rheumatic diseases: a population-based study](https://rmdopen.bmj.com/content/10/1/e003622).” **In their study, they found that the odds of developing rheumatic disease increased by 40% in individuals with previous acute or persistent sinusitis.** These researchers were spurred to look for an association between sinusitis and rheumatic diseases because previous studies have pointed to the link between a variety of autoimmune diseases and respiratory irritants and respiratory diseases. It’s possible (but untested) that the inflammation seen in sinus infections has a role in the development of rheumatic disease. ##### Citation: Kronzer, V. L., et al. (2024). Association between Sinusitis and incident rheumatic diseases: A population-based study. *RMD Open*, *10*(1). <https://doi.org/10.1136/rmdopen-2023-003622> **Category:** Autoimmune Diseases, Research Studies, Rheumatoid Arthritis, Risk Factors --- ### [FDA Approves Oral Drug for Ulcerative Colitis](https://www.autoimmuneinstitute.org/research_updates/fda-approves-oral-drug-for-ulcerative-colitis/) **Published:** October 16, 2023 **Author:** Lukshmi Solos **Content:** The FDA approved a once-daily oral drug for treating moderate to severe [ulcerative colitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ulcerative-colitis/ "Ulcerative Colitis") (UC). This drug, VELSIPITY™, is a selective sphingosine-1-phosphate (S1P) receptor modulator and was developed by Pfizer, Inc. Modulating S1P receptors sequesters a specific type of immune cells in the lymph nodes so that they are not available for inflammation in sites such as the gastrointestinal tract. The drug gained approval after “two independent randomised, multicentre, double-blind, placebo-controlled, phase 3 trials” showed more patients achieved remission after taking VELSIPITY compared to the placebo group. The results of the clinical trial was published in The Lancet article title “[Etrasimod as induction and maintenance therapy for ulcerative colitis (ELEVATE): two randomised, double-blind, placebo-controlled, phase 3 studies](https://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2823%2900061-2/fulltext).” More information on VELSIPITY can be found [here](https://www.businesswire.com/news/home/20231012073213/en/U.S.-FDA-Approves-Pfizer%E2%80%99s-VELSIPITY%E2%84%A2-for-Adults-with-Moderately-to-Severely-Active-Ulcerative-Colitis-UC). ##### Citation: *U.S. FDA approves Pfizer’s VELSIPITYTM for adults with moderately to severely active ulcerative colitis (UC)*. Business Wire. (2023, October 13). <https://www.businesswire.com/news/home/20231012073213/en/U.S.-FDA-Approves-Pfizer%E2%80%99s-VELSIPITY%E2%84%A2-for-Adults-with-Moderately-to-Severely-Active-Ulcerative-Colitis-UC> **Category:** Autoimmune Diseases, Clinical Trials, IBD (Crohn's and UC), Therapies --- ### [Infant Gut Microbiome Holds Clues on Juvenile Idiopathic Arthritis](https://www.autoimmuneinstitute.org/research_updates/infant-gut-microbiome-holds-clues-on-juvenile-idiopathic-arthritis/) **Published:** August 1, 2023 **Author:** Lukshmi Solos **Excerpt:** The NIH has compiled fact sheets outlining the current state of science on specific health topics. In the section titled "Autoimmune Diseases and Women’s Health," the focus is specifically on autoimmune disease, highlighting several important points. **Content:** In a publication titled “[Infant gut microbiota and environment associate with juvenile idiopathic arthritis many years prior to disease onset, especially in genetically vulnerable children](https://www.thelancet.com/journals/ebiom/article/PIIS2352-3964(23)00219-0/fulltext),” scientists describe how children who develop juvenile idiopathic arthritis have signs of the disease in the gut microbiomes at least 10 years before diagnosis. They found that children who develop juvenile idiopathic arthritis had higher abundances of certain bacteria, including those that are proinflammatory, and lower abundances of other bacteria compared to children that did not develop the disease. Breastfeeding duration and antibiotic exposure also had an effect, as they can shape the formation of the gut microbiome. This study, which is the first to examine the early gut microbiome in the context of juvenile idiopathic arthritis, lays the groundwork for the development of early screening or intervention for this disease. ##### Citation: Kindgren, E., Ahrens, A. P., Triplett, E. W., & Ludvigsson, J. (2023). Infant gut microbiota and environment associate with juvenile idiopathic arthritis many years prior to disease onset, especially in genetically vulnerable children. *eBioMedicine*, *93*, 104654. <https://doi.org/10.1016/j.ebiom.2023.104654> **Category:** Autoimmune Diseases, Genetics, Microbiome, Research Studies, Risk Factors --- ### [Stopping Rheumatoid Arthritis From Becoming Clinical](https://www.autoimmuneinstitute.org/research_updates/stopping-rheumatoid-arthritis-from-becoming-clinical/) **Published:** June 1, 2023 **Author:** Lukshmi Solos **Content:** A phase IIb clinical trial called “[Arthritis Prevention In the Pre-clinical Phase of Rheumatoid Arthritis with Abatacept](https://www.isrctn.com/ISRCTN46017566)” found that treatment with abatacept prevented preclinical rheumatoid arthritis (RA) from becoming clinical. This study was aimed towards individuals with a high risk of developing RA. These individuals are at the preclinical stage of disease and generate autoantibodies associated with RA in the blood. These patients experience joint pain, but have not progressed to joint swelling characteristic of RA. This study found that those treated with abatacept were less likely to develop clinical RA than the placebo group after one year of treatment. When treatment was stopped after one year, a fraction of patients in the treatment group developed clinical RA. However, for a particular group of patients which were positive for multiple RA biomarkers, only 10% of the treatment group developed clinical RA after 2 years compared to 50% of the placebo group. Preventing RA from progressing to the clinical stage of disease has been a goal of many rheumatologists and scientists studying this disease. **Citation:** Cope A, et al “Abatacept in individuals at risk of developing rheumatoid arthritis: results from the Arthritis Prevention in the Pre-clinical Phase of RA with Abatacept (APIPPRA) trial” *EULAR 2023*; Abstract OP0130. **Category:** Autoimmune Diseases, Clinical Trials, Events, Rheumatoid Arthritis, Therapies --- ### [Sex Differences in Neutrophil Biology and Autoimmunity](https://www.autoimmuneinstitute.org/research_updates/sex-differences-in-neutrophil-biology-and-autoimmunity/) **Published:** March 29, 2022 **Author:** GAI-assistant **Content:** Data shows that there is a difference in susceptibility to infectious diseases and autoimmunity based on whether an individual is biologically female or male. However, the mechanics leading to these differences are still not well understood. A recent paper published in PNAS titled “[Sex differences in neutrophil biology modulate response to type I interferons and immunometabolism](https://www.pnas.org/doi/full/10.1073/pnas.2003603117)” helps give insight into some of these differences. In this study, researchers collected blood samples from healthy males and females. They focused on neutrophils, the most abundant innate immune cells circulating in the blood. Neutrophils are also known to be associated with the pathogenesis of many autoimmune diseases. So, determining the differences in neutrophils between men and women may help us understand why women are more prone to autoimmune diseases. Researchers compared the gene expression (how the process of a gene being made into a protein is turned on or off) in neutrophils from male and female participants. They discovered that neutrophils from females exhibit increased responsiveness to interferon, a molecule produced by the immune system. Consequently, females demonstrated elevated levels of interferon-stimulated genes, which can help promote inflammation. [Dysregulation in interferon](https://www.sciencedirect.com/science/article/pii/S0022202X21026063#:~:text=The%20IFN%2D1%20system%20is,of%20various%20systemic%20autoimmune%20diseases.) has been implicated in contributing to many autoimmune diseases, so this data supports these findings. Additionally, the researchers noted that these differences in neutrophils are likely due to fluctuations in sex hormones between males and females. While more research is needed, these differences help us begin to understand why women are more prone to autoimmune diseases than men. The more we understand this mechanism, the more hope there is for developing targeted treatments. Citations: Gupta, et al. (2020). **Sex differences in neutrophil biology modulate response to type I interferons and immunometabolism**. *Proceedings of the National Academy of Sciences of the United States of America*, *117*(28), 16481–16491. <https://doi.org/10.1073/pnas.2003603117> Fernandez-Ruiz, R., & Niewold, T. B. (2022). **Type I Interferons in Autoimmunity**. *The Journal of investigative dermatology*, *142*(3 Pt B), 793–803. <https://doi.org/10.1016/j.jid.2021.11.031> **Category:** Genetics, Research Studies, Risk Factors --- ### [Rising Incidence of Autoimmune Diseases: Insights from the UK](https://www.autoimmuneinstitute.org/research_updates/rising-incidence-of-autoimmune-diseases-insights-from-the-uk/) **Published:** June 13, 2023 **Author:** GAI-assistant **Content:** Reports have indicated that the incidence of autoimmune diseases is rising. However, there is limited data on the incidence (new cases) and prevalence (total number of cases) of autoimmune diseases and how these metrics are changing over time. Additionally, it is unclear how age, socioeconomic factors, and other diseases may impact the incidence. To address this, a 2023 paper titled “[Incidence, prevalence, and co-occurrence of autoimmune disorders over time and by age, sex, and socioeconomic status: a population-based cohort study of 22 million individuals in the UK](https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00457-9/abstract)” was published in The Lancet. In this study, the authors examined health records of 22,009,375 individuals in the UK to calculate incidence rates of 19 different autoimmune diseases between 2000 and 2019. They found that 10.2% of the population was affected by an autoimmune disease, with women being more impacted than men. The incidence of autoimmune diseases increased over this period, with [Celiac disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/celiac-disease/ "Celiac disease"), [Sjogren’s syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sjogren-syndrome/ "Sjögren’s Syndrome"), and [Graves’ disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/graves-disease/ "Graves’ disease") showing the largest increases. However, some autoimmune diseases, such as pernicious anemia and Hashimoto’s thyroiditis, decreased in incidence. The study also found that having one autoimmune disease increased the likelihood of being diagnosed with another. The authors noted differences in diagnosis rates based on the time of year and socioeconomic factors, suggesting an environmental contribution to the onset of autoimmunity. This data underscores that autoimmunity is a pressing health concern and highlights the need for more research to understand the factors contributing to its increase. ##### Citation: Conrad, N., et al. (2023). **Incidence, prevalence, and co-occurrence of autoimmune disorders over time and by age, sex, and socioeconomic status: a population-based cohort study of 22 million individuals in the UK**. *Lancet (London, England)*, *401*(10391), 1878–1890. <https://doi.org/10.1016/S0140-6736(23)00457-9> **Category:** Celiac Disease, Research Studies, Sjögren disease --- ### [Injectable Antibody Shows Promise for Food Allergies](https://www.autoimmuneinstitute.org/research_updates/injectable-antibody-shows-promise-for-food-allergies/) **Published:** March 11, 2024 **Author:** Elevation **Content:** A recent study published in the New England Journal of Medicine, “[Omalizumab for the Treatment of Multiple Food Allergies](https://www.nejm.org/doi/full/10.1056/NEJMoa2312382#ap0),” suggests an FDA-approved injectable antibody called Omalizumab may offer protection from accidental exposure to certain food allergens. #### **Dealing with the hidden dangers in foods** - Nearly 5.5 million children have food allergies, many with allergies to more than one food. - Accidental exposure, even in small amounts, can trigger severe, life-threatening reactions like anaphylaxis. Until recently, oral immunotherapy, which involves daily consumption of increasing doses of trigger foods, has been the primary treatment. #### **How well did Omalizumab work?** In the study, 177 children and adolescents allergic to peanuts and at least two other foods, received either Omalizumab or a placebo for 16 to 20 weeks. At the end of the trial period, they consumed a dose of peanut protein and other study foods and were observed for symptoms. #### **Here were the findings:** - Nearly 67% of the study participants who received Omalizumab could eat 2 ½ peanuts without experiencing any allergic symptoms, compared with 7% of those who received the placebo. - Similar tolerance to other study foods was seen in the participants who received Omalizumab. #### **What questions still need to be answered?** - Does Omalizumab work for other foods? - Is it effective in more diverse populations than the mostly white participants in this study? - How well does it handle larger amounts of trigger food consumption? #### **What does this research mean for food allergy sufferers?** Omalizumab treatment brings us closer to managing accidental exposures for those with multiple food allergies. It’s a significant step towards a future free from food allergy fears. ##### Citation: Wood, R. A., et al. (2024). Omalizumab for the Treatment of Multiple Food Allergies. *The New England journal of medicine*, *390*(10), 889–899. <https://doi.org/10.1056/NEJMoa2312382> **Category:** Clinical Trials, Research Studies, Therapies --- ### [The Potential of Circular RNA Therapy for Autoimmune Disease](https://www.autoimmuneinstitute.org/research_updates/the-potential-of-circular-rna-therapy-for-autoimmune-disease/) **Published:** January 9, 2024 **Author:** Elevation **Excerpt:** Scientists have explored the role of circRNAs and found they can be engineered in the lab to deliver instructions into cells, potentially making new proteins to correct gene mutations or develop vaccines. Additional studies suggest that circRNAs could serve as biomarkers for autoimmune disease and may eventually be targeted for better therapeutics.  **Content:** There are many types of RNA in cells. Some are used as the directions to make protein, while others are regulatory RNAs that control whether a protein will be made or not. Changes in these regulatory RNAs may contribute to the development of various diseases, including autoimmune disease. One type of regulatory RNA is called circular RNA (circRNA). CircRNA was first described in the EMBO journal in a paper titled “[miRNA‐dependent gene silencing involving Ago2‐mediated cleavage of a circular antisense RNA](https://www.embopress.org/doi/full/10.1038/emboj.2011.359).” In this study, scientists discovered a circRNA molecule that regulated the mRNA levels of a related gene known as CDR1. This marked the first time a function for circRNA in humans was identified. Since then scientists have [explored](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9644292/) the role of circRNAs and found they can be engineered in the lab to deliver instructions into cells, potentially making new proteins to correct gene mutations or develop vaccines. [Additional studies](https://www.cell.com/heliyon/fulltext/S2405-8440(23)10902-9) suggest that circRNAs could serve as biomarkers for autoimmune disease and may eventually be targeted for better therapeutics. While more research is needed to fully understand the potential of circRNA-based therapies, this emerging field holds promise for treating a wide range of diseases. ##### Citations: Zhao, R. J., Zhang, W. Y., & Fan, X. X. (2023). **Circular RNAs: Potential biomarkers and therapeutic targets for autoimmune diseases**. *Heliyon*, *10*(1), e23694. <https://doi.org/10.1016/j.heliyon.2023.e23694> Liu, X., Zhang, Y., Zhou, S., Dain, L., Mei, L., & Zhu, G. (2022). **Circular RNA: An emerging frontier in RNA therapeutic targets, RNA therapeutics, and mRNA vaccines**. *Journal of controlled release : official journal of the Controlled Release Society*, *348*, 84–94. <https://doi.org/10.1016/j.jconrel.2022.05.043> Hansen, T. B., Wiklund, E. D., Bramsen, J. B., Villadsen, S. B., Statham, A. L., Clark, S. J., & Kjems, J. (2011). **miRNA-dependent gene silencing involving Ago2-mediated cleavage of a circular antisense RNA**. *The EMBO journal*, *30*(21), 4414–4422. <https://doi.org/10.1038/emboj.2011.359> **Category:** Genetics, Research Studies, Therapies --- ### [Gut Dysbiosis Associated with Lupus Flares](https://www.autoimmuneinstitute.org/research_updates/gut-dysbiosis-associated-with-lupus-flares/) **Published:** November 1, 2023 **Author:** Lukshmi Solos **Content:** A five-year study tracked microbes from fecal samples from [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic Lupus Erythematosus") (SLE) patients to find out how gut microbes affect lupus flares. Their publication, [Longitudinal gut microbiome analyses and blooms of pathogenic strains during lupus disease flares](https://ard.bmj.com/content/82/10/1315), documents their findings. The researchers found that the bacteria *Ruminococcus gnavus* increased during lupus flares. While they identified dozens of genes that may favor the bacterium’s growth in inflammatory conditions, the most common feature among the strains was the expression of a lipoglycan that can prompt an immune response. However, the researchers found that some patients had low levels of *Ruminococcus gnavus*, further underscoring the complexity behind the many factors contributing to autoimmune disease flare ups. This work was the first longitudinal study of the role of gut microbes in SLE. **Citation:** Azzouz, D. F., et al. (2023). Longitudinal gut microbiome analyses and blooms of pathogenic strains during lupus disease flares. *Annals of the Rheumatic Diseases*, *82*(10), 1315–1327. <https://doi.org/10.1136/ard-2023-223929> **Category:** Autoimmune Diseases, Genetics, Lupus, Microbiome, Research Studies, Risk Factors --- ### [Monoclonal Antibodies Target Glycoproteins on Epstein-Barr Virus](https://www.autoimmuneinstitute.org/research_updates/monoclonal-antibodies-target-glycoproteins-on-epstein-barr-virus/) **Published:** November 14, 2022 **Author:** Lukshmi Solos **Content:** A panel of six human monoclonal antibodies targeting five distinct regions of Epstein-Barr virus (EBV) was reported in a publication called “[Epstein-Barr virus gH/gL has multiple sites of vulnerability for virus neutralization and fusion inhibition](https://pubmed.ncbi.nlm.nih.gov/36306784/).” These monoclonal antibodies were developed against different sites of two glycoproteins that help the virus bind human cells. Each of the antibodies blocks infection of EBV in human B cells and epithelial cells, which line the throat. One antibody on its own was able to almost completely protect against EBV infection in mice.  EBV, which causes mononucleosis, has been associated with the autoimmune disease [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/). ##### Citation: Chen, W.-H., et al. (2022). Epstein-Barr virus GH/GL has multiple sites of vulnerability for virus neutralization and fusion inhibition. *Immunity*, *55*(11). <https://doi.org/10.1016/j.immuni.2022.10.003> **Category:** Autoimmune Diseases, Multiple Sclerosis, Research Studies, Risk Factors --- ### [Genetic Variations Behind the Link Between EBV and MS](https://www.autoimmuneinstitute.org/research_updates/genetic-variations-behind-the-link-between-ebv-and-ms/) **Published:** January 16, 2024 **Author:** Lukshmi Solos **Excerpt:** The amino acid, tryptophan, affects the function of various T cells. The therapeutic potential of the enzyme which metabolizes tryptophan has recently been studied in rat models for the treatment of T-cell mediated autoimmune diseases; initial findings were published earlier this month. **Content:** Research from Medical University of Vienna sheds light on why Epstein-Barr virus (EBV) infection leads to [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/) (MS) in some people but not others. Their study was titled “[Ineffective Immune Control of Epstein-Barr Virus-Induced Autoreactive Responses is an Important Cause of Multiple Sclerosis](https://s3.eu-central-1.amazonaws.com/m-anage.com.storage.congrex/abstracts_ectrims2023/148347.pdf).” EBV, the causative agent behind mononucleosis, contains a protein that is similar to one found in the human brain. While the researchers found that the immune response shortly after infection targets both the protein found in the virus and the brain, they also noticed that people who developed MS had reduced levels of regulatory immune cells. These cells help eliminate immune cells that target the brain protein before they can cause autoimmunity. The reason behind the reduced levels of these regulatory immune cells may be explained by genetics. People with lower levels of these cells had variations in immune-related genes. Variations in the EBV genome itself also affect the immune response with some strains correlating to reduced activity of these immune regulatory cells. The scientists calculated that patients with genetic predispositions who were infected with one of these strains were 260 times more likely to develop MS compared to those without genetic predispositions infected with other EBV strains. ##### **Citation:** Vietzen, H., et al. (2023). Ineffective control of Epstein-Barr-virus-induced autoimmunity increases the risk for multiple sclerosis. *Cell*, *186*(26), 5705–5718. <https://doi.org/10.1016/j.cell.2023.11.015> **Category:** Autoimmune Diseases, Genetics, Multiple Sclerosis, Research Studies, Risk Factors --- ### [Pilot Study Shows Success of CAR-T Therapy for Lupus](https://www.autoimmuneinstitute.org/research_updates/pilot-study-shows-success-of-car-t-therapy-for-lupus/) **Published:** September 30, 2022 **Author:** Lukshmi Solos **Content:** In a study titled [Anti-CD19 CAR T cell therapy for refractory systemic lupus erythematosus](https://www.nature.com/articles/s41591-022-02017-5), scientists report the results of a pilot study that investigates how [CAR-T (chimeric antigen receptor T-cell) therapy](https://www.autoimmuneinstitute.org/articles/car-t-cell-therapy-for-autoimmune-disease "CAR T-Cell Therapy For Autoimmune Disease") can effectively target B cells involved in [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic Lupus Erythematosus") (SLE). In their study, five patients received one dose of CAR-T cell therapy. All five patients reached remission in three months and did not need any other medication for SLE at 12 months. The therapy works like this: 1. T cells are extracted from the patient. 2. These T cells are modified to express receptor proteins that bind to CD19 on B cells involved in SLE. 3. The T cells are reintroduced into patients. 4. Once in the patient, these T cells bind CD19 on the B cells and kill them. After treatment, all five patients did not have autoantibodies against double stranded DNA, one of the defining characteristics of SLE, and did not have any other SLE-associated antibodies. There were no or mild adverse reactions to CAR-T treatment. The success of this pilot study could spur the interest in using CAR-T cell therapy to treat other autoimmune conditions, like multiple sclerosis, where B cells play a role. Citation: Mackensen, A., Müller, et al. (2022). Anti-cd19 car T cell therapy for refractory systemic lupus erythematosus. *Nature Medicine*, *28*(10), 2124–2132. <https://doi.org/10.1038/s41591-022-02017-5> **Category:** Autoimmune Diseases, Lupus, Multiple Sclerosis, Research Studies, Therapies --- ### [Lung Microbiome Regulates Microglial Cell Inflammation in the Brain](https://www.autoimmuneinstitute.org/research_updates/lung-microbiome-regulates-microglial-cell-inflammation-in-the-brain/) **Published:** April 4, 2022 **Author:** Lukshmi Solos **Excerpt:** Chemokines are proteins made by cells of the immune system that normally function to alert and guide immune cells to an infection site. The paper titled Chemokines form nanoparticles with DNA and can superinduce TLR-driven immune inflammation, published in The Journal of Experimental Medicine, uncovers a new role of chemokines potentially linked to autoimmune disease. **Content:** Research from the University Medical Center Göttingen finds evidence of a “lung-brain axis” that influences the development of autoimmune disease in rat brains. They report their findings in a publication in Nature titled [The lung microbiome regulates brain autoimmunity](https://www.nature.com/articles/s41586-022-04427-4.epdf?sharing_token=t_hC2Ia7soN-sVPMt-Yr59RgN0jAjWel9jnR3ZoTv0PkliNmDmyW3md1fOcJHBSjrqDWmbZ382nPBzDT_nUIsi9lLvgeMKvC1ITUQ44N5TCe4fWau5JsPWNrn0Po46hTpL0b7W6dtxlJKX1jlZ24YymjwSCtUc0Sb-Sviwd1GPjjAxDQKdCvZlnzNmO6jkY85LSY-EbAg4ebo2mfuhaUhdYtg00BnMgC_5pvE9SLaoU%3D&tracking_referrer=www.the-scientist.com). Their study used antibiotics to modulate the lung microbiome in different ways. Antibiotic treatment that reduced the amount of one type of bacteria resulted in microglial cells of the brain to enter an anti-inflammatory state. However, treatment with a different antibiotic led the microglial cells to enter a pro-inflammatory state. [Microglial cells](https://www.nature.com/articles/s41583-023-00709-6) normally help clean out dead and damaged cells from the brain and its inflammatory activity has roles in multiple sclerosis. While it is still unclear what exactly is being transported from the lungs to the brain, this study demonstrates the importance of the lung microbiome in influencing the health of other organs. ##### Citation Leslie, M. (2022). New class of killer T cells may prevent autoimmune diseases. *AAAS Articles DO Group*, *375*(6585), 1080–1080. <https://doi.org/10.1126/science.adb1862> **Category:** Microbiome, Research Studies --- ### [Adapting to Life with Sjogren’s Syndrome](https://www.autoimmuneinstitute.org/research_updates/adapting-to-life-with-sjogrens-syndrome-a-medical-narrative/) **Published:** October 7, 2024 **Author:** Elevation **Content:** Jennifer Walker’s medical narrative, *[Finding my new “Normal” with Sjogren’s Syndrome](https://www.jmirs.org/article/S1939-8654(24)00462-4/fulltext)*, details her journey from the onset of symptoms to a diagnosis of [Sjogren’s Syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sjogren-syndrome/ "Sjögren’s Syndrome") and the ongoing process of adapting to her new life with the disease. She initially experienced symptoms like fatigue, shortness of breath, and chest pain, which were mistakenly attributed to Long COVID. After multiple misdiagnoses, Jennifer was finally diagnosed with Sjogren’s Syndrome in 2023, following extensive testing. She emphasizes the importance of self-advocacy, acknowledging symptoms, and relying on a support system. Jennifer describes how medication, including hydroxychloroquine, has improved her condition, although she continues to face challenges with flare-ups and fatigue. She reflects on her personal and professional life, learning to manage her health while continuing to teach and raise her family. Despite the physical and emotional toll, Jennifer remains determined to find balance, maintain an active role in her treatment, and not let Sjogren’s define her life. ##### Read the full story here: Medical narrative: **[Finding my new “Normal” with Sjogren’s Syndrome](https://www.jmirs.org/article/S1939-8654(24)00462-4/fulltext "Finding my new “Normal” with Sjogren's Syndrome")**. Walker, Jennifer. *Journal of Medical Imaging and Radiation Sciences*, Volume 55, Issue 3, 101731 **Category:** Case Studies, Sjögren disease --- ### [Key Takeaways from 2024 Autoimmune Community Summit](https://www.autoimmuneinstitute.org/research_updates/key-takeaways-from-2024-autoimmune-community-summit/) **Published:** October 28, 2024 **Author:** Elevation **Content:** The 2024 Autoimmune Community Summit Day 2 focused on exploring the latest developments in autoimmune disease research, patient care, and the impact of environmental factors like diet and climate change. Sessions included: **Impact of Diet on Autoimmune Health**: Dr. Tamiko Katsumoto emphasized the benefits of sustainable, anti-inflammatory diets for managing autoimmune diseases, showing that plant-based eating can reduce inflammation and improve symptoms. **Rising Autoimmune Disease Rates**: Dr. Yasmine Ventura highlighted the growing prevalence of autoimmune conditions, attributing this rise to environmental changes like air pollution, climate change, and lifestyle shifts, rather than purely genetic factors. **Climate Change and Autoimmune Flares**: Increasing temperatures, UVB radiation, and air pollution have been linked to more frequent autoimmune disease flares and new diagnoses, making climate adaptation strategies critical for patient care. **Trauma’s Role in Autoimmune Disease**: Veronique Mead’s insights connected early-life trauma and chronic stress to the onset of autoimmune diseases, suggesting that addressing trauma can be an integral part of treatment. **AI in Autoimmune Healthcare**: Discussions highlighted the potential of AI to transform diagnosis and treatment, emphasizing the importance of developing transparent, patient-centered AI models to ensure safe and effective use in clinical settings. **Holistic Care Approach**: The summit reinforced the need for a comprehensive approach to autoimmune disease management, integrating patient advocacy, lifestyle adjustments, and technological advances to improve the quality of life for those affected. **Category:** Events --- ### [Combining a Steroid with a TNF Inhibitor for RA Treatment](https://www.autoimmuneinstitute.org/research_updates/combining-a-steroid-with-a-tnf-inhibitor-for-ra-treatment/) **Published:** June 26, 2023 **Author:** GAI-assistant **Content:** Many patients with [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid Arthritis") (RA) are familiar with treatments such as steroids, biologics, or traditional immune suppressants. However, not all patients respond to these standard therapies. Recognizing this challenge, scientists have explored a novel drug called ABBV-3373. This drug combines a steroid with an inhibitor against TNF, an immune system molecule implicated in various autoimmune diseases. The results of this exploratory trial have been published in the journal *Arthritis & Rheumatology*, titled “[Efficacy and Safety of ABBV-3373, a Novel Anti–Tumor Necrosis Factor Glucocorticoid Receptor Modulator Antibody–Drug Conjugate, in Adults with Moderate-to-Severe Rheumatoid Arthritis Despite Methotrexate Therapy: A Randomized, Double-Blind, Active-Controlled Proof-of-Concept Phase IIa Trial](https://acrjournals.onlinelibrary.wiley.com/doi/full/10.1002/art.42415).” The trial enrolled 48 adults with moderate-to-severe RA who were already receiving methotrexate. Participants were divided into groups receiving either ABBV-3373 or adalimumab, an already approved drug that works as a TNF inhibitor alone. Scientists assessed changes in the 28-joint Disease Activity Score with C-reactive protein (DAS-28-CRP), which measures patient symptoms. They found that patients receiving ABBV-3373 experienced improvements in DAS-28-CRP scores comparable to those receiving adalimumab. Additional data examining other measures of severity, such as the clinical disease activity index, showed greater improvement with ABBV-3373 compared to adalimumab. ABBV-3373 was generally well tolerated. This trial, though small, successfully demonstrated proof of concept. Further large-scale trials are necessary to confirm its safety and effectiveness before it potentially becomes available to patients. ##### Citation: Buttgereit, F., et al. (2023). Efficacy and Safety of ABBV-3373, a Novel Anti-Tumor Necrosis Factor Glucocorticoid Receptor Modulator Antibody-Drug Conjugate, in Adults with Moderate-to-Severe Rheumatoid Arthritis Despite Methotrexate Therapy: A Randomized, Double-Blind, Active-Controlled Proof-of-Concept Phase IIa Trial. *Arthritis & rheumatology (Hoboken, N.J.)*, *75*(6), 879–889. <https://doi.org/10.1002/art.42415> **Category:** Clinical Trials, Rheumatoid Arthritis, Therapies --- ### [Pirfenidone's Potential in Rheumatoid Arthritis-Associated Interstitial Lung Disease](https://www.autoimmuneinstitute.org/research_updates/pirfenidones-potential-in-rheumatoid-arthritis-associated-interstitial-lung-disease/) **Published:** January 24, 2023 **Author:** GAI-assistant **Content:** Some patients with [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid Arthritis") (RA) can develop interstitial lung disease (ILD), which is a complication where their lung forms scar tissue known as fibrosis. ILD can be challenging to treat and new avenues are needed. A recent paper published in The Lancet Journal of Respiratory Medicine titled, “[Safety, tolerability, and efficacy of pirfenidone in patients with rheumatoid arthritis-associated interstitial lung disease: a randomised, double-blind, placebo-controlled, phase 2 study](https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(22)00260-0/abstract)”, describes the findings from a phase two trial. This trial focused on pirfenidone, a drug already approved for the treatment of idiopathic pulmonary fibrosis, to determine its safety and effectiveness for RA patients with ILD. This phase 2 trial was conducted in four countries and included adults aged between 18 and 85. Patients were treated for 52 weeks with either pirfenidone or a placebo. Unfortunately, the trial ended early due to the COVID-19 pandemic, which impeded their ability to enroll as many patients as needed. Despite this, the results supported that pirfenidone was safe and appeared to slow the progression of lung fibrosis over the treatment period. Further trials are needed, but this data suggests that pirfenidone and similar anti-fibrotic drugs may be beneficial for RA patients with ILD. ##### Citation: **[Safety, tolerability, and efficacy of pirfenidone in patients with rheumatoid arthritis-associated interstitial lung disease: a randomised, double-blind, placebo-controlled, phase 2 study](https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(22)00260-0/abstract)**. Solomon, J et al. *The Lancet Respiratory Medicine*, Volume 11, Issue 1, 87 – 96 **Category:** Clinical Trials, Rheumatoid Arthritis, Risk Factors, Therapies --- ### [A New Type of Regulatory T Cells May Prevent Autoimmune Disease](https://www.autoimmuneinstitute.org/research_updates/a-new-type-of-regulatory-t-cells-may-prevent-autoimmune-disease/) **Published:** April 12, 2022 **Author:** Lukshmi Solos **Content:** Scientists from Stanford University School of Medicine identify a new type of regulatory T cells that can help suppress autoimmune disease. They report their findings in a recent publication  titled “[KIR+CD8+ T cells suppress pathogenic T cells and are active in autoimmune diseases and COVID-19](https://doi.org/10.1126/science.abi9591).” This regulatory T cell is a type of CD8+ T cell known for killing infected or cancerous cells. While scientists have found that CD8+ T cells bearing a Ly49 receptor are involved in curbing autoimmune responses in mice, they have not been able to find a human counterpart until now. The team of scientists found that human CD8+ T cells have KIR proteins which are similar to the Ly49 receptor found in mice. In patients with autoimmune diseases, they found that these T cells were more common in the blood compared to healthy people. These cells were also more abundant in tissues where autoimmune damage occurred. Further research into the role of KIR+CD8+ T cells could help scientists develop new therapeutics to suppress autoimmunity. ##### Citation: Li, J., et al. (2022). Kir+cd8+T cells suppress pathogenic T cells and are active in autoimmune diseases and covid-19. *Science*, *376*(6590). <https://doi.org/10.1126/science.abi9591> **Category:** Autoimmune Diseases, Research Studies, Therapies --- ### [Nipocalimab Demonstrates Efficacy for Myasthenia Gravis and Sjogren's Disease Treatment](https://www.autoimmuneinstitute.org/research_updates/nipocalimab-demonstrates-efficacy-for-myasthenia-gravis-and-sjogrens-disease-treatment/) **Published:** March 1, 2024 **Author:** GAI-assistant **Content:** In a [recent press release](https://www.jnj.com/media-center/press-releases/johnson-johnson-reports-positive-topline-results-for-nipocalimab-from-a-phase-3-pivotal-study-in-generalized-myasthenia-gravis-gmg-and-a-phase-2-study-in-sjogrens-disease-sjd), Johnson and Johnson reported positive results from their trials looking at an antibody known as nipocalimab for the treatment of [myasthenia gravis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/myasthenia-gravis/ "Myasthenia Gravis") (MG) and [Sjogren’s Disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sjogren-syndrome/ "Sjögren’s Syndrome") (SjD). In its phase 3 trial for MG they reported a statistically significant reduction in scores of disease compared to those in the placebo group. In its phase 2 trial for SjD they also reported a significant statistical improvement of scores of disease compared to placebo. Earlier results from Johnson and Johnson also reported benefit of nipocalimab for those with [rheumatoid arthritis](https://www.jnj.com/press-releases/phase-2-nipocalimab-data-establish-proof-of-mechanism-in-adults-living-with-moderate-to-severe-rheumatoid-arthritis-supporting-its-progression-into-a-combination-study) and [hemolytic disease of the fetus and newborn](https://www.jnj.com/media-center/press-releases/johnson-johnson-reports-positive-topline-results-for-nipocalimab-from-a-phase-3-pivotal-study-in-generalized-myasthenia-gravis-gmg-and-a-phase-2-study-in-sjogrens-disease-sjd#:~:text=hemolytic%20disease%20of%20the%20fetus%20and%20newborn%20(HDFN))[.](https://www.jnj.com/media-center/press-releases/johnson-johnson-reports-positive-topline-results-for-nipocalimab-from-a-phase-3-pivotal-study-in-generalized-myasthenia-gravis-gmg-and-a-phase-2-study-in-sjogrens-disease-sjd#:~:text=hemolytic%20disease%20of%20the%20fetus%20and%20newborn%20(HDFN)) Overall, these results suggest that nipocalimab has potential for many autoimmune diseases. The next steps are to seek FDA approval for MG and to continue onto Phase 3 trials for those with SjD. **Category:** Clinical Trials, Rheumatoid Arthritis, Sjögren disease, Therapies --- ### [Vicarious Racism Linked to Increased Lupus Activity in Black Women](https://www.autoimmuneinstitute.org/research_updates/vicarious-racism-linked-to-increased-lupus-activity-in-black-women/) **Published:** September 7, 2024 **Author:** GAI-assistant **Content:** In a recent study, “[Vicarious Racism and Disease Activity: The Black Women’s Experiences Living with Lupus (BeWELL) Study](https://pubmed.ncbi.nlm.nih.gov/31215018/),” researchers have unveiled a potential link between vicarious racism and increased lupus activity in Black women. [Systemic lupus erythematosus](https://www.autoimmuneinstitute.org/diseases_list/systemic-lupus-erythematosus/) (SLE), commonly known as lupus, is an autoimmune disease that causes widespread inflammation in the body. Black women are diagnosed with SLE 2-4 times more often than white women and experience more severe symptoms. #### **What is Vicarious Racism?**  Vicarious racism refers to exposure to racism against others. The study assessed stress from vicarious racism through: - Experiences of family or friends - Witnessing racism in public - Hearing about racism in the news - Seeing it depicted in media #### **Study Findings**  The study analyzed survey data of 431 Black women with SLE from the Black Women’s Experience Living with Lupus (BeWELL) Study to explore the effects of direct and indirect racism on disease activity. Key findings include: - **Increased Disease Activity:** Vicarious racism was linked to greater SLE activity in Black women, independent of their personal experiences with racism. - **Racial Stress Impact:** The study highlights the significant impact of racial stress on health outcomes, particularly for Black women who bear a disproportionate burden of SLE. #### **What role does understanding racial trauma play in autoimmunity?** This study underscores the need for better support and interventions tailored to Black women with SLE. Understanding the impact of racial trauma on health is essential for developing effective treatments and improving patient outcomes. The findings add to the growing body of evidence on racial trauma’s impact and emphasize the importance of addressing these issues in healthcare. ##### Citation: Martz, C. D., et al (2019). Vicarious Racism Stress and Disease Activity: the Black Women’s Experiences Living with Lupus (BeWELL) Study. *Journal of racial and ethnic health disparities*, *6*(5), 1044–1051. <https://doi.org/10.1007/s40615-019-00606-8> **Category:** Lupus, Research Studies, Risk Factors --- ### [How Close Are We Toward a Path to Cure Multiple Sclerosis? ](https://www.autoimmuneinstitute.org/research_updates/how-close-are-we-toward-a-path-to-cure-multiple-sclerosis/) **Published:** October 24, 2023 **Author:** GAI-assistant **Content:** At the [2023 Joint ECTRIMS-ACTRIMS Meeting](https://ectrims.eu/msmilan2023-ectrims-lecture-multiple-sclerosis-path-to-a-cure/) in Milan, Dr. Stephen Hauser, Professor of Neurology at the University of California, San Francisco (UCSF), gave a lecture where he summarized the latest research on [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/) (MS). In his lecture, Dr. Hauser focused on advancements in genetics research on MS. Recent findings have shown that certain genetic markers may indicate MS onset, which could inform earlier treatment and potentially slow disease progression. These findings are promising but additional data are needed to better understand how these disease markers could inform clinical practice. A greater understanding of the progressive drivers of MS, including the effects of long-term treatment on the immune system, may shed additional light on the multiple factors that determine the disease course. The ability to monitor these disease drivers, which include chronic active plaques, meningeal follicles/cortical lesions, and white matter change, as well as imaging biomarkers, could provide great benefits for clinicians. “I think that it’s possible that MS could be the first autoimmune disease to be cured, and I think we have a chance to see this in our lifetime,” says Dr. Hauser. “We’re halfway home, but we’re not all the way there.” [Learn more](https://www.youtube.com/watch?v=jCfw8QCqCKE) about Dr. Hauser’s research and perspectives on MS. **Category:** Genetics, Multiple Sclerosis, Research Studies, Therapies --- ### [CAR T Cell Therapy for Systemic Lupus Erythematosus?](https://www.autoimmuneinstitute.org/research_updates/car-t-cell-therapy-for-systemic-lupus-erythematosus/) **Published:** October 31, 2022 **Author:** GAI-assistant **Content:** A small clinical study called [Anti-CD19 CAR T cell therapy for refractory systemic lupus erythematosus](https://www.nature.com/articles/s41591-022-02017-5) published in *Nature Medicine* investigated the effects of [chimeric antigen receptor (CAR) T cell therapy](https://www.autoimmuneinstitute.org/articles/car-t-cell-therapy-for-autoimmune-disease "CAR T-Cell Therapy For Autoimmune Disease") on patients with refractory [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic Lupus Erythematosus") (SLE). [CAR T cell therapy](https://www.cancer.gov/news-events/cancer-currents-blog/2023/car-t-cell-therapies-overcoming-limitations) is a type of immunotherapy in which a patient’s own T cells (immune cells) are engineered to produce CARs that can bind certain antigens (proteins). The altered cells are infused back into the patient’s body where they can fight off certain cells with those antigens. CAR T has been approved to treat numerous types of blood cancers that affect B cells (another type of immune cell), including leukemia, by binding to the antigen CD19. As pre-clinical studies demonstrated the potential efficacy of CAR T for the treatment of SLE, researchers evaluated anti-CD19 CAR T cell therapy in 5 adults (four women and one man) who no longer responded to immunosuppressive medications (refractory SLE). The patient’s white blood cells were removed, altered to targeted CD-19, and then infused back into the patient. The CAR T cell population expanded and depleted the patients’ B cells, leading to immunosuppression. CAR T was effective in improving the signs and symptoms of SLE in all five patients 3 months following treatment, indicating disease remission; patients continued to show signs of remission for a median of 8 months after treatment. Patients experienced mild side effects that are commonly associated with CAR T therapy, and it was well tolerated overall. While these findings are very promising, it is important to note that this was a very small study. Larger clinical trials must be conducted to confirm these data, as CAR T can cause potentially serious side effects. Additional data will also shed light on the effects of CAR T on patients earlier on in their disease course. ##### Citation: Mackensen, A., et al. (2022). Anti-CD19 CAR T cell therapy for refractory systemic lupus erythematosus. *Nature medicine*, *28*(10), 2124–2132. <https://doi.org/10.1038/s41591-022-02017-5> **Category:** Clinical Trials, Lupus, Therapies --- ### [Neutrophil Extracellular Traps and Autoimmunity](https://www.autoimmuneinstitute.org/research_updates/neutrophil-extracellular-traps-and-autoimmunity/) **Published:** October 1, 2020 **Author:** GAI-assistant **Content:** A study called [*Autoantibodies to neutrophil extracellular traps represent a potential serological biomarker in rheumatoid arthritis*](https://livrepository.liverpool.ac.uk/3087911/) published in the *Journal of Autoimmunity* explored the role of neutrophil networks as potential biomarkers of [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid Arthritis") (RA) due to their role in autoimmunity.[ Biomarkers](https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2023.1111719/full) that can facilitate early diagnosis, monitor disease activity, or predict prognosis are of great utility to clinicians. Biomarkers may also shed light on shared mechanisms underlying autoimmune disease. Neutrophil extracellular traps (NETs), networks of antimicrobial proteins attached to extracellular chromatin, are believed to be involved in several autoimmune conditions due to their role in trapping pathogens. Researchers investigated if anti-NET antibodies (ANETA) could be used as a biomarker by evaluating their presence in neutrophils isolated from sera (the liquid part of the blood) of RA patients compared to sera from healthy participants, as well as those with [scleroderma](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/scleroderma/ "Scleroderma") (SSc), [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic Lupus Erythematosus") (SLE), and [Sjögren’s syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sjogren-syndrome/ "Sjögren Syndrome") (SjS). A high percentage of ANETA was identified in the sera of RA patients and was also found in the sera of SSc, SLE, and SJS patients; however, there was no difference in ANETA reactivity in RA sera compared to healthy sera. The presence of ANETA was significantly and selectively higher in patients positive for rheumatoid factor (RF), indicating that ANETA may in fact be a potential independent biomarker. This research group is currently performing clinical studies exploring the role of NETs as a[ potential drug target](https://news.liverpool.ac.uk/2022/05/17/identifying-new-drug-targets-for-inflammatory-autoimmune-diseases/) for autoimmune diseases. ##### Citation: de Bont, C. M., et al. (2020). Autoantibodies to neutrophil extracellular traps represent a potential serological biomarker in rheumatoid arthritis. *Journal of autoimmunity*, *113*, 102484. <https://doi.org/10.1016/j.jaut.2020.102484> **Category:** Diagnostic Testing, Lupus, Research Studies, Rheumatoid Arthritis, Sjögren disease --- ### [Retinal Thickness May Indicate Multiple Sclerosis Relapse](https://www.autoimmuneinstitute.org/research_updates/retinal-thickness-may-indicate-multiple-sclerosis-relapse/) **Published:** November 1, 2022 **Author:** GAI-assistant **Content:** A study called[ Retinal layer thinning after optic neuritis is associated with future relapse remission in relapsing multiple sclerosis](https://www.neurology.org/doi/10.1212/WNL.0000000000200970), published in *Neurology,* evaluated the potential clinical utility of retinal thinning associated with acute optic neuritis (ON) as a biomarker of relapse remission in [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/ "Multiple Sclerosis") (MS). Relapsing-remitting MS (RRMS), the most common type of MS, is characterized by[ disease flare-ups](https://www.dovepress.com/aadvances-in-the-treatment-of-relapsingndashremitting-multiple-sc-peer-reviewed-fulltext-article-DNND) in which symptoms worsen with intermittent periods of remission or recovery. Periods of remission are an important indicator of prognosis that can help guide treatment-making decisions. In this study, researchers utilized optical coherence tomography (OCT), a specialized eye exam, to analyze retinal thickness in patients with MS-associated acute optic neuritis (MS-ON). ON, a common early sign of MS, is an inflammatory condition that causes pain and vision loss due to neuronal (brain) damage. Optical coherence tomography (OCT) is a noninvasive technique that can be used to[ evaluate retinal damage](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5398757/) by measuring the thickness of retinal nerve tissue. Patients from the Vienna MS database were observed over a 3.4-year period following an ON episode. Analysis of OCT measurements within 12 months prior to ON onset, within 1 week after ON onset, 3-6 months after ON, and 1 non-ON relapse after the ON episode revealed that **retinal thinning was predictive of the severity of future MS relapses**. These results suggest that retinal thinning may reflect neurodegeneration in MS and that OCT could provide important prognostic information following an ON episode in MS patients. ##### Citation: Bsteh, G., et al (2022). Retinal Layer Thinning After Optic Neuritis Is Associated With Future Relapse Remission in Relapsing Multiple Sclerosis. *Neurology*, *99*(16), e1803–e1812. <https://doi.org/10.1212/WNL.0000000000200970> **Category:** Multiple Sclerosis, Research Studies, Risk Factors --- ### [OCT's Role in Improving Early MS Diagnosis](https://www.autoimmuneinstitute.org/research_updates/octs-role-in-improving-early-ms-diagnosis/) **Published:** August 24, 2023 **Author:** GAI-assistant **Content:** Early diagnosis of [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/) (MS), crucial for initiating disease-modifying therapies (DMTs) to halt disease progression, remains a significant challenge. In their article “[Diagnostic Performance of Adding the Optic Nerve Region Assessed by Optical Coherence Tomography to the Diagnostic Criteria for Multiple Sclerosis](https://www.neurology.org/doi/10.1212/WNL.0000000000207507),” Austrian researchers propose modifying current [diagnostic criteria](https://www.researchgate.net/figure/2017-McDonald-Criteria-for-the-Diagnosis-of-Multiple-Sclerosis_tbl1_327945310) to facilitate earlier MS diagnosis. MS is diagnosed based on clinical symptoms and MRI evidence of central nervous system lesions (DIS). This study suggests that measuring retinal thickness using optical coherence tomography (OCT) could aid in detecting MS sooner. The study involved 267 patients experiencing their first demyelinating event. Alongside standard diagnostic methods, OCT was used to detect reduced retinal fiber thickness within six months of the initial event. Combining retinal thickness measurement with existing criteria (DIS + OCT) was more accurate in predicting a second demyelinating event than using DIS alone. #### **Key findings:** - Of the 175 individuals who experienced a second attack, 107 had abnormal OCT findings. - DIS + OCT was more accurate in predicting a second demyelinating attack than using DIS alone. - DIS + OCT was associated with a greater risk of a second attack than DIS alone. - OCT detected abnormal retinal thickness in both symptomatic and asymptomatic optic neuritis. #### **Implications for managing MS** OCT is a quick, reliable tool that can improve the accuracy of diagnosing MS. Early detection enables prompt initiation of DMTs, which is crucial for slowing disease progression. #### **Future directions** The authors propose revising MS diagnostic criteria to include OCT but acknowledge the need to confirm results in a more diverse population. They also caution that while OCT improves predicting future demyelinating events, clinical findings consistent with MS remain essential for diagnosis. ##### Citation: Bsteh, G., et al (2023). Diagnostic Performance of Adding the Optic Nerve Region Assessed by Optical Coherence Tomography to the Diagnostic Criteria for Multiple Sclerosis. *Neurology*, *101*(8), e784–e793. <https://doi.org/10.1212/WNL.0000000000207507> **Category:** Diagnostic Testing, Multiple Sclerosis, Research Studies --- ### [Unpacking the Vitamin D-Autoimmune Thyroid Disease Link](https://www.autoimmuneinstitute.org/research_updates/unpacking-the-vitamin-d-autoimmune-thyroid-disease-link/) **Published:** February 14, 2023 **Author:** GAI-assistant **Content:** A growing body of research links vitamin D (vit D) deficiency to a host of autoimmune diseases, such as type 1 diabetes, multiple sclerosis, rheumatoid arthritis, and autoimmune thyroid diseases (AITD). The review article, [The Role of Vitamin D in Autoimmune Thyroid Disease: A Narrative Review Article](https://pubmed.ncbi.nlm.nih.gov/36835987/), explores this link. #### **What Do We Know About the Link Between Vit D and AITD?** This review analyzed research published from October 1980 to December 2022, specifically focusing on the potential link between vit D and AITD. Despite some variation in findings, the majority of studies identified a connection between low vitamin D levels and AITD. #### **Key Findings:** - **Vital link:** The review found a significant association between vit D deficiency and AITD in adults and children. Specifically, people with low vit D were more likely to have Hashimoto’s, Graves’, and postpartum thyroiditis. - **Antibody connection:** The study also showed a link between low vit D and higher levels of anti-thyroid antibodies, immune system proteins that attack thyroid tissue in AITD. - **Supplementation potential:** The review suggests vit D supplementation might help prevent or manage AITD. However, more research is needed to confirm this benefit. - **Levels matter:** The study revealed that people with severely low Vit D levels may be less likely to go into remission, have more relapses, and may have symptoms for longer. #### **Uncertainty Remains** - **Variability:** Not all studies showed an association, suggesting other factors might influence the link between vit D and AITD. - **Cause or Effect:** The review doesn’t answer whether low vit D directly causes AITD or is connected in another way. This review strengthens the evidence for a link between vit D deficiency and AITD. While more studies are needed to clarify the cause-and-effect relationship, understanding this connection could be crucial for developing better prevention and treatment strategies for people living with thyroid conditions. ##### Citation: Czarnywojtek, A., et al. (2023). The Role of Vitamin D in Autoimmune Thyroid Diseases: A Narrative Review. *Journal of clinical medicine*, *12*(4), 1452. <https://doi.org/10.3390/jcm12041452> **Category:** Multiple Sclerosis, Research Studies, Rheumatoid Arthritis, Thyroid Disease, Type 1 Diabetes --- ### [Is There New Hope for Controlling Multiple Sclerosis?](https://www.autoimmuneinstitute.org/research_updates/is-there-new-hope-for-controlling-multiple-sclerosis/) **Published:** October 17, 2022 **Author:** GAI-assistant **Content:** New targeted therapies for [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/) (MS) are on the horizon. A recent research article titled, [Antigen-specific depletion of CD4+ T cells by CAR T cells reveals distinct roles of higher- and lower-affinity TCRs during autoimmunity](https://www.science.org/doi/10.1126/sciimmunol.abo0777), investigates targeted gene therapy as a new approach for treating multiple sclerosis. Faulty immune cells, autoreactive T cells, are thought to cause MS by destroying nerve tissue. In this study, researchers modeled a possible treatment after a cancer treatment that uses genetically altered immune cells to find and kill cancer cells. #### **Key Findings** Using mice with autoimmune encephalomyelitis (EAE), a disease that mimics MS, the researchers modified a line of T cells that can destroy autoreactive T cells. Here’s what they found: - Modified T cells depleted autoreactive T cells, blocking the initiation of EAE. - Two variants of autoreactive T cells are responsible for initiating EAE and maintaining ongoing disease. - Further modifications to the T cells targeted both variants of autoreactive T cells. #### **A New Direction in MS Treatment** Targeting myelin-specific autoreactive T cells could be a significant turning point in the fight against MS. While current treatments help decrease the number of relapses, they don’t effectively stop disease progression. New targeted therapies offer hope of treating relapses and stalling ongoing disease. #### **What’s on the Research Horizon?** In the study, modified T cells didn’t deplete the autoreactive T cells that sustain ongoing EAE as effectively as those that initiate disease. Hopefully, future research will solve this puzzle. While this therapy offers hope in treating MS, preventing the disease’s onset is another essential goal of further research. Targeted gene therapies offer a path toward a cure for MS and other autoimmune diseases. ##### Citation: Yi, J., et al. (2022). Antigen-specific depletion of CD4+ T cells by CAR T cells reveals distinct roles of higher- and lower-affinity TCRs during autoimmunity. *Science immunology*, *7*(76), eabo0777. <https://doi.org/10.1126/sciimmunol.abo0777> **Category:** Multiple Sclerosis, Research Studies, Therapies --- ### [Faster and More Cost-Effective MS Diagnosis Test?](https://www.autoimmuneinstitute.org/research_updates/faster-and-more-cost-effective-ms-diagnosis-test/) **Published:** May 2, 2022 **Author:** GAI-assistant **Content:** Mayo Clinic researchers may have unlocked the door to a faster, more affordable test to help diagnose [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/) (MS). A research article titled “[CSF Kappa Free Light Chains: Cutoff Validation for Diagnosing Multiple Sclerosis](https://pubmed.ncbi.nlm.nih.gov/34893322/#:~:text=The%20retrospective%20data%20established%20a,27%29.)” shows that measuring kappa free light chains (KCSF) gives results comparable to current testing that measures oligoclonal bands (OCB). KCSF and OCB are immunoglobulin proteins found in the cerebral spinal fluid (CSF). The researchers suggest this new antibody test might be quicker and cheaper. The researchers compared KCSF testing to OCB testing in over 1300 people with and without MS. They found that a KCSF level of 0.1mg/dL offers similar accuracy in diagnosing MS as the OCB testing. #### **Why is this important?** - **Faster:** KCSF testing is quicker than OCB testing. - **More Affordable:** KCSF testing may be less expensive than the current test. - **Reduced Errors:** KCSF testing is less prone to human error as it relies on quantitative measurement alone. - **Consistent Results:** KCSF testing may provide more consistent results across different labs. KCSF testing might be a viable diagnostic alternative to OCB testing, with similar results. Such an option could allow people with MS to access treatment sooner, potentially slowing the progression of their disease. Citation: Saadeh, R. S., et al. (2022). CSF Kappa Free Light Chains: Cutoff Validation for Diagnosing Multiple Sclerosis. *Mayo Clinic proceedings*, *97*(4), 738–751. <https://doi.org/10.1016/j.mayocp.2021.09.014> **Category:** Clinical Trials, Diagnostic Testing, Multiple Sclerosis, Therapies --- ### [Low-dose IL-2 as a Potential Treatment for Primary Sjögren Syndrome](https://www.autoimmuneinstitute.org/research_updates/low-dose-il-2-as-a-potential-treatment-for-primary-sjogren-syndrome/) **Published:** November 4, 2022 **Author:** GAI-assistant **Content:** Patients diagnosed with Primary Sjögren Syndrome (pSS) experience symptoms such as dry eyes, dry mouth, and systemic manifestations due to the immune system attacking itself. pSS patients are commonly treated with steroids and other immunosuppressive medications. However, these can have harsh side effects and are not always effective. Recent research exploring an alternative was published in the *Journal Rheumatology* titled, “[Efficacy and Safety of Low-Dose Interleukin 2 for Primary Sjögren Syndrome. A Randomized Clinical Trial](https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2798245).” In this phase two trial, 60 patients were given low-dose interleukin 2 (IL-2), a molecule secreted by the immune system that has various impacts on the immune response. The trial aimed to assess the safety of low-dose IL-2 treatment for pSS patients and its potential to improve disease activity. The results confirmed safety and patients reported improved disease symptoms. Furthermore, the scientists noted improvement in markers of the immune system that are associated with a better immune balance, such as T-regulatory cells. This medication is not currently available, the next step involves conducting a larger Phase 3 trial. Nonetheless, these positive results suggest that low-dose IL-2 could become a viable treatment option for pSS patients in the future. ##### Citation: He, J., et al. (2022). Efficacy and Safety of Low-Dose Interleukin 2 for Primary Sjögren Syndrome: A Randomized Clinical Trial. *JAMA network open*, *5*(11), e2241451. <https://doi.org/10.1001/jamanetworkopen.2022.41451> **Category:** Clinical Trials, Sjögren disease --- ### [Phase 2 Trial of Litifilimab for SLE Shows Some Promise](https://www.autoimmuneinstitute.org/research_updates/phase-2-trial-of-litifilimab-for-sle-shows-some-promise/) **Published:** September 9, 2022 **Author:** GAI-assistant **Content:** [Systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic Lupus Erythematosus") (SLE), is an autoimmune disease that is characterized by higher levels of an immune system molecule known as interferon (IFN). Normally, IFN helps activate the immune system in cases of infection, but in those with autoimmunity, it may exacerbate disease progression. A recent Phase 2 trial was published in the New England Journal of Medicine titled, “[Trial of Anti-BDCA2 Antibody Litifilimab for Systemic Lupus Erythematosus](https://www.nejm.org/doi/full/10.1056/NEJMoa2118025)”, that discusses one method aimed at lowering IFN levels in SLE patients. In this study, scientists administered either a placebo or an antibody known as litifilimab to SLE patients as part of a phase 2 trial. Litifilimab targets a specific immune system cell called a plasmacytoid dendritic cell, which is responsible for making large amounts of IFN. The trial results were mixed: those who received litifilimab had less swollen and tender joint areas than the placebo. However, many of the other metrics did not see significant improvement between placebo and litifilimab group. Nevertheless, these results were sufficient for the group to proceed to a phase 3 trial, which will help clarify the extent of the benefit of litifilimab treatment. **Category:** Clinical Trials, Lupus, Therapies --- ### [mRNA Vaccines Promise Effective Autoimmune Disease Treatments](https://www.autoimmuneinstitute.org/research_updates/mrna-vaccines-promise-effective-autoimmune-disease-treatments/) **Published:** January 12, 2021 **Author:** GAI-assistant **Content:** In some autoimmune diseases T cells become autoreactive and target the patient’s own tissues. One goal of treatment aims to control these autoreactive T cells, without harming the rest of the immune response. A paper titled [A noninflammatory mRNA vaccine for treatment of experimental autoimmune encephalomyelitis](https://www.science.org/doi/10.1126/science.aay3638), published in *Science* in 2021, describes how mRNA vaccines may help do this. In this study, scientists used mouse models of multiple sclerosis to investigate if an mRNA vaccine may be able to improve disease outcomes. The mRNA vaccine was designed specifically based on the auto-antigens (pieces of self-proteins that a patient’s immune system targets) known to be involved in the disease. They found that after administering the vaccine, the mice had reduced amounts of autoreactive T cells and increased amounts of T-regulatory cells, which help control the immune system. More importantly, the mice no longer displayed any clinical symptoms, and disease progression was halted. However, these mice were able to have normal immune responses to pathogens, which means the treatment was helping their disease without making them immunocompromised. These are exciting results, and scientists are working on translating these findings from mice to human patients. ##### Citation: Krienke, C., et al. (2021). A noninflammatory mRNA vaccine for treatment of experimental autoimmune encephalomyelitis. *Science (New York, N.Y.)*, *371*(6525), 145–153. <https://doi.org/10.1126/science.aay3638> **Category:** Multiple Sclerosis, Research Studies, Therapies --- ### [Deciphering the Role of miR-30e: From Viral Defense to Autoimmunity](https://www.autoimmuneinstitute.org/research_updates/deciphering-the-role-of-mir-30e-from-viral-defense-to-autoimmunity/) **Published:** August 3, 2020 **Author:** GAI-assistant **Excerpt:** Our immune system relies on numerous factors to ensure that it is turned on or off appropriately. One factor is small RNA molecules known as microRNAs (miRNAs). Some RNAs serve as a messenger between DNA and protein production. However, miRNAs regulate the production of other proteins without being made into proteins themselves. A paper published in iScience, titled "MicroRNA-30e-5p has an Integrated Role in the Regulation of the Innate Immune Response during Virus Infection and Systemic Lupus Erythematosus," provides insights into how a specific miRNA may contribute to the development of systemic lupus erythematosus (SLE). **Content:** Our immune system relies on numerous factors to ensure that it is turned on or off appropriately. One factor is small RNA molecules known as microRNAs (miRNAs). Some RNAs serve as a messenger between DNA and protein production. However, miRNAs regulate the production of other proteins without being made into proteins themselves. A paper published in iScience, titled “[MicroRNA-30e-5p has an Integrated Role in the Regulation of the Innate Immune Response during Virus Infection and Systemic Lupus Erythematosus](https://www.cell.com/iscience/fulltext/S2589-0042(20)30509-5?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS2589004220305095%3Fshowall%3Dtrue),” provides insights into how a specific miRNA may contribute to the development of systemic lupus erythematosus (SLE). Scientists in this study examined data from humans and mouse models to identify miRNAs involved in the immune response to viral infections. Specifically, they focused on miRNA miR-30e. Their findings indicated that miR-30e plays a crucial role in fighting viral infections. miR-30e was found to work by turning off some of the brakes of the immune system, enabling the immune system to respond effectively to viral infections. However, it is crucial that these brakes work when needed. Otherwise autoimmune diseases can occur. Knowing this, the scientists used a mouse model of SLE and human patient samples to investigate whether miR-30e may play a role in autoimmunity. Their analysis uncovered elevated levels of miR-30e compared to non-autoimmune samples. This means the brakes were not functioning as well in these samples. The scientists then developed a molecule they named an antagomir to lower the mir-30e levels. They found that the antagomir worked, and the excessive immune response they saw in the autoimmune mice improved after treatment. This work provides an exciting foundation for exploring therapeutics that target miR-30e to improve the immune system’s ability to fight viral infections or to help treat autoimmune disease. ##### Citation: Mishra, R., et al. (2020). MicroRNA-30e-5p has an Integrated Role in the Regulation of the Innate Immune Response during Virus Infection and Systemic Lupus Erythematosus. *iScience*, *23*(7), 101322. <https://doi.org/10.1016/j.isci.2020.101322> **Category:** Research Studies, Therapies --- ### [Inclusive Research in Autoimmunity: Addressing Sex Disparities ](https://www.autoimmuneinstitute.org/research_updates/inclusive-research-in-autoimmunity-addressing-sex-disparities/) **Published:** September 4, 2020 **Author:** GAI-assistant **Excerpt:** We know that autoimmune diseases tend to impact those born female more often than males. One study published in The Journal of Clinical Investigations titled, The X-linked histone demethylase Kdm6a in CD4+ T lymphocytes modulates autoimmunity, identified a likely contributor: a gene on the X chromosome known as Kmd6a. **Content:** We know that autoimmune diseases tend to impact those born female more often than males. One study published in *The Journal of Clinical Investigations* titled, [The X-linked histone demethylase Kdm6a in CD4+ T lymphocytes modulates autoimmunity](https://www.jci.org/articles/view/126250), identified a likely contributor: a gene on the X chromosome known as Kmd6a. Individuals born female have two X chromosomes, while those born male have one X and one Y chromosome. In females, one X chromosome is typically turned off through X-inactivation. This process should result in similar levels of proteins from the X chromosome in males and females. However, X-inactivation can be inconsistent.  In this study, scientists found that female mice with [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/ "Multiple Sclerosis") had higher levels of the Kdm6a protein. When Kmd6a was removed, the female mice showed improvement in their symptoms and disease progression. This finding highlights one possible reason why females are more susceptible to autoimmunity than males and underscores the importance of including females in research studies. Unfortunately, for many years, research studies primarily included only male subjects. In 2016, the NIH began to address this disparity and required scientists to consider sex as an important biological variable. To assess the impact of this requirement, the paper [Meta-Research: A 10-year follow-up study of sex inclusion in the biological sciences](https://elifesciences.org/articles/56344), published in *eLife*, examined nine different biological disciplines to evaluate the implementation of this policy. Importantly, their analysis indicates that many biological disciplines have increased the inclusion of females in their data, including fields like immunology, neuroscience, and endocrinology. However, the study authors found that while more females were included, many studies didn’t analyze the sexes separately. This suggests that there is still work needed in this area to recognize the biological differences that may help explain research findings, such as why women are impacted by autoimmunity more than men. ##### Citations: Itoh, Y., et al. (2019). The X-linked histone demethylase Kdm6a in CD4+ T lymphocytes modulates autoimmunity. *The Journal of clinical investigation*, *129*(9), 3852–3863. <https://doi.org/10.1172/JCI126250> Woitowich, N. C., Beery, A., & Woodruff, T. (2020). A 10-year follow-up study of sex inclusion in the biological sciences. *eLife*, *9*, e56344. <https://doi.org/10.7554/eLife.56344> **Category:** Genetics, Multiple Sclerosis, Research Studies, Risk Factors --- ### [The Population Burden of Autoimmune Diseases in the U.S.](https://www.autoimmuneinstitute.org/research_updates/the-population-burden-of-autoimmune-diseases-in-the-u-s/) **Published:** September 1, 2020 **Author:** GAI-assistant **Excerpt:** Autoimmune diseases significantly impact individuals. However, the full extent of their impact on the population level has been unclear, as many statistics focus on only one or two autoimmune diseases rather than the full spectrum. To address this gap, a paper titled “Epidemiology and Estimated Population Burden of Selected Autoimmune Diseases in the United States” was published in Immunopathology. **Content:** Autoimmune diseases significantly impact individuals. However, the full extent of their impact on the population level has been unclear, as many statistics focus on only one or two autoimmune diseases rather than the full spectrum. To address this gap, a paper titled “[Epidemiology and Estimated Population Burden of Selected Autoimmune Diseases in the United States](https://www.sciencedirect.com/science/article/pii/S0090122997944123?via%3Dihub)” was published in Immunopathology. In this study, the authors chose 24 known autoimmune diseases and conducted a literature search on papers published between 1965 and 1997, the year of the study’s publication. They used the collected data to determine the incidence (the number of new cases) and prevalence (the number of existing cases) of these autoimmune diseases. From their analysis, the researchers estimated that about 1 in 31 Americans have an autoimmune disease, with 1,186,015 new cases occurring in the United States every five years. They also noted that due to data limitations, these figures might be underestimated, as not all diseases have available literature to estimate their incidence and prevalence. This work underscores the significant impact of autoimmune diseases and highlights the need for more research into their prevention, treatment, and potential cures. ##### Citation: Jacobson, D. L., Gange, S. J., Rose, N. R., & Graham, N. M. (1997). **Epidemiology and estimated population burden of selected autoimmune diseases in the United States**. *Clinical immunology and immunopathology*, *84*(3), 223–243. <https://doi.org/10.1006/clin.1997.4412> **Category:** Research Studies --- ### [Linking Premature Ovarian Insufficiency to Autoimmune Diseases](https://www.autoimmuneinstitute.org/research_updates/linking-premature-ovarian-insufficiency-to-autoimmune-diseases/) **Published:** September 30, 2024 **Author:** Elevation **Content:** Premature ovarian insufficiency (POI) occurs when an individual’s ovaries stop functioning before the age of 40. Autoimmune mechanisms have long been suspected to play a role in this condition for some patients. However, there is limited data directly assessing whether those with POI are more likely to develop an autoimmune disease. A new paper published in *Human Reproduction* titled “[Excess of severe autoimmune diseases in women with premature ovarian insufficiency: a population-based study](https://academic.oup.com/humrep/advance-article/doi/10.1093/humrep/deae213/7774591#google_vignette)” addresses this question. In this study, researchers looked at the rates of autoimmune disease diagnoses from childhood through 2017 in 3,972 individuals with spontaneous POI and 15,708 controls. They focused on severe autoimmune diseases,defined as those diagnosed and treated by specialized health care providers. The data demonstrated an increased prevalence of severe autoimmune disease in those with POI compared to controls. Specifically, they found that individuals with POI were more likely to have polyglandular autoimmune disease, [Addison’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-addisons-disease/ "Autoimmune Addison’s disease"), vasculitis, [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic Lupus Erythematosus"), [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid Arthritis"), [sarcoidosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sarcoidosis/ "Sarcoidosis"), inflammatory bowel disease and hyperthyroidism. Overall, this study supports an association between POI and the development of autoimmune disease. This information is valuable for individuals to know when planning for a family. It also suggests that similar immune system dysfunction that contributes to autoimmune disease may also cause some cases of POI. More research is needed to fully understand this connection. ##### Citation: S M Savukoski, H Silvén, P Pesonen, E Pukkala, M Gissler, E Suvanto, M -M Ollila, M Niinimäki, Excess of severe autoimmune diseases in women with premature ovarian insufficiency: a population-based study, *Human Reproduction*, 2024;, deae213, <https://doi.org/10.1093/humrep/deae213> **Category:** Autoimmune Diseases, IBD (Crohn's and UC), Lupus, Research Studies, Rheumatoid Arthritis --- ### [IDO1 Effectively Reduces Autoimmune Disease Symptoms in Study](https://www.autoimmuneinstitute.org/research_updates/ido1-effectively-reduces-autoimmune-disease-symptoms-in-study/) **Published:** September 18, 2024 **Author:** Elevation **Excerpt:** The amino acid, tryptophan, affects the function of various T cells. The therapeutic potential of the enzyme which metabolizes tryptophan has recently been studied in rat models for the treatment of T-cell mediated autoimmune diseases; initial findings were published earlier this month. **Content:** Tryptophan is an amino acid with important biological functions, but it must be properly regulated. It can be broken down by an enzyme called Indoleamine-2,3-dioxygenase 1 (IDO1). When tryptophan is metabolized by IDO1, it affects the function of various T cells. If IDO1 is not functioning properly, there is an increased risk of T cell-mediated autoimmune diseases in humans. Until now, research on the therapeutic potential of IDO1 in treating autoimmune diseases has been limited. However, a recent paper published in *Cell Reports Medicine*, titled “[mRNA-delivery of IDO1 suppresses T cell-mediated autoimmunity](https://www.cell.com/cell-reports-medicine/fulltext/S2666-3791%2824%2900438-5),” addresses this issue. In the study, scientists used lipid nanoparticles to deliver human mRNA for IDO1 into cells of three rodent models of T cell-mediated autoimmune diseases: experimental autoimmune encephalomyelitis, rat collagen-induced arthritis, and acute graft-versus-host disease. The delivery of IDO1 mRNA led to the production of the IDO1 protein and a reduction in tryptophan levels. As a result, all three rodent models showed improved disease symptoms. More research is needed to determine whether this approach would be safe and effective in treating T cell-mediated autoimmune diseases in humans. ##### **Citation:** Kenney, L. L., Chiu, R. S.-Y., Dutra, M. N., Wactor, A., Honan, C., Shelerud, L., Corrigan, J. J., Yu, K., Ferrari, J. D., Jeffrey, K. L., Huang, E., & Stein, P. L. (2024). MRNA-delivery of IDO1 suppresses T cell-mediated autoimmunity. *Cell Reports Medicine*. <https://doi.org/10.1016/j.xcrm.2024.101717> **Category:** Autoimmune Diseases, Research Studies --- ### [The Link Between Mucosal Tissue and Rheumatoid Arthritis](https://www.autoimmuneinstitute.org/research_updates/the-link-between-mucosal-tissue-and-rheumatoid-arthritis/) **Published:** September 10, 2024 **Author:** Lukshmi Solos **Excerpt:** A recent article published in Nature Reviews Immunology linked alterations of the microbes along mucosal tissues in the lungs, gut, and oral tissues, and pre-RA. **Content:** [Rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid Arthritis") (RA) is an autoimmune disease in which the immune system attacks the lining of the joints. Research has shown that patients often develop autoantibodies that are detectable in their blood prior to the onset of symptoms. These patients are referred to as being at risk for RA or in a pre-RA state. However, the events that lead to or contribute to the transition to full-blown RA remain unknown. In a recent *Nature Reviews Immunology* paper titled “[Distinct mucosal endotypes as initiators and drivers of rheumatoid arthritis](https://www.nature.com/articles/s41584-024-01154-0),” the authors review factors that may contribute to RA onset. The review focuses on mucosal tissues, which are thin layers covering internal surfaces such as the nasal passages, and the linings of the mouth and gut. These tissues are home to many different microbes that form a part of our microbiome and contain immune cells. Research has identified alterations in the microbes and immune system within these mucosal tissues in those with pre-RA, particularly in the lungs, gut, and oral and gum tissues. Certain microbial strains may contribute to the development of inflammation and progression to symptomatic RA by altering the immune system or damaging the mucosal lining. These findings highlight the significant link between microbial exposure and the development of RA. Eventually, we may be able to modify the microbes and immune cells residing in these tissues to treat or prevent RA. ##### Citation: Holers, V.M., Demoruelle, K.M., Buckner, J.H. *et al.* Distinct mucosal endotypes as initiators and drivers of rheumatoid arthritis. *Nat Rev Rheumatol* (2024). <https://doi.org/10.1038/s41584-024-01154-0> **Category:** Autoimmune Diseases, Microbiome, Research Studies, Rheumatoid Arthritis, Risk Factors --- ### [The Potential of Circular RNA](https://www.autoimmuneinstitute.org/research_updates/the-potential-of-circular-rna/) **Published:** November 22, 2022 **Author:** Lukshmi Solos **Excerpt:** There are many types of RNA in cells. Some are used as the directions to make protein, while others are regulatory RNAs that control whether a protein will be made or not. Changes in these regulatory RNAs may contribute to the development of various diseases, including autoimmune disease. **Content:** There are many types of RNA in cells. Some are used as the directions to make protein, while others are regulatory RNAs that control whether a protein will be made or not. Changes in these regulatory RNAs may contribute to the development of various diseases, including autoimmune disease. One type of regulatory RNA is called circular RNA (circRNA). CircRNA was first described in the EMBO journal in a paper titled “[miRNA‐dependent gene silencing involving Ago2‐mediated cleavage of a circular antisense RNA](https://www.embopress.org/doi/full/10.1038/emboj.2011.359).” In this study, scientists discovered a circRNA molecule that regulated the mRNA levels of a related gene known as CDR1. This marked the first time a function for circRNA in humans was identified. Since then scientists have [explored](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9644292/) the role of circRNAs and found they can be engineered in the lab to deliver instructions into cells, potentially making new proteins to correct gene mutations or develop vaccines. [Additional studies](https://www.cell.com/heliyon/fulltext/S2405-8440(23)10902-9) suggest that circRNAs could serve as biomarkers for autoimmune disease and may eventually be targeted for better therapeutics. While more research is needed to fully understand the potential of circRNA-based therapies, this emerging field holds promise for treating a wide range of diseases. **Citation for report:** Liu, X., Zhang, Y., Zhou, S., Dain, L., Mei, L., & Zhu, G. (2022). Circular RNA: An emerging frontier in RNA therapeutic targets, RNA therapeutics, and mRNA vaccines. *Journal of controlled release : official journal of the Controlled Release Society*, *348*, 84–94. <https://doi.org/10.1016/j.jconrel.2022.05.043> **Category:** Autoimmune Diseases, Diagnostic Testing, Genetics, Research Studies, Therapies --- ### [Reproductive Factors Linked to Increased SLE Risk in Black Women](https://www.autoimmuneinstitute.org/research_updates/reproductive-factors-linked-to-increased-sle-risk-in-black-women/) **Published:** February 15, 2021 **Author:** Lukshmi Solos **Excerpt:** Black women are more prone to developing SLE, an autoimmune disorder that leads to widespread inflammation. A multi-center research study identified key reproductive factors that may influence prevalence and severity amongst this specific group, including age of first menstrual cycle and breastfeeding. **Content:** A recent study titled “[A prospective study of reproductive factors in relation to the risk of systemic lupus erythematosus among black women](https://pubmed.ncbi.nlm.nih.gov/33231506/#:~:text=Conclusion%3A%20Our%20results%20suggest%20that,potential%20associations%20should%20be%20pursued.)” sheds light on unique factors affecting Black women with [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/diseases_list/systemic-lupus-erythematosus/) (SLE). SLE, an autoimmune disorder that leads to widespread inflammation, typically appears during the reproductive years (ages 15 to 40). Conducted by a multi-site research group, this study identifies key reproductive factors that may influence the higher prevalence and severity of SLE in Black women, who are more affected by SLE than any other racial or ethnic group. **Key Findings** The study identified 125 cases of SLE from surveys of over 58,000 participants of the Black Women’s Health Study. The surveys covered various reproductive factors, including: - Age at first period - Breastfeeding status and duration - Age at first birth - Menopausal status - Hysterectomy history - History of endometriosis **Factors linked to an increased SLE risk** - **Late Menarche:** Women who had their first period after age 15 had a higher risk of developing SLE compared to those who started at age 12. - **Extended Breastfeeding:** Breastfeeding for longer than six months was associated with an increased risk of SLE compared to not breastfeeding at all. **What’s the next step?** This study offers important insights into how SLE uniquely affects Black women. However, the authors note that these findings are preliminary and differ from previous studies involving other racial and ethnic groups. The relatively small number of SLE cases limits the conclusions, underscoring the need for larger, more comprehensive studies. Further research is essential to understand the biological mechanisms underlying these associations and to improve the diagnosis and management of SLE in Black women. **Citation for report:** Cozier, Y. C., Barbhaiya, M., Castro-Webb, N., Costenbader, K. H., & Rosenberg, L. (2021). A prospective study of reproductive factors in relation to risk of systemic lupus erythematosus among black women. *Lupus*, *30*(2), 204–210. https://doi.org/10.1177/0961203320973074 **Category:** Lupus, Research Studies, Risk Factors --- ### [A Breakthrough in Understanding Autoimmune Disease Genetics](https://www.autoimmuneinstitute.org/research_updates/a-breakthrough-in-understanding-autoimmune-disease-genetics/) **Published:** June 10, 2024 **Author:** Elevation **Excerpt:** Discover how the ETS2 gene on chromosome 21 drives inflammation in autoimmune diseases like IBD and ankylosing spondylitis, offering new targets for treatment. **Content:** June 10, 2024 There is a specific region on chromosome 21 known as chr21q22 that has been associated with the development of five autoimmune diseases: inflammatory bowel disease, ankylosing spondylitis, primary sclerosing cholangitis, and Takayasu’s arteritis. Until recently, the exact gene in this area responsible for this increased susceptibility and its mechanism were unknown.A Nature paper titled “[A disease-associated gene desert directs macrophage inflammation through ETS2](https://www.nature.com/articles/s41586-024-07501-1)” identified the gene and potential mechanism for this association. In this study scientists identified that the gene on chromosome 21 responsible is ETS2. They then determined that it regulates a type of immune cell that promotes inflammation known as the inflammatory macrophage. When they increased the amount of ETS2 made in macrophages they were able to reproduce the type of inflammation seen in autoimmune diseases. This provides evidence that this association is contributing to disease development in patients. This is a major discovery because it helps us better understand why some people are genetically predisposed to developing certain autoimmune diseases. It also gives us a clear target for drug development that may help us better treat patients with these diseases. Citation: Stankey, C.T., Bourges, C., Haag, L.M. *et al.* A disease-associated gene desert directs macrophage inflammation through ETS2. *Nature* **630**, 447–456 (2024). <https://doi.org/10.1038/s41586-024-07501-1> **Category:** Genetics, IBD (Crohn's and UC), Research Studies --- ### [Understanding How Molecular Mimicry May Spur Autoimmunity](https://www.autoimmuneinstitute.org/research_updates/understanding-how-molecular-mimicry-may-spur-autoimmunity/) **Published:** January 2, 2023 **Author:** Elevation **Excerpt:** Researchers identify protein fragments linked to ankylosing spondylitis and uveitis through molecular mimicry, revealing potential autoimmune triggers. **Content:** Scientists report a new method to identify protein fragments that may drive autoimmunity in a recent publication titled “[Autoimmunity-associated T cell receptors recognize HLA-B\*27-bound peptides](https://doi.org/10.1038/s41586-022-05501-7).” In their paper, they identified protein fragments that bound HLA-B\*27, an HLA variant associated with [ankylosing spondylitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ankylosing-spondylitis/) and [uveitis](https://www.autoimmuneinstitute.org/articles/about-autoimmune/autoimmunity-and-the-eyes-a-spotlight-on-uveitis/). HLA genes are highly variable among different people, with many autoimmune diseases linked to specific HLA variants. HLA proteins help immune cells distinguish between self and microbial proteins by picking up protein fragments and displaying them to a type of immune cell called T cells. These T cells then determine whether the fragment is self before mounting an immune response. Whether the immune system responds depends on three things: the HLA protein, the protein fragment, and the specific T cell. The researchers behind this paper began with two pieces of the puzzle: T cells associated with ankylosing spondylitis and uveitis and the HLA variant commonly found with those diseases. Then, by screening the T cells and HLA-B\*27 with collections of protein fragments, they identified the ones that could activate the immune cells. This work provides evidence of the molecular mimicry between human and microbial proteins that may be behind these two autoimmune diseases. In molecular mimicry, an immune response against a foreign protein fragment may trigger a cross-reaction with self-peptides. This method has potential to identify other protein fragments involved in other autoimmune diseases. ##### Citation for Report: Yang, X., Garner, L.I., Zvyagin, I.V. *et al.* **Autoimmunity-associated T cell receptors recognize HLA-B\*27-bound peptides**. *Nature* **612**, 771–777 (2022). <https://doi.org/10.1038/s41586-022-05501-7> **Category:** Eye Disease, Genetics, Research Studies --- ### [Biomarker of Autoimmunity Increasing in the United States](https://www.autoimmuneinstitute.org/research_updates/biomarker-of-autoimmunity-increasing-in-the-united-states/) **Published:** January 3, 2023 **Author:** Elevation **Excerpt:** ANA, a key autoimmunity biomarker, has increased in prevalence in the U.S. over the past 25 years, suggesting environmental or lifestyle factors may be involved. **Content:** Researchers report the increase in the prevalence of antinuclear antibodies (ANA) in the United States population over the last 25 years in a publication titled [Increasing Prevalence of Antinuclear Antibodies in the United States](https://doi.org/10.1002/art.42330). ANA is the most common biomarker for autoimmunity. While there has been increasing evidence of the increase in autoimmunity over the last decades, this was the first study to quantify how ANA levels changed over time. Because a population’s genetics change slowly over time, scientists believe that changes in the environment or lifestyle could account for the increase in ANA. However, the increased ANA prevalence was not explained by trends in weight, smoking exposure, or alcohol consumption. They hope that this finding will spur more research on how environment and lifestyle affect the development of autoimmune disease. ##### Citation for Report: Dinse, G. E., Parks, C. G., Weinberg, C. R., Co, C. A., Wilkerson, J., Zeldin, D. C., Chan, E. K. L., & Miller, F. W. (2022). **Increasing Prevalence of Antinuclear Antibodies in the United States**. *Arthritis & rheumatology (Hoboken, N.J.)*, *74*(12), 2032–2041. <https://doi.org/10.1002/art.42330> **Category:** Genetics, Research Studies, Risk Factors --- ### [B Cells and T Cells as the Key Drivers of Autoimmune Hepatitis](https://www.autoimmuneinstitute.org/research_updates/b-cells-and-t-cells-as-the-key-drivers-of-autoimmune-hepatitis/) **Published:** August 13, 2024 **Author:** Elevation **Excerpt:** Liver damage caused by autoimmune hepatitis begins with a liver autoantigen that initiates an immune response. A recent review article titled B and T cells: (Still) the dominant orchestrators in autoimmune hepatitis describes the complex cascade of events initiated by the autoantigen. Currently, autoimmune hepatitis is treated with immunosuppressive drugs but advances in regulatory T cell based immunotherapies can lead to more targeted approaches.  **Content:** Liver damage caused by [autoimmune hepatitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-hepatitis/) begins with a liver autoantigen that initiates an immune response. A recent review article titled [B and T cells: (Still) the dominant orchestrators in autoimmune hepatitis](https://www.sciencedirect.com/science/article/pii/S156899722400082X?dgcid=raven_sd_aip_email#s0060) describes the complex cascade of events initiated by the autoantigen. Central to autoimmune hepatitis are B cells and T cells of the immune system: - **B cells:** B cells have roles in displaying autoantigens to self-reactive T cells, in secreting pro-inflammatory cytokines, and in producing autoantibodies. - **T cells:** Regulatory T cells, which typically suppress autoimmune responses, become dysregulated in autoimmune hepatitis. Killer T cells, which normally attack viruses or cancer cells, begin to target liver cells. Currently, autoimmune hepatitis is treated with immunosuppressive drugs but advances in regulatory T cell based immunotherapies can lead to more targeted approaches. ##### Citation: Longhi, M.S., Zhang, L., Mieli-Vergani, G., et al. **B and T cells: (Still) the dominant orchestrators in autoimmune hepatitis**. *Autoimmunity Reviews*  103591 (2024). <https://doi.org/10.1016/j.autrev.2024.103591> **Category:** Autoimmune Diseases, Research Studies --- ### [Automating Multiple Sclerosis Diagnosis with AI](https://www.autoimmuneinstitute.org/research_updates/automating-multiple-sclerosis-diagnosis-with-ai/) **Published:** July 31, 2024 **Author:** Elevation **Excerpt:** While multiple sclerosis (MS) has been traditionally diagnosed by clinical symptoms, lab tests, and MRI, new work augmenting imaging with artificial intelligence can help clinicians reach a diagnosis faster. A publication released earlier this year in Translational Vision Science & Technology titled “SLO-Net: Enhancing Multiple Sclerosis Diagnosis Beyond Optical Coherence Tomography Using Infrared Reflectance Scanning Laser Ophthalmoscopy Images” describes the use of AI to analyze data from two imaging techniques to more accurately diagnose MS.  **Content:** While [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/) (MS) has been traditionally diagnosed by clinical symptoms, lab tests, and MRI, new work augmenting imaging with artificial intelligence can help clinicians reach a diagnosis faster. A publication released earlier this year in *Translational Vision Science & Technology* titled “[SLO-Net: Enhancing Multiple Sclerosis Diagnosis Beyond Optical Coherence Tomography Using Infrared Reflectance Scanning Laser Ophthalmoscopy Images](https://tvst.arvojournals.org/article.aspx?articleid=2800432)” describes the use of AI to analyze data from two imaging techniques to more accurately diagnose MS. The two techniques are: - **Optical coherence tomography (OCT):** OCT can reveal early thinning in specific the retinal layers that is common in MS patients compared to healthy individuals. - **Infrared reflectance scanning laser ophthalmoscopy (IR-SLO)**: IR-SLO constructs 2D images of the retina and can help visualize structures that would have otherwise been missed. When used with OCT, it helps create accurate alignments of OCT scans despite eye movements. This improves signal-to-noise ratio and reduces variability in follow-up exams. While there are currently AI-based diagnoses of MS, they rely only on OCT measurements. In their study, the authors obtained OCT and IR-SLO images from healthy individuals and individuals with MS as a training set to build their model. Then, they tested their model using images from healthy controls and individuals with MS. They found that adding IR-SLO measurements to OCT measurements increases the accuracy and sensitivity of AI-based diagnosis of MS. ##### Citation: Arian, R., et al. (2024). SLO-Net: Enhancing Multiple Sclerosis Diagnosis Beyond Optical Coherence Tomography Using Infrared Reflectance Scanning Laser Ophthalmoscopy Images. *Translational Vision Science & Technology*, 13, 13. <https://doi.org/10.1167/tvst.13.7.13> **Category:** Diagnostic Testing, Multiple Sclerosis, Research Studies --- ### [The Role of Hormones and Sex Chromosomes in Autoimmune Disease](https://www.autoimmuneinstitute.org/research_updates/the-role-of-hormones-and-sex-chromosomes-in-autoimmune-disease/) **Published:** February 26, 2024 **Author:** Elevation **Excerpt:** Understand how hormones and sex chromosomes contribute to autoimmune diseases, with insights from a review in Nature Review Immunology. Females are more likely to develop autoimmune diseases due to hormonal differences and X chromosome inactivation issues. This combination may lead to higher production of immune cell genes in females, increasing their risk. Ongoing research aims to develop targeted treatments. **Content:** Chromosomally female individuals (referred to as female here) are more likely to develop autoimmune diseases than those chromosomally male (referred to as male here). We also see differences in response to infections. The underlying reason for these differences is an ongoing area of active research. A recent review article published in Nature Review Immunology titled “[The conneXion between sex and immune responses](https://doi.org/10.1038/s41577-024-00996-9)”  discusses our current understanding. One known factor is the differences in hormones between these two groups. Hormones like testosterone, progesterone and estrogen can impact the function of immune cells and lead to proinflammatory or antiinflammatory impacts depending on their concentration and combination. Another factor is the chromosomal makeup themselves: females have two X chromosomes, while males have one X and one Y chromosome.  The X chromosome contains many immune cell genes. Typically, one copy of X is turned off through a process known as X-inactivation. This should help keep the levels of immune cell genes similar between males and females. However, this process does not always occur correctly, and the second X chromosome can sometimes escape inactivation. This can increase the amount of certain immune cells genes produced in the cells of females, and can contribute to the development of autoimmune diseases and immune function. Current research suggests it is likely a combination of hormones and X-linked differences that predisposes females to autoimmune disease. More research in this realm will help develop treatments targeting these factors. ##### Citation: Forsyth, K.S., Jiwrajka, N., Lovell, C.D. *et al.* **The conneXion between sex and immune responses**. *Nat Rev Immunol* **24**, 487–502 (2024). <https://doi.org/10.1038/s41577-024-00996-9> **Category:** Autoimmune Diseases, Genetics, Research Studies, Risk Factors --- ### [Skin and Internal Organ Involvement in Patients with Sjögren Syndrome](https://www.autoimmuneinstitute.org/research_updates/skin-and-internal-organ-involvement-in-patients-with-sjogren-syndrome/) **Published:** July 29, 2024 **Author:** Elevation **Excerpt:** Get insights into the complications of Sjögren Syndrome from a study of 185 patients over 16 years. This research highlights skin and internal organ involvement, showing that 74.9% of patients had skin issues and 65.9% had internal organ problems. **Content:** [Sjögren Syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sjogren-syndrome/ "Sjögren Syndrome") is an autoimmune condition where the immune system attacks moisture-producing glands. There are two types of Sjögren Syndrome: primary (pSS) and secondary (sSS). In pSS, patients are diagnosed based on criteria of symptoms that involve eye and oral dryness. In sSS, patients are diagnosed secondary to another autoimmune disease. Both types can lead to skin and internal organ involvement. However, it is unclear how often this occurs. In a recent study titled “[Sjögren syndrome from a dermatological perspective: A retrospective study of 185 SSA-Ro positive patients](https://onlinelibrary.wiley.com/doi/10.1002/jvc2.498)” scientists sought to find out. This study characterizes skin and internal organ involvement in 185 cases by analyzing medical records over a 16 year period. In this cohort 90% of cases were in women and all patients reported eye and/or oral dryness. Patients with sSS reported joint pain and fatigue more often than those with pSS. Skin manifestations were present in about 74.9% of the patients, whereas internal organ involvement was found in 65.9% of cases. Both pSS and sSS patients were impacted by these complications. This work provides important insights into the complications patients may face after a diagnosis of Sjögren Syndrome and highlights the need for more research to assist medical providers in identifying and treating these complications. ##### CItation: André F, Bujak M, Frischhut N, Kronbichler A, Sepp N, Ratzinger G, et al. **Sjögren syndrome from a dermatological perspective: a retrospective study of 185 SSA-Ro positive patients**. *JEADV Clin Pract*. 2024; 1–9. <https://doi.org/10.1002/jvc2.498> **Category:** Case Studies, Research Studies, Sjögren disease --- ### [Stem Cell Transplantation as a Treatment for Multiple Sclerosis](https://www.autoimmuneinstitute.org/research_updates/stem-cell-transplantation-as-a-treatment-for-multiple-sclerosis/) **Published:** June 3, 2024 **Author:** Elevation **Excerpt:** Discover the potential of stem cell transplantation as a promising treatment for multiple sclerosis. This comprehensive meta-analysis reviews nine randomized control trials, highlighting short-term benefits such as improved disability scores and reduced brain lesions. While initial results are encouraging, further research is needed to understand long-term effects and optimize patient outcomes. **Content:** [Multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/ "Multiple Sclerosis") is a neurological autoimmune disease in which a patient’s immune system targets the protective coating around the nerves, known as the myelin sheath. This is a progressive disease, with patients reporting increasing symptoms over time. Developing effective treatments to halt or reverse some of the damage is a major research goal. In a recent paper titled “[Efficacy and safety of stem cell transplantation for multiple sclerosis: a systematic review and meta-analysis of randomized controlled trials](https://www.nature.com/articles/s41598-024-62726-4),” scientists conducted a review of the literature on the benefits of stem cell transplants for this purpose. This study combined the data from nine randomized control trials that were looking at the benefits of stem cell therapy (SCT) for treating multiple sclerosis. Their analysis found that there are short term benefits to SCT. Patients who received the treatment noted improved disability scores and reduced brain lesions after two months. However, the data for six and twelve months did not show significant differences from the control groups. Patients who received the SCT reported only minor side effects such as injection site reactions. In general, this data suggests that there may be at least a short-term benefit of SCT for patients with multiple sclerosis. However, more data is needed to determine if these benefits are maintained and if other interventions are needed to provide patients with the best possible improvement. ##### Citation: Nawar, A.A., Farid, A.M., Wally, R. *et al.* **Efficacy and safety of stem cell transplantation for multiple sclerosis: a systematic review and meta-analysis of randomized controlled trials**. *Sci Rep* **14**, 12545 (2024). <https://doi.org/10.1038/s41598-024-62726-4> **Category:** Multiple Sclerosis, Research Studies, Therapies --- ### [UNC93B1's Role in TLR-Mediated Autoimmune Disease](https://www.autoimmuneinstitute.org/research_updates/unc93b1s-role-in-tlr-mediated-autoimmune-disease/) **Published:** July 22, 2024 **Author:** Elevation **Excerpt:** Toll-like receptors (TLRs) detect foreign invaders in the immune system. Proper control is crucial, as increased signaling can lead to autoimmune disease. **Content:** Toll-like receptors (TLRs) are critical components of the immune system responsible for detecting foreign invaders. Maintaining careful control over them is essential since increased TLR signaling can potentially lead to systemic autoimmune diseases and other inflammatory conditions. A recent 2024 publication in the Journal of Experimental Medicine titled “[Large-scale mutational analysis identifies UNC93B1 variants that drive TLR-mediated autoimmunity in mice and humans](https://rupress.org/jem/article/221/8/e20232005/276771/Large-scale-mutational-analysis-identifies-UNC93B1)” delves into genetic factors contributing to TLR-driven autoimmunity. In this study, researchers aimed to identify the mechanisms that regulate TLR function, with a particular focus on UNC93B1, a protein that interacts with TLRs. Through mutating UNC93B1, they were able to pinpoint crucial regions that change TLR activity. They then identified a family affected by cutaneous tumid lupus and juvenile idiopathic arthritis and found that they carried mutations in the same regions of UNC93B1. These mutations were found to enhance TLR responses, promoting autoimmunity and inflammation. Overall, these findings support the crucial role of UNC93B1 in controlling TLR function and demonstrate how genetic mutations in this protein can contribute to the development of autoimmune diseases. Citation: Rael, V. E., Yano, et al. (2024). **Large-scale mutational analysis identifies UNC93B1 variants that drive TLR-mediated autoimmunity in mice and humans**. *The Journal of experimental medicine*, *221*(8), e20232005. <https://doi.org/10.1084/jem.20232005> **Category:** Autoimmune Diseases, Genetics, Research Studies --- ### [How Interferon Alters T Cell Dynamics in Lupus](https://www.autoimmuneinstitute.org/research_updates/how-interferon-alters-t-cell-dynamics-in-lupus/) **Published:** July 11, 2024 **Author:** Elevation **Excerpt:** A new Nature research study provides new insights into how interferon may lead to altered types of T cells in those with systemic lupus erythematosus. **Content:** July 10, 2024 [Systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic Lupus Erythematosus") (SLE) is an autoimmune disease that impacts multiple body systems and is very difficult to treat. Patients with SLE have abnormal immune responses involving both B cells and T cells, producing higher levels of a molecule called interferon that alters the immune response. However, much remains unknown about these alterations. A recent paper published in *Nature*, titled “[Interferon subverts an AHR–JUN axis to promote CXCL13+ T cells in lupus](https://www.nature.com/articles/s41586-024-07627-2#Sec8),” provides new insights into how interferon may lead to altered types of T cells in patients. In this study, scientists collected samples from patients with SLE, [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid Arthritis") (RA), and healthy controls with no inflammatory disease. They compared the types of immune cells found among these three groups. They identified an imbalance of certain types of T cells in patients with SLE that produce a marker called CXCL13. These T cells, known as T-follicular helper (TFH) cells and T-peripheral helper (TPH) cells, support B cells in their production of antibodies. However, in patients with SLE, some of these antibodies are autoantibodies that target the body’s own tissues. The scientists then sought to determine the factors that normally regulate the amount of TFH and TPH cells. They found that two proteins, AHR and JUN, typically work together with interferon to regulate the balance of these cells. AHR and JUN reduce the amount of TFH and TPH cells produced, while interferon promotes their production. Patients with SLE produce larger amounts of interferon and, therefore, have increased levels of TFH and TPH cells, which can drive disease progression. This work is exciting because it adds more evidence that targeting interferon may help alleviate some of the damage and symptoms occurring in SLE. Citation: Law, C., Wacleche, V.S., Cao, Y. *et al.* Interferon subverts an AHR–JUN axis to promote CXCL13+ T cells in lupus. *Nature* (2024). <https://doi.org/10.1038/s41586-024-07627-2> **Category:** Lupus, Research Studies, Rheumatoid Arthritis --- ### [New Theory Explaining Higher Prevalancy of Autoimmunity in Females](https://www.autoimmuneinstitute.org/research_updates/new-theory-explaining-higher-prevalancy-of-autoimmunity-in-females/) **Published:** February 2, 2024 **Author:** Elevation **Excerpt:** An article published this week explores a new explanation for the longstanding question of why women are more prone to developing autoimmune disease. Previous theories focus on sex hormones and gene regulation, but this new theory adds complexity by suggesting that a molecular coating found on one of women’s X chromosomes, related to a process called X-chromosome inactivation (which dampens the function of one X chromosome in the majority of XX cells), may trigger immune responses. **Content:** February 2, 2024 An [article](https://www.cell.com/cell/fulltext/S0092-8674(24)00002-3?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0092867424000023%3Fshowall%3Dtrue) published this week explores a new explanation for the longstanding question of why women are more prone to developing autoimmune disease. [Previous theories](https://www.autoimmuneinstitute.org/articles/how-sex-genetics-influence-autoimmunity) focus on sex hormones and gene regulation, but this new theory adds complexity by suggesting that a molecular coating found on one of women’s X chromosomes, related to a process called X-chromosome inactivation (which dampens the function of one X chromosome in the majority of XX cells), may trigger immune responses. The coating consists of long strands of RNA (known as XIST) that wrap around the chromosome and recruit various proteins to form complexes that silence the genes within. However, some genes manage to evade this inactivation and can provoke immune reactions, potentially contributing to autoimmune diseases like [lupus](https://www.autoimmuneinstitute.org/autoimmune-resources/systemic-lupus-erythematosus/) and [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/rheumatoid-arthritis/). It has long been discovered that many proteins interacting with XIST can be targets of autoantibodies, supporting the [hypothesis](https://insight.jci.org/articles/view/169344) that the XIST molecule itself has the potential to trigger inflammatory immune reactions. This study demonstrated that male mice, which don’t naturally express XIST, exhibited increased levels of autoantibodies and tissue damage resembling autoimmune diseases when bioengineered to express a form of XIST that did not silence gene expression but did form the characteristic RNA–protein complexes. This study highlights the importance of understanding XIST-related mechanisms to manage autoimmune diseases and potentially improve diagnostic techniques. **Category:** Genetics, Research Studies --- ### [Immune Checkpoint Discovery Provides Insight for Treating Autoimmune Disease](https://www.autoimmuneinstitute.org/research_updates/immune-checkpoint-discovery-provides-insight-for-treating-autoimmune-disease/) **Published:** March 28, 2024 **Author:** Elevation **Excerpt:** The immune system has a “brake system” through checkpoints (like PD-1) that prevent attacks on healthy cells by regulating immune responses. While the study of these interactions has been extensively examined, a research team has made an unexpected discovery about how a key immune checkpoint works. They discuss this and how the understanding potentially has important implications for immune activity-altering therapies in their recent publication, Transmembrane domain–driven PD-1 dimers mediate T cell inhibition. **Content:** March 28, 2024 The immune system has a “brake system” through checkpoints (like PD-1) that prevent attacks on healthy cells by regulating immune responses. While the study of these interactions has been extensively examined, a research team has made an unexpected discovery about how a key immune checkpoint works. They discuss this and how the understanding potentially has important implications for immune activity-altering therapies in their recent publication, *[Transmembrane domain–driven PD-1 dimers mediate T cell inhibition](https://www.science.org/doi/10.1126/sciimmunol.ade6256).* PD-1 interacts with PD-L1 and PD-L2 proteins, inhibiting T-cell activity when engaged (T-cells recognize, attack, and destroy invaders). Cancer cells exploit this brake to hide from the immune system by overexpressing PD-L1. Some drugs help release this brake to fight cancer, while others keep it activated to treat autoimmune diseases. Recent research shows that PD-1 doesn’t always work alone but can pair up with another PD-1 protein, making it more effective at stopping the immune system. Understanding this could lead to better treatments for cancer and autoimmune diseases like [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/) and [lupus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/). **Citation for report:** Philips, E. A., Liu, J., Kvalvaag, A., Mørch, A. M., Tocheva, A. S., Ng, C., Liang, H., Ahearn, I. M., Pan, R., Luo, C. C., Leithner, A., Qin, Z., Zhou, Y., Garcia-España, A., Mor, A., Littman, D. R., Dustin, M. L., Wang, J., & Kong, X. P. (2024). **Transmembrane domain-driven PD-1 dimers mediate T cell inhibition**. *Science immunology*, *9*(93), eade6256. <https://doi.org/10.1126/sciimmunol.ade6256> **Category:** Lupus, Research Studies, Rheumatoid Arthritis, Therapies --- ### [Link Between Celiac Disease and Kidney Damage Uncovered in New Study](https://www.autoimmuneinstitute.org/research_updates/link-between-celiac-disease-and-kidney-damage-uncovered-in-new-study/) **Published:** May 12, 2021 **Author:** Elevation **Excerpt:** In this study, researchers examined kidney biopsies from patients with IgA Nephropathy, including those with and without celiac disease. **Content:** May 12, 2021 [Celiac disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/celiac-disease/) is an immune disorder where the body’s immune system reacts to gluten, found in wheat, cereal, rye, barley, and oats, as a threat. This reaction produces autoantibodies, specifically IgA-class tissue transglutaminase (tTG) autoantibodies, which are deposited in the small intestine and other organs. Celiac disease has been suggested to be associated with [IgA Nephropathy](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/iga-nephropathy/), a kidney condition caused by IgA antibody deposits leading to kidney inflammation and damage. Previous studies hinted that tTG might be involved in the development of IgA deposits in IgA Nephropathy and that a gluten-free diet could improve symptoms for IgA Nephropathy patients. However, the connection between celiac disease and IgA Nephropathy remains unclear. **In this [study](https://pubmed.ncbi.nlm.nih.gov/34064541/), researchers examined kidney biopsies from patients with IgA Nephropathy, including those with and without celiac disease.** Among the nine patients studied, three with both conditions had IgA-tTG deposits in their kidneys, while the fourth patient, who followed a gluten-free diet, did not. In patients with only IgA Nephropathy, three out of five had these deposits. The findings suggest that IgA-tTG deposits are present in the kidneys of patients with both conditions who consume gluten. However, due to the small sample size, further research with a larger population is needed to draw definitive conclusions. **Citation for report:** Nurmi, R., Korponay-Szabó, I., Laurila, K., Huhtala, H., Niemelä, O., Mustonen, J., Mäkelä, S., Kaukinen, K., & Lindfors, K. (2021). **Celiac Disease-Type Tissue Transglutaminase Autoantibody Deposits in Kidney Biopsies of Patients with IgA Nephropathy**. *Nutrients*, *13*(5), 1594. <https://doi.org/10.3390/nu13051594> **Category:** Autoimmune Diseases, Celiac Disease, Research Studies --- ### [Preventing Lupus: Early B Cell Targeting Delays Autoimmunity](https://www.autoimmuneinstitute.org/research_updates/preventing-lupus-early-b-cell-targeting-delays-autoimmunity/) **Published:** September 1, 2021 **Author:** Elevation **Excerpt:** A new study in iScience shows that targeting B cells in the pre-disease phase of a mouse model of SLE can reset the immune system and delay the onset of autoimmunity. **Content:** September 1, 2021 One of the most important tasks for the developing immune system is learning not to attack the body’s own cells. The loss of this humoral tolerance can be detected in the blood of individuals with [systemic lupus erythematosus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/) (SLE) years before they develop symptoms. A [new study](https://www.cell.com/iscience/fulltext/S2589-0042(21)01044-0?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS2589004221010440%3Fshowall%3Dtrue) in *iScience* shows that targeting B cells in the pre-disease phase of a mouse model of SLE can reset the immune system and delay the onset of autoimmunity. > Nearly 9 out of 10 people with SLE have at least one disease-related autoantibody three years before diagnosis. This represents a window of opportunity to delay disease onset. In a mouse model of SLE, scientists showed that short-term depletion of B cells during the pre-clinical phase of the disease eliminated many later symptoms, including immune system activation, lymph node swelling, and organ damage. Researchers suggest that pre-clinical B cell depletion may help limit autoimmune disease damage by restoring immune balance. **Citation for report:** Werner, A., Schäfer, S., Zaytseva, O., Albert, H., Lux, A., Krištić, J., Pezer, M., Lauc, G., Winkler, T., & Nimmerjahn, F. (2021). **Targeting B cells in the pre-phase of systemic autoimmunity globally interferes with autoimmune pathology**. *iScience*, *24*(9), 103076. <https://doi.org/10.1016/j.isci.2021.103076> **Category:** Autoimmune Diseases, Lupus, Research Studies --- ### [New Research Reveals Microbiome's Role in Brain Disorders](https://www.autoimmuneinstitute.org/research_updates/new-research-reveals-microbiomes-role-in-brain-disorders/) **Published:** February 5, 2021 **Author:** Elevation **Excerpt:** According to new research, the origins of some brain disorders may not be in the head but rather in the gut. Scientists studying the vast populations of microbes living in and on our bodies (known as the microbiome) have found they play a major role in brain function and behavior. **Content:** February 5, 2021 According to [new research](https://www.nature.com/articles/d41586-021-00260-3), the origins of some brain disorders may not be in the head but rather in the gut. Scientists studying the vast populations of microbes living in and on our bodies (known as the microbiome) have found they play a major role in brain function and behavior. Although researchers have yet to map out the exact path from cause to effect in linking the microbiome and behavior, the findings are driving the development of new therapies. The brain-microbiome connection revolves around the vagus nerve, which links the brain stem to organs like the colon. In the 1970s, surgery to cut this neural pathway, initially done to treat stomach ulcers, also reduced the risk of developing Parkinson’s disease. Other studies have shown that small molecules produced by gut bacteria can enter the bloodstream and influence the brain. This discovery has prompted many biopharma startups to start creating treatments that target the gut-brain link. **Citation for report:** Willyard C. (2021). **How gut microbes could drive brain disorders**. *Nature*, *590*(7844), 22–25. <https://doi.org/10.1038/d41586-021-00260-3> **Category:** Autoimmune Brain Inflammation, Autoimmune Diseases, Microbiome, Neurological Disorders, Research Studies, Risk Factors --- ### [Patient-Reported Outcomes Reveal Hidden Challenges in Antiphospholipid Syndrome](https://www.autoimmuneinstitute.org/research_updates/patient-reported-outcomes-reveal-hidden-challenges-in-antiphospholipid-syndrome/) **Published:** January 5, 2023 **Author:** Elevation **Excerpt:** People with antiphospholipid syndrome (APS), an autoimmune disease causing abnormal blood clots, often experience challenges beyond what lab reports reveal. **Content:** January 5, 2023 People with [antiphospholipid syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/antiphospholipid-syndrome/) (APS), an autoimmune disease causing abnormal blood clots, often experience challenges beyond what lab reports reveal. A research article called [*Predictors and Interrelationship of Patient-Reported Outcomes in Antiphospholipid Syndrome: A Cross-Sectional Study*](https://acrjournals.onlinelibrary.wiley.com/doi/10.1002/acr2.11512), presented in part at the American College of Rheumatology Convergence 2020, explores a new way to understand their experience: patient-reported outcomes (PROs). ### What is living with APS like? Previously, doctors relied on lab tests and their observations to learn about APS. This study adds another crucial piece: how patients themselves feel. 139 people with APS shared their experiences through surveys, revealing important insights: - Nearly half (47%) reported mild limitations in daily activities, pain intensity, and thinking abilities. - People experiencing difficulties in one area were likelier to face issues in another. - Age, smoking, pain medication use, and some antidepressants were linked to reported limitations in physical daily activities and thinking abilities. ### How can patient experiences influence care? This research offers a unique perspective – the patient’s own story. By understanding their experiences, healthcare providers can: - Better address individual needs and tailor care to each patient’s specific challenges. - Gain deeper insights by tracking disease progression and tailoring treatment plans accordingly. - Choose more effective therapies that consider the impact of treatment on patients’ daily lives. ### How else can research improve understanding of APS? Future research will explore how combining patient reports with objective data can create a more complete picture. Such research can involve comparing patients’ reports of cognitive difficulties with formal cognitive testing, for example. ### What’s next? This study is a step towards a more comprehensive understanding of APS. By including the patient’s perspective alongside traditional medical data, healthcare professionals can provide better, more personalized care for individuals with this condition. **Citation for report:** Weiner, J. K., Smith, T., Hoy, C. K., Sarosh, C., Madison, J. A., Ambati, A., Tambralli, A., Peters, N., Packel, C., Gockman, K., Zuo, Y., Briceño, E. M., Nagaraja, V., & Knight, J. S. (2023). Predictors and Interrelationship of Patient-Reported Outcomes in Antiphospholipid Syndrome: A Cross-Sectional Study. *ACR open rheumatology*, *5*(1), 28–37. <https://doi.org/10.1002/acr2.11512> **Category:** Autoimmune Diseases, Events, Research Studies --- ### [The Puzzling Link Between EBV and MS](https://www.autoimmuneinstitute.org/research_updates/the-puzzling-link-between-ebv-and-ms/) **Published:** May 19, 2023 **Author:** Elevation **Excerpt:** Our immune system uses specialized proteins called antibodies to target and eliminate harmful invaders. This study found that in some individuals with MS, these antibodies might be mistaking a protein in EBV (EBNA1) for a similar protein found in the nervous system (CRYAB). **Content:** May 19, 2023 A recent journal article in *Science Advances*, titled [*Cross-reactive EBNA1 immunity targets alpha-crystallin B and is associated with multiple sclerosis*](https://www.science.org/doi/10.1126/sciadv.adg3032), has uncovered another link between [Multiple Sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/) (MS) and the Epstein Barr Virus (EBV). The study reveals how cross-reactivity might play a key role in the body’s antibodies targeting certain cells in people with MS. Our immune system uses specialized proteins called antibodies to target and eliminate harmful invaders. This study found that in some individuals with MS, these antibodies might be mistaking a protein in EBV (EBNA1) for a similar protein found in the nervous system (CRYAB). This confusion leads to an attack on healthy tissues, through cross-reactivity, potentially contributing to people developing MS. MS is a chronic autoimmune disease where the body’s immune system attacks the protective covering around nerve cells, leading to a range of symptoms like muscle weakness and cognitive difficulties. Previous research has shown that it is likely that people who have MS have been infected by EBV ([1](https://pubmed.ncbi.nlm.nih.gov/35931816/)) ([2](https://pubmed.ncbi.nlm.nih.gov/28855411/)) ([3](https://pubmed.ncbi.nlm.nih.gov/35025605/)). EBV, one of the most common viruses in the world, can cause infectious mononucleosis (Mono) in some people. However, only a small number of people infected with EBV will go on to have MS. ### **Key Findings:** - People with MS had more antibodies targeting CRYAB than people without MS. - People who had high antibodies targeting EBNA1 were more likely to have MS. - People who had both antibodies targeting CRYAB and high antibodies targeting EBNA1 were even more likely to have MS. - CRYAB and EBNA1 have an identical protein sequence, a potential target for cross-reactivity. ### **A Piece to the Puzzle, but Not the Whole Picture** This research strengthens the connection between EBV and MS, but some questions remain. While some people with these findings had MS, not all of them did. Some people who didn’t have MS also had these findings. Understanding EBV’s role in MS offers potential targets for vaccines and treatments for MS. Future research can add more pieces to the puzzle to help solve the mystery of MS. **Citation for report:** Thomas, O. G., Bronge, M., Tengvall, K., Akpinar, B., Nilsson, O. B., Holmgren, E., Hessa, T., Gafvelin, G., Khademi, M., Alfredsson, L., Martin, R., Guerreiro-Cacais, A. O., Grönlund, H., Olsson, T., & Kockum, I. (2023). Cross-reactive EBNA1 immunity targets alpha-crystallin B and is associated with multiple sclerosis. *Science advances*, *9*(20), eadg3032. <https://doi.org/10.1126/sciadv.adg3032> **Category:** Autoimmune Diseases, Multiple Sclerosis, Research Studies, Risk Factors --- ### [First Steps Towards Precision Therapy for Multiple Sclerosis](https://www.autoimmuneinstitute.org/research_updates/first-steps-towards-precision-therapy-for-multiple-sclerosis/) **Published:** January 8, 2021 **Author:** Elevation **Excerpt:** The ability to control autoreactive T cells without inducing systemic immune suppression is the major goal for treatment of autoimmune diseases. The key challenge is the safe and efficient delivery of pharmaceutically well-defined antigens in a noninflammatory context. **Content:** January 8, 2021 Most treatments for autoimmune disease work by reducing the activity of the entire immune system, which can leave individuals vulnerable to infection. Researchers have been working to develop mRNA vaccines to control the T cells responsible for autoimmune conditions while leaving the rest of the immune system intact. [A study in *Science*](https://www.science.org/doi/10.1126/science.aay3638) showed that the delivery of an mRNA vaccine that coded for multiple sclerosis-related antigens was associated with the selective reduction of certain pro-inflammatory T cells in mice. Although mRNA vaccines might be most famous for their deployment against COVID-19, ones aimed at autoimmune conditions have a very different set of requirements. Instead of producing antigens to create antibodies against pathogens, autoimmunity mRNA vaccines must synthesize antigens that reduce inflammation. In a mouse model of [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/), known as experimental autoimmune encephalomyelitis, scientists designed a nanoparticle-formulated m1Ψ mRNA vaccine that helped expand regulatory T cells that tamped down MS-specific autoimmunity. These benefits were also linked to a reduction in pro-inflammatory effector T cells. **Citation for report:** Krienke, C., Kolb, L., Diken, E., Streuber, M., Kirchhoff, S., Bukur, T., Akilli-Öztürk, Ö., Kranz, L. M., Berger, H., Petschenka, J., Diken, M., Kreiter, S., Yogev, N., Waisman, A., Karikó, K., Türeci, Ö., & Sahin, U. (2021). A noninflammatory mRNA vaccine for treatment of experimental autoimmune encephalomyelitis. *Science (New York, N.Y.)*, *371*(6525), 145–153. <https://doi.org/10.1126/science.aay3638> **Category:** Autoimmune Diseases, Multiple Sclerosis, Research Studies, Therapies --- ### [New Research Illuminates Connection Between Fibromyalgia Antibodies And Pain](https://www.autoimmuneinstitute.org/research_updates/new-research-illuminates-connection-between-fibromyalgia-antibodies-and-pain/) **Published:** July 1, 2021 **Author:** Elevation **Excerpt:** People with fibromyalgia can experience pain, stiffness, headaches, and cognitive issues, as well as fatigue and emotional distress. Although the causes of fibromyalgia aren’t well established, new research published in the Journal of Clinical Investigation shows that IgG antibodies make certain types of neurons more sensitive to painful physical and thermal stimuli. **Content:** July 1, 2021 People with fibromyalgia can experience pain, stiffness, headaches, and cognitive issues, as well as fatigue and emotional distress. Although the causes of fibromyalgia aren’t well established, [new research published](https://www.jci.org/articles/view/144201) in the *Journal of Clinical Investigation* shows that IgG antibodies make certain types of neurons more sensitive to painful physical and thermal stimuli. These results are part of growing evidence linking the nervous and immune systems, especially in autoimmunity and chronic pain, the authors say. A team of scientists from the UK, Canada, and Sweden purified IgG from the blood of 8 individuals with fibromyalgia and 6 healthy controls, which they administered to female mice on 4 consecutive days. Subsequent tests revealed the mice that received IgG from those with fibromyalgia had increased sensitivity to cold temperatures and physical pressure compared to IgG from healthy controls. Electrophysiological studies also revealed a dose-dependent relationship between neuron sensitization and fibromyalgia IgG. Determining the antigens to which these autoantibodies respond and blocking this activity may provide new avenues for therapies. **Citation for report:** Goebel, A., Krock, E., Gentry, C., Israel, M. R., Jurczak, A., Urbina, C. M., Sandor, K., Vastani, N., Maurer, M., Cuhadar, U., Sensi, S., Nomura, Y., Menezes, J., Baharpoor, A., Brieskorn, L., Sandström, A., Tour, J., Kadetoff, D., Haglund, L., Kosek, E., … Andersson, D. A. (2021). Passive transfer of fibromyalgia symptoms from patients to mice. *The Journal of clinical investigation*, *131*(13), e144201. <https://doi.org/10.1172/JCI144201> **Category:** Autoimmune Diseases, Research Studies --- ### [New Study Reveals Piezo1's Key Role in Multiple Sclerosis and Autoimmunity](https://www.autoimmuneinstitute.org/research_updates/new-study-reveals-piezo1s-key-role-in-multiple-sclerosis-and-autoimmunity/) **Published:** July 7, 2021 **Author:** Elevation **Excerpt:** As T cells circulate through the body, they must squeeze through tight spaces between cells, probe the outsides of antigen-presenting cells, and search for antigens in tissues of a variety of shapes and textures. Previous work showed that a protein that detects these mechanosensory cues, Piezo1, helps trigger the inflammatory response in everything from bacterial infections to cancer. **Content:** July 7, 2021 As T cells circulate through the body, they must squeeze through tight spaces between cells, probe the outsides of antigen-presenting cells, and search for antigens in tissues of a variety of shapes and textures. Previous work showed that a protein that detects these mechanosensory cues, Piezo1, helps trigger the inflammatory response in everything from bacterial infections to cancer. A [new study in *Science*](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8262815/) has discovered that Piezo1 also plays a major role in autoimmunity in conditions like [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/). Researchers at the University of California, Irvine used a mouse model of multiple sclerosis called experimental [autoimmune encephalomyelitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/acute-disseminated-encephalomyelitis/) (EAE). When they induced EAE in mice lacking Piezo1, they found these mice had a significantly reduced disease severity compared to controls thanks to more rapid disease remission. Further experiments showed that helper T cells didn’t rely on Piezo1 for cell differentiation or movement to lymph nodes, but deleting Piezo1 did create an increased pool of regulatory T cells. However, the scientists also showed that deleting Piezo1 on regulatory T cells also reduced EAE disease severity in mice. **Citation for report:** Jairaman, A., Othy, S., Dynes, J. L., Yeromin, A. V., Zavala, A., Greenberg, M. L., Nourse, J. L., Holt, J. R., Cahalan, S. M., Marangoni, F., Parker, I., Pathak, M. M., & Cahalan, M. D. (2021). Piezo1 channels restrain regulatory T cells but are dispensable for effector CD4+ T cell responses. *Science advances*, *7*(28), eabg5859. <https://doi.org/10.1126/sciadv.abg5859> **Category:** Autoimmune Diseases, Multiple Sclerosis, Research Studies --- ### [Understanding the Link between EBV and MS: The Role of CRYAB](https://www.autoimmuneinstitute.org/research_updates/understanding-the-link-between-ebv-and-ms-the-role-of-cryab/) **Published:** May 17, 2023 **Author:** Elevation **Excerpt:** The Epstein-Barr virus causes the infectious disease mononucleosis. However, prior work has found it can also lead to the development of multiple sclerosis. **Content:** May 17, 2023 The Epstein-Barr virus (EBV) causes the infectious disease mononucleosis. However, [prior work](https://pubmed.ncbi.nlm.nih.gov/35025605/) has found it can also lead to the development of [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/) (MS). In a recent paper titled [**Cross-reactive EBNA1 immunity targets alpha-crystallin B and is associated with multiple sclerosis**](https://www.science.org/doi/10.1126/sciadv.adg3032), published in *Science Advances*, scientists identified that immune cells generated during an EBV infection can also attack an individual’s own cells, potentially contributing to MS development. In this study, scientists examined 700 blood samples from patients with MS. They focused on a protein known as alpha-crystallin B (CRYAB), which helps prevent cell damage by keeping other proteins from clumping together. It can also be produced in oligodendrocytes, a type of neuronal cell, and [may help reduce](https://pubmed.ncbi.nlm.nih.gov/17568699/) inflammation. Their research demonstrated that 13-27% of MS patients have autoantibodies that target CRYAB. Furthermore, they found that some of the immune cells generated in response to EBV can also accidentally target CRYAB. This suggests that in some MS patients, a combination of these errors may be contributing to autoimmune disease development. This is an important step in understanding how EBV can lead to MS, but since this wasn’t seen in all patients, more research is needed to fully understand the connection. **Citation for report:** Thomas, O. G., Bronge, M., Tengvall, K., Akpinar, B., Nilsson, O. B., Holmgren, E., Hessa, T., Gafvelin, G., Khademi, M., Alfredsson, L., Martin, R., Guerreiro-Cacais, A. O., Grönlund, H., Olsson, T., & Kockum, I. (2023). **Cross-reactive EBNA1 immunity targets alpha-crystallin B and is associated with multiple sclerosis**. *Science advances*, *9*(20), eadg3032. <https://doi.org/10.1126/sciadv.adg3032> **Category:** Autoimmune Diseases, Multiple Sclerosis, Research Studies, Risk Factors --- ### [Immune Checkpoint Could be a New Target against Autoimmune Disease](https://www.autoimmuneinstitute.org/research_updates/immune-checkpoint-could-be-a-new-target-against-autoimmune-diseases/) **Published:** January 17, 2020 **Author:** Elevation **Excerpt:** The immune system has many ways to keep itself in check. One method includes using negative checkpoint regulators that prevent a specific type of immune cells called T cells from attacking our own bodies and causing autoimmunity. **Content:** January 17, 2020 The immune system has many ways to keep itself in check. One method includes using negative checkpoint regulators that prevent a specific type of immune cells called T cells from attacking our own bodies and causing autoimmunity. Most negative checkpoint regulators previously identified come into play when the T cells are already in an active state. A research article titled [**VISTA is a checkpoint regulator for naïve T cell quiescence and peripheral tolerance**](https://doi.org/10.1126/science.aay0524), published in *Science,* identified a regulator called VISTA that prevents T cells from becoming active in the first place. The researchers also found that VISTA helps prevent T cells from attacking the body’s own cells and identified how VISTA impacted pathways important in the immune response. The immunomodulatory role of VISTA has also caught the eye of pharmaceutical companies. Several companies are beginning to develop drugs that modulate VISTA’s effects on the immune system in hopes of treating cancer and inflammatory diseases. **Citation for report:** ElTanbouly, M. A., Zhao, Y., Nowak, E., Li, J., Schaafsma, E., Le Mercier, I., Ceeraz, S., Lines, J. L., Peng, C., Carriere, C., Huang, X., Day, M., Koehn, B., Lee, S. W., Silva Morales, M., Hogquist, K. A., Jameson, S. C., Mueller, D., Rothstein, J., Blazar, B. R., … Noelle, R. J. (2020). **VISTA is a checkpoint regulator for naïve T cell quiescence and peripheral tolerance**. *Science (New York, N.Y.)*, *367*(6475), eaay0524. <https://doi.org/10.1126/science.aay0524> **Category:** Autoimmune Diseases, Research Studies, Therapies --- ### [New Treatments Based on Specific Genetic and Autoimmune Causes of Psychiatric Illness Under Investigation](https://www.autoimmuneinstitute.org/research_updates/new-treatments-based-on-specific-genetic-and-autoimmune-causes-of-psychiatric-illness-under-investigation/) **Published:** July 5, 2023 **Author:** Elevation **Excerpt:** Doctors and researchers have found that some patients with refractory schizophrenia and schizoaffective disorder have underlying lupus, and once treated for lupus, their psychiatric symptoms disappear. Dr. Sander Marx found that two patients with schizophrenia and schizoaffective disorder who were completely detached from reality and had been institutionalized for decades almost completely recovered following treatment for lupus. **Content:** July 5, 2023 Doctors and researchers have found that some patients with refractory schizophrenia and schizoaffective disorder have underlying lupus, and once treated for lupus, their psychiatric symptoms disappear. Dr. Sander Marx found that two patients with schizophrenia and schizoaffective disorder who were completely detached from reality and had been institutionalized for decades almost completely recovered following treatment for [lupus](https://www.autoimmuneinstitute.org/autoimmune-resources/systemic-lupus-erythematosus/). This finding has impressive implications for the future of psychiatric care. Screening for underlying causes of psychiatric disorders could help many patients. This finding led the way for the development of the[ Stavros Niarchos Foundation Center for Precision Psychiatry and Mental Health at Columbia University](https://www.snfghi.org/en/pillars/mental-health/snf-center-for-precision-psychiatry-and-mental-health-at-columbia-university/). This clinic aims to identify underlying genetic and autoimmune causes for various psychiatric conditions and then use this information to develop treatments. Scientists and doctors working in neuroscience, epidemiology, statistics, and genomics have been brought together to tackle the issues of diagnosing complex psychiatric diseases in a way that is less reliant on doctors’ intuition and is supplemented with diagnostic testing using biomarkers and genetics. This strategy is being called “[precision psychiatry](https://zuckermaninstitute.columbia.edu/columbia-just-launched-stavros-niarchos-foundation-center-precision-psychiatry-and-mental-health),” and the plan is to tackle psychiatric disorders in an individualized way, similar to cancer treatments. A one-size-fits-all approach to diagnosis and treatment is ineffective for many patients. By mapping the genetic mutations that are associated with psychiatric diseases, researchers hope to develop precise testing, tracking, and treatment tools that can enable better care for more people. At the Stavros Niarchos Foundation[ conference later this month](https://www.thenationalherald.com/niarchos-foundation-center-genetic-treatments-target-psychiatric-patients/#), researchers from the new Center for Precision Psychiatry and Mental Health are set to release the findings of a study on autoimmune causes of psychiatric diseases. Hopefully, this marks a turning point in treatment for psychiatric diseases and their connection to autoimmunity. **Category:** Autoimmune Diseases, Genetics, Lupus, Neurological Disorders, Research Studies, Risk Factors --- ### [Heightened Susceptibility to Autoimmune Disease in Those with Childhood Rotavirus-Associated Hospitalization](https://www.autoimmuneinstitute.org/research_updates/heightened-susceptibility-to-autoimmune-disease-in-those-with-childhood-rotavirus-associated-hospitalization/) **Published:** July 26, 2023 **Author:** Elevation **Excerpt:** A research article investigating the potential link between rotavirus infection during childhood and the subsequent development of autoimmune diseases was published in JAMA Network Open. The researchers conducted a retrospective cohort study using data from a large health database, focusing on children who had been hospitalized due to rotavirus infection. The study aimed to determine whether these children had an increased risk of autoimmune diseases compared to the general population. **Content:** July 26, 2023 A [research article](https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2807635) investigating the potential link between rotavirus infection during childhood and the subsequent development of autoimmune diseases was published today in *JAMA Network Open*. The researchers conducted a retrospective cohort study using data from a large health database, focusing on children who had been hospitalized due to rotavirus infection. The study aimed to determine whether these children had an increased risk of autoimmune diseases compared to the general population. The researchers used robust statistical methods to analyze the data, controlling for confounding factors such as age, sex, and other underlying health conditions. > **The findings revealed that children hospitalized with rotavirus had a higher likelihood of developing various autoimmune conditions, such as [type 1 diabetes](https://www.autoimmuneinstitute.org/autoimmune-resources/diabetes-type-1/), inflammatory bowel disease ([Crohn’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/crohns-disease/) and [ulcerative colitis](https://www.autoimmuneinstitute.org/autoimmune-resources/ulcerative-colitis/)), and [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/rheumatoid-arthritis/).** It is interesting to note that the researchers found not only an increased risk for developing autoimmune diseases that affect different organs but also an increased risk of developing [multiple autoimmune syndromes](https://www.autoimmuneinstitute.org/articles/comorbidities-multiple-autoimmune-syndrome/). This research contributes valuable insights into evidence supporting a link between rotavirus infection and subsequent autoimmune diseases, though further research is needed to establish the underlying mechanisms that might be responsible for this association. The findings underscore the importance of monitoring and early intervention in children with a history of severe rotavirus infections and the need to investigate potential preventive measures or interventions to reduce the risk of autoimmune diseases. **Category:** Research Studies, Risk Factors --- ### [Yale’s Groundbreaking Research on Gut-Brain Interactions to Combat Parkinson’s](https://www.autoimmuneinstitute.org/research_updates/yales-groundbreaking-research-on-gut-brain-interactions-to-combat-parkinsons/) **Published:** August 9, 2022 **Author:** Elevation **Excerpt:** An interdisciplinary team of doctors and scientists at Yale School of Medicine received a grant from the Aligning Sciences Across Parkinson’s (ASAP) initiative to study the link between the gut and the brain (also known as the gut-brain axis). This research can help scientists understand how the gut-brain axis influences the development of neurodegenerative diseases like Parkinson’s disease. **Content:** August 9, 2022 An interdisciplinary team of doctors and scientists at Yale School of Medicine [received a grant from the Aligning Sciences Across Parkinson’s (ASAP) initiative](https://medicine.yale.edu/news-article/does-parkinsons-disease-begin-in-the-gut/) to study the link between the gut and the brain (also known as the gut-brain axis). This research can help scientists understand how the gut-brain axis influences the development of neurodegenerative diseases like Parkinson’s disease. While it is not considered an autoimmune disease, some studies suggest that immune factors such as microglia, T cells, and autoantibodies may play a role in Parkinson’s Disease. ###### **Past research on the gut-brain axis revealed that:** - Immune cells in the gut have roles in regulating functions beyond the gut - Gut microbes send messages to the brain via the vagus nerve - Small molecules made by gut microbes impact the brain ###### **In the context of Parkinson’s disease, scientists, including those from Yale, have found that:** - Microbes in the gut produce psychoactive metabolites that make their way into the brain - Misfolded proteins, which have been associated with Parkinson’s disease, traveled to the brain after they were injected into the gut With the ASAP grant, the Yale researchers will focus on understanding the gut-brain axis during homeostasis, the process of maintaining stable internal conditions. The researchers hope that their research will build a foundation for future clinical trials focused on treating Parkinson’s disease. **Category:** Autoimmune Diseases, Clinical Trials, Microbiome, Research Studies --- ### [How Gut Microbes Evolve to Escape the Intestines and Trigger Chronic Infection](https://www.autoimmuneinstitute.org/research_updates/how-gut-microbes-evolve-to-escape-the-intestines-and-trigger-chronic-infection/) **Published:** July 13, 2022 **Author:** Elevation **Excerpt:** The gut is home to a plethora of pathobionts. When housed within the gut, they typically don’t cause problems. But when they escape the intestines in what is known as “leaky gut syndrome,” they can trigger chronic inflammation that leads to the development of autoimmune diseases. **Content:** July 13, 2022 The gut is home to a plethora of pathobionts. When housed within the gut, they typically don’t cause problems. But when they escape the intestines in what is known as “leaky gut syndrome,” they can trigger chronic inflammation that leads to the development of autoimmune diseases. A team of researchers hypothesized that pathobionts evolve to become more pathogenic and potentially leave the gut over time. A study titled [Within-host evolution of a gut pathobiont facilitates liver translocation ](https://doi.org/10.1038%2Fs41586-022-04949-x)published in *Nature* examined how a pathobiont species evolves in mice over the course of three months. At the end of the experiment, they found that the microbes separated into two populations: one reminiscent of the original microbes, and one that gained mutations that allowed them to live outside of the gut and persist in lymph nodes and the liver. To limit the pathobionts’ evolution, the authors of the study believe a diverse microbiome, which is in part based on diet, can prevent the overgrowth of one species and the potential evolution of harmful characteristics from repeated rounds of growth. **Citation for report:** Yang, Y., Nguyen, M., Khetrapal, V., Sonnert, N. D., Martin, A. L., Chen, H., Kriegel, M. A., & Palm, N. W. (2022). **Within-host evolution of a gut pathobiont facilitates liver translocation**. *Nature*, *607*(7919), 563–570. <https://doi.org/10.1038/s41586-022-04949-x> **Category:** Autoimmune Diseases, Microbiome, Research Studies, Risk Factors --- ### [Microbes within the Host 2019 Conference](https://www.autoimmuneinstitute.org/research_updates/microbes-within-the-host-conference-at-salk-institutenews-san-diego-conference-microbes-within-the-host-at-salk-institute/) **Published:** January 24, 2019 **Author:** Elevation **Excerpt:** At the January 2019 Salk IPSEN Conference in San Diego, California, a diverse group of scientists and medical professionals shared their exciting projects and latest research, exploring our intricate relationship with the microbes that live in and around us. Our understanding of the human body and the way it interacts with the environment has undergone a massive transformation in recent years. **Content:** Our understanding of the human body and the way it interacts with the environment has undergone a massive transformation in recent years. The discovery that microbes – including fungi, bacteria, viruses, and parasites – were responsible for terrible disease, led us to wage war on pathogens and greatly improve human health. But **we are now realizing that most microorganisms are not harmful and in fact, are completely essential to human life.** The blooming field of microbiome science is shifting perspectives on the way we live and the way we view the natural world. At the **January [2019 Salk IPSEN Conference](https://www.salk.edu/events/science-events/salk-ipsen-science-2019/) in San Diego, California**, a diverse group of scientists and medical professionals shared their exciting projects and latest research, exploring our intricate relationship with the microbes that live in and around us. This was an inspiring event showcasing the most progressive, cutting-edge research and brilliant minds studying the microbiome and its connection to health and disease. #### TAKEAWAYS: - **The modern diet of ultra-processed foods, screen time, nature deficit, stress, and sleep disturbance are all factors that drive disruptions in microbial ecosystems**, also known as dysbiosis. Early dysbiosis influences the long-term risk of chronic inflammation. *-Microbiome and Dysbiosis Immunometabolism,* Susan Prescott - **Autism spectrum disorder, anxiety, depression, cognition, Alzheimer’s, Parkinson’s are linked to the microbiome** *-The Gut Microbiome-Brain Connection in a Model of Parkinson’s Disease,* Sarkis Mazmanian - **Factors affecting brain health and disease:** - **Prenatal environment** - **Genetics** - **Microbiota** - **Environmental exposures** *-Gut Feelings: The Microbiome as a Regulator of Brain and Behavior Across the Lifespan,* John Cryan - **The skin has its own microbiome**. Harsh detergents could alter this delicate ecosystem and negatively affect the immune system *-Homeostatic Immunity to the Microbiota*, Yasmine Belkaid - **Our microbiome has changed, and we are losing diversity due to the widespread overuse of antibiotics and other medications, C-section births, extensive bathing, and bottle feeding with formula** *-Microbial Communities in Health and Disease,* Marty Blaser **Category:** Events, Microbiome --- ### [The Autoimmune Tautology: An Update](https://www.autoimmuneinstitute.org/research_updates/the-autoimmune-tautology-an-update/) **Published:** June 22, 2022 **Author:** Elevation **Excerpt:** An Autoimmune Tautology refers to the fact that autoimmune diseases share several clinical signs and symptoms, physiopathological mechanisms, and genetic factors that support their having a common ancestor. **Category:** Events, Genetics, Research Studies --- ### [IL-2 Fusion Protein Boosts Tregs to Help Combat Autoimmune Disease](https://www.autoimmuneinstitute.org/research_updates/il-2-fusion-protein-boosts-tregs-to-help-combat-autoimmune-disease/) **Published:** October 18, 2022 **Author:** Elevation **Excerpt:** T-regulatory cells (Tregs) act as brakes for our immune system by helping to turn off immune responses. In this study, scientists developed a mechanism to increase the number of Tregs in mouse models of autoimmune disease. **Content:** October 18, 2022 A well-balanced immune system is critical for overcoming infections and preventing the immune system from going rogue and attacking its own tissues. T-regulatory cells (Tregs) are a critical part of maintaining this balance. Tregs act as brakes for our immune system by helping to turn off immune responses. In a study titled [**Engineered human cytokine/antibody fusion proteins expand regulatory T cells and confer autoimmune disease protection**](https://www.cell.com/cell-reports/fulltext/S2211-1247(22)01328-6#secsectitle0045) published in *Cell Reports*, scientists developed a mechanism to increase the number of Tregs in mouse models of autoimmune disease. These researchers focused on an immune system protein called IL-2. Prior work has demonstrated that this protein is important for making Tregs. However, scientists found that using IL-2 alone had unwanted side effects and did not last long enough in the body. To overcome these challenges, the scientists attached IL-2 to another molecule called F5111, creating a fusion protein. After administering this fusion protein to the mice, they found that the number of Tregs increased. Furthermore, this increase improved the disease outcomes in mice with colitis and autoimmune diabetes. This holds a lot of potential to improve patient outcomes and quality of life. Future work will focus on verifying the safety and efficacy in human patients. **Citation for report:** VanDyke, D., Iglesias, M., Tomala, J., Young, A., Smith, J., Perry, J. A., Gebara, E., Cross, A. R., Cheung, L. S., Dykema, A. G., Orcutt-Jahns, B. T., Henclová, T., Golias, J., Balolong, J., Tomasovic, L. M., Funda, D., Meyer, A. S., Pardoll, D. M., Hester, J., Issa, F., … Spangler, J. B. (2022). **Engineered human cytokine/antibody fusion proteins expand regulatory T cells and confer autoimmune disease protection**. *Cell reports*, *41*(3), 111478. <https://doi.org/10.1016/j.celrep.2022.111478> **Category:** Genetics, Research Studies --- ### [CRISPR/Cas9 Mapping of Immune Gene Networks](https://www.autoimmuneinstitute.org/research_updates/crispr-cas9-mapping-of-immune-gene-networks/) **Published:** July 11, 2022 **Author:** Elevation **Excerpt:** Genetic changes can play a significant role in the development of immune system disorders, including autoimmunity. In this study, scientists used CRISPR/Cas9, a genome-editing tool, to disrupt various genes that make transcription factors in human T cells. **Content:** July 11, 2022 Genetic changes can play a significant role in the development of immune system disorders, including autoimmunity. A paper titled [**Systematic discovery and perturbation of regulatory genes in human T cells reveals the architecture of immune networks**](https://www.nature.com/articles/s41588-022-01106-y) published in *Nature Genetics* took this understanding to a new level by creating a gene map that identifies the interconnectedness of genes and how they impact immune system functioning. In this study, scientists used CRISPR/Cas9, a genome-editing tool, to disrupt various genes that make transcription factors in human T cells. They then investigated how these disruptions affected genes involved in immune cell functioning, enabling scientists to map connections. Their findings revealed that alterations in different genes can lead to similar diseases due to these connections. By utilizing this map, scientists can identify key genes that could serve as promising targets for drug therapies to address numerous diseases caused by immune system dysfunction. **Citation for report:** Freimer, J. W., Shaked, O., Naqvi, S., Sinnott-Armstrong, N., Kathiria, A., Garrido, C. M., Chen, A. F., Cortez, J. T., Greenleaf, W. J., Pritchard, J. K., & Marson, A. (2022). **Systematic discovery and perturbation of regulatory genes in human T cells reveals the architecture of immune networks**. *Nature genetics*, *54*(8), 1133–1144. <https://doi.org/10.1038/s41588-022-01106-y> **Category:** Genetics, Research Studies, Therapies --- ### [Protecting Pancreatic Beta Cells in Type 1 Diabetes](https://www.autoimmuneinstitute.org/research_updates/protecting-pancreatic-beta-cells-in-type-1-diabetes/) **Published:** June 28, 2022 **Author:** Elevation **Excerpt:** Scientists utilized mice to investigate the potential mechanisms underlying the development of autoimmunity within the beta cells. More research is needed, but this work suggests that developing a therapy to prevent damage to pancreatic beta cells may eventually be possible.  **Content:** June 28, 2022 [Type 1 diabetes](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/diabetes-type-1/) (T1D) is an autoimmune disease where a patient’s immune system attacks their pancreatic islet beta cells. These cells play a crucial role in regulating blood glucose levels by producing insulin. As T1D progresses, patients lose their ability to make insulin. In a study titled [**Proinflammatory signaling in islet β cells propagates invasion of pathogenic immune cells in autoimmune diabetes**](https://www.cell.com/cell-reports/fulltext/S2211-1247(22)00800-2?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS2211124722008002%3Fshowall%3Dtrue), published in *Cell*, scientists utilized mice to investigate the potential mechanisms underlying the development of autoimmunity within the beta cells. The researchers focused on the gene *Alox15*, which produces the enzyme 12/15-Lipoxygenase. They genetically removed *Alox15* from NOD mice, a strain predisposed to T1D, and studied the resulting effects. The results revealed significant changes in these mice. Notably, they observed overall protection against developing T1D. They also found a reduction in inflammation in the beta cells and increases in immune cell markers known to help suppress autoimmunity. These immune cell changes may explain why the mice were protected from T1D development. To extend this work, they also included data from human islet cells treated with a molecule to inhibit lipoxygenase, the enzyme produced by *Alox15*. They noted similar cellular changes to that noted in the mice. More research is needed, but this work suggests that developing a therapy to prevent damage to pancreatic beta cells may eventually be possible. **Citation for report:** Piñeros, A. R., Kulkarni, A., Gao, H., Orr, K. S., Glenn, L., Huang, F., Liu, Y., Gannon, M., Syed, F., Wu, W., Anderson, C. M., Evans-Molina, C., McDuffie, M., Nadler, J. L., Morris, M. A., Mirmira, R. G., & Tersey, S. A. (2022). **Proinflammatory signaling in islet β cells propagates invasion of pathogenic immune cells in autoimmune diabetes**. *Cell reports*, *39*(13), 111011. <https://doi.org/10.1016/j.celrep.2022.111011> **Category:** Autoimmune Diseases, Research Studies, Type 1 Diabetes --- ### [How the Immune System Learns to Distinguish Between Self and Non-Self](https://www.autoimmuneinstitute.org/research_updates/how-the-immune-system-learns-to-distinguish-between-self-and-non-self/) **Published:** June 16, 2022 **Author:** Elevation **Excerpt:** T cells circulate throughout the body to aid in its defense. Critical T cell training happens within the thymus to help make T cells tolerant to self, including a process known as negative selection. **Content:** June 16, 2022 T cells are an important immune cell. They develop in the thymus and then circulate throughout the body to aid in its defense. Critical T cell training happens within the thymus to help make T cells tolerant to self, including a process known as negative selection. During negative selection, T cells that identify the body’s own tissues as foreign are eliminated. This ensures that self-reactive T cells that could contribute to autoimmunity do not survive. In a study titled [**Thymic epithelial cells co-opt lineage-defining transcription factors to eliminate autoreactive T cells**](https://www.cell.com/cell/fulltext/S0092-8674(22)00649-3?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0092867422006493%3Fshowall%3Dtrue#secsectitle0080), published in *Cell*, scientists discovered insight into how this process happens. This study used mouse models to investigate the process of T cell training within the thymus by focusing on cells known as medulla thymic epithelial cells, also known as mTECs. These cells are the ones that help show T cells self-antigens, which are proteins from the body’s own cells. For a long time, scientists believed that a protein called AIRE played the primary role in assisting mTECs in presenting self-antigens for T cell selection. However, this study revealed additional factors contributing to the development of distinct types of mTECs. These mTECs appear similar to those found in cells from other parts of the body, leading the researchers to call them ‘mimetic cells’. This is a significant finding as it provides further insights into how T cells can be trained to recognize and tolerate the diverse array of body cells they encounter after leaving the thymus. These mimetic cells look similar to those body cells, so T cells can be trained to tolerate them prior to leaving the thymus. More research is needed to understand how this process may be altered in individuals with autoimmunity and if it can be targeted for future treatments. **Citation for report:** Michelson, D. A., Hase, K., Kaisho, T., Benoist, C., & Mathis, D. (2022). **Thymic epithelial cells co-opt lineage-defining transcription factors to eliminate autoreactive T cells**. *Cell*, *185*(14), 2542–2558.e18. [https://doi.org/10.1016/j.cell.2022.05.018.](https://doi.org/10.1016/j.cell.2022.05.018) **Category:** Research Studies --- ### [Decoding Inflammation: Mitochondrial Triggers in Autoimmunity](https://www.autoimmuneinstitute.org/research_updates/decoding-inflammation-mitochondrial-triggers-in-autoimmunity/) **Published:** August 9, 2022 **Author:** Elevation **Excerpt:** In this study, researchers used mice and cell culture to investigate how mtDNA escapes the mitochondria and triggers inflammation. These are valuable findings, as they help us understand how mtDNA escapes and triggers inflammation. **Content:** August 9, 2022 Inflammation is a normal part of an immune response that helps fight infections and subsides once an infection has been eliminated. However, in individuals with autoimmunity, inflammation becomes chronic and contributes to symptoms and damage. Research has been focused on understanding the triggers of inflammation in autoimmune disease patients. One such trigger has been identified as mitochondrial DNA (mtDNA). Mitochondria are the part of the cell that generates the energy needed to fuel body processes. It contains its own unique DNA (mtDNA). The mtDNA usually stays inside the mitochondria. [Prior work](https://www.sciencedirect.com/science/article/abs/pii/S1471490619302182) has shown that mtDNA can trigger inflammation when it escapes. This work has also shown that there are elevated levels of mtDNA in the cells and blood of patients with certain autoimmune diseases. However, how the mtDNA exits is still unclear. A study titled [**Oxidized DNA fragments exit mitochondria via mPTP- and VDAC-dependent channels to activate NLRP3 inflammasome and interferon signaling**](https://pubmed.ncbi.nlm.nih.gov/35835107/) published in *Immunity,* has helped answer this question. In this study, researchers used mice and cell culture to investigate how mtDNA escapes the mitochondria and triggers inflammation. They found that when mitochondria are stressed, some of the mtDNA becomes damaged and is subsequently cut by an enzyme named FEN1. Then, channels open in the mitochondria that allow it to exit. Once mtDNA is in the cytoplasm, it triggers NLRP3 inflammasome activation, cGAS-STING activation, and interferon signaling which generates inflammation. These are valuable findings, as they help us understand how mtDNA escapes and triggers inflammation. Now that these processes are known, further studies may lead to therapeutics that reduce inflammation in patients by targeting these processes. **Citation for report:** Xian, H., Watari, K., Sanchez-Lopez, E., Offenberger, J., Onyuru, J., Sampath, H., Ying, W., Hoffman, H. M., Shadel, G. S., & Karin, M. (2022). **Oxidized DNA fragments exit mitochondria via mPTP- and VDAC-dependent channels to activate NLRP3 inflammasome and interferon signaling**. *Immunity*, *55*(8), 1370–1385.e8. <https://doi.org/10.1016/j.immuni.2022.06.007>. **Category:** Research Studies --- ### [Digestive Disease Week (DDW) San Diego Conference](https://www.autoimmuneinstitute.org/research_updates/digestive-disease-week-conference/) **Published:** May 18, 2019 **Author:** Elevation **Excerpt:** The May 2019 DDW Conference in San Diego, California, supported the largest international gathering of top physicians, researchers, and industry leaders in the fields of gastroenterology, endoscopy, hepatology, and gastrointestinal surgery. They discussed advancements in autoimmune and other diseases related to the gastrointestinal system, as well as what the future holds for diagnosing and treating these types of conditions. **Category:** Celiac Disease, Events, IBD (Crohn's and UC), Microbiome, Research Studies, Therapies --- ### [International Celiac Disease Symposium Paris Conference](https://www.autoimmuneinstitute.org/research_updates/paris-conference-international-celiac-disease-symposium/) **Published:** September 13, 2019 **Author:** Elevation **Excerpt:** At the September 2019 ICDS Conference in Paris, France, many of the foremost experts in celiac disease presented their work on various topics to rooms full of gastroenterologists, pediatricians, dieticians, and celiac-related organizations and programs. **Category:** Celiac Disease, Events, Research Studies --- ### [Gluten and Neurodegenerative Diseases](https://www.autoimmuneinstitute.org/research_updates/gluten-and-neurodegenerative-diseases/) **Published:** June 22, 2022 **Author:** Elevation **Excerpt:** Gluten is proinflammatory, oxidative, increases intestinal permeability, and compromises immune functions. A gluten-free diet can improve non-celiac autoimmune diseases. **Category:** Celiac Disease, Events, Neurological Disorders, Research Studies, Therapies --- ### [One in Ten Affected by Autoimmune Disease Says New Study of 22+ Million People](https://www.autoimmuneinstitute.org/research_updates/one-in-ten-affected-by-ad/) **Published:** May 9, 2023 **Author:** Elevation **Excerpt:** A new population-based study involving 22 million people shows that 19 of the most common autoimmune disorders now affect about 10% of the population –13% of women and 7% of men, which is higher than previous estimates ranging from 3% to 9% (often relying on smaller sample sizes and including fewer autoimmune conditions). **Content:** A new population-based cohort [study](https://pubmed.ncbi.nlm.nih.gov/37156255/) conducted in the United Kingdom has shed light on the incidence, prevalence, and co-occurrence of autoimmune disorders. The study followed 22,009,375 individuals in the UK between January 2000 and June 2019 and analyzed their health records to identify 19 of the most common autoimmune diseases, including [rheumatoid arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/rheumatoid-arthritis/), [psoriasis](https://www.autoimmuneinstitute.org/autoimmune-resources/psoriasis/), [type 1 diabetes](https://www.autoimmuneinstitute.org/autoimmune-resources/diabetes-type-1/), [lupus](https://www.autoimmuneinstitute.org/autoimmune-resources/systemic-lupus-erythematosus/), and [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/multiple-sclerosis/). **The team found that together these 19 autoimmune diseases affect about 10% of the population –13% of women and 7% of men, which is higher than previous estimates ranging from 3% to 9% (often relying on smaller sample sizes and including fewer autoimmune conditions).** The researchers also highlighted socioeconomic, seasonal, and regional differences for several autoimmune disorders and provide new insights into possible causes behind these diseases. Overall, this study provides important insights into the changing epidemiology of autoimmune diseases, highlighting the need for further research into the underlying mechanisms and risk factors contributing to the development of these conditions. The findings also have important implications for healthcare policy and resource allocation, particularly in the context of increasing rates of autoimmune diseases and socioeconomic disparities in disease incidence and prevalence. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/04/shutterstock_68753686-1024x1024-1.jpg) **Category:** Autoimmune Diseases, Research Studies --- ### [Revolutionary Discovery: Sarcoidosis Diagnosis with a Simple Blood Test](https://www.autoimmuneinstitute.org/research_updates/revolutionary-discovery-sarcoidosis-diagnosis-with-a-simple-blood-test/) **Published:** February 22, 2024 **Author:** Elevation **Excerpt:** Today, the National Institutes of Health announced that a groundbreaking blood test has been developed to diagnose sarcoidosis swiftly and inexpensively. Sarcoidosis, characterized by granuloma growth in various organs, often requires invasive tests for diagnosis. This new tool, described in the American Journal of Respiratory and Critical Care Medicine, promises a more straightforward approach using a blood test. **Content:** February 22, 2024 Today, the [National Institutes of Health announced](https://www.nih.gov/news-events/news-releases/scientists-develop-simple-blood-test-quickly-diagnose-sarcoidosis) that a groundbreaking blood test has been developed to diagnose sarcoidosis swiftly and inexpensively. [Sarcoidosis](https://www.autoimmuneinstitute.org/autoimmune-resources/sarcoidosis/), characterized by granuloma growth in various organs, often requires invasive tests for diagnosis. This new tool, described in the [*American Journal of Respiratory and Critical Care Medicine*](http://www.atsjournals.org/doi/abs/10.1164/rccm.202306-1054OC), promises a more straightforward approach using a blood test. Researchers analyzed lung fluid and blood samples to identify specific antigens linked to sarcoidosis. They then devised a highly accurate blood test to distinguish sarcoidosis from other respiratory conditions. While further testing is needed, this method could revolutionize sarcoidosis diagnosis within a few years, according to Dr. Lobelia Samavati of Wayne State University, the study’s senior author. **Category:** Autoimmune Diseases, Diagnostic Testing, Research Studies --- ## Autoimmune Stories ### [Claire's Story: Gender Bias & the Long Road to Diagnosis](https://www.autoimmuneinstitute.org/autoimmune_stories/claires-story-gender-bias-the-long-road-to-diagnosis/) **Published:** December 9, 2021 **Author:** Carolyn Serraino **Excerpt:** Freshman year I was hospitalized sixteen times, eleven times for anaphylaxis. One of my hospitalizations was for pneumonia and kidney failure. After the school year ended, I went home and bounced around from doctor to doctor. **Content:** > ***When diagnosis is delayed, suffering is prolonged. Left untreated, disease worsens, new symptoms and conditions pile up, and healing becomes more difficult.*** Claire Lapat is no stranger to this pattern. For years, many doctors dismissed her symptoms, brushing off serious health concerns while insisting on physical evidence of disease before taking them seriously. By the time she was diagnosed with **[Crohn’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crohns-disease/)**, years of untreated illness had taken a significant toll on her health. She has since been diagnosed with multiple autoimmune diseases including **[Sjögren disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sjogren-syndrome/ "Sjögren disease (SjD)")**, **[mixed connective tissue disease ](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/mixed-connective-tissue-disease/ "Mixed connective tissue disease")(MCTD)**, **[Henoch-Schönlein purpura](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/henoch-schonlein-purpura/ "Henoch-Schonlein purpura") (IgA vasculitis)**, **[Berger’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/iga-nephropathy/ "IgA nephropathy (Berger’s disease)") (IgA nephropathy)**, and **[chronic glomerulonephritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/glomerulonephritis/ "Glomerulonephritis")**, along with several non-autoimmune conditions. Claire shares her experiences here, bringing awareness to some of our medical system’s limitations and the undeniable sexism that prevents women from getting the care they deserve. ## **Claire’s Story** I was diagnosed with an autoimmune disease during a global pandemic after doctors struggled to diagnose me for years. At age 14, as a freshman in high school, I started experiencing serious abdominal pain. I brushed it off and assumed the abdominal pain was somehow correlated with my extensive concussion history and persistent symptoms. The spring of my sophomore year, I broke my hip running track. Due to the nature of the fracture, my orthopedist did some blood work, which showed malnutrition. #### He referred me to an eating disorder clinic, making that assumption since I was young, thin, and female, in addition to being a distance runner. I knew I did not have an eating disorder, and my primary care physician agreed with me, so I never went. My hip never healed right and senior year I saw another orthopedist who did an MRI. The visualized part of the large intestine was inflamed, and he told me to see a gastroenterologist (GI doctor). All the GI doctor did was stick a popsicle stick up into my rectum and tell me I was too young for a colonoscopy. My symptoms had worsened throughout high school, but my health steadily declined once I got to college. #### Freshman year I was hospitalized sixteen times, eleven times for anaphylaxis. One of my hospitalizations was for pneumonia and kidney failure. After the school year ended, I went home and bounced around from doctor to doctor. Pulmonologists thought I had [sarcoidosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sarcoidosis/ "Sarcoidosis") until my ACE (angiotensin-converting enzyme) levels came back normal. #### I saw an infectious disease doctor and he thought I was “just stressed.” I started my sophomore year with no answers, and my health continued to worsen. My classmates and I went home for spring break in March 2020 and never returned for the rest of the semester due to COVID-19. My allergist/immunologist was getting concerned with how sick I was and the frequency in which I was getting pneumonia. I told her how severe my abdominal pain was and she referred me to a different GI doctor who wanted an endoscopy and colonoscopy right away. Both showed inflammation, ulceration, and bleeding in my intestines and stomach. #### Capsule endoscopy finally confirmed a diagnosis: [Crohn’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crohns-disease/ "Crohn’s disease"). Since my Crohn’s diagnosis, I have also been diagnosed with other autoimmune diseases including [Sjogren’s](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sjogrens-syndrome/ "Sjögren’s Syndrome"), [MCTD](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/mixed-connective-tissue-disease/ "Mixed Connective Tissue Disease"), Crohn’s-related arthritis, [Henoch-Schönlein purpura](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/henoch-schonlein-purpura/ "Henoch-Schonlein purpura"), [Berger’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/iga-nephropathy/ "IgA nephropathy (Berger’s disease)"), and [chronic glomerulonephritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/glomerulonephritis/ "Glomerulonephritis"). I also have some non-autoimmune conditions such as persistent post-concussion syndrome, POTS, mastocytosis, and restless leg syndrome. #### My doctors believe that I had Crohn’s for eight years before being diagnosed and thus receiving treatment. I am sure that my diagnoses were delayed due to the fact that I am a young woman. My experiences have shown how biased the healthcare system is in how it treats men and women. I do not think it is wrong for doctors to ask about eating disorders in patients who present with malnutrition. However, it is sexist for doctors to assume that an eating disorder is the only plausible diagnosis, especially because this usually happens to women and girls. I am now a senior at the University of Pittsburgh and am majoring in microbiology. My goal is to go to medical school, and I am motivated by both my good and bad experiences with the healthcare system. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Claire-2-1.jpg) **If anyone reading this is going through something similar, keep advocating for yourself:** - Do your research. - Do not be afraid to ask questions or ask about certain conditions. It shows initiative and doctors may respect you more. - Do not be afraid of second, third, or fourth opinions. See as many doctors as you need to get answers. You deserve care. #### Despite having answers, I still have severe symptoms and have never been in remission. My disease is extremely hard to treat because it went undiagnosed for so long. **If you are struggling with hard-to-treat disease, it is not your fault, and you are not alone.** – Claire ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/SpacerShield.jpg) The views and opinions expressed are those of the author and do not necessarily reflect the views and opinions of the Global Autoimmune Institute. The experiences and health outcomes described in this article are unique to the author and do not serve as medical advice. **Category:** Berger’s disease & glomerulonephritis, Crohn’s Disease, Henoch-Schönlein purpura, Mixed connective tissue disease (MCTD), Multiple Autoimmune Diseases, Sjogren’s Disease --- ### [Heather's Story: The Hurt and Healing](https://www.autoimmuneinstitute.org/autoimmune_stories/heathers-story-the-hurt-and-healing/) **Published:** June 15, 2026 **Author:** Carolyn Serraino **Excerpt:** In her story, Heather shares her journey from years of unexplained symptoms and repeated surgeries to a diagnosis of hypermobile Ehlers-Danlos syndrome (hEDS), and the resilience, self-discovery, and hope she found along the way. While Ehlers-Danlos syndrome (EDS) is not classified as an autoimmune disease, many people living with EDS face challenges that will feel familiar to those in the autoimmune community, including chronic pain, diagnostic delays, complex symptoms, and the emotional toll of an often invisible condition. **Content:** Living with a chronic illness often means navigating uncertainty, searching for answers, and learning to adapt to a life that looks very different from the one you once imagined. While Ehlers-Danlos syndrome (EDS) is not classified as an autoimmune disease, many people living with EDS face challenges that will feel familiar to those in the autoimmune community, including chronic pain, diagnostic delays, complex symptoms, and the emotional toll of an often invisible condition. In her story, Heather shares her journey from years of unexplained symptoms and repeated surgeries to a diagnosis of hypermobile Ehlers-Danlos syndrome (hEDS), and the resilience, self-discovery, and hope she found along the way. [**Learn more about Ehlers-Danlos syndrome and its relationship to autoimmunity**](https://www.autoimmuneinstitute.org/research_updates/is-ehlers-danlos-an-autoimmune-disease/) ## **Heather’s Story**: ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/01/IMG_2289-768x1024.jpeg) ### I was born with Hypermobile Ehlers-Danlos Syndrome Imagine going 23 years of your life not knowing you have a genetic connective tissue disorder. Growing up, I experienced many symptoms that were played off as minor or as growing pains. I was a two-sport athlete, with my main passion being soccer, playing for over 14 years on the same team. I was always tall. My mom loves to tell me that I could no longer fit in a baby carrier at three months old because my legs were too long. I struggled with a lot of joint pain growing up. I could do all the “cool party tricks”, like touching my thumbs to my wrists with no problem. What I thought was normal actually wasn’t. I woke up with a different kind of pain I had never experienced before. #### During my freshman-year basketball season, my life changed forever overnight. Throughout the season, I had been slowly getting worse, to the point that I developed severe left leg pain, known as sciatica, from two herniated discs and very advanced spinal stenosis that caused foot drop. I became homeschooled midway through the school year. On August 16, 2016, I had a double laminectomy and double discectomy. A laminectomy consists of removing part of the lamina bone to reach the injured herniated disc. A discectomy is the removal of unwanted disc material in the spinal canal. The double just means two different levels in my spine: L4-L5-L5-S1. I returned to a new school that September and slowly improved over the next seven years, though with what was considered “normal” back pain. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/06/shutterstock_1197627253-743x1024.jpg) #### No one had ever given me an answer as to why I woke up one day needing major back surgery at such a young age, with no accident or injury. Fast forward to 2022. I began experiencing extreme fatigue and worsening joint pain. I saw a local rheumatologist who told me I was vitamin D deficient and left it at that. Two months later, I woke up with my left arm and half of my left hand numb and tingling. I thought I just needed to shake it off, but that was not the case. I had just started my first job as a Certified Clinical Medical Assistant, and now I needed ulnar nerve surgery at twenty-one. Once again, I woke up needing surgery with no clear explanation. I was frustrated and felt there had to be a reason behind all of this, but my concerns were dismissed by my pediatricians and the rheumatologist. In early 2023, while at work, I felt shooting nerve pain going down my previously injured leg. I was in denial, but not for long, as the pain quickly became unbearable and the foot drop returned. I had re-herniated the same two discs at L4–L5 and L5–S1. #### I needed a spinal fusion; I was practically bone-on-bone. During the fusion, my surgeon had to spend an additional two hours removing an abnormal amount of scar tissue. He referred me to rheumatology for possible Hypermobile Ehlers-Danlos Syndrome. Being chronically ill can be unbearably isolating. There are few, if any, who truly understand what it’s like. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/06/Heather-Blair-3-1024x576.jpg) #### We suffer in silence, not wanting to be a burden, repeating the same daily cycle over and over. Meanwhile, the world moves on around us, and we feel trapped in a haunting, never-ending time loop, mourning not just who we’ve lost, but who we used to be. During my hospital stay, doctors also suggested a rheumatology referral. I had many key indicators: difficulty holding IVs, translucent and doughy skin, very flat feet, and hypermobility in most areas of my body, along with other signs. During my spine surgeries in 2023, my incisions had to be surgically glued shut while I was awake. In 2025, after my CSF repair surgery, my incision reopened after stitch removal performed by plastic surgery, again while I was awake. The new rheumatologist diagnosed me with hypermobile Ehlers-Danlos Syndrome on the spot. He said I was a classic hEDS patient based on my appearance alone. #### It’s heartbreaking that I spent twenty-three years wondering what was wrong with me, when a doctor less than two hundred miles away could diagnose me simply by using his eyes. HEDS is a genetic connective tissue disorder. It can cause stretchy skin, chronic pain, overly flexible joints, fatigue, gastrointestinal issues, and it affects nearly every part of the human body. HEDS does not yet have a specific genetic test; diagnosis is based on a Beighton score, medical history, and physical evaluation. #### There is no cure, only management. Medication has helped me manage chronic pain and improve my hyper-POTS. I am still working to find a dose that works best for me. Unfortunately, HEDS affects many aspects of the body: mast cell activation, POTS, CRPS, inflammation, spinal instability, poor wound healing, small fiber neuropathy, IBS, pelvic prolapse, endometriosis, PCOS (currently under evaluation), joint subluxation, easy bruising, and pelvic floor dysfunction. #### The way I explain it to people is this: a “normal” person’s body is held together with glue, and people with HEDS lack that glue in almost every part of their body. Grief has five stages: denial, bargaining, anger, depression, and acceptance. Most people experience it after losing a loved one, but for those of us with chronic illness, grief takes on a different shape. We grieve the person we used to be before sickness changed everything. #### The truth I wish I had encountered earlier is this: “Terminal illness is a death sentence. Chronic illness is a life sentence.” It’s not a temporary struggle. It’s a lifetime of starting over, learning to live in a body that feels like a stranger, one that has betrayed you. In 2024, I had yet another surgery on my right elbow (my dominant arm), the third surgery of my life for the same issue. At least this time, I finally had an answer as to why. HEDS changed my life overnight when I was fifteen. If only that little girl knew the journey that lay ahead. Today, I have experienced eight hospital stays, two inpatient rehabilitation stays, four spine surgeries, more than ten epidurals, three blood patches, two myelograms, two elbow surgeries, deterioration of my autonomic nervous system, a migraine disorder, and one life-changing surgery that I am only a year post-op from. HEDS marked the beginning of my health struggles at fifteen and accelerated the deterioration of my body at twenty-one. My passion and love for sports were taken from me. I don’t get to use the certifications I worked so hard for. I am still figuring out who I am every day, with a body that says “no” and a mind that says “yes.” Some days, I feel incredibly unaccomplished and behind for my age. #### Being chronically ill has taught me some of life’s hardest lessons. Some of which include: - you can’t expect people to treat you the way you treat them - healing isn’t linear: the little things are actually the big things - you can’t just stop going through it - self-love is not selfish - your body is the captor of your soul; you need to take care of it; be grateful for the little things; it could always be worse - celebrate the milestones - growth is uncomfortable; the choice is yours - you are the one to make it happen for yourself; no one is going to do it for you - it’s okay to ask for help - scars are stories of strength - kindness is a gift for others and myself Of course, there are still many lessons to learn, but it’s the hard times that teach us the most valuable lessons. I am learning to accept myself for what I bring to the table and for the person I am becoming. I am trying to wear my scars proudly, as reminders of what I have survived. #### My journey has reshaped my understanding of life’s purpose, and I’ve realized it all comes down to one thing: love. It has shown me resilience, strength, wisdom, and a respect for myself I never knew existed. What I remind myself at the end of the day is this: you are nothing without your health. Take care of yourself. Chronic illness comes in many forms, but the most important ones are often invisible to the naked eye. Be kind. My heart is heavy for the fifteen-year-old girl who was oblivious to the journey ahead, but it also feels pride for the strength and resilience it has taken to get this far. I am aware that this is my life’s journey, but I refuse to let it define who I am. I cried until there were no tears left and lived long stretches consumed by sadness. Even in moments of happiness, I found it difficult to allow myself joy. Hope felt impossible when my inner world was caught in a relentless loop, a rollercoaster with no end. Through it all, I’ve learned that mental health is vital. It is no longer optional; it is a priority. As my father always said, “**Don’t make a permanent decision on a temporary timeline**.” ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/06/IMG_4833-715x1024.jpeg) #### Through the darkest days, I’ve realized my best and happiest days are still ahead. I am still searching for my light and purpose, but I know the best version of myself shines when I am surrounded by people who love me unapologetically and authentically. For so long, I felt ashamed, embarrassed, and compelled to shrink because of my illness. Now, I am on fire to raise awareness for these complex conditions, even if it helps just one person. – Heather ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/GAI-Logo-Image-e1707845715517.png) *The views and opinions expressed are those of the author and do not necessarily reflect the views and opinions of the Global Autoimmune Institute. The experiences and health outcomes described in this article are unique to the author and do not serve as medical advice.* **Category:** Diagnostic Delays --- ### [Hannah's Story: Celebrating Progress While Battling Crohn’s Disease](https://www.autoimmuneinstitute.org/autoimmune_stories/hannahs-story-celebrating-progress-while-battling-crohns-disease/) **Published:** August 12, 2022 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** When I first heard the words “you have Crohn’s disease” I thought my life was over and that I’d be stuck in bed and feeling sick for the rest of my life. **Content:** *Sometimes, autoimmune disease completely alters the timeline that you had envisioned for your life. When Hannah was diagnosed with [Crohn’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crohns-disease/ "Crohn’s disease") at just 15 years old, her whole life changed. In the beginning, Hannah’s illness drained her of health, social activities, and time. As she navigated these challenges, Hannah began to work out a new timeline for her life. Hannah’s story is a reminder that progress is worth celebrating, even when chronic illness slows you down.* *Read Hannah’s autoimmune story to learn about her journey and to find out where she is now.* ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Hannah-1.png) **HANNAH’S STORY** Hi! I’m Hannah, a 22-year-old from Cape Town, South Africa. I was diagnosed with Crohn’s disease just after my 15th birthday, after roughly 6 months of fevers, abdominal pain, nausea, vomiting, and diarrhea. > **The hardest thing about being diagnosed as a teenager was feeling isolated.** I missed out on so many school days, birthdays, parties, family occasions, and trips. My peers and teachers struggled to understand what I was going through and I remember feeling very alone during this time. I would get in trouble for not handing in assignments on time, missing school, and leaving classes to go to the bathroom. I wasn’t reliable and I struggled to stick to plans, which made socializing extremely challenging. After I started biological treatment, my health slowly began to improve and I was able to enjoy life again– however, this didn’t last long. During my 8 years of living with this illness, there have been many ups and downs. I have a flare-up that lands me in the hospital at least once a year, and oftentimes my medications give me terrible side effects. Regardless, things are much better than they were back then. I will never forget the fear I felt the first time I noticed blood. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Hannah-1-768x1024.jpg) > When I first heard the words “you have Crohn’s disease” I thought my life was over and that I’d be stuck in bed and feeling sick for the rest of my life. If I could go back in time, I’d give my 15-year-old self a big hug and tell her that everything is going to be okay– things get better and you are way more resilient than you may think. My struggles inspired me to start an Instagram page as a way of showing others what it’s like to live with IBD, as well as to connect with others also suffering from a chronic illness. It can be a very isolating journey and I think it’s important that others, especially those who are younger, know that they don’t need to go through it alone. There are people out there who know what it feels like and to whom they can relate. As a way to deal with my illnesses, I have started running. I aim to complete a half marathon in September. Since my diagnosis, I have traveled locally and internationally and I’ve had an amazing time. I am a big foodie, so I love cooking at home or trying new foods and restaurants around Cape Town. I have a newfound appreciation for being able to eat delicious foods since it’s been something my Crohn’s tends to get in the way of. **While things might be a little more challenging for me now and I sometimes take longer to achieve my goals than those around me, I think it’s important to highlight that these goals aren’t always out of reach.** ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Hannah-2.jpeg) My illnesses have brought me a considerable amount of pain (both mentally and physically) and it is not something I’d wish on anyone. I would be lying if I said that I didn’t wake up every day wishing that I wasn’t ill, but I cannot change the cards that I have been dealt – all I can do is choose how to play them. Although bowel disease is becoming more prominent and widely spoken about, the symptoms surrounding IBD remain very taboo. > Over the years, I have become very open and comfortable speaking about the not-so-glamorous aspects of IBD, and it’s made a massive difference with regard to sharing my symptoms with my doctors and accepting my illness. Through my [Instagram page](https://www.instagram.com/crohnswellness/), I’ve been able to share my story and chat with so many amazing people from all over the world– I have even had the privilege of meeting a few of them in person. Since my Crohn’s diagnosis in 2014, I have also been diagnosed with psoriatic arthritis and colon motility issues. But, I am determined not to let these issues stop me from living my life and achieving my goals. In 2020, I earned a BA in Psychology and Communications with distinction. Last year, I received my BA Honours in Psychology degree with distinction– I even completed my thesis on the psychological impact of IBD. – Hannah > [View this post on Instagram](https://www.instagram.com/reel/CebqRKqAAWB/?utm_source=ig_embed&utm_campaign=loading) > > [A post shared by hannah 🌞 (@crohnswellness)](https://www.instagram.com/reel/CebqRKqAAWB/?utm_source=ig_embed&utm_campaign=loading) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/SpacerShield.jpg) The views and opinions expressed are those of the author and do not necessarily reflect the views and opinions of the Global Autoimmune Institute. The experiences and health outcomes described in this article are unique to the author and do not serve as medical advice. **Category:** Crohn’s Disease --- ### [Melanie’s Story: Living With Type 1 Diabetes](https://www.autoimmuneinstitute.org/autoimmune_stories/melanies-story-living-with-type-1-diabetes/) **Published:** March 6, 2026 **Author:** Carolyn Serraino **Excerpt:** Melanie grew up watching her father manage Type 1 diabetes. When she was diagnosed years later, familiarity did not make the reality any easier. In this personal story, she reflects on adjusting to a new normal and finding her footing, one day at a time. **Content:** *Melanie grew up watching her father manage [Type 1 diabetes](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/type-1-diabetes-insulin-dependent-diabetes/ "Type 1 diabetes / insulin-dependent diabetes"). When she was diagnosed years later, familiarity did not make the reality any easier. In this personal story, she reflects on adjusting to a new normal and finding her footing, one day at a time.* ### Melanie’s Story: ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/02/Melanie.jpg) I am so familiar with Type 1 Diabetes. My dad was diagnosed when I was seven, so I grew up alongside it. I knew our pantry was full of whole grains and “healthier” options. I knew he always had something on his arm. I knew to grab something sugary if he went low. I knew that sometimes when he was irritable, it wasn’t anyone’s fault. I was used to the periodic beeps and alarms. **What I didn’t know was the permanence, the seriousness, the commitment.** I didn’t know you had to plan for everything. I didn’t know you’d have to constantly calculate food, insulin, and exercise. I didn’t know there were 42 factors that could affect your blood sugar each day. I didn’t know it was a full-time job. #### Familiarity didn’t prepare me for my diagnosis. A routine blood test over Thanksgiving revealed that I, too, was Type 1 diabetic. Instead of focusing on finals, I was suddenly juggling insulin therapy, blood sugar checks, and the reality that nothing would ever be the same. It was overwhelming, disorienting, and emotional. I learned pretty quickly that grief doesn’t always look dramatic. **Sometimes it’s quiet.** Sometimes it’s realizing the ease with which you once moved through the day is gone. I had to mourn the version of ‘normal’ I didn’t know I was so attached to, my routines, my assumptions, the ability to leave the house without thinking twice. And while it was painful, I had no choice but to feel everything: fear, anger, and the sheer exhaustion of it all. This diagnosis is monumental, and while at first it felt insurmountable, slowly but surely, I am adjusting to a ‘new normal.’ **Over time, I began to understand that adjustment doesn’t happen all at once.** It happens in small, ordinary moments. Earlier this week, I dosed insulin for a meal without thinking twice. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/02/Melanie-GAI-portrait-shot-768x1024.jpeg) #### What once felt impossible is now routine. Some things I’ve picked up: eating vegetables, protein, THEN carbs helps prevent blood sugar spikes. There’s a muscle in your calf, the soleus muscle, that lives off glucose. Calf raises can bring down blood sugar substantially. Dress your carbs; always combine with a protein or fat. Trust your trend arrow on your CGM more than the number itself. Stop overexplaining yourself. You don’t owe anyone a reason for why you’re pricking your finger, or why something on you is beeping. No two days are the same. It’s trial and error. But I promise—you’ll start to see what works. #### When I returned to college, I found I could still do everything I loved, as long as I was prepared. Snacks, insulin, and supplies now come with me everywhere. Managing my diabetes is not optional; it’s nonnegotiable. At first, that responsibility felt consuming. Now, I feel empowered by my ability to care for myself. My experience with Type 1 diabetes is shaped by the moment I’m living in. I’m constantly reminded that I’m not navigating this in the same world that other T1Ds entered before me. **The technology and treatments available today are tools of freedom**. They allow flexibility, independence, and the ability to live fully. That perspective doesn’t erase the difficulty, but it does bring gratitude into the picture. #### Perhaps the most surprising lesson has been this: living *with* diabetes doesn’t mean living *as* diabetes. There are moments—more and more now—when I let it fade into the background. Not through denial, and never through shame, but by refusing to let it replace my identity. Diabetes is something I live with, not something that defines me. **The fear and chaos that once consumed my every thought are still present, but no longer control my every second.** In the months since my diagnosis, I’ve been forced to pay attention to myself in ways I never had to before. I nourish my body with food that makes me feel good. I move more. I spend time outside. I read, draw, write, and surround myself with friends who ground me. #### I feel strong, not in spite of this diagnosis, but alongside it. Growing up around Type 1 diabetes taught me how to recognize it. Being diagnosed taught me how to live with it. I’m still learning, still adjusting, still figuring out my new life. But I’m also discovering something I didn’t expect: a deeper awareness of myself, a stronger sense of resilience, and the confidence that even when life changes overnight, I can grow into what comes next. – Melanie ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/03/Melanie-GAI-portrait-2-768x1024.jpeg)![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/GAI-Logo-Image-e1707845715517.png) *The views and opinions expressed are those of the author and do not necessarily reflect the views and opinions of the Global Autoimmune Institute. The experiences and health outcomes described in this article are unique to the author and do not serve as medical advice.* **Category:** Type 1 Diabetes --- ### [Gracie's Story: Reclaiming my Life](https://www.autoimmuneinstitute.org/autoimmune_stories/gracies-story-reclaiming-my-life/) **Published:** January 26, 2026 **Author:** Carolyn Serraino **Excerpt:** Gracie reflects on how a once-active life was reshaped by POTS and how persistence, support, and patient advocacy helped her reclaim stability, purpose, and strength. **Content:** *For many people living with [postural orthostatic tachycardia syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/postural-orthostatic-tachycardia-syndrome/ "Postural orthostatic tachycardia syndrome") (POTS), the road to diagnosis is marked by sudden life disruption, dismissed symptoms, and the challenge of being believed. In her story, Gracie reflects on how a once-active life was reshaped by chronic illness and how persistence, support, and patient advocacy helped her reclaim stability, purpose, and strength.* ## Battling POTS and Finding Strength Through Advocacy ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/01/IMG_7046-scaled.jpeg) Pennsylvania’s woods and job sites shaped my young adulthood. As a business owner and outdoor enthusiast, life was once filled with long days hunting, riding side-by-sides, and building homes with my husband. But at 21, everything changed. After the heartbreak of losing my grandfather, the anxiety of my brother’s deployment, and the pressures of wedding planning, my life took a sudden and mysterious turn. Symptoms arrived abruptly with all of these big life changes—dizzy spells, relentless brain fog, palpitations, fainting, daily migraines, and so much more. Simple joys vanished, replaced by a haze of confusion and fear. #### For seven months, my pleas for answers were met with dismissals: “It’s just anxiety.” Appointment after appointment blurred together. I fought, not just to be heard by doctors, but to find the person I once was. Everything changed when my biggest advocates—my husband, family, and a determined primary care provider—refused to give up on me. With their help, the puzzle finally fit. I had Postural Orthostatic Tachycardia Syndrome (POTS) and chronic migraines. The diagnosis brought relief, grief, and validation. Suddenly, my story was one among thousands walking this invisible path. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/01/7F0BDCC8-9A54-4E1C-94E9-BFAE1086F8B2-768x1024.jpeg) #### POTS is a daily storm. Normal tasks—standing to make breakfast, answering client calls, folding laundry—require careful planning. Each day is dictated by unpredictable symptoms, dietary sensitivities, and chronic fatigue. I’ve learned the importance of planning ahead and accepting help, savoring small victories, and protecting my comfort at all costs. My management toolbox includes a carefully chosen diet, hydration, and extra salt to support blood pressure, daily compression gear, and vital supplements. I found a lifeline in a community of POTS patients and a recumbent biking physical therapy program—spaces where strength and hope flourish. #### In connecting with others in the program, on social media, and through support groups, I found purpose: sharing my story to help others feel less alone. Chronic illness forced me to redefine resilience. My priorities—family, business, the outdoors—remain, but I have gained perspective and empathy. I aim to show others they are not alone, and to remind those searching for answers to never stop advocating for themselves. Your story matters, and you know your body best. Keep speaking up. #### Together, our voices create change. – Gracie ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/GAI-Logo-Image-e1707845715517.png) *The views and opinions expressed are those of the author and do not necessarily reflect the views and opinions of the Global Autoimmune Institute. The experiences and health outcomes described in this article are unique to the author and do not serve as medical advice.* **Category:** POTS --- ### [Bárbara's Story: The Invisibility of Continuity](https://www.autoimmuneinstitute.org/autoimmune_stories/barbaras-story-the-invisibility-of-continuity/) **Published:** January 27, 2026 **Author:** Carolyn Serraino **Excerpt:** Chronic illness reshaped how Bárbara creates, leads, and moves through the world, but not why she makes music. This is a story about continuity, adaptation, and remaining visible when illness is not. **Content:** > *“Illness did not end my artistic life. It forced a deep reconfiguration of my relationship with music, leadership, and creation. Excess was stripped away, urgency gave way to attention, and artistic practice became more concentrated, more intentional, and more human.”* > – Bárbara Barros *excerpt of Castelo / Bárbara Barros* ## Art, Chronic Illness, and the Right to Remain Visible I founded Melopoetica in London in 2003, at a time when my artistic life was defined by movement, intensity, and constant creation. Music was my language of freedom — a place of rigor, curiosity, and emotional truth. Over time, Melopoetica became the most intimate and coherent expression of my artistic identity. Six years ago, that continuity was interrupted. #### What began as unexplained pain and fatigue gradually revealed itself as a complex convergence of chronic conditions. None of these arrived alone. They accumulated, overlapped, and reshaped my daily life in ways that were neither visible nor easily explained. My professional life has been profoundly reshaped by complex chronic illness. I live with multiple, overlapping conditions — including autoimmune and neurological disease, chronic pain, mobility challenges, visual disturbances, and cognitive fatigue — all of which require constant adaptation and careful management. These conditions are not episodic. They are present every day. They affect how I move, how I see, how long I can rehearse, perform, travel, and lead, and how I manage time, memory, and physical endurance. #### There was no single moment of collapse — only a long process of loss, adaptation, and recalibration. I lost certainty in my body. I lost trust in time. I lost the illusion that discipline alone could overcome physical limits. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2026/01/Screenshot-2026-01-27-at-1.06.09-PM.png) But I did not lose music. Instead, music changed place. It moved closer to silence, to fragility, and to restraint. It became slower, more attentive, and more essential. What I could no longer sustain through force, I learned to sustain through precision, care, and depth. #### Illness did not make me weaker as an artist. It made me more exact. Every rehearsal, every programme, every collaboration now requires conscious negotiation with energy, pain, and recovery. Leadership became quieter. Gesture became economical. Excess fell away. What remained was clarity. From the outside, continuity can look like absence. From the inside, continuity is an act of daily courage. My story is not one of overcoming illness, but of coexisting with it — ethically, professionally, and artistically. It is about insisting that an artistic life does not end when the body changes, and that experience, depth, and vulnerability are cultural resources worth sustaining. #### Music remains the place where I am whole. Through Melopoetica, that wholeness becomes shared — quietly, precisely, and truthfully. I would also like to acknowledge the medical team that has profoundly supported my artistic continuity across different countries: Hospital de Santo António, Porto, Portugal and Trnava Hospital, Slovakia. – Bárbara ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/GAI-Logo-Image-e1707845715517.png) *The views and opinions expressed are those of the author and do not necessarily reflect the views and opinions of the Global Autoimmune Institute. The experiences and health outcomes described in this article are unique to the author and do not serve as medical advice.* **Category:** Multiple Autoimmune Diseases, Multiple Sclerosis (MS), Undiagnosed --- ### [Dillon’s Story: My 12-Year Journey to a Lyme Disease Diagnosis](https://www.autoimmuneinstitute.org/autoimmune_stories/dillons-story-my-12-year-journey-to-a-lyme-disease-diagnosis/) **Published:** February 22, 2024 **Author:** Elevation **Excerpt:** After years of relentless fatigue, muscle weakness, and a slew of debilitating symptoms, a journey spanning numerous doctors, tests, and treatments finally led to a breakthrough. Despite consultations with various specialists and undergoing numerous examinations and therapies, no definitive answers emerged. It wasn’t until exploring functional medicine that a glimmer of hope emerged. This story underscores the importance of persistence, advocating for oneself, and seeking alternative approaches when conventional methods fall short. **Content:** *After years of relentless fatigue, muscle weakness, and a slew of debilitating symptoms, a journey spanning numerous doctors, tests, and treatments finally led to a breakthrough. Despite consultations with various specialists and undergoing numerous examinations and therapies, no definitive answers emerged. Misdiagnoses like [fibromyalgia](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/fibromyalgia/ "Fibromyalgia") left Dillon grappling with unrelenting pain and discomfort and even exclusive medical memberships failed to provide conclusive results. It wasn’t until exploring functional medicine that a glimmer of hope emerged. Dylan’s story underscores the importance of persistence, advocating for oneself, and seeking alternative approaches when conventional methods fall short.* ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/04/Dillon.png) ### **Dillon’s Story** After about 12 years, I figured it out. When I was about 19, I found myself feeling fatigued. It seemed as though, “Well, everyone is tired sometimes,” but after a few months of this off and on, bam! Every single day, all day long, I was plagued with this ongoing, relentless fatigue. I lived my life this way for a couple of years before the next step came into play. One day at work, when I was about 22, my legs started to feel super tired, shaky, and weak in general, I sat down for a few minutes thinking, “Hmmm, this is kind of weird, maybe I’m getting sick?” After a few hours, things seemed to be going back to normal. **During this time, I was doing my best to take a nap every single day as I simply could not stay awake past about noon.** I started seeing a few doctors. I would explain to them, “I’m exhausted, my legs feel shaky, my body feels weak, I can’t figure this out.” During this time, I saw a handful of them. I did a sleep study, and everything came back normal. I tried gabapentin (nerve medication), and that didn’t change a thing. I tried a vitamin regimen and that did nothing. A doctor asked me, “Do you think you’re depressed? Let’s try some antidepressants.” So now, not only do I feel terrible, but I get to be a zombie as well. I tried to mention this to family members every now and again, “You know, Mom? I really don’t feel very good.” Of course, they are as helpful as possible, but what were they going to do? I had tried IV vitamins and minerals, I tried anxiety medication, nerve medications, cellular energy supplements, physical therapy, and many many other things, but nothing had even made the slightest dent. I put up with feeling this way, being nervous about looking weak to others, but also not having any idea what I would even say to any of them. **I started to get a very anxious, uneasy feeling on a regular basis because I would find myself constantly thinking, “How can I make it through this today?” Or “I can’t do this anymore.”** I had a son and so I pushed on. Fast forward a few years to when I was 25, I had moved back to Utah and found a job. On my way to work one morning, I remember literally feeling it hit me, it felt like I had instantly caught the flu in a matter of a few seconds. My head hurt, my body was aching, I could barely stay awake, I felt absolutely awful. #### I’ll never forget that day, that is the day things became the definition of chronic. > Every day after that was filled with burning muscle pain, joint pain, fatigue, headaches, skin problems, gut issues, skin issues, you name it. I started going to see doctors a lot more because I knew that something was seriously wrong. Each doctor had their own idea, “Maybe it’s your thyroid? Let’s check your levels,” – the next doctor – “Maybe you’re anemic? Let’s check your levels.” #### I saw pain doctors, internal medicine doctors, gastroenterologists, a urologist, a neurologist; the list goes on and on. I explained my symptoms to each doctor and told them how long, difficult, and painful this had been. **They would run a few tests and say everything looked normal. It was easy to tell that they had no intention of continuing this journey with me.** The diagnosis I received two different times was “fibromyalgia.” They love to throw that out there when they can’t figure it out. I remember going to see a doctor who required a VIP membership. On top of the visit, lab work, etc., there was a $1,800 annual fee to see this doctor. I figured, well, this will be it, they will figure it out. After a wide array of testing, she comes up with nothing. **I asked one day, “Can you test me for Lyme disease? Which she did, and the results came back, and she told me, “You don’t have Lyme disease.”** I said, “Are you sure? It matches my symptoms very well.” She said yes, it’s not that. After that doctor, I thought I would try a wellness clinic. This doctor found that I had high ferritin levels (too much iron storage – not the amount of iron in your blood, but rather the amount that is stored around different areas of your body). The doctor said, “I think you might have hemochromatosis.” I remember thinking to myself, “This is amazing, I have an answer.” So he ran the test for the gene mutation that makes up hemochromatosis, and it came back negative. My iron storage was too high, but I did not, in fact, have the disease associated with it. I spent about a year bloodletting, which lowers your iron storage, and I never did feel a whole lot better. 1.5 years after seeing that doctor, I started reading about functional medicine and how these doctors are very good at finding the root cause of people’s issues. They look at results and study symptoms on a much deeper level than most doctors do. Insurance doesn’t cover these places though, so boy was it expensive. However, I wanted to try one last time before I gave up and just lived with it. This doctor asked me, “Have you been tested for Lyme disease?” And I said yes, about 2 years ago, and it was negative. **He very confidently said that a lot of doctors test for Lyme disease without realizing how inaccurate the testing actually is.** Basically, after about 6 weeks and $1,200 in specialty blood testing, the doctor came back to me and said we had a positive for Lyme disease. #### After 12 years, I finally figured it out. > I started treatment recently and am so grateful that I won’t feel this way forever. I would like people to know that these functional medicine doctors are amazing! **I saw probably 20 doctors over about 10 years – I bet I went to at least 75 appointments and spent thousands of dollars – and this doctor found it in 6 weeks!** If you think you might have Lyme disease, then please look into alternative Lyme testing. The CDC standard is not accurate enough. I was one of probably thousands of people that went on undiagnosed for no reason. – Dillon ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/SpacerShield.jpg) *The views and opinions expressed are those of the author and do not necessarily reflect the views and opinions of the Global Autoimmune Institute. The experiences and health outcomes described in this article are unique to the author and do not serve as medical advice.* ## Additional Information Regarding the Diagnostic Testing of Lyme Disease According to the CDC, these are the [key points to remember regarding the diagnosis and testing of Lyme Disease](https://www.cdc.gov/lyme/diagnosistesting/index.html): - Most Lyme disease tests are designed to detect antibodies made by the body in response to infection. - Antibodies can take several weeks to develop, so patients may test negative if infected only recently. - Antibodies normally persist in the blood for months or even years after the infection is gone; therefore, the test cannot be used to determine cure. - Infection with other diseases, including some tickborne diseases, or some viral, bacterial, or autoimmune diseases, can result in false positive test results. - Some tests give results for two types of antibody, IgM and IgG. Positive IgM results should be disregarded if the patient has been ill for more than 30 days. **July 29, 2019**: The Food and Drug Administration (FDA) cleared several Lyme disease serologic assays with new indications for use, allowing for an enzyme immunoassay (EIA)/immunofluorescence assay rather than western immunoblot assay as the second test in a Lyme disease testing algorithm. For more information, see the: [Updated CDC Recommendation for Serologic Diagnosis of Lyme Disease](http://dx.doi.org/10.15585/mmwr.mm6832a4) **May 2021**: The Association of Public Health Laboratories released a new [Guidance and Interpretation of Lyme Disease Serologic Test Results Report](https://www.aphl.org/aboutAPHL/publications/Documents/ID-2021-Lyme-Disease-Serologic-Testing-Reporting.pdf), which describes the proper interpretation of serologic testing for *B. burgdorferi* and identifies best practices for reporting results to clinicians, public health agencies, and patients. **Category:** Lyme Disease, Undiagnosed --- ### [Erika's Story: Still Me](https://www.autoimmuneinstitute.org/autoimmune_stories/erikas-story/) **Published:** August 8, 2025 **Author:** Carolyn Serraino **Excerpt:** Mom of three. Six autoimmune diseases. Endless resilience. Erika’s story is one of strength, purpose, and powerful chronic illness advocacy. **Content:** ## **Living, Loving, and Advocating Through Chronic Illness** ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/08/Erika-e1754582995999.png) I’m a mom to three amazing kids, married to my best friend, and I work in philanthropy/development at a medical school. I’m also living with six autoimmune diseases, including [SLE](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic lupus erythematosus"), [Sjögren’s](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/sjogren-syndrome/ "Sjögren’s syndrome"), Dysautonomia, [RA](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid arthritis"), [Pernicious anemia](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/pernicious-anemia/ "Pernicious anemia"), and a few others that make everyday life a bit of a juggling act. I’m a proud South Texan who loves iced coffee, meaningful conversations, and singing ’90s songs a little too loudly in the car. I never imagined I’d become an advocate for chronic illness, especially not while dealing with all the medical chaos myself. But life had other plans. ## **The Beginning Was a Blur** Like so many others, my journey started with years of vague symptoms and unanswered questions. My hair fell out, and I felt fatigued, like I was dragging cement blocks. I had joint pain. Brain fog was so intense that I’d forget conversations five minutes after having them. #### I knew something was off, but every doctor seemed to brush it off as stress or hormones or just being “a tired mom.” It took 7 years and a whole lot of persistence to finally get answers. And even when I did, the answers came with more layers: conflicting diagnoses, medication side effects, and constant uncertainty. But I kept showing up. For my kids. For myself. And eventually, for others. ## **Turning Pain Into Purpose** #### One day, I realized I wasn’t just navigating this alone anymore. I was part of something bigger. I started sharing my story, first in small ways: support groups, DMs with other patients, blog comments. Then came invitations to sit on panels, speak at national events, and meet with pharmaceutical companies to share the patient perspective. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/08/unnamed-790x1024.jpg) Now I serve on the [Lupus Voices Council](https://lupusabc.org/committees-and-members/lupus-voices-council/), a patient advisory council, and I’m part of the PALS (Patient Advocates for Lupus Studies) program. With PALS, I’ve had the honor of helping push for more inclusive [clinical trials](https://www.autoimmuneinstitute.org/articles/the-importance-of-clinical-trials-for-autoimmunity "The Importance of Clinical Trials for Autoimmunity") for people of color, who often get excluded from research. #### I’m loud about it because we deserve to be seen. To be counted. I regularly meet with policymakers to push for more funding and comprehensive care for patients like myself. I’ve also participated in clinical trials and help support others navigating their diagnoses through peer-to-peer education. It’s not about having all the answers. It’s about making sure the right questions are being asked. And that someone like me, or my daughter, or your cousin, or your neighbor, won’t have to wait years to be believed. ## **The Day-to-Day** ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/08/Erika-2-758x1024.jpg) Most days, I wake up and check in with my body like it’s a weather app. > *“Are we flaring today? > What hurts? > Can I do the thing or should I cancel?”* It’s exhausting, frustrating, and honestly kind of ridiculous that I have to make peace with feeling awful just to be considered “functioning.” But I’ve also learned how to slow down (sometimes). To ask for help (working on it). To speak up even when my voice shakes. ## **What I’ve Learned** Advocacy saved me. It gave me purpose when I felt like my life had been put on hold. It’s given me a platform to help others feel less alone and to help change the system that failed so many of us for so long. #### To anyone new to this journey: You don’t have to be brave all the time. Some days, just getting out of bed is an act of strength. You’re allowed to grieve, rage, cry, and still be proud of yourself. You’re doing better than you think. ## **If You Only Remember One Thing…** Chronic illness doesn’t make me fragile; it’s created a fire within me. I fight for my kids, for future patients, and for the version of me who once thought she was just “lazy” or “crazy” or “too sensitive.” #### I show up tired, in pain, and full of passion. I’m still here. I’m still me. And I’m not done fighting. – Erika ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2025/08/Erika-Reyna-cow-768x1024.jpg) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/GAI-Logo-Image-e1707845715517.png) *The views and opinions expressed are those of the author and do not necessarily reflect the views and opinions of the Global Autoimmune Institute. The experiences and health outcomes described in this article are unique to the author and do not serve as medical advice.* **Category:** Lupus (SLE), Multiple Autoimmune Diseases, Rheumatoid Arthritis, Sjogren’s Disease --- ### [Zoe's Story: Embracing Your New Normal](https://www.autoimmuneinstitute.org/autoimmune_stories/zoes-story-embracing-your-new-normal/) **Published:** August 29, 2023 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Zoe’s story of managing ulcerative colitis and seizures highlights the importance of self-advocacy and support from family and institutions. **Content:** *Zoe’s journey with *[ulcerative colitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ulcerative-colitis/ "Ulcerative Colitis")* began in her teens, marked by denial, embarrassment, and misdiagnosis. Learning to manage flares while excelling academically was challenging.* *Only later did she realize the importance of self-advocacy and seeking second opinions.* *Her internship at the Global Autoimmune Institute ignited her passion to support others with autoimmune conditions, emphasizing the power of knowledge and solidarity.* ### **Zoe’s Story** I’m never sure where I fit in the range of healthy to sick. Right now, I feel healthy. > I don’t have any symptoms, and the only way you’d know I have an autoimmune disease is if you saw me take my meds. But that hasn’t always been true and won’t always be. My name is Zoe. I’m a junior in college majoring in biology. I have ulcerative colitis. Let me set the scene. I was 14. It was going to be a fabulous summer, I was helping out at my local riding stable a couple days a week and rehearsing for *Hamlet* with my friends every afternoon. Then I got sick. At first, it was just a hint of red in the toilet bowl, but soon there was enough blood that the smell lingered after the flush. And I was so out of breath. I couldn’t jog for the life of me and even walking too quickly made me out of breath. At one point early on I tried to mention the blood to my Mom, but she dismissed it as “probably from the cherries” I had eaten. Unfortunately, it was not from the cherries, but I made no further attempts to bring it up to my Mom (I would like to be clear that this was *not* her ignoring me but a pretty rational reassurance to a kid who didn’t seem sick. My mom is my biggest advocate). > I got very good at ignoring it and hoping it would go away. As the summer went on I lost a lot of weight and got increasingly tired. *Hamlet* performances came and went (let’s just say I got very good at managing large skirts and petticoats in small bathroom stalls between scenes). I began waking up several times every night and frantically stumbling to the toilet. School started… (I knew the locations of all the bathrooms on campus and which were the cleanest within the first week). ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Untitled-design-23.png) Eventually, my parents made me a doctor’s appointment. **The doctor did a basic check-up and found nothing wrong, but I was too embarrassed to tell them about my symptoms.** Fortunately, my Mom spoke up. “She’s been having blood in her poop.” I couldn’t even make eye contact with my physician, I was so embarrassed. They drew some blood, advised me to cut out dairy, and said to check back in a couple weeks. The nurse called the next day and insisted I go to the Emergency Room. I was severely anemic and they were worried I might need a blood transfusion. Luckily, I didn’t, but that ER trip was the first step to seeing the only pediatric gastroenterologist in the state. Several blood and stool tests, and one colonoscopy later, and I was diagnosed with ulcerative colitis. **It was only after I was started on prednisone that I realized how sick I really had been.** > The long slow decline had really blinded me to my symptoms. So, the sudden efficacy of the medications left me feeling better than I had in months. I stopped bleeding. I had energy. I was hungry again. By this point, I was about a month into my first year of high school. I got my IEP (individualized education plan) around winter vacation, which allowed me bathroom breaks, stop-the-clock testing, and schedule rearrangements. I switched out of P.E. (ever tried to do the PACER test when you’re severely anemic? It’s one of my most embarrassing memories from high school) and was allowed to have an extra study hall. I would like to say that it was all smooth sailing from then on, but I dealt with flares throughout high school. **Whenever I was stressed out, my colitis would flare up.** I know that for many people, their autoimmune disease can negatively impact their academic performance. For me, that’s never been the case. My grades did not suffer, but my health did. This is the main reason academic accommodations are so important for me. > *I can take a full course load and get good grades, but this level of stress leads to flares.* This is something I still struggle with in college (though I have academic accommodations with my university). **I’m torn between my desire to do as much as my peers (take a full course load, get a part-time job, volunteer, etc.) and my need for less stress and a lighter schedule.** I wish I had someone tell me when I was first diagnosed that this was normal… > It is okay to need to do fewer things at a time… even when you don’t feel sick. **The second thing I wish someone might have told me is that doctors are not right all the time.** I had two seizures one weekend when I was 15. I wasn’t that worried about it because, unlike the symptoms of ulcerative colitis, seizures are vastly more concerning to onlookers than to the ones experiencing them (at least for me). My seizures happened in my sleep, so they weren’t really impacting my life that much. Other than some brain fog and biting my tongue, I was fine. They did freak out my family (to this day, if I start drifting off on a car ride, my brother will wake me to make sure I’m okay). ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Untitled-design-24.png) I saw a neurologist. After an MRI and several EEGs (electroencephalograms), he said that I was fine. While I did technically meet the criteria for epilepsy (two or more unexplained seizures greater than 24 hours apart), my EEG results were borderline, and he didn’t think I was epileptic, so wasn’t going to put me on medication. This was not a very satisfying answer, so my parents and I wrote the seizures off as a side effect of the prednisone I was taking at the time. It wasn’t until I was eighteen, when I had a couple of seizures while not on prednisone, that I went through the whole EEG/MRI process again and was diagnosed with epilepsy and put on anticonvulsant medication. This is so frustrating looking back because I had a couple of seizures a year throughout high school and never sought a second opinion. I never knew that this was potentially dangerous (the more seizures you have, the greater your chances of having another one). I now know that epilepsy is more common in those with ulcerative colitis. **Had the first neurologist known this, I might have been diagnosed four years earlier.** This brings me to the last thing I wish someone told me: > the more you know about your health, the better you are prepared to make decisions and advocate for yourself. I didn’t really understand what ulcerative colitis was until I looked it up so that I’d be able to explain it to my college roommates. This, in turn led me to reading about the mechanisms of the disease and discovering that there is research suggesting a connection between my two seemingly unrelated conditions (vagus nerve anyone?). I love going down an interesting research rabbit hole, which is part of what led me to choose to major in biology. I wanted to fully understand the research I was reading. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Untitled-design-25.png) This past summer, I got the chance to intern with the Global Autoimmune Institute, doing research and writing content on all sorts of autoimmune topics. **There is something extremely validating in reading research about your disease and other autoimmune conditions and feeling as if you’re part of something bigger than yourself.** I learned that there is a lot that science still doesn’t understand about autoimmunity, but at least people are trying to figure it out. Doing this internship helped me to realize **I am not alone and not the odd one out.** It has made me more sure than ever that I want to do something to help others with similar conditions. I’m hoping that by sharing this story, I will help someone realize that their symptoms are not something to be embarrassed by, their accommodations are valid and necessary, and learning about their health problems can be empowering, not scary. – Zoe ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/SpacerShield.jpg) The views and opinions expressed are those of the author and do not necessarily reflect the views and opinions of the Global Autoimmune Institute. The experiences and health outcomes described in this article are unique to the author and do not serve as medical advice. **Category:** Ulcerative Colitis --- ### [Savannah’s Story: Finding My Inner Superwoman While Battling a Rare Disease](https://www.autoimmuneinstitute.org/autoimmune_stories/savannahs-story-finding-my-inner-superwoman-while-battling-a-rare-disease/) **Published:** September 1, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** In chronic illness, we often grieve for the life we once had and the things we love to do that we suddenly cannot do anymore. Savannah’s story of living with Devic’s disease reminds us how we can still find joy and satisfaction in life. **Content:** ***In chronic illness, we often grieve for the life we once had and the things we love to do that we suddenly cannot do anymore.*** *We move through intense feelings of anger, frustration, denial, and sadness that cycle back when new symptoms or situations arise. But here and there, we may feel a sense of acceptance creeping in. Once acceptance comes into the picture, the possibilities on this new path start to unveil themselves.* *We may not be able to have what’s considered a “normal” life, but we can work with what we’ve got, and continue to find joy, happiness, and satisfaction. Savannah’s story offers a reminder of how powerful mindset can be in living our best life.* ### **SAVANNAH’S STORY** **[Devic’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/neuromyelitis-optica/ "Neuromyelitis Optica/Devic’s disease") is a neurological disease of the brain and spinal cord** dominated by inflammation of the optic nerve (optic neuritis) and inflammation of the spinal cord (myelitis). It’s often mistaken for [multiple sclerosis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/ "Multiple Sclerosis") (MS) because both diseases have similar symptoms. I suffer from a relapsing form of the disease, which means a patient can go through multiple attacks, which accumulate disability over time. I was diagnosed in 2019 and I was put on a preventative chemotherapy treatment called Soliris after they found three brain lesions and my optic nerve was inflamed. In Devic’s disease, the attack results in inflammation and damage to the nerve fibers, disrupting nerve cell communication. Patients who endure this disease suffer from blindness, paralysis, and life-threatening complications. In the beginning of my diagnosis, it shattered every kind of normalcy I had. I went half-blind and still am to this day. **Being the independent woman that I am, battling this crippling disease was extremely humbling.** > **I had to finally accept help from others.** I’m a public special education teacher and in February during my second year of teaching, three months after my diagnosis, I had to quit my job. I felt like I had failed so many people in my life: my husband, my students, and my co-workers. **I could no longer do what had been so easy for me, like washing the dishes, cooking, and waking up in the morning to dress myself.** I was shattered–the superwoman part of me was no longer alive. > My disease fully intended for me to lose all hope. To never jog with my full strength again, or get out of a hot bath on my own, or get out of bed without burning feet, or see a day where I wasn’t throwing up in pain. But I have seen all of those things through today, and though I live with chronic pain, I know I’m a stronger woman for it. **Sometimes tough situations build strong people, strong women.** Fast forward to now, two years later after living with my diagnosis. I am working again with special needs students as a public school teacher and I survived teaching through the COVID-19 pandemic! Every morning that I wake up and enter my classroom, I feel a sense of accomplishment. I sip my coffee, looking around my room with the feeling that I made it again. I chose to do what I love, despite my daily health challenges and biweekly treatment. > **I chose to go through my life not allowing pain to dictate how I live.** **I’d rather live a painful life than not live one at all.** Living with a rare disease like mine is lonely, yes. I fight for my health every day. People may think I’m lazy or dramatic. People will give their homeopathic advice, but an arnica mountain daisy isn’t going to cure my crippling disease. People have made me feel the most lonely I’ve ever felt in my life. But here I am—living despite the battle of not only my disease, but of people that don’t understand what I’m going through. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Savannah-3-1-768x1024.jpg) I’ve learned that it doesn’t matter how bad the pain we are feeling is, either physical or mental. > As long as we can still *feel the love of those that love us, we will survive that pain, over and over again.* And I’ll keep going and doing the things I love with passion, grit, and heart. ***I am my own superwoman.*** -Savannah ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/SpacerShield.jpg) The views and opinions expressed are those of the author and do not necessarily reflect the views and opinions of the Global Autoimmune Institute. The experiences and health outcomes described in this article are unique to the author and do not serve as medical advice. **Category:** Devic’s disease/Neuromyelitis Optica --- ### [Rahel's Story: MCTD, Raynaud’s, & Living with Gratitude](https://www.autoimmuneinstitute.org/autoimmune_stories/rahels-story-mctd-raynauds-living-with-gratitude/) **Published:** January 10, 2022 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** How did this happen? Even several years before the diagnosis, which was ultimately made in 2020, I was often tired and quickly exhausted. I blamed pain in my foot, knee, and shoulder joints on my excess weight and poor posture. My fingers became discolored in the cold and during times of stress. First, they turned pale, then blue, and then they returned to normal. **Content:** *Rahel manages her chronic illnesses ([Mixed Connective Tissue Disease, Raynaud’s, dermatomyositis](https://www.autoimmuneinstitute.org/2022/01/10/rahels-story-mctd-raynauds-living-with-gratitude/ "Rahel’s Story: MCTD, Raynaud’s, & Living with Gratitude")), while living with gratitude and encouraging others to do the same.* ### **RAHEL’S STORY** At first, I thought I should write a philosophical article about the sense and nonsense of my disease. But then I decided to write about my life, how I found a diagnosis, and how I deal with it. If you prefer something philosophical, you can read the essay by Albert Camus “The Myth of Sisyphus”. > **With an illness, you feel similar to Sisyphus: one day you have rolled the rock almost to the top, and the next day the boulder rolls over you and down towards the valley again.** About 20 years ago, I was working in a retirement home and I remember a conversation with a resident when she said, “You see, I get up every morning and I’m in pain. But I am happy about every new day and being able to get up.” At the time, I thought that it must be terrible, to be in pain every day and know that it is not going to stop. **Now I am in a similar position, feeling a few decades away from entering a retirement home myself.** How did this happen? Even several years before the diagnosis, which was ultimately made in 2020, I was often tired and quickly exhausted. I blamed pain in my foot, knee, and shoulder joints on my excess weight and poor posture. My fingers became discolored in the cold and during times of stress. First, they turned pale, then blue, and then they returned to normal. > When my wrists finally started to hurt as well, I could no longer find an adequate excuse. That was when I went to see my family doctor. She referred me to a rheumatologist in our hospital, who arranged for a wide range of examinations in various specialist areas. **After some time, mixed connective tissue disease became my new “emotive word”.** I also added the tongue twister dermatomyositis, as well as Raynaud’s disease, to my vocabulary. And what does a modern person do in the digital age with all these new terms? Of course, they look up their diagnosis on Mr. Google. Not a bad idea if you can reach out to your doctor with questions and if you do not panic so quickly. Because on your search, questions will inevitably arise. And you are well advised to discuss them with a real person. **Medication can help a lot with this disease.** At the beginning, my muscles deteriorated relatively quickly. I could hardly get up from sitting or lying down, and opening bottles and doors became a challenge. > *Walking was, and still is, painful and exhausting.* However, with the medications, I can get up better again, open doors, and just go about my daily life more or less normally. I think that I have also been able to make progress thanks to the fact that the doctors reacted so quickly and the therapy started so soon. The therapy, which is now almost 10 tablets a day, includes an immunosuppressant, cortisone, and an anti-malarial drug (probably the most important ones). This is my very own chemical trinity. **Admittedly, at the beginning, when the muscles were beginning to show signs of giving up the ghost, I already saw myself in a wheelchair.** I saw all my chances being lost and I panicked a bit now and then. But my family and friends have always been a good support. The daily walks with our little dog keep me moving and provide mental balance as well. I also do moderate strength training in order to keep the strength I have. I have learned a lot about the human body. This whole thing would be very exciting and interesting if it were not so limiting and painful. It is unbelievable what the body does. > *I am always amazed at my hands when Raynaud’s disease strikes, in terms of the colors.* **Social media opens great networking opportunities for people with rare diseases.** ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Rahels-Story-2-2-1-768x1024.jpg) Thanks to Instagram I’ve learned about other sufferers and can learn quite a few things about how others manage their daily lives. Many institutions offer help as well. First and foremost, I would like to thank the Global Autoimmune Institute. They provide helpful information, including the [Autoimmune & Chronic Illness Toolkit](https://www.autoimmuneinstitute.org/autoimmune-chronic-illness-toolkit/). In our region of Switzerland, the “[Rheumaliga Schweiz](https://www.rheumaliga.ch/)”, for example, offers help in various forms. **Finally, I would like to say that you should not lose hope. It is worth fighting even if the road is rocky. I stick to the statement of the elderly woman from the retirement home: “I am happy about every new day”.** -Rahel ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/SpacerShield.jpg) The views and opinions expressed are those of the author and do not necessarily reflect the views and opinions of the Global Autoimmune Institute. The experiences and health outcomes described in this article are unique to the author and do not serve as medical advice. **Category:** Mixed connective tissue disease (MCTD), Raynaud’s --- ### [Presha's Story: Being Okay With Not Being Okay](https://www.autoimmuneinstitute.org/autoimmune_stories/preshas-story-being-okay-with-not-being-okay/) **Published:** October 18, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** The beauty of a chronic illness is that it forces you to eventually acknowledge, then tolerate, and dare I say, gradually embrace the multitude of everyday setbacks and find something in each day that is worth being grateful for. **Content:** ***When sudden, unexplainable symptoms continued to intensify, Presha Kardile knew something was wrong.*** *What followed was a year of constant ER visits, normal bloodwork, and no medical explanation for why she was so sick.* *Following an antibody test, it was eventually revealed that Presha lives with [mixed connective tissue disease (MCTD)](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/mixed-connective-tissue-disease-mctd/ "Mixed Connective Tissue Disease (Mctd)"), with a strong clinical manifestation of lupus. MCTD is a serious rheumatic illness that affects multiple parts of the body, and presents with signs and symptoms of other autoimmune diseases.* *The difficulty of living with her condition and searching for answers left her grieving the loss of her former life. Eventually, it also led to a place of deep reflection. In her thoughtful essay below, Presha explores the bright lights of acceptance and gratitude, and how they changed the way she sees her body and her life with chronic illness.* ### **PRESHA’S STORY** > **Some days make me aware of every breath, every movement, every blink of my eyes, and every single inch of my body because of the effort it takes to simply be.** Ironically, today, those are the same moments that make me feel grateful to be who I am, and grateful for how my body gives itself to me so selflessly. While I was penning down my initial thoughts pondering on how to best approach this topic, I could feel the side of my right thumb throbbing painfully. An accidental brush of my leg against the corner of the couch reminded me of the sleepy, or rather dormant, pain that always accompanies days like these. Days like these.. stretched periodically into weeks or months and even the better part of a whole year, eventually become the new normal of human experience. > **Being diagnosed with an autoimmune disease at the prime of my life was definitely not something that I had factored in.** I was a young woman with dreams of traveling the world and no ceiling on her ambitions. It also did not occur to me how embarrassingly ill-prepared the world and its institutions are. Rather than someone with a chronic health condition living life on their own terms, they are forced to dive in and out of the accepted flow of ‘normal’ life. So, how does a gym-going state-level basketball athlete, who signs up for every club and activity, runs for leadership positions, and somehow also finds the time to be a part of a dance group, react to adopting a new normal? How does she react to taking as many medications as her father’s sixty year-old self while struggling to sit upright, fold her legs, or get up to fetch a glass of water? Not kindly. My chronic illness was never ever acknowledged out loud within my familial sphere. **It was something that had reared its ugly fangs temporarily and would ‘go away’ one day, once we had conquered it with a lot of unsolicited advice and medications.** It was only a matter of time.. apparently. While originally from a town called Nashik in the state of Maharashtra, India, I had spent close to eight years in the United States attending college and working, away from everything that I had ever known. Yet I had never felt more isolated or out of my depth than when I was living back in Nashik, back in familiar surroundings, with a chronic illness. > I was pressured, nonverbally and relentlessly, to reach a state of normalcy that was unattainable. It certainly did not help much when I realized, with every passing day, that day-to-day life was not designed to accommodate people like me. To top it off, deemed to be of marriageable age, there was an undercurrent of urgency that came along with every new treatment that I was subjected to, in the hope that I would soon be back to “normal.” **It came to a point where I was unable to decide if my mental state was causing me more anguish than the autoimmune disease itself.** After several years of denial, dramatic manifestations of angst, and overall feeling miserable for myself, I had a profound realization. The realization was in no way groundbreaking, but it did shift my perspective for the better and save me from myself in innumerable ways. > **The key was to be okay.. with not being okay.** Easier said than done, right? **The beauty of a chronic illness is that it forces you to eventually acknowledge, then tolerate, and dare I say, gradually embrace the multitude of everyday setbacks** and find something in each day that is worth being grateful for. This is important because if you cannot accept your own limitations with compassion, you cannot hope that the world will, either. Change always starts from within and then slowly, through your own mindful actions, begins to manifest itself in the outer world. For me, it all started with a passionate blog post I wrote in the month of March, which happens to be World Autoimmune Awareness Month. > This simple act of accepting myself in my current state of being not only helped me cope mentally, but also made me want to help those around me who are silently struggling as well. It’s hilarious how, a lifetime ago, thirteen-year-old Presha wanted to be anybody else but who she was physically. She wanted to be one of those girls who was not looked at like she was was committing a crime by occupying a body this size, this dark, this fat, this tall.. this and that. How meaningless all of that seems now. The embarrassment and hesitancy, the worrying that I was too much, too big, too heavy, too tall, or too wide. **Now, I look at my heavily-medicated, bloated self with blotchy skin and achy joints, and I could not be more in love with the woman I have grown to be.** As devastating as this pandemic is, I finally feel like a part of the world once more. It feels like the world paused and, respectfully, made space for me and my body. Now, when I talk to people in everyday life, I can feel a similar tiredness and exhaustion reflected in their eyes, as they are in mine. Every smile and word of empathy has become more meaningful, with emotions that come from a place of understanding. As I sit in my pajamas on a Saturday night typing out my notes with sore knees and tired eyes, the pressure of pretending to be “okay” slowly dissolves into the vast ocean of self-manufactured compassion and acceptance of life as it is in this moment. The world still has a lot of catching up to do. It continues to be a place where anyone who does not fit into the standard, everyday systems of life is left behind, or has to put in double the effort to catch up in the race. > **If this pain is inevitable, so is change.** My hope is that one day I feel as comfortable with navigating the world in my body, as I do with living in my body today. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Presha-2-IMG-20180510-WA0012-1022x1024.jpg) **But, for tonight, it is enough that I love who I am, and have found a way back to myself through all the suffering of the recent past.** Tomorrow.. is a new day with a new opportunity to be a catalyst for change, to speak and be heard, to debate and discuss, to embrace and let go, and to lead and be led. But, for tonight, it is enough that I am.. breathing in the moment, grateful for this day and looking forward to a new tomorrow. -Presha ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/SpacerShield.jpg) The views and opinions expressed are those of the author and do not necessarily reflect the views and opinions of the Global Autoimmune Institute. The experiences and health outcomes described in this article are unique to the author and do not serve as medical advice. **Category:** Lupus (SLE), Mixed connective tissue disease (MCTD) --- ### [Morgan’s Story: Getting Help with Crohn’s Disease](https://www.autoimmuneinstitute.org/autoimmune_stories/morgans-story-getting-help-with-crohns-disease/) **Published:** August 6, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Morgan, who has lived with Crohn’s disease for years, describes the experience of avoiding help and offers insights she learned along the way. **Content:** ***Raise your hand if you’ve ever hidden your symptoms from others—or even from yourself.*** *Just about everyone living with chronic illness has likely done this, whether knowingly or not. The pull to feel normal and the fear of being judged are 100% valid. We all know that this world can be unfriendly to those of us managing chronic conditions like autoimmune disease.* *But we need help! We have to hang onto the hope that there are peers and doctors out there who understand, who can give us the support and treatment we need. In Morgan’s story below, she describes the experience of avoiding help and offers insights she learned along the way.* ### **Morgan’s Story** Hi, I’m Morgan. I am 21 years old, and I have [Crohn’s disease](https://www.autoimmuneinstitute.org/crohns-disease/). I was diagnosed when I was 16, although I can say I definitely showed symptoms much earlier. As a teenager you will do almost anything to fit in, to not be seen as the slightest bit different. So, as a naïve 16 year old, I hid the IV bruises with long sleeves, and the pain I was in with fake smiles. I didn’t even tell my family something was wrong for a few months. All I knew was I was having severe pain after eating, and low grade fevers every evening after getting home from the beginning of my junior year of high school. Once I finally told my dad something wasn’t right, he took me to my pediatrician. She had no idea what was going on, so she referred me to a gastroenterologist. The GI then scheduled me for my first colonoscopy and endoscopy, which was how I was diagnosed with Crohn’s. I went to my follow up appointment not knowing what to expect, and left a completely changed person. > I had never heard of Crohn’s disease before. I was terrified. I should have been worrying about boys and my upcoming tests for school, not a diagnosis that changed my life overnight. But, that’s what happened. What makes it even worse, is I knew absolutely no one with a chronic illness, much less Crohn’s. It was such a battle to get myself out of bed in the morning and go to school. I had pretty good grades, but my work ethic fluctuated. Some days I would give everything I had to my school work, and others, not so much. It was hard but with determination, I did it. > *“I*t’s possible to pull through and live with a chronic illness*.”* I didn’t start a biologic or regularly start seeing a GI doctor for a really long time; I’m talking years after my diagnosis. I saw a GI once in 2016, which is when I received my diagnosis. But I didn’t start seeing one again or receiving treatment until 2019. Thinking back on that is very shocking for me. > *“*Prior to getting myself the help I deserved, I was miserable around the clock*.”* Nausea, vomiting, unbearable pain, fevers, aches.. I had it all. Once I got help, I felt relief from some of my symptoms very quickly. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Morgans-Autoimmune-Story-1-684x1024.jpg) If I can give you two pieces of advice, it would be: 1. **Surround yourself with people who love you, support you, and care about you.** With the right support in place, life starts feeling a bit easier and less heavy. 2. **Get yourself the help you deserve.** Don’t stay in pain and agony. While I know everyone’s experience with IBD varies, I promise you, getting help is worth it. If you know you need help, but don’t know where to start, the [Crohn’s and Colitis Foundation](https://www.crohnscolitisfoundation.org/) has so many resources available to help patients with IBD. Lastly, whether you are newly diagnosed or have been for a while, please remember there is ALWAYS hope. You just can’t stop fighting for yourself. Please hang onto hope. -Morgan ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/SpacerShield.jpg) The views and opinions expressed are those of the author and do not necessarily reflect the views and opinions of the Global Autoimmune Institute. The experiences and health outcomes described in this article are unique to the author and do not serve as medical advice. **Category:** Crohn’s Disease --- ### [Morgan's Update: Keeping Dreams in View While Having Multiple Illnesses](https://www.autoimmuneinstitute.org/autoimmune_stories/morgans-update-keeping-dreams-in-view-while-having-multiple-illnesses/) **Published:** July 25, 2022 **Author:** Elevation **Excerpt:** When you have multiple chronic illnesses, a new diagnosis often brings new waves of frustration, fear, and grief. That’s what Morgan experienced when she was diagnosed with two new diseases. Through overwhelming struggles, Morgan was eventually able to achieve one of her greatest dreams. **Content:** *When you have multiple chronic illnesses, a new diagnosis often brings new waves of frustration, fear, and grief. That’s what Morgan experienced when she was diagnosed with two new diseases. Through overwhelming struggles, Morgan was eventually able to achieve one of her greatest dreams. Now, she wants to remind others that it gets better. In this update, Morgan shares the latest developments in her life and health journey.* ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Morgan.png) **MORGAN’S STORY: AN UPDATE** Hi, As some of you may already know, my name is Morgan. I’m 22 now, and since [the last time I shared my story](https://www.autoimmuneinstitute.org/2024/02/20/morgans-story-getting-help-with-crohns-disease/), A LOT has changed. > In January 2022, I was diagnosed with 2 more chronic illnesses in addition to my [Crohn’s Disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crohns-disease/ "Crohn’s disease"). I was diagnosed with Gastroparesis and Colonic Dysmotility These 2 new diagnoses shook my world. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/morgan-240x300-1.jpg) **I knew something was wrong for quite some time, but it was extremely difficult to get any doctors to truly listen to me, as a young female.** Soon after receiving my diagnosis of Gastroparesis, I had a surgical feeding tube placed. There were complications with it, one after the other. But eventually, my condition stabilized to the point where I don’t have to use my tube that often, unless hydrating because of difficulty due to nausea. **After I started feeling better, I was able to start applying for jobs again! And now, I work at Walt Disney World!** ### **IF I COULD GIVE SOME ADVICE, THIS IS WHAT I’D LIKE TO SHARE:** ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/morgan2-225x300-1.jpg) 1\) **It gets better, I promise**. Tomorrow needs you here, so do whatever it takes to get you to tomorrow. 2\) **Having someone around to support you** through the tough moments is SUCH a game changer. For me, this was my friend Ally, when my feeding tube was placed. She held my hand, advocated for me when I couldn’t and reminded me I wasn’t alone. If it wasn’t for her, I’m not sure how I would’ve gotten through that night. 3\) **Being chronically ill doesn’t get to hold you back.** You fight for answers, you adapt, you grow, you fight, and you keep going. I never imagined I’d be here working at my dream job for the past 2 months, but here I am.. and I’m so happy! Please, don’t let your diagnoses stop you. Our lives may look a little different than others’ lives, but we can still reach our goals with some accommodations, patience, and time. If there’s a will, there’s a way. I believe in you. 4\) Use your voice. If you can’t speak for yourself, find someone in your life to help advocate for you. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/morgan4.jpg) > If you feel like something is wrong, speak up. And if no one’s listening, SHOUT until someone does. **YOU know YOU best.** No one knows you better than you. You deserve answers, you don’t deserve to suffer. If you’d like to know more about my story, follow my Instagram: @[mightymorganl](https://www.instagram.com/mightymorganl/) – Morgan ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/SpacerShield.jpg) The views and opinions expressed are those of the author and do not necessarily reflect the views and opinions of the Global Autoimmune Institute. The experiences and health outcomes described in this article are unique to the author and do not serve as medical advice. **Category:** Crohn’s Disease --- ### [Monwabisi's Story: Growing up with Vitiligo, Growing into Self-Acceptance](https://www.autoimmuneinstitute.org/autoimmune_stories/monwabisis-story-growing-up-with-vitiligo-growing-into-self-acceptance/) **Published:** April 1, 2022 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** This was emotionally tough for me. I cannot say I enjoyed my teenage years like other boys. Low self-esteem and fear of rejection were part of my high school and post-tertiary life, and that has affected my confidence and social life. **Content:** *Although [vitiligo](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/vitiligo/ "Vitiligo") is usually visible to others, the emotional impact of living with this autoimmune skin disease is not always outwardly apparent. When Monwabisi began developing signs of vitiligo, members of his rural community were perplexed, and sometimes unkind, about his appearance. Undiagnosed and struggling to feel comfortable in his own skin, Monwabisi realized that he needed to look beyond his small town for answers. In his story, Monwabisi reflects on being diagnosed with multiple autoimmune diseases and learning to embrace his “perfect imperfections”!* ### **MONWABISI’S STORY** > Vitiligo is exotic, beautiful, and unique – but for me, it’s “perfect imperfections!” My journey has not been easy. My vitiligo appeared when I started high school in 1991. I can remember my teacher making fun of my appearance, saying that my pink and peeling mouth looked like that of an alcoholic. Growing up in a small rural town where there are superstitions and beliefs, people said a lot of things about my skin. To try and find answers, I visited traditional healers and a local doctor who had a practice in a nearby village. That doctor got it wrong and said that I had been poisoned. > **To be diagnosed correctly, I had to go to an academic hospital in another province.** That was made possible by my aunt, who was a nurse at the time and was also diagnosed with vitiligo years after her retirement. My treatment started with topical creams. Later, PUVA therapy became necessary because my skin was not responding. At one point, I had to do this therapy three times a week. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/image-2-1-473x1024.jpg) This was emotionally tough for me. I cannot say I enjoyed my teenage years like other boys. Low self-esteem and fear of rejection were part of my high school and post-tertiary life, and that has affected my confidence and social life. **Just when I had accepted and embraced my condition earlier this year, I was diagnosed with not one but two other autoimmune conditions**: [Rheumatoid Arthritis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/rheumatoid-arthritis/ "Rheumatoid Arthritis") and [Hashimoto’s thyroiditis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/hashimotos-thyroiditis/ "Hashimoto’s Thyroiditis/autoimmune thyroiditis"). Now, I have no choice for managing my pain and other symptoms: I have to take medication with immunosuppressants. Surprisingly, within a few months of starting this new medication, my skin is starting to heal and I am beginning to have less back pain. > The medication has its side effects, but so far the benefits outweigh them. My view of available vitiligo treatments is that **they treat the symptoms, not the cause.** If the focus is on finding a cure for the cause, the healing will happen on its own. In South Africa, vitiligo is not classified as a chronic condition. The treatments are expensive and not covered by medical aids- however, other autoimmune conditions are covered. Support from family and friends is very important, especially if the person with vitiligo is a child. > Support is essential, especially for a person who deals with invisible pain which might lead to depression and low self-esteem. – Monwabisi ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/SpacerShield.jpg) The views and opinions expressed are those of the author and do not necessarily reflect the views and opinions of the Global Autoimmune Institute. The experiences and health outcomes described in this article are unique to the author and do not serve as medical advice. **Category:** Vitiligo --- ### [Meshach's Story: Believing in Yourself and Turning Burdens into Blessings](https://www.autoimmuneinstitute.org/autoimmune_stories/meshachs-story-believing-in-yourself-and-turning-burdens-into-blessings/) **Published:** August 24, 2022 **Author:** Elevation **Excerpt:** For many with autoimmune disease, the biggest obstacle is just getting a diagnosis. A combination of the complexity of most autoimmune diseases and the tendency for patients’ concerns to be dismissed play a large role in this. Whether you are visiting a doctor for the first time since your health issues started, transitioning to a new practitioner, or getting a second or fifth opinion, the process can feel daunting and many leave feeling dismissed or unseen. **Content:** *For many with autoimmune disease, the biggest obstacle is just getting a diagnosis. A combination of the complexity of most autoimmune diseases and the tendency for patients’ concerns to be dismissed play a large role in this. Whether you are visiting a doctor for the first time since your health issues started, transitioning to a new practitioner, or getting a second or fifth opinion, the process can feel daunting and many leave feeling dismissed or unseen.* Read Meshach’s story where she shares her experience with misdiagnosis, her steps to becoming her own health advocate, receiving her [Neuromyelitis Optica (NMO)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/neuromyelitis-optica/ "Neuromyelitis Optica/Devic’s disease") diagnosis, and finding [gratitude](https://www.autoimmuneinstitute.org/2023/11/13/what-is-gratitude/ "What Is Gratitude?") throughout the journey. ## **MESHACH’S STORY** ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/04/Meshach.png) In October 2014, I was a senior at North Carolina A&T State University preparing myself for graduation. I was already a semester behind the “normal” graduation expectancy timeline and was dealing with an unknown condition. I remember waking up one day, feeling unbearably sharp pains in my right leg. I was still able to walk, so I thought I had pulled something while exercising. I didn’t think much of it, but it wasn’t going away. A few days later, the pain transferred to my left leg, so I decided to go to Urgent Care. They diagnosed me with sciatica and gave me a prescription for Adderall and Tylenol. > > I felt so unseen. I did not feel that the diagnosis was adequate. I chose not to take the drugs prescribed to me and I wanted a second opinion as I felt so unseen. As the days went on, the pain persisted; I knew something wasn’t right with my body. One night, I couldn’t take the pain anymore and went to the Emergency Room. I expressed everything that I was going through and they checked me into the hospital and conducted an MRI and multiple blood work panels. **A strong opinion I hold that I will always tell people is, “if it does not feel right, never settle and always advocate for yourself.”** ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Meshach-3-768x1024.jpeg) The next day in the hospital, doctors came back with the diagnosis that I had [multiple sclerosis (MS)](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/multiple-sclerosis/ "Multiple Sclerosis"). I still wasn’t able to fully walk without dragging my left leg. They wanted to conduct more exams and even took a sample of my spinal fluid for testing. At this point, I was thinking, “I have MS and my entire world is shattering.” > My mind started being consumed with all the negative thoughts I could think of; could life get any harder? I was worried about school, worried about how my life was going to be moving forward, and ultimately feeling insecure in every way possible. By December 2014, I had accepted the diagnosis but it still didn’t sit well with me. I was on break from school and came back home to New York where I met with a neurologist. He ran his own exams, a physical test, blood work, and provided me with steroids in the meantime in order to thoroughly examine me. I expressed a new symptom of hiccups. **This was when he realized I did not have MS, and for the last time, I was diagnosed with Neuromyelitis Optica (NMO), otherwise known as Devic’s disease.** NMO occurs when your own immune system reacts against its own cells in the central nervous system, spinal cord, and sometimes also the brain. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Meshach-1-549x1024.jpeg) > At the young age of 22, I became an Autoimmune Warrior. **With my neurologist’s help and consideration, I can happily say I am living a “normal” life (which he promised when we met) with no flare-ups.** Every year I have my infusion appointment, doctor’s visit, MRI exams, and blood work done. I am a woman who believes in faith and knows that with God by my side I am capable of facing my fears and see this diagnosis as a blessing now! This blessing has led me to start my own nonprofit organization, which is a safe space for anyone, especially people of color, to share their journey without judgment, with numerous other involvements. – Meshach > [View this post on Instagram](https://www.instagram.com/reel/CgSNDceNmGz/?utm_source=ig_embed&utm_campaign=loading) > > [A post shared by Blacks With An Autoimmune Disease 🫶🏾 (@\_blackswithanautoimmune\_)](https://www.instagram.com/reel/CgSNDceNmGz/?utm_source=ig_embed&utm_campaign=loading) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/SpacerShield.jpg) The views and opinions expressed are those of the author and do not necessarily reflect the views and opinions of the Global Autoimmune Institute. The experiences and health outcomes described in this article are unique to the author and do not serve as medical advice. **Category:** Misdiagnosis, Neuromyelitis Optica --- ### [Margaux’s Story: When Food Sensitivities Catch You Off Guard](https://www.autoimmuneinstitute.org/autoimmune_stories/margauxs-story-when-food-sensitivities-catch-you-off-guard/) **Published:** January 26, 2020 **Author:** GAI **Excerpt:** Margaux shares her experiences with unexpected food sensitivities, revealing the impact on her life and the importance of diet and stress management. **Content:** ***Adverse reactions to various foods are quite common for people with autoimmune disease or related conditions. For many of us, it’s simply part of living with chronic illness.*** Gluten, dairy, soy, eggs, and other sensitivities mean that nourishing ourselves is walking a tightrope. Even a previously “safe” food can trigger symptoms, depending on when and how it was eaten, what it was eaten with, the amount consumed, and undiscovered sensitivities. Diet and other lifestyle factors also play into this disorienting balancing act. For Margaux, food sensitivities result in a frequent bombardment of symptoms like acid reflux, abdominal and joint pain, bloating, flu-like aches, nausea, migraines, and faintness. They are triggered by some foods and food additives as well as harsh chemicals and pollutants, and are more or less severe depending on factors like stress levels and sleep hygiene. When Margaux is tempted to neglect her mental health and her intuition, the scene below serves as a gentle reminder to listen to her body and act upon what it’s telling her. ### **Margaux’s Story** **The First Sign** It was a dark morning as I went into the kitchen for breakfast, groping the walls for a light switch. A cyclone of to-do lists and worries had jolted me out of a deep sleep, insisting that my brain was alert enough to take on the day. I warmed my porridge on the stove, ignoring the waft of nausea that fluttered up my throat. I was used to this sickly feeling at mealtimes because of my chronic acid reflux, but after just waking up? This was odd. Still, I shrugged my shoulders and kept poking at the frozen, orange cylinder sizzling in the pot. **Using Food to Heal** A few weeks ago I’d made a large batch of “noatmeal” and stuffed my freezer full of single portions. It was a cozy breakfast porridge made with acorn squash instead of oats, plus coconut milk and a few spices. “Noatmeal” is a comforting, grain-free option for those of us on certain elimination and healing diets, like the Autoimmune Protocol (a.k.a. AIP). The AIP approach excludes anything that could potentially cause inflammation or exacerbate intestinal dysbiosis like dairy, gluten, processed foods, nuts, nightshades, and sugar, while adding in more nutrient-dense foods. It involves a primary elimination period, followed by multiple reintroduction phases. > The [Autoimmune Protocol](https://www.thepaleomom.com/start-here/the-autoimmune-protocol/) has helped me pinpoint which foods are causing harm and triggering painful reactions. It has also alleviated many symptoms and allowed for more control over my illness. I’ve since combined it with a [low-FODMAP diet](https://www.monashfodmap.com/ibs-central/i-have-ibs/starting-the-low-fodmap-diet/) and other adjustments, according to what my body can tolerate. If you’re considering [elimination diets](https://www.autoimmuneinstitute.org/2022/01/13/elimination-diets-what-you-need-to-know/ "Elimination Diets: What You Need to Know") like these, I recommend working with a registered dietitian who can guide you through this very personal and challenging process. **Stress and Food Reactions** I was attempting to calmly stir my food, but a long list of to-do’s invaded my head-space, circling like vultures. *Don’t forget to… Review that list before the call…* *Gotta write that down!* Thus commenced the studio apartment version of the hundred yard dash – kitchen to office to kitchen to office. Stirring pot. Writing on laptop. Stirring pot. Writing on paper. Adding raisins to pot. Writing on phone. You get the idea. My downstairs neighbors were probably wondering if I started a side gig running a kangaroo daycare. I was simply trying to generate a new superpower where you sprout an extra brain and a couple more limbs, and suddenly have the ability to cook, check email, write, and put on makeup all at the same time. *Just stop working by 4pm today*, a voice echoed in my head, *then you can relax*. *Relax*. This is code for spending two hours cooking dinner and eating while researching air purifiers. Speeding over to a coffee shop to meet a friend. Falling asleep while scrolling through articles about Candida overgrowth and estrogen mimickers. In the middle of a restless sleep, I’d wake up at 3am with a fiery, burning throat and equally burning desire to write down all my brilliant ideas before they disappeared. I might fall asleep for another hour, before opening my bloodshot eyes to Instagram and emails. And then I’d dive out of bed (despite the lack of fire alarm or other emergency) to get back on that hamster wheel. > Those crazed, 3am wake-ups were signaling a major problem. My cortisol (a hormone responsible for mediating metabolism, sleep cycles, and stress response) was spiking at the wrong time, and remaining active for much too long. Cortisol is meant to increase in the morning when we’re ready to start the day, and decrease at night as we wind down for bed. **This stress hormone – cortisol – also acts as the body’s alarm system, rising in the form of elevated heart rate, blood pressure, and blood glucose levels as the sympathetic nervous system (a.k.a. fight or flight mode) is activated.** This enables appropriate responses when faced with threats. If the body stays in this state for extended periods of time or at inappropriate times, however, it can have negative effects. It is not normal or healthy for our bodies to be in a chronic, low-grade state of stress. The consequences can involve issues with the gut microbiome and endocrine, immune, digestive, and reproductive systems. Those spikes in cortisol in the middle of the night, that perpetual state of frenzy I was living in – they were the result of my chronic conditions. But they were equally influenced by the choices I was making in my life and how I was reacting to external stressors. My body has been a hodgepodge of hormonal imbalances and inflammation since 2013. It took six years (yes, SIX years!) to finally recognize the emotional component in healing. It didn’t matter how strong I was, or how well I felt I was handling my health issues. > Deep down, the burden of my health condition – of trying to find a diagnosis, advocating for myself, budgeting for all the care that my insurance didn’t cover – weighed heavily on me. **Having a chronic condition is a stressor all on its own.** This ball and chain I dragged around 24/7 came with a train of fluctuating emotions like frustration, overwhelm, shame, sorrow, disappointment, anger, fear, and hopelessness. I’m sure there’s many more. Once in a while, a deep grief for the life I’d lost would also settle in amidst the chaos. Add in a heaping spoonful of daily life and work challenges, plus the enormous amount of time and energy spent in the kitchen addressing food sensitivities and using nutrition to heal. I was left with this vicious cycle of chronic pain and symptoms fueling imbalanced stress responses to that pain, and vice versa. It got so bad that, mentally, that I had nowhere to go. Years of my chronic illness life had been spent discounting the fact that living on-edge, in a constant state of worry and pressure, could exacerbate symptoms or contribute to my inability to heal. Now it was time to acknowledge the power I possessed to influence my current circumstances. The only thing to do was tiptoe forward into the lukewarm embrace of acceptance. > I had been putting too much pressure on myself and neglecting my mental health. **Step one was understanding that I needed to better manage my stress levels. Step two was finding the tools to properly address them** – a phase I hadn’t yet entered as I rushed around my apartment that morning. **Pushing the Limit** I dug into my to-do list while slopping spoons of squash into my mouth. Creamy, nutty, easy fuel. There was no time to prep an elaborate meal, to sit and chew and relax. No time to notice that I was breathing through my mouth to avoid the smell of it. About halfway through the bowl, I had the feeling that I should stop eating. It gradually started to taste – not just smell – like vomit. > *That makes no sense. I ate this the other day, and I was fine…* As I continued, a low roar muffled deep within my gut. I nearly finished the bowl, forcing the spoon up to my mouth, when the pain shot into my torso. *Oh no.. not again.* When this happens, I imagine a noxious little creature crouched inside my belly, slowly wringing out sections of my intestines like wet socks. The unwelcome resident then dries them with a bike pump, stretching the tissue so taught it almost pops. I got up to rid myself of tight yoga pants and put a dress on, walking gingerly to my closet as if the floor was made of broken glass. Stomach acid was crawling up the walls of my esophagus, threatening to shoot out my mouth. Every object in front of me flickered like a hologram. When I got back to my chair, I folded over my searing, swollen bump thinking, *I don’t want to do this anymore.* *WHY didn’t I just STOP eating it!?* But if you were to see me in that moment, you would’ve assumed that I’d had some iffy shrimp. Or that I’d gone a little overboard on wine Wednesday. The pain wasn’t written all over my face in streaky tears or a hot, bumpy rash. People might’ve simply written off my reaction as an attention-getting tactic, or rolled their eyes and insisted that it wasn’t that bad, that I was being dramatic, or even “faking it.” **Part of what made me feel dysfunctional was the pain. Another part was the frustration of having an invisible illness, and the energy it takes to explain what no one else can see.** But there was an additional, less familiar, element. As if my brain had been taken over by a 2-year-old playing with a Rubix cube. > I lost my ability to focus or process clear thoughts and I happened to be in the middle of a meeting. This was a new, alien symptom I would later find out is called “brain fog.” **Recovery** Thankfully, the work I do is centered around autoimmune disease, and therefore, moments like this when I’m on a call and can barely put together a sentence, are greeted with compassion rather than judgement. **Many of us are not so lucky, as it’s all too common for autoimmune patients to lose their jobs because of their illnesses.** Instead, my symptoms serve as a catalyst for the work we do, and a constant reminder that you never know what someone else may be going through. I stayed on the call and after about two hours, the pain, brain fog, and general malaise faded. Running hot water over the rest of the frozen “noatmeal”, I barely felt a prick of guilt as I dumped it into the compost bin. Now I could pretend to be normal again – until the next time. The next day or two it would be crucial to avoid all known trigger foods. But apart from a little extra bloating and stomach upset, I would go on as if nothing had happened. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Autoimmune-Story-When-Food-Sensitivities-Catch-You-Off-Guard.jpg) It could’ve been a new sensitivity to acorn squash or maybe a cross-contamination. > I chalked it up to a perfect storm of high stress, an unhappy gut, and the wrong food at the wrong time for my challenged system. After a six-month squash hiatus and healing my body a little more, I would go back to eating acorn squash without any reactions. **There’s still a long way to go, but through some deep internal work, compassionate practitioners, and lifestyle adjustments, these debilitating episodes have become less and less frequent.** -Margaux ### **Tips for dealing with unexpected food reactions** - **Listen to your senses.** The subconscious mind is constantly giving you hints, which are important to distinguish from fear. Fear is emotionally-charged and based upon past experiences or future uncertainties, while intuition is a clear signal anchored in the present. I casually check in with myself if I’m unsure. *Do I see, smell, hear, taste, or feel something that gives me pause?* And I always have an ear out for that little voice. - **Accept the unexpected.** Sometimes, eating a food on the “yes” list will lead to a reaction. You may also accidentally (or intentionally) eat a food on the “no” list. Rather than creating fear and frustration around it, try to reframe the reaction. It’s not possible to turn back time. Instead, pay attention to the internal language rotating through your mind and repeat kind, comforting words like: *It’s ok, it happens. Nothing is permanent. This is where I am now, but it’s only temporary. What can I do to move forward? How can I treat myself with kindness?* - **Enjoy meals in a calm state of mind.** Sharing meals with others is a wonderful practice. But if you work from home like I do, you may be eating alone a lot. I like to read a fun book that helps me unwind and forget about the pressures of daily life. It’s also soothing to play some nature sounds in the background. - **Eat at the table.** Mealtime is a ritual for me, like my bedtime routine. I try not to pick at food while I’m cooking, snack at my desk (that’s a tough one!), or multitask during meals. Breakfast, lunch, and dinner are often eaten at an uncluttered, simply-set table with placemats and little bunch of flowers or small plant. It helps me stay mindful, and focused on nothing but relaxing, tasting, chewing slowly, and digesting. - **Pay attention to stress.** Becoming aware of unhealthy (and completely normal!) reactions to having a chronic illness can be extremely helpful. Chronic stress can impact the digestive, immune, and endocrine system, playing a role in imbalanced and unusual reactions to food as well as other things. It can also influence the ability to tap into what your subconscious mind is telling you. - **Practice self-awareness and self-care.** There are healthy ways to respond to stress or prevent it from taking control in the first place. I’m learning to say “no” to things that would make me feel overwhelmed, to wake up in the morning and journal instead of jumping down an internet rabbit hole, to practice deep breathing, and to listen to my needs and take action. I periodically check in with myself on a mental and emotional level, just as I do when exploring food reactions. *What emotions am I feeling today? Am I experiencing physical signs of my emotional state like a tight chest or elevated heartrate? What is one small thing I can do to keep myself calm? Am I taking breaks from researching and thinking about my illness?* **Note**: If incorporating these kinds of practices into your life is causing more stress, if you are frustrated or disappointed with yourself for not “doing everything right” or sticking to certain lifestyle adjustments, the best thing you can do in those moments is show yourself compassion. It’s also highly recommended to seek counsel from a licensed therapist with experience in chronic illness or a practitioner specializing in food sensitivities. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/SpacerShield.jpg) The views and opinions expressed are those of the author and do not necessarily reflect the views and opinions of the Global Autoimmune Institute. The experiences and health outcomes described in this article are unique to the author and do not serve as medical advice. *Interested in* ***[sharing your story](https://www.autoimmuneinstitute.org/share-your-story/)*** *of autoimmune disease or chronic illness? Our prompts and tips may help!* **Category:** Food Sensitivities, Undiagnosed --- ### [KarlaMary's Story: Finding Yourself After an Autoimmune Diagnosis](https://www.autoimmuneinstitute.org/autoimmune_stories/karlamarys-story-finding-yourself-after-an-autoimmune-diagnosis/) **Published:** June 20, 2022 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** KarlaMary’s journey with Hashimoto’s reveals her path to self-discovery and resilience. Learn how she navigates life post-diagnosis and finds new purpose. **Content:** *After* *her life was shaken up by a [Hashimoto’s](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/hashimotos-thyroiditis/ "Hashimoto’s Thyroiditis/autoimmune thyroiditis") diagnosis, KarlaMary was left to deal with debilitating symptoms. But for her, the journey to healing wasn’t just about physical symptoms- it was also about finding herself again. Read KarlaMary’s story of searching for a new sense of purpose after an autoimmune diagnosis.* ### **KARLAMARY’S STORY** > In May of 2021, I was diagnosed with Hashimoto’s hypothyroidism- and I learned that I would be taking medication for the rest of my life. Prior to being diagnosed, I suffered a great amount of anxiety and depression. I experienced every symptom: fatigue, sensitivity to cold, constipation, and sluggishness. My face and thyroid were enlarged. I struggled with dry skin, which was challenging because I am already prone to having eczema. I also dealt with weight gain, which was up and down. For four months, I had an eating problem that caused me to starve myself on some days because I could not bring myself to eat. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/KarlaMary-768x1024.jpg) For a year, I became pretty much isolated from everybody. I was especially inactive on social media during that time because I was just hoping to find myself again. I felt like a lost soul: physically here but mentally gone. Today, I am working on finding myself and my purpose. I know that in time, I will! I say all of this as a reminder to everyone who may be going through a similar journey with Hashimoto’s or any autoimmune disease: > **You are not alone. Do not give up on yourself. Living with an autoimmune disease is hard, but it is worth the fight.** – KarlaMary ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/SpacerShield.jpg) The views and opinions expressed are those of the author and do not necessarily reflect the views and opinions of the Global Autoimmune Institute. The experiences and health outcomes described in this article are unique to the author and do not serve as medical advice. **Category:** Hashimoto’s --- ### [Justin's Story: Braving the Sacrifices That Come With Chronic Illness](https://www.autoimmuneinstitute.org/autoimmune_stories/justins-story-braving-the-sacrifices-that-come-with-chronic-illness/) **Published:** June 27, 2022 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Read Justin’s journey of resilience and sacrifices while battling ankylosing spondylitis, highlighting the challenges of chronic illness and caregiving. **Content:** *Living with an autoimmune disease is difficult, even when you have a strong support system. This autoimmune story is shared from the perspective of Justin’s mother, Katrina, who has been caring for her son since his [ankylosing spondylitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ankylosing-spondylitis/ "Ankylosing Spondylitis") diagnosis. Guided by faith and a mother’s love, Katrina continues to advocate for her son. Here, she reflects on Justin’s battle with debilitating illness, his eventual diagnosis, and the many sacrifices made along the way.* ### **JUSTIN’S STORY** My name is Katrina. I am writing this because I don’t know what to do. **My son, Justin, was diagnosed with ankylosing spondylitis, a painful chronic disease that attacks his spine and joints.** Because of his disease, Justin has been unable to walk or work since the age of 18. Before his illness, my son was working and running track and field. But one day, he started to feel pain that was so severe it brought him to tears. > I took Justin to numerous doctors but no one could ever tell me what was wrong with him. As time went by, he started to lose muscle mass. At 106 pounds, he was skin and bones. **Because of his declining health, we were more determined than ever to find answers about Justin’s illness.** I took some time off work and we traveled from our home in the Bahamas to Gainesville, Florida, where Justin was able to see a team of specialists. After three years of suffering, he was finally diagnosed with ankylosing spondylitis. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/eeafcd17-f00c-4dfb-a3d1-ba1806160cdf.jpg) Ankylosing spondylitis has a genetic component, and the doctors informed me that the risk factor gene for the disease was inherited from his father. Justin’s father left when he was 6 years old, so handling this situation on our own has been really hard for us. Justin now takes a medication called Humira to help manage his disease. He will have to take this medication for the rest of his life, but I always pray that God will heal him. > Justin’s disease has had an enormous impact on his life and on our family. I even lost my job due to the demands of caring for him. We were able to receive some assistance after our home was damaged by hurricane Dorian, but we had to spend that money in order to get Justin to the United States for his specialist visits. Now, we have nothing. I am sharing Justin’s story to encourage others. If you are living with an autoimmune disease, please share your story too. > **I hope that by speaking up, we can bring more attention to this disease and get more experts involved in looking for a cure.** Thanks for listening. – Katrina ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/SpacerShield.jpg) The views and opinions expressed are those of the author and do not necessarily reflect the views and opinions of the Global Autoimmune Institute. The experiences and health outcomes described in this article are unique to the author and do not serve as medical advice. **Category:** Ankylosing Spondylitis, Caregiver’s Story --- ### [Holly's Story: Courage Doesn’t Always Roar](https://www.autoimmuneinstitute.org/autoimmune_stories/hollys-story-courage-doesnt-always-roar/) **Published:** May 11, 2023 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Holly's journey with Guillain-Barré Syndrome (GBS) highlights resilience, recovery, and the power of quiet courage in overcoming life's toughest challenges. **Content:** *Many are struck out of nowhere with their autoimmune disease symptoms and diagnosis.* *Holly’s [Guillain-Barré Syndrome](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/guillain-barre-syndrome/ "Guillain-Barrè Syndrome") symptoms quickly progressed within 72 hours, leaving her paralyzed from the neck down and requiring a ventilator for breathing. While in the ICU, she began to slowly recover with the help of a survivor’s visit and the inspiration of getting home to her newborn daughter.* *Despite initially feeling weak and wanting to give up, she persevered and eventually breathed and walked on her own again, feeling stronger than she ever had before.* ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Holly.png) **HOLLY’S STORY** I had never heard of Guillain-Barré Syndrome (GBS) when I was first diagnosed with it 12 years ago. I had gone to the emergency room with weakness in my legs, severe pain in my neck, and tingling in my fingers—I thought I had a pinched nerve. My symptoms progressed very quickly, which thankfully made it easier for the doctor to recognize it, and when he said, “I think you have Guillain-Barré syndrome,” I remember thinking, “I have a newborn baby at home, so please just give whatever medication I need so I can leave.” Unfortunately, that didn’t happen. GBS is a rare autoimmune disorder that affects the peripheral nerves (all the nerves excluding the brain and spinal cord), causing weakness and paralysis. It can be very severe. > **This weakness spread through my body like wildfire and within 72 hours, I was completely paralyzed from the neck down in the ICU, breathing through a ventilator on life support**. It was devastating to me and, of course, my family and friends, especially when there were no signs of recovery for so long. I had just given birth to my daughter Casey by c-section three weeks prior, which was likely my trigger, and I felt utterly hopeless that I was ever going to make it out of this and get back to my little girl. **I felt angry and robbed of my life as the weeks passed, and I lay completely paralyzed in ICU.** I remember thinking, “This can’t be happening. This sort of thing only happens to other people— people on the news. Not me.” > My life as I knew had been taken away from me in the blink of an eye. My friends and family had also never of GBS. Many of the doctors and nurses who cared for me had only seen a case or two in their entire careers, if at all. I was paralyzed, trapped in my own body, in the most pain I’d ever experienced in my life, unable to communicate other than by having my family members point to letters on a communication board. I would blink my eyes when they pointed to the letters I wanted to use. I’d spend quite a while forming sentences. I remember one time shaking my head back and forth to motion my mom to grab the communication board and having her spell out C-A-L-L O-P-R-A-H. Call Oprah. I remember thinking, “Oprah needs to come here right now to see what this rare disease did to me. Now, I was on a lot of drugs at that time and actually believed that they could just pick up the phone and have Oprah by my bedside in a matter of days. But it wasn’t just the drugs. **Even in that fragile state, something inside of me knew at that time that I wanted people to know more about GBS.** I went from being completely healthy to breathing on a ventilator in days, uncertain if I had a future at all. > I knew then that I wanted my story to bring awareness to this rare disease that devastated my life. For weeks and weeks, I struggled, with emotional and physical pain, at times certain I would never get out of ICU. To lift my spirits, my nurses asked another GBS survivor named Kit to visit me. Like me, he had a severe case of GBS and had been on a ventilator, and not only had he been in the same hospital but in the same room I was in. And when he walked into my hospital room completely recovered, for the first time, I believed that if he could do this, then maybe so could I. Kit brought along with him a sign that he immediately taped to the wall right in front of my hospital bed. It read: > “Courage doesn’t always roar. Sometimes, it’s the soft voice at day’s end saying I will try again tomorrow.” ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/holly-780x1024.jpg) And for the first time in my journey, I felt understood by someone else. Because prior to that, I didn’t feel strong. I had wanted to give up many times, pleading with my nurses to shut off the machine and let me die. **I was ashamed that I didn’t feel strong the way everyone thought and was telling me I was.** That quote reminded me that I didn’t have to feel strong to get through this. I could do it with tears in my eyes, whispering to myself at the end of any other horrific day, saying I’ll try again tomorrow. My daughter, of course, was my biggest inspiration of all. I hadn’t even had a chance to be a mother to her yet, something I had wanted to be my entire life, and I knew I had to fight for that. There were many things I still needed to do, like take her on her first walk, take her to her first day of school, watch her graduate, and dance with her at her wedding. My daughter kept me going. Over time, I improved very slowly. And very slowly, my lungs got stronger, and I started to wean off the ventilator. At first, it felt impossible. Seconds off of it felt like I was underwater about to run out of air. I remember thinking, “I can’t do this. I’m never going to be able to do this.” I had to last over 48 hours off the ventilator before they would take out the tube in my throat, and I could barely last a few seconds. But I looked up at the sign in front of me every day and promised to always try again tomorrow. I went from lasting 1 minute to two minutes to an hour to two and so forth. Weeks later, I accomplished that goal. I could finally breathe on my own, had the tube removed from my throat, and left ICU after 70 long days. **After realizing what I had overcome, it sparked this fire in me. I had done something I thought was impossible.** > **I promised never to doubt myself again.** From there, I learned how to use my body again. How to hold cutlery to feed myself. To brush my hair and teeth. To take care of myself. To hold my daughter in my arms. I eventually moved to a rehab hospital where I learned to walk with a walker, then later a cane, and eventually on my own. I went home after 126 days in the hospital when my daughter was almost 6 months old. I have continued to use that “Courage” quote in my life, and it’s followed me throughout my recovery from GBS. I first did outpatient therapy, where I met an incredible physiotherapist who convinced me he could get me even stronger than I was now. He taught me how to exercise, and I fell in love with the way it made me feel. I eventually got into running on a treadmill for a few minutes at a time, which was awkward and hard, but over time it got easier. When I finished with physiotherapy, I knew my recovery was on me, and I had to put in the work. I got fitness bands and exercised from my couch. I went for walks every day with my daughter in her stroller. I wasn’t back to normal, I couldn’t walk very far and had trouble with balance and strength, but at least I was home. At one point, I decided to start running outside, and I remember one of the first few times I did it was so painful and challenging that I had to stop halfway through and walk the rest of the way home. **I remember at that point just feeling defeated, feeling like I should stop and give up—but at least I could walk.** I wasn’t even a runner before GBS, did I really need to run? But I knew I wanted to play tag with my daughter one day. I thought back to that sign in the ICU and reminded myself I could just try again tomorrow. So that’s what I did. > I learned to rest but also to get back up and go again. Over time running got easier until I was eventually running 5km every few days. I got into strength training, then the best shape of my life, and later was certified in fitness training all because I promised myself to keep trying again tomorrow. I still remember the first GBS conference I went to back in 2011, the year I was diagnosed. It happened to be in Edmonton, where I lived. I walked in very slowly and awkwardly because I was still recovering, and I instantly felt this warmth and comfort, and sense of community. **For a long time, I felt very alone, even though I had an incredible support system who was by my side every step of the way, but they didn’t have GBS, so there was no way they could truly understand what I was going through**. But at the conference, I met all these people who understood exactly what it was like. And then to meet the doctors and neurologists who were passionate about GBS and understood the disorder in ways I hadn’t seen from other healthcare workers was very heartwarming. After I recovered, I knew that I wanted to be a part of the foundation and help raise awareness and provide support. I had to give hope to others the way Kit had done for me. **While GBS was one of the worst experiences of my life, and while I still struggle with residuals such as nerve pain and fatigue, I still look at it as of the best things to happen to me.** > **My diagnosis changed my entire view of the world and put me on a new path in life.** My mom had taken many videos of me in the hospital, which I spliced together into a YouTube video that ended up going viral. And it was then that I knew I was diagnosed with GBS for a reason. People were reaching out to me from all over the world, people with family members recently diagnosed, survivors who had GBS 20 years ago and had never talked to another survivor, and even doctors and nurses thanking me for sharing my story. This encouraged me to write my book [Life Support: Surviving Guillain-Barre Syndrome – A Mother’s Story of Hope and Recovery](https://www.amazon.com/dp/B0BP9MV69J?ref_=cm_sw_r_cp_ud_dp_NXXQVFDB29347VN4CDHH), published in January of 2023. I was brought up believing that everything happens for a reason. And I see that for my case, I’ve been able to bring awareness all over the world through my videos. I’ve been able to visit patients in the hospital the way Kit did for me. **I’ve been able to educate doctors and nurses, the ones who held our hands and wiped our tears but who didn’t always understand our pain.** For some autoimmune survivors, they may also believe that everything happens for a reason and that their diagnosis changed their life for the better. But it’s also okay not to believe that. It’s okay if you have to search deep to find a reason yourself. > We certainly didn’t have any control over what happened to us before, but we can make the choice to turn our pain into power. To search for the blessings within in our journeys. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Holly-2-1024x576.jpg) I personally have this intense gratitude for getting to be a mom to my daughter again, who is now 12 years old. We have an incredible bond, one that I’m not sure we would have had we not gone through what we did together. So that’s something special that I got from my pain. So, whether you are new in your autoimmune journey or have been living with the after-effects for years: promise yourself that you will keep fighting, that you will remember that courage doesn’t always roar, sometimes it will be the soft voice at day’s end saying I will try again. **Never give up on yourself, no matter how hard things get.** Learn to listen to your body and rest, then get back up again. And promise yourself that you will try to look for the positives from your experience, even if it’s hard, so that you can turn your tragedy into something beautiful. Because what I have learned, and I hope you have too, is that we are all so much stronger than we realize. > **Life isn’t easy, but it’s most certainly worth it.** – Holly > [@hollyaftergbs](https://www.tiktok.com/@hollyaftergbs?refer=embed "@hollyaftergbs") Getting my original [\#guillainbarresyndrome](https://www.tiktok.com/tag/guillainbarresyndrome?refer=embed "guillainbarresyndrome") [♬ Where Is My Mind – Maxence Cyrin](https://www.tiktok.com/music/Where-Is-My-Mind-7145828446172612609?refer=embed "♬ Where Is My Mind - Maxence Cyrin") ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/SpacerShield.jpg) The views and opinions expressed are those of the author and do not necessarily reflect the views and opinions of the Global Autoimmune Institute. The experiences and health outcomes described in this article are unique to the author and do not serve as medical advice. **Category:** Guillain–Barré syndrome (GBS) --- ### [Roxanne’s Story: Mindfulness & Holistic Healing with Lupus](https://www.autoimmuneinstitute.org/autoimmune_stories/roxannes-story-mindfulness-holistic-healing-with-lupus/) **Published:** September 16, 2021 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** When you’re hit out-of-the-blue with symptoms like fatigue and joint pain, you may feel lost and overwhelmed. Roxanne, who lives with lupus, describes her holistic path to wellness and how mindfulness helps her thrive with chronic illness. **Content:** ***When you’re hit out-of-the-blue with symptoms like fatigue and joint pain, you may feel lost and overwhelmed.*** *There are so many ways of approaching the problem, or moving through the emotions that accompany a health crisis, that taking the first step is often quite difficult.* *For Roxanne, the desperation she experienced drove her to research, explore, and try new things, focusing on her health in a holistic sense (mind, body, and spirit). In her story, she describes the particular path she took to get herself feeling better and thriving.* ### **ROXANNE’S STORY** I was living and working in New York City when a diagnosis of [lupus](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/systemic-lupus-erythematosus/ "Systemic Lupus Erythematosus"), at the age of 27, changed my life forever. It all started with my hands – as I tried to explain then, they just stopped working. Swollen and painful joints made it hard to even make my bed. I was experiencing unexplained weight loss and fatigue to the point where I was unable to stay awake past 8pm, and I was feeling anxious and depressed. > **In a state of desperation, I took on my health like a full-time job.** Willing to try just about anything to feel even a tiny bit better, I dove headfirst into meditation, something that was foreign to me. It took much practice to quiet what meditation teachers call the “monkey mind,” allowing me to give myself the time and space to sit in stillness and find some ease in my mind and body. Back then, mindfulness and meditation were not the buzzwords they are today. But I found my spiritual home through different teachers in New York City, including Gabby Bernstein, who is now widely popular and well known for her books, trainings, and Super Soul Sunday talks with Oprah. > When I allowed myself to get quiet in the minutes I was meditating, I was giving my nervous and immune systems a break. I didn’t realize this at the time. This was my gateway into trusting my intuition. **I believed that I would get better and my affirmation, “thank you for my healing” flowed through me daily.** From there, I moved on to my diet and read books like “Crazy Sexy Diet” by Kris Carr, a cancer survivor and thriver as she calls herself, and “The Autoimmune Recovery Plan” by Dr. Susan Blum, a functional medicine doctor who herself healed from an autoimmune condition. These two books helped me navigate an elimination diet that taught me gluten, dairy, and soy were not my friends. **Without those foods in my system, my joint pain and swelling started to dissipate.** I knew that movement helped me with the fatigue and inflammation so I made the gym a part of my daily routine, even if only for 15-20 minutes on the bike. I also incorporated pilates and yoga, which I still practice today. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Roxanne-1-1-768x1024.jpg) > I never imagined having the kind of energy that I do now. It allows me to care for my two little ones, dachshund, and husband all while working as a health coach and development professional outside Washington, DC. **I see my story as one of hope and inspiration and it is my mission to help others achieve positive and lasting changes in their own lives.** -Roxanne ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/SpacerShield.jpg) The views and opinions expressed are those of the author and do not necessarily reflect the views and opinions of the Global Autoimmune Institute. The experiences and health outcomes described in this article are unique to the author and do not serve as medical advice. **Category:** Lupus (SLE) --- ### [Daanya's Story: Breaking the Stigma of Crohn’s Disease](https://www.autoimmuneinstitute.org/autoimmune_stories/daanyas-story-breaking-the-stigma-of-crohns-disease/) **Published:** July 15, 2022 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** It all started with an unexplained fever that lasted for at least 3 months. I had blood tests, scans, and ultrasound, but nothing showed up. I started to lose hope because I was suffering every day with fever and fatigue, with no answer. **Content:** *For many people, finding a supportive community can help ease the burden of living with chronic illness. But what happens when your disease is so stigmatized that nobody talks about it? As a newly diagnosed [Crohn’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/crohns-disease/ "Crohn’s disease") patient, Daanya found solace in the online chronic illness community. Now, she is determined to help others and fight back against the stigma of inflammatory bowel disease. In her autoimmune story, Daanya opens up about the many ways that Crohn’s has impacted her life and her future plans.* **DAANYA’S STORY** ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/image-3-1024x615.jpg) Hey! I’m Daanya. I’m a 19-year-old student from Malaysia, studying Medical Bioscience. I was diagnosed with Crohn’s disease in November 2020. It all started with an unexplained fever that lasted for at least 3 months. I had blood tests, scans, and ultrasound, but nothing showed up. > **I started to lose hope because I was suffering every day with fever and fatigue, with no answer.** As time went by, the abdominal pain came on. It got to a point where even a sip of water would leave me curled up in pain. Finally, I was able to see a gastroenterologist in a private hospital. They did an endoscopy & colonoscopy, which showed that there was an abscess in my colon and that my appendix was about to burst. I had emergency surgery and was then diagnosed with Crohn’s disease. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Daanya-1-576x1024.jpeg) I was on Azathioprine and Mesalazine for about 11 months. In October 2021, I had a severe flare-up which led to an intestinal hemorrhage. I was in the hospital again, 2 weeks before my final exams. **I have now switched to my very first biologic therapy, Vedolizumab (Entyvio), and I’m working my way to remission.** We don’t know if Entyvio is working well as I still have bad days, but I’m so much better than before. As an Asian with IBD, there are a few struggles that I go through daily. The awareness of IBD is extremely low here in Asia, and in Malaysia specifically. It’s either no one has heard about it, or they call it a “Western disease” because it’s rare in Asian culture. Every person I’ve come across has told me: “How did you end up getting a disease that doesn’t run in your blood?” Then they start blaming it on diet and western culture influence because they don’t medically understand the root cause of IBD. > Another reason why IBD is barely spoken about in Malaysia is that “bowel diseases” are taboo and should be kept private. It’s immediately labeled as “disgusting.” **I also struggled getting accommodations in school and college because I look healthy on the outside.** When I mention “Crohn’s disease,” it doesn’t ring a bell to anyone. They assume it’s like IBS or acid reflux so nobody knows the seriousness of it. Having a rare disease in my country is so mentally exhausting because you can keep explaining yourself and yet no one will understand. You always feel alone in your battle. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Daanya-2-576x1024.jpeg) I couldn’t bear the narrow-mindedness of the Asian society. I wanted to break the discrimination because no individual should suffer alone. So, I made an Instagram page to connect with people from my country and overseas who have Crohn’s disease. > I want to find support and be the support to as many people as I can. I’m so blessed to find a chronic illness community because not only did it support me throughout my rough times, but it also made my whole journey with Crohn’s much more pleasant, despite being an Asian. **Crohn’s disease has sparked an interest in me to pursue healthcare, which is why I switched my major from accounting to medical bioscience.** I want to contribute to healthcare and help people with similar conditions. I hope to continue to raise awareness about this debilitating disease. > It’s okay to have bad days and negative thoughts, but you should never let those thoughts get to you. **Keep fighting and pushing through.** One major piece of advice I would give is to never stop advocating and fighting for your rights. If you are not getting the answers you’re looking for, get a second opinion. Never settle for less. It’s your body and your health, therefore you should own it. – Daanya > [View this post on Instagram](https://www.instagram.com/reel/CblRfRjB2Cs/?utm_source=ig_embed&utm_campaign=loading) > > [A post shared by \*ੈ✩ Daanya (@talking.crohns)](https://www.instagram.com/reel/CblRfRjB2Cs/?utm_source=ig_embed&utm_campaign=loading) ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/SpacerShield.jpg) The views and opinions expressed are those of the author and do not necessarily reflect the views and opinions of the Global Autoimmune Institute. The experiences and health outcomes described in this article are unique to the author and do not serve as medical advice. **Category:** Crohn’s Disease --- ### [Aubrey’s Story: Mind-Body Connection & Healing](https://www.autoimmuneinstitute.org/autoimmune_stories/aubreys-story-mind-body-connection-healing/) **Published:** June 14, 2020 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Diagnosing, managing, and treating an autoimmune disease or chronic illness can feel like putting together a 1,000-piece puzzle with your eyes closed. **Content:** ***Diagnosing, managing, and treating an autoimmune disease or chronic illness can feel like putting together a 1,000-piece puzzle with your eyes closed.*** *It’s easy for pieces to get lost in the chaos, or to not even realize they weren’t in the box to begin with. And sometimes you may feel like the people helping you are actually on the opposing team.* *By being open-minded to factors you never considered—including the connection between mental and physical health—and to lifestyle change and new, safe approaches, you may find a path to healing.* *In the following story, Aubrey describes her experience of sudden, unexplained symptoms that were never diagnosed, and the journey to heal her chronic issues.* ### **AUBREY’S STORY** I was born into a multicultural family, as my father is Chinese-Indonesian and my mother is Caucasian. My three siblings and I all grew up as California natives and spent our childhood hiking, camping, and being outdoors as much as possible. My family traveled A LOT, exposing us to other cultures, traditions, and languages. **I was raised in an environment that was active, wholesome, loving, and extremely open-minded towards various outlooks on life.** Around the age of 25, I discovered a newfound sport called ultrarunning, which consists of completing any distance beyond a marathon, otherwise known as ultramarathons. These can take place on roads, trails, or both—but mainly on trails. The sport itself is brutal, downright depleting, and super tough on the physical body. But it had the opposite effect on my heart and soul. **You see, when I started becoming more involved and meeting like-minded friends in this community, something inside of my heart began to change.** I saw my relationships with others and my relationship with the universe in a more holistic light. I realized that everything was connected—from my body, diet, and thoughts, to destiny, mother earth, the universe, and the surrounding energy from people I was meeting. I was having what one would call a “spiritual awakening” and knew it was the height of my existence. Like many things in our lifetime, not everything can be perfect or last forever. > My high instantly came crashing down when I suddenly experienced severe, autoimmune-like symptoms. It started with waking up to red, itchy, scaly, irritated eyelids after going out to celebrate Halloween the night before. Within a week, the discomfort spread to my entire face and neck. Within 30 days it had spread to my scalp, shoulders and chest. **Eventually, within 2 months, this reaction spread all the way down to my toes.** I started experiencing even more symptoms that I can now identify as brain fog, slurred speech, dizziness, joint pains, blurred vision, memory loss, high/low body temperatures, hair loss, heart palpitations, digestive issues, bowel issues – the list goes on and on. Of course I went straight to my PCP. She referred me to a dermatologist, who confirmed that it was just eczema. Well, duh! I knew I had eczema; but how do you explain ALL of the other symptoms? This tale is as old as time. I was prescribed a steroidal cortisone cream, some steroid pills, and wished “good luck!” > *“*I felt defeated, lost, helpless, powerless, and like it was all my fault.*”* About four months and a few more frustrating doctor visits later, the universe stepped in. A friend suggested I see her Acupuncturist and Traditional Chinese Medicine Practitioner (TCM) to calm down my stress levels, but it turned into much more than that. The TCM performed acupuncture and treated me with herbal medicine, while simultaneously expanding my views on health, wellness, and medicine. I did not believe in this man’s remedies. > *“*I did not believe in holistic medicine. But I did believe in my will to heal*”* So I started opening my mind to treatment and alternative medicine. **I learned to heal my body from the inside out** by using food and herbs as medicine, incorporating real, whole foods into my diet. I started practicing gentle movement such as Vinyasa Yoga, Tai Chi, Qigong (pronounced “chee-gong”), walking, and hiking. I put my beloved ultramarathons on pause until my body felt strong enough to restart. I started journaling and addressing some deeply rooted traumas and underlying stress triggers in my life—relationships I had to let go of. I started speaking up and defending myself in uncomfortable situations, as well as having very difficult internal conversations. I frequently asked myself, “Am I happy in this job, relationship, home, life, etc.?” > “I had to learn that everything within our bodies and surrounding environment is connected.” The food we eat, the physical stress we endure, mental and emotional stress, our level of happiness, and the thoughts we allow to come into our minds and hearts. They are all parts of a whole. **This experience led me to the world of Eastern-inspired, alternative medical disciplines, including functional medicine.** Here, the ultimate goal is finding the root cause rather than addressing individual symptoms. Other similar disciplines include integrative and naturopathic medicine. I decided to incorporate both Western (a.k.a. allopathic or conventional) and Eastern (a.k.a alternative or holistic) medicine by making one cohesive medical team. While my attempt was successful, in the end, it took me two years and four different Primary Care Physicians (PCPs), to find one who had a more open mind and holistic approach. Even still, I had to work with a Functional Medicine Doctor to order certain tests confirming I had Candida overgrowth. My allopathic practitioner had no idea what I was talking about when I first brought it up testing for Candida, SIBO, and H. Pylori to that team. **The doctors were able to conclude that my symptoms were autoimmune-related, but without further testing they could not confirm a diagnosis.** Truthfully, I was starting to feel better by changing my diet and lifestyle so I did not feel it was worth the risk of feeling sick again just to get a diagnosis. After 4.5 years, 38 different doctors, no confirmed diagnosis, countless supplements, years of agony and anguish, endless recipe testing, and more self-healing work than I could ever imagine, I am finally healing. > *“***I can confidently say that I was able to reverse my autoimmune condition—to about 97% remission.***”* I live well and manage my condition every single day based on all of the tactics I’ve mentioned: - Healthy and minimally processed whole foods - Meditation - Journaling - Exercise - Reducing stress - Embracing community Growing up in a multicultural, open-minded family—one that introduced me to diverse worldviews and instilled a love of the outdoors – helped set me up with tools to heal. My friends, if I can leave you all with one piece of advice, it would be to focus on your thoughts and that inner voice inside of your heart. **We are all going to have moments of despair and doubt, but it is how we break free and overcome those moments that matters most.** This is when the REAL work begins. If you believe you can overcome your struggles then it may come true; but it takes patience, love and true self-reflection. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Aubrey-headshot-e1592164598483-227x300-1.jpg) -Aubrey ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/SpacerShield.jpg) The views and opinions expressed are those of the author and do not necessarily reflect the views and opinions of the Global Autoimmune Institute. The experiences and health outcomes described in this article are unique to the author and do not serve as medical advice. **Category:** Undiagnosed --- ### [Ashley's Story: Turning the Tables on Primary Raynaud’s Disease](https://www.autoimmuneinstitute.org/autoimmune_stories/ashleys-story-turning-the-tables-on-primary-raynauds-disease/) **Published:** August 4, 2022 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** I was burning up on the inside of my body, but on the outside, I was so cold my arms and legs were turning purple. My limbs were so cold to the touch that I couldn’t feel a single thing. **Content:** *Chronic illness can change your life in the blink of an eye. That’s what happened to Ashley, who was enjoying a carefree vacation when she began to suffer numbness and blackouts out of nowhere. After a complicated and frightening journey, she was finally diagnosed with primary [Raynaud’s disease](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/raynauds-syndrome/ "Raynaud’s Syndrome"). While battling the physical and emotional effects of her illness, Ashley began looking for ways to turn things around. In her autoimmune story, Ashley reflects on her struggles, her growth, and how she is now giving back to the Raynaud’s community.* **ASHLEY’S STORY** ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Ashley-1.png) Hi, I’m Ashley Spivey and I’m 23 years old. My story started in May 2021 in Destin, Florida. I was vacationing with my boyfriend and his family for the first time, and the trip was my birthday present. Everything was going wonderfully until our last day. We had gotten a really bad sunburn, but nothing really stuck out at the time. We just thought we had bad sun poisoning, so we figured we’d go back to our place, relax, and get out of the sun. No biggie, right? Wrong– **in my case, it was the start of a terrifying journey.** While we were relaxing, my boyfriend went to get me a cup of water because I had started feeling lightheaded, weak, and dizzy. He took two steps away from me and I blacked out. When I came to, he told me that I passed out and had started shaking and convulsing really hard for around 15-20 seconds. I was so sore I had to be carried to bed. > I was burning up on the inside of my body, but on the outside, I was so cold my arms and legs were turning purple. My limbs were so cold to the touch that I couldn’t feel a single thing. I refused to go to the hospital because I thought, “Why go? They are just gonna tell me it’s sun poisoning and waste our last day of vacation.” Plus, my family wasn’t there, and that added a little more fear as well. So we drove back to our home state of West Virginia the next morning.​​ **Soon, I had another blackout.** This time, I was gathering some things from the restroom when I suddenly woke up next to the tub. My head was sore as if it had hit the tub when I fell. My feet were so swollen that my Crocs wouldn’t fit, so I had to wear socks while my boyfriend carried me. When I finally got home, I learned that my boyfriend had already told my mom about the blackouts. She booked me a doctor’s appointment for the very next morning. > That one visit turned into multiple visits with about ten different doctors, and nobody could figure out what was really going on– until one doctor took the time to hear me out. She knew without a doubt what was wrong with me: I had primary Raynaud’s disease. The medicine they put me on had me feeling so awful– I didn’t feel like me anymore. I was depressed, binge eating, sleeping all the time, and in a funk that I couldn’t escape from. I was so worried about what people would think of me now. One day it hit me randomly: why don’t I do something great about this and start a nonprofit with custom Raynaud’s gear, where all the money goes to a nonprofit supporting Raynaud’s disease? ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Raynauds-819x1024.jpeg) Over time, I got my mental health right where I needed to be. I got healthier, started going to the gym more, and started taking a positive spin on all of the bad things. **Yes, I have good and bad days–but you can’t let the bad days break you.** That’s what gets me through. I couldn’t have gotten through any of this without my mom, my boyfriend, and my friends who were always there for me. I thank them from the bottom of my heart. – Ashley ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/SpacerShield.jpg) The views and opinions expressed are those of the author and do not necessarily reflect the views and opinions of the Global Autoimmune Institute. The experiences and health outcomes described in this article are unique to the author and do not serve as medical advice. **Category:** Raynaud’s --- ### [Anthony's Story: Waging a War Within](https://www.autoimmuneinstitute.org/autoimmune_stories/anthonys-story-waging-a-war-within/) **Published:** January 10, 2024 **Author:** Elevation **Excerpt:** Anthony describes the daily agony, numerous medical consultations, and misdiagnoses before finally receiving the diagnosis he suspected: ankylosing spondylitis. The revelation brought a mix of emotions, but armed with knowledge, a more personalized treatment plan, a focus on fitness, and a positive mindset, he now feels prepared to face the difficult journey ahead. **Content:** ## A Journey Through Ankylosing Spondylitis Anthony describes the daily agony, numerous medical consultations, and misdiagnoses before finally receiving the diagnosis he suspected: [ankylosing spondylitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/ankylosing-spondylitis/ "Ankylosing Spondylitis"). The revelation brought a mix of emotions, but armed with knowledge, a more personalized treatment plan, a focus on fitness, and a positive mindset, he now feels prepared to face the difficult journey ahead. His story explores the transformative power of pain, presenting it as a teacher shaping resilience and identity. Despite the ongoing battle, he embraces a path forward, using the affliction as a catalyst for personal growth and enhancement. ### **Anthony’s Story** In the blackness of the early morning, before the day had begun to shape itself, a suffocating grip abruptly awakened me, as if an unseen python had coiled its presence tightly around me, each breath becoming a laborious struggle against its constricting embrace. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/04/Anthony-1.png) > The pain started as a sinister whisper in my lower back, then surged up my spine like a bolt of electricity, enveloping my chest in a wave of misery. My ribs creaked under this imagined grasp, each breath a fight against an unseen foe. Each morning’s struggle wasn’t an anomaly but a recurring testament to the reality of living with Ankylosing Spondylitis (AS). This rare, chronic condition stealthily wages war within, inflaming major joints and entwining my body in a web of pain and stiffness, threatening the very essence of mobility. **Lying there, consumed by agony, I reflected on the constant battle my body waged against me, a ferocious adversary within. In those quiet, painful moments, I would close my eyes, searching memories for a time when this morning ritual did not exist.** > I have been at war with my body for the last ten years. Each battle is a fight with chronic pain. These clashes have led me to encounter numerous orthopedic surgeons, pain management doctors, and physical therapists, while relying on a wide range of medications, from over-the-counter anti-inflammatories to potent opioid painkillers, typically intended for cancer patients. Throughout the years, the diagnoses exposed a torn labrum in my left hip, a lumbar disc rupture, and two more herniations in my neck, while arthritis and stenosis wreaked havoc on my spine. **Despite enduring multiple surgeries, countless cortisone injections, and rigorous physical therapy, the pain remained undefeated, unyielding to any attempts at relief.** > Chronic pain had become a familiar opponent, a daily clash fought in silence. Two years ago, my battle took a new turn. I awoke to a searing pain that reverberated through my chest and ribs, amplifying the already tumultuous eight-year-long struggle. The overbearing torture became my morning alarm, a fiery sensation burning inside my chest, radiating through my ribcage and encircling the thoracic region of my back. Even the gentlest inhale or shift was unbearable. For the next hour, I would focus on taking slow, deliberate breaths, gradually increasing my body’s range of motion until I could muster the strength to emerge from my bed. **Embracing movement proved to be a powerful antidote.** Unlike past maladies, the pain in my torso melted away as the day matured. Only a faint trace of discomfort remained by lunchtime. The intensity of my pain mirrored my frustration. Trips to the orthopedist and pain specialists seemed to be unproductive. Imaging of the thoracic area yielded unremarkable findings. > My complaints of discomfort fell on deaf ears. The doctors attributed the pain to my past surgeries while confronting me with skepticism as if I were a hypochondriac. **Despite presenting extensive research I had meticulously collected on my symptoms, the doctors swiftly brushed aside any consideration of a possible Ankylosing Spondylitis diagnosis.** Hope was quickly fading away. During each appointment, the doctors would propose a different treatment option, dismiss the possibility of AS, and provide no respite from my recurring pain. The predictability of each appointment signaled the need for a change. The impression that the physicians were downplaying the significant correlation between my recent string of orthopedic injuries and the ongoing chronic pain lingered in my mind. My doctors, akin to sailors who merely patch the cracks of a vessel without seeing the entire boat, concentrated on treating symptoms rather than revealing the underlying cause. > Guided by my intuition and armed with thorough research, I found myself in the office of a specialized rheumatologist who dedicated her practice to autoimmune diseases such as Ankylosing Spondylitis. Her comforting bedside manner, her insightful questions, and the depth of her knowledge left me feeling assured of my choice of care. **My treatment evolved from a one-size-fits-all perspective to a bespoke approach that assessed all my symptoms, listened attentively, and delivered a holistic solution.** Prior to that rheumatologist appointment, each battle with my body ended in a losing effort. For an arduous nine-year period, I found myself locked in an uphill fight against an elusive antagonist, with no set rules of engagement. The battlefield tilted in my favor inside the rheumatologist’s office. A vial of blood and an MRI confirmed my nagging suspicion – I had Ankylosing Spondylitis. > Upon hearing my diagnosis, a tumultuous sea of emotions engulfed me, each wave a surge of disbelief, fear, and then an unexpected sense of liberation. The question of identity — ‘Am I now Tony, forever defined by Ankylosing Spondylitis?’ — echoed briefly in my mind, only to be washed away by a sense of relief. This newfound clarity, though shadowed by the reality of a lifelong journey, illuminated the path forward. Armed with knowledge, we were no longer fighting an invisible foe. **My enemy now had a name, and with that, a newfound strength coursed through me.** In the relentless quest for the perfect combination, my doctor and I have spent the last year testing numerous medications. Through extensive drug experimentation, we ultimately discovered the most effective treatment for my AS. A monthly injectable biologic, coupled with a renewed emphasis on fitness and a positive mindset, has proven to be the most successful treatment for pain and inflammation. Although I have maintained an intimate 30-year-long relationship with weightlifting and conditioning, my primary motivation has regularly been on the aesthetics of my body. > Incorporating extra rest and recovery into my workout routine, as well as being mindful of my body’s needs, has played a vital role in treating my AS. Sarah Anne Shockley, in her insightful book ‘The Pain Companion,’ suggests that **healing from chronic pain is less about subduing the physical sensation and more about redefining our relationship with pain, ourselves, and life itself.** Her words resonate deeply with my own experience. Throughout this decade-long odyssey with Ankylosing Spondylitis, pain has not just been a physical presence; it has been a relentless teacher. **Its lessons have pushed me into uncharted emotional depths, challenging me to either be consumed by its darkness or to rise above it.** This journey has sculpted my identity, my resilience, and my perception of life. While often unbearable, the pain has unwittingly bestowed upon me a profound choice: to let this affliction weaken me or to harness it as a catalyst for growth and resilience. In the face of persistent adversity, my choice is clear – a path forward to the unwavering enhancement of my mind, body, and soul. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/SpacerShield.jpg) *The views and opinions expressed are those of the author and do not necessarily reflect the views and opinions of the Global Autoimmune Institute. The experiences and health outcomes described in this article are unique to the author and do not serve as medical advice.* **Category:** Ankylosing Spondylitis --- ### [Anna's Story: Holding On To Hope with an Undiagnosed Illness](https://www.autoimmuneinstitute.org/autoimmune_stories/annas-story-holding-on-to-hope-with-an-undiagnosed-illness/) **Published:** April 8, 2022 **Author:** agustin.fernandezb@elevationweb.org **Excerpt:** Read Anna’s inspiring story of resilience and hope as she navigates life with an undiagnosed autoimmune illness. Discover her journey, struggles, and the strength she finds in holding on to hope despite the challenges of living without a clear diagnosis. **Content:** For many people, living with a chronic illness is like fighting multiple battles at once. Grief, frustration, and exhaustion are just a few ways to describe what it feels like to deal with debilitating health issues. Although the process of learning to cope with illness is complex and deeply personal, many chronic illness fighters struggle to find the support they need -especially within medical systems that are often dismissive of the chronically ill. In her story, Anna opens up about her life with a painful, undiagnosed digestive disease. Her experiences range from feeling the agonizing loss of everything that chronic illness has taken from her to her endless determination to find answers about her health. Anna’s story reminds us that everyone’s experience is valid and that hope is always worth holding on to. ### **ANNA’S STORY** *Hello, I’m Anna!* For two years I have had terrible stomach pain. Before my illness, I used to be a visionary, artist, super creepy, and sexy woman: somebody you would never forget! I still have a goal of one day becoming a famous artist. > My illness started as a standard stomach ache. I went to see a doctor, where I received my first gastroscopy. They diagnosed me with mild reflux and esophagitis, then they sent me home with one medication. But my stomach pains continued to get worse. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/Screenshot-2023-10-24-at-2.47.40-PM.png) I thought I would be able to cure my stomach issues with diet and medicine- however, my symptoms grew worse. > Now, I experience constant pain after every meal, after every sip of water, and even on an empty stomach. A lot of times, the pain is so severe that all I can do is lay in bed, massage my belly, and cry. I’ve spent a lot of money on over-the-counter treatments and products that are supposed to help with stomach pain and digestion, but nothing has worked. After my second gastroscopy, I was told that I had no reflux at all and that my stomach looked healthy, so I went in for a colonoscopy. That was normal, too. I’ve also had CTs, blood tests, allergy tests, and ultrasounds. > The test results offered no explanation for my pain. I saw a second gastroenterologist who was very rude and said to my face: “Your stomach is ok. I don’t know what to do with you so go home.” Now I have a third gastroenterologist who is very nice. He did another gastroscopy and a gallbladder gastroscopy, but he couldn’t find the cause of my illness. Doctors also measured the PH of my stomach, but again I was diagnosed with reflux and sent home without any other help. To make matters worse, doctors have recently discovered that my body has developed a tolerance to pain medication. In addition to medication, I try to manage my pain with acupuncture, aromatherapy, massage, and a healthy lifestyle. A little bit of exercising helps as well, even though the pain makes it more difficult. I look forward to reading about new methods for chronic pain treatment here in the Czech Republic because it gives me hope. ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/C360_2016-04-23-23-01-54-001.jpg) > The hardest part for me is waking up to hopelessness every day, starting each new day with pain – because the pain is all day, every day. I had to give up all meetings with friends. I used to draw, go to the gym, and do programming classes. I loved mathematical problem-solving. Now everything is lost. Even my ex-boyfriend walked out of my life, which left me completely broken. My parents are there for me but my illness makes them worried and unhappy, and they feel depressed because they cannot help me. When friends send me pictures of things they’re doing, I cry because it hurts that I cannot be with them and enjoy those moments with them. Without health, everything feels impossible to do. I have hit rock bottom several times, but I am proud that I survived. > If I could give any piece of advice it would be this: **do not give it up**. If one doctor has failed you, **keep going, keep searching, and keep holding on to the small hope that a cure will come**. I hold onto the hope that one day, something or someone will come into my life and I will begin to heal. – Anna *The artwork included in this story was created by the author, Anna.* ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/SpacerShield.jpg) The views and opinions expressed are those of the author and do not necessarily reflect the views and opinions of the Global Autoimmune Institute. The experiences and health outcomes described in this article are unique to the author and do not serve as medical advice. **Category:** Food Sensitivities, Undiagnosed --- ### [Aashika's Story: Finding Hope and Gratitude In the Journey to Healing](https://www.autoimmuneinstitute.org/autoimmune_stories/aashikas-story-finding-hope-and-gratitude-in-the-journey-to-healing/) **Published:** November 16, 2022 **Author:** Elevation **Excerpt:** Aashika recounts the ups and downs of being suddenly diagnosed with Autoimmune Hepatitis – including the physical, mental, and emotional tolls – and finding hope, gratitude, and a new perspective on health. **Content:** *Some people stumble upon an autoimmune disease diagnosis when they least expect it. This surprise can come with its own set of obstacles, like emotionally processing the diagnosis while simultaneously addressing complex health challenges. This can often be daunting for someone first learning about their autoimmune disease – one they may not have even known existed.* Read Aashika’s story as she recounts the ups and downs of being suddenly diagnosed with [Autoimmune Hepatitis](https://www.autoimmuneinstitute.org/autoimmune-resources/autoimmune-diseases-list/autoimmune-hepatitis/ "Autoimmune Hepatitis") – including the physical, mental, and emotional tolls – and finding hope, gratitude, and a new perspective on health. ## **AASHIKA’S STORY** ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/04/Aashika.png) On August 20th, 2021, I was on a family trip to celebrate my birthday, and my mother-in-law noticed that my face looked a bit pale and that my eyes were yellow. > Even though I had been feeling exhausted, weak, and feverish for a week and had lost my appetite, I did not pay much attention to it. I assumed it must have been because of my hectic schedule for a month or maybe due to my ongoing periods. However, within a day, my symptoms worsened. I did not feel like eating anything and puked whatever I ate, my energy had gone down, my entire body turned pale, and I had a fever of 101 degrees. The next day, I rushed to the hospital to consult my physician. Looking at the symptoms, it was clear that I had jaundice but to identify the root cause, the doctor asked me to do Hepatitis A,B,C,D & E tests, all of which came back negative. This meant the jaundice was not due to contaminated food/water nor any hepatitis viruses. My physician asked me to get an ultrasound test. The left lobe of my liver appeared to be shrunken in the reports. Usually, during a liver infection, the organ tends to get inflamed, meaning larger in size. But my case was different. Looking at the report, my physician immediately transferred my file to the Hepatologist, as the case seemed severe and required a specialist to diagnose. > I was diagnosed with Autoimmune Hepatitis. Following my diagnosis, my doctor immediately put me on medication – including Prednisolone and Azathioprine – as well as supportive supplements like calcium, multivitamins, anti-acid reflux, and a hepatoprotective medication. I started taking high doses of steroids and Azathioprine, which took my body a while to get used to. The moment I took my pills, my heartbeat would pace faster, chills and shivers would run down my entire body, my nerves turned blue and I would sweat uncontrollably. It was as if I was getting a panic attack. I was not sure if this was normal to experience. During my next visit to my doctor, along with my weekly LFT (liver function test) reports, I highlighted my symptoms. My doctor reduced the dosage of Azathioprine and asked me to continue it for one week and observe changes to my side effects, but there weren’t any. The symptoms were the same. In fact, I started getting terrible cramps in the palms of my hands and feet, the pain of which was so bad that it made me restless and burst into tears. I again went to him but he asked me to observe my symptoms for another week. After three weeks, my LFT reports showed that my bilirubin markings were coming down, but my GGTP (a test for liver damage) markings were increasing, and my symptoms continued. My doctor had me stop Azathioprine after analyzing that my body did not respond well to it and switched me to an alternate immunosuppressant. > Every medicine comes with its own list of side effects, and I happened to experience some of them. Initially, when I was on the maximum dose of steroids, I felt a burst of energy flowing through my body. Despite being so weak due to pre-diagnosis weight loss, I was surprisingly on my toes throughout the day. I felt restless if I sat idle for even a minute – that’s the kind of energy I was experiencing. Having said that, the energy was superficially caused by the drugs I was taking. From within, my immunity cells were getting suppressed, and my body couldn’t handle the extra energy. Because of this, the horrible cramps continued. It became difficult for me to walk even 50 steps without getting them. After a month of continuing with the medications, my doctor had me do a Fibroscan to understand the extent of the damage. > The doctor broke the news to me that I have compensated (1st Stage) liver cirrhosis. It took me a while to register this massive and shocking news. For several weeks, I couldn’t gather my thoughts; I was devastated mentally and emotionally. I won’t deny that the basic questions, “why me?” and “what have I done wrong?” and “this damn disease is not even my fault so why am I suffering?” crossed my mind. I had no option but to gather the shattered pieces and build them into hope – the hope of survival, the hope of getting through this, the hope of faster recovery, and the hope of making everything better again. I started researching Autoimmune Hepatitis. Until I was diagnosed with it, I had never even heard of this term. When my doctor would explain it to me, my mind would go blank most of the time; maybe I did not have the courage to hear and understand what it was exactly. > This is when I started my journey towards healing. I was able to take a complete break from work for 3 months, avoided unnecessary socializing, and did not indulge in things that did not do me any good. This gave me a lot of time to focus on my self-healing. I started reading self-help books, practiced yoga and meditation, inclined myself to spiritual healing and awareness, and modified my lifestyle and eating habits while the medicines were doing their job. Another thing that really helped me come out of this trauma was regularly penning down my thoughts, affirmations, and gratitude. I cannot quantify the extent it helped me, but one thing was certain: it calmed my mind to an unimaginable extent and I started to see positivity in everything and anything. Even the negative questions in my mind took a positive route. > “Why me?” changed to, “I am so grateful my disease was diagnosed at the right time and immediate action could be taken.” I was also grateful that because of this disease, I was able to slow down, take a pause, and understand life from a different perspective. **It turned me into a kinder and more empathetic soul.** It has been exactly one year where I am penning my story here; I am still taking my medication and undergoing the healing process. As my steroid dosage has tapered, I have experienced withdrawal symptoms along with side effects of taking steroids; increased appetite, severe backaches, extreme mood swings, anxiety, panic attacks, excessive gum bleeding, bloating, acid reflux, gastric headaches, emotional disturbance, constipation, tender muscles, easy bruising, dry skin, hair loss, body pain, drowsiness, loss of stamina, breathlessness and chills, and borderline depression – to name a few. This past year has been a rollercoaster ride living with this rare condition, and I won’t say that I am completely healed mentally and physically, but what I have extracted out of this journey is that our mental and physical health is only in our hands – treat them with care and it is completely okay to be selfish for the self-care. Nothing is above our health and happiness. – Aashika ![](https://www.autoimmuneinstitute.org/wp-content/uploads/2024/02/SpacerShield.jpg) The views and opinions expressed are those of the author and do not necessarily reflect the views and opinions of the Global Autoimmune Institute. The experiences and health outcomes described in this article are unique to the author and do not serve as medical advice. **Category:** Autoimmune Hepatitis --- ## Categories ### [Living Well with Autoimmune Disease](https://www.autoimmuneinstitute.org/category/living-well-understanding-the-body/) --- ### [Autoimmune Care & Caregiver Support](https://www.autoimmuneinstitute.org/category/autoimmune-care-and-support/) **Description:** Expert-informed articles to help people with autoimmune disease and their caregivers navigate healthcare, communicate effectively, advocate for quality care, and find practical support throughout the disease journey. --- ### [COVID-19 and Long Covid](https://www.autoimmuneinstitute.org/category/covid-19-and-long-covid/) --- ### [Diagnosis & Treatment](https://www.autoimmuneinstitute.org/category/diagnosis-treatment/) --- ### [About Autoimmune Disease](https://www.autoimmuneinstitute.org/category/about-autoimmune-disease/) --- ## Autoimmune Disease ### [Autoimmune Hepatitis](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/autoimmune-hepatitis/) **Description:** Inflammation of the liver resulting from the immune system attacking liver cells. There are two types: Type 1 autoimmune hepatitis is the most common form, which is associated with other autoimmune diseases and can occur at any age. Type 2 autoimmune hepatitis is less common and affects younger children between the age of 2 and 14. --- ### [Celiac Disease](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/celiac-disease/) **Description:** Also known as celiac sprue or gluten-sensitive enteropathy, celiac disease causes damage to the small intestine in response to gluten consumption. --- ### [Crohn's Disease](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/crohns-disease/) **Description:** A type of chronic inflammatory bowel disease that causes inflammation throughout the gastrointestinal (GI) tract. --- ### [Eosinophilic Esophagitis](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/eosinophilic-esophagitis/) **Description:** An immune system condition of chronic esophagus inflammation, marked by an abnormal presence of eosinophils (white blood cells) in the lining of the esophagus. --- ### [Ulcerative Colitis](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/ulcerative-colitis/) **Description:** A condition involving the formation of ulcers and inflammation of the innermost layer of the colon and rectum of the digestive tract. --- ### [Ankylosing Spondylitis](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/ankylosing-spondylitis/) **Description:** A chronic form of arthritis that causes inflammation of the joints and over time can cause some of the vertebrae of the spine to fuse. --- ### [Dermatomyositis](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/dermatomyositis/) **Description:** Degenerative changes of the muscles and skin, caused by an inappropriate autoimmune reaction that leads to obstructive inflammatory changes of blood vessels within muscle, connective tissues of the skin, and other tissues. --- ### [Juvenile Idiopathic Arthritis](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/juvenile-idiopathic-arthritis/) --- ### [Scleroderma](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/scleroderma/) **Description:** An overproduction of collagen protein which leads to the hardening and inflammation of connective tissues and skin. --- ### [Systemic Lupus Erythematosus](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/systemic-lupus-erythematosus/) **Description:** SLE is the most common form of lupus in which the immune system attacks its own healthy tissues resulting in widespread inflammation and tissue damage of joints, skin, brain, lungs, kidneys, and blood vessels. --- ### [Autoimmune Encephalitis/Acute Disseminated Encephalomyelitis (ADEM)](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/acute-disseminated-encephalomyelitis/) **Description:** Occurs when healthy cells and tissues in the brain or spinal cord are attacked by the body’s immune system, leading to inflammation. --- ### [Guillain-Barre Syndrome](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/guillain-barre-syndrome/) **Description:** Occurs when the immune system attacks part of the nerves in the peripheral nervous system. --- ### [Henoch–Schönlein Purpura](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/henoch-schonlein-purpura/) **Description:** HSP, also known as IgA vasculitis, is characterized by inflammation of the small blood vessels located in the skin, joints, intestines, and kidneys, sometimes accompanied by bleeding. --- ### [Multiple Sclerosis](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/multiple-sclerosis/) **Description:** A neurological disease that is thought to be triggered by environmental factors in individuals with genetic susceptibility. Involves immune attacks on the axons and myelin in the CNS that cover nerve fibers, which causes permanent communication problems between your brain and the rest of your body. --- ### [Myasthenia Gravis](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/myasthenia-gravis/) **Description:** When nerve impulse transmission is interrupted at the neuromuscular junction where nerve cells and muscles connect, due to acetylcholine receptors being blocked or destroyed by antibodies. Acetylcholine receptors activate muscle contractions; thus, their destruction prevents those contractions from occurring. --- ### [Hashimoto’s Encephalopathy](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/hashimotos-encephalopathy/) --- ### [Vasculitis](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/vasculitis/) --- ### [Polymyositis](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/polymyositis/) **Description:** Inflammation of the muscles and associated tissues, affecting the skeletal muscles that control movement. --- ### [Aplastic Anemia](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/aplastic-anemia/) **Description:** A blood disorder that occurs when bone marrow (where red and white blood cell and platelet production occurs) is attacked by autoantibodies. --- ### [Autoimmune Hemolytic Anemia](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/autoimmune-hemolytic-anemia/) **Description:** Autoantibodies attack red blood cells at a faster rate than they can be replaced, leading to dangerously low red blood cell levels. --- ### [Evans Syndrome](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/evans-syndrome/) **Description:** When autoantibodies attack healthy red blood cells, platelets, and neutrophils (white blood cells), depleting the levels of blood cells necessary for normal functioning. --- ### [Immune Thrombocytopenia Purpura](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/immune-thrombocytopenia/) **Description:** Also known as autoimmune thrombocytopenia purpura, ITP involves low levels of cells that help with blood clotting, resulting in significant bruising or bleeding. This can be chronic in adults, but full recoveries can typically be expected for children. --- ### [Sarcoidosis](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/sarcoidosis/) **Description:** Characterized by the growth of granulomas, which are abnormal accumulations of inflammatory immune system cells called macrophages. --- ### [Addison's Disease](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/addisons-disease/) **Description:** Affects the function of the adrenal glands, which disrupts the production of several hormones including cortisol and aldosterone, which regulate stress response (fight or flight) and blood pressure. --- ### [Agammaglobulinemia](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/agammaglobulinemia/) **Description:** Characterized by the attack of antibodies known as gammaglobulins (responsible for defending the body from infection), leaving those affected very susceptible to illnesses, which then progress aggressively and are more likely to prove deadly. --- ### [Juvenile Arthritis](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/juvenile-arthritis/) --- ### [Juvenile Dermatomyositis](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/juvenile-dermatomyositis/) --- ### [Lyme Disease](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/lyme-disease/) **Description:** A vector-borne (results from an infection transmitted to humans and other animals by blood-feeding arthropods such as mosquitoes, ticks, and fleas) disease characterized by four specific species of bacteria, including Borrelia burgdorferi, Borrelia mayonii, Borrelia afzelii, and Borrelia garinii. --- ### [Transverse Myelitis](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/transverse-myelitis/) --- ### [Type 1 Diabetes](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/type-1-diabetes/) **Description:** Historically called juvenile diabetes or insulin-dependent diabetes, T1D occurs when the body’s immune system attacks insulin-producing pancreatic beta cells (islets), causing the body to have insufficient insulin stores. These insufficient insulin levels hinder glucose from entering cells, negatively impairing the energy production process in the body. --- ### [Lupus Nephritis](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/lupus-nephritis/) **Description:** A type of kidney disease caused by Systemic Lupus Erythematosus (SLE). Autoantibodies attack structures in the kidneys that filter out waste leading to impaired kidney function and potentially kidney failure. --- ### [Neuromyelitis Optica/Devic's Disease](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/neuromyelitis-optica/) **Description:** Inflammation of the optic nerve, which carries information from the eye to the brain, accompanied by inflammation of the spinal cord. --- ### [Primary Biliary Cholangitis](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/primary-biliary-cholangitis/) **Description:** Caused by a buildup of bile (a substance used to facilitate digestion and eliminate toxins in the liver) due to progressive destruction of the bile ducts by the immune system, this disease can eventually lead to liver damage and cirrhosis. --- ### [Primary Sclerosing Cholangitis](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/primary-sclerosing-cholangitis/) **Description:** Characterized by inflammation and destruction of the bile ducts, a series of tubes carrying bile (digestive fluid) from the liver to the small intestine. --- ### [Graves' Disease](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/graves-disease/) **Description:** Occurs when specific antibodies mistakenly bind to thyroid cells, overriding the normal regulation of the thyroid, causing the thyroid to produce and release excessive thyroid hormones (hyperthyroidism). --- ### [Glomerulonephritis](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/glomerulonephritis/) **Description:** Various conditions that develop when the kidney’s glomeruli become inflamed. --- ### [Autoimmune Cytopenia](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/autoimmune-cytopenia/) --- ### [Autoimmune Lymphoproliferative Syndrome](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/autoimmune-lymphoproliferative-syndrome/) **Description:** Dysregulation of lymphocytes (immune system cells) results in overproduction and subsequent enlargement of the lymph nodes, spleen, and liver. --- ### [Psoriasis](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/psoriasis/) **Description:** A skin disease that causes red, itchy, or scaly patches, usually on the knees, elbows, trunk, and scalp, occurring in cycles of flare-ups that may last for weeks or months before subsiding. --- ### [Vitiligo](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/vitiligo/) **Description:** A skin disease that occurs when autoantibodies attack melanocytes (the skin cells that produce melanin or the chemical that produces skin color). --- ### [Kawasaki Disease](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/kawasaki-disease/) --- ### [Psoriatic Arthritis](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/psoriatic-arthritis/) **Description:** A type of arthritis that develops after psoriasis. Cycles of flares and remission are common and treatment can help manage symptoms, but usually the condition does not entirely resolve. --- ### [Primary Immunodeficiency](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/primary-immunodeficiency/) --- ### [Behçet’s Disease](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/behcets-disease/) **Description:** A systemic disease that manifests as blood vessel inflammation throughout the entire body. This inflammation impacts several organs including the skin, eyes, joints, intestines, lung, and central nervous system. --- ### [Churg-Strauss Syndrome/Eosinophilic Granulomatosis with Polyangiitis (EGPA)](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/churg-strauss-syndrome-egpa/) **Description:** also known as Eosinophilic Granulomatosis with Polyangiitis (EGPA), Churg-Strauss Syndrome is the inflammation of blood vessels, clustering of white blood cells, and development of granulomas. --- ### [Mixed Connective Tissue Disease](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/mixed-connective-tissue-disease/) **Description:** MCTD develops as ribonucleoprotein molecules are attacked by antibodies, inhibiting the production of messenger RNA. The body’s fibers that help to establish its framework and physical support (connective tissues) are also attacked. --- ### [Polymyalgia Rheumatica](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/polymyalgia-rheumatica/) **Description:** Characterized by muscle pain and stiffness in the neck, shoulders, and hips, equally affecting both sides of the body. The pain and discomfort are normally so great that it interferes with normal day-to-day activities. PR may appear overnight, or more gradually, and may last up to several years. --- ### [Rheumatoid Arthritis](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/rheumatoid-arthritis/) **Description:** The most common chronic inflammatory joint disease, autoantibodies attack the joints and cause joint destruction. --- ### [Sjögren Syndrome](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/sjogren-syndrome/) **Description:** When the glands responsible for producing moisture in the eyes, mouth, and other parts of the body are destroyed by autoantibodies. --- ### [Undifferentiated Connective Tissue Disease](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/undifferentiated-connective-tissue-disease/) **Description:** When the symptoms and lab test results of a systemic connective tissue disease are present but do not meet enough characteristics for a specific diagnosis (such as rheumatoid arthritis or lupus). --- ### [Cogan Syndrome](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/cogan-syndrome/) **Description:** Occurs when the immune system attacks the tissues and blood vessels of the eyes and ears. --- ### [Giant Cell Arteritis](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/giant-cell-arteritis/) **Description:** Also known as temporal arteritis or Horton’s disease, Giant cell arteritis is a disease of the blood vessels. --- ### [Polyarteritis Nodosa](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/polyarteritis-nodosa/) **Description:** A systemic blood vessel disease characterized by inflammation of small and medium-sized arteries which prevents their transport of oxygen and food to organs. --- ### [Postural Orthostatic Tachycardia Syndrome (POTS)](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/postural-orthostatic-tachycardia-syndrome-pots/) **Description:** Related to blood volume, the primary indicator of POTS is orthostatic intolerance, which is when too little blood returns to the heart when moving from a lying down to a standing up position. --- ### [Autoimmune Pancreatitis](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/autoimmune-pancreatitis/) **Description:** Also known as immunoglobulin G4-related disease, AIP is caused by an immune system attack on the pancreas which causes chronic inflammation, enlargement, or a mass in the pancreas. --- ### [Parsonage-Turner Syndrome](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/parsonage-turner-syndrome/) **Description:** A neurological autoimmune disease characterized by rapid development of severe shoulder and arm pain followed by muscular atrophy in the areas affected. --- ### [Sclerosing Mesenteritis](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/sclerosing-mesenteritis/) --- ### [Central Nervous System Vasculitis](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/centralnervoussystem-vasculitis/) --- ### [Amyloidosis](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/amyloidosis/) --- ### [Antiphospholipid Syndrome](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/antiphospholipid-syndrome/) **Description:** Autoantibodies damage proteins that are attached to fat molecules (phospholipids) causing blood clots to form in the body’s arteries and veins and making the blood “stickier” than normal. --- ### [Dressler’s Syndrome](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/dresslers-syndrome/) **Description:** Also known as postmyocardial infarction syndrome or postpericardiotomy syndrome, Dressler’s syndrome is characterized by pericarditis (inflammation of the sac surrounding the heart that occurs after damage to the organ itself or to the pericardium). --- ### [Ehlers-Danlos Syndrome](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/ehlers-danlos-syndrome/) --- ### [Sydenham's Chorea](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/sydenhams-chorea/) **Description:** Characterized by rapid, jerky, irregular, and involuntary movements (especially of the face and limbs). In children, these symptoms often appear after strep throat or rheumatic fever, caused by a group A streptococcus infection. --- ### [Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease (MOGAD)](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/anti-mog-associated-disease/) --- ### [Juvenile Idiopathic Arthritis/Adult-Onset Still's Disease](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/stills-disease-jia/) **Description:** JIA is a diagnosis that covers all forms of arthritis in individuals under 16 that last more than 6 weeks and whose origin is unknown. When diagnosed in adults, JIA is more commonly called adult-onset Still’s disease. --- ### [Chilblain Lupus Erythematosus](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/chilblain-lupus/) --- ### [Discoid Lupus](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/discoid-lupus/) **Description:** A type of lupus that is limited to the skin and presents as coin-shaped lesions on the skin form, either localized (on the face, ears, scalp) or disseminated (above and below the neck). --- ### [Eosinophilic Fasciitis](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/eosinophilic-fasciitis/) **Description:** Inflammation of the fascia (the tough band of tissue under the skin) along the arms and legs due to abnormal accumulation of white blood cells which causes skin swelling, thickening, and hardening. --- ### [Myositis](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/myositis/) --- ### [Relapsing Polychondritis](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/relapsing-polychondritis/) **Description:** Characterized by recurrent inflammation of the cartilage and other tissues, RP affects the ears, nose, joints, eyes, skin, heart valves, and brain. --- ### [Vexas Syndrome](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/vexas-syndrome/) --- ### [Autoimmune Autonomic Ganglionopathy](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/autoimmune-autonomic-ganglionopathy/) **Description:** Caused by the immune system’s attack on the autonomic nervous system, which regulates non-voluntary bodily functions such as heartbeat, AAG can either be classified as being associated with high levels of g-AchR antibodies (seropositive) or as having no detectable levels of the antibodies (seronegative). --- ### [Pulmonary Alveolar Proteinosis](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/pulmonary-alveolar-proteinosis/) --- ### [Iga Nephropathy/Berger's Disease](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/iga-nephropathy-bergers/) **Description:** Occurs when immunoglobulin A (IgA) antibodies build up in the kidneys, causing inflammation that hinders the ability of the kidneys to filter waste from the blood. --- ### [Primary Adrenal Insufficiency](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/primary-adrenal-insufficiency/) --- ### [Hashimoto's Thyroiditis/Autoimmune Thyroiditis](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/hashimotos/) **Description:** The thyroid gland becomes inflamed, impairing its ability to produce thyroid hormones. This leads to a gradual decline in function and eventually an underactive thyroid, which causes many functions of the body to slow down. --- ### [Juvenile Myositis](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/juvenile-myositis/) --- ### [Juvenile Polymyositis](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/juvenile-polymyositis/) --- ### [Juvenile Psoriatic Arthritis](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/juvenile-psoriatic-arthritis/) --- ### [Juvenile Rheumatoid Arthritis](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/juvenile-rheumatoid-arthritis/) --- ### [Oligoarticular Juvenile Arthritis](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/oligoarticular-juvenile-arthritis/) --- ### [Polyarticular Juvenile Arthritis](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/polyarticular-juvenile-arthritis/) --- ### [Pemphigoid](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/pemphigoid/) --- ### [Pemphigus](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/pemphigus/) --- ### [Ménière's disease](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/menieres-disease/) **Description:** A chronic disease that affects the inner ear, though typically only one ear. The onset of symptoms is typically a result of fluid building up in the inner ear (specifically the labyrinth compartment of the inner ear that controls the human body’s balance and hearing capacities). --- ### [Cryoglobulinemia](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/cryoglobulinemia/) --- ### [Cryoglobulinemic Vasculitis](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/cryoglobulinemic-vasculitis/) --- ### [Raynaud Syndrome/Phenomenon](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/raynauds/) **Description:** Narrowing of arteries that carry blood from the heart to other parts of the body, known as vasospasm attacks, results in reduced blood flow in the fingers and toes and is typically triggered by cold temperatures and emotional stress. --- ### [Primary Biliary Cirrhosis](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/primary-biliary-cirrhosis/) **Description:** Caused by a buildup of bile (a substance used to facilitate digestion and eliminate toxins in the liver) due to progressive destruction of the bile ducts by the immune system, this disease can eventually lead to liver damage and cirrhosis. --- ### [Dysautonomia](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/dysautonomia/) --- ### [Lambert-Eaton Myasthenic Syndrome](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/lambert-eaton-myasthenic-syndrome/) **Description:** Occurs when the immune system attacks the areas where the nerves and muscles of the body connect (neuromuscular junctions). As a result, patients experience muscular weakness. --- ### [Nonvasculitic Autoimmune Inflammatory Meningoencephalitis](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/nonvasculitic-autoimmune-inflammatory-meningoencephalitis/) --- ### [POEMS Syndrome](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/poems-syndrome/) **Description:** Characterized by polyneuropathy (simultaneous malfunction of many peripheral nerves throughout the body), organomegaly (enlargement of an organ or organs), endocrinopathy (endocrine gland disease that disrupts hormone production), monoclonal gammopathy (abnormal proteins found in the blood), and skin changes. --- ### [Igg4-Related Disease](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/igg4-related-disease/) **Description:** A systemic fibroinflammatory disease that has the potential to impact all organ systems, but tends to affect the following organs: pancreas, bile ducts, lacrimal glands, major salivary glands (parotid, submandibular, sublingual), lungs, kidneys, aorta, meninges, and thyroid gland. --- ### [Chronic Granulomatous Disease](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/chronic-granulomatous-disease/) --- ### [Autoimmune Enteropathy](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/autoimmune-enteropathy/) --- ### [Cronkhite-Canada Syndrome](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/cronkhite-canada-syndrome/) **Description:** A non-hereditary disease affecting the gastrointestinal tract, with a possible autoimmune etiology. It is primarily characterized by the formation of polyps, or abnormal tissue growths. --- ### [Bullous Pemphigoid](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/bullous-pemphigoid/) **Description:** A skin disease characterized by large fluid-filled blisters on the areas that flex, such as the lower abdomen, upper thighs, or armpits, due to autoantibodies targeting the skin. --- ### [Lichen Planus](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/lichen-planus/) **Description:** Characterized by inflammation of the mucous membranes in the mouth and of skin cells, resulting in the swelling and irritation of the skin, mouth, scalp, nails, and genitals. --- ### [Plaque Psoriasis](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/plaque-psoriasis/) --- ### [Spondyloarthritis](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/spondyloarthritis/) --- ### [Primary Immunodeficiency Disorders](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/primary-immunodeficiency-disorders/) --- ### [Connective Tissue Disease](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/connective-tissue-disease/) --- ### [Cutaneous Lupus](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/cutaneous-lupus/) --- ### [Anti-NMDA Receptor Encephalitis](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/anti-nmdar-encephalitis/) **Description:** A form of encephalitis that occurs when the immune system attacks NMDA receptors in the brain, resulting in brain swelling and disruption of signaling pathways. --- ### [Stiff Person Syndrome](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/stiff-person-syndrome/) --- ### [Necrobiosis Lipoidica](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/necrobiosis-lipoidica/) --- ### [Pyoderma Gangrenosum](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/pyoderma-gangrenosum/) --- ### [Microscopic Polyangiitis (MPA)/ANCA-Associated Vasculitis](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/mpa-anca-vasculitis/) **Description:** Blood vessel inflammation that damages organ systems, nerves, skin, and joints. Often associated with anti-neutrophil cytoplasmic antibodies (ANCA), antibodies directed against certain constituents of white blood cells. --- ### [Takayasu's arteritis](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/takayasus-arteritis/) --- ### [Autoimmune Polyglandular Syndrome](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/autoimmune-polyglandular-syndrome/) **Description:** A combination of endocrine and nonendocrine autoimmune diseases causing increased thyroid secretion and thyroid gland enlargement. --- ### [Various Autoimmune Diseases](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/various-autoimmune-diseases/) --- ### [Juvenile Ankylosing Spondylitis](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/juvenile-ankylosing-spondylitis/) --- ### [Uveitis](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/uveitis/) --- ### [Cutaneous Vasculitis](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/cutaneous-vasculitis/) --- ### [Reactive Arthritis](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/reactive-arthritis/) **Description:** Formerly referred to as Reiter’s syndrome, reactive arthritis causes inflammation in various joints in the body, especially the knees, feet, toes, hips and ankles. It typically develops following an infection (particularly sexually transmitted) or food poisoning. --- ### [Autoimmune Inner Ear Disease](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/autoimmune-inner-ear-disease/) **Description:** Rapidly progressive hearing loss and/or dizziness caused by antibodies attacking the inner ear, usually occurring suddenly and beginning in one ear before spreading to both. --- ### [Juvenile Lupus](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/juvenile-lupus/) --- ### [Juvenile Scleroderma](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/juvenile-scleroderma/) --- ### [Dermatitis Herpetiformis](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/dermatitis-herpetiformis/) **Description:** Chronic skin rashes of bumps and blisters. --- ### [Hyperthyroidism](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/hyperthyroidism/) --- ### [Temporal Arteritis](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/temporal-arteritis/) --- ### [Goodpasture Syndrome](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/goodpastures-syndrome/) **Description:** Also known as anti–glomerular basement membrane disease, autoantibodies attack the lungs and kidneys and if left untreated this can quickly escalate to glomerulonephritis, kidney failure, or even death. --- ### [Alopecia Areata](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/alopecia/) **Description:** An unpredictable, transient, non-skin-scarring hair loss caused by destruction of hair follicles, which can eventually lead to the loss of all scalp hair (alopecia totalis) or all body hair (alopecia universalis). --- ### [Arteriosclerosis / atherosclerosis](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/arteriosclerosis-atherosclerosis/) **Description:** Thickening and stiffening of the blood vessels cause restricted blood flow to the organs and tissues. --- ### [Chronic Inflammatory Demyelinating Polyneuropathy](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/chronic-inflammatory-demyelinating-polyneuropathy/) **Description:** Caused by the inflammation of the nerves and destruction of the myelin sheath (insulated covering) of the nerve fibers, CIPD may be closely related to or even a chronic form of Guillain-Barré syndrome. --- ### [Paraneoplastic Pemphigus](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/paraneoplastic-pemphigus/) **Description:** The least common but most severe form of pemphigus disease resulting in painful blisters on the mouth, lips, skin, and esophagus. Typically associated with cancer. --- ### [Linear IgA Bullous Dermatosis](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/linear-iga-bullous-dermatosis/) **Description:** Also known as linear IgA bullous dermatosis or chronic bullous disease of childhood, LAD causes blisters on the skin and mucous membranes. Typically, the skin blisters form in a line, and a corresponding line of IgA antibodies is found below the epidermis during skin biopsies. --- ### [Autonomic Neuropathy](https://www.autoimmuneinstitute.org/medical_institutions/autoimmune_disease/autonomic-neuropathy/) --- ## State ### [Massachusetts](https://www.autoimmuneinstitute.org/medical_institutions/state/massachusetts/) --- ### [California](https://www.autoimmuneinstitute.org/medical_institutions/state/california/) --- ### [Colorado](https://www.autoimmuneinstitute.org/medical_institutions/state/colorado/) --- ### [Washington DC](https://www.autoimmuneinstitute.org/medical_institutions/state/washington-dc/) --- ### [Ohio](https://www.autoimmuneinstitute.org/medical_institutions/state/ohio/) --- ### [North Carolina](https://www.autoimmuneinstitute.org/medical_institutions/state/north-carolina/) --- ### [Pennsylvania](https://www.autoimmuneinstitute.org/medical_institutions/state/pennsylvania/) --- ### [Maryland](https://www.autoimmuneinstitute.org/medical_institutions/state/maryland/) --- ### [Minnesota](https://www.autoimmuneinstitute.org/medical_institutions/state/minnesota/) --- ### [New York](https://www.autoimmuneinstitute.org/medical_institutions/state/new-york/) --- ### [New Jersey](https://www.autoimmuneinstitute.org/medical_institutions/state/new-jersey/) --- ### [Delaware](https://www.autoimmuneinstitute.org/medical_institutions/state/delaware/) --- ## Category ### [Covid-19 Antibodies](https://www.autoimmuneinstitute.org/research_updates/ad-news/covid-antibodies/) **Description:** Research on COVID-19 antibodies and immune response, including studies connecting antibody activity to autoimmune disease risk and outcomes. --- ### [Covid-19 Clinical Trials](https://www.autoimmuneinstitute.org/research_updates/ad-news/covid-clinical-trials/) **Description:** Major COVID-19 and Long Covid clinical trials, highlighting findings relevant to autoimmunity and patient care. --- ### [Long COVID](https://www.autoimmuneinstitute.org/research_updates/ad-news/long-covid/) **Description:** Insights into Long COVID research, with emphasis on immune dysregulation and autoimmune disease connections. --- ### [ME/CFS & Covid-19](https://www.autoimmuneinstitute.org/research_updates/ad-news/me-cfs-covid/) **Description:** Findings on the relationship between COVID-19 and ME/CFS, including infection risks, vaccine response, and immune system interactions. --- ### [Covid-19 Policy](https://www.autoimmuneinstitute.org/research_updates/ad-news/covid-policy-and-health-decisions/) **Description:** Policy decisions, regulatory actions, and public health guidance related to COVID-19, including implications for autoimmune disease research and patient care. --- ### [Covid-19 Variants](https://www.autoimmuneinstitute.org/research_updates/ad-news/covid-variants/) **Description:** Research on COVID-19 variants, their evolution, and effects on infection, vaccination, and autoimmune health. --- ### [Autoimmune Diseases & Covid-19](https://www.autoimmuneinstitute.org/research_updates/ad-news/autoimmune-disease-covid/) **Description:** Insights on the impact of COVID-19 on autoimmune diseases, including risks, outcomes, and immune system interactions. --- ### [T1D & Covid-19](https://www.autoimmuneinstitute.org/research_updates/ad-news/type-1-diabetes-covid/) **Description:** Studies on type 1 diabetes in the context of COVID-19, including infection outcomes, vaccine responses, and immune activity. --- ### [GBS & Covid-19](https://www.autoimmuneinstitute.org/research_updates/ad-news/guillain-barre-syndrome-covid/) **Description:** Research and case reports on the intersection of COVID-19 with Guillain-Barré syndrome. --- ### [Covid-19 Infections](https://www.autoimmuneinstitute.org/research_updates/ad-news/covid-infections/) **Description:** Research on COVID-19 infection outcomes and their implications for autoimmunity and post-viral illness. --- ### [Covid-19 Research Studies](https://www.autoimmuneinstitute.org/research_updates/ad-news/covid-research-studies/) **Description:** Important COVID-19 research studies, with focus on immune response, treatment, and autoimmune disease relevance. --- ### [RA & Covid-19](https://www.autoimmuneinstitute.org/research_updates/ad-news/rheumatoid-arthritis-covid/) **Description:** Research on rheumatoid arthritis during the COVID-19 pandemic, covering disease activity, treatment adjustments, and immune response. --- ### [Lupus & Covid-19](https://www.autoimmuneinstitute.org/research_updates/ad-news/lupus-covid/) **Description:** Research on systemic lupus erythematosus during COVID-19, including risks, immune responses, and treatment considerations. --- ### [Johnson & Johnson](https://www.autoimmuneinstitute.org/research_updates/ad-news/johnson-and-johnson/) **Description:** Developments on Johnson & Johnson’s COVID-19 vaccine, with emphasis on safety, efficacy, and autoimmune implications. --- ### [Moderna](https://www.autoimmuneinstitute.org/research_updates/ad-news/moderna/) **Description:** Research and updates on Moderna’s COVID-19 vaccine, including safety monitoring and immune response data. --- ### [Pfizer](https://www.autoimmuneinstitute.org/research_updates/ad-news/pfizer/) **Description:** Updates on Pfizer’s COVID-19 vaccine, covering safety, efficacy, and immune-related outcomes. --- ### [Vaccine Manufacturers](https://www.autoimmuneinstitute.org/research_updates/ad-news/vaccine-manufacturers/) **Description:** Information on COVID-19 vaccine manufacturers, including research, safety monitoring, and autoimmune disease relevance. --- ### [Vaccine Adverse Events](https://www.autoimmuneinstitute.org/research_updates/ad-news/vaccine-adverse-events/) **Description:** Findings on COVID-19 vaccine adverse events, including autoimmune-related cases and safety monitoring. --- ### [Covid-19 & Long Covid Treatments](https://www.autoimmuneinstitute.org/research_updates/ad-news/covid-long-covid-treatments/) **Description:** Therapeutic approaches to COVID-19, including antivirals, immunomodulators, and relevance for autoimmune patients. --- ### [AstraZeneca](https://www.autoimmuneinstitute.org/research_updates/ad-news/astrazeneca/) **Description:** Updates on AstraZeneca’s COVID-19 vaccine, including trial outcomes, immune responses, and safety data. --- ### [Novavax](https://www.autoimmuneinstitute.org/research_updates/ad-news/novavax/) **Description:** Findings on Novavax’s COVID-19 vaccine, highlighting safety, efficacy, and immune system interactions. --- ### [Covid-19 Boosters](https://www.autoimmuneinstitute.org/research_updates/ad-news/covid-boosters/) **Description:** Developments in COVID-19 booster vaccines, including immune response data and autoimmune-related findings. --- ### [Thyroid disease & Covid-19](https://www.autoimmuneinstitute.org/research_updates/ad-news/thyroid-disease-covid/) **Description:** Findings on the intersection of COVID-19 and thyroid disease, including hypothyroidism, hyperthyroidism, Graves’ disease, Hashimoto’s thyroiditis, and immune system activity. --- ### [Celiac disease & Covid-19](https://www.autoimmuneinstitute.org/research_updates/ad-news/celiac-disease-covid/) **Description:** Studies and findings on COVID-19 and celiac disease, with attention to immune response and patient outcomes. --- ### [MS & Covid-19](https://www.autoimmuneinstitute.org/research_updates/ad-news/multiple-sclerosis-covid/) **Description:** Findings on the relationship between COVID-19 and MS, including infection risks, vaccine response, and immune system interactions. --- ### [IBD & Covid-19](https://www.autoimmuneinstitute.org/research_updates/ad-news/inflammatory-bowel-disease-covid/) **Description:** Findings on the intersection of COVID-19 and inflammatory bowel diseases (Crohn’s disease and ulcerative colitis). --- ### [Sjögren disease & Covid-19](https://www.autoimmuneinstitute.org/research_updates/ad-news/sjogrens-covid/) **Description:** Research on Sjögren disease during COVID-19, including patient outcomes and immune system interactions. --- ### [Myasthenia gravis & Covid-19](https://www.autoimmuneinstitute.org/research_updates/ad-news/myasthenia-gravis-covid/) **Description:** Findings on the relationship between COVID-19 and Myasthenia Gravis, including infection risks, vaccine response, and immune system interactions. --- ### [Covid-19 Vaccines](https://www.autoimmuneinstitute.org/research_updates/ad-news/covid-vaccines/) **Description:** Research and developments on COVID-19 vaccines, with attention to efficacy, safety, and autoimmune considerations. --- ## Category ### [Celiac Disease](https://www.autoimmuneinstitute.org/research_updates/ad-news/celiac-disease-ads/) **Description:** Advances in celiac disease research, diagnosis, and gluten-related autoimmunity. --- ### [Events](https://www.autoimmuneinstitute.org/research_updates/ad-news/conferences-webinars/) **Description:** Autoimmune-related events, conferences, and webinars that advanced research, treatment, and awareness. --- ### [Neurological Disorders](https://www.autoimmuneinstitute.org/research_updates/ad-news/neurological-disorders/) **Description:** Research and findings on neurological disorders linked to autoimmunity, including diagnosis, pathogenesis, and therapies. --- ### [Research Studies](https://www.autoimmuneinstitute.org/research_updates/ad-news/research-studies-ad-news/) **Description:** Studies that contribute to the evolving science of autoimmune disease mechanisms, diagnosis, and therapies. --- ### [Therapies](https://www.autoimmuneinstitute.org/research_updates/ad-news/therapies/) **Description:** Therapeutic developments that transformed autoimmune disease care, from early drugs to biologics. --- ### [Diagnostic Testing](https://www.autoimmuneinstitute.org/research_updates/ad-news/testing/) **Description:** Developments in diagnostic testing for autoimmune conditions, including biomarkers and evolving criteria. --- ### [Autoimmune Diseases](https://www.autoimmuneinstitute.org/research_updates/ad-news/ads/) **Description:** Major developments in the understanding, diagnosis, and treatment of autoimmune diseases, highlighting progress across multiple conditions. --- ### [Microbiome](https://www.autoimmuneinstitute.org/research_updates/ad-news/microbiome/) **Description:** Major milestones in microbiome research that shaped understanding of autoimmune disease mechanisms. --- ### [Risk Factors](https://www.autoimmuneinstitute.org/research_updates/ad-news/risk-factors/) **Description:** Discoveries showing how genetics, environment, and exposures are linked to autoimmune disease. --- ### [Genetics](https://www.autoimmuneinstitute.org/research_updates/ad-news/genetics/) **Description:** Key genetic findings that revealed predispositions and pathways in autoimmune disease. --- ### [Lupus](https://www.autoimmuneinstitute.org/research_updates/ad-news/sle/) **Description:** Key breakthroughs in systemic lupus erythematosus, from diagnostic criteria to therapeutic innovations. --- ### [IBD (Crohn's and UC)](https://www.autoimmuneinstitute.org/research_updates/ad-news/ibd/) **Description:** Key discoveries and therapies that shaped the understanding and management of Crohn’s disease and ulcerative colitis. --- ### [Multiple Sclerosis](https://www.autoimmuneinstitute.org/research_updates/ad-news/ms/) **Description:** Pivotal studies and therapies that advanced knowledge of multiple sclerosis and transformed patient care. --- ### [Rheumatoid Arthritis](https://www.autoimmuneinstitute.org/research_updates/ad-news/ra/) **Description:** Advances in rheumatoid arthritis research, diagnostics, and therapies that reshaped patient outcomes. --- ### [Type 1 Diabetes](https://www.autoimmuneinstitute.org/research_updates/ad-news/type-1-diabetes-ads/) **Description:** Advances in type 1 diabetes research, including immunological insights and treatment innovations. --- ### [Clinical Trials](https://www.autoimmuneinstitute.org/research_updates/ad-news/clinical-trials-ad-news/) **Description:** Clinical trials that influenced autoimmune disease research and reshaped treatment options. --- ### [Autoimmune Brain Inflammation](https://www.autoimmuneinstitute.org/research_updates/ad-news/autoimmune-encephalomyelitis/) **Description:** Key findings and research milestones on autoimmune brain inflammation, including encephalomyelitis and related neurological conditions. --- ### [Eye Disease](https://www.autoimmuneinstitute.org/research_updates/ad-news/eye-disease/) **Description:** Developments in autoimmune conditions affecting the eyes, including diagnostic and therapeutic advances. --- ### [Psoriasis](https://www.autoimmuneinstitute.org/research_updates/ad-news/psoriasis/) **Description:** Key research developments in psoriasis, including breakthroughs in immunology and targeted therapies. --- ### [Sjögren disease](https://www.autoimmuneinstitute.org/research_updates/ad-news/sjogrens-syndrome/) **Description:** Research discoveries and treatment advances that deepened understanding of Sjögren disease. --- ### [Thyroid Disease](https://www.autoimmuneinstitute.org/research_updates/ad-news/thyroid-disease/) **Description:** Major research milestones in autoimmune thyroid conditions, including Hashimoto’s thyroiditis and Graves’ disease. --- ### [Case Studies](https://www.autoimmuneinstitute.org/research_updates/ad-news/case-studies/) **Description:** Significant case studies highlighting unusual presentations and clinical insights into autoimmune disease. --- ### [Policy & Health Decisions](https://www.autoimmuneinstitute.org/research_updates/ad-news/government-policy/) **Description:** Government actions and policies that impact autoimmune disease research, funding, and patient care. --- ### [ME/CFS](https://www.autoimmuneinstitute.org/research_updates/ad-news/me-cfs/) **Description:** Important findings in myalgic encephalomyelitis/chronic fatigue syndrome, with emphasis on immune dysfunction and disease mechanisms. --- ### [Resources](https://www.autoimmuneinstitute.org/research_updates/ad-news/resources/) **Description:** Educational and informational resources that expand knowledge and support for autoimmune disease. --- ### [Autoimmune Stories](https://www.autoimmuneinstitute.org/research_updates/ad-news/autoimmune-stories/) --- ### [OADR (NIH Office of Autoimmune Disease Research)](https://www.autoimmuneinstitute.org/research_updates/ad-news/oadr-nih-autoimmune-research/) **Description:** The Office of Autoimmune Disease Research (OADR-ORWH) coordinates autoimmune disease research across the NIH. This category covers OADR reports, strategic planning, funding initiatives, and updates shaping the future of autoimmune research. --- ### [GAI-Funded](https://www.autoimmuneinstitute.org/research_updates/ad-news/gai-funded/) --- ## Category ### [Ankylosing Spondylitis](https://www.autoimmuneinstitute.org/autoimmune_stories/category_stories/ankylosing-spondylitis/) --- ### [Autoimmune Hepatitis](https://www.autoimmuneinstitute.org/autoimmune_stories/category_stories/autoimmune-hepatitis/) --- ### [Berger’s disease & glomerulonephritis](https://www.autoimmuneinstitute.org/autoimmune_stories/category_stories/bergers-disease-glomerulonephritis/) --- ### [Caregiver’s Story](https://www.autoimmuneinstitute.org/autoimmune_stories/category_stories/caregivers-story/) --- ### [Crohn’s Disease](https://www.autoimmuneinstitute.org/autoimmune_stories/category_stories/crohns-disease/) --- ### [Devic’s disease/Neuromyelitis Optica](https://www.autoimmuneinstitute.org/autoimmune_stories/category_stories/devics-disease-neuromyelitis-optica/) --- ### [Food Sensitivities](https://www.autoimmuneinstitute.org/autoimmune_stories/category_stories/food-sensitivities/) --- ### [Guillain–Barré syndrome (GBS)](https://www.autoimmuneinstitute.org/autoimmune_stories/category_stories/guillain-barre-syndrome-gbs/) --- ### [Hashimoto’s](https://www.autoimmuneinstitute.org/autoimmune_stories/category_stories/hashimotos/) --- ### [Henoch-Schönlein purpura](https://www.autoimmuneinstitute.org/autoimmune_stories/category_stories/henoch-schonlein-purpura/) --- ### [Lupus (SLE)](https://www.autoimmuneinstitute.org/autoimmune_stories/category_stories/lupus-sle/) --- ### [Misdiagnosis](https://www.autoimmuneinstitute.org/autoimmune_stories/category_stories/misdiagnosis/) --- ### [Mixed connective tissue disease (MCTD)](https://www.autoimmuneinstitute.org/autoimmune_stories/category_stories/mixed-connective-tissue-disease-mctd/) --- ### [Neuromyelitis Optica](https://www.autoimmuneinstitute.org/autoimmune_stories/category_stories/neuromyelitis-optica/) --- ### [Raynaud’s](https://www.autoimmuneinstitute.org/autoimmune_stories/category_stories/raynauds/) --- ### [Sjogren’s Disease](https://www.autoimmuneinstitute.org/autoimmune_stories/category_stories/sjogrens-disease/) --- ### [Ulcerative Colitis](https://www.autoimmuneinstitute.org/autoimmune_stories/category_stories/ulcerative-colitis/) --- ### [Undiagnosed](https://www.autoimmuneinstitute.org/autoimmune_stories/category_stories/undiagnosed/) --- ### [Vitiligo](https://www.autoimmuneinstitute.org/autoimmune_stories/category_stories/vitiligo/) --- ### [Lyme Disease](https://www.autoimmuneinstitute.org/autoimmune_stories/category_stories/lyme-disease/) --- ### [Rheumatoid Arthritis](https://www.autoimmuneinstitute.org/autoimmune_stories/category_stories/rheumatoid-arthritis/) --- ### [Multiple Autoimmune Diseases](https://www.autoimmuneinstitute.org/autoimmune_stories/category_stories/multiple-autoimmune-diseases/) --- ### [POTS](https://www.autoimmuneinstitute.org/autoimmune_stories/category_stories/pots/) --- ### [Multiple Sclerosis (MS)](https://www.autoimmuneinstitute.org/autoimmune_stories/category_stories/multiple-sclerosis-ms/) --- ### [Type 1 Diabetes](https://www.autoimmuneinstitute.org/autoimmune_stories/category_stories/type-1-diabetes/) --- ### [Diagnostic Delays](https://www.autoimmuneinstitute.org/autoimmune_stories/category_stories/diagnostic-delays/) ---