Newly developed molecules may provide more reliable relief for people with autoimmune diseases

Living with an autoimmune disease can feel like an insider is attacking your body. 
Now, Purdue University researchers have developed a series of molecules that may provide more reliable relief with fewer side effects for people with any of several autoimmune diseases. 
The new molecules overcome difficulties with current drugs in targeting, for purposes of inhibiting, the appropriate form of Janus kinase, which has four forms affecting cell signaling and gene expression.
The new inhibitors may provide relief for people suffering from rheumatoid arthritis, psoriasis, myelofibrosis and other autoimmune diseases with a reduction in side effects compared with current therapies. The research appears in the November edition of the Journal of Medicinal Chemistry.
"Our new molecules fit within the emerging field of therapeutically useful Janus kinase inhibitors that have attracted a lot of attention and excitement within the medicinal chemistry community and the general field of medicine," said Mark Cushman, a distinguished professor of medicinal chemistry in Purdue's College of Pharmacy, who leads the research team. "Our compounds contribute a new structural chemotype that is expected to have unique pharmacological properties relative to the other known Janus kinase inhibitors."
Cushman, a member of the Purdue University Center for Cancer Research, said the new molecules also show potential to allow for more treatment options for people with autoimmune diseases. Abnormalities of the immune system often lead to autoimmune diseases or cancer.



The value of dietary fibre in preventing autoimmune neurological disease

Dietary fibre in preventing autoimmune neurological disease

A diet that incorporates non-fermentable fiber — a common component of a vegetarian diet — during early life can help prevent the onset of autoimmune diseases such as multiple sclerosis (MS), a new study shows.

The dietary habits of humans have changed drastically over the past few decades, which is a trend paralleled by an ever-increasing prevalence of autoimmune diseases like MS.
It is thought that a “Western diet” can alter the gut microbiome – referring to the bacteria and other microorganisms that reside in the gut – leading to the development of autoimmune disease.
Identifying the dietary factors that contribute to the development of these diseases may help develop therapeutic strategies to help treat or prevent autoimmunity.

dietary fibre preventing autoimmune disease
Dietary fibers, which are composed of both fermentable and non-fermentable fibers, have a wide range of physiological effects. Fermentable fibers are easily fermented by bacteria in the colon, while non-fermentable fiber are not.
Earlier studies have focused on fermentable dietary fibers, which have shown significant beneficial evidence in inflammatory disorders.
However, the role of non-fermentable dietary fibers — a major component of vegetables and fruits, including cellulose —in autoimmune disease is unclear.
So, researchers set out to investigate the effects of non-fermentable dietary fiber in the mechanisms that lead to the development of central nervous system (CNS)-specific autoimmune disease.
Researchers used a genetically engineered spontaneous experimental autoimmune encephalomyelitis mouse model (an MS-like mouse model) to investigate this effect.
Interestingly, results indicated that consumption of non-fermentable dietary fiber (a diet rich in cellulose) helped protect mice from developing spontaneous CNS-directed autoimmunity.
The protective effect was related to robust changes in the composition of the gut microbiome and a change in the balance of immune cells. In particular, researchers noticed an increase in the immune responses of TH2 cells (a type of immune cell) within and outside the intestine. TH2 cells have an anti-inflammatory profile and have been associated with positive effects in MS.
Overall, the researchers concluded: “Together, these findings establish that dietary non-fermentable fiber as a modulator of gut microbial profile and offer a simple way to prevent CNS autoimmunity that warrants nutritional studies in human MS.”


10 subtle signs and symptoms of lupus

10 subtle signs and symptoms of lupus
If you're curious whether your subtle symptoms could actually be signs of lupus, you should know the common signs and symptoms associated with the disease.
Here are 10 subtle signs of lupus.

You're extremely fatigued.

Fatigue is one common symptom associated with lupus, but the problem is, it's also commonly associated with many other illnesses, which can sometimes make getting an accurate diagnosis difficult.

You get unexplained headaches.

Headaches can also mean any number of different issues, and when you just get one out of the blue, you likely don't think that it indicates lupus. If you're getting regular headaches, however, it's definitely worth telling your doctor because it could point to the autoimmune condition.

You've gotten strange rashes on your skin.

One of the most notable signs of lupus is a so-called "butterfly rash.""Very frequently patients with systemic lupus will present with acute cutaneous lupus, a photosensitive rash, most typically across the face and nose known as the classic 'butterfly rash,'" Bard told INSIDER. If you notice this sort of rash, you should definitely raise the subject with your doctor.

Your joints hurt, or are red or swollen.

If your joints are red, swollen, or painful and you can't come up with any sort of explanation for what could've happened that would cause it, that might be worth chatting with your doctor about, because it could be a sign of an autoimmune condition, if not lupus, perhaps rheumatoid arthritis.

You have ulcers in your mouth.

You might not think that ulcers in your mouth would have anything to do with lupus or an autoimmune condition, but as it turns out, they could be an early sign that that's what's going on.

Your eyes are pretty dry.

Though dry eyes aren't directly themselves a sign of lupus, they are a sign of Sjogren's Syndrome, which commonly occurs in conjunction with lupus.

You're losing your hair.

"Many systemic lupus patients, about 85%, will also present with a variety of skin and hair manifestations," Stella Bard said. That means that if you're dealing with hair or skin issues that seem like they could be related to lupus, it could definitely be worth exploring further.

You have swelling in soft tissue areas of your body.

If you notice swelling in your body, that too could potentially mean that you have lupus. Dr. Bard said that if you experience swelling in your hands, feet, legs, or around your eyes, in particular, those could be signs of lupus. 

Your joints are stiff.

Like joint pain and swelling, joint stiffness can also be a sign of lupus. The Lupus Foundation noted that Lupus arthritis causes pain, stiffness, swelling, tenderness, and warmth in your joints. Compared to rheumatoid arthritis, lupus arthritis is less disabling, however.
"Any of these symptoms should be brought to the attention of the physician," Susan Bard said. "It's the physician's role to distinguish the symptoms of lupus from other ailments. Particularly concerning symptoms such as shortness of breath, chest pain, and foamy urine should be evaluated immediately by a board-certified physician specialist."
Regardless of what you think might be causing any serious or long-lasting symptom, it's worth talking to your doctor about it. They're the one who will be able to help determine what might actually be causing it and though lupus can be tricky to diagnose, the sooner you know what you're up against, the sooner you can seek the treatment you may need.

Celiac Disease and Sjogren's Syndrome

Celiac Disease and Sjogren's Syndrome

Studies show that up to 15% of people diagnosed with Sjögren's syndrome also have the biopsy-proven celiac disease, making it far more common in Sjögren's patients than it is in the general population.
But as with celiac disease and other autoimmune diseases, it's not clear exactly why celiac and Sjögren's occur together frequently. It may be that they share common genetic roots, making a person with one more likely to get the other, as well. Or, it may be that there's a common trigger—possibly gluten, but that's far from proven—involved in both.

Sjögren's Patients May Be Silent Celiacs

In some cases, people with Sjögren's syndrome who also have celiac disease have silent celiac disease, in which they don't notice medical symptoms but still have intestinal damage.
In one study, some 12% of Sjögren's patients had tTG-IgA antibodies, indicating a strong chance of celiac disease. Not all of these had celiac symptoms, but five out of the six had symptoms or biopsy results consistent with celiac disease.
In another study, researchers in Hungary found five biopsy-confirmed cases of celiac disease in 111 people with Sjögren's syndrome, many of whom didn't report intestinal symptoms that might have indicated celiac disease.
Based on those results, the Hungarian researchers recommended "screening, follow-up and regular gastrointestinal care" for people with Sjögren's syndrome to help them avoid malnutrition and cancers associated with the untreated celiac disease.

Non-Celiac Gluten Sensitivity, Sjögren's Possibly Linked

In a study conducted in Sweden and published in the Scandinavian Journal of Gastroenterology, researchers took 20 people with Sjögren's syndrome, plus 18 people without the condition...
Before the gluten challenge, 15 out of the 20 Sjögren's patients reported gastrointestinal symptoms, and eight said they were intolerant to various foods, including gluten grains. However, the study's authors didn't find a correlation between gluten sensitivity and self-reported food intolerance or gastrointestinal symptoms.
Of course, clinicians still are exploring the concept of non-celiac gluten sensitivity, and it's not clear exactly what type of entity it will turn out to be. Consequently, many physicians still don't accept the diagnosis.

What This Means for People With Sjögren's

...there is some evidence that people with Sjögren's might want to consider getting tested for celiac disease, especially if they have possible symptoms (remember, not everyone has primarily intestinal symptoms from celiac disease—symptoms can be neurological or skin-based, as well). Of course, you should always complete any celiac testing prior to going gluten-free, since it's impossible to get accurate test results on the gluten-free diet.
Full article at verywellhealth

Celiac Disease and Sjogren's Syndrome


Clinical Efficacy of Leflunomide/Hydroxychloroquine Combination Therapy in Patients with Primary Sjogren’s Syndrome

Combination Therapy in Patients with Primary Sjogren’s Syndrome
This study, Clinical Efficacy of Leflunomide/Hydroxychloroquine Combination Therapy in Patients with Primary Sjogren’s Syndrome: Results of a Placebo-Controlled Double-Blind Randomized Clinical Trial was recently presented at the American College of Rheumatology 2018 Meeting.

Clinical trials in patients with primary Sjogren's Syndrome (pSS) using leflunomide (LEF) or
hydroxychloroquine (HCQ) previously showed that they inhibited B cell hyperactivity, but only with moderate effect.

The researchers wanted to study the potential of these 2 drugs when used together. They conducted a randomized, double–blind, placebo-controlled, mono-center proof of concept study to evaluate the efficacy, safety and tolerability of LEF/HCQ therapy in patients with pSS.

Twenty-nine patients were enrolled: 8 patients received placebo and 21 received LEF/HCQ combination therapy.
Overall, LEF/HCQ was safe and well-tolerated. 
As anticipated, lymphopenia and elevated CK levels were significantly higher in the LEF/HCQ group.
There were significant improvements in other measures such as pain,  fatigue, Physician’s Global Assessment, and Patient’s Global Assessment were also observed in the LEF/HCQ group but not in those receiving placebo

This pilot Randomized Clinical Trial (RCT) suggests clinical efficacy for LEF/HCQ combination therapy in almost half of the patients with primary Sjögren`s syndrome. 
Larger RCT’s are needed to confirm the observed effects and to identify potential biomarkers for response.

Travel Tip With an Autoimmune Disease

How To Travel With an Autoimmune Disease

Here is a tip to help when traveling when you have chronic illness.
Here a specialist shares some advice on traveling when you need to take medications with you. As always however, talk to your doctor for specific advice related to your condition, depending on where you plan to visit.
Prepare your prescriptions before you go

“Make sure your disease is under control before you travel,” said Dr. Michael Chiorean, director of the Inflammatory Bowel Disease (IBD) Center of Excellence at Virginia Mason. “I encourage my patients to choose destinations where they don’t need to get a live vaccine, like yellow fever, because it can lead to other health issues, or where they won’t be exposed to deadly organisms.”
He also recommends carrying on medications in their original packaging with a copy of prescriptions, as well as a doctor’s letter detailing their condition and necessary medications to decrease any chance of confiscation by airport or border security.

“Visiting regions like Western Europe where it’s easy to replace medications is also helpful,” he added. If specialty drugs are lost or confiscated, patients can contact their health insurance’s or drug company’s patient support programs, which typically provide a rescue supply of medications through a local specialty pharmacy or hospital (depending on the country). For generic drugs, patients can usually go to local pharmacies to get a short-term refill.
Travel Tip With an Autoimmune Disease

Get more tips from  NY Times Travel on eating and traveling safely when you have an autoimmune disease.


Autoimmune disease and salt

Autoimmune disease and salt

Autoimmune disorders are thought to be caused by a number of factors. Some people think that some contributing factors may be smoking, lack of Vitamin D, obesity, and dietary habits.

According to new research from Yale University high-salt diets may trigger inflammation and possibly contribute to the development of autoimmune diseases, Activated β-catenin in Foxp3+ regulatory T cells links inflammatory environments to autoimmunity


New Link Between Autoimmune Diseases and a Gut Bacterium

Queen’s University researchers have, for the first time, found a specific microbe in the gut that pumps out protein molecules that mimic a human protein, causing the human defence system to turn on its own cells by mistake.
The culprit in this case is called Bacteroides fragilis, a bacterium that normally lives in the human gut. The Queen’s team has shown that this bacterium produces a human-like protein that could trigger autoimmune diseases, such as rheumatoid arthritis.  This human protein is called ‘ubiquitin’ and is needed for all the normal cell processes in our bodies.
New Link Between Autoimmune Diseases and a Gut Bacterium


What is an Autoantibody?

What is an Autoantibody?
An autoantibody is an antibody (a type of protein) produced by the immune system that is directed against one or more of the individual's own proteins. 

Our immune system can usually discriminate between foreign substances "non-self" and it's own cells "self". 

Antibodies are proteins that your immune system – white blood cells (B cells) – makes to recognize and fight foreign substances. It produces antibodies only when it perceives that it has been exposed to a threat "non-self", such as virus or other illness

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