Understanding must precede therapy as scientists seek to adequately relieve the suffering of millions with autoimmune conditions. Initial understanding pointed repeatedly to an immune messenger or cytokine called Interleukin 1b as a critical factor in the development and progression of autoimmune diseases like multiple sclerosis, type 1 diabetes, and inflammatory bowel disease. For a number of years, medications to block this messenger were used to treat these diseases without fully understanding and without adequately relieving the process. Researchers now believe they have found the pathway leading to interleukin 1b production in autoimmunity.
In the past, scientists suspected that IL 1b came from inflammasomes, cellular structures involved in activating inflammation. These protein inflammasomes have gained recent attention from their involvement in COVID 19 disease. With the recent discovery described in this article, IL 1b in autoimmune diseases appears to arise form CD4+ T cells interacting with other immune cells. Instead of its normal antimicrobial function, the IL 1b drives other cells to attack our own bodies.
It appears that two other immune messengers, TNF (tumor necrosis factor) and FasL (fas ligand) lie behind the IL 1b activity in autoimmune conditions. While prior work had looked at suppressing inflammasomes, these finding indicate that TNF (tumor necrosis factor) and FasL (fas ligand) will be better targets for future autoimmune therapies.
The design of our bodies continues to indicate the need for therapies which address multiple pathways. The design also gives us reason to be careful when applying any therapy which completely turns on or turns off a given pathway. Each pathway has a particular function that should be preserved while preventing its misapplication in a disease process. The problem with many pharmaceuticals remains their tendency for turning pathways 100% on or 100% off. Natural options act more like thermostats, turning things up or down in degrees.
As scientists continue their work in uncovering these pathways as well as how to modify them when the pathways are dysfunctioning, those of us in functional medicine applaud and eagerly await further research. While waiting, we utilize the natural and pharmaceutical options available, especially the natural options which target multiple pathways without completely turning them all on or all off. Helping patients live healthier more abundant lives requires both understanding the pathways and wise application of available therapies.
Aakanksha Jain, Ricardo A. Irizarry-Caro, Margaret M. McDaniel, Amanpreet Singh Chawla, Kaitlin R. Carroll, Garrett R. Overcast, Naomi H. Philip, Andrew Oberst, Alexander V. Chervonsky, Jonathan D. Katz, Chandrashekhar Pasare. T cells instruct myeloid cells to produce inflammasome-independent IL-1β and cause autoimmunity. Nature Immunology, 2019; 21 (1): 65 DOI: 10.1038/s41590-019-0559-y
Thanks to Science Daily:
Cincinnati Children’s Hospital Medical Center. “New twist to fight against autoimmune diseases: New drivers of destructive inflammation.” ScienceDaily. ScienceDaily, 17 December 2019. <www.sciencedaily.com/releases/2019/12/191217114232.htm>.
Sanctuary Functional Medicine, under the direction of Dr Eric Potter, IFMCP MD, provides functional medicine services to Nashville, Middle Tennessee and beyond. We frequently treat patients from Kentucky, Alabama, Mississippi, Georgia, Ohio, Indiana, and more... offering the hope of healthier more abundant lives to those with chronic illness.