Last Updated on June 14, 2023 by Beth Skwarecki
Asthma is a chronic respiratory disease that affects millions of people worldwide. It is characterized by inflammation and narrowing of the airways, leading to difficulty breathing, wheezing, coughing, and chest tightness. While the exact causes of asthma are not fully understood, it is widely accepted that immune system dysfunction plays a significant role in the development and progression of the disease.
In recent years, there has been increasing evidence to suggest that asthma may be an autoimmune disease, in which the body’s immune system mistakenly attacks its healthy tissues. This article will provide an overview of autoimmune diseases, the immune system’s role in asthma, the evidence supporting asthma as an autoimmune disease, current and future treatment options, and implications for future research.
What is Asthma?
Asthma is a chronic respiratory disease that affects the airways in the lungs. The airways become inflamed and narrowed, leading to difficulty breathing. The primary asthma symptoms include wheezing, coughing, chest tightness, and shortness of breath.
Asthma is a complex condition whose exact causes are not fully understood. However, it is believed to be triggered by a combination of genetic and environmental factors. Environmental triggers that can cause asthma symptoms include allergens (such as dust mites, pollen, and animal dander), air pollution, respiratory infections, exercise, and stress.
The pathophysiology of asthma involves the airways becoming inflamed and narrowed due to a complex interaction of various cells and mediators in the immune system. This inflammation can be triggered by multiple environmental factors, leading to a chronic cycle of inflammation and damage in the airways.
Autoimmune diseases are a group of disorders in which the immune system mistakenly attacks the body’s healthy tissues, leading to chronic inflammation and tissue damage. There are over 80 known autoimmune diseases, each with its specific symptoms, causes, and treatment options.
Examples of autoimmune diseases include rheumatoid arthritis, lupus, multiple sclerosis, type 1 diabetes, celiac disease, psoriasis, and inflammatory bowel disease. The exact causes of autoimmune diseases are not fully understood, but a combination of genetic and environmental factors is thought to play a role. Genetic variations make some individuals more susceptible to developing autoimmune diseases, and environmental factors such as infections, toxins, and stress can trigger or exacerbate the immune system’s response.
Is Asthma an Autoimmune Disease?
Asthma is not considered an autoimmune disease, although it does involve a complex interplay between the immune system, inflammation, and the respiratory system.
The immune system plays a critical role in the development and progression of asthma, which is characterized by chronic inflammation of the airways and reduced airflow. This inflammation is caused by the immune system’s response to various triggers, such as allergens, irritants, and respiratory infections. In people with asthma, the immune system overreacts to these triggers, leading to an exaggerated inflammatory response in the airways.
This results in the release of various inflammatory mediators, such as cytokines, chemokines, and prostaglandins, which cause swelling, mucus production, and bronchoconstriction. Additionally, there is an imbalance between different types of immune cells, such as Th2 cells and regulatory T cells, which contributes to the chronic inflammation and airway hyperresponsiveness seen in asthma.
While asthma is not an autoimmune disease, the immune system does play a role in the development and progression of asthma. In people with asthma, the immune system can overreact to triggers such as allergens or irritants, causing inflammation and constriction of the airways.
Comparison Table for Asthma & Autoimmune Diseases
|Definition||Chronic respiratory condition causing airway inflammation||Disorders where the immune system attacks the body|
|Pathogenesis||Inflammation and narrowing of airways||Immune system dysfunction|
|Triggers||Allergens, pollutants, exercise, infections||Genetic, environmental, hormonal factors|
|Symptoms||Wheezing, coughing, shortness of breath||Vary depending on the specific autoimmune disease|
|Body Systems||Primarily affects the respiratory system||Can affect any body system|
|Diagnosis||Medical history, physical examination, lung function tests||Blood tests, imaging, biopsy, clinical evaluation|
|Treatment||Inhalers, bronchodilators, corticosteroids, lifestyle changes||Immunosuppressants, anti-inflammatory drugs, specific disease-targeted therapies|
|Common Examples||Allergic asthma, exercise-induced asthma||Rheumatoid arthritis, lupus, multiple sclerosis|
Please note that this table provides a general overview, and individual cases may vary. It’s always important to consult with a healthcare professional for accurate diagnosis and treatment.
Evidence Supporting Asthma As an Autoimmune Disease
There is growing evidence to suggest that asthma may be an autoimmune disease. Here are some of the key pieces of evidence supporting this hypothesis:
#1. Inflammatory Response to Asthma
Asthma is characterized by chronic inflammation of the airways, and many of the inflammatory mediators involved in asthma are also found in other autoimmune diseases. For example, interleukin-4 (IL-4), IL-5, and IL-13, which are produced by Th2 cells in asthma, are also involved in other autoimmune diseases such as rheumatoid arthritis and systemic lupus erythematosus.
#2. Autoantibodies in Asthma
Autoantibodies are antibodies that mistakenly target the body’s healthy tissues. Several studies have found that people with asthma have higher levels of autoantibodies compared to healthy individuals. For example, some people with asthma produce autoantibodies against epithelial cells in the airways, which can contribute to airway damage and inflammation.
#3. Genetics and Asthma
Many autoimmune diseases have a genetic component, and several genetic variants have been associated with an increased risk of developing asthma. For example, a variant of the IL-33 gene has been linked to both asthma and autoimmune diseases such as rheumatoid arthritis and psoriasis.
Can Untreated Asthma Weaken Your Immune System?
Untreated asthma can potentially weaken your immune system indirectly, as it can cause ongoing inflammation in the airways and lungs, which can make you more susceptible to respiratory infections.
The immune system plays a critical role in fighting off infections, including those that affect the respiratory system. When you have untreated asthma, your airways become inflamed and narrow, which can make it more difficult for your body to fight off infections. In addition, asthma medications, such as corticosteroids, can suppress the immune system when taken in high doses or for prolonged periods of time.
Untreated asthma can also lead to chronic stress on the body, which can negatively impact the immune system. For example, stress hormones can reduce the body’s ability to fight off infections, making you more susceptible to illnesses.
Diagnosis and Treatment
Diagnosis of asthma as an autoimmune disease is challenging due to the lack of specific diagnostic tests. Treatment may involve a combination of traditional asthma medications, such as bronchodilators and corticosteroids, as well as medications that target the immune system.
Other immunomodulatory therapies, such as methotrexate and azathioprine, may also be used to help manage symptoms of autoimmune asthma. Additionally, lifestyle changes such as avoiding triggers and improving overall health can help manage symptoms. Regular monitoring and testing to assess lung function and immune function can help guide treatment decisions and ensure that medications are effectively managing symptoms.
While the exact causes of asthma are still not fully understood, it is clear that the immune system plays a critical role in its development and progression. Evidence suggests that asthma may be an autoimmune disease, and while current treatments can effectively manage symptoms for many people, ongoing research into new treatments offers hope for more effective and personalized care in the future. With appropriate management and care, people with asthma can lead healthy and fulfilling lives.
Beth is Cloudmineinc’s senior health editor and a certified personal trainer. She has over 10 years experience as a science journalist and is the author of two books. She deadlifts over 315 lbs.