For at least 50 years, industrialized countries have experienced a dramatic increase in the incidence of autoimmune disorders.1 Up to fifty million people are estimated to be affected in the US alone,2 and prevalence is increasing.3 This year, IFM’s Annual International Conference brings together expert researchers and clinicians to explore the mechanisms, assessments, and clinical interventions in this important area.
In a recent study examining antinuclear antibodies (ANA) in NHANES data, almost 15% of participants were ANA positive.4 Given the known rise in autoimmunity, this suggests a growing need for experts in autoimmune care. In many patients, ANA levels rise in the years before an autoimmune diagnosis, offering a predictive window where successful interventions may stop the disease process before it emerges.5-6
One key theme of this conference is the autoimmune triad. Alessio Fasano, MD, PhD, pediatric gastroenterologist, research scientist, and director of the Center for Celiac Research at Massachusetts General Hospital, has proposed a causal autoimmune triad: genetic susceptibility, antigen exposure, and increased intestinal permeability.7 As Functional Medicine clinicians know well, research has shown that impaired mucosal barriers contribute to autoimmune incidence.8-10 Autoimmune incidence is elevated for individuals with functional gastrointestinal disorders like irritable bowel syndrome (IBS) and dyspepsia.11 Combined with predictive ANA testing, this triad and interventions to repair intestinal barriers offer enormous opportunities to improve outcomes and promote wellness among a wide range of patients.
In 2018, IFM’s Annual International Conference was Solving the Puzzle of Autoimmunity: The Interplay of Gut, Genes, and Environment.
Expert researchers and clinicians explored the many therapeutic options to help patients before symptoms emerge, as well as to halt the disease process. Speakers included:
- Alessio Fasano, MD, PhD
- Yehuda Shoenfeld, MD, FRCP
- Sidney Baker, MD
- Terry Wahls, MD
- Robert Rountree, MD
- Len Calabrese, DO
- And many more
View the Solving the Puzzle of Autoimmunity: The Interplay of Gut, Genes, and Environment Conference Proceedings to explore clinical topics from IFM’s 2018 Annual International Conference.
- Okada H, Kuhn C, Feillet H, Bach J-F. The “hygiene hypothesis” for autoimmune and allergic diseases: an update. Clin Exp Immunol. 2010;160(1):1-9. doi:10.1111/j.1365-2249.2010.04139.x.
- Autoimmune disease statistics. American Autoimmune Related Diseases Association. https://www.aarda.org/news-information/statistics/. Published June 7, 2016. Accessed November 9, 2017.
- Cooper GS, Bynum ML, Somers EC. Recent insights in the epidemiology of autoimmune diseases: improved prevalence estimates and understanding of clustering of diseases. J Autoimmun. 2009;33(3-4):197-207. doi:10.1016/j.jaut.2009.09.008.
- Dinse GE, Parks CG, Weinberg CR, et al. Antinuclear antibodies and mortality in the National Health and Nutrition Examination Survey (1999-2004). PLoS One. 2017;12(10):e0185977. doi:10.1371/journal.pone.0185977.
- Pérez D, Gilburd B, Cabrera-Marante Ó, et al. Predictive autoimmunity using autoantibodies: screening for anti-nuclear antibodies [published online June 17, 2017]. Clin Chem Lab Med. doi:10.1515/cclm-2017-0241.
- Arbuckle MR, McClain MT, Rubertone MV, et al. Development of autoantibodies before the clinical onset of systemic lupus erythematosus. N Engl J Med. 2003;349(16):1526-1533. doi:10.1056/NEJMoa021933.
- Fasano A. Leaky gut and autoimmune diseases. Clin Rev Allerg Immunol. 2012;42(1):71-78. doi:10.1007/s12016-011-8291-x.
- Fasano A. Zonulin, regulation of tight junctions, and autoimmune diseases. Ann N Y Acad Sci. 2012;1258(1):25-33. doi:10.1111/j.1749-6632.2012.06538.x.
- Fasano A. Zonulin and its regulation of intestinal barrier function: the biological door to inflammation, autoimmunity, and cancer. Physiol Rev. 2011;91(1):151-175. doi:10.1152/physrev.00003.2008.
- Mu Q, Kirby J, Reilly CM, Luo XM. Leaky gut as a danger signal for autoimmune diseases. Front Immunol. 2017;8:598. doi:10.3389/fimmu.2017.00598.
- Ford AC, Talley NJ, Walker MM, Jones MP. Increased prevalence of autoimmune diseases in functional gastrointestinal disorders: case-control study of 23471 primary care patients. Aliment Pharmacol Ther. 2014;40(7):827-834. doi:10.1111/apt.12903.