Disorders of the Immune System

Allergic Diseases

The most common types of allergic diseases occur when the immune system responds to a false alarm. In an allergic person, a normally harmless material such as grass pollen, food particles, mold, or house dust mites is mistaken for a threat and attacked.

Allergies such as pollen allergy are related to the antibody known as IgE. Like other antibodies, each IgE antibody is specific; one acts against oak pollen and another against ragweed, for example.

Immune Complex Diseases

Immune complexes are clusters of interlocking antigens and antibodies. Normally, immune complexes are rapidly removed from the bloodstream. Sometimes, however, they continue to circulate and eventually become trapped in the tissues of the kidneys, lungs, skin, joints, or blood vessels. There, they set off reactions with complement that lead to inflammation and tissue damage. Immune complexes work their mischief in many diseases. These include malaria and viral hepatitis, as well as many autoimmune diseases.

Autoimmune Diseases

Sometimes the immune system’s recognition apparatus breaks down, and the body begins to manufacture T cells and antibodies directed against self antigens in its own cells and tissues. As a result, healthy cells and tissues are destroyed, which leaves the person’s body unable to perform important functions.

Misguided T cells and autoantibodies, as they are known, contribute to many autoimmune diseases. For instance, T cells that attack certain kinds of cells in the pancreas contribute to a form of diabetes, whereas an autoantibody known as rheumatoid factor is common in people with rheumatoid arthritis. People with systemic lupus erythematosus (SLE) have antibodies to many types of their own cells and cell components. SLE patients can develop a severe rash, serious kidney inflammation, and disorders of other important tissues and organs.

No one knows exactly what causes an autoimmune disease, but many factors are likely to be involved. These include elements in the environment, such as viruses, certain drugs, and sunlight, all of which may damage or alter normal body cells. Hormones are suspected of playing a role because most autoimmune diseases are far more common in women than in men. Heredity, too, seems to be important. Many people with autoimmune diseases have characteristic types of self-marker molecules.

Immune Deficiency Disorders

When the immune system is missing one or more of its parts, the result is an immune deficiency disorder. These disorders can be inherited, acquired through infection, or produced as a side effect by drugs such as those used to treat people with cancer or those who have received transplants.

Temporary immune deficiencies can develop in the wake of common virus infections, including influenza, infectious mononucleosis, and measles. Immune responses can also be depressed by blood transfusions, surgery, malnutrition, smoking, and stress.

Some children are born with poorly functioning immune systems. Some have flaws in the B cell system and cannot produce antibodies. Others, whose thymus is either missing or small and abnormal, lack T cells. Very rarely, infants are born lacking all of the major immune defenses. This condition is known as severe combined immune deficiency disease or SCID.

AIDS is an immune deficiency disorder caused by a virus (HIV) that infects immune cells. HIV can destroy or disable vital T cells, paving the way for a variety of immunologic shortcomings. The virus also can hide out for long periods in immune cells. As the immune defenses falter, a person develops AIDS and falls prey to unusual, often life-threatening infections and rare cancers.