Autoinflammatory vs. Autoimmune

Autoinflammatory diseases originate from a faulty innate immune system caused by genetic mutations and dysregulated inflammasomes. Many of these diseases are due to monogenic inborn errors of immunity. These diseases are characterized by episodes of uncontrolled hyperinflammation that may be triggered by stress, illness, accidents, environmental temperatures, physical exertion, menstruation, etc. Symptoms usually present with rashes, spiking fevers (not every patient gets a fever!), pain, and fatigue.

Autoinflammatory diseases are usually caused by mutations that play a role in innate genetic function. There are more than 40 types of autoinflammatory disorders confirmed by genetics. Additionally, there are many patients who are classified as undifferentiated systemic autoinflammatory diseases (uSAID) where no genetic mutations are found. However, symptoms are correlated by a clinical presentation.

The innate immune system is composed of:

• Physical Barriers include skin, vascular system, gastrointestinal tract, respiratory tract, nasopharynx, cilia, eyelashes, and hair.

• Defence Mechanisms include secretions such as mucous, bile, gastric acid, saliva, tears, and sweat.

• Immune Responses include elevated; inflammatory markers (CRP, ESR, SAA), complements, caspases, and non-specific cellular responses, which impact immune cell functions (neutrophils, macrophages, cytokines, etc.).

​Autoimmune diseases develop when the adaptive immune system encounters antigens and then mounts an immune attack relying on B & T cells. These cells and others of acquired immunity will then become dysregulated and cause autoimmunity, as the body destroys its own healthy tissues mistakenly. There are more than 80 types of autoimmune disorders.
 
The "auto" in both diseases is the commonality, which means "immune-mediated". Both autoimmune and autoinflammatory diseases have an immune system malfunction as the underlying cause of the symptoms, but because they are triggered by distinct pathways, the underlying causes or mechanisms of both types of diseases are different. The diseases differ by symptom presentation, treatment options, long-term health risks, and possible complications from the systemic inflammation.

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Autoimmune and Autoinflammatory diseases may share similar features, including:

• Fatigue that is debilitating and unusual

• Flu-like symptoms and general malaise

• Brain fog

• Fevers (afebrile -- high temperatures)

• Joint pain

• Swelling

• Rashes

• Eye problems

• Neuropathy

• GI discomfort