Autoinflammatory vs. Autoimmune

The human body has two types of immune defense capabilities to defend itself. These two important responses are found in both the “innate” and “adaptive” systems.

 

Autoinflammatory diseases stem from innate immune dysregulation caused by genetic mutations and are referred to as monogenic inborn errors of immunity. These diseases are characterized by episodes of uncontrolled hyperinflammation that may be caused by a variety of triggers including stress, illness, accidents, environmental temperatures, physical exertion, menstruation, etc. Symptoms usually present with rashes, spiking fevers, and fatigue. Autoinflammatory diseases are almost exclusively caused by mutations that play a role in innate genetic function. There are more than 40 types of autoinflammatory disorders identified by genetics. This does not include unspecified systemic autoinflammatory diseases (uSAID) where no genetic mutations have been found.

When the innate immune system encounters potentially harmful disease-causing pathogens such as bacteria or viruses, it immediately responds in a variety of ways, including:

 

Physical Barriers include skin, gastrointestinal tract, respiratory tract, nasopharynx, cilia, eyelashes, and other body hair.

 

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

 

Immune Responses include inflammation (CRP, ESR, SAA), complements, and non-specific cellular responses. This response drives immune cells (neutrophils, macrophages, etc.), cytokines, etc., enabling the innate system.

Autoimmune diseases occur when the immune system encounters foreign substances (antigens) and mount an immune attack relying on B & T cells. These cells and others of acquired immunity learn to attack antigens and to develop long-lasting memorized protection, i.e. immunological memory. An autoimmune disorder presents when the immune system attacks itself and destroys healthy tissues by mistake. 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 different parts, the underlying causes or mechanisms of the diseases are different. This difference can affect symptom presentation, treatment options, long-term health risks, and possible complications from the systemic inflammation.

Autoimmune and Autoinflammatory diseases share similar features including:

• Fatigue that is debilitating and unusual

• Flu-like symptoms and general malaise

• Brain fog

• Fever (afebrile -- high temperatures)

• Joint pain

• Swelling

• Rashes

• Eye problems

• Neuropathy