In this episode, we explore the complex journey of living with GBS, CIDP, or MMN alongside other autoimmune conditions. In our Speaker Series webinar featuring Dr. Maureen Su, she breaks down how the immune system functions, what happens when it goes off track, and why some individuals develop multiple autoimmune diagnoses. Dr. Su also shares practical tips for managing multiple conditions, communicating effectively with your healthcare team, and finding the support you need along the way.
Introduction
Maureen A. Su, MD leads an immunology research group focused on autoimmunity, anti-cancer immunity, and sex differences in immunity. She is a tenured Professor of Pediatrics and Microbiology Immunology and Medical Genetics (MIMG) at UCLA and serves as Associate Director of the UCLA/Caltech Medical Scientist Training Program (MSTP). Dr. Su is a member of the GBS|CIDP Foundation International’s Global Medical Advisory Board.
What is the immune system and how does it work?
The immune system defends the body against pathogens (e.g., bacteria, viruses, fungi). It has two main parts:
- Adaptive immune system (slower, specific) — includes B cells (which make antibodies) and T cells.
- Innate immune system (fast, nonspecific) — includes neutrophils and macrophages.
What is an autoimmune disease?
When the immune system mistakenly attacks the body’s own tissues, thinking they are foreign invaders.
- In diseases like GBS, CIDP, and MMN, immune responses damage peripheral nerves.
Can pathogens trigger autoimmune responses?
Yes. For instance, Campylobacter jejuni infection is linked to GBS through molecular mimicry — where pathogens resemble nerve tissue, triggering misdirected immune attacks.
Are people with GBS, CIDP, or MMN more likely to have other autoimmune diseases?
Yes. Studies show increased incidence of co-existing autoimmune disorders in these patients.
Why does this happen?
- Genetics: Certain immune-related genes (e.g., MHC) increase susceptibility.
- Epigenetics & environment: Lifestyle and environmental factors can affect immune system regulation over time.
- Aging: Immune regulation weakens with age, increasing risk.
Examples of common autoimmune conditions often diagnosed with:
- CIDP: Lupus, hepatitis, and inflammatory bowel disease (IBD).
- MMN: Crohn’s, celiac disease, type 1 diabetes, and hyperthyroidism.
What are the key immune system targets for treatment?
- Complement system: A set of proteins that support immune response, now a focus for therapies in clinical trials.
- IgG antibodies & neonatal Fc receptor (FcRn): Therapies for CIDP aim to reduce harmful antibody levels.
- B cells (e.g., Rituximab): Used in conditions with specific harmful antibodies like anti-MAG neuropathy.
Who manages care when someone has multiple autoimmune diseases?
It often requires coordination between specialists (e.g., neurologist, endocrinologist, GI). Patients should:
- Bring organized medical records.
- Encourage communication between doctors.
- Consider care within the same health system for easier coordination.
Are there lifestyle changes that help manage autoimmunity?
- Sleep, nutrition, exercise, and mental health are crucial.
- Supplements should be discussed with a doctor—many are not well-regulated.
What about chronic inflammation?
- Aging is linked to low-grade chronic inflammation, possibly increasing autoimmune risk.
- Research is ongoing to understand and target this phenomenon.
How is anti-MAG different from GBS/CIDP?
Anti-MAG is primarily driven by specific autoantibodies produced by B cells. This makes it more straightforward to target therapies (e.g., B cell depletion).
Do we know of a molecular mimicry example in CIDP or MMN like in GBS?
No well-established mimicry links for CIDP or MMN yet, though research is ongoing.
Final take aways
- The immune system can mistakenly attack healthy tissue, leading to GBS, CIDP, or MMN.
- People with one autoimmune disease are more likely to develop others, like lupus or Crohn’s.
- Infections such as Campylobacter may trigger conditions like GBS through immune confusion.
- New treatments are targeting parts of the immune system like complement proteins and antibodies.
- Chronic inflammation tends to increase with age and may contribute to autoimmune risk.
- Managing multiple autoimmune conditions requires communication between doctors and organized records from patients.
- Healthy sleep, nutrition, movement, and mental health support immune function.
Spotlight
