(Explained with Addison’s Disease)**
Part of the Aspergillosis Immune System Knowledge Hub
Autoimmune disease occurs when the immune system mistakenly attacks the body’s own tissues. This is different from allergy, infection, or inflammation caused by fungal disease. Addison’s disease is a clear example of autoimmunity and helps explain how this process works.
❌ 1. Autoimmunity = Loss of Immune Tolerance
In autoimmune disease:
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the immune system starts recognising the body’s own tissues as “foreign”
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T cells and B cells become misdirected
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autoantibodies form
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inflammation destroys healthy cells
This process develops over months or years.
🧬 2. What Specifically Happens in Addison’s Disease?
Addison’s disease is caused by an autoimmune attack on the adrenal cortex, the part of the adrenal gland that makes:
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cortisol
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aldosterone
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DHEA (adrenal androgens)
The steps include:
1. Loss of tolerance
The immune system mistakenly targets adrenal enzymes (especially 21-hydroxylase).
2. Autoantibodies form
These can be detected in blood tests.
3. Cytotoxic T cells attack adrenal tissue
Gradually destroying hormone-producing cells.
4. Hormone levels fall
Leading to:
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severe fatigue
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weight loss
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low blood pressure
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salt loss
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nausea
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risk of adrenal crisis
Addison’s must be treated with lifelong hormone replacement.
🔄 3. Why Does Autoimmunity Happen?
Factors include:
✔ Genetic susceptibility (HLA types)
✔ Prior viral infection or severe inflammation
✔ Stressful life events
✔ Regulatory T-cell failure
✔ Microbiome disruption
✔ Hormonal influences
Importantly:
Autoimmune disease is never the patient’s fault.
🆚 4. How Autoimmunity Differs from Aspergillosis
| Aspergillosis | Autoimmune Disease |
|---|---|
| Driven by external organism (Aspergillus fungus) | Driven by immune system attacking “self” |
| ABPA → IgE allergies; CPA → IgG infection response | Autoantibodies + T-cell attack |
| Treatment aims at fungus + inflammation | Treatment replaces missing hormones |
| Damage = collateral | Damage = direct |
Some patients live with both conditions (e.g., ABPA + adrenal insufficiency), but they arise via very different mechanisms.
🧠 5. Key Message
Autoimmune disease results from a failure of immune tolerance, not from weakness, lifestyle, or exposure. Understanding this helps patients feel more in control and reduces self-blame.
Next articles:
- **Understanding your immune system
- How the Immune System Knows “Self”
- What Happens in Autoimmune Disease (Addison’s Explained)
- Eosinophils and Type-2 Inflammation in Aspergillosis
- **Where Do All These Immune Cells Live, and Where Are They Made?
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