(Explained with Addison’s Disease)**

Part of the Aspergillosis Immune System Knowledge Hub

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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.

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❌ 1. Autoimmunity = Loss of Immune Tolerance

In autoimmune disease:

• the immune system starts recognising the body’s own tissues as “foreign”

• T cells and B cells become misdirected

• autoantibodies form

• inflammation destroys healthy cells

This process develops over months or years.

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🧬 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:

• cortisol

• aldosterone

• 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:

• severe fatigue

• weight loss

• low blood pressure

• salt loss

• nausea

• risk of adrenal crisis

Addison’s must be treated with lifelong hormone replacement.

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🔄 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.

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🆚 4. How Autoimmunity Differs from Aspergillosis

Some patients live with both conditions (e.g., ABPA + adrenal insufficiency), but they arise via very different mechanisms.

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🧠 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.

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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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