Autoimmunerkrankungen

  • Christoph Heesen
  • Stefan M. Gold

Zusammenfassung

Autoimmunerkrankungen stellen eine heterogene Gruppe von 70–80 verschiedenen entzundlichen Erkrankungen dar, die ca. 4–10% der Bevolkerung betreff en (Shapira et al. 2009). Kosten fur Autoimmunerkrankungen fur das Gesundheitswesen werden mittlerweile im Bereich von Herz-Kreislauf-Erkrankungen und Krebserkrankungen gesehen, insbesondere aufgrund des oft uber Jahrzehnte chronischen Verlaufs (Shapira et al. 2009). Daten sprechen fur einen Anstieg der Inzidenz und Pravalenz in den Industrienationen (Shapira et al. 2009). Autoimmunerkrankungen lassen sich nachweisen auf der Basis einer Immunantwort, die sich gegen Gewebe richtet. Diese lassen sich nach dem Zielorgan, dem Zielgewebe oder Funktionssystem gegen den sich die Immunreaktivitat richtet klassifizieren. Autoimmunerkrankungen konnen fruh bis zur 2. Dekade auft reten, z. B. Diabetes mellitus Typ 1, lassen sich jedoch typischerweise in der 3. bis 6. Dekade diagnostizieren. Die Atiopathogenese von Autoimmunerkrankungen ist komplex. Im Vordergrund stehen genetische, immunologische, endokrine und Umweltfaktoren. Fur wesentliche Autoimmunerkrankungen wie Diabetes mellitus Typ 1, multiple Sklerose (MS), autoimmune Schilddrusenerkrankungen und entzundliche Darmerkrankungen lasst sich eine Haufung in gema.igten Breiten und damit in hochentwickelten Industrienationen nachweisen. Bei den Umweltfaktoren werden im Wesentlichen UV-Strahlungen, westlicher Lebensstil, Infektionen, Umweltgift e, Ernahrungsfaktoren und einige krankheitsspezifische Faktoren wie z. B. Jodexposition bei Autoimmunthyreoiditis diskutiert. Die Th erapien sind oft teilwirksam, palliativ, die Lebensqualitat ist oft erheblich eingeschrankt. Damit haben Autoimmunerkrankungen eine hohe personliche und okonomische Relevanz. Vor dem Hintergrund, dass 80% der Autoimmunerkrankungen bei Frauen auft reten, sind schon epidemiologisch endokrine Faktoren in der Pathogenese hochwahrscheinlich. Eine grundsatzlich unterschiedliche immunologische Antwort auf inflammatorische Stimuli zwischen Mannern und Frauen konnte hier relevant sein. Bei Frauen kommt es verstarkt zu einer Antikorperantwort, bei Mannern eher zu einer allgemeinen inflammatorischen Reaktion. So finden sich z. B. Unterschiede in der Interferon-Gamma-Antwort auf Stressreize (Cutolo u. Straub 2009).

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Copyright information

© Springer-Verlag Berlin Heidelberg 2011

Authors and Affiliations

  • Christoph Heesen
    • 1
  • Stefan M. Gold
    • 2
  1. 1.Institute of Neuroimmunology and Clinical MS Research (inims)Hamburg
  2. 2.Neurologische Klinik, Medizinische PsychologieUniversitätsklinikum Hamburg-EppendorfHamburg

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