Is Eczema an Autoimmune Disease? The Complex Relationship Explained
Eczema is a common chronic skin condition characterized by itchy, inflamed skin. It often causes red, scaly rashes that can ooze and crust over when scratched. Eczema symptoms tend to flare up periodically and then subside. While eczema itself is not autoimmune, research shows people with certain autoimmune diseases have a higher prevalence of eczema.
Autoimmune Diseases and the Immune System
An autoimmune disease results when the immune system mistakes healthy cells in the body for foreign invaders and attacks them. This leads to inflammation and damage to tissues and organs. Some common autoimmune diseases include rheumatoid arthritis, lupus, type 1 diabetes, multiple sclerosis, and celiac disease.
Normally the immune system can tell the difference between your own cells and harmful viruses and bacteria. But with autoimmunity, something goes awry and the body turns against itself. It's not fully understood what causes this immune system misfire.
Contributing Factors of Eczema
While not autoimmune itself, eczema often involves immune system activation and inflammation. However, allergies and irritants like detergents typically trigger eczema not one's own tissues. Known contributing factors include:
- Genetic mutations - Alter skin barrier proteins
- Allergies and asthma - Overactive immune response
- Environmental irritants - Soaps, fabrics, smoke, pollutants
- Microbes - Bacteria like staph can infect eczema lesions
- Stress and emotions - Stress hormones worsen inflammation
The Immune Systems Role in Eczema
Research suggests the immune system and inflammation drive the eczema process. People with eczema often have an overabundance of chemicals called inflammatory cytokines. These signal the immune system to act against perceived threats. The immune system response leads to increased inflammation.
Eczema patients also have fewer antimicrobial peptides in their skin. These natural peptides help protect against bacteria, viruses, and fungi. With this compromised barrier, microbes can more easily penetrate the skin and worsen inflammation.
Is Eczema Associated with Autoimmunity?
Eczema itself does not meet the definition of an autoimmune disease. With autoimmunity the immune system specifically attacks elements of ones own body. In eczema, the target is typically external triggers like allergens, irritants, and microbes not ones own tissues.
However, research shows eczema occurs up to three times more often in people who have autoimmune diseases like type 1 diabetes, celiac disease, and rheumatoid arthritis. Eczema is also associated with a higher risk for developing certain autoimmune conditions later in life.
Shared Genetic Factors
One theory for the eczema-autoimmunity link involves shared genetic mutations. Certain genetic variations affect immune system pathways and skin barrier proteins. This could predispose people to developing eczema, autoimmunity, or both conditions.
For example, a mutation in the gene FILAGGRIN is strongly associated with eczema and altered skin barrier function. Studies show this mutation also increases risk of developing rheumatoid arthritis an autoimmune disorder.
The Leaky Gut Connection
Changes in intestinal permeability, or leaky gut, may also help explain the association between eczema and autoimmunity. When gaps form between intestinal cells, substances that should not escape the gut enter the bloodstream. This exposure can trigger inflammatory immune system responses.
Research shows children with eczema have increased intestinal permeability. Leaky gut allows more allergens and microbes into their bodies that can flare conditions like eczema. Increased gut permeability is also linked to numerous autoimmune diseases.
Chronic Inflammation
Chronic inflammation from eczema could potentially contribute to developing autoimmunity later. The constant inflammation triggers certain cells to produce inflammatory chemicals. Experts theorize this can lead the immune system to eventually start attacking healthy cells and tissues.
Studies show eczema early in life is associated with increased risk for certain autoimmune diseases like rheumatoid arthritis and lupus as adults. More research is still needed, but chronic inflammation may be the driver.
The Microbiome Connection
Changes in the microorganisms that live on the skin and in the gut likely also play a role in eczema and autoimmunity. The microbiomes of people with eczema and autoimmune diseases differ from healthy individuals. When balanced, microbiomes help regulate immunity.
Antibiotics taken for infections can disrupt skin and gut microbiomes. This imbalance and reduction of beneficial microbes is linked to higher risks of eczema, asthma, and certain autoimmune conditions.
Allergies
Eczema is strongly associated with allergies and asthma other hypersensitive immune conditions. This allergic tendency stems from an overreaction of the immune system to harmless substances like pet dander or pollen. Environmental allergies are also connected to some autoimmune diseases like lupus and rheumatoid arthritis.
Stress
Psychological stress is a known trigger for eczema flares. Stress causes the body to release hormones like cortisol that ramp up inflammatory pathways. Chronic stress can dysregulate the immune system and contribute to systemic inflammation.
Research also demonstrates that stress can exacerbate certain autoimmune disorders. Finding healthy ways to manage stress may help both eczema and autoimmune conditions.
The Takeaway on Eczema and Autoimmunity
Eczema itself does not appear to be an autoimmune condition. However, research shows strong links between eczema and autoimmunity. People with certain autoimmune diseases have higher rates of eczema. And eczema early in life increases later autoimmunity risk.
Several factors likely explain this complex relationship including genetics, chronic inflammation, microbiome disturbances, and immune system dysregulation. Identifying and managing eczema early may help lower future autoimmune risks.
FAQs
Is eczema an autoimmune disease?
No, eczema itself does not meet the criteria for an autoimmune disease. In eczema, the immune reaction is triggered by external factors like allergens rather than the body's own tissues.
Why are eczema and autoimmunity connected?
Research shows an association between eczema and higher risks of certain autoimmune diseases. Shared genetic mutations, chronic inflammation, leaky gut, microbiome imbalances, and immune dysregulation may help explain this relationship.
Can having eczema increase my autoimmune disease risk?
Yes, studies show having eczema, especially in childhood, is linked to a higher likelihood of developing certain autoimmune diseases like rheumatoid arthritis and lupus later in life.
Do eczema and autoimmunity have similar causes?
Eczema and autoimmunity share some common contributing factors like genetics, microbiome disturbances, chronic inflammation, and immune system dysfunction. But eczema has unique external triggers like irritants and allergens.
Should I get screened for autoimmunity if I have eczema?
There is no general screening for autoimmune diseases. But with the increased risks associated, you should be aware of potential symptoms and alert your doctor about your eczema history.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.
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