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Is It Really Autoimmunity? | El Paso, TX. | Part II

by Dr Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP | Functional Medicine

Autoimmunity:�One of the most common things is to leave the doctor�s office with a diagnosis of an autoimmune disease and no nutritional or lifestyle changing insight. Autoimmune diseases are related to inflammation. Keeping� the inflammation down is the goal with autoimmune attacks. The foods you eat make a huge difference in the frequency and severity of flare-ups. Steady dietary changes can help you reach your optimal self.

Is Autoimmune Disease A Result Of The Collective Perturbations Of The Exposome & Its Impact On The Immunometabolic System?

http://science.sciencemag.org/content/330/6003/460.summary?sid=1ab5a992-4406-499c-b24f-6e7a46c1dc95

The Exposome

Semin Arthritis Rheum. 2018; 47(5): 710?717.

Exposome Influence On SLE

The Ecology Of The Exposome

Exposome & The Alteration Of �Self�

The Exposome Connections To Autoimmune Diseases Converting Self Into Non?Self

Immunometabolic dysfunctions through diet and lifestyle imbalances
Gut Ecology and the Microbiome
ViralorBacterialInfections
Hormones
Drugs
Chemicals
IonizingRadiation
PsychologicalStress

FEBS Lett. 2017 Oct;591(19):3119?3134.

Cell. 2018 Jan 11;172(1?2):22?40.

Cross?Talk Among The Endocrine, Immune & Metabolic Systems

Multi?Organ Network Biology

In Autoimmunity, Warburg Metabolism Is Increased Through Increased Activity Of GAPDH

Science. 2018; 360: 377?78. Dietary Influence?

Blocking Immune Cell Glycolysis & �Starving� Its Function

Science. 2018; 360: 449?54.

Ketogenic Diet�s Potential Impact On GAPDH Immunometabolic Regulation

Cell. 2018 Jan 11;172(1?2):162?175.

Gut Microbes. 2016;7(1):82?9.

Front Immunol. 2017 Mar 21;8:311.

Origin Of IL?17 Producing Th17 Cells

What Is The Relationship Of The Gut Microbiome To Autoimmune Disease?

https://www.cell.com/cell/issue?pii=S0092-8674(17)X0006-8

Science. 2018 Mar 9;359(6380):1097?98.

Science. 2018 Mar 9;359(6380):1156?61.

Allergol Int. 2018 Jan 6;67(1):32?42.

Int J Mol Sci. 2015 Sep 1;16(9):20841?58.

Science. 2018 Mar 9;359(6380):1151?56.

High Fiber Influences On Diabetes In Animal Model

80% Of Patients With Autoimmune Disease Are Female

Why?

Estrogen & Autoimmunity

The greatest association with autoimmune diseases is the female gender
17?beta estradiol seems to play a role in activating T cells in autoimmune disease
T cells have ER?alpha receptors that are activated by 17?beta estradiol resulting in the production of inflammatory cytokines
Blocking ER?alpha receptors may have a beneficial effect on autoimmune activation

Sci Signal. 2018 Apr 17;11(526). piieaap 9415

Eleanor Rogan, PhD IFM Linus Pauling Award Winner

www.JeffreyBland.com

Estrogen & Androgen Metabolism

4?Hydroxyestrogens & DNA reactivity

https://www.ncbi.nlm.nih.gov/pubmed/22155198

https://www.ncbi.nlm.nih.gov/pubmed/21432907

Indole?3?Carbinol (I3C) Inhibition Of ER?Alpha

https://www.ncbi.nlm.nih.gov/pubmed/27312859

Relationship Of Hepatic Drug Detoxification To Anti?Nuclear Antibody Development

https://onlinelibrary.wiley.com/doi/pdf/10.1002/art.1780240805

https://www.ncbi.nlm.nih.gov/pubmed/24763537

Biomed Res Int. 2015;2015:194031.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4365752/

https://www.ncbi.nlm.nih.gov/pubmed/18995849

https://www.ncbi.nlm.nih.gov/pubmed/24530186

Making Friends With Ourselves: Clinical Implications

Reduce exposure to agents that activate immunometabolic dysfunction through the exposome
� Dietary
� Infection
� Parasites
� Xenobiotics
� Hormone
� Allergy
� Specific medications
� Dysbiosis
Reduce exposure to DNA damage (radiation, chemicals)
Support hepatic detoxification
Implement gastrointestinal restoration program
Reduce metabolic inflammation and endotoxin
Reduce psychological stress factors that activate HPA axis

Jeffrey Bland, PhD

Chairman Emeritus & Member, Board of Directors The Institute for Functional Medicine

Is It Really Autoimmunity? | El Paso, TX. | Part I

by Dr Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP | Functional Medicine

The western diet is associated with inflammation, and inflammation is central to autoimmunity and autoimmune diseases. Keeping the inflammation down can help in lengthening time between attacks. What to eat and what not to eat are the common questions. In order to quiet� inflammation triggers, educate ourselves and live a normal life is the focus.

My 2006 Seminar Series

�Understanding the Origins of Autoimmune Disease�

Autoimmunity:

The Central Question I Asked In This series,

Are We Allergic to Ourselves?

� Autoantibodies

� Are they really �autoantibodies�?

� Self or Non?self?

I would like to re?explore this question using what we have learned in 2018.

www.aarda.org

Endocrine

Endocrine Thyroid

Endocrine?Thyroid

Musculoskeletal

Musculoskeletal & Kidney

Neurological

Autoimmunity

Our Immune system in battle with our self?

Presence of Anti?Chromatin, DNA and RNA Antibodies

What Biological Processes May Make Self Into Non?Self?

Post?translationalmodificationofProtein
� Glycation of protein
� Protein Oxidation
� Amino Acid Conjugation of Protein (Citrullinated Protein/AntiCCP and RA)
ProteinSynthesisErrors
DNA and RNA Changes
� Radiation Induced Crosslinking of DNA
� Oxidation of DNA
� Copy Errors not corrected by DNA repair process � Epigenetic Changes (the methylome)

Where Do Anti?Cyclic Citrullinated Peptides (AntiCCPs) Come From?

Activation of the immune system resulting in increased iNOS production of nitric oxide
Arginine residues in proteins can be converted in situ into citrulline with the release of nitric oxide by iNOS
The citrulline produced in the protein is now �foreign� and can be recognized by the immune system as such
Antibodies can then be produced against this �foreign protein�

Disease Modifying Anti?Rheumatic Drugs (DMARDs)

The Facts on Methotrexate For Rheumatoid Arthritis Treatment

Methotrexate is the most commonly prescribed drug to treat rheumatoid arthritis, yet it only helps about half of those who try it. Find out how it works and how to lessen its side effects.