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Links between autoimmune disorders, stress & the gut

Autoimmune disorders are multifactorial with genetic, epigenetic, and environmental components all known to contribute to patho-aetiology of these conditions. Autoimmune disorders are characterised by an inappropriate immune response toward self-antigens, resulting in tissue destruction and inflammation. The prevalence of Autoimmune disorders is increasing, and our understanding of trigger factors involved in the onset of many Autoimmune disorders is still unknown. The authors of a recent paper reviewed current research on the role of psychological stress in disrupting the intestinal barrier in the development of the Autoimmune disorders.

This review found that stress and intestinal barrier dysfunction are key factors involved in the onset and progression of Autoimmune Disorders (ADs). The authors of this study concluded that stress-induced intestinal barrier disruption is involved in many ADs, especially autoimmune type 1 diabetes, multiple sclerosis and systemic lupus erythematosus. Key findings form this study included:

  • Many people with ADs experience a period of intense emotional stress before disease onset.

  • Many people with ADs experience early life stress.

  • Psychological stress impairs the intestinal barrier.

  • ADs are associated with a defect of the intestinal barrier.

The intestinal barrier is critical for the regulation of intestinal microbial health, nutrient absorption, and immune responses (both innate and adaptive). The intestinal epithelium is renewed every five days, and this constant renewing confers high plasticity and protection to the intestinal barrier because defective cells are removed rapidly. However, it is known that stress can disrupt this renewal process, causing intestinal barrier hyper-permeability. A defective intestinal barrier can then lead to inappropriate intestinal and systemic immune responses, leading to ADs on genetically predisposed individuals.

Additionally, psychological stress is known to increase levels of neurotransmitters/hormones such as epinephrine, norepinephrine, corticotropin-releasing hormone (CRH), adrenocorticotropic hormone (ACTH), glucocorticoids (cortisol). Many of these hormones are known to enhance inflammation and detrimentally effect immunity, further strengthening the link between stress and AD onset and/or progression.

This research highlights the importance of addressing stress and intestinal barrier integrity in patients with ADs, or those who are at risk of developing one.

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