Why Autoimmunity?

Autoimmunity is defined as occurring when the body’s immune system attacks healthy cells of a given organ. Given the process through which humans evolved, logic should have posed the question of why suddenly over 100 human diseases developed in which the body turned against one of its integral components.

When applied to human diseases, the concept of autoimmunity becomes but a deliberate game of smoke and mirrors. From its genesis, human disease allegedly caused by autoimmunity was based upon limited circumstantial evidence. The over 100 disease entities labeled as being due to autoimmunity can be segregated into three groups: those whose disease manifestations can be suppressed by disrupting the effector arm of the TH1 immune response, those which have demonstrable antibodies directed against some component of the target organ, and those that have no explanation as to their pathogenesis.

All three subpopulations of diseases share in common one thing in common: lack of convincing scientific validation of autoimmune causation. That did not prevent the creation of the Journal of Autoimmunity and that of Autoimmune Diseases. Launching and sustaining publication of a journal is not without cost. The existence of journals specifically dedicated to the publication of topic on autoimmunity inferred scientific validity to a concept that is highly speculative. When affixed to a given disease entity, the label of autoimmunity has a near mind-paralyzing effect on the quest for alternate causation. It shifts the burden from having to prove autoimmunity to having to disprove it.

Crohn’s disease has long been the poster boy for “autoimmunity.” With its pathogenesis now being in evidence and the potential of a cure being a very real probability, Crohn’s disease has become the linchpin that unravels the smoke and mirrors used to hold afflicted individuals of “autoimmune diseases” at ransom to the industry. What antibiotics taught the pharmaceutical industry is that there is limited profit in curing a disease, but vast more profit from servicing a chronic disease over a lifetime. Crohn’s disease has been described “as a disease entity created by the industrialization of milk production for maximum profit, protected by those who profit from milk protein-based products, and exploited by those who profit from the adverse consequences created”.

In cracking the enigma of causation of Crohn’s disease, the Hruska Postulate identified the mechanism by which other antigens or agents can cause the immune response to become fixed within immunological memory. Other chronic diseases that biologics can suppress, but not cure (i.e. rheumatoid arthritis, psoriasis, polymyositis etc.) must now be taken out of the intellectual darkness imposed by “autoimmunity” and the quest for causality and cure renewed.

The sustainment of the myth of autoimmunity over a nearly two-decade period puts into question medicine’s role within the public trust. A recent series of publications have focused on the ability of industry to influence decision leaders within medicine. The JAMA has just published two articles, Institutional Conflict of Interest and Public Trust and Should Failure to Disclose Significant Conflict of Interest Be Considered Research Misconduct, that describe how funding by the private sector has the potential to undermine The World Medical Association’s Declaration of Helsinki regarding the ethical principles for medical research. Medical research in the United States has increasingly relied on funding from the private sector. The ability to influence the medical questions being pursued and the experimental design by which an answer is sought can potentially bias the data and/or its interpretation.

In September, the chief medical officer of Memorial Sloan Kettering Cancer Center resigned after The New York Times reported that he had not revealed his ties to industry. In another New York Times article dated December 8, 2018, Charles Ornstein and Katie Thomas identify three prominent  physicians, a Dean at Yale’s medical school,  the director of a cancer center in Texas, and the president-elect of the most prominent cancer society, doctors who failed to report their substantial financial relationship with industry. “Studies have found that industry-sponsored research tends to be more positive than that financed by other sources.”

What if the biasing of information leads to adverse patient outcomes?

In describing its official practice recommendations, the American College of Gastroenterology’s 2018 Clinical Guideline for Crohn’s disease states “Despite the recent advances in the treatment of patients with CD, there still remains a large group of patients who do not respond adequately to our current medication armamentarium. …  We will certainly expand our medical treatment war chest and uncover effective biologics with different mechanism of action to treat our patient. If the initial biologic drug fails, the patient will be able to switch to another agent and even combination biologics may become a reality.”

With its methodology used for publication review, its omission of critical information dealing with the pathogenesis of Crohn’s disease and its therapeutic ramification, its stated censorship of anti-MAP therapy and its omission from discussion of dietary therapeutics, the 2018 Guideline, in essence, is a document whose apparent intent is to reaffirm, with minor adjustments, the prevailing, but failed, standard of care that will continue to destroyed human lives. By the intent to deceive, one becomes complicit with the consequences!

These findings are described in the article entitled The myth of autoimmunity, recently published in the journal Medical Hypotheses. This work was conducted by Gilles R.G. Monif from the University of Florida College of Veterinary Medicine.

References:

1. Cigarroa, F. G., Masters, B. S., & Sharphorn, D. (2018). Institutional Conflicts of Interest and Public Trust. JAMA. doi:10.1001/jama.2018.18482
2. Botkin, J. R. (2018). Should Failure to Disclose Significant Financial Conflicts of Interest Be Considered Research Misconduct? JAMA. doi:10.1001/jama.2018.17525
3. Ornstein, C., & Thomas, K. (2018, December 08). What These Medical Journals Don’t Reveal: Top Doctors’ Ties to Industry. The New York Times. Retrieved December 26, 2018, from https://www.nytimes.com/2018/12/08/health/medical-journals-conflicts-of-interest.html?rref=collection%2Fbyline%2Fkatie-thomas&action=click&contentCollection=undefined&region=stream&module=stream_unit&version=latest&contentPlacement=3&pgtype=collection