Even as summer is winding down, the heat in Oklahoma is still oppressive. The weather this time of year is tough on everybody, but for patients with certain autoimmune diseases, it can be the cruelest season of the year.
Autoimmune diseases are disorders in which the body’s immune system becomes confused or unbalanced and causes harm to the body instead of protecting it. While there are some visible symptoms of these conditions, they are often hidden from the outside world.
“It can be frustrating for patients, because it takes a daily toll on their quality of life,” said OMRF scientist Kathy Sivils, Ph.D., who studies the genetic basis of Sjögren’s Syndrome. An estimated 4 million Americans have the autoimmune disease, which is characterized by immune cells attacking the moisture-producing glands. It can cause dry eyes, dry mouth, fatigue and joint pain.
“Most people don’t fully understand the true impact of the disease. Everyone experiences some dryness occasionally, and they are comparing it to what they know. But for a Sjögren’s patient, dry eyes means they might have to use eye drops just to get their eyes open in the morning. Dry mouth means some must use an artificial saliva every few minutes,” she said. “And in the summer it gets harder. Underlying neurological problems may disturb normal sweating, and they have trouble regulating their body temperature.”
That can lead to overheating and fatigue that lasts for days at a time, Sivils said. Hot, dry air can exacerbate problems with dry eyes and intense sunlight can bring on rashes.
In lupus, an autoimmune disease that can harm organs and tissues, the sensitivity to sunlight is a symptom for more than half of the 1.5 million Americans with the disease.
“Some medications and some illnesses such as lupus can cause rashes that are either triggered by or made worse by sun exposure,” said scientist Joan Merrill, M.D., who heads up OMRF’s Clinical Pharmacology Research Program.
In some cases, sun-induced lupus flares are the first sign of the disease, she said. Still, most rashes made worse by the sun are not related to lupus.
“I don’t want to scare everybody who goes out in the sun and gets either a simple sunburn or a real rash into thinking they might have lupus,” Merrill said.
In multiple sclerosis, rogue immune cells attack nerve cells, causing scars that inhibit the brain’s ability to communicate with the body. The disease carries with it a variety of symptoms, including problems with vision, tremors, paralysis, painful spasms, imbalance and cognitive changes.
As the body temperature rises, it can cause temporary worsening of those symptoms, said OMRF clinician Farhat Husain, M.D. Called “Uhthoff’s phenomenon,” overheating caused by fever, hot weather, saunas or even a warm shower can slow or block nerve signals beyond the normal levels of MS.
For patients with optic neuritis, it can temporarily make blurring of vision worse. Extreme fatigue is also common, she said.
The old saying “Don’t judge a book by its cover” comes to mind, Sivils said.
“Patients whose symptoms can’t be easily seen by the rest of the world must still deal with their diseases every day,” she said. “Part of what drives our research is knowing that people need help. Whether it’s finding out if and what kind of autoimmune disease they have or finding new therapeutic targets to manage their symptoms, our work can make lives better.”
For decades, OMRF has been a world leader in autoimmune disease research. Scientists at OMRF developed diagnostic tests for lupus, have helped discover dozens of genes related to lupus and Sjögren’s, and, in 2011, opened the Multiple Sclerosis Center of Excellence at OMRF—a one-stop-shop for MS patients in the region. In 2009, OMRF was named one of just nine Autoimmunity Centers of Excellence in the U.S. by the National Institutes of Health.