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How blood biomarkers can aid in prevention and management of autoimmune processes – part 2

Autoimmunity appears to be on the rise. But what is an autoimmune condition, why does it happen, and why should we try to detect one as soon as possible? Read on to find out more in part 2 of this blog.

Testing for antibodies

With more than 100 diseases related to autoimmunity and many of these exhibiting similar systems, ascertaining root cause, potential triggers and the other biological systems that may be affected can be challenging. In part 1 of this blog, we addressed some of the markers that could indicate a risk for autoimmune development. Here we will discuss the relevance of direct antibody testing when thinking about early detection, as well as how this might fit in the context of a systems biology assessment.

FunctionalDX offers an ANA IFA panel with Titer that detects antinuclear antibodies in the blood that can be the first step to assessing the presence of an autoimmune condition. These are often raised years before the symptomatic manifestation of autoimmune disease – therefore if they are found to be high, they indicate a loss of immune tolerance and suggest input for immune modulation is required.

Serum protein electrophoresis can also be tested, with high levels of Gamma globulins associated with immune function and autoimmunity. This test is available via the FDX 65: Serum Protein Electrophoresis (SPE) panel. Additionally, high levels of IgG, IgM, and IgE Immunoglobulins have been associated with many autoimmune conditions, and can be tested via the FDX 69 Add On Panel. The presence of Glutamic Acid Decarboxylase antibodies can provide early detection of autoimmune activity, and is available in the FDX 66: Glutamic Acid Decarboxylase Autoantibodies Panel.

Further tissue-specific testing can be performed to ascertain which bodily system is affected, for example in autoimmune thyroid conditions, a number of markers can be measured to identify the presence of and type of disease. TSH receptor antibodies can be used to determine Graves’ disease and is also indicated in the diagnosis of Hashimoto’s. This marker is available in the FDX Thyroid Check+, Thyroid Ultra and TSH Receptor Antibodies Panels. Other thyroid autoimmune markers include Thyroglobulin Abs and Thyroid Peroxidase antibody, which can be found in all of the FDX Thyroid Panels.

FDX Thyroid Ultra

FDX Thyroid Ultra is the ultimate testing and reporting tool when it comes to assessing thyroid disorders and imbalances. Thyroid dysfunction can attribute to numerous conditions including complications with autoimmune diseases.

It is critical to avoid further thyroid degeneration such as Autoimmune Graves’ and Hashimoto’s thyroiditis, some of the most frequent autoimmune disorders.

FDX Thyroid Ultra provides our ultimate range of thyroid markers alongside our most comprehensive panel of biomarkers. These consider endocrine, cardiovascular, inflammation levels, sugar and lipid management, enzyme production, vitamin and mineral status alongside Thyroid function.

We have included Parathyroid hormone, TSH receptor Auto-antibodies, Thyroid binding globulin, free T3: reverse T3 ratio, Selenium, Copper and Zinc Serum levels and Epstein Barr Auto-antibodies to offer our most in-depth and accurate Thyroid assessment.

The pathogenesis of autoimmune disease

The pathogenesis of autoimmune disease consists of three factors: genetic susceptibility, failure of regulatory T cells to control the immune system and internal or external triggers (1). Triggers may include exposure to toxins, heavy metals, mould, bacteria, viruses, stress, food sensitivities or hormonal changes such as pregnancy or menopause. These can also then become perpetuators of the disease process and therefore must be addressed. A comprehensive functional blood test can provide important insight into toxicity levels, inflammation, pathogenic activity, stress/oxidative stress and hormonal imbalances, thus informing what areas need to be targeted and rebalanced in our intervention.

As discussed in part 1 of this blog, white blood cell patterns can be indicators of various types of acute or chronic infections. For further assessment, certain antibody tests can be used to detect the presence of specific infections or viruses such as the Epstein-Barr virus (available via the FDX 20: Epstein-Barr virus panel), Helicobacter Pylori (available via the FDX 35: Helicobacter Pylori Antibodies panel) and the COVID 19 virus (via the FDX 89: CV-19 Antibodies Panel). Even once an autoimmune condition has been identified, it is important to ascertain if these antibodies were once present or are still present to assist in the improvement of symptoms and management of the condition.

Other systems at play

Crucially, the immune system is not the only physiological system at play in autoimmunity, and the health of many other systems should also be monitored in people with autoimmune conditions. For example, we know there is an association between thyroid dysfunction, particularly due to Hashimoto’s, and glucose dysregulation/insulin resistance (2). Markers of glucose and insulin may be helpful in these cases and these can be found in the FDX Inspect and Ultra Panels. 

Additionally, low thyroid function can also affect cardiovascular health by downregulation of LDL receptor binding (3). This has been found to occur even in subclinical hypothyroidism where thyroid antibodies are present (4). LDL status is measured in all FDX panels.

In addition to this, many people may have more than one autoimmune disease, for example in the case of hyperparathyroidism and Graves’ disease there is a higher risk of developing pernicious anaemia. This can be shown in a blood test by testing Vitamin B12 levels, CBC, homocysteine, and gastric parietal and intrinsic factor antibodies (available as an add-on test in the FDX Pernicious Anaemia Panel). In the context of comorbidities, as a clinician, one would want to know whether there are underlying mechanisms such as inflammation, toxicity, oxidative stress, that might be underpinning the multiple manifestations of disease.

FDX tests can help to support the management of autoimmune conditions from a systems biology approach, by both assessing baseline markers of inflammation, nutrient status, adrenal health, oxidative stress, toxicity and methylation status (as touched on in part1), then retesting after interventions to see how the body is responding to the strategies employed to manage the condition.

We offer a range of markers in our tests that can serve to detect risk factors for autoimmunity.

Read part 1 of this blog here

References

  1. Johns Hopkins Pathology. Disease Development – Autoimmune Disease | Johns Hopkins Pathology [Internet]. [cited 2022 Nov 14]. Available from: https://pathology.jhu.edu/autoimmune/development
  2. Wang C. The relationship between type 2 diabetes mellitus and related thyroid diseases [Internet]. Vol. 2013, Journal of Diabetes Research. Hindawi Limited; 2013 [cited 2022 Nov 14]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3647563/
  3. Rizos C. Effects of Thyroid Dysfunction on Lipid Profile. Open Cardiovasc Med J [Internet]. 2011 Mar 28 [cited 2022 Nov 14];5(1):76–84. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3109527/
  4. Michalopoulou G, Alevizaki M, Piperingos G, et al. High serum cholesterol levels in persons with “high-normal” TSH levels: Should one extend the definition of subclinical hypothyroidism? Eur J Endocrinol [Internet]. 1998 Feb [cited 2022 Nov 14];138(2):141–5. Available from: https://pubmed.ncbi.nlm.nih.gov/9506856/