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Autoimmune and allergic disorders

A lesson on defense from our T cells

Administrators in politics, social policy, security, intelligence and defense, who in the wake of recent world events are currently grappling with how to re-engineer a free society that is immune to disruption from within or without, could do well by studying immunology from both a western and eastern perspective.

A Sanskrit expression from Charaka Samhita, the oldest textbook of medicine, states, yatha pinde tatha brahmande, i.e. "as is the individual physiology, so is the universe." This means that the body is an expression of an underlying field of intelligence, the same intelligence that also governs the functioning of larger structures such as galaxies, ecosystems and societies. In the wake of recent horrific events, we have all wondered if there is any intelligence at all at work in a human society. Quantum mechanics and chaos theory both insist, "Yes! But like biology, it is an intelligence that operates with probabilities and uncertainty." This also means that social systems have their own physiology.

The ancient Ayurvedic texts call this intelligence Veda, and describe it as a blueprint for the physiology, indeed for the cosmos. Veda functions as a constitution of the universe, describing the laws of nature at work as unmanifest, unexpressed intelligence expresses itself into a human, a virus or a star. The verses of Veda and the Vedic literature also have a discrete structure, an architecture defined by the relationships between the syllables, words, chapters and rhythms.

If Veda indeed provides the blueprint for nature including for humankind, one would expect that human physiology and anatomy reflects the architecture and functioning of Veda. Tony Nader, MD, PhD, a Harvard-trained neuroscientist guided by Vedic scientist, Maharishi Mahesh Yogi, investigated whether the structure of Veda could be found in the human neuroanatomy. Dr. Nader analyzed all 40 areas of Veda and the Vedic literature and discovered that each Vedic text has an almost identical corresponding structure in the human anatomy. For example, Rg Veda, the primordial Vedic text which gives rise to all others, is composed of 192 groups of verses. Similarly, the human autonomic nervous system governing our vital functions consists of 192 nerves.

This recent insight from neuroscience provides one of the strongest confirmations of the existence of an underlying blueprint for creation and that every human individual is cosmic. This correspondence also validates the biblical understanding that man is made in the image of the divine.

Agnivesha, a medical student who lived thousands of years ago, poses in the ancient Ayurvedic medical text a question about immunity that is still pertinent today. "Why is it that some people eat all the right things and they still get disease and infections, while some people never eat well and they seem to never fall sick?" His professor, Atreya, gives an answer that prophesies our modern understanding. "Predisposition to disease also depends on how and when the food is eaten, the environment of the individual, as well as on genetics."

Immune disorders, like problems with security systems or militias, can be categorized as either 1) weak immunity or 2) strong immunity, but lacking organization and leadership. AIDS is an example of the former because the immune cells are both scarce and weak. Allergies and autoimmune disorders are examples of the latter. In allergic conditions, a strong immune system aims its formidable weapons at a non-threatening foreign irritant, the proverbial cannon against the mosquito.

Autoimmune disorders are the most interesting to a student of social policy and domestic security, because they represent an imbalance between adequate internal vigilance and tolerance of individuality. Autoimmune diseases are disorders caused by activation of immune cells for no apparent reason such as an infection. The immune response is directed against one's own tissues, perhaps tissues that, to a T cell, look a lot like an invader. This includes common disorders such as hypothyroidism, rheumatoid arthritis, psoriasis, juvenile diabetes and probably multiple sclerosis, as well as uncommon problems such as lupus, spondylitis and inflammatory bowel disease.

Immune cells are not designed simply to discriminate self from foreign, but to attack in an environment of inflammation triggered by chemical signals. Autoimmune disease usually implies both a genetic predisposition and the presence of triggers such as viruses or bacteria, drugs, a woman's natural estrogen or even stress. It seems that Atreya was right: genes and one's environment are just as important as a good diet.

The standard medical approach is to subdue the immune system using harmful steroids and other risky immune suppressants otherwise used for preventing transplant rejection. Continuing our analogy, this is comparable to so weakening the FBI and other domestic security agencies, simply because they lacked perfect discrimination between the innocent citizenry and subversives, that it endangered the whole society.

It has long been known that stress aggravates allergic disorders like asthma, eczema and hives. What experienced ER doc hasn't seen kids with severe wheezing at home, who are fine as soon as they enter the hospital, knowing that they wouldn't suffocate? Now several studies have shown that stress can also be a trigger for autoimmune disorders, including Grave's disease, lupus, colitis, and rheumatoid arthritis. Our forebears fleeing a saber-tooth tiger had a good chance of being wounded, and needed an immune system that would be mobilized and stimulated from the chase alone. Today the tiger and its like are extinct, but we go about our business with our nervous systems in high gear as if these dangers were present, creating neuropeptides and stress hormones in the brain that circulate through our bodies to turn our immune systems on inappropriately. Serenity, on the other hand, allows proliferating cells to be quiescent.

So intimately are the nervous and immune systems connected that a new science called psychoneuroimmunology has arisen that may make this connection not only legitimate but also practical. Brains and immune cells both have memories and intellects, and even share some common cells. Most importantly, a nervous system free of anxiety and depression creates a neurochemistry that signals the immune system to deactivate. Countries at peace, like Switzerland and Costa Rica, marshal small, inconspicuous armies.

The Ayurvedic approach to autoimmunity is to put the immune system to rest rather than to suppress it. Transcendental Meditation has been shown to improve the inflammatory response of gingivitis and to lower cortisol and increase DHEA, exactly the opposite of the stress response. Several Ayurvedic herbs, including guggulu, have powerful anti-inflammatory effects and have been shown effective in rheumatoid arthritis, the autoimmune disorder that wreaks the most widespread suffering.

When I was in medical school, we thought that the body naturally eliminates clones of cells that attack one's self, leaving intact only the T and B cells which react against foreign antigens such as bacteria. Now we understand that a low level of autoreactivity is natural and even critical to normal immune function. Apparently, tissues that provoke an immune response help naïve immune cells to differentiate and survive. In addition, since our bodies create cancer cells every day, a hint of autoreactivity may be one of the ways the immune system is recruited to eliminate these abnormal cells, which don't look quite like "self."

It seems that the healthiest condition for the body is akin to a benign yet testy society that is perpetually challenging the domestic security agencies to keep them on their toes. In these challenging times, may we have the humility to take a few lessons from Nature in establishing our new world order.

Jay Glaser, MD is a board-certified internist, researcher and medical director at the Lancaster Ayurveda Medical Center in Sterling, MA

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