6 ms·

Enemy within: gut bacteria drive autoimmune disease

110 points by pilingual 9y ago

kzrdude 9y ago
I see a lot about autoimmune disease on Hacker News. I guess that it's a wide medical area, that many can relate to?
- jhartmann 9y ago
  I know of several hackers that have gone through YC have autoimmune conditions, and I would say there is a larger population of people that have autoimmune conditions then our parents generation. I myself have ankylosing spondylitis, and live with chronic pain, back and neck problems. Probably just really interesting to people like us, who want to hack our way out of problems that medicine doesn't have good answers for yet.
  - nerdponx 9y ago
    I don't think I'd be any kind of "hacker" if it weren't for undiagnosed celiac disease. If I wasn't been too sick to go out and do my normal activities, I never would have sat at home learning to program. It's incidence also, anecdotally, seems to be increasing.
    - borne0 9y ago
      Isn't untreated Celiac disease also associated with foggy cognition and poor memory?
      - nerdponx 9y ago
        Yes. That was a bad time in my life.
  - colordrops 9y ago
    I've got the same thing - my neck and shoulders are wrecked, with two slipped discs and severe degeneration, more than should be for my age. The two things that worked to remove nearly all of my pain: * Whole 30 anti-inflammation diet * Mysore-style Ashtanga Yoga If both are done diligently together every day, after 2 weeks you will likely see drastic improvement. It's not a cure - if I stop, after 2 days I'm back in excruciating pain. But when I do these regularly, I can go through the day forgetting that I have neck problems.
    - halfjoking 9y ago
      I'm currently on the "low-lectin" diet which seems to be the most extreme of the anti-inflammation diets. Even though the doctor (Gundry) provides mostly anecdotal evidence in his book The Plant Paradox - you might want to try cutting out cashews and nightshade vegetables which are approved on Whole 30. I felt a difference when I cut those two things out.
      - graeme 9y ago
        Is there any authoritative source on nightshades and inflammation/digestive issues? After extensive testing, I believe they cause serious issues for me (fatigue, bowel issues, etc) But when I search for info, I just find sites from sort of woo-woo sources. (Chiropractors, naturopaths, etc) I'd like to read something more definitive. Both for my own purposes, and also to point people to, as the category itself makes people skeptical. Spicy food, sure, people get that. But potatoes? That's a weird one for most.
        halfjoking 9y ago
        Nope. The only studies are in mice/rats. I was disappointed that The Plant Paradox "references" linked to articles on the web like this: https://www.dietvsdisease.org/nightshade-vegetables/ https://www.dietvsdisease.org/nightshade-vegetables/
        graeme 9y ago
- scorpioxy 9y ago
  That and probably most people with autoimmune diseases have been surprised how little is known about these diseases. Just getting diagnosed with one often takes months if not years and multiple specialists all telling you that it's "all in your head". Also hearing that there's nothing that can be done except watch your body deteriorate is a slap in the face to any one. What you're left with is trying the "unconventional".
  - epmaybe 9y ago
    I think it depends on the type of autoimmune disease. Some are fairly obvious, such as alopecia areata.
  - theprotocol 9y ago
    >multiple specialists all telling you that it's "all in your head" This has been my experience since I started having systemic inflammatory symptoms since the age of 12. It has wrecked my life in as literal and as figurative a way as one can imagine. A lot of doctors blur the lines between their own hypotheses and facts. It's always "all in your head" until it isn't, but few ever admit they were wrong even after the facts come out. Many also have such an ego that they prefer to concoct convoluted and implausible explanations for irregular test results and obvious symptoms rather than to concede that their prior implications about the patient's character (as being one who makes up symptoms) were unacceptable.
    - chiefalchemist 9y ago
      Not to get off topic but when science (i.e., doctors) act this way it undermines the broader faith in Science. It would be more accurate to say, "We're not sure. We're sorry. We can't help you at this time." But instead they blame you? The person who brought them opportunity? Science could stand a heavy dose of humility. No one trusts an egotistical bully. Note: I'm not a Luddite. I think the scientific method is a great tool. It's enabled us to do wonderful things. But humans being human do make mistakes, there a false flags, etc. My rub, despite history, is there's a (false) belief that Science can do not wrong. That disconnect - and the ongoing insistence it doesn't exit - only undermines Brand Science (if you will). The irony is, there's plenty of Science to show how such denial is a mistake. It's as if Science won't listen to itself. But blames us for not listening? Huh?
- Daishiman 9y ago
  It's a set of conditions where most doctors' best answers are "beats me", where conditions are extremely variable from individual to individual, and where lifestyle changes can have drastic differences in outcome. It is the ideal playground for the lifestyle hacker.
  - colordrops 9y ago
    Wow, great summary as to why people are interested. Seriously.
    - ianai 9y ago
      I also think the autoimmune system contributes largely to the overall system. To understand the autoimmune system is to do things like “beat” cancer, aids, possibly some brain disorders, and so on. I personally suspect even life extension could be affected with a full understanding- ie maybe we’d be able to genetically engineer an organism that would repair our telomeres or clean our brains of damage as a symbiosis. It sounds crazy, but I got the idea after hearing about fungi providing nutrients to tree roots in a symbiotic relationship. But first we’d have to find a way for our immune systems to allow it.
      - EGreg 9y ago
        I would prefer taking a snapshot of our DNA and then making a retrovirus to go in and restore it, and then get flushed out.
  - trhway 9y ago
    >most doctors' best answers are "beats me" i take your "beats me" doctors and raise you the gastroenterologist i saw recently - he said straight out, end of discussion, "our infectionist doesn't believe in candida in the gut" As we have that saying in Russia - "the duty to save the drowning person lies solely with the drowning person" ("spasenie utopayuschih delo ruk samih utopayuschih")
    - CodeWriter23 9y ago
- Nomentatus 9y ago
  Autoimmune diseases used to be very rare a century or two ago. For a long time they were doubling in prevalence every decade or two. But that will not happen again, because over half the population now has at least one (eczema.) Doctors obviously haven't had much to offer during this debacle.
- tomtimtall 9y ago
  It’s an extremely interesting field where decieses act in extraordinarily ways. An ex boyfriend of my best friend got an autoimmune response and went from perfectly healthy to lying in a respirator close to death in one week, only to be fully out of the hospital two weeks later. And as it went on the doctors seemed to have next to no clue about what was happening just saying that he needed to “ride it out”. Another close friend had an autoimmune condition where she woke up one day partially blind on one eye. It looked like her body was attacking her own eye. But today there is no issue anymore. I think that for anyone who’s come across the subject it’s just intensely interesting.
mirimir 9y ago
Immune responses to bacteria colonizing unusual tissues doesn't seem like "autoimmune disease". That is, unless there's cross-recognition between bacterial and host epitopes. But there are known examples of such molecular mimicry.[0] Such as "Campylobacter jejuni lipooligosaccharide (LOS) mimicry of human GM1 ganglioside and mimicry between the dietary antigen butyrophilin and myelin oligodendrocyte glycoprotein". So maybe this is another example. 0) https://www.sciencedirect.com/topics/immunology-and-microbiology/molecular-mimicry https://www.sciencedirect.com/topics/immunology-and-microbio...
- smnplk 9y ago
  I have hashimoto's thyroiditis autoimmune condition and I read somewhere that one possible cause could be very subtle gluten allergy. So antibodies are produced to attack a specific gluten protein, but this protein is similar in molecular structure as the protein thyroid is made of, thyroglobulin, so at the same time thyroid is attacked. Is this what molecular mimicry is ? I know next to nothing about human microbiology, feel free to educate me. I really should pick up a book on it if I want to experiment with my health, any suggestions where to start ?
  - nicwilson 9y ago
    > Is this what molecular mimicry is ? Yes, but it usually works the other way around, i.e. the immune system should not recognise the "specific gluten protein" because it looks like self. After all the microbe(?) that produces it is trying to survive by looking like its host, it isn't trying to induce thyroiditis in its host. Another common case is mimicry of the A, B blood antigens and the Rhesus factor. Patients that are AB+ treat A,B and Rhesus factor as self and so can accept blood from any donor (i.e. AB+ is the universal recipient). In contrast, O- patients who do not treat A,B and Rhesus factor as self and due to mimicry will likely treat them as foreign bad (as opposed to foreign neutral), so if they receive a transfusion from any other blood type the immune system will attack the transfusion. Since O- lacks A,B and Rhesus it is the universal donor. > any suggestions where to start? The topics fall under microbiology / immunology, so Ugrad textbooks, Wikipedia etc.
  - 9y ago
allthenews 9y ago
It is frustrating how slow medical progress is with respect to gut biota and such personalized medicine. This seems like the perfect place for machine learning and big data. What exactly is the hold up? Is it regulations? Is it old fashioned doctors unwilling to push boundaries? Ive been dealing with mysterious stomach issues for a long time myself, and I'm living for the day where I can hack something together to cure myself, at this point I've lost faith in doctors; and my problems in the grand scheme of things aren't even that bad, I can only imagine how other hackers must feel... Edit: I've been getting my own ML startup off the ground just recently, but if anyone is doing something in this area, even open source, I may be interested in collaborating, let's talk!
- vymague 9y ago
  But aren't all medical progress pretty slow? Human body is complex and research is expensive.
- ianai 9y ago
  This place is trying: https://viome.com/ https://viome.com/ My guess is that human flora are orders of magnitude higher in complexity. They all interact with one another and diet. It’s hard to find numbers, but at least one place indicated over 500 different strains in the human gut.
  - zxcb1 9y ago
    This type of analysis will probably be a cornerstone in future health assessment. Since there are more cells and genes in the microbiome than in the human body, it seems reasonable that different compositions may have profound effects. Untangling this might take a while, meanwhile, changes in food production, environmental degradation and pollution are probably affecting microbial “landscapes” in detrimental ways. For now, options are limited to experimenting with diets, switching to organic alternatives, and the most radical method, temporarily change environment to isolate or eliminate the causes. All these more or less worked for me, the last one most effective, restoring a dysfunctional gut flora, however not permanently which speaks for environmental factors beyond diet.
- 9y ago

110 points by pilingual 9y ago

kzrdude 9y ago

I see a lot about autoimmune disease on Hacker News. I guess that it's a wide medical area, that many can relate to?

jhartmann 9y ago
I know of several hackers that have gone through YC have autoimmune conditions, and I would say there is a larger population of people that have autoimmune conditions then our parents generation. I myself have ankylosing spondylitis, and live with chronic pain, back and neck problems. Probably just really interesting to people like us, who want to hack our way out of problems that medicine doesn't have good answers for yet.
- nerdponx 9y ago
  I don't think I'd be any kind of "hacker" if it weren't for undiagnosed celiac disease. If I wasn't been too sick to go out and do my normal activities, I never would have sat at home learning to program. It's incidence also, anecdotally, seems to be increasing.
  - borne0 9y ago
    Isn't untreated Celiac disease also associated with foggy cognition and poor memory?
    - nerdponx 9y ago
      Yes. That was a bad time in my life.
- colordrops 9y ago
  I've got the same thing - my neck and shoulders are wrecked, with two slipped discs and severe degeneration, more than should be for my age. The two things that worked to remove nearly all of my pain: * Whole 30 anti-inflammation diet * Mysore-style Ashtanga Yoga If both are done diligently together every day, after 2 weeks you will likely see drastic improvement. It's not a cure - if I stop, after 2 days I'm back in excruciating pain. But when I do these regularly, I can go through the day forgetting that I have neck problems.
  - halfjoking 9y ago
    I'm currently on the "low-lectin" diet which seems to be the most extreme of the anti-inflammation diets. Even though the doctor (Gundry) provides mostly anecdotal evidence in his book The Plant Paradox - you might want to try cutting out cashews and nightshade vegetables which are approved on Whole 30. I felt a difference when I cut those two things out.
    - graeme 9y ago
      Is there any authoritative source on nightshades and inflammation/digestive issues? After extensive testing, I believe they cause serious issues for me (fatigue, bowel issues, etc) But when I search for info, I just find sites from sort of woo-woo sources. (Chiropractors, naturopaths, etc) I'd like to read something more definitive. Both for my own purposes, and also to point people to, as the category itself makes people skeptical. Spicy food, sure, people get that. But potatoes? That's a weird one for most.
      - halfjoking 9y ago
        Nope. The only studies are in mice/rats. I was disappointed that The Plant Paradox "references" linked to articles on the web like this: https://www.dietvsdisease.org/nightshade-vegetables/ https://www.dietvsdisease.org/nightshade-vegetables/
        graeme 9y ago
scorpioxy 9y ago
That and probably most people with autoimmune diseases have been surprised how little is known about these diseases. Just getting diagnosed with one often takes months if not years and multiple specialists all telling you that it's "all in your head". Also hearing that there's nothing that can be done except watch your body deteriorate is a slap in the face to any one. What you're left with is trying the "unconventional".
- epmaybe 9y ago
  I think it depends on the type of autoimmune disease. Some are fairly obvious, such as alopecia areata.
- theprotocol 9y ago
  >multiple specialists all telling you that it's "all in your head" This has been my experience since I started having systemic inflammatory symptoms since the age of 12. It has wrecked my life in as literal and as figurative a way as one can imagine. A lot of doctors blur the lines between their own hypotheses and facts. It's always "all in your head" until it isn't, but few ever admit they were wrong even after the facts come out. Many also have such an ego that they prefer to concoct convoluted and implausible explanations for irregular test results and obvious symptoms rather than to concede that their prior implications about the patient's character (as being one who makes up symptoms) were unacceptable.
  - chiefalchemist 9y ago
    Not to get off topic but when science (i.e., doctors) act this way it undermines the broader faith in Science. It would be more accurate to say, "We're not sure. We're sorry. We can't help you at this time." But instead they blame you? The person who brought them opportunity? Science could stand a heavy dose of humility. No one trusts an egotistical bully. Note: I'm not a Luddite. I think the scientific method is a great tool. It's enabled us to do wonderful things. But humans being human do make mistakes, there a false flags, etc. My rub, despite history, is there's a (false) belief that Science can do not wrong. That disconnect - and the ongoing insistence it doesn't exit - only undermines Brand Science (if you will). The irony is, there's plenty of Science to show how such denial is a mistake. It's as if Science won't listen to itself. But blames us for not listening? Huh?
Daishiman 9y ago
It's a set of conditions where most doctors' best answers are "beats me", where conditions are extremely variable from individual to individual, and where lifestyle changes can have drastic differences in outcome. It is the ideal playground for the lifestyle hacker.
- colordrops 9y ago
  Wow, great summary as to why people are interested. Seriously.
  - ianai 9y ago
    I also think the autoimmune system contributes largely to the overall system. To understand the autoimmune system is to do things like “beat” cancer, aids, possibly some brain disorders, and so on. I personally suspect even life extension could be affected with a full understanding- ie maybe we’d be able to genetically engineer an organism that would repair our telomeres or clean our brains of damage as a symbiosis. It sounds crazy, but I got the idea after hearing about fungi providing nutrients to tree roots in a symbiotic relationship. But first we’d have to find a way for our immune systems to allow it.
    - EGreg 9y ago
      I would prefer taking a snapshot of our DNA and then making a retrovirus to go in and restore it, and then get flushed out.
- trhway 9y ago
  >most doctors' best answers are "beats me" i take your "beats me" doctors and raise you the gastroenterologist i saw recently - he said straight out, end of discussion, "our infectionist doesn't believe in candida in the gut" As we have that saying in Russia - "the duty to save the drowning person lies solely with the drowning person" ("spasenie utopayuschih delo ruk samih utopayuschih")
  - CodeWriter23 9y ago
Nomentatus 9y ago
Autoimmune diseases used to be very rare a century or two ago. For a long time they were doubling in prevalence every decade or two. But that will not happen again, because over half the population now has at least one (eczema.) Doctors obviously haven't had much to offer during this debacle.
tomtimtall 9y ago
It’s an extremely interesting field where decieses act in extraordinarily ways. An ex boyfriend of my best friend got an autoimmune response and went from perfectly healthy to lying in a respirator close to death in one week, only to be fully out of the hospital two weeks later. And as it went on the doctors seemed to have next to no clue about what was happening just saying that he needed to “ride it out”. Another close friend had an autoimmune condition where she woke up one day partially blind on one eye. It looked like her body was attacking her own eye. But today there is no issue anymore. I think that for anyone who’s come across the subject it’s just intensely interesting.

mirimir 9y ago

Immune responses to bacteria colonizing unusual tissues doesn't seem like "autoimmune disease". That is, unless there's cross-recognition between bacterial and host epitopes. But there are known examples of such molecular mimicry.[0] Such as "Campylobacter jejuni lipooligosaccharide (LOS) mimicry of human GM1 ganglioside and mimicry between the dietary antigen butyrophilin and myelin oligodendrocyte glycoprotein". So maybe this is another example. 0) https://www.sciencedirect.com/topics/immunology-and-microbiology/molecular-mimicry https://www.sciencedirect.com/topics/immunology-and-microbio...

smnplk 9y ago
I have hashimoto's thyroiditis autoimmune condition and I read somewhere that one possible cause could be very subtle gluten allergy. So antibodies are produced to attack a specific gluten protein, but this protein is similar in molecular structure as the protein thyroid is made of, thyroglobulin, so at the same time thyroid is attacked. Is this what molecular mimicry is ? I know next to nothing about human microbiology, feel free to educate me. I really should pick up a book on it if I want to experiment with my health, any suggestions where to start ?
- nicwilson 9y ago
  > Is this what molecular mimicry is ? Yes, but it usually works the other way around, i.e. the immune system should not recognise the "specific gluten protein" because it looks like self. After all the microbe(?) that produces it is trying to survive by looking like its host, it isn't trying to induce thyroiditis in its host. Another common case is mimicry of the A, B blood antigens and the Rhesus factor. Patients that are AB+ treat A,B and Rhesus factor as self and so can accept blood from any donor (i.e. AB+ is the universal recipient). In contrast, O- patients who do not treat A,B and Rhesus factor as self and due to mimicry will likely treat them as foreign bad (as opposed to foreign neutral), so if they receive a transfusion from any other blood type the immune system will attack the transfusion. Since O- lacks A,B and Rhesus it is the universal donor. > any suggestions where to start? The topics fall under microbiology / immunology, so Ugrad textbooks, Wikipedia etc.
- 9y ago

allthenews 9y ago

It is frustrating how slow medical progress is with respect to gut biota and such personalized medicine. This seems like the perfect place for machine learning and big data. What exactly is the hold up? Is it regulations? Is it old fashioned doctors unwilling to push boundaries? Ive been dealing with mysterious stomach issues for a long time myself, and I'm living for the day where I can hack something together to cure myself, at this point I've lost faith in doctors; and my problems in the grand scheme of things aren't even that bad, I can only imagine how other hackers must feel... Edit: I've been getting my own ML startup off the ground just recently, but if anyone is doing something in this area, even open source, I may be interested in collaborating, let's talk!

vymague 9y ago
But aren't all medical progress pretty slow? Human body is complex and research is expensive.
ianai 9y ago
This place is trying: https://viome.com/ https://viome.com/ My guess is that human flora are orders of magnitude higher in complexity. They all interact with one another and diet. It’s hard to find numbers, but at least one place indicated over 500 different strains in the human gut.
- zxcb1 9y ago
  This type of analysis will probably be a cornerstone in future health assessment. Since there are more cells and genes in the microbiome than in the human body, it seems reasonable that different compositions may have profound effects. Untangling this might take a while, meanwhile, changes in food production, environmental degradation and pollution are probably affecting microbial “landscapes” in detrimental ways. For now, options are limited to experimenting with diets, switching to organic alternatives, and the most radical method, temporarily change environment to isolate or eliminate the causes. All these more or less worked for me, the last one most effective, restoring a dysfunctional gut flora, however not permanently which speaks for environmental factors beyond diet.
9y ago