Could IC be an immune disorder?
In the hunt to determine what the cause of IC is - and what can be done to treat it - many theories have abounded. Certain ideas are more plausible than others (for example it appears to be far more likely that IC could be related to the nervous system than its likelihood of being an STD), and some have not been studied in-depth or at great length. One topic which seems to fall a bit in the middle, is the idea of IC as an autoimmune or immune related condition.
In the hunt to determine what the cause of IC is - and what can be done to treat it - many theories have abounded. Certain ideas are more plausible than others (for example it appears to be far more likely that IC could be related to the nervous system than its likelihood of being an STD), and some have not been studied in-depth or at great length. One topic which seems to fall a bit in the middle, is the idea of IC as an autoimmune or immune related condition. Before we take a look at potential reasons why IC could have immune system involvement, let's briefly discuss the function of the immune system itself.
What exactly is our immune system? Our immunes systems are complex networks of highly specialized and important organs (usually referred to as the lymphoid organs) and cells (including white blood cells) which help to protect us from external biological elements and “intruders”. If your immune system is functioning properly it battles off potentially harmful agents like viruses (also known as viral infections), parasites, bacteria and infectious fungi. It also works to destroy things such as foreign matter and severe medical conditions like cancer.
If however, something weakens our immune system it becomes less resistant to these types of invaders or pathogens (such as flu bugs and cold germs) which try to take up home in our bodies and rapidly multiply. A healthy immune system will try to keep unwanted “visitors” at bay or destroy them (if possible). Without an immune system we would be extremely vulnerable to almost any type of harmful agent, and unlikely to thrive as a species. Our immune systems are so important that they can be looked at as a sort of biological suit of amour.
This network is so complex that it is right up their with our nervous system and our brain in terms of in-depth components and functions. It is a remarkable system, which has the uncanny ability to differentiate between our own bodies and outside elements. It can recall past experiences and take the right coarse of action if presented with something like a virus or disease that we have had in the past (it is our immune systems which help to prevent us from coming down with things like the chicken pox more than once).
The immune system has an almost magical ability to counteract and create antibodies for literally millions of infectious and dangerous “non-self” (aka, not part of the normal make up of the body) agents. The strength and power of the immune system lies in its ability to work with the body as a whole, in what is a truly complex network of signs, functions and abilities. Swarms of cells share and communicate information between themselves, alerting each one of potential dangers and working as a team to combat invaders. What we end up with is a highly advanced, highly delicate network of intricate balances and reliances that are able to create the human immune response system.
When you were a baby you were most likely vaccinated against a host of diseases. Though the majority of these vaccines stay affective through out our entire lies, we can still fail pry to many, many illnesses which were not covered in those childhood shots. This is where we need the strength and agility of our immune system to come into play. But as virtually everyone knows first hand, at times something in our natural immune structure weakens and we develop a cold, flu or other ailment.
As well the human body is capable of suffering from what is known as an immune disorder. These fall into two primary categories, one type is called attenuated immune responses (also known as immunodeficiency disorders). These are conditions which are either genetic (present at birth) or that can be acquired later in life (such as the serious infectious condition, Aids). In both cases the body's immune system is disrupted and it's ability to protect itself is highly compromised. Not all examples of this type of immunodeficiency disorder as nearly as severe as Aids. The common cold, flues and the measles themselves all fall into this category, and are known as “temporary immune deficiencies”.
At the other end of the spectrum we have what are known as overactive immune disorders (also known as autoimmune disorders). Examples of this type of condition include lupus erythematosus, psoriasis, rheumatoid arthritis, allergies, asthma and multiple sclerosis. When a person develops one of these kinds of conditions their body has for some reason failed to be able to correctly distinguish between what is the body itself and what is “non-self”. Sadly, the immune system then begins to attack a certain part (depending on which condition or conditions are present) of the body itself, mistaking it for an unwanted invader or danger instead of a natural part of the human make up. Note worthy is the fact that autoimmune disorders – like IC itself – are more prevalent in women. The majority of all immune system disorders require some type of treatment to help battle their affects, unless the condition is severely moderate.
Interstitial Cystitis itself has not been determined to be an immune disorder, but by the same token no precise cause of IC has thus far been found. Interestingly on the subject of IC and immune functions, in the past decade or so a small handful of researchers have been studying the use of a specific strain of tuberculosis related bacteria known as bacillus Calmette Guerin (BCG) as a treatment method for IC. BCG works to actually boost and increase the immune system. This bacteria has a low risk of infection in humans and has been used experimentally as a type of bladder instillation for both bladder cancer and IC. Though it's success with the later has not been concretely established, and it has not yet gained mainstream usage in the treatment of IC.
At times IC seems to hint that it may be an immune disorder, but we cannot yet conclusively say whether it is or is not, until a cause (or multiple causes) of Interstitial Cystitis are determined. Fascinatingly IC patients as a population have a higher likelihood of developing certain autoimmune disorders such as asthma than the non-IC population. Arthritis, Sjogren's Syndrome and Lupus are other conditions which are known to occur with some regularity amongst ICers. While this could be coincidental, it may also point to immune system (and or nervous system) involvement in the bodies of IC patients.
One could also note that ICers have a high rate of developing both UTIs (urinary tract and bladder infections) and yeast infections, both before and after the onset of IC itself. Could it be possible that even if IC is not an autoimmune disorder it weakens our immune system? This is probable as almost any medical condition or disease that is present in the body automatically decreases the overall strength of our immune system.
If we look at the possibility that IC is genetic (in other words, that it could be passed along from one generation to another through out genes) than in theory, there is a very small (and undocumented) chance that IC could be an attenuated immune response. The same could be hypothetically put on the table if IC was somehow (and there is very, very little evidence whatsoever to support this) an infectious disease. For now vague ideas like these have not been overly perused in the medical community, and IC treatment options are not really geared towards these slim possibilities.
One point where the term “immune system disorder” does cross paths with a more established IC theory is in the area of mast cell and histamine involvement. In very simple terms when an allergy (allergies being considered a type of immune disorder) occurs the body produces a higher level of mast cells than it normally does. Mast cells in turn provoke (potential) inflammation. ICers have often been noted (through bladder biopsies) to have higher than normal levels of mast cells in their bladders, and thusly some forms of IC treatment are targeted specifically at healing this problem (and reducing bladder inflammation). The most common medication used to treat mast cell inflammation in IC patients is called hydroxyzine (Atarax and Vistaril are two name brands), a considerably common antihistamine (allergy) medication. Some ICers have also reported success with over the counter antihistamines as well. Interestingly hydroxyzine seems to work particularly well for some ICers if taken in conjunction with another established IC medication such as Elmiron, or the antidepressant drug, Atarax.
Numerous factors can influence the strength of our immune system these include, but are by no means limited to:
Age: As we get older our immune system naturally decreases and weakens.
Alcohol abuse: Excessive amounts of alcohol can have far-reaching affects on our body's ability to fend of illness and maintain a properly functioning system.
Poor diet: A diet that is lacking excessively in necessary minerals and vitamins, and/or one that is comprised of excess fats, sugars and chemicals can certainly damper our immune systems. As well as possibly lead to conditions like diabetes, osteoarthritis or heart problems.
Radiation: Exposure to radiation can be deadly in high enough quantities, and it is able to harm our bodies extensively if prolonged or high level exposure is experienced.
Drug use: This applies both to illegal narcotics such as cocaine and heroine, and certain types of pharmaceutical medications as well. Examples of drugs which are known to have a negative affect on the immune system are antibiotics (though they can be very helpful, antibiotics are a double edged sword because they are notorious for wiping out both good and bad bacteria from the body) and corticosteroids.
Continual wounds and sores (rashes, blisters, cuts, burns, etc): Wounds that are not allowed time to properly heal, not given adequate medical treatment or are continually re-wounded in the same area. A wound can be looked at in certain ways like a portal through which external germs and pathogens try to enter the body.
Exposure to certain environmental toxins and pollutants: This is a very broad reaching category which can include everything from industrial waste to many types of solvents to cigarette smoke.
Stress: Medical and scientific research has shown that prolonged levels of elevated stress or highly stressful situations can weaken your immune system and potentially set you up for being more vulnerable to colds and infections.
The presence of an immune disorder: A pre-existing or developed immune disorder will almost always deplete and weaken the immune system (this certainly includes things like environmental allergies and food allergies).
In many respects almost any continual ailment from IC to Vulvodynia, a broken leg to migraine headaches that persists in a patient for any amount of time stands to weaken the immune system. For many the best line of defense is – as sports coaches are fond of saying – a good offense. The more you can work to reduce the number of factors in your life the can weaken your immune system the better your chances of staying healthy and fending off colds and flues. The healthier that your body is overall, the better able it will be to help you deal with the ongoing affects of IC. Especially until the exact cause of IC, be it immune related or not, is discovered.
For excellent, bladder friendly ways to increase and support your immune health please see the ICadvice self-help article, 6 tips to help boost your immune system