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When Your Body Attacks Itself – Autoimmune
What happens when the immune system meant to protect you becomes your worst enemy? This is the betrayal of autoimmune diseases like Type 1 diabetes, multiple sclerosis, celiac disease, lupus, Crohn’s disease, and many others. What exactly goes on in your body and why does it happen in the first place?

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00:00Your immune system is an omnipresent, terrifying entity, made of billions of nuclear weapons
00:06and kamikaze bombers, saturating every little tissue, bone and fluid in your body.
00:12It scans, patrols, and when it finds an enemy, it kills.
00:17But what if it suddenly decides that you are the enemy?
00:21This is the betrayal of autoimmunity.
00:24These like type 1 diabetes, multiple sclerosis, celiac disease, lupus and Crohn's disease
00:31and many more.
00:32Literally every tissue can be affected, from your nerves to your thyroid or joints.
00:37They are all unique and different kinds of bad, from manageable to life-changing to deadly.
00:44All share one fundamental property, your immune system thinks some healthy part of you is
00:49the enemy.
00:50It's like a country attacking itself.
00:54Fighter jets bomb roads, snipers hunt doctors and baristas, artillery levels daycare centers.
01:01While there's usually a certain amount of genetic risk for autoimmunity, to get an actual autoimmune
01:06disease you also need a colossal case of bad luck on top of that.
01:10How does this work?
01:12The shape of life.
01:14The fundamental building blocks of life are proteins.
01:17Like ultra-complex Lego blocks, each of them has a precise shape, allowing them to perform
01:22highly specific tasks, like breaking down food or transcribing DNA.
01:27In total, your body produces about 100,000 different proteins or shapes.
01:33Your immune system evolved to constantly check the proteins of your cells and look for shapes
01:37that are not you, and to kill whatever's attached to them violently and brutally.
01:43Autoimmunity is when your soldier cells suddenly think that your own healthy and natural proteins
01:49belong to an enemy.
01:50We explained this in more detail in this video, but in a nutshell, this is such a critical danger
01:56to your survival that your body created an entire murder university to prevent this from
02:01happening.
02:02Here, young immune cells go through ruthless training.
02:05If they recognize the shapes of your own proteins, they're executed immediately.
02:10But sometimes, through sheer dumb luck, one makes it through.
02:14Right at this moment, you probably have a few million cells patrolling your body with the
02:18potential to trigger an autoimmune disease.
02:21Another way to trigger autoimmunity is through your enemies.
02:25Some bacteria and viruses have evolved proteins that are extremely similar to the ones in your
02:29own body, because they just have to if they want to interact with your cells and to stay
02:34hidden.
02:35We see this everywhere in nature, from moths that look like bark or crocodiles that disappear
02:41in muddy water.
02:43For bacteria, your tissue is a hostile jungle full of angry predators looking for them.
02:48So they try to cover themselves in shapes that are very similar to your proteins.
02:53But both of these things are not enough.
02:55The final ingredient is a trigger event and a colossal case of bad luck.
03:01The war that never ends.
03:04The trigger can be anything that activates your defenses.
03:07A common cold, the flu, a tiny wound.
03:10Any sort of infection floods your body with cytokines, signals that tell your body, this
03:15is a real fight, take this seriously, which truly wakes up your immune system.
03:21These cells start to gather proteins, shapes, from the battlefield.
03:25These shapes are the physical information of what's going on and are carried to your
03:29lymph nodes, information distribution centers.
03:31Here, your heavy weapons, T-cells, pass through, taking a look at the shapes that are being presented
03:37here.
03:38If they recognize the shape of an invader, they activate the whole immune system.
03:42And a few days later, the attacker will be wiped out.
03:46But this time, the worst things happen in the worst kind of way.
03:50Maybe an intelligence officer picked up a piece of one of your healthy cells that died
03:54in the battle.
03:55Or maybe a bacteria had a protein pretty similar to one of yours.
03:59And by sheer extremely bad luck, a few months ago, a single T-cell that can recognize this
04:04shape survived the murder university.
04:07And today, exactly this T-cell happened to pass exactly this lymph node and is activated.
04:14This single T-cell now starts a big immune reaction against your own body.
04:19It clones itself thousands of times, gathers other cells for support, and streams into
04:24your tissue.
04:25When the misguided immune cells arrive, they see nothing but enemies.
04:29The proteins they're looking for are everywhere, which can only mean that there's a full-on invasion
04:34going on.
04:35They spread out and start attacking and killing your tissue.
04:38How bad is this?
04:40Well, it depends.
04:42There are more than 100 different autoimmune diseases, and basically any tissue can be
04:46affected.
04:47In multiple sclerosis, your immune cells are attacking the insulation of your nerve cells,
04:52making them sort of short-circuit or slow down dramatically, causing numbness, muscle cramps,
04:58problems with your vision and concentration.
05:02In type 1 diabetes, your immune system kills the cells that produce your insulin in your pancreas,
05:07starving your cells of glucose and turning your blood into acid.
05:11In rheumatoid arthritis, angry cells invade your joints and literally start to dissolve
05:15cartilage and bone.
05:17Lupus is a body-wide blitzkrieg that attacks literally every part of your body, causing painful,
05:23unpredictable and widespread destruction with a variety of bad symptoms.
05:28And almost all autoimmune diseases come with crushing fatigue and exhaustion.
05:33Because when you're sick, your immune system tells your body to shut down and rest.
05:38Even if the immune system is itself the attacker, it still sends out the same orders.
05:42It feels like you have the flu, but the real enemy is your own body.
05:47The worst part about autoimmunity is that it never stops.
05:51Your immune system is a self-enforcing machine of destruction.
05:54The more enemies your initial autoimmunity cells encounter, the more cells they clone and
06:00activate.
06:01So its nature prevents lasting peace.
06:05Why is your body allowing this?
06:08Most if not all autoimmune diseases have a genetic component, but this is kind of weird.
06:13If some variants of genes are actively harmful to us, evolution should weed them out and make
06:18them less common.
06:20But up to 1 in 10 people in the industrialized world suffers from them.
06:23So why did they stick around?
06:25Well, when it comes to genes, we often have to work with trade-offs.
06:29At their core, autoimmune diseases always mean that your immune system is more aggressive.
06:34And while this is mostly bad, until recently in human history, this was pretty great.
06:40In the past, infectious diseases were the most common cause of death.
06:44Terrible pandemics ravaged our cities regularly, sometimes decimating communities.
06:50Researchers analyzed DNA samples from London cemeteries before, during, and after the Black
06:55Death pandemic that killed about half of the population.
06:58They found that individuals with gene variants that increased the risk for Crohn's disease
07:02seemed to have died at a much lower rate.
07:05What helped them against a deadly disease back then might make us vulnerable to autoimmune
07:10diseases.
07:11It's easy today.
07:11Evolution doesn't care about perfect solutions, it's only looking for good enough.
07:16If variants made it more likely to survive the deadliest diseases, why care if, down the
07:20line, this might lead to something else?
07:23If you have an autoimmune disease, you may only be alive because your ancestors carried these
07:27genes and survived a pandemic that wiped out their neighbors.
07:31And then, a hot second ago, we changed our world.
07:35Hygiene, antibiotics, vaccines and modern medicine revolutionized our lives and how we die.
07:41So much so that most of us don't even think a lot about infectious diseases.
07:46And this is great.
07:48But now, we're left with genes that make our immune systems more aggressive for no good
07:53reason.
07:54Add a bit of bad luck, and all these billions of nuclear weapons and kamikaze bombers take
08:00came at the wrong target.
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