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Asthma and Autoimmunity

Reviewed by: HU Medical Review Board | Last reviewed: January 2023

If you have asthma, your immune system reacts to certain triggers. It causes your airways to narrow and increases inflammation. These reactions then lead to the symptoms of asthma. The immune reaction is different from what happens in autoimmune conditions. In autoimmune conditions, the immune system attacks your own healthy cells.1,2

Asthma is not an autoimmune condition. It is caused by a different immune reaction than autoimmune conditions. But autoimmunity may play a role in some types of asthma. For example, it may affect how well asthma treatments work. We need more research to understand the role of autoimmunity in asthma.1,3

What is autoimmunity?

Our immune system defends us from infections by fighting foreign invaders. It makes proteins that recognize foreign substances. These proteins are antibodies. Antibodies tag foreign invaders for immune cells to destroy.2

Autoimmunity happens when the immune system makes proteins that tag healthy cells. These proteins are autoantibodies. When this leads to tissue damage, it causes an autoimmune condition. Examples of autoimmune conditions include:2

  • Rheumatoid arthritis
  • Multiple sclerosis
  • Systemic lupus erythematosus
  • Type 1 diabetes
  • Hashimoto’s thyroiditis
  • Ankylosing spondylitis
  • Graves’ disease

Why is asthma not an autoimmune condition?

Asthma is not an autoimmune condition. Asthma and autoimmune conditions are caused by different problems in the immune system. They involve different inflammatory responses and body processes.1,3

One difference is the white blood cell that activates the immune response. In autoimmune conditions, “type 1 helper T cells” lead to “type 1 inflammation.” In asthma, “type 2 helper T cells” lead to “type 2 inflammation.” These processes seem to counteract each other. But research has shown that the distinction is not as clear.1,3

Another key difference is the antibodies made by the immune system. In autoimmune conditions, the immune system makes autoantibodies. In asthma, the immune system makes the antibody immunoglobulin E (IgE). IgE leads to the release of histamine and other chemicals that increase inflammation.1,3

How are asthma and autoimmunity similar?

The processes underlying asthma and autoimmune conditions have some overlap. We know this because of evidence of:1,3

  • Increasing rates of both asthma and autoimmune conditions worldwide
  • Higher rates of allergy and asthma in people with autoimmune conditions
  • Autoantibodies in people with asthma (especially nonallergic asthma)

Asthma is a diverse condition, with many possible causes and triggers. Some asthma types may involve autoimmune processes more than other types of asthma. For example, autoimmune processes play more of a role in nonallergic asthma.1,3

As far as we know, asthma is not an autoimmune condition. But we have a lot to learn about how autoimmunity may play a role in asthma. And as we learn more, our understanding of the significance and role of autoimmune processes will continue to change.1,3

Why is it important to know how asthma and autoimmunity overlap?

Autoimmune processes may play a key role in nonallergic asthma. If this is true, treatments for autoimmune conditions may help people with nonallergic asthma. But we do not yet understand exactly how autoimmunity plays a role. We need more research to understand the role of autoimmunity and its effects on treatment.1,4

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