The leaky gut hypothesis is an extension of this, not a different theory. A lot of people have focused on intestinal permeability to proteins and have not put nearly as much emphasis on the intestinal absorption of endotoxin and viable microorganisms. Many of these microorganisms are "pathobionts" which means they are normally harmless except in conditions that allow them to cause disease. Such as translocating from the lumen of the gut to systemic circulation. There ARE other mechanisms of autoimmunity besides molecular mimicry but it all comes back to the basics. Without activation of TLR, CLR, Nod-like receptors from pathogen associated molecules (PAMP) like Lipid A or flagellin it is very unlikely that you sustain a chronic inflammatory response. There are so many redundant mechanisms for preventing this.
To be honest I don't know why people keep thinking that. One problem that is rampant is the inability to differentiate "absence of evidence" from "evidence of absence." Many assume if they haven't found a pathogen it's not there. But advancements in microbial ecology have shown a small glimpse of how limited out detection methods are. Another problem is that our culture has a habit of treating the body as a fragile and often faulty system. The immune system is "over reacting", insulin resistance is "pathological", your cholesterol is "too" high, beta amyloids are "misfolded". See what I'm saying? Very few stop and ask "what is the functional purpose of this, what do these states actually indicate" which is usually a responsive behavior to infection or stressors of various types.
And yeah. I finished my bachelors in biochemistry last year, have been studying these darned diseases since I got sick 4 years ago, and am applying to medical school right now. Don't be hard on yourself. It's confusing stuff. Not because the concepts are hard but because of the politics surrounding it obscuring the truth. I feel like I'm constantly trying to untangle myself from it.
As for the drugs. Like I said, these drugs can prevent irreparable damage. I absolutely recommend them when they are warranted. My criticism is that they are not used as indicated. Which is as an adjunct to treating the actual cause and not a permanent solution. If you are experiencing progressive joint damage that you are worried about
being permanent it's worth talking to a doctor about
trying it and seeing how it goes. I'm just saying, if you have a chance to actually treat underlying causes and get off that crap you owe it to yourself. It's not always easy though and in those cases it's good to have immunosuppresives as an option. If it's a virus it can be tough. Even bacteria can be tough due to drug resistance/tolerance. I was lucky in that my disease responded very strongly to antibacterials and I've been able to reverse all my "autoimmune symptoms". But others are not as lucky. It's all about
balancing quality of life with optimal health and there is no right or wrong way to go so long as you know what you're up again and are making the decision that feels most right to you
Post Edited (Psilociraptor) : 7/28/2018 8:03:17 PM (GMT-6)