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