Autoimmunity: An Impending Epidemic?

With the passage of time, the world is gradually facing an "epidemiological shift", a transition from communicable diseases to noncommunicable diseases (NCDs), which are becoming the leading causes of mortality and morbidity.Although countries like India also face a "double burden", where both communicable and non-communicable diseases are to be dealt with, there is no doubt that the same trend encompasses all humanity.Improvement in sanitation, immunization, and therapeutic options has significantly reduced the burden of infectious diseases, while economic and social development, changes in dietary patterns, physical inactivity, behavioral risk factors, along with population aging and increased life expectancy, have led to chronic diseases.In recent times, apart from metabolic diseases and cancers, another emerging group of chronic diseases is autoimmune diseases all over the world.Autoimmunity is a growing public health concern in India as well, with a significant increase observed postpandemic.Predominantly manifested in women in the age bracket of 20-50 years, it appears to be more prevalent in urban areas.Even hyperimmune syndromes in conjunction with viral diseases seem to have increased in frequency in the last few years.There are many challenges though, in assessing the exact incidence of autoimmune diseases, as there is a lack of universal consensus on definitions of cases and disease criteria.Also, it is a fact that there are inadequate standardized databases on which to determine these figures, as well as referral biases to Tertiary Care Centers, which are our main sources of information.Still, various studies indicate a global trend showing an exponential rise in Celiac disease, Sjgren's syndrome, Graves' disease, and rheumatoid arthritis in adults, and also inflammatory bowel disease (IBD) and type 1 diabetes, in children and adolescents since the year 2000.National health and nutrition examination survey (NHANES) data has shown that antinuclear antibodies (ANA) prevalence increased from 11.0 in 1988-1991, to 16.1% in 2011-2012 and the pattern exacerbated post-2020.The steepest increase was in adolescents, and also significantly increased in both sexes (especially males), older adults, and non-Hispanic whites.