Immune cells are like robots. They’re made to recognize certain things and attack them. They don’t think about it. They just attack it.
If they get screwed up, they’ll start recognizing your body’s cells. Then they attack. Your body’s not good at stopping that. There isn’t a smart kind of cell that knows to attack “just bad immune cells”. If you’re lucky these screwed up immune cells won’t multiply. If you’re not, your immune system increasingly believes your body is an enemy.
Cortisol is a chemical that tells your immune system to chill. So it can be effective against these cells by making them not be so aggressive about their seek and destroy mission. It doesn’t really *fix* the problem. It’s more like giving a super aggressive dog a sedative.
Very generally speaking, a failure of tolerance or self-recognition must occur at some point, e.g. autoreactive T/B cells don’t get destroyed as they should be or some protective factor like complement FH is missing. The different ways in which these mechanisms fail gives rise to different diseases.
Cortisol, and corticosteroids/glucocorticoids more generally, are broad-acting anti-inflammatory drugs. That makes them useful in a lot of autoimmune diseases. However, they also come with a ton of bad side effects, so it’s preferable to avoid them if possible.
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