What precautions should individuals with autoimmune diseases or allergies take to prevent infections and cancer?

From the Guidelines

Individuals with autoimmune diseases or allergies should prioritize staying up-to-date on vaccinations, practicing good hygiene, and maintaining regular medical check-ups to prevent infections and cancer, as these conditions and their treatments can compromise normal immune function. According to the most recent and highest quality study, 1, infections are a significant cause of non-cancer-related mortality in patients with cancer, and vaccinations can help reduce the severity of infections and associated hospitalizations. Key precautions include:

• Regular hand washing with soap and water for at least 20 seconds
• Avoiding close contact with sick individuals
• Staying up-to-date on vaccinations, though live vaccines may be contraindicated for those on immunosuppressive medications
• Maintaining regular medical check-ups, including cancer screenings appropriate for their age and risk factors
• Practicing food safety by thoroughly cooking meats and washing produce
• Sun protection with SPF 30+ sunscreen, as some autoimmune medications increase skin cancer risk
• Avoiding tobacco and limiting alcohol consumption to further reduce cancer risk Additionally, individuals with autoimmune diseases or allergies should be aware of the potential increased risk of certain infections and cancers associated with their condition and treatment, as highlighted in studies such as 1, 1, and 1. It is essential to note that the management of autoimmune diseases and allergies requires a delicate balance between controlling autoimmune activity and preserving protective immunity, and staying up-to-date on vaccinations and maintaining regular medical check-ups are crucial in achieving this balance.

From the FDA Drug Label

Corticosteroids, including prednisone tablets, suppress the immune system and increase the risk of infection with any pathogen, including viral, bacterial, fungal, protozoan, or helminthic pathogens Corticosteroids can: • Reduce resistance to new infections • Exacerbate existing infections • Increase the risk of disseminated infections • Increase the risk of reactivation or exacerbation of latent infections • Mask some signs of infection

Individuals with autoimmune diseases or allergies taking prednisone should be aware of the increased risk of infections and take precautions to prevent them. The risk of infection increases with increasing corticosteroid dosages. Key precautions include:

• Monitoring for the development of infection
• Considering prednisone withdrawal or dosage reduction as needed
• Avoiding exposure to varicella and measles
• Screening for hepatitis B infection before initiating immunosuppressive treatment with prednisone
• Ruling out latent amebiasis or active amebiasis before initiating prednisone in patients who have spent time in the tropics or patients with unexplained diarrhea 2

From the Research

Infection Risk in Autoimmune Diseases or Allergies

• Individuals with autoimmune diseases or allergies are at a higher risk of developing infections due to their compromised immune system 3.
• Vaccination against influenza is recommended as a preventive measure, as influenza infection can cause mild to severe illness and even lead to death 3.
• However, it is essential to note that influenza vaccination can also trigger autoimmune adverse events in some cases 3.

Cancer Risk in Autoimmune Diseases or Allergies

• There is a dynamic and bidirectional link between autoimmunity and cancer, with chronic inflammation from autoimmune diseases or their therapies contributing to the onset and promotion of cancer 4.
• Conversely, antitumor immune responses may become cross-reactive with self-tissues, resulting in the development of autoimmunity 4.
• The relationship between autoimmune diseases and cancer is complex, with some studies suggesting that patients with pre-existing autoimmune diseases have an increased incidence of certain types of cancer, but decreased cancer-specific mortality 5.

Precautions to Prevent Infections and Cancer

• Individuals with autoimmune diseases or allergies should take precautions to prevent infections, such as getting vaccinated against influenza and practicing good hygiene 3.
• They should also be aware of their increased risk of developing cancer and discuss cancer screening recommendations with their healthcare provider 4.
• Additionally, understanding the potential mechanisms that link autoimmune diseases and cancer can help guide targeted cancer screening and prevention strategies 4.

Environmental Factors and Autoimmune Diseases

• The increasing prevalence of autoimmunity and autoimmune diseases may be attributed to changes in environmental factors, such as alterations in food, xenobiotics, air pollution, infections, personal lifestyles, stress, and climate change 6.
• It is essential to increase efforts to understand autoimmune disease risk factors and pathogeneses, and improve diagnostic, therapeutic, and preventive approaches to mitigate the impact of autoimmune diseases on individuals and society 6.