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Olff M, Hein I, Amstadter AB, Armour C, Skogbrott Birkeland M, Bui E, Cloitre M, Ehlers A, Ford JD, Greene T, Hansen M, Harnett NG, Kaminer D, Lewis C, Minelli A, Niles B, Nugent NR, Roberts N, Price M, Reffi AN, Seedat S, Seligowski AV, Vujanovic AA. The impact of trauma and how to intervene: a narrative review of psychotraumatology over the past 15 years. Eur J Psychotraumatol 2025; 16:2458406. [PMID: 39912534 PMCID: PMC11803766 DOI: 10.1080/20008066.2025.2458406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2025] Open
Abstract
To mark 15 years of the European Journal of Psychotraumatology, editors reviewed the past 15-year years of research on trauma exposure and its consequences, as well as developments in (early) psychological, pharmacological and complementary interventions. In all sections of this paper, we provide perspectives on sex/gender aspects, life course trends, and cross-cultural/global and systemic societal contexts. Globally, the majority of people experience stressful events that may be characterized as traumatic. However, definitions of what is traumatic are not necessarily straightforward or universal. Traumatic events may have a wide range of transdiagnostic mental and physical health consequences, not limited to posttraumatic stress disorder (PTSD). Research on genetic, molecular, and neurobiological influences show promise for further understanding underlying risk and resilience for trauma-related consequences. Symptom presentation, prevalence, and course, in response to traumatic experiences, differ depending on individuals' age and developmental phase, sex/gender, sociocultural and environmental contexts, and systemic socio-political forces. Early interventions have the potential to prevent acute posttraumatic stress reactions from escalating to a PTSD diagnosis whether delivered in the golden hours or weeks after trauma. However, research on prevention is still scarce compared to treatment research where several evidence-based psychological, pharmacological and complementary/ integrative interventions exist, and novel forms of delivery have become available. Here, we focus on how best to address the range of negative health outcomes following trauma, how to serve individuals across the age spectrum, including the very young and old, and include considerations of sex/gender, ethnicity, and culture in diverse contexts, beyond Western, Educated, Industrialized, Rich, and Democratic (WEIRD) countries. We conclude with providing directions for future research aimed at improving the well-being of all people impacted by trauma around the world. The 15 years EJPT webinar provides a 90-minute summary of this paper and can be downloaded here [http://bit.ly/4jdtx6k].
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Affiliation(s)
- Miranda Olff
- Department of Psychiatry, Amsterdam UMC location University of Amsterdam, Amsterdam Public Health and Amsterdam Neuroscience, Amsterdam, The Netherlands
- ARQ National Psychotrauma Centre, Diemen, The Netherlands
| | - Irma Hein
- Department of Psychiatry, Amsterdam UMC location University of Amsterdam, Amsterdam Public Health and Amsterdam Neuroscience, Amsterdam, The Netherlands
- Levvel, Amsterdam, The Netherlands
| | - Ananda B. Amstadter
- Departments of Psychiatry, Psychology, & Human and Molecular Genetics, Virginia Commonwealth University, Richmond, USA
| | - Cherie Armour
- Trauma and Mental Health Research Centre, School of Psychology, Queens University Belfast, Belfast, UK
| | | | - Eric Bui
- Caen University Hospital, University of Caen Normandy, Caen, France
- Massachusetts General Hospital, Boston, MA, USA
| | - Marylene Cloitre
- National Center for PTSD, Palo Alto, CA, USA
- New York University, Silver School of Social Work, New York, NY, USA
| | - Anke Ehlers
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Julian D. Ford
- Department of Psychiatry, University of Connecticut Health Center, Farmington, USA
| | - Talya Greene
- Clinical, Educational and Health Psychology, University College London, London, UK
| | - Maj Hansen
- THRIVE, Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - Nathaniel G. Harnett
- Neurobiology of Affective and Traumatic Experiences Laboratory, McLean Hospital, Belmont, USA
- Harvard Medical School, Boston, MA, USA
| | - Debra Kaminer
- Department of Psychology, University of Cape Town, Cape Town, South Africa
| | - Catrin Lewis
- National Centre for Mental Health (NCMH), Cardiff University, Cardiff, UK
| | - Alessandra Minelli
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
- Genetics Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Barbara Niles
- Boston University Chobonian and Avedisian School of Medicine, USA
- National Center for PTSD Behavioral Science Division at VA Boston Healthcare System, Boston, MA, USA
| | - Nicole R. Nugent
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence RI, USA
| | - Neil Roberts
- Psychology & Psychological Therapies Directorate, Cardiff & Vale University Health Board, Cardiff, UK
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | | | - Anthony N. Reffi
- Sleep Disorders & Research Center, Henry Ford Health, Detroit, MI, USA
- Department of Surgery, Division of Acute Care Surgery, Henry Ford Health, Detroit, MI, USA
| | - Soraya Seedat
- SAMRC/SU Genomics of Brain Disorders Research Unit, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Antonia V. Seligowski
- Department of Psychiatry, Massachusetts General Hospital & Harvard Medical School, USA
| | - Anka A. Vujanovic
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, USA
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Kim Y, Koopman JJ, Choi M, Feldman CH, Costenbader KH. Environmental Risk Factors for Systemic Lupus Erythematosus Through the Lens of Social Determinants of Health. Arthritis Care Res (Hoboken) 2025; 77:689-699. [PMID: 39800912 PMCID: PMC12122242 DOI: 10.1002/acr.25497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2024] [Accepted: 12/11/2024] [Indexed: 01/28/2025]
Abstract
Systemic lupus erythematosus (SLE) is a serious multisystem autoimmune disease, marked by alarming sociodemographic inequities. In the United States and around the world, social disadvantage is strongly tied to higher prevalence, more severe disease, and poorer outcomes. A growing list of environmental exposures that contribute to the risk and incidence of SLE have been investigated, and many are now established. However, these environmental exposures-including exposure to air pollution and other contaminants, lifestyle and behavioral factors, and psychologic stress and distress-are not evenly distributed in any population. Individuals of lower socioeconomic status and historically minoritized groups suffer from an imbalanced burden of adverse environmental exposures. In research, clinical practice, and policy making, the strong association of social determinants of health (SDoH) with these exposures has not been given adequate spotlight. In this narrative review, we examine known associations between environmental exposures and SLE risk through the lens of SDoH, laying the foundation for future research and policies to target the environmental risk factors for SLE with awareness of the populations disproportionately affected and the contributing SDoH.
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Affiliation(s)
- Youngmin Kim
- Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Jacob J.E. Koopman
- Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - May Choi
- University of Calgary, Calgary, Alberta, Canada
| | - Candace H Feldman
- Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
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Chen L, Zhang M, Xiang S, Zhang J, Chang R, Hu C, Qian S, Liu T, Shi Y, Ding X. Post-traumatic stress disorder and risk of systemic lupus erythematosus: Meta-analysis and Mendelian randomization study. J Psychosom Res 2025; 190:112049. [PMID: 39923328 DOI: 10.1016/j.jpsychores.2025.112049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 01/02/2025] [Accepted: 02/02/2025] [Indexed: 02/11/2025]
Abstract
OBJECTIVE We conducted a meta-analysis and Mendelian randomization study to analyze the association and causal relationship of genetic prediction between post-traumatic stress disorder and the risk of systemic lupus erythematosus. METHODS A meta-analysis was conducted using hazard ratio, relative risk, odds ratio, and 95 % confidence intervals as effect measures. Summary data from genome-wide association studies on post-traumatic stress disorder and systemic lupus erythematosus were utilized to assess the causal relationship of genetic prediction between post-traumatic stress disorder and systemic lupus erythematosus using Mendelian randomization. RESULTS A meta-analysis showed that post-traumatic stress disorder was positively associated with the risk of systemic lupus erythematosus (RR = 1.85, 95 % CI = 1.61-2.12, p < 0.001). The results of Egger's test showed no publication bias (p = 0.823, p > 0.05). Sensitivity analysis showed that the meta-analysis results were stable (RR = 1.85, 95 % CI = 1.61-2.12). However, Mendelian Randomization analysis revealed no evidence of a causal relationship of genetic prediction between post-traumatic stress disorder and systemic lupus erythematosus (IVW OR: 1.001, 95 % CI: 0.805-1.245, p = 0.993). CONCLUSION There is a correlation between post-traumatic stress disorder and systemic lupus erythematosus, but Mendelian Randomization does not support a genetic causal effect of post-traumatic stress disorder on systemic lupus erythematosus. The potential causal relationship between the two factors may necessitate further in-depth research.
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Affiliation(s)
- Lingfeng Chen
- School of Basic Medical Sciences, Zhejiang Chinese Medical University, 310053, China
| | - Mengge Zhang
- School of Basic Medical Sciences, Zhejiang Chinese Medical University, 310053, China
| | - Shate Xiang
- School of Basic Medical Sciences, Zhejiang Chinese Medical University, 310053, China
| | - Jingjing Zhang
- School of Basic Medical Sciences, Zhejiang Chinese Medical University, 310053, China
| | - Runyu Chang
- School of Basic Medical Sciences, Zhejiang Chinese Medical University, 310053, China
| | - Chao Hu
- School of Basic Medical Sciences, Zhejiang Chinese Medical University, 310053, China
| | - Suhai Qian
- School of Basic Medical Sciences, Zhejiang Chinese Medical University, 310053, China
| | - Ting Liu
- School of Basic Medical Sciences, Zhejiang Chinese Medical University, 310053, China
| | - Yufeng Shi
- The First Affiliated Hospital of Zhejiang Chinese Medical University, 310053, China.
| | - Xinghong Ding
- School of Basic Medical Sciences, Zhejiang Chinese Medical University, 310053, China.
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Mandagere K, Stoy S, Hammerle N, Zapata I, Brooks B. Systematic review and meta-analysis of post-traumatic stress disorder as a risk factor for multiple autoimmune diseases. Front Psychiatry 2025; 16:1523994. [PMID: 40051767 PMCID: PMC11882857 DOI: 10.3389/fpsyt.2025.1523994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2024] [Accepted: 02/06/2025] [Indexed: 03/09/2025] Open
Abstract
Background Post Traumatic Stress Disorder (PTSD) is a prevalent and debilitating psychiatric illness that has been linked to poor health outcomes and increased risk of developing chronic health conditions, including multiple autoimmune diseases such as Systemic Lupus Erythematosus (SLE), Inflammatory Bowel Disease (IBD), Rheumatoid Arthritis (RA), and Multiple Sclerosis (MS). Aim This meta-analysis assesses the epidemiological research in this field and briefly explores the hypothesized neurobiological and immunological mechanisms that may underlie the association between PTSD and the development of Autoimmune Disease. Methods PubMed, SCOPUS, and Cochrane Reviews databases were searched for all relevant articles in August 2023. Studies were systematically screened for relevance and inclusion criteria by two reviewers before quality assessment and data extraction were performed. Fixed and random-effect meta-analyses were performed to evaluate PTSD as a risk factor for the development of specific autoimmune diseases. Subgroup analyses examining the roles of biological sex and PTSD severity were also performed. Results The initial search yielded 3010 articles where only eight prospective and retrospective cohort studies met criteria for inclusion in the meta-analysis. These eight studies were subdivided based on specific disease outcomes. Random effects model for risk of developing any autoimmune disease in persons with PTSD vs. control was 1.291 (95% CI = 1.179 to 1.412; P <0.001; n=1,984,310; 4 studies included). The strength of the association between PTSD and risk of developing specific autoimmune diseases varied by outcome condition from 1.142 (95% CI = 1.085 to 1.202, P <0.001) for risk of IBD to 1.302 (1.037 to 1.635, P = 0.023) for risk of MS. Random effects models showed statistically significant associations between PTSD and IBD, SLE, RA, MS, and Thyroiditis. Conclusion These results suggest that the risk for developing autoimmune conditions, including SLE, MS, RA, and IBD, is significantly increased in the setting of PTSD. This association may have important implications on clinical practice and research into the pathophysiology of stress disorders.
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Affiliation(s)
- Kevin Mandagere
- Rocky Vista University College of Osteopathic Medicine, Englewood, CO, United States
| | - Savanna Stoy
- Rocky Vista University College of Osteopathic Medicine, Englewood, CO, United States
| | - Nathan Hammerle
- Rocky Vista University College of Osteopathic Medicine, Englewood, CO, United States
| | - Isain Zapata
- Department of Biomedical Sciences, Rocky Vista University College of Osteopathic Medicine, Englewood, CO, United States
| | - Benjamin Brooks
- Department of Biomedical Sciences, Rocky Vista University College of Osteopathic Medicine, Ivins, UT, United States
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Liu X, Jia X, Wang X, Wei YB, Liu JJ. Mental health conditions in patients with systemic lupus erythematosus: a systematic review and meta-analysis. Rheumatology (Oxford) 2024; 63:3234-3242. [PMID: 38652594 DOI: 10.1093/rheumatology/keae239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 04/10/2024] [Accepted: 04/11/2024] [Indexed: 04/25/2024] Open
Abstract
OBJECTIVES The reported prevalence of mental health conditions (MHCs) in people with systemic lupus erythematosus (SLE) ranges widely. Whether MHCs are associated with increased risk of SLE or the outcomes of the disease is unclear. This study aimed to conduct an umbrella and updated meta-analysis of MHCs in people with SLE and to identify whether MHCs are associated with the risk of SLE or patient outcomes. METHODS We comprehensively searched PubMed, Web of Science and Embase databases to identify relevant studies published before June 2023. Random-effect models were used to calculate the pooled prevalence and risk ratios (RR) for each MHC. RESULTS In total, 203 studies with 1 485 094 individuals were included. The most MHCs observed in patients with SLE were sleep disturbance (59.7% [95% CI, 52.4-66.8%]) among adults and cognitive dysfunction (63.4% [95% CI, 46.9-77.9%]) among children. We found that depressive disorders (RR = 2.30, 95% CI = 1.94-2.75) and posttraumatic stress disorder (RR = 1.93, 95% CI = 1.61-2.31) in the general population were significantly associated with an increased likelihood of developing SLE. Furthermore, concurrent MHCs were linked to unfavourable outcomes in patients with SLE, such as decreased quality of life, increased risk of unemployment and other somatic comorbidities. CONCLUSION Our study demonstrated a high prevalence of MHCs among patients with SLE. Individuals with pre-existing mental disorders exhibited an elevated susceptibility to developing SLE and patients presenting with MHCs were at increased risk of experiencing suboptimal health and functional outcomes. Therefore, evaluating and preventing MHCs should be considered as an integral component of the comprehensive treatment strategy for SLE.
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Affiliation(s)
- Xiaotong Liu
- School of Nursing, Peking University, Beijing, China
| | - Xinlei Jia
- School of Nursing, Peking University, Beijing, China
| | - Xiao Wang
- Shandong Province Clinical Research Center for Immune Diseases and Gout, Jinan, China
- Department of Rheumatology, Qilu Hospital of Shandong University, Jinan, China
| | - Ya Bin Wei
- Beijing Key Laboratory of Drug Dependence Research, National Institute on Drug Dependence, Peking University, Beijing, China
| | - Jia Jia Liu
- School of Nursing, Peking University, Beijing, China
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Chiche L, Truchetet ME, Cornec D, Immediato Daien C. [Between the normal and the pathological: The concept of pre-disease applied to systemic autoimmune rheumatic diseases]. Rev Med Interne 2024:S0248-8663(24)01282-7. [PMID: 39592283 DOI: 10.1016/j.revmed.2024.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2024] [Accepted: 11/10/2024] [Indexed: 11/28/2024]
Abstract
The incidence of systemic autoimmune diseases is constantly rising. They are chronic diseases requiring prolonged treatment, with considerable psychosocial impact. While attention to the promising results obtained with CAR-T cells in refractory patients is justified, it seems important not to overlook the opportunities for prevention based on the identification of a pre-disease state. After clarifying the various stages that make up this pre-disease state, using the prototypical example of systemic lupus erythematosus, we will apply a transdisciplinary and transpathological approach to describe comparatively recent data obtained for other systemic autoimmune diseases (rheumatoid arthritis, Sjögren's syndrome and systemic scleroderma). We will then discuss the practical implications of this new paradigm in the typical consultation of a potentially "pre-sick" individual, and on the prospects opened up by this new paradigm in care and research.
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Affiliation(s)
- L Chiche
- Service de médecine interne, hôpital européen, 6, rue Désirée-Clary, 13003 Marseille, France.
| | - M-E Truchetet
- Université de Bordeaux, CNRS, ImmunoConcEpT, UMR 5164, 33000 Bordeaux, France; CHU de Bordeaux, FHU ACRONIM, Centre national de référence des maladies auto-immunes et systémiques rares Est/Sud-Ouest (RESO), 33000 Bordeaux, France
| | - D Cornec
- Inserm UMR1227 LBAI, Univ Brest, service de rhumatologie, centre national de référence des maladies auto-immunes systémiques rares CERAINOM, CHU de Brest, Brest, France
| | - C Immediato Daien
- Service d'immuno-rhumatologie, CHU de Montpellier, Inserm U1046, CNRS UMR 9214, université de Montpellier, physiologie et médecine expérimentale du cœur et des muscles (PhyMedExp), Montpellier, France
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Bolton C. Review of evidence linking exposure to environmental stressors and associated alterations in the dynamics of immunosenescence (ISC) with the global increase in multiple sclerosis (MS). Immun Ageing 2024; 21:73. [PMID: 39438909 PMCID: PMC11494837 DOI: 10.1186/s12979-024-00473-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2024] [Accepted: 10/07/2024] [Indexed: 10/25/2024]
Abstract
Historical survey confirms that, over the latter part of the 20th century, autoimmune-based diseases, including multiple sclerosis (MS), have shown a worldwide increase in incidence and prevalence. Analytical population studies have established that the exponential rise in MS is not solely due to improvements in diagnosis and healthcare but relates to an increase in autoimmune risk factors. Harmful environmental exposures, including non-communicable social determinants of health, anthropogens and indigenous or transmissible microbes, constitute a group of causal determinants that have been closely linked with the global rise in MS cases. Exposure to environmental stressors has profound effects on the adaptive arm of the immune system and, in particular, the associated intrinsic process of immune ageing or immunosenescence (ISC). Stressor-related disturbances to the dynamics of ISC include immune cell-linked untimely or premature (p) alterations and an accelerated replicative (ar) change. A recognised immune-associated feature of MS is pISC and current evidence supports the presence of an arISC during the disease. Moreover, collated data illustrates the immune-associated alterations that characterise pISC and arISC are inducible by environmental stressors strongly implicated in causing duplicate changes in adaptive immune cells during MS. The close relationship between exposure to environmental risk factors and the induction of pISC and arISC during MS offers a valid mechanism through which pro-immunosenescent stressors may act and contribute to the recorded increase in the global rate and number of new cases of the disease. Confirmation of alterations to the dynamics of ISC during MS provides a rational and valuable therapeutic target for the use of senolytic drugs to either prevent accumulation and enhance ablation of less efficient untimely senescent adaptive immune cells or decelerate the dysregulated process of replicative proliferation. A range of senotherapeutics are available including kinase and transcriptase inhibitors, rapalogs, flavanols and genetically-engineered T cells and the use of selective treatments to control emerging and unspecified aspects of pISC and arISC are discussed.
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Tang X, Wang J, Chen J, Liu W, Qiao P, Quan H, Li Z, Dang E, Wang G, Shao S. Epidermal stem cells: skin surveillance and clinical perspective. J Transl Med 2024; 22:779. [PMID: 39169334 PMCID: PMC11340167 DOI: 10.1186/s12967-024-05600-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2024] [Accepted: 08/12/2024] [Indexed: 08/23/2024] Open
Abstract
The skin epidermis is continually influenced by a myriad of internal and external elements. At its basal layer reside epidermal stem cells, which fuels epidermal renovation and hair regeneration with powerful self-renewal ability, as well as keeping diverse signals that direct their activity under surveillance with quick response. The importance of epidermal stem cells in wound healing and immune-related skin conditions has been increasingly recognized, and their potential for clinical applications is attracting attention. In this review, we delve into recent advancements and the various physiological and psychological factors that govern distinct epidermal stem cell populations, including psychological stress, mechanical forces, chronic aging, and circadian rhythm, as well as providing an overview of current methodological approaches. Furthermore, we discuss the pathogenic role of epidermal stem cells in immune-related skin disorders and their potential clinical applications.
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Affiliation(s)
- Xin Tang
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, Shannxi, China
| | - Jiaqi Wang
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, Shannxi, China
| | - Jiaoling Chen
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, Shannxi, China
| | - Wanting Liu
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, Shannxi, China
| | - Pei Qiao
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, Shannxi, China
| | - Huiyi Quan
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, Shannxi, China
| | - Zhiguo Li
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, Shannxi, China
| | - Erle Dang
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, Shannxi, China
| | - Gang Wang
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, Shannxi, China.
| | - Shuai Shao
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, Shannxi, China.
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Chiche L, Di Lelio L, Jourde-Chiche N, Escoda T. Pathological griefs and neuropsychiatric symptoms in autoimmune diseases: new insights from interdisciplinary qualitative research. Rheumatology (Oxford) 2024; 63:e177-e178. [PMID: 38216713 DOI: 10.1093/rheumatology/keae018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 11/09/2023] [Accepted: 12/02/2023] [Indexed: 01/14/2024] Open
Affiliation(s)
- Laurent Chiche
- Service de Médecine Interne, Hôpital Européen Marseille, Marseille, France
| | | | - Noémie Jourde-Chiche
- Aix-Marseille Univ, INSERM, INRAE, C2VN, AP-HM Centre de Néphrologie et Transplantation Rénale, CHU de la Conception, Marseille, France
| | - Thomas Escoda
- Service de Médecine Interne, Hôpital Européen Marseille, Marseille, France
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Oakes EG, Ellrodt J, Yee J, Guan H, Kubzansky LD, Koenen KC, Costenbader KH. Posttraumatic stress disorder symptoms in systemic autoimmune rheumatic disease patients during the early COVID-19 pandemic. Int J Rheum Dis 2024; 27:e14974. [PMID: 37984371 DOI: 10.1111/1756-185x.14974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 10/24/2023] [Accepted: 10/31/2023] [Indexed: 11/22/2023]
Abstract
AIM Given reports of increased prevalence of PTSD symptoms at COVID-19 pandemic onset, we aimed to assess the prevalence of posttraumatic stress disorder (PTSD) symptoms at pandemic onset in individuals with and without systemic autoimmune rheumatic disease (SARD). METHODS In May 2020, we invited 6678 patients to complete the Brief Trauma Questionnaire and the Posttraumatic Stress Disorder Checklist (PCL-5), validated PTSD symptom screenings. We compared responses from patients with and without SARD using multivariable logistic regression. RESULTS We received 1473 responses (22% response rate) from 5/2020 to 9/2021 (63 with prior PTSD diagnoses, 138 with SARD history). The SARD population was more female (p .0001) and had a higher baseline prevalence of stress disorders (56% vs. 43%, p .004). SARD subjects reported more experiences with life-threatening illness, 60%, versus 53% among those without SARD (p .13), and more antidepressant or anxiolytic medication use pre-pandemic (78% vs. 59%, p .0001). Adjusting for pre-pandemic PTSD diagnosis, younger age and history of stress disorder were the most significant predictors of PCL-5 positivity. There were no significant differences in PCL-5 score or positivity among those with or without SARD. CONCLUSION In this population, patients with SARD had a higher pre-COVID-19 prevalence of stress-related conditions, but it was not the case that they had an increased risk of PTSD symptoms in the early pandemic. Younger individuals, those with baseline depression, anxiety, or adjustment disorders, and those taking antidepressant or anxiolytic medications were more likely to have PTSD symptoms in the first waves of the COVID-19 pandemic.
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Affiliation(s)
- Emily G Oakes
- Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Jack Ellrodt
- Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Jeong Yee
- Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Hongshu Guan
- Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Laura D Kubzansky
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Karestan C Koenen
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Karen H Costenbader
- Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
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11
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Pandey SP, Bhaskar R, Han SS, Narayanan KB. Autoimmune Responses and Therapeutic Interventions for Systemic Lupus Erythematosus: A Comprehensive Review. Endocr Metab Immune Disord Drug Targets 2024; 24:499-518. [PMID: 37718519 DOI: 10.2174/1871530323666230915112642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 06/05/2023] [Accepted: 07/22/2023] [Indexed: 09/19/2023]
Abstract
Systemic Lupus Erythematosus (SLE) or Lupus is a multifactorial autoimmune disease of multiorgan malfunctioning of extremely heterogeneous and unclear etiology that affects multiple organs and physiological systems. Some racial groups and women of childbearing age are more susceptible to SLE pathogenesis. Impressive progress has been made towards a better understanding of different immune components contributing to SLE pathogenesis. Recent investigations have uncovered the detailed mechanisms of inflammatory responses and organ damage. Various environmental factors, pathogens, and toxicants, including ultraviolet light, drugs, viral pathogens, gut microbiome metabolites, and sex hormones trigger the onset of SLE pathogenesis in genetically susceptible individuals and result in the disruption of immune homeostasis of cytokines, macrophages, T cells, and B cells. Diagnosis and clinical investigations of SLE remain challenging due to its clinical heterogeneity and hitherto only a few approved antimalarials, glucocorticoids, immunosuppressants, and some nonsteroidal anti-inflammatory drugs (NSAIDs) are available for treatment. However, the adverse effects of renal and neuropsychiatric lupus and late diagnosis make therapy challenging. Additionally, SLE is also linked to an increased risk of cardiovascular diseases due to inflammatory responses and the risk of infection from immunosuppressive treatment. Due to the diversity of symptoms and treatment-resistant diseases, SLE management remains a challenging issue. Nevertheless, the use of next-generation therapeutics with stem cell and gene therapy may bring better outcomes to SLE treatment in the future. This review highlights the autoimmune responses as well as potential therapeutic interventions for SLE particularly focusing on the recent therapeutic advancements and challenges.
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Affiliation(s)
- Surya Prakash Pandey
- Aarogya Institute of Healthcare and Research, Jaipur, Rajasthan, 302033, India
- Department of Zoology, School of Science, IFTM University, Moradabad, Uttar Pradesh, 244102, India
| | - Rakesh Bhaskar
- School of Chemical Engineering, Yeungnam University, Gyeongsan, 38541, South Korea
- Research Institute of Cell Culture, Yeungnam University, Gyeongsan, Gyeongbuk, 38541, South Korea
| | - Sung Soo Han
- School of Chemical Engineering, Yeungnam University, Gyeongsan, 38541, South Korea
- Research Institute of Cell Culture, Yeungnam University, Gyeongsan, Gyeongbuk, 38541, South Korea
| | - Kannan Badri Narayanan
- School of Chemical Engineering, Yeungnam University, Gyeongsan, 38541, South Korea
- Research Institute of Cell Culture, Yeungnam University, Gyeongsan, Gyeongbuk, 38541, South Korea
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He Y, Qu C, Tian J, Miszczyk J, Guan H, Huang R. Association of Perfluoroalkyl and polyfluoroalkyl substances (PFASs) exposures and the risk of systemic lupus erythematosus: a case-control study in China. Environ Health 2023; 22:78. [PMID: 37932789 PMCID: PMC10629165 DOI: 10.1186/s12940-023-01019-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 09/22/2023] [Indexed: 11/08/2023]
Abstract
Perfluoroalkyl and polyfluoroalkyl substances (PFASs) may have a role in impaired health. However, the data on the association between PFASs and Systemic lupus erythematosus (SLE) have been limited. We designed a population-based case-control study in China and evaluated the association. 100 normal persons (Control) and 100 SLE patients (Case) were obtained from 113 controls and 125 cases according to matching conditions. Serum samples were collected by venipuncture for UHPLC-MRM-MS Analysis to obtain the concentration of five PFASs in participants. Demographic characterization description was performed for the two groups of participants, the PFASs concentration distribution of the two groups was described and compared, then divided into three tiers (< 50th, 50th ~ 75th, > 75th) for subsequent analysis. Conditional logistic regression models were utilized to calculate the odds ratios (ORs) and 95% CIs for SLE. Relationship between changes in the concentration of PFASs and the risk of SLE assessed by restricted cubic spline. As the highest serum levels of the five PFASs tested in this study population, the highest perfluoroundecanoic acid (PFUnA) quartile had a 2.78-fold (95%CI: 1.270, 6.10) compared with the lowest quartile of PFUnA exposure, other types of PFASs also showed high association with SLE as well as PFASs mixture. Additionally, the exposure of PFASs exist a dose-response relationship (ptrend < 0.05). This risk association remained be found after adjusting the covariates in model 1 (adjustment of BMI) and in model 2(adjustment of BMI, smoking, drinking, hypertension and leukocyte). The restricted cubic spline illustrated a gradual increase in the possible risk of SLE with the increasing exposure of PFASs components levels. Our study firstly revealed that PFASs are risk factors for SLE and PFASs exposures are associated with SLE risk in a dose - response manner. Evidence from larger and more adequately powered cohort studies is needed to confirm our results.
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Affiliation(s)
- Yan He
- Department of Ophthalmology, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
- Hunan Clinical Research Center of Ophthalmic Disease, Changsha, 410011, Hunan, China
| | - Can Qu
- Department of Occupational and Environmental Health, Xiangya School of Public Health, Central South University, Changsha, 410078, Hunan Province, China
| | - Jing Tian
- Department of Rheumatology and Immunology, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Justyna Miszczyk
- Department of Experimental Physics of Complex Systems, The H. Niewodniczański Institute of Nuclear Physics Polish Academy of Sciences, Kraków, Poland
| | - Hua Guan
- Department of Radiation Biology, Beijing Key Laboratory for Radiobiology,, Beijing Institute of Radiation Medicine, Beijing, 100850, China.
| | - Ruixue Huang
- Department of Occupational and Environmental Health, Xiangya School of Public Health, Central South University, Changsha, 410078, Hunan Province, China.
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