HPE Autoimmune disease: The fundamentals | Page 9

Sex steroid hormones have multiple influences on immune system function . Exogenous hormone use ( including oral contraceptives and hormone replacement therapy ) is associated with an increased SLE risk among women . 9 Oestrogens and vitamin D may modulate immune responses in tandem , and exogenous oestrogens may have differential effects depending on vitamin D sufficiency , which requires further investigation . 9

Lifestyle behaviours , such as lack of exercise , stress and an unhealthy diet all contribute to an increased risk of developing autoimmune disease . 17 Obesity , smoking and stress are known to produce a state of chronic systemic low-grade inflammation . 17 A screening and prevention strategy that involves the identification of early disease biomarkers , modification of lifestyle and environmental risk factors and initiation of preventive therapies could impact on the incidence and
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burden of autoimmune diseases in high-risk individuals .
Vaccinations have been proposed as potential triggers for the onset of autoimmune diseases given their role in stimulating an antigen-specific immune response . 9 For genetically predisposed individuals , there are rare reports of autoimmune reactions and diseases that have been
Identification of early disease biomarkers , modification of lifestyle and environmental risk factors and initiation of preventive therapies could impact on the incidence and burden of autoimmune diseases precipitated by vaccines , likely via molecular mimicry . Less well understood is whether vaccination can exacerbate existing autoimmune disease . 1
Conclusions Autoimmune diseases have a major impact on individuals and their families , as well as on society and healthcare costs . While the precise mechanisms for development of autoimmunity are still to be elucidated , it is understood that multiple genetic and environmental risk factors interact in complex ways over a long time to induce disease evolution . A recent ‘ call to action ’ appeals for coordination of resources to improve understanding of autoimmune disease risk factors and pathogeneses and improve diagnostic , therapeutic , and preventive approaches , in order to decrease the future frequency , morbidity , mortality , and costs of these conditions . 24
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References 1 Wang L , Wang FS , Gershwin ME . Human autoimmune diseases : a comprehensive update . J Int Med 2015 ; 278:369 – 95 . 2 Jose J et al . Pathogenesis of Autoimmune Diseases : A Short Review . Oral Maxillofac Pathol J 2014 ; 5 ( 1 ): 434 – 6 . 3 Hayter SM , Cook MC . Updated assessment of the prevalence , spectrum and case definition of autoimmune disease . Autoimmun Rev 2012 ; 11 ( 10 ): 754 – 65 . 4 National Institute of Allergy and Infectious Diseases . 2022 . Autoimmune diseases . www . niaid . nih . gov / diseasesconditions / autoimmune-diseases ( accessed March 2023 ). 5 Akkoc N , Khan MA . Is axial spondyloarthritis more common than rheumatoid arthritis ? Curr Rheumatol Rep 2020 ; 22 ( 9 ): 54 . 6 Damiani G et al . The global , regional , and national burden of psoriasis : results and insights from the Global Burden of Disease 2019 study . Front Med 2021 ; 8:743180 .
7 Dinse GE et al . Increasing prevalence of antinuclear antibodies in the United States . Arthritis Rhematol 2022 ; 74 ( 12 ): 2032 – 41 . 8 Lerner A , Jeremias P , Matthias T . The world incidence and prevalence of autoimmune diseases is increasing . Intl J Celiac Dis 2015 ; 3 ( 4 ): 151 – 5 . 9 Woo JMP et al . The role of environmental exposures and gene – environment interactions in the etiology of systemic lupus erythematous . J Intern Med 2022 ; 291:755 – 78 . 10 Playfair JHL , Chain BM . Immunology at a glance . Tenth Edition . 2012 . Blackwell Science Ltd . Oxford , UK . 11 Caso F et al . From autoinflammation to autoimmunity : old and recent findings . Clin Rheumatol 2018 ; 37:2305 – 21 . 12 El-Shebiny EM et al . Bridging autoinflammatory and autoimmune diseases . Egyptian J Int Med 2021 ; 33:11 . 13 Funes SC et al . Trained immunity contribution to autoimmune and inflammatory disorders . Front Immunol 2022 ; 13:868343 . 14 McInnes IB , Gravallese EM . Immunemediated
inflammatory disease therapeutics : past , present and future . Nat Rev Immunol 2021 ; 21:680 – 6 . 15 Schett G , McInnes IB , Neurath MF . Reframing immune-mediated inflammatory disease through signature cytokine hubs . N Engl J Med 2021 ; 385:628 – 39 . 16 Rosenblum MD , Remedios KA , Abbas AK . Mechanisms of human autoimmunity . J Clin Invest 2015 ; 125 ( 6 ): 2228 – 33 . 17 Frazzei G et al . Preclinical autoimmune disease : a comparison of rheumatoid arthritis , systemic lupus erythematosus , multiple sclerosis and type 1 diabetes . Front Immunol 2022 ; 13:899372 . 18 Choi MY , Costenbader KH . Understanding the concept of pre-clinical autoimmunity : prediction and prevention of systemic lupus erythematosus : identifying risk factors and developing strategies against disease development . Front Immunol 2022 ; 13:890522 . 19 Gutierrez-Arcelus M , Rich SS , Raychaudhuri S . Autoimmune diseases
– connecting risk alleles with molecular traits of the immune system . Nat Rev Genet 2016 ; 17 ( 3 ): 160 – 74 . 20 Seldin MF . The genetics of human autoimmune disease : a perspective on progress in the field and future directions . J Autoimmun 2015 ; 64:1 – 12 . 21 Ding J , Frantzeskos A , Orozco G . Functional genomics in autoimmune diseases . Hum Mol Genet 2020 ; 29 ( R1 ): R60 – R66 . 22 Anaya JM . Common mechanisms of autoimmune diseases ( the autoimmune tautology ). Autoimmun Rev 2012 ; 11:781 – 84 . 23 Chen J et al . Life factors acting on systemic lupus erythematosus . Front Immunol 2022 ; 13:986239 . 24 Miller FW . The increasing prevalence of autoimmunity and autoimmune diseases : an urgent call to action for improved understanding , diagnosis , treatment , and prevention . Curr Opin Immunol 2023,80:102266 .
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