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Trauma exposure, PTSD in women may lead to autoimmune disease

10 Oct 2017

Women with trauma exposure or post-traumatic stress disorder (PTSD) have a more than twofold risk of developing systemic lupus erythematosus (SLE), a study suggests.

The longitudinal study included 54,763 women who completed the Short Screening Scale for DSM-IV PTSD and the Brief Trauma Questionnaire. These women were categorized as follows: no trauma, trauma and no PTSD symptoms, subclinical PTSD (one to three symptoms), or probable PTSD (four to seven symptoms).

Incident SLE with ≥4 American College of Rheumatology criteria was self-reported, with subsequent confirmation by medical record review. Longitudinally assessed health risk factors (eg, smoking, body mass index [BMI], oral contraceptive use) were also examined whether they accounted for increased SLE risk among women with vs without trauma exposure and PTSD.

During 24 years of follow-up, 73 women developed SLE. Compared with no trauma, probable PTSD increased SLE risk by nearly threefold (hazard ratio [HR], 2.94; 95 percent CI, 1.19 to 7.26; p<0.05). Subclinical PTSD also increased SLE risk, although this association was not statistically significant (HR, 1.83; 0.74 to 4.56; p=0.19).

Smoking, BMI and oral contraceptive use slightly attenuated the observed associations (eg, probable PTSD: adjusted HR, 2.62; 1.09 to 6.48; p<0.05).

Regardless of PTSD symptoms, trauma exposure showed a strong association with incident SLE (HR, 2.87; 1.31 to 6.28; p<0.01).

The present data add to growing evidence that psychosocial trauma and associated stress responses lead to autoimmune disease, researchers said.

“Identification of the biological pathways by which psychosocial trauma may increase risk for autoimmune disease is crucial and may provide greater insight into disease aetiology, as well as strategies for prevention. In addition, identification of mechanisms by which trauma and PTSD are associated with increased risk of SLE may indicate mechanisms for the association of PTSD and trauma exposure with other chronic diseases,” they added.

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Most Read Articles
Pearl Toh, 10 May 2017
Celecoxib is preferred over naproxen when added to proton-pump inhibitor (PPI) for preventing recurrent upper gastrointestinal (GI) bleeding in patients at high risk of both GI and cardiovascular (CV) events, who require concomitant aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs), according to the CONCERN* study.
Audrey Abella, 10 Oct 2017
The SYSADOA* chondroitin sulfate was as effective as the NSAID** celecoxib and superior to placebo in reducing pain and improving function for over 6 months in patients with symptomatic knee osteoarthritis (OA), according to the CONCEPT*** trial.
11 Feb 2017
Nonsteroidal anti-inflammatory drugs (NSAIDs) provide potential therapeutic benefits for spinal pain, although the effect does not significantly differ from that provided by placebo, according to a meta-analysis.
06 Jan 2018
Celecoxib at approved dosages show similar or better cardiovascular, gastrointestinal, and renal safety profiles compared with ibuprofen and naproxen in the management of osteoarthritis and rheumatoid arthritis, a recent study has reported.