Traumatic stress creates ‘feedback loop that perpetuates’ autoimmune rheumatic diseases
Click Here to Manage Email Alerts
Key takeaways:
- Diverse types of traumatic experiences showed significant links to the development and severity of autoimmune rheumatic diseases.
- Overall research is lacking, particularly on less common diseases.
Despite a lack of research in the area, there is significant evidence that traumatic stress contributes to the onset and worsening of autoimmune rheumatic diseases, according to a review published in Seminars in Arthritis and Rheumatism.
“The pathogenic role of stress in autoimmune diseases is presumed to involve neuroendocrine hormones triggered during stress episodes, leading to immune dysregulation and altered cytokine production, contributing to the development of autoimmune conditions,” Mihaela B. Taylor, MD, professor of clinical medicine at the UCLA David Geffen School of Medicine, told Healio. “We decided to take a step further into raising the awareness of the link between traumatic stress and rheumatic autoimmune disorders.”
To assess the current literature and state of research regarding the link between traumatic stress and autoimmune rheumatic diseases, Taylor and colleagues conducted a scoping review, noting a lack of “comprehensive” systematic reviews on the topic. Their review included 15 full-text studies and six conference abstracts published from 2000 to 2023, which were identified through Embase, Medline, Web of Science and associated bibliographies.
The studies were organized and analyzed based on which diseases they evaluated. Seven studies focused solely on rheumatoid arthritis, nine analyzed systemic lupus erythematosus, and five evaluated “various” autoimmune rheumatic diseases, including RA and SLE. Meanwhile, types of traumas examined in the studies included adverse childhood experiences, major life events, psychological trauma and childhood physical and sexual abuse.
According to the researchers, patients with RA generally report more emotional abuse and depression. PTSD and major life events were associated with both RA onset and exacerbation.
The review additionally demonstrated significant links between adverse childhood experiences and SLE, both childhood- and adult-onset. Exposure to trauma came with increased disease activity and severity, and one study showed that PTSD doubled the risk for subsequent SLE diagnosis.
“I hope that the data we published will help bring awareness to the medical profession regarding the role of traumatic stress as a risk factor for triggering and flares of autoimmune rheumatic diseases,” Taylor said.
“Not only does traumatic stress contribute to the onset and exacerbation of autoimmune rheumatic diseases, but the chronic and debilitating nature of these diseases can also lead to increased psychological stress, creating a feedback loop that perpetuates these conditions,” she added. “Effective coping mechanisms, including stress management techniques, cognitive behavioral therapy and social support networks, play a crucial role in mitigating the impact of stress on autoimmune rheumatic diseases.”
The review additionally revealed an “overall scarcity” of studies exploring traumatic stress and autoimmune rheumatic diseases, Taylor said, noting “only 21 selected studies from an initial pool of 4,162 records evaluated.”
“We want to highlight the need for prospective studies to further investigate causality,” she added. “However, direct comparisons between the physiological effects of chronic low-level stress and traumatic stress on autoimmune rheumatic diseases are non-existent. Future research should aim to explore these differences, particularly in how varying stress levels might influence immune system dysregulation and disease outcomes.”
Collapse
Click Here to Manage Email Alerts