An epidemiologic study of the autoimmune diseases taken together has not been done heretofore. The National Patient Register of Denmark is used to estimate population prevalence of 31 possible or probable autoimmune diseases. Record linkage is used to estimate 465 pairwise comorbidities in individuals among the 31 diseases, and familial aggregation among sibs, parents and offspring. The prevalence of any of the 31 diseases in the population is more than 5%. Within individuals, there is extensive comorbidity across the 31 diseases. Within families, aggregation is strongest for individual diseases, and weak across diseases. These data confirm the importance of the autoimmune diseases as a group, and suggest that common etiopathologies exist among them.

Associations regarding family history of type 1 diabetes and infantile autism and maternal history of rheumatoid arthritis and ASDs were confirmed from previous studies. A significant association between maternal history of celiac disease and ASDs was observed for the first time. The observed associations between familial autoimmunity and ASDs/infantile autism are probably attributable to a combination of a common genetic background and a possible prenatal antibody exposure or alteration in fetal environment during pregnancy.

Findings suggest there is an association between birth weight and adult mental disorder, but there is no indication this effect is specific to birth weight less than 2500 g or to schizophrenia. Future research should explore common disorder-specific mechanisms that may link birth weight to development of psychiatric disorder in adulthood.

Objective-Clinic-based studies of immune function, as well as comorbidity of autoimmune diseases, bipolar disorder, and schizophrenia, suggest a possible autoimmune etiology. Studies of non-affective psychosis and schizophrenia suggest common etiologies. The objective was to determine the degree to which 30 different autoimmune diseases are antecedent risk factors for bipolar disorder, schizophrenia, and non-affective psychosis.Methods-A cohort of 3.57 million births in Denmark was linked to the Psychiatric Case Register and the National Hospital Register. There were 20,317 cases of schizophrenia, 39,076 cases of non-affective psychosis, and 9,920 cases of bipolar disorder.Results-As in prior studies, there were a range of autoimmune diseases which predicted raised risk of schizophrenia in individuals who had a history of autoimmune diseases, and also raised risk in persons whose first-degree relatives had an onset of autoimmune disease prior to onset of schizophrenia in the case. These relationships also existed for the broader category of nonaffective psychosis. Only pernicious anemia in the family was associated with raised risk for bipolar disorder (relative risk: 1.7), suggesting a small role for genetic linkage. A history of Guillain-Barré syndrome, Crohn's disease, and autoimmune hepatitis in the individual was associated with raised risk of bipolar disorder.Conclusions-The familial relationship of schizophrenia to a range of autoimmune diseases extends to non-affective psychosis, but not to bipolar disorder. The data suggest that autoimmune processes precede onset of schizophrenia, but also non-affective psychosis and bipolar disorder.Keywords autoimmune disease; bipolar disorder; epidemiology; non-affective psychosis; register; schizophrenia This paper extends earlier work on autoimmune diseases and schizophrenia (1) to bipolar disorder and disorders with features similar to schizophrenia, sometimes termed nonaffective psychosis. This new analysis, with more than twice as many observations, allows comparison of bipolar disorder to schizophrenia, as well as facilitating more precise study of the temporal relationship of autoimmune disease and the first diagnosis of bipolar disorder, schizophrenia, and non-affective psychosis. The presentation of these disorders in parallel fashion facilitates assessment of the value of the nosologic distinctions between them.The autoimmune diseases which have been studied most thoroughly in their relationship to bipolar disorder are the autoimmune thyroid diseases and multiple sclerosis (MS). The relationship between affective psychosis and thyroid disorder was noticed as early as 1888 (2). The metabolic slowing related to thyroid hormone deficiency could possibly be related to symptoms of depression (e.g., 3), but there is also a consistent association with psychosis, including a particular association, not always confirmed, with rapid-cycling bipolar disorder (4-6). The serotonin and thyroid systems are connected (7), and there are putative but unproven associa...

In cellulose-to-ethanol processes a physico-chemical pretreatment of the lignocellulosic feedstock is a crucial prerequisite for increasing the amenability of the cellulose to enzymatic attack. Currently published pretreatment strategies span over a wide range of reaction conditions involving different pH values, temperatures, types of catalysts and holding times. The consequences of the pretreatment on lignocellulosic biomass are described with special emphasis on the chemical alterations of the biomass during pretreatment, especially highlighting the significance of the pretreatment pH. We present a new illustration of the pretreatment effects encompassing the differential responses to the pH and temperature. A detailed evaluation of the use of severity factor calculations for pretreatment comparisons signifies that the multiple effects of different pretreatment factors on the subsequent monosaccharide yields after enzymatic hydrolysis cannot be reliably compared by a one-dimensional severity factor, even within the same type of pretreatment strategy. However, a quantitative comparison of published data for wheat straw pretreatment illustrates that there is some correlation between the hydrolysis yields (glucose and xylose) and the pretreatment pH, but no correlation with the pretreatment temperature (90-200°C). A better recognition and understanding of the factors affecting biomatrix opening, and use of more standardized evaluation protocols, will allow for the identification of new pretreatment strategies that improve biomass utilization and permit rational enzymatic hydrolysis of the cellulose.