Evidence of a distinct group of Black African patients with systemic lupus erythematosus

Sibanda, Elopy; Chase-Topping, Margo; Pfavayi, Lorraine Tsitsi; Woolhouse, Mark E. J.; Mutapi, Francisca

doi:10.1136/bmjgh-2017-000697

Cited by 6 publications

(4 citation statements)

References 40 publications

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“…An ethnic prevalence trend from low to high frequency is also seen in systemic lupus erythematosus (SLE) [ 25 , 26 ]. SLE occurs much more frequently and with increased severity in persons of African and Asian ancestry born and living in western countries [ 27 ]. Clinical observations support the contention that the immune system of BAME persons may be historically primed to respond more strongly when exposed to novel offending antigens and the pathophysiology of an inherent immunologically based increased inflammatory response is supported by genetic studies [ 28 ].…”

Section: Short Commentarymentioning

confidence: 99%

There are similarities between rheumatic disease with lung involvement and COVID-19 pneumonia

Williamson

Black

et al. 2021

Ir J Med Sci

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Introduction There is considerable overlap between the clinical manifestations of covid-19 pneumonia and the acute interstitial lung disease seen in certain rheumatic disorders. In addition, pulmonary fibrosis is increasingly recognised as a potentially serious consequence of both. Methods This review explores this overlap of clinical features, risk factors and causation, offering insights into the immune mechanisms that contribute to both sets of disorders. Results The therapeutic role of immunosuppression and biologic agents in the treatment of covid-19 is explained in the light of this. Discussion We propose how lessons learned from the insights recently gained into each disorder can improve our insight into immunological mechanisms and application of therapeutic interventions in the other.

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Section: Short Commentarymentioning

confidence: 99%

There are similarities between rheumatic disease with lung involvement and COVID-19 pneumonia

Williamson

Black

et al. 2021

Ir J Med Sci

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“…Systemic lupus erythematosus is 3 times more common in African American women than in Caucasian women, and up to 1 in every 250 African American women will develop SLE. 78 , 79 Furthermore, its symptoms tend to be more severe in African Americans than in other races. 79 , 80 Lupus anticoagulants, anticardiolipin antibodies, and β-2-glycoprotein I antibodies are antiphospholipid antibodies that are common in patients with SLE (as well as certain other patients).…”

Section: Covid-19 Disease Trendsmentioning

confidence: 99%

“…78 , 79 Furthermore, its symptoms tend to be more severe in African Americans than in other races. 79 , 80 Lupus anticoagulants, anticardiolipin antibodies, and β-2-glycoprotein I antibodies are antiphospholipid antibodies that are common in patients with SLE (as well as certain other patients). It is common for women, especially African American women, to develop antiphospholipid antibodies during pregnancy, a major cause of miscarriage in African American women.…”

Section: Covid-19 Disease Trendsmentioning

confidence: 99%

Coagulation Status and Venous Thromboembolism Risk in African Americans: A Potential Risk Factor in COVID-19

Frydman

Boyer

Nazarian

et al. 2020

Clin Appl Thromb Hemost

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Severe acute respiratory syndrome coronavirus 2 infection (COVID-19) is known to induce severe inflammation and activation of the coagulation system, resulting in a prothrombotic state. Although inflammatory conditions and organ-specific diseases have been shown to be strong determinants of morbidity and mortality in patients with COVID-19, it is unclear whether preexisting differences in coagulation impact the severity of COVID-19. African Americans have higher rates of COVID-19 infection and disease-related morbidity and mortality. Moreover, African Americans are known to be at a higher risk for thrombotic events due to both biological and socioeconomic factors. In this review, we explore whether differences in baseline coagulation status and medical management of coagulation play an important role in COVID-19 disease severity and contribute to racial disparity trends within COVID-19.

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“…In addition, ethnicity might also influence the treatment response in lupus nephritis (LN) 2. Socioeconomics factors could in part explain these differences, as the interaction between ethnicity and poverty has been associated with disease activity,3 along with genetic polymorphisms 4–6…”

Section: Introductionmentioning

confidence: 99%

Impact of patient ancestry on heterogeneity of Sjögren’s disease

et al. 2023

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ObjectivesWe aimed to compare disease characteristics between primary Sjögren’s syndrome (pSS) patients of African ancestry (AA) and Caucasian ancestry.MethodsWe conducted a retrospective, case–control study in a French national and European referral centre for pSS. All patients with pSS of AA were matched with two Caucasians patients having similar follow-up duration. We explored clinical and biological parameters associated with a cumulative EULAR Sjögren’s Syndrome Disease Activity Index (cumESSDAI ≥5) (consisting of individual clinESSDAI domain maximum throughout follow-up).ResultsWe identified 74 patients of AA matched with 148 Caucasian. Median age at pSS diagnosis was younger in AA patients (43 years (IQR 33–51) vs 56 years (44.8–59.2), p<0.001). AA patients presented higher median titre of gammaglobulins (18.5 g/L (IQR 15–22.8) vs 13.4 g/L (9.9–16.9), p<0.001), more frequently positive for anti-SSA (88% vs 72%, p=0.007) and anti-RNP (11% vs 2.7%, p=0.023) antibodies. During the follow-up (median: 6 years (IQR 2–11)), AA patients presented more systemic complications: arthritis, myositis, interstitial lung disease, lymphadenopathy, central nervous system involvement. Median cumESSDAI score was higher in AA patients (7.5 (IQR 3.2–16.0) vs 4.0 (IQR 2.0–9.0), p=0.002). Interestingly, in multivariate analyses, factors associated with disease activity were sub-Saharan AA (OR 2.65 (95% CI 1.06 to 6.94)), rheumatoid factor (OR 2.50 (95% CI 1.28 to 4.96)) and anti-RNP positivity (OR 11.1 (95% CI 1.88 to 212)).ConclusionPatients of AA display higher disease activity with a hallmark of higher B-cell activation. Studies to investigate biological drivers behind such differences are needed.

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Evidence of a distinct group of Black African patients with systemic lupus erythematosus

Cited by 6 publications

References 40 publications

There are similarities between rheumatic disease with lung involvement and COVID-19 pneumonia

There are similarities between rheumatic disease with lung involvement and COVID-19 pneumonia

Coagulation Status and Venous Thromboembolism Risk in African Americans: A Potential Risk Factor in COVID-19

Impact of patient ancestry on heterogeneity of Sjögren’s disease

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