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The effect of ethnicity and genetic ancestry on the epidemiology, clinical features and outcome of systemic lupus erythematosus.
Rheumatology (Oxford) 2017; 56(suppl_1):i67-i77R

Abstract

In this in-depth review, we examine the worldwide epidemiology of SLE and summarize current knowledge on the influence of race/ethnicity on clinical manifestations, disease activity, damage accumulation and outcome in SLE. Susceptibility to SLE has a strong genetic component, and trans-ancestral genetic studies have revealed a substantial commonality of shared genetic risk variants across different genetic ancestries that predispose to the development of SLE. The highest increased risk of developing SLE is observed in black individuals (incidence 5- to 9-fold increased, prevalence 2- to 3-fold increased), with an increased risk also observed in South Asians, East Asians and other non-white groups, compared with white individuals. Black, East Asian, South Asian and Hispanic individuals with SLE tend to develop more severe disease with a greater number of manifestations and accumulate damage from lupus more rapidly. Increased genetic risk burden in these populations, associated with increased autoantibody reactivity in non-white individuals with SLE, may explain the more severe lupus phenotype. Even after taking into account socio-economic factors, race/ethnicity remains a key determinant of poor outcome, such as end-stage renal failure and mortality, in SLE. Community measures to expedite diagnosis through increased awareness in at-risk racial/ethnic populations and ethnically personalized treatment algorithms may help in future to improve long-term outcomes in SLE.

Authors+Show Affiliations

Centre for Experimental Medicine and Rheumatology, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.Centre for Experimental Medicine and Rheumatology, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.

Pub Type(s)

Journal Article
Review
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

27940583

Citation

Lewis, Myles J., and Ali S. Jawad. "The Effect of Ethnicity and Genetic Ancestry On the Epidemiology, Clinical Features and Outcome of Systemic Lupus Erythematosus." Rheumatology (Oxford, England), vol. 56, no. suppl_1, 2017, pp. i67-i77.
Lewis MJ, Jawad AS. The effect of ethnicity and genetic ancestry on the epidemiology, clinical features and outcome of systemic lupus erythematosus. Rheumatology (Oxford). 2017;56(suppl_1):i67-i77.
Lewis, M. J., & Jawad, A. S. (2017). The effect of ethnicity and genetic ancestry on the epidemiology, clinical features and outcome of systemic lupus erythematosus. Rheumatology (Oxford, England), 56(suppl_1), pp. i67-i77. doi:10.1093/rheumatology/kew399.
Lewis MJ, Jawad AS. The Effect of Ethnicity and Genetic Ancestry On the Epidemiology, Clinical Features and Outcome of Systemic Lupus Erythematosus. Rheumatology (Oxford). 2017 04 1;56(suppl_1):i67-i77. PubMed PMID: 27940583.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The effect of ethnicity and genetic ancestry on the epidemiology, clinical features and outcome of systemic lupus erythematosus. AU - Lewis,Myles J, AU - Jawad,Ali S, PY - 2016/07/25/received PY - 2016/12/13/pubmed PY - 2017/6/21/medline PY - 2016/12/13/entrez KW - ancestry KW - autoantibodies KW - epidemiology KW - ethnic groups KW - ethnicity KW - genetics KW - incidence KW - lupus nephritis KW - prevalence KW - systemic lupus erythematosus SP - i67 EP - i77 JF - Rheumatology (Oxford, England) JO - Rheumatology (Oxford) VL - 56 IS - suppl_1 N2 - In this in-depth review, we examine the worldwide epidemiology of SLE and summarize current knowledge on the influence of race/ethnicity on clinical manifestations, disease activity, damage accumulation and outcome in SLE. Susceptibility to SLE has a strong genetic component, and trans-ancestral genetic studies have revealed a substantial commonality of shared genetic risk variants across different genetic ancestries that predispose to the development of SLE. The highest increased risk of developing SLE is observed in black individuals (incidence 5- to 9-fold increased, prevalence 2- to 3-fold increased), with an increased risk also observed in South Asians, East Asians and other non-white groups, compared with white individuals. Black, East Asian, South Asian and Hispanic individuals with SLE tend to develop more severe disease with a greater number of manifestations and accumulate damage from lupus more rapidly. Increased genetic risk burden in these populations, associated with increased autoantibody reactivity in non-white individuals with SLE, may explain the more severe lupus phenotype. Even after taking into account socio-economic factors, race/ethnicity remains a key determinant of poor outcome, such as end-stage renal failure and mortality, in SLE. Community measures to expedite diagnosis through increased awareness in at-risk racial/ethnic populations and ethnically personalized treatment algorithms may help in future to improve long-term outcomes in SLE. SN - 1462-0332 UR - https://www.unboundmedicine.com/medline/citation/27940583/The_effect_of_ethnicity_and_genetic_ancestry_on_the_epidemiology_clinical_features_and_outcome_of_systemic_lupus_erythematosus_ L2 - https://academic.oup.com/rheumatology/article-lookup/doi/10.1093/rheumatology/kew399 DB - PRIME DP - Unbound Medicine ER -