The Geography of Autoimmunity, Part 2

08/17/23 • 38 min

This episode delves into what we can learn about the impact of the environment on autoimmunity, digging into how rates of autoimmunity can vary drastically in different parts of the world.

· Intro 0:12

· In this episode 0:16

· Dr. Brian Greenwood 0:22

· The geography of autoimmunity 7:01

· Type 1 diabetes 10:31

· Finland and type 1 diabetes 13:57

· Socioeconomics 17:59

· Genetics and autoimmune diseases 24:19

· Migration studies 24:53

· Denmark and multiple sclerosis 30:06

· Coming up in part 3 36:02

· Thanks for listening 38:16

Disclosures: Brown reports no relevant financial disclosures.

We’d love to hear from you! Send your comments/questions to Dr. Brown at [email protected]. Follow us on Twitter @HRheuminations @AdamJBrownMD @HealioRheum.

References:

Bach JF. N Engl J Med. 2002;doi:10.1056/NEJMra020100.

Bodansky HJ, et al. BMJ. 1992;doi:10.1136/bmj.304.6833.1020.

Dean G, et al. J Neurol Neurosurg Psychiatry. 1997;doi:10.1136/jnnp.63.5.565.

Hammond SR, et al. Brain. 2000;doi:10.1093/brain/123.5.968.

Hawkes CH, et al. Mult Scler Relat Disord. 2019;doi:10.1016/j.msard.2019.08.001.

Karvonen M, et al. Diabetes Care. 1999;doi:10.2337/diacare.22.7.1066.

Kondrashova A, et al. Diabetes Care. 2007;doi:10.2337/dc06-0711.

Marciulionyte D, et al. Diabetologia. 2001;doi:10.1007/s001250051574.

Nielsen NM, et al. Brain. 2019;doi:10.1093/brain/awz088.

Patterson CC, et al. Diabetologia. 2012;doi:10.1007/s00125-012-2571-8.

Sandy JL, et al. Pediatr Diabetes. 2021;doi:10.1111/pedi.13191.

This episode delves into what we can learn about the impact of the environment on autoimmunity, digging into how rates of autoimmunity can vary drastically in different parts of the world.

· Intro 0:12

· In this episode 0:16

· Dr. Brian Greenwood 0:22

· The geography of autoimmunity 7:01

· Type 1 diabetes 10:31

· Finland and type 1 diabetes 13:57

· Socioeconomics 17:59

· Genetics and autoimmune diseases 24:19

· Migration studies 24:53

· Denmark and multiple sclerosis 30:06

· Coming up in part 3 36:02

· Thanks for listening 38:16

Disclosures: Brown reports no relevant financial disclosures.

We’d love to hear from you! Send your comments/questions to Dr. Brown at [email protected]. Follow us on Twitter @HRheuminations @AdamJBrownMD @HealioRheum.

References:

Bach JF. N Engl J Med. 2002;doi:10.1056/NEJMra020100.

Bodansky HJ, et al. BMJ. 1992;doi:10.1136/bmj.304.6833.1020.

Dean G, et al. J Neurol Neurosurg Psychiatry. 1997;doi:10.1136/jnnp.63.5.565.

Hammond SR, et al. Brain. 2000;doi:10.1093/brain/123.5.968.

Hawkes CH, et al. Mult Scler Relat Disord. 2019;doi:10.1016/j.msard.2019.08.001.

Karvonen M, et al. Diabetes Care. 1999;doi:10.2337/diacare.22.7.1066.

Kondrashova A, et al. Diabetes Care. 2007;doi:10.2337/dc06-0711.

Marciulionyte D, et al. Diabetologia. 2001;doi:10.1007/s001250051574.

Nielsen NM, et al. Brain. 2019;doi:10.1093/brain/awz088.

Patterson CC, et al. Diabetologia. 2012;doi:10.1007/s00125-012-2571-8.

Sandy JL, et al. Pediatr Diabetes. 2021;doi:10.1111/pedi.13191.

Previous Episode

The Environment and Autoimmunity, Part 1

This episode delves into the history of the hygiene hypothesis. What do we know about different exposures changing risk for asthma and allergies, and do these exposures have the same protection for autoimmunity?

· Intro 0:12

· In this episode 0:18

· Hygiene hypothesis 0:33

· Allergic rhinitis (or Hay fever) 2:32

· Pollen and the allergy skin test 8:58

· Exposure and cleanliness 10:22

· Allergic rhinitis and Cree Native Americans 11:51

· Appendicitis 13:10

· Family size and asthma 14:36

· Rural versus urban populations 17:41

· Dust 18:31

· Children, day care and infections 22:43

· The “old friends” theory 28:29

· Farming and allergies 30:07

· The Amish and the Hutterites 33:02

· Mice, dust and asthma 34:47

· Thanks for listening 37:40

Disclosures: Brown reports no relevant financial disclosures.

We’d love to hear from you! Send your comments/questions to Dr. Brown at [email protected]. Follow us on Twitter @HRheuminations @AdamJBrownMD @HealioRheum.

References:

Emanuel MB. Clin Exp Allergy. 1988;doi:10.1111/j.1365-2222.1988.tb02872.x.

Flohr C, et al. Clin Exp Allergy. 2010;doi:10.1111/j.1365-2222.2009.03346.x.

Genuneit J. Pediatr Allergy Immunol. 2012;doi:10.1111/j.1399-3038.2012.01312.x.

Karvonen AM, et al. J Allergy Clin Immunol. 2019;doi:10.1016/j.jaci.2019.07.035.

Perkin MR, et al. Front Allergy. 2022;doi:10.3389/falgy.2022.1051368.

Rantala AK, et al. Epidemiol. 2020;doi:10.1097/EDE.000000000001163.

Sangrador CO, et al. Allergol Immunopathol (Madr). 2018;doi:10.1016/j.aller.2018.03.006.

Stein MM, et al. N Engl J Med. 2016;doi:10.1056/NEJMoa1508749.

Strachan DP. BMJ. 1989;doi:10.1136/bmj.299.6710.1259.

Weber J, et al. Am J Respir Crit Care Med. 2015;doi:10.1164/rccm.201410-1899OC.

Next Episode

Autoimmunity, Part 3: The Lupus Gradient

In this episode, we dig through the data of lupus in Africa and speak with experts on the Lupus Gradient, the impact of malaria and what we can learn from it all.

· Intro 0:12

· In the previous episode 0:30

· Lupus Gradient 2:01

· Back to Dr. Brian Greenwood 3:48

· Polyarthritis 4:04

· Rates of autoimmune diseases 6:00

· Malaria and mouse models 7:33

· Back to lupus 8:48

· First case of lupus 15:14

· Prevalence of lupus 17:15

· Papers on lupus 21:23

· Dr. Mickael Essouma 23:38

· Dr. Essouma, how did you conduct this study? 24:01

· Did you ever believe there was a gradient? 26:09

· Dr. Sandro Vento 30:56

· Dr. Vento, do you believe there was a lupus gradient? 31:51

· What are the connections to infectious disease? 38:51

· That’s a wrap! 43:04

· Coming up in part 4 44:55

· Thanks for listening 45:05

Disclosures: Brown reports no relevant financial disclosures. Healio could not confirm relevant financial disclosures for Essouma and Vento at the time of posting.

Mickael Essouma, MD, is physician from Cameroon specialized in internal medicine at the University of Yaounde I in Cameroon, with a complimentary certificate on rheumatology from the EULAR online course and a certificate on lupus from the European Lupus Society (SLEuro). He is an advocate of lupus and other autoimmune diseases in Africans.

Sandro Vento, MD, is the dean of faculty of medicine at the University of Puthisastra, Phnom Penh, Cambodia and a consultant and collaborating specialist at Mayo Clinic Center for Tuberculosis, WHO Collaborating Center.

We’d love to hear from you! Send your comments/questions to Dr. Brown at [email protected]. Follow us on Twitter @HRheuminations @AdamJBrownMD @HealioRheum.

References:

Bae SC, et al. Arthritis Rheum. 1998;doi:10.1002/1529-0131(199812)41:123.0.CO;2-D.

Bryc K, et al. Am J Hum Genet. 2015;doi:10.1016/j.ajhg.2014.11.010.

Essouma M, et al. J Autoimmun. 2020;doi:10.1016/j.jaut.2019.102348.

Gilkeson GS, et al. Lupus. 2011;doi:10.1177/0961203311404915.

Micheletti SJ, et al. Am J Hum Genet. 2020;doi:10.1016/j.ajhg.2020.06.012.

Symmons DP. Lupus. 1995;doi:10.1177/096120339500400303.

Vento S, et al. Front Med. 2020;doi:10.3389/fmed.2020.00202.