RECENT findings have underscored the role of traumatic stress as a potent trigger for autoimmune rheumatic diseases (ARDs), emphasizing a feedback loop that perpetuates these conditions. A scoping review brings fresh insight into the association between psychological trauma and ARDs, especially rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). Researchers have pointed out that traumatic experiences, ranging from adverse childhood events (ACEs) to Post-Traumatic Stress Disorder (PTSD) and major life stressors, are closely linked to increased ARD risk, progression, and symptom severity.
The research, led by Mihaela B. Taylor from UCLA, Los Angeles, California, reviewed 21 studies from 2000 to 2023, drawing from over 4,000 records. These studies primarily involved patients in high-income countries, with a substantial portion of the research conducted in the United States. The findings revealed that traumatic stress contributes not only to the initial development of ARDs but also exacerbates disease activity. For example, PTSD was associated with a doubled risk of SLE diagnosis, and individuals with RA often reported higher rates of depression and emotional abuse.
The research team highlight the potential neuroendocrine mechanisms that link trauma to immune dysregulation. Stress-induced hormonal changes appear to provoke immune responses that may worsen inflammation, triggering or intensifying autoimmune disease symptoms. Additionally, the team emphasizes that ARDs’ chronic nature can itself induce stress, further intensifying disease severity, a feedback loop that complicates treatment.
The review underscores the need for more comprehensive, longitudinal studies to explore the distinct impacts of chronic, low-level stress versus traumatic stress on autoimmune diseases. Effective interventions, such as stress management, cognitive behavioral therapy, and social support, may play crucial roles in mitigating these impacts. Researchers call for a greater emphasis on prospective studies that can examine the physiological pathways trauma affects within immune responses, potentially paving the way for more targeted ARD treatment strategies.
Reference: Ploesser M et al. The link between traumatic stress and autoimmune rheumatic diseases: A systematic scoping review. Semin Arthritis Rheum. 2024;69(152558).
Anaya Malik | AMJ
