Autoimmune Disease More Common Than Previously Thought

May 28, 2020

Researchers are reporting in the June issue of Arthritis and Rheumatology that antinuclear antibodies (ANA), the most common biomarker of autoimmune disease, is more common than what we may have realized.

Researchers are reporting in the June issue of Arthritis and Rheumatology that antinuclear antibodies (ANA), the most common biomarker of autoimmune disease, is more common than what we may have realized.

Led by Frederick W. Miller, M.D., Ph.D., of the National Institute of Environmental Health Sciences, researchers said there was growing evidence to suggest  increasing frequencies of autoimmunity and autoimmune diseases which affects one in 20 individuals, but to date there is no systematic data to definitely show more cases of autoimmunity and autoimmune diseases.

“They are thought to impact 3–5% of the population, with increasing rates observed several decades ago. Recent studies suggest continued increases in the rates of certain autoimmune diseases, but it is unclear whether these trends are due to changes in recognition and diagnosis, or if they are true temporal changes in incidence,” the authors wrote.

The findings are based on a systematic review of data from 14,211 participants 12 years old and older who were enrolled in the National Health and Nutrition Examination Survey (NHANES) between 1988 to 2012.

“Our novel and robust findings suggest that ANA prevalence increased substantially in the U.S. over the 25‐year time frame examined, increasing from 11.0% in 1988–1991 to 11.5% in 1999–2004 to 15.9% in 2011–2012, which corresponds to ~22 million, ~27 million, and ~41 million affected persons, respectively,”  the authors wrote.

Adolescents between the ages of 12 and 19 years old were most commonly affected with odds ratios of 2.02 from 1999–2004 and 2.88 from 2011–2012. Men were more often found to test positive as compared to women, adults over 50 years old and non-Hispanic whites. And, even though autoimmune diseases are sometimes associated with obesity, smoking and alcohol consumption, these traits did not seem to be strongly associated with the presence of ANA.

“Increasing evidence suggests that autoantibodies precede the onset of symptomatic autoimmune disease by several years; thus, ANA may be an intermediate marker on the pathway toward disease or may signal increased susceptibility to autoimmune diseases through related causal pathways,” the authors wrote.

More research on underlying factors that may be associated with the increasing presence of ANA is warranted, they wrote.

Writing in an editorial published with the study, Richard J. Bucala, M.D., Ph.D., of Yale School of Medicine, suggested that environmental factors may be at play here.

"Since genetic susceptibility has not changed in 25 years, the only meaningful conclusion, as proposed by Dinse et al, is the changing nature of human environmental exposure," he wrote. "New challenges in rheumatology are forecast. Beyond the investigative requirement to understand the origins of autoantibodies in different rheumatic diseases and in the steps that lead to disease progression, our rheumatology workforce will be further constrained by the projected increase in the prevalence of autoimmune diseases."

 

REFERENCE:   Gregg E. Dinse  Christine G. Parks  Clarice R. Weinberg , et a;l. “Increasing Prevalence of Antinuclear Antibodies in the United States,”Arthritis and Rheumatology. April 7, 2020. https://doi.org/10.1002/art.41214

 

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