Abstract
The accumulative global burden of autoimmune and inflammatory rheumatic diseases is substantial. Studying the distribution of these conditions across various global regions and ethnic groups by means of geoepidemiology might readily provide epidemiological data and also advance our understanding of their genetic and environmental underpinnings. In order to depict the geoepidemiology of autoimmune and inflammatory rheumatic diseases, namely rheumatoid arthritis, juvenile rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis, ankylosing spondylitis and Sjögren's syndrome, we present a comprehensive collection of epidemiological reports from various world regions, including the prevalence of each of these conditions. The accumulated data show that the reviewed rheumatic diseases are global phenomena, and, with some variance, seem to be relatively evenly distributed. This finding is in contrast with the obviously uneven distribution of some major nonrheumatic autoimmune conditions. In addition, geoepidemiology demonstrates that ethnogenetic susceptibility interacts with lifestyle and environmental factors, which include socioeconomic status, infectious agents (triggering or protective agents), environmental pollutants, and vitamin D (dependent on sunlight exposure), in determining the risk of developing rheumatic autoimmunity.
Key Points
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Geoepidemiology provides a comprehensible picture of the burden of autoimmune and inflammatory rheumatic diseases across various regions and ethnicities, and helps to unravel potential causative factors
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The global distribution of rheumatic autoimmune diseases, with some variance, seems to be ubiquitous, although prominent gradients are present in the distribution of some major nonrheumatic autoimmune conditions
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Our knowledge of the genetics of rheumatic autoimmunity is supported and advanced by geoepidemiology
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The risk of developing these illnesses is also affected by environmental factors, such as socioeconomic status and exposure to infectious agents (protective or pathogenic), ultraviolet radiation and pollution
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Shapira, Y., Agmon-Levin, N. & Shoenfeld, Y. Geoepidemiology of autoimmune rheumatic diseases. Nat Rev Rheumatol 6, 468–476 (2010). https://doi.org/10.1038/nrrheum.2010.86
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