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Systemic lupus erythematosus

Stress and the onset of SLE

New evidence strengthens the hypothesis that exposure to trauma and the associated physiological responses contribute to the development of autoimmune diseases, including systemic lupus erythematosus.

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  1. Roberts, A. L. et al. Association of trauma and posttraumatic stress disorder with incident systemic lupus erythematosus in a longitudinal cohort of women. Arthritis Rheumatol. 69, 2162–2169 (2017).

    CAS  Article  Google Scholar 

  2. O'Donovan, A. et al. Elevated risk for autoimmune disorders in Iraq and Afghanistan veterans with posttraumatic stress disorder. Biol. Psychiatry 77, 365–374 (2015).

    Article  Google Scholar 

  3. Selye, H. A syndrome produced by diverse nocuous agents. Nature 138, 32 (1936).

    Article  Google Scholar 

  4. Cain, D. W. & Cidlowski, J. A. Immune regulation by glucocorticoids. Nat. Rev. Immunol. 17, 233–247 (2017).

    CAS  Article  Google Scholar 

  5. Sternberg, E. M., Chrousos, G. P., Wilder, R. L. & Gold, P. W. The stress response and the regulation of inflammatory disease. Ann. Intern. Med. 117, 854–866 (1992).

    CAS  Article  Google Scholar 

  6. Crofford, L. J. The hypothalamic–pituitary–adrenal axis in the pathogenesis of rheumatic diseases. Endocrinol. Metab. Clin. North Am. 31, 1–13 (2002).

    CAS  Article  Google Scholar 

  7. Gutierrez, M. A., Garcia, M. E., Rodriguez, J. A., Rivero, S. & Jacobelli, S. Hypothalamic–pituitary–adrenal axis function and prolactin secretion in systemic lupus erythematosus. Lupus 7, 404–408 (1998).

    CAS  Article  Google Scholar 

  8. Golier, J. A., Schmeidler, J., Legge, J. & Yehuda, R. Twenty-four hour plasma cortisol and adreno-corticotropic hormone in Gulf War veterans: relationships to posttraumatic stress disorder and health symptoms. Biol. Psychiatry 62, 1175–1178 (2007).

    CAS  Article  Google Scholar 

  9. Pascual, V., Farkas, L. & Banchereau, J. Systemic lupus erythematosus: all roads lead to type I interferons. Curr. Opin. Immunol. 18, 676–682 (2006).

    CAS  Article  Google Scholar 

  10. Guiducci, C. et al. TLR recognition of self nucleic acids hampers glucocorticoid activity in lupus. Nature 465, 937–941 (2010).

    CAS  Article  Google Scholar 

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Correspondence to Eric F. Morand.

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Morand, E. Stress and the onset of SLE. Nat Rev Rheumatol 14, 127–128 (2018).

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