Associations Between Non-neurological Autoimmune Disorders and Psychosis: A Meta-analysis
People with autoimmune disorders, a collection of diseases where the body’s immune system attacks its own cells, are more likely to have psychosis, according to a new study, the King’s College London reports.
A relationship between non-neurological autoimmune (NNAI) disorders and psychosis has been widely reported but not yet subjected to meta-analysis. We conducted the first meta-analysis examining the association between NNAI disorders and psychosis and investigated the effect of 1) temporality (as determined by study design), 2) psychiatric diagnosis, and 3) specific autoimmune disorders.
Major databases were searched for articles published until April 2018; 31 studies, comprising data for >25 million individuals, were eligible. Using random-effects models, we examined the overall association between all NNAI disorders and psychosis; rheumatoid arthritis was examined separately given the well-established negative association with psychosis. Stratified analyses investigated the effect of temporality, psychiatric diagnosis, and specific NNAI disorders.
We observed a positive overall association between NNAI disorders and psychosis (odds ratio [OR] = 1.26; 95% confidence interval [CI], 1.12–1.41) that was consistent across study designs and psychiatric diagnoses; however, considerable heterogeneity was detected (I2 = 88.08). Patterns varied across individual NNAI disorders; associations were positive for pernicious anemia (OR = 1.91; 95% CI, 1.29–2.84), pemphigoid (OR = 1.90; 95% CI, 1.62–2.24), psoriasis (OR = 1.70; 95% CI, 1.51–1.91), celiac disease (OR = 1.53; 95% CI, 1.12–2.10), and Graves’ disease (OR = 1.33; 95% CI, 1.03–1.72) and negative for ankylosing spondylitis (OR = 0.72; 95% CI, 0.54–0.98) and rheumatoid arthritis (OR = 0.65; 95% CI, 0.50–0.84).
While we observed a positive overall association between NNAI disorders and psychosis, this was not consistent across all NNAI disorders. Specific factors, including distinct inflammatory pathways, genetic influences, autoantibodies targeting brain proteins, and exposure to corticosteroid treatment, may therefore underlie this association.
Developmental Exposure to a Mixture of 23 Chemicals Associated With Unconventional Oil and Gas Operations Alters the Immune System of Mice
Chemicals commonly found in groundwater near fracked oil and gas wells appear to impair the proper functioning of the immune system, Environmental Health News reports.
The new study suggests that baby girls born to mothers near fracking wells may not fight diseases later in life as well as they could have with a pollution-free pregnancy.
2018 Study Abstract
Chemicals used in unconventional oil and gas (UOG) operations have the potential to cause adverse biological effects, but this has not been thoroughly evaluated. A notable knowledge gap is their impact on development and function of the immune system.
Herein, we report an investigation of whether developmental exposure to a mixture of chemicals associated with UOG operations affects the development and function of the immune system. We used a previously characterized mixture of 23 chemicals associated with UOG, and which was demonstrated to affect reproductive and developmental endpoints in mice. C57Bl/6 mice were maintained throughout pregnancy and during lactation on water containing two concentrations of this 23-chemical mixture, and the immune system of male and female adult offspring was assessed. We comprehensively examined the cellularity of primary and secondary immune organs, and used three different disease models to probe potential immune effects: house dust mite-induced allergic airway disease, influenza A virus infection, and experimental autoimmune encephalomyelitis (EAE). In all three disease models, developmental exposure altered frequencies of certain T cell sub-populations in female, but not male, offspring. Additionally, in the EAE model disease onset occurred earlier and was more severe in females.
Our findings indicate that developmental exposure to this mixture had persistent immunological effects that differed by sex, and exacerbated responses in an experimental model of autoimmune encephalitis. These observations suggest that developmental exposure to complex mixtures of water contaminants, such as those derived from UOG operations, could contribute to immune dysregulation and disease later in life.
This 2010 study provides little support for an association between prenatal DES exposure and development of autoimmune disease
DES Follow-up Study Summary
Data shows no difference between rates of autoimmune diseases among the DES exposed and unexposed women.
Autoimmune disease is a class of diseases where antibodies usually meant to recognize foreign organisms instead react to a person’s own cells and tissues. We studied four specific types of autoimmune disease to investigate whether prenatal Diethylstilbestrol (DES) exposure affects the occurrence of these diseases. Systemic Lupus Erythematosus, or lupus, is an inflammatory disease resulting from an antibody attack on tissues and organs resulting in skin rashes, arthritis (chronic joint swelling), renal failure, or nervous system disorders. Rheumatoid arthritis (RA), not to be confused with commonly occurring osteoarthritis, is a disorder resulting from an immune response to an individual’s own connective tissue. The disease results in joint swelling and stiffness. Optic neuritis (ON) is a swelling of the optic nerve due to immune response resulting in vision loss in one eye, painful eye movement, and loss of color vision. Idiopathic Thrombocytopenia Purpura (ITP) is an unexplained decrease in the amount of platelets, cells designed to aid in blood clotting.
The rates of these diseases were compared among women who were and were not prenatally exposed to DES. Women who reported a diagnosis of any of these four diseases on the questionnaires sent in 1994, 1998, or 2001 were asked for permission to contact their doctors to verify the diagnosis. Considering all verified reports, there was no difference between the combined rates of these autoimmune diseases among the DES-exposed and unexposed women. Individually, there was also no difference in the rates of lupus and ON in these two groups. While there was no overall difference in RA between the two groups, there did appear to be a higher rate of RA among exposed women under the age of 45 compared to unexposed women of the same age. This difference however was based on a small number of cases (17 DES-exposed and 2 unexposed) and as a result there is some uncertainty as to the magnitude of this increase. Also there was no increase in RA among DES-exposed women 45 years and older compared with unexposed women of the same age. There were too few ITP cases to conclude whether or not there was a difference in the rate of this disease in the two groups.
Research has suggested that early life characteristics, such as size at birth and age at menarche, may be associated with health conditions later in life. For example, some studies have suggested that low birth weight babies tend to have a higher risk of cardiovascular disease later in life. Other studies have shown that women who begin having periods at a young age have a slightly higher risk of breast cancer than those who begin menstruation later.
2010 Study Abstract
Animal studies have suggested that prenatal diethylstilbestrol (DES) exposure may alter immune system development and function including antigen self-recognition. A cohort study was conducted to investigate whether prenatal DES exposure might influence the incidence of at least some specific autoimmune diseases in women.
A group of women who were and were not prenatally exposed to DES have been followed for more than 25 years for numerous health outcomes including autoimmune disease. To verify diagnoses, medical records or physician abstracts were requested for all women who reported a diagnosis of rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), optic neuritis (ON), and idiopathic thrombocytopenic purpura (ITP). Incidence rates of these autoimmune diseases were compared between women who were and who were not prenatally DES-exposed.
Overall, there was no increase in verified autoimmune disease among DES-exposed women relative to those who were not exposed (RR 1.2; 95% CI 0.7, 2.1). There was, however, a positive association between prenatal DES exposure and RA among women younger than 45 years (RR 4.9; 95% CI 1.1, 21.6) and an inverse association among women who were 45 years and older (RR 0.1; 95% CI 0.01, 0.7).
Overall, these data provide little support for an association between prenatal DES exposure and development of autoimmune disease. The implication that such exposure may be related to RA in an unusual age-related manner is based on small numbers of cases and warrants further study.
Autoimmune disease incidence among women prenatally exposed to diethylstilbestrol,NCBI, PMID: 20634240, 2010 Oct;37(10):2167-73. doi: 10.3899/jrheum.091092. Epub 2010 Jul 15. Full text link.