Autoimmune Rheumatic Disease with Cutaneous Manifestations in North American Indigenous Populations: A Review of Regional Prevalence Data and Disease Characteristics
Abstract
Patients with cutaneous findings of systemic autoimmune rheumatological disease often require a multidisciplinary approach to diagnosis and management. In general, the first signs of systemic rheumatological diseases may be skin manifestations, which prompt those affected to visit the dermatology clinic. The basis and presentations of conditions such as systemic lupus erythematosus (SLE) and systemic sclerosis (SSc) are complex, and involve genetic and environmental influences that are embedded in broad and overlapping factors of the socioecological model. This review recognizes that North American Indigenous (NAI) peoples are diverse, by region, language, culture, home environment, and more; therefore, generalizations are not intended. Furthermore, interpretations of the literature are limited by factors such as region and location (e.g., remote-rural vs. urban), sample size, study design, and statistical interpretations. Additionally, knowledge of biological and genetic predispositions of autoimmune diseases in the NAI population is lacking and beyond the scope of this article. The use of racial and ethnic terminologies can vary greatly and is often based in social concepts. These terms are also used in the context of current categorizations employed by the US Census or as categories that are often used in clinical trials. Thus, further use of the term “North American Indigenous” (NAI) in this article takes this into account. It is worth noting that commonalities surrounding historical contexts and barriers to care are found for many NAI individuals and communities, for example for those living rurally and remotely. The purpose of this review is to provide a broad overview of what is known about mostly regional prevalence data and disease characteristics of autoimmune diseases such as SLE and SSc in the NAI population. Unique considerations surrounding barriers to care reported to be faced by some NAI populations will also be explored.
References
Peschken CA, Esdaile JM. Systemic lupus erythematosus in North American Indians: a population based study. J Rheumatol. 2000;27(8):1884-891.
Atkins C, Reuffel L, Roddy J, Platts M, Robinson H, Ward R. Rheumatic disease in the Nuu-Chah-Nulth native Indians of the Pacific Northwest. J Rheumatol.1988;15(4):684-690.
Houghton KM, Page J, Cabral DA, Petty RE, Tucker LB. Systemic lupus erythematosus in the pediatric North American Native population of British Columbia. J Rheumatol. 2006;33(1):161-163.
Barnabe C, Joseph., Belisle P, Labrecque J, Edworthy S, Barr SG, et al. Prevalence of systemic lupus erythematosus and systemic sclerosis in the First Nations population of Alberta, Canada. Arthritis Care Res (Hoboken). 2012:64(1):138-143. https://doi.org/10.1002/acr.20656
Izmirly PM, Parton H, Wang L, McCune WJ, Lim SS, Drenkard C, et al. Prevalence of systemic lupus erythematosus in the United States: estimates from a meta-analysis of the Centers for Disease Control and Prevention National Lupus Registries. Arthritis Rheumatol. 2021:73(6):991-996. https://doi.org/10.1002/art.41632
Ferucci ED, Johnston JM, Gaddy JR, Sumner L, Posever JO, Choromanski TL, et al. Prevalence and incidence of systemic lupus erythematosus in a population-based registry of American Indian and Alaska Native people, 2007-2009. Arthritis Rheumatol. 2014;66(9):2494-2502. https://doi.org/10.1002/art.38720
Boyer GS, Templin DW, Lanier AP. Rheumatic diseases in Alaskan Indians of the southeast coast: high prevalence of rheumatoid arthritis and systemic lupus erythematosus. J Rheumatol. 1991;18(10):1477-1484.
Feldman CH, Hiraki LT, Liu J, Fischer MA, Solomon DH, Alarcón GS, et al. Epidemiology and sociodemographics of systemic lupus erythematosus and lupus nephritis among US adults with Medicaid coverage, 2000-2004. Arthritis Rheum. 2013;65(3):753-763. https://doi.org/10.1002/art.37795
Arnett FC, Howard RF, Tan F, Moulds JM, Bias WB, Durban E, et al. Increased prevalence of systemic sclerosis in a Native American tribe in Oklahoma. Association with an Amerindian HLA haplotype. Arthritis Rheum. 1996;39(8):1362-1370. https://doi.org/10.1002/art.1780390814
Scofield RH. Sharma R, Pezant N, Kelly JA, Radfar L, Lewis DM, et al. American Indians have a higher risk of Sjögren’s Syndrome and more disease activity than European Americans and African Americans. Arthritis Care Res. (Hoboken). 2020;72(8):1049-056. https://doi.org/10.1002/acr.24003
Muruganandam M, Rolle NA, Sibbitt WL, Jr, Cook GB, Emil NS, Fangtham M, et al. Characteristics of Behcet’s disease in the American Southwest. Semin Arthritis Rheum. 2019;49(2):296-302. https://doi.org/10.1016/j.semarthrit.2019.03.003
Ferucci ED, Johnston JM, Gordon C, Helmick CG, Lim SS. Prevalence of mixed connective tissue disease in a population-based registry of American Indian/Alaska Native People in 2007. Arthritis Care Res, 2017;69(8):1271-1275. https://doi.org/10.1002/acr.23135
Gaddy JR, Vista ES, Robertson JM, Dedeke AB, Roberts VC, Klein WS, et al. Rheumatic disease among Oklahoma tribal populations: a cross-sectional study. J Rheumatol. 2012;39(10):1934-1941. https://doi.org/10.3899/jrheum.110984
Bacher A, Mittoo S, Hudson M, Tatibouet S; Canadian Scleroderma Research Group, Baron M. Systemic sclerosis in Canada’s North American Native population: assessment of clinical and serological manifestations. J Rheumatol. 2013;40(7):1121-1126. https://doi.org/10.3899/jrheum.121212
Morton RO, Gershwin ME, Brady C, Steinberg AD. The incidence of systemic lupus erythematosus in North American Indians. J Rheumatol. 1976;3(2):186-190.
Mejia Otero C, Assassi S, Hudson M, Mayes MD, Estrada-Y-Martin R, Pedroza C, Mills TW, et al. Antifibrillarin antibodies are associated with Native North American Ethnicity and poorer survival in systemic sclerosis. J Rheumatol. 2017;44(6):799-805. https://doi.org/10.3899/jrheum.160574
Tan FK, Wang N, Kuwana M, Chakraborty R, Bona CA, Milewicz DM, et al. Association of fibrillin 1 single-nucleotide polymorphism haplotypes with systemic sclerosis in Choctaw and Japanese populations. Arthritis Rheum. 2001;44(4):893-901. https://doi.org/10.1002/1529-0131(200104)44:4<893::AID-ANR146>3.0.CO;2-3
Zhou X, Tan FK, Reveille JD, Wallis D, Milewicz DM, Ahn C, et al. Association of novel polymorphisms with the expression of SPARC in normal fibroblasts and with susceptibility to scleroderma. Arthritis Rheum. 2002;46(11):2990-2999. https://doi.org/10.1002/art.10601
McDougall JA, Helmick CG, Lim SS, Johnston JM, Gaddy JR, Gordon C, et al. Differences in the diagnosis and management of systemic lupus erythematosus by primary care and specialist providers in the American Indian/Alaska Native population. Lupus. 2018;27(7):1169–1176. https://doi.org/10.1177/0961203318763529
Forquera R. The Seattle Indian Health Board. Urban Indian Health: Issue Brief [Internet]. Menlo Park, CA: Kaiser Family Foundation; November 2001. Available from https://www.kff.org/wp-content/uploads/2001/10/6326urbanindianhealth.pdf
Urban Indian Health [Internet]. Seattle, WA: Urban Indian Health Institute. 2023. [Date of Access: November 1, 2023] Available from: https://www.uihi.org/urban-indian-health/
Profile of Indigenous Canada: Trends and Data Needs [Internet]. Organisation for Economic Cooperation and Development (OECD). 2022. [Date of Access: November 1, 2023] Available from: https://www.oecd-ilibrary.org/sites/e6cc8722-en/index.html?itemId=/content/component/e6cc8722-en
Falasinnu T, Chaichian Y, Bass MB, Simard JF. The representation of gender and race/ethnic groups in randomized clinical trials of individuals with systemic lupus erythematosus. Curr Rheumatol Rep.2018;20(4):20. https://doi.org/10.1007/s11926-018-0728-2
