Comorbidity network of chronic, non-communicable inflammatory diseases

慢性非传染性炎症性疾病的合并症网络

• 批准号: 531280420
• 负责人: Professor Dr. Ralf Joachim Ludwig
• 金额: --
• 依托单位: Lübecker Institut für Experimentelle Dermatologie (LIED)
• 依托单位国家: 德国
• 项目类别: Research Grants
• 资助国家: 德国
• 项目状态: 未结题
• 来源: https://gepris.dfg.de/gepris/projekt/531280420?language=en
• 关键词: Comorbidity; network; chronic; non; communicable

Chronic, non-communicable inflammatory diseases (CIDs) impose a major medical burden. This is due to their high prevalence, the lack of curative treatment options and a high comorbidity. Regarding the latter, patients diagnosed with a given CID, e.g., psoriasis, rheumatoid arthritis, or celiac disease, have an increased risk to develop cardiovascular and metabolic comorbidity. Notably, the risk to develop an additional CID is also increased. This presumed risk for the development of additional CIDs is, however, a matter of lively controversy for most CIDs. These discrepancies may stem from differences in the cohorts, as sex-, age- and/or race-specific risks have not been addressed in most studies. Regarding rare or orphan CIDs, reports on the inflammatory comorbidity are sparse at best. Insights into the inflammatory comorbidity of CID patients would improve disease management because screening for and early treatment of comorbid CID would potentially better treatment outcomes. Furthermore, co-occurrence of CIDs potentially points towards shared pathogenic pathways, thus allowing future insights into disease pathogenesis. Addressing the inflammatory comorbidity of CIDs has, in the past, been hampered by limited availability to large databases and/or prospective patient registries. We recently obtained access to TriNetX, a database including over 120 million electronic medical records (EMRs). These EMRs include longitudinal data on demographics, diagnoses, medications, and laboratory findings. Therefore, we are now in the unique position to address the inflammatory comorbidity of CIDs. For this, we will contrast the risk to develop any one of 50 selected CIDs in patients diagnosed with each one of the CIDs to propensity matched controls that had not been diagnosed with any CID upon inclusion into the study. Project-related preliminary work determined the sample size and evaluated the approach by running the analysis for one of the selected CIDs, namely celiac disease. Here, we confirmed already established risks, as well as identified novel risks regarding the immunological comorbidity of celiac disease. Validation of the obtained data will be done by use of additional networks within TriNetX. Our analysis will also include determination of the sex-, age and race-specific risks for the inflammatory comorbidity of CIDs. At completion, we will have generated a comorbidity/risk network of chronic, non-communicable inflammatory diseases. This will be useful for clinical care as well as provide insights into potentially shared pathogenic pathways.

慢性，非传染性炎症性疾病（CIDS）施加重大医疗负担。这是由于它们的高患病率，缺乏治疗方法和合并症高。关于后者，例如牛皮癣，类风湿关节炎或乳糜泻的患者患有心血管和代谢合并症的风险增加。值得注意的是，开发额外CID的风险也会增加。然而，对于大多数CID而言，这种推动开发其他CID的风险是生动争议的问题。这些差异可能源于人群的差异，因为在大多数研究中尚未解决性别，年龄和/或种族特异性的风险。关于稀有或孤儿CID，有关炎症合并症的报告充其量很少。对CID患者的炎症合并症的见解将改善疾病管理，因为对合并症CID进行筛查和早期治疗可能会更好地治疗结果。此外，CID的同时存在可能指向共同的致病途径，从而使未来对疾病发病机理的见解。过去，解决CID的炎症合并症过去对大型数据库和/或预期患者注册处的可用性有限。我们最近获得了Trinetx的访问，这是一个数据库，其中包括超过1.2亿个电子病历（EMRS）。这些EMR包括有关人口统计学，诊断，药物和实验室发现的纵向数据。因此，我们现在处于解决CID炎症合并症的独特位置。为此，我们将与诊断为每种CID的患者中的50个选定的CID中的任何一个中的任何一个中的任何一种与倾向匹配的对照组合起来，而该对照尚未被诊断出任何CID。与项目相关的初步工作确定了样本量，并通过对选定的CID（即腹腔疾病）进行分析来评估该方法。在这里，我们确认已经确定了风险，并确定了有关乳糜泻的免疫合并症的新风险。验证获得的数据将通过使用Trinetx中的其他网络来完成。我们的分析还将包括确定CID炎症合并症的性别，年龄和种族特异性风险。完成后，我们将产生一个合并症/风险网络的慢性炎症性疾病。这对于临床护理以及对潜在共享致病途径的见解将很有用。