Psychosocial Factors and Lupus Disease Progression Among African American Women

非裔美国女性的心理社会因素和狼疮疾病进展

• 批准号: 10224407
• 负责人: H. David Chae
• 金额: $ 21.73万
• 依托单位: TULANE UNIVERSITY OF LOUISIANA
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-08-02 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10224407
• 关键词: Psychosocial; Factors; Lupus; Disease; Progression

DESCRIPTION (provided by applicant): There is a lack of research on systematic lupus erythematosus (SLE), a multisystem, chronic, autoimmune disease that shows clear patterns along racial and gender lines. African American women not only have a greater prevalence of SLE, but also experience greater severity and faster progression compared to their White counterparts, being more frequently affected by organ damage and comorbid conditions that emerge as a consequence of disease activity and disease-related chronic inflammation and tissue damage. Racial disparities in SLE complications and mortality are well documented; however, the reasons for these disparities are poorly understood. To address these gaps in knowledge, this study aims to: (1) examine the role that psychosocial stressors experienced by African American women have in exacerbating SLE in this population; (2) identify social factors and psychological resources that are protective or buffer the effects of stress on SLE-related health declines; and (3) explore the biological implications of psychosocial stressors and SLE, in relation to elevated systemic inflammation and accelerated aging at the cellular level. The experiences of African American women with SLE are particularly challenging, and include psychosocial stressors related to disease management, as well as disproportionately greater poverty and living in disadvantaged communities; in addition to routine stressors such as those associated with work, family and relationship demands, parenting, and caregiving. Experiences of racial discrimination constitute a qualitatively distinct source of psychosocial stress, adding o existing everyday hassles. In this study, we will examine how these stressors impact SLE severity and progression through a longitudinal study design. We will collect three waves of data from 480 African American women, all with validated SLE. Participants will be recruited from the Georgians Organized Against Lupus (GOAL) cohort, a truly one-of-a-kind, population-based study of SLE in Atlanta, including a full spectrum of patients from all levels of socioeconomic strata, across a range of disease severity. We will examine the effects of racial discrimination, financial and neighborhood-related strains, and other stressors associated with various role strains. Potential protective factors, including those related to racial identity and social suppor will also be assessed. We will collect dried blood spots (DBS), a minimally invasive alternative to venipuncture, to examine indicators of biological dysregulation which we hypothesize will be impacted by psychosocial stress as well as SLE activity. This study will be the most in-depth investigation of the multifactorial nature of psychosocial stressors and their impact on SLE disease progression among African American women, and thus fills an important gap in the science on this understudied disease. This research is important in advancing knowledge of how aspects of the social environment and psychological processes impact health among African American women with SLE, and also contributes to scientific knowledge on the underpinnings of racial disparities in the progression of this disease.

描述（由申请人提供）：缺乏对系统性红斑狼疮（SLE）的研究，系统性红斑狼疮是一种多系统、慢性、自身免疫性疾病，在种族和性别方面表现出明显的模式。与白人女性相比，非洲裔美国女性不仅患有系统性红斑狼疮（SLE），而且病情更严重，进展更快，更容易受到器官损伤和因疾病活动和与疾病相关的慢性炎症而出现的合并症的影响和组织损伤。 SLE 并发症和死亡率的种族差异已有充分记录；然而，人们对造成这些差异的原因知之甚少。为了解决这些知识差距，本研究旨在：（1）研究非裔美国女性所经历的心理社会压力因素在加剧该人群的系统性红斑狼疮方面的作用； (2) 确定能够保护或缓冲压力对 SLE 相关健康下降影响的社会因素和心理资源； (3) 探索社会心理压力源和系统性红斑狼疮与细胞水平上全身炎症升高和加速衰老相关的生物学意义。 患有系统性红斑狼疮的非裔美国女性的经历尤其具有挑战性，其中包括与疾病管理相关的心理社会压力，以及不成比例的更大贫困和生活在弱势社区；除了日常压力源，例如与工作、家庭和关系需求、养育和照顾相关的压力源。种族歧视的经历构成了心理社会压力的一个本质上不同的来源，增加了现有的日常麻烦。在本研究中，我们将通过纵向研究设计来研究这些压力因素如何影响系统性红斑狼疮的严重程度和进展。我们将从 480 名非裔美国女性那里收集三轮数据，她们都患有经过验证的 SLE。参与者将从佐治亚州抗狼疮组织 (GOAL) 队列中招募，这是一项真正独一无二的、基于人群的亚特兰大 SLE 研究，包括来自社会经济阶层各个层面的全谱患者。疾病的严重程度。我们将研究种族歧视、经济和邻里相关压力以及与各种角色压力相关的其他压力源的影响。潜在的保护因素，包括与种族认同和社会支持相关的因素也将被评估。我们将收集干血斑（DBS），这是静脉穿刺的一种微创替代方案，以检查生物失调指标，我们假设这些指标将受到社会心理压力和系统性红斑狼疮活动的影响。这项研究将是对非裔美国女性心理社会压力因素的多因素性质及其对 SLE 疾病进展影响的最深入调查，从而填补了这一尚未充分研究的疾病的科学空白。这项研究对于增进对社会环境和心理过程的各个方面如何影响患有系统性红斑狼疮的非裔美国女性健康的认识非常重要，并且还有助于增进关于这种疾病进展中种族差异的基础的科学知识。