Changing epidemiology of immune-mediated inflammatory diseases in immigrants: A systematic review of population-based studies.,Journal of Autoimmunity

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Changing epidemiology of immune-mediated inflammatory diseases in immigrants: A systematic review of population-based studies.
Journal of Autoimmunity ( IF 12.8 ) Pub Date : 2019-07-25 , DOI: 10.1016/j.jaut.2019.07.002
Manasi Agrawal ₁ , Shailja Shah ₂ , Anish Patel ₃ , Rachel Pinotti ₄ , Jean-Frederic Colombel ₁ , Johan Burisch ₅

Affiliation

BACKGROUND Immune-mediated inflammatory diseases (IMIDs) are systemic diseases of multifactorial etiology that share aberrant immune responses as the common final pathway. With rising globalization, their incidence is increasing in developing countries and among immigrants. Our primary objective was to systematically review the epidemiology of IMIDs in immigrants and conduct a meta-analysis to estimate the risk of IMIDs in immigrant populations according to their origin and destination countries. METHODS We systematically searched five biomedical databases and reviewed population-based studies, from inception through August 2018, that reported incidence or prevalence data of inflammatory bowel disease (IBD), multiple sclerosis (MS), type 1 diabetes (T1D), systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), ankylosing spondylitis (AS) or psoriasis and psoriatic arthritis (PPA) among immigrants and the host population. RESULTS The incidence and prevalence of IMIDs among immigrants differ from host populations, and evolve over subsequent generations. The risk of IBD among immigrants approximates that in hosts, especially among South Asians, with ulcerative colitis incidence changing prior to Crohn's disease incidence. MS risk is highest in Iranian immigrants, T1D in African immigrants and SLE in African and Iraqi immigrants. Data on other IMIDs are sparse. Significant heterogeneity between the studies precluded meta-analysis. CONCLUSION Based on our systematic review, the epidemiology of IMIDs among immigrants varies according to native and host countries, immigrant generation, and IMID type. The rapid evolution suggests a role for non-genetic factors and gene-environment interactions. Future studies should focus on these pattern shifts, given implications of rising global burden of IMIDs and immigration.

更新日期：2019-11-18

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