The Influence ACE Factors on the Development of Autoimmune Diseases

1. The Influence ACE Factors on the Development of Autoimmune Diseases Kelly Strine, RN Sociology 410 SUNY IT April 24th, 2012

2. What are ACE Factors? ACE stands for Adverse Childhood Experiences. Categories for ACE Factors include Abuse, Neglect or Household Dysfunction. ACE factors have been shown to impact the health of our adult lives. Autoimmune Diseases have been shown to be one class of diseases that are precipitated by ACE Factors.

3. What are Autoimmune Diseases Autoimmune Diseases consists of 70-80 different inflammatory diseases. They affect between 14.7 to 23.5 million people in the United States. A healthy immune system consists of lymphocytes call T-cells that helps the body fight against antigens. In Autoimmune Diseases, the body cannot distinguish between an antigen and its own cellular makeup.

4. Autoimmune Diseases • Autoimmune Diseases affect the blood vessels, connective tissues, endocrine glands, joints, muscles, red blood cells, and the skin. • Some examples of Autoimmune Diseases are: • Addison’s Disease, autoimmune hemolytic anemia, autoimmune thrombocytopenia purpura, celiac disease, dermatomyositis, Grave’s disease, Hashimoto’s thyroiditis, idiopathic myocarditis, idiopathic pulmonary fibrosis, insulin-dependent diabetes mellitus, irritable bowel disease, multiple sclerosis, myasthenia gravis, pernicious anemia, psoriasis, rheumatoid arthritis, scleroderma, Sjogren disease, systemic lupus erythematous, vitiligo, and Wegener’s granulomatosis.

5. Gender Difference An overwhelming proportion of 80% affected by autoimmune diseases are women. This is thought to occur due to the immune response differences of glucocorticoid (steroid hormone) women experience when stress is present. A physical or psychological stress such as the flu, pregnancy, or death of close relative, can precipitate the onset of an Autoimmune Disease.

6. The Link Between ACE Factors and Autoimmune Disease Physical or emotional stress can create a physiologic response on the body yet that process if still unknown. One study has linked PTSD in Vietnam vets to the development of Psoriasis an Autoimmune Disease affecting the skin. In another study Neglect posed an increase risk to women for the development of Autoimmune Disease. Chronic Stress was shown in another study to affect Autoimmune Disease in a culminating effect.

7. Techniques to Combat Stress Minimizing the number of traumatic experience that children endure will decrease the risk for the development of Autoimmune Disease. A trauma sensitive yoga intervention has been shown to decrease the stress and adverse behaviors experienced by youth in residential treatment settings.

8. Further Research Conducting longitudinal studies should be conducted to gain insight into several periods in one's life. There are several Autoimmune Disease with their own disease etiology. Looking at each disease’s link to ACE facts could help us better understand the relationship. Primary and secondary prevention strategies should be looked at to decrease the number of Autoimmune Diseases precipitated by ACE Factors.

9. The Role of the Healthcare Provider Health care providers need to be aware of the effects that ACE factors have on adult health. While it is important to treat the disease symptoms, the treatment of the underlying disease may be the most beneficial treatment plan for those who have suffered from ACE factors. This may require a holist treatment plan involving a multidisciplinary team, and not just the use of traditional medicine.

10. References Boscarino, J. The New York Academy of Medicine, Division of Health and Science Policy. (2004). Posttraumatic stress disorder and physical illness: Results from clinical and epidemiologic studies. doi: 10.1196/annals.1314.011 Centers for Disease Control and Prevention, (2011). Adverse childhood experience study. http://www.cdc.gov/ace/about.htm Dube, S., Fairweather, D., Pearson, W., Felitti, V., Anda, R., & Croft, J. (2009). Cumulative childhood stress and autoimmune diseases in adults. Psychosomatic Medicine, 71, 243-250. doi: 10.1097/PSY.0b013e3181907888 Felitti, V., Anda, R. A., Nordenberg, D., Williamsom, D., Spitz, A., Edwards, V., Koss, M., & Marks, J. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The adverse childhood experiences (ace) study. American Journal of Preventive Medicine, 14(4), 245-258. Goodwin, R., & Stein, M. (2004). Association between childhood trauma and physical disorders among adults in the united states. Psychological Medicine, 34, 509-520. doi: 10.1017/S003329170300134X Jessop, D. S., Richards, L. J., & Harbuz, M. S. (2004). Effects of stress on inflammaroty autoimmune disease: Destructive or protective. Henry wellcomelaboratories for integrative neuroscience and encrinology, 7(4), 261-266. doi: 10.1080/10253890400025497 Lanius, R., & Vermetten, (2009). Book chapter for: The hidden epidemic. Cambridge: Cambridge University Press. Medline Plus. Autoimmune disorders. (2011, May 29). http://www.nlm.nih.gov/medlineplus/ency/article/000816.htm Osborn, K., Wraa, C., & Watson, A. (2010). Medical-surgican nursing: Preparation for practice. (Vol. II). Upper Saddle River, NJ: Pearson Education, Inc, publishing as Prentice Hall. Simonic, E., Kastelan, M., Peternel, S., Pernar, M., Brajac, I., Roncevic-Grzeta, I., & Kardum, I. (2010). Childhood and adulthood traumatic experiences in patients with psoriasis. The Journal of Dermatoology, 37, 793-800. doi: 10.1111/j.1346-8138.2010.00870.x Spinazzola, J., Rhodes, A., Emerson, D., Earle, E., & Monroe, K. (2011). Application of yoga in residential treatment of traumatized youth. Journal of the American Psychiatric Nurses Association, 17(6), 431-444. doi: 10.1177/1078390311418359 U.S. Department of Health and Human Services, Office on Women's Health. (2012). Autoimmune diseases: Overview. http://www.womenshealth.gov/publications/our-publications/fact-sheet/autoimmune-diseases.cfm