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在美国体现结构性种族主义和多发性硬化症风险和结果

Annette M Langer-Gould^1,2, Tara J Cepon-Robins³, Jada Benn Torres^4,5

¹Department of Neurology, Los Angeles Medical Center, Southern California Permanente Medical Group, Los Angeles, CA, USA. annette.m.langer-gould@kp.org.

Nature reviews. Neurology

|May 27, 2025

概括

多发性硬化症 (MS) 的种族和民族差异很大,黑人患病率和死亡率更高. 社会因素,而不是遗传,驱动这些MS结果差异.

科学领域:

神经免疫学神经免疫学
健康差距研究研究研究研究
健康的社会决定因素

背景情况:

多发性硬化症 (MS) 的发病率,流行率和结果在美国表现出显著的种族和民族差异.
与普遍认为的相反,黑人个体的MS发病率最高,残疾累积速度更快,死亡率增加.
这些差异往往被错误地归因于先天的生物学差异,而不是社会结构.

研究的目的:

挑战MS作为一种主要影响白人人口的疾病的误解.
探索种族和种族的社会构造如何通过生活经验 ('体现') 影响与MS相关的生物因素.
提出一个概念模型,以了解和解决MS的种族和民族差异.

主要方法:

对有关多发性硬化症差异,结构性种族主义和生物体现现实的现有文献的审查.
分析结构性种族主义的下游影响如何影响免疫系统的发展和爱斯坦-巴尔病毒的反应.
在MS预后中考虑医疗保健的获取,质量,发病年龄和并发症负担.

主要成果:

结构性种族主义有助于与MS易感性相关的生物学结果,包括免疫调节失调和儿童肥胖.
不公平的医疗保健准入和更高的并发症负担加剧了MS预后差异.
种族和种族是通过生活经验影响生物学的社会结构,而不是先天的生物学决定因素.

结论:

在MS的种族和民族差异是由社会决定因素和体现驱动的,而不是固有的生物变异.
解决结构性种族主义和医疗保健不平等问题对于缓解MS差异至关重要.
提出了一个概念模型来指导未来的研究和干预措施,旨在减少多发性硬化症的结果差距.

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