title: I too, am America: a review of research on systemic lupus erythematosus in African-Americans.
abstract: Systemic lupus erythematosus (SLE) is a multi-organ autoimmune disorder that can cause significant morbidity and mortality. A large body of evidence has shown that African-Americans experience the disease more severely than other racial-ethnic groups. Relevant literature for the years 2000 to August 2015 were obtained from systematic searches of PubMed, Scopus, and the EBSCOHost platform that includes MEDLINE, CINAHL, etc. to evaluate research focused on SLE in African-Americans. Thirty-six of the 1502 articles were classified according to their level of evidence. The systematic review of the literature reported a wide range of adverse outcomes in African-American SLE patients and risk factors observed in other mono and multi-ethnic investigations. Studies limited to African-Americans with SLE identified novel methods for more precise ascertainment of risk and observed novel findings that hadn't been previously reported in African-Americans with SLE. Both environmental and genetic studies included in this review have highlighted unique African-American populations in an attempt to isolate risk attributable to African ancestry and observed increased genetic influence on overall disease in this cohort. The review also revealed emerging research in areas of quality of life, race-tailored interventions, and self-management. This review reemphasizes the importance of additional studies to better elucidate the natural history of SLE in African-Americans and optimize therapeutic strategies for those who are identified as being at high risk.
authors.affiliation: Division of Rheumatology, Department of Public Health Sciences, Medicine, MUSC Center for Health Disparities Research, Medical University of South Carolina , Charleston, South Carolina , USA.
authors.forename: Edith M
authors.initials: EM
authors.lastname: Williams
authors.affiliation: Arnold School of Public Health, University of South Carolina , Columbia, South Carolina , USA.
authors.forename: Larisa
authors.initials: L
authors.lastname: Bruner
authors.affiliation: University of South Carolina , Columbia, South Carolina , USA.
authors.forename: Alyssa
authors.initials: A
authors.lastname: Adkins
authors.affiliation: Department of Public Health Sciences , Medical University of South Carolina , Charleston, South Carolina , USA.
authors.forename: Caroline
authors.initials: C
authors.lastname: Vrana
authors.affiliation: The Department of Public Health and Programs in Nurse Anesthesia , Liaison for College of Nursing, Medical University of South Carolina Library , Charleston, South Carolina , USA.
authors.forename: Ayaba
authors.initials: A
authors.lastname: Logan
authors.affiliation: Department of Rheumatology and Immunology , Medical University of South Carolina , Charleston, South Carolina , USA.
authors.forename: Diane
authors.initials: D
authors.lastname: Kamen
authors.affiliation: Department of Medicine, Division of Rheumatology, Medical University of South Carolina , Charleston, South Carolina , USA.
authors.forename: James C
authors.initials: JC
authors.lastname: Oates
keywords: Autoimmune Diseases; Epidemiology; Systemic Lupus Erythematosus