PMR and Ethnicity

[ChinaWuntoo]

This subject was raised in a recent thread - it has been on my mind very recently.

During a literature search I discovered that southern climes do not have many cases of PMR - as is noted in the other thread.

My question is about possible implications for understanding of the disease amongst some medics in some areas of the UK and elswhere.

I live in a London Borough where very percentages of people of African, Caribbean and Indian subcontinent background live (I presume that children born here of such people would have the same predisposition to PMR as their parents, although this may not be the case - my PMR seems to have genetic connections).

This means that GP's in my area are likely to come across PMR less frequently than their counterparts in less diverse areas (I think). In addition, my GP was trained over 25 years ago in an African country and I wonder what was included in this training. It may be significant that my PMR actually was first diagnosed by two young recently qualified doctors, although they were alerted to the fact that I have a sister with PMR.

Perhaps we ought to try to persuade someone to do some original research?

Anyone have any experience similar to mine or who has information / views on the subject?

[PMRpro Ambassador]

Never mind persuading - they will look at most things if they have the money! I fear that is what it comes down to.

[ChinaWuntoo in reply to PMRpro]

OK, I understand!

[ChinaWuntoo]

Thinking.... perhaps it needs to catch the eye of a Rheumatology professor (Keele? Bristol? Southend? London? Spain? Italy? - which I see are main places with an interest in PMR) who has a group of students who need a project. Then it would be necessary for sufficient GP practices to be interested in cooperating.

But I'm not sure whether such a project would contribute sufficiently to be deemed worthwhile (but I've read some articles with minimal application, I think).

Just thinking.

[Theziggy in reply to ChinaWuntoo]

As PMRpro said "money"

[Susan1705]

I also live in a London Borough, my experience of diagnosis and understanding of the disorder by 3 rheumatologists and my GP has been really positive. I had never heard of PMR before I was diagnosed.

[HeronNS]

Possibly a rich subject for a keen doctoral student.

[ChinaWuntoo]

That was sort of my thought, too. And it would be an 'original research' doctorate not a taught one! (Ouch, my prejudiecs are showing?!) There's plenty of supervisory skills and background work / databases already done by places like Keele. There would still be costs and I agree that's the problem - unless someone somewhere takes the bait.

[Amkoffee]

I've read that it's more common with those of Eastern European roots.

[ChinaWuntoo in reply to Amkoffee]

Do you have a link for that, please? I'd be very interested to know.

[PMRpro Ambassador in reply to Amkoffee]

No - Scandinavian, not eastern European.

[ChinaWuntoo in reply to PMRpro]

Thought it was a bit odd! Thanks.

But if it's norff o Watford .....

[Amkoffee in reply to PMRpro]

Your right. It's Northern Europe. I got the wrong direction

[DorsetLady PMRGCAuk volunteer]

Here are a couple of viewpoints -

academic.oup.com/rheumatolo...

pubmed.ncbi.nlm.nih.gov/113...

academic.oup.com/rheumatolo...

[ChinaWuntoo in reply to DorsetLady]

Thanks DorsetLady

I find the first link particularly interesting - especially as it is more recent than many articles and it is located in London.

If the hypothesis that immigrant South Asian communities acquire risk of GCA in northern latitudes is true (it doesn't sound sensible to me, but I am no expert) this has huge implications for an overall / general understanding of GCA and PMR probably.

Now will someone come up with the dosh?

I will follow-up that article in some way.

BTW I do wonder about eastern european connection as we have many migrant workers in our Borough.

[DorsetLady PMRGCAuk volunteer in reply to ChinaWuntoo]

I think the eastern European connection may be rather tenuous. As PMRpro say - Scandinavian most certainly - see lighthearted post linked below -

South Asian connection is probably due to trading between Europe and Asia is days of yore. I know a lady with Dutch/Sri Lankan heritage who has GCA

healthunlocked.com/pmrgcauk...

[ChinaWuntoo in reply to DorsetLady]

What a beautiful child!

So we are talking about mixed marriages / relationships, I suppose, which I would understand. However, such formal relationships were/are comparatively rare outside of culture? This makes me wonder about people of mixed Caribbean heritage - European slave owners etc etc!

I suspect that one problem in setting up a research project might be the fear of being seen as not PC although that can be nullified, surely?

I also wonder about stress factors....do people who come to live in UK suffer more stress than they would otherwise and does this contribute to PMR/GCA?

I continue to ponder.

[DorsetLady PMRGCAuk volunteer in reply to ChinaWuntoo]

I don’t think coming to live in UK is necessarily more stressful. The lady I spoke about now lives in NZ - born in Sri Lanka and did live in UK for some time.

The UK probably has a bigger number of Viking genes than other countries- although emigration following hardship took English, Scots and Irish to the US, NZ & Oz.

Plus back in the heyday of the spice trade various Europeans settled in Asia, or their spouses/families came to Europe. Don’t think it’s so common with those of African/Caribbean heritage generally.

[ChinaWuntoo in reply to DorsetLady]

I came across this....

Ethnicity and Inflammatory Pathways - Implications for Vascular Disease, Vascular Risk and therapeutic Intervention by Miller, M.A. and Cappuccio, F.P. in 'Current Medicinal Chemistry 2007[/url]

(Sorry, tried to do a link but didn't work).

I'm sure it's an interesting article if I could understand it! No mention of PMR or GCA that I could find although lupus gets a line. It may be interesting for CRP markers and also for Interlukin-6 which I have read is significant in our diseases here.

There seems to be general agreement that little research has been undertaken which involves people who are not white/Caucasian.

[PMRpro Ambassador in reply to ChinaWuntoo]

researchgate.net/publicatio...

[DorsetLady PMRGCAuk volunteer in reply to PMRpro]

Thx - beat me to it!

[PMRpro Ambassador in reply to DorsetLady]

Wanted to know where it was so I can go back and look at the PDF later

[ChinaWuntoo in reply to PMRpro]

Thank you very much. I can do it on another Forum but didn't seem to work here.

[PMRpro Ambassador in reply to ChinaWuntoo]

There must be spaces at each end of the link when you copy it over, maybe it was that

[ChinaWuntoo in reply to PMRpro]

Have sent you a PM.