To the Editor Dr Song and colleagues1 reported that stress-related disorders were associated with increased risk of subsequent autoimmune disease. Stress is an adverse event that is associated with various mental disorders and physical diseases, possibly through hypothalamic-pituitary-adrenal axis dysregulation, epigenetic modification, or the inflammatory response.2,3 The study presented several problems that require further discussion.
Liu J, Lu J, Luo X. Stress-Related Disorders and Autoimmune Disease. JAMA. 2018;320(17):1816–1817. doi:10.1001/jama.2018.12394
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