Should we finally consider the biopsychosocial model in systemic autoimmune diseases?, 2020, Chiche et al

Andy

Retired committee member
We read with interest the study by Posada et al. (1) evaluating the therapeutic effects of RSLV‐132 (a new RNase compound) in patients with primary Sjogren syndrome (pSS). At first glance, one may be surprised by the enthusiastic conclusion of authors in spite of a biological effect opposite to what was expected, namely an increased expression of interferon (IFN)‐stimulated genes (ISG), while pSS is considered as an acquired interferonopathy. However, therapeutic trials are also a unique opportunity to learn about the pathogenesis of such complex condition. Indeed, this study showed a significant improvement of fatigue (measured by various validated scales) in treated patients, surprisingly correlated with the increased expression of ISG.
Paywall, https://onlinelibrary.wiley.com/doi/10.1002/art.41582
Sci hub, https://sci-hub.se/10.1002/art.41582
 
So since there is no experimental consensus of higher interferon Type I levels increasing or decreasing fatigue, it must be psychological, is what the article professes.

Uh-uh, I don't think so. Sure, maybe some 1% of fatigue is related to depression, but not the overwhelming exhaustion in systemic autoimmune diseases.

Need to look at other factors or cascade of factors.
 
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