TY - JOUR T1 - The Value of Studying Clinical and Serologic Phenotypes in North American Native Populations with Autoimmune Disease JF - The Journal of Rheumatology JO - J Rheumatol SP - 1031 LP - 1033 DO - 10.3899/jrheum.130561 VL - 40 IS - 7 AU - CHRISTINE PESCHKEN Y1 - 2013/07/01 UR - http://www.jrheum.org/content/40/7/1031.abstract N2 - In the last 10–15 years there has been increasing awareness of a high rheumatic disease burden in North American Natives (NAN), resulting in a growing number of studies describing clinical and serological phenotypes in these populations. But what is the value of these largely descriptive studies?In this issue of The Journal, Bacher and colleagues add to the body of literature on rheumatic disease in NAN populations, describing the manifestations and symptoms of scleroderma (systemic sclerosis; SSc) in a group of 71 Native Canadians1. This is the largest NAN cohort ever described with this relatively rare disease, and the authors suggest possible differences in the phenotype of SSc compared to white populations.Variability in the phenotypic expression of many autoimmune diseases between different ethnicities has long been recognized; in NAN populations autoimmune disease is generally recognized to be severe2,3,4. At the very least, descriptions of disparate burdens of disease can help guide public health policy, and direct increased health resources to affected ethnic groups. Ethnicity, however, is a complex concept, which includes racial designations or genotypic groupings, but transcends them, representing instead the aggregate of cultural practices, lifestyle patterns, social influences, religious pursuits, and racial characteristics that shape the distinctive identity of a community5. Autoimmune diseases, such as SSc and systemic lupus erythematosus (SLE), are known to arise from a complex interaction between genetic, environmental, socioeconomic, cultural, and … Address correspondence to Dr. Peschken; E-mail: cpeschken{at}exchange.hsc.mb.ca ER -