{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T05:45:54Z","timestamp":1785735954077,"version":"3.56.0"},"reference-count":38,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Irritable bowel syndrome (IBS) is a prevalent disorder of gut\u2013brain interaction increasingly linked to immune and inflammatory dysregulation. Whether IBS predisposes to systemic rheumatic diseases remains uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study using the TriNetX Global Collaborative Network, which integrates anonymized electronic health records from more than 150 healthcare organizations and 150 million patients worldwide. Adults (\u226518 years) diagnosed with IBS (\u22652 visits) between 2015 and 2023 were compared with matched controls undergoing routine health evaluations without IBS. Exclusion criteria included malignancy, pre-existing systemic rheumatic diseases, and death before the index date. Propensity score matching (1:1) balanced demographics, comorbidities, psychiatric disorders, and socioeconomic factors. The primary outcome was incident systemic rheumatic disease, categorized into inflammatory arthritis (ankylosing spondylitis, psoriatic arthritis, rheumatoid arthritis, gout) and connective tissue disorders (systemic lupus erythematosus, systemic sclerosis, Sj\u00f6gren syndrome, dermatomyositis\/polymyositis). Risk estimates were generated using the TriNetX analytic function, reporting hazard ratios with 95% confidence intervals. Sensitivity analyses included alternative definitions, extended washout periods (24 and 36 months), varying follow-up durations, active comparator cohorts, and negative controls. Cross-dataset validation was performed using the TriNetX US Collaborative Network.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>After matching, 459966 patients were included in each cohort. Irritable bowel syndrome was associated with increased risks of ankylosing spondylitis (HR 2.57, 95% CI 2.22\u20132.98), psoriatic arthritis (HR 2.03, 95% CI 1.80\u20132.29), rheumatoid arthritis (HR 1.42, 95% CI 1.28\u20131.56), and gout (HR 1.34, 95% CI 1.27\u20131.42). Elevated risks were also observed for systemic lupus erythematosus (HR 1.84, 95% CI 1.65\u20132.04), Sj\u00f6gren syndrome (HR 2.84, 95% CI 2.60\u20133.12), systemic sclerosis (HR 2.09, 95% CI 1.64\u20132.67), and dermatomyositis (HR 1.52, 95% CI 1.11\u20132.07). These associations remained across multiple sensitivity and stratified analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>IBS was associated with a higher risk of diverse systemic rheumatic diseases. Further studies are warranted to clarify the mechanisms underlying these observed associations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1779191","type":"journal-article","created":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T05:29:48Z","timestamp":1785734988000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Risk of systemic rheumatic diseases in people with irritable bowel syndrome: a global-federated cohort analysis"],"prefix":"10.3389","volume":"17","author":[{"given":"Shuo-Yan","family":"Gau","sequence":"first","affiliation":[{"name":"Department of Medical Education, Ditmanson Medical Foundation Chia-Yi Christian Hospital","place":["Chiayi, Taiwan"]},{"name":"Institute of Allergology, Charit\u00e9-Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin","place":["Berlin, Germany"]},{"name":"Department and Graduate Institute of Business Administration, National Taiwan University","place":["Taipei, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Jung","family":"Su","sequence":"additional","affiliation":[{"name":"Orthopedics Department, Chi-Mei Medical Center","place":["Tainan, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shih-Chi","family":"Yang","sequence":"additional","affiliation":[{"name":"Education Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University","place":["Tainan, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chien-Chin","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Pathology, Ditmanson Medical Foundation Chia-Yi Christian Hospital","place":["Chiayi, Taiwan"]},{"name":"Department of Cosmetic Science, Chia Nan University of Pharmacy and Science","place":["Tainan, Taiwan"]},{"name":"Ph.D. Program in Translational Medicine, Rong Hsing Research Center for Translational Medicine, National Chung Hsing University","place":["Taichung, Taiwan"]},{"name":"Department of Biotechnology and Bioindustry Sciences, College of Bioscience and Biotechnology, National Cheng Kung University","place":["Tainan, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Solomon Chih-Cheng","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Ditmanson Medical Foundation Chia-Yi Christian Hospital","place":["Chiayi, Taiwan"]},{"name":"Department of Pediatrics, College of Medicine, Taipei Medical University","place":["Taipei, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui-Chin","family":"Chang","sequence":"additional","affiliation":[{"name":"Evidence-based Medicine Center, Chung Shan Medical University Hospital","place":["Taichung, Taiwan"]},{"name":"Library, Chung Shan Medical University Hospital","place":["Taichung, Taiwan"]},{"name":"School of Medicine, Chung Shan Medical University","place":["Taichung, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meng-Che","family":"Wu","sequence":"additional","affiliation":[{"name":"School of Medicine, Chung Shan Medical University","place":["Taichung, Taiwan"]},{"name":"Division of Pediatric Gastroenterology, Children\u2019s Medical Center, Taichung Veterans General Hospital","place":["Taichung, Taiwan"]},{"name":"Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University","place":["Taichung, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,3]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1002\/9781119211419.ch20","article-title":"Irritable bowel syndrome","volume":"376","author":"Ford","year":"2017","journal-title":"N Engl J 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