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. 2022 Jun 29;9(1):e000698. doi: 10.1136/lupus-2022-000698

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© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Study description. We posit that social support compensates for the detrimental, independent effect of racism on lupus outcomes, taking into account other sociodemographic and behavioural characteristics, through epigenetic and gene regulatory mechanisms. We will: (1) identify DNA methylation (DNAm) variation associated with exposure to racial discrimination and to social support; (2) assess whether these DNAm sites influence gene expression, taking genetic variation into account; (3) identify the joint and synergistic effects of social factors on DNAm changes associated with lupus outcomes; and (4) develop a social factors-DNAm predictive model for disease outcomes.