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Moore JM, Norris JM, Clark ML. Exposure to air pollutants and rheumatoid arthritis biomarkers: A scoping review. Semin Arthritis Rheum 2024; 65:152365. [PMID: 38232624 DOI: 10.1016/j.semarthrit.2024.152365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 12/20/2023] [Accepted: 01/03/2024] [Indexed: 01/19/2024]
Abstract
INTRODUCTION Rheumatoid arthritis (RA) is a common autoimmune disease with a complex and poorly understood etiology that includes genetic, hormonal, and environmental factors. OBJECTIVE Our objective was to assess current literature that investigated the association between exposure to environmental and occupational air pollutants and RA-related biomarkers rheumatoid factor (RF) and anti-citrullinated peptide antibody (ACPA). DESIGN PubMed and Web of Science were used to identify epidemiological studies that measured or estimated air pollution and at least one RA biomarker. Information was charted for comparison of evidence, including pollutant(s) studied, exposure assessment, biomarker measurement, analysis method, study population, size, dates, adjustment variables, and findings. RESULTS Several common air pollutants (including two mixtures) and a few dozen occupational inhalants were assessed in 13 eligible studies. Associations between industrial sulfur dioxide and particulate matter less than 2.5 µm in diameter with ACPA were observed most frequently, including associations between residential proximity to pollution sources and ACPA positivity. Consistency of associations with other pollutants was either not observed or limited to single studies. Three studies evaluated the modifying impact of SE alleles (a genetic factor associated with RA) and found that pollutant associations were stronger among participants positive for SE alleles. CONCLUSION Based on mixed results, there was no consistent link between any single pollutant and RA-related biomarker outcomes. Comparisons across studies were limited by differences in study populations (e.g., by RA status, by sociodemographic groups) and study design (including designs focused on different sources of air pollution, methodological approaches with varying levels of potential exposure misclassification, and assessments of inconsistent biomarker cut-points). However, given that multiple studies reported associations between exposure to air pollution and RA biomarkers, continued exploration utilizing studies that can be designed with a more robust causal framework, including continued consideration of effect modification by genetic status, may be necessary.
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Affiliation(s)
- Jillian M Moore
- Department of Environmental and Radiological Health Sciences, Colorado State University, 1681 Campus Delivery, Fort Collins, CO 80523, USA
| | - Jill M Norris
- Department of Epidemiology, Colorado School of Public Health, Aurora CO, USA
| | - Maggie L Clark
- Department of Environmental and Radiological Health Sciences, Colorado State University, 1681 Campus Delivery, Fort Collins, CO 80523, USA.
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Kim SH, Kim SY, Yoon HY, Song JW. PM 10 increases mortality risk in rheumatoid arthritis-associated interstitial lung disease. RMD Open 2024; 10:e003680. [PMID: 38331470 PMCID: PMC10860120 DOI: 10.1136/rmdopen-2023-003680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Accepted: 01/22/2024] [Indexed: 02/10/2024] Open
Abstract
OBJECTIVES The effect of air pollution on the prognosis of rheumatoid arthritis-associated interstitial lung disease (RA-ILD) remains poorly understood. We aimed to evaluate the effect of long-term exposure to particulate matter with an aerodynamic diameter of ≤10 µm (PM10) and nitrogen dioxide (NO2) on mortality in patients with RA-ILD. METHODS We included 309 patients (mean age, 61.7 years; male, 44.3%) with RA-ILD. Individual-level long-term exposures to PM10 and NO2 at their residential addresses were estimated using a national-scale exposure prediction model. The effect of the two air pollutants on mortality was estimated using a Cox-proportional hazards model adjusted for individual-level and area-level characteristics. RESULTS The median follow-up period was 4.8 years, and 40.8% of patients died or underwent lung transplantation. The annual average concentrations of PM10 and NO2 were 56.3 μg/m3 and 22.4 ppb, respectively. When air pollutant levels were stratified by quartiles, no association was observed between air pollutant concentration and mortality in patients with RA-ILD. However, when stratified by two groups (high exposure (top 25th percentile) vs low exposure (bottom 75th percentile)), we observed a significant association between high PM10 exposure and mortality (HR 1.68; 95% CI 1.11 to 2.52; p=0.013) but no association between NO2 exposure and mortality. In the subgroup analyses, the effect of high PM10 exposure on mortality was significant in patients aged <65 years (HR 1.98; 95% CI 1.02 to 3.85; p=0.045). CONCLUSIONS Our results indicated that high PM10 exposure may be associated with mortality in patients with RA-ILD.
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Affiliation(s)
- Soo Han Kim
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
- Department of Internal Medicine, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, South Korea
| | - Sun-Young Kim
- Department of Cancer AI & Digital Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, South Korea
| | - Hee-Young Yoon
- Division of Allergy and Respiratory Diseases, Soonchunhyang University Seoul Hospital, Seoul, South Korea
| | - Jin Woo Song
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
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Zhang J, Chen Z, Shan D, Wu Y, Zhao Y, Li C, Shu Y, Linghu X, Wang B. Adverse effects of exposure to fine particles and ultrafine particles in the environment on different organs of organisms. J Environ Sci (China) 2024; 135:449-473. [PMID: 37778818 DOI: 10.1016/j.jes.2022.08.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 08/04/2022] [Accepted: 08/08/2022] [Indexed: 10/03/2023]
Abstract
Particulate pollution is a global risk factor that seriously threatens human health. Fine particles (FPs) and ultrafine particles (UFPs) have small particle diameters and large specific surface areas, which can easily adsorb metals, microorganisms and other pollutants. FPs and UFPs can enter the human body in multiple ways and can be easily and quickly absorbed by the cells, tissues and organs. In the body, the particles can induce oxidative stress, inflammatory response and apoptosis, furthermore causing great adverse effects. Epidemiological studies mainly take the population as the research object to study the distribution of diseases and health conditions in a specific population and to focus on the identification of influencing factors. However, the mechanism by which a substance harms the health of organisms is mainly demonstrated through toxicological studies. Combining epidemiological studies with toxicological studies will provide a more systematic and comprehensive understanding of the impact of PM on the health of organisms. In this review, the sources, compositions, and morphologies of FPs and UFPs are briefly introduced in the first part. The effects and action mechanisms of exposure to FPs and UFPs on the heart, lungs, brain, liver, spleen, kidneys, pancreas, gastrointestinal tract, joints and reproductive system are systematically summarized. In addition, challenges are further pointed out at the end of the paper. This work provides useful theoretical guidance and a strong experimental foundation for investigating and preventing the adverse effects of FPs and UFPs on human health.
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Affiliation(s)
- Jianwei Zhang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Zhao Chen
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Dan Shan
- Department of Medical, Tianjin Stomatological Hospital, School of Medicine, Nankai University, Tianjin 300041, China
| | - Yang Wu
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Yue Zhao
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Chen Li
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin 300070, China; National Demonstration Center for Experimental Preventive Medicine Education (Tianjin Medical University), Tianjin 300070, China
| | - Yue Shu
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Xiaoyu Linghu
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Baiqi Wang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin 300070, China; National Demonstration Center for Experimental Preventive Medicine Education (Tianjin Medical University), Tianjin 300070, China.
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Gumtorntip W, Kasitanon N, Louthrenoo W, Chattipakorn N, Chattipakorn SC. Potential roles of air pollutants on the induction and aggravation of rheumatoid arthritis: From cell to bedside studies. Environ Pollut 2023; 334:122181. [PMID: 37453681 DOI: 10.1016/j.envpol.2023.122181] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 07/03/2023] [Accepted: 07/10/2023] [Indexed: 07/18/2023]
Abstract
Rheumatoid arthritis (RA) is an involving chronic systemic inflammatory disease which mainly affects the joints. Several factors including genetic, environment and infections have been acknowledged as being involved in the pathogenesis and aggravation of RA. Air pollution, particularly particulate matter is widely recognized as a cause of health problems. This review is to summarize and discuss the association between air pollutants and the development or the aggravation of RA based on evidence from in vitro, in vivo and clinical studies. The results from the review found that air pollutants can stimulate immunological processes and stimulate inflammatory mediators and autoantibodies productions, both in intro and in vivo studies. In addition, air pollutants can induce RA and aggravate RA disease activity. Unfortunately, there also are some discrepancies in the results, which might be due to the type cell line and the concentration of air pollutants used in the in vitro and in vivo studies, as well as the concentration and duration of exposure in human studies. These findings suggest that future studies focused on elucidating these mechanisms using advanced techniques and identifying reliable biomarkers to assess individual susceptibility and disease activity should be carried out. Longitudinal studies, intervention strategies, and policy implications also should be explored. A comprehensive understanding on these association will facilitate targeted approaches for prevention and management of air pollutant-induced RA and improve health outcome.
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Affiliation(s)
- Wanitcha Gumtorntip
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Nuntana Kasitanon
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Worawit Louthrenoo
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Nipon Chattipakorn
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand; Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, 50200, Thailand; Cardiac Electrophysiology Unit, Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Siriporn C Chattipakorn
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand; Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, 50200, Thailand; Department of Oral Biology and Diagnostic Sciences, Faculty of Dentistry, Chiang Mai University, Chiang Mai, 50200, Thailand.
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Biton J, Saidenberg-Kermanac'h N, Decker P, Boissier MC, Semerano L, Sigaux J. The exposome in rheumatoid arthritis. Joint Bone Spine 2022; 89:105455. [PMID: 35964886 DOI: 10.1016/j.jbspin.2022.105455] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Revised: 07/08/2022] [Accepted: 07/25/2022] [Indexed: 10/16/2022]
Abstract
The exposome integrates the variety and accumulation of exposures (external and internal) to which an individual is submitted to from conception to death. Exposome may therefore be a useful tool for understanding the diversity of these factors and their role in the pathophysiology of rheumatoid arthritis (RA). Life is perceived as a continuum of cumulative changes, with key periods of disruption (e.g. birth, adolescence, pregnancy, prolonged treatment). The combination of these changes and the external signals that cause them constitute an individual's exposome, which is constantly changing and expanding throughout life. Thus, measuring the exposome requires specific tools and approaches as well as a global perspective. RA, a complex, heterogeneous, pro-inflammatory autoimmune disease with a genetic component and for which a large number of environmental factors have already been incriminated is an appropriate field of application for the exposome. The aim of this review is to define the exposome concept, outline the different analytic tools available for its study and finally apply them to the field of RA.
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Affiliation(s)
- Jerome Biton
- Inserm U1125, Bobigny, France; Université Sorbonne Paris Nord, UFR SMBH, Li2P, Bobigny, France
| | | | - Patrice Decker
- Inserm U1125, Bobigny, France; Université Sorbonne Paris Nord, UFR SMBH, Li2P, Bobigny, France
| | - Marie-Christophe Boissier
- Inserm U1125, Bobigny, France; Université Sorbonne Paris Nord, UFR SMBH, Li2P, Bobigny, France; Rheumatology department, Avicenne university hospital, Assistance publique-Hôpitaux de Paris, Bobigny, France
| | - Luca Semerano
- Inserm U1125, Bobigny, France; Université Sorbonne Paris Nord, UFR SMBH, Li2P, Bobigny, France; Rheumatology department, Avicenne university hospital, Assistance publique-Hôpitaux de Paris, Bobigny, France
| | - Johanna Sigaux
- Inserm U1125, Bobigny, France; Université Sorbonne Paris Nord, UFR SMBH, Li2P, Bobigny, France; Rheumatology department, Avicenne university hospital, Assistance publique-Hôpitaux de Paris, Bobigny, France.
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Ho WC, Chou LW, Wang RY, Doan TN, Yu HL, Chou TH, Liu KY, Wu PC, Shieh SH. Association between Exposure to Ambient Air Pollution and the Risk of Rheumatoid Arthritis in Taiwan: A Population-Based Retrospective Cohort Study. Int J Environ Res Public Health 2022; 19:ijerph19127006. [PMID: 35742255 PMCID: PMC9222243 DOI: 10.3390/ijerph19127006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 06/06/2022] [Accepted: 06/06/2022] [Indexed: 02/01/2023]
Abstract
Background: The association between ambient air pollution (AAP) and the risk of Rheumatoid arthritis (RA) remains debatable. We conducted a population-based cohort study to investigate the association between exposure to AAP and the risk of RA in Taiwan. Methods: We analyzed and combined the longitudinal Health Insurance Database (LHID) and the Taiwan Air Quality-Monitoring Database (TAQMD), which were in line with the residential areas. We calculated the RA incidence rates per 10,000 person-years exposed to each quartile of PM2.5 or PM10 concentrations or RH. Hazards regression was conducted to analyze the associations between exposure to each quartile of PM2.5 and PM10 concentrations and the risk of developing RA. The hazard ratios of RA were analyzed between participants exposed to annual average concentrations of PM2.5 and PM10. All the hazard ratios of RA were stratified by gender and adjusted for age and relative humidity (RH). A p-value < 0.05 was considered statistically significant. Results: Among 722,885 subjects, 9338 RA cases were observed. The analyses adjusted for age, gender, and humidity suggested an increased risk of developing RA in the exposure to PM2.5 in the last quartile (Q4) with the adjusted hazard ratio (aHR) was 1.053 (95%CI: 1.043 to 1.063). Conclusion: Our study suggests that exposure to PM2.5 is associated with an increased risk of RA. The finding has implications for policymaking to develop coping strategies to confront AAP as a risk factor for RA.
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Affiliation(s)
- Wen-Chao Ho
- Department of Public Health, College of Public Health, China Medical University, Taichung 406040, Taiwan; (W.-C.H.); (R.-Y.W.); (T.-N.D.); (T.-H.C.); (K.-Y.L.)
| | - Li-Wei Chou
- Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung 404332, Taiwan;
- Department of Physical Medicine and Rehabilitation, Asia University Hospital, Asia University, Taichung 41354, Taiwan
- Department of Physical Therapy and Graduate Institute of Rehabilitation Science, China Medical University, Taichung 406040, Taiwan
| | - Ruey-Yun Wang
- Department of Public Health, College of Public Health, China Medical University, Taichung 406040, Taiwan; (W.-C.H.); (R.-Y.W.); (T.-N.D.); (T.-H.C.); (K.-Y.L.)
| | - Thanh-Nhan Doan
- Department of Public Health, College of Public Health, China Medical University, Taichung 406040, Taiwan; (W.-C.H.); (R.-Y.W.); (T.-N.D.); (T.-H.C.); (K.-Y.L.)
- Department of Rehabilitation, Quang Nam Northern Mountainous Region General Hospital, Quang Nam 560000, Vietnam
| | - Hwa-Lung Yu
- Department of Bioenvironmental Systems Engineering, National Taiwan University, Taipei 10617, Taiwan;
| | - Ting-Hsuan Chou
- Department of Public Health, College of Public Health, China Medical University, Taichung 406040, Taiwan; (W.-C.H.); (R.-Y.W.); (T.-N.D.); (T.-H.C.); (K.-Y.L.)
| | - Kang-Yung Liu
- Department of Public Health, College of Public Health, China Medical University, Taichung 406040, Taiwan; (W.-C.H.); (R.-Y.W.); (T.-N.D.); (T.-H.C.); (K.-Y.L.)
| | - Po-Chang Wu
- Ph.D. Program in Translational Medicine, National Chung Hsing University, Taichung 40227, Taiwan
- School of Medicine, College of Medicine, China Medical University, Taichung 40402, Taiwan
- Rong Hsing Research Center For Translational Medicine, National Chung Hsing University, Taichung 40227, Taiwan
- Rheumatology and Immunology Center, China Medical University Hospital, Taichung 404332, Taiwan
- Correspondence: (P.-C.W.); (S.-H.S.)
| | - Shwn-Huey Shieh
- Department of Health Services Administration, College of Public Health, China Medical University, Taichung 406040, Taiwan
- Department of Nursing, Asia University, Taichung 41354, Taiwan
- Correspondence: (P.-C.W.); (S.-H.S.)
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Adami G, Pontalti M, Cattani G, Rossini M, Viapiana O, Orsolini G, Benini C, Bertoldo E, Fracassi E, Gatti D, Fassio A. Association between long-term exposure to air pollution and immune-mediated diseases: a population-based cohort study. RMD Open 2022; 8:rmdopen-2021-002055. [PMID: 35292563 PMCID: PMC8969049 DOI: 10.1136/rmdopen-2021-002055] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 01/15/2022] [Indexed: 12/18/2022] Open
Abstract
Objective Environmental air pollution has been associated with disruption of the immune system at a molecular level. The primary aim of the present study was to describe the association between long-term exposure to air pollution and risk of developing immune-mediated conditions. Methods We conducted a retrospective observational study on a nationwide dataset of women and men. Diagnoses of various immune-mediated diseases (IMIDs) were retrieved. Data on the monitoring of particulate matter (PM)10 and PM2.5 concentrations were retrieved from the Italian Institute of Environmental Protection and Research. Generalised linear models were employed to determine the relationship between autoimmune diseases prevalence and PM. Results 81 363 subjects were included in the study. We found a positive association between PM10 and the risk of autoimmune diseases (ρ+0.007, p 0.014). Every 10 µg/m3 increase in PM10 concentration was associated with an incremental 7% risk of having autoimmune disease. Exposure to PM10 above 30 µg/m3 and PM2.5 above 20 µg/m3 was associated with a 12% and 13% higher risk of autoimmune disease, respectively (adjusted OR (aOR) 1.12, 95% CI 1.05 to 1.20, and aOR 1.13, 95% CI 1.06 to 1.20). Exposure to PM10 was associated with an increased risk of rheumatoid arthritis; exposure to PM2.5 was associated with an increased risk of rheumatoid arthritis, connective tissue diseases (CTDs) and inflammatory bowel diseases (IBD). Conclusion Long-term exposure to air pollution was associated with higher risk of developing autoimmune diseases, in particular rheumatoid arthritis, CTDs and IBD. Chronic exposure to levels above the threshold for human protection was associated with a 10% higher risk of developing IMIDs.
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Affiliation(s)
- Giovanni Adami
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
| | - Marco Pontalti
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
| | - Giorgio Cattani
- Italian Institute for Environmental Protection and Research, Rome, Italy
| | - Maurizio Rossini
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
| | - Ombretta Viapiana
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
| | - Giovanni Orsolini
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
| | - Camilla Benini
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
| | - Eugenia Bertoldo
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
| | - Elena Fracassi
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
| | - Davide Gatti
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
| | - Angelo Fassio
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
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Park JS, Choi S, Kim K, Chang J, Kim SM, Kim SR, Lee G, Son JS, Kim KH, Lee EY, Park SM. Association of particulate matter with autoimmune rheumatic diseases among adults in South Korea. Rheumatology (Oxford) 2021; 60:5117-5126. [PMID: 33560298 PMCID: PMC8566218 DOI: 10.1093/rheumatology/keab127] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 01/18/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The primary objective of this study was to investigate adverse effects of ambient particulate matter of various sizes on the incidence of the prevalent autoimmune rheumatic diseases (AIRDs): RA, AS and SLE. METHODS We investigated 230 034 participants in three metropolitan cities of South Korea from the National Health Insurance Service-National Sample Cohort (NHIS-NSC). Starting from January 2010, subjects were followed up until the first event of prevalent AIRDs, death, or December 2013. The 2008-2009 respective averages of particulate matter2.5 (<2.5 μm) and particulate mattercoarse (2.5 μm to 10 μm) were linked with participants' administrative district codes. Adjusted hazard ratios (aHRs) and 95% CIs were estimated using Cox regression analysis in one- and two-pollutant models. RESULTS Adjusted for age, sex, region, and household income, in the two-pollutant model, RA incidence was positively associated with the 10 μg/m³ increment of particulate matter2.5 (aHR = 1.74, 95% CI: 1.06, 2.86), but not with particulate mattercoarse (aHR = 1.27, 95% CI: 0.87, 1.85). In the one-pollutant model, the elevated incidence rate of RA was slightly attenuated (particulate matter2.5 aHR = 1.61, 95% CI: 0.99, 2.61; particulate mattercoarse aHR = 1.13, 95% CI: 0.80, 1.61), with marginal statistical significance for particulate matter2.5. The RA incidence was also higher in the 4th quartile group of particulate matter2.5 compared with the first quartile group (aHR = 1.83, 95% CI: 1.07, 3.11). Adverse effects from particulate matter were not found for AS or SLE in either the one- or two-pollutant models. CONCLUSION The important components of particulate matter10 associated with RA incidence were the fine fractions (particulate matter2.5); no positive association was found between particulate matter and AS or SLE.
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Affiliation(s)
- Jun Seok Park
- College of Medicine, Seoul National University Hospital
| | - Seulggie Choi
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul
| | - Kyuwoong Kim
- Division of Cancer Control and Policy, National Cancer Control Institute, National Cancer Center, Goyang
| | - Jooyoung Chang
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul
| | - Sung Min Kim
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul
| | - Seong Rae Kim
- College of Medicine, Seoul National University Hospital
| | - Gyeongsil Lee
- Department of Family Medicine, Seoul National University Hospital
| | - Joung Sik Son
- Department of Family Medicine, Seoul National University Hospital
| | - Kyae Hyung Kim
- Department of Family Medicine, Seoul National University Hospital
| | - Eun Young Lee
- Division of Rheumatology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - Sang Min Park
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul.,Department of Family Medicine, Seoul National University Hospital
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Celen H, Dens AC, Ronsmans S, Michiels S, De Langhe E. Airborne pollutants as potential triggers of systemic autoimmune rheumatic diseases: a narrative review. Acta Clin Belg 2021; 77:874-882. [PMID: 34666637 DOI: 10.1080/17843286.2021.1992582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The pathogenesis of systemic autoimmune rheumatic diseases (SARDs) is complex and remains insufficiently understood. It is commonly accepted that both intrinsic and extrinsic environmental factors interact to induce a self-reactive immune response. Case reports and observational studies have revealed an association between SARDs and specific airborne environmental factors, but the heterogeneity of the published studies hampers clear conclusions. The aim of this review is to provide an overview of the available epidemiological evidence on the relationship between airborne pollutants and SARDs. We performed a narrative review using the PubMed database. Observational studies have shown significant associations between airborne pollutants and SARDs. Cigarette smoking is strongly associated with the development of rheumatoid arthritis (RA) while the association between cigarette smoke and the development of other SARDs remains controversial. For decades, silica exposure has been linked to systemic sclerosis (SSc), RA and systemic lupus erythematosus (SLE). There is also strong evidence for a link between solvents and SSc. Recent observations even suggest that ambient air pollution is associated with the development of SARDs. Some studies have shown associations between asbestos, organic dust, metals and pesticides and SARDs, but more studies are needed to confirm these findings. Increasing evidence has linked airborne pollutants to SARDs. Although more studies are needed to understand the potential mechanisms by which these environmental agents contribute to disease pathogenesis, awareness of the link between environmental agents and SARDs is important to recognize and prevent work-related and environmentally induced diseases.
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Affiliation(s)
- Hannelore Celen
- Department of Rheumatology, University Hospitals Leuven, Leuven, Belgium
| | - Anne-Cathérine Dens
- Skeletal Biology and Engineering Research Centre, Department of Development and Regeneration, KU Leuven, Leuven, Belgium
- Department of Dermatology, University Hospitals Leuven, Leuven, Belgium
| | - Steven Ronsmans
- Clinic for Occupational and Environmental Medicine, Department of Pulmonary Medicine, University Hospitals Leuven, Leuven, Belgium
- Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Stijn Michiels
- Department of Rheumatology, Imelda General Hospital, Bonheiden, Belgium
| | - Ellen De Langhe
- Department of Rheumatology, University Hospitals Leuven, Leuven, Belgium
- Skeletal Biology and Engineering Research Centre, Department of Development and Regeneration, KU Leuven, Leuven, Belgium
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Ingegnoli F, Ubiali T, Schioppo T, Longo V, Murgo A, Lucia O, Favalli EG, Iodice S, Bollati V, Caporali R. Potential Short-Term Air Pollution Effects on Rheumatoid Arthritis Activity in Metropolitan Areas in the North of Italy: A Cross-Sectional Study. Int J Environ Res Public Health 2021; 18:8490. [PMID: 34444236 DOI: 10.3390/ijerph18168490] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 08/03/2021] [Accepted: 08/09/2021] [Indexed: 02/07/2023]
Abstract
Rheumatoid arthritis (RA) flare is related to increased joint damage, disability, and healthcare use. The impact of short-term air pollution exposure on RA disease activity is still a matter of debate. In this cross-sectional study, we investigated whether short-term exposure to particulate matter (PM)10, PM2.5, nitrogen dioxide (NO2), and ozone (O3) affected RA disease activity (DAS28 and SDAI) in 422 consecutive RA residents in Lombardy, North of Italy. Air pollutant concentrations, estimated by Regional Environmental Protection Agency (Lombardy—Italy) at the municipality level, were used to assign short-term exposure from the day of enrolment, back to seven days. Some significant negative associations emerged between RA disease activity, PM10, and NO2, whereas some positive associations were observed for O3. Patients were also stratified according to their ongoing Disease-Modifying anti-Rheumatic Drugs (DMARDs) treatment: no DMARDs (n = 25), conventional synthetic DMARDs (n = 108), and biological or targeted synthetic DMARDs (n = 289). Therapy interaction seemed partially able to influence the relationship between short-term air pollution exposure and RA disease activity (PM2.5 levels and DAS28 at the day of the visit-O3 levels and disease activity scores for the seven days before the evaluation). According to our results, the impact of short-term air pollution exposure (seven days) minimally impacts disease activity. Moreover, our study suggests therapy could alter the response to environmental factors. Further evidence is needed to elucidate determinants of RA flare and its management.
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Deng Y, Gao Q, Yang T, Wu B, Liu Y, Liu R. Indoor solid fuel use and incident arthritis among middle-aged and older adults in rural China: A nationwide population-based cohort study. Sci Total Environ 2021; 772:145395. [PMID: 33578144 DOI: 10.1016/j.scitotenv.2021.145395] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 01/08/2021] [Accepted: 01/19/2021] [Indexed: 05/26/2023]
Abstract
BACKGROUND Many households in developing countries, including China, rely on the traditional use of solid fuels for cooking and heating. Arthritis is highly prevalent in middle-aged and older adults and is a major cause of disability. However, evidence linking indoor solid fuel use with arthritis is scarce in this age group (≥45 years) in developing countries. OBJECTIVES To investigate whether exposure to indoor solid fuel for cooking and heating is associated with arthritis in middle-aged and older adults in rural China. METHODS Data for the present study were extracted from the China Health and Retirement Longitudinal Study (CHARLS), a longitudinal national prospective study of adults aged 45 years and older enrolled in 2010 and followed up through 2015. We included 7807 rural participants without arthritis at baseline, of whom 1548 living in a central heating area in winter were included in the heating analysis (taking the Qinling-Huaihe line as the heating boundary). Cox proportional hazards models were used to examine the association between indoor solid fuel use and arthritis, controlling for age, sex, education, marital status, smoking status, drinking status, self-reported socioeconomic status, BMI, sleep time, napping time, independent cooking, hypertension, diabetes, dyslipidemia, heart problems and stroke. We also investigated the effect of switching primary fuels and using solid fuels for both cooking and heating on arthritis risk. RESULTS The mean (SD) age of the study participants was 59.2 (10.0) years old, and 48.0% of participants were women. A total of 64.8% and 63.0% of the participants reported primarily using solid fuel for cooking and heating, respectively. Arthritis incidence rates were lower among clean fuel users than solid fuel users. Compared to those using clean fuels, cooking and heating solid fuel users had a higher risk of arthritis, with hazard ratios (HRs) of 1.22 (95% confidence interval (CI): 1.01, 1.49) and 1.76 (95% CI: 1.07, 2.89), respectively. Switching from clean fuels to solid fuels for heating (HR: 3.28, 95% CI: 1.21, 7.91) and using solid fuels for both cooking and heating (HR, 1.71, 95% CI, 1.01-2.79) increased the risk of arthritis. CONCLUSIONS Long-term solid fuel use for indoor cooking and heating is associated with an increased risk of arthritis events among adults aged 45 years and older in rural China. The potential benefits of reducing indoor solid fuel use in groups at high risk for arthritis merit further exploration.
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Affiliation(s)
- Yan Deng
- Department of Environmental Health, School of Public Health, China Medical University, Shenyang 110122, China
| | - Qian Gao
- Department of Environmental Health, School of Public Health, China Medical University, Shenyang 110122, China
| | - Tianyao Yang
- Department of Environmental Health, School of Public Health, China Medical University, Shenyang 110122, China
| | - Bo Wu
- Department of Anal and Rectal Diseases, First Hospital, China Medical University, Shenyang 110001, China
| | - Yang Liu
- Department of Environmental Health, School of Public Health, China Medical University, Shenyang 110122, China
| | - Ruxi Liu
- Department of Immunology and Rheumatology, First Hospital, China Medical University, Shenyang 110001, China.
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12
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Prisco LC, Martin LW, Sparks JA. Inhalants other than personal cigarette smoking and risk for developing rheumatoid arthritis. Curr Opin Rheumatol 2020; 32:279-88. [PMID: 32141952 DOI: 10.1097/BOR.0000000000000705] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE OF REVIEW The current review summarizes the current evidence on inhalants other than personal cigarette smoking and risk for developing rheumatoid arthritis (RA). RECENT FINDINGS Personal cigarette smoking has been implicated as an environmental risk factor for seropositive RA, perhaps by inducing autoimmunity at pulmonary mucosa. Since many patients with RA are nonsmokers, other inhalants are being investigated as potential RA risk factors. Recent case-control and cohort studies have investigated passive cigarette smoking, air pollution, inhalant-related occupations, silica, pesticides, household environment, and allergic inhalants as inhalant exposures for RA risk. Inhalant-related occupations and silica inhalants have the most consistent evidence for associations with increased RA risk. However, most studies relied on retrospective designs and had limited ability to adjust for personal cigarette smoking or investigate associations among nonsmokers. SUMMARY Several inhalants other than personal cigarette smoking may be associated with increased risk for developing RA. These results support the hypothesis that inhalants, pulmonary mucosal inflammation, and RA pathogenesis may be linked. Future studies are needed to firmly establish the independence of these findings from personal cigarette smoking and to determine the specific inhalants and biologic mechanisms related to RA pathogenesis.
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Wu Q, Xu Z, Dan YL, Cheng J, Zhao CN, Mao YM, Xiang K, Hu YQ, He YS, Pan HF. Association between traffic-related air pollution and hospital readmissions for rheumatoid arthritis in Hefei, China: A time-series study. Environ Pollut 2021; 268:115628. [PMID: 33049484 DOI: 10.1016/j.envpol.2020.115628] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 09/04/2020] [Accepted: 09/07/2020] [Indexed: 06/11/2023]
Abstract
Air pollution is an important risk factor for autoimmune diseases, but its association with the recurrence of rheumatoid arthritis (RA) remains unclear so far. This study aimed to investigate the short-term association between traffic-related air pollutants and hospital readmissions for RA in Hefei, China. Data on daily hospital readmissions for RA and traffic-related air pollutants, including particulate matter (PM2.5 and PM10), nitrogen dioxide (NO2), and carbon monoxide (CO), from 2014 to 2018 were retrieved. A time-series approach using generalized linear regression model was employed. The analysis was further stratified by sex, age and season. A total of 1153 readmissions for RA were reported during the study period. A significant association between high-concentration PM2.5 (90th percentile) and RA readmissions was observed on lag1 (relative risk (RR) = 1.09, 95% confidence interval (CI): 1.01-1.19) and lasted until lag3 (RR = 1.06, 95%CI: 1.01-1.12). From lag2 to lag5, high-concentration NO2 (90th percentile) was associated with increased risk of RA readmissions, with the highest RR observed at lag 4 (1.11, 95%CI: 1.05-1.17). Stratified analyses indicated that females and the elderly appeared to be more vulnerable to high-concentration PM2.5 and NO2 exposure. High-concentration PM2.5 and NO2 in cold seasons were consistently significantly associated with increased risk of RA readmissions. Exposure to high-concentration PM2.5 and NO2 was associated with increased risk of RA readmissions. Protective measures against the exposure to high-concentration PM2.5 and NO2 should be taken to reduce the recurrence risk in RA patients, especially in females, the elderly and during cold seasons.
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Affiliation(s)
- Qian Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, 81 Meishan Road, Hefei, Anhui, China
| | - Zhiwei Xu
- School of Public Health, Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Yi-Lin Dan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, 81 Meishan Road, Hefei, Anhui, China
| | - Jian Cheng
- School of Public Health and Social Work & Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Chan-Na Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, 81 Meishan Road, Hefei, Anhui, China
| | - Yan-Mei Mao
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, 81 Meishan Road, Hefei, Anhui, China
| | - Kun Xiang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, 81 Meishan Road, Hefei, Anhui, China
| | - Yu-Qian Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, 81 Meishan Road, Hefei, Anhui, China
| | - Yi-Sheng He
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, 81 Meishan Road, Hefei, Anhui, China
| | - Hai-Feng Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, 81 Meishan Road, Hefei, Anhui, China.
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14
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Zhao N, Smargiassi A, Colmegna I, Hudson M, Fritzler M, Bernatsky S. Sunlight exposure, sun-protective behaviour, and anti-citrullinated protein antibody positivity: A general population-based study in Quebec, Canada. Arthritis Care Res (Hoboken) 2020; 74:236-242. [PMID: 32961027 DOI: 10.1002/acr.24448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 08/04/2020] [Accepted: 09/08/2020] [Indexed: 11/09/2022]
Abstract
OBJECTIVES To examine associations between sunlight exposure and anti-citrullinated protein antibodies (ACPA) using general population data in Quebec, Canada. METHODS A random sample of 7600 individuals (including 786 positive ACPA subjects and 201 self-reported rheumatoid arthritis, RA cases) from the CARTaGENE cohort was studied cross-sectionally. All subjects were nested in four census metropolitan areas, and mixed-effects logistic regression models were used to calculate odds ratios (OR) and 95% confidence intervals (CIs) for ACPA positivity related to sunlight exposure, adjusting for sun-block use, industrial fine particulate matter (PM2.5 ) exposures, smoking, age, sex, French Canadian ancestry, and family income. We also performed sensitivity analyses excluding subjects with RA, defining ACPA positivity by higher titers, and stratifying by age and sex. RESULTS The adjusted ORs and 95% CIs did not suggest conclusive associations between ACPA and sunlight exposure or sun-block use, but robust positive relationships were observed between industrial PM2.5 emissions and ACPA (OR 1.19 per µg/m3 , 95% CI 1.03 - 1.36 in primary analyses). CONCLUSIONS We did not see clear links between ACPA and sunlight exposure or sun-block use, but we did note positive associations with industrial PM2.5 . Future studies of sunlight and RA (or ACPA) should take air pollution exposures into account.
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Affiliation(s)
- Naizhuo Zhao
- Division of Clinical Epidemiology, McGill University Health Centre, Montreal, QC, Canada
| | - Audrey Smargiassi
- Département de Santé Environnementale et de Santé au Travail, Université de Montréal, Montréal, QC, Canada.,Institut National de Santé Publique du Québec, Montréal, QC, Canada.,Centre de Recherche en Santé Publique de l, Université de Montréal, Montréal, QC, Canada
| | - Ines Colmegna
- Department of Medicine, McGill University, Montréal, QC, Canada.,Division of Rheumatology, McGill University Health Center, Montréal, QC, Canada
| | - Marie Hudson
- Department of Medicine, McGill University, Montréal, QC, Canada.,Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada
| | - Marvin Fritzler
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Sasha Bernatsky
- Division of Clinical Epidemiology, McGill University Health Centre, Montreal, QC, Canada.,Department of Medicine, McGill University, Montréal, QC, Canada.,Division of Rheumatology, McGill University Health Center, Montréal, QC, Canada
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15
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Zhao N, Smargiassi A, Hatzopoulou M, Colmegna I, Hudson M, Fritzler MJ, Awadalla P, Bernatsky S. Long-term exposure to a mixture of industrial SO 2, NO 2, and PM 2.5 and anti-citrullinated protein antibody positivity. Environ Health 2020; 19:86. [PMID: 32727483 PMCID: PMC7391811 DOI: 10.1186/s12940-020-00637-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 07/21/2020] [Indexed: 06/02/2023]
Abstract
BACKGROUND Studies of associations between industrial air emissions and rheumatic diseases, or diseases-related serological biomarkers, are few. Moreover, previous evaluations typically studied individual (not mixed) emissions. We investigated associations between individual and combined exposures to industrial sulfur dioxide (SO2), nitrogen dioxide (NO2), and fine particles matter (PM2.5) on anti-citrullinated protein antibodies (ACPA), a characteristic biomarker for rheumatoid arthritis (RA). METHODS Serum ACPA was determined for 7600 randomly selected CARTaGENE general population subjects in Quebec, Canada. Industrial SO2, NO2, and PM2.5 concentrations, estimated by the California Puff (CALPUFF) atmospheric dispersion model, were assigned based on residential postal codes at the time of sera collection. Single-exposure logistic regressions were performed for ACPA positivity defined by 20 U/ml, 40 U/ml, and 60 U/ml thresholds, adjusting for age, sex, French Canadian origin, smoking, and family income. Associations between regional overall PM2.5 exposure and ACPA positivity were also investigated. The associations between the combined three industrial exposures and the ACPA positivity were assessed by weighted quantile sum (WQS) regressions. RESULTS Significant associations between individual industrial exposures and ACPA positivity defined by the 20 U/ml threshold were seen with single-exposure logistic regression models, for industrial emissions of PM2.5 (odds ratio, OR = 1.19, 95% confidence intervals, CI: 1.04-1.36) and SO2 (OR = 1.03, 95% CI: 1.00-1.06), without clear associations for NO2 (OR = 1.01, 95% CI: 0.86-1.17). Similar findings were seen for the 40 U/ml threshold, although at 60 U/ml, the results were very imprecise. The WQS model demonstrated a positive relationship between combined industrial exposures and ACPA positivity (OR = 1.36, 95% CI: 1.10-1.69 at 20 U/ml) and suggested that industrial PM2.5 may have a closer association with ACPA positivity than the other exposures. Again, similar findings were seen with the 40 U/ml threshold, though 60 U/ml results were imprecise. No clear association between ACPA and regional overall PM2.5 exposure was seen. CONCLUSIONS We noted positive associations between ACPA and industrial emissions of PM2.5 and SO2. Industrial PM2.5 exposure may play a particularly important role in this regard.
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Affiliation(s)
- Naizhuo Zhao
- Division of Clinical Epidemiology, McGill University Health Centre, Montreal, QC Canada
| | - Audrey Smargiassi
- Département de Santé Environnementale et de Santé au Travail, Université de Montréal, Montréal, QC Canada
- Institut National de Santé Publique du Québec, Montréal, QC Canada
- Centre de Recherche en Santé Publique de l’Université de Montréal (CReSP), Montréal, QC Canada
| | | | - Ines Colmegna
- Department of Medicine, McGill University, Montréal, QC Canada
- Division of Rheumatology, McGill University Health Center, Montréal, QC Canada
| | - Marie Hudson
- Department of Medicine, McGill University, Montréal, QC Canada
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC Canada
| | - Marvin J. Fritzler
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB Canada
| | - Philip Awadalla
- Ontario Institute for Cancer Research, Toronto, ON Canada
- Department of Molecular Genetics, University of Toronto, Toronto, ON Canada
| | - Sasha Bernatsky
- Division of Clinical Epidemiology, McGill University Health Centre, Montreal, QC Canada
- Department of Medicine, McGill University, Montréal, QC Canada
- Division of Rheumatology, McGill University Health Center, Montréal, QC Canada
- Centre for Outcomes Research & Evaluation, 5252 boul de Maisonneuve Ouest, (3F.51), Montreal, QC H4A 3S5 Canada
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16
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Sesé L, Jeny F, Uzunhan Y, Khamis W, Freynet O, Valeyre D, Bernaudin JF, Annesi-Maesano I, Nunes H. [The effect of air pollution in diffuse interstitial lung disease]. Rev Mal Respir 2020; 37:389-398. [PMID: 32278507 DOI: 10.1016/j.rmr.2020.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 02/09/2020] [Indexed: 11/30/2022]
Abstract
Few studies have examined the effects of air pollution in diffuse interstitial lung disease and they have focused on small numbers of patients. Most data are available in idiopathic pulmonary fibrosis and studies suggest that the level of exposure to pollutants may influence the development of acute exacerbations (ozone and NO2), their incidence (NO2), decline in respiratory function (PM10) and death (PM10 and PM2.5). Several studies show an increase in the incidence of rheumatoid arthritis in people living near busy roads. In systemic scleroderma, hypersensitivity pneumonitis and sarcoidosis although negative effects of pollution have been reported the data are insufficient to be conclusive. Nevertheless, the observed effects of air pollution are consistent with those described for other chronic respiratory diseases. Exposure to pollution induces oxidative stress, chronic inflammation and shortening of telomeres, which are all mechanisms described in fibrogenesis. New epidemiological studies are needed with individual measurements of exposure to outdoor and indoor pollution, as well as fundamental studies to clarify the effect of pollution on fibrogenesis.
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Affiliation(s)
- L Sesé
- Service de pneumologie, hôpital Avicenne, AP-HP, Bobigny, France; EPAR, INSERM UMR-S 1136, Sorbonne Université, Paris, France; Service d'explorations fonctionnelles, AP-HP, hôpital Avicenne, Bobigny, France.
| | - F Jeny
- Service de pneumologie, hôpital Avicenne, AP-HP, Bobigny, France; INSERM 1272 « Réponses cellulaires et fonctionnelles à l'hypoxie », Université Paris 13, Bobigny, France
| | - Y Uzunhan
- Service de pneumologie, hôpital Avicenne, AP-HP, Bobigny, France; INSERM 1272 « Réponses cellulaires et fonctionnelles à l'hypoxie », Université Paris 13, Bobigny, France
| | - W Khamis
- Service de pneumologie, hôpital Avicenne, AP-HP, Bobigny, France
| | - O Freynet
- Service de pneumologie, hôpital Avicenne, AP-HP, Bobigny, France
| | - D Valeyre
- Service de pneumologie, hôpital Avicenne, AP-HP, Bobigny, France; INSERM 1272 « Réponses cellulaires et fonctionnelles à l'hypoxie », Université Paris 13, Bobigny, France
| | - J-F Bernaudin
- Service de pneumologie, hôpital Avicenne, AP-HP, Bobigny, France; INSERM 1272 « Réponses cellulaires et fonctionnelles à l'hypoxie », Université Paris 13, Bobigny, France
| | | | - H Nunes
- Service de pneumologie, hôpital Avicenne, AP-HP, Bobigny, France; INSERM 1272 « Réponses cellulaires et fonctionnelles à l'hypoxie », Université Paris 13, Bobigny, France
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Zhao N, Smargiassi A, Hudson M, Fritzler MJ, Bernatsky S. Investigating associations between anti-nuclear antibody positivity and combined long-term exposures to NO 2, O 3, and PM 2.5 using a Bayesian kernel machine regression approach. Environ Int 2020; 136:105472. [PMID: 31991236 DOI: 10.1016/j.envint.2020.105472] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 12/06/2019] [Accepted: 01/06/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND Air pollution has many adverse health effects, but the combined or synergistic effects of multiple ambient air pollutants on anti-nuclear antibodies (ANA, a serologic marker of systemic autoimmune rheumatic disease, SARDs) have never been assessed. OBJECTIVE To flexibly model ANA and individual and joint associations of long-term exposures to nitrogen dioxide (NO2), ozone (O3), and fine particles matter (PM2.5) using a Bayesian Kernel machine regression (BKMR) approach and to compare the results to those from individual logistic regressions. METHODS Serum ANA positivity was determined for randomly selected CARTaGENE general population subjects in Quebec, Canada. CARTaGENE is a public research platform created for investigating the associations of environmental, genomic, and lifestyle factors on chronic diseases. Ambient NO2, O3, and PM2.5 estimates, derived from ground-measurement and chemical-transport-model simulated concentrations, were assigned to subjects based on residential postal codes at the time of blood collection. Our models adjusted for age, sex, French Canadian origin, smoking, and family income. RESULTS Concentrations of NO2, O3, and PM2.5 were closely correlated in space. In the 5485 CARTaGENE subjects studied, we did not see clear associations between NO2, PM2.5 or O3 and ANA positivity, with either the BKMR or logistic models. CONCLUSIONS BKMR did not uncover associations between ANA positivity and individual levels or combined exposures of NO2, O3, and PM2.5; neither did simpler logistic models. Additional studies (in younger populations, in distinct race/ethnicity groups, and/or in jurisdictions with high air pollution levels) would be helpful to reinforce current findings.
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Affiliation(s)
- Naizhuo Zhao
- Division of Clinical Epidemiology, McGill University Health Centre, Montreal, QC, Canada
| | - Audrey Smargiassi
- Département de Santé Environnementale et de Santé au Travail, Université de Montréal, Montréal, QC, Canada; Institut National de Santé Publique du Québec, Montréal, QC, Canada; Centre de Recherche en Santé Publique de l'Université de Montréal (CReSP), Montréal, QC, Canada
| | - Marie Hudson
- Department of Medicine, McGill University, Montreal, QC, Canada; Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
| | - Marvin J Fritzler
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Sasha Bernatsky
- Department of Medicine, McGill University, Montreal, QC, Canada; Divisions of Rheumatology and Clinical Epidemiology, McGill University Health Centre, Montreal, QC, Canada.
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18
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Di D, Zhang L, Wu X, Leng R. Long-term exposure to outdoor air pollution and the risk of development of rheumatoid arthritis: A systematic review and meta-analysis. Semin Arthritis Rheum 2019; 50:266-275. [PMID: 31761290 DOI: 10.1016/j.semarthrit.2019.10.005] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Revised: 09/18/2019] [Accepted: 10/04/2019] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Air pollution ranks high among risk factors for the global burden of disease. The associations of air pollution and rheumatoid arthritis (RA) are controversial. This systematic review and meta-analyses has analyzed the association between outdoor air pollution and the development of RA. METHODS PubMed, Embase and Web of science (last search, May 21, 2019) were searched. A meta-analysis was performed with a random-effects model, and summarized syntheses effects were expressed as relative risks (RRs). RESULTS Eight studies were identified from among 1296 articles. The pooled RR for the association between ozone (O3) exposure and RA was 1.16 (95% CI: 1.15, 1.18). The pooled RR for the association of RA risk with proximity to traffic road was 1.34 (95% CI: 1.11, 1.62) for residence ≤ 50 m from a traffic road compared with residence more far away. In contrast, there was an inverse effect between PM2.5 exposure and incident RA, and similar result of PM10 was found by subgroup analysis in seropositive RA. In addition, there was no clear evidence between exposing to PM10, CO, NO2 and NO2 (tenth year prior) and RA risk. CONCLUSION Existing evidence indicated significant associations between some markers (ozone, proximity to traffic road and PM2.5) of air pollution and RA. For generalizability of evidence, that research should be extended to developing countries where air pollution (including indoor) is high may provide more complete insight into risk factors for RA.
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Affiliation(s)
- Dongsheng Di
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui 230032, China
| | - Linlin Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui 230032, China
| | - Xiaoxiao Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui 230032, China
| | - Ruixue Leng
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui 230032, China.
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19
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Zhao CN, Xu Z, Wu GC, Mao YM, Liu LN, Qian-Wu, Dan YL, Tao SS, Zhang Q, Sam NB, Fan YG, Zou YF, Ye DQ, Pan HF. Emerging role of air pollution in autoimmune diseases. Autoimmun Rev. 2019;18:607-614. [PMID: 30959217 DOI: 10.1016/j.autrev.2018.12.010] [Citation(s) in RCA: 161] [Impact Index Per Article: 32.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Accepted: 12/23/2018] [Indexed: 02/07/2023]
Abstract
Autoimmune diseases (ADs) are a broad spectrum of disorders featured by the body's immune responses being directed against its own tissues, resulting in prolonged inflammation and subsequent tissue damage. Recently, the exposure to ambient air pollution has been implicated in the occurrence and development of ADs. Mechanisms linking air pollution exposures and ADs mainly include systemic inflammation, increased oxidative stress, epigenetic modifications induced by exposures and immune response caused by airway damage. The lung may be an autoimmunity initiation site in autoimmune diseases (ADs). Air pollutants can bind to the Aryl hydrocarbon receptor (AHR) to regulate Th17 and Treg cells. Oxidative stress and inducible bronchus associated lymphoid tissue caused by the pollutants can influence T, B cells, resulting in the production of proinflammatory cytokines. These cytokines stimulate B cell and dendritic cells, resulting in a lot of antibodies and self-reactive T lymphocytes. Moreover, air pollutants may induce epigenetic changes to contribute to ADs. In this review, we will concern the associations between air pollution and immune-inflammatory responses, as well as mechanisms linking air pollution exposure and autoimmunity. In addition, we focus on the potential roles of air pollution in major autoimmune diseases including systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), multiple sclerosis (MS), and type 1 diabetes mellitus (T1DM).
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Lin SY, Hsu WH, Lin CL, Lin CC, Lin CH, Wang IK, Hsu CY, Kao CH. Association of Exposure to Fine-Particulate Air Pollution and Acidic Gases with Incidence of Nephrotic Syndrome. Int J Environ Res Public Health 2018; 15:E2860. [PMID: 30558173 DOI: 10.3390/ijerph15122860] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 11/29/2018] [Accepted: 12/12/2018] [Indexed: 01/15/2023]
Abstract
Background: Air pollution has been associated with autoimmune diseases. Nephrotic syndrome is a clinical manifestation of immune-mediated glomerulopathy. However, the association between nephrotic syndrome and air pollution constituents remains unknown. We conducted this nationwide retrospective study to investigate the association between PM2.5 and nephrotic syndrome. Methods: We used the Longitudinal Health Insurance Database (LHID) and the Taiwan Air Quality-Monitoring Database (TAQMD). We combined and stratified the LHID and the TAQMD data by residential areas of insurants linked to nearby air quality-monitoring stations. Air pollutant concentrations were grouped into four levels based on quartile. Univariable and multivariable Cox proportional hazard regression models were applied. Findings: Relative to Q1-level SO₂, subjects exposed to the Q4 level were associated with a 2.00-fold higher risk of nephrotic syndrome (adjusted HR = 2.00, 95% CI = 1.66⁻2.41). In NOx, relative to Q1 NOx concentrations, the adjusted HRs of nephrotic syndrome risk were 1.53 (95% CI = 1.23⁻1.91), 1.30 (95% CI = 1.03⁻1.65), and 2.08 (95% CI = 1.69⁻2.56) for Q2, Q3, and Q4 levels, respectively. The results revealed an increasing trend for nephrotic syndrome risk correlating with increasing levels of NO, NO₂, and PM2.5 concentrations. Interpretation: High concentrations of PM2.5, NO, NO₂, and SO₂ are associated with increased risk of nephrotic syndrome.
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Weinmayr G, Pedersen M, Stafoggia M, Andersen ZJ, Galassi C, Munkenast J, Jaensch A, Oftedal B, Krog NH, Aamodt G, Pyko A, Pershagen G, Korek M, De Faire U, Pedersen NL, Östenson CG, Rizzuto D, Sørensen M, Tjønneland A, Bueno-de-Mesquita B, Vermeulen R, Eeftens M, Concin H, Lang A, Wang M, Tsai MY, Ricceri F, Sacerdote C, Ranzi A, Cesaroni G, Forastiere F, de Hoogh K, Beelen R, Vineis P, Kooter I, Sokhi R, Brunekreef B, Hoek G, Raaschou-Nielsen O, Nagel G. Particulate matter air pollution components and incidence of cancers of the stomach and the upper aerodigestive tract in the European Study of Cohorts of Air Pollution Effects (ESCAPE). Environ Int 2018; 120:163-171. [PMID: 30096610 DOI: 10.1016/j.envint.2018.07.030] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 07/20/2018] [Accepted: 07/21/2018] [Indexed: 05/25/2023]
Abstract
INTRODUCTION Previous analysis from the large European multicentre ESCAPE study showed an association of ambient particulate matter <2.5 μm (PM2.5) air pollution exposure at residence with the incidence of gastric cancer. It is unclear which components of PM are most relevant for gastric and also upper aerodigestive tract (UADT) cancer and some of them may not be strongly correlated with PM mass. We evaluated the association between long-term exposure to elemental components of PM2.5 and PM10 and gastric and UADT cancer incidence in European adults. METHODS Baseline addresses of individuals were geocoded and exposure was assessed by land-use regression models for copper (Cu), iron (Fe) and zinc (Zn) representing non-tailpipe traffic emissions; sulphur (S) indicating long-range transport; nickel (Ni) and vanadium (V) for mixed oil-burning and industry; silicon (Si) for crustal material and potassium (K) for biomass burning. Cox regression models with adjustment for potential confounders were used for cohort-specific analyses. Combined estimates were determined with random effects meta-analyses. RESULTS Ten cohorts in six countries contributed data on 227,044 individuals with an average follow-up of 14.9 years with 633 incident cases of gastric cancer and 763 of UADT cancer. The combined hazard ratio (HR) for an increase of 200 ng/m3 of PM2.5_S was 1.92 (95%-confidence interval (95%-CI) 1.13;3.27) for gastric cancer, with no indication of heterogeneity between cohorts (I2 = 0%), and 1.63 (95%-CI 0.88;3.01) for PM2.5_Zn (I2 = 70%). For the other elements in PM2.5 and all elements in PM10 including PM10_S, non-significant HRs between 0.78 and 1.21 with mostly wide CIs were seen. No association was found between any of the elements and UADT cancer. The HR for PM2.5_S and gastric cancer was robust to adjustment for additional factors, including diet, and restriction to study participants with stable addresses over follow-up resulted in slightly higher effect estimates with a decrease in precision. In a two-pollutant model, the effect estimate for total PM2.5 decreased whereas that for PM2.5_S was robust. CONCLUSION This large multicentre cohort study shows a robust association between gastric cancer and long-term exposure to PM2.5_S but not PM10_S, suggesting that S in PM2.5 or correlated air pollutants may contribute to the risk of gastric cancer.
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Affiliation(s)
- Gudrun Weinmayr
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany.
| | - Marie Pedersen
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark; The Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Massimo Stafoggia
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Rome, Italy; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Zorana J Andersen
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Claudia Galassi
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention (CPO), Turin, Italy
| | - Jule Munkenast
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Andrea Jaensch
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | | | - Norun H Krog
- Norwegian Institute of Public Health, Oslo, Norway
| | - Geir Aamodt
- Department of Public Health Science, LANDSAM, NMBU, Ås, Norway
| | - Andrei Pyko
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Göran Pershagen
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Michal Korek
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Ulf De Faire
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Nancy L Pedersen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Claes-Göran Östenson
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
| | - Debora Rizzuto
- Aging Research Center, Department of Neurobiology Care Science and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Mette Sørensen
- The Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Anne Tjønneland
- The Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Bas Bueno-de-Mesquita
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK
| | - Roel Vermeulen
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, the Netherlands; MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK; Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Marloes Eeftens
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands; Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Hans Concin
- Agency for Preventive and Social Medicine, Bregenz (aks), Austria
| | - Alois Lang
- Vorarlberg cancer registry; Agency for Preventive and Social Medicine, Bregenz (aks), Austria
| | - Meng Wang
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Ming-Yi Tsai
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; University of Basel, Basel, Switzerland; Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Fulvio Ricceri
- Unit of Epidemiology, Regional Health Service ASL TO3, Grugliasco, Italy; Department of Clinical and Biological Sciences, University of Turin, Orbassano, Italy
| | - Carlotta Sacerdote
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention (CPO), Turin, Italy
| | - Andrea Ranzi
- Environmental Health Reference Centre, Regional Agency for Environmental Prevention of Emilia-Romagna, Modena, Italy
| | - Giulia Cesaroni
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Rome, Italy
| | - Francesco Forastiere
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Rome, Italy
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Rob Beelen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands; National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Paolo Vineis
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, the Netherlands; Molecular end Epidemiology Unit, HuGeF, Human Genetics Foundation, Torino, Italy
| | - Ingeborg Kooter
- Netherlands Organization for Applied Scientific Research, Utrecht, the Netherlands
| | - Ranjeet Sokhi
- Centre for Atmospheric and Climate Physics Research (CACP), University of Hertfordshire, Hatfield, UK
| | - Bert Brunekreef
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK; Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Gerard Hoek
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Ole Raaschou-Nielsen
- The Danish Cancer Society Research Center, Copenhagen, Denmark; Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | - Gabriele Nagel
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany; Agency for Preventive and Social Medicine, Bregenz (aks), Austria
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Abstract
Pollution has long been incriminated in many cardiovascular and respiratory diseases. More recently, studies evaluated the potential role for particulate pollutants in autoimmune diseases, including rheumatoid arthritis (RA). The incidence of RA was found to be higher in urban areas. Living near air pollution emitters was associated with higher risks of developing RA and of producing RA-specific autoantibodies. Nevertheless, no strong epidemiological evidence exists to link one or more specific air pollution particles to RA. The presence in the bronchi of lymphoid satellite islands (inducible bronchus-associated lymphoid tissue, iBALT) is strongly associated with both inflammatory lung disease and RA-associated lung disease. Diesel exhaust particles can stimulate iBALT formation. The induction by air pollution of an inflammatory environment with high citrullination levels in the lung may induce iBALT formation, thereby causing a transition toward a more specific immune response via the production of anti-citrullinated peptide antibodies. Air pollution not only triggers innate immune responses at the molecular level, increasing the levels of proinflammatory cytokines and reactive oxygen species, but is also involved in adaptive immune responses. Thus, via the aryl hydrocarbon receptor (AHR), diesel exhaust particles can trigger a T-cell switch to the Th17 profile. Finally, in the murine collagen-induced arthritis model, animals whose lymphocytes lack the AHR develop milder arthritis.
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Affiliation(s)
- Johanna Sigaux
- Inserm UMR 1125, 74, rue Marcel-Cachin, 93017 Bobigny, France; Sorbonne Paris Cité, université Paris 13, 74, rue Marcel-Cachin, 93017 Bobigny, France; Service de rhumatologie, Groupe hospitalier Avicenne-Jean-Verdier-René-Muret, Assistance publique-Hôpitaux de Paris (AP-HP), 125, rue de Stalingrad, 93017 Bobigny, France.
| | - Jérôme Biton
- Inserm UMR 1125, 74, rue Marcel-Cachin, 93017 Bobigny, France; Sorbonne Paris Cité, université Paris 13, 74, rue Marcel-Cachin, 93017 Bobigny, France
| | - Emma André
- Inserm UMR 1125, 74, rue Marcel-Cachin, 93017 Bobigny, France; Sorbonne Paris Cité, université Paris 13, 74, rue Marcel-Cachin, 93017 Bobigny, France; Service de rhumatologie, Groupe hospitalier Avicenne-Jean-Verdier-René-Muret, Assistance publique-Hôpitaux de Paris (AP-HP), 125, rue de Stalingrad, 93017 Bobigny, France
| | - Luca Semerano
- Inserm UMR 1125, 74, rue Marcel-Cachin, 93017 Bobigny, France; Sorbonne Paris Cité, université Paris 13, 74, rue Marcel-Cachin, 93017 Bobigny, France; Service de rhumatologie, Groupe hospitalier Avicenne-Jean-Verdier-René-Muret, Assistance publique-Hôpitaux de Paris (AP-HP), 125, rue de Stalingrad, 93017 Bobigny, France
| | - Marie-Christophe Boissier
- Inserm UMR 1125, 74, rue Marcel-Cachin, 93017 Bobigny, France; Sorbonne Paris Cité, université Paris 13, 74, rue Marcel-Cachin, 93017 Bobigny, France; Service de rhumatologie, Groupe hospitalier Avicenne-Jean-Verdier-René-Muret, Assistance publique-Hôpitaux de Paris (AP-HP), 125, rue de Stalingrad, 93017 Bobigny, France
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Abstract
An increased risk for Systemic Autoimmune Diseases (SAID) was reported in the population of Libby, Montana, where extensive exposure to asbestiform amphiboles occurred through mining and use of asbestiform fiber-laden vermiculite. High frequencies of antinuclear autoantibodies (ANA) were detected in individuals and mice exposed to Libby Asbestiform Amphiboles (LAA). Among the 6603 individuals who have undergone health screening at the Center for Asbestos Related Diseases (CARD, Libby MT), the frequencies of rheumatoid arthritis, systemic lupus erythematosus, sarcoidosis, and systemic sclerosis are significantly higher than expected prevalence in the United States. While these data support the hypothesis that LAA can trigger autoimmune responses, evidence suggests that chrysotile asbestos does not. Serological testing was therefore performed in subjects exposed to LAA or predominantly chrysotile (New York steamfitters) using multiplexed array technologies. Analyses were performed in order to determine a) autoantibody profiles in each cohort, and b) whether the two populations could be distinguished through predictive modeling. Analysis using perMANOVA testing confirmed a significant difference between autoantibody profiles suggesting differential pathways leading to autoantibody formation. ANA were more frequent in the LAA cohort. Specific autoantibodies more highly expressed with LAA-exposure were to histone, ribosomal P protein, Sm/Ribonucleoproteins, and Jo-1 (histidyl tRNA synthetase). Myositis autoantibodies more highly expressed in the LAA cohort were Jo-1, PM100, NXP2, and Mi2a. Predictive modeling demonstrated that anti-histone antibodies were most predictive for LAA exposure, and anti-Sm was predictive for the steamfitters' exposure. This emphasizes the need to consider fiber types when evaluating risk of SAID with asbestos exposure.
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Affiliation(s)
- Jean C. Pfau
- Department of Microbiology & Immunology, Montana State University, Bozeman MT 59718
| | - Christopher Barbour
- Statistical Consulting and Research Services, Montana State University, Bozeman MT 59718
| | - Brad Black
- Center for Asbestos Related Diseases, Libby MT 59923
| | - Kinta M. Serve
- Idaho State University, Department of Biological Sciences, Pocatello ID 83209
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Poole JA, Mikuls TR, Duryee MJ, Warren KJ, Wyatt TA, Nelson AJ, Romberger DJ, West WW, Thiele GM. A role for B cells in organic dust induced lung inflammation. Respir Res 2017; 18:214. [PMID: 29273051 PMCID: PMC5741951 DOI: 10.1186/s12931-017-0703-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 12/13/2017] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Agriculture organic dust exposures induce lung disease with lymphoid aggregates comprised of both T and B cells. The precise role of B cells in mediating lung inflammation is unknown, yet might be relevant given the emerging role of B cells in obstructive pulmonary disease and associated autoimmunity. METHODS Using an established animal model, C57BL/6 wild-type (WT) and B-cell receptor (BCR) knock-out (KO) mice were repetitively treated with intranasal inhalation of swine confinement organic dust extract (ODE) daily for 3 weeks and lavage fluid, lung tissues, and serum were collected. RESULTS ODE-induced neutrophil influx in lavage fluid was not reduced in BCR KO animals, but there was reduction in TNF-α, IL-6, CXCL1, and CXCL2 release. ODE-induced lymphoid aggregates failed to develop in BCR KO mice. There was a decrease in ODE-induced lung tissue CD11c+CD11b+ exudative macrophages and compensatory increase in CD8+ T cells in lavage fluid of BCR KO animals. Compared to saline, there was an expansion of conventional B2-, innate B1 (CD19+CD11b+CD5+/-)-, and memory (CD19+CD273+/-CD73+/-) B cells following ODE exposure in WT mice. Autoreactive responses including serum IgG anti-citrullinated protein antibody (ACPA) and anti-malondialdehyde-acetaldehyde (MAA) autoantibodies were increased in ODE treated WT mice as compared to saline control. B cells and serum immunoglobulins were not detected in BCR KO animals. CONCLUSIONS Lung tissue staining for citrullinated and MAA modified proteins were increased in ODE-treated WT animals, but not BCR KO mice. These studies show that agriculture organic dust induced lung inflammation is dependent upon B cells, and dust exposure induces an autoreactive response.
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Affiliation(s)
- Jill A Poole
- Pulmonary, Critical Care, Sleep & Allergy Division, Department of Internal Medicine, University of Nebraska Medical Center (UNMC), 985990 Nebraska Medical Center, Omaha, NE, 68198-5990, USA.
| | - Ted R Mikuls
- Veterans Affairs Nebraska-Western Iowa Health Care System, Research Service, Omaha, NE, USA.,Rheumatology Division, Department of Internal Medicine, UNMC, Omaha, NE, USA
| | - Michael J Duryee
- Veterans Affairs Nebraska-Western Iowa Health Care System, Research Service, Omaha, NE, USA.,Rheumatology Division, Department of Internal Medicine, UNMC, Omaha, NE, USA
| | - Kristi J Warren
- Pulmonary, Critical Care, Sleep & Allergy Division, Department of Internal Medicine, University of Nebraska Medical Center (UNMC), 985990 Nebraska Medical Center, Omaha, NE, 68198-5990, USA
| | - Todd A Wyatt
- Pulmonary, Critical Care, Sleep & Allergy Division, Department of Internal Medicine, University of Nebraska Medical Center (UNMC), 985990 Nebraska Medical Center, Omaha, NE, 68198-5990, USA.,Veterans Affairs Nebraska-Western Iowa Health Care System, Research Service, Omaha, NE, USA.,Department of Environmental, Agricultural, and Occupational Health, UNMC, Omaha, NE, USA
| | - Amy J Nelson
- Pulmonary, Critical Care, Sleep & Allergy Division, Department of Internal Medicine, University of Nebraska Medical Center (UNMC), 985990 Nebraska Medical Center, Omaha, NE, 68198-5990, USA
| | - Debra J Romberger
- Pulmonary, Critical Care, Sleep & Allergy Division, Department of Internal Medicine, University of Nebraska Medical Center (UNMC), 985990 Nebraska Medical Center, Omaha, NE, 68198-5990, USA.,Veterans Affairs Nebraska-Western Iowa Health Care System, Research Service, Omaha, NE, USA
| | - William W West
- Pathology and Microbiology Department, UNMC, Omaha, NE, USA
| | - Geoffrey M Thiele
- Veterans Affairs Nebraska-Western Iowa Health Care System, Research Service, Omaha, NE, USA.,Rheumatology Division, Department of Internal Medicine, UNMC, Omaha, NE, USA
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