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Tang B, Shi Y, Zeng Z, He X, Yu J, Chai K, Liu J, Liu L, Zhan Y, Qiu X, Tang R, Xiao Y, Xiao R. Silica's silent threat: Contributing to skin fibrosis in systemic sclerosis by targeting the HDAC4/Smad2/3 pathway. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 355:124194. [PMID: 38782158 DOI: 10.1016/j.envpol.2024.124194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 04/26/2024] [Accepted: 05/20/2024] [Indexed: 05/25/2024]
Abstract
Nowadays, silica products are widely used in daily life, especially in skin applications, which inevitably increases the risk of silica exposure in general population. However, inadequate awareness of silica's potential hazards and lack of self-protection are of concern. Systemic sclerosis (SSc) is characterized by progressive tissue fibrosis under environmental and genetic interactions. Silica exposure is considered an important causative factor for SSc, but its pathogenesis remains unclear. Within this study, we showed that lower doses of silica significantly promoted the proliferation, migration, and activation of human skin fibroblasts (HSFs) within 24 h. Silica injected subcutaneously into mice induced and exacerbated skin fibrosis. Notably, silica increased histone deacetylase-4 (HDAC4) expression by inducing its DNA hypomethylation in normal HSFs. The elevated HDAC4 expression was also confirmed in SSc HSFs. Furthermore, HDAC4 was positively correlated with Smad2/3 phosphorylation and COL1, α-SMA, and CTGF expression. The HDAC4 inhibitor LMK235 mitigated silica-induced upregulation of these factors and alleviated skin fibrosis in SSc mice. Taken together, silica induces and exacerbates skin fibrosis in SSc patients by targeting the HDAC4/Smad2/3 pathway. Our findings provide new insights for evaluating the health hazards of silica exposure and identify HDAC4 as a potential interventional target for silica-induced SSc skin fibrosis.
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Affiliation(s)
- Bingsi Tang
- Department of Dermatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China; Hunan Key Laboratory of Medical Epigenetics, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Yaqian Shi
- Department of Dermatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China; Hunan Key Laboratory of Medical Epigenetics, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Zhuotong Zeng
- Department of Dermatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China; Hunan Key Laboratory of Medical Epigenetics, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Xinglan He
- Department of Dermatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China; Hunan Key Laboratory of Medical Epigenetics, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Jiangfan Yu
- Department of Dermatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China; Hunan Key Laboratory of Medical Epigenetics, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Ke Chai
- Department of Dermatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China; Hunan Key Laboratory of Medical Epigenetics, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Jiani Liu
- Department of Dermatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China; Hunan Key Laboratory of Medical Epigenetics, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Licong Liu
- Department of Dermatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China; Hunan Key Laboratory of Medical Epigenetics, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Yi Zhan
- Department of Dermatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China; Hunan Key Laboratory of Medical Epigenetics, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Xiangning Qiu
- Department of Dermatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China; Hunan Key Laboratory of Medical Epigenetics, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Rui Tang
- Department of Rheumatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Yangfan Xiao
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China; Department of Anesthesiology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China.
| | - Rong Xiao
- Department of Dermatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China; Hunan Key Laboratory of Medical Epigenetics, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China.
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Yan S, Zhao Y, Yan J, Guan Y, Lyu M, Xu G, Yang X, Bai Y, Yao S. Low Expression of Lipoic Acid Synthase Aggravates Silica-Induced Pulmonary Fibrosis by Inhibiting the Differentiation of Tregs in Mice. Antioxid Redox Signal 2024; 41:216-232. [PMID: 38062726 DOI: 10.1089/ars.2023.0387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/17/2024]
Abstract
Aims: In addition to reducing the respiratory function, crystalline silica (SiO2) disturbs the immune response by affecting immune cells during the progression of silicosis. Regulatory T cell (Treg) differentiation may play a key role in the abnormal polarization of T helper cell (Th)1 and Th2 cells in the development of silicosis-induced fibrosis. Alpha-lipoic acid (ALA) has immunomodulatory effects by promoting Tregs differentiation. Thus, ALA may have a therapeutic potential for treating autoimmune disorders in patients with silicosis. However, little is known regarding whether ALA regulates the immune system during silicosis development. Results: We found that the expression levels of collagen increased, and the antioxidant capacity was lower in the Lias-/-+SiO2 group than in the Lias+/++SiO2 group. The proportion of Tregs decreased in the peripheral blood and spleen tissue in mice exposed to SiO2. The proportion of Tregs in the Lias-/-+SiO2 group was significantly lower than that in the Lias+/++SiO2 group. Supplementary exogenous ALA attenuates the accumulation of inflammatory cells and extracellular matrix in lung tissues. ALA promotes the immunological balance between Th17 and Treg responses during the development of silicosis-induced fibrosis. Innovation and Conclusion: Our findings confirmed that low expression of lipoic acid synthase aggravates SiO2-induced silicosis, and that supplementary exogenous ALA has therapeutic potential by improving Tregs in silicosis fibrosis.
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Affiliation(s)
- Sensen Yan
- School of Public Health, Xinxiang Medical University, Xinxiang, People's Republic of China
| | - Yingzheng Zhao
- School of Public Health, Xinxiang Medical University, Xinxiang, People's Republic of China
| | - Jingyi Yan
- School of Public Health, Xinxiang Medical University, Xinxiang, People's Republic of China
| | - Yabo Guan
- School of Public Health, Xinxiang Medical University, Xinxiang, People's Republic of China
| | - Mengdi Lyu
- School of Public Health, Xinxiang Medical University, Xinxiang, People's Republic of China
| | - Guangcui Xu
- School of Public Health, Xinxiang Medical University, Xinxiang, People's Republic of China
| | - Xuesi Yang
- School of Public Health, Xinxiang Medical University, Xinxiang, People's Republic of China
| | - Yichun Bai
- School of Public Health, Xinxiang Medical University, Xinxiang, People's Republic of China
| | - Sanqiao Yao
- School of Public Health, Xinxiang Medical University, Xinxiang, People's Republic of China
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3
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Kosarek NN, Preston EV. Contributions of Synthetic Chemicals to Autoimmune Disease Development and Occurrence. Curr Environ Health Rep 2024; 11:128-144. [PMID: 38653907 DOI: 10.1007/s40572-024-00444-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2024] [Indexed: 04/25/2024]
Abstract
PURPOSE OF REVIEW Exposure to many synthetic chemicals has been linked to a variety of adverse human health effects, including autoimmune diseases. In this scoping review, we summarize recent evidence detailing the effects of synthetic environmental chemicals on autoimmune diseases and highlight current research gaps and recommendations for future studies. RECENT FINDINGS We identified 68 recent publications related to environmental chemical exposures and autoimmune diseases. Most studies evaluated exposure to persistent environmental chemicals and autoimmune conditions including rheumatoid arthritis (RA), systemic lupus (SLE), systemic sclerosis (SSc), and ulcerative colitis (UC) and Crohn's disease. Results of recent original research studies were mixed, and available data for some exposure-outcome associations were particularly limited. PFAS and autoimmune inflammatory bowel diseases (UC and CD) and pesticides and RA appeared to be the most frequently studied exposure-outcome associations among recent publications, despite a historical research focus on solvents. Recent studies have provided additional evidence for the associations of exposure to synthetic chemicals with certain autoimmune conditions. However, impacts on other autoimmune outcomes, particularly less prevalent conditions, remain unclear. Owing to the ubiquitous nature of many of these exposures and their potential impacts on autoimmune risk, additional studies are needed to better evaluate these relationships, particularly for understudied autoimmune conditions. Future research should include larger longitudinal studies and studies among more diverse populations to elucidate the temporal relationships between exposure-outcome pairs and to identify potential population subgroups that may be more adversely impacted by immune modulation caused by exposure to these chemicals.
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Affiliation(s)
- Noelle N Kosarek
- Department of Biomedical Data Science, Dartmouth College, Hanover, NH, 03755, USA
| | - Emma V Preston
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Building 1, Floor 14, Boston, MA, 02115, USA.
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Ciaffi J, Liem SIE, Cannegieter S, Ahmed S, Hoekstra EM, Wiland P, Atsumi T, Szücs G, Balbir Gurman A, Czirják L, Zanatta E, Koetter I, Henes JC, Matucci-Cerinic M, Airò P, Ursini F, Huizinga TWJ, De Vries-Bouwstra J, Collaborators E. Untangling the relationship between smoking and systemic sclerosis: an analysis of the EUSTAR cohort. RMD Open 2024; 10:e004101. [PMID: 38772679 PMCID: PMC11328649 DOI: 10.1136/rmdopen-2024-004101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 04/12/2024] [Indexed: 05/23/2024] Open
Abstract
OBJECTIVES To untangle the association between smoking and systemic sclerosis (SSc). METHODS In the European Scleroderma Trials and Research cohort, the autoantibody status was compared between ever-smokers and never-smokers. Time until disease progression was assessed using Kaplan-Meier curves. Cox models were built to investigate the influence of smoking over 15 years of follow-up. All analyses were performed for the total cohort and stratified for sex and for positivity of anti-centromere (ACA) and anti-topoisomerase antibodies (ATA). RESULTS Overall, 12 314 patients were included in the study. Of these, 10 393 were women (84%), 4637 were ACA-positive (38%), 3919 were ATA-positive (32%) and 4271 (35%) were ever-smokers. In men, but not in women, smoking was associated with mortality (HR 1.63, 95% CI 1.23 to 2.16, p=0.001). Ever-smoking women were at higher risk for skin progression (HR 1.10, 95% CI 1.00 to 1.22, p=0.046) and for 'any organ progression' (HR 1.07, 95% CI 1.00 to 1.13, p=0.036). In women, 34% of never-smokers were ATA-positive compared with 21% of ever-smokers (p<0.001). In the group of ever-smokers, higher exposure rates, reflected by the number of pack-years (OR 0.98, 95% CI 0.97 to 0.99, p<0.001) and by smoking duration (OR 0.96, 95% CI 0.95 to 0.97, p<0.001), were associated with lower frequency of ATA. In ACA-positive patients, the risk of mortality (HR 1.29, 95% CI 1.02 to 1.63, p=0.033), cardiac involvement (HR 1.25, 95% CI 1.03 to 1.43, p=0.001), skin progression (HR 1.21, 95% CI 1.03 to 1.42, p=0.018) and 'any organ progression' (HR 1.14, 95% CI 1.05 to 1.24, p=0.002) was increased among smokers. In ATA-positive smoking patients, mortality (HR 1.40, 95% CI 1.10 to 1.78, p=0.006), skin progression (HR 1.19, 95% CI 1.03 to 1.37, p=0.020) digital ulcers (HR 1.17, 95% CI 1.02 to 1.34, p=0.029) and 'any organ progression' (HR 1.11, 95% CI 1.00 to 1.22, p=0.048) occurred more frequently. CONCLUSIONS Our stratified analysis demonstrates that smoking is associated with an increased risk for mortality in male SSc patients but not in women. Strikingly, smoking is associated with lower prevalence of ATA positivity, in particular in women. In both ATA-positive and ACA-positive patients, smoking is a risk factor for mortality, skin progression and 'any organ progression'.
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Affiliation(s)
- Jacopo Ciaffi
- Medicine and Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Sophie I E Liem
- Department of Rheumatology, Leiden University Medical Centre (LUMC), Leiden, The Netherlands
| | - Suzanne Cannegieter
- Department of Clinical Epidemiology, Leiden University Medical Center (LUMC), Leiden, The Netherlands
- Department of Internal Medicine, Division of Thrombosis and Haemostasis, Leiden University Medical Center (LUMC), Leiden, The Netherlands
| | - Saad Ahmed
- Department of Rheumatology, Leiden University Medical Centre (LUMC), Leiden, The Netherlands
| | - Eva M Hoekstra
- Department of Rheumatology, Leiden University Medical Centre (LUMC), Leiden, The Netherlands
| | - Piotr Wiland
- Department of Rheumatology and Internal Medicine, Wroclaw Medical University, Wroclaw, Poland
| | - Tatsuya Atsumi
- Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Gabriella Szücs
- Department of Rheumatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Alexandra Balbir Gurman
- Rheumatology Department, Rambam Health Care Campus, Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | - László Czirják
- Department of Rheumatology and Immunology, Medical School, University of Pécs, Pécs, Hungary
| | - Elisabetta Zanatta
- Department of Medicine-DIMED, Unit of Rheumatology, Padova University Hospital, Padova, Italy
| | - Ina Koetter
- Medical Department 4, Rheumatology, Immunology, Nephrology, Asklepios Klinik Altona, Hamburg, Germany
| | - Joerg C Henes
- Internal Medicine II - Oncology, haematology, clinical immunology and rheumatology, University Hospital and Faculty of Medicine, University of Tübingen, Tubingen, Germany
| | - Marco Matucci-Cerinic
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Paolo Airò
- Rheumatology and Clinical Immunology Service, Spedali Civili di Brescia, Brescia, Italy
| | - Francesco Ursini
- Medicine and Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Tom W J Huizinga
- Department of Rheumatology, Leiden University Medical Centre (LUMC), Leiden, The Netherlands
| | - Jeska De Vries-Bouwstra
- Department of Rheumatology, Leiden University Medical Centre (LUMC), Leiden, The Netherlands
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5
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Freire M, Sopeña B, González-Quintela A, Del Castillo AG, Moraga EC, Lledó-Ibañez GM, Rubio-Rivas M, Trapiella L, Argibay A, Tolosa C, Alfonso BM, Vargas-Hitos JA, Salas XP, González-Echávarri C, Chamorro AJ, Fraile IP, García AG, de la Red Bellvis G, Bello DB, Salomó AC, Jiménez Pérez de Heredia I, Marín-Ballve A, Rodríguez-Pintó I, Saez-Comet L, Ortego-Centeno N, Todolí-Parra JA, Fonollosa Pla V, Simeón-Aznar CP. Exposure to different occupational chemicals and clinical phenotype of a cohort of patients with systemic sclerosis. Autoimmun Rev 2024; 23:103542. [PMID: 38599508 DOI: 10.1016/j.autrev.2024.103542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2024] [Accepted: 04/07/2024] [Indexed: 04/12/2024]
Affiliation(s)
- Mayka Freire
- Unit of Systemic Diseases, Department of Internal Medicine, Hospital Clínico Universitario de Santiago de Compostela, A Coruña, Spain.
| | - Bernardo Sopeña
- Unit of Systemic Diseases, Department of Internal Medicine, Hospital Clínico Universitario de Santiago de Compostela, A Coruña, Spain
| | - Arturo González-Quintela
- Unit of Systemic Diseases, Department of Internal Medicine, Hospital Clínico Universitario de Santiago de Compostela, A Coruña, Spain
| | - Alfredo Guillén Del Castillo
- Unit of Autoimmune Diseases, Department of Internal Medicine, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - Eduardo Callejas Moraga
- Unit of Autoimmune Diseases, Department of Internal Medicine, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - Gema M Lledó-Ibañez
- Department of Autoimmune Diseases. Reference Centre for Systemic Autoimmune Diseases (UEC/CSUR) of the Catalan and Spanish Health Systems-Member of ERNReCONNET, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Manuel Rubio-Rivas
- Unit of Autoimmune Diseases, Department of Internal Medicine, Hospital Universitario de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Luis Trapiella
- Department of Internal Medicine, Hospital de Cabueñes, Gijón, Spain
| | - Ana Argibay
- Unit of Systemic Diseases, Department of Internal Medicine, Complejo Hospitalario Universitario de Vigo, Spain
| | - Carles Tolosa
- Department of Internal Medicine, Corporación Sanitaria Universitaria Parc Taulí, Sabadell, Barcelona, Spain
| | - Begoña Marí Alfonso
- Department of Internal Medicine, Corporación Sanitaria Universitaria Parc Taulí, Sabadell, Barcelona, Spain
| | | | - Xavier Pla Salas
- Unit of Systemic Autoimmune Diseases, Department of Internal Medicine, Consorci Hospitalari de Vic, Barcelona, Spain
| | - Cristina González-Echávarri
- Autoimmune Diseases Research Unit, Department of Internal Medicine, Hospital Universitario de Cruces, Baracaldo, Spain
| | - Antonio-J Chamorro
- Department of Internal Medicine, Complejo Asistencial Universitario de Salamanca, Spain
| | - Isabel Perales Fraile
- Department of Internal Medicine, Hospital Universitario Infanta Sofía, Madrid, Spain
| | | | | | - David Bernal Bello
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | - Antoni Castro Salomó
- Department of Internal Medicine, Hospital Universitari Sant Joan de Reus, Tarragona, Spain
| | | | - Adela Marín-Ballve
- Unit of Autoimmune Diseases, Department of Internal Medicine, Hospital Clínico Universitario Lozano Blesa, IIS Aragón, Zaragoza, Spain
| | - Ignasi Rodríguez-Pintó
- Department of Internal Medicine, Hospital Universitario Mútua Terrassa, Terrassa, Barcelona, Spain
| | - Luis Saez-Comet
- Department of Internal Medicine, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Norberto Ortego-Centeno
- Inst Invest Biosanitaria Ibs Granada. Department of Internal Medicine, Unit of Systemic Autoimmune Diseases. Department of Medicine, Facultad de Medicina, Hospital Universitario San Cecilio, Granada, Spain
| | | | - Vicent Fonollosa Pla
- Unit of Autoimmune Diseases, Department of Internal Medicine, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - Carmen Pilar Simeón-Aznar
- Unit of Autoimmune Diseases, Department of Internal Medicine, Hospital Universitario Vall d'Hebron, Barcelona, Spain
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Babaei V, Ashtarinezhad A, Torshabi M, Teimourian S, Shahmirzaie M, Abolghasemi J, Zeraatgar Gohardani H, Vernousfaderani EK, Shirazi FH. High inflammatory cytokines gene expression can be detected in workers with prolonged exposure to silver and silica nanoparticles in industries. Sci Rep 2024; 14:5667. [PMID: 38454025 PMCID: PMC11319723 DOI: 10.1038/s41598-024-56027-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 02/29/2024] [Indexed: 03/09/2024] Open
Abstract
Occupational health must be strictly considered in industries particularly in nanoparticle factories where workers were exposed to different types of chemicals. We measured the serum levels of inflammatory cytokines in workers who developed skin lesions after exposure to silver and silica nanoparticles. Using a questionnaire in this cross-sectional study, we identified 110 workers in nanoparticle industries who were exposed to silver and silica nanoparticles. We also included 40 healthy subjects as controls from the administrative department of the same factories who were not exposed to nanoparticles. Peripheral blood samples used to measure the mRNA levels of inflammatory cytokines by qRT-PCR. In comparison with the control group, the workers who developed skin lesions had significantly higher levels of interleukin IL4, IL6, IL8, and TNF-α, particularly after two or three decades of exposure to silver and silica nanoparticles. Participants who were exposed to silver had higher levels of IL6 and IL8 compared with those who were exposed to silica. Necessary measures must be considered to protect workers in nanoparticle industries against the potential toxic effects of these compounds. Our network pharmacology study suggests corresponding biochemical pathways for these disorders.
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Affiliation(s)
- Vahid Babaei
- Pharmaceutical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Azadeh Ashtarinezhad
- Department of Occupational Health Engineering, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Torshabi
- Department of Dental Biomaterials, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shahram Teimourian
- Department of Medical Genetics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Morteza Shahmirzaie
- Pharmaceutical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Jamileh Abolghasemi
- Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | | | - Eisa Kaveh Vernousfaderani
- Department of Pharmacology and Toxicology, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farshad H Shirazi
- Pharmaceutical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
- Department of Pharmacology and Toxicology, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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7
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Huo X, Zeng Z, Lin Y, Lin J, Xu D. Clinical characteristics of systemic sclerosis patients with occupational silicosis. Clin Rheumatol 2024; 43:277-287. [PMID: 37713025 PMCID: PMC10774212 DOI: 10.1007/s10067-023-06706-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 06/19/2023] [Accepted: 07/15/2023] [Indexed: 09/16/2023]
Abstract
To explore the clinical characteristics of systemic sclerosis complicated with silicosis. The systemic sclerosis patients treated in the Guangxi Workers' Hospital and the People's Hospital of Guangxi Zhuang Autonomous Region from January 2000 to December 2020 were divided into the systemic sclerosis with silicosis group and the systemic sclerosis without silicosis group. Survival analysis was performed using Kaplan-Meier estimates the Cox proportional hazards model. A propensity score matching was applied in order to avoid the selection bias.Over the past 20 years, 72 systemic sclerosis patients with silicosis and 238 systemic sclerosis patients without silicosis were treated in the two hospitals. The systemic sclerosis patients with silicosis group had more males (P < 0.000),lower mean age at onset of SSc (P < 0.000), more frequent occurrence of weight loss (P = 0.028), smoking (P < 0.000), tuberculosis (P < 0.000), cardiac involvement (P < 0.000), ILD (P = 0.017), pulmonary hypertension (P = 0.024), elevated BNP (P < 0.000). With regards to the multivariate Cox regression analysis, silicosis was related with a higher overall mortality before (HR = 3.666, 95% CI = 1.440-11.234, p = 0.025) and after the propensity score matching analysis (HR = 2.817, 95% CI = 1.196-10.764, p = 0.014). Independent risk factors for overall mortality were Gangrene (HR = 3.003, 95% CI = 1.343-9.431), Cardiac involved (HR = 5.370, 95% CI = 1.910-15.472), Scl-70 (HR = 3.569, 95% CI = 1.333-10.869), Elevated BNP (HR = 2.135, 95% CI = 1.293-9.564).Concomitant silicosis worsens systemic sclerosis patients' prognoses. Gangrene, Scl-70, elevated BNP and cardiac involvement are independent risk factors for overall mortality. Key Points •Concomitant silicosis worsens SSc patients' prognoses. •For individuals with occupational exposure, close observation of the symptoms of SSc, early diagnosis, and interruption of exposure may improve the prognosis. •Gangrene, Scl-70, elevated BNP and cardiac involvement are independent risk factors for overall mortality.
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Affiliation(s)
- Xiaocong Huo
- Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, Guangxi Key Laboratory of Precision Medicine in Cardio-cerebrovascular Diseases Control and Prevention, Guangxi Clinical Research Center for Cardio-cerebrovascular Disease. The People's Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences, No. 6 Shuangyong Road, Nanning, Guangxi, 530021, China
| | - Zhiyu Zeng
- Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, Guangxi Key Laboratory of Precision Medicine in Cardio-Cerebrovascular Diseases Control and Prevention, Guangxi Clinical Research Center for Cardio-Cerebrovascular Diseases, Nanning, Guangxi, 530021, China.
| | - Yongjun Lin
- Guangxi Workers' Hospital, Nanning, 530021, Guangxi, China
| | - Jinying Lin
- The People's Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences, Nanning, 530021, Guangxi, China
| | - Dong Xu
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100032, China
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8
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Alahmari H, Ahmad Z, Johnson SR. Environmental Risks for Systemic Sclerosis. Rheum Dis Clin North Am 2022; 48:845-860. [PMID: 36332999 DOI: 10.1016/j.rdc.2022.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
There is an increasing body of literature suggesting a relationship between environmental factors and the development of systemic sclerosis (SSc). These include occupational exposures, chemical materials, medications, alterations in the microbiome, and dysbiosis. Environmental exposures may impact epigenetic regulation thereby triggering an aberrant immune response resulting in the clinical and serologic phenotype that we diagnose as SSc. Screening and studying putative triggers will not only improve our understanding of the pathogenesis of SSc but also inform the institution for protective measures.
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Affiliation(s)
- Hana Alahmari
- Toronto Scleroderma Program, Mount Sinai Hospital, 2nd Floor, Box 9, 60 Murray Street, Toronto, Ontario M5T 3L9, Canada
| | - Zareen Ahmad
- Toronto Scleroderma Program, Mount Sinai Hospital, 2nd Floor, Box 9, 60 Murray Street, Toronto, Ontario M5T 3L9, Canada
| | - Sindhu R Johnson
- Toronto Scleroderma Program, Division of Rheumatology, Department of Medicine, Toronto Western Hospital, Mount Sinai Hospital, Institute of Health Policy, Management and Evaluation, University of Toronto, Room 2-004, Box 9, 60 Murray Street, Toronto, Ontario M5T 3L9, Canada.
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9
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Liu JY, Sayes CM. A toxicological profile of silica nanoparticles. Toxicol Res (Camb) 2022; 11:565-582. [PMID: 36051665 PMCID: PMC9424711 DOI: 10.1093/toxres/tfac038] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 05/16/2022] [Accepted: 05/29/2022] [Indexed: 08/02/2023] Open
Abstract
Humans are regularly exposed to silica nanoparticles in environmental and occupational contexts, and these exposures have been implicated in the onset of adverse health effects. Existing reviews on silica nanoparticle toxicity are few and not comprehensive. There are natural and synthetic sources by which crystalline and amorphous silica nanoparticles are produced. These processes influence physiochemical properties, which are factors that can dictate toxicological effects. Toxicological assessment includes exposure scenario (e.g. environmental, occupational), route of exposure, toxicokinetics, and toxicodynamics. Broader considerations include pathology, risk assessment, regulation, and treatment after injury. This review aims to consolidate the most relevant and up-to-date research in these areas to provide an exhaustive toxicological profile of silica nanoparticles.
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Affiliation(s)
- James Y Liu
- Department of Environmental Science, Baylor University, One Bear Place # 97266, Waco, TX 76798-7266, United States
| | - Christie M Sayes
- Corresponding author: Department of Environmental Science, Baylor University, One Bear Place # 97266, Waco, TX 76798-7266, United States.
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10
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Mandler WK, Qi C, Qian Y. Hazardous dusts from the fabrication of countertop: a review. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2022; 78:118-126. [PMID: 35912480 PMCID: PMC9909587 DOI: 10.1080/19338244.2022.2105287] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Artificial countertop materials, including solid surface composites (SSC) and engineered stone (ES) may pose significant pulmonary health risks for workers who manipulate them. These materials have rapidly become popular in the multibillion-dollar countertop industry, rivaling that of natural materials such as granite and marble due to their variety of desirable esthetic qualities and reduced costs. Both SSC and ES consist of a mineral substrate bound together in a polymer matrix. For SSC the mineral is about 70% aluminum trihydrate (ATH) while ES contains up to 95% crystalline silica by weight. Both materials emit airborne dusts when being manipulated with power tools during the fabrication process. Several deaths and dozens of cases of silicosis have been identified worldwide in workers who fabricate ES, while a single case of fatal pulmonary fibrosis has been associated with SCC dust exposure. This review examines the current state of knowledge for both SSC and ES regarding the composition, particle emission characteristics, workplace exposure data, particle constituent toxicity, and possible methods for reducing worker exposure.
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Affiliation(s)
- W. Kyle Mandler
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - Chaolong Qi
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, Cincinnati, OH, USA
| | - Yong Qian
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, WV, USA
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11
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Ferri C, De Angelis R, Giuggioli D, Bajocchi G, Dagna L, Zanframundo G, Foti R, Cacciapaglia F, Cuomo G, Ariani A, Rosato E, Guiducci S, Girelli F, Riccieri V, Zanatta E, Bosello S, Cavazzana I, Ingegnoli F, De Santis M, Murdaca G, Abignano G, Romeo N, Rossa AD, Caminiti M, Iuliano A, Ciano G, Beretta L, Bagnato G, Lubrano E, De Andres I, Giollo A, Saracco M, Agnes C, Lumetti F, Spinella A, Magnani L, Campochiaro C, De Luca G, Codullo V, Visalli E, Masini F, Gigante A, Bellando-Randone S, Pellegrino G, Pigatto E, Lazzaroni MG, Franceschini F, Generali E, Mennillo G, Barsotti S, Mariano GP, Calabrese F, Furini F, Vultaggio L, Parisi S, Peroni CL, Rozza D, Zanetti A, Carrara G, Landolfi G, Scirè CA, Bianchi G, Fusaro E, Sebastiani GD, Govoni M, D'Angelo S, Cozzi F, Doria A, Iannone F, Salvarani C, Matucci-Cerinic M. Geographical heterogeneity of clinical and serological phenotypes of systemic sclerosis observed at tertiary referral centres. The experience of the Italian SIR-SPRING registry and review of the world literature. Autoimmun Rev 2022; 21:103159. [DOI: 10.1016/j.autrev.2022.103159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 07/24/2022] [Indexed: 12/18/2022]
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12
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The Relationship between Tumor Development and Sarcoidosis in Aspects of Carcinogenesis before and after the Onset of Sarcoidosis. Medicina (B Aires) 2022; 58:medicina58060768. [PMID: 35744031 PMCID: PMC9230813 DOI: 10.3390/medicina58060768] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/01/2022] [Accepted: 06/03/2022] [Indexed: 12/13/2022] Open
Abstract
Background and Objectives: It is still unclear whether sarcoidosis is likely to be associated with tumors. In addition, the use of an immune checkpoint inhibitor has been reported to initiate the onset of sarcoidosis. We retrospectively analyzed tumor development before and after the diagnosis of sarcoidosis and examined the impact of having a history of tumors on the activity or the severity of sarcoidosis. Materials and Methods: We recruited 312 consecutive cases of sarcoidosis and analyzed the tumor development before and after the onset of sarcoidosis. Results: Among them, 25 cases were diagnosed with malignant tumor after diagnosis of sarcoidosis. In the analysis of the tumor-development group after diagnosis of sarcoidosis, both serum angiotensin I-converting enzyme and mediastinal lymph node size were significantly reduced at the time of malignant tumor diagnosis compared to at the onset of sarcoidosis, indicating that the decreasing activity of sarcoidosis may be partly associated with tumor development. Furthermore, we examined 34 cases having tumor history before the onset of sarcoidosis and analyzed the effect of tumor history on the severity of sarcoidosis. Cases with a malignant tumor in the past were older and had less complicated organs of sarcoidosis than cases without malignant tumors in the past. Oral corticosteroid therapy was administrated more frequently in cases without malignant tumors in the past, indicating that the history of a malignant tumor may influence the severity of sarcoidosis. Conclusion: These results indicate that tumor development may be partly associated with the activity or severity of sarcoidosis.
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13
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A Narrative Review of Pathogenetic and Histopathologic Aspects, Epidemiology, Classification Systems, and Disease Outcome Measures in Systemic Sclerosis. Clin Rev Allergy Immunol 2022; 64:358-377. [PMID: 35254622 PMCID: PMC10167186 DOI: 10.1007/s12016-022-08929-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2022] [Indexed: 11/03/2022]
Abstract
Systemic sclerosis (SSc) is a rare systemic autoimmune disease, characterized by the presence of three main actors: vasculopathy, immune activation, and fibrosis. This pathologic process is then translated in a clinical picture with great variability among different patients in terms of type of organ involvement, disease severity and prognosis. This heterogeneity is a main feature of SSc, which, in addition to the presence of early phases of the disease characterized by mild symptoms, can explain the high difficulty in establishing classification criteria, and in defining patients' subsets and disease outcomes. The definition of disease outcomes is particularly relevant in the setting of clinical trials, where the aim is to provide reliable endpoints, able to measure the magnitude of the efficacy of a certain drug or intervention. For this reason, in the last years, increasing efforts have been done to design measures of disease activity, damage, severity, and response to treatment, often in the context of composite indexes. When considering disease outcomes, the experience of the patient represents a relevant and complementary aspect. The tools able to capture this experience, the patient-reported outcomes, have been increasingly used in the last years in clinical practice and in clinical trials, both as primary and secondary endpoints. This comprehensive narrative review on SSc will therefore cover pathogenetic and histopathologic aspects, epidemiology, classification systems, and disease outcome measures, in order to focus on issues that are relevant for clinical research and design of clinical trials.
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14
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Starnoni M, Pappalardo M, Spinella A, Testoni S, Lattanzi M, Feminò R, De Santis G, Salvarani C, Giuggioli D. Systemic sclerosis cutaneous expression: Management of skin fibrosis and digital ulcers. Ann Med Surg (Lond) 2021; 71:102984. [PMID: 34840747 PMCID: PMC8606707 DOI: 10.1016/j.amsu.2021.102984] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 10/25/2021] [Accepted: 10/28/2021] [Indexed: 11/30/2022] Open
Abstract
Systemic sclerosis is a connective tissue disease with cutaneous involvement. Clinical manifestations result from the balance of inflammations/autoimmunity process and fibrogenesis. Patients suffer from skin ulcers, non-ulcerative lesions including digital pitting scars, telangiectasias, subungual hyperkeratosis, abrasions, fissures, and subcutaneous calcinosis. A review about the pathophysiology of the disease, the physical examination of the patients, the instrumental assessment, and possible treatments is performed.
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Affiliation(s)
- Marta Starnoni
- Department of Medical and Surgical Sciences, Division of Plastic Surgery, University of Modena and Reggio Emilia, Policlinico of Modena, Largo Pozzo 71, 41124, Modena, Italy
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - Marco Pappalardo
- Department of Medical and Surgical Sciences, Division of Plastic Surgery, University of Modena and Reggio Emilia, Policlinico of Modena, Largo Pozzo 71, 41124, Modena, Italy
| | - Amelia Spinella
- Department of Rheumatology, Division of Rheumatology, University of Modena and Reggio Emilia, Policlinico of Modena, Largo Pozzo 71, 41124, Modena, Italy
| | - Sofia Testoni
- Department of Rheumatology, Division of Rheumatology, University of Modena and Reggio Emilia, Policlinico of Modena, Largo Pozzo 71, 41124, Modena, Italy
| | - Melba Lattanzi
- Department of Medical and Surgical Sciences, Division of Plastic Surgery, University of Modena and Reggio Emilia, Policlinico of Modena, Largo Pozzo 71, 41124, Modena, Italy
| | - Raimondo Feminò
- Department of Anesthesiology, University of Modena and Reggio Emilia, Policlinico of Modena, Largo Pozzo 71, 41124, Modena, Italy
| | - Giorgio De Santis
- Department of Medical and Surgical Sciences, Division of Plastic Surgery, University of Modena and Reggio Emilia, Policlinico of Modena, Largo Pozzo 71, 41124, Modena, Italy
| | - Carlo Salvarani
- Department of Rheumatology, Division of Rheumatology, University of Modena and Reggio Emilia, Policlinico of Modena, Largo Pozzo 71, 41124, Modena, Italy
| | - Dilia Giuggioli
- Department of Rheumatology, Division of Rheumatology, University of Modena and Reggio Emilia, Policlinico of Modena, Largo Pozzo 71, 41124, Modena, Italy
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15
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Ferri C, Arcangeletti MC, Caselli E, Zakrzewska K, Maccari C, Calderaro A, D'Accolti M, Soffritti I, Arvia R, Sighinolfi G, Artoni E, Giuggioli D. Insights into the knowledge of complex diseases: Environmental infectious/toxic agents as potential etiopathogenetic factors of systemic sclerosis. J Autoimmun 2021; 124:102727. [PMID: 34601207 DOI: 10.1016/j.jaut.2021.102727] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 09/16/2021] [Accepted: 09/17/2021] [Indexed: 12/14/2022]
Abstract
Systemic sclerosis (SSc) is a connective tissue disease secondary to three cardinal pathological features: immune-system alterations, diffuse microangiopathy, and fibrosis involving the skin and internal organs. The etiology of SSc remains quite obscure; it may encompass multiple host genetic and environmental -infectious/chemical-factors. The present review focused on the potential role of environmental agents in the etiopathogenesis of SSc based on epidemiological, clinical, and laboratory investigations previously published in the world literature. Among infectious agents, some viruses that may persist and reactivate in infected individuals, namely human cytomegalovirus (HCMV), human herpesvirus-6 (HHV-6), and parvovirus B19 (B19V), and retroviruses have been proposed as potential causative agents of SSc. These viruses share a number of biological activities and consequent pathological alterations, such as endothelial dysfunction and/or fibroblast activation. Moreover, the acute worsening of pre-existing interstitial lung involvement observed in SSc patients with symptomatic SARS-CoV-2 infection might suggest a potential role of this virus in the overall disease outcome. A variety of chemical/occupational agents might be regarded as putative etiological factors of SSc. In this setting, the SSc complicating silica dust exposure represents one of the most promising models of study. Considering the complexity of SSc pathogenesis, none of suggested causative factors may explain the appearance of the whole SSc; it is likely that the disease is the result of a multifactorial and multistep pathogenetic process. A variable combination of potential etiological factors may modulate the appearance of different clinical phenotypes detectable in individual scleroderma patients. The in-deep investigations on the SSc etiopathogenesis may provide useful insights in the broad field of human diseases characterized by diffuse microangiopathy or altered fibrogenesis.
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Affiliation(s)
- Clodoveo Ferri
- Rheumatology Unit, Medical School, University of Modena and Reggio E, University-Hospital Policlinico of Modena, Modena, Italy; Rheumatology Unit, Casa di Cura Madonna dello Scoglio, Cotronei (KR), Italy.
| | | | - Elisabetta Caselli
- Section of Microbiology, Department of Chemical, Pharmaceutical and Agricultural Sciences and LTTA, University of Ferrara, Ferrara, Italy
| | - Krystyna Zakrzewska
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Clara Maccari
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Adriana Calderaro
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Maria D'Accolti
- Section of Microbiology, Department of Chemical, Pharmaceutical and Agricultural Sciences and LTTA, University of Ferrara, Ferrara, Italy
| | - Irene Soffritti
- Section of Microbiology, Department of Chemical, Pharmaceutical and Agricultural Sciences and LTTA, University of Ferrara, Ferrara, Italy
| | - Rosaria Arvia
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Gianluca Sighinolfi
- Rheumatology Unit, Medical School, University of Modena and Reggio E, University-Hospital Policlinico of Modena, Modena, Italy.
| | - Erica Artoni
- Rheumatology Unit, Medical School, University of Modena and Reggio E, University-Hospital Policlinico of Modena, Modena, Italy
| | - Dilia Giuggioli
- Rheumatology Unit, Medical School, University of Modena and Reggio E, University-Hospital Policlinico of Modena, Modena, Italy
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16
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Li X, Wang X, Li J, Liu S, Liu Z. Serum Concentrations of Trace Elements/Minerals in Patients with Diffuse Systemic Sclerosis. Biol Trace Elem Res 2021; 199:2440-2443. [PMID: 32880801 DOI: 10.1007/s12011-020-02368-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 09/01/2020] [Indexed: 11/28/2022]
Abstract
Trace elements and minerals are essential for cellular physiology and components of biological structures. Previous studies demonstrated that proper serum concentration of trace elements/minerals such as copper maintains optimum function of the immune system, and trace elements/mineral imbalance was associated with various autoimmune disorders. The current study aimed to measure the serum concentrations of trace elements/minerals potassium (K), sodium (Na), chlorine (Cl), calcium (Ca), phosphorus (P), iron (Fe), copper (Cu), and magnesium (Mg) in patients with diffuse systemic sclerosis (dSSc). Fifty-one patients with dSSc were enrolled in this study. Healthy 106 participants with similar age and gender to the patients were used as healthy control. Roche Cobas 8000 was used to measure the serum concentrations of K, Na, Cl, Ca, P, Fe, Cu, and Mg. The results demonstrated that the serum concentrations of K, Ca, P, and Mg were significantly increased in patients with dSSc, while the serum concentration of Cu was decreased. We next examined the serum concentration of trace elements/minerals in dSSc patients with or without pulmonary fibrosis. The result revealed that the serum concentration of Cu in dSSc patients with pulmonary fibrosis was significantly lower than that in patents without pulmonary fibrosis. Our study provided evidence that serum concentrations of K, Ca, P, Cu, and Mg were changed significantly in dSSc patients, and lower serum concentration of Cu was associated with pulmonary fibrosis.
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Affiliation(s)
- Xia Li
- Clinical Laboratory, Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, China
| | - Xiujuan Wang
- College of Medical Laboratory Science, Guilin Medical University, No. 109, Huanchengbeier Road, Guilin, 541004, Guangxi, China
| | - Jin Li
- Department of Publicity, Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, China
| | - Shanshan Liu
- Clinical Laboratory, Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, China
| | - Zheng Liu
- College of Medical Laboratory Science, Guilin Medical University, No. 109, Huanchengbeier Road, Guilin, 541004, Guangxi, China.
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17
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Novel classifications for systemic sclerosis: challenging historical subsets to unlock new doors. Curr Opin Rheumatol 2021; 32:463-471. [PMID: 32941248 DOI: 10.1097/bor.0000000000000747] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
PURPOSE OF REVIEW Systemic sclerosis (SSc) is a severe rheumatic disease characterized by a considerable heterogeneity in clinical presentations and pathophysiological mechanisms. This variability has a substantial impact on morbidity and mortality and limits the generalizability of clinical trial results. This review aims to highlight recent studies that have proposed new innovative approaches to decipher this heterogeneity, in particular, by attempting to optimize disease classification. RECENT FINDINGS The historical dichotomy limited/diffuse subsets based on cutaneous involvement has been challenged by studies highlighting an underestimated heterogeneity between these two subtypes and showing that presence of organ damage and autoantibody profiles markedly influenced survival beyond skin extension. Advanced computational methods using unsupervised machine learning analyses of clinical variables and/or high-throughput omics technologies, clinical variables trajectories modelling overtime or radiomics have provided significant insights on key pathogenic processes that could help defining new subgroups beyond the diffuse/limited subsets. SUMMARY We can anticipate that a future classification of SSc patients will integrate innovative approaches encompassing clinical phenotypes, variables trajectories, serological features and innovative omics molecular signatures. It nevertheless seems crucial to also pursue the implementation and standardization of readily available and easy to use tools that can be used in clinical practice.
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18
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Abstract
PURPOSE OF REVIEW This review details recent findings related to the health effects of occupational exposure to artificial stone dust and the rapid increase in cases of artificial stone associated silicosis around the world. RECENT FINDINGS High crystalline silica content artificial stone is now commonly used for the production of kitchen benchtops. Reports of artificial stone silicosis from many countries have noted that workers were typically employed at small workplaces and were often diagnosed in their 30s or 40s. Poor exposure control measures were common, including the practice of 'dry processing'. Dust generated from artificial stone has been noted to have properties that influence toxicity, including high silica content, generation of nanosized particles and presence of metals and resins. Artificial stone silicosis differs from silicosis associated with other occupational settings including shorter latency and rapid disease progression. High-resolution computed tomography (CT) chest imaging of artificial stone silicosis has often noted the presence of ground glass opacities, which may not be detected in chest x-ray screening. Increased prevalence of autoimmune disease, such as scleroderma, has also been reported in this industry. SUMMARY Further evaluation of the safety of work with artificial stone is required, including the effectiveness of dust control measures. Current reports of artificial stone silicosis indicate the potential for widespread undiagnosed respiratory disease in this industry. Provision of more sensitive health screening methods for all at-risk workers and the development of new treatment options particularly for this form of silicosis is urgently required.
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Affiliation(s)
- Ryan F Hoy
- School of Public Health & Preventive Medicine Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
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19
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Ma R, Qi Y, Zhao X, Li X, Sun X, Niu P, Li Y, Guo C, Chen R, Sun Z. Amorphous silica nanoparticles accelerated atherosclerotic lesion progression in ApoE -/- mice through endoplasmic reticulum stress-mediated CD36 up-regulation in macrophage. Part Fibre Toxicol 2020; 17:50. [PMID: 33008402 PMCID: PMC7531166 DOI: 10.1186/s12989-020-00380-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 09/14/2020] [Indexed: 01/10/2023] Open
Abstract
Background The biosafety concern of silica nanoparticles (SiNPs) is rapidly expanding alongside with its mass production and extensive applications. The cardiovascular effects of SiNPs exposure have been gradually confirmed, however, the interaction between SiNPs exposure and atherosclerosis, and the underlying mechanisms still remain unknown. Thereby, this study aimed to explore the effects of SiNPs on the progression of atherosclerosis, and to investigate related mechanisms. Results We firstly investigated the in vivo effects of SiNPs exposure on atherosclerosis via intratracheal instillation of ApoE−/− mice fed a Western diet. Ultrasound microscopy showed a significant increase of pulse wave velocity (PWV) compared to the control group, and the histopathological investigation reflected a greater plaque burden in the aortic root of SiNPs-exposed ApoE−/− mice. Compared to the control group, the serum levels of total triglycerides (TG) and low-density lipoprotein cholesterol (LDL-C) were elevated after SiNPs exposure. Moreover, intensified macrophage infiltration and endoplasmic reticulum (ER) stress was occurred in plaques after SiNPs exposure, as evidenced by the upregulated CD68 and CHOP expressions. Further in vitro, SiNPs was confirmed to activate ER stress and induce lipid accumulation in mouse macrophage, RAW264.7. Mechanistic analyses showed that 4-PBA (a classic ER stress inhibitor) pretreatment greatly alleviated SiNPs-induced macrophage lipid accumulation, and reversed the elevated CD36 expression induced by SiNPs. Conclusions Our results firstly revealed the acceleratory effect of SiNPs on the progression of atherosclerosis in ApoE−/− mice, which was related to lipid accumulation caused by ER stress-mediated upregulation of CD36 expression in macrophage. Graphical abstract ![]()
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Affiliation(s)
- Ru Ma
- Department of Occupational Health and Environmental Health, School of Public Health, Capital Medical University, Beijing, 100069, China.,Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, 100069, China
| | - Yi Qi
- Department of Occupational Health and Environmental Health, School of Public Health, Capital Medical University, Beijing, 100069, China.,Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, 100069, China
| | - Xinying Zhao
- Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, 100069, China.,Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing, 100069, China
| | - Xueyan Li
- Department of Occupational Health and Environmental Health, School of Public Health, Capital Medical University, Beijing, 100069, China.,Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, 100069, China
| | - Xuejing Sun
- Department of Occupational Health and Environmental Health, School of Public Health, Capital Medical University, Beijing, 100069, China.,Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, 100069, China
| | - Piye Niu
- Department of Occupational Health and Environmental Health, School of Public Health, Capital Medical University, Beijing, 100069, China.,Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, 100069, China
| | - Yanbo Li
- Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, 100069, China. .,Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing, 100069, China.
| | - Caixia Guo
- Department of Occupational Health and Environmental Health, School of Public Health, Capital Medical University, Beijing, 100069, China. .,Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, 100069, China.
| | - Rui Chen
- Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, 100069, China.,Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing, 100069, China
| | - Zhiwei Sun
- Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, 100069, China.,Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing, 100069, China
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20
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Ballerie A, Cavalin C, Lederlin M, Nicolas A, Garlantézec R, Jouneau S, Lecureur V, Cazalets C, Belhomme N, Paris C, Rosental PA, Jégo P, Lescoat A. Association of silica exposure with chest HRCT and clinical characteristics in systemic sclerosis. Semin Arthritis Rheum 2020; 50:949-956. [DOI: 10.1016/j.semarthrit.2020.08.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 08/06/2020] [Accepted: 08/21/2020] [Indexed: 12/30/2022]
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21
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Ouchene L, Muntyanu A, Lavoué J, Baron M, Litvinov IV, Netchiporouk E. Toward Understanding of Environmental Risk Factors in Systemic Sclerosis [Formula: see text]. J Cutan Med Surg 2020; 25:188-204. [PMID: 32988228 DOI: 10.1177/1203475420957950] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
IMPORTANCE Systemic sclerosis (SSc) is a severe, chronic, and incurable autoimmune fibrotic skin disease with significant extracutaneous involvement. Low concordance rate in twin studies and unequal geographic distribution of SSc argues for importance of environment in disease initiation and progression. OBJECTIVE In this manuscript we provide a summary of all investigated potential external risk factors for SSc. DATA SOURCES A literature search in PubMed and EMBASE database was performed for studies published until January 1, 2020 by 2 reviewers (EN and LO) independently. FINDINGS Occupational and/or environmental exposures to silica and organic solvents are associated with increased incidence and severity of SSc. Exposure to epoxy resins, asbestos, and particulate air pollution favors increased risk of SSc, but data are based on limited number of observational studies. There is insufficient evidence to conclude an association between SSc development and other occupational (eg, welding fumes) or personal exposures (eg, smoking, vitamin D deficiency). Association of SSc with silicone breast implants has been disproven. Infectious pathogens (eg, Helicobacter pylori and angiotropic viruses) and dysbiosis seem to play a role in SSc development and severity, but their role remains to be clarified. CONCLUSIONS AND RELEVANCE It may be prudent to counsel our patients with SSc (or those at risk of SSc) to avoid occupations with exposure to silica, organic solvents, asbestos and epoxy resins; restraint from smoking, using cocaine or drugs with pro-fibrotic potential. While the association between low vitamin D and SSc remains to be confirmed, we believe that SSc patients should be encouraged to maintain healthy vitamin D levels as benefits outweigh the risks.
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Affiliation(s)
- Lydia Ouchene
- 12367 Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Anastasiya Muntyanu
- 54473 Division of Dermatology, Department of Medicine, McGill University Health Centre, Montreal, QC, Canada
| | - Jérôme Lavoué
- 5622 Department of Environmental and Occupational Health, School of Public Health, Université de Montreal, Montreal, Québec, Canada
| | - Murray Baron
- 5621 Division of Rheumatology, Department of Medicine, Jewish General Hospital, Montreal, QC, Canada
| | - Ivan V Litvinov
- 54473 Division of Dermatology, Department of Medicine, McGill University Health Centre, Montreal, QC, Canada
| | - Elena Netchiporouk
- 54473 Division of Dermatology, Department of Medicine, McGill University Health Centre, Montreal, QC, Canada
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22
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Patel S, Morrisroe K, Proudman S, Hansen D, Sahhar J, Sim MR, Ngian GS, Walker J, Strickland G, Wilson M, Ferdowsi N, Major G, Roddy J, Stevens W, Nikpour M, Nikpour M, Proudman S, Stevens W, Sahhar J, Cooley H, Croyle L, Ferdowsi N, Hill C, Host L, Major G, Morrisroe K, Ngian GS, Rischmueller M, Roddy J, Strickland G, Tay T, Tymms K, Walker J, Youssef P. Occupational silica exposure in an Australian systemic sclerosis cohort. Rheumatology (Oxford) 2020; 59:3900-3905. [DOI: 10.1093/rheumatology/keaa446] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 06/01/2020] [Indexed: 12/13/2022] Open
Abstract
Abstract
Objective
To determine the frequency of self-reported occupational exposure to silica in SSc patients enrolled in the Australian Scleroderma Cohort Study, and to compare the disease characteristics of the silica-exposed patients with those of the non-exposed patients.
Method
Data collected over a 12-year period from 1670 SSc patients were analysed. We compared the demographic and clinical characteristics of those who reported occupational silica exposure with those who did not. A subgroup analysis of male patients was performed, as well as a multivariable analysis of correlates of silica exposure.
Results
Overall, 126 (7.5%) of the cohort reported occupational silica exposure. These individuals were more likely to be male (73 of 231, i.e. 31.6% males exposed) and to have worked in mining and construction industries. Those who reported silica exposure were younger at the onset of SSc skin involvement [odds ratio (OR) 0.9, P = 0.02], of male gender (OR 14.9, P < 0.001), have joint contractures (OR 1.8, P = 0.05) and have higher physical disability as defined by scleroderma HAQ (OR 1.4, P = 0.01).
Conclusion
The highest percentage of silica exposure was found in males. These patients were more likely to have the presence of certain clinical manifestations and Scl-70 antibody, which is known to confer a poor prognosis. These findings support the association between occupational silica exposure and the subsequent development of SSc. Further investigation is required to describe the range of clinical manifestations and disease course, including prognosis and treatment response, in those diagnosed with occupationally induced SSc compared with idiopathic SSc.
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Affiliation(s)
- Shreeya Patel
- Department of Rheumatology, St Vincent’s Hospital Melbourne, Melbourne, Victoria
| | - Kathleen Morrisroe
- Department of Rheumatology, St Vincent’s Hospital Melbourne, Melbourne, Victoria
- Department of Medicine, The University of Melbourne at St Vincent’s Hospital (Melbourne), Fitzroy, Victoria
| | - Susanna Proudman
- Rheumatology Unit, Royal Adelaide Hospital
- Discipline of Medicine, University of Adelaide, Adelaide, South Australia
| | - Dylan Hansen
- Department of Rheumatology, St Vincent’s Hospital Melbourne, Melbourne, Victoria
| | - Joanne Sahhar
- Department of Rheumatology, Monash Health
- Department of Medicine, Monash University
| | - Malcolm R Sim
- Centre for Occupational & Environmental Health, Monash University, Melbourne, Victoria
| | - Gene-Siew Ngian
- Department of Rheumatology, Monash Health
- Department of Medicine, Monash University
| | | | - Gemma Strickland
- Department of Rheumatology, St Vincent’s Hospital Melbourne, Melbourne, Victoria
| | - Michelle Wilson
- Department of Rheumatology, St Vincent’s Hospital Melbourne, Melbourne, Victoria
| | - Nava Ferdowsi
- Department of Rheumatology, St Vincent’s Hospital Melbourne, Melbourne, Victoria
| | - Gabor Major
- Department of Rheumatology, Bone and Joiny Institute, Royal Newcastle Centre, John Hunter Hospital, Newcastle, New South Wales
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales
| | - Janet Roddy
- Department of Rheumatology, Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - Wendy Stevens
- Department of Rheumatology, St Vincent’s Hospital Melbourne, Melbourne, Victoria
| | - Mandana Nikpour
- Department of Rheumatology, St Vincent’s Hospital Melbourne, Melbourne, Victoria
- Department of Medicine, The University of Melbourne at St Vincent’s Hospital (Melbourne), Fitzroy, Victoria
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Arcangeletti MC, D’Accolti M, Maccari C, Soffritti I, Conto FD, Chezzi C, Calderaro A, Ferri C, Caselli E. Impact of Human Cytomegalovirus and Human Herpesvirus 6 Infection on the Expression of Factors Associated with Cell Fibrosis and Apoptosis: Clues for Implication in Systemic Sclerosis Development. Int J Mol Sci 2020; 21:E6397. [PMID: 32899126 PMCID: PMC7504027 DOI: 10.3390/ijms21176397] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 08/26/2020] [Accepted: 08/31/2020] [Indexed: 02/07/2023] Open
Abstract
Systemic sclerosis (SSc) is a severe autoimmune disorder characterized by vasculopathy and multi-organ fibrosis; its etiology and pathogenesis are still largely unknown. Herpesvirus infections, particularly by human cytomegalovirus (HCMV) and human herpesvirus 6 (HHV-6), have been suggested among triggers of the disease based on virological and immunological observations. However, the direct impact of HCMV and/or HHV-6 infection on cell fibrosis and apoptosis at the cell microenvironment level has not yet been clarified. Thus, this study aimed to investigate the effects of HCMV and HHV-6 infection on the induction of pro-fibrosis or pro-apoptosis conditions in primary human dermal fibroblasts, one of the relevant SSc target cells. The analysis, performed by microarray in in vitro HCMV- or HHV-6-infected vs. uninfected cells, using specific panels for the detection of the main cellular factors associated with fibrosis or apoptosis, showed that both viruses significantly modified the expression of at least 30 pro-fibrotic and 20 pro-apoptotic factors. Notably, several recognized pro-fibrotic factors were highly induced, and most of them were reported to be involved in vivo in the multifactorial and multistep pathogenic process of SSc, thus suggesting a potential role of both HCMV and HHV-6.
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Affiliation(s)
- Maria-Cristina Arcangeletti
- Department of Medicine and Surgery, Unit of Virology, University-Hospital of Parma, University of Parma, 43126 Parma, Italy; (C.M.); (F.D.C.); (C.C.); (A.C.)
| | - Maria D’Accolti
- Department of Chemical and Pharmaceutical Sciences, Section of Microbiology and Medical Genetics, University of Ferrara, 44121 Ferrara, Italy; (M.D.); (I.S.); (E.C.)
| | - Clara Maccari
- Department of Medicine and Surgery, Unit of Virology, University-Hospital of Parma, University of Parma, 43126 Parma, Italy; (C.M.); (F.D.C.); (C.C.); (A.C.)
| | - Irene Soffritti
- Department of Chemical and Pharmaceutical Sciences, Section of Microbiology and Medical Genetics, University of Ferrara, 44121 Ferrara, Italy; (M.D.); (I.S.); (E.C.)
| | - Flora De Conto
- Department of Medicine and Surgery, Unit of Virology, University-Hospital of Parma, University of Parma, 43126 Parma, Italy; (C.M.); (F.D.C.); (C.C.); (A.C.)
| | - Carlo Chezzi
- Department of Medicine and Surgery, Unit of Virology, University-Hospital of Parma, University of Parma, 43126 Parma, Italy; (C.M.); (F.D.C.); (C.C.); (A.C.)
| | - Adriana Calderaro
- Department of Medicine and Surgery, Unit of Virology, University-Hospital of Parma, University of Parma, 43126 Parma, Italy; (C.M.); (F.D.C.); (C.C.); (A.C.)
| | - Clodoveo Ferri
- Department of Medical and Surgical Sciences for Children and Adults, Rheumatology Unit, University-Hospital Policlinico of Modena, University of Modena and Reggio Emilia, 41121 Modena, Italy;
| | - Elisabetta Caselli
- Department of Chemical and Pharmaceutical Sciences, Section of Microbiology and Medical Genetics, University of Ferrara, 44121 Ferrara, Italy; (M.D.); (I.S.); (E.C.)
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24
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Aguila LA, da Silva HC, Medeiros-Ribeiro AC, Bunjes BG, Luppino-Assad AP, Sampaio-Barros PD. Is exposure to environmental factors associated with a characteristic clinical and laboratory profile in systemic sclerosis? A retrospective analysis. Rheumatol Int 2020; 41:1143-1150. [PMID: 32862308 DOI: 10.1007/s00296-020-04693-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 08/20/2020] [Indexed: 01/19/2023]
Abstract
To identify environmental factors (EF) in a large cohort of patients with systemic sclerosis (SSc) analyzing their clinical and laboratory presentation. A cohort of consecutive patients attended at a single Brazilian SSc outpatient clinic was analyzed regarding EF. Data were analyzed according to clinical, demographic and laboratory characteristics, as well as SSc subtype. In a cohort of 662 patients, 70 (10.6%) had known previous exposure to EF, predominantly organic solvents (51.4%), silica (20%), silicone (12.9%) and pesticides (11.4%). In the SSc cohort, patients with EF had a significantly higher frequency of male gender (p < 0.01), African-Brazilian ethnicity (p = 0.01), myopathy (p = 0.02), and pigmentary disorders (p = 0.04), with shorter disease duration (p = 0.01). When SSc subtypes were analyzed separately, there was positive association with male gender in limited (p < 0.01) and diffuse (p < 0.01) SSc, as well as African-Brazilian ethnicity (p = 0.04), severe interstitial lung disease (p < 0.01), myopathy (p = 0.02) and SD pattern at nailfold capillaroscopy (p = 0.01) in limited SSc, and negative association with esophageal hypomotility (p < 0.01) and ANA positivity (p = 0.02) in diffuse SSc. Multiple regression analyses showed that myopathy was independently associated with previous exposure to EF (OR = 2.09; 95% CI 1.15-3.82), especially silica exposure (OR = 3.09; 95% CI 1.67-5.73). This study showed that SSc patients with previous exposure to EF may have some specific clinical characteristics, mainly a higher frequency of myopathy, also showing more severe ILD, preferably in male and African-Brazilian patients, associated with a lower frequency of ANA positivity.
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Affiliation(s)
- Lisbeth A Aguila
- Division of Rheumatology, Faculdade de Medicina, Hospital das Clinicas HCFMUSP, Universidade de São Paulo, Av. Dr. Arnaldo, 455, 3o. Andar, Cerqueira César, São Paulo, SP, 01246-903, Brasil
| | - Henrique Carriço da Silva
- Division of Rheumatology, Faculdade de Medicina, Hospital das Clinicas HCFMUSP, Universidade de São Paulo, Av. Dr. Arnaldo, 455, 3o. Andar, Cerqueira César, São Paulo, SP, 01246-903, Brasil
| | - Ana Cristina Medeiros-Ribeiro
- Division of Rheumatology, Faculdade de Medicina, Hospital das Clinicas HCFMUSP, Universidade de São Paulo, Av. Dr. Arnaldo, 455, 3o. Andar, Cerqueira César, São Paulo, SP, 01246-903, Brasil
| | - Bruna Giusto Bunjes
- Division of Rheumatology, Faculdade de Medicina, Hospital das Clinicas HCFMUSP, Universidade de São Paulo, Av. Dr. Arnaldo, 455, 3o. Andar, Cerqueira César, São Paulo, SP, 01246-903, Brasil
| | - Ana Paula Luppino-Assad
- Division of Rheumatology, Faculdade de Medicina, Hospital das Clinicas HCFMUSP, Universidade de São Paulo, Av. Dr. Arnaldo, 455, 3o. Andar, Cerqueira César, São Paulo, SP, 01246-903, Brasil
| | - Percival D Sampaio-Barros
- Division of Rheumatology, Faculdade de Medicina, Hospital das Clinicas HCFMUSP, Universidade de São Paulo, Av. Dr. Arnaldo, 455, 3o. Andar, Cerqueira César, São Paulo, SP, 01246-903, Brasil.
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25
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Lescoat A, Ballerie A, Lelong M, Augagneur Y, Morzadec C, Jouneau S, Jégo P, Fardel O, Vernhet L, Lecureur V. Crystalline Silica Impairs Efferocytosis Abilities of Human and Mouse Macrophages: Implication for Silica-Associated Systemic Sclerosis. Front Immunol 2020; 11:219. [PMID: 32133004 PMCID: PMC7039938 DOI: 10.3389/fimmu.2020.00219] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 01/27/2020] [Indexed: 12/14/2022] Open
Abstract
Inhalation of crystalline silica (SiO2) is a risk factor of systemic autoimmune diseases such as systemic sclerosis (SSc) and fibrotic pulmonary disorders such as silicosis. A defect of apoptotic cell clearance (i.e., efferocytosis, a key process in the resolution of inflammation) is reported in macrophages from patients with fibrotic or autoimmune diseases. However, the precise links between SiO2 exposure and efferocytosis impairment remain to be determined. Answering to this question may help to better link innate immunity and fibrosis. In this study, we first aim to determine whether SiO2 might alter efferocytosis capacities of human and mouse macrophages. We secondly explore possible mechanisms explaining efferocytosis impairment, with a specific focus on macrophage polarization and on the RhoA/ROCK pathway, a key regulator of cytoskeleton remodeling and phagocytosis. Human monocyte-derived macrophages (MDM) and C57BL/6J mice exposed to SiO2 and to CFSE-positive apoptotic Jurkat cells were analyzed by flow cytometry to determine their efferocytosis index (EI). The effects of ROCK inhibitors (Y27632 and Fasudil) on EI of SiO2-exposed MDM and MDM from SSc patients were evaluated in vitro. Our results demonstrated that SiO2 significantly decreased EI of human MDM in vitro and mouse alveolar macrophages in vivo. In human MDM, this SiO2-associated impairment of efferocytosis, required the expression of the membrane receptor SR-B1 and was associated with a decreased expression of M2 polarization markers (CD206, CD204, and CD163). F-actin staining, RhoA activation and impairment of efferocytosis, all induced by SiO2, were reversed by ROCK inhibitors. Moreover, the EI of MDM from SSc patients was similar to the EI of in vitro- SiO2-exposed MDM and Y27632 significantly increased SSc MDM efferocytosis capacities, suggesting a likewise activation of the RhoA/ROCK pathway in SSc. Altogether, our results demonstrate that SiO2 exposure may contribute to the impairment of efferocytosis capacities of mouse and human macrophages but also of MDM in SiO2-associated autoimmune diseases and fibrotic disorders such as SSc; in this context, the silica/RhoA/ROCK pathway may constitute a relevant therapeutic target.
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Affiliation(s)
- Alain Lescoat
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) – UMR_S 1085, Rennes, France
- Department of Internal Medicine and Clinical Immunology, Rennes University Hospital, Rennes, France
| | - Alice Ballerie
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) – UMR_S 1085, Rennes, France
- Department of Internal Medicine and Clinical Immunology, Rennes University Hospital, Rennes, France
| | - Marie Lelong
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) – UMR_S 1085, Rennes, France
| | - Yu Augagneur
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) – UMR_S 1085, Rennes, France
| | - Claudie Morzadec
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) – UMR_S 1085, Rennes, France
| | - Stéphane Jouneau
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) – UMR_S 1085, Rennes, France
- Department of Respiratory Diseases, Rennes University Hospital, Rennes, France
| | - Patrick Jégo
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) – UMR_S 1085, Rennes, France
- Department of Internal Medicine and Clinical Immunology, Rennes University Hospital, Rennes, France
| | - Olivier Fardel
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) – UMR_S 1085, Rennes, France
- Pôle Biologie, Rennes University Hospital, Rennes, France
| | - Laurent Vernhet
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) – UMR_S 1085, Rennes, France
| | - Valérie Lecureur
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) – UMR_S 1085, Rennes, France
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26
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Caselli E, Soffritti I, D’Accolti M, Bortolotti D, Rizzo R, Sighinolfi G, Giuggioli D, Ferri C. HHV-6A Infection and Systemic Sclerosis: Clues of a Possible Association. Microorganisms 2019; 8:microorganisms8010039. [PMID: 31878218 PMCID: PMC7022325 DOI: 10.3390/microorganisms8010039] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 12/20/2019] [Indexed: 12/11/2022] Open
Abstract
Systemic sclerosis (SSc) is an autoimmune disease characterized by vasculopathy, excessive extracellular matrix deposition, and fibrosis of the skin and internal organs. Several infectious agents, including human herpesvirus-6 (HHV-6), have been suggested as possible triggering factors, but a direct association is still missing. We characterized 26 SSc patients for the presence of HHV-6 in tissues and blood, the anti-HHV-6 response, HLA-G plasma levels, and KIR typing. Given the prominent role of endothelial cells (EC) in SSc pathogenesis, along with HHV-6 tropism for EC, we also investigated the expression of pro-fibrosis factors in HHV-6 infected EC. Results showed the presence of HHV-6A in skin biopsies, and an increased virus load was associated with disease severity and poor natural killer (NK) response against the virus, particularly in subjects exhibiting a KIR2 phenotype. HLA-G plasma levels were significantly higher in HHV-6A/B-KIR2 positive SSc patients and in vitro HHV-6A infection-induced pro-fibrosis factors expression in EC, supporting its role in the development of the fibrosing process. Our data suggest an association between virus infection/reactivation and disease, opening the way to future studies to understand the mechanisms by which HHV-6A might contribute to the multifactorial pathogenesis of SSc.
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Affiliation(s)
- Elisabetta Caselli
- Section of Microbiology and Medical Genetics, Department of Chemical and Pharmaceutical Sciences, University of Ferrara, 44121 Ferrara, Italy
- Correspondence: ; Tel.: +39-0532-455387
| | - Irene Soffritti
- Section of Microbiology and Medical Genetics, Department of Chemical and Pharmaceutical Sciences, University of Ferrara, 44121 Ferrara, Italy
| | - Maria D’Accolti
- Section of Microbiology and Medical Genetics, Department of Chemical and Pharmaceutical Sciences, University of Ferrara, 44121 Ferrara, Italy
| | - Daria Bortolotti
- Section of Microbiology and Medical Genetics, Department of Chemical and Pharmaceutical Sciences, University of Ferrara, 44121 Ferrara, Italy
| | - Roberta Rizzo
- Section of Microbiology and Medical Genetics, Department of Chemical and Pharmaceutical Sciences, University of Ferrara, 44121 Ferrara, Italy
| | - Gianluca Sighinolfi
- Rheumatology Unit, Medical School, University of Modena and Reggio Emilia, University-Hospital Policlinico of Modena, 41121 Modena, Italy
| | - Dilia Giuggioli
- Rheumatology Unit, Medical School, University of Modena and Reggio Emilia, University-Hospital Policlinico of Modena, 41121 Modena, Italy
| | - Clodoveo Ferri
- Rheumatology Unit, Medical School, University of Modena and Reggio Emilia, University-Hospital Policlinico of Modena, 41121 Modena, Italy
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27
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Zakrzewska K, Arvia R, Torcia MG, Clemente AM, Tanturli M, Castronovo G, Sighinolfi G, Giuggioli D, Ferri C. Effects of Parvovirus B19 In Vitro Infection on Monocytes from Patients with Systemic Sclerosis: Enhanced Inflammatory Pathways by Caspase-1 Activation and Cytokine Production. J Invest Dermatol 2019; 139:2125-2133.e1. [DOI: 10.1016/j.jid.2019.03.1144] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 03/22/2019] [Accepted: 03/22/2019] [Indexed: 01/28/2023]
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28
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Yu Y, Zhu T, Li Y, Jing L, Yang M, Li Y, Duan J, Sun Z. Repeated intravenous administration of silica nanoparticles induces pulmonary inflammation and collagen accumulation via JAK2/STAT3 and TGF-β/Smad3 pathways in vivo. Int J Nanomedicine 2019; 14:7237-7247. [PMID: 31564876 PMCID: PMC6735659 DOI: 10.2147/ijn.s209458] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 07/30/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The health hazards of silica nanoparticle (SiNP) are raising worldwide concern as SiNPs has become the second largest manufactured nanomaterial in global markets. However, insufficient data for the adverse health effects and safety evaluation of SiNPs are remaining a big question. PURPOSE We evaluated the effects and related mechanism of SiNPs on pulmonary inflammation and collagen production through repeated intravenous administration in mice in a 45-day observation period. METHODS Morphological and ultrastructural change, ultradistribution of SiNPs in lungs were observed in ICR mice through intravenous administration. Oxidative damage, pro-inflammatory cytokines, hydroxyproline content, the marker of fibroblasts and epithelial-mesenchymal transition (EMT), and JAK2/STAT3 and TGF-β1/Smad3 signaling pathways were detected to explore the lung injuries and related mechanism. RESULTS The results showed repeated intravenous exposure of SiNPs increased the weight of lung tissues and destroyed pulmonary histomorphological structure. The increased MDA content, depletion of SOD and GSH-Px in lungs were observed in SiNP-treated mice. The protein expressions of JAK2/STAT3 pathway were upregulated in lungs, and the levels of inflammatory cytokines TNF-α, IL-1β, and IL-6 in serum and lungs were also elevated in SiNPs treated group. The increased hydroxyproline content indicated collagen accumulation in lungs of SiNP-treated mice. Meanwhile, the protein expressions of the marker of myofibroblast (a-SMA), the regulators in connective tissue remodeling (CTGF), TGF-β, and p-Smad3 were all upregulated in lungs. In addition, we found intravenous administration of SiNPs-induced ultrastructural changes in type II alveolar epithelial cells but without downregulation of the protein expression of the key markers of epithelial cells (E-Cadherin). CONCLUSION Our results revealed that oxidative stress and inflammation contributed to the collagen accumulation through activation of JAK2/STAT3 and TGF-β/Smad3 pathways. It suggests that pulmonary aberrant inflammation and collagen accumulation induced by nanoparticles should be seriously considered for the safety application in diagnostics or therapeutics.
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Affiliation(s)
- Yang Yu
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing, People’s Republic of China
- Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, People’s Republic of China
| | - Tingting Zhu
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing, People’s Republic of China
| | - Yang Li
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing, People’s Republic of China
- Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, People’s Republic of China
| | - Li Jing
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing, People’s Republic of China
- Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, People’s Republic of China
| | - Man Yang
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing, People’s Republic of China
- Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, People’s Republic of China
| | - Yanbo Li
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing, People’s Republic of China
- Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, People’s Republic of China
| | - Junchao Duan
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing, People’s Republic of China
- Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, People’s Republic of China
| | - Zhiwei Sun
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing, People’s Republic of China
- Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, People’s Republic of China
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