Autoimmunity by pesticides: a critical review of the state of the science

Organochlorine pesticides disrupt T helper cell regulation and reduce IL-2 and IFN-γ favoring infection and production of autoantibodies among pemphigus patients

The list of environmental factors that trigger autoimmune diseases in genetically susceptible individuals has grown in the recent years and is far from complete. The possible intervention of the environment in triggering these diseases is ever more perceived by the clinicians. This study investigated the effect of environmental factors like organochlorine pesticides (OCPs) on proportions of different T lymphocyte subsets and their cytokine secretion in-vitro among pemphigus patients, before and after specific immunosuppressive therapy. Higher levels of OCPs like β-HCH (isoform of hexachlorohexane), α-endosulfan (a form of endosulfan) and p,p΄-DDE (a metabolite of o,p'-dichlorodiphenyltrichloroethane) were observed in the blood of pemphigus patients as compared to healthy controls. HCH and DDT exposure caused specific reduction in CD8+CD45RA+ and CD4+CD25+ T lymphocyte subpopulations in these patient PBMCs. A strong reduction in Th1 (IL-2 and IFN-γ) cytokines upon exposure to these OCPs in-vitro was also observed. These findings indicate that HCH and DDT have a significant impact on Th1 lymphocytes. Impaired production of these cytokines might favor infections and production of autoantibodies. We therefore speculate that the systemic absorption of the pesticide after the topical contact may be one of the factors triggering the immunological mechanism among pemphigus patients.

Exploratory analysis of the association between pyrethroid exposure and rheumatoid arthritis among US adults: 2007-2014 data analysis from the National Health and Nutrition Examination Survey (NHANES)

Previous studies indicate that pesticide use may play an important role in the occurrence and development of rheumatoid arthritis (RA); however, little is known about the effect of specific pesticides on RA. The objective of this study was to evaluate whether pyrethroid exposure was linked to RA in adults. Data were originated from the 2007-2014 National Health and Nutrition Examination Survey (NHANES). The levels of pyrethroid exposure were assessed by 3-phenoxybenzoic acid (3-PBA) concentrations in urine samples. We built multivariate logistic regression models to assess associations between pyrethroid exposure and RA among US adults. A restricted cubic spline plot (three knots) was applied to test whether there was a nonlinear relationship between exposure to pyrethroid pesticides and the prevalence of RA. Finally, 4384 subjects were included in our analysis with 278 RA patients. In crude model, higher level of 3-PBA (creatinine-adjusted) was positively associated with RA (OR: 1.51, 95% CI: 1.07, 2.15). After adjustment for sex, race/ethnicity, education, body mass index, family poverty income, level of education, marital status, smoking status, alcohol usage, physical activity, hypertension, and urinary creatinine, the highest (vs lowest) quartile of 3-PBA was associated with an increased prevalence of RA (OR: 1.23, 95% CI: 0.86, 1.79). Significantly positive associations between 3-PBA concentration and RA were observed in the population aged between 40 and 59 years and with lower level of education. The restricted cubic spline plot presented an increase in trend and indicated that pyrethroid exposure was linearly associated with occurrence of RA (p for nonlinearity = 0.728). In conclusion, our study indicated that pyrethroid pesticide exposure was associated with an increased risk of RA. Higher levels of pyrethroid exposure were linearly associated with increased prevalence of RA in adults. Certainly, our findings are in great need of further corroboration by prospective studies with strict design.

Lifetime Pesticide Use and Antinuclear Antibodies in Male Farmers From the Agricultural Health Study

Farming and pesticide use have been associated with systemic autoimmune diseases, and while certain organochlorine insecticides and other pesticides are suspected to influence risk, the role of specific pesticides in the development of systemic autoimmunity is not known. We measured serum antinuclear autoantibodies (ANA) by immunofluorescence on Hep-2 cells in 668 male farmers in the study of Biomarkers of Exposure and Effect in Agriculture (BEEA; 2010-2013), an Agricultural Health Study (AHS) subcohort. We examined ANA in relation to lifetime use of 46 pesticides first reported at AHS enrollment (1993-1997) and updated at intervals through BEEA enrollment. Odds ratios (OR) and 95% confidence intervals (CI) were estimated after adjusting for age, state, education, season of blood draw, current pesticide use, and correlated pesticides. Having ANA antibodies (3 or 4+ intensity at a 1:80 dilution, 21% of study participants) was associated with a reported history of seeking medical care due to exposure to pesticides (OR 2.15; 95%CI 1.17, 3.95), use of the fumigant methyl bromide (OR 3.16; 95%CI 1.05, 9.5), and use of petroleum oil/distillates (OR 1.50; 95%CI 1.00, 2.25). Using a higher threshold (3 or 4+ at a 1:160 dilution, 9%) ANA positivity was associated with the carbamate insecticide aldicarb (OR 4.82; 95%CI 1.33, 17.5) and greater combined use of four cyclodiene organochlorine insecticides (top tertile of intensity-weighted lifetime days vs. no use; OR T3 3.20; 95%CI 1.10, 9.27). By contrast, greater use of non-cyclodiene organochlorine insecticides was inversely associated with ANA (1:80 dilution 3 or 4+, OR T3 0.24; 95%CI 0.08, 0.72). Specific autoantibodies (to extractable nuclear antigens and anti-dsDNA), measured on those with ANA detected at the 1:80 dilution 3 or 4+, were seen in 15 individuals (2%), and were associated with use of two or more cyclodiene organochlorine insecticides and several other pesticides (e.g., carbofuran, ethylene dibromide). These findings suggest that specific pesticide exposures may have long-term effects on ANA prevalence and support the hypothesis that certain organochlorine insecticides may increase the risk of developing systemic autoimmunity.

Increased Frequency of Rheumatoid Arthritis and Allergic Rhinitis among Pesticide Sprayers and Associations with Pesticide Use

Objective: The aim of this study was to identify diseases linked with the pesticide sprayer occupation and explore possible associations with exposure history data. Methods: A cross sectional study was conducted among pesticide sprayers (n = 80) and the general population (n = 90) in Thessaly (Greece). Medical history, demographic characteristics and detailed exposure history were recorded by conducting personal interviews. Lifetime exposure indicators were calculated for several pesticide chemical subclasses. Moreover, organophosphate metabolite levels were quantified in urine samples of all participants by using gas chromatography-mass spectrometry (GC-MS). Multinomial analysis was used to determine associations between occupational pesticide exposure and diseases or disorders. Results: In the pesticide sprayers group, significantly higher frequencies for rheumatoid arthritis (RA) and allergic rhinitis were observed compared with the control group (p = 0.002 and p = 0.024 respectively). Within the pesticide sprayers group, high lifetime pesticide exposure was associated with increased risk for reporting RA (OR: 43.07 95% CI: 3.09–600.67) and allergic rhinitis (OR: 9.72 95% CI: 2.31–40.89), compared with low pesticide exposure. Exposure to organophsphate, guanidine and quinone pesticides were associated with RA while organophosphates, pyrethroids and paraquat were associated with allergic rhinitis. Despite the higher levels of certain pesticide metabolites observed among participants with rheumatoid arthritis, the differences were not statistically significant. One metabolite (diethylthiophosphate) was found to be significantly increased in allergic rhinitis cases (p = 0.037). Conclusions: The results from the current study suggest a possible association of occupational pesticide exposure with RA and allergic rhinitis that should be further investigated.

Rheumatoid Arthritis in Agricultural Health Study Spouses: Associations with Pesticides and Other Farm Exposures

BACKGROUND

Farming has been associated with rheumatoid arthritis (RA), but the role of pesticides is not known.

OBJECTIVES

We examined associations between RA and pesticides or other agricultural exposures among female spouses of licensed pesticide applicators in the Agricultural Health Study.

METHODS

Women were enrolled between 1993 and 1997 and followed through 2010. Cases (n = 275 total, 132 incident), confirmed by a physician or by self-reported use of disease modifying antirheumatic drugs, were compared with noncases (n = 24,018). Odds ratios (OR) and 95% confidence intervals (CI) were estimated using logistic regression models adjusted for age, state, and smoking pack-years.

RESULTS

Overall, women with RA were somewhat more likely to have reported lifetime use of any specific pesticide versus no pesticides (OR = 1.4; 95% CI: 1.0, 1.6). Of the 15 pesticides examined, maneb/mancozeb (OR = 3.3; 95% CI: 1.5, 7.1) and glyphosate (OR = 1.4; 95% CI: 1.0, 2.1) were associated with incident RA compared with no pesticide use. An elevated, but non-statistically significant association with incident RA was seen for DDT (OR = 1.9; 95% CI: 0.97, 3.6). Incident RA was also associated with the application of chemical fertilizers (OR = 1.7; 95% CI: 1.1, 2.7) and cleaning with solvents (OR = 1.6; 95% CI: 1.1, 2.4), but inversely associated with lifetime livestock exposure as a child and adult (OR = 0.48; 95% CI: 0.24, 0.97) compared with no livestock exposure.

CONCLUSIONS

Our results suggest that specific agricultural pesticides, solvents, and chemical fertilizers may increase the risk of RA in women, while exposures involving animal contact may be protective. Citation: Parks CG, Hoppin JA, De Roos AJ, Costenbader KH, Alavanja MC, Sandler DP. 2016. Rheumatoid arthritis in Agricultural Health Study spouses: associations with pesticides and other farm exposures. Environ Health Perspect 124:1728-1734; http://dx.doi.org/10.1289/EHP129.

Is organic farming safer to farmers' health? A comparison between organic and traditional farming

Exposure to pesticides is a major public health concern, because of the widespread distribution of these compounds and their possible long term effects. Recently, organic farming has been introduced as a consumer and environmental friendly agricultural system, although little is known about the effects on workers' health. The aim of this work was to evaluate genetic damage and immunological alterations in workers of both traditional and organic farming. Eighty-five farmers exposed to several pesticides, thirty-six organic farmers and sixty-one controls took part in the study. Biomarkers of exposure (pyrethroids, organophosphates, carbamates, and thioethers in urine and butyrylcholinesterase activity in plasma), early effect (micronuclei in lymphocytes and reticulocytes, T-cell receptor mutation assay, chromosomal aberrations, comet assay and lymphocytes subpopulations) and susceptibility (genetic polymorphisms related to metabolism - EPHX1, GSTM1, GSTT1 and GSTP1 - and DNA repair-XRCC1 and XRCC2) were evaluated. When compared to controls and organic farmers, pesticide farmers presented a significant increase of micronuclei in lymphocytes (frequency ratio, FR=2.80) and reticulocytes (FR=1.89), chromosomal aberrations (FR=2.19), DNA damage assessed by comet assay (mean ratio, MR=1.71), and a significant decrease in the proportion of B lymphocytes (MR=0.88). Results were not consistent for organic farmers when compared to controls, with a 48% increase of micronuclei in lumphocytes frequency (p=0.016) contrasted by the significant decreases of TCR-Mf (p=0.001) and %T (p=0.001). Our data confirm the increased presence of DNA damage in farmers exposed to pesticides, and show as exposure conditions may influence observed effects. These results must be interpreted with caution due to the small size of the sample and the unbalanced distribution of individuals in the three study groups.

Microbial and human heat shock proteins as 'danger signals' in sarcoidosis

In the light of the Matzinger's model of immune response, human heat shock proteins (HSPs) as main 'danger signals' (tissue damage-associated molecular patterns-DAMPs) or/and microbial HSPs as pathogen-associated molecular patterns (PAMPs) recognized by pattern recognition receptors (PRR), may induce sarcoid granuloma by both infectious and non-infectious factors in genetically different predisposed host. Regarding infectious causes of sarcoid models, low-virulence strains of, e.g. mycobacteria and propionibacteria recognized through changed PRR and persisting in altered host phagocytes, generate increased release of both human and microbial HSPs with their molecular and functional homology. High chronic spread of human and microbial HSPs altering cytokines, co-stimulatory molecules, and Tregs expression, apoptosis, oxidative stress, induces the autoimmunity, considered in sarcoidosis. Regarding non-infectious causes of sarcoidosis, human HSPs may be released at high levels during chronic low-grade exposure to misfolding amyloid precursor protein in stressed cells, phagocyted metal fumes, pigments with/without aluminum in tattoos, and due to heat shock in firefighters. Therefore, human HSPs as DAMPs and/or microbial HSPs as PAMPs produced as a result of non-infectious and infectious factors may induce different models of sarcoidosis, depending on the genetic background of the host. The number/expression of PRRs/ligands may influence the occurrence of sarcoidosis in particular organs.

Alterations in T-lymphocyte sub-set profiles and cytokine secretion by PBMC of systemic lupus erythematosus patients upon in vitro exposure to organochlorine pesticides

Chronic exposure to organochlorine pesticides (OCP) has been suspected of causing immunoregulatory abnormalities that eventually lead to development and progression of systemic lupus erythematosus (SLE), but the role of these non-genetic stimuli has remained poorly understood. The objectives of the study were to quantify the levels of different OCP residues in the blood of SLE patients and to study the effects of in vitro treatment of peripheral blood mononuclear cells (PBMC) from these patients and healthy controls with OCP. Levels of different OCP residues in the blood were measured by gas-liquid chromatography. Isolated PBMC were treated in vitro with hexachlorocyclohexane (HCH), o,p'-dichlorodiphenyltrichloroethane (DDT), or phytohemagglutinin-M (PHA-M) for 72 h, then stained with different dye-labeled monoclonal antibodies to analyze alterations in T-lymphocytes using flow cytometry. Levels of different T(H)1 and T(H)2 cytokines were also estimated by ELISA. Significantly higher levels of p,p'-DDE and β-HCH were detected in the blood of SLE patients than in healthy controls. HCH exposure markedly increased the percentages of CD3(+)CD4(+) T-lymphocytes and expression of CD45RO(+) on CD4(+) and CD8(+) T-lymphocytes, but decreased CD4(+)CD25(+) T-lymphocytes in SLE patients. DDT exposure increased the percentages of CD3(+)CD4(+) T-lymphocytes and decreased those of CD4(+)CD25(+) T-lymphocytes in SLE patients as compared to healthy controls. No significant responsiveness of patient PBMC to PHA-M stimulation was observed indicating suppression of T-lymphocytes by these OCP. Further, both HCH and DDT decreased the levels of IL-2 and IFNγ but had no effect on IL-4 levels in SLE patients. DDT also increased significantly the levels of IL-10 in patients. It is likely that higher levels and prolonged durations of exposure to HCH and DDT may significantly influence T-lymphocyte sub-sets and cytokine expression in vivo that could lead to the development or exacerbation of SLE.

A prospective study of lupus and rheumatoid arthritis in relation to deployment in support of iraq and afghanistan: the millennium cohort study

The objective of this study was to prospectively assess the association between deployment in support of the operations in Iraq and Afghanistan and newly reported lupus and rheumatoid arthritis while also considering the effects of demographic, behavioral, and occupational characteristics. A total of 77,047 (2001-2003) and 31,110 (2004-2006) participants completed the baseline Millennium Cohort questionnaire and were resurveyed approximately every 3 years. Longitudinal analyses were used to assess the adjusted association between deployment to Iraq and Afghanistan with and without combat exposures and newly reported disease. After adjusting, deployment was not significantly associated with newly reported lupus compared with nondeployers. However, compared with nondeployers, deployers with and without combat exposures were significantly less likely to newly report rheumatoid arthritis. Women, non-Hispanic black, and Hispanic participants had a significantly elevated risk for both diseases. Overall, deployment was not associated with an increased risk of newly reported lupus or rheumatoid arthritis.

Insecticide use and risk of rheumatoid arthritis and systemic lupus erythematosus in the Women's Health Initiative Observational Study

OBJECTIVE

Farming and agricultural pesticide use has been associated with 2 autoimmune rheumatic diseases, rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). However, risk associated with other residential or work place insecticide use is unknown.

METHODS

We analyzed data from the Women's Health Initiative Observational Study (n=76,861 postmenopausal women, ages 50-79 years). Incident cases (n=213: 178 for RA, 27 for SLE, and 8 for both) were identified based on self-report and use of disease-modifying antirheumatic drugs at year 3 of followup. We examined self-reported residential or work place insecticide use (personally mixing/applying by self and application by others) in relation to RA/SLE risk, overall and in relation to farm history. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) were adjusted for age, race, region, education, occupation, smoking, reproductive factors, asthma, other autoimmune diseases, and comorbidities.

RESULTS

Compared with never used, personal use of insecticides was associated with increased RA/SLE risk, with significant trends for greater frequency (HR 2.04, 95% CI 1.17-3.56 for ≥6 times/year) and duration (HR 1.97, 95% CI 1.20-3.23 for ≥20 years). Risk was also associated with long-term insecticide application by others (HR 1.85, 95% CI 1.07-3.20 for ≥20 years) and frequent application by others among women with a farm history (HR 2.73, 95% CI 1.10-6.78 for ≥6 times/year).

CONCLUSION

These results suggest residential and work place insecticide exposure is associated with the risk of autoimmune rheumatic diseases in postmenopausal women. Although these findings require replication in other populations, they support a role for environmental pesticide exposure in the development of autoimmune rheumatic diseases.

Occupational exposures and risk of systemic lupus erythematosus

This review summarizes the growing body of epidemiologic and experimental research pertaining to the relationship between SLE and occupational exposures, such as crystalline silica, solvents, and pesticides. Epidemiologic studies, using different designs in different settings, have demonstrated moderate to strong associations between occupational silica exposure and SLE. Recent experimental studies of silica in lupus-prone mice provide support for the idea that, in addition to its known adjuvant effect, silica exposure increases the generation of apoptotic material, an important source of self-antigen. Despite compelling experimental studies of the organic solvent trichloroethylene (TCE) in lupus-prone mice, there is little evidence of an overall association of SLE and occupational exposure to a broad classification of solvents in humans. However, there is a lack of data on SLE in occupational cohorts with exposures to TCE or other specific solvents. One epidemiologic study reported an association of pesticide mixing and SLE, while a recent experimental study reported accelerated disease in pesticide-treated lupus-prone mice. Other occupational exposures worth investigating include asbestos, metals, and UV radiation. Attention should also be given to the role of gene-environment interactions, which may require large, multi-site studies that collect both genetic material and occupational exposure data. The quality of exposure assessment is an important consideration in designing and evaluating these studies. The use of pre-clinical endpoints (e.g. high-titer autoantibodies) in occupational cohorts with well-characterized exposure histories may reveal occupational risk factors for autoimmunity, and may also provide baseline data for studies of determinants of progression to SLE.

Evaluation of immunotoxicity induced by pirimiphos-methyl in male Balb/c mice following exposure to for 28 days

Pirimiphos-methyl (O-2-diethylamino-6-methylpyrimidin-4-yl O,O-dimethyl phosphorothioate: POM) is widely used organophosphorous (OP) insecticide as a grain protectant to control insects during storage. This study was carried out to assess the immunologic effects of POM in Balb/c mice after 28-day oral exposure. Three dose levels of POM (10, 60, or 120 mg/kg/day) were administered orally to mice for 4 weeks. At autopsy after 28-day exposure, there were significant decreases in relative spleen weight and splenic cellularity found at 120 mg POM, but body weight, relative thymic weight, thymic cellularity, and splenic and thymic subsets were not affected. T cell proliferation response induced by Con A was significantly decreased at all dosages though no statistical differences were observed in splenic B cell proliferation. Significant increases in the production of cytokines (IL-2, IL-4, IL-6, IFN-gamma, and IL-10) were evident on the whole, but the increase in production of inflammatory cytokines overwhelmed that of the T(H)1 cell suppressive cytokine (IL-10). The relative levels of three types of autoantibodies, anti-dsDNA, anti-histone, and antinuclear antibody (ANA) were dose-dependently decreased in serum. Oral exposure to POM induced a significant decrease in Immunoglobulin M production capability in Balb/c mice. This decrease in antibody production capability may result from disturbances in cytokine balance produced by splenic immune cells. These results show that POM may induce allergic responses by relatively enhancing T(H)2 development and additionally contribute to chronic inflammation by attracting macrophage by IFN-gamma.

Exploring central and peripheral diversity in antibody evolution

The antigen-binding site, the paratope, of an antibody can be seen as being composed of a central core and a more peripheral area situated at its rim. Naturally these regions acquire their diversity using different mechanisms and they also have dissimilar roles, as they contribute differently to the binding interaction. Also, antigens of different size utilize these regions differently; while haptens mainly interact with the central core, larger antigens have additional interactions in more peripheral regions. Since haptens do not occupy the entire available paratope we hypothesized that hapten-specific antibodies, as they develop naturally or in the laboratory, have an imprint of the carrier protein they were once selected on. By using combinatorial library and phage display technologies on a hapten-specific antibody we were able to demonstrate that a peripheral carrier imprint indeed exists. We further show that such an imprint can act as a seed in the evolution of binders that recognize the carrier protein even in the absence of the hapten modification. The observed results provide a plausible mechanism for how haptenization of self-antigens can lead to the development of autoimmunity.

Multiorgan autoimmune inflammation, enhanced lymphoproliferation, and impaired homeostasis of reactive oxygen species in mice lacking the antioxidant-activated transcription factor Nrf2

Nuclear factor erythroid 2-related factor 2 (Nrf2) is an antioxidant-activated cap "n" collar basic leucine zipper transcription factor. To assess the function of Nrf2 in the antioxidant response, we examined mice with targeted disruption of the Nrf2 gene. Nrf2-null mice developed complex disease manifestations, with a majority exhibiting a lupus-like autoimmune syndrome characterized by multiorgan inflammatory lesions with a marked female predominance, appearance of anti-double-stranded DNA antibodies in young adulthood, intravascular deposition of immunoglobulin complexes in blood vessels, and premature death due to rapidly progressing membranoproliferative glomerular nephritis. Mechanistic analyses revealed that the null mice showed enhanced proliferative response of CD4+ T cells, altered ratios of CD4+ and CD8+ cells, and increased oxidative lesions in tissues. Analyses of antioxidant-induced gene expression showed that the knockout mice were devoid of the basal and inducible expression of certain phase 2 detoxification enzymes and antioxidant genes in hepatic and lymphoid cells in vivo. Our findings suggest that Nrf2 mediates important antioxidant functions involved in the control of peripheral lymphocyte homeostasis and autoimmune surveillance.

Environment and systemic lupus erythematosus: an overview

Systemic lupus erythematosus (SLE) is an autoimmune disease of unknown etiology that manifests as a pleomorphic systemic disease mainly affecting females. The variety of autoantibodies found in the serum of patients indicate that SLE is an autoimmune disease, but the mechanisms leading to the aberrant responses are not clearly understood although it is thought that a number of genetic and environmental factors may be involved. Environmental (or non-genetic) exposures could include infectious agents, chemicals or other compounds capable of modulating immune responses such as occupational/environmental pollutants or drugs, and behavioural factors such as smoking and diet. Environmental exposures may lead to the production of autoreactive T cells and autoantibodies, the stimulation of pro- and antiinflammatory cytokines, and target end-organ damage, but are not so convincing as agents causing SLE. Exposure to viruses increases antibody titres, but these may be the result of polyclonal B cell activation. The amount and timing of exposure to different environmental factors may play a significant and complex role in the pathogenesis of SLE and other autoimmune diseases. A better understanding of the etiopathogenetic mechanism of SLE is required in order to clarify the multiple interactions between environmental exposures and genetic factors.

Potentiation of Apoptosis by Heat Stress Plus Pesticide Exposure in Stress Resistant Human B-Lymphoma Cells and Its Attenuation through Interaction with Follicular Dendritic Cells: Role for c-Jun N-terminal Kinase Signaling

B lymphocytes (B cells) become increasingly resistant to apoptosis induction during their differentiation in the microenvironment of the germinal center of lymphoid follicles. This is due to increases in the levels of Bcl-2 protein as well as survival signals generated through B-cell binding to follicular dendritic cells (FDC). However, it is not known whether this cellular resistance may be bypassed as a result of exposure to multiple environmental stress factors resulting in excessive apoptosis induction in B cells. We examined this question of whether apoptosis may be induced, and possibly potentiated, as a result of exposure of the human EW36 B-lineage cell line, having elevated Bcl-2 protein, to heat stress and pesticide combination exposures in a co-culture system with a human FDC cell line. This co-culture system recapitulates essential features of a human germinal center including adherence of B cells to FDC generating survival signals. We found that heat stress plus pesticide exposures resulted in substantial potentiation of apoptosis in EW36 cells, effectively bypassing their stress resistance. Similar results were obtained when paraquat was substituted for heat stress. Furthermore, the JNK pathway was activated by some combination exposures, such as heat stress plus antimycin A, but this pathway was found to play a cytoprotective role in EW36 cells. Importantly, EW36 cell binding to FDC reduced the extent of apoptosis induction by most combination exposures. These results reveal cell stress scenarios that can greatly augment apoptosis in stress-resistant human B-cells and a germinal center interaction that selectively attenuates pesticide-induced apoptosis.

Occupational and environmental exposures as risk factors for systemic lupus erythematosus

Although genetic susceptibility plays a strong role in the etiology of systemic lupus erythematosus (SLE), recent research has provided new evidence of the potential influence of environmental factors in the risk for this disease. This paper describes epidemiologic and experimental research pertaining to occupational and environmental sources of exposure to respirable crystalline silica, solvents and pesticides, and two "lifestyle" factors (smoking and hair dye use). As has been seen with other systemic autoimmune diseases (eg, systemic sclerosis and rheumatoid arthritis), a series of epidemiologic studies, using different designs in different settings, have demonstrated relatively strong and consistent associations between occupational silica exposure and SLE. The type and quality of exposure assessment is an important consideration in evaluating these studies. Recent experimental studies examined the effect of trichloroethylene exposure in MRL+/+ mice, but to date there have been few epidemiologic studies of solvents and SLE. There are numerous avenues with respect to environmental factors in SLE that need additional research.

Environmental contaminant and disinfection by-product trichloroacetaldehyde stimulates T cells in vitro

It had been shown previously that MRL+/+ mice exposed to occupationally relevant doses of the environmental contaminant trichloroethylene in their drinking water developed lupus-like symptoms and autoimmune hepatitis in association with activation of Interferon-gamma (IFN-gamma)-producing CD4+ T cells. Since trichloroethylene must be metabolized in order to promote the T-cell activation associated with autoimmunity, the present study was initiated to determine whether the immunoregulatory effects of trichloroethylene could be mimicked by one of its major metabolites, trichloroacetaldehyde (TCAA). At concentrations ranging from 0.04 to 1 mM TCAA co-stimulated proliferation of murine T-helper type 1 (Th1) cells treated with anti-CD3 antibody or antigen in vitro. TCAA at similar concentrations also induced phenotypic alterations commensurate with activation (upregulation of CD28 and downregulation of CD62L) in both cloned memory Th1 cells, as well as naïve CD4+ T cells from MRL+/+ mice. TCAA-induced Th1 cell activation was accompanied by phoshorylation of activating transcription factor 2 (ATF-2) and c-Jun, two components of the activator protein-1 (AP-1) transcription factor. TCAA at higher concentrations was also shown to form a Schiff base on T cells, and inhibition of Schiff base formation suppressed the ability of TCAA to phosphorylate ATF-2. Taken together, these results suggest that TCAA promotes T-cell activation via stimulation of the mitogen-activated protein (MAP) kinase pathway in association with Schiff base formation on T-cell surface proteins. By demonstrating that TCAA can stimulate T-cell function directly, these results may explain how the environmental toxicant trichloroethylene promotes T-cell activation and related autoimmunity in vivo.

Alopecia areata susceptibility in rodent models

With our current view of alopecia areata as an autoimmune disease, it is probable that disease development in an individual is dependent on multiple genetic and environmental factors interacting in a complex system. Rodent models afford the opportunity to investigate alopecia areata development and to define the significance of the different factors involved. Recently, rodent model characterization has been conducted using flow cytometry, microarray analysis, and functional studies. From these a pattern of events in alopecia areata development has emerged. Although the preliminary activation events for the onset of alopecia areata remain unknown, the response of the immune system is characterized by antigen presentation and costimulation of lymphocytes in the lymph nodes and skin, a deficiency of CD4+/CD25+ regulatory cells, and an action of activated lymphocytes on hair follicles via Fas/FasL signaling and cytokines. Thus, onset of disease may require appropriate (or inappropriate) expression of stimulatory antigens within the hair follicle, the breakdown of the putative hair follicle immune privilege, the presentation of antigens to the immune system, a failure of immune system regulation, and the ability of the activated immune system to disrupt anagen-stage hair follicles. Once the sequence of events is initiated, it may become a self-perpetuating cycle, with epitope spreading leading to a wider range of targets in chronic alopecia areata. Rodent model studies have provided significant insight into alopecia areata, but much more remains to be explained about the mechanisms of disease development.