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Kwon HM, Han M, Lee TS, Jung I, Song JJ, Yang HM, Lee J, Lee SH, Lee YH, Park KK. Effect of Corticosteroid Use on the Occurrence and Progression of Osteonecrosis of the Femoral Head: A nationwide Nested Case-Control Study. J Arthroplasty 2024:S0883-5403(24)00459-5. [PMID: 38830431 DOI: 10.1016/j.arth.2024.05.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 05/06/2024] [Accepted: 05/08/2024] [Indexed: 06/05/2024] Open
Abstract
BACKGROUND Although it is very well known that corticosteroids cause osteonecrosis of the femoral head (ONFH), it is unclear as to which patients develop ONFH. Additionally, there are no studies on the association between corticosteroid use and femoral head collapse in ONFH patients. We aimed to investigate the association between corticosteroid use and the risk of ONFH among the general population and what factors affect ONFH occurrence. Additionally, we aimed to demonstrate which factors affect femoral head collapse and total hip arthroplasty (THA) after ONFH occurrence. METHODS A nationwide, nested case-control study was conducted with data from the National Health Insurance Service Physical Health Examination Cohort (2002 to 2019) in the Republic of Korea. We defined ONFH (N = 3,500) using diagnosis and treatment codes. Patients who had ONFH were matched 1:5 to form a control group based on the variables of birth year, sex, and follow-up duration. Additionally, in patients who have ONFH, we looked for risk factors for progression to THA. RESULTS Compared with the control group, ONFH patients had a low household income and had more diabetes, hypertension, dyslipidemia, and heavy alcohol use (drinking more than 3 to 7 drinks per week). Systemic corticosteroid use (≥ 1,800 mg) was significantly associated with an increased risk of ONFH incidence. However, lipid profiles, corticosteroid prescription, and cumulative doses of corticosteroid did not affect the progression to THA. CONCLUSION The ONFH risk increased rapidly when cumulative prednisolone use was ≥ 1,800 mg. However, oral or high-dose intravenous corticosteroid use and cumulative dose did not affect the prognosis of ONFH. Since the occurrence and prognosis of ONFH are complex and multifactorial processes, further study is needed.
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Affiliation(s)
- Hyuck Min Kwon
- Department of Orthopedic Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Minkyung Han
- Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Tae Sung Lee
- Department of Orthopedic Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Inkyung Jung
- Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jason Jungsik Song
- Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Hun-Mu Yang
- Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Joohee Lee
- Translational Laboratory for Clinical Anatomy, Department of Anatomy, Yonsei University College of Medicine, Seoul, Korea
| | - Seung Hwan Lee
- Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Young Han Lee
- Translational Laboratory for Clinical Anatomy, Department of Anatomy, Yonsei University College of Medicine, Seoul, Korea.
| | - Kwan Kyu Park
- Department of Orthopedic Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
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Jin H, Lin Z, Pang T, Wu J, Zhao C, Zhang Y, Lei Y, Li Q, Yao X, Zhao M, Lu Q. Effects and mechanisms of polycyclic aromatic hydrocarbons in inflammatory skin diseases. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 925:171492. [PMID: 38458465 DOI: 10.1016/j.scitotenv.2024.171492] [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: 01/06/2024] [Revised: 03/03/2024] [Accepted: 03/03/2024] [Indexed: 03/10/2024]
Abstract
Polycyclic aromatic hydrocarbons (PAHs) are hydrocarbons characterized by the presence of multiple benzene rings. They are ubiquitously found in the natural environment, especially in environmental pollutants, including atmospheric particulate matter, cigarette smoke, barbecue smoke, among others. PAHs can influence human health through several mechanisms, including the aryl hydrocarbon receptor (AhR) pathway, oxidative stress pathway, and epigenetic pathway. In recent years, the impact of PAHs on inflammatory skin diseases has garnered significant attention, yet many of their underlying mechanisms remain poorly understood. We conducted a comprehensive review of articles focusing on the link between PAHs and several inflammatory skin diseases, including psoriasis, atopic dermatitis, lupus erythematosus, and acne. This review summarizes the effects and mechanisms of PAHs in these diseases and discusses the prospects and potential therapeutic implications of PAHs for inflammatory skin diseases.
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Affiliation(s)
- Hui Jin
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China; Key Laboratory of Basic and Translational Research on Immune-Mediated Skin Diseases, Chinese Academy of Medical Sciences, Nanjing, China; Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, China; Research Unit of Key Technologies of Immune-related Skin Diseases Diagnosis and Treatment, Chinese Academy of Medical Sciences Institute of Dermatology, Nanjing, China
| | - Ziyuan Lin
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China; Key Laboratory of Basic and Translational Research on Immune-Mediated Skin Diseases, Chinese Academy of Medical Sciences, Nanjing, China; Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, China; Research Unit of Key Technologies of Immune-related Skin Diseases Diagnosis and Treatment, Chinese Academy of Medical Sciences Institute of Dermatology, Nanjing, China
| | - Tianyi Pang
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jingwen Wu
- Hunan Key Laboratory of Medical Epigenomics, Department of Dermatology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Cheng Zhao
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China; Key Laboratory of Basic and Translational Research on Immune-Mediated Skin Diseases, Chinese Academy of Medical Sciences, Nanjing, China; Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, China; Research Unit of Key Technologies of Immune-related Skin Diseases Diagnosis and Treatment, Chinese Academy of Medical Sciences Institute of Dermatology, Nanjing, China; Hunan Key Laboratory of Medical Epigenomics, Department of Dermatology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Ying Zhang
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China; Key Laboratory of Basic and Translational Research on Immune-Mediated Skin Diseases, Chinese Academy of Medical Sciences, Nanjing, China; Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, China; Research Unit of Key Technologies of Immune-related Skin Diseases Diagnosis and Treatment, Chinese Academy of Medical Sciences Institute of Dermatology, Nanjing, China; Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Yu Lei
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China; Key Laboratory of Basic and Translational Research on Immune-Mediated Skin Diseases, Chinese Academy of Medical Sciences, Nanjing, China; Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, China; Research Unit of Key Technologies of Immune-related Skin Diseases Diagnosis and Treatment, Chinese Academy of Medical Sciences Institute of Dermatology, Nanjing, China; Hunan Key Laboratory of Medical Epigenomics, Department of Dermatology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Qilin Li
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China; Key Laboratory of Basic and Translational Research on Immune-Mediated Skin Diseases, Chinese Academy of Medical Sciences, Nanjing, China; Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, China; Research Unit of Key Technologies of Immune-related Skin Diseases Diagnosis and Treatment, Chinese Academy of Medical Sciences Institute of Dermatology, Nanjing, China; Hunan Key Laboratory of Medical Epigenomics, Department of Dermatology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Xu Yao
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China.
| | - Ming Zhao
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China; Key Laboratory of Basic and Translational Research on Immune-Mediated Skin Diseases, Chinese Academy of Medical Sciences, Nanjing, China; Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, China; Research Unit of Key Technologies of Immune-related Skin Diseases Diagnosis and Treatment, Chinese Academy of Medical Sciences Institute of Dermatology, Nanjing, China.
| | - Qianjin Lu
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China; Key Laboratory of Basic and Translational Research on Immune-Mediated Skin Diseases, Chinese Academy of Medical Sciences, Nanjing, China; Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, China; Research Unit of Key Technologies of Immune-related Skin Diseases Diagnosis and Treatment, Chinese Academy of Medical Sciences Institute of Dermatology, Nanjing, China.
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Chen H, Wu J, Yang R, Yu H, Shang S, Hu Y. Ambient fine particulate matter is associated with daily outpatient visits for ankylosing spondylitis: A time-series analysis in Beijing, China. Heliyon 2024; 10:e28933. [PMID: 38633636 PMCID: PMC11021888 DOI: 10.1016/j.heliyon.2024.e28933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 03/20/2024] [Accepted: 03/27/2024] [Indexed: 04/19/2024] Open
Abstract
Exposure to ambient fine particulate matter (PM2.5) has a great impact on human body's immune system, but the correlation between PM2.5 and ankylosing spondylitis has not yet been clarified. We extracted 58,600 outpatient visits for ankylosing spondylitis from the Beijing Medical Claim Data for Employees database from 2010 to 2017. The percentage of outpatient visits following PM2.5 concentrations was estimated using generalized additive models with Poisson connections. Increase by 10 μ g/m3, PM2.5 is associated with daily outpatient visits for ankylosing spondylitis. In this test, the average concentration of PM2.5 was 86.8 ± 74.3 μ g/m3. For every 10 μg/m3 increase in PM2.5 concentration, there was a 0.34% (95% CI, 0.26-0.42%) increase in the risk of patients who visited the doctor on the same day. Females and younger patients were most susceptible to the impact of PM2.5 exposure (P<0.05). This study revealed the relationship between exposure to PM2.5 and ankylosing spondylitis, and future research can further confirm this finding and explore the potential mechanisms.
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Affiliation(s)
- Hongbo Chen
- Peking University Third Hospital, Beijing, China
| | - Junhui Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
- School of Nursing, Peking University, Beijing, China
| | - Ruotong Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Huan Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Shaomei Shang
- School of Nursing, Peking University, Beijing, China
| | - Yonghua Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
- Medical Informatics Center, Peking University, Beijing, China
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Cai X, Song Q, Meng X, Li K, Shi S, Jin L, Kan H, Wang S. Epigenome-wide association study on ambient PM 2.5 exposure in Han Chinese, the NSPT study. ENVIRONMENTAL RESEARCH 2024; 247:118276. [PMID: 38246299 DOI: 10.1016/j.envres.2024.118276] [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: 10/10/2023] [Revised: 01/02/2024] [Accepted: 01/18/2024] [Indexed: 01/23/2024]
Abstract
Ambient PM2.5 exposure has been recognized as a major health risk and related to aging, cardiovascular, respiratory and neurologic diseases, and cancer. However, underlying mechanism of epigenetic alteration and regulated pathways still remained unclear. The study on methylome effect of PM2.5 exposure was quite limited in Chinese population, and cohort-based study was absent. The study included blood-derived DNA methylation for 3365 Chinese participants from the NSPT cohort. We estimated individual PM2.5 exposure level of short-medium-, medium- and long-term, based on a validated prediction model. We preformed epigenome-wide association studies to estimate the links between PM2.5 exposure and DNA methylation change, as well as stratification and sensitive analysis to examined the robustness of the association models. A systematic review was conducted to obtain the previously published CpGs and examined for replication. We also conducted comparison on the DNA methylation variation corresponding to different time windows. We further conducted gene function analysis and pathway enrichment analysis to reveal related biological response. We identified a total of 177 CpGs and 107 DMRs associated with short-medium-term PM2.5 exposure, at a strict genome-wide significance (P < 5 × 10-8). The effect sizes on most CpGs tended to cease with the exposure of extended time scale. Associated markers and aligned genes were related to aging, immunity, inflammation and carcinogenesis. Enriched pathways were mostly involved in cell cycle and cell division, signal transduction, inflammatory pathway. Our study is the first EWAS on PM2.5 exposure conducted in large-scale Han Chinese cohort and identified associated DNA methylation change on CpGs and regions, as well as related gene functions and pathways.
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Affiliation(s)
- Xiyang Cai
- CAS Key Laboratory of Computational Biology, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, China
| | - Qinglin Song
- CAS Key Laboratory of Computational Biology, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, China
| | - Xia Meng
- School of Public Health, Shanghai Institute of Infectious Disease and Biosecurity, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, 200032, China
| | - Kaixuan Li
- CAS Key Laboratory of Computational Biology, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, China
| | - Su Shi
- School of Public Health, Shanghai Institute of Infectious Disease and Biosecurity, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, 200032, China
| | - Li Jin
- State Key Laboratory of Genetic Engineering, Collaborative Innovation Center for Genetics and Development, and Human Phenome Institute, Fudan University, Shanghai, China; Ministry of Education Key Laboratory of Contemporary Anthropology, Department of Anthropology and Human Genetics, School of Life Sciences, Fudan University, Shanghai, China; Taizhou Institute of Health Sciences, Fudan University, Taizhou, Jiangsu, China
| | - Haidong Kan
- School of Public Health, Shanghai Institute of Infectious Disease and Biosecurity, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, 200032, China; Children's Hospital of Fudan University, National Center for Children's Health, Shanghai, 201102, China.
| | - Sijia Wang
- CAS Key Laboratory of Computational Biology, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, China; Taizhou Institute of Health Sciences, Fudan University, Taizhou, Jiangsu, China; Center for Excellence in Animal Evolution and Genetics, Chinese Academy of Sciences, Kunming, China.
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Gumtorntip W, Kasitanon N, Louthrenoo W, Chattipakorn N, Chattipakorn SC. Potential roles of air pollutants on the induction and aggravation of rheumatoid arthritis: From cell to bedside studies. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 334:122181. [PMID: 37453681 DOI: 10.1016/j.envpol.2023.122181] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 07/03/2023] [Accepted: 07/10/2023] [Indexed: 07/18/2023]
Abstract
Rheumatoid arthritis (RA) is an involving chronic systemic inflammatory disease which mainly affects the joints. Several factors including genetic, environment and infections have been acknowledged as being involved in the pathogenesis and aggravation of RA. Air pollution, particularly particulate matter is widely recognized as a cause of health problems. This review is to summarize and discuss the association between air pollutants and the development or the aggravation of RA based on evidence from in vitro, in vivo and clinical studies. The results from the review found that air pollutants can stimulate immunological processes and stimulate inflammatory mediators and autoantibodies productions, both in intro and in vivo studies. In addition, air pollutants can induce RA and aggravate RA disease activity. Unfortunately, there also are some discrepancies in the results, which might be due to the type cell line and the concentration of air pollutants used in the in vitro and in vivo studies, as well as the concentration and duration of exposure in human studies. These findings suggest that future studies focused on elucidating these mechanisms using advanced techniques and identifying reliable biomarkers to assess individual susceptibility and disease activity should be carried out. Longitudinal studies, intervention strategies, and policy implications also should be explored. A comprehensive understanding on these association will facilitate targeted approaches for prevention and management of air pollutant-induced RA and improve health outcome.
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Affiliation(s)
- Wanitcha Gumtorntip
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Nuntana Kasitanon
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Worawit Louthrenoo
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Nipon Chattipakorn
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand; Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, 50200, Thailand; Cardiac Electrophysiology Unit, Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Siriporn C Chattipakorn
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand; Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, 50200, Thailand; Department of Oral Biology and Diagnostic Sciences, Faculty of Dentistry, Chiang Mai University, Chiang Mai, 50200, Thailand.
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Klareskog L, Alfredsson L. Prevention vs treatment of rheumatoid arthritis. IMMUNOTHERAPY ADVANCES 2023; 3:ltad016. [PMID: 37662832 PMCID: PMC10473452 DOI: 10.1093/immadv/ltad016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 08/27/2023] [Indexed: 09/05/2023] Open
Abstract
Whether a yet chronic and not curable disease like rheumatoid arthritis (RA) can be subject to prevention or whether available resources should be focused on treatment is a classical dilemma. Similar to the case in most other chronic diseases, the focus in research as well as in clinical practice has been on the treatment of established diseases, resulting in drugs that are efficient in eliminating most joint damage but not able to cure the disease or stop needs for continuous treatment of the disease. Less effort has been spent on identifying and implementing ways to prevent the disease. We argue in this review that knowledge concerning the longitudinal evolvement of the major, 'seropositive' subset of RA has now come to a stage where prevention should be a large part of the research agenda and that we should prepare for prevention as part of clinical practice in RA. We describe briefly the knowledge basis for broad public health-based prevention as well as for a 'precision prevention' strategy. In the latter, individuals at high risk for RA will be identified, monitored, and ultimately provided with advice on how to change lifestyle/environment or be given treatment with drugs able to delay and ultimately stop the development of RA. Whether this potential of precision prevention for RA will change the broader clinical practice will depend on whether specific and long-lasting interference with disease-inducing immunity, ultimately 'tolerance therapy', will become a reality.
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Affiliation(s)
- Lars Klareskog
- Rheumatology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
| | - Lars Alfredsson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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Kao CM, Chen YM, Huang WN, Chen YH, Chen HH. Association between air pollutants and initiation of biological therapy in patients with ankylosing spondylitis: a nationwide, population-based, nested case-control study. Arthritis Res Ther 2023; 25:75. [PMID: 37147678 PMCID: PMC10161550 DOI: 10.1186/s13075-023-03060-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 04/29/2023] [Indexed: 05/07/2023] Open
Abstract
BACKGROUND Outdoor air pollution has been found to trigger systemic inflammatory responses and aggravate the activity of certain rheumatic diseases. However, few studies have explored the influence of air pollution on the activity of ankylosing spondylitis (AS). As patients with active AS in Taiwan can be reimbursed through the National Health Insurance programme for biological therapy, we investigated the association between air pollutants and the initiation of reimbursed biologics for active AS. METHODS Since 2011, hourly concentrations of ambient air pollutants, including PM2.5, PM10, NO2, CO, SO2, and O3, have been estimated in Taiwan. Using Taiwanese National Health Insurance Research Database, we identified patients with newly diagnosed AS from 2003 to 2013. We selected 584 patients initiating biologics from 2012 to 2013 and 2336 gender-, age at biologic initiation-, year of AS diagnosis- and disease duration-matched controls. We examined the associations of biologics initiation with air pollutants exposure within 1 year prior to biologic use whilst adjusting for potential confounders, including disease duration, urbanisation level, monthly income, Charlson comorbidity index (CCI), uveitis, psoriasis and the use of medications for AS. Results are shown as adjusted odds ratio (aOR) with 95% confidence intervals (CIs). RESULTS The initiation of biologics was associated with exposure to CO (per 1 ppm) (aOR, 8.57; 95% CI, 2.02-36.32) and NO2 (per 10 ppb) (aOR, 0.23; 95% CI, 0.11-0.50). Other independent predictors included disease duration (incremental year, aOR, 8.95), CCI (aOR, 1.31), psoriasis (aOR, 25.19), use of non-steroidal anti-inflammatory drugs (aOR, 23.66), methotrexate use (aOR, 4.50; 95% CI, 2.93-7.00), sulfasalazine use (aOR, 12.16; 95% CI, 8.98-15.45) and prednisolone equivalent dosages (mg/day, aOR, 1.12). CONCLUSIONS This nationwide, population-based study revealed the initiation of reimbursed biologics was positively associated with CO levels, but negatively associated with NO2 levels. Major limitations included lack of information on individual smoking status and multicollinearity amongst air pollutants.
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Affiliation(s)
- Chung-Mao Kao
- Division of Allergy, Immunology, and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, No.1650, Sec.4, Taiwan Boulevard, Taichung, 40705, Taiwan
- Division of Translational Medicine, Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Yi-Ming Chen
- Division of Allergy, Immunology, and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, No.1650, Sec.4, Taiwan Boulevard, Taichung, 40705, Taiwan
- Division of Translational Medicine, Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
- Institute of Biomedical Science and Rong Hsing Research Center for Translational Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Wen-Nan Huang
- Division of Allergy, Immunology, and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, No.1650, Sec.4, Taiwan Boulevard, Taichung, 40705, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
- Department of Business Administration, Ling-Tung University, Taichung, Taiwan
| | - Yi-Hsing Chen
- Division of Allergy, Immunology, and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, No.1650, Sec.4, Taiwan Boulevard, Taichung, 40705, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Hsin-Hua Chen
- Division of Allergy, Immunology, and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, No.1650, Sec.4, Taiwan Boulevard, Taichung, 40705, Taiwan.
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan.
- Institute of Biomedical Science and Rong Hsing Research Center for Translational Medicine, National Chung Hsing University, Taichung, Taiwan.
- Department of Industrial Engineering and Enterprise Information, Tunghai University, Taichung, Taiwan.
- Institute of Public Health and Community Medicine Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan.
- Big Data Center, National Chung Hsing University, Taichung, Taiwan.
- Division of General Medicine, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
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Zhang J, Fang XY, Wu J, Fan YG, Leng RX, Liu B, Lv XJ, Yan YL, Mao C, Ye DQ. Association of Combined Exposure to Ambient Air Pollutants, Genetic Risk, and Incident Rheumatoid Arthritis: A Prospective Cohort Study in the UK Biobank. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:37008. [PMID: 36913237 PMCID: PMC10010395 DOI: 10.1289/ehp10710] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 02/03/2023] [Accepted: 02/06/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Evidence for a potential link between air pollution and rheumatoid arthritis (RA) is inconsistent, and the modified effect of genetic susceptibility on the relationship between air pollution and RA has not been well studied. OBJECTIVE Using a general population cohort from the UK Biobank, this study aimed to investigate the associations between various air pollutants and the risk of incident RA and to further estimate the impact of combined exposure to ambient air pollutants on the risk of developing RA under the modification effect of genetic predisposition. METHODS A total of 342,973 participants with completed genotyping data and who were free of RA at baseline were included in the study. An air pollution score was constructed by summing the concentrations of each pollutant weighted by the regression coefficients with RA from single-pollutant models to assess the combined effect of air pollutants, including particulate matter (PM) with diameters ≤ 2.5 μ m (PM 2.5 ), between 2.5 and 10 μ m (PM 2.5 - 10 ), and ≤ 10 μ m (PM 10 ), as well as nitrogen dioxide (NO 2 ) and nitrogen oxides (NO x ). In addition, the polygenic risk score (PRS) of RA was calculated to characterize individual genetic risk. The Cox proportional hazard model was used to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs) of associations of single air pollutant, air pollution score, or PRS with incident RA. RESULTS During a median follow-up time of 8.1 y, 2,034 incident events of RA were recorded. The HRs (95% CIs) of incident RA per interquartile range increment in PM 2.5 , PM 2.5 - 10 , PM 10 , NO 2 , and NO x were 1.07 (1.01, 1.13), 1.00 (0.96, 1.04), 1.01 (0.96, 1.07), 1.03 (0.98, 1.09), and 1.07 (1.02, 1.12), respectively. We also found a positive exposure-response relationship between air pollution score and RA risk (p Trend = 0.000053 ). The HR (95% CI) of incident RA was 1.14 (1.00, 1.29) in the highest quartile group compared with the lowest quartile group of the air pollution score. Furthermore, the results of the combined effect of air pollution score and PRS on the RA risk showed that the risk of RA incidence in the highest genetic risk and air pollution score group was almost twice that of the lowest genetic risk and air pollution score group [incidence rate (IR) per 100,000 person-years: 98.46 vs. 51.19, and HR = 1.73 (95% CI: 1.39, 2.17) vs. 1 (reference)], although no statistically significant interaction between the air pollution and genetic risk for incident RA was found (p Interaction > 0.05 ). DISCUSSION The results revealed that long-term combined exposure to ambient air pollutants might increase the risk of RA, particularly in those with high genetic risk. https://doi.org/10.1289/EHP10710.
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Affiliation(s)
- Jie Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
| | - Xin-Yu Fang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
| | - Jun Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Medical University, Dongguan, Guangdong, China
| | - Yin-Guang Fan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
| | - Rui-Xue Leng
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
| | - Bo Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
| | - Xiao-Jie Lv
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
| | - Yu-Lu Yan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
| | - Chen Mao
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Dong-Qing Ye
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
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9
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McDermott GC, Sparks JA. Invited Perspective: Air Pollutants, Genetics, and the Mucosal Paradigm for Rheumatoid Arthritis Risk. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:31303. [PMID: 36913236 PMCID: PMC10010382 DOI: 10.1289/ehp12167] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 11/08/2022] [Accepted: 02/06/2023] [Indexed: 06/18/2023]
Affiliation(s)
- Gregory C. McDermott
- Division of Rheumatology, Inflammation, and Immunity, Brigham and Women’s Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Jeffrey A. Sparks
- Division of Rheumatology, Inflammation, and Immunity, Brigham and Women’s Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
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10
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Zhang RD, Chen C, Wang P, Fang Y, Jiang LQ, Fang X, Zhao Y, Ni J, Wang DG, Pan HF. Air pollution exposure and auto-inflammatory and autoimmune diseases of the musculoskeletal system: a review of epidemiologic and mechanistic evidence. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2023:10.1007/s10653-023-01495-x. [PMID: 36735155 DOI: 10.1007/s10653-023-01495-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 01/24/2023] [Indexed: 06/18/2023]
Abstract
Auto-inflammatory and autoimmune diseases of the musculoskeletal system can be perceived as a spectrum of rheumatic diseases, with the joints and connective tissues are eroded severely that progressively develop chronic inflammation and lesion. A wide range of risk factors represented by genetic and environmental factors have been uncovered by population-based surveys and experimental studies. Lately, the exposure to air pollution has been found to be potentially involved in the mechanisms of occurrence or development of such diseases, principally manifest in oxidative stress, local and systemic inflammation, and epigenetic modifications, as well as the mitochondrial dysfunction, which has been reported to participate in the intermediate links. The lungs might serve as a starting area of air pollutants, which would cause oxidative stress-induced bronchial-associated lymphoid tissue (iBALT) to further to influence T, B cells, and the secretion of pro-inflammatory cytokines. The binding of aromatic hydrocarbon receptor (AhR) to the corresponding contaminant ligands tends to regulate the reaction of Th17 and Tregs. Furthermore, air pollution components might spur on immune and inflammatory responses by damaging mitochondria that could interact with and exacerbate oxidative stress and pro-inflammatory cytokines. In this review, we focused on the association between air pollution and typical auto-inflammatory and autoimmune diseases of the musculoskeletal system, mainly including osteoarthritis (OA), rheumatoid arthritis (RA), spondyloarthritis (SpA) and juvenile idiopathic arthritis (JIA), and aim to collate the mechanisms involved and the potential channels. A complete summary and in-depth understanding of the autoimmune and inflammatory effects of air pollution exposure should hopefully contribute new perspectives on how to formulate better public health policies to alleviate the adverse health effects of air pollutants.
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Affiliation(s)
- Ruo-Di Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
- Institute of Kidney Disease, Inflammation and Immunity Mediated Diseases, The Second Hospital of Anhui Medical University, Hefei, 230032, Anhui, People's Republic of China
| | - Cong Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
- Institute of Kidney Disease, Inflammation and Immunity Mediated Diseases, The Second Hospital of Anhui Medical University, Hefei, 230032, Anhui, People's Republic of China
| | - Peng Wang
- Institute of Kidney Disease, Inflammation and Immunity Mediated Diseases, The Second Hospital of Anhui Medical University, Hefei, 230032, Anhui, People's Republic of China
- Teaching Center for Preventive Medicine, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
| | - Yang Fang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
- Institute of Kidney Disease, Inflammation and Immunity Mediated Diseases, The Second Hospital of Anhui Medical University, Hefei, 230032, Anhui, People's Republic of China
| | - Ling-Qiong Jiang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
- Institute of Kidney Disease, Inflammation and Immunity Mediated Diseases, The Second Hospital of Anhui Medical University, Hefei, 230032, Anhui, People's Republic of China
| | - Xi Fang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
- Institute of Kidney Disease, Inflammation and Immunity Mediated Diseases, The Second Hospital of Anhui Medical University, Hefei, 230032, Anhui, People's Republic of China
| | - Yan Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
- Institute of Kidney Disease, Inflammation and Immunity Mediated Diseases, The Second Hospital of Anhui Medical University, Hefei, 230032, Anhui, People's Republic of China
| | - Jing Ni
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
- Institute of Kidney Disease, Inflammation and Immunity Mediated Diseases, The Second Hospital of Anhui Medical University, Hefei, 230032, Anhui, People's Republic of China
| | - De-Guang Wang
- Institute of Kidney Disease, Inflammation and Immunity Mediated Diseases, The Second Hospital of Anhui Medical University, Hefei, 230032, Anhui, People's Republic of China
- Department of Nephrology, The Second Hospital of Anhui Medical University, Hefei, 230032, Anhui, People's Republic of China
| | - Hai-Feng Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China.
- Institute of Kidney Disease, Inflammation and Immunity Mediated Diseases, The Second Hospital of Anhui Medical University, Hefei, 230032, Anhui, People's Republic of China.
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11
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Chen H, Wu J, Wang M, Wang S, Wang J, Yu H, Hu Y, Shang S. Association between ambient fine particulate matter and adult outpatient visits for rheumatoid arthritis in Beijing, China. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2023; 67:149-156. [PMID: 36399197 DOI: 10.1007/s00484-022-02393-0] [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: 11/28/2021] [Revised: 09/23/2022] [Accepted: 10/17/2022] [Indexed: 06/16/2023]
Abstract
The association between fine particulate matter (PM2.5) and rheumatoid arthritis (RA) is currently unclear, especially in Beijing, a city with severe air pollution. Our study aimed to explore the relationship between short-term outdoor exposure to PM2.5 and RA outpatient visits using a time-series analysis in Beijing. We used the Beijing's Medical Claims for Employees database to identify patients with RA in 2010-2012. A generalized additive model with a Poisson link was used to estimate the percentage change in RA outpatient visits after the PM2.5 concentration increased by 10 μg/m3. From January 1, 2010, to June 30, 2012, a total of 541,061 RA outpatient visits were identified. During the study period, the average daily (standard deviation) concentration of PM2.5 was 99.5 (75.3) µg/m3. A 10 µg/m3 increase in PM2.5 concentration was correlated with a 0.21% (95% CI, 0.18-0.23%) increase in outpatient visits for RA on the same day. A significant association for the cumulative effect of PM2.5 was found, and the largest significant association was observed for a lag of 0-3 days (0.26%; 95% CI, 0.23-0.29%). Stratified analyses revealed that females (0.29%, 95% CI: 0.26-0.33%) and 18-65 years old patients (0.29%, 95% CI: 0.25-0.32%) were most susceptible to the effects of PM2.5 exposure. The current findings showed that short-term exposure to PM2.5 was followed by an increase in the number of outpatient visits for RA in Beijing. Future studies should investigate the mechanisms underlying this association.
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Affiliation(s)
- Hongbo Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing, 100191, China
- School of Nursing, Peking University, China, No. 38 Xueyuan Road, Beijing, 100191, China
| | - Junhui Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing, 100191, China
- School of Nursing, Peking University, China, No. 38 Xueyuan Road, Beijing, 100191, China
| | - Mengying Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing, 100191, China
| | - Siyue Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing, 100191, China
| | - Jiating Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing, 100191, China
| | - Huan Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing, 100191, China
| | - Yonghua Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing, 100191, China.
- Medical Informatics Center, Peking University, No. 38 Xueyuan Road, Beijing, 100191, China.
| | - Shaomei Shang
- School of Nursing, Peking University, China, No. 38 Xueyuan Road, Beijing, 100191, China.
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12
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Ayala-Ramirez M, MacNell N, McNamee LE, McGrath JA, Akhtari FS, Curry MD, Dunnon AK, Fessler MB, Garantziotis S, Parks CG, Fargo DC, Schmitt CP, Motsinger-Reif AA, Hall JE, Miller FW, Schurman SH. Association of distance to swine concentrated animal feeding operations with immune-mediated diseases: An exploratory gene-environment study. ENVIRONMENT INTERNATIONAL 2023; 171:107687. [PMID: 36527873 PMCID: PMC10962257 DOI: 10.1016/j.envint.2022.107687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 12/03/2022] [Accepted: 12/07/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Concentrated animal feeding operations (CAFOs) are a source of environmental pollution and have been associated with a variety of health outcomes. Immune-mediated diseases (IMD) are characterized by dysregulation of the normal immune response and, while they may be affected by gene and environmental factors, their association with living in proximity to a CAFO is unknown. OBJECTIVES We explored gene, environment, and gene-environment (GxE) relationships between IMD, CAFOs, and single nucleotide polymorphisms (SNPs) of prototypical xenobiotic response genes AHR, ARNT, and AHRR and prototypical immune response gene PTPN22. METHODS The exposure analysis cohort consisted of 6,464 participants who completed the Personalized Environment and Genes Study Health and Exposure Survey and a subset of 1,541 participants who were genotyped. We assessed the association between participants' residential proximity to a CAFO in gene, environment, and GxE models. We recombined individual associations in a transethnic model using METAL meta-analysis. RESULTS In White participants, ARNT SNP rs11204735 was associated with autoimmune diseases and rheumatoid arthritis (RA), and ARNT SNP rs1889740 was associated with RA. In a transethnic genetic analysis, ARNT SNPs rs11204735 and rs1889740 and PTPN22 SNP rs2476601 were associated with autoimmune diseases and RA. In participants living closer than one mile to a CAFO, the log-distance to a CAFO was associated with autoimmune diseases and RA. In a GxE interaction model, White participants with ARNT SNPs rs11204735 and rs1889740 living closer than eight miles to a CAFO had increased odds of RA and autoimmune diseases, respectively. The transethnic model revealed similar GxE interactions. CONCLUSIONS Our results suggest increased risk of autoimmune diseases and RA in those living in proximity to a CAFO and a potential role of the AHR-ARNT pathway in conferring risk. We also report the first association of ARNT SNPs rs11204735 and rs1889740 with RA. Our findings, if confirmed, could allow for novel genetically-targeted or other preventive approaches for certain IMD.
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Affiliation(s)
- Montserrat Ayala-Ramirez
- Clinical Research Branch, National Institute of Environmental Health Sciences, National Institutes of Health, 111 T.W. Alexander Drive, Research Triangle Park, NC 27709, USA.
| | - Nathaniel MacNell
- Social and Scientific Systems, 505 Emperor Blvd Suite 400, Durham, NC 27703, USA.
| | - Lucy E McNamee
- Clinical Research Branch, National Institute of Environmental Health Sciences, National Institutes of Health, 111 T.W. Alexander Drive, Research Triangle Park, NC 27709, USA.
| | - John A McGrath
- Social and Scientific Systems, 505 Emperor Blvd Suite 400, Durham, NC 27703, USA.
| | - Farida S Akhtari
- Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, 111 T.W. Alexander Drive, Research Triangle Park, NC 27709, USA.
| | - Matthew D Curry
- Social and Scientific Systems, 505 Emperor Blvd Suite 400, Durham, NC 27703, USA.
| | - Askia K Dunnon
- Clinical Research Branch, National Institute of Environmental Health Sciences, National Institutes of Health, 111 T.W. Alexander Drive, Research Triangle Park, NC 27709, USA.
| | - Michael B Fessler
- Immunity, Inflammation and Disease Laboratory, National Institute of Environmental Health Sciences, National Institutes of Health, P.O. Box 12233, Mail Drop D2-01, Durham, NC 27709, USA.
| | - Stavros Garantziotis
- Clinical Research Branch, National Institute of Environmental Health Sciences, National Institutes of Health, BG 109 RM 109 MSC CU-01, 111 T.W. Alexander Drive, Research Triangle Park, NC 27709, USA.
| | - Christine G Parks
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, P.O. Box 12233, Mail Drop A3-05, Durham, NC 27709, USA.
| | - David C Fargo
- Office of Scientific Computing, National Institute of Environmental Health Sciences, National Institutes of Health, P.O. Box 12233, Mail Drop B3-01, Durham, NC 27709, USA.
| | - Charles P Schmitt
- Office of Data Science, National Institute of Environmental Health Sciences, National Institutes of Health, P.O. Box 12233, Mail Drop K2-02, Durham, NC 27709, USA.
| | - Alison A Motsinger-Reif
- PEGS Co-PI, Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, 111 T.W. Alexander Drive, RTP 101, Research Triangle Park, NC 27709, USA.
| | - Janet E Hall
- PEGS Co-PI, Clinical Research Branch, National Institute of Environmental Health Sciences, National Institutes of Health, BG 101 RM A222 MSC A2-03. 111 T.W. Alexander Drive, Research Triangle Park, NC 27709, USA.
| | - Frederick W Miller
- Clinical Research Branch, National Institute of Environmental Health Sciences, National Institutes of Health, 111 T.W. Alexander Drive, RTP 101 David P. Rall Building, Research Triangle Park, NC 27709, USA.
| | - Shepherd H Schurman
- Clinical Research Branch, National Institute of Environmental Health Sciences, National Institutes of Health, 111 T.W. Alexander Drive, Research Triangle Park, NC 27709, USA.
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13
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Liu JL, Woo JMP, Parks CG, Costenbader KH, Jacobsen S, Bernatsky S. Systemic Lupus Erythematosus Risk: The Role of Environmental Factors. Rheum Dis Clin North Am 2022; 48:827-843. [PMID: 36332998 DOI: 10.1016/j.rdc.2022.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Systemic lupus erythematosus (SLE) is a complex, chronic autoimmune disease. The etiology of SLE is multifactorial and includes potential environmental triggers, which may occur sequentially (the "multi-hit" hypothesis). This review focuses on SLE risk potentially associated with environmental factors including infections, the microbiome, diet, respirable exposures (eg, crystalline silica, smoking, air pollution), organic pollutants, heavy metals, and ultraviolet radiation.
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Affiliation(s)
- Jia Li Liu
- McGill University, Montreal, Quebec, Canada
| | - Jennifer M P Woo
- Epidemiology Branch, Department of Health and Human Services, National Institutes of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA
| | - Christine G Parks
- Epidemiology Branch, Department of Health and Human Services, National Institutes of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA
| | - Karen H Costenbader
- Division of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Søren Jacobsen
- Copenhagen Lupus and Vasculitis Clinic, Rigshospitalet, Copenhagen University Hospital, Denmark
| | - Sasha Bernatsky
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada.
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14
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Ho WC, Chou LW, Wang RY, Doan TN, Yu HL, Chou TH, Liu KY, Wu PC, Shieh SH. Association between Exposure to Ambient Air Pollution and the Risk of Rheumatoid Arthritis in Taiwan: A Population-Based Retrospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127006. [PMID: 35742255 PMCID: PMC9222243 DOI: 10.3390/ijerph19127006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 06/06/2022] [Accepted: 06/06/2022] [Indexed: 02/01/2023]
Abstract
Background: The association between ambient air pollution (AAP) and the risk of Rheumatoid arthritis (RA) remains debatable. We conducted a population-based cohort study to investigate the association between exposure to AAP and the risk of RA in Taiwan. Methods: We analyzed and combined the longitudinal Health Insurance Database (LHID) and the Taiwan Air Quality-Monitoring Database (TAQMD), which were in line with the residential areas. We calculated the RA incidence rates per 10,000 person-years exposed to each quartile of PM2.5 or PM10 concentrations or RH. Hazards regression was conducted to analyze the associations between exposure to each quartile of PM2.5 and PM10 concentrations and the risk of developing RA. The hazard ratios of RA were analyzed between participants exposed to annual average concentrations of PM2.5 and PM10. All the hazard ratios of RA were stratified by gender and adjusted for age and relative humidity (RH). A p-value < 0.05 was considered statistically significant. Results: Among 722,885 subjects, 9338 RA cases were observed. The analyses adjusted for age, gender, and humidity suggested an increased risk of developing RA in the exposure to PM2.5 in the last quartile (Q4) with the adjusted hazard ratio (aHR) was 1.053 (95%CI: 1.043 to 1.063). Conclusion: Our study suggests that exposure to PM2.5 is associated with an increased risk of RA. The finding has implications for policymaking to develop coping strategies to confront AAP as a risk factor for RA.
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Affiliation(s)
- Wen-Chao Ho
- Department of Public Health, College of Public Health, China Medical University, Taichung 406040, Taiwan; (W.-C.H.); (R.-Y.W.); (T.-N.D.); (T.-H.C.); (K.-Y.L.)
| | - Li-Wei Chou
- Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung 404332, Taiwan;
- Department of Physical Medicine and Rehabilitation, Asia University Hospital, Asia University, Taichung 41354, Taiwan
- Department of Physical Therapy and Graduate Institute of Rehabilitation Science, China Medical University, Taichung 406040, Taiwan
| | - Ruey-Yun Wang
- Department of Public Health, College of Public Health, China Medical University, Taichung 406040, Taiwan; (W.-C.H.); (R.-Y.W.); (T.-N.D.); (T.-H.C.); (K.-Y.L.)
| | - Thanh-Nhan Doan
- Department of Public Health, College of Public Health, China Medical University, Taichung 406040, Taiwan; (W.-C.H.); (R.-Y.W.); (T.-N.D.); (T.-H.C.); (K.-Y.L.)
- Department of Rehabilitation, Quang Nam Northern Mountainous Region General Hospital, Quang Nam 560000, Vietnam
| | - Hwa-Lung Yu
- Department of Bioenvironmental Systems Engineering, National Taiwan University, Taipei 10617, Taiwan;
| | - Ting-Hsuan Chou
- Department of Public Health, College of Public Health, China Medical University, Taichung 406040, Taiwan; (W.-C.H.); (R.-Y.W.); (T.-N.D.); (T.-H.C.); (K.-Y.L.)
| | - Kang-Yung Liu
- Department of Public Health, College of Public Health, China Medical University, Taichung 406040, Taiwan; (W.-C.H.); (R.-Y.W.); (T.-N.D.); (T.-H.C.); (K.-Y.L.)
| | - Po-Chang Wu
- Ph.D. Program in Translational Medicine, National Chung Hsing University, Taichung 40227, Taiwan
- School of Medicine, College of Medicine, China Medical University, Taichung 40402, Taiwan
- Rong Hsing Research Center For Translational Medicine, National Chung Hsing University, Taichung 40227, Taiwan
- Rheumatology and Immunology Center, China Medical University Hospital, Taichung 404332, Taiwan
- Correspondence: (P.-C.W.); (S.-H.S.)
| | - Shwn-Huey Shieh
- Department of Health Services Administration, College of Public Health, China Medical University, Taichung 406040, Taiwan
- Department of Nursing, Asia University, Taichung 41354, Taiwan
- Correspondence: (P.-C.W.); (S.-H.S.)
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15
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Adami G, Pontalti M, Cattani G, Rossini M, Viapiana O, Orsolini G, Benini C, Bertoldo E, Fracassi E, Gatti D, Fassio A. Association between long-term exposure to air pollution and immune-mediated diseases: a population-based cohort study. RMD Open 2022; 8:rmdopen-2021-002055. [PMID: 35292563 PMCID: PMC8969049 DOI: 10.1136/rmdopen-2021-002055] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 01/15/2022] [Indexed: 12/18/2022] Open
Abstract
Objective Environmental air pollution has been associated with disruption of the immune system at a molecular level. The primary aim of the present study was to describe the association between long-term exposure to air pollution and risk of developing immune-mediated conditions. Methods We conducted a retrospective observational study on a nationwide dataset of women and men. Diagnoses of various immune-mediated diseases (IMIDs) were retrieved. Data on the monitoring of particulate matter (PM)10 and PM2.5 concentrations were retrieved from the Italian Institute of Environmental Protection and Research. Generalised linear models were employed to determine the relationship between autoimmune diseases prevalence and PM. Results 81 363 subjects were included in the study. We found a positive association between PM10 and the risk of autoimmune diseases (ρ+0.007, p 0.014). Every 10 µg/m3 increase in PM10 concentration was associated with an incremental 7% risk of having autoimmune disease. Exposure to PM10 above 30 µg/m3 and PM2.5 above 20 µg/m3 was associated with a 12% and 13% higher risk of autoimmune disease, respectively (adjusted OR (aOR) 1.12, 95% CI 1.05 to 1.20, and aOR 1.13, 95% CI 1.06 to 1.20). Exposure to PM10 was associated with an increased risk of rheumatoid arthritis; exposure to PM2.5 was associated with an increased risk of rheumatoid arthritis, connective tissue diseases (CTDs) and inflammatory bowel diseases (IBD). Conclusion Long-term exposure to air pollution was associated with higher risk of developing autoimmune diseases, in particular rheumatoid arthritis, CTDs and IBD. Chronic exposure to levels above the threshold for human protection was associated with a 10% higher risk of developing IMIDs.
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Affiliation(s)
- Giovanni Adami
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
| | - Marco Pontalti
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
| | - Giorgio Cattani
- Italian Institute for Environmental Protection and Research, Rome, Italy
| | - Maurizio Rossini
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
| | - Ombretta Viapiana
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
| | - Giovanni Orsolini
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
| | - Camilla Benini
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
| | - Eugenia Bertoldo
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
| | - Elena Fracassi
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
| | - Davide Gatti
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
| | - Angelo Fassio
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
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16
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Wang C, Cardenas A, Hutchinson JN, Just A, Heiss J, Hou L, Zheng Y, Coull BA, Kosheleva A, Koutrakis P, Baccarelli AA, Schwartz JD. Short- and intermediate-term exposure to ambient fine particulate elements and leukocyte epigenome-wide DNA methylation in older men: the Normative Aging Study. ENVIRONMENT INTERNATIONAL 2022; 158:106955. [PMID: 34717175 PMCID: PMC8710082 DOI: 10.1016/j.envint.2021.106955] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 10/18/2021] [Accepted: 10/22/2021] [Indexed: 05/08/2023]
Abstract
BACKGROUND Several epigenome-wide association studies (EWAS) of ambient particulate matter with aerodynamic diameter ≤ 2.5 µm (PM2.5) have been reported. However, EWAS of PM2.5 elements (PEs), reflecting different emission sources, are very limited. OBJECTIVES We performed EWAS of short- and intermediate-term exposure to PM2.5 and 13 PEs. We hypothesized that significant changes in DNAm may vary by PM2.5 mass and its elements. METHODS We repeatedly collected blood samples in the Normative Aging Study and measured leukocyte DNA methylation (DNAm) with the Illumina HumanMethylation450K BeadChip. We collected daily PM2.5 and 13 PEs at a fixed central site. To estimate the associations between each PE and DNAm at individual cytosine-phosphate-guanine (CpG) sites, we incorporated a distributed-lag (0-27 d) term in the setting of median regression with subject-specific intercept and examined cumulative lag associations. We also accounted for selection bias due to loss to follow-up and mortality prior to enrollment. Significantly differentially methylated probes (DMPs) were identified using Bonferroni correction for multiple testing. We further conducted regional and pathway analyses to identify significantly differentially methylated regions (DMRs) and pathways. RESULTS We included 695 men with 1,266 visits between 1999 and 2013. The subjects had a mean age of 75 years. The significant DMPs, DMRs, and pathways varied by to PM2.5 total mass and PEs. For example, PM2.5 total mass was associated with 2,717 DMPs and 10,470 DMRs whereas Pb was associated with 3,173 DMPs and 637 DMRs. The identified pathways by PM2.5 mass were mostly involved in mood disorders, neuroplasticity, immunity, and inflammation, whereas the pathways associated with motor vehicles (BC, Cu, Pb, and Zn) were related with cardiovascular disease and cancer (e.g., "PPARs signaling"). CONCLUSIONS PM2.5 and PE were associated with methylation changes at multiple probes and along multiple pathways, in ways that varied by particle components.
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Affiliation(s)
- Cuicui Wang
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA.
| | - Andres Cardenas
- Division of Environmental Health Sciences, School of Public Health and Center for Computational Biology, University of California, Berkeley, Berkeley, CA 94720, USA
| | - John N Hutchinson
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA
| | - Allan Just
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Jonathan Heiss
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Lifang Hou
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Yinan Zheng
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Brent A Coull
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA
| | - Anna Kosheleva
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Petros Koutrakis
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Andrea A Baccarelli
- Department of Environmental Health Sciences, Columbia Mailman School of Public Health, New York, NY 10032, USA
| | - Joel D Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
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