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Liu JY, Sayes CM. A toxicological profile of silica nanoparticles. Toxicol Res (Camb) 2022; 11:565-582. [PMID: 36051665 PMCID: PMC9424711 DOI: 10.1093/toxres/tfac038] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 05/16/2022] [Accepted: 05/29/2022] [Indexed: 08/02/2023] Open
Abstract
Humans are regularly exposed to silica nanoparticles in environmental and occupational contexts, and these exposures have been implicated in the onset of adverse health effects. Existing reviews on silica nanoparticle toxicity are few and not comprehensive. There are natural and synthetic sources by which crystalline and amorphous silica nanoparticles are produced. These processes influence physiochemical properties, which are factors that can dictate toxicological effects. Toxicological assessment includes exposure scenario (e.g. environmental, occupational), route of exposure, toxicokinetics, and toxicodynamics. Broader considerations include pathology, risk assessment, regulation, and treatment after injury. This review aims to consolidate the most relevant and up-to-date research in these areas to provide an exhaustive toxicological profile of silica nanoparticles.
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Affiliation(s)
- James Y Liu
- Department of Environmental Science, Baylor University, One Bear Place # 97266, Waco, TX 76798-7266, United States
| | - Christie M Sayes
- Corresponding author: Department of Environmental Science, Baylor University, One Bear Place # 97266, Waco, TX 76798-7266, United States.
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2
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Gołębiowski T, Kuźniar J, Porażko T, Wojtala R, Konieczny A, Krajewska M, Klinger M. Multisystem Amyloidosis in a Coal Miner with Silicosis: Is Exposure to Silica Dust a Cause of Amyloid Deposition? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042297. [PMID: 35206498 PMCID: PMC8871531 DOI: 10.3390/ijerph19042297] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 02/12/2022] [Accepted: 02/13/2022] [Indexed: 02/04/2023]
Abstract
The over-secretion of monoclonal immunoglobulin light chains by clonal B cells followed by the aggregation and extracellular deposition of fibrillar deposits are responsible forthe clinical course AL amyloidosis. It is well documented that silica significantly increases the number of immunoglobulin-secreting cells. In the present paper, we report on a coal miner with silicosis and fast progressing primary amyloidosis with predominantly heart, kidney, and lung manifestations. Severeheart failure due to myocardial hypertrophy resulted in the patient’s death. We conclude that long-term environmental silica exposure and silica deposition may contribute to the development of monoclonal gammopathy and amyloidosis due to chronic stimulus and the dysregulation of the immune system.
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Affiliation(s)
- Tomasz Gołębiowski
- Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, 50-556 Wroclaw, Poland; (J.K.); (A.K.); (M.K.)
- Correspondence: ; Tel.: +48-717332546
| | - Jakub Kuźniar
- Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, 50-556 Wroclaw, Poland; (J.K.); (A.K.); (M.K.)
| | - Tomasz Porażko
- Department of Internal Medicine and Nephrology, Institute of Medical Sciences, University of Opole, 45-052 Opole, Poland; (T.P.); (M.K.)
| | - Renata Wojtala
- Departament of Patomorphology, Wroclaw Medical University, 50-556 Wroclaw, Poland;
| | - Andrzej Konieczny
- Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, 50-556 Wroclaw, Poland; (J.K.); (A.K.); (M.K.)
| | - Magdalena Krajewska
- Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, 50-556 Wroclaw, Poland; (J.K.); (A.K.); (M.K.)
| | - Marian Klinger
- Department of Internal Medicine and Nephrology, Institute of Medical Sciences, University of Opole, 45-052 Opole, Poland; (T.P.); (M.K.)
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3
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Hoy RF, Chambers DC. Silica-related diseases in the modern world. Allergy 2020; 75:2805-2817. [PMID: 31989662 DOI: 10.1111/all.14202] [Citation(s) in RCA: 183] [Impact Index Per Article: 45.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 12/20/2019] [Accepted: 01/08/2020] [Indexed: 11/28/2022]
Abstract
Silicosis is an ancient and potentially fatal pneumoconiosis caused by exposure to respirable crystalline silica. Silicosis is historically a disease of miners; however, failure to recognize and control the risk associated with silica exposure in contemporary work practices such as sandblasting denim jeans and manufacturing of artificial stone benchtops has led to re-emergence of silicosis around the world. This review outlines the mineralogy, epidemiology, clinical and radiological features of the various forms of silicosis and other silica-associated diseases. Perspective is provided on the most recent studies shedding light on pathogenesis, including the central role of innate immune effector cells and subsequent inflammatory cascades in propagating pulmonary fibrosis and the extrapulmonary manifestations, which uniquely characterize this pneumoconiosis. Clinical conundrums in differential diagnosis, particularly between silicosis and sarcoidosis, are highlighted, as is the importance of obtaining a careful occupational history in the patient presenting with pulmonary infiltrates and/or fibrosis. While silicosis is a completely preventable disease, unfortunately workers around the world continue to be affected and experience progressive or even fatal disease. Although no treatments have been proven, opportunities to intervene to prevent progressive disease, founded in a thorough cellular and molecular understanding of the immunopathology of silicosis, are highlighted.
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Affiliation(s)
- Ryan F. Hoy
- Department of Epidemiology and Preventive Medicine School of Public Health and Preventive Medicine Monash University Melbourne VIC. Australia
- Department of Respiratory Medicine Alfred Hospital Melbourne VIC. Australia
| | - Daniel C. Chambers
- School of Clinical Medicine The University of Queensland Brisbane QLD Australia
- Queensland Lung Transplant Program The Prince Charles Hospital Brisbane QLD Australia
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4
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The Effects of Asbestos Fibers on Human T Cells. Int J Mol Sci 2020; 21:ijms21196987. [PMID: 32977478 PMCID: PMC7584019 DOI: 10.3390/ijms21196987] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 09/14/2020] [Accepted: 09/22/2020] [Indexed: 01/20/2023] Open
Abstract
Asbestos exposure causes malignant tumors such as lung cancer and malignant mesothelioma. The effects of asbestos fibers on immunocompetent cells, however, have not been well studied. Asbestos physically comprises a fibrous substance, which differs from silica particles which are a particulate substance, although chemically it is a mineral silicate. Since silicosis patients previously exposed to silica particles often suffer from lung and autoimmune diseases, it is clear that silica exposure impairs immune tolerance. Similarly, asbestos may alter the immune system in asbestos-exposed individuals. Given that malignant tumors can result following exposure to asbestos, the attenuation of anti-tumor immunity in cases of asbestos exposure is an important area of investigation. We observed the effect of asbestos fibers on T lymphocytes, such as CD8+ cytotoxic T lymphocytes (CTLs), CD4+ helper T (Th), and regulatory T (Treg) cells, and showed that anti-tumor immunity was attenuated, as demonstrated in a system that stimulates fresh cells isolated from peripheral blood in vitro and a system that is continuously exposed to a cell line. In this manuscript, we introduce the experiments and results of studies on CTLs, as well as Th and Treg cells, and discuss how future changes in immunocompetent cells induced by asbestos fibers can be clinically linked.
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5
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Chen FF, Tang HY, Yu F, Que CL, Zhou FD, Wang SX, Wang GF, Zhao MH. Renal involvement in a silicosis patient - case report and literature review. Ren Fail 2020; 41:1045-1053. [PMID: 31809666 PMCID: PMC6913658 DOI: 10.1080/0886022x.2019.1696209] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
A 43-year-old Chinese man with a silicosis history was admitted to our hospital due to bilateral lower extremity edema for 1 year, exacerbating with hematuria for 2 months. He started working as a coal miner 30 years ago, and was diagnosed as silicosis 3 months ago. Lab tests revealed hematuria 3+, proteinuria 3+, and a serum creatinine value 2.47 mg/dl on routine check. He was diagnosed with focal proliferative IgA nephropathy (IgAN) and acute tubulo-interstitial nephritis by renal biopsy. He was treated with corticosteroids and got a remission 4 months later. Immunohistochemical staining showed the deposition of macrophage receptor with collagenous structure (MARCO), nod-like receptor pyrin domain-containing-3 (NLRP3), Caspase-1, apoptosis-associated speck (ASC), interleukin (IL)-1β, and IL-18 in both glomerular and tubulo-interstitial areas. We proposed that the silicon exposure could be related to his kidney disease in the patient and NLRP3 mediated inflammation might be involved in its pathogenesis which needs further explorations.
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Affiliation(s)
- Fei-Fei Chen
- Renal Division, Department of Medicine, Peking University First Hospital, Beijing, P.R. China.,Institute of Nephrology, Peking University, Beijing, P.R. China.,Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, P.R. China
| | - Hai-Yan Tang
- Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, P.R. China
| | - Feng Yu
- Renal Division, Department of Medicine, Peking University First Hospital, Beijing, P.R. China.,Institute of Nephrology, Peking University, Beijing, P.R. China.,Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, P.R. China.,Renal Division, Peking University International Hospital, Beijing, P.R. China
| | - Cheng-Li Que
- Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, P.R. China
| | - Fu-de Zhou
- Renal Division, Department of Medicine, Peking University First Hospital, Beijing, P.R. China.,Institute of Nephrology, Peking University, Beijing, P.R. China.,Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, P.R. China
| | - Su-Xia Wang
- Renal Division, Department of Medicine, Peking University First Hospital, Beijing, P.R. China.,Institute of Nephrology, Peking University, Beijing, P.R. China.,Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, P.R. China
| | - Guang-Fa Wang
- Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, P.R. China
| | - Ming-Hui Zhao
- Renal Division, Department of Medicine, Peking University First Hospital, Beijing, P.R. China.,Institute of Nephrology, Peking University, Beijing, P.R. China.,Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, P.R. China
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6
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Zhang S, Yuan D, Tan G. Neurological Involvement in Primary Systemic Vasculitis. Front Neurol 2019; 10:430. [PMID: 31105641 PMCID: PMC6498988 DOI: 10.3389/fneur.2019.00430] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 04/09/2019] [Indexed: 11/16/2022] Open
Abstract
Primary systemic vasculitis can affect every structure in both the central and peripheral nervous system, causing varied neurological manifestations of neurological dysfunction. Early recognition of the underlying causes of the neurological symptoms can facilitate timely treatment and improve the prognosis. This review highlights the clinical manifestations of primary systemic vasculitis in the nervous system.
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Affiliation(s)
- Shanshan Zhang
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Dongli Yuan
- The Institute of Medical Information, Chongqing Medical University, Chongqing, China
| | - Ge Tan
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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7
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Nishimura Y, Tsuda T, Nishina S, Omoto A, Misawa M, Yabe H, Nagao T. Silicosis, then microscopic polyangiitis-antineutrophil cytoplasmic antibodies-associated vasculitis may be work-related disease in patients with silicosis. J Gen Fam Med 2017; 18:288-290. [PMID: 29264045 PMCID: PMC5689428 DOI: 10.1002/jgf2.77] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Accepted: 11/22/2016] [Indexed: 11/12/2022] Open
Abstract
A 74-year-old man with silicosis was admitted to the hospital because of prolonged fever. After referral to internal medicine for persistent fever and renal dysfunction, workup revealed antineutrophil cytoplasmic antibodies (ANCA) positivity. He was diagnosed with microscopic polyangiitis (MPA). After treatment with immunosuppressive therapy, his condition improved. Herein, we discuss silica exposure and the risk of ANCA-associated vasculitis (AAV), particularly in terms of work-related diseases. Silica exposure is a notorious risk factor for developing AAV, which is potentially lethal when not identified. When we see a silicosis patient with new-onset prolonged fever and generalized fatigue, AAV should be taken into consideration. This case report provides beneficial information to reliably assess patients at high risk of developing AAV in primary care settings.
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Affiliation(s)
- Yoshito Nishimura
- Department of Internal Medicine Ako Central Hospital Hyogo Japan.,Department of General Medicine Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Okayama Japan
| | - Tomohiro Tsuda
- Department of Internal Medicine Ako Central Hospital Hyogo Japan
| | - Shinichi Nishina
- Department of Internal Medicine Ako Central Hospital Hyogo Japan
| | - Akiyoshi Omoto
- Department of Internal Medicine Ako Central Hospital Hyogo Japan
| | - Mahito Misawa
- Department of Internal Medicine Ako Central Hospital Hyogo Japan
| | - Hiroki Yabe
- Department of Internal Medicine Ako Central Hospital Hyogo Japan
| | - Toshihiko Nagao
- Department of Cardiovascular Medicine Ako Central Hospital Hyogo Japan
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8
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9
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Rapid Growth of Lung Nodules due to Combined Pulmonary Vasculitis, Silicoanthracosis, and Chondrocalcinosis. Can Respir J 2016; 2016:9254374. [PMID: 27478398 PMCID: PMC4958431 DOI: 10.1155/2016/9254374] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Accepted: 06/13/2016] [Indexed: 11/18/2022] Open
Abstract
Background. Silicoanthracosis is a pneumoconiosis due to occupational inhalation of silica and carbon dusts. Clinically, it can be associated with vasculitis or rheumatoid arthritis. In association with these diseases, silicoanthracosis can present within the lung with multiple pulmonary nodules which, as a differential diagnosis, can mimic metastatic disease or multiple abscesses. Case Presentation. We present the case of a 62-year old former pit worker with pulmonary nodules, chondrocalcinosis due to calcium pyrophosphate deposition (CPPD), and a history of renal cancer. Within a short period of time, pulmonary nodules grew rapidly. Thoracoscopically, the resected lung specimen revealed silicoanthracosis associated with small-to-medium-size vasculitis in the presence of antineutrophil cytoplasmatic autoantibodies (c-ANCA). Conclusion. Pulmonary silicoanthracotic lesions on the base of ANCA-associated vasculitis and CPPD arthritis can rapidly grow. A mutual correlation between silicoanthracosis, ANCA-associated vasculitis, and CPPD seems possible. Apart from this, consideration of metastatic disease should be obligatory in patients with a history of cancer at the same time being immunosuppressed.
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10
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Ying C, Maeda M, Nishimura Y, Kumagai-Takei N, Hayashi H, Matsuzaki H, Lee S, Yoshitome K, Yamamoto S, Hatayama T, Otsuki T. Enhancement of regulatory T cell-like suppressive function in MT-2 by long-term and low-dose exposure to asbestos. Toxicology 2015; 338:86-94. [PMID: 26505785 DOI: 10.1016/j.tox.2015.10.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Revised: 10/08/2015] [Accepted: 10/13/2015] [Indexed: 01/02/2023]
Abstract
Asbestos exposure causes lung fibrosis and various malignant tumors such as lung cancer and malignant mesothelioma. The effects of asbestos on immune cells have not been thoroughly investigated, although our previous reports showed that asbestos exposure reduced anti-tumor immunity. The effects of continuous exposure of regulatory T cells (Treg) to asbestos were examined using the HTLV-1 immortalized human T cell line MT-2, which possesses a suppressive function and expresses the Treg marker protein, Foxp3. Sublines were generated by the continuous exposure to low doses of asbestos fibers for more than one year. The sublines exposed to asbestos showed enhanced suppressive Treg function via cell-cell contact, and increased production of soluble factors such as IL-10 and transforming growth factor (TGF)-β1. These results also indicated that asbestos exposure induced the reduction of anti-tumor immunity, and efforts to develop substances to reverse this reduction may be helpful in preventing the occurrence of asbestos-induced tumors.
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Affiliation(s)
- Chen Ying
- Division of Pneumoconiosis, School of Public Health, China Medical University, Shenyang, PR China; Department of Hygiene, 4: Department of Dermatology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Megumi Maeda
- Department of Biofunctional Chemistry, Division of Bioscience, Okayama University Graduate School of Natural Science and Technology, Okayama, Japan; Department of Hygiene, 4: Department of Dermatology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Yasumitsu Nishimura
- Department of Hygiene, 4: Department of Dermatology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Naoko Kumagai-Takei
- Department of Hygiene, 4: Department of Dermatology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Hiroaki Hayashi
- Division of Pneumoconiosis, School of Public Health, China Medical University, Shenyang, PR China; Department of Dermatology, Kawasaki Medical School, Kurashiki, Japan
| | - Hidenori Matsuzaki
- Department of Hygiene, 4: Department of Dermatology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Suni Lee
- Department of Hygiene, 4: Department of Dermatology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Kei Yoshitome
- Department of Hygiene, 4: Department of Dermatology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Shoko Yamamoto
- Department of Hygiene, 4: Department of Dermatology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Tamayo Hatayama
- Department of Hygiene, 4: Department of Dermatology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Takemi Otsuki
- Department of Hygiene, 4: Department of Dermatology, Kawasaki Medical School, Kurashiki, Okayama, Japan.
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11
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Al-Rajhi A, Brega EF, Colman NC. Microscopic polyangiitis associated with pleuropericarditis, pulmonary embolism and pulmonary hemorrhage as a complication of silicosis. Respir Med Case Rep 2015; 15:106-9. [PMID: 26236617 PMCID: PMC4501504 DOI: 10.1016/j.rmcr.2015.03.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 03/22/2015] [Indexed: 11/30/2022] Open
Abstract
Silica (silicon dioxide) occupational exposure has been linked to both pulmonary and extra-pulmonary toxicity. Silicosis is the major pulmonary toxicity, which has also been associated with the development of collagen-vascular disease and with anti-neutrophil cytoplasmic antibody (ANCA)-positive vasculitis, especially perinuclear anti-neutrophil cytoplasmic antibodies (P-ANCA). The most common pulmonary manifestations of microscopic polyangitis (MPA) are interstitial fibrosis and alveolar hemorrhage. We describe a patient who had unusual presentation of microscopic polyangitis, characterized by lung hemorrhage, rapidly progressive glomerulonephritis, pleuropericarditis and pulmonary embolism that was associated with a history of silica exposure and radiologic evidence for silicosis.
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Affiliation(s)
- Amjad Al-Rajhi
- McGill University, Montreal General Hospital, D7.201, Montreal, Quebec H3G 1A4, Canada
| | - Elisa Ferreira Brega
- Department of Pathology, McGill University, Duff Medical Building, 3775 University Street, Montreal, Quebec H3A 2B4, Canada
| | - Neil C Colman
- McGill University Health Centre, McGill University, Montreal General Hospital, D7.201, Montreal, Quebec H3G 1A4, Canada
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12
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Poliangítis microscópica secundaria a exposición a sílice. ACTA ACUST UNITED AC 2014; 10:180-2. [DOI: 10.1016/j.reuma.2013.04.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2013] [Revised: 04/02/2013] [Accepted: 04/03/2013] [Indexed: 11/20/2022]
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Silicon, a Possible Link between Environmental Exposure and Autoimmune Diseases: The Case of Rheumatoid Arthritis. ARTHRITIS 2012; 2012:604187. [PMID: 23119159 PMCID: PMC3483651 DOI: 10.1155/2012/604187] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Accepted: 09/13/2012] [Indexed: 12/28/2022]
Abstract
Silicon is one of the most common chemicals on earth. Several compounds such as silica, asbestos, silicone or, nanoparticles are built from tetrahedral units with silicon as the central atom. Despite these, structural similarities, they have rarely been analyzed as a group. These compounds generate significant biological alterations that include immune hyperactivation, production of the reactive species of oxygen and tissue injury. These pathological processes may trigger autoimmune responses and lead to the development of rheumatoid arthritis. Populations at risk include those that constantly work in industrial process, mining, and agriculture as well as those that undergo silicone implants. Herein a review on the main features of these compounds and how they may induce autoimmune responses is presented.
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14
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Farhat SCL, Silva CA, Orione MAM, Campos LMA, Sallum AME, Braga ALF. Air pollution in autoimmune rheumatic diseases: a review. Autoimmun Rev 2011; 11:14-21. [PMID: 21763467 DOI: 10.1016/j.autrev.2011.06.008] [Citation(s) in RCA: 133] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2011] [Accepted: 06/06/2011] [Indexed: 12/11/2022]
Abstract
Air pollution consists of a heterogeneous mixture of gasses and particles that include carbon monoxide, nitrates, sulfur dioxide, ozone, lead, toxic by-product of tobacco smoke and particulate matter. Oxidative stress and inflammation induced by inhaled pollutants may result in acute and chronic disorders in the respiratory system, as well as contribute to a state of systemic inflammation and autoimmunity. This paper reviews the mechanisms of air contaminants influencing the immune response and autoimmunity, and it focuses on studies of inhaled pollutants triggering and/or exacerbating rheumatic diseases in cities around the world. Remarkably, environmental factors contribute to the onset of autoimmune diseases, especially smoking and occupational exposure to silica in rheumatoid arthritis and systemic lupus erythematosus. Other diseases such as scleroderma may be triggered by the inhalation of chemical solvents, herbicides and silica. Likewise, primary vasculitis associated with anti-neutrophil cytoplasmic antibody (ANCA) may be triggered by silica exposure. Only few studies showed that air pollutants could trigger or exacerbate juvenile idiopathic arthritis and systemic lupus erythematosus. In contrast, no studies of tropospheric pollution triggering inflammatory myopathies and spondyloarthropathies were carried out. In conclusion, air pollution is one of the environmental factors involved in systemic inflammation and autoimmunity. Further studies are needed in order to evaluate air pollutants and their potentially serious effects on autoimmune rheumatic diseases and the mechanisms involved in the onset and the exacerbation of these diseases.
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Affiliation(s)
- Sylvia C L Farhat
- Environmental Epidemiology Study Group, Laboratory of Experimental Air Pollution, University of Sao Paulo Faculty of Medical Sciences, Brazil
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15
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Goodpasture's Syndrome and Silica: A Case Report and Literature Review. Case Rep Med 2010; 2010. [PMID: 20886021 PMCID: PMC2945665 DOI: 10.1155/2010/426970] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2010] [Revised: 07/15/2010] [Accepted: 08/24/2010] [Indexed: 11/26/2022] Open
Abstract
We report a case of Goodpasture's syndrome following chronic low level and an acute, high level of exposure to crystalline silica. A 38-year-old male tilesetter was admitted to the emergency room with dyspnea and respiratory failure. He reported that his symptoms had developed over the previous week after inhaling a large amount of dust while dry-sanding and sweeping a silica-based product used to fill cracks in a cement floor. Over the following days, his pulmonary function declined and he developed acute renal failure. Tests of antiglomerular basement membrane antibody were positive and renal biopsy revealed global glomerulonephritis. He was diagnosed with Goodpasture's syndrome and treated with steroids, plasmapheresis, and hemodialysis. This man had a history of childhood asthma and a remote, one pack-year history of cigarette use. He used the flooring product for seven years prior to the inciting event, however, previous jobs had utilized significantly smaller amounts. Goodpasture's syndrome and other autoimmune diseases have been reported in association with silica exposure. The acute onset following high level silica exposure in this previously healthy man, suggest that clinicians should investigate silica exposure as a causal factor in cases of Goodpasture's syndrome.
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16
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Shibuya H, Sano H, Osamura K, Kujime K, Hara K, Hisada T. Microscopic polyangiitis accompanied by pleuritis as the only pulmonary manifestation of occupational silica exposure. Intern Med 2010; 49:925-9. [PMID: 20467178 DOI: 10.2169/internalmedicine.49.3046] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A 68-year-old man, who had worked for processing quartz-containing stones for more than 50 years, complained of low-grade fever and arthralgia. Mediastinal lymph nodes were markedly swollen on chest computed tomography. Pathological findings of the lymph node were compatible with silicosis, with a high titer of myeloperoxidase anti-neutrophil cytoplasmic antibody (MPO-ANCA). During follow-up with prednisolone treatment, pleuritis and uveitis developed as manifestations of vasculitis. Thus, he was diagnosed with MPO-ANCA-associated vasculitis with occupational silica exposure, possibly microscopic polyangiitis (MPA). This case is rare, because pleuritis was the only pulmonary manifestation, without interstitial pneumonia, alveolar hemorrhage or glomerulonephritis.
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Affiliation(s)
- Hideki Shibuya
- Department of Respiratory Medicine, Tokyo Teishin Hospital.
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17
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Rihova Z, Maixnerova D, Jancova E, Pelclova D, Bartunkova J, Fenclova Z, Vankova Z, Reiterova J, Merta M, Rysava R, Tesar V. Silica and Asbestos Exposure in ANCA-Associated Vasculitis with Pulmonary Involvement. Ren Fail 2009; 27:605-8. [PMID: 16153001 DOI: 10.1080/08860220500200395] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Silica and asbestos exposure are thought to belong to the triggering factors of antineutrophil cytoplasm antibodies (ANCA)-associated vasculitis. We carried out a study to find out whether patients with pulmonary involvement attributable to ANCA-associated vasculitis (AAV) have been exposed to silicon-containing materials. Thirty-one patients (12 women, 19 men, median age 51 years) were interviewed using a structured questionnaire. Occupational exposure to silicon-containing chemicals was reported by 22.6% of the patients (12.9% to SiO2, 9.7% to asbestos), compared with 0% of control subjects (p<0.05). Our findings support the pathophysiologic role of silica in AAV.
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Affiliation(s)
- Zuzana Rihova
- Nephrology Unit, 1st Medical Faculty, Charles University, Prague, Czech Republic.
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Eiras A, Vizcaíno L, Eiras P. Anticuerpos anticitoplasma de neutrófilo en enfermedades distintas a las vasculitis idiopáticas: correlaciones clínicas y especificidades antigénicas. Rev Clin Esp 2007; 207:341-3. [PMID: 17662199 DOI: 10.1157/13107946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The value of antineutrophil cytoplasmic antibodies (ANCA) in the diagnosis of several types of idiopathic vasculitis has been well-documented: In these diseases the ANCA show two classical immunofluorescence patterns, C-ANCA and P-ANCA, which have antigen specificity for the myeloperoxidase and proteinase 3, respectively. However, the appearance of ANCA in very different diseases other than the mentioned vasculitis, has been documented in recent years. In these diseases, the ANCA generally have atypical immunofluorescence patterns and are directed against neutrophil antigens that are different from the previous two, their clinical value still being under debate.
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Affiliation(s)
- A Eiras
- Unidad de Biología Molecular e Histocompatibilidad, Centro de Transfusión de Galicia, Santiago de Compostela, La Coruña, Spain
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