1
|
Tomic D, Hoy RF, Sin J, Jimenez Martin J, Gwini SM, Barnes H, Nikpour M, Morrisroe K, Lim YZ, Walker-Bone K. Autoimmune diseases, autoantibody status and silicosis in a cohort of 1238 workers from the artificial stone benchtop industry. Occup Environ Med 2024; 81:388-394. [PMID: 39134395 DOI: 10.1136/oemed-2024-109526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 07/29/2024] [Indexed: 09/01/2024]
Abstract
OBJECTIVES Autoimmune disorders are multifactorial but occupational exposures have long been implicated, including respirable crystalline silica (RCS). A modern epidemic of silicosis is emerging internationally, associated with dry processing of engineered stone with high (>90%) RCS content. We aimed to investigate the prevalence of clinical autoimmune disease and common autoantibodies in exposed workers. METHODS Stone benchtop industry workers in Victoria, Australia were offered free screening for silicosis and related disorders. Symptoms or diagnoses of autoimmune disease were evaluated by questionnaire and blood tests taken for rheumatoid factor (RF), antinuclear antibodies (ANAs) and extractable nuclear antigens (ENAs). RESULTS Among 1238 workers (93.3% male) screened from 2019 to 2021, 0.9% were confirmed with autoimmune disease. Among those without clinical disease, 24.6% had detectable ANAs (93.5% male), 4.6% detectable ENAs and 2.6% were positive for RF. Silicosis was diagnosed in 253 workers (24.3% of those with diagnostic information available). Of those with ANA readings, 54 (6.6%) had ANA titre >1:320. The likelihood of positive autoantibodies increased with age; smoking; higher exposure to RCS and silicosis diagnosis. CONCLUSION The proportion of workers with detectable ANAs or ENAs was considerably higher than the 5%-9% expected in the general population. Some of the antibodies detected (eg, Scl-70, CENPB) have high sensitivity and specificity for systemic sclerosis. Long-term follow-up will be needed to estimate incidence. Rheumatologists should explore occupational history in new cases of autoimmune disease. Screening for autoimmune disease is indicated in workers exposed to RCS as these individuals need specialised management and may be entitled to compensation.
Collapse
Affiliation(s)
- Dunya Tomic
- Centre for Occupational and Environmental Health, Monash University School of Public Health and Preventive Medicine, Melbourne, Victoria, Australia
| | - Ryan F Hoy
- Centre for Occupational and Environmental Health, Monash University School of Public Health and Preventive Medicine, Melbourne, Victoria, Australia
- Department of Respiratory Medicine, Alfred Health, Melbourne, Victoria, Australia
| | - Jesselyn Sin
- Centre for Occupational and Environmental Health, Monash University School of Public Health and Preventive Medicine, Melbourne, Victoria, Australia
| | - Javier Jimenez Martin
- Centre for Occupational and Environmental Health, Monash University School of Public Health and Preventive Medicine, Melbourne, Victoria, Australia
| | - Stella May Gwini
- Centre for Occupational and Environmental Health, Monash University School of Public Health and Preventive Medicine, Melbourne, Victoria, Australia
| | - Hayley Barnes
- Centre for Occupational and Environmental Health, Monash University School of Public Health and Preventive Medicine, Melbourne, Victoria, Australia
- Department of Respiratory Medicine, Alfred Health, Melbourne, Victoria, Australia
| | - Mandana Nikpour
- Department of Medicine, The University of Melbourne Medicine at St Vincent's Hospital, Fitzroy, Victoria, Australia
- Department of Rheumatology, St Vincent's Hospital Melbourne Pty Ltd, Fitzroy, Victoria, Australia
| | - Kathleen Morrisroe
- Department of Medicine, The University of Melbourne Medicine at St Vincent's Hospital, Fitzroy, Victoria, Australia
- Department of Rheumatology, St Vincent's Hospital Melbourne Pty Ltd, Fitzroy, Victoria, Australia
| | - Yuan Z Lim
- Monash University School of Public Health and Preventive Medicine, Melbourne, Victoria, Australia
| | - Karen Walker-Bone
- Centre for Occupational and Environmental Health, Monash University School of Public Health and Preventive Medicine, Melbourne, Victoria, Australia
- MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton MRC Lifecourse Epidemiology Centre, Southampton, UK
| |
Collapse
|
2
|
Fukushige M, Lu X, Satoh M, Oda M, Ohba T, Katoh T. Association between antinuclear antibody positivity and chemical exposure among pregnant Japanese women: A cross-sectional study based on the Japan environment and Children's study. Int J Hyg Environ Health 2023; 248:114094. [PMID: 36610096 DOI: 10.1016/j.ijheh.2022.114094] [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: 09/02/2022] [Revised: 10/21/2022] [Accepted: 12/01/2022] [Indexed: 01/06/2023]
Abstract
Antinuclear antibodies (ANAs) are detected in healthy individuals, they are more prevalent in women than in men. Pregnant women are immunologically unique, but epidemiological data on ANA positivity in them remain limited. The exposure received from the mother during the fetal period impacts the future health of the fetus and has thus received increased attention in recent years. Thus, we investigated the association between ANA positivity and chemical exposure among pregnant Japanese women, registered in the Japan Environment and Children's Study (JECS). ANA titers were assessed by indirect immunofluorescence with HEp-2 cells at a cutoff dilution of 1:40. Sociodemographic and other data were obtained in the JECS from a self-administered questionnaire. We analyzed 1,235 Japanese women in their first trimester of pregnancy. The ANA prevalence was 17.2%. Among ANA-positive women, a speckled pattern was the most common (95.3%), followed by a homogeneous pattern (72.3%). Exposure to chemicals more than once a week significantly increased the probability of ANA positivity (kerosene, petroleum, benzene, or gasoline: adjusted odds ratio [AOR], 2.11; 95% confidence interval [95% CI], 1.03-4.34; chlorine bleach or germicide: AOR, 1.97; 95% CI, 1.10-3.54; organic solvents: AOR, 5.34; 95% CI, 1.40-20.36; and photocopying machines or laser printers: AOR, 1.73; 95% CI, 1.17-2.54). ANA positivity was associated with exposure to several chemicals in Japanese women. Our exploratory results suggested that ANAs as potential markers of chemical exposure warrant further research.
Collapse
Affiliation(s)
- Mami Fukushige
- Department of Nursing, Faculty of Life Sciences, Kumamoto University, 4-24-1 Kuhonji, Chuo-ku, Kumamoto-shi, Kumamoto, 862-0976, Japan; Department of Public Health, Faculty of Life Sciences, Kumamoto University, 1-1-1 Kuhonji, Chuo-ku, Kumamoto-shi, Kumamoto, 860-8556, Japan; Kumamoto University Regional Centre, The Japan Environment and Children's Study (JECS), 718, Medical Research Building, 1-1-1 Honjo, Chuo-ku, Kumamoto-shi, Kumamoto, 860-8556, Japan.
| | - Xi Lu
- Department of Public Health, Faculty of Life Sciences, Kumamoto University, 1-1-1 Kuhonji, Chuo-ku, Kumamoto-shi, Kumamoto, 860-8556, Japan
| | - Minoru Satoh
- Department of Clinical Nursing, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu-shi, Fukuoka, 807-8555, Japan; Department of Medicine, Kitakyushu Yahata-Higashi Hospital, 2-1-17 Nishihonmachi, Yahatahigashi-ku, Kitakyushu-shi, Fukuoka, 805-0061, Japan
| | - Masako Oda
- Kumamoto University Regional Centre, The Japan Environment and Children's Study (JECS), 718, Medical Research Building, 1-1-1 Honjo, Chuo-ku, Kumamoto-shi, Kumamoto, 860-8556, Japan
| | - Takashi Ohba
- Kumamoto University Regional Centre, The Japan Environment and Children's Study (JECS), 718, Medical Research Building, 1-1-1 Honjo, Chuo-ku, Kumamoto-shi, Kumamoto, 860-8556, Japan; Department of Obstetrics and Gynecology, Faculty of Life Science, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kitakyushu-shi, Fukuoka, 860-8556, Japan
| | - Takahiko Katoh
- Department of Public Health, Faculty of Life Sciences, Kumamoto University, 1-1-1 Kuhonji, Chuo-ku, Kumamoto-shi, Kumamoto, 860-8556, Japan; Kumamoto University Regional Centre, The Japan Environment and Children's Study (JECS), 718, Medical Research Building, 1-1-1 Honjo, Chuo-ku, Kumamoto-shi, Kumamoto, 860-8556, Japan
| |
Collapse
|
3
|
Sahihazar ZM, Ghahramani A, Galvani S, Hajaghazadeh M. Probabilistic health risk assessment of occupational exposure to crystalline silica in an iron foundry in Urmia, Iran. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:82014-82029. [PMID: 35748987 DOI: 10.1007/s11356-022-21487-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 06/11/2022] [Indexed: 06/15/2023]
Abstract
This study aimed to quantify the exposure of foundry workers to crystalline silica and associated cancer and non-cancer health risks using a probabilistic approach. Breathing zone air samples were collected according to the NIOSH 7602 method and analyzed using Fourier transform infrared spectroscopy. The health risks posed by crystalline silica were then assessed using the EPA-developed inhalation risk assessment model and Monte Carlo simulation. The sensitivity analysis was also conducted to determine the contribution of input parameters to the health risks. The mean concentration of crystalline silica in six foundry stations ranged from 0.029 to 0.064 mg m-3, exceeding the occupational exposure limits. The average values of cancer risks were greater than the USEPA level, i.e., 1E - 6 in all workstations of the foundry. Workers in sand preparation and molding stations suffered the greatest cancer risks, with the mean value of 2.35E - 5 and 2.10E - 5, respectively. Non-cancer hazard quotient exceeded 1 in all foundry stations ranging from 1.56 (in melting and pouring) to 3.37 (in sand preparation). The 95% upper-bound values of the health risks decreased by 77.52% and 56.77%, assuming the use of engineering controls and wearing respirators by workers, respectively. Sensitivity analyses indicate that concentration was the most sensitive factor contributing to the carcinogenic (46.13%) and non-carcinogenic (67.08%) risks. These findings can aid managers in gaining a better understanding of the silica risks faced by foundry workers and the role of engineering controls and respirators in protecting workers' health.
Collapse
Affiliation(s)
- Zahra Moutab Sahihazar
- Department of Occupational Health, School of Public Health, Urmia University of Medical Sciences, Urmia, Iran
| | - Abolfazl Ghahramani
- Department of Occupational Health, School of Public Health, Urmia University of Medical Sciences, Urmia, Iran
| | - Sadjad Galvani
- Department of Power Engineering, Faculty of Electrical, and Computer Engineering, Urmia University, Urmia, Iran
| | - Mohammad Hajaghazadeh
- Department of Occupational Health, School of Public Health, Urmia University of Medical Sciences, Urmia, Iran.
| |
Collapse
|
4
|
Inhalants other than personal cigarette smoking and risk for developing rheumatoid arthritis. Curr Opin Rheumatol 2021; 32:279-288. [PMID: 32141952 DOI: 10.1097/bor.0000000000000705] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE OF REVIEW The current review summarizes the current evidence on inhalants other than personal cigarette smoking and risk for developing rheumatoid arthritis (RA). RECENT FINDINGS Personal cigarette smoking has been implicated as an environmental risk factor for seropositive RA, perhaps by inducing autoimmunity at pulmonary mucosa. Since many patients with RA are nonsmokers, other inhalants are being investigated as potential RA risk factors. Recent case-control and cohort studies have investigated passive cigarette smoking, air pollution, inhalant-related occupations, silica, pesticides, household environment, and allergic inhalants as inhalant exposures for RA risk. Inhalant-related occupations and silica inhalants have the most consistent evidence for associations with increased RA risk. However, most studies relied on retrospective designs and had limited ability to adjust for personal cigarette smoking or investigate associations among nonsmokers. SUMMARY Several inhalants other than personal cigarette smoking may be associated with increased risk for developing RA. These results support the hypothesis that inhalants, pulmonary mucosal inflammation, and RA pathogenesis may be linked. Future studies are needed to firmly establish the independence of these findings from personal cigarette smoking and to determine the specific inhalants and biologic mechanisms related to RA pathogenesis.
Collapse
|
5
|
Altundaş Hatman E, Acar Karagül D, Kılıçaslan Z. Rheumatological Diseases in Denim Sandblasters with Silicosis: What Should Pulmonologists Look for? Turk Thorac J 2020; 21:446-450. [PMID: 33352101 DOI: 10.5152/turkthoracj.2019.19055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Accepted: 08/31/2019] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Silica exposure is not only the cause of silicosis, also associated rheumatological diseases like rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and systemic sclerosis (SSc). This report will reveal the rheumatological diseases of silicosis patients who were exposed to silica while working as denim sandblasters. Additionally, we will describe some clinical and laboratory findings that will help pulmonologist suspect, recognize and manage rheumatological diseases related to silica exposure in patients with silicosis. MATERIAL AND METHODS We reviewed the records of 142 sandblasters diagnosed with silicosis and found ten silicosis cases who also had rheumatological diseases between the years 2009 and 2017. The occupational characteristics, serological, functional and radiological data, were collected for patients of silicosis with rheumatological diseases. RESULTS Ten silicosis patients with concomitant rheumatological diseases were found. Six patients among our cases had diagnosed SSc (4.2%), three of them had RA (2.1%), and one of them was being monitored for SLE (0.7%). The mean silica exposure time of the cases was 4.3±1.9 years (min: 1 max: 8). We also found elevated LD, sedimentation and CRP levels in our cases. CONCLUSION It should be kept in mind that, in silicosis cases with arthralgia, joint tenderness or sclerosis at the fingertips may be indicative of rheumatological diseases related to silica exposure, and in these cases, the unexplained elevations of sedimentation and CRP levels may also be a result of silica-induced rheumatological diseases.
Collapse
Affiliation(s)
- Elif Altundaş Hatman
- Department of Occupational Medicine, İstanbul Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey
| | - Duygu Acar Karagül
- Department of Public Health, Occupational Health Training Programme, İstanbul University School of Medicine, İstanbul, Turkey
| | - Zeki Kılıçaslan
- Department of Pulmonary Medicine, İstanbul University School of Medicine, İstanbul, Turkey
| |
Collapse
|
6
|
Brilland B, Beauvillain C, Mazurkiewicz G, Rucay P, Roquelaure Y, Tabiasco J, Vinatier E, Riou J, Jeannin P, Renier G, Subra JF, Augusto JF. T Cell Dysregulation in Non-silicotic Silica Exposed Workers: A Step Toward Immune Tolerance Breakdown. Front Immunol 2019; 10:2743. [PMID: 31824514 PMCID: PMC6883424 DOI: 10.3389/fimmu.2019.02743] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 11/08/2019] [Indexed: 12/26/2022] Open
Abstract
Background: Chronic silica exposure can lead to silicosis, complicated or not by autoimmune diseases (AID). The pathophysiology of silica-induced AID remains not fully understood, especially immune mechanisms that may develop in patients without yet established silicosis. We conducted a prospective clinical study to analyze the impact of crystalline silica (CS) on T cell phenotype and regulatory T cells (Tregs) frequency, as well as on auto-antibodies development in non-silicotic workers exposed to CS. Methods: Workers with moderate to high exposure level to CS and aged between 30 and 60 years-old were considered for inclusion. Peripheral blood mononuclear cells were analyzed by flow cytometry. Auto-antibodies were screened in serum by immunofluorescence. Blood from 42 and 45 healthy subjects (HC) was used as control for T cell phenotype and serum analyses, respectively. Results: Among the 63 included workers exposed to CS, 55 had full data available and were analyzed. Ten were exposed to CS for <5 years, 18 for 5–10 years and 27 for more than 10 years. The frequency of Tregs (CD4+CD25+CD127−FoxP3+) was significantly lower in CS exposed workers as compared to HC. We found an increased expression of the activation marker HLA-DR on T cells (CD3+, CD4+, and CD8+) of CS exposed workers as compared to HC. Tregs to activated T cells ratio was also lower in exposed subjects. In the latter, HLA-DR expression level and Tregs frequency were significantly associated with CS exposure duration. Serum autoantibody detection was significantly higher in CS exposed workers as compared to HC. Especially, among workers exposed more than 10 years, antinuclear antibodies and ANCA were detected in 44 and 22% among them, as compared to 5 and 2.5% in HC, respectively. Conclusion: This work shows that CS exposure is associated with a decrease of Tregs frequency, an increase of T cell activation status, and a tolerance breakdown against auto-antigens. These results show that alterations of the T cell compartment can be detected early over the course of CS exposure, preceding silicosis development or AID onset.
Collapse
Affiliation(s)
- Benoit Brilland
- Service de Néphrologie-Dialyse-Transplantation, CHU d'Angers, Angers, France.,CRCINA, INSERM, Université de Nantes, Université d'Angers, Angers, France
| | - Céline Beauvillain
- CRCINA, INSERM, Université de Nantes, Université d'Angers, Angers, France.,Laboratoire d'Immunologie et d'Allergologie, CHU d'Angers, Angers, France
| | - Gery Mazurkiewicz
- Service Santé au Travail Côte de Lumière, Les Sables-d'Olonne, France
| | - Pierre Rucay
- Service de Médecine du Travail, CHU d'Angers, Angers, France
| | - Yves Roquelaure
- Service de Médecine du Travail, CHU d'Angers, Angers, France
| | - Julie Tabiasco
- CRCINA, INSERM, Université de Nantes, Université d'Angers, Angers, France
| | - Emeline Vinatier
- CRCINA, INSERM, Université de Nantes, Université d'Angers, Angers, France.,Laboratoire d'Immunologie et d'Allergologie, CHU d'Angers, Angers, France
| | - Jérémie Riou
- MINT, UNIV Angers, INSERM 1066, CNRS 6021, IBS- CHU, Angers, France
| | - Pascale Jeannin
- CRCINA, INSERM, Université de Nantes, Université d'Angers, Angers, France.,Laboratoire d'Immunologie et d'Allergologie, CHU d'Angers, Angers, France
| | - Gilles Renier
- Laboratoire d'Immunologie et d'Allergologie, CHU d'Angers, Angers, France
| | - Jean-François Subra
- Service de Néphrologie-Dialyse-Transplantation, CHU d'Angers, Angers, France.,CRCINA, INSERM, Université de Nantes, Université d'Angers, Angers, France
| | - Jean-François Augusto
- Service de Néphrologie-Dialyse-Transplantation, CHU d'Angers, Angers, France.,CRCINA, INSERM, Université de Nantes, Université d'Angers, Angers, France
| |
Collapse
|
7
|
Beshir S, Shaheen WA, Elserougy S, Aziz HM. Serum autoantibodies in silicosis and non-silicosis cement workers. Am J Ind Med 2015; 58:238-44. [PMID: 25564983 DOI: 10.1002/ajim.22413] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2014] [Indexed: 12/26/2022]
Abstract
AIM To study serum autoantibodies and immunoglobulin levels in cement workers. METHODS Blood samples for numerous antibodies were collected from 30 silicosis and 42 non-silicosis cement workers. Spirometry of the silicosis workers was also studied. RESULTS Serum IgA mean level showed a significant increase in the silicosis group compared to the non-silicosis group. Elevated titers of serum anti-smooth muscle antibodies (ASMA) and anti-glomerular basement membrane (anti-GBM) were detected only in the silicosis group. The duration of exposure showed a significant positive correlation with serum IgA, ASMA and anti-GBM, and a significant negative correlation with serum IgG. Serum anti-GBM showed a significant positive correlation with IgG while the inverse titer (1/titer) of anti-GBM showed highly significant positive correlations with serum IgA and ASMA. The percent predicted FVC was the ventilatory function most closely associated with immunological parameters in silicosis group. CONCLUSION Serum IgA, ASMA, and anti-GBM are the principal immunologic parameters associated with silicosis.
Collapse
Affiliation(s)
- Safia Beshir
- Department of Environmental and Occupational Medicine; National Research Center; Cairo Egypt
| | - Weam A. Shaheen
- Department of Environmental and Occupational Medicine; National Research Center; Cairo Egypt
| | - Safaa Elserougy
- Department of Environmental and Occupational Medicine; National Research Center; Cairo Egypt
| | - Hisham M. Aziz
- Department of Environmental and Occupational Medicine; National Research Center; Cairo Egypt
| |
Collapse
|
8
|
Parks CG, De Roos AJ. Pesticides, chemical and industrial exposures in relation to systemic lupus erythematosus. Lupus 2014; 23:527-36. [PMID: 24763537 DOI: 10.1177/0961203313511680] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Growing evidence suggests exposure to chemicals and industrial pollutants may increase risk of systemic lupus erythematosus (SLE). Here we review research on SLE associations with occupational and industrial exposures, primarily drawing on studies in human populations and summarizing epidemiologic research published in the past decade. The association of occupational silica exposure with SLE is well established, but key questions remain, including the required dose and susceptibility factors, and SLE risk due to other silicate exposures. Research on SLE and other exposures is less well developed, though several potential associations merit further consideration because of the consistency of preliminary human findings, experimental animal research, and biologic plausibility. These include pesticides and solvents, for which experimental findings also support investigation of specific agents, including organochlorines and trichloroethylene. Experimental findings and biologic plausibility suggest research on SLE and occupational exposure to hydrocarbons (i.e. mineral oils) is warranted, especially given the widespread exposures in the population. Experimental and limited human findings support further investigation of SLE related to mercury exposure, especially in dental occupations. Research on environmental risk factors in risk-enriched cohorts (family-based) is recommended, as is further investigation of exposures in relation to intermediate markers of effect (e.g. antinuclear antibodies), clinical features (e.g. nephritis), and outcomes.
Collapse
Affiliation(s)
- C G Parks
- 1Epidemiology Branch, National Institute of Environmental Health Sciences, NC, USA
| | | |
Collapse
|
9
|
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.
Collapse
|
10
|
Abstract
PURPOSE OF REVIEW To examine potential interventions, including modification of environmental risk factors and use of pharmacologic agents, in at-risk populations to prevent progression to (or development of) rheumatoid arthritis (RA). This review is timely given the increasing interest in early intervention strategies and new opportunities to identify patients early in the pathogenesis of RA. RECENT FINDINGS Despite the growing literature demonstrating a link between anticitrullinated protein antibodies, synovitis, genetic and environmental risk factors such as smoking and RA, there are no studies that have evaluated the effect of modifying environmental risk factors in late preclinical RA. This article describes several studies that have evaluated the ability of pharmacologic interventions to modify outcomes in patients at risk for RA. SUMMARY The prevention of RA in at-risk populations is feasible; however, this will necessitate novel efforts to identify patients very early in disease development to examine the effectiveness and cost of preventive interventions.
Collapse
|