Understanding the role of environmental factors in the development of systemic lupus erythematosus
Systemic lupus erythematosus (SLE) is a multisystem disease with a complex etiology. Its risk is higher among women, racial and ethnic minorities, and individuals with a family history of SLE or related autoimmune diseases. It is believed that genetic factors interact with environmental exposures th...
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| Published in: | Best practice & research. Clinical rheumatology Vol. 31; no. 3; pp. 306 - 320 |
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01-06-2017
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| Abstract | Systemic lupus erythematosus (SLE) is a multisystem disease with a complex etiology. Its risk is higher among women, racial and ethnic minorities, and individuals with a family history of SLE or related autoimmune diseases. It is believed that genetic factors interact with environmental exposures throughout the lifespan to influence susceptibility to developing SLE. The strongest epidemiologic evidence exists for increased risk of SLE associated with exposure to crystalline silica, current cigarette smoking, use of oral contraceptives, and postmenopausal hormone replacement therapy, while there is an inverse association with alcohol use. Emerging research results suggest possible associations of SLE risk with exposure to solvents, residential and agricultural pesticides, heavy metals, and air pollution. Ultraviolet light, certain infections, and vaccinations have also been hypothesized to be related to SLE risk. Mechanisms linking environmental exposures and SLE include epigenetic modifications resulting from exposures, increased oxidative stress, systemic inflammation and inflammatory cytokine upregulation, and hormonal effects. Research needs to include new studies of environmental risk factors for SLE in general, with a focus on lifetime exposure assessment. In addition, studies in susceptible subgroups, such as family members, studies based on genetic risk profiles, and studies in individuals with evidence of pre-clinical autoimmunity based on the detection of specific auto-antibodies are also required. Understanding the role of environmental exposures in the development of SLE may help identify modifiable risk factors and potential etiological mechanisms. |
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| AbstractList | Systemic lupus erythematosus (SLE) is a multisystem disease with a complex etiology. Its risk is higher among women, racial and ethnic minorities, and individuals with a family history of SLE or related autoimmune diseases. It is believed that genetic factors interact with environmental exposures throughout the lifespan to influence susceptibility to developing SLE. The strongest epidemiologic evidence exists for increased risk of SLE associated with exposure to crystalline silica, current cigarette smoking, use of oral contraceptives, and postmenopausal hormone replacement therapy, while there is an inverse association with alcohol use. Emerging research results suggest possible associations of SLE risk with exposure to solvents, residential and agricultural pesticides, heavy metals, and air pollution. Ultraviolet light, certain infections, and vaccinations have also been hypothesized to be related to SLE risk. Mechanisms linking environmental exposures and SLE include epigenetic modifications resulting from exposures, increased oxidative stress, systemic inflammation and inflammatory cytokine upregulation, and hormonal effects. Research needs to include new studies of environmental risk factors for SLE in general, with a focus on lifetime exposure assessment. In addition, studies in susceptible subgroups, such as family members, studies based on genetic risk profiles, and studies in individuals with evidence of pre-clinical autoimmunity based on the detection of specific auto-antibodies are also required. Understanding the role of environmental exposures in the development of SLE may help identify modifiable risk factors and potential etiological mechanisms. Systemic lupus erythematosus (SLE) is a multisystem disease with a complex etiology. Risk is higher among women, racial and ethnic minorities, and individuals with a family history of SLE or related autoimmune diseases. It is thought that genetic factors interact with environmental exposures throughout the lifespan to influence susceptibility to developing SLE. The strongest epidemiologic evidence exists for increased risk of SLE associated with exposure to crystalline silica, current cigarette smoking, use of oral contraceptives and postmenopausal hormone replacement therapy, while there is an inverse association with alcohol use. Emerging research results suggest possible associations of SLE risk with exposure to solvents, residential and agricultural pesticides, heavy metals, and air pollution. Ultraviolet light, certain infections, and vaccinations have also been hypothesized to be related to SLE risk. Mechanisms linking environmental exposures and SLE include epigenetic modifications resulting from exposures, and increased oxidative stress, systemic inflammation and inflammatory cytokine upregulation, and hormonal effects. Research needs to include new studies of environmental risk factors for SLE generally, with a focus on lifetime exposure assessment, and studies in susceptible subgroups, such as family members or based on genetic risk profiles, or in individuals with evidence of pre-clinical autoimmunity based on detection of specific auto-antibodies. Understanding the role of environmental exposures in the development of SLE may help to identify modifiable risk factors and potential etiologic mechanisms. |
| Author | Barbhaiya, Medha Costenbader, Karen H. Parks, Christine G. de Souza Espindola Santos, Aline |
| AuthorAffiliation | 3 Department of Medicine, Division of Rheumatology, Hospital for Special Surgery, Weill- Cornell Medical School, New York, NY 2 Occupational and Environmental Health Branch, Public Health Institute, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil 1 Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Durham, NC 4 Department of Medicine, Division of Rheumatology, Immunology and Allergy, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA |
| AuthorAffiliation_xml | – name: 3 Department of Medicine, Division of Rheumatology, Hospital for Special Surgery, Weill- Cornell Medical School, New York, NY – name: 4 Department of Medicine, Division of Rheumatology, Immunology and Allergy, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA – name: 2 Occupational and Environmental Health Branch, Public Health Institute, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil – name: 1 Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Durham, NC |
| Author_xml | – sequence: 1 givenname: Christine G. surname: Parks fullname: Parks, Christine G. organization: Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Durham, NC, USA – sequence: 2 givenname: Aline surname: de Souza Espindola Santos fullname: de Souza Espindola Santos, Aline organization: Occupational and Environmental Health Branch, Public Health Institute, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil – sequence: 3 givenname: Medha surname: Barbhaiya fullname: Barbhaiya, Medha organization: Department of Medicine, Division of Rheumatology, Hospital for Special Surgery, Weill-Cornell Medical School, New York, NY, USA – sequence: 4 givenname: Karen H. surname: Costenbader fullname: Costenbader, Karen H. email: kcostenbader@bwh.harvard.edu organization: Department of Medicine, Division of Rheumatology, Immunology and Allergy, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/29224673$$D View this record in MEDLINE/PubMed |
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| Keywords | Environment Exposure Systemic lupus erythematosus Pathogenesis SLE Risk factor |
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| Snippet | Systemic lupus erythematosus (SLE) is a multisystem disease with a complex etiology. Its risk is higher among women, racial and ethnic minorities, and... Systemic lupus erythematosus (SLE) is a multisystem disease with a complex etiology. Risk is higher among women, racial and ethnic minorities, and individuals... |
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| SubjectTerms | Environment Environmental Exposure - adverse effects Exposure Female Humans Lupus Erythematosus, Systemic - etiology Lupus Erythematosus, Systemic - immunology Pathogenesis Risk factor Risk Factors SLE Systemic lupus erythematosus |
| Title | Understanding the role of environmental factors in the development of systemic lupus erythematosus |
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