Clinical peculiarities of patients with scleroderma exposed to silica: A systematic review of the literature

“…According to this report, Raynaud’s syndrome occurred in 81% of patients with crystalline silica exposure-related systemic sclerosis, digital ulcers in 48%, interstitial lung disease in 78%, silicosis in 40%, and anti-Scl-70 positivity in 44%. In addition, patients who were exposed to crystalline silica developed the above conditions early and had a worse prognosis compared with controls, who were not exposed to crystalline silica [29]. …”

Section: Discussionmentioning

confidence: 99%

Systemic sclerosis due to crystalline silica exposure among jewelry workers in Korea: two case reports

Kim

Yoon

Moon

et al. 2017

Ann of Occup and Environ Med

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BackgroundOccupational exposure to crystalline silica is a potential risk factor for various systemic autoimmune diseases including systemic sclerosis. The etiology of systemic sclerosis is not conclusively known, but there are epidemiological studies that show the relationship between exposure to crystalline silica and risk of systemic sclerosis. Here we report, for the first time, two cases of crystalline silica-related systemic sclerosis in patients who worked in crystal processing in the jewelry-manufacturing field.Case presentationCase 1 is a 57-year-old man who had worked mainly in crystal processing for multiple jewelry-processing companies for 17 years, since the age of 15 years. He contracted tuberculosis at the age of 25 years and showed Raynaud’s phenomenon of both the hands and feet at age 32 years. Digital cyanosis and sclerosis developed at approximately age 41 years. The patient was diagnosed with systemic sclerosis at age 48 years.Case 2 is a 52-year-old man who worked in crystal processing for various jewelry-processing companies for 7 years, since the age of 23 years. He first showed signs of cyanosis in the third and fourth digits of both hands at age 32 years, was diagnosed with Raynaud’s syndrome at age 37 years, and was diagnosed with systemic sclerosis at age 38 years.Crystal processing is a detailed process that involves slabbing and trimming the selected amethyst and quartz crystals, which requires close proximity of the worker’s face with the target area. In the 1980s and 1990s, the working hours were 12 h per day, and the working environment involved 15 workers crowded into a small, 70-m2 space with poor ventilation.ConclusionTwo workers who processed crystals with a maximum crystalline silica content of 56.66% developed systemic sclerosis. Considering the epidemiological and experimental evidence, exposure to crystalline silica dust was an important risk factor for systemic sclerosis. An active intervention is necessary to reduce exposure in similar exposure groups in the field of jewelry processing.

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“…[34,40] Scleroderma may be caused by vascular and immune abnormalities that initiate impaired angiogenesis, endothelial damage, and upregulation of adhesion molecules that chemoattract leukocytes, fibroblasts, and myofibroblasts resulting in tissue fibrosis. Additionally, scleroderma may be initiated by genetic mutations in the HLA gene [41] and environmental factors (e.g., exposure to silica [42] ). Current treatments for autoimmune diseases affecting connective tissues include NSAIDs, [43] corticosteroids, [44] immunosuppressants, [45] vitamin D, [46] and other biologics.…”

Section: Impact Of Autoimmune Diseases On Connective Tissues-autoimmunementioning

confidence: 99%

Biomaterials to Mimic and Heal Connective Tissues

2019

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Connective tissue is one of the four major types of animal tissue and plays essential roles throughout the human body. Genetic factors, aging, and trauma all contribute to connective tissue dysfunction and motivate the need for strategies to promote healing and regeneration. The goal of this Review is to link a fundamental understanding of connective tissues and their multiscale properties to better inform the design and translation of novel biomaterials to promote their regeneration. We discuss major clinical problems in adipose tissue, cartilage, dermis, and tendon that inspire the need to replace native connective tissue with biomaterials. We then detail multiscale structure-function relationships in native soft connective tissues that may be used to guide material design. Several biomaterials strategies to improve healing of these tissues that incorporate biologics and are biologic-free are reviewed. Finally, we highlight important guidance documents and standards (ASTM, FDA, EMA) that are important to consider for translating new biomaterials into clinical practice.

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Clinical peculiarities of patients with scleroderma exposed to silica: A systematic review of the literature

Cited by 35 publications

References 31 publications

Erasmus syndrome: Association of silicosis and systemic sclerosis

Erasmus syndrome: Association of silicosis and systemic sclerosis

Systemic sclerosis due to crystalline silica exposure among jewelry workers in Korea: two case reports

Biomaterials to Mimic and Heal Connective Tissues

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