Could the inhalation of cadmium and other metals in addition to textile dust inhalation account for the observed increased risk of rheumatoid arthritis in textile workers?

Dl, Murphy; Mathew, Aishwarya; James, Benjamin; Hutchinson, David

doi:10.1136/annrheumdis-2016-209228

Cited by 6 publications

(3 citation statements)

References 9 publications

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“…A recent study on Malaysian RA women who rarely smoke has demonstrated an increased risk of RA (OR 2.8, 95% CI 1.6 to 5.2) associated with working in the textile industry 37. However, this finding might have been confounded by exposure to Cd as the textile industry has used Cd in dyes to colour textiles 5. Most other occupations associated with RA38 39 also have the potential to predispose individuals to Cd inhalation and raise serum Cd levels.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of rheumatoid arthritis in relation to serum cadmium concentrations: cross-sectional study using Korean National Health and Nutrition Examination Survey (KNHANES) data

et al. 2019

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ObjectivesIt has been suggested that exposure to heavy metal cadmium (Cd) may contribute to a high risk of developing rheumatoid arthritis (RA). This study was to investigate the association of RA prevalence and serum concentrations of Cd and other heavy metals through large survey data analysis.DesignA retrospective cross-sectional survey study.SettingLarge population survey in Korea.Participants53 829 subjects participated in Korean National Health and Nutrition Examination Survey (KNHANES) from 2008 to 2013.InterventionsHeavy metals were measured in different time periods of the survey programme which resulted in three different data sets for analysis: Cd, mercury (Hg) and lead (Pb) from 2008 to 2012 survey; serum manganese (Mn) and urine arsenic (As) from 2008 to 2009 survey; and serum zinc (Zn) from 2010 survey. RA prevalence and its associations with serum heavy metals were analysed using a general linear/logistic regression model of complex sample design.ResultsSerum Cd was elevated in patients with RA (RA vs control: 1.30±0.07 µg/L vs 1.17±0.01 µg/L, p<0.01). There were no significant differences in urine levels of As or serum levels of Pb, Hg, Mn or Zn between patients with RA and controls. OR (95% CI) of RA prevalence according to 1 µg/L increase of serum Cd level was 1.28(95% CI 1.03 to 1.61). Prevalence of RA in women was increased with increasing quartiles of Cd levels, with a 19-fold difference in female RA prevalence between individuals in the lowest quartile of serum Cd level and those in the highest quartile (0.18% vs 3.42%). Cubic spline curve of prevalence OR showed increased risk of RA according to increased serum Cd level. Increased risk of RA in men was not observed with increased serum Cd levels.ConclusionThere was an increased prevalence of RA in females associated with increased serum levels of Cd in the Korean population.

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Section: Discussionmentioning

confidence: 99%

Prevalence of rheumatoid arthritis in relation to serum cadmium concentrations: cross-sectional study using Korean National Health and Nutrition Examination Survey (KNHANES) data

et al. 2019

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“…Given that the process is induced in vivo by cadmium and that cadmium levels are higher in smokers [93,94] the association of cadmium inhalation from smoking with nodule formation in the lungs of RA patients is the strongest evidence yet for a causative involvement of metal ions in the disease [11]. In addition to smoking, epidemiological evidence for the association between cadmium inhalation and nodular rheumatoid arthritis stems from occupational settings such as workers in the mining, steel, textile, and other industries [95][96][97]. It is thought that the inhaled cadmium leads to nodules (granulomas) in the lung and the observed formation of RF, ACPAs and other autoantibodies that are typical of RA.…”

Section: Cigarette Smoking and Occupational Exposurementioning

confidence: 99%

Zinc and Cadmium in the Aetiology and Pathogenesis of Osteoarthritis and Rheumatoid Arthritis

Frangos

Maret

2020

Nutrients

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Osteoarthritis (OA) and rheumatoid arthritis (RA) are inflammatory articular conditions with different aetiology, but both result in joint damage. The nutritionally essential metal zinc (Zn2+) and the non-essential metal cadmium (Cd2+) have roles in these arthritic diseases as effectors of the immune system, inflammation, and metabolism. Despite both metal ions being redox-inert in biology, they affect the redox balance. It has been known for decades that zinc decreases in the blood of RA patients. It is largely unknown, however, whether this change is only a manifestation of an acute phase response in inflammation or relates to altered availability of zinc in tissues and consequently requires changes of zinc in the diet. As a cofactor in over 3000 human proteins and as a signaling ion, zinc affects many pathways relevant for arthritic disease. How it affects the diseases is not just a question of zinc status, but also an issue of mutations in the many proteins that maintain cellular zinc homoeostasis, such as zinc transporters of the ZIP (Zrt-/Irt-like protein) and ZnT families and metallothioneins, and the multiple pathways that change the expression of these proteins. Cadmium interferes with zinc’s functions and there is increased uptake under zinc deficiency. Remarkably, cadmium exposure through inhalation is now recognized in the activation of macrophages to a pro-inflammatory state and suggested as a trigger of a specific form of nodular RA. Here, we discuss how these metal ions participate in the genetic, metabolic, and environmental factors that lead to joint destruction. We conclude that both metal ions should be monitored routinely in arthritic disease and that there is untapped potential for prognosis and treatment.

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“…Synovial vascularity detected by PD ultrasound has been associated with the level of joint inflammation. 19,20 Naredo et al reported a correlation between positive synovial vascularity and total joint damage progression at 1 year. 21 In addition, PD ultrasonography has been shown to be correlated with vascular endothelial growth factor (VEGF), providing further evidence of the important role of VEGF in synovial neo-angiogenesis.…”

Section: Discussionmentioning

confidence: 99%

Generalized estimating equation model to compare drug effects on synovitis of the dominant wrist in severe rheumatoid arthritis between tocilizumab versus adalimumab versus abatacept using high‐resolution ultrasound

Chen

Chiu

et al. 2017

Int J of Rheum Dis

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Could the inhalation of cadmium and other metals in addition to textile dust inhalation account for the observed increased risk of rheumatoid arthritis in textile workers?

Cited by 6 publications

References 9 publications

Prevalence of rheumatoid arthritis in relation to serum cadmium concentrations: cross-sectional study using Korean National Health and Nutrition Examination Survey (KNHANES) data

Prevalence of rheumatoid arthritis in relation to serum cadmium concentrations: cross-sectional study using Korean National Health and Nutrition Examination Survey (KNHANES) data

Zinc and Cadmium in the Aetiology and Pathogenesis of Osteoarthritis and Rheumatoid Arthritis

Generalized estimating equation model to compare drug effects on synovitis of the dominant wrist in severe rheumatoid arthritis between tocilizumab versus adalimumab versus abatacept using high‐resolution ultrasound

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