Exposure to environmental air pollutants as a risk factor for primary Sjögren’s syndrome

Abstract

BackgroundEnvironmental etiology of primary Sjögren’s syndrome (pSS), an autoimmune disease, has been proposed. This study determined whether the exposure to air pollutants was an independent risk factor for pSS.MethodsParticipants were enrolled from a population-based cohort registry. Daily average concentrations of air pollutants from 2000 to 2011 were divided into 4 quartiles. Adjusted hazard ratios (aHRs) of pSS for exposure to air pollutants were estimated in a Cox proportional regression model adjusting for age, sex, socioeconomic status, and residential areas. A subgroup analysis stratified by sex was conducted to validate the findings. Windows of susceptibility indicated years of exposure which contributed the most to the observed association. Ingenuity Pathway Analysis was used to identify underlying pathways of air pollutant-associated pSS pathogenesis, using Z-score visualization.ResultsTwo hundred patients among 177,307 participants developed pSS, with a mean age of 53.1 years at acumulative incidence of 0.11% from 2000 to 2011. Exposure to carbon monoxide (CO), nitric oxide (NO), and methane (CH4) was associated with a higher risk of pSS. Compared to those exposed to the lowest concentration level, the aHRs for pSS were 2.04 (95%CI=1.29-3.25), 1.86 (95%CI=1.22-2.85), and 2.21 (95%CI=1.47-3.31) for those exposed to high levels of CO, NO, and CH4, respectively. The findings persisted in the subgroup analysis, in which females exposed to high levels of CO, NO, and CH4 and males exposed to high levels of CO were associated with significantly great risk of pSS. The cumulative effect of air pollution on pSS was time-dependent. The underlying cellular mechanisms involved chronic inflammatory pathways including the interleukin-6 signaling pathway.ConclusionExposure to CO, NO, and CH4 was associated with a high risk of pSS, which was biologically plausible.

Visual analysis of autoimmune dry eye studies based on bibliometrics

“…Studies have explored risk factors associated with autoimmune dry eye. [9] Many clinical randomized controlled trials have been reported, exploring many drugs and therapies for the treatment of autoimmune diseases. Intramuscular injection of ianalumab (VAY736), shown to be effective and safe [10] ; Autologous versus allogeneic versus umbilical cord sera has obvious effect on severe dry eye [11] ; LD-IL-2 was effective and well tolerated in patients with pSS, and it restored immune balance, with enhanced regulatory T cells and CD24highCD27 + B cells.…”

The impact of perfluoroalkyl substances on the clinical manifestations of primary Sjögren syndrome

“…Hitherto, the Epstein-Barr virus (EBV), cytomegalovirus (CMV), hepatitis C (HCV), Coxsackievirus and human Tlymphocyte virus type I (HTLV-1), mumps virus, hepatitis B and human parvovirus B19 have been reported [27][28][29]. The role of particulate pollutants in the development of SS has been examined in several studies, revealing that certain particulate pollutants can be recognized as antigens by airway epithelial cells and subsequently presented to immune cells [30]. Other environmental factors may also in uence pSS.…”

Influence of exposure to climate-related hazards in the phenotypic expression of primary Sjögren's syndrome

“…Personal determinants, closely connected to the local environment, are also involved in the pathogenesis of primary SjS (22). Evidence for the critical role of lifestyle and environmental factors is increasing, including a potential influence of diet (23,24), soil metals (25), seasonality (7), and air pollution (26). We recently reported that the significant variability in the presentation of systemic SjS is strongly linked with geoepidemiological personal determinants such as age, gender, ethnicity, and place of residence (27).…”