Occupational exposure in ANCA-positive patients: A case-control study

Beaudreuil, Séverine; Lasfargues, G.; Lauériere, Laurence; Ghoul, Zen El; Fourquet, Florence; Longuet, Cédric; Halimi, Jean‐Michel; Nivet, Hubert; Büchler, Matthias

doi:10.1111/j.1523-1755.2005.00295.x

Cited by 70 publications

(44 citation statements)

References 31 publications

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“…Beaudreuil et al have compared exposure intensity in 60 ANCA-positive patients, 20 with WG and 120 hospitalized, age-(± 5 years), gender-matched controls. 17 They found that patients with the highest category of silica exposure had the highest risk of ANCA positivity (OR=6.9, 95% CI: 1.33-35.1), but they found no difference in silica exposure in subject groups identified by ANCA subtype.…”

Section: Discussionmentioning

confidence: 96%

“…[13][14][15] The smoking prevalence in 197 patients with small vessel vasculitis and ANCA was observed to be lower than age-comparable values for the general population of Germany, suggesting that cigarette smoking could have a protective effect on disease development. 16 However, a study comparing previous or current smoking history between 60 ANCA-positive patients and 120 ANCA-negative controls did not identify an association, 17 nor did a study of 129 ANCA small vessel vasculitis cases and 109 population-based controls. 5,6 The role of environmental factors in the development of autoimmune diseases is of particular concern in Western Montana where occupational asbestos exposures have been associated with acquiring both systemic autoimmune responses and various autoimmune disorders.…”

Section: Introductionmentioning

confidence: 99%

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Wegener’s granulomatosis and environmental factors in Western Montana

et al. 2010

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The objective of our study was to determine whether exposure to silica or other environmental factors is associated with developing Wegener's granulomatosis (WG), in a geographically isolated region of Western Montana. We sought to identify and interview all cases of WG diagnosed during 1993-2006 among residents of a ten-county region of Western Montana, as well as a group of demographically similar controls (n=39) without autoimmune disease. In the interview, we ascertained occupational silica and other exposures (metals, solvents, pesticides, tobacco). We enumerated 32 cases of WG, of whom 27 were included in the case-control study. Overall, a history of silica exposure was not associated with WG (OR = 0.68, 95% CI: 0.13-3.27), although there was a suggestion of increase in risk among persons with relatively recent (OR=2.67, 95% CI: 0.54-17.2), heavy (OR=1.82, 95% CI: 0.09-112.9), and prolonged (OR=1.53, 95% CI: 0.16-20.0) exposures. A history of having worked in the mining industry was associated with WG (six cases including three with no silica exposure, zero controls, lower 95% CI: 1.53). Risk was not associated with occupational or aerial pesticide exposure, but with residential rodenticide use (OR=12.15, 95% CI: 1.54-552). Occupational exposure to metals or solvents was not associated with WG, nor was a history of cigarette smoking. Results of earlier studies of WG support the hypothesis that silica exposure adversely influences the risk of developing WG. Our small study of WG failed to identify an association with silica overall, but the results are compatible with an increased risk in persons with relatively heavy, prolonged, and/or recent exposure.

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Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

Wegener’s granulomatosis and environmental factors in Western Montana

et al. 2010

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“…Elevated antibodies (cPR3, plasminogen, lysosomal-associated membrane protein 2, cathepsin G, lactoferrin, azurocidin, and elastase), elevated cytokines (TNF-a, IL-17, and IL-23), reduced regulatory T cell to effective T cell ratio, alterations in CD8+ T cell transcription, dysfunctional neutrophil apoptosis, and disrupted epigenetic silencing are all possible contributors to internal neutrophil activation (1,3,5,7,22). Environmental exposures (silica and asbestos), pathogens (Staphylococcus aureus, Ross virus, and Entamoeba histolytica), or medications (propylthiouracil and hydralazine) could all provide an external stimulus for neutrophil activation (2,3,(23)(24)(25)(26)(27)(28).…”

Section: Discussionmentioning

confidence: 99%

Relation between Asymptomatic Proteinase 3 Antibodies and Future Granulomatosis with Polyangiitis

Olson

Owshalimpur

Yuan

et al. 2013

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives The subclinical pathogenesis of granulomatosis with polyangiitis (GPA) has not been completely elucidated. Proteinase 3 (PR3) antibodies are strongly associated with GPA, but have not been evaluated before disease presentation.Design, setting, participants, & measurements This was a retrospective case-control serum bank study in which PR3 antibodies and C-reactive protein (CRP) in up to three longitudinal serum samples for 27 GPA patients before diagnosis (1 day-19 years) were compared with 27 controls whose serum samples were matched for age, sex, and race. This study analyzed all patients with American College of Rheumatology criteria-confirmed disease identified in the Department of Defense electronic medical records between 1990 and 2008.Results A greater percentage of GPA patients had at least one elevated PR3 antibody level ($6 U/ml) as well as at least one detectable PR3 antibody level (.1 U/ml) before diagnosis compared with matching controls ( Conclusions Subclinical PR3 antibody presence, trajectory, and temporal relationship to CRP associates with the future diagnosis of GPA. This data set further elucidates the pathogenesis of GPA.

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“…Beaudreuil et al showed that exposure to silica is associated with a nearly seven-fold increased risk of being ANCA-positive [69]. ANCA, both PR3 and MPO, are detected in sera of patients with protracted infections; however, in most infections, ANCA are directed against a wide repertoire of antigens and tend to be dual [70].…”

Section: Updates In the Diagnosis And Treatment Of Vasculitismentioning

confidence: 99%