Occupational exposure to asbestos and silica and risk of developing rheumatoid arthritis: findings from a Swedish population-based case-control study

Ilar, Anna; Klareskog, Lars; Saevarsdóttir, Saedís; Wiebert, Pernilla; Askling, Johan; Gustavsson, Per; Alfredsson, Lars

doi:10.1136/rmdopen-2019-000978

Cited by 29 publications

(40 citation statements)

References 28 publications

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“…cSiO 2 also induced AAbs with specificities for neutrophil cytoplasmic proteins [61,62], collagen [63], and complement [64,65]. Exposure to respirable cSiO 2 has also been aetiologically linked to several autoimmune diseases besides lupus [66][67][68][69][70][71][72][73]. Thus, it was noteworthy that cSiO 2 induced AAbs associated with rheumatoid arthritis (collagen II, fibrinogen IV, fibrinogen S, fibronectin, and vimentin), Sj€ ogren's syndrome (a-fodrin), systemic sclerosis (topoisomerase I), vasculitis (MPO and PR3), myositis (Mi-2, TIF1-c, MDA5), autoimmune hepatitis (LC-1), and coeliac disease (TTG) [74][75][76][77][78].…”

Section: Discussionmentioning

confidence: 99%

Omega-3 fatty acid intake suppresses induction of diverse autoantibody repertoire by crystalline silica in lupus-prone mice

Rajasinghe

Zhu

et al. 2020

Autoimmunity

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Inhalation of crystalline silica (cSiO 2) in the workplace is etiologically linked to lupus and other autoimmune diseases. Exposing lupus-prone NZBWF1 mice to respirable cSiO 2 unleashes a vicious cycle of inflammation and cell death in the lung that triggers interferon-regulated gene expression, ectopic lymphoid structure (ELS) development, elevation of local and systemic autoantibodies (AAbs), and glomerulonephritis. However, cSiO 2-induced inflammation and onset of autoimmunity can be prevented by inclusion of the x-3 polyunsaturated fatty acid docosahexaenoic acid (DHA) into the diet of these mice. Since cSiO 2 both causes cell death and interferes with efferocytosis, secondary necrosis of residual cell corpses might provide a rich and varied autoantigen (AAg) source in the lung. While it is known that the particle induces anti-nuclear and anti-dsDNA AAbs in NZBWF1 mice, the full extent of the cSiO 2-induced AAb response relative to specificity and isotype is not yet understood. The purpose of this study was to test the hypotheses that cSiO 2 exposure induces a wide spectrum of AAbs in the pulmonary and systemic compartments, and that dietary DHA intervention prevents these changes. Archived tissue fluid samples were obtained from a prior study in which NZBWF1 mice were fed purified isocaloric diets containing no DHA (control) or DHA corresponding calorically to human doses of 2 and 5 g/day. Mice were intranasally instilled with 1 mg cSiO 2 or saline vehicle weekly for 4 weeks, then groups euthanized 1, 5, 9, or 13 weeks post-instillation (PI) of the last cSiO 2 dose. Bronchoalveolar lavage fluid (BALF) and plasma from each time point were subjected to AAb profiling using a microarray containing 122 AAgs. cSiO 2 triggered robust IgG and IgM AAb responses against lupus-associated AAgs, including DNA, histones, ribonucleoprotein, Smith antigen, Ro/SSA, La/SSB, and complement as early as 1 week PI in BALF and 5 weeks PI in plasma, peaking at 9 and 13 weeks PI, respectively. Importantly, cSiO 2 also induced AAbs to AAgs associated with rheumatoid arthritis (collagen II, fibrinogen IV, fibrinogen S, fibronectin, and vimentin), Sj€ ogren's syndrome (a-fodrin), systemic sclerosis (topoisomerase I), vasculitis (MPO and PR3), myositis (Mi-2, TIF1-c, MDA5), autoimmune hepatitis (LC-1), and celiac disease (TTG). cSiO 2 elicited comparable but more modest IgA AAb responses in BALF and plasma. cSiO 2-induced AAb production was strongly associated with time dependent inflammatory/autoimmune gene expression, ELS development, and glomerulonephritis. AAb responses were dose-dependently suppressed by DHA supplementation and negatively correlated with the x-3 index, an erythrocyte biomarker of x-3 content in tissue phospholipids. Taken together, these findings suggest that cSiO 2 exposure elicits a diverse multi-isotype repertoire of AAbs, many of which have been reported in individuals with lupus and other autoimmune diseases. Furthermore, induction of this broad AAb spectrum could be impeded by increasing x-3 tissue content v...

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Section: Discussionmentioning

confidence: 99%

Omega-3 fatty acid intake suppresses induction of diverse autoantibody repertoire by crystalline silica in lupus-prone mice

Rajasinghe

Zhu

et al. 2020

Autoimmunity

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“…Also, other environmental/occupational exposures have been investigated, with silica exposure as an interesting example. Thus, silica exposure has been identified as a risk factor both for RA as a whole (before appropriate subdivisions into subsets was done) [76] and later found to be restricted mainly but not exclusively to the seropositive (RF and/or ACPA-positive) subsets [77][78][79]. Interestingly, a significant interaction between the two environmental exposures smoking and silica exposure was observed in providing risk for ACPApositive RA [77,81].…”

Section: Smoking and Other Airway Exposuresmentioning

confidence: 99%

“…An additional exposure with possible effects both in airways and elsewhere was observed in textile workers in Malaysia, where an increased risk was seen both for anti-CCP-positive and anti-CCP-negative patients [80]. More recently, we have obtained indications that also heavy occupational exposure to asbestos may provide an increased risk for RA [79]. Also, exposure to more general air pollution has been investigated, but provided variable results.…”

Section: Smoking and Other Airway Exposuresmentioning

confidence: 99%

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The importance of differences; On environment and its interactions with genes and immunity in the causation of rheumatoid arthritis

et al. 2020

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“…Airborne occupational exposures are prevalent in the construction and production industry, and employment in these industries have been observed to be associated with an increased risk of RA, even after adjustment for potential confounding from smoking 5. Exposure to the inorganic dusts such as asbestos and silica appears to be two airborne exposures contributing to this observation 6–8. Women are much less represented in occupations at risk of being exposed to inorganic dusts, yet 7 out of 10 patients with RA in Sweden are women 9.…”

Section: Introductionmentioning

confidence: 99%

Occupational exposure to organic dusts and risk of developing rheumatoid arthritis: findings from a Swedish population-based case–control study

et al. 2019

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ObjectivesWe estimated the association between occupational exposures to five different organic dusts: wood, animal, paper, textile and flour dust and the risk of developing rheumatoid arthritis (RA).MethodsThis population-based case–control study analysed 12 582 incident cases and 129 335 controls. Participants were identified from national public authority and quality registers. Census data on occupations were collected 1960–2010 and we estimated the exposure to organic dust with the help of job-exposure matrices. We used logistic regression to assess the OR of seropositive or seronegative RA. Estimates were adjusted for the matching variables (sex, county, age and index year), education and occupational silica exposure.ResultsExposure to animal dust was associated with an increased risk of RA among both men and women. The OR was 1.2 (95% CI=1.1 to 1.4) for seropositive RA and 1.3 (95% CI=1.1 to 1.5) for seronegative RA among ever exposed participants compared with unexposed. The risk increased with duration of exposure for seropositive RA, and participants who had been exposed in five or more censuses had an OR of 1.6 (95% CI=1.1 to 2.2, p for trend=0.003). Exposure to textile dust also generated a significant dose–response relationship for seropositive RA (p for trend=0.014). We detected no association between exposure to wood, paper or flour dust and risk of RA.ConclusionsOverall, exposure to animal dust and textile dust was associated with an increased risk of developing RA. These observations give further support to the notion that airborne exposures are involved in the aetiology of RA.

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Occupational exposure to asbestos and silica and risk of developing rheumatoid arthritis: findings from a Swedish population-based case-control study

Cited by 29 publications

References 28 publications

Omega-3 fatty acid intake suppresses induction of diverse autoantibody repertoire by crystalline silica in lupus-prone mice

Omega-3 fatty acid intake suppresses induction of diverse autoantibody repertoire by crystalline silica in lupus-prone mice

The importance of differences; On environment and its interactions with genes and immunity in the causation of rheumatoid arthritis

Occupational exposure to organic dusts and risk of developing rheumatoid arthritis: findings from a Swedish population-based case–control study

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