Potential occupational and environmental factors in SSc onset

Abstract

Introduction and objective. Systemic sclerosis [SSc; scleroderma] is a rare, connective tissue disorder affecting all organs and systems. The primary feature of this disease is a chronic, progressive fibrosis due to excessive production of collagen and other components. There are two subsets of systemic sclerosis: 1) diffused SSc (dSSc), 2) limited SSc (lSSc) and 3) scleroderma without sclerosis (SSSC). The presented review is an attempt to summarize recent data regarding environmental and occupational factors in SSc onset. State of knowledge. There are many factors to be taken under consideration with SSc onset, although a strong correlation has been established for only a few. The most distinct factors are: crystalline silica and organic solvents (such as white spirit, aromatic, aliphatic-chain, chlorinated solvents, ketones, welding fumes). For other factors, which include abstestos, air pollution, other chemicals, silicone breast implants, tobacco smoking, drug reactions, diet influence and exposure to heavy metals, the jury is still out, and their position in SSc onset needs further studies. Conclusions. Although the pathogenesis of scleroderma remains unclear, there is a marked correlation between the onset of SSc and certain environmental or occupational factors.

Pathogenic Roles of Autoantibodies and Aberrant Epigenetic Regulation of Immune and Connective Tissue Cells in the Tissue Fibrosis of Patients with Systemic Sclerosis

“…Until recently, a growing body of evidence has suggested that environmental factors play an initiating role in the alterations/modulations of epigenetic determinants for the onset and progression of genetically predisposed SSc. These environmental risk factors include silica, inorganic compounds, organic solvents, drugs, white spirits, vaccination [55][56][57][58][59][60], rapeseed oil [61], and heavy metals [62]. These environmental risks interact with genetic or epigenetic factors to breakdown the immune tolerance to self-antigens.…”

Etiological factors of systemic sclerosis in the southeast region of Romania

“…The ratio of smokers in the diffuse SSc subtype was slightly higher than that found in those suffering from limited SSc. Our observations suggest that tobacco smoking may be involved in the onset of the disease, especially in diffuse forms of SSc, although the findings are divergent (16,23).…”

“…In another review, Walecka et al highlighted the role of silicates in the etiology of SSc, but also of multiple organic solvents such as ketones, aromatic and aliphatic hydrocarbons, white spirit solvent for oil-based paints, smoke from welding; underlining the need for protective measures for workers with such occupational exposure. The authors pointed out the lack of clear evidence concerning air pollution involvement in the onset of SSc; the same issue concerns asbestos exposure, heavy metals and silicone implant (16). Occupational exposure raises the issue of introducing SSc to the occupational diseases category.…”

“…This study opens the opportunity for further research in clarifying the toxic profile of these compounds (22). After in-depth analysis of smoking involvement in the onset of SSc, Walecka et al concluded that its role is not clearly supported (16). Although there is no solid evidence that smoking could induce SSc, Hissaria et al revealed that smoking has an adverse effect on disease progression and decreases the survival rate in former and current smoking patients (23).…”

Características de los pacientes con esclerosis sistémica y cáncer

“…De los factores medioambientales identificados, los más reconocidos son la exposición a la sílice y a algunos disolventes orgánicos (la trementina o aguarrás, disolventes aromáticos, disolventes clorados, tricloroetileno y cetonas). La exposición a estos compuestos además provoca formas más graves de la enfermedad (10,11). Los agentes infecciosos, también ha sido objeto de estudio, fundamentalmente los virus.…”