Rheumatoid Disease and Pneumoconiosis (Caplan's Syndrome)

Abstract

IN 1952 at a meeting of the Thoracic Society of Great Britain, attention was first drawn to an association in coal miners in South Wales of rheumatoid arthritis and certain unusual radiological appearances in chest radiograms (Caplan 1953). Epidemiological studies of rheumatoid arthritis in a community of coal miners in South Wales were carried out by the Pneumoconiosis Research Unit to investigate this syndrome (Miall et al., 1953; Miall, 1955). The investigations confirmed the observation that a particular type of radiological appearance in the chest X-ray films of coal miners is closely associated with the presence of rheumatoid disease. Examples of the syndrome have now been observed in coal workers in other parts of Great Britain and in other European countries

Asbestos-Induced Cellular and Molecular Alteration of Immunocompetent Cells and Their Relationship with Chronic Inflammation and Carcinogenesis

“…Patients with silicosis often present with complications involving autoimmune diseases such as rheumatoid arthritis (known as Caplan's syndrome) [23–25], systemic sclerosis [26, 27], systemic lupus erythematosus [28, 29], and antineutrophil cytoplasmic antibody (ANCA)-related vasculitis/nephritis [30–32]. Although these have been considered adjuvant effects of silica, we have assumed that silica may influence circulating immunocompetent cells, particularly T lymphocytes, and have reported that silica can activate CD4 + 25 + FoxP3 (forkhead box P3) + regulatory T cells (Treg) and responder T cells (Tresp) [33–38].…”

Immunostimulation by Silica Particles and the Development of Autoimmune Dysregulation

“…Another typical substance is silica. Patients exposed to silica particles were shown to develop not only pulmonary fibrosis, known as silicosis [9,10], one of the typical forms of pneumoconiosis, but also various autoimmune diseases [11,12] such as RA (historically known as Caplan syndrome) [13,14], SSc [15][16][17], systemic lupus erythematous (SLE) [18,19], and anti-neutrophil cytoplasmic antibody (ANCA)-related vasculitis/ nephritis [20][21][22]. Many epidemiological reports have demonstrated that silica exposure is a risk factor of autoimmune diseases [11,12].…”

Environmental factors producing autoimmune dysregulation – Chronic activation of T cells caused by silica exposure

“…In addition, it is well known that silicosis patients often develop secondary (i.e., complications of) autoimmune diseases (Uber and McReynolds 1982;Steenland and Goldsmith 1995;Iannello et al 2002). Complicated rheumatoid arthritis is known as Caplan's syndrome (Caplan 1959;Caplan et al 1962). Moreover, SLE (Bartsch et al 1980;Yamazaki et al 2007), systemic sclerosis (SSc) (Sluis-Cremer et al 1985;Haustein et al 1990), and anti-neutrophil cytoplasmic autoantibody (ANCA)-related vasculitis/nephritis (Saeki et al 2004;Bartůnková et al 2006) have been reported as complications of silicosis.…”