Risk factors for the development of systemic sclerosis: a systematic review of the literature

Abstract

Objectives Although numerous studies have investigated the roles of various genetic, epigenetic and environmental factors that may impact its aetiology, SSc is still regarded as an idiopathic disease. Given that there is significant heterogeneity in what has been proposed to influence the development of SSc, this systematic review was conducted to assess the impacts of different factors on the aetiology of scleroderma. Methods The search was performed in the PubMed, CINAHL and SCOPUS databases on 17 May 2017. Any study that made explicit reference to scleroderma or SSc that had information about the risk factors or epidemiology of the disease was included. The extracted outcome variables were prevalence, gender preponderance, geographical distribution, family history and various proposed environmental risk factors. Results One thousand five hundred and seventy-four articles were screened for eligibility. Thirty-four articles were eligible for the systematic literature review. Conclusion Age between 45 and 64 years, female sex, positive family history and exposure to silica were found to be risk factors. There were conflicting findings regarding the impact of exposure to organic solvents and microchimerism. No relationship between infectious agents, alcohol consumption or cigarette smoking and the development of SSc was identified.

Stem Cell Therapies in Systemic Sclerosis: An Updated Review

“…The etiology of SSc is multifactorial. The various factors that are involved in the etiology and associations of SSc are shown in Table 1 [7][8][9][10][11][12][13][14][15][16]. However, there are familial aggregates of SSc [13].…”

“…In a systematic review and a meta-analysis that included 34 published studies, the following results were obtained [8]: 1. The confirmed risk factors included: female gender, age between 45 and 64 years, positive family history, and exposure to silica 2.…”

Juvenile systemic sclerosis – observations of one clinical centre

“…CREST syndrome -the name comes from the first letter of the main symptoms of the disease: Calcinosis, Raynaud's Phenomenon, Esophageal dysfunction, Sclerodactyly, Telangiectasia. 8 years of age may point to hormonal predisposition, and low birthweight is considered as an independent risk factor of SSc [4,5].…”

“…Some studies show that the disease is more common in subjects with a certain genetic predisposition, such as the presence of the HLA-DRB1 *10 antigen [ 3 ], or after exposure to specific environmental factors (various viruses, toxins, drugs). The more frequent occurrence in girls after 8 years of age may point to hormonal predisposition, and low birthweight is considered as an independent risk factor of SSc [ 4 , 5 ].…”

Etiological factors of systemic sclerosis in the southeast region of Romania

“…In a 2018 review, Abbot et al concluded that exposure to silicates alone is an important risk factor. Various authors express divergent views concerning exposure to organic solvents ( 15 ). 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.…”