Powell J J, Van de Water J, Gershwin M E
Division of RHeumatology/Allergy and Clinical Immunology, University of Califronia at Davis School of Medicine, 95616, USA.
Environ Health Perspect. 1999 Oct;107 Suppl 5(Suppl 5):667-72. doi: 10.1289/ehp.99107s5667.
The concordance of autoimmune disease among identical twins is virtually always less than 50% and often in the 25-40% range. This observation, as well as epidemic clustering of some autoimmune diseases following xenobiotic exposure, reinforces the thesis that autoimmune disease is secondary to both genetic and environmental factors. Because nonliving agents do not have genomes, disease characteristics involving nonliving xenobiotics are primarily secondary to host phenotype and function. In addition, because of individual genetic susceptibilities based not only on major histocompatibility complex differences but also on differences in toxin metabolism, lifestyles, and exposure rates, individuals will react differently to the same chemicals. With these comments in mind it is important to note that there have been associations of a number of xenobiotics with human autoimmune disease, including mercury, iodine, vinyl chloride, canavanine, organic solvents, silica, l-tryptophan, particulates, ultraviolet radiation, and ozone. In addition, there is discussion in the literature that raises the possibility that xenobiotics may also exacerbate an existing autoimmune disease. In this article we discuss these issues and, in particular, the evidence for the role of environmental agents in the initiation or progression of autoimmune conditions. With the worldwide deterioration of the environment, this is a particularly important subject for human health.
同卵双胞胎自身免疫性疾病的一致性几乎总是低于50%，通常在25%-40%的范围内。这一观察结果，以及一些自身免疫性疾病在接触外源性物质后出现的流行聚集现象，强化了自身免疫性疾病继发于遗传和环境因素的观点。由于无生命物质没有基因组，涉及无生命外源性物质的疾病特征主要继发于宿主表型和功能。此外，由于个体遗传易感性不仅基于主要组织相容性复合体的差异，还基于毒素代谢、生活方式和接触率的差异，个体对相同化学物质的反应会有所不同。考虑到这些情况，需要注意的是，许多外源性物质已被证实与人类自身免疫性疾病有关，包括汞、碘、氯乙烯、刀豆氨酸、有机溶剂、二氧化硅、L-色氨酸、颗粒物、紫外线辐射和臭氧。此外，文献中也有讨论提出外源性物质可能会加重现有的自身免疫性疾病。在本文中，我们将讨论这些问题，特别是环境因素在自身免疫性疾病发生或发展中所起作用的证据。随着全球环境的恶化，这对人类健康来说是一个尤为重要的课题。
