Division of Clinical Epidemiology, McGill University Health Centre, Montreal, Quebec, Canada.
Environ Health Perspect. 2011 Jan;119(1):45-9. doi: 10.1289/ehp.1002123. Epub 2010 Sep 22.
Systemic lupus erythematosus (SLE) is a chronic disease of unclear etiology, characterized by an overactive immune system and the production of antibodies that may target normal tissues of many organ systems, including the kidneys. It can arise at any age and occurs mainly in women.
Our aim was to evaluate the potential influence of particulate matter (PM) air pollution on clinical aspects of SLE.
We studied a clinic cohort of SLE patients living on the island of Montreal, followed annually with a structured clinical assessment. We assessed the association between ambient levels of fine PM [median aerodynamic diameter ≤ 2.5 μm (PM2.5)] measured at fixed-site monitoring stations and SLE disease activity measured with the SLE Disease Activity Index, version 2000 (SLEDAI-2K), which includes anti-double-stranded DNA (anti-dsDNA) serum-specific autoantibodies and renal tubule cellular casts in urine, which reflects serious renal inflammation. We used mixed effects regression models that we adjusted for daily ambient temperatures and ozone levels.
We assessed 237 patients (223 women) who together had 1,083 clinic visits from 2000 through 2007 (mean age at time of first visit, 41.2 years). PM2.5 levels were associated with anti-dsDNA and cellular casts. The crude and adjusted odds ratios (reflecting a 10-μg/m3 increase in PM2.5 averaged over the 48 hr prior to clinical assessment) were 1.26 [95% confidence interval (CI), 0.96-1.65] and 1.34 (95% CI, 1.02-1.77) for anti-dsDNA antibodies and 1.43 (95% CI, 1.05-1.95) and 1.28 (0.92-1.80) for cellular casts. The total SLEDAI-2K scores were not associated with PM2.5 levels.
We provide novel data that suggest that short-term variations in air pollution may influence disease activity in established autoimmune rheumatic disease in humans. Our results add weight to concerns that pollution may be an important trigger of inflammation and autoimmunity.
系统性红斑狼疮（SLE）是一种病因不明的慢性疾病，其特征是免疫系统过度活跃，产生的抗体可能针对包括肾脏在内的许多器官系统的正常组织。它可以在任何年龄发生，主要发生在女性。
我们旨在评估空气中的颗粒物（PM）污染对 SLE 临床方面的潜在影响。
我们研究了居住在蒙特利尔岛的 SLE 患者的临床队列，每年进行一次结构化的临床评估。我们评估了固定监测站测量的细颗粒物（中位空气动力学直径≤2.5μm（PM2.5））水平与使用 2000 版系统性红斑狼疮疾病活动指数（SLEDAI-2K）测量的 SLE 疾病活动之间的关联，该指数包括抗双链 DNA（抗 dsDNA）血清特异性自身抗体和尿液中的肾小管细胞管型，反映严重的肾脏炎症。我们使用混合效应回归模型进行调整，模型中调整了每日环境温度和臭氧水平。
我们评估了 237 名患者（223 名女性），他们在 2000 年至 2007 年间共进行了 1083 次就诊（首次就诊时的平均年龄为 41.2 岁）。PM2.5 水平与抗 dsDNA 和细胞管型有关。未调整和调整后的比值比（反映临床评估前 48 小时内 PM2.5 平均增加 10μg/m3）分别为 1.26（95%置信区间（CI），0.96-1.65）和 1.34（95%CI，1.02-1.77）与抗 dsDNA 抗体和 1.43（95%CI，1.05-1.95）和 1.28（0.92-1.80）与细胞管型。SLEDAI-2K 总分与 PM2.5 水平无关。
我们提供了新的数据，表明短期空气污染变化可能会影响人类已确立的自身免疫性风湿病的疾病活动。我们的结果增加了人们对污染可能是炎症和自身免疫的重要触发因素的担忧。
