Department of Rheumatology, Saint-Antoine Hospital, Paris, France.
Sorbonne Université, CRSA Inserm UMR S938, Paris, France.
RMD Open. 2022 Jun;8(2). doi: 10.1136/rmdopen-2021-001983.
Considering non-classical environmental risk factors for osteoarthritis (OA), a systematic literature review (SLR) was performed to summarise existing knowledge on associations between OA and pollutants.
PubMed was used to identify studies reporting data on OA and pollutants in humans (examples of MeSH terms: "Pesticides" or "Polychlorinated Biphenyls" or 'Lead'). Reports included epidemiological clinical studies, pollutant assessments in ex vivo OA joint, and in vitro effects of pollutants on chondrocytes.
Among the 193 potentially relevant articles, 14 were selected and combined with 9 articles obtained by manual search. Among these 23 articles there were: (1) 11 epidemiological studies on the relationship between OA and pollutants exposure, (2) 8 on pollutant concentrations in ex vivo OA joint, (3) 4 on the in vitro effects of pollutants on human chondrocytes. Epidemiological studies investigating mainly chlorinated and fluorinated pollutants suggested a possible link with OA. In cross-sectional studies, radiographic knee OA prevalence increased with higher serum lead levels. There was also a relationship between serum lead levels and serum/urine joint biomarkers. A high concentration of heavy metals in the cartilage tidemark was found in ex vivo joints. In vitro, the viability of chondrocytes was reduced in presence of some pollutants. However, the level of knowledge currently remains low, justifying the need for new methodologically sound studies.
This SLR supports the hypothesis of a possible involvement of pollutants in OA disease risk. Large-scale epidemiological and biological studies and ideally big-data analysis are needed to confirm that pollutants could be risk factors for OA.
考虑到骨关节炎 (OA) 的非经典环境风险因素，进行了系统文献综述 (SLR)，以总结 OA 与污染物之间关联的现有知识。
使用 PubMed 确定报告人类 OA 和污染物数据的研究（例如 MeSH 术语：“农药”或“多氯联苯”或“铅”）。报告包括流行病学临床研究、体外 OA 关节中的污染物评估以及污染物对软骨细胞的体外影响。
在 193 篇潜在相关文章中，选择了 14 篇，并结合手动搜索获得的 9 篇文章。在这 23 篇文章中，有：（1）11 项关于 OA 与污染物暴露关系的流行病学研究，（2）8 项关于体外 OA 关节中污染物浓度的研究，（3）4 项关于污染物对人软骨细胞的体外影响的研究。研究主要涉及氯化和氟化污染物的流行病学研究表明，它们与 OA 之间可能存在联系。在横断面研究中，血清铅水平较高与放射学膝关节 OA 患病率增加有关。血清铅水平与血清/尿液关节生物标志物之间也存在关系。在体外关节中发现软骨嵴痕处重金属浓度较高。在体外，一些污染物存在时软骨细胞的活力降低。然而，目前的知识水平仍然很低，需要新的方法合理的研究。
这项 SLR 支持了污染物可能参与 OA 疾病风险的假设。需要进行大规模的流行病学和生物学研究，理想情况下还需要进行大数据分析，以确认污染物可能是 OA 的危险因素。
