环境暴露于多环芳烃：系统性红斑狼疮发病和进展的一个被低估的风险因素。

Environmental exposure to polycyclic aromatic hydrocarbons: An underestimated risk factor for systemic lupus erythematosus onset and progression.

机构信息

Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, 210042, China; Key Laboratory of Basic and Translational Research on Immune-Mediated Skin Diseases, Chinese Academy of Medical Sciences, Nanjing, China; Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, China; Research Unit of Key Technologies of Immune-related Skin Diseases Diagnosis and Treatment, Chinese Academy of Medical Sciences Institute of Dermatology, Nanjing, China; Hunan Key Laboratory of Medical Epigenomics, Department of Dermatology, The Second Xiangya Hospital of Central South University, Changsha, China.

出版信息

Sci Total Environ. 2024 May 20;926:171841. doi: 10.1016/j.scitotenv.2024.171841. Epub 2024 Mar 20.

DOI:10.1016/j.scitotenv.2024.171841

PMID:38513863

Abstract

OBJECTIVE

To investigate the link between systemic lupus erythematosus (SLE) incidence and exposure to environmental polycyclic aromatic hydrocarbons (PAH).

METHODS

A case-control study (ChiCTR2000038187) involving 316 SLE patients and 851 healthy controls (HCs) was executed. Environmental exposure was assessed via a questionnaire, stratified by gender and age (females <35 and ≥35 years, males). Blood samples collected from 89 HCs, 85 inactive, and 95 active SLE patients were used to measure serum benzo[a]pyrene diol epoxide -albumin (BPDE-Alb) adducts and PAH concentrations, indicating long-term and short-term exposure respectively. Intergroup comparisons and statistical analyses were conducted using R version 4.3.1.

RESULTS

Diverse patterns were found in how environmental factors affect SLE onset across different demographics. Lifestyle exposure factors were found to be a stronger determinant of SLE onset than occupational exposure factors in women under 35. Indoor air pollution had a significant impact on SLE incidence, potentially comparable to outdoor air pollution. Lifestyle-related PAH exposure had a greater impact on SLE than occupational PAH exposure. PAH exposure levels progressively increase from HCs to inactive and active SLE patients. Active SLE patients show markedly higher BPDE-Alb levels than HCs.

CONCLUSIONS

Environmental PAH, particularly lifestyle-related, are significant, yet under-recognized, risk factors for SLE.

STATEMENT OF ENVIRONMENTAL IMPLICATION

We examined the relationship between exposure to environmental polycyclic aromatic hydrocarbons (PAH) and the incidence of systemic lupus erythematosus (SLE). PAH, prevalent in sources such as cigarette smoke, air pollution, and charred food, pose significant health hazards. This study is the first to investigate specific PAH exposure levels in SLE patients. We determined actual PAH exposure levels in both SLE patients and healthy individuals and indicated that long-term PAH exposure biomarker is more reliable for evaluating exposure in non-occupationally exposed groups like SLE, compared to short-term markers. These findings provide valuable insights for future research on similar non-occupationally exposed populations.

摘要

目的

探讨系统性红斑狼疮（SLE）发病与环境多环芳烃（PAH）暴露的关系。

方法

采用病例对照研究（ChiCTR2000038187），纳入 316 例 SLE 患者和 851 例健康对照（HC）。通过问卷评估环境暴露情况，按性别和年龄（女性<35 岁和≥35 岁、男性）分层。从 89 名 HC、85 名非活动期 SLE 患者和 95 名活动期 SLE 患者中采集血样，用于检测血清苯并[a]芘二醇环氧化物-白蛋白（BPDE-Alb）加合物和 PAH 浓度，分别反映长期和短期暴露情况。采用 R 版本 4.3.1 进行组间比较和统计分析。

结果

不同人群中环境因素对 SLE 发病的影响模式不同。在 35 岁以下女性中，生活方式暴露因素比职业暴露因素更能决定 SLE 的发病。室内空气污染对 SLE 发病的影响显著，可能与室外空气污染相当。与职业性 PAH 暴露相比，生活方式相关的 PAH 暴露对 SLE 的影响更大。PAH 暴露水平从 HC 逐渐升高到非活动期和活动期 SLE 患者。活动期 SLE 患者的 BPDE-Alb 水平明显高于 HC。

结论

环境 PAH，尤其是与生活方式相关的 PAH，是 SLE 的重要但被低估的危险因素。

环境意义声明

我们研究了环境多环芳烃（PAH）暴露与系统性红斑狼疮（SLE）发病之间的关系。PAH 广泛存在于香烟烟雾、空气污染和烧焦食物等来源中，对健康构成重大危害。本研究首次调查了 SLE 患者中特定 PAH 暴露水平。我们在 SLE 患者和健康个体中确定了实际的 PAH 暴露水平，并表明与短期标志物相比，长期 PAH 暴露生物标志物更可靠地评估 SLE 等非职业暴露人群的暴露情况。这些发现为未来对类似非职业暴露人群的研究提供了有价值的见解。