Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
University of Michigan, Ann Arbor.
Arthritis Rheumatol. 2024 Oct;76(10):1459-1466. doi: 10.1002/art.42919. Epub 2024 Jun 4.
Increases in global temperatures and extreme weather events associated with climate change have complex yet poorly understood detrimental impacts on human health. We reviewed the current published literature on climate change-related effects and rheumatic conditions.
To summarize our current understanding of the likely effects of climate change, including increased air pollution, on rheumatic disease, we searched the published, peer-reviewed English-language literature from January 2000 to December 2022. Articles were reviewed by a team of rheumatologists and clinical and translational science researchers. Systematic review articles were not included but informed additional literature searches.
After extensive examination and adjudication, 88 articles met inclusion criteria and were selected for review. Much of the epidemiologic investigations assessed associations between air pollution and increased risk of development of rheumatoid arthritis, anti-citrullinated protein antibodies, flares of gout, and hospitalizations for systemic lupus erythematosus. Increased heat vulnerability was associated with higher odds of recurrent hospitalizations across rheumatic conditions. Mechanisms for observed associations are poorly understood but could include the effects of epigenetic changes, oxidative stress, and inflammatory cytokines. Studies had limitations, including restricted geography and populations studied without focus on historically marginalized communities at highest risk for adverse effects from pollution and climate change, the relative lack of mechanistic evaluations, and most with only indirect links to climate change.
To date, the published literature lacks studies that directly examine effects of climate change on rheumatic diseases. Collaborative translational and epidemiologic research is needed to enhance our understanding and awareness in this area.
与气候变化相关的全球气温升高和极端天气事件对人类健康造成了复杂且尚未被充分理解的有害影响。我们回顾了与气候变化相关影响和风湿性疾病相关的现有文献。
为了总结我们对气候变化相关影响（包括空气污染增加）对风湿性疾病可能产生的影响的现有理解，我们检索了 2000 年 1 月至 2022 年 12 月发表的、同行评审的英文文献。由一组风湿病学家和临床与转化科学研究人员对文章进行了审查。未包括系统评价文章，但为进一步的文献检索提供了信息。
经过广泛的检查和裁决，有 88 篇文章符合纳入标准并被选入进行审查。许多流行病学研究评估了空气污染与类风湿关节炎、抗瓜氨酸化蛋白抗体、痛风发作和系统性红斑狼疮住院风险增加之间的关联。高温脆弱性与风湿性疾病反复发作住院的可能性更高有关。观察到的关联的机制尚不清楚，但可能包括表观遗传变化、氧化应激和炎症细胞因子的影响。这些研究存在局限性，包括研究区域和人群受限，没有关注历史上处于最不利地位的社区，这些社区面临着污染和气候变化不利影响的高风险，缺乏对机制的评估，而且大多数研究与气候变化只有间接联系。
迄今为止，发表的文献缺乏直接研究气候变化对风湿性疾病影响的研究。需要开展合作性转化和流行病学研究，以增进我们在这一领域的理解和认识。
