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空气污染与类风湿关节炎风险和进展:对黏膜起源假说和气候变化对类风湿关节炎发病机制影响的启示。

Air Pollution and Rheumatoid Arthritis Risk and Progression: Implications for the Mucosal Origins Hypothesis and Climate Change for RA Pathogenesis.

机构信息

Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, 60 Fenwood Road, #6016U, Boston, MA, 02115, USA.

Harvard Medical School, Boston, MA, USA.

出版信息

Curr Rheumatol Rep. 2024 Oct;26(10):343-353. doi: 10.1007/s11926-024-01160-x. Epub 2024 Aug 2.

Abstract

PURPOSE OF REVIEW

The goal of this review paper is to summarize the main research and findings regarding air pollution and its association with the risk and progression of rheumatoid arthritis (RA).

RECENT FINDINGS

The most studied components of air pollution included particulate matter of ≤ 2.5 microns in diameter (PM), PM, carbon monoxide (CO), nitrogen dioxide (NO), nitric oxide (NOx), sulfur dioxide (SO), and ozone (O). In addition, specific occupations and occupational inhalants have been investigated for RA risk. Several studies showed that increased exposure to air pollutants increased the risk of developing RA, particularly seropositive RA. There was evidence of gene-inhalant interactions for seropositive RA risk. Fewer studies have been conducted on RA disease activity and bone erosions. Some studies suggest that patients with RA-associated interstitial lung disease may have worse outcomes if exposed to air pollution. We summarized associations between air pollution and increased RA risk, including RA-associated interstitial lung disease. Relatively few studies investigated air pollution and RA disease activity or other outcomes. These results suggest an important role of air pollution for seropositive RA development and suggest that climate change could be a driver in increasing RA incidence as air pollution increases.

摘要

目的综述:本文旨在总结有关空气污染及其与类风湿关节炎(RA)风险和进展关系的主要研究和发现。

最新发现:研究最多的空气污染成分包括直径≤2.5 微米的颗粒物(PM)、细颗粒物(PM)、一氧化碳(CO)、二氧化氮(NO)、氮氧化物(NOx)、二氧化硫(SO)和臭氧(O)。此外,还研究了特定职业和职业性吸入物与 RA 风险的关系。一些研究表明,暴露于空气污染物增加会增加 RA 的发病风险,尤其是血清阳性 RA。有证据表明血清阳性 RA 风险与基因-吸入物相互作用。关于 RA 疾病活动和骨侵蚀的研究较少。一些研究表明,如果患有 RA 相关间质性肺病的患者暴露于空气污染中,其预后可能更差。我们总结了空气污染与 RA 风险增加之间的关联,包括与 RA 相关的间质性肺病。相对较少的研究调查了空气污染与 RA 疾病活动或其他结果之间的关系。这些结果表明空气污染对血清阳性 RA 的发生有重要作用,并表明随着空气污染的增加,气候变化可能是 RA 发病率增加的一个驱动因素。

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