Kim Youngmin, Koopman Jacob J E, Choi May, Feldman Candace H, Costenbader Karen H
Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
University of Calgary, Calgary, Alberta, Canada.
Arthritis Care Res (Hoboken). 2025 Jun;77(6):689-699. doi: 10.1002/acr.25497. Epub 2025 Jan 25.
Systemic lupus erythematosus (SLE) is a serious multisystem autoimmune disease, marked by alarming sociodemographic inequities. In the United States and around the world, social disadvantage is strongly tied to higher prevalence, more severe disease, and poorer outcomes. A growing list of environmental exposures that contribute to the risk and incidence of SLE have been investigated, and many are now established. However, these environmental exposures-including exposure to air pollution and other contaminants, lifestyle and behavioral factors, and psychologic stress and distress-are not evenly distributed in any population. Individuals of lower socioeconomic status and historically minoritized groups suffer from an imbalanced burden of adverse environmental exposures. In research, clinical practice, and policy making, the strong association of social determinants of health (SDoH) with these exposures has not been given adequate spotlight. In this narrative review, we examine known associations between environmental exposures and SLE risk through the lens of SDoH, laying the foundation for future research and policies to target the environmental risk factors for SLE with awareness of the populations disproportionately affected and the contributing SDoH.
系统性红斑狼疮（SLE）是一种严重的多系统自身免疫性疾病，存在令人担忧的社会人口统计学不平等现象。在美国及世界各地，社会劣势与更高的患病率、更严重的疾病以及更差的预后密切相关。越来越多的导致SLE风险和发病率的环境暴露因素已被研究，其中许多现已明确。然而，这些环境暴露因素，包括接触空气污染和其他污染物、生活方式和行为因素以及心理压力和困扰，在任何人群中分布都不均衡。社会经济地位较低的个体以及历史上受边缘化的群体承受着不均衡的不良环境暴露负担。在研究、临床实践和政策制定中，健康的社会决定因素（SDoH）与这些暴露因素之间的紧密关联尚未得到充分关注。在这篇叙述性综述中，我们通过SDoH的视角审视环境暴露与SLE风险之间的已知关联，为未来的研究和政策奠定基础，以便在认识到受影响尤为严重的人群以及相关SDoH的情况下，针对SLE的环境风险因素采取措施。
