Conrad K, Mehlhorn J, Lüthke K, Dörner T, Frank K H
Institute of Immunology, Medical Faculty, Technical University Dresden, FRG.
Lupus. 1996 Feb;5(1):62-9. doi: 10.1177/096120339600500112.
Epidemiological, clinical and serological data of uranium miners with symptoms of connective tissue diseases (CTD) were collected during the control examinations for occupational lung diseases since 1975. Twenty eight definite (four or more ARA criteria) and 15 probable (2-3 ARA criteria) SLE were diagnosed. The estimated prevalence among heavily silica exposed uranium miners was up to 93 in 100,000. The only significant differences to nonexposed SLE patients were decreased frequency of arthritis and photosensitivity and the absence of anti-Sm and anti-U1-RNP antibodies. ANA were found in all definite SLE patients examined with the following specificities: anti-dsDNA (in 44.4%), & anti-Ro/SSA (in 55.6%, four cases together with anti-dsDNA) and anti-La/SSB (in 22.2%). The autoantibody profiles of patients with probable SLE were similar, but with a lower frequency of ANA, anti-dsDNA and anti-Ro/SSA. Middle to high-titred autoantibodies to dsDNA, Ro/SSA and La/SSB were detected in 3.2% uranium miners with no (N = 1229) and in 20.6% with some symptoms (one ARA criterion and/or two or more of other CTD typical symptoms, N = 68) of CTD development. We conclude, that the strong exposure to dust with a high content of silica may predispose to or initiate the development of SLE. The detection of SLE-typical antibodies in quartz dust-exposed miners may indicate a higher risk for the development of systemic autoimmune disease.
自1975年以来，在职业性肺病对照检查期间收集了患有结缔组织病（CTD）症状的铀矿工人的流行病学、临床和血清学数据。确诊了28例（符合4条或更多条美国风湿病学会（ARA）标准）和15例可能（符合2 - 3条ARA标准）的系统性红斑狼疮（SLE）病例。在重度接触二氧化硅的铀矿工人中，估计患病率高达十万分之九十三。与未接触者的SLE患者相比，唯一显著的差异是关节炎和光敏反应的发生率降低，以及缺乏抗Sm和抗U1 - RNP抗体。在所有接受检查的确诊SLE患者中均检测到抗核抗体（ANA），其特异性如下：抗双链DNA（dsDNA）（44.4%）、抗Ro/SSA（55.6%，4例同时伴有抗dsDNA）和抗La/SSB（22.2%）。可能患有SLE的患者自身抗体谱相似，但ANA、抗dsDNA和抗Ro/SSA的发生率较低。在未出现CTD症状（N = 1229）的铀矿工人中，3.2%检测到针对dsDNA、Ro/SSA和La/SSB的中高滴度自身抗体；在出现某些CTD症状（符合1条ARA标准和/或2条或更多条其他CTD典型症状，N = 68）的铀矿工人中，20.6%检测到此类抗体。我们得出结论，重度接触高含量二氧化硅粉尘可能易患或引发SLE的发生。在接触石英粉尘的矿工中检测到SLE典型抗体可能表明其发生系统性自身免疫性疾病的风险更高。
