Environmental exposures and the development of systemic lupus erythematosus.
Environmental exposures and the development of systemic lupus erythematosus.
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DOI：
10.1097/bor.0000000000000318
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发表时间：
2016-09
影响因子：
5.1
通讯作者：
Costenbader KH
中科院分区：
文献类型：
--
作者：
Barbhaiya M;Costenbader KH
本综述探讨了环境因素与系统性红斑狼疮 (SLE) 发生相关的证据。最有力的流行病学证据表明二氧化硅、吸烟、口服避孕药、绝经后激素治疗和子宫内膜异位症与 SLE 发病率之间存在关联。最近的研究还提供了强有力的证据，证明饮酒与降低系统性红斑狼疮风险之间存在关联。有初步的、相互矛盾的或未经证实的数据表明，其他因素，包括空气污染、紫外线、感染、疫苗接种、溶剂、杀虫剂和汞等重金属，与系统性红斑狼疮风险有关。环境暴露与系统性红斑狼疮风险相关的生物学机制包括氧化应激增加、全身炎症和炎症细胞因子上调、激素触发因素，以及可能导致系统性红斑狼疮的暴露所导致的表观遗传修饰。识别与系统性红斑狼疮风险相关的环境风险因素至关重要，因为这将有助于加深对这种复杂疾病发病机制的了解，并且还可以为高危人群调整风险因素。
This review examines evidence relating environmental factors to the development of systemic lupus erythematosus (SLE). The strongest epidemiologic evidence exists for the associations of silica, cigarette smoking, oral contraceptives, postmenopausal hormone therapy, and endometriosis, with SLE incidence. Recent studies have also provided robust evidence of the association between alcohol consumption and decreased SLE risk. There are preliminary, conflicting or unsubstantiated data that other factors, including air pollution, ultraviolet light, infections, vaccinations, solvents, pesticides, and heavy metals such as mercury, are related to SLE risk. Biologic mechanisms linking environmental exposures and SLE risk include increased oxidative stress, systemic inflammation and inflammatory cytokine upregulation, and hormonal triggers, as well as epigenetic modifications resulting from exposure that could lead to SLE. Identifying the environmental risk factors related to risk of SLE is essential as it will lead to increased understanding of pathogenesis of this complex disease and will also make risk factor modification possible for those at increased risk.