Fw: Subject Reference: [Fwd: Occupational exposures and autoimmune diseases]

[Guest guest]

Occupational exposures and autoimmune diseases [in Process Citation]Int Immunopharmacol 2002 Feb;2(2-3):303-13 (ISSN: 1567-5769) GS; FW; Germolec DR Epidemiology Branch, National Institute of Environmental HealthSciences, Research Triangle Park, NC 27709,USA.Autoimmune diseases are pathologic conditions defined by abnormalautoimmune responses and characterized byimmune system reactivity in the form of autoantibodies and T cellresponses to self-structures. Here we reviewthe limited but growing epidemiologic and experimental literaturepertaining to the association betweenautoimmune diseases and occupational exposure to silica, solvents,pesticides, and ultraviolet radiation. Thestrongest associations (i.e., relative risks of 3.0 and higher) havebeen documented in investigations of silica dust andrheumatoid arthritis, lupus, scleroderma and glomerulonephritis. Weakerassociations are seen, however, for solventexposures (in scleroderma, undifferentiated connective tissue disease,and multiple sclerosis) and for farming orpesticide exposures (in rheumatoid arthritis). Experimental studiessuggest two different effects of these exposures:an enhanced proinflammatory (TH1) response (e.g., TNF-alpha and IL-1cytokine production with T cellactivation), and increased apoptosis of lymphocytes leading to exposureto or modification of endogenous proteinsand subsequent autoantibody formation. The former is a general mechanismthat may be relevant across a spectrumof autoimmune diseases, whereas the latter may be a mechanism morespecific to particular diseases (e.g.,ultraviolet radiation, Ro autoantibodies, and lupus). Occupationalexposures are important risk factors for someautoimmune diseases, but improved exposure assessment methods and bettercoordination betweenexperimental/animal models and epidemiologic studies are needed todefine these risks more precisely.