Environmental risk factors in systemic sclerosis

  title={Environmental risk factors in systemic sclerosis},
  author={Paula Dospinescu and Gareth T. Jones and Neil Basu},
  journal={Current Opinion in Rheumatology},
Purpose of reviewEnvironmental risk factors have been implicated in the pathogenesis of systemic sclerosis (SSc). Recent evidence further supports this relationship and constitutes the focus of this review article. Recent findingsExposure to silica through various occupations remains one of the main environmental risk factors for SSc. Emerging evidence has also implicated organic solvents in the development of this difficult-to-manage condition. The individual role of these toxins is, however… 

An overview of environmental risk factors in systemic sclerosis

The following review analyzes the most recent literature to examine the relationship between environmental exposures and SSc and concludes that the disease is probably caused by both endogenous and exogenous factors.

Occupational and environmental scleroderma. Systematic review and meta-analysis

A meta-analysis of all studies published on SSc associated with occupational and environmental exposure from 1960 to 2014 found silica and solvents were the two most likely substances related to the pathogenesis of SSc.

Is exposure to environmental factors associated with a characteristic clinical and laboratory profile in systemic sclerosis? A retrospective analysis

It is shown that SSc patients with previous exposure to EF may have some specific clinical characteristics, mainly a higher frequency of myopathy, also showing more severe ILD, preferably in male and African–Brazilian patients, associated with a lower frequency of ANA positivity.

Systemic sclerosis and silica exposure: a rare association in a large Brazilian cohort

To conclude, ES was rare in this large SSc cohort, although associated with a bad prognosis, and Multivariate analysis did not confirm that silicosis is an independent risk factor for SSc.

Pathophysiology and recent findings of primary biliary cirrhosis complicated by systemic sclerosis

Because PBC is often complicated by rheumatic disease, hepatologists should keep the possibility of systemic disorder in mind when examining PBC patients, and particular attention should be paid to the management of gastroesophageal varices.

The spectrum of orofacial manifestations in systemic sclerosis: a challenging management.

The identification of specific radiological and clinical signs at the early stage will improve the management of systemic sclerosis patients and suggest clues for the oral management that remains challenging.

Proinflammatory Effects of Diesel Exhaust Nanoparticles on Scleroderma Skin Cells

It is suggested that environmental DEP could trigger the development of SSc acting on genetically hyperreactive cell systems, in which the pathogenetic role of environment has been highlighted.

Association of Silicone Breast Implants, Breast Cancer and Anti-RNA Polymerase III Autoantibodies in Systemic Sclerosis: Case-Based Review

A case is described that can support previous observations, strengthening this association with previous silicone implants and/or breast cancer, and Clinicians should be aware of this new clinical entity, given the widespread use of silicone implants.

Nonendocrine mechanisms of sex bias in rheumatic diseases

  • N. Lambert
  • Medicine, Biology
    Nature Reviews Rheumatology
  • 2019
This Review outlines several genetic and epigenetic mechanisms that could explain sex bias in rheumatic diseases, including X chromosome inactivation, sex chromosome aneuploidy and microchimerism, considering evidence from clinical and experimental studies.



Relationship between occupational risk factors and severity markers of systemic sclerosis.

The results indicate that occupational toxic factors have an influence on the severity of SSc, mainly patients exposed during their occupational life to toxic agents.

Systemic sclerosis and occupational risk factors: role of solvents and cleaning products.

Analysis of occupational and non-occupational exposure factors suspected of being associated with scleroderma identified exposure to either cleaning products or solvents emerged as a risk factor for SSc.

Occupational silica exposure as a risk factor for scleroderma: a meta-analysis

The findings suggest that silica exposure may be a significant risk factor for developing SSc and specifically in males.

Occupational exposure to crystalline silica and autoimmune disease.

Experimental studies demonstrate that silica can act as an adjuvant to nonspecifically enhance the immune response, one mechanism by which silica might be involved in the development of autoimmune diseases.

What is the contribution of occupational environmental factors to the occurrence of scleroderma in men?

An occupational analysis of 56 men with scleroderma in the United Kingdom showed no evidence that silica exposure was implicated in the onset of the disease, in contrast with older published reports

Is occupational organic solvent exposure a risk factor for scleroderma?

Evidence is provided that occupational solvent exposure may be associated with an increased risk of systemic sclerosis, and men with SSc were more likely than controls to have a high cumulative intensity score and a high maximum intensity score for any solvent exposure.

Occupational exposure to solvents and gender-related risk of systemic sclerosis: a metaanalysis of case-control studies.

Whereas SSc affects women predominantly, among subjects with occupational exposure to solvents, men are at higher risk than women for the disease.

Male systemic sclerosis and occupational silica exposure-a population-based study.

Silica is a disease determinant in male systemic sclerosis, with disease features including a long latency and clinical characteristics indistinguishable from idiopathic disease and cross-sectional 'current' occupational data underestimate cumulative occupational silica exposure.

Scleroderma and occupational exposure to hand-transmitted vibration

Owing to the rarity of the disease and the small number of cases in the present studies, a genetic susceptibility to connective tissue disorders in SSc patients with occupational exposure to hand-transmitted vibration and/or silica cannot be ruled out.

Occupational exposures and autoimmune diseases.