Influence of air pollution on airway inflammation and disease activity in childhood-systemic lupus erythematosus

Author(s):Show less -

Ferreira Alves, Andressa Guariento ^{[1, 2]} ; de Azevedo Giacomin, Maria Fernanda ^{[1, 2]} ; Ferreira Braga, Alfesio Luis ^{[3, 4, 5]} ; Elias Sallum, Adriana Maluf ^{[1, 2]} ; Amador Pereira, Luiz Alberto ^{[3, 4, 5]} ; Farhat, Luis Carlos ^[3] ; Strufaldi, Fernando Louzada ^[3] ; de Faria Coimbra Lichtenfels, Ana Julia ^{[4, 6]} ; Carvalho, Tomas de Santana ^[7] ; Nakagawa, Naomi Kondo ^{[4, 7]} ; Silva, Clovis Artur ^{[8, 1, 2]} ; Lima Farhat, Sylvia Costa ^{[2, 3, 4]}

Affiliation

^[1] Univ Sao Paulo, Fac Med, Hosp Clin HCFMUSP, Pediat Rheumatol Unit, Sao Paulo, SP - Brazil

^[2] Univ Sao Paulo, Fac Med, Dept Pediat, Hosp Clin HCFMUSP, Sao Paulo, SP - Brazil

^[3] Univ Sao Paulo, Fac Med, Lab Expt Air Pollut, Environm Epidemiol Study Grp, Sao Paulo - Brazil

^[4] Univ Sao Paulo, Fac Med, Lab Expt Air Pollut, LIM05, Sao Paulo - Brazil

^[5] Univ Catolica Santos, Collect Hlth Postgrad Program, Environm Exposure & Risk Assessment Grp, Santos - Brazil

^[6] Univ Sao Paulo, Fac Med, Lab Expt Therapeut, Sao Paulo - Brazil

^[7] Univ Sao Paulo, Fac Med, Dept Physiotherapy Commun Sci & Disorders, Occupat Therapy, LIM 34, Sao Paulo - Brazil

^[8] Univ Sao Paulo, Fac Med, Div Rheumatol, Sao Paulo - Brazil

• Document type: Journal article
• Source: CLINICAL RHEUMATOLOGY; v. 37, n. 3, p. 683-690, MAR 2018.
• Web of Science Citations: 6

Abstract

Exposure to fine particles may trigger pulmonary inflammation/systemic inflammation. The objective of this study was to investigate the association between daily individual exposure to air pollutants and airway inflammation and disease activity in childhood-onset systemic lupus erythematosus (cSLE) patients. A longitudinal panel study was carried out in 108 consecutive appointments with cSLE patients without respiratory diseases. Over four consecutive weeks, daily individual measures of nitrogen dioxide (NO2), fine particulate matter (PM2.5), ambient temperature, and humidity were obtained. This cycle was repeated every 2.5 months along 1 year, and cytokines of exhaled breath condensate-EBC {[}interleukins (IL) 6, 8, 17 and tumoral necrose factor-alpha (TNF-alpha)], fractional exhaled NO (FeNO), and disease activity parameters were collected weekly. Specific generalized estimation equation models were used to assess the impact of these pollutants on the risk of Systemic Lupus Erythematous Disease Activity Index 2000 (SLEDAI-2K) ae<yen> 8, EBC cytokines, and FeNO, considering the fixed effects for repetitive measurements. The models were adjusted for inflammatory indicators, body mass index, infections, medication, and weather variables. An IQR increase in PM2.5 4-day moving average (18.12 mu g/m(3)) was associated with an increase of 0.05 pg/ml (95% CI 0.01; 0.09, p = 0.03) and 0.04 pg/ml (95% CI 0.02; 0.06, p = 0.01) in IL-17 and TNF-alpha EBC levels, respectively. Additionally, a short-term effect on FeNO was observed: the PM2.5 3-day moving average was associated with a 0.75 ppb increase (95% CI 0.38; 1.29, p = 0.03) in FeNO. Also, an increase of 1.47 (95% CI 1.10; 1.84) in the risk of SLEDAI-2K ae<yen> 8 was associated with PM2.5 7-day moving average. Exposure to inhalable fine particles increases airway inflammation/pulmonary and then systemic inflammation in cSLE patients. (AU)

• FAPESP's process: 13/21508-2 - Influence of air pollution, measured individually, on disease activity in childhood-onset systemic lupus erythematosus patients through the evaluation of inflammatory biomarkers in exhaled condensed air
• Grantee: Sylvia Costa Lima Farhat
• Support Opportunities: Regular Research Grants