Influence of air pollution on renal activity in patients with childhood-onset systemic lupus erythematosus

Author(s)

Giacomin Goulart, Maria Fernanda ^{[1, 2]} ; Ferreira Alves, Andressa Guariento ^{[1, 2]} ; Farhat, Juliana ^[3] ; Ferreira Braga, Alfesio Luis ^{[4, 5, 3]} ; Amador Pereira, Luiz Alberto ^{[4, 5, 3]} ; de Faria Coimbra Lichtenfels, Ana Julia ^{[4, 6]} ; de Arruda Campos, Lucia Maria ^{[1, 2]} ; Almeida da Silva, Clovis Artur ^{[1, 2, 7]} ; Elias, Adriana Maluf ^{[1, 2]} ; Lima Farhat, Sylvia Costa ^{[4, 2, 3]}

Affiliation

^[1] Univ Sao Paulo, Fac Med, Childrens Inst, Pediat Rheumatol Unit, Sao Paulo - Brazil

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

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

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

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

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

^[7] Univ Sao Paulo, Fac Med, Rheumatol Dept, Sao Paulo - Brazil

• Document type: Journal article
• Source: Pediatric Nephrology; v. 35, n. 7 APR 2020.
• Web of Science Citations: 0

Abstract

Background Childhood-onset systemic lupus erythematosus (cSLE) is an autoimmune and multifactorial disease that can affect the renal system. Exposure to air pollution can trigger systemic inflammation in cSLE patients and increase risk of disease activity. We evaluated effects of individual real-time exposure to air pollutants on renal activity in cSLE patients using the Systemic Lupus Erythematosus Disease Activity Index 2000. Methods Longitudinal panel study of 108 repetitive measures from 9 pediatric lupus patients. Over three consecutive weeks, daily individual levels of fine particulate matter (PM2.5) and nitrogen dioxide (NO2) were measured, as well as weekly clinical evaluation and laboratory tests. This was repeated every 10 weeks over a 1-year period. Specific generalized estimating equation models were used to evaluate the impact of these pollutants on risk of nephritis and anti-dsDNA > 20 UI/mL and on 24-h urine protein and serum complement (C3) levels. Results An interquartile range (IQR) increase of 18.12 mu g/m(3) in PM2.5 daily concentration was associated with increased risk of nephritis and positive results for anti-dsDNA. Moreover, increase in 24-h urine protein and decrease in C3 serum levels also associated with exposure to pollutants. An IQR increase in PM(2.5)7-day moving average was associated with increased risks of leukocyturia (3.4; 95% CI 2.6:4.3), positive anti-dsDNA (3.1; 95% CI 2.1:4.0), and 36.3-mg increase (95% IC 20.2:52.3) in 24-h urine protein. An IQR increase (63.1 mu g/m(3)) in 7-day cumulative NO2 levels was associated with decreased serum C3 levels. Conclusions This prospective study suggests exposure to air pollution can trigger renal activity 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