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The bm12 Inducible Model of Systemic Lupus Erythematosus SLE in C57BL/6 Mice
Published on: November 1, 2015
Are prematurity and environmental factors determinants for developing childhood-onset systemic lupus erythematosus?
Paola G Conde1, Luis C Farhat1, Alfésio L F Braga2,3
1a Pediatric Rheumatology Unit, Children's Institute , Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo , Sao Paulo , Brazil.
Insights
Environmental exposures like maternal occupational exposure, volatile vapor, and smoking during pregnancy and after birth are significant risk factors for childhood-onset systemic lupus erythematosus (cSLE). Prematurity also increases the risk of developing cSLE.
Area of Science:
- Environmental Health
- Pediatric Rheumatology
- Toxicology
Background:
- Childhood-onset systemic lupus erythematosus (cSLE) is a complex autoimmune disease with multifactorial etiology.
- Understanding environmental influences during critical developmental periods is crucial for identifying preventable risk factors.
Purpose of the Study:
- To investigate the association between exposure to air pollutants and environmental elements during pregnancy and postnatally with the development of cSLE.
- To identify specific environmental risk factors contributing to cSLE onset in children.
Main Methods:
- A case-control study involving 30 cSLE patients and 86 healthy controls from the Sao Paulo metropolitan area.
- Data collected via a structured questionnaire on demographic, gestational, perinatal factors, and environmental exposures (occupational, volatile vapor, tobacco smoke, proximity to industrial sites).
- Analysis included assessment of tropospheric pollutants (PM10, SO2, NO2, O3, CO) and multivariate statistical modeling.
Main Results:
- cSLE patients showed significantly higher frequencies of prematurity, maternal occupational exposure during pregnancy, exposure to volatile vapor, and fetal smoking compared to controls.
- Multivariate analysis confirmed maternal occupational exposure, fetal smoking, and prematurity as significant risk factors during gestation.
- Exposure to secondhand smoke during pregnancy and postnatally was also identified as a risk factor for cSLE development.
Conclusions:
- Prematurity and specific environmental exposures are significant risk factors for the development of childhood-onset systemic lupus erythematosus.
- Findings highlight the importance of reducing environmental exposures during pregnancy and early life to mitigate cSLE risk.
Objective:
The objective of this study is to evaluate the influence of exposure to air pollutants and inhalable environmental elements during pregnancy and after birth until childhood-onset systemic lupus erythematosus(cSLE) diagnosis.
Methods:
This case-control study comprised 30 cSLE patients and 86 healthy controls living in the Sao Paulo metropolitan area. A structured and reliable questionnaire (kappa index for test-retest was 0.78) assessed demographic data, gestational and perinatal-related-factors, and exposure to inhalable elements during pregnancy and after birth (occupational exposure to inhalable particles and/or volatile vapor, and/or tobacco, as well as, the presence of industrial activities or gas stations near the home/work/daycare/school). Tropospheric pollutants included: particulate matter (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), ozone (O3) and carbon monoxide (CO).
Results:
The median current age was similar between cSLE patients and healthy controls [16.0 (5-21) versus 15.0 (4-21) years, p = .32], likewise the frequency of female gender (87% versus 78%, p = .43). The frequencies of prematurity (30% versus 6%, p = .001), maternal occupational exposure during pregnancy (59% versus 12%, p < .001), exposure to volatile vapor (48% versus 8%, p < .001) and fetal smoking (maternal and/or secondhand) (37% versus 19%, p = .008) were significantly higher in cSLE patients compared with controls. In a multivariate analysis regarding the gestation period, maternal occupational exposure (OR 13.5, 95% CI 2.5-72.4, p = .002), fetal smoking (OR 8.6, 95%CI 1.6-47, p = .013) and prematurity (OR 15.8, 95%CI 1.9-135.3, p = .012) remained risk factors for cSLE development. Furthermore, exposure to secondhand smoking during pregnancy and after birth (OR 9.1, 95%CI 1.8-42.1, p = .002) was also a risk factor for cSLE development.
Conclusions:
Prematurity and environmental factors were risk factors for developing cSLE.
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