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Published in: Clinical Rheumatology 3/2018

01-03-2018 | Original Article

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

Authors: Andressa Guariento Ferreira Alves, Maria Fernanda de Azevedo Giacomin, Alfésio Luis Ferreira Braga, Adriana Maluf Elias Sallum, Luiz Alberto Amador Pereira, Luis Carlos Farhat, Fernando Louzada Strufaldi, Ana Julia de Faria Coimbra Lichtenfels, Tômas de Santana Carvalho, Naomi Kondo Nakagawa, Clovis Artur Silva, Sylvia Costa Lima Farhat

Published in: Clinical Rheumatology | Issue 3/2018

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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-α (TNF-α)], 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) ≥ 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 μg/m3) 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-α 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 ≥ 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.
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Metadata
Title
Influence of air pollution on airway inflammation and disease activity in childhood-systemic lupus erythematosus
Authors
Andressa Guariento Ferreira Alves
Maria Fernanda de Azevedo Giacomin
Alfésio Luis Ferreira Braga
Adriana Maluf Elias Sallum
Luiz Alberto Amador Pereira
Luis Carlos Farhat
Fernando Louzada Strufaldi
Ana Julia de Faria Coimbra Lichtenfels
Tômas de Santana Carvalho
Naomi Kondo Nakagawa
Clovis Artur Silva
Sylvia Costa Lima Farhat
Publication date
01-03-2018
Publisher
Springer London
Published in
Clinical Rheumatology / Issue 3/2018
Print ISSN: 0770-3198
Electronic ISSN: 1434-9949
DOI
https://doi.org/10.1007/s10067-017-3893-1

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