Air Pollution Strongly Linked to Disease Activity in Study of Young Lupus Patients in Brazil

Air pollution was strongly linked to disease activity in children and adolescents with systemic lupus erythematosus (SLE) in the study, “Air pollution exposure may worsen lupus in children,” presented at the recent European League Against Rheumatism Annual Congress (EULAR 2016) in London.

SLE, also known as lupus, is an inflammatory condition induced by immune attacks against healthy body cells. Although its causes are not fully understood, unknown environmental triggers combined with genetic susceptibility and altered immune system are thought to play key roles in disease development. Some studies have also suggested that outdoor pollution raised hospital admissions among children with rheumatic diseases and the risk the of disease activity in patients with childhood-onset SLE.

Researchers investigated the influence of air pollution in Brazilian children and adolescents with lupus. As in many countries around the world, air pollution in Brazil is a major health problem and one associated with numerous diseases, including respiratory and cardiovascular ills, and cancer.

They found that increased daily concentration of dangerous, fine airborne pollution particles called PM2.5  significantly increased lupus activity at four and 11 days after exposure. Laboratory renal and blood analyses further confirmed the triggering of lupus activity in the patients. (PM2.5 refers to inhalable “particle matter” that is 2.5 micrometers in diameter or finer; in comparison, a strand of human hair is, on average, 30 times larger — 70 micrometers in diameter.)

The exposure to fine air pollutants also induced airway inflammation in these patients, confirmed by two biomarkers: significant acidification of exhaled breath condensate recorded at days seven and 10, and incremented fractional concentration of exhaled nitric oxide. However, young lupus patients presented no evidence of increased acute respiratory symptoms.

“Our findings have shown that air pollution doesn’t just increase the incidence and prevalence of chronic lung disease and acute respiratory infections … it is also an important contributory factor in childhood rheumatic diseases, such as lupus,” Dr. Maria Fernanda Goulart, with the Department of Paediatric Rheumatology, University of São Paulo, said in a press release. “With air pollution increasing in many major cities, paediatric rheumatologists can expect to see a resultant impact on the disease activity of their lupus patients.”