Recent research highlights a concerning relationship between air pollution and Systemic Lupus Erythematosus (SLE), a chronic autoimmune disease whose exact causes remain elusive. SLE disproportionately affects women, with around 90% of cases occurring in biological females. The disease's prevalence is rising, contributing to the estimated 50 million Americans living with autoimmune diseases. One staggering statistic shows that nearly 40% of Americans inhabit areas with unhealthy air pollution levels, which may significantly increase their risk of developing SLE.
Air pollution has emerged as a potential trigger for SLE, especially for those genetically predisposed. Long-term exposure to polluted air may elevate the risk of SLE, with individuals facing a 316% to 461% greater likelihood of developing the disease when both genetic predisposition and high pollution exposure coincide. However, air pollution alone does not determine whether someone will develop SLE. Instead, it takes a combination of genetic and multiple environmental factors for the disease to manifest.
"Genetic factors set the stage for the onset of most diseases, including SLE," stated Dr. Sasha Bernatsky, MD, PhD. Most individuals affected by SLE do not possess a family history or any easily detectable genetic markers, complicating the understanding of its origins. While genetics play a crucial role, each individual genetic factor contributes minimally to SLE risk. It takes various environmental exposures, including air pollution, to ultimately trigger the disease.
Dr. Bernatsky further explained, "Usually it takes a multitude of environmental exposures for an individual to ultimately develop SLE." These environmental exposures act in conjunction with genetic predispositions, setting off a chain of events leading to the onset of SLE. Estrogen and specific genes on the X chromosome may also be involved in the disease's development, given its higher prevalence in women.
The increasing incidence of autoimmune diseases like SLE underscores the complex interplay between genetics and environment. Dr. Giovanni Adami, MD, PhD, highlighted this complexity by stating, "The most common hypothesis is that you have two or three factors for the disease." He emphasized that while air pollution might be a significant contributor, it is not the sole factor responsible for disease development.
"A lot of evidence is showing that in some diseases, like arthritis, air pollution might be the most important factor contributing to the disease, but not the only one," Dr. Adami noted. This suggests that while air pollution exacerbates genetic risk factors, an ultimate trigger, such as a viral infection, is necessary to activate the immune response characteristic of SLE.
The research findings advocate for stricter air quality regulations to minimize exposure to harmful pollutants, thereby reducing lupus risk. Dr. Yaohua Tian, PhD, emphasized that "the findings can inform the development of stricter air quality regulations to mitigate exposure to harmful pollutants."
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