Amphibole asbestos as an environmental trigger for systemic autoimmune diseases

IF 9.2 1区 医学 Q1 IMMUNOLOGY Autoimmunity reviews Pub Date : 2024-07-01 DOI:10.1016/j.autrev.2024.103603
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Abstract

A growing body of evidence supports an association between systemic autoimmune disease and exposure to amphibole asbestos, a form of asbestos typically with straight, stiff, needle-like fibers that are easily inhaled. While the bulk of this evidence comes from the population exposed occupationally and environmentally to Libby Amphibole (LA) due to the mining of contaminated vermiculite in Montana, studies from Italy and Australia are broadening the evidence to other sites of amphibole exposures. What these investigations have done, that most historical studies have not, is to evaluate amphibole asbestos separately from chrysotile, the most common commercial asbestos in the United States. Here we review the current and historical evidence summarizing amphibole asbestos exposure as a risk factor for autoimmune disease. In both mice and humans, amphibole asbestos, but not chrysotile, drives production of both antinuclear autoantibodies (ANA) associated with lupus-like pathologies and pathogenic autoantibodies against mesothelial cells that appear to contribute to a severe and progressive pleural fibrosis. A growing public health concern has emerged with revelations that a) unregulated asbestos minerals can be just as pathogenic as commercial (regulated) asbestos, and b) bedrock and soil occurrences of asbestos are far more widespread than previously thought. While occupational exposures may be decreasing, environmental exposures are on the rise for many reasons, including those due to the creation of windborne asbestos-containing dusts from urban development and climate change, making this topic an urgent challenge for public and heath provider education, health screening and environmental regulations.

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闪石石棉是全身性自身免疫性疾病的环境诱因。
越来越多的证据表明,全身性自身免疫性疾病与暴露于闪石石棉之间存在关联,闪石石棉是一种典型的具有直、硬、针状纤维的石棉,很容易被吸入。虽然大部分证据来自于因在蒙大拿州开采受污染的蛭石而暴露于利比闪石(Libby Amphibole,LA)的职业和环境人群,但来自意大利和澳大利亚的研究正在将证据扩大到暴露于闪石的其他场所。与大多数历史研究不同的是,这些调查将闪石石棉与温石棉(美国最常见的商用石棉)分开进行评估。在此,我们回顾了当前和历史证据,总结了暴露于闪石石棉作为自身免疫性疾病风险因素的情况。在小鼠和人类中,闪石石棉(而非温石棉)会促使产生与狼疮样病症相关的抗核自身抗体(ANA),以及针对间皮细胞的致病性自身抗体,这些抗体似乎会导致严重的渐进性胸膜纤维化。随着人们发现:a)未受管制的石棉矿物与商业(受管制)石棉一样具有致病性;b)石棉在基岩和土壤中的分布比以前想象的要广泛得多,公共健康问题日益受到关注。虽然职业暴露可能在减少,但环境暴露却在增加,原因有很多,包括城市发展和气候变化产生的风媒含石棉粉尘,这使得公众和医疗机构的教育、健康检查和环境法规面临紧迫挑战。
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来源期刊
Autoimmunity reviews
Autoimmunity reviews 医学-免疫学
CiteScore
24.70
自引率
4.40%
发文量
164
审稿时长
21 days
期刊介绍: Autoimmunity Reviews is a publication that features up-to-date, structured reviews on various topics in the field of autoimmunity. These reviews are written by renowned experts and include demonstrative illustrations and tables. Each article will have a clear "take-home" message for readers. The selection of articles is primarily done by the Editors-in-Chief, based on recommendations from the international Editorial Board. The topics covered in the articles span all areas of autoimmunology, aiming to bridge the gap between basic and clinical sciences. In terms of content, the contributions in basic sciences delve into the pathophysiology and mechanisms of autoimmune disorders, as well as genomics and proteomics. On the other hand, clinical contributions focus on diseases related to autoimmunity, novel therapies, and clinical associations. Autoimmunity Reviews is internationally recognized, and its articles are indexed and abstracted in prestigious databases such as PubMed/Medline, Science Citation Index Expanded, Biosciences Information Services, and Chemical Abstracts.
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