Abstract
BackgroundGenetic and epigenetic factors interacting with the environment over time are the main causes of complex diseases such as autoimmune diseases (ADs). Among the environmental factors are organic solvents (OSs), which are chemical compounds used routinely in commercial industries. Since controversy exists over whether ADs are caused by OSs, a systematic review and meta-analysis were performed to assess the association between OSs and ADs.Methods and FindingsThe systematic search was done in the PubMed, SCOPUS, SciELO and LILACS databases up to February 2012. Any type of study that used accepted classification criteria for ADs and had information about exposure to OSs was selected. Out of a total of 103 articles retrieved, 33 were finally included in the meta-analysis. The final odds ratios (ORs) and 95% confidence intervals (CIs) were obtained by the random effect model. A sensitivity analysis confirmed results were not sensitive to restrictions on the data included. Publication bias was trivial. Exposure to OSs was associated to systemic sclerosis, primary systemic vasculitis and multiple sclerosis individually and also to all the ADs evaluated and taken together as a single trait (OR: 1.54; 95% CI: 1.25–1.92; p-value<0.001).ConclusionExposure to OSs is a risk factor for developing ADs. As a corollary, individuals with non-modifiable risk factors (i.e., familial autoimmunity or carrying genetic factors) should avoid any exposure to OSs in order to avoid increasing their risk of ADs.
Highlights
Autoimmune diseases (ADs) are initiated by the loss of immune tolerance and mediated through T or B cell activation leading to tissue damage
Individuals with non-modifiable risk factors should avoid any exposure to organic solvents (OSs) in order to avoid increasing their risk of autoimmune diseases (ADs)
794 articles were found in PubMed, SCOPUS, SciELO and LILACS
Summary
Autoimmune diseases (ADs) are initiated by the loss of immune tolerance and mediated through T or B cell activation leading to tissue damage. ADs share clinical signs and symptoms, physiopathological mechanisms, and genetic factors [1] They are complex diseases caused by the interaction between genetic, epigenetic, and environmental factors over time [2,3]. A significant body of research has pointed out that, for autoimmunity to occur, the genetic background warrants to be combined with environmental injuries and novel associations has been described as the case of the air pollution [5,16]. These environmental factors often explain only a small number of cases, and, on their own, they are not sufficient to cause the disease [5]. Since controversy exists over whether ADs are caused by OSs, a systematic review and meta-analysis were performed to assess the association between OSs and ADs
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