European Journal of Rheumatology
Literature Review

Is air pollution affecting the disease activity in patients with systemic lupus erythematosus? State of the art and a systematic literature review


UNESCO Chair, Department of Culture, Politics and Society, University of Turin, Italy


Department of Agricultural, Forest and Food Sciences (DISAFA), University of Turin, Italy


Department of Biomedical Sciences, Personalised Medicine Clinic Asthma & Allergy, Humanitas University, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy


Center of Research of Immunopathology and Rare Diseases - Coordinating Center of Piemonte and Valle d'Aosta Network for Rare Diseases, and SCDU Nephrology and Dialysis, University of Turin and S. Giovanni Bosco Hospital, Turin, Italy


Department of Rheumatology, Clinica Universidad de Navarra, Madrid, Spain

Eur J Rheumatol 2020; 7: 31-34
DOI: 10.5152/eurjrheum.2019.19141
Read: 930 Downloads: 346 Published: 13 January 2020

Objective: It has been documented that several major components of air pollution, including trace elements and polycyclic aromatic hydrocarbons, are associated with the prevalence of systemic lupus erythematosus (SLE). However, the impact of air pollution on the SLE disease activity is still elusive. In this paper, we review the current evidence investigating the link between air pollution, especially when measured as PM2.5, and SLE severity and activity.

Methods: A detailed literature search was applied a priori to the Ovid MEDLINE In-Process and Other Non-Indexed Citation 1986 to present. Presented abstracts from the European League Against Rheumatism and American College of Rheumatology (ACR)/Association for Rheumatology Health Professionals (ARHP) Annual Meetings (2011-2018) were also screened.

Results: Out of a total of 1354 papers retrieved from search and references list for detailed evaluation, data from 652 patients with SLE from three studies were analyzed. Two studies had an observational longitudinal design, counting for 348 patients with a follow-up of 24 months and 79 months. Retrieved studies differed for disease activity assessment and air pollution quantifications.

Conclusion: Current evidence suggests that variations in air pollution may influence the disease activity in patients with SLE. However, the sample size, methodological biases, and differences across the studies make further research mandatory. Understanding the increased burden of SLE and its complications, not only from a medical, but also from a socio-demographic perspective, including an exposure to pollutants, should have implications for resource allocation and access to subspecialty care.

Cite this article as: Gilcrease GW, Padovan D, Heffler E, Peano C, Massaglia S, Roccatello D, et al. Is air pollution affecting the disease activity in patients with systemic lupus erythematosus? State of the art and a systematic literature review. Eur J Rheumatol 2020; 7(1): 31-4.

EISSN 2148-4279