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Organic solvents as risk factor for autoimmune diseases: a systematic review and meta-analysis.

Barragán-Martínez C, Speck-Hernández CA, Montoya-Ortiz G, Mantilla RD, Anaya JM, Rojas-Villarraga A - PLoS ONE (2012)

Bottom Line: 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.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).

View Article: PubMed Central - PubMed

Affiliation: Center for Autoimmune Diseases Research (CREA), School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia.

ABSTRACT

Background: Genetic 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 findings: The 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).

Conclusion: Exposure 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.

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Forest plot of studies meta-analyzed grouping by comparison of specific autoimmune diseases.Footnote: random effect model showing significant association between SSC and OSs exposure. PBC and PSV included only one study (100% of the weight). Q value for SSc analysis: 33.7, I2:79,2, Degree of freedom (Q):7, p-value<0,0001. GN: glomerulonephritis; MS: multiple sclerosis; PBC: primary biliary cirrhosis; PSV: primary systemic vasculitis; RA: rheumatoid arthritis; RP: raynaud disease; SLE: systemic lupus erythematosus; SSc: systemic sclerosis. Diot, et al 1: organic solvent as a whole; Thompson AE, et al 1: turpentine exposure (the most significant result); Purdie GL, et al 1: confirmed RP population; Nelson NA, et al 1. 1994: disabled population.
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pone-0051506-g003: Forest plot of studies meta-analyzed grouping by comparison of specific autoimmune diseases.Footnote: random effect model showing significant association between SSC and OSs exposure. PBC and PSV included only one study (100% of the weight). Q value for SSc analysis: 33.7, I2:79,2, Degree of freedom (Q):7, p-value<0,0001. GN: glomerulonephritis; MS: multiple sclerosis; PBC: primary biliary cirrhosis; PSV: primary systemic vasculitis; RA: rheumatoid arthritis; RP: raynaud disease; SLE: systemic lupus erythematosus; SSc: systemic sclerosis. Diot, et al 1: organic solvent as a whole; Thompson AE, et al 1: turpentine exposure (the most significant result); Purdie GL, et al 1: confirmed RP population; Nelson NA, et al 1. 1994: disabled population.

Mentions: Additional analysis limited to the association between each specific AD and OSs exposure presented significant associations in the random model. For MS, the OR was 1.53 with 95& CI 1.03–2.29 and p value: 0.035, with fifteen studies included. For primary systemic vasculitis (PSV), the OR was 3.15 with 95% CI: 1.56–6.36 and p-value: 0.001, with one study included in the cumulative analysis for this disease. Systemic sclerosis (SSc) showed these results OR: 2.54; 95% CI: 1.23–5.14; p-value: 0.011, with eight studies included (Figure 3). Primary biliary cirrhosis (PBC) was positively associated but not statistically significant (OR: 1.002; 95% CI: 1–1.004; p-value: 0.092).


Organic solvents as risk factor for autoimmune diseases: a systematic review and meta-analysis.

Barragán-Martínez C, Speck-Hernández CA, Montoya-Ortiz G, Mantilla RD, Anaya JM, Rojas-Villarraga A - PLoS ONE (2012)

Forest plot of studies meta-analyzed grouping by comparison of specific autoimmune diseases.Footnote: random effect model showing significant association between SSC and OSs exposure. PBC and PSV included only one study (100% of the weight). Q value for SSc analysis: 33.7, I2:79,2, Degree of freedom (Q):7, p-value<0,0001. GN: glomerulonephritis; MS: multiple sclerosis; PBC: primary biliary cirrhosis; PSV: primary systemic vasculitis; RA: rheumatoid arthritis; RP: raynaud disease; SLE: systemic lupus erythematosus; SSc: systemic sclerosis. Diot, et al 1: organic solvent as a whole; Thompson AE, et al 1: turpentine exposure (the most significant result); Purdie GL, et al 1: confirmed RP population; Nelson NA, et al 1. 1994: disabled population.
© Copyright Policy
Related In: Results  -  Collection

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getmorefigures.php?uid=PMC3526640&req=5

pone-0051506-g003: Forest plot of studies meta-analyzed grouping by comparison of specific autoimmune diseases.Footnote: random effect model showing significant association between SSC and OSs exposure. PBC and PSV included only one study (100% of the weight). Q value for SSc analysis: 33.7, I2:79,2, Degree of freedom (Q):7, p-value<0,0001. GN: glomerulonephritis; MS: multiple sclerosis; PBC: primary biliary cirrhosis; PSV: primary systemic vasculitis; RA: rheumatoid arthritis; RP: raynaud disease; SLE: systemic lupus erythematosus; SSc: systemic sclerosis. Diot, et al 1: organic solvent as a whole; Thompson AE, et al 1: turpentine exposure (the most significant result); Purdie GL, et al 1: confirmed RP population; Nelson NA, et al 1. 1994: disabled population.
Mentions: Additional analysis limited to the association between each specific AD and OSs exposure presented significant associations in the random model. For MS, the OR was 1.53 with 95& CI 1.03–2.29 and p value: 0.035, with fifteen studies included. For primary systemic vasculitis (PSV), the OR was 3.15 with 95% CI: 1.56–6.36 and p-value: 0.001, with one study included in the cumulative analysis for this disease. Systemic sclerosis (SSc) showed these results OR: 2.54; 95% CI: 1.23–5.14; p-value: 0.011, with eight studies included (Figure 3). Primary biliary cirrhosis (PBC) was positively associated but not statistically significant (OR: 1.002; 95% CI: 1–1.004; p-value: 0.092).

Bottom Line: 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.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).

View Article: PubMed Central - PubMed

Affiliation: Center for Autoimmune Diseases Research (CREA), School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia.

ABSTRACT

Background: Genetic 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 findings: The 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).

Conclusion: Exposure 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.

Show MeSH
Related in: MedlinePlus