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Environmental risk factors of systemic sclerosis

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Abstract

Systemic sclerosis (SSc) has a complex pathogenesis. Although, there is a growing evidence that environmental factors have an impact on alterations and modulation of epigenetic determinants, resulting in SSc onset and progression. A marked correlation has thus been found between SSc onset and occupational exposure to crystalline silica and the following organic solvents: white spirit, aromatic solvents, chlorinated solvents, trichloroethylene, and ketones; the risk associated with high cumulative exposure to silica and organic solvents further appears to be strongly increased in SSc. Altogether, occupational exposure should be systematically checked in all SSc patients at diagnosis, as (1) exposed patients seem to develop more severe forms of SSc and (2) the identification of the occupational agents will allow its interruption, which may lead to potential improvement of SSc outcome. By contrast, based on current published data, there is insufficient evidence that exposure to other chemical agents (including notably pesticides as well as personal care such as silicone and hair dye), physical agents (ionizing radiation, ultraviolet radiation, electric and magnetic fields), and biological agents (infections and diet, foods, and dietary contaminants) is a causative factor of SSc. Further investigations are still warranted to identify other environmental factors that may be associated with SSc onset and progression.

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Acknowledgments

This study was supported by a grant from the French Ministry of Health (PHRCIR 2003-0549) and was sponsored by Rouen University Hospital (Etude TOSCAN, 2002-039-HP).

Conflict of interest

The authors declare that they have no competing interests.

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Authors and Affiliations

  1. Department of Internal Medicine, Centre hospitalier universitaire de Rouen, 76031, Rouen Cedex, France

    Isabelle Marie

  2. Institute for Biochemical Research, INSERM U 905, University of Rouen IFRMP, Rouen, France

    Isabelle Marie

  3. Department of Occupational Medicine, CHU Rouen, Rouen, France

    Jean-François Gehanno

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  1. Isabelle Marie
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  2. Jean-François Gehanno
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Correspondence to Isabelle Marie.

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This article is a contribution to the Special Issue on Immunopathology of Systemic Sclerosis - Guest Editors: Jacob M. van Laar and John Varga

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Marie, I., Gehanno, JF. Environmental risk factors of systemic sclerosis. Semin Immunopathol 37, 463–473 (2015). https://doi.org/10.1007/s00281-015-0507-3

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