Atmospheric and Environmental Changes Tied to Organ-Specific Lupus Flares

By Megan Brooks

November 20, 2019

NEW YORK (Reuters Health) - Changes in atmospheric and environmental factors may contribute to organ-specific disease exacerbation in patients with systemic lupus erythematosus (SLE), according to a new study.

The study found "strong associations between atmospheric variables and fine particulate matter concentration over the 10 days prior to a patient visit and organ-specific lupus flares at the visit," lead researcher Dr. George Stojan of the Johns Hopkins Lupus Center in Baltimore, Maryland, reported November 9 at the American College of Rheumatology (ACR) annual meeting in Atlanta.

"The seasonality of lupus flares is likely the result of atmospheric and climate factors. These findings may have wide ranging clinical and epidemiological implications," he reported.

Using data from the U.S. Environmental Protection Agency (EPA), the researchers examined the effects of fine particulate matter (PM2.5) concentration, temperature, relative humidity, winds, ozone concentration and barometric pressure on the flare ups associated with different organs in more than 1,600 patients with SLE. They calculated the average values for each factor 10 days prior to a patient visit.

In multivariate analysis, there were statistically significant associations between environmental factors and lupus activity. Rash, serositis, hematologic and joint flares were all associated with an increase in temperature. Renal flares decreased as the temperature and ozone concentration increased.

Joint, neurologic, renal, hematologic and pulmonary flares were directly associated with residual wind, and humidity was significantly associated with joint and serositis flares.

PM2.5 concentration was significantly associated with rash, joints, serositis and hematologic flares. Barometric pressure had no significant associations.

"These data could add an important aspect to lupus trials, the outcomes of which may be affected by so far unrecognized environmental factors, and ultimately it could allow predictive modeling of lupus flares which would revolutionize the approach to treatment," the authors write in their meeting abstract.

Dr. Stojan told Reuters Health by email, "It's too early to infer any definite connection between the environmental factors we analyzed and lupus flares. If confirmed, the implications could be profound and could change our understanding of the interaction of our immune system with the environment leading to better clinical trial design and new potential therapeutic options."

"We are just beginning to understand how our immune system is affected by external factors but I do believe this is a very exciting field," he added.

The study had no commercial funding and the authors have no relevant disclosures.


American College of Rheumatology 2019.


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