Air pollution exposure may worsen lupus in kids: Study

Rising pollution in major cities may have impact on the disease activity of lupus patients, say experts

Exposure to air pollution may trigger disease activity as well as airway inflammation in children and adolescents with lupus, a new study has warned.

The study, conducted in Brazil, confirmed a direct link between an individual’s personal exposure to fine pollution particles and their Systemic Lupus Erythematosus (SLE) disease activity, researchers said.

SLE is a chronic autoimmune disease in which the body’s immune system mistakenly attacks healthy tissue.

Previous studies have shown exposure of a population to outdoor pollutants was associated with an increase in hospital admissions due to paediatric rheumatic diseases, as well as a higher risk of disease activity in those patients attending a hospital with childhood-onset SLE.

“Our findings have shown air pollution does not only increase the incidence and prevalence of chronic lung disease and acute respiratory infections, lung cancer, heart disease and strokes, it is also an important contributory factor in childhood rheumatic diseases, such as lupus,” said Maria Fernanda from University of Sao Paulo in Brazil.

“With air pollution increasing in many major cities, paediatric rheumatologists can expect to see a resultant impact on the disease activity of their lupus patients,” she said. Using a standard measure of moderate to severe lupus disease activity, an increase of 18.12 microgrammes per cubic metre in the daily concentration of the most dangerous of the airborne pollution particles Particulate Matter (PM) 2.5 was associated with a significant increase in lupus activity at four and 11 days after exposure, researchers said.

The spike in disease severity may be reflected in worsening of a variety of laboratory findings, mainly renal (proteinuria, haematuria, leukocyturia) and haematological (thrombocytopenia and leukopenia) involvement.

Measurement of two biomarkers after exposure to an increase in PM 2.5 showed a significant acidification of exhaled breath condensate at days seven and 10, and an increase in fractional concentration of exhaled nitric oxide, both of which suggest a significant increase in airway inflammation related to air pollution, researchers said.

Despite this worsening airway inflammation, children and adolescents with SLE did not present any evidence of an increase in acute respiratory symptoms.