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A Review on The Role of Environmental Exposures in IgG4-Related Diseases. in Current environmental health reports / Curr Environ Health Rep. 2023 Sep;10(3):303-311. doi: 10.1007/s40572-023-00401-y. Epub 2023 Jun 14.

2023
AOU Alessandria
ASL Alessandria

Tipo pubblicazione

Review

Autori/Collaboratori (5)Vedi tutti...

Bertolotti M
SC Infrastruttura Ricerca Formazione Innovazione, Dipartimento Attività Integrate Ricerca Innovazione, Azienda Ospedaliera "SS. Antonio E Biagio E Cesare Arrigo", Alessandria, Italy. MBertolotti@ospedale.al.it.
Maconi A
SC Infrastruttura Ricerca Formazione Innovazione, Dipartimento Attività Integrate Ricerca Innovazione, Azienda Ospedaliera "SS. Antonio E Biagio E Cesare Arrigo", Alessandria, Italy.
Crivellari S
SC Infrastruttura Ricerca Formazione Innovazione, Dipartimento Attività Integrate Ricerca Innovazione, Azienda Ospedaliera "SS. Antonio E Biagio E Cesare Arrigo", Alessandria, Italy.

et alii...

Abstract

PURPOSE OF REVIEW: Immunoglobulin G4-related diseases (IgG4-RDs) are immune-mediated fibroinflammatory multisystemic conditions identified by the presence of tumefactive lesions with a rich infiltrate of IgG4-positive plasma cells, and often by a high IgG4 serum concentration. IgG-RDs have a prevalence of at least 1 case every 100,000 persons, and they are mostly diagnosed after age 50, with a male to female ratio of about 3:1. IgG4-RD pathophysiology is still uncertain: it has been proposed that both genetic predisposition and chronic environmental exposures may play a role by triggering abnormal immune activation that perpetuates the disease. The purpose of this review is to summarize the evidences supporting the hypothesis that certain environmental/occupational exposures can trigger IgG4-RDs, focusing on the possible role of asbestos in an emerging IgG4-RD called idiopathic retroperitoneal fibrosis (IRF). RECENT FINDINGS: Although some studies suggested a relationship between tobacco smoking and IgG4-RD risk, occupational exposures seem to have the most interesting effects. Positive history of blue-collar work increases the risk of developing an IgG4-RD, and mineral dusts and asbestos were the most strongly associated industrial compounds. Asbestos has been found to be a risk factor for IRF years before its classification as IgG4-RD, and later in two large case-control studies. In the most recent one, conducted on 90 patients and 270 controls, asbestos exposure conferred an increased IRF risk, quantified by odds ratios from 2.46 to 7.07. Further structured studies including serum IgG4 evaluation should be conducted to clarify the effect of asbestos on patients with confirmed diagnosis of IgG4-related IRF. Environmental exposures, especially of occupational origin, appear to play a role in the development of different types of IgG-RDs. In particular, although first suggested very recently, the relationship between asbestos and IRF deserves to be explored in more structured studies, especially because of the biological plausibility of the role of asbestos in IRF pathogenesis.

PMID : 37314670

DOI : 10.1007/s40572-023-00401-y

Keywords

Smoking; Asbestos/adverse effects; Immunoglobulin G; Asbestos; Environmental exposures; Idiopathic retroperitoneal fibrosis; Retroperitoneal Fibrosis/etiology/pathology; Immunoglobulin G4-related diseases; Environmental Exposure/adverse effects; Immunoglobulin G4-Related Disease/complications/pathology; Autoimmune Diseases; Middle Aged; Female; Male; Humans;