Global climate change poses a huge risk to the future health of the general population, according to an extensive literature in recent years. The specific consequences concern patients with autoimmune rheumatic diseases in particular.
“Both autoimmunity and autoimmune diseases are increasing dramatically in many parts of the world, likely as a result of changes in our exposure to environmental factors: food, air pollution, infections, lifestyle, stress and climate change. “Autoimmune diseases have a significant impact on sufferers and their families, while affecting society and healthcare costs,” points out Mrs. Eleni Komninou Rheumatologist, Director of the Clinic for Autoimmune Rheumatic Diseases Metropolitan General and continues, “However, much progress has been made in understanding the mechanisms by which the environment can influence various immune responses, such as:
Air pollutants can stimulate immune cells (cells of the Immune System) through immune pathways involving specific cell receptors, reactive oxygen species or specific hydrocarbon receptors to activate pro-inflammatory signals and support the inflammatory response through synergistic effects.
There is research on air pollution that shows that disease flares in SLE patients are associated with increased particulate matter suspended in the atmosphere, especially in areas with increased pollutionas well as from increased particles coming from large forest fires.
However, some of the risk factors for poor disease outcomes described in the general population, such as respiratory and heart disease, are frequently encountered in patients with Rheumatoid Arthritis, Systemic Scleroderma, Systemic Lupus Erythematosus and Systemic Vasculitis.
Rheumatoid arthritis and scleroderma have an increased risk of interstitial lung disease and pulmonary fibrosis.
There is an increased incidence of coronary artery disease in rheumatoid arthritis and systemic lupus erythematosus. ANCA-associated vasculitis often presents with pulmonary manifestations.
Extreme weather events have also been associated with significant adverse health effects. Major floods and hurricanes are expected to increase in frequency with global warming. Tropical cyclones have been associated with high rates of hospitalization. Heat waves are also expected to increase in frequency in the coming decades.
This could adversely affect patients with autoimmune rheumatic diseases – associated pulmonary or cardiac comorbidities. Interstitial lung disease is found in up to 50% of patients with scleroderma and in 10% of patients with rheumatoid arthritis. An increase in premature cardiovascular disease has been found in Rheumatoid Arthritis and Systemic Lupus Erythematosus with adjusted odds ratios of 1.72 and 1.69 respectively.”
Ms Komnenou adds that “heat waves have also been associated with a 10% increase in admissions for kidney disease and acute kidney failure. This could put SLE and ANCA-associated vasculitis patients at risk, given the common comorbidity of renal involvement in up to 50% and 80% of these diseases respectively.
Also, a gradual increase in ambient temperature and/or humidity could have adverse effects on arthritic patients. Many geographical areas are experiencing a gradual rise in ambient temperature. The effect of climate change on humidity is more complex. Warm air can contain more moisture, resulting in lower moisture in cold air, despite its higher water vapor content.
Higher humidity, rather than temperature, appears to cause more joint pain in osteoarthritis and rheumatoid arthritis.
In the context of climate change there is a complex relationship between the effect of greenhouse gases on UV-B exposure. Patients with Systemic Lupus Erythematosus develop photosensitivity and increased systemic activity of the disease – with exposure to UV-B radiation,” explains the specialist.
Climate change events and potential adverse health effects associated with rheumatic diseases:
“The rapid rise of autoimmune diseases around the world has significant public health implications, which will continue to increase without intervention and change.
More research is urgently needed to understand the adverse health consequences of climate change that may be unique to patients with Autoimmune Rheumatic Diseases,” concludes Ms Komninou.
Source :Skai
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