REVIEW article
Front. Immunol.
Sec. Autoimmune and Autoinflammatory Disorders : Autoimmune Disorders
Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1613441
This article is part of the Research TopicEnvironmental Triggers and Epigenetics, involved in Autoimmune and Autoinflammatory DisordersView all 5 articles
Air pollution, emerging chemical exposures, and systemic lupus erythematosus: a meta-epidemiology study
Provisionally accepted
- 1Zhejiang Chinese Medical University, Hangzhou, China
- 2Zhejiang Provincial Hospital of Traditional Chinese Medicine, Hangzhou, Jiangsu Province, China
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Objectives: This meta-analysis evaluated the direction and strength of associations between air pollution, emerging chemical pollutants, and systemic lupus erythematosus (SLE) incidence, clarifying distinct relationships by pollutant type. Method:By utilizing medical subject headings and keywords from the PubMed and EMBASE databases, a thorough search was conducted for published observational studies linking air pollution and SLE from inception until August 2024. The Newcastle-Ottawa Scale (NOS) was utilized to evaluate the quality of the studies. Statistical analyses were performed using STATA software (version 14.0), with the assessment of publication bias conducted through funnel plots and Egger's test. Result: This meta-analysis encompassed 8 studies published between 2018 and 2024, involving a total of 1,390,348 individuals. We assessed exposure to standard air pollutants and emerging chemical pollutants, specifically including perfluoroalkyl and polyfluoroalkyl substances (PFASs, a type of persistent chemical widely used in nonstick cookware and waterproof products) and bisphenol compounds (BPs, a synthetic chemical primarily used in plastic products and resins). These eight studies identified significant positive associations between SLE incidence and exposure to PM2.5 [OR=1.16, 95% CI (1.02-1.32), I2=62.4%, p=0.031], NO₂ [OR = 1.24, 95% CI (1.11-1.38), I² = 0.0%, P = 0.603], and PFASs [OR = 2.47, 95% CI (1.54-2.57)], while O3 exhibited a negative association [OR = 0.83, 95% CI (0.70-0.98), I² = 19.3%, P = 0.290]. No significant links were found for PM₁₀ [OR = 1.11, 95% CI (0.90–1.36), I² = 66.3%, P = 0.031], SO₂ [OR = 0.99, 95% CI (0.66-1.48), I² = 79.0%, P = 0.001], and BPs [OR = 1.26, 95% CI (0.80-1.99)]. Sensitivity analyses supported robustness without evidence of publication bias. Conclusion: The results of this meta-analysis suggest that air pollutants PM2.5 and NO2 may be potential environmental risk factors for SLE, while the negative correlation with O3 requires further research to validate its potential mechanisms. It is worth noting that although a study on PFASs showed a strong association with SLE, this finding requires further evidence due to the limited number of relevant studies currently available.
Keywords: Air Pollution, systemic lupus erythematosus, Environmental Exposure, Particulate Matter, Meta-epidemiology study
Received: 17 Apr 2025; Accepted: 30 Sep 2025.
Copyright: © 2025 Xu, Pan, Yu, Li, Dai and Huang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Lin Huang, huanglin@zcmu.edu.cn
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