title: Environmental epidemiology and risk factors for autoimmune disease.
abstract: It has long been recognized that environmental influences play an important role in the risk of developing chronic rheumatic disease. Defining specific pathogenic environmental mediators that may trigger the development or progression of autoimmune disease remains a focus of increasing investigative effort. Factors promoting disease may not be identical to factors that influence the severity or progression of the disorder. Human monozygotic twin studies, animal studies, and genetic models demonstrate that genetic influences strongly determine whether one will develop autoimmunity, however, genes affecting the metabolism of exogenous agents that may trigger disease expression have only recently drawn attention. In this article the authors review recent reports that advance our understanding of previously recognized environmental risk factors and challenge accepted beliefs that increased estrogenic exposures predate the incidence of autoimmune disorders, systemic lupus erythematosus in particular.
authors.affiliation: Division of Rheumatology and Immunology, University of North Carolina at Chapel Hill, 27599, USA. Mary_Dooley@med.unc.edu
authors.forename: M A
authors.initials: MA
authors.lastname: Dooley
authors.forename: S L
authors.initials: SL
authors.lastname: Hogan
mesh_terms: D001172:Arthritis, Rheumatoid / Q000453:epidemiology* / Q000209:etiology*; D001327:Autoimmune Diseases / Q000453:epidemiology* / Q000209:etiology*; D016022:Case-Control Studies; D004781:Environmental Exposure / Q000009:adverse effects*; D004784:Environmental Monitoring; D004785:Environmental Pollutants / Q000009:adverse effects; D062665:Epidemiological Monitoring; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D011379:Prognosis; D012307:Risk Factors
chemical_list: D004785:Environmental Pollutants