title: Expert panel workshop consensus statement on the role of the environment in the development of autoimmune disease.
abstract: Autoimmune diseases include 80 or more complex disorders characterized by self-reactive, pathologic immune responses in which genetic susceptibility is largely insufficient to determine disease onset. In September 2010, the National Institute of Environmental Health Sciences (NIEHS) organized an expert panel workshop to evaluate the role of environmental factors in autoimmune diseases, and the state of the science regarding relevant mechanisms, animal models, and human studies. The objective of the workshop was to analyze the existing data to identify conclusions that could be drawn regarding environmental exposures and autoimmunity and to identify critical knowledge gaps and areas of uncertainty for future study. This consensus document summarizes key findings from published workshop monographs on areas in which "confident" and "likely" assessments were made, with recommendations for further research. Transcribed notes and slides were reviewed to synthesize an overview on exposure assessment and questions addressed by interdisciplinary panels. Critical advances in the field of autoimmune disease research have been made in the past decade. Collaborative translational and interdisciplinary research is needed to elucidate the role of environmental factors in autoimmune diseases. A focus on exposure assessment methodology is needed to improve the effectiveness of human studies, and more experimental studies are needed to focus on causal mechanisms underlying observed associations of environmental factors with autoimmune disease in humans.
authors.affiliation: Epidemiology Branch, National Institute of Environmental Health Sciences (NIEHS), National Institutes of Health (NIH), Research Triangle Park, NC 27709, USA. parks1@niehs.nih.gov.
authors.forename: Christine G
authors.initials: CG
authors.lastname: Parks
authors.affiliation: Environmental Autoimmunity Group, NIEHS, NIH, Bethesda, MD 20892, USA. millerf@mail.nih.gov.
authors.forename: Frederick W
authors.initials: FW
authors.lastname: Miller
authors.affiliation: Department of Molecular and Experimental Medicine, the Scripps Research Institute, La Jolla, CA 92037, USA. mpollard@scripps.edu.
authors.forename: Kenneth Michael
authors.initials: KM
authors.lastname: Pollard
authors.affiliation: Division of Rheumatology, Allergy and Clinical Immunology, University of California, Davis, CA 95616, USA. carlo.selmi@unimi.it.
authors.forename: Carlo
authors.initials: C
authors.lastname: Selmi
authors.affiliation: National Toxicology Program, NIEHS, NIH, Morrisville, NC 27560, USA. germolec@niehs.nih.gov.
authors.forename: Dori
authors.initials: D
authors.lastname: Germolec
authors.affiliation: Department of History and Politics, Drexel University, Philadelphia, PA 19104, USA. kaj68@drexel.edu.
authors.forename: Kelly
authors.initials: K
authors.lastname: Joyce
authors.affiliation: John Hopkins Center for Autoimmune Disease Research, Bloomberg School of Public Health, Baltimore, MD 21205, USA. nrose2@jhu.edu.
authors.forename: Noel R
authors.initials: NR
authors.lastname: Rose
authors.affiliation: Division of Extramural Research and Training, NIEHS, NIH, Research Triangle Park, NC 27709, USA. humble@niehs.nih.gov.
authors.forename: Michael C
authors.initials: MC
authors.lastname: Humble
mesh_terms: D001327:Autoimmune Diseases / Q000453:epidemiology* / Q000209:etiology; D004781:Environmental Exposure / Q000009:adverse effects*; D006801:Humans