Environmental Pollution Impact on the Severity of Some Rheumatic Diseases: a Comparative Analytical Study on Inflammatory and Non-inflammatory Samples

Overview

Journal BMC Rheumatol

Specialty Rheumatology

Date 2024 Oct 8

PMID 39380067

Authors

Adel Elbeialy

Soaad El Sawy

Hala Elzomor

Rana Haddad

Affiliations

Soon will be listed here.

Abstract

Objective: Environmental pollution of heavy metals is increasingly a problem and has become of great concern due to the adverse effects it causes worldwide. Heavy metal exposure has been implicated in health problems, including fibromyalgia and rheumatoid arthritis. We aim to evaluate the rule of chronic heavy metals toxicity on the induction of vitamin D3 (VD) deficiency and parathyroid hormone (PTH) disturbances in an inflammatory disease like rheumatoid arthritis (RA) and non-inflammatory disease like fibromyalgia syndrome (FMS).

Methods: This comparative analytical study was conducted on sixty adults (age ≥ 18 years). Participants were divided into three groups. Group I: twenty patients diagnosed with RA according to the specific ACR/EULAR criteria for RA. Group II: twenty patients diagnosed with FMS according to the specific 2010 (ACR) criteria for FMS. Group III: twenty healthy adults. All patients and controls were subjected to routine laboratory tests as well as the measurement of PTH, VD and estimation of serum levels of lead, cadmium, and chromium.

Results: VD was significantly inversely correlated to PTH, lead, cadmium, chromium, and activity scores in the RA and FMS groups. Lead, Cadmium and Chromium had a significant independent risk on the VD level in RA patients, while lead had a significant independent risk on the VD level in FMS patients.

Conclusion: Heavy metals may affect VD synthesis, leading to hypovitaminosis D and secondary hyperparathyroidism in RA and FMS patients. Heavy metals play a key role in the pathogenesis of RA, FMS, and their disease activity.

References

Afridi H, Talpur F, Kazi T, Brabazon D . Estimation of toxic elements in the samples of different cigarettes and their effect on the essential elemental status in the biological samples of Irish smoker rheumatoid arthritis consumers. Environ Monit Assess. 2015; 187(4):157. DOI: 10.1007/s10661-015-4353-5. View

Elbeialy A, Bauomi A, Elnaggar B, Elzomor H . Middle east pain syndrome is a pollution-induced new disease mimicking rheumatoid arthritis. Sci Rep. 2021; 11(1):22263. PMC: 8593135. DOI: 10.1038/s41598-021-01698-1. View

Kumar A, Barki S, Raghav V, Chaturvedi A, Hari Kumar K . Correlation of Vitamin D with metabolic parameters in polycystic ovarian syndrome. J Family Med Prim Care. 2017; 6(1):115-119. PMC: 5629874. DOI: 10.4103/2249-4863.214985. View

Hanfi M, Mostafa M, Zhukovsky M . Heavy metal contamination in urban surface sediments: sources, distribution, contamination control, and remediation. Environ Monit Assess. 2019; 192(1):32. DOI: 10.1007/s10661-019-7947-5. View

Romano F, Serpico D, Cantelli M, Di Sarno A, Dalia C, Arianna R . Osteoporosis and dermatoporosis: a review on the role of vitamin D. Front Endocrinol (Lausanne). 2023; 14:1231580. PMC: 10484397. DOI: 10.3389/fendo.2023.1231580. View

Bellato E, Marini E, Castoldi F, Barbasetti N, Mattei L, Bonasia D . Fibromyalgia syndrome: etiology, pathogenesis, diagnosis, and treatment. Pain Res Treat. 2012; 2012:426130. PMC: 3503476. DOI: 10.1155/2012/426130. View

Rossini M, Maddali Bongi S, La Montagna G, Minisola G, Malavolta N, Bernini L . Vitamin D deficiency in rheumatoid arthritis: prevalence, determinants and associations with disease activity and disability. Arthritis Res Ther. 2010; 12(6):R216. PMC: 3046526. DOI: 10.1186/ar3195. View

Soltani Bajestani F, Khajavian N, Salarbashi D, Kafili M, Ashori F, Hajavi J . Relationship Between Serum Vitamin D Level and Disease Severity in Rheumatoid Arthritis. Clin Med Insights Arthritis Musculoskelet Disord. 2023; 16:11795441231182997. PMC: 10331176. DOI: 10.1177/11795441231182997. View

Okumus M, Koybasi M, Tuncay F, Ceceli E, Ayhan F, Yorgancioglu R . Fibromyalgia syndrome: is it related to vitamin D deficiency in premenopausal female patients?. Pain Manag Nurs. 2013; 14(4):e156-e163. DOI: 10.1016/j.pmn.2011.09.006. View

10.

Plotnikoff G, Quigley J . Prevalence of severe hypovitaminosis D in patients with persistent, nonspecific musculoskeletal pain. Mayo Clin Proc. 2003; 78(12):1463-70. DOI: 10.4065/78.12.1463. View

11.

Akar N, Sayiner Caglar N, Aytekin E, Akar A, Aksu O, Oz N . Low levels of serum vitamin D3 are associated with fibromyalgia syndrome in pre-menopausal women: A pilot study. Turk J Phys Med Rehabil. 2020; 66(1):67-72. PMC: 7171881. DOI: 10.5606/tftrd.2020.2928. View

12.

Braun-Moscovici Y, Toledano K, Markovits D, Rozin A, Nahir A, Balbir-Gurman A . Vitamin D level: is it related to disease activity in inflammatory joint disease?. Rheumatol Int. 2009; 31(4):493-9. DOI: 10.1007/s00296-009-1251-6. View

13.

Chowdhury R, Ramond A, OKeeffe L, Shahzad S, Kunutsor S, Muka T . Environmental toxic metal contaminants and risk of cardiovascular disease: systematic review and meta-analysis. BMJ. 2018; 362:k3310. PMC: 6113772. DOI: 10.1136/bmj.k3310. View

14.

Hashmi G, Shah M . Comparative assessment of essential and toxic metals in the blood of rheumatoid arthritis patients and healthy subjects. Biol Trace Elem Res. 2011; 146(1):13-22. DOI: 10.1007/s12011-011-9220-9. View

15.

Mukherjee A, Wanjari U, Renu K, Vellingiri B, Gopalakrishnan A . Heavy metal and metalloid - induced reproductive toxicity. Environ Toxicol Pharmacol. 2022; 92:103859. DOI: 10.1016/j.etap.2022.103859. View

16.

Dey S, Kumar S, Rani D, Maurya S, Banerjee P, Verma M . Implications of vitamin D deficiency in systemic inflammation and cardiovascular health. Crit Rev Food Sci Nutr. 2023; 64(28):10438-10455. DOI: 10.1080/10408398.2023.2224880. View

17.

Joo S, Lee J, Hutchinson D, Song Y . Prevalence of rheumatoid arthritis in relation to serum cadmium concentrations: cross-sectional study using Korean National Health and Nutrition Examination Survey (KNHANES) data. BMJ Open. 2019; 9(1):e023233. PMC: 6326419. DOI: 10.1136/bmjopen-2018-023233. View

18.

Craig S, Yu F, Curtis J, Alarcon G, Conn D, Jonas B . Vitamin D status and its associations with disease activity and severity in African Americans with recent-onset rheumatoid arthritis. J Rheumatol. 2009; 37(2):275-81. PMC: 3133625. DOI: 10.3899/jrheum.090705. View

19.

de Rezende Pena C, Grillo L, das Chagas Medeiros M . Evaluation of 25-hydroxyvitamin D serum levels in patients with fibromyalgia. J Clin Rheumatol. 2010; 16(8):365-9. DOI: 10.1097/RHU.0b013e3181fe8a90. View

20.

Schwalfenberg G, Genuis S . Vitamin D, Essential Minerals, and Toxic Elements: Exploring Interactions between Nutrients and Toxicants in Clinical Medicine. ScientificWorldJournal. 2015; 2015:318595. PMC: 4539504. DOI: 10.1155/2015/318595. View