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How the Frequency and Phenotype of Sarcoidosis is Driven by Environmental Determinants

  • Manuel Ramos-CasalsEmail author
  • Belchin Kostov
  • Pilar Brito-Zerón
  • Antoni Sisó-Almirall
  • Robert P. Baughman
  • the Autoimmune Big Data Study Group
INTERSTITIAL LUNG DISEASE
  • 14 Downloads

Abstract

Background

Sarcoidosis is a systemic disease in which the personal environment seems to drive a differentiated disease frequency and clinical expression. The main epidemiological studies suggest a key influence of potential environmentally linked exposures related to the type of occupation, the household, life style, socioeconomic status, and region of residence.

Objective

To provide an update on how sarcoidosis may be modulated by environmental factors.

Data Sources

We searched PubMed for epidemiological studies.

Synthesis

The risk of sarcoidosis is enhanced in people working in jobs related to agriculture, water, construction, metal machining, education, and health, and reduced in those working in jobs mainly centered on personal care. Studies have confirmed seasonal-related peaks of sarcoidosis incidence that follow geographical North–South and West–East gradients. Other personal factors include smoking, personal household exposures, and leisure activities. The evidence pointing to the crucial role of the environment in the etiopathogenesis of sarcoidosis is mounting rapidly. Few diseases so strongly combine geography, environment, gender, and ethnicity as key etiopathogenic factors, with susceptibility to any putative agent being modulated by the individual exposome and genome.

Conclusion

Geoepidemiological research should focus on evaluating the combined effects of environmental and genetic factors, the identification of clusters of geographically driven exposures, and more precise measurement of all personal exposures (degree of combination, length, and level of exposure).

Keywords

Sarcoidosis Occupational disease Geolocation Environment Seasonality 

Notes

Acknowledgements

The members of the Autoimmune Big Data Study Group involved in this project (serving as scientific advisors, critically reviewing the study proposal, helping to collect data, and participating in writing or technical editing of the manuscript) are Pilar Brito-Zerón1,2,17, Roberto Pérez-Alvarez3,17, Daphne Superville4, Belchin Kostov5, Nihan Acar-Denizli6, Antoni Sisó-Almirall5, Alejandra Flores-Chavez2,8, Courtney Grant15, Soledad Retamozo16, Xavier Bosch7, Lucio Pallarés9,17, David Buss2, Yehuda Shoenfeld12, Munther A. Khamashta11, Robert P. Baughman14, Manuel Ramos-Casals2,13,17 (coordinator). (1) Autoimmune Diseases Unit, Department of Medicine, Hospital CIMA- Sanitas, Barcelona, Spain; (2) Laboratory of Autoimmune Diseases Josep Font, IDIBAPS-CELLEX, Department of Autoimmune Diseases, ICMiD, Hospital Clínic, Barcelona, Spain; (3) Department of Internal Medicine, Hospital Alvaro Cunqueiro, Vigo, Spain; (4) University of California San Francisco, San Francisco, CA, USA; (5) Primary Healthcare Transversal Research Group, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CAPSBE, Barcelona, Spain; (6) Department of Statistics, Faculty of Science and Letters, Mimar Sinan Fine Arts University, Istanbul, Turkey; (7) Department of Internal Medicine, ICMiD, Hospital Clínic, Barcelona, Spain; (8) Biomedical Research Unit 02, Clinical Epidemiology Research Unit, UMAE, Specialties Hospital, Western Medical Center, Mexican Institute for Social Security (IMSS), Guadalajara, Mexico; Postgraduate Program of Medical Science, University Center for Biomedical Research (CUIB), University of Colima, Colima, Mexico; (9) Systemic Autoimmune Diseases Unit, Department of Internal Medicine, Hospital de Son Espases, Palma de Mallorca, Spain; (11) Lupus Research Unit, The Rayne Institute, St Thomas’ Hospital, King’s College University, London, UK; (12) Zabludowicz Center for Autoimmune Diseases, Chaim Sheba Medical Center, Tel Hashomer, Israel Incumbent of the Laura Schwarz-Kipp Chair for Research of Autoimmune Diseases, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel; (13) Department of Medicine, University of Barcelona, Barcelona, Spain; (14) University of Cincinnati Medical Center, Department of Medicine, Cincinnati, OH, USA; (15) Glasgow University, UK; (16) Instituto De Investigaciones En Ciencias De La Salud (INICSA), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET) - CORDOBA - Argentina; (17) SarcoGEAS Study Group, Grupo de Estudio de Enfermedades Autoinmunes Sistémicas (GEAS) de la Sociedad Española de Medicina Interna (SEMI).

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

408_2019_243_MOESM1_ESM.pdf (216 kb)
Supplementary material 1 (PDF 216 kb)

References

  1. 1.
    Baughman RP, Lower EE, du Bois RM (2003) Sarcoidosis. Lancet (Lond, Engl) 361(9363):1111–1118CrossRefGoogle Scholar
  2. 2.
    Iannuzzi MC, Rybicki BA, Teirstein AS (2007) Sarcoidosis. N Engl J Med 357(21):2153–2165CrossRefGoogle Scholar
  3. 3.
    Culver DA (2012) Sarcoidosis. Immunol Allergy Clin North Am 32(4):487–511CrossRefGoogle Scholar
  4. 4.
    Pereira CAC, Dornfeld MC, Baughman R, Judson MA (2014) Clinical phenotypes in sarcoidosis. Curr Opin Pulm Med 20(5):496–502CrossRefGoogle Scholar
  5. 5.
    Dubrey S, Shah S, Hardman T, Sharma R (2014) Sarcoidosis: the links between epidemiology and aetiology. Postgrad Med J 90(1068):582–589CrossRefGoogle Scholar
  6. 6.
    Ramos-Casals M et al (2015) Google-driven search for big data in autoimmune geoepidemiology: analysis of 394,827 patients with systemic autoimmune diseases. Autoimmun Rev 14(8):670–679CrossRefGoogle Scholar
  7. 7.
    Poukkula A, Huhti E, Lilja M, Saloheimo M (1986) Incidence and clinical picture of sarcoidosis in a circumscribed geographical area. Br J Dis Chest 80(2):138–147CrossRefGoogle Scholar
  8. 8.
    Putkonen T, Hannuksela M, Mustakallio KK (1966) Cold season prevalence of the clinical onset of sarcoidosis. Arch Environ Health 12(5):564–568CrossRefGoogle Scholar
  9. 9.
    Gupta D, Agarwal R, Aggarwal AN (2013) Seasonality of sarcoidosis: the ‘heat’ is on…. Sarcoidosis Vasc Diffus Lung Dis 30(3):241–243Google Scholar
  10. 10.
    Wilsher ML (1998) Seasonal clustering of sarcoidosis presenting with erythema nodosum. Eur Respir J 12(5):1197–1199CrossRefGoogle Scholar
  11. 11.
    Glennas A et al (1995) Acute sarcoid arthritis: occurrence, seasonal onset, clinical features and outcome. Br J Rheumatol 34(1):45–50CrossRefGoogle Scholar
  12. 12.
    Visser H et al (2002) Sarcoid arthritis: clinical characteristics, diagnostic aspects, and risk factors. Ann Rheum Dis 61(6):499–504CrossRefGoogle Scholar
  13. 13.
    Henke CE, Henke G, Elveback LR, Beard CM, Ballard DJ, Kurland LT (1986) The epidemiology of sarcoidosis in Rochester, Minnesota: a population-based study of incidence and survival. Am J Epidemiol 123(5):840–845CrossRefGoogle Scholar
  14. 14.
    Gonzalez SF, Gonzalez RL (2011) Epidemiology, presentation forms, radiological stage and diagnostic methods of sarcoidosis in the area of Leon (2001-2008). Rev Clin Esp 211(6):291–297CrossRefGoogle Scholar
  15. 15.
    Badrinas F et al (1989) Sarcoidosis in Catalonia: analysis of 425 cases. Med Clin (Barc) 93(3):81–87Google Scholar
  16. 16.
    Demirkok SS, Basaranoglu M, Coker E, Karayel T (2007) Seasonality of the onset of symptoms, tuberculin test anergy and Kveim positive reaction in a large cohort of patients with sarcoidosis. Respirology 12(4):591–593CrossRefGoogle Scholar
  17. 17.
    Panayeas S, Theodorakopoulos P, Bouras A, Constantopoulos S (1991) Seasonal occurrence of sarcoidosis in Greece. Lancet (Lond, Engl) 338(8765):510–511CrossRefGoogle Scholar
  18. 18.
    Hosoda Y et al (1976) A cooperative study of sarcoidosis in Asia and Africa: analytic epidemiology. Ann N Y Acad Sci 278:355–367CrossRefGoogle Scholar
  19. 19.
    Deubelbeiss U, Gemperli A, Schindler C, Baty F, Brutsche MH (2010) Prevalence of sarcoidosis in Switzerland is associated with environmental factors. Eur Respir J 35(5):1088–1097CrossRefGoogle Scholar
  20. 20.
    Arkema EV, Grunewald J, Kullberg S, Eklund A, Askling J (2016) Sarcoidosis incidence and prevalence: a nationwide register-based assessment in Sweden. Eur Respir J 48(6):1690–1699CrossRefGoogle Scholar
  21. 21.
    Newman LS et al (2004) A case control etiologic study of sarcoidosis: environmental and occupational risk factors. Am J Respir Crit Care Med 170(12):1324–1330CrossRefGoogle Scholar
  22. 22.
    Kieszko R et al (2016) The impact of ACE gene polymorphism on the incidence and phenotype of sarcoidosis in rural and urban settings. Arch Med Sci 12(6):1263–1272CrossRefGoogle Scholar
  23. 23.
    Alilovic M, Peros-Golubicic T, Tekavec-Trkanjec J, Smojver-Jezek S, Liscic R (2006) Epidemiological characteristics of sarcoidosis patients hospitalized in the University Hospital for Lung Diseases ‘Jordanovac’ (Zagreb, Croatia) in the 1997-2002 period. Coll Antropol 30(3):513–517Google Scholar
  24. 24.
    Leza MA et al (2003) Sarcoidosis in a sanitary area at Leon (Spain). Epidemiology and clinical features. An Med Interna 20(12):617–620Google Scholar
  25. 25.
    Buxbaum LA, Lackland DT, Judson MA, Hoel DG, Mohr LC Jr (2000) Geographic patterns of pulmonary disease in south carolina. Ann Epidemiol 10(7):460–461CrossRefGoogle Scholar
  26. 26.
    Gupta D, Vinay N, Agarwal R, Agarwal AN (2013) Socio-demographic profile of patients with sarcoidosis vis-a-vis tuberculosis. Sarcoidosis Vasc Diffus Lung Dis Off J WASOG 30(3):186–193Google Scholar
  27. 27.
    Kajdasz DK, Lackland DT, Mohr LC, Judson MA (2001) A current assessment of rurally linked exposures as potential risk factors for sarcoidosis. Ann Epidemiol 11(2):111–117CrossRefGoogle Scholar
  28. 28.
    Beghe D et al (2017) Sarcoidosis in an Italian province. Prevalence and environmental risk factors. PLoS ONE 12(5):6859CrossRefGoogle Scholar
  29. 29.
    Pirozzi CS, Mendoza DL, Xu Y, Zhang Y, Scholand MB, Baughman RP (2018) Short-term particulate air pollution exposure is associated with increased severity of respiratory and quality of life symptoms in patients with fibrotic sarcoidosis. Int J Environ Res Public Health 15(6):1077CrossRefGoogle Scholar
  30. 30.
    Kajdasz DK, Judson MA, Mohr LCJ, Lackland DT (1999) Geographic variation in sarcoidosis in South Carolina: its relation to socioeconomic status and health care indicators. Am J Epidemiol 150(3):271–278CrossRefGoogle Scholar
  31. 31.
    Werner E (1959) Boeck’s disease as an occupational disease. Tuberkulosearzt 13:780–785Google Scholar
  32. 32.
    Seiler E (1960) On the epidemiology of sarcoidosis (Boeck’s disease) in Switzerland. Statistical research on the geographical and occupational distribution of 108 military patients with sarcoidosis. Schweizerische Zeitschrift fur Tuberkulose und Pneumonol Rev suisse la Tuberc Pneumonol Riv Svizz della Tuberc e della Pneumonol 17:205–228Google Scholar
  33. 33.
    Prezant DJ et al (1999) The incidence, prevalence, and severity of sarcoidosis in New York City firefighters. Chest 116(5):1183–1193CrossRefGoogle Scholar
  34. 34.
    Rossman MD et al (2008) HLA and environmental interactions in sarcoidosis. Sarcoidosis Vasc Diffus Lung Dis Off J WASOG 25(2):125–132Google Scholar
  35. 35.
    Kucera GP et al (2003) Occupational risk factors for sarcoidosis in African-American siblings. Chest 123(5):1527–1535CrossRefGoogle Scholar
  36. 36.
    Barnard J et al (2005) Job and industry classifications associated with sarcoidosis in A Case-Control Etiologic Study of Sarcoidosis (ACCESS). J Occup Environ Med 47(3):226–234CrossRefGoogle Scholar
  37. 37.
    Kreider ME et al (2005) Relationship of environmental exposures to the clinical phenotype of sarcoidosis. Chest 128(1):207–215CrossRefGoogle Scholar
  38. 38.
    Jordan HT, Stellman SD, Prezant D, Teirstein A, Osahan SS, Cone JE (2011) Sarcoidosis diagnosed after September 11, 2001, among adults exposed to the World Trade Center disaster. J Occup Environ Med 53(9):966–974CrossRefGoogle Scholar
  39. 39.
    Liu H et al (2016) Association between occupational exposures and sarcoidosis: an analysis from death certificates in the United States, 1988-1999. Chest 150(2):289–298CrossRefGoogle Scholar
  40. 40.
    Gorham ED, Garland CF, Garland FC, Kaiser K, Travis WD, Centeno JA (2004) Trends and occupational associations in incidence of hospitalized pulmonary sarcoidosis and other lung diseases in Navy personnel: a 27-year historical prospective study, 1975-2001. Chest 126(5):1431–1438CrossRefGoogle Scholar
  41. 41.
    Crowley LE et al (2011) ‘Sarcoid like’ granulomatous pulmonary disease in World Trade Center disaster responders. Am J Ind Med 54(3):175–184CrossRefGoogle Scholar
  42. 42.
    Bours S et al (2016) Risk of vertebral and non-vertebral fractures in patients with sarcoidosis: a population-based cohort. Osteoporos Int 27(4):1603–1610CrossRefGoogle Scholar
  43. 43.
    Valeyre D et al (1988) Smoking and pulmonary sarcoidosis: effect of cigarette smoking on prevalence, clinical manifestations, alveolitis, and evolution of the disease. Thorax 43(7):516–524CrossRefGoogle Scholar
  44. 44.
    Hance AJ et al (1986) Smoking and interstitial lung disease. The effect of cigarette smoking on the incidence of pulmonary histiocytosis X and sarcoidosis. Ann N Y Acad Sci 465:643–656CrossRefGoogle Scholar
  45. 45.
    Harf RA, Ethevenaux C, Gleize J, Perrin-Fayolle M, Guerin JC, Ollagnier C (1986) Reduced prevalence of smokers in sarcoidosis. Results of a case-control study. Ann N Y Acad Sci 465:625–631CrossRefGoogle Scholar
  46. 46.
    Douglas JG et al (1986) Sarcoidosis: a disorder commoner in non-smokers? Thorax 41(10):787–791CrossRefGoogle Scholar
  47. 47.
    Ungprasert P, Carmona EM, Utz JP, Ryu JH, Crowson CS, Matteson EL (2016) Epidemiology of sarcoidosis 1946-2013: a population-based study. Mayo Clin Proc 91(2):183–188CrossRefGoogle Scholar
  48. 48.
    Krell W, Bourbonnais JM, Kapoor R, Samavati L (2012) Effect of smoking and gender on pulmonary function and clinical features in sarcoidosis. Lung 190(5):529–536CrossRefGoogle Scholar
  49. 49.
    Janot AC et al (2015) Cigarette smoking and male sex are independent and age concomitant risk factors for the development of ocular sarcoidosis in a New Orleans sarcoidosis population. Sarcoidosis Vasc Diffus Lung Dis Off J WASOG 32(2):138–143Google Scholar
  50. 50.
    Gupta D, Singh AD, Agarwal R, Aggarwal AN, Joshi K, Jindal SK (2010) Is tobacco smoking protective for sarcoidosis? A case-control study from North India. Sarcoidosis Vasc Diffus Lung Dis Off J WASOG 27(1):19–26Google Scholar
  51. 51.
    Hattori T, Konno S, Shijubo N, Ohmichi M, Nishimura M (2013) Increased prevalence of cigarette smoking in Japanese patients with sarcoidosis. Respirology 18(7):1152–1157Google Scholar
  52. 52.
    Cozier YC, Berman JS, Palmer JR, Boggs DA, Serlin DM, Rosenberg L (2011) Sarcoidosis in black women in the United States: data from the Black Women’s Health Study. Chest 139(1):144–150CrossRefGoogle Scholar
  53. 53.
    Gvozdenovic BS et al (2013) Effect of obesity on patient-reported outcomes in sarcoidosis. Int J Tuberc Lung Dis 17(4):559–564CrossRefGoogle Scholar
  54. 54.
    Rodrigues MM, Coletta ENAM, Ferreira RG, de Pereira CAC (2013) Delayed diagnosis of sarcoidosis is common in Brazil. J Bras 39(5):539–546Google Scholar
  55. 55.
    Rabin DL, Richardson MS, Stein SR, Yeager HJ (2001) Sarcoidosis severity and socioeconomic status. Eur Respir J 18(3):499–506CrossRefGoogle Scholar
  56. 56.
    Westney GE, Judson MA (2006) Racial and ethnic disparities in sarcoidosis: from genetics to socioeconomics. Clin Chest Med 27(3):453–462 vi CrossRefGoogle Scholar
  57. 57.
    Newman LS (2005) Aetiologies of sarcoidosis. In: Drent M, Costabel U (eds) Sarcoidosis. European Respiratory Society, Lausanne, pp 23–48Google Scholar
  58. 58.
    Parkes SA, Baker SB, Bourdillon RE, Murray CR, Rakshit M (1987) Epidemiology of sarcoidosis in the Isle of Man–1: a case controlled study. Thorax 42(6):420–426CrossRefGoogle Scholar
  59. 59.
    Stewart IC, Davidson NM (1982) Clustering of sarcoidosis. Thorax 37(5):398–399CrossRefGoogle Scholar
  60. 60.
    Esteves T, Aparicio G, Garcia-Patos V (2016) Is there any association between Sarcoidosis and infectious agents?: A systematic review and meta-analysis. BMC Pulm Med 16(1):165CrossRefGoogle Scholar
  61. 61.
    Rybicki BA et al (2001) Familial aggregation of sarcoidosis. A case-control etiologic study of sarcoidosis (ACCESS). Am J Respir Crit Care Med 164(11):2085–2091CrossRefGoogle Scholar
  62. 62.
    Michael MJ (1956) Epidemiology of sarcoidosis. Ann Intern Med 45(1):151–155CrossRefGoogle Scholar
  63. 63.
    Newman KL, Newman LS (2012) Occupational causes of sarcoidosis. Curr Opin Allergy Clin Immunol 12(2):145–150CrossRefGoogle Scholar
  64. 64.
    Baughman RP et al (2016) Sarcoidosis in America. Analysis based on health care use. Ann Am Thorac Soc 13(8):1244–1252CrossRefGoogle Scholar
  65. 65.
    Culver DA, Newman LS, Kavuru MS (2007) Gene-environment interactions in sarcoidosis: challenge and opportunity. Clin Dermatol 25(3):267–275CrossRefGoogle Scholar
  66. 66.
    Rossman MD, Kreider ME (2007) Lesson learned from ACCESS (A Case Controlled Etiologic Study of Sarcoidosis). Proc Am Thorac Soc 4(5):453–456CrossRefGoogle Scholar
  67. 67.
    Rybicki BA, Iannuzzi MC (2007) Epidemiology of sarcoidosis: recent advances and future prospects. Semin Respir Crit Care Med 28(1):22–35CrossRefGoogle Scholar

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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Laboratory of Autoimmune Diseases Josep Font, IDIBAPS-CELLEX, Department of Autoimmune Diseases, ICMiD, Hospital ClínicUniversity of BarcelonaBarcelonaSpain
  2. 2.Primary Healthcare Transversal Research GroupInstitut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CAPSBEBarcelonaSpain
  3. 3.Autoimmune Diseases Unit, Department of MedicineHospital CIMA- SanitasBarcelonaSpain
  4. 4.Department of MedicineUniversity of Cincinnati Medical CenterCincinnatiUSA

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