Scleroderma causes
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Causes
There is no clear obvious cause for scleroderma and systemic sclerosis. Genetic predisposition appears to be limited: genetic concordance is small; still, there often is a familial predisposition for autoimmune disease. Polymorphisms in COL1A2 and TGF-β1 may influence severity and development of the disease. There is limited evidence implicating cytomegalovirus (CMV) as the original epitope of the immune reaction, and organic solvents and other chemical agents have been linked with scleroderma.[1]
One of the suspected mechanisms behind the autoimmune phenomenon is the existence of microchimerism, i.e. fetal cells circulating in maternal blood, triggering an immune reaction to what is perceived as "foreign" material.[2][3]
A distinct form of scleroderma and systemic sclerosis may develop in patients with chronic renal failure. This entity, nephrogenic fibrosing dermopathy or nephrogenic systemic fibrosis,[4] has been linked to the exposure to gadolinium-containing radiocontrast.[5]
Bleomycin[6] (a chemotherapeutic agent) and possibly taxane chemotherapy[7] may cause scleroderma, and occupational exposure to solvents has been linked with an increased risk of systemic sclerosis.[8]
References
- ↑ Jimenez SA, Derk CT (2004). "Following the molecular pathways toward an understanding of the pathogenesis of systemic sclerosis". Annals of Internal Medicine. 140 (1): 37–50. PMID 14706971. Retrieved 2012-08-30. Unknown parameter
|month=ignored (help) - ↑ Bianchi DW (2000). "Fetomaternal cell trafficking: a new cause of disease?". Am. J. Med. Genet. 91 (1): 22–8. PMID 10751084.
- ↑
- ↑ Galan A, Cowper SE, Bucala R (2006). "Nephrogenic systemic fibrosis (nephrogenic fibrosing dermopathy)". Current opinion in rheumatology. 18 (6): 614–7. doi:10.1097/01.bor.0000245725.94887.8d. PMID 17053507.
- ↑ Boyd AS, Zic JA, Abraham JL (2007). "Gadolinium deposition in nephrogenic fibrosing dermopathy". J. Am. Acad. Dermatol. 56 (1): 27–30. doi:10.1016/j.jaad.2006.10.048. PMID 17109993.
- ↑ Sharma SK, Handa R, Sood R; et al. (2004). "Bleomycin-induced scleroderma". The Journal of the Association of Physicians of India. 52: 76–7. PMID 15633728.
- ↑ Farrant PB, Mortimer PS, Gore M (2004). "Scleroderma and the taxanes. Is there really a link?". Clin. Exp. Dermatol. 29 (4): 360–2. doi:10.1111/j.1365-2230.2004.01519.x. PMID 15245529.
- ↑ Kettaneh A, Al Moufti O, Tiev KP; et al. (2007). "Occupational exposure to solvents and gender-related risk of systemic sclerosis: a metaanalysis of case-control studies". J. Rheumatol. 34 (1): 97–103. PMID 17117485.