Silice e Immunopatie : Possibili Prospettive In Medicina Del Lavoro. Atti del 69° Congresso Nazionale della Società Italiana di Medicina del Lavoro e Igiene Industriale

Occupational exposure to crystalline silica dust rapresented in the last century one of the most important dispose of enviromental medicine mainly for lung involvement. Thechnological advances have contributed to substantially reducing the occurrence of silicosis and other respiratory disorders by decreasing the exposure levels to silica dust. Actually there is increasing evidence from epidemiologic studies that silica dust exposure is associated with increased risk for a wide variety of autoimmune diseases, including scleroderma, rheumatoid artritis, systemic sclerosis, systemic lupus erythematosus, vasculitis and impared renal function and end-stage renal diseases. Mechanisms of autoimmune induction following exposure to particulate silica are unclear, although an adjuvant effect is proposed. Silica dust may act to promote or accelerate disease development, requiring some other factor to break immune tolerance or initiate autoimmunity. It has been hypotizied that crystalline silica could promote both the activation of inflammatory pathway, that the production of autoantibodies through abnormal regulation of apoptosis. The specific manifestation of this effect may depend on underlying differences in genetic susceptibility or other environmental exposures. However more affords are needed to clarified the pathogenesis of autoimmunity. We report three clinical case in which crystalline silica dust exposure could has promoted development of autoimmune disease.