The Autoimmune Epidemic: Bodies Gone Haywire in a World Out of Balance--and the Cutting-Edge Science that Promises Hope (No Series) (39 page)

Significant effects can be seen at extremely low levels:
Daly D. Hundreds of man-made chemicals—in our air, our water, and our food—could be damaging the most basic building blocks of human development. OnEarth 2006 Winter:24.

None of 11 studies conducted:
Ibid.

In the wake of the mounting data:
National Institutes of Health, Autoimmune Diseases Coordinating Committee. Progress in autoimmune diseases research. Report to Congress, 2005 Mar;31.

As an aside, while urban myth holds:
Public Health News Center, Johns Hopkins Bloomberg School of Public Health. Researcher dispels myth of dioxins and plastic water bottles. Press release, 2004 June 24. Available from http://www.jhsph.edu/publichealthnews/articles/halden_dioxins.html (accessed May 18, 2007).

Phthalates are also key ingredients:
http://www.thinkbeforeyoupink.org/Pages/CosmeticCompanies.html (accessed May 18, 2007). Also see Waldman P. From an ingredient in cosmetics, toys, a safety concern. Wall Street Journal 2005 Oct 4;A1. In this article, Waldman discusses the fact that the United States does not restrict phthalates and has lobbied the European Union hard in the last few years to avoid burdening manufacturers with new regulations on chemicals.

Like dioxin, bisphenol A, PFOAs, PBDEs, and pesticides, phthalates:
http://www.ewg.org/sites/humantoxome (accessed May 18, 2007).

Most sufferers of any one autoimmune syndrome:
Cooper GS et al. N-acetyl transferase genotypes in relation to risk of developing systemic lupus erythematosus. J Rheumatol 2004 Jan;31(1):76–80; also Freni-Titulaer LW et al. Connective tissue disease in southeastern Georgia: A case-control study of etiologic factors. Am J Epidemiol 1989 Aug;130(2):404–9.

Although Becky is not a frequent user of solvents:
Cooper GS et al. Occupational exposures and autoimmune diseases. Int Immunopharmacol 2002 Feb;2(23):303–13. Aryal BK et al. Meta analysis of systemic sclerosis and exposure to solvents. Am J Ind Med 2001 Sep;40(3):271–4. Garabrant DH et al. Scleroderma and solvent exposure among women. Am J Epidemiol 2003 Mar 15;157(6):493–500. Bovenzi M et al. A case-control study of occupational exposures and systemic sclerosis. Int Arch Occup Environ Health 2004 Jan;77(1):10–6. Epub 2003 Oct 3.

Fibrous bits of nine different synthetics:
Thompson RC et al. Lost at sea: Where is all the plastic? Science 2004 May 7;304(5672):838.

When Becky eats a dinner of mako shark:
Environmental aspects of pharmaceuticals and personal care products. Symposium, American Chemical Society National Meeting; 2004 Aug 22–26; Philadelphia. Available from http://www.scienceblog.com/community/older/2004/3/20042309.shtml (accessed May 18, 2007); see Highlights.

blends of certain synthetic compounds:
Crofton KM et al. Thyroid-hormone-disrupting chemicals: Evidence for dose-dependent additivity or synergism. Environ Health Perspect 2005 Nov;113 (11):1549–54. Bergeron JM et al. PCBs as environmental estrogens: Turtle sex determination as a biomarker of environmental contamination. Environ Health Perspect 1994 Sep;102(9):780–1.

If you were to visit the National Library of Medicine’s
TOXMAP
:
http://toxmap.nlm.nih.gov/toxmap/main/quickSearch.do;jsessionid=8AD8DC4EA0E6B4572432B80A581870C7 (accessed May 18, 2007).

In many locations, especially those with porous ground:
Magner M. Pentagon blocks EPA; Deadly solvent still threatens millions. Los Angeles Times, 2006 Mar 29. Available from http://www.storiesthatmatter.org/index.php?option=com_content&task=view&id=15&Itemid=39 (accessed May 18, 2007).

In other cities, including both Tucson and Phoenix:
Kilburn KH and Warshaw RH. Prevalence of symptoms of systematic lupus erythematosus (SLE) and of fluorescent antinuclear antibodies associated with chronic exposure to trichloroethylene and other chemicals in well water. Environ Res 1992 Feb;57(1):1–9. Kardestuncer T, Frumkin H. Systemic lupus erythematosus in relation to environmental pollution: An investigation in an African-American community in North Georgia. Arch Environ Health 1997 Mar–Apr;52(2):85–90.

TCE is regularly detected in breast milk:
National Institute of Environmental Health Sciences. Substance profile, trichloroethylene. Available from http://ntp.niehs.nih.gov/ntp/roc/eleventh/profiles/s180tce.pdf (accessed May 18, 2007).

Nevertheless, the Department of Defense:
Magner M. Pentagon blocks EPA; Deadly solvent still threatens millions. Los Angeles Times, 2006 March 29. Available from http://www.storiesthatmatter.org/index.php?option=com_content&task=view&id=15&Itemid=39 (accessed May 18, 2007).

As one epidemiologist put it:
The TCE Blog/Trichloroethylene is Everywhere, http://www.tceblog.com/posts/1154029184.shtml (accessed April 12, 2007).

certain signaling molecules:
Zouali M. Taming lupus. Sci Am, 2005 Mar;75.

In 2000, Gilbert and Pumford and colleagues:
Gilbert KM et al. Environmental contaminant trichloroethylene promotes autoimmune disease and inhibits T cell apoptosis in MRL+/+ mice. J Immunotoxicol, in press. Blossom SJ, Gilbert KM. Ability of environmental toxicant trichloroethylene to promote immune pathology is strain-specific. J Immunotoxicol, in press. Blossom SJ et al. Chronic exposure to a trichloroethylene metabolite in autoimmune-prone MRL+/+ mice promotes immune modulation and alopecia. Toxicol Sci 2007 Feb;95(2):401–11. Blossom SJ, Gilbert KM. Exposure to a metabolite of the environmental toxicant trichloroethylene attenuates CD4
⁺
T cell activation-induced cell death by metalloproteinase-dependent FasL shedding. Toxicol Sci 2006 July; 92(1):103–14. Pumford NR, Gilbert KM. Autoimmunity hepatitis. In Vohr H, ed.
Encyclopedic reference of immunotoxicology.
New York: Springer Publishing Co., 2005. Blossom SJ et al. Activation and apoptosis of CD4
⁺
T cells following
in vivo
exposure to two common environmental toxicants, trichloroacetaldehyde hydrate and trichloroacetic acid. J Autoimmun 2004 Nov;23(3):211–20. Gilbert KM et al. Environmental contaminant and disinfection by-product trichloroacetaldehyde stimulates T cells
in vitro
. Int Immunopharmacol 2004 Jan;4(1):25–36. Gilbert KM et al. Butyric acid derivative induces allospecific T-cell energy and prevents graft-versus-host disease. Immunopharmacol Immunotoxicol 2003 Feb; 25(1):13–27. Griffin JM et al. CD4+ T cell activation and induction of autoimmune hepatitis following trichloroethylene treatment in MRL+/+ mice. Toxicol Sci 2000 Oct;57(2):345–52. Gilbert KM et al. Potential clinical use of butyric acid derivatives to induce antigen-specific T cell inactivation, J Pharmacol Exp Ther 2000 Sep; 294(3):1146–53. Griffin JM et al. Inhibition of CYP2E1 reverses CD4
⁺
T cell alterations in trichloroethylene-treated MRL+/+ mice. Toxicol Sci 2000 Apr;54(2):384–9. Griffin JM et al. Trichloroethylene accelerates an autoimmune response in association with Th1 T cell activation in MRL+/+ mice. Immunopharmacology 2000 Feb; 46(2):123–37. Gilbert KM et al. Trichloroethylene activates CD4
⁺
T cells: Potential role in an autoimmune response. Drug Metab Rev 1999 Nov;31(4):901–16.

one in four people carries a gene variant:
Moore EA. Autoimmune diseases and their environmental triggers. Jefferson, N.C.: McFarland & Company, 2002;5. Also see Swanberg M et al. MHC2TA is associated with differential MHC molecule expression and susceptibility to rheumatoid arthritis, multiple sclerosis, and myocardial infarction. Nat Genet 2005 May;37(5):486–94. Epub 2005 Apr 10.

Even though they themselves are physicians:
Powell JJ et al. Evidence for the role of environmental agents in the initiation or progression of autoimmune conditions. Environ Health Perspect 1999 Oct;107(Suppl 5):667–72.

Moreover, the sheer volume of particles:
Based on an interview with Tony Ward, research assistant professor at the University of Montana in the Center for Environmental Health Sciences, January 29, 2007. Also see Missoulian.com news online, http://www.missoulian.com/articles/2003/08/19/news/local/news03.txt (accessed May 18, 2007).

Five months after Jan’s ordeal:
Ghio AJ and Huang YC. Exposure to concentrated ambient air particles alters hematologic indices in humans. Inhal Toxicol 2003 Dec;15(14):1465–78.

Eighteen months later:
Vermylen J et al. Ambient air pollution and acute myocardial infarction. J Thromb Haemost 2005 Sep;3(9):1955–61.

Individuals with rheumatoid arthritis or lupus:
Laden F et al. Reduction in fine particulate air pollution and mortality: Extended follow-up of the Harvard Six Cities study. Am J Respir Crit Care Med, 2006 Mar 15;173(6):667–72. Epub 2006 Jan 19.

If an estimated 25 percent of people:
Dale E et al. A role for transcription factor NF-kappaB in autoimmunity: Possible interactions of genes, sex, and the immune response. Adv Physiol Educ 2006 Dec;30(4):152–8. Fairweather D, Rose NR. Women and autoimmune diseases. Emerg Infect Dis 2004 Nov;10(11):2005–11.

Today, the National Institutes of Health spends:
National Institutes of Health, Autoimmune Diseases Coordinating Committee. Progress in autoimmune diseases research. Report to Congress, 2005 Mar; ii.

autoimmune disease is the number-two cause of chronic illness:
National Institutes of Health, Autoimmune Diseases Coordinating Committee, Progress in autoimmune diseases research. Report to Congress 2005 Mar; 9. In this report NIH states that cancer affects approximately 9 million people in the U.S.; heart disease affects approximately 22 million; and autoimmune disease up to 22 million. This suggests that autoimmune disease is at least the second most common cause of chronic illness.

slices fifteen years off a patient’s life:
On March 16, 2005, I attended a congressional briefing in Washington, D.C., at which Dr. Bhagirath Singh, scientific director of the Canadian Institutes of Health Research, Institute of Infection and Immunity, presented this statistic.

A report by the Institute of Medicine:
American Autoimmune Related Diseases Association. Autoimmune diseases—are a major health problem! Fact sheet, 2004 Winter. Available from the American Autoimmune Related Diseases Association, 22100 Gratiot Avenue, East Detroit, MI 48021-2227, (586) 776-3900, [email protected].

While Japan recently spent $135 million:
Daly G. Hundreds of man-made chemicals—in our air, our water, and our food—could be damaging the most basic building blocks of human development. OnEarth 2006 Winter;27.

First, the success rate for federal research:
Garrison HH, Palazzo RE. What’s happening to the new investigator? FASEB Journal 2006 Jul;20(9):1288–9. Available from http://www.fasebj.org/cgi/content/full/20/9/1288 (accessed May 18, 2007).

This makes it less likely that grants:
Correspondence by e-mail with Kathleen Gilbert, May 2, 2007.

The FDA approves about 90 percent:
Duncan DE. The pollution within. Nat Geog 2006 Oct; 122.

CHAPTER THREE: DIRTY LITTLE SECRETS

Now watch as your computer monitor:
http://www.epa.gov/enviro/emef (accessed May 18, 2007).

When lupus goes undiagnosed:
http://www.lupus.org/education/stats.html (accessed May 18, 2007).

Three months later a thirty-eight-year-old:
This patient’s last name has been changed.

The majority of soil samples:
This information on the Environmental Protection Agency’s standards is based on a conversation with Enesta Jones, EPA media office, September 15, 2006. Details regarding East Ferry’s lead soil tests are from New York State Department of Environmental Conservation, Division of Environmental Remediation. Environmental restoration record of decision, 858 East Ferry Street site, City of Buffalo, Erie County, site number B-00007-9. 1999 Mar; 7.

After that letter appeared, a piece ran:
Dolan TJ. E. side residents fear site may be causing lupus. Buffalo News, 2000 June 10;1C.

Still, while the coalition’s numbers were growing:
It should be noted here that Crystal D. Peoples, state assemblywoman, also worked with Grant and supported her efforts, sending a representative from her office to meetings. Peoples later helped to secure the reinstatement of the Superfund account.

However, in one monitored area:
New York State Department of Environmental Conservation, Division of Environmental Remediation. Record of decision, Vibratech Inc. site, Buffalo (C), Erie County, New York, Site No. 915165. 1997 Mar.

Residents learned that night:
Based on two e-mails from Julien Terrell, Toxic Waste/Lupus Coalition, February 16, 2006.

Indeed, exposure to lead in lab animals:
Farrer DG et al. Lead enhances CD4+ T cell proliferation indirectly by targeting antigen presenting cells and modulating antigen-specific interactions. Toxicol Appl Pharmacol 2005 Sep 1;207(2):125–37.