Toggle Main Menu Toggle Search

Open Access padlockePrints

Influence of exposure to climate-related hazards in the phenotypic expression of primary Sjögren's syndrome

Lookup NU author(s): Professor Fai NgORCiD, Dr Kyle Thompson


Full text for this publication is not currently held within this repository. Alternative links are provided below where available.


OBJECTIVES: To analyse how the key components at the time of diagnosis of the Sjögren's phenotype (epidemiological profile, sicca symptoms, and systemic disease) can be influenced by the potential exposure to climate-related natural hazards. METHODS: For the present study, the following variables were selected for harmonisation and refinement: age, sex, country, fulfilment of 2002/2016 criteria items, dry eyes, dry mouth, and overall ESSDAI score. Climate-related hazards per country were defined according to the OECD and included seven climate-related hazard types: extreme temperature, extreme precipitation, drought, wildfire, wind threats, river flooding, and coastal flooding. Climatic variables were defined as dichotomous variables according to whether each country is ranked among the ten countries with the most significant exposure. RESULTS: After applying data-cleaning techniques and excluding people from countries not included in the OECD climate rankings, the database study analysed 16,042 patients from 23 countries. The disease was diagnosed between 1 and 3 years earlier in people living in countries included among the top 10 worst exposed to extreme precipitation, wildfire, wind threats, river flooding, and coastal flooding. A lower frequency of dry eyes was observed in people living in countries exposed to wind threats, river flooding, and coastal flooding, with a level of statistical association being classified as strong (p<0.0001 for the three variables). The frequency of dry mouth was significantly lower in people living in countries exposed to river flooding (p<0.0001) and coastal flooding (p<0.0001). People living in countries included in the worse climate scenarios for extreme temperature (p<0.0001) and river flooding (p<0.0001) showed a higher mean ESSDAI score in comparison with people living in no-risk countries. In contrast, those living in countries exposed to worse climate scenarios for wind threats (p<0.0001) and coastal flooding (p<0.0001) showed a lower mean ESSDAI score in comparison with people living in no-risk countries. CONCLUSIONS: Local exposure to extreme climate-related hazards plays a role in modulating the presentation of Sjögren across countries concerning the age at which the disease is diagnosed, the frequency of dryness, and the degree of systemic activity.

Publication metadata

Author(s): Flores-Chavez A, Brito-Zeron P, Ng W-F, Szanto A, Rasmussen A, Priori R, Baldini C, Armagan B, Ozkiziltas B, Praprotnik S, Suzuki Y, Quartuccio L, Hernandez-Molina G, Inanc N, Bartoloni E, Rischmueller M, Reis-de Oliveira F, Fernandes Moca Trevisani V, Jurcut C, Nordmark G, Carubbi F, Hofauer B, Valim V, Pasoto SG, Retamozo S, Atzeni F, Fonseca-Aizpuru E, Lopez-Dupla M, Giacomelli R, Nakamura H, Akasbi M, Thompson K, Fanny Horvath I, Farris AD, Simoncelli E, Bombardieri S, Kilic L, Tufan A, Perdan Pirkmajer K, Fujisawa Y, De Vita S, Abacar K, Ramos-Casals M

Publication type: Article

Publication status: Published

Journal: Clinical and Experimental Rheumatology

Year: 2023

Volume: 41

Issue: 12

Pages: 2437-2447

Print publication date: 23/12/2023

Online publication date: 27/11/2023

Acceptance date: 24/10/2023

ISSN (print): 0392-856X

ISSN (electronic): 1593-098X

Publisher: Clinical and Experimental Rheumatology


DOI: 10.55563/clinexprheumatol/pmbay6

PubMed id: 38019164


Altmetrics provided by Altmetric