{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T06:32:00Z","timestamp":1786516320432,"version":"build-2736575974"},"reference-count":47,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Ambient air pollutants have been increasingly implicated in immune-mediated disorders, yet the metabolic perturbations through which long-term exposure may contribute to rheumatoid arthritis (RA) remain insufficiently characterized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We used data from 403,332 RA-free participants in the UK Biobank cohort to investigate the associations among long-term ambient air pollution exposure, plasma metabolic signatures, and incident RA risk. Participants were followed for a median of 14.01 years. Residential annual average concentrations of PM\n                      <jats:sub>2.5<\/jats:sub>\n                      , PM\n                      <jats:sub>10<\/jats:sub>\n                      , NO\n                      <jats:sub>2<\/jats:sub>\n                      , and NO\n                      <jats:sub>x<\/jats:sub>\n                      were linked to participants' addresses, and a composite air pollution score (APS) was calculated to reflect overall exposure burden. Plasma metabolomics data were used to characterize metabolic perturbations related to each pollutant. A machine learning model was applied to identify air pollutant-associated metabolites and construct corresponding metabolic signatures. We then examined the relationships of air pollutants and derived metabolic signatures with RA risk using Cox proportional hazards models. Generalized propensity score analyses were performed to assess whether the findings persisted after covariate balancing, and mediation analyses were conducted to estimate the contribution of metabolic signatures to the relationship of air pollutants and RA.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Each standard deviation increase in the\n                      <jats:inline-formula>\n                        <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\">\n                          <mml:msub>\n                            <mml:mrow>\n                              <mml:mtext>PM<\/mml:mtext>\n                            <\/mml:mrow>\n                            <mml:mrow>\n                              <mml:mn>2<\/mml:mn>\n                              <mml:mo>.<\/mml:mo>\n                              <mml:msup>\n                                <mml:mrow>\n                                  <mml:mn>5<\/mml:mn>\n                                <\/mml:mrow>\n                                <mml:mrow>\n                                  <mml:mo>-<\/mml:mo>\n                                <\/mml:mrow>\n                              <\/mml:msup>\n                            <\/mml:mrow>\n                          <\/mml:msub>\n                        <\/mml:math>\n                      <\/jats:inline-formula>\n                      ,\n                      <jats:inline-formula>\n                        <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\">\n                          <mml:msub>\n                            <mml:mrow>\n                              <mml:mtext>NO<\/mml:mtext>\n                            <\/mml:mrow>\n                            <mml:mrow>\n                              <mml:msup>\n                                <mml:mrow>\n                                  <mml:mn>2<\/mml:mn>\n                                <\/mml:mrow>\n                                <mml:mrow>\n                                  <mml:mo>-<\/mml:mo>\n                                <\/mml:mrow>\n                              <\/mml:msup>\n                            <\/mml:mrow>\n                          <\/mml:msub>\n                        <\/mml:math>\n                      <\/jats:inline-formula>\n                      ,\n                      <jats:inline-formula>\n                        <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M3\">\n                          <mml:msub>\n                            <mml:mrow>\n                              <mml:mtext>NO<\/mml:mtext>\n                            <\/mml:mrow>\n                            <mml:mrow>\n                              <mml:msup>\n                                <mml:mrow>\n                                  <mml:mtext>x<\/mml:mtext>\n                                <\/mml:mrow>\n                                <mml:mrow>\n                                  <mml:mo>-<\/mml:mo>\n                                <\/mml:mrow>\n                              <\/mml:msup>\n                            <\/mml:mrow>\n                          <\/mml:msub>\n                        <\/mml:math>\n                      <\/jats:inline-formula>\n                      , and APS-related metabolic signatures was associated with elevated RA risk, with hazard ratios of 1.208 (95% CI: 1.180, 1.236), 1.141 (95% CI: 1.109, 1.173), 1.174 (95% CI: 1.148, 1.201), and 1.184 (95% CI: 1.156, 1.212), respectively. Similar estimates were observed in generalized propensity score analyses. Metabolic signatures accounted for 15.7% to 21.1% of the associations between air pollution exposure and RA risk.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These findings suggest that long-term air pollution exposure is associated with incident RA risk and that systemic metabolic perturbations may represent potential biological pathways underlying this association.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1901951","type":"journal-article","created":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T06:00:29Z","timestamp":1786514429000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Plasma metabolomic signatures of air pollution and rheumatoid arthritis risk"],"prefix":"10.3389","volume":"14","author":[{"given":"Yangchang","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Rheumatology and Immunology, The First Affiliated Hospital of Chongqing University of Chinese Medicine","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tian","family":"Liang","sequence":"additional","affiliation":[{"name":"School of Public Health, Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Pu","sequence":"additional","affiliation":[{"name":"School of General Education, Chongqing University of Chinese Medicine","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linpeng","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Immunology, The First Affiliated Hospital of Chongqing University of Chinese Medicine","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lingli","family":"Ding","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Immunology, The First Affiliated Hospital of Chongqing University of Chinese Medicine","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chengyin","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Immunology, The First Affiliated Hospital of Chongqing University of Chinese Medicine","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xun","family":"Lei","sequence":"additional","affiliation":[{"name":"School of Public Health, Chongqing Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Immunology, The First Affiliated Hospital of Chongqing University of Chinese Medicine","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,12]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"102036","DOI":"10.1016\/j.berh.2025.102036","article-title":"A review on the epidemiology of rheumatoid arthritis: An update and trends from current literature. Best practice & research","volume":"39","author":"Uke","year":"2025","journal-title":"Clinic Rheumatol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1186\/s40364-025-00760-8","article-title":"Global, regional and national burden of rheumatoid arthritis from 1990 to 2021, with projections of incidence to 2050: a systematic and comprehensive analysis of the Global Burden of Disease study 2021","volume":"13","author":"Ma","year":"2025","journal-title":"Biom Res."},{"key":"B3","doi-asserted-by":"publisher","first-page":"591","DOI":"10.1038\/s41584-022-00827-y","article-title":"Global epidemiology of rheumatoid arthritis","volume":"18","author":"Finckh","year":"2022","journal-title":"Nat Rev Rheumatol."},{"key":"B4","doi-asserted-by":"publisher","first-page":"669","DOI":"10.3899\/jrheum.200367","article-title":"The prevalence of rheumatoid arthritis: a systematic review of population-based studies","volume":"48","author":"Almutairi","year":"2021","journal-title":"J Rheumatol."},{"key":"B5","doi-asserted-by":"publisher","first-page":"851","DOI":"10.3390\/toxics12120851","article-title":"The relationship between PM2.5 and eight common lung diseases: a two-sample Mendelian randomization analysis","volume":"12","author":"Jiang","year":"2024","journal-title":"Toxics"},{"key":"B6","doi-asserted-by":"publisher","first-page":"37008","DOI":"10.1289\/EHP10710","article-title":"Association of combined exposure to ambient air pollutants, genetic risk, and incident rheumatoid arthritis: a prospective cohort study in the UK Biobank","volume":"131","author":"Zhang","year":"2023","journal-title":"Environ Health Perspect."},{"key":"B7","doi-asserted-by":"publisher","first-page":"118187","DOI":"10.1016\/j.ecoenv.2025.118187","article-title":"Long-term air pollution exposure and cardiovascular disease progression in rheumatoid arthritis: as prospective cohort study using multi-state model analysis","volume":"296","author":"Zhang","year":"2025","journal-title":"Ecotoxicol Environ Saf."},{"key":"B8","doi-asserted-by":"publisher","first-page":"e002055","DOI":"10.1136\/rmdopen-2021-002055","article-title":"Association between long-term exposure to air pollution and immune-mediated diseases: a population-based cohort study","volume":"8","author":"Adami","year":"2022","journal-title":"RMD Open"},{"key":"B9","doi-asserted-by":"publisher","first-page":"e003680","DOI":"10.1136\/rmdopen-2023-003680","article-title":"PM(10) increases mortality risk in rheumatoid arthritis-associated interstitial lung disease","volume":"10","author":"Kim","year":"2024","journal-title":"RMD Open"},{"key":"B10","doi-asserted-by":"publisher","first-page":"4591","DOI":"10.1093\/rheumatology\/keab049","article-title":"Association between environmental air pollution and rheumatoid arthritis flares","volume":"60","author":"Adami","year":"2021","journal-title":"Rheumatology (Oxford)."},{"key":"B11","doi-asserted-by":"publisher","first-page":"266","DOI":"10.1016\/j.semarthrit.2019.10.005","article-title":"Long-term exposure to outdoor air pollution and the risk of development of rheumatoid arthritis: a systematic review and meta-analysis","volume":"50","author":"Di","year":"2020","journal-title":"Semin Arthritis Rheum."},{"key":"B12","doi-asserted-by":"publisher","first-page":"1190","DOI":"10.1002\/acr.21975","article-title":"Ambient air pollution exposures and risk of rheumatoid arthritis","volume":"65","author":"Hart","year":"2013","journal-title":"Arthritis Care Res."},{"key":"B13","doi-asserted-by":"publisher","first-page":"888","DOI":"10.1136\/annrheumdis-2012-201587","article-title":"Ambient air pollution exposures and risk of rheumatoid arthritis: results from the Swedish EIRA case-control study","volume":"72","author":"Hart","year":"2013","journal-title":"Ann Rheum Dis."},{"key":"B14","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1002\/acr.25403","article-title":"Fine particulate matter components and risk of rheumatoid arthritis: a large general Canadian open cohort study","volume":"77","author":"Zhao","year":"2025","journal-title":"Arthritis Care Res."},{"key":"B15","doi-asserted-by":"publisher","first-page":"1333811","DOI":"10.3389\/fpubh.2024.1333811","article-title":"Causal association between air pollution and autoimmune diseases: a two-sample Mendelian randomization study","volume":"12","author":"Hu","year":"2024","journal-title":"Front Public Health."},{"key":"B16","doi-asserted-by":"publisher","first-page":"e14260","DOI":"10.1002\/advs.202514260","article-title":"PM(10) impairs CD56(dim) NK cell cytotoxicity via FNBP1 suppression to exacerbate rheumatoid arthritis: insights from multimodal multi-omics","volume":"13","author":"Zhao","year":"2026","journal-title":"Adv Sci."},{"key":"B17","doi-asserted-by":"publisher","first-page":"124","DOI":"10.1016\/j.envint.2018.11.034","article-title":"Impact of short-term traffic-related air pollution on the metabolome - Results from two metabolome-wide experimental studies","volume":"123","author":"van Veldhoven","year":"2019","journal-title":"Environ Int."},{"key":"B18","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1016\/j.ajcnut.2023.04.034","article-title":"Metabolic signature of healthy lifestyle and risk of rheumatoid arthritis: observational and Mendelian randomization study","volume":"118","author":"Zhang","year":"2023","journal-title":"Am J Clin Nutr."},{"key":"B19","doi-asserted-by":"publisher","first-page":"e003560","DOI":"10.1136\/rmdopen-2023-003560","article-title":"Metabolomic profiles, polygenic risk scores and risk of rheumatoid arthritis: a population-based cohort study in the UK Biobank","volume":"9","author":"Fang","year":"2023","journal-title":"RMD Open"},{"key":"B20","doi-asserted-by":"publisher","first-page":"e1001779","DOI":"10.1371\/journal.pmed.1001779","article-title":"UK biobank: an open access resource for identifying the causes of a wide range of complex diseases of middle and old age","volume":"12","author":"Sudlow","year":"2015","journal-title":"PLoS Med."},{"key":"B21","doi-asserted-by":"publisher","first-page":"419","DOI":"10.1007\/s11926-014-0419-6","article-title":"Preclinical rheumatoid arthritis (autoantibodies): an updated review","volume":"16","author":"Deane","year":"2014","journal-title":"Curr Rheumatol Rep."},{"key":"B22","doi-asserted-by":"publisher","first-page":"1084","DOI":"10.1093\/aje\/kwx016","article-title":"Quantitative serum nuclear magnetic resonance metabolomics in large-scale epidemiology: a primer on -omic technologies","volume":"186","author":"W\u00fcrtz","year":"2017","journal-title":"Am J Epidemiol."},{"key":"B23","doi-asserted-by":"publisher","first-page":"3690","DOI":"10.1038\/s41467-026-70393-4","article-title":"Residential green space, air pollution, and related metabolites in association with depression among cancer survivors","volume":"17","author":"Zhao","year":"2026","journal-title":"Nat Commun"},{"key":"B24","doi-asserted-by":"publisher","first-page":"5903","DOI":"10.1038\/s41467-024-50258-4","article-title":"Effects of diets on risks of cancer and the mediating role of metabolites","volume":"15","author":"Fan","year":"2024","journal-title":"Nat Commun."},{"key":"B25","doi-asserted-by":"publisher","first-page":"604","DOI":"10.1038\/s41467-023-36231-7","article-title":"Atlas of plasma NMR biomarkers for health and disease in 118,461 individuals from the UK Biobank","volume":"14","author":"Julkunen","year":"2023","journal-title":"Nat Commun."},{"key":"B26","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1186\/s12933-026-03129-9","article-title":"Circulating cardiometabolic metabolite profiles associated with ambient air pollution and atrial fibrillation risk: a prospective cohort study","volume":"25","author":"Shi","year":"2026","journal-title":"Cardiovasc Diabetol."},{"key":"B27","doi-asserted-by":"publisher","first-page":"140506","DOI":"10.1016\/j.jhazmat.2025.140506","article-title":"Mapping plasma metabolic profiles reflecting air pollution and their association with kidney failure: a prospective cohort study","volume":"500","author":"Hu","year":"2025","journal-title":"J Hazard Mater."},{"key":"B28","doi-asserted-by":"publisher","first-page":"e70007","DOI":"10.1002\/acr.70007","article-title":"Characterizing metabolic signatures of air pollution and their association with the risk of gout: a population-based cohort study","volume":"7","author":"Hu","year":"2025","journal-title":"Arthritis Care Res."},{"key":"B29","doi-asserted-by":"publisher","first-page":"5117","DOI":"10.1093\/rheumatology\/keab127","article-title":"Association of particulate matter with autoimmune rheumatic diseases among adults in South Korea","volume":"60","author":"Park","year":"2021","journal-title":"Rheumatology."},{"key":"B30","doi-asserted-by":"publisher","first-page":"808","DOI":"10.1002\/art.43113","article-title":"3rd, et al. Associations of fire smoke and other pollutants with incident rheumatoid arthritis and rheumatoid arthritis-associated interstitial lung disease","volume":"77","author":"Kronzer","year":"2025","journal-title":"Arthritis Rheumatol"},{"key":"B31","doi-asserted-by":"publisher","first-page":"495","DOI":"10.1016\/j.envint.2016.06.008","article-title":"Air pollution exposure increases the risk of rheumatoid arthritis: A longitudinal and nationwide study","volume":"94","author":"Chang","year":"2016","journal-title":"Environ Int."},{"key":"B32","doi-asserted-by":"publisher","first-page":"341","DOI":"10.1016\/j.envres.2017.03.042","article-title":"The impact of ambient air pollution on the human blood metabolome","volume":"156","author":"Vlaanderen","year":"2017","journal-title":"Environ Res."},{"key":"B33","doi-asserted-by":"publisher","first-page":"1425","DOI":"10.1002\/art.70054","article-title":"Late-onset rheumatoid arthritis and air pollution in the multiethnic cohort","volume":"78","author":"Wu","year":"2026","journal-title":"Arthritis Rheumatol."},{"key":"B34","doi-asserted-by":"publisher","first-page":"132844","DOI":"10.1016\/j.jhazmat.2023.132844","article-title":"Ambient air pollution exposure, plasma metabolomic markers, and risk of type 2 diabetes: A prospective cohort study","volume":"463","author":"Xu","year":"2023","journal-title":"J Hazard Mater."},{"key":"B35","doi-asserted-by":"publisher","first-page":"120131","DOI":"10.1016\/j.envres.2024.120131","article-title":"Long-term air pollution exposure and the blood metabolome: the Rotterdam study","volume":"263","author":"Ginos","year":"2024","journal-title":"Environ Res"},{"key":"B36","doi-asserted-by":"publisher","first-page":"107632","DOI":"10.1016\/j.envint.2022.107632","article-title":"Longitudinal associations between metabolites and long-term exposure to ambient air pollution: Results from the KORA cohort study","volume":"170","author":"Yao","year":"2022","journal-title":"Environ Int."},{"key":"B37","doi-asserted-by":"publisher","first-page":"607","DOI":"10.1016\/j.autrev.2018.12.010","article-title":"Emerging role of air pollution in autoimmune diseases","volume":"18","author":"Zhao","year":"2019","journal-title":"Autoimmun Rev."},{"key":"B38","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1089\/ars.2020.8096","article-title":"Pathogenic role of air pollution particulate matter in cardiometabolic disease: evidence from mice and humans","volume":"33","author":"Marchini","year":"2020","journal-title":"Antioxid Redox Signal."},{"key":"B39","doi-asserted-by":"publisher","first-page":"116242","DOI":"10.1016\/j.envpol.2020.116242","article-title":"Emerging role of mitochondria in airborne particulate matter-induced immunotoxicity","volume":"270","author":"Sharma","year":"2021","journal-title":"Environ pollut"},{"key":"B40","doi-asserted-by":"publisher","first-page":"1556","DOI":"10.1093\/ntr\/ntw030","article-title":"Smoking and air pollution as pro-inflammatory triggers for the development of rheumatoid arthritis","volume":"18","author":"Anderson","year":"2016","journal-title":"Nicotine Tobacco Res."},{"key":"B41","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1016\/j.jbspin.2018.03.001","article-title":"Air pollution as a determinant of rheumatoid arthritis","volume":"86","author":"Sigaux","year":"2019","journal-title":"Joint Bone Spine."},{"key":"B42","doi-asserted-by":"publisher","first-page":"118008","DOI":"10.1016\/j.envpol.2021.118008","article-title":"Proinflammatory lipid signals trigger the health effects of air pollution in individuals with prediabetes","volume":"290","author":"Wang","year":"2021","journal-title":"Environ Pollut"},{"key":"B43","doi-asserted-by":"publisher","first-page":"115449","DOI":"10.1016\/j.envres.2023.115449","article-title":"UV radiation and air pollution as drivers of major autoimmune conditions","volume":"224","author":"Piovani","year":"2023","journal-title":"Environ Res."},{"key":"B44","doi-asserted-by":"publisher","first-page":"100253","DOI":"10.1016\/j.jtauto.2024.100253","article-title":"Airborne culprits: A comprehensive review of PM, silica, and TCDD in autoimmune diseases","volume":"9","author":"Galeano-S\u00e1nchez","year":"2024","journal-title":"J Transl Autoimmun."},{"key":"B45","doi-asserted-by":"publisher","first-page":"909879","DOI":"10.3389\/fmed.2022.909879","article-title":"What is the impact of sex hormones on the pathogenesis of rheumatoid arthritis?","volume":"9","author":"Raine","year":"2022","journal-title":"Front Med."},{"key":"B46","doi-asserted-by":"publisher","first-page":"e004180","DOI":"10.1136\/rmdopen-2024-004180","article-title":"What role do socioeconomic and clinical factors play in disease activity states in rheumatoid arthritis? Data from a large UK early inflammatory arthritis audit","volume":"10","author":"Adas","year":"2024","journal-title":"RMD open"},{"key":"B47","doi-asserted-by":"publisher","first-page":"945762","DOI":"10.3389\/fimmu.2022.945762","article-title":"Sex bias in lymphocytes: implications for autoimmune diseases","volume":"13","author":"Dodd","year":"2022","journal-title":"Front Immunol."}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1901951\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T06:00:30Z","timestamp":1786514430000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1901951\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,12]]},"references-count":47,"alternative-id":["10.3389\/fpubh.2026.1901951"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2026.1901951","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,12]]},"article-number":"1901951"}}