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. 2008 Mar 5;116(6):695–702. doi: 10.1289/ehp.11092

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Possible immune-related effects of silica in relation to SLE pathogenesis. Apoptosis of macrophages needed for efficient clearance of debris, along with proinflammatory cytokines, results in uptake of apoptotic debris by activated APCs. The self-antigen may be altered structurally or spatially by oxidative stress. Inflammation helps drive both fibrosis and autoimmunity, resulting in reciprocal exacerbation.