RESEARCH - Smoking as a trigger for inflammatory rheumatic diseases

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Curr Opin Rheumatol. 2007 Jan;19(1):49-54.

Smoking as a trigger for inflammatory rheumatic diseases.

aRheumatology Unit, Department of Medicine, Karolinska Institutet at

Karolinska University Hospital Solna bInstitute of Environmental Medicine,

Karolinska Institutet, and Stockholm Center for Public Health, Stockholm

County Council, Stockholm, Sweden.

PURPOSE OF REVIEW: This review has two purposes: to describe the known

effects of cigarette smoking on the development of inflammatory rheumatic

diseases, in particular rheumatoid arthritis and systemic lupus

erythematosus, and to review recent research aimed at understanding the

mechanisms by which smoking may interact with genes and immunity in

triggering these diseases. RECENT FINDINGS: Large case-control studies as

well as cohort studies have demonstrated that cigarette smoking is a risk

factor for RF positive and anti-citrulline antibody with rheumatoid

arthritis and that the risk diminishes only several years after cessation of

smoking. Evidence exists that smoking is a risk factor also for systemic

lupus erythematosus, and that the risk may be related to the presence of

anti-dsDNA antibodies. Mechanistic studies are reviewed that suggest that

smoking can trigger specific and potentially disease-inducing immune

reactions against citrullinated proteins in rheumatoid arthritis, and dsDNA

in systemic lupus erythematosus, and it is suggested that the genetic

context determines which immune reactions may be triggered by smoking.

SUMMARY: Counselling against smoking should be mandatory in rheumatological

practice both to patients and to their relatives. Studies on the mechanisms

whereby smoking triggers rheumatoid arthritis and systemic lupus

erythematosus may provide fundamental new knowledge about the cause and

molecular pathogenesis of these diseases.

PMID: 17143096

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed & cmd=Retrieve & dopt=Abstra\

ctPlus & list_uids=17143096

Not an MD