RESEARCH - Tobacco smoking and autoimmune rheumatic diseases

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Nat Clin Pract Rheumatol. 2007 Dec;3(12):707-15.

Tobacco smoking and autoimmune rheumatic diseases.

Harel-Meir M, Sherer Y, Shoenfeld Y.

Department of Medicine 'B', Chaim Sheba Medical Center, Tel-Hashomer, Israel.

Autoimmune rheumatic diseases are considered to be influenced by both

genetic and environmental factors. Tobacco smoking has been linked to

the development of rheumatic diseases, namely systemic lupus

erythematosus and rheumatoid arthritis, and has been shown to interact

with genetic factors to create a significant combined risk of disease.

Smoking also affects both the course and the outcome of rheumatic

diseases. Smoking increases the risk of dermatologic features and

nephritis in systemic lupus erythematosus, rheumatoid nodules and

multiple joint involvement in rheumatoid arthritis and digital

ischemia in systemic sclerosis, as well as further increasing the risk

of accelerated atherosclerosis in these diseases. Smoking is known to

modulate the immune system through many mechanisms, including the

induction of the inflammatory response, immune suppression, alteration

of cytokine balance, induction of apoptosis, and DNA damage that

results in the formation of anti-DNA antibodies. No sole mechanism,

however, has been linked to any of the autoimmune illnesses, which

therefore complicates full comprehension of the 'smoking effect'.

Further studies, perhaps using animal models, are needed to analyze

the exact effect of smoking on each disease separately.

PMID: 18037930

http://www.ncbi.nlm.nih.gov/pubmed/18037930

Not an MD