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Smoking and rheumatoid arthritis
Kathleen Chang1, So Min Yang2, Seong Heon Kim3
1Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne 3800, Australia. kcha105@student.monash.edu.
International Journal of Molecular Sciences
|December 6, 2014
Summary
Smoking is a major risk factor for rheumatoid arthritis (RA) development and severity. Heavy smokers show poorer response to anti-tumour necrosis factor (anti-TNF) therapies, with potential immunological mechanisms discussed.
Area of Science:
- Immunology
- Rheumatology
- Environmental Health
Background:
- Rheumatoid arthritis (RA) is a chronic inflammatory condition influenced by genetic and environmental factors.
- Smoking is a significant extrinsic risk factor linked to RA development and disease severity.
- Pathophysiological mechanisms in RA smokers include oxidative stress, inflammation, autoantibody production, and epigenetic alterations.
Purpose of the Study:
- To review the impact of smoking on rheumatoid arthritis pathophysiology.
- To investigate how smoking influences treatment response to disease-modifying antirheumatic drugs (DMARDs), particularly biological agents.
- To explore potential immunological mechanisms behind smoking's effect on anti-tumour necrosis factor (anti-TNF) therapy.
Main Methods:
- Review of epidemiological studies demonstrating the association between smoking and RA.
- Analysis of in vivo and animal models of RA related to smoking.
- Examination of recent evidence on smoking's effect on anti-TNF therapy response and drug survival.
Main Results:
- Epidemiological data and animal models confirm smoking's role in RA development and severity.
- Evidence indicates poorer treatment response and drug survival with anti-TNF therapy in heavy smokers.
- The paper discusses possible immunological mechanisms underlying these observed effects.
Conclusions:
- Smoking is a critical environmental factor in rheumatoid arthritis.
- Smokers, especially heavy smokers, may experience reduced efficacy from anti-TNF therapies.
- Understanding these effects is crucial for optimizing RA treatment strategies.
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