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The causal relationship between rheumatoid arthritis and bronchiectasis: a bidirectional Mendelian randomization
Yuanyuan Li1, Weina Wang1, Dengfeng Zhou1
1Department of Respiratory and Critical Care Medicine, Wuhan Fourth Hospital, Wuhan, Hubei, China.
Frontiers in Medicine
|July 5, 2024
Summary
Rheumatoid arthritis (RA) causally increases the risk of developing bronchiectasis. This study found no evidence that bronchiectasis increases RA risk, highlighting potential roles for immunosuppressants in RA-related lung conditions.
Area of Science:
- Rheumatology
- Pulmonology
- Genetic Epidemiology
Background:
- Observational studies suggest an association between rheumatoid arthritis (RA) and bronchiectasis.
- A causal link between RA and bronchiectasis requires further investigation.
Purpose of the Study:
- To determine if genetically predicted rheumatoid arthritis (RA) is associated with bronchiectasis risk.
- To investigate the reverse causal relationship: if bronchiectasis is associated with RA risk.
Main Methods:
- Utilized genome-wide association study (GWAS) data for RA and bronchiectasis.
- Employed univariate and bidirectional Mendelian randomization (MR) analyses, including inverse variance weighted (IVW) and multivariate MR (MVMR).
- Conducted mediation and sensitivity analyses to validate findings and explore mediating factors.
Main Results:
- Mendelian randomization confirmed that RA significantly increases the risk of bronchiectasis (OR=1.18).
- No evidence was found for a causal effect of bronchiectasis on RA risk.
- Immunosuppressants were identified as mediators, explaining 58% of the RA-to-bronchiectasis effect.
Conclusions:
- Established a positive causal relationship between rheumatoid arthritis and an increased risk of bronchiectasis.
- Findings support early bronchiectasis prevention strategies in RA patients.
- Highlighted the potential mediating role of immunosuppressants in RA-associated lung disease.
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