Association between smoking and Behçet's disease: a nationwide population‐based study in Korea

Lee, Y.B.; Lee, J.H.; Lee, S.Y.; Yu, D.S.; Han, Kyung Do; Park, Y.G.

doi:10.1111/jdv.15708

Cited by 17 publications

(15 citation statements)

References 65 publications

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“…A study from Japan has shown that neurological involvement is more likely to develop in male smokers [39], suggesting that the recent shrinkage in cluster 5 is relate to fewer male smokers in Japan, though positive or negative effects of smoking on BD have been controversial [39][40][41][42]. Alternatively, improvement of oral hygiene [43] and altered microbiota [44] can also contribute to lowering the rate of serious BD phenotypes.…”

Section: Discussionmentioning

confidence: 99%

Changes in the proportion of clinical clusters contribute to the phenotypic evolution of Behçet’s disease in Japan

et al. 2021

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Background We hypothesized that Behçet’s disease (BD) consists of several clinical subtypes with different severity, resulting in heterogeneity of the disease. Here, we conducted a study to identify clinical clusters of BD. Methods A total of 657 patients registered in the Yokohama City University (YCU) regional BD registry between 1990 and 2018, as well as 6754 patients who were initially registered in the Japanese Ministry of Health, Labour and Welfare (MHLW) database between 2003 and 2014, were investigated. The YCU registry data regarding the clinical manifestations of BD, human leukocyte antigen (HLA) status, treatments, and hospitalizations were analyzed first, followed by similar analyses of the MHLW for validation. A hierarchical cluster analysis was independently performed in both patient groups. Results A hierarchical cluster analysis determined five independent clinical clusters in the YCU cohort. Individual counterparts of the YCU clusters were confirmed in the MHLW registry. Recent phenotypical evolutions of BD in Japan, such as increased gastrointestinal (GI) involvement, reduced complete type according to the Japan Criteria, and reduced HLA-B51 positivity were associated with chronologically changing proportions of the clinical clusters. Conclusions In this study, we identified independent clinical clusters among BD patients in Japan and found that the proportion of each cluster varied over time. We propose five independent clusters namely “mucocutaneous”, “mucocutaneous with arthritis”, “neuro”, “GI”, and “eye.”

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Section: Discussionmentioning

confidence: 99%

Changes in the proportion of clinical clusters contribute to the phenotypic evolution of Behçet’s disease in Japan

et al. 2021

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“…Development of aphthous ulcers is associated with cessation of smoking [44][45][46][47][48][49][50] . The beneficial effects of smoking on oral ulcers in Behçet's disease has been shown in several reports [34][35][36] . Behçet's disease oral lesions appear after cessation of smoking; therefore, the beneficial effects of nicotine have been suggested [51][52][53][54] .…”

Section: Discussionmentioning

confidence: 92%

“…Smoking is known to have detrimental effects on and a positive association with psoriasis [16][17][18][19] , palmoplantar pustulosis, 20 and hidradenitis suppurativa [21][22][23][24][25][26][27] . However, several autoimmune skin diseases, such as pemphigus vulgaris, foliaceous, and 28-33 Behçet's disease [34][35][36] , show a negative association with smoking. We recently reported that the incidence of Behçet's disease in current smokers was significantly decreased compared to that of never-smokers in South Korea 36 .…”

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confidence: 99%

Association between vitiligo and smoking: A nationwide population-based study in Korea

Lee

et al. 2020

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no study has examined the associations between vitiligo and smoking. the purpose of this study was to investigate the incidence of vitiligo according to smoking status. We used clinical data from individuals aged over 20 years who received a health examination in the National Insurance Program between 2009 and 2012 (n = 23,503,807). We excluded individuals with pre-existing vitiligo who had ever been diagnosed with vitiligo before the index year (n = 35,710) or who were diagnosed with vitiligo within a year of the index year (n = 46,476). Newly diagnosed vitiligo was identified using claims data from baseline to date of diagnosis or December 31, 2016 (n = 22,811). The development of vitiligo was compared according to self-reported smoking status by a health examination survey. the hazard ratio of vitiligo in current smokers was 0.69 (95% confidence interval; 0.65-0.72) with a reference of neversmokers after adjustment for age, sex, regular exercise, drinking status, body mass index, diabetes mellitus, hypertension, dyslipidemia, history of stroke, and history of ischemic heart diseases. the decreased risk of vitiligo in current smokers persisted after subgroup analysis of sex and age groups. The results suggested there are suppressive effects of smoking on the development of vitiligo. Further studies are needed to evaluate the mechanism of smoking on the development of vitiligo.Vitiligo is a common depigmentation skin disease with an estimated prevalence of 0.5-1% in the worldwide population 1 . Vitiligo affects all skin types and ethnic groups. The highest incidence is recorded in India (up to 8.8%) 2 , followed by Mexico (4%) 3 , Japan (1.68%) 4 , and Denmark (0.38%) 5 . The annual incidence of vitiligo in South Korea was estimated at 0.12-0.13% 6 .Vitiligo is a multifactorial disease. It is hypothesized to be mainly caused by autoimmune factors, although genetic susceptibility, oxidative stress, and cell detachment abnormalities are also suggested etiologies 7 . The autoimmune diseases vitiligo is associated with include autoimmune thyroid disorders, rheumatoid arthritis, adult-onset diabetes mellitus, pernicious anemia, and systemic lupus erythematosus 8,9 . Once vitiligo develops, it is difficult to treat and affects quality of life. Vitiligo can negatively affect social relations 10-13 . One study showed that vitiligo has an adverse effect on patient sexuality 14 , and it has been associated with pessimistic emotions such as shame, insecurity, and sadness 15 . Therefore, evaluating the preventive and risk factors for vitiligo is important.Smoking is one of the most prevalent addictive habits that affects multi-organ systems and results in several diseases. The well-known risks of smoking habits include respiratory and cardiovascular diseases. Smoking also affects the immune system and results in inflammatory reactions. Tobacco contains as many as 6,000 different components including nicotine, polycyclic aromatic hydrocarbons, tobacco glycoprotein, and some metals, many of which are considered antigenic, c...

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“…It has been suggested that smoking increases the risk of relapse of inflammatory and autoimmune diseases, in general [84][85][86]. Lee et al [87] reported that smoking and Behçet disease were closely associated in a Korean population-based study. Costa et al [88] also reported that smoking was associated with the risk of uveitis in Portuguese patients with spondyloarthropathies.…”

Section: Discussionmentioning

confidence: 99%

Signature of Circulating Biomarkers in Recurrent Non-Infectious Anterior Uveitis. Immunomodulatory Effects of DHA-Triglyceride. A Pilot Study

et al. 2021

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The purpose of this study was to identify circulating biomarkers of recurrent non-infectious anterior uveitis (NIAU), and to address the anti-inflammatory effects of triglyceride containing docosahexaenoic acid (DHA-TG). A prospective multicenter study was conducted in 72 participants distributed into: patients diagnosed with recurrent NIAU in the quiescence stage (uveitis group (UG); n = 36) and healthy controls (control group (CG); n = 36). Each group was randomly assigned to the oral supplementation of one pill/day (+) containing DHA-TG (n = 18) or no-pill condition (−) (n = 17) for three consecutive months. Data from demographics, risk factors, comorbidities, eye complications and therapy were recorded. Blood was collected and processed to determine pro-inflammatory biomarkers by bead-base multiplex assay. Statistical processing with multivariate statistical analysis was performed. The mean age was 50, 12 (10, 31) years. The distribution by gender was 45% males and 55% females. The mean number of uveitis episodes was 5 (2). Higher plasma expression of interleukin (IL)-6 was detected in the UG versus the CG (p = 5 × 10−5). Likewise, significantly higher plasma levels were seen for IL-1β, IL-2, INFγ (p = 10−4), and TNFα (p = 2 × 10−4) in the UG versus the CG. Significantly lower values of the above molecules were found in the +DHA-TG than in the -DHA-TG subgroups, after 3 months of follow-up, TNFα (p = 10−7) and IL-6 (p = 3 × 10−6) being those that most significantly changed. Signatures of circulating inflammatory mediators were obtained in the quiescent stage of recurrent NIAU patients. This 3-month follow-up strongly reinforces that a regular oral administration of DHA-TG reduces the inflammatory load and may potentially supply a prophylaxis-adjunctive mediator for patients at risk of uveitis vision loss.

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Association between smoking and Behçet's disease: a nationwide population‐based study in Korea

Cited by 17 publications

References 65 publications

Changes in the proportion of clinical clusters contribute to the phenotypic evolution of Behçet’s disease in Japan

Changes in the proportion of clinical clusters contribute to the phenotypic evolution of Behçet’s disease in Japan

Association between vitiligo and smoking: A nationwide population-based study in Korea

Signature of Circulating Biomarkers in Recurrent Non-Infectious Anterior Uveitis. Immunomodulatory Effects of DHA-Triglyceride. A Pilot Study

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