Association of smoking with dsDNA autoantibody production in systemic lupus erythematosus

Abstract

Objective: To determine whether exposure to tobacco smoke is associated with double stranded DNA (dsDNA) seropositivity in patients with systemic lupus erythematosus (SLE). Methods: Medical record review was used to confirm the diagnosis of SLE and evaluate dsDNA antibody status. Smoking status at the time of autoantibody testing was assessed by patients' questionnaire responses. Multivariate regression analysis was used to determine whether exposure to tobacco smoke is associated with dsDNA seropositivity, while controlling for sex and age at SLE diagnosis. Results: A significantly higher risk of dsDNA seropositivity in current smokers than never smokers (odds ratio (OR) = 4.0, 95% confidence interval (CI) 1.6 to 10.4) was shown by multivariate analysis. Current smokers were found to be at higher risk for dsDNA seropositivity than former smokers (OR = 3.0, 95% CI 1.3 to 7.1). The association between current smoking and dsDNA seropositivity remained significant after adjustment for sex, age at SLE diagnosis, amount smoked, age when smoking began, and the duration of smoking cessation (for former smokers). Conclusion:The association of smoking with dsDNA seropositivity provides insight into the potential mechanisms underlying autoantibody formation. This information may also serve as a possible point of intervention to prevent disease or target treatment.

Cigarette smoking in primary Sjögren’s syndrome: positive association only with ANA positivity

“…It is not clear why, in pSS, the effect of smoking on the production of anti-Ro and anti-La antibodies is not similar to either the effect of smoking on the production of RF and anti-CCP in RA or the effect of smoking on anti-dsDNA production in SLE [13]. Likewise, it remains unknown why smoking might cause a lower lip focus score in pSS.…”

“…Besides RA, smoking possibly contributes to the pathogenesis of systemic lupus erythematosus (SLE), as well [2][3][4][5]. In a large retrospective study performed in SLE patients, the titers of anti-double-stranded DNA (dsDNA) antibodies were also shown to be significantly higher in current and past smokers, compared to non-smokers [13].…”

Effects of tobacco smoke on immunity, inflammation and autoimmunity

“…Costenbader et al [67] performed a meta-analysis of seven case-control studies and two large cohort studies and concluded that smoking has a mild, yet significant contribution, elevating the risk for developing SLE with an OR of 1.50 (95% CI 1.09e2.08), with no increased risk for former smokers compared to non-smokers. In a large retrospective study, higher titers of anti-double-stranded DNA (dsDNA) were found in current and past smokers compared to non-smokers (OR 4.0 and 1.4, respectively) [68].…”

Work dynamics among persons with systemic lupus erythematosus

“…The data source for the present study was the University of California, San Francisco (UCSF) Lupus Outcomes Study (LOS). Participants in the LOS had formerly participated in a study of genetic risk factors for SLE outcomes (17,18). These participants became eligible for the LOS upon completion of their involvement in the genetics study.…”