Rheumatoid arthritis and smoking: putting the pieces together

Abstract

Besides atherosclerosis and lung cancer, smoking is considered to play a major role in the pathogenesis of autoimmune diseases. It has long been known that there is a connection between rheumatoid factor-positive rheumatoid arthritis and cigarette smoking. Recently, an important gene–environment interaction has been revealed; that is, carrying specific HLA-DRB1 alleles encoding the shared epitope and smoking establish a significant risk for anti-citrullinated protein antibody-positive rheumatoid arthritis. We summarize how smoking-related alteration of the cytokine balance, the increased risk of infections (the possibility of cross-reactivity) and modifications of autoantigens by citrullination may contribute to the development of rheumatoid arthritis.

Predictors of mortality in rheumatoid arthritis-associated interstitial lung disease

“…Tobacco exposure plays a major role in the development of anti-CCP positive rheumatoid arthritis and RA-ILD [16][17][18]. Smokers are more likely to have citrullinated proteins in lung lavage [19], and they have increased rheumatoid arthritis disease activity [20].…”

Aryl Hydrocarbon Receptor Antagonism Attenuates Growth Factor Expression, Proliferation, and Migration in Fibroblast-Like Synoviocytes from Patients with Rheumatoid Arthritis

“…There is an increasing body of epidemiologic research pointing to smoking as a risk factor for RA. The fact that tobacco smoke is a rich source of planar polycyclic aromatic hydrocarbons, many of which are AHR agonists (e.g., benzo[a]pyrene), suggests that activation of the AHR may play a significant role in disease progression (Baka et al, 2009). Furthermore, smoking has been shown to modulate the immune system by altering Th17 cell-mediated responses (Onozaki, 2009;Fig.…”

Smoking and the Microbiome in the Pathogenesis of Rheumatoid Arthritis

“…As tobacco smoke is a rich source of planar polycyclic aromatic hydrocarbons, many of which are AhR agonists (e.g. benzo[a]pyrene) it is possible that the activation of the AhR may play a significant role in disease progression [17]. Furthermore, smoking has been shown to modulate the immune system by altering Th-17 cell-mediated responses in a manner consistent with the ability of AHR activation to influence Th-17 cell differentiation [18,19].…”