Smoking history, alcohol consumption, and systemic lupus erythematosus: a case-control study

Hardy, Carolyn; Palmer, Ben; Muir, Kenneth; Sutton, Alex J.; Powell, Richard J.

doi:10.1136/ard.57.8.451

Cited by 122 publications

(127 citation statements)

References 17 publications

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“…Smoking has been associated with the development of SLE (18)(19)(20)(21) as well as with a worse outcome (22)(23)(24)(25). It has been proposed that cigarette consumption may interfere with the therapeutic effect of hydroxychloroquine (26).…”

Section: Discussionmentioning

confidence: 99%

Systemic lupus erythematosus in a multiethnic US cohort (LUMINA): XXV. Smoking, older age, disease activity, lupus anticoagulant, and glucocorticoid dose as risk factors for the occurrence of venous thrombosis in lupus patients

Calvo‐Alén

Toloza

Fernández

et al. 2005

Arthritis & Rheumatism

127

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Objective. Venous thrombosis is a relatively frequent and serious complication in systemic lupus erythematosus (SLE) that has been associated with the presence of antiphospholipid antibodies (aPL). However, venous thrombotic events can also be seen in patients without aPL, and only a few patients with aPL develop venous thrombosis. This study was carried out to ascertain other factors contributing to the development of venous thrombosis in SLE.Methods. Patients with SLE, ages >16 years with <5 years disease duration and of Hispanic, African American, or Caucasian ethnicity, from LUMINA (LUpus in MInorities, NAture versus nurture), a multiethnic, longitudinal study of outcome, were studied. Selected socioeconomic/demographic, clinical, laboratory, and treatment-exposure variables were compared between patients who developed and those who did not develop venous thrombotic events. Significant and clinically relevant variables were then entered into different multivariable models (Cox proportional hazards and unconditional stepwise logistic regression) to identify independent risk factors associated with the primary outcome. In another model, only patients who developed an event after enrollment (time 0) in the cohort were included.Results. Of 570 LUMINA patients, 51 developed at least 1 venous thrombotic event after SLE diagnosis. In univariable analyses, smoking (P ‫؍‬ 0.020), shorter disease duration at time 0 (P ‫؍‬ 0.017), serum levels of total cholesterol, low-density lipoprotein, and triglycerides (all P < 0.0001), and presence of lupus anticoagulant (LAC) (P ‫؍‬ 0.045) were associated with venous thrombotic events. Survival analyses showed a timedependent significant association of the primary outcome with smoking (P ‫؍‬ 0.008) and a borderline significant association with the presence of LAC (P ‫؍‬ 0.070). Multivariable models showed an independent association with smoking, age at time 0, disease activity over time, LAC, mean dose of glucocorticoids, and shorter disease duration at time 0.Conclusion. Venous thrombotic events occur early in the course of SLE. Our data confirm the association between LAC and venous thrombotic events. Smoking, shorter disease duration, older age, disease activity over

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Section: Discussionmentioning

confidence: 99%

Systemic lupus erythematosus in a multiethnic US cohort (LUMINA): XXV. Smoking, older age, disease activity, lupus anticoagulant, and glucocorticoid dose as risk factors for the occurrence of venous thrombosis in lupus patients

Calvo‐Alén

Toloza

Fernández

et al. 2005

Arthritis & Rheumatism

127

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“…Indeed, some investigators have found that exposure to ethanol is associated with a lower risk for developing SLE (10,11), whereas others did not observe any effect of alcohol consumption on the incidence of SLE (12,13). The association between ethanol and rheumatoid arthritis (RA) has been discussed in some studies, but definite conclusions could not be drawn (14)(15)(16).…”

mentioning

confidence: 98%

Ethanol prevents development of destructive arthritis

Jonsson

Verdrengh

Brisslert

et al. 2007

Proc. Natl. Acad. Sci. U.S.A.

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Environmental factors are thought to play a major role in the development of rheumatoid arthritis. Because the use of ethanol is widespread, we assessed the role of ethanol intake on the propensity to develop chronic arthritis. Collagen type II-immunized mice were given water or water containing 10% (vol/vol) ethanol or its metabolite acetaldehyde. Their development of arthritis was assessed, as well as the impact of ethanol on leukocyte migration and activation of intracellular transcription factors. Mice exposed daily to this dose of ethanol did not display any liver toxicity, and the development of erosive arthritis was almost totally abrogated. In contrast, the antibody-mediated effector phase of collageninduced arthritis was not influenced by ethanol exposure. Also, the major ethanol metabolite, acetaldehyde, prevented the development of arthritis. This antiinflammatory and antidestructive property of ethanol was mediated by (i) down-regulation of leukocyte migration and (ii) up-regulation of testosterone secretion, with the latter leading to decreased NF-B activation. We conclude that low but persistent ethanol consumption delays the onset and halts the progression of collagen-induced arthritis by interaction with innate immune responsiveness.inflammation ͉ cytokines ͉ sex hormones ͉ antibodies ͉ immunity E xcessive alcohol consumption depresses the immune system and increases the propensity to severe bacterial infections, including pneumonia (1), tuberculosis (2), and bacterial peritonitis (3), and to viral infections (4-6). However, some epidemiological studies have suggested that light to moderate ethanol consumption has protective effects against several diseases including chronic heart diseases (7, 8) and ischemic stroke (9).Ethanol consumption has also been implicated in the pathogenesis of systemic lupus erythematosus (SLE), a complex autoimmune disease in the development of which environmental and genetic factors interact. Indeed, some investigators have found that exposure to ethanol is associated with a lower risk for developing SLE (10, 11), whereas others did not observe any effect of alcohol consumption on the incidence of SLE (12, 13). The association between ethanol and rheumatoid arthritis (RA) has been discussed in some studies, but definite conclusions could not be drawn (14-16). Studies so far have been of an epidemiological nature and therefore have not provided any hints about the biological mechanisms of environmental stimuli in the development of autoimmune disease. Our aim here was to assess whether low but persistent consumption of ethanol in quantities nontoxic to liver might affect the incidence and disease manifestation of collagen type II (CII)-induced arthritis (CIA), an established model of human RA. Our results suggest that ethanol intake delays the onset and halts the progression of destructive arthritis. Results Effect of Ethanol Consumption on Development of CIA.To assess whether ethanol drinking has any impact on the development of CIA, CII-immunized mice were provided w...

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“…33 Se ha descrito la asociación de LES principalmente con el uso de fármacos antihipertensivos, anticonvulsivantes, antifímicos y antibióticos. [21][22][23][24] Sin embargo, en estudios epidemiológicos previos [25][26][27][28][29][30][31] no se había evaluado esta variable. En nuestro estudio hubo un riesgo cinco veces mayor (RM 5.0, IC 95%1.6-21.6) al evaluar en conjunto el antecedente de uso a dosis convencionales de isoniazida, alfametildopa o carbamazepina y no hubo asociación con el uso de otros medicamentos.…”

Section: No3 Mayo-junio De 2002unclassified

“…[25][26][27][28][29][30][31] Nosotros no evaluamos otros factores que se han asociado con el desarrollo de lupus como el antecedente de trabajar en un medio ambiente "polvoriento" 37 (RM 3.9, IC 95% 1.6-9.7), consumo frecuente de carnes rojas 30 (RM 3.3, IC 95%1.10-10.2), irregularidad en el periodo menstrual 30 (RM 3.7, IC 95% 1.4-10.0), exposición prolongada a emisiones industriales, 17 contaminación del agua con tricloroetileno 38 y exposición a sílice. 39 En conclusión, nuestro estudio mostró que el antecedente heredo-familiar de lupus y de ETC en familiares de primer grado fue el factor más asociado con el desarrollo de LES.…”

Section: No3 Mayo-junio De 2002unclassified

“…[25][26][27][28][29][30][31] Tres de estos estudios 26,28,30 tuvieron menos de 100 casos, lo cual limita el poder estadístico, y en otro 26 los casos tenían más de 10 años de evolución, lo cual afecta la calidad de la información evaluada. El objetivo del presente trabajo fue determinar la asociación de factores de riesgo y el desarrollo de LES, con un estudio de casos y controles en población mexicana.…”

Section: Introductionunclassified

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Factores de riesgo relacionados con lupus eritematoso sistémico en población mexicana

et al. 2002

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Smoking history, alcohol consumption, and systemic lupus erythematosus: a case-control study

Cited by 122 publications

References 17 publications

Systemic lupus erythematosus in a multiethnic US cohort (LUMINA): XXV. Smoking, older age, disease activity, lupus anticoagulant, and glucocorticoid dose as risk factors for the occurrence of venous thrombosis in lupus patients

Systemic lupus erythematosus in a multiethnic US cohort (LUMINA): XXV. Smoking, older age, disease activity, lupus anticoagulant, and glucocorticoid dose as risk factors for the occurrence of venous thrombosis in lupus patients

Ethanol prevents development of destructive arthritis

Factores de riesgo relacionados con lupus eritematoso sistémico en población mexicana

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