Increased inflammation and disease activity among current cigarette smokers with rheumatoid arthritis: A cross-sectional analysis of US veterans

Jeremy Sokolove, Catriona A. Wagner, Lauren J. Lahey, Harlan Sayles, Michael J. Duryee, Andreas M. Reimold, Gail Kerr, William H. Robinson, Grant W. Cannon, Geoffrey Milton Thiele, Ted R Mikuls

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Objectives. Cigarette smoking is a major risk factor for RA and has been associated with increased disease severity and lower rates of disease remission. We hypothesized that inflammation and disease activity would be associated with smoking status and this would be related to levels of ACPA. Methods. RA patients from the Veterans Affairs RA registry were studied (n = 1466): 76.9% anti-CCP2 positive, 89% male, median age 63 years (interquartile range 57-72), median disease duration 8.45 years (interquartile range 2.8-18). Baseline serum samples were evaluated for levels of anti-CCP2, RF, 19 distinct ACPAs and 17 cytokines. Smoking status at baseline was recorded as current, former or never. The association of smoking status with cytokines, autoantibodies and disease activity (DAS28) was evaluated. Results. Among anti-CCP-positive RA patients, RA-associated cytokines (false-discovery rates q < 0.1%) and DAS28 (P<0.01) were higher in current smokers compared with former or never smokers. DAS28 and cytokine levels were similar between former and never smokers. In contrast, ACPA concentrations were higher among both current and former smokers compared with never smokers, and levels of ACPA were not associated with DAS28 or cytokine levels. Conclusion. Among anti-CCP2-positive RA patients, current smoking status is associated with elevations in pro-inflammatory cytokines and increased RA disease activity. Similar levels of inflammation and disease activity among former and never smokers suggests that the detrimental effects of smoking could be ameliorated through tobacco cessation. The effect of tobacco cessation on RA disease activity should be evaluated prospectively.

Original languageEnglish (US)
Pages (from-to)1969-1977
Number of pages9
JournalRheumatology (United Kingdom)
Volume55
Issue number11
DOIs
StatePublished - Nov 1 2016

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Veterans
Tobacco Products
Rheumatoid Arthritis
Cross-Sectional Studies
Inflammation
Smoking
Cytokines
Tobacco Use Cessation
Autoantibodies
Registries
Serum

Keywords

  • Disease activity
  • Inflammation
  • Rheumatoid arthritis
  • Smoking

ASJC Scopus subject areas

  • Rheumatology
  • Pharmacology (medical)

Cite this

Increased inflammation and disease activity among current cigarette smokers with rheumatoid arthritis : A cross-sectional analysis of US veterans. / Sokolove, Jeremy; Wagner, Catriona A.; Lahey, Lauren J.; Sayles, Harlan; Duryee, Michael J.; Reimold, Andreas M.; Kerr, Gail; Robinson, William H.; Cannon, Grant W.; Thiele, Geoffrey Milton; Mikuls, Ted R.

In: Rheumatology (United Kingdom), Vol. 55, No. 11, 01.11.2016, p. 1969-1977.

Research output: Contribution to journalArticle

Sokolove, Jeremy ; Wagner, Catriona A. ; Lahey, Lauren J. ; Sayles, Harlan ; Duryee, Michael J. ; Reimold, Andreas M. ; Kerr, Gail ; Robinson, William H. ; Cannon, Grant W. ; Thiele, Geoffrey Milton ; Mikuls, Ted R. / Increased inflammation and disease activity among current cigarette smokers with rheumatoid arthritis : A cross-sectional analysis of US veterans. In: Rheumatology (United Kingdom). 2016 ; Vol. 55, No. 11. pp. 1969-1977.
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abstract = "Objectives. Cigarette smoking is a major risk factor for RA and has been associated with increased disease severity and lower rates of disease remission. We hypothesized that inflammation and disease activity would be associated with smoking status and this would be related to levels of ACPA. Methods. RA patients from the Veterans Affairs RA registry were studied (n = 1466): 76.9{\%} anti-CCP2 positive, 89{\%} male, median age 63 years (interquartile range 57-72), median disease duration 8.45 years (interquartile range 2.8-18). Baseline serum samples were evaluated for levels of anti-CCP2, RF, 19 distinct ACPAs and 17 cytokines. Smoking status at baseline was recorded as current, former or never. The association of smoking status with cytokines, autoantibodies and disease activity (DAS28) was evaluated. Results. Among anti-CCP-positive RA patients, RA-associated cytokines (false-discovery rates q < 0.1{\%}) and DAS28 (P<0.01) were higher in current smokers compared with former or never smokers. DAS28 and cytokine levels were similar between former and never smokers. In contrast, ACPA concentrations were higher among both current and former smokers compared with never smokers, and levels of ACPA were not associated with DAS28 or cytokine levels. Conclusion. Among anti-CCP2-positive RA patients, current smoking status is associated with elevations in pro-inflammatory cytokines and increased RA disease activity. Similar levels of inflammation and disease activity among former and never smokers suggests that the detrimental effects of smoking could be ameliorated through tobacco cessation. The effect of tobacco cessation on RA disease activity should be evaluated prospectively.",
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T1 - Increased inflammation and disease activity among current cigarette smokers with rheumatoid arthritis

T2 - A cross-sectional analysis of US veterans

AU - Sokolove, Jeremy

AU - Wagner, Catriona A.

AU - Lahey, Lauren J.

AU - Sayles, Harlan

AU - Duryee, Michael J.

AU - Reimold, Andreas M.

AU - Kerr, Gail

AU - Robinson, William H.

AU - Cannon, Grant W.

AU - Thiele, Geoffrey Milton

AU - Mikuls, Ted R

PY - 2016/11/1

Y1 - 2016/11/1

N2 - Objectives. Cigarette smoking is a major risk factor for RA and has been associated with increased disease severity and lower rates of disease remission. We hypothesized that inflammation and disease activity would be associated with smoking status and this would be related to levels of ACPA. Methods. RA patients from the Veterans Affairs RA registry were studied (n = 1466): 76.9% anti-CCP2 positive, 89% male, median age 63 years (interquartile range 57-72), median disease duration 8.45 years (interquartile range 2.8-18). Baseline serum samples were evaluated for levels of anti-CCP2, RF, 19 distinct ACPAs and 17 cytokines. Smoking status at baseline was recorded as current, former or never. The association of smoking status with cytokines, autoantibodies and disease activity (DAS28) was evaluated. Results. Among anti-CCP-positive RA patients, RA-associated cytokines (false-discovery rates q < 0.1%) and DAS28 (P<0.01) were higher in current smokers compared with former or never smokers. DAS28 and cytokine levels were similar between former and never smokers. In contrast, ACPA concentrations were higher among both current and former smokers compared with never smokers, and levels of ACPA were not associated with DAS28 or cytokine levels. Conclusion. Among anti-CCP2-positive RA patients, current smoking status is associated with elevations in pro-inflammatory cytokines and increased RA disease activity. Similar levels of inflammation and disease activity among former and never smokers suggests that the detrimental effects of smoking could be ameliorated through tobacco cessation. The effect of tobacco cessation on RA disease activity should be evaluated prospectively.

AB - Objectives. Cigarette smoking is a major risk factor for RA and has been associated with increased disease severity and lower rates of disease remission. We hypothesized that inflammation and disease activity would be associated with smoking status and this would be related to levels of ACPA. Methods. RA patients from the Veterans Affairs RA registry were studied (n = 1466): 76.9% anti-CCP2 positive, 89% male, median age 63 years (interquartile range 57-72), median disease duration 8.45 years (interquartile range 2.8-18). Baseline serum samples were evaluated for levels of anti-CCP2, RF, 19 distinct ACPAs and 17 cytokines. Smoking status at baseline was recorded as current, former or never. The association of smoking status with cytokines, autoantibodies and disease activity (DAS28) was evaluated. Results. Among anti-CCP-positive RA patients, RA-associated cytokines (false-discovery rates q < 0.1%) and DAS28 (P<0.01) were higher in current smokers compared with former or never smokers. DAS28 and cytokine levels were similar between former and never smokers. In contrast, ACPA concentrations were higher among both current and former smokers compared with never smokers, and levels of ACPA were not associated with DAS28 or cytokine levels. Conclusion. Among anti-CCP2-positive RA patients, current smoking status is associated with elevations in pro-inflammatory cytokines and increased RA disease activity. Similar levels of inflammation and disease activity among former and never smokers suggests that the detrimental effects of smoking could be ameliorated through tobacco cessation. The effect of tobacco cessation on RA disease activity should be evaluated prospectively.

KW - Disease activity

KW - Inflammation

KW - Rheumatoid arthritis

KW - Smoking

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