Passive smoking and air pollution related to arthritis and poor response to therapy

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There is growing evidence that air pollution from the environment is associated with people who develop inflammatory arthritis. At the 2021 EULAR conference, a large population-based study of French women reported that passive exposure to smoking during childhood or adulthood increases the risk of developing rheumatoid arthritis (RA). A second study in Italy found that air pollution also has an impact, as air pollution levels show an association with the failure of biological therapy.

RA is an autoimmune inflammatory disease that causes pain, swelling, and stiffness in the joints. It can also cause fatigue and the underlying inflammation can affect other body systems. It is more common in than in men. Meet up, has been the most reproduced risk factor for a type of RA called anti-protein anti-citrulline positive antibody (ACPA), especially in people carrying shared epitopes alleles with HLA-DRB1.

Nguyen and his colleagues set out to investigate the relationship between and the risk of developing RA in a large prospective cohort of healthy French women.

The E3N-EPIC (Etude Epidemiologique au prèsdes femmes de la Mutuelle générale de l’Education Nationale) has been collecting data on healthy French women since 1990. Cases of RA have been identified with specific questionnaires and through the reimbursement database of drugs. Women were considered to be exposed to liabilities in childhood, if they were declared automatically housed in a smoked room several hours a day during childhood, and in passive smoking as adults if they were declared exposed for at least 1 hour a day.

79,806 women were included in the study. Among them, 698 cases of RA were identified. Across the cohort, 10,810 (13.5%) were exposed to secondhand smoke when they were children and 42,807 (53.6%) to secondhand smoke when they were adults. 6,581 (8.25%) were exposed to both and 47,036 (58.9%) were exposed to both.

Across the population, passive smoking during childhood was positively associated with the risk of RA. When analyzed according to each person’s smoking status, passive smoking during childhood was associated with RA among women who had never smoked themselves, but not among those who had never smoked themselves. same.

When the authors examined passive smoking in adulthood, there was also a positive risk association across the population. But when re-analyzed for individual smoking status, the association with an increased risk of RA was found only among women who did not smoke, not among those who had never been smokers.

These results suggest that smoking byproducts, either actively or passively inhaled, could generate autoimmunity, at least to the antigens involved in the pathogenesis of RA.

In a poster examining another link between lungs and inflammatory arthritis, Adami and colleagues examined the association between air pollutant concentration and biological drug retention rates in people with chronic inflammatory arthritis ( CIA) living in the Verona area of ​​Italy.

This was a cross-sectional case study to compare exposure to pollutants in the 30- to 60-day periods prior to a change or exchange of medications due to disease progression.

We included 1,286 patients with CIA (888 with RA, 260 with psoriatic arthritis, and 138 with ankylosing spondylitis) and 13,636 per day. records were recovered. The authors found an exposure-dependent relationship between exposure to air pollutants and markers of inflammation in people with CIA. Exposures above 50 μg / m3 and greater than 40 μg / m3 had a 150% and 65% higher risk of having C-reactive protein (CRP) levels above 5 mg / L, respectively.

If the contamination threshold is set at 30μg / m3 (below the European Union health protection limit) there was still a 38% higher risk of having altered PCR.

Air pollutant concentrations were higher before a change or exchange due to the ineffectiveness of the drug. The authors concluded that air pollution from the environment was a determining factor in the poor response to biological treatment. Interventions to reduce fossil fuel emissions can have beneficial effects on the rate of persistence of biological treatments in people with .


Consumer health: smoking and rheumatoid arthritis: what is the relationship?


Provided by the European Alliance of Associations for Rheumatology

Citation: Passive smoking and air pollution related to arthritis and poor response to therapy (2021, June 18), retrieved June 19, 2021 at https://medicalxpress.com/news/2021-06- passive-air-pollution-linked-arthritis.html

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