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Chung C, Kim H, Han K, Jung J, Eun Y, Lee H, Park J, Shin DW, Lee SW. Does Rheumatoid Arthritis Increase the Risk of COPD?: A Nationwide Retrospective Cohort Study. Chest 2024; 165:1362-1371. [PMID: 38365176 DOI: 10.1016/j.chest.2024.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 01/31/2024] [Accepted: 02/12/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND Most reports of pulmonary manifestations in rheumatoid arthritis (RA) have been related to interstitial lung diseases. RA and COPD are both chronic inflammatory systemic diseases. RESEARCH QUESTION Does RA increase the risk of developing COPD? Is there a difference between seropositive and seronegative RA in the risk of COPD? STUDY DESIGN AND METHODS Using the Korean National Health Insurance Database, we screened individuals diagnosed with RA between 2010 and 2017. We identified 46,030 patients with RA (32,608 with seropositive RA and 13,422 with seronegative RA) and 230,150 matched control individuals; we monitored them until December 2019. We used multivariate Cox proportional hazard models to estimate the adjusted hazard ratio (aHR) of risk factors for the development of COPD. RESULTS The incidence of COPD among patients with RA was 5.04 per 1,000 person-years; it was 2.23 per 1,000 person-years in the control group. Patients with RA showed a higher risk of developing COPD (aHR, 2.11; 95% CI, 1.96-2.28) compared with the control group. Although both seropositive RA and seronegative RA were associated with an increased risk of COPD, patients with seropositive RA had a higher risk for the development of COPD (aHR, 1.26; 95% CI, 1.09-1.46) than patients with seronegative RA. In the subgroup analyses, smoking history did not demonstrate significant interactions between RA and COPD development. INTERPRETATION RA was shown to be associated with an increased risk of COPD development, augmented by seropositivity. Physicians should monitor respiratory symptoms and pulmonary function carefully in patients with RA.
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Affiliation(s)
- Chiwook Chung
- Department of Pulmonary and Critical Care Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung
| | - Hyungjin Kim
- Departments of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul; Department of Medical Humanites, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul
| | - Jinhyoung Jung
- Department of Medical Statistics, College of Medicine, Catholic University of Korea, Seoul
| | - Yeonghee Eun
- Division of Rheumatology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul
| | - Hyun Lee
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul
| | - Junhee Park
- Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul
| | - Dong Wook Shin
- Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul; Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Science and Technology, Sungkyunkwan University, Seoul
| | - Sei Won Lee
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
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Sarangi S, Barik D, Nahak SK, Panda AK. Association of Interleukin 23 Receptor Polymorphisms with Predisposition to Rheumatoid Arthritis: An Updated Meta and Trial Sequential Analysis. Biochem Genet 2024:10.1007/s10528-023-10644-x. [PMID: 38270697 DOI: 10.1007/s10528-023-10644-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 12/18/2023] [Indexed: 01/26/2024]
Abstract
The etiology of Rheumatoid Arthritis (RA) development remained unclear, and several factors, such as environmental, genetic, and immune system dysfunction, have been attributed to the susceptibility. Interleukin 23 (IL23) induces expansion of the Th17 cells through the IL-23 receptor (IL-23R) and believes in playing a major role in RA pathogenesis. Various genetic mutants in the IL23R gene (rs10489629, rs1343151, rs2201841, rs7517847, rs1004819, rs10889677, rs11209026, rs7530511) have been associated with the susceptibility RA, but results are contradictories. We performed a meta-analysis to establish the association of IL23R polymorphisms with susceptibility RA. For the meta-analysis, a detailed search of databases like Google Scholar, PubMed, Scopus, Web of Science, and Science Direct was conducted, and data were extracted from the included reports. The meta-analysis was performed by the Comprehensive Meta-Analysis v3 software. A significant association of IL-23R rs11209026 (AA vs. GG: Odds ratio = 2.250, p-value = 0.01; AA vs. GG+GA: Odds ratio = 2.271, p-value = 0.01), rs1343151 (A vs. G: Odds ratio = 1.091, p-value = 0.001; AA vs. GG: Odds ratio = 1.209, p-value = 0.001; GA vs. GG: Odds ratio = 1.116, p-value = 0.004; AA+GA vs. GG: Odds ratio = 1.135, p-value = 0.000; AA vs. GG+GA: Odds ratio = 1.144, p-value = 0.012) and rs10889677 (CA vs. CC: Odds ratio = 1.375, p-value = 0.041) polymorphisms were observed with increased susceptibility for the development of RA. In contrast, IL-23R rs10489629 (G vs. A: odds ratio = 0.901, p-value = 0.047, GG vs. AA: Odds ratio = 0.763, p-value = 0.022, GG vs. AA+AG: Odds ratio = 0.852, p-value = 0.00) and IL23R rs2201841 (CC vs. TT+TC: Odds ratio = 0.826, p-value = 0.026) variants were linked with protection against the development of RA. In addition, the trial sequential analysis revealed the inclusion of a sufficient number of studies in the present meta-analysis, and no further additional studies are required. IL-23R variants are associated with genetic susceptibility or resistance against the development of RA.
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Affiliation(s)
- Surjyapratap Sarangi
- ImmGen EvSys Lab, Department of Biotechnology, Berhampur University, Bhanja Bihar, Berhampur, Odisha, 760007, India
| | - Debashis Barik
- ImmGen EvSys Lab, Department of Biotechnology, Berhampur University, Bhanja Bihar, Berhampur, Odisha, 760007, India
| | - Suraj Kumar Nahak
- ImmGen EvSys Lab, Department of Biotechnology, Berhampur University, Bhanja Bihar, Berhampur, Odisha, 760007, India
| | - Aditya K Panda
- ImmGen EvSys Lab, Department of Biotechnology, Berhampur University, Bhanja Bihar, Berhampur, Odisha, 760007, India.
- Centre of Excellence on Bioprospecting of "Ethnopharmaceuticals of Southern Odisha" (CoE-BESO), Berhampur University, Bhanja Bihar, Berhampur, Odisha, 760007, India.
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Abd El-Raheim D, Mohamed A, Fatouh M, Abou-Ziyan H. Comfort and economic aspects of phase change materials integrated with heavy-structure buildings in hot climates. APPLIED THERMAL ENGINEERING 2022; 213:118785. [DOI: 10.1016/j.applthermaleng.2022.118785] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Abstract
Rheumatoid arthritis (RA) is a common condition affecting approximately 1% of the general population. RA is a multisystem disorder that causes progressive articular destruction through synovial inflammation. One of the most common extraarticular manifestations of RA is pulmonary involvement, where all compartments of the pulmonary system can be impacted (e.g., pulmonary vasculature, pleura, parenchyma, and the airways). Although it has been known for decades that a portion of patients with RA develop interstitial lung disease, and recent advancements in understanding the genetic risk and treatment for RA-interstitial lung disease have drawn attention, more recent data have begun to highlight the significance of airway disease in patients with RA. Yet, little is known about the underlying pathogenesis, clinical impact, or optimal treatment strategies for airway disease in RA. This review will focus on airway disease involvement in patients with RA by highlighting areas of clinical inquiry for pulmonologists and rheumatologists and discuss areas for future research. Finally, we discuss a potential screening algorithm for providers when approaching patients with RA with respiratory complaints.
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Asoudeh F, Dashti F, Jayedi A, Hemmati A, Fadel A, Mohammadi H. Caffeine, Coffee, Tea and Risk of Rheumatoid Arthritis: Systematic Review and Dose-Response Meta-analysis of Prospective Cohort Studies. Front Nutr 2022; 9:822557. [PMID: 35223954 PMCID: PMC8866764 DOI: 10.3389/fnut.2022.822557] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 01/11/2022] [Indexed: 12/29/2022] Open
Abstract
Objective Prospective cohort studies on coffee, tea and caffeine in relation to the risk of rheumatoid arthritis (RA) have shown conflicting results. The aim of this study was to conduct a dose–response meta-analysis of cohort studies on the association between dietary caffeine, different types of coffee and tea consumption and the risk of RA. Methods PubMed/Medline, Scopus and EMBASE were searched up to July 2021 to identify relevant studies that had considered different types of coffee (caffeinated or decaffeinated), tea or caffeine exposure with RA as the main, or one of the, outcome(s). Two authors independently screened 742 publications. Finally, five prospective cohort studies were included in our meta-analysis. Pooled relative risks (RRs) were calculated by using a fixed-effects model. We also performed linear and non-linear dose-response analyses to examine the dose-response relations. Results Comparing extreme categories, we found a positive, significant association between coffee (RR: 1.30; 95% CI: 1.04–1.62; I2 = 0%, n = 5) and decaffeinated coffee (RR: 1.89; 95% CI: 1.35–2.65; I2 = 38.1%, n =3) consumption and risk of RA. One additional cup of coffee consumed per day was associated with an increased risk of RA by 6% (95% CI: 1.02–1.10; I2 = 0%). This increase in the risk of RA for one cup/d of decaffeinated coffee was 11% (95% CI: 1.05–1.18; I2 = 38). No significant association was observed between caffeinated coffee, tea or caffeine intake and the risk of RA. Conclusion We found that a higher intake of coffee and decaffeinated coffee was associated with increased risk of RA. No significant association between caffeinated coffee, tea or caffeine intake and the risk of RA was observed. Systematic Review Registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=227665, identifier: CRD42021227665.
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Affiliation(s)
- Farzaneh Asoudeh
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Dashti
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Jayedi
- Social Determinant of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Amirhossein Hemmati
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Abdulmannan Fadel
- School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Hamed Mohammadi
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
- *Correspondence: Hamed Mohammadi
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Analysis of the Thermal and Cooling Energy Performance of the Perimeter Zones in an Office Building. BUILDINGS 2022. [DOI: 10.3390/buildings12020141] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Indoor thermal conditions can be highly influenced through building envelopes by outdoor conditions, especially climatic parameters. While a lot of attention has been paid to the thermal performance in core zones in buildings, other zones, such as perimeters, experience significant heat loss and gain through building envelopes. Focusing on the energy and thermal performance in perimeter zones, the present study performed an energy simulation to find the most susceptible building orientation in an office building in South Korea regarding the cooling loads during the summer. Through field measurements, the solar radiation impact on the thermal performance in the perimeter zones was practically investigated. To reduce the cooling loads in the perimeter zones, an air barrier system was utilized. As a result, the biggest amount of heat was observed in the perimeter zones facing the west façade in the winter, according to the measurements. While the highest temperature was observed at the internal surface of the windows, the temperature in the perimeter and core zones was stably maintained. The heat that occurred through the west façade was reduced by the air barrier system by removing the vertical thermal stratification using the fan-powered unit in the system.
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Albarzinji N, Ismael SA, Albustany D. Association of rheumatoid arthritis and its severity with human leukocytic antigen-DRB1 alleles in Kurdish region in North of Iraq. BMC Rheumatol 2022; 6:4. [PMID: 35016727 PMCID: PMC8753826 DOI: 10.1186/s41927-021-00229-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Accepted: 07/30/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Rheumatoid arthritis is a complex multifactorial chronic disease, the importance of human leukocytic antigen (HLA) as a major genetic risk factor for rheumatoid arthritis was studied worldwide. The objective of this study is to identify the association of HLA-DRB1 subtypes with rheumatoid arthritis and its severity in Kurdish region. METHODS A case-control study recruited 65 rheumatoid arthritis patients and 100 healthy individuals as control group all over the Kurdistan region/Iraq. Both patient and control groups are genotyped using polymerase chain reaction with sequence specific primer. Anti-CCP antibodies were measured by ELISA test. Rheumatoid factor, C-reactive protein, and disease activity score 28 which measured by DAS-28 values were calculated. The DAS-28 was used to assess the clinical severity of the patients. RESULTS HLA-DRB1-0404 and HLA-DRB1-0405 frequencies showed a strong association with disease susceptibility (P < 0.001). The frequency of HLA-DRB1-0411 and HLA-DRB1-0413 were significantly higher in control group (P < 0.001). The frequency of rheumatoid factor and Anti-CCP were significantly higher among shared epitope-positive patients compared to shared epitope-negative patients (P < 0.001). Regarding the disease activity by DAS-28, rheumatoid arthritis patients didn't show significant difference between the shared epitope-positive and shared epitope-negative patients. CONCLUSIONS HLA-DR0404 and HLA-DR0405 alleles are related to RA, while HLA-DR1-0411 and HLA-DRB1-0413 protect against RA in the Kurdistan region in the North of Iraq.
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Xu L, Jiang L, Nie L, Zhang S, Liu L, Du Y, Xue J. Soluble programmed death molecule 1 (sPD-1) as a predictor of interstitial lung disease in rheumatoid arthritis. BMC Immunol 2021; 22:69. [PMID: 34654367 PMCID: PMC8518160 DOI: 10.1186/s12865-021-00460-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 09/30/2021] [Indexed: 01/23/2023] Open
Abstract
Background Previous studies have indicated that the programmed death molecule 1 (PD-1) signaling pathway may play a key role in rheumatoid arthritis (RA). However, the pathogenesis of rheumatoid arthritis-related interstitial lung disease (RA-ILD) is not clear. We examined the serum levels of soluble PD-1 in patients with RA and its relationship with RA-ILD.
Methods Blood samples were obtained from 87 patients with RA (58 with ILD and 29 without ILD) and 45 healthy controls. Serum sPD-1 was measured by Enzyme-Linked Immunosorbent Assay. The pulmonary interstitial disease score was completed by a pulmonary physician and a radiologist through chest high-resolution computed tomography. Patients with RA-ILD were tested for lung function [e.g., forced vital capacity (FVC%), diffusing capacity of lungs for carbon monoxide (DLCO%)]. Associations between ILD and various markers, including sPD-1 and confounding factors, were investigated by logistic regression analysis. Diagnostic values of sPD-1 for the presence of ILD were investigated using receiver operating characteristic curve analysis. Results Serum sPD-1 levels were higher in RA patients with ILD than in RA patients without ILD and healthy controls (185.1 ± 109.0 pg/ml vs. 119.1 ± 77.5 pg/ml vs. 52.1 ± 21.7 pg/ml, P < 0.05). Serum sPD-1 levels were positively correlated with RF titer (P = 0.02, r = 0.249), anti-cyclic citrullinated peptide antibody status (P = 0.02, r = 0.243), and serum IgG levels (P < 0.001, r = 0.368), negatively associated with FVC% (P = 0.02, r = − 0.344), forced expiratory volume (FEV1%) (P = 0.01, r = − 0.354), total lung capacity (TLC%) (P = 0.046, r = − 0.302), and was independently associated with the presence of ILD in RA patients by multivariate logistic regression analysis. The sensitivity and specificity of sPD-1 levels for the detection of ILD in RA patients were 58.6% and 75.9%, respectively. The area under the curve was 0.689. Conclusion Serum sPD-1 levels were increased in RA patients with ILD. Increased sPD-1 may be a valuable biomarker to predict the presence of ILD in patients with RA. Supplementary Information The online version contains supplementary material available at 10.1186/s12865-021-00460-6.
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Affiliation(s)
- Li Xu
- Department of Rheumatology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310009, China.,Department of Medical, Jiaxing University Affiliated Women and Children Hospital (Jiaxing Maternity and Child Health Care Hospital), Jiaxing, 314000, China
| | - Lichun Jiang
- Department of Rheumatology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310009, China.,Department of Rheumatology, Jiaxing First Hospital, Jiaxing, 314000, China
| | - Liuyan Nie
- Department of Rheumatology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310009, China
| | - Songzhao Zhang
- Department of Clinical Laboratory, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310009, China
| | - Lei Liu
- Department of Rheumatology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310009, China
| | - Yan Du
- Department of Rheumatology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310009, China.
| | - Jing Xue
- Department of Rheumatology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310009, China.
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Maritati F, Peyronel F, Fenaroli P, Pegoraro F, Lastrucci V, Benigno GD, Palmisano A, Rossi GM, Urban ML, Alberici F, Fraticelli P, Emmi G, Corradi M, Vaglio A. Occupational Exposures and Smoking in Eosinophilic Granulomatosis With Polyangiitis: A Case-Control Study. Arthritis Rheumatol 2021; 73:1694-1702. [PMID: 33750006 DOI: 10.1002/art.41722] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 03/02/2021] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis. Environmental agents and occupational exposures may confer susceptibility to EGPA, but data are scarce. This study was undertaken to investigate the association between occupational exposures (e.g., silica, farming, asbestos, and organic solvents) and other environmental agents (e.g., smoking) and the risk of EGPA. METHODS Patients with newly diagnosed EGPA (n = 111) and general population controls (n = 333) who were matched for age, sex, and geographic area of origin were recruited at a national referral center for EGPA. Exposures were assessed using a dedicated questionnaire administered by a specialist in occupational medicine, under blinded conditions. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated. RESULTS Exposures to silica (OR 2.79 [95% CI 1.55-5.01], P = 0.001), organic solvents (OR 3.19 [95% CI 1.91-5.34], P < 0.001), and farming (OR 2.71 [95% CI 1.71-4.29], P < 0.001) were associated with an increased risk of EGPA. Co-exposure to silica and farming yielded an OR of 9.12 (95% CI 3.06-27.19, P < 0.001), suggesting a multiplicative effect between these 2 exposures. Smoking (current and former smokers combined) was significantly less frequent among patients with EGPA compared to controls (OR 0.49 [95% CI 0.29-0.70], P < 0.001). The pack-year index was also lower among patients with EGPA (OR 0.96 [95% CI 0.94-0.98], P < 0.001). The association of silica and farming was primarily aligned with ANCA-positive EGPA, while the association of smoking status and organic solvents was primarily aligned with ANCA-negative EGPA. CONCLUSION The environment can influence susceptibility to EGPA. Exposure to silica, farming, or organic solvents is associated with an increased risk of EGPA, while smoking is associated with a lower risk. These exposures seem to have distinct effects on different EGPA subsets.
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Affiliation(s)
| | | | | | | | - Vieri Lastrucci
- University of Florence and Meyer Children's University Hospital, Florence, Italy
| | | | | | | | | | - Federico Alberici
- Spedali Civili Hospital, Brescia, and University of Brescia, Brescia, Italy
| | | | - Giacomo Emmi
- University of Florence and Meyer Children's University Hospital, Florence, Italy
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Khanna N, Kumar A, Pawar SV. A Review on Rheumatoid Arthritis Interventions and Current Developments. Curr Drug Targets 2021; 22:463-483. [PMID: 33243118 DOI: 10.2174/1389450121999201125200558] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 09/08/2020] [Accepted: 10/13/2020] [Indexed: 11/22/2022]
Abstract
Rheumatoid arthritis is a chronic autoimmune disorder characterized by inflammation, swelling, and joint destruction primarily affecting the peripheral joints. In recent years, RA has become an alarming concern affecting more than 1.5% of the population worldwide. The majority of the drugs in clinical trials for rheumatoid arthritis are immunomodulatory. The development of novel drugs for RA is impending and scientists are exploring new strategies through various innovative approaches for RA drug development. Treat-to-target and window of opportunity hypothesis are the new approaches that are used to treat, improve outcomes, and prevent long-term use of ineffective therapy, respectively. Novel therapeutic agents (e.g. GM-CSF inhibitors, Matrix metalloproteinase inhibitors) and delivery systems (e.g., Liposomes, Superparamagnetic iron oxide nano particles (SPIONs)) are under investigation for more target based therapy with reduced side effects and toxicity. The new drug discovery and repositioning of previously FDA-approved drugs are also being considered for chronic inflammatory disorder. The review encompasses a vast array of information, including genetics, etiology, clinical symptoms, current treatment, and newer therapeutics approaches, focused on the development of RA interventions. The introduction of the bioinformatics-based approach in RA has also been significantly discussed in the review. This review provides a general understanding of the challenges and uncertainties in the treatment of RA and summarizes the evolving scenario as well as innovative approaches taken into consideration for drug development in rheumatoid arthritis.
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Affiliation(s)
- Nikita Khanna
- University Institute of Pharmaceutical Sciences (UIPS), Panjab University, Chandigarh, India
| | - Anil Kumar
- University Institute of Pharmaceutical Sciences (UIPS), Panjab University, Chandigarh, India
| | - Sandip V Pawar
- University Institute of Pharmaceutical Sciences (UIPS), Panjab University, Chandigarh, India
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Bacelis J, Compagno M, George S, Pospisilik JA, Brundin P, Naluai ÅT, Brundin L. Decreased Risk of Parkinson's Disease After Rheumatoid Arthritis Diagnosis: A Nested Case-Control Study with Matched Cases and Controls. JOURNAL OF PARKINSON'S DISEASE 2021; 11:821-832. [PMID: 33682730 PMCID: PMC8150472 DOI: 10.3233/jpd-202418] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/10/2021] [Indexed: 01/13/2023]
Abstract
BACKGROUND Rheumatoid arthritis (RA) and the genetic risk landscape of autoimmune disorders and Parkinson's disease (PD) overlap. Additionally, anti-inflammatory medications used to treat RA might influence PD risk. OBJECTIVE To use a population-based approach to determine if there is an association between pre-occurring rheumatoid arthritis (RA) and later-life risk of PD. METHODS The study population was 3.6 million residents of Sweden, who were alive during part or all of the follow-up period; 1997-2016. We obtained diagnoses from the national patient registry and identified 30,032 PD patients, 8,256 of whom each was matched to ten controls based on birth year, sex, birth location, and time of follow-up. We determined the risk reduction for PD in individuals previously diagnosed with RA. We also determined if the time (in relation to the index year) of the RA diagnosis influenced PD risk and repeated the analysis in a sex-stratified setting. RESULTS Individuals with a previous diagnosis of RA had a decreased risk of later developing PD by 30-50% compared to individuals without an RA diagnosis. This relationship was strongest in our conservative analysis, where the first PD diagnosis occurred close to the earliest PD symptoms (odds ratio 0.47 (CI 95% 0.28-0.75, p = 0.0006); with the greatest risk reduction in females (odds ratio 0.40 (CI 95% 0,19-0.76, p = 0.002). DISCUSSION Our findings provide evidence that individuals diagnosed with RA have a significantly lower risk of developing PD than the general population. Our data should be considered when developing or repurposing therapies aimed at modifying the course of PD.
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Affiliation(s)
- Jonas Bacelis
- Center for Neurodegenerative Science, Van Andel Institute, Grand Rapids, MI, USA
| | - Michele Compagno
- Department of Clinical Sciences Lund, Rheumatology, Lund University, Lund, Sweden
| | - Sonia George
- Center for Neurodegenerative Science, Van Andel Institute, Grand Rapids, MI, USA
| | | | - Patrik Brundin
- Center for Neurodegenerative Science, Van Andel Institute, Grand Rapids, MI, USA
| | - Åsa Torinsson Naluai
- Institute of Biomedicine, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Lena Brundin
- Center for Neurodegenerative Science, Van Andel Institute, Grand Rapids, MI, USA
- Department of Psychiatry West, College of Human Medicine, Michigan State University, Grand Rapids, MI, USA
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Effects of Supply Angle on Thermal Environment of Residential Space with Hybrid Desiccant Cooling System for Multi-Room Control. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10207271] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In this study, local measurement and computational fluid dynamics (CFD) were employed to evaluate the thermal comfort in a residential environment where desiccant cooling is performed in an outdoor air condition, which is the typical summer weather in Korea. The desiccant cooling system in the present study has been developed for multi-room control with a hybrid air distribution, whereby mixing and displacement ventilation occur simultaneously. Due to this distribution of air flow, the thermal comfort was changed, and the thermal comfort indicators conflicted. The evaluation indicators included the ASHRAE (American Society of Heating, Refrigerating and Air-Conditioning Engineers) comfort zone, predicted mean vote (PMV), and effective draft temperature (EDT). The dry-bulb temperature displayed a distribution of 26.2–26.8 °C in the cooling spaces, i.e., living room, kitchen, and dining room. When determined based on the standard ASHRAE comfort zone, the space where desiccant cooling takes place entered the comfort zone for summer. Due to the influence of solar radiation, the globe temperature was more than 2 °C higher than the dry-bulb temperature at the window. A difference of up to 6% in humidity was observed locally in the cooling space. In the dining room located along the outlet of the desiccant cooling device, the PMV entered the comfort zone, but was slightly above 1 in the rest of the space. Conversely, as for the EDT, its value was lower than −1.7 in the dining room, but was included in the comfort zone in the rest of the space. By adjusting the discharge angle upward, the PMV and EDT were expected to be more uniform in the cooling space. In particular, the optimum discharge angle obtained was 40° upward from the discharge surface.
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Zeng Z, Zhang W, Qian Y, Huang H, Wu DJH, He Z, Ye D, Mao Y, Wen C. Association of telomere length with risk of rheumatoid arthritis: a meta-analysis and Mendelian randomization. Rheumatology (Oxford) 2020; 59:940-947. [PMID: 31697380 DOI: 10.1093/rheumatology/kez524] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 09/30/2019] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE To evaluate the telomere length (TL) in patients with RA relative to that in controls and to test whether TL is causally associated with risk of RA. METHODS Systematic review and meta-analysis of relevant literature was conducted to evaluate the association between TL and RA. Standardized mean differences with 95% CIs of TL in RA patients relative to controls were pooled using fixed or random-effects models. TL-related single-nucleotide polymorphisms were selected from a genome-wide association study of 37 684 individuals, and summary statistics of RA were obtained from a genome-wide association study meta-analysis including 14 361 RA patients and 43 923 controls. Mendelian randomization was performed using the inverse-variance weighted, weighted-median and likelihood-based methods. Sensitivity analyses were performed to test the robustness of the association. RESULTS In the meta-analysis of 911 RA patients and 2498 controls, we found that patients with RA had a significantly shorter TL compared with controls (standardized mean differences = -0.50; 95% CI -0.88, -0.11; P = 0.012). In the Mendelian randomization analysis, we found that genetically predicted longer TL was associated with a reduced risk of RA [odds ratio = 0.68; 95% CI 0.54, 0.86; P = 0.002 using the inverse-variance weighted method]. Sensitivity analyses using alternative Mendelian randomization approaches yielded similar findings, suggesting the robustness of the causal association. CONCLUSION Our study provides evidence for a negative causal association of TL with risk of RA. Further studies are warranted to elucidate the underlying mechanism for the role of telomeres in the development of RA.
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Affiliation(s)
- Zhen Zeng
- School of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Wanting Zhang
- School of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Yu Qian
- School of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Huijun Huang
- School of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - David J H Wu
- School of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China.,University of Minnesota Medical School, University of Minnesota, Minneapolis, MN, USA
| | - Zhixing He
- School of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Ding Ye
- School of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Yingying Mao
- School of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Chengping Wen
- School of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
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14
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Li X, Yang Y, Sun G, Dai W, Jie X, Du Y, Huang R, Zhang J. Promising targets and drugs in rheumatoid arthritis: a module-based and cumulatively scoring approach. Bone Joint Res 2020; 9:501-514. [PMID: 32922758 PMCID: PMC7468554 DOI: 10.1302/2046-3758.98.bjr-2019-0301.r1] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
AIMS Rheumatoid arthritis (RA) is a systematic autoimmune disorder, characterized by synovial inflammation, bone and cartilage destruction, and disease involvement in multiple organs. Although numerous drugs are employed in RA treatment, some respond little and suffer from severe side effects. This study aimed to screen the candidate therapeutic targets and promising drugs in a novel method. METHODS We developed a module-based and cumulatively scoring approach that is a deeper-layer application of weighted gene co-expression network (WGCNA) and connectivity map (CMap) based on the high-throughput datasets. RESULTS Four noteworthy RA-related modules were identified, revealing the immune- and infection-related biological processes and pathways involved in RA. HLA-DMA, HLA-DMB, HLA-DPA1, HLA-DPB1, HLA-DQB1, HLA-DRA, HLA-DRB1, BLNK, BTK, CD3D, CD4, IL2RG, INPP5D, LCK, PTPRC, RAC2, SYK, and VAV1 were recognized as the key hub genes with high connectivity in gene regulation networks and gene pathway networks. Moreover, the long noncoding RNAs (lncRNAs) in the RA-related modules, such as FAM30A and NEAT1, were identified as the indispensable interactors with the hub genes. Finally, candidate drugs were screened by developing a cumulatively scoring approach based on the selected modules. Niclosamide and the other compounds of T-type calcium channel blocker, IKK inhibitor, and PKC activator, HIF activator, and proteasome inhibitor, which harbour the similar gene signature with niclosamide, were promising drugs with high specificity and broad coverage for the RA-related modules. CONCLUSION This study provides not only the promising targets and drugs for RA but also a novel methodological insight into the target and drug screening.Cite this article: Bone Joint Res 2020;9(8):501-514.
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Affiliation(s)
- Xingyan Li
- Department of Bone and Joint Surgery, The Third Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Yejing Yang
- Department of Bone and Joint Surgery, The Third Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Guili Sun
- Department of Nutriology, The Third Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Wanwu Dai
- Department of Bone and Joint Surgery, The Third Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Xuri Jie
- Department of Hematology, The Third Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Yongjun Du
- Department of Bone and Joint Surgery, The Third Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Runjie Huang
- Second Clinical College, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jiaming Zhang
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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15
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McDermott G, Fu X, Stone JH, Wallwork R, Zhang Y, Choi HK, Wallace ZS. Association of Cigarette Smoking With Antineutrophil Cytoplasmic Antibody-Associated Vasculitis. JAMA Intern Med 2020; 180:870-876. [PMID: 32282021 PMCID: PMC7154954 DOI: 10.1001/jamainternmed.2020.0675] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
IMPORTANCE Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a systemic small vessel vasculitis characterized by circulating ANCAs targeting proteinase 3 (PR3) or myeloperoxidase (MPO) and associated with excess morbidity and mortality. Myeloperoxidase-ANCA-positive AAV and PR3-ANCA-positive AAV are increasingly recognized to have differences in genetic risk, pathogenesis, and response to treatment. Risk factors for AAV, including cigarette smoking, are poorly understood. OBJECTIVE To examine the association between cigarette smoking and AAV. DESIGN, SETTING, AND PARTICIPANTS This case-control study included a consecutive inception cohort of 484 patients with AAV diagnosed from 2002 to 2017 compared with a cohort of sex-, race-, and age-matched controls. Eleven cases were excluded owing to discordant smoking information in the electronic health record. Controls were randomly selected from participants recruited to the Partners HealthCare Biobank between its inception in 2010 and 2018 and who completed a smoking questionnaire and were not diagnosed with AAV (n = 30 536). EXPOSURES Smoking status (current, former, never) and pack-years of cigarette smoking were determined from review of the electronic medical record and smoking questionnaires. MAIN OUTCOMES AND MEASURES Patients with AAV were individually matched with 3 randomly-selected controls based on sex, race, and age (within 2 years difference). Conditional logistic regression was performed to examine the association between cigarette smoking and AAV using odds ratios (OR) and 95% confidence intervals (CIs). RESULTS Overall, 473 cases were matched with 1419 controls (mean [SD] age, 59 [16] years; 281 women [59%], 396 white [84%]). Patients with AAV were more likely to be former (OR, 1.6; 95% CI, 1.3-2.0) or current smokers (OR, 2.7; 95% CI, 1.8-4.1); there was a dose-response relationship according to pack-years of exposure (P < .001). These associations were especially strong among participants with MPO-ANCA-positive disease (former smokers: OR, 1.7; 95% CI, 1.3-2.3; current smokers: OR, 3.5; 95% CI, 2.1-6.1) but not in participants with PR3-ANCA-positive AAV (former smokers: OR, 1.3; 95% CI, 0.9-2.0; current smokers: OR, 1.7; 95% CI, 0.8-3.5). After stratifying by selected demographics and disease manifestations, these associations remained strong. CONCLUSIONS AND RELEVANCE Cigarette smoking was associated with AAV, especially MPO-ANCA-positive AAV. Further studies are needed to investigate a potential pathogenic mechanism.
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Affiliation(s)
- Greg McDermott
- Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston
| | - Xiaoqing Fu
- Clinical Epidemiology Program, Massachusetts General Hospital and Harvard Medical School, Boston.,Mongan Institute; all at Massachusetts General Hospital and Harvard Medical School, Boston
| | - John H Stone
- Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston.,Rheumatology Unit, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital and Harvard Medical School, Boston
| | - Rachel Wallwork
- Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston.,Rheumatology Unit, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital and Harvard Medical School, Boston
| | - Yuqing Zhang
- Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston.,Clinical Epidemiology Program, Massachusetts General Hospital and Harvard Medical School, Boston.,Rheumatology Unit, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital and Harvard Medical School, Boston.,Mongan Institute; all at Massachusetts General Hospital and Harvard Medical School, Boston
| | - Hyon K Choi
- Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston.,Clinical Epidemiology Program, Massachusetts General Hospital and Harvard Medical School, Boston.,Rheumatology Unit, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital and Harvard Medical School, Boston.,Mongan Institute; all at Massachusetts General Hospital and Harvard Medical School, Boston
| | - Zachary S Wallace
- Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston.,Clinical Epidemiology Program, Massachusetts General Hospital and Harvard Medical School, Boston.,Rheumatology Unit, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital and Harvard Medical School, Boston.,Mongan Institute; all at Massachusetts General Hospital and Harvard Medical School, Boston
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16
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Elter E, Wagner M, Buchenauer L, Bauer M, Polte T. Phthalate Exposure During the Prenatal and Lactational Period Increases the Susceptibility to Rheumatoid Arthritis in Mice. Front Immunol 2020; 11:550. [PMID: 32308655 PMCID: PMC7145968 DOI: 10.3389/fimmu.2020.00550] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 03/10/2020] [Indexed: 12/13/2022] Open
Abstract
The prenatal and early postnatal period is highly sensitive to environmental exposures that may interfere with the developmental programming of the immune system leading to an altered disease risk in later life. To clarify the role of early influences in activation or exacerbation of autoimmune diseases like rheumatoid arthritis (RA) we investigated the effect of maternal exposure during the prenatal and lactational period of DBA/1 mice to the plasticizer benzyl butyl phthalate (BBP) on the development of RA in the offspring. Using a mild collagen-induced arthritis (CIA) model, maternal BBP-exposure increased both the prevalence and the severity of RA in the progeny compared to un-exposed dams. Additionally, maternal BBP exposure led to elevated serum IgG1 and IgG2a level in the offspring and increased the IFN-γ and IL-17 release from collagen-re-stimulated spleen cells. Transcriptome analysis of splenocytes isolated from 3-week-old pups before RA-induction revealed considerable changes in gene expression in the offspring from BBP-exposed dams. Among them were regulator of G-protein signaling 1 (rgs1), interleukin-7 receptor (il-7r) and CXC chemokine 4 (cxcr4), all genes that have previously been described as associated with RA pathology. In summary, our results demonstrate that perinatal exposure to BBP increases the susceptibility of the offspring to RA, probably via a phthalate-induced disturbed regulation of RA-relevant genes or signaling pathways.
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Affiliation(s)
- Elena Elter
- Department of Environmental Immunology, UFZ-Helmholtz Centre for Environmental Research Leipzig-Halle, Leipzig, Germany.,Department of Dermatology, Venerology and Allergology, Leipzig University Medical Center, Leipzig, Germany
| | - Marita Wagner
- Department of Environmental Immunology, UFZ-Helmholtz Centre for Environmental Research Leipzig-Halle, Leipzig, Germany.,Department of Dermatology, Venerology and Allergology, Leipzig University Medical Center, Leipzig, Germany
| | - Lisa Buchenauer
- Department of Environmental Immunology, UFZ-Helmholtz Centre for Environmental Research Leipzig-Halle, Leipzig, Germany.,Department of Dermatology, Venerology and Allergology, Leipzig University Medical Center, Leipzig, Germany
| | - Mario Bauer
- Department of Environmental Immunology, UFZ-Helmholtz Centre for Environmental Research Leipzig-Halle, Leipzig, Germany
| | - Tobias Polte
- Department of Environmental Immunology, UFZ-Helmholtz Centre for Environmental Research Leipzig-Halle, Leipzig, Germany.,Department of Dermatology, Venerology and Allergology, Leipzig University Medical Center, Leipzig, Germany
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17
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Mehri F, Jenabi E, Bashirian S, Shahna FG, Khazaei S. The association Between Occupational Exposure to silica and Risk of Developing Rheumatoid Arthritis: A Meta-Analysis. Saf Health Work 2020; 11:136-142. [PMID: 32596007 PMCID: PMC7303526 DOI: 10.1016/j.shaw.2020.02.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 01/31/2020] [Accepted: 02/22/2020] [Indexed: 02/06/2023] Open
Abstract
Background Rheumatoid arthritis (RA) is an autoimmune disease with systemic inflammatory arthritis. This meta-analysis was conducted to examine the association between occupational exposure to silica and the risk of developing RA among different workers. Methods In this meta-analysis, we searched relevant published studies using major electronic databases including Scopus, PubMed, ISI Web of Science, and Google Scholar search engine up to October 2019, and the references of retrieved articles were also checked for further possible sources. A random-effects model was used to account for heterogeneity among the results of the studies using the pooled odds ratios (ORs) and their 95% confidence intervals (CIs). The Q-statistic and I2 tests were calculated to assess heterogeneity between the studies. Results The pooled calculation of OR indicated a significant association between occupational exposure to silica and risk of developing RA among different workers (OR = 2.59, 95% CI = 1.73 to 3.45). In addition, the pooled estimates of OR in smokers were statistically significant (OR = 2.49, 95% CI = 1.13 to 3.86). Conclusions The findings of the present study reveal that occupational exposure to silica may be associated with increased risk of developing RA.
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Affiliation(s)
- Fereshteh Mehri
- Department of Nutritional Sciences, Nutrition Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Ensiyeh Jenabi
- Department of Nursing & Midwifery, Autism Spectrum Disorders Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Saeed Bashirian
- Department of Public Health, Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Farshid Ghorbani Shahna
- Department of Occupational Health, Occupational Health and Safety Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Salman Khazaei
- Department of Epidemiology, Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
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18
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Moghimi N, Sigari N, Mohammad Hosinian S, Saeedi A, Roshani D, Ali Zeinolabedin Moshref M, Nourbakhsh S, Babahajian A. Anti-citrullinated peptide antibodies in rheumatoid arthritis patients exposed to wood smoke. AIMS MEDICAL SCIENCE 2020. [DOI: 10.3934/medsci.2020001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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19
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Yamamoto SS, Yacyshyn E, Jhangri GS, Chopra A, Parmar D, Jones CA. Household air pollution and arthritis in low-and middle-income countries: Cross-sectional evidence from the World Health Organization's study on Global Ageing and Adult Health. PLoS One 2019; 14:e0226738. [PMID: 31881058 PMCID: PMC6934325 DOI: 10.1371/journal.pone.0226738] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 12/06/2019] [Indexed: 02/07/2023] Open
Abstract
Background Evidence points to a clear link between air pollution exposure and several chronic diseases though investigations regarding arthritis are still lacking. Emerging evidence suggests an association between ambient air pollution and rheumatoid arthritis. Household air pollution exposure, conversely, is largely unstudied but may be an important consideration for arthritis, particularly in low- and middle-income countries (LMICs), where cooking and heating activities can generate high indoor air pollutant levels. Methods We investigated the association of household air pollution (electricity vs. gas; kerosene/paraffin; coal/charcoal; wood; or agriculture/crop/animal dung/shrubs/grass as the main fuel used for cooking) and arthritis in six LMICs (China, Ghana, India, Mexico, the Russian Federation, South Africa) using data from Wave I of the World Health Organization Study on Global AGEing and Adult Health (SAGE) (2007–2010). Multivariable analyses were adjusted for sociodemographic, household and lifestyle characteristics and several comorbidities. Results The use of gas (aOR = 1.76, 95%CI: 1.40–2.21); coal (aOR = 1.74, 95%CI: 1.22–2.47); wood (aOR = 1.69, 95%CI: 1.30–2.19); or agriculture/crop/animal dung/shrubs/grass: aOR = 1.95 (1.46–2.61) fuels for cooking were strongly associated with an increased odds of arthritis, compared to electricity in cluster and stratified adjusted analyses. Gender (female), age (≥50 years), overweight (25.0 ≤BMI<30.0 kg/m2), obesity (BMI ≥30.0 kg/m2), former and current alcohol consumption, and the comorbidities angina pectoris, diabetes, chronic lung disease, depression and hypertension were also associated with a higher odds of arthritis. Underweight (BMI<18.5 kg/m2) and higher education levels (college/university completed/post-graduate studies) were associated with a lower odds of arthritis. Conclusions These findings suggest that exposure to household air pollution from cook fuels is associated with an increased odds of arthritis in these regions, which warrants further investigation.
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Affiliation(s)
- Shelby S. Yamamoto
- School of Public Health, University of Alberta, Edmonton, Canada
- * E-mail:
| | - Elaine Yacyshyn
- Division of Rheumatology, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Canada
| | - Gian S. Jhangri
- School of Public Health, University of Alberta, Edmonton, Canada
| | | | - Divya Parmar
- School of Health Sciences, City, University of London, London, England, United Kingdom
| | - C. Allyson Jones
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
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20
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Sundström B, Ljung L, Di Giuseppe D. Consumption of Meat and Dairy Products Is Not Associated with the Risk for Rheumatoid Arthritis among Women: A Population-Based Cohort Study. Nutrients 2019; 11:nu11112825. [PMID: 31752273 PMCID: PMC6893662 DOI: 10.3390/nu11112825] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 11/07/2019] [Accepted: 11/12/2019] [Indexed: 01/21/2023] Open
Abstract
Diet has gained attention as a risk factor for the development of rheumatoid arthritis (RA), especially with regards to food of animal origin, such as meat and dairy products. By using data from national patient registers and dietary data from a large prospective population cohort, the Swedish Mammography Cohort, we aimed to investigate whether the consumption of meat and dairy products had any impact on the risk of subsequent development of RA. During 12 years of follow-up (January 2003–December 2014; 381, 456 person-years), 368 patients with a new diagnosis of RA were identified. No associations between the development of RA and the consumption of meat and meat products (hazard ratio [HR] for the fully adjusted model: 1.08 [95% CI: 0.77–1.53]) or the total consumption of milk and dairy products (HR for the fully adjusted model: 1.09 [95% CI: 0.76–1.55]) were observed. In conclusion, in this large prospective cohort of women, no associations were observed between dietary intake of meat and dairy products and the risk of RA development.
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Affiliation(s)
- Björn Sundström
- Department of Public Health and Clinical Medicine, Rheumatology, Umeå University, 90187 Umeå, Sweden;
- Correspondence: ; Tel.: +46-(0)907-85-1894
| | - Lotta Ljung
- Department of Public Health and Clinical Medicine, Rheumatology, Umeå University, 90187 Umeå, Sweden;
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, 171 77 Solna, Sweden;
| | - Daniela Di Giuseppe
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, 171 77 Solna, Sweden;
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21
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Oluwagbemigun K, Yucel-Lindberg T, Dietrich T, Tour G, Sherina N, Hansson M, Bergmann M, Lundberg K, Boeing H. A cross-sectional investigation into the association between Porphyromonas gingivalis and autoantibodies to citrullinated proteins in a German population. Ther Adv Musculoskelet Dis 2019; 11:1759720X19883152. [PMID: 31723356 PMCID: PMC6831975 DOI: 10.1177/1759720x19883152] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 09/26/2019] [Indexed: 01/22/2023] Open
Abstract
Background Porphyromonas gingivalis (P.g) is unique among pathogens due to its ability to generate citrullinated proteins in an inflammatory milieu, potentially mediating the loss of immune tolerance, the production of anticitrullinated protein antibodies (ACPAs), and subsequently the development of rheumatoid arthritis (RA). Based on this hypothesis, we set out to investigate whether P.g is linked to ACPAs in a well-characterized German population. Participants and methods A total of 600 participants (292 women and 308 men with a mean age of 67 years) of the European Prospective Investigation into Cancer and Nutrition-Potsdam study were selected in 2013, and paired saliva and serum samples were collected. Salivary P.g DNA and serum anticyclic citrullinated peptide (anti-CCP2) levels were quantified by real-time polymerase chain reaction and anti-CCP2 enzyme-linked immunosorbent assay, respectively. In selected participants, additional ACPA fine-specificities were also analysed on a custom-made multiplex peptide array. Results Among participants with C-reactive protein greater than 3.0 mg/l, a one-unit increase in P.g DNA was associated with an almost twofold increase in anti-CCP2 levels. Moreover, participants with high P.g DNA had on average approximately 2.8-times higher anti-CCP2 levels when compared with participants with low P.g DNA, (Holm-adjusted p value = 0.01). Furthermore, citrullinated epitopes on α-enolase and vimentin were common ACPA reactivities among participants who also had high P.g DNA and elevated C-reactive protein. Conclusions Our study suggests that in specific subgroups of individuals with systemic inflammation, higher salivary P.g DNA is associated with elevated serum ACPA. These data support a role for P.g in the development of anticitrulline immunity.
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Affiliation(s)
- Kolade Oluwagbemigun
- Nutritional Epidemiology, Department of Nutrition and Food Sciences, University of Bonn, Endenicher Allee 19b, Bonn, 53115, Germany
| | - Tülay Yucel-Lindberg
- Periodontology Unit, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Thomas Dietrich
- Department of Oral Surgery, School of Dentistry, University of Birmingham, Birmingham, UK
| | - Gregory Tour
- Periodontology Unit, Department of Dental Medicine, Karolinska Institutet, Sweden
| | - Natalia Sherina
- Rheumatology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Monika Hansson
- Rheumatology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Manuela Bergmann
- Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Nuthetal, Germany
| | - Karin Lundberg
- Rheumatology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Heiner Boeing
- Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Nuthetal, Germany
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22
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Empirical Model of Thermal Comfort for Medium-Sized Cities in Subtropical Climate. ATMOSPHERE 2019. [DOI: 10.3390/atmos10100576] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The present study sought to elaborate an empirical model of thermal comfort for medium-sized cities in subtropical climate, based on a cross-sectional survey in the city of Santa Maria, state of Rio Grande do Sul, Brazil. The research was based on the collection of meteorological, subjective and individual data collected simultaneously in August 2015, January and July 2016, which were submitted to multiple linear regression for the elaboration of the Bioclimatic Model for Subtropical Medium-Sized Cities (MBCMS). The proposed model was validated through a normality test, obtained by the measure of obliquity and kurtosis of the distribution, heteroscedasticity and covariance, as well as by the comparison between already traditional models in the literature, such as PET, SET and PMV, which were calibrated to the study area, and the results observed for MBCMS. The results presented high multiple R-squared and adjusted R-squared, 0.928 and 0.925, respectively, for the proposed model, as well as an F-statistic of 447.6. In the validation, the MBCMS presented R equal to 0.83 and an accuracy score 60% more efficient than the PET, SET and PMV indexes.
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23
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A specific amino acid motif of HLA-DRB1 mediates risk and interacts with smoking history in Parkinson's disease. Proc Natl Acad Sci U S A 2019; 116:7419-7424. [PMID: 30910980 PMCID: PMC6462083 DOI: 10.1073/pnas.1821778116] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Parkinson’s disease (PD) is a chronic, progressive neurodegenerative disease with both familial and sporadic forms and a clear genetic component. In addition, underlying immunoregulatory dysfunction and inflammatory processes have been implicated in PD pathogenesis. In this study, deep sequencing of HLA genes, which encode highly variable cell surface immune receptors, reveals specific variants conferring either risk or protection in PD. Because a history of cigarette smoking is known to be protective in PD, we analyzed the interaction of these genetic variants with smoking history in PD patients and healthy controls and found that the genetic effects are modified by history of cigarette smoking. These results provide a molecular model that explains the unique epidemiology of smoking in PD. Parkinson’s disease (PD) is a neurodegenerative disease in which genetic risk has been mapped to HLA, but precise allelic associations have been difficult to infer due to limitations in genotyping methodology. Mapping PD risk at highest possible resolution, we performed sequencing of 11 HLA genes in 1,597 PD cases and 1,606 controls. We found that susceptibility to PD can be explained by a specific combination of amino acids at positions 70–74 on the HLA-DRB1 molecule. Previously identified as the primary risk factor in rheumatoid arthritis and referred to as the “shared epitope” (SE), the residues Q/R-K/R-R-A-A at positions 70–74 in combination with valine at position 11 (11-V) is highly protective in PD, while risk is attributable to the identical epitope in the absence of 11-V. Notably, these effects are modified by history of cigarette smoking, with a strong protective effect mediated by a positive history of smoking in combination with the SE and 11-V (P = 10−4; odds ratio, 0.51; 95% confidence interval, 0.36–0.72) and risk attributable to never smoking in combination with the SE without 11-V (P = 0.01; odds ratio, 1.51; 95% confidence interval, 1.08–2.12). The association of specific combinations of amino acids that participate in critical peptide-binding pockets of the HLA class II molecule implicates antigen presentation in PD pathogenesis and provides further support for genetic control of neuroinflammation in disease. The interaction of HLA-DRB1 with smoking history in disease predisposition, along with predicted patterns of peptide binding to HLA, provide a molecular model that explains the unique epidemiology of smoking in PD.
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O'Driscoll CA, Mezrich JD. The Aryl Hydrocarbon Receptor as an Immune-Modulator of Atmospheric Particulate Matter-Mediated Autoimmunity. Front Immunol 2018; 9:2833. [PMID: 30574142 PMCID: PMC6291477 DOI: 10.3389/fimmu.2018.02833] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 11/16/2018] [Indexed: 12/22/2022] Open
Abstract
This review examines the current literature on the effects of atmospheric particulate matter (PM) on autoimmune disease and proposes a new role for the aryl hydrocarbon receptor (AHR) as a modulator of T cells in PM-mediated autoimmune disease. There is a significant body of literature regarding the strong epidemiologic correlations between PM exposures and worsened autoimmune diseases. Genetic predispositions account for 30% of all autoimmune disease leaving environmental factors as major contributors. Increases in incidence and prevalence of autoimmune disease have occurred concurrently with an increase in air pollution. Currently, atmospheric PM is considered to be the greatest environmental health risk worldwide. Atmospheric PM is a complex heterogeneous mixture composed of diverse adsorbed organic compounds such as polycyclic aromatic hydrocarbons (PAHs) and dioxins, among others. Exposure to atmospheric PM has been shown to aggravate several autoimmune diseases. Despite strong correlations between exposure to atmospheric PM and worsened autoimmune disease, the mechanisms underlying aggravated disease are largely unknown. The AHR is a ligand activated transcription factor that responds to endogenous and exogenous ligands including toxicants present in PM, such as PAHs and dioxins. A few studies have investigated the effects of atmospheric PM on AHR activation and immune function and demonstrated that atmospheric PM can activate the AHR, change cytokine expression, and alter T cell differentiation. Several studies have found that the AHR modulates the balance between regulatory and effector T cell functions and drives T cell differentiation in vitro and in vivo using murine models of autoimmune disease. However, there are very few studies on the role of AHR in PM-mediated autoimmune disease. The AHR plays a critical role in the balance of effector and regulatory T cells and in autoimmune disease. With increased incidence and prevalence of autoimmune disease occurring concurrently with increases in air pollution, potential mechanisms that drive inflammatory and exacerbated disease need to be elucidated. This review focuses on the AHR as a potential mechanistic target for modulating T cell responses associated with PM-mediated autoimmune disease providing the most up-to-date literature on the role of AHR in autoreactive T cell function and autoimmune disease.
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Affiliation(s)
- Chelsea A O'Driscoll
- Division of Transplantation, Department of Surgery, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States.,Molecular and Environmental Toxicology Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Joshua D Mezrich
- Division of Transplantation, Department of Surgery, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
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Sharaki OA, Elgerby AH, Nassar ES, Khalil SSE. Impact of methylenetetrahydrofolate reductase (MTHFR) A1298C gene polymorphism on the outcome of methotrexate treatment in a sample of Egyptian rheumatoid arthritis patients. ALEXANDRIA JOURNAL OF MEDICINE 2018. [DOI: 10.1016/j.ajme.2017.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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26
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Housing conditions and non-communicable diseases among older adults in Ireland. QUALITY IN AGEING AND OLDER ADULTS 2018. [DOI: 10.1108/qaoa-03-2018-0013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Housing quality across the life course is an important health determinant. The purpose of this paper is to profile the current housing conditions of older adults in Ireland, and to investigate the association between housing conditions and heating problems and two types of non-communicable diseases: respiratory health problems and bone and joint conditions.
Design/methodology/approach
Data are from the Healthy and Positive Ageing Initiative Age-friendly Cities and Counties Survey, a random-sample, population representative survey of 10,540 adults aged 55 and older collected in 2015–2016. Mixed-effects logistic regression analysis was used to investigate the association between poor housing (leaks, rot and damp) and poor heating (unable to keep the home adequately warm) and the likelihood of having a respiratory health problem or a bone or joint condition. Results are reported as odds ratios with 95% confidence intervals.
Findings
Overall, 10.2 per cent had poor housing and 10.4 per cent had poor heating. Poor housing and poor heating were strongly associated with respiratory health problems and there was a strong association between poor housing and bone and joint conditions. These associations were not explained by health behaviours or socio-demographic characteristics.
Originality/value
Despite a number of publicly funded schemes available to assist in upgrading and maintaining housing, a considerable number of adults aged 55 years and older continue to report problems which are associated with an increased likelihood of respiratory health problem and bone and joint conditions and present a considerable threat to healthy ageing in place.
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Webster AP, Plant D, Ecker S, Zufferey F, Bell JT, Feber A, Paul DS, Beck S, Barton A, Williams FMK, Worthington J. Increased DNA methylation variability in rheumatoid arthritis-discordant monozygotic twins. Genome Med 2018; 10:64. [PMID: 30176915 PMCID: PMC6122744 DOI: 10.1186/s13073-018-0575-9] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 07/31/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Rheumatoid arthritis is a common autoimmune disorder influenced by both genetic and environmental factors. Epigenome-wide association studies can identify environmentally mediated epigenetic changes such as altered DNA methylation, which may also be influenced by genetic factors. To investigate possible contributions of DNA methylation to the aetiology of rheumatoid arthritis with minimum confounding genetic heterogeneity, we investigated genome-wide DNA methylation in disease-discordant monozygotic twin pairs. METHODS Genome-wide DNA methylation was assessed in 79 monozygotic twin pairs discordant for rheumatoid arthritis using the HumanMethylation450 BeadChip array (Illumina). Discordant twins were tested for both differential DNA methylation and methylation variability between rheumatoid arthritis and healthy twins. The methylation variability signature was then compared with methylation variants from studies of other autoimmune diseases and with an independent healthy population. RESULTS We have identified a differentially variable DNA methylation signature that suggests multiple stress response pathways may be involved in the aetiology of the disease. This methylation variability signature also highlighted potential epigenetic disruption of multiple RUNX3 transcription factor binding sites as being associated with disease development. Comparison with previously performed epigenome-wide association studies of rheumatoid arthritis and type 1 diabetes identified shared pathways for autoimmune disorders, suggesting that epigenetics plays a role in autoimmunity and offering the possibility of identifying new targets for intervention. CONCLUSIONS Through genome-wide analysis of DNA methylation in disease-discordant monozygotic twins, we have identified a differentially variable DNA methylation signature, in the absence of differential methylation in rheumatoid arthritis. This finding supports the importance of epigenetic variability as an emerging component in autoimmune disorders.
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Affiliation(s)
- Amy P Webster
- Arthritis Research UK Centre for Genetics and Genomics, Centre for Musculoskeletal Research, The University of Manchester, Manchester, UK. .,Department of Cancer Biology, UCL Cancer Institute, University College London, London, UK.
| | - Darren Plant
- NIHR Manchester Biomedical Research Centre, Manchester Academy of Health Sciences, Manchester University Foundation Trust, Manchester, UK
| | - Simone Ecker
- Department of Cancer Biology, UCL Cancer Institute, University College London, London, UK
| | - Flore Zufferey
- Department of Twin Research and Genetic Epidemiology, King's College London, London, UK
| | - Jordana T Bell
- Department of Twin Research and Genetic Epidemiology, King's College London, London, UK
| | - Andrew Feber
- Department of Cancer Biology, UCL Cancer Institute, University College London, London, UK.,Division of Surgery and Interventional Science, University College London, London, UK
| | - Dirk S Paul
- MRC/BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Stephan Beck
- Department of Cancer Biology, UCL Cancer Institute, University College London, London, UK
| | - Anne Barton
- Arthritis Research UK Centre for Genetics and Genomics, Centre for Musculoskeletal Research, The University of Manchester, Manchester, UK.,NIHR Manchester Biomedical Research Centre, Manchester Academy of Health Sciences, Manchester University Foundation Trust, Manchester, UK
| | - Frances M K Williams
- Department of Twin Research and Genetic Epidemiology, King's College London, London, UK
| | - Jane Worthington
- Arthritis Research UK Centre for Genetics and Genomics, Centre for Musculoskeletal Research, The University of Manchester, Manchester, UK. .,NIHR Manchester Biomedical Research Centre, Manchester Academy of Health Sciences, Manchester University Foundation Trust, Manchester, UK.
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Tung CH, Lai NS, Li CY, Tsai SJ, Chen YC, Chen YC. Risk of rheumatoid arthritis in patients with hepatitis C virus infection receiving interferon-based therapy: a retrospective cohort study using the Taiwanese national claims database. BMJ Open 2018; 8:e021747. [PMID: 30037875 PMCID: PMC6059328 DOI: 10.1136/bmjopen-2018-021747] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES To illuminate the association between interferon-based therapy (IBT) and the risk of rheumatoid arthritis (RA) in patients infected with hepatitis C virus (HCV). DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS This retrospective cohort study used Taiwan's Longitudinal Health Insurance Database 2005 that included 18 971 patients with HCV infection between 1 January 1997 and 31 December 2012. We identified 1966 patients with HCV infection who received IBT (treated cohort) and used 1:4 propensity score-matching to select 7864 counterpart controls who did not receive IBT (untreated cohort). OUTCOME MEASURES All study participants were followed until the end of 2012 to calculate the incidence rate and risk of incident RA. RESULTS During the study period, 305 RA events (3.1%) occurred. The incidence rate of RA was significantly lower in the treated cohort than the untreated cohort (4.0 compared with 5.5 per 1000 person-years, p<0.018), and the adjusted HR remained significant at 0.63 (95% CI 0.43 to 0.94, p=0.023) in a Cox proportional hazards regression model. Multivariate stratified analyses revealed that the attenuation in RA risk was greater in men (0.35; 0.15 to 0.81, p=0.014) and men<60 years (0.29; 0.09 to 0.93, p=0.036). CONCLUSIONS This study demonstrates that IBT may reduce the risk of RA and contributes to growing evidence that HCV infection may lead to development of RA.
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Affiliation(s)
- Chien-Hsueh Tung
- Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan
- School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Ning-Sheng Lai
- Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan
- School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Chung-Yi Li
- Department and Graduate Institute of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan
| | - Shiang-Jiun Tsai
- Department of Medical Research, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan
| | - Yen-Chun Chen
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan
| | - Yi-Chun Chen
- School of Medicine, Tzu Chi University, Hualien, Taiwan
- Division of Nephrology, Department of Internal Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan
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Dzhambov AM, Dimitrova DD. Lifetime exposure to self-reported occupational noise and prevalent rheumatoid arthritis in the National Health and Nutrition Examination Survey (2011-2012). INTERNATIONAL JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HEALTH 2018; 23:215-221. [PMID: 29557725 DOI: 10.1080/10773525.2018.1451809] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Multiple risk factors for rheumatoid arthritis (RA) have been studied, but there is a dearth of research on occupational noise, which is highly prevalent in the United States (U.S.). This study aimed to determine whether occupational noise exposure was associated with an elevated risk of prevalent RA in the U.S. general population. Data from the 2011 to 2012 cross-sectional, population-based National Health and Nutrition Examination Survey were used for secondary analysis. Self-reported lifetime exposure to very loud noise was linked to self-reported doctor-diagnosed RA in a sample of 4192 participants. Weighted logistic regression was used to obtain nationally representative prevalence odds ratios (OR). The main and fully adjusted models yielded OR = 3.98 (95% CI: 1.74, 9.11) and OR = 2.84 (95% CI: 1.23, 6.57) for participants exposed for ≥ 15 years compared to never exposed participants. Excluding those diagnosed with RA more than five years before the interview, the effect dropped to OR = 3.67 (95% CI: 1.06, 12.75) in the main model, and was no longer significant in the fully adjusted model (OR = 2.68, 95% CI: 0.80, 8.96). The only significant effect modifier was race/ethnicity, with higher risk in Non-Hispanic whites. To conclude, long-term occupational noise exposure might be a modifiable risk factor for RA, but currently, the evidence base is very thin and tenuous.
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Affiliation(s)
- Angel M Dzhambov
- a Department of Hygiene and Ecomedicine, Faculty of Public Health , Medical University of Plovdiv , Plovdiv , Bulgaria
| | - Donka D Dimitrova
- b Department of Health Management and Healthcare Economics, Faculty of Public Health , Medical University of Plovdiv , Plovdiv , Bulgaria
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Human MHC-II with Shared Epitope Motifs Are Optimal Epstein-Barr Virus Glycoprotein 42 Ligands-Relation to Rheumatoid Arthritis. Int J Mol Sci 2018; 19:ijms19010317. [PMID: 29361739 PMCID: PMC5796260 DOI: 10.3390/ijms19010317] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2017] [Revised: 01/15/2018] [Accepted: 01/17/2018] [Indexed: 12/14/2022] Open
Abstract
Rheumatoid arthritis (RA) is a chronic systemic autoimmune disorder of unknown etiology, which is characterized by inflammation in the synovium and joint damage. Although the pathogenesis of RA remains to be determined, a combination of environmental (e.g., viral infections) and genetic factors influence disease onset. Especially genetic factors play a vital role in the onset of disease, as the heritability of RA is 50–60%, with the human leukocyte antigen (HLA) alleles accounting for at least 30% of the overall genetic risk. Some HLA-DR alleles encode a conserved sequence of amino acids, referred to as the shared epitope (SE) structure. By analyzing the structure of a HLA-DR molecule in complex with Epstein-Barr virus (EBV), the SE motif is suggested to play a vital role in the interaction of MHC II with the viral glycoprotein (gp) 42, an essential entry factor for EBV. EBV has been repeatedly linked to RA by several lines of evidence and, based on several findings, we suggest that EBV is able to induce the onset of RA in predisposed SE-positive individuals, by promoting entry of B-cells through direct contact between SE and gp42 in the entry complex.
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31
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Kristen Demoruelle M, Olson AL, Solomon JJ. The Epidemiology of Rheumatoid Arthritis-Associated Lung Disease. LUNG DISEASE IN RHEUMATOID ARTHRITIS 2018. [DOI: 10.1007/978-3-319-68888-6_4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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32
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Jahreis S, Kuhn S, Madaj AM, Bauer M, Polte T. Mold metabolites drive rheumatoid arthritis in mice via promotion of IFN-gamma- and IL-17-producing T cells. Food Chem Toxicol 2017; 109:405-413. [DOI: 10.1016/j.fct.2017.09.027] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 09/08/2017] [Accepted: 09/14/2017] [Indexed: 01/15/2023]
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34
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Tan BE, Lim AL, Kan SL, Lim CH, Ng YF, Tng SLC, Hassin NS, Chandran L, Hamid NA, Lee YYL. Management of rheumatoid arthritis in clinical practice using treat-to-target strategy: Where do we stand in the multi-ethnic Malaysia population? Rheumatol Int 2017; 37:905-913. [PMID: 28389855 DOI: 10.1007/s00296-017-3705-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2016] [Accepted: 03/15/2017] [Indexed: 01/08/2023]
Abstract
To evaluate the achievement of treat-to-target (T2T) strategy in rheumatoid arthritis (RA) and identify factors associated with failed treatment target in a public rheumatology center. A cross-sectional study was conducted from June 2015 to February 2016. RA patients with disease duration greater than 2 years and under T2T for over a year were invited to the study. Demographic, clinical data, disease activity score of 28 joints (DAS28), and clinical disease activity index (CDAI) were collected in a single routine clinic visit. Treatment target was defined as DAS28 <3.2 or CDAI ≤10. Retrospective chart review was performed to determine reasons of failed treatment target. A total of 371 patients were recruited and 87.1% were female. Mean age and duration of RA were 53.5 years (SD 10.3) and 9.1 years (SD 6.6), respectively. Ethnic distribution was 49% Chinese, 27% Malay, and 24% Indian. T2T was achieved in 81.7% of the cohort. Non-Chinese ethnicity, positive rheumatoid factor, and treatment with three disease modifying anti-rheumatic drugs (DMARDs) were associated with failed treatment target. After controlling for covariates, Malay ethnicity (OR 2.96; 95% CI 1.47-5.96) and treatment with three DMARDs (OR 2.14; 95% CI 1.06-4.35) were associated with failed treatment target. There was no association between age, gender, duration of RA, BMI, smoking status, anti-citrulinated cyclic peptide, and achievement of T2T. The most common reasons of failed treatment target were inability to escalate DMARDs due to side effects (18.8%), lack of biologics fund (15.6%), and persistent disease despite optimum treatment (14.1%). T2T was successfully implemented. Malay patients need aggressive treatment adaptation to achieve optimal outcome.
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Affiliation(s)
- Bee Eng Tan
- Rheumatology Unit, Department of Medicine, Hospital Pulau Pinang, Jalan Residensi, 10990, Penang, Malaysia.
| | - Ai Lee Lim
- Rheumatology Unit, Department of Medicine, Hospital Pulau Pinang, Jalan Residensi, 10990, Penang, Malaysia
| | - Sow Lai Kan
- Rheumatology Unit, Department of Medicine, Hospital Pulau Pinang, Jalan Residensi, 10990, Penang, Malaysia
| | - Chong Hong Lim
- Rheumatology Unit, Department of Medicine, Hospital Pulau Pinang, Jalan Residensi, 10990, Penang, Malaysia
| | - Ying Fun Ng
- Rheumatology Unit, Department of Medicine, Hospital Pulau Pinang, Jalan Residensi, 10990, Penang, Malaysia
| | | | | | | | | | - Yvonne Yin Leng Lee
- Outcome and Evidence, Health and Value, Pfizer Malaysia Sdn Bhd, Kuala Lumpur, Malaysia
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35
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Zhang Y, Li H, Wu N, Dong X, Zheng Y. Retrospective study of the clinical characteristics and risk factors of rheumatoid arthritis-associated interstitial lung disease. Clin Rheumatol 2017; 36:817-823. [PMID: 28191607 DOI: 10.1007/s10067-017-3561-5] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 01/18/2017] [Accepted: 01/22/2017] [Indexed: 01/17/2023]
Abstract
This study aims to explore the clinical characteristics and risk factors of rheumatoid arthritis (RA)-associated interstitial lung disease (ILD). This is a retrospective study of 550 patients with RA. All patients underwent chest high-resolution computed tomography (HRCT) scanning. (1) Two hundred thirty-seven out of five hundred fifty (43.1%) patients with RA were diagnose with ILD. 13.5% ILD occurred before RA onset, 69.6% ILD occurred within 10 years of RA onset, and 16.9% ILD occurred more than 10 years after RA onset. (2) The most common chest CT characteristics of RA-ILD included reticular patterns (57.8%), pleural thickening (57%), ground-glass attenuation (53.2%), followed by interlobular septum thickening, nodules, emphysematous bullae, honeycombing, and bronchiectasis. The proportion of the UIP pattern and NSIP on HRCT was 18.6% and 57.8%. (3) RA-ILD was often associated with other lung lesions, including pleural disease, bronchiectasis, and pulmonary hypertension. (4) the comparisons between RA with ILD and RA without ILD showed that male, smoking, age, disease duration, number of swelling joints, globulin levels, erythrocyte sedimentation rate, C-reactive protein levels, lactate dehydrogenase, the positive rate of rheumatoid factor (RF) and the absolute value of RF, forced vital capacity, forced expiratory volume in 1 s, and carbon monoxide diffusion rate, were statistically different (P < 0.05). Logistic regression analysis showed that age, smoking, elevated lactate dehydrogenase, and RF positive were closely correlated to RA-ILD. RA-ILD occurs more often within 10 years of RA onset and coexists with other lung lesions. The elevated lactate dehydrogenase, RF positive, smoking, and advanced age are closely correlated with RA-ILD.
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Affiliation(s)
- Yongfeng Zhang
- Department of Rheumatology and Immunology, Beijing Chao-Yang Hospital, Capital Medical University, No. 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, Beijing, 100020, China
| | - Hongbin Li
- Department of Rheumatology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, 010050, China
| | - Nawei Wu
- Department of Internal Medicine, Miyunqu Hospital, Beijing, 101500, China
| | - Xin Dong
- Department of Rheumatology and Immunology, Beijing Chao-Yang Hospital, Capital Medical University, No. 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, Beijing, 100020, China
| | - Yi Zheng
- Department of Rheumatology and Immunology, Beijing Chao-Yang Hospital, Capital Medical University, No. 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, Beijing, 100020, China.
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Beltrán Ramírez O, Mendoza Rincón JF, Barbosa Cobos RE, Alemán Ávila I, Ramírez Bello J. STAT4 confers risk for rheumatoid arthritis and systemic lupus erythematosus in Mexican patients. Immunol Lett 2016; 175:40-3. [PMID: 27178308 DOI: 10.1016/j.imlet.2016.05.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Accepted: 05/09/2016] [Indexed: 12/21/2022]
Abstract
STAT4 has been consistently associated with several autoimmune diseases, including rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). The aim of this study was to determine whether the STAT4 rs7574865G/T polymorphism confers susceptibility for RA and SLE in a sample of Mexican patients. This study included 869 individuals: 415 patients with RA, 128 patients with SLE, and 326 controls. Genotyping using TaqMan probes showed an association between the STAT4 rs7574865G/T polymorphism and RA (GG vs. TT: OR 1.99, p=0.0009; G vs. T: OR 1.42, p=0.0009) and SLE (GG vs. TT: OR 2.98, 0.0003; G vs. T: OR 1.74, p=0.0002). Gender stratification showed an association with RA (GG vs. TT: OR 1.99, 95% CI 1.3-3.1, p=0.002; G vs. T: OR 1.42, 95% CI 1.1-1.8, p=0.002) and SLE (GG vs. TT: OR 3.3, 95% CI 1.7-6.2, p=0.0002; G vs. T: OR 1.8, 95% CI 1.3-2.4, p=0.0002) in women. Thus, the STAT4 rs7574865G/T polymorphism confers risk for RA and SLE in the Mexican population.
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Affiliation(s)
- O Beltrán Ramírez
- Research Unit in Endocrine and Metabolic Diseases, Hospital Juárez de México, Mexico City, Mexico
| | - J F Mendoza Rincón
- Laboratorio de Oncología Molecular, Unidad de Diferenciación Celular y Cáncer, FES-Zaragoza, UNAM, Mexico City, Mexico
| | - R E Barbosa Cobos
- Rheumatology Department, Hospital Juárez de México, Mexico City, Mexico
| | - I Alemán Ávila
- Research Unit in Endocrine and Metabolic Diseases, Hospital Juárez de México, Mexico City, Mexico
| | - J Ramírez Bello
- Research Unit in Endocrine and Metabolic Diseases, Hospital Juárez de México, Mexico City, Mexico.
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Chen J, Wright K, Davis JM, Jeraldo P, Marietta EV, Murray J, Nelson H, Matteson EL, Taneja V. An expansion of rare lineage intestinal microbes characterizes rheumatoid arthritis. Genome Med 2016; 8:43. [PMID: 27102666 PMCID: PMC4840970 DOI: 10.1186/s13073-016-0299-7] [Citation(s) in RCA: 508] [Impact Index Per Article: 63.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 04/08/2016] [Indexed: 12/30/2022] Open
Abstract
Background The adaptive immune response in rheumatoid arthritis (RA) is influenced by an interaction between host genetics and environment, particularly the host microbiome. Association of the gut microbiota with various diseases has been reported, though the specific components of the microbiota that affect the host response leading to disease remain unknown. However, there is limited information on the role of gut microbiota in RA. In this study we aimed to define a microbial and metabolite profile that could predict disease status. In addition, we aimed to generate a humanized model of arthritis to confirm the RA-associated microbe. Methods To identify an RA biomarker profile, the 16S ribosomal DNA of fecal samples from RA patients, first-degree relatives (to rule out environment/background as confounding factors), and random healthy non-RA controls were sequenced. Analysis of metabolites and their association with specific taxa was performed to investigate a potential mechanistic link. The role of an RA-associated microbe was confirmed using a human epithelial cell line and a humanized mouse model of arthritis. Results Patients with RA exhibited decreased gut microbial diversity compared with controls, which correlated with disease duration and autoantibody levels. A taxon-level analysis suggested an expansion of rare taxa, Actinobacteria, with a decrease in abundant taxa in patients with RA compared with controls. Prediction models based on the random forests algorithm suggested that three genera, Collinsella, Eggerthella, and Faecalibacterium, segregated with RA. The abundance of Collinsella correlated strongly with high levels of alpha-aminoadipic acid and asparagine as well as production of the proinflammatory cytokine IL-17A. A role for Collinsella in altering gut permeability and disease severity was confirmed in experimental arthritis. Conclusions These observations suggest dysbiosis in RA patients resulting from the abundance of certain rare bacterial lineages. A correlation between the intestinal microbiota and metabolic signatures could determine a predictive profile for disease causation and progression. Electronic supplementary material The online version of this article (doi:10.1186/s13073-016-0299-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jun Chen
- Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, Mayo Clinic, 200 First St. S.W., Rochester, MN, 55905, USA
| | - Kerry Wright
- Department of Medicine, Division of Rheumatology, Mayo Clinic, 200 First St. S.W., Rochester, MN, 55905, USA
| | - John M Davis
- Department of Medicine, Division of Rheumatology, Mayo Clinic, 200 First St. S.W., Rochester, MN, 55905, USA
| | - Patricio Jeraldo
- Department of Surgery, Mayo Clinic, 200 First St. S.W., Rochester, MN, 55905, USA
| | - Eric V Marietta
- Department of Gastroenterology, Mayo Clinic, 200 First St. S.W., Rochester, MN, 55905, USA
| | - Joseph Murray
- Department of Gastroenterology, Mayo Clinic, 200 First St. S.W., Rochester, MN, 55905, USA
| | - Heidi Nelson
- Department of Surgery, Mayo Clinic, 200 First St. S.W., Rochester, MN, 55905, USA
| | - Eric L Matteson
- Department of Medicine, Division of Rheumatology, Mayo Clinic, 200 First St. S.W., Rochester, MN, 55905, USA
| | - Veena Taneja
- Department of Immunology and Division of Rheumatology, Mayo Clinic, 200 First St. S.W., Rochester, MN, 55905, USA.
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Weng CH, Gupta S, Geraghty P, Foronjy R, Pernis AB. Cigarette smoke inhibits ROCK2 activation in T cells and modulates IL-22 production. Mol Immunol 2016; 71:115-122. [PMID: 26882474 PMCID: PMC4797327 DOI: 10.1016/j.molimm.2016.01.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 01/04/2016] [Accepted: 01/12/2016] [Indexed: 12/29/2022]
Abstract
Gene-environment interactions are known to play a key role in the development of rheumatoid arthritis (RA). Exposure to cigarette smoke (CS) is one of the strongest environmental risk factors associated with RA and has been shown to mediate a range of complex immunomodulatory effects from decreased T and B cell activation to depressed phagocytic function. The effects of CS on the function of TH17 cells, one of the key TH effector subsets implicated in RA pathogenesis, are not fully understood. IRF4 is one of the crucial transcription factors involved in TH-17 differentiation and is absolutely required for the production of IL-17 and IL-21 but, interestingly, inhibits the synthesis of IL-22. The production of IL-17 and IL-21 by IRF4 can be augmented by its phosphorylation by the serine-threonine kinase ROCK2. Given that CS has been reported to increase ROCK activity in endothelial cells, here we investigated the effects of CS on the ROCK2-IRF4 axis in T cells. Surprisingly, we found that CS leads to decreased ROCK2 activation and IRF4 phosphorylation in T cells. This effect was associated with increased IL-22 production. Using a GEF pull-down assay we furthermore identify ARHGEF1 as a key upstream regulator of ROCK2 whose activity in T cells is inhibited by CS. Thus CS can inhibit the ROCK2-IRF4 axis and modulate T cell production of IL-22.
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Affiliation(s)
- Chien-Huan Weng
- Graduate Program in Biochemistry, Cell and Molecular Biology, Weill Cornell Graduate School of Medical Sciences, Cornell University, New York, NY 10065, USA; Autoimmunity and Inflammation Program, Hospital for Special Surgery, New York, NY 10021, USA.
| | - Sanjay Gupta
- Autoimmunity and Inflammation Program, Hospital for Special Surgery, New York, NY 10021, USA.
| | - Patrick Geraghty
- SUNY Downstate Medical Center, 450Clarkson Avenue, Brooklyn, New York, NY 11203, USA.
| | - Robert Foronjy
- SUNY Downstate Medical Center, 450Clarkson Avenue, Brooklyn, New York, NY 11203, USA.
| | - Alessandra B Pernis
- Autoimmunity and Inflammation Program, Hospital for Special Surgery, New York, NY 10021, USA; David Z. Rosensweig Genomics Research Center, Hospital for Special Surgery, New York, NY 10021, USA; Department of Medicine, Weill Cornell Medical College, Cornell University, New York, NY 10021, USA.
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Dzhambov AM, Dimitrova Dimitrova D, Hristova Turnovska T. Long-Term Residential Ambient Air Pollution and Rheumatoid Arthritis: A Systematic Review. HEALTH SCOPE 2016. [DOI: 10.17795/jhealthscope-33053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Peschken CA, Hitchon CA, Garland A, Bernstein CN, Chen H, Fransoo R, Marrie RA. A Population-based Study of Intensive Care Unit Admissions in Rheumatoid Arthritis. J Rheumatol 2015; 43:26-33. [PMID: 26628597 DOI: 10.3899/jrheum.150312] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2015] [Indexed: 01/22/2023]
Abstract
OBJECTIVE We aimed to determine the incidence of and mortality after critical illness in rheumatoid arthritis (RA) compared with the general population, and to describe the risks for and characteristics of critical illness in patients with RA. METHODS We used population-based administrative data from the Data Repository at the Manitoba Centre for Health Policy from 1984 to 2010, and linked clinical data from an intensive care unit (ICU) database to identify all persons with RA in the province requiring ICU admission. We identified a population-based control group, matched by age, sex, socioeconomic status, and region of residence. The incidence of ICU admission, reasons for, and mortality after ICU admission were compared between populations using age- and sex-standardized rates, rate ratios, Cox proportional hazards models, and logistic regression models. RESULTS We identified 10,078 prevalent and 5560 incident cases of RA. After adjustment, the risk for ICU admission was higher for RA (HR 1.65, 95% CI 1.50-1.83) versus the matched general population. From 2000-2010, the annual incidence of ICU admission among prevalent patients was about 1% in RA, with a crude 10-year incidence of 8%. Compared with the general population admitted to ICU, 1 year after ICU admission, mortality was increased by 40% in RA. Cardiovascular disorders were the most common reason for ICU admission in RA. CONCLUSION Patients with RA have a higher risk for admission to the ICU than the general population and increased mortality 1 year after admission. Even with advances in management, RA remains a serious disease with significant morbidity.
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Affiliation(s)
- Christine A Peschken
- From the Department of Internal Medicine, and Department of Community Health Sciences, and Manitoba Centre for Health Policy, and the IBD Clinical and Research Centre, University of Manitoba, Winnipeg, Manitoba, Canada.C.A. Peschken, MD, MSc, FRCPC, Associate Professor, Department of Internal Medicine, and Department of Community Health Sciences, University of Manitoba; C.A. Hitchon, MD, MSc, Department of Internal Medicine, University of Manitoba; A. Garland, MD, MA, Department of Internal Medicine, and Department of Community Health Sciences, and Manitoba Centre for Health Policy, University of Manitoba;C.N. Bernstein, MD, Department of Internal Medicine, and IBD Clinical and Research Centre, University of Manitoba; H. Chen, MSc, Manitoba Centre for Health Policy, University of Manitoba; R. Fransoo, PhD, Department of Community Health Sciences, and Manitoba Centre for Health Policy, University of Manitoba; R.A. Marrie, MD, PhD, Department of Internal Medicine, and Department of Community Health Sciences, University of Manitoba.
| | - Carol A Hitchon
- From the Department of Internal Medicine, and Department of Community Health Sciences, and Manitoba Centre for Health Policy, and the IBD Clinical and Research Centre, University of Manitoba, Winnipeg, Manitoba, Canada.C.A. Peschken, MD, MSc, FRCPC, Associate Professor, Department of Internal Medicine, and Department of Community Health Sciences, University of Manitoba; C.A. Hitchon, MD, MSc, Department of Internal Medicine, University of Manitoba; A. Garland, MD, MA, Department of Internal Medicine, and Department of Community Health Sciences, and Manitoba Centre for Health Policy, University of Manitoba;C.N. Bernstein, MD, Department of Internal Medicine, and IBD Clinical and Research Centre, University of Manitoba; H. Chen, MSc, Manitoba Centre for Health Policy, University of Manitoba; R. Fransoo, PhD, Department of Community Health Sciences, and Manitoba Centre for Health Policy, University of Manitoba; R.A. Marrie, MD, PhD, Department of Internal Medicine, and Department of Community Health Sciences, University of Manitoba
| | - Allan Garland
- From the Department of Internal Medicine, and Department of Community Health Sciences, and Manitoba Centre for Health Policy, and the IBD Clinical and Research Centre, University of Manitoba, Winnipeg, Manitoba, Canada.C.A. Peschken, MD, MSc, FRCPC, Associate Professor, Department of Internal Medicine, and Department of Community Health Sciences, University of Manitoba; C.A. Hitchon, MD, MSc, Department of Internal Medicine, University of Manitoba; A. Garland, MD, MA, Department of Internal Medicine, and Department of Community Health Sciences, and Manitoba Centre for Health Policy, University of Manitoba;C.N. Bernstein, MD, Department of Internal Medicine, and IBD Clinical and Research Centre, University of Manitoba; H. Chen, MSc, Manitoba Centre for Health Policy, University of Manitoba; R. Fransoo, PhD, Department of Community Health Sciences, and Manitoba Centre for Health Policy, University of Manitoba; R.A. Marrie, MD, PhD, Department of Internal Medicine, and Department of Community Health Sciences, University of Manitoba
| | - Charles N Bernstein
- From the Department of Internal Medicine, and Department of Community Health Sciences, and Manitoba Centre for Health Policy, and the IBD Clinical and Research Centre, University of Manitoba, Winnipeg, Manitoba, Canada.C.A. Peschken, MD, MSc, FRCPC, Associate Professor, Department of Internal Medicine, and Department of Community Health Sciences, University of Manitoba; C.A. Hitchon, MD, MSc, Department of Internal Medicine, University of Manitoba; A. Garland, MD, MA, Department of Internal Medicine, and Department of Community Health Sciences, and Manitoba Centre for Health Policy, University of Manitoba;C.N. Bernstein, MD, Department of Internal Medicine, and IBD Clinical and Research Centre, University of Manitoba; H. Chen, MSc, Manitoba Centre for Health Policy, University of Manitoba; R. Fransoo, PhD, Department of Community Health Sciences, and Manitoba Centre for Health Policy, University of Manitoba; R.A. Marrie, MD, PhD, Department of Internal Medicine, and Department of Community Health Sciences, University of Manitoba
| | - Hui Chen
- From the Department of Internal Medicine, and Department of Community Health Sciences, and Manitoba Centre for Health Policy, and the IBD Clinical and Research Centre, University of Manitoba, Winnipeg, Manitoba, Canada.C.A. Peschken, MD, MSc, FRCPC, Associate Professor, Department of Internal Medicine, and Department of Community Health Sciences, University of Manitoba; C.A. Hitchon, MD, MSc, Department of Internal Medicine, University of Manitoba; A. Garland, MD, MA, Department of Internal Medicine, and Department of Community Health Sciences, and Manitoba Centre for Health Policy, University of Manitoba;C.N. Bernstein, MD, Department of Internal Medicine, and IBD Clinical and Research Centre, University of Manitoba; H. Chen, MSc, Manitoba Centre for Health Policy, University of Manitoba; R. Fransoo, PhD, Department of Community Health Sciences, and Manitoba Centre for Health Policy, University of Manitoba; R.A. Marrie, MD, PhD, Department of Internal Medicine, and Department of Community Health Sciences, University of Manitoba
| | - Randy Fransoo
- From the Department of Internal Medicine, and Department of Community Health Sciences, and Manitoba Centre for Health Policy, and the IBD Clinical and Research Centre, University of Manitoba, Winnipeg, Manitoba, Canada.C.A. Peschken, MD, MSc, FRCPC, Associate Professor, Department of Internal Medicine, and Department of Community Health Sciences, University of Manitoba; C.A. Hitchon, MD, MSc, Department of Internal Medicine, University of Manitoba; A. Garland, MD, MA, Department of Internal Medicine, and Department of Community Health Sciences, and Manitoba Centre for Health Policy, University of Manitoba;C.N. Bernstein, MD, Department of Internal Medicine, and IBD Clinical and Research Centre, University of Manitoba; H. Chen, MSc, Manitoba Centre for Health Policy, University of Manitoba; R. Fransoo, PhD, Department of Community Health Sciences, and Manitoba Centre for Health Policy, University of Manitoba; R.A. Marrie, MD, PhD, Department of Internal Medicine, and Department of Community Health Sciences, University of Manitoba
| | - Ruth Ann Marrie
- From the Department of Internal Medicine, and Department of Community Health Sciences, and Manitoba Centre for Health Policy, and the IBD Clinical and Research Centre, University of Manitoba, Winnipeg, Manitoba, Canada.C.A. Peschken, MD, MSc, FRCPC, Associate Professor, Department of Internal Medicine, and Department of Community Health Sciences, University of Manitoba; C.A. Hitchon, MD, MSc, Department of Internal Medicine, University of Manitoba; A. Garland, MD, MA, Department of Internal Medicine, and Department of Community Health Sciences, and Manitoba Centre for Health Policy, University of Manitoba;C.N. Bernstein, MD, Department of Internal Medicine, and IBD Clinical and Research Centre, University of Manitoba; H. Chen, MSc, Manitoba Centre for Health Policy, University of Manitoba; R. Fransoo, PhD, Department of Community Health Sciences, and Manitoba Centre for Health Policy, University of Manitoba; R.A. Marrie, MD, PhD, Department of Internal Medicine, and Department of Community Health Sciences, University of Manitoba
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Understanding the Role of the Immune System in the Development of Cancer: New Opportunities for Population-Based Research. Cancer Epidemiol Biomarkers Prev 2015; 24:1811-9. [DOI: 10.1158/1055-9965.epi-15-0681] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Accepted: 09/16/2015] [Indexed: 11/16/2022] Open
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Salgado E, Bes-Rastrollo M, de Irala J, Carmona L, Gómez-Reino JJ. High Sodium Intake Is Associated With Self-Reported Rheumatoid Arthritis: A Cross Sectional and Case Control Analysis Within the SUN Cohort. Medicine (Baltimore) 2015; 94:e0924. [PMID: 26376372 PMCID: PMC4635786 DOI: 10.1097/md.0000000000000924] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Sodium intake is a potential environmental factor for immune-mediated inflammatory diseases. The aim of this study is to investigate the association of sodium intake with rheumatoid arthritis. We performed a cross-sectional study nested in a highly educated cohort investigating dietary habits as determinants of disease. Daily sodium intake in grams per day was estimated from a validated food frequency questionnaire. We identified prevalent self-reported cases of rheumatoid arthritis. Logistic regression models were used to estimate the odds ratio for rheumatoid arthritis by sodium intake adjusting for confounders. Linear trend tests and interactions between variables were explored. Sensitivity analyses included age- and sex-matched case-control study, logistic multivariate model adjusted by residuals, and analysis excluding individuals with prevalent diabetes or cardiovascular disease. The effective sample size was 18,555 individuals (mean age 38-years old, 60% women) including 392 self-reported rheumatoid arthritis. Median daily sodium intake (estimated from foods plus added salt) was 3.47 (P25-75: 2.63-4.55) grams. Total sodium intake in the fourth quartile showed a significant association with rheumatoid arthritis (fully adjusted odds ratio 1.5; 95% CI 1.1-2.1, P for trend = 0.02). Never smokers with high sodium intake had higher association than ever smokers with high sodium intake (P for interaction = 0.007). Dose-dependent association was replicated in the case-control study. High sodium intake may be associated with a diagnosis of rheumatoid arthritis. This confirms previous clinical and experimental research.
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Affiliation(s)
- Eva Salgado
- From the Rheumatology Unit, Complejo Hospitalario Universitario de Santiago de Compostela, IDIS Ramon Dominguez, Santiago, A Coruña (ES, LC, JJG-R); Rheumatology Unit, Complejo Hospitalario Universitario de Ourense, Ourense (ES); Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Navarra (MB-R, JDI); Instituto de Salud Musculoesquelética; Universidad Camilo José Cela, Madrid (LC); and Department of Medicine, School of Medicine, Universidad de Santiago de Compostela, A Coruña, Spain (JJG-R)
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Lagha A, Zidi S, Stayoussef M, Gazouani E, Kochkar R, Kochbati S, Almawi W, Yacoubi-Loueslati B. Interleukin-1β, Interleukin1-Ra, Interleukin-10, and tumor necrosis factor-α polymorphisms in Tunisian patients with rheumatoid arthritis. ACTA ACUST UNITED AC 2015; 63:179-84. [DOI: 10.1016/j.patbio.2015.04.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Accepted: 04/22/2015] [Indexed: 01/22/2023]
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Guillou C, Derambure C, Fréret M, Verdet M, Avenel G, Golinski ML, Sabourin JC, Loarer FL, Adriouch S, Boyer O, Lequerré T, Vittecoq O. Prophylactic Injection of Recombinant Alpha-Enolase Reduces Arthritis Severity in the Collagen-Induced Arthritis Mice Model. PLoS One 2015; 10:e0136359. [PMID: 26302382 PMCID: PMC4547710 DOI: 10.1371/journal.pone.0136359] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 07/31/2015] [Indexed: 01/13/2023] Open
Abstract
Objective To evaluate the ability of the glycolytic enzyme alpha-enolase (ENO1) or its immunodominant peptide (pEP1) to reduce the severity of CIA in DBA/1 mice when injected in a prophylactic way. Methods Mice were treated with mouse ENO1 or pEP1 one day prior to collagen II immunization. Clinical assessment was evaluated using 4 parameters (global and articular scores, ankle thickness and weight). Titers of serum anti-ENO1, anti-cyclic citrullinated peptides (anti-CCP) and anti-CII (total IgG and IgG1/IgG2a isotypes) antibodies were measured by ELISA at different time-points. Disease activity was assessed by histological analysis of both anterior and hind paws at the end of experimentation. Results Prophylactic injection of 100 μg of ENO1 reduced severity of CIA. Serum levels of anti-CII antibodies were reduced in ENO1-treated mice. Concordantly, ENO1-treated mice joints presented less severe histological signs of arthritis. ENO1 did not induce a shift toward a Th2 response since IgG1/IgG2a ratio of anti-CII antibodies remained unchanged and IL-4 serum levels were similar to those measured in the control group. Conclusions Pre-immunization with ENO1 or its immunodominant peptide pEP1 reduces CIA severity at the clinical, immunological and histological levels. Effects of pEP1 were less pronounced. This immunomodulatory effect is associated with a reduction in anti-CII antibodies production but is not due to a Th1/Th2 shift.
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Affiliation(s)
- Clément Guillou
- INSERM, U905, Rouen, France
- Normandy University, Institute for Research and Innovation in Biomedicine (IRIB), Rouen, France
| | - Céline Derambure
- INSERM, U905, Rouen, France
- Normandy University, Institute for Research and Innovation in Biomedicine (IRIB), Rouen, France
| | - Manuel Fréret
- INSERM, U905, Rouen, France
- Normandy University, Institute for Research and Innovation in Biomedicine (IRIB), Rouen, France
| | - Mathieu Verdet
- Rouen University Hospital, Department of Rheumatology, Rouen, France
| | - Gilles Avenel
- Rouen University Hospital, Department of Rheumatology, Rouen, France
| | - Marie-Laure Golinski
- INSERM, U905, Rouen, France
- Normandy University, Institute for Research and Innovation in Biomedicine (IRIB), Rouen, France
| | - Jean-Christophe Sabourin
- Normandy University, Institute for Research and Innovation in Biomedicine (IRIB), Rouen, France
- Rouen University Hospital, Department of Pathology, Rouen, France
| | | | - Sahil Adriouch
- INSERM, U905, Rouen, France
- Normandy University, Institute for Research and Innovation in Biomedicine (IRIB), Rouen, France
| | - Olivier Boyer
- INSERM, U905, Rouen, France
- Normandy University, Institute for Research and Innovation in Biomedicine (IRIB), Rouen, France
- Rouen University Hospital, Department of Immunology, Rouen, France
| | - Thierry Lequerré
- INSERM, U905, Rouen, France
- Normandy University, Institute for Research and Innovation in Biomedicine (IRIB), Rouen, France
- Rouen University Hospital, Department of Rheumatology, Rouen, France
| | - Olivier Vittecoq
- INSERM, U905, Rouen, France
- Normandy University, Institute for Research and Innovation in Biomedicine (IRIB), Rouen, France
- Rouen University Hospital, Department of Rheumatology, Rouen, France
- * E-mail:
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Abstract
Rheumatoid arthritis is a chronic inflammatory debilitating disease triggered by a complex interaction involving genetic and environmental factors. Active smoking and occupational exposures such as silica increase its risk, suggesting that initial inflammation and generation of rheumatoid arthritis-related autoantibodies in the lungs may precede the clinical disease. This hypothesis paved the way to epidemiological studies investigating air pollution as a potential determinant of rheumatoid arthritis. Studies designed for epidemiology of rheumatoid arthritis found a link between traffic, a surrogate of air pollution, and this disease. Furthermore, a small case–control study recently found an association between wood smoke exposure and anticyclic citrullinated protein/peptide antibody in sera of patients presenting wood-smoke-related chronic obstructive pulmonary disease. However, reports addressing impact of specific pollutants on rheumatoid arthritis incidence and severity across populations are somewhat conflicting. In addition to the link reported between other systemic autoimmune rheumatic diseases and particulate matters/gaseous pollutants, experimental observation of exacerbated rheumatoid arthritis incidence and severity in mice models of collagen-induced arthritis after diesel exhaust particles exposure as well as hypovitaminosis D-related autoimmunity can help understand the role of air pollution in rheumatoid arthritis. All these considerations highlight the necessity to extend high quality epidemiological researches investigating different sources of atmospheric pollution across populations and particularly in low-and-middle countries, in order to further explore the biological plausibility of air pollution’s effect in the pathogenesis of rheumatoid arthritis. This should be attempted to better inform policies aiming to reduce the burden of rheumatoid arthritis.
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Affiliation(s)
- Mickael Essouma
- Division of Medicine, Sangmelima's Reference Hospital, P.O. Box 890, Sangmelima, Cameroon
| | - Jean Jacques N Noubiap
- Department of Medicine, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa ; Medical Diagnostic Center, Yaoundé, Cameroon
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Verma MK, Sobha K. Understanding the major risk factors in the beginning and the progression of rheumatoid arthritis: current scenario and future prospects. Inflamm Res 2015; 64:647-59. [DOI: 10.1007/s00011-015-0843-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Revised: 06/14/2015] [Accepted: 06/15/2015] [Indexed: 12/19/2022] Open
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Ghawi H, Crowson CS, Rand-Weaver J, Krusemark E, Gabriel SE, Juhn YJ. A novel measure of socioeconomic status using individual housing data to assess the association of SES with rheumatoid arthritis and its mortality: a population-based case-control study. BMJ Open 2015; 5:e006469. [PMID: 25926142 PMCID: PMC4420936 DOI: 10.1136/bmjopen-2014-006469] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
OBJECTIVES To assess whether HOUSES (HOUsing-based index of socioeconomic status (SES)) is associated with risk of and mortality after rheumatoid arthritis (RA). DESIGN We conducted a population-based case-control study which enrolled population-based RA cases and their controls without RA. SETTING The study was performed in Olmsted County, Minnesota. PARTICIPANTS Study participants were all residents of Olmsted County, Minnesota, with RA identified using the 1987 American College of Rheumatology criteria for RA from 1 January 1988, to 31 December 2007, using the auspices of the Rochester Epidemiology Project. For each patient with RA, one control was randomly selected from Olmsted County residents of similar age and gender without RA. PRIMARY AND SECONDARY OUTCOME MEASURE The disease status was RA cases and their matched controls in relation to HOUSES as an exposure. As a secondary aim, post-RA mortality among only RA cases was an outcome event. The associations of SES measured by HOUSES with the study outcomes were assessed using logistic regression and Cox models. HOUSES, as a composite index, was formulated based on a summed z-score for housing value, square footage and number of bedrooms and bathrooms. RESULTS Of the eligible 604 participants, 418 (69%) were female; the mean age was 56±15.6 years. Lower SES, as measured by HOUSES, was associated with the risk of developing RA (0.5±3.8 for controls vs -0.2±3.1 for RA cases, p=0.003), adjusting for age, gender, calendar year of RA index date, smoking status and BMI. The lowest quartile of HOUSES was significantly associated with increased post-RA mortality compared to higher quartiles of HOUSES (HR 1.74; 95% CI 1.10 to 2.74; p=0.017) in multivariate analysis. CONCLUSIONS Lower SES, as measured by HOUSES, is associated with increased risk of RA and mortality after RA. HOUSES may be a useful tool for health disparities research concerning rheumatological outcomes when conventional SES measures are unavailable.
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Affiliation(s)
- Husam Ghawi
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Cynthia S Crowson
- Division of Rheumatology, Department of Health Sciences Research and Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Jennifer Rand-Weaver
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Elizabeth Krusemark
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Sherine E Gabriel
- Division of Rheumatology, Department of Health Sciences Research and Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Young J Juhn
- Department of Pediatric and Adolescent Medicine and Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
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Smoking and rheumatoid arthritis. Int J Mol Sci 2014; 15:22279-95. [PMID: 25479074 PMCID: PMC4284707 DOI: 10.3390/ijms151222279] [Citation(s) in RCA: 173] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Revised: 10/11/2014] [Accepted: 10/17/2014] [Indexed: 12/26/2022] Open
Abstract
Rheumatoid arthritis (RA) is a chronic inflammatory disease caused by both genetic and environmental factors. Smoking has been implicated as one of the most important extrinsic risk factors for its development and severity. Recent developments have shed light on the pathophysiology of RA in smokers, including oxidative stress, inflammation, autoantibody formation and epigenetic changes. The association of smoking and the development of RA have been demonstrated through epidemiologic studies, as well as through in vivo and animal models of RA. With increased use of biological agents in addition to standard disease-modifying antirheumatic drugs (DMARDs), there has been interest in how smoking affects drug response in RA treatment. Recent evidence suggests the response and drug survival in people treated with anti-tumour necrosis factor (anti-TNF) therapy is poorer in heavy smokers, and possible immunological mechanisms for this effect are presented in the current paper.
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Kochi Y, Suzuki A, Yamamoto K. Genetic basis of rheumatoid arthritis: a current review. Biochem Biophys Res Commun 2014; 452:254-62. [PMID: 25078624 DOI: 10.1016/j.bbrc.2014.07.085] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Accepted: 07/18/2014] [Indexed: 12/22/2022]
Abstract
Rheumatoid arthritis (RA) is one of the most common autoimmune diseases. As with other complex traits, genome-wide association studies (GWASs) have tremendously enhanced our understanding of the complex etiology of RA. In this review, we describe the genetic architecture of RA as determined through GWASs and meta-analyses. In addition, we discuss the pathologic mechanism of the disease by examining the combined findings of genetic and functional studies of individual RA-associated genes, including HLA-DRB1, PADI4, PTPN22, TNFAIP3, STAT4, and CCR6. Moreover, we briefly examine the potential use of genetic data in clinical practice in RA treatment, which represents a challenge in medical genetics in the post-GWAS era.
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Affiliation(s)
- Yuta Kochi
- Laboratory for Autoimmune Diseases, Center for Integrative Medical Sciences, RIKEN, Yokohama, Japan.
| | - Akari Suzuki
- Laboratory for Autoimmune Diseases, Center for Integrative Medical Sciences, RIKEN, Yokohama, Japan
| | - Kazuhiko Yamamoto
- Laboratory for Autoimmune Diseases, Center for Integrative Medical Sciences, RIKEN, Yokohama, Japan; Department of Allergy and Rheumatology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Yılmaz N, Karadağ Ö, Kimyon G, Yazıcı A, Yılmaz S, Kalyoncu U, Kaşifoğlu T, Temiz H, Baysal B, Tözün N. Prevalence of hepatitis B and C infections in rheumatoid arthritis and ankylosing spondylitis: A multicenter countrywide study. Eur J Rheumatol 2014; 1:51-54. [PMID: 27708874 DOI: 10.5152/eurjrheumatol.2014.018] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Accepted: 04/02/2014] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE Immunosuppressive therapies, especially tumor necrosis factor-α inhibitors, are frequently used in treatment of rheumatoid arthritis (RA) and ankylosing spondylitis (AS). These therapies can induce viral reactivation in concurrent hepatitis B virus (HBV)- or hepatitis C virus (HCV)-positive patients. On the other hand, the prevalence of HBV and HCV infections is not exactly known in RA and AS patients. The aim of this study was to investigate the prevalence of HBV and HCV infections in RA and AS patients. MATERIAL AND METHODS A group of 1517 RA and 886 AS consecutive patients followed by six different rheumatology outpatient clinics of Turkey were recruited in this study. The prevalence of HBV surface antigen (HBsAg) and HCV antibody (anti-HCV) were retrospectively investigated. RESULTS The mean age was 49.0±13.2 years in RA and 37.3±10.5 years in AS patients. HBsAg prevalence was 35 (2.3%) in RA and 27 (3%) in AS patients. Anti-HCV prevalence was 17 (1.1%) and 10 (1.1%), respectively. In the RA group, both HBsAg and anti-HCV positive patients were older than negative ones (p<0.05), and the highest prevalence was found in those 60-69 years (p<0.05). CONCLUSION In previous national data, the prevalence of HBsAg has been reported as 3.99% and shown to increase with age. In this study we have found a lower HBV infection prevalence in both RA and AS patients according to Turkish national data. This result may explain by being younger age of our patients. In another conclusion, lower prevalence could be related to, joint complaints may less consulted to Rheumatologist in HBV positive.
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Affiliation(s)
- Neslihan Yılmaz
- Department of Rheumatology, İstanbul Bilim University Faculty of Medicine, İstanbul, Turkey
| | - Ömer Karadağ
- Department of Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Gezmiş Kimyon
- Department of Rheumatology, Gaziantep University Faculty of Medicine, Gaziantep, Turkey
| | - Ayten Yazıcı
- Department of Rheumatology, Kocaeli University Faculty of Medicine, Kocaeli, Turkey
| | - Sema Yılmaz
- Department of Rheumatology, Selçuklu University, Faculty of Medicine, Konya, Turkey
| | - Umut Kalyoncu
- Department of Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Timuçin Kaşifoğlu
- Department of Rheumatology, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir, Turkey
| | - Hakan Temiz
- Department of Microbiology, Diyarbakır Training and Research Hospital, Diyarbakir, Turkey
| | - Birol Baysal
- Department of Gastroenterology, Diyarbakır Training and Research Hospital, Diyarbakir, Turkey
| | - Nurdan Tözün
- Department of Gastroenterology, Acıbadem University Faculty of Medicine, Istanbul, Turkey
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