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Gabbireddy S, Shetty S, Coutinho D, Ramadan H, Makary C. Association of autoimmune and autoinflammatory disorders with chronic rhinosinusitis in children. Int J Pediatr Otorhinolaryngol 2024; 181:111988. [PMID: 38795462 DOI: 10.1016/j.ijporl.2024.111988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 05/11/2024] [Accepted: 05/21/2024] [Indexed: 05/28/2024]
Abstract
BACKGROUND Increasing evidence suggests that autoimmune disorders and their immunomodulating medications may increase the risk of rhinosinusitis. The goal of this study is to determine if autoimmune and autoinflammatory diseases are associated with increased risk of chronic rhinosinusitis (CRS) in children. METHODS A retrospective case-control study of pediatric patients (age 2-18 years) seen in the West Virginia University Hospitals System in the past 10 years was performed. Cases were children with autoimmune or autoinflammatory diseases. Controls were children without any autoimmune or autoinflammatory disorders. Query of our electronic medical record (Epic) was performed using ICD-10 codes. Univariate (unadjusted) and multivariate (adjusted) logistic regression were used to calculate the strength of association of autoimmune or autoinflammatory disorders with CRS and the other airway disorders while adjusting for age, sex, and race. RESULTS 420582 pediatric patients were queried with mean age of 10.8 years (SD of 4.8, range of 2-18 years), and 47.9% being female. 1956 (0.5%) had autoimmune disorders and 293 (0.07%) had autoinflammatory disorders. Both autoimmune and autoinflammatory disorders increase the odds of having CRS in the unadjusted [OR = 3.36, p < 0.001 and 5.69, p < 0.001 for the respectively] and the adjusted [OR = 2.90, p < 0.001 and OR = 5.07, p < 0.001 respectively after adjusting for age, sex, and race] models. CONCLUSION Autoimmune and autoinflammatory disorders increase the risk of CRS and chronic rhinitis in children.
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Affiliation(s)
| | - Sameer Shetty
- West Virginia University School of Medicine, Morgantown, WV, USA
| | - Dominic Coutinho
- West Virginia University School of Medicine, Morgantown, WV, USA
| | - Hassan Ramadan
- West Virginia University Department of Otolaryngology, Morgantown, WV, USA
| | - Chadi Makary
- West Virginia University Department of Otolaryngology, Morgantown, WV, USA.
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Lemmetyinen RE, Toppila-Salmi SK, But A, Renkonen R, Pekkanen J, Haukka J, Karjalainen J. Comorbidities associated with adult asthma: a population-based matched cohort study in Finland. BMJ Open Respir Res 2024; 11:e001959. [PMID: 38485249 PMCID: PMC10941122 DOI: 10.1136/bmjresp-2023-001959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 02/29/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Asthma is a common chronic disease characterised by variable respiratory symptoms and airflow limitation, affecting roughly 4%-10% of the adult population. Adult asthma is associated with higher all-cause mortality compared to individuals without asthma. In this study, we investigate the comorbidities that may affect the management of asthma. METHODS Total of 1648 adults with asthma and 3310 individuals without asthma aged 30-93 were matched with age, gender and area of residency, and followed from 1 January 1997 to 31 December 2013. Baseline information was collected with questionnaires 1997 and follow-up register data from the national discharge registry Finnish Institute for Health and Welfare. Data included diagnoses from outpatient care and day surgery of specialised health care, and data from inpatient care of specialised and primary health care. We included all main diagnoses that had at minimum 200 events and number of diagnoses based on their common appearance with adult asthma. RESULTS The mean follow-up time varied between 14.2 and 15.1 years, and age at the time of enrolment was 53.9 years for subjects without asthma and 54.4 years for patients with asthma. Chronic obstructive pulmonary disease was 10 times more common among asthmatics. Risk of acute rhinosinusitis, chronic rhinosinusitis with nasal polyps, atopic dermatitis and vocal cord dysfunction was fourfold and risk of pneumonia, and chronic rhinosinusitis was 2.5 times more common among asthmatics. Sleep apnoea, gastro-oesophageal reflux disease, diabetes, allergic rhinitis and dysfunctional breathing were twofold and cataract nearly twofold higher in the asthmatic group. Adult asthma was also significantly associated with musculoskeletal diseases, incontinence and bronchiectasis. CONCLUSIONS The most common and most severe comorbidity of adult asthma in this study was chronic obstructive pulmonary disease. Other common comorbidities of adult asthma include acute rhinosinusitis, chronic rhinosinusitis with nasal polyps, atopic dermatitis, allergic rhinitis, dysfunctional breathing, diabetes, pneumonia, sleep apnoea and gastro-oesophageal reflux disease.
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Affiliation(s)
- Riikka Emilia Lemmetyinen
- Department of Public Health and Inflammation Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Sanna Katriina Toppila-Salmi
- Department of Otorhinolaryngology, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland
- Department of Allergy, Helsinki University Hospital, Helsinki, Uusimaa, Finland
| | - Anna But
- Department of Public Health, University of Helsinki, Helsinki, Uusimaa, Finland
| | - Risto Renkonen
- Haartman Institute, University of Helsinki, Helsinki, Finland
- HUS Diagnostic Center, Helsinki University Hospital, Helsinki, Uusimaa, Finland
| | - Juha Pekkanen
- Department of Public Health and Inflammation Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Finnish Institute for Health and Welfare, Helsinki, Uusimaa, Finland
| | - Jari Haukka
- Public Health, University of Helsinki, Helsinki, Uusimaa, Finland
| | - Jussi Karjalainen
- Allergy Centre, University of Tampere, Tampere, Pirkanmaa, Finland
- Faculty of Medicine and Health Technology, University of Tampere, Tampere, Pirkanmaa, Finland
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Kronzer VL, Hayashi K, Crowson CS, Davis JM, McDermott GC, Cui J, Losina E, Juge PA, Cerhan JR, Sparks JA. Gene-respiratory disease interactions for rheumatoid arthritis risk. Semin Arthritis Rheum 2023; 63:152254. [PMID: 37595508 PMCID: PMC10840753 DOI: 10.1016/j.semarthrit.2023.152254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 06/30/2023] [Accepted: 08/07/2023] [Indexed: 08/20/2023]
Abstract
OBJECTIVE We aimed to identify gene by respiratory tract disease interactions that increase RA risk. METHODS In this case-control study using the Mass General Brigham Biobank, we matched incident RA cases, confirmed by ACR/EULAR criteria, to four controls on age, sex, and electronic health record history. Genetic exposures included a validated overall genetic risk score (GRS) for RA, a Human Leukocyte Antigen (HLA) GRS for RA, and the MUC5B promoter variant, an established risk factor for RA-associated interstitial lung disease (ILD). Preceding respiratory tract diseases came from diagnosis codes (positive predictive value 86%). We estimated attributable proportions (AP) and multiplicative odds ratios (OR) with 95% confidence intervals (CI) for RA for each genetic and respiratory exposure using conditional logistic regression models, adjusting for potential confounders. RESULTS We identified 653 incident RA cases and 2,607 matched controls (mean 54 years, 76% female). The highest tertile of the overall GRS and the HLA GRS were both associated with increased RA risk (OR 2.28, 95% CI 1.89,2.74; OR 2.02, 95% CI 1.67-2.45). ILD and the HLA GRS exhibited a synergistic relationship for RA risk (OR for both exposures 4.30, 95% CI 1.28,14.38; AP 0.51, 95% CI-0.16,1.18). Asthma and the MUC5B promoter variant also exhibited a synergistic interaction for seropositive RA (OR for both exposures 2.58, 95% CI 1.10,6.07; AP 0.62, 95% CI 0.24,1.00). CONCLUSION ILD-HLA GRS and asthma-MUC5B promoter variant showed synergistic interactions for RA risk. Such interactions may prove useful for RA prevention and screening.
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Affiliation(s)
| | - Keigo Hayashi
- Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital; Harvard Medical School, Boston, USA.
| | - Cynthia S Crowson
- Division of Rheumatology, Mayo Clinic, Rochester, MN, USA; Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA.
| | - John M Davis
- Division of Rheumatology, Mayo Clinic, Rochester, MN, USA.
| | - Gregory C McDermott
- Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital; Harvard Medical School, Boston, USA.
| | - Jing Cui
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, USA.
| | - Elena Losina
- Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, USA.
| | - Pierre-Antoine Juge
- Dept of Rheumatology, DMU Locomotion, INSERM UMR1152, Hôpital Bichat-Claude Bernard, APHP, Université de Paris, Paris, France.
| | - James R Cerhan
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA.
| | - Jeffrey A Sparks
- Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital; Harvard Medical School, Boston, USA.
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Morselli Gysi D, Barabási AL. Noncoding RNAs improve the predictive power of network medicine. Proc Natl Acad Sci U S A 2023; 120:e2301342120. [PMID: 37906646 PMCID: PMC10636370 DOI: 10.1073/pnas.2301342120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 09/09/2023] [Indexed: 11/02/2023] Open
Abstract
Network medicine has improved the mechanistic understanding of disease, offering quantitative insights into disease mechanisms, comorbidities, and novel diagnostic tools and therapeutic treatments. Yet, most network-based approaches rely on a comprehensive map of protein-protein interactions (PPI), ignoring interactions mediated by noncoding RNAs (ncRNAs). Here, we systematically combine experimentally confirmed binding interactions mediated by ncRNA with PPI, constructing a comprehensive network of all physical interactions in the human cell. We find that the inclusion of ncRNA expands the number of genes in the interactome by 46% and the number of interactions by 107%, significantly enhancing our ability to identify disease modules. Indeed, we find that 132 diseases lacked a statistically significant disease module in the protein-based interactome but have a statistically significant disease module after inclusion of ncRNA-mediated interactions, making these diseases accessible to the tools of network medicine. We show that the inclusion of ncRNAs helps unveil disease-disease relationships that were not detectable before and expands our ability to predict comorbidity patterns between diseases. Taken together, we find that including noncoding interactions improves both the breath and the predictive accuracy of network medicine.
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Affiliation(s)
- Deisy Morselli Gysi
- Network Science Institute, Northeastern University, Boston, MA02115
- Department of Physics, Northeastern University, Boston, MA02115
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA02115
- US Department of Veteran Affairs, Boston, MA02130
| | - Albert-László Barabási
- Network Science Institute, Northeastern University, Boston, MA02115
- Department of Physics, Northeastern University, Boston, MA02115
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA02115
- US Department of Veteran Affairs, Boston, MA02130
- Department of Network and Data Science, Central European University, Budapest1051, Hungary
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Yan J, Zhang Y, Zhang X, Chen G, Wei D, Duan K, Li Z, Peng L, Liu J, Li Z, Liu Y. Increased Risk of Rheumatoid Arthritis in Patients With Asthma: A Genetic Association Study Using Two-Sample Mendelian Randomization Analysis. Arthritis Care Res (Hoboken) 2023. [PMID: 37465942 DOI: 10.1002/acr.25193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 05/23/2023] [Accepted: 07/11/2023] [Indexed: 07/20/2023]
Abstract
OBJECTIVE Observational studies have explored the association between asthma and some types of arthritis, including rheumatoid arthritis and osteoarthritis, but the results are largely contradictory. We aimed to investigate the causal effects of asthma on arthritis, including osteoarthritis, rheumatoid arthritis, gout, and ankylosing spondylitis. METHODS Two-sample Mendelian randomization (MR) analysis was used to investigate the causal effects of asthma on each arthritis. The genetic instruments for asthma were obtained from a large genome-wide association study of asthma. The inverse-variance weighted (IVW) method was used as the main analysis of MR. Bonferroni-adjusted P value threshold was used to account for multiple comparisons. RESULTS MR-IVW analysis suggested that adult-onset asthma (AOA) was associated with increased risk of rheumatoid arthritis. The odds ratio for rheumatoid arthritis associated with AOA and childhood-onset asthma (COA) were 1.018 (95% confidence interval [95% CI], 1.011-1.025; P < 0.001) and 1.006 (95% CI 1.001-1.012; P = 0.046), respectively. For osteoarthritis, gout, or ankylosing spondylitis, all the MR analyses showed no significant causal effects of AOA or COA on them. We also performed a reverse MR analysis to explore the causal effects of rheumatoid on all asthma, allergic asthma, or nonallergic asthma and found no significant causal effects on them. CONCLUSION Genetically predicted AOA predisposes patients to an increased risk of rheumatoid arthritis but has no causal effects on osteoarthritis, gout, and ankylosing spondylitis. The result of COA on rheumatoid arthritis is suggestive of potential causal relationship but needs to be confirmed in further studies.
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Affiliation(s)
- Jiyuan Yan
- The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Yi Zhang
- Southwest Medical University, Luzhou, Sichuan, China
| | - Xiaofei Zhang
- The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Ge Chen
- The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Daiqing Wei
- The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Ke Duan
- Sichuan Provincial Laboratory of Orthopaedic Engineering, Luzhou, Sichuan, China
| | - Zheng Li
- The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Lin Peng
- The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Jialin Liu
- The Affiliated Stomatology Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Zhong Li
- The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Yanshi Liu
- The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
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Yamane T, Hashiramoto A. A case of chronic eosinophilic pneumonia associated with rheumatoid arthritis in glucocorticoid-free remission with JAK inhibitor: A case report. Medicine (Baltimore) 2023; 102:e33396. [PMID: 37000107 PMCID: PMC10063316 DOI: 10.1097/md.0000000000033396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 03/09/2023] [Indexed: 04/01/2023] Open
Abstract
RATIONALE Chronic eosinophilic pneumonia (CEP) presents eosinophil infiltrations in the lung due to allergic reactions. Most CEP patients continue to take glucocorticoids, and their prolonged use induces various side effects. In this case report, based on the efficacy of baricitinib in patients with rheumatoid arthritis (RA) and CEP, we aimed to show that the administration of Janus kinase (JAK) inhibitors, when RA is complicated by an allergic disease, can stabilize the disease state and help avoid the adverse effects of long-term systemic glucocorticoid administration. PATIENTS CONCERNS A 56-year-old woman developed RA at the age of 19 years. Treatment of the arthritis was initiated, but the joint destruction had progressed. At the age of 42, she developed eosinophilic pneumonia, which was relieved by glucocorticoid therapy. Since then, maintenance therapy has been continued with the diagnosis of CEP. She was treated with concomitant tacrolimus for persistent arthritis, and the prednisolone (PSL) dose was reduced to 3 mg/day after 10 years. However, around this time, an increase in peripheral blood eosinophil counts and respiratory symptoms was observed. DIAGNOSIS The peripheral blood eosinophil count was 4000/µL and computed tomography revealed multiple ground-glass opacities in the peripheral lung fields. As interstitial pneumonia due to infection or other causes was ruled out, CEP relapse was diagnosed. INTERVENTIONS Pneumonia rapidly recovered when the PSL dose was increased to 15 mg/day, and asymptomatic eosinophilic infiltrates reappeared in the lung field along with a relapse of arthritis when the PSL dose was reduced to 5 mg/day. Concomitant use of methotrexate and baricitinib has been introduced to suppress allergic reactions to pneumonia. OUTCOMES After starting combination therapy with baricitinib and methotrexate, both arthritis and eosinophilia improved, and glucocorticoid-free remission was achieved. LESSONS Recently, inhibition of IL-5 signaling via JAK2 has been reported to be effective in bronchial asthma and atopic dermatitis. Although complications of RA and CEP are not common, the actions of baricitinib are useful not only in arthritis but also in allergic diseases. The efficacy of some JAK inhibitors should be actively tested in patients with RA and these complications.
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Affiliation(s)
- Takashi Yamane
- Department of Rheumatology, Kakogawa Central City Hospital, Kakogawa, Japan
| | - Akira Hashiramoto
- Department of Biophysics, Kobe University Graduate School of Health Sciences, Kobe, Japan
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Zhou W, Cai J, Li Z, Lin Y. Association of atopic dermatitis with autoimmune diseases: A bidirectional and multivariable two-sample mendelian randomization study. Front Immunol 2023; 14:1132719. [PMID: 37063839 PMCID: PMC10098361 DOI: 10.3389/fimmu.2023.1132719] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 03/21/2023] [Indexed: 04/18/2023] Open
Abstract
Background Observational studies have suggested the association between atopic dermatitis (AD) and the risks of autoimmune diseases. It is still unclear, however, whether or in which direction causal relationships exist, because these associations could be confounded. Objectives Our study seeks to assess the possibility of AD as a cause of autoimmune diseases, and to estimate the magnitude of the causal effect. Methods Two-sample mendelian randomization (MR) analyses were performed using genome-wide association study (GWAS) summary-level statistics. Specifically, bidirectional MR analyses were conducted to examine the direction of association of AD with autoimmune diseases; multivariable MR analyses (MVMR1) were used to test the independence of causal association of AD with autoimmune diseases after controlling other atopic disorders (asthma and allergic rhinitis), while MVMR2 analyses were conducted to account for potential confounding factors such as smoking, drinking, and obesity. Genetic instruments for AD (Ncases=22 474) were from the latest GWAS meta-analysis. The GWAS summary data for asthma and allergic rhinitis were obtained from UK Biobank. The GWAS summary data for smoking, alcohol consumption, obesity and autoimmune diseases (alopecia areata, vitiligo, systemic lupus erythematosus, ankylosing spondylitis, rheumatoid arthritis, and type 1 diabetes) were selected from the largest GWASs available. Causal estimates were derived by the inverse-variance weighted method and verified through a series of sensitivity analyses. Results Genetically predicted AD linked to higher risks of rheumatoid arthritis (OR, 1.28; P=0.0068) (ORMVMR1, 1.65; P=0.0020) (ORMVMR2, 1.36; P<0.001), type 1 diabetes (OR, 1.37; P=0.0084) (ORMVMR1, 1.42; P=0.0155) (ORMVMR2, 1.45; P=0.002), and alopecia areata (OR, 1.98; P=0.0059) (ORMVMR1, 2.55; P<0.001) (ORMVMR2, 1.99; P=0.003) in both univariable and multivariable MR. These causal relationships were supported by sensitivity analyses. No causal effect of AD was identified in relation to systemic lupus erythematosus, vitiligo, and ankylosing spondylitis. Concerning the reverse directions, no significant association was noted. Conclusion The results of this MR study provide evidence to support the idea that AD causes a greater risk of rheumatoid arthritis, type 1 diabetes and alopecia areata. Further replication in larger samples is needed to validate our findings, and experimental studies are needed to explore the underlying mechanisms of these causal effects.
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Affiliation(s)
- Weixin Zhou
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jie Cai
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zifan Li
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Ying Lin
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Dermatology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, China
- Guangdong Provincial Key Laboratory of Chinese Medicine for Prevention and Treatment of Refractory Chronic Diseases, Guangzhou, China
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Kim JG, Kang J, Lee JH, Koo HK. Association of rheumatoid arthritis with bronchial asthma and asthma-related comorbidities: A population-based national surveillance study. Front Med (Lausanne) 2023; 10:1006290. [PMID: 36968830 PMCID: PMC10036351 DOI: 10.3389/fmed.2023.1006290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 02/20/2023] [Indexed: 03/12/2023] Open
Abstract
BackgroundThe aim of this study was to investigate the impact of rheumatoid arthritis (RA) on the prevalence of bronchial asthma and asthma-related comorbidities. We also aimed to identify the influence of RA on interrelationship between asthma and asthma-related comorbidities.MethodsFrom the Korean National Health and Nutrition Examination Survey, participants >40 years of age who completed questionnaires and spirometry tests were enrolled. Patient data on RA, asthma, allergic rhinitis, atopic dermatitis, chronic obstructive pulmonary disease (COPD), sinusitis, otitis media, and body mass index (BMI) were collected. Logistic regression and network analyses were performed.ResultsA total of 14,272 subjects were enrolled, among which, 334 (2.4%) had RA. RA was significantly associated with asthma (OR 2.32; 95% CI 1.51–3.57), allergic rhinitis (OR 1.51; 95% CI 1.08–2.10), and sinusitis (OR 1.64; 95% CI 1.08–2.50). The network analysis of total patients revealed a positive interrelationship between asthma and allergic rhinitis, sinusitis, otitis media, atopic dermatitis, BMI, and RA. The interrelationship between asthma and sinusitis was stronger in the RA group. Of note, the relationship between asthma and BMI was distinctively found only in the RA group (r = 0.214, P < 0.05). In patients with asthma, the prevalence of obesity was 64% in the presence of RA, and 40% in the absence of RA (P = 0.034).ConclusionThis study supports the positive association of RA with asthma, allergic rhinitis, and sinusitis. Our analysis suggests a notable interrelationship between the presence of asthma and higher BMI values in patients with RA, indicating that asthma is more obesity-related in patients with RA.
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Affiliation(s)
- Jung Gon Kim
- Division of Rheumatology, Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang-si, Republic of Korea
| | - Jiyeon Kang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang-si, Republic of Korea
| | - Joo-Hyun Lee
- Division of Rheumatology, Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang-si, Republic of Korea
| | - Hyeon-Kyoung Koo
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang-si, Republic of Korea
- *Correspondence: Hyeon-Kyoung Koo,
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Chen C, Su L, Duan W, Zheng Y, Zhang D, Wang Y. Asthma and atopic dermatitis as risk factors for rheumatoid arthritis: a bidirectional mendelian randomization study. BMC Med Genomics 2023; 16:41. [PMID: 36869337 PMCID: PMC9985208 DOI: 10.1186/s12920-023-01461-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 02/14/2023] [Indexed: 03/05/2023] Open
Abstract
BACKGROUND Previous observational studies have shown an association between asthma, atopic dermatitis (AD) and rheumatoid arthritis (RA). However, the bidirectional cause-effect chain between asthma and AD and RA has not been proven yet. METHODS We performed bidirectional two-sample Mendelian randomization (TSMR) and selected single nucleotide polymorphisms (SNPs) associated with asthma, AD, and RA as instrumental variables. All of the SNPs were obtained from the latest genome-wide association study in Europeans. Inverse variance weighted (IVW) was the main method used in MR analysis. MR-Egger, weighted model, simple model, and weighted median were used for quality control. The robustness of the results was tested by sensitivity analysis. RESULTS Asthma was found to be the largest effect size for RA susceptibility using the IVW method (OR, 1.35;95%CI, 1.13-1.60; P, 0.001), followed by AD (OR, 1.10;95%CI, 1.02-1.19; P, 0.019). In contrast, there was no causal relationship between RA and asthma (IVW: P = 0.673) or AD (IVW: P = 0.342). No pleiotropy or heterogeneity was found in the sensitivity analysis. CONCLUSION Findings from this study showed a causal relationship between genetic susceptibility to asthma or AD and increased risk of RA, but do not support a causal relationship between genetic susceptibility to RA and asthma or AD.
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Affiliation(s)
- Chuiji Chen
- Department of Orthopedic Surgery, Tangdu Hospital, Fourth Military Medical University, No. 1 of Xinsi Road, Baqiao District, 710038, Xi'an City, Shaanxi Province, China
| | - Le Su
- Department of Orthopedic Surgery, The Fourth People's Hospital of Zibo, No. 210 of Shanquan Road, Zhangdian District, 255051, Shandong, Shandong Province, China
| | - Wenhao Duan
- Xi'an Medical University, No. 1 of Xinwang Road, Weiyang District, 710021, Xi'an City, Shaanxi Province, China
| | - Yansen Zheng
- School of Medicine, Yellow River Institute of Science and Technology, 666 Zijing Shan South Road, 450015, Zhengzhou City, Henan Province, China
| | - Dianzhong Zhang
- Department of Orthopedic Surgery, Tangdu Hospital, Fourth Military Medical University, No. 1 of Xinsi Road, Baqiao District, 710038, Xi'an City, Shaanxi Province, China
| | - Yucai Wang
- Department of Orthopedic Surgery, Tangdu Hospital, Fourth Military Medical University, No. 1 of Xinsi Road, Baqiao District, 710038, Xi'an City, Shaanxi Province, China.
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Luedders BA, Mikuls TR, Thiele GM, Poole JA, England BR. Inhalant and Additional Mucosal-Related Environmental Risks for Rheumatoid Arthritis. Rheum Dis Clin North Am 2022; 48:781-798. [PMID: 36332995 PMCID: PMC10120871 DOI: 10.1016/j.rdc.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Rheumatoid arthritis (RA) occurs as the result of a complex interplay of environmental factors in a genetically susceptible individual. There is considerable evidence that the lungs may serve as an initial site of tolerance loss in the generation of RA-related autoimmunity, and several environmental inhalant exposures and lung diseases have been associated with RA risk. There is additional evidence that immune and microbial dysregulation of other mucosal sites, including the oral and gastrointestinal mucosa, may contribute to the development of RA. Epidemiologic evidence linking mucosal exposures to various environmental insults as risk determinants in RA will be reviewed.
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Affiliation(s)
- Brent A Luedders
- Division of Rheumatology & Immunology, University of Nebraska Medical Center, 986270 Nebraska Medical Center, Omaha, NE 68198-6270, USA; VA Nebraska-Western Iowa Health Care System, 4101 Woolworth Avenue, Omaha, NE 68105, USA
| | - Ted R Mikuls
- Division of Rheumatology & Immunology, University of Nebraska Medical Center, 986270 Nebraska Medical Center, Omaha, NE 68198-6270, USA; VA Nebraska-Western Iowa Health Care System, 4101 Woolworth Avenue, Omaha, NE 68105, USA
| | - Geoffrey M Thiele
- Division of Rheumatology & Immunology, University of Nebraska Medical Center, 986270 Nebraska Medical Center, Omaha, NE 68198-6270, USA; VA Nebraska-Western Iowa Health Care System, 4101 Woolworth Avenue, Omaha, NE 68105, USA
| | - Jill A Poole
- Division of Allergy & Immunology, University of Nebraska Medical Center, 985990 Nebraska Medical Center, Omaha, NE 68198-5990, USA
| | - Bryant R England
- Division of Rheumatology & Immunology, University of Nebraska Medical Center, 986270 Nebraska Medical Center, Omaha, NE 68198-6270, USA; VA Nebraska-Western Iowa Health Care System, 4101 Woolworth Avenue, Omaha, NE 68105, USA.
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Finckh A, Gilbert B, Hodkinson B, Bae SC, Thomas R, Deane KD, Alpizar-Rodriguez D, Lauper K. Global epidemiology of rheumatoid arthritis. Nat Rev Rheumatol 2022; 18:591-602. [PMID: 36068354 DOI: 10.1038/s41584-022-00827-y] [Citation(s) in RCA: 88] [Impact Index Per Article: 44.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2022] [Indexed: 11/09/2022]
Abstract
Rheumatoid arthritis (RA) is a systemic autoimmune disease that predominantly affects the joints. The prevalence of RA varies globally, with generally a higher prevalence in industrialized countries, which may be explained by exposures to environmental risk factors, but also by genetic factors, differing demographics and under-reporting in other parts of the world. Over the past three decades, strong trends of the declining severity of RA probably reflect changes in treatment paradigms and overall better management of the disease. Other trends include increasing RA prevalence. Common risk factors for RA include both modifiable lifestyle-associated variables and non-modifiable features, such as genetics and sex. A better understanding of the natural history of RA, and of the factors that contribute to the development of RA in specific populations, might lead to the introduction of specific prevention strategies for this debilitating disease.
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Affiliation(s)
- Axel Finckh
- Division of Rheumatology, Department of Medicine, Geneva University Hospital (HUG), Geneva, Switzerland.
| | - Benoît Gilbert
- Division of Rheumatology, Department of Medicine, Geneva University Hospital (HUG), Geneva, Switzerland
| | - Bridget Hodkinson
- Division of Rheumatology, Department of Medicine, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
| | - Sang-Cheol Bae
- Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Hanyang University Institute for Rheumatology and Hanyang University Institute of Bioscience and Biotechnology, Seoul, Republic of Korea
| | - Ranjeny Thomas
- The University of Queensland Diamantina Institute, The University of Queensland, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
| | - Kevin D Deane
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | | | - Kim Lauper
- Division of Rheumatology, Department of Medicine, Geneva University Hospital (HUG), Geneva, Switzerland.,Centre for Epidemiology versus Arthritis, Centre for Musculoskeletal Research, University of Manchester, Manchester, UK
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Chang WC, Livneh H, Chen WJ, Hsieh CC, Wang YH, Lu MC, Guo HR, Tsai TY. Adding Chinese Herbal Medicine to Routine Care is Associated With a Lower Risk of Rheumatoid Arthritis Among Patients With Asthma: A Population-Based Retrospective Cohort Study. Front Pharmacol 2022; 13:895717. [PMID: 36059972 PMCID: PMC9431954 DOI: 10.3389/fphar.2022.895717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 06/22/2022] [Indexed: 11/13/2022] Open
Abstract
Objective: Due to the shared pathogenesis of asthma and rheumatoid arthritis (RA), patients with asthma were found to have a higher risk of RA. While the benefits and safety of Chinese herbal medicine (CHM) for asthma have been reported, the scientific evidence regarding its effect on RA is limited. This longitudinal cohort study aimed to determine the relation between CHM use and RA risk in patients with asthma.Methods: Using the nationwide claims data, we enrolled 33,963 patients 20–80 years of age who were newly diagnosed with asthma and simultaneously free of RA between 2000 and 2007. From this sample, we utilized propensity score matching to create sets of participants as treatment and control groups, which comprised 13,440 CHM users and 13,440 non-CHM users. The incidence rate and hazard ratio (HR) for RA between the two groups were estimated at the end of 2013. A Cox proportional hazards model was constructed to examine the impact of the CHM use on the risk of RA.Results: The cumulative incidence of RA was substantially lower in the CHM user group. In the follow-up period, 214 patients in the CHM user group (1.92 per 1,000 person-years) and 359 patients in the non-CHM user group (2.92 per 1,000 person-years) developed RA (adjusted HR = 0.63, 95% confidence interval: 0.54–0.75). Of the commonly-prescribed formulae, nine CHM products were associated with a lower RA risk: Xiao-Qing-Long-Tang, Ma-Xing-Gan-Shi-Tang, Ding-Chuan-Tang, Xin-Yi-Qing-Fei-Tang, Bei Mu, Jie Geng, Xing Ren, Da Huang, and San Chi.Conclusion: This study found that patients with asthma who received CHM treatment, in addition to the conventional therapy, had a lower risk of RA. Use of CHM treatment may be integrated into conventional therapy to reduce subsequent RA risk among asthma patients.
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Affiliation(s)
- Wei-Chiao Chang
- Department of Chinese Medicine, Dalin Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation, Chiayi, Taiwan
| | - Hanoch Livneh
- Rehabilitation Counseling Program, Portland State University, Portland, OR, United States
| | - Wei-Jen Chen
- Department of Chinese Medicine, Dalin Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation, Chiayi, Taiwan
- Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan, Taiwan
- School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien, Taiwan
- Center of Sports Medicine, Dalin Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation, Chiayi, Taiwan
| | - Chang-Cheng Hsieh
- Department of Family Medicine, Dalin Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation, Chiayi, Taiwan
| | - Yu-Han Wang
- Center of Sports Medicine, Dalin Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation, Chiayi, Taiwan
| | - Ming-Chi Lu
- Division of Allergy, Immunology and Rheumatology, Dalin Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation, Chiayi, Taiwan
- School of Medicine, Tzu Chi University, Hualien, Taiwan
- *Correspondence: Ming-Chi Lu, ; How-Ran Guo, ; Tzung-Yi Tsai,
| | - How-Ran Guo
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
- Occupational Safety, Health and Medicine Research Center, National Cheng Kung University, Tainan, Taiwan
- *Correspondence: Ming-Chi Lu, ; How-Ran Guo, ; Tzung-Yi Tsai,
| | - Tzung-Yi Tsai
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Nursing, Tzu Chi University of Science and Technology, Hualien, Taiwan
- Department of Medical Research, Dalin Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation, Chiayi, Taiwan
- *Correspondence: Ming-Chi Lu, ; How-Ran Guo, ; Tzung-Yi Tsai,
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Network Pharmacology and Molecular Docking Study of Yupingfeng Powder in the Treatment of Allergic Diseases. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:1323744. [PMID: 35855823 PMCID: PMC9288288 DOI: 10.1155/2022/1323744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 06/22/2022] [Indexed: 11/17/2022]
Abstract
Objective To explore the potential mechanisms of Yupingfeng Powder (YPFP) in the treatment of allergic diseases by using network pharmacology and molecular docking technology. Methods The active components and targets of YPFP were screened by the TCMSP database. The targets associated with atopic dermatitis, asthma, allergic rhinitis, and food allergy were obtained from GeneCards and OMIM databases, respectively. The intersection of the above disease-related targets was identified as allergy-related targets. Then, allergy-related targets and YPFP-related targets were crossed to obtain the potential targets of YPFP for allergy treatment. A protein-protein-interaction (PPI) network and a drug-target-disease topology network were constructed to screen hub targets and key ingredients. Next, GO and KEGG pathway enrichment analyses were performed separately on the potential targets and hub targets to identify the biological processes and signaling pathways involved. Finally, molecular docking was conducted to verify the binding affinity between key ingredients and hub targets. Results In this study, 45 active ingredients were identified from YPFP, and 48 allergy-related targets were predicted by network pharmacology. IL6, TNF, IL1B, PTGS2, CXCL8, JUN, CCL2, IL10, IFNG, and IL4 were screened as hub targets by the PPI network. However, quercetin, kaempferol, wogonin, formononetin, and 7-O-methylisomucronulatol were identified as key ingredients by the drug-target-disease topological network. GO and KEGG pathway enrichment analysis indicated that the therapeutic effect of YPFP on allergy involved multiple biological processes and signaling pathways, including positive regulation of fever generation, positive regulation of neuroinflammatory response, vascular endothelial growth factor production, negative regulation of cytokine production involved in immune response, positive regulation of mononuclear cell migration, type 2 immune response, and negative regulation of lipid storage. Molecular docking verified that all the key ingredients had good binding affinity with hub targets. Conclusion This study revealed the key ingredients, hub targets, and potential mechanisms of YPFP antiallergy, and these data can provide some theoretical basis for subsequent allergy treatment and drug development.
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Kronzer VL, Huang W, Crowson CS, Davis JM, Vassallo R, Doyle TJ, Losina E, Sparks JA. Timing of sinusitis and other respiratory tract diseases and risk of rheumatoid arthritis. Semin Arthritis Rheum 2022; 52:151937. [PMID: 35042150 PMCID: PMC8820230 DOI: 10.1016/j.semarthrit.2021.11.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 11/02/2021] [Accepted: 11/15/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To investigate the association between timing of respiratory tract diseases and risk of rheumatoid arthritis (RA). METHODS This case-control study using the Mass General Brigham Biobank matched incident RA cases, confirmed by ACR/EULAR criteria, with at least seven years preceding electronic health record (EHR) data to three controls on age, sex, and EHR history from RA diagnosis (index date). We ascertained timing (>0-5 years/>5-10 years/>10 years) of the first documented respiratory tract disease prior to index date using diagnosis codes. We estimated odds ratios (OR) with 95% confidence intervals (CI) for RA for each respiratory exposure using logistic regression models, adjusting for potential confounders. We also conducted a stratified analysis by serostatus and smoking. RESULTS We identified 625 incident RA cases (median 56 years, 75% female, 57% seropositive) and 1,875 controls. Acute sinusitis was associated with RA only in the >5 to 10 years before RA (OR 3.90, 95% CI:1.90,8.01). In contrast, pneumonia was associated with RA only in the >0 to 5 years before RA (OR 1.73, 95% CI:1.00,3.00), and chronic respiratory tract diseases only >10 years before RA (OR 1.43, 95% CI:1.00,2.05). All respiratory tract diseases tended to show a stronger association with seronegative RA than seropositive RA, although the interaction was statistically significant only for chronic sinusitis (p=0.04). Respiratory diseases showed a nonsignificantly stronger association among smokers than nonsmokers. CONCLUSION Sinusitis and other respiratory diseases are associated with increased risk of RA, especially 5 years before RA onset. RA may begin many years before clinical onset.
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Affiliation(s)
- Vanessa L Kronzer
- Division of Rheumatology, Mayo Clinic, Rochester, Minnesota, USA.,Corresponding Author: Vanessa L. Kronzer, , 200 First Street SW, Rochester, MN 55905, P: 651-308-1523 F: 507-266-1799
| | - Weixing Huang
- Division of Rheumatology, Inflammation, and Immunity; Brigham and Women’s Hospital; Harvard Medical School; Boston, USA
| | - Cynthia S. Crowson
- Division of Rheumatology, Mayo Clinic, Rochester, Minnesota, USA.,Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
| | - John M. Davis
- Division of Rheumatology, Mayo Clinic, Rochester, Minnesota, USA
| | - Robert Vassallo
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Tracy J. Doyle
- Division of Pulmonary and Critical Care; Brigham and Women’s Hospital and Harvard Medical School; Boston, USA
| | - Elena Losina
- Department of Orthopedic Surgery; Brigham and Women’s Hospital; Boston, USA,Department of Biostatistics; Boston University School of Public Health; Boston, USA
| | - Jeffrey A Sparks
- Division of Rheumatology, Inflammation, and Immunity; Brigham and Women’s Hospital; Harvard Medical School; Boston, USA
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15
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Kronzer VL, Huang W, Zaccardelli A, Crowson CS, Davis JM, Vassallo R, Doyle TJ, Losina E, Sparks JA. Association of sinusitis and upper respiratory tract diseases with incident rheumatoid arthritis: A case-control study. J Rheumatol 2021; 49:358-364. [PMID: 34654732 DOI: 10.3899/jrheum.210580] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE We aimed to determine whether specific respiratory tract diseases are associated with increased rheumatoid arthritis (RA) risk. METHODS This case-control study within the Mass General Brigham Biobank matched newly diagnosed RA cases to three controls on age, sex, and electronic health record history. We identified RA using a validated algorithm and confirmed by medical record review. Respiratory tract disease exposure required one inpatient or two outpatient codes at least two years before index date of RA clinical diagnosis or matched date. Logistic regression models calculated odds ratios (OR) for RA with 95% confidence intervals (CI), adjusting for confounders. We then stratified by serostatus ("seropositive" was positive rheumatoid factor and/or anti-citrullinated protein antibodies) and smoking. RESULTS We identified 741 RA cases and 2,223 controls (both median age 55, 76% female). Acute sinusitis (OR 1.61, 95% CI:1.05,2.45), chronic sinusitis (OR 2.16, 95% CI:1.39,3.35), and asthma (OR 1.39, 95% CI:1.03,1.87) were associated with increased risk of RA. Acute respiratory tract disease burden during the pre-index exposure period was also associated with increased RA risk (OR 1.30 per 10 codes, 95% CI:1.08,1.55). Acute pharyngitis was associated with seronegative (OR 1.68, 95% CI:1.02,2.74) but not seropositive RA; chronic rhinitis/pharyngitis was associated with seropositive (OR 2.46, 95% CI:1.01,5.99) but not seronegative RA. Respiratory tract diseases tended towards higher associations in smokers, especially >10 packyears (OR 1.52, 95% CI:1.02,2.27; p=0.10 for interaction). CONCLUSION Acute/chronic sinusitis and pharyngitis and acute respiratory burden increased RA risk. The mucosal paradigm of RA pathogenesis may involve the upper respiratory tract.
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Affiliation(s)
- Vanessa L Kronzer
- Division of Rheumatology, Mayo Clinic, Rochester, Minnesota, USA; Division of Rheumatology, Inflammation, and Immunity; Brigham and Women's Hospital; Harvard Medical School; Boston, USA; Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA; Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota, USA; Division of Pulmonary and Critical Care; Brigham and Women's Hospital and Harvard Medical School; Boston, USA; Department of Orthopedic Surgery; Brigham and Women's Hospital; Boston, USA. Funding: This study was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases awards NIH-P30-AR072577 (VERITY Pilot & Feasibility award to VLK), K23 AR069688 (JAS), R03 AR075886 (JAS), L30 AR066953 (JAS), R03 HL148484 (TJD), and P30 AR070253 (Joint Biology Consortium). It was also supported by the R Bridge Award (JAS) from the Rheumatology Research Foundation. The funders had no role in the decision to publish or preparation of this manuscript. The content is solely the responsibility of the authors and does not necessarily represent the official views of Harvard University, its affiliated academic health care centers, or the National Institutes of Health. Conflict of interest: The authors declare no conflicts of interest related to this work. Corresponding Author: Vanessa L. Kronzer, 200 First Street SW, Rochester, MN 55905
| | - Weixing Huang
- Division of Rheumatology, Mayo Clinic, Rochester, Minnesota, USA; Division of Rheumatology, Inflammation, and Immunity; Brigham and Women's Hospital; Harvard Medical School; Boston, USA; Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA; Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota, USA; Division of Pulmonary and Critical Care; Brigham and Women's Hospital and Harvard Medical School; Boston, USA; Department of Orthopedic Surgery; Brigham and Women's Hospital; Boston, USA. Funding: This study was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases awards NIH-P30-AR072577 (VERITY Pilot & Feasibility award to VLK), K23 AR069688 (JAS), R03 AR075886 (JAS), L30 AR066953 (JAS), R03 HL148484 (TJD), and P30 AR070253 (Joint Biology Consortium). It was also supported by the R Bridge Award (JAS) from the Rheumatology Research Foundation. The funders had no role in the decision to publish or preparation of this manuscript. The content is solely the responsibility of the authors and does not necessarily represent the official views of Harvard University, its affiliated academic health care centers, or the National Institutes of Health. Conflict of interest: The authors declare no conflicts of interest related to this work. Corresponding Author: Vanessa L. Kronzer, 200 First Street SW, Rochester, MN 55905
| | - Alessandra Zaccardelli
- Division of Rheumatology, Mayo Clinic, Rochester, Minnesota, USA; Division of Rheumatology, Inflammation, and Immunity; Brigham and Women's Hospital; Harvard Medical School; Boston, USA; Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA; Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota, USA; Division of Pulmonary and Critical Care; Brigham and Women's Hospital and Harvard Medical School; Boston, USA; Department of Orthopedic Surgery; Brigham and Women's Hospital; Boston, USA. Funding: This study was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases awards NIH-P30-AR072577 (VERITY Pilot & Feasibility award to VLK), K23 AR069688 (JAS), R03 AR075886 (JAS), L30 AR066953 (JAS), R03 HL148484 (TJD), and P30 AR070253 (Joint Biology Consortium). It was also supported by the R Bridge Award (JAS) from the Rheumatology Research Foundation. The funders had no role in the decision to publish or preparation of this manuscript. The content is solely the responsibility of the authors and does not necessarily represent the official views of Harvard University, its affiliated academic health care centers, or the National Institutes of Health. Conflict of interest: The authors declare no conflicts of interest related to this work. Corresponding Author: Vanessa L. Kronzer, 200 First Street SW, Rochester, MN 55905
| | - Cynthia S Crowson
- Division of Rheumatology, Mayo Clinic, Rochester, Minnesota, USA; Division of Rheumatology, Inflammation, and Immunity; Brigham and Women's Hospital; Harvard Medical School; Boston, USA; Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA; Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota, USA; Division of Pulmonary and Critical Care; Brigham and Women's Hospital and Harvard Medical School; Boston, USA; Department of Orthopedic Surgery; Brigham and Women's Hospital; Boston, USA. Funding: This study was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases awards NIH-P30-AR072577 (VERITY Pilot & Feasibility award to VLK), K23 AR069688 (JAS), R03 AR075886 (JAS), L30 AR066953 (JAS), R03 HL148484 (TJD), and P30 AR070253 (Joint Biology Consortium). It was also supported by the R Bridge Award (JAS) from the Rheumatology Research Foundation. The funders had no role in the decision to publish or preparation of this manuscript. The content is solely the responsibility of the authors and does not necessarily represent the official views of Harvard University, its affiliated academic health care centers, or the National Institutes of Health. Conflict of interest: The authors declare no conflicts of interest related to this work. Corresponding Author: Vanessa L. Kronzer, 200 First Street SW, Rochester, MN 55905
| | - John M Davis
- Division of Rheumatology, Mayo Clinic, Rochester, Minnesota, USA; Division of Rheumatology, Inflammation, and Immunity; Brigham and Women's Hospital; Harvard Medical School; Boston, USA; Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA; Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota, USA; Division of Pulmonary and Critical Care; Brigham and Women's Hospital and Harvard Medical School; Boston, USA; Department of Orthopedic Surgery; Brigham and Women's Hospital; Boston, USA. Funding: This study was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases awards NIH-P30-AR072577 (VERITY Pilot & Feasibility award to VLK), K23 AR069688 (JAS), R03 AR075886 (JAS), L30 AR066953 (JAS), R03 HL148484 (TJD), and P30 AR070253 (Joint Biology Consortium). It was also supported by the R Bridge Award (JAS) from the Rheumatology Research Foundation. The funders had no role in the decision to publish or preparation of this manuscript. The content is solely the responsibility of the authors and does not necessarily represent the official views of Harvard University, its affiliated academic health care centers, or the National Institutes of Health. Conflict of interest: The authors declare no conflicts of interest related to this work. Corresponding Author: Vanessa L. Kronzer, 200 First Street SW, Rochester, MN 55905
| | - Robert Vassallo
- Division of Rheumatology, Mayo Clinic, Rochester, Minnesota, USA; Division of Rheumatology, Inflammation, and Immunity; Brigham and Women's Hospital; Harvard Medical School; Boston, USA; Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA; Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota, USA; Division of Pulmonary and Critical Care; Brigham and Women's Hospital and Harvard Medical School; Boston, USA; Department of Orthopedic Surgery; Brigham and Women's Hospital; Boston, USA. Funding: This study was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases awards NIH-P30-AR072577 (VERITY Pilot & Feasibility award to VLK), K23 AR069688 (JAS), R03 AR075886 (JAS), L30 AR066953 (JAS), R03 HL148484 (TJD), and P30 AR070253 (Joint Biology Consortium). It was also supported by the R Bridge Award (JAS) from the Rheumatology Research Foundation. The funders had no role in the decision to publish or preparation of this manuscript. The content is solely the responsibility of the authors and does not necessarily represent the official views of Harvard University, its affiliated academic health care centers, or the National Institutes of Health. Conflict of interest: The authors declare no conflicts of interest related to this work. Corresponding Author: Vanessa L. Kronzer, 200 First Street SW, Rochester, MN 55905
| | - Tracy J Doyle
- Division of Rheumatology, Mayo Clinic, Rochester, Minnesota, USA; Division of Rheumatology, Inflammation, and Immunity; Brigham and Women's Hospital; Harvard Medical School; Boston, USA; Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA; Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota, USA; Division of Pulmonary and Critical Care; Brigham and Women's Hospital and Harvard Medical School; Boston, USA; Department of Orthopedic Surgery; Brigham and Women's Hospital; Boston, USA. Funding: This study was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases awards NIH-P30-AR072577 (VERITY Pilot & Feasibility award to VLK), K23 AR069688 (JAS), R03 AR075886 (JAS), L30 AR066953 (JAS), R03 HL148484 (TJD), and P30 AR070253 (Joint Biology Consortium). It was also supported by the R Bridge Award (JAS) from the Rheumatology Research Foundation. The funders had no role in the decision to publish or preparation of this manuscript. The content is solely the responsibility of the authors and does not necessarily represent the official views of Harvard University, its affiliated academic health care centers, or the National Institutes of Health. Conflict of interest: The authors declare no conflicts of interest related to this work. Corresponding Author: Vanessa L. Kronzer, 200 First Street SW, Rochester, MN 55905
| | - Elena Losina
- Division of Rheumatology, Mayo Clinic, Rochester, Minnesota, USA; Division of Rheumatology, Inflammation, and Immunity; Brigham and Women's Hospital; Harvard Medical School; Boston, USA; Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA; Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota, USA; Division of Pulmonary and Critical Care; Brigham and Women's Hospital and Harvard Medical School; Boston, USA; Department of Orthopedic Surgery; Brigham and Women's Hospital; Boston, USA. Funding: This study was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases awards NIH-P30-AR072577 (VERITY Pilot & Feasibility award to VLK), K23 AR069688 (JAS), R03 AR075886 (JAS), L30 AR066953 (JAS), R03 HL148484 (TJD), and P30 AR070253 (Joint Biology Consortium). It was also supported by the R Bridge Award (JAS) from the Rheumatology Research Foundation. The funders had no role in the decision to publish or preparation of this manuscript. The content is solely the responsibility of the authors and does not necessarily represent the official views of Harvard University, its affiliated academic health care centers, or the National Institutes of Health. Conflict of interest: The authors declare no conflicts of interest related to this work. Corresponding Author: Vanessa L. Kronzer, 200 First Street SW, Rochester, MN 55905
| | - Jeffrey A Sparks
- Division of Rheumatology, Mayo Clinic, Rochester, Minnesota, USA; Division of Rheumatology, Inflammation, and Immunity; Brigham and Women's Hospital; Harvard Medical School; Boston, USA; Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA; Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota, USA; Division of Pulmonary and Critical Care; Brigham and Women's Hospital and Harvard Medical School; Boston, USA; Department of Orthopedic Surgery; Brigham and Women's Hospital; Boston, USA. Funding: This study was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases awards NIH-P30-AR072577 (VERITY Pilot & Feasibility award to VLK), K23 AR069688 (JAS), R03 AR075886 (JAS), L30 AR066953 (JAS), R03 HL148484 (TJD), and P30 AR070253 (Joint Biology Consortium). It was also supported by the R Bridge Award (JAS) from the Rheumatology Research Foundation. The funders had no role in the decision to publish or preparation of this manuscript. The content is solely the responsibility of the authors and does not necessarily represent the official views of Harvard University, its affiliated academic health care centers, or the National Institutes of Health. Conflict of interest: The authors declare no conflicts of interest related to this work. Corresponding Author: Vanessa L. Kronzer, 200 First Street SW, Rochester, MN 55905
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Atopic Dermatitis is a Risk Factor for Rheumatoid Arthritis: A Systematic Review and Meta-Analysis. Dermatitis 2021; 32:S15-S23. [PMID: 34405833 DOI: 10.1097/der.0000000000000781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND It is still unclear whether patients with atopic dermatitis (AD) have an increased risk of developing rheumatoid arthritis (RA). OBJECTIVE We aimed to investigate the association between AD and risk of RA using systematic review and meta-analysis. METHODS We searched Medline and EMBASE up to April 2021 using search strategy, including terms for "atopic dermatitis" and "rheumatoid arthritis." Eligible cohort study must compare the incidence of RA between patients with AD and comparators without AD. Eligible case-control study must recruit cases with RA and controls without RA. Then, the study must compare the prevalence of AD between the groups. Point estimates with standard errors from each study were combined using the generic inverse variance method. RESULTS The meta-analysis found that AD patients had a significantly higher risk of incident RA than individuals without AD with a pooled odds ratio (OR) of 1.30 (95% confidence interval [CI], 1.17-1.44; I2, 48%). Subgroup analysis revealed a significantly higher risk of RA in cohort study subgroup (pooled OR, 1.37; 95% CI, 1.25-1.50; I2, 63%) but not case-control study subgroup (pooled OR, 0.99; 95% CI, 0.77-1.28; I2, 10%). CONCLUSIONS This study found a significantly higher risk of incident RA among AD patients.
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Yingchoncharoen P, Charoenngam N, Ponvilawan B, Thongpiya J, Chaikijurajai T, Ungprasert P. The Association Between Asthma and Risk of Myasthenia Gravis: A Systematic Review and Meta-analysis. Lung 2021; 199:273-280. [PMID: 33987703 DOI: 10.1007/s00408-021-00444-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 03/25/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE This study aimed to investigate the association between asthma and risk of myasthenia gravis (MG) using the method of systematic review and meta-analysis. METHODS Potentially eligible studies were identified from Medline and EMBASE databases from inception to July 2020 using search strategy that comprised terms for "Asthma" and "Myasthenia Gravis". Eligible cohort study must consist of one cohort of individuals with asthma and another cohort of individuals without asthma. Then, the study must report relative risk (RR) with 95% confidence intervals (95% CIs) of incident MG between the groups. Eligible case-control studies must include cases with MG and controls without MG. Then, the study must explore their history of asthma. Odds ratio (OR) with 95% CIs of the association between asthma status and MG must be reported. Point estimates with standard errors were retrieved from each study and were combined together using the generic inverse variance method. RESULTS A total of 6,835 articles were identified. After two rounds of independent review by five investigators, two cohort studies and three case-control studies met the eligibility criteria and were included into the meta-analysis. Pooled analysis showed that asthma was significantly associated with risk of MG with the pooled risk ratio of 1.38 (95% CI 1.02-1.86). Funnel plot was symmetric, which was not suggestive of publication bias. CONCLUSION The current study found a significant association between asthma and increased risk of MG.
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Affiliation(s)
- Pitchaporn Yingchoncharoen
- Department of Clinical Pathology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Nipith Charoenngam
- Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand. .,Section Endocrinology, Diabetes, Nutrition and Weight Management, Department of Medicine, Boston University School of Medicine, 85 E Newton St., Boston, MA, 02118, USA.
| | - Ben Ponvilawan
- Department of Pharmacology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Jerapas Thongpiya
- Department of Parasitology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Thanat Chaikijurajai
- Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH, USA.,Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Patompong Ungprasert
- Department of Rheumatologic and Immunologic Diseases, Cleveland Clinic, Cleveland, OH, USA
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18
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Etiologies of Rheumatoid Arthritis: Update on Mucosal, Genetic, and Cellular Pathogenesis. Curr Rheumatol Rep 2021; 23:21. [PMID: 33646410 PMCID: PMC7919619 DOI: 10.1007/s11926-021-00993-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/20/2021] [Indexed: 12/11/2022]
Abstract
Purpose of Review Over the last few years, the scientific community has made significant progress in understanding the etiology of rheumatoid arthritis (RA). In this review, we summarize those key findings and trends. Recent Findings New data strongly implicates respiratory exposures, obesity, diet and microbiome, genetics, and their interactions in the etiology of RA. Furthermore, anti-posttranslationally modified protein antibodies (AMPAs) and abnormal glycosylation may be additional biomarkers for RA. Finally, functional genomics techniques implicate loss of certain macrophage populations and proliferation of synovial fibroblasts in RA. Summary These findings support the notion that RA originates at mucosal sites, augmented by genetic predisposition, and mediated by certain cell types including macrophages and fibroblasts. Weight loss, physical activity, and diet are additional modifiable factors beyond smoking cessation that can reduce risk of RA. Future epidemiologic and translational studies leveraging multi-omics approaches will help map the precise sequence of events in RA pathogenesis.
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