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Cigarette smoking, antiphospholipid antibodies and vascular events in Systemic Lupus Erythematosus
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2015 (English)In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 74, no 8, 1537-1543 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: Smoking can induce autoantibodies in persons who are genetically predisposed to rheumatoid arthritis. We investigated the association between smoking and antiphospholipid antibodies (aPL) in systemic lupus erythematosus (SLE), a question not previously addressed. Further, we explored the relationship between smoking, aPL and vascular events (arterial and venous, VE).

METHODS: In this cross-sectional study, clinical evaluation and questionnaire data were collected from 367 prevalent SLE patients. At the same time, we measured aPL (anticardiolipin (aCL), anti-β2 glycoprotein-1 (aβ2GP1) antibodies IgG/IgM/IgA, and lupus anticoagulant (LA)), and a large set of other SLE-associated autoantibodies for comparison. Association analyses using logistic regression models with smoking, (ever, former and current with never as reference) and antibody status as outcome variable were performed. As a secondary outcome, we investigated the associations between aPL, smoking and VE.

RESULTS: In multivariable-adjusted models ever, and in particular former, cigarette smoking was associated with the most pathogenic aPL; LA, aCL IgG and aβ2GP1 IgG. Other SLE-associated autoantibodies were not associated with smoking. The combination of smoking and aPL was strongly associated with VE. We noted a positive interaction between smoking-LA and smoking-'triple aPL' positivity for previous VE.

CONCLUSIONS: We investigated a large set of commonly occurring autoantibodies in SLE, but only aPL were positively associated with a history of smoking. This association was especially apparent in former smokers. Among ever regular smokers who were aPL positive, we observed a strikingly high frequency of former VE. The underlying mechanisms and temporality between smoking, aPL and VE need further investigations.

Place, publisher, year, edition, pages
2015. Vol. 74, no 8, 1537-1543 p.
National Category
Immunology in the medical area
URN: urn:nbn:se:uu:diva-239508DOI: 10.1136/annrheumdis-2013-205159ISI: 000357683600021PubMedID: 24692586OAI: oai:DiVA.org:uu-239508DiVA: diva2:774767
Swedish Rheumatism AssociationSwedish Research CouncilÅke Wiberg Foundation
Available from: 2014-12-29 Created: 2014-12-29 Last updated: 2015-08-24Bibliographically approved

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Rönnelid, Johan
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