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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, p. 1537-1543Article 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, p. 1537-1543
National Category
Immunology in the medical area
Identifiers
URN: urn:nbn:se:uu:diva-239508DOI: 10.1136/annrheumdis-2013-205159ISI: 000357683600021PubMedID: 24692586OAI: oai:DiVA.org:uu-239508DiVA, id: diva2:774767
Funder
Swedish Rheumatism AssociationSwedish Research CouncilÅke Wiberg FoundationAvailable from: 2014-12-29 Created: 2014-12-29 Last updated: 2018-02-27Bibliographically approved

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Rönnelid, Johan

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