title: Effect of tobacco smoking on tissue protein citrullination and disease progression in patients with rheumatoid arthritis.
abstract: The aim of the present work was to study the effect of tobacco smoking on disease progression in rheumatoid arthritis patients and its relation to anti-cyclical citrullinated peptide (anti-CCP) antibodies. The study included 54 patients; 20 non-smokers, 9 ex-smokers, 14 mild to moderate smokers and 11 heavy smokers. Fifteen normal volunteers were also studied as controls. Disease stage was clinically and radiologically determined, rheumatoid factor (RF) and anti-CCP antibodies were measured in serum. Higher percentage of severe disease (stage III) was seen in heavy smoker patients than mild to moderate smokers (54.6% versus 35.7%) and in moderate smokers than ex-smokers (35.7% versus 33.6%). Lowest percentage of severe disease was seen in non-smokers (15%). RF and anti-CCP were significantly higher in smoker than non-smoker and in heavy than mild to moderate smoker patients (p < 0.01, p < 0.05 and p < 0.01, p < 0.001, respectively). In smoker patients, both RF and anti-CCP antibodies correlated significantly and positively with smoking index (r = 0.581, p < 0.001; r = 0.661, p < 0.001). Also, smoking index and anti-CCP correlated significantly and positively with disease stage (r = 0.424, p < 0.05; r = 0.523, p < 0.01). It appears from our results that, tobacco smoking mostly play a role in progression of rheumatoid arthritis through tissue protein citrullination. So all rheumatoid arthritis patients must quit completely to achieve a good control.
authors: Department of Chest, Faculty of Medicine, Benha University, Benha, Egypt.
authors: Mahmoud M
authors: MM
authors: Alsalahy
authors: Hamdy S
authors: HS
authors: Nasser
authors: Manal M
authors: MM
authors: Hashem
authors: Sahar M
authors: SM
authors: Elsayed
keywords: Anti-CCP; Arthritis; Rheumatoid; Smoking
references: QJM. 2007 Apr;100(4):193-201
references: 17434910
references: Rheumatology (Oxford). 2008 Jun;47(6):849-54
references: 18390589
references: Ann Rheum Dis. 2007 Jan;66(1):59-64
references: 16901955
references: J Rheumatol. 2000 Mar;27(3):630-7
references: 10743800
references: Lupus. 2006;15(11):737-45
references: 17153844
references: Ann Rheum Dis. 2006 May;65(5):561-3
references: 16611864
references: J Am Med Assoc. 1949 Jun 25;140(8):659-62
references: 18150288
references: J Rheumatol. 1997 Jun;24(6):1037-44
references: 9195506
references: Ann Rheum Dis. 2008 Apr;67(4):466-70
references: 17660221
references: Ann Rheum Dis. 2009 Feb;68(2):201-8
references: 18390910
references: Arthritis Rheum. 1988 Mar;31(3):315-24
references: 3358796
references: Ann Rheum Dis. 2003 Sep;62(9):835-41
references: 12922955
references: Ann Rheum Dis. 2001 Mar;60(3):223-7
references: 11171682
references: J Immunol. 2005 Nov 1;175(9):5575-80
references: 16237041
references: Ann Rheum Dis. 2008 Nov;67(11):1529-34
references: 18198196
references: Rheumatology (Oxford). 2008 Sep;47(9):1317-22
references: 18617548
references: Ann Rheum Dis. 2007 Aug;66(8):1066-71
references: 17237117
references: Ann Rheum Dis. 1997 Aug;56(8):463-9
references: 9306868