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Rheumatoid arthritis: Exposure to smoking at young age increases risk by 75 percent

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A new study has found a potential direct link between exposure to parental smoking during childhood and increased risk of seropositive rheumatoid arthritis (RA) later in life.

The study was conducted by investigators from Brigham and Women’s Hospital and found a potential direct link between exposure to parental smoking during childhood and increased risk of seropositive rheumatoid arthritis (RA) later in life.

Researchers looked at data from 90,923 women in the Nurses’ Health Study II (NHSII) to elucidate the relationship between passive smoking exposure and incident RA.

Passive exposure was broken down into three categories, including maternal smoking during pregnancy, parental smoking during childhood, and years lived with smokers since age 18.

Even with personal smoking accounted for, passive exposure to parental smoking during childhood was found to increase risk of incident seropositive RA by 75 percent.

The study found that for individuals who experienced passive childhood exposure to parental smoking had a 75 percent higher risk of developing arthritis.

This risk increased in participants who themselves became active smokers.

Maternal smoking during pregnancy and years lived with smokers beyond age 18 showed no significant association with incident RA risk.

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“There has been intense interest in mucosal lung inflammation from personal smoking as a site of RA pathogenesis,” said senior author Dr Jeffrey Sparks of the Department of Medicine at the Brigham.

He added: “But the majority of RA patients aren’t smokers, so we wanted to look at another inhalant that might precede RA.”

To link passive smoking and incident RA more conclusively, Sparks and colleagues used data collected between 1989 and 2017 from 90,923 women aged 35 to 52 years.

Statistical modelling was then used to estimate the direct effect of each passive smoking exposure on RA risk.

“Our findings give more depth and gravity to the negative health consequences of smoking in relation to RA, one of the most common autoimmune diseases,” said lead and co-corresponding author Dr Kazuki Yoshida, MD, ScD, of the Brigham’s Division of Rheumatology, Inflammation and Immunity.

He continued: “This relationship between childhood parental smoking and adult-onset RA may go beyond rheumatology — future studies should investigate whether childhood exposure to inhalants may predispose individuals to general autoimmunity later in life.”

Smokers also have an increased risk of more-severe rheumatoid arthritis. In addition, they may be less likely to experience remission, said the Mayo Clinic.

The health site added: “Smoking decreases the effectiveness of some drugs used to treat rheumatoid arthritis and can be a barrier to engaging in activities that may relieve symptoms of rheumatoid arthritis, such as exercise.

“The exact reason why smoking is linked to rheumatoid arthritis isn’t well understood, but researchers suspect smoking somehow ignites faulty immune system functioning in people genetically predisposed to getting rheumatoid arthritis.”
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