Smoking and Immunity: an Additional Player in the Mosaic of Autoimmunity

George, Jacob; Levy, Yair; Shoenfeld, Yehuda

doi:10.1046/j.1365-3083.1997.d01-366.x

Cited by 74 publications

(41 citation statements)

References 32 publications

(43 reference statements)

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“…Fung et al also found that smoking was related to PPTD (24); others, however, did not find smoking related to PPTD or autoimmune hypothyroidism (21,25 relation are: the possible dose-response effect that we found, the noxious effect of diverse components of tobacco on the thyroid and the effect of smoking on the immune system (26,27). This is the first study describing breast feeding as an independent protecting factor: women not breast feeding had a RR ¼ 11.1 for developing PPTD.…”

Section: Discussionmentioning

confidence: 47%

Prediction of post partum thyroid dysfunction: can it be improved?

Kuijpens¹,

Pop

Vader³

et al. 1998

Eur J Endocrinol

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Background: Screening pregnant women for thyroid peroxidase antibodies (TPOAb) to identify those at risk for post partum thyroid dysfunction (PPTD) is controversial, mainly because of the low positive predictive value (ppv) of TPOAb. Objectives: To evaluate if the ppv of TPOAb can be enhanced, either by taking into account the time of TPOAb testing, or by combining this parameter with other putative determinants of PPTD such as smoking, family history or other autoimmune diseases. Methods: A prospective study was performed in the Kempenland region (southeastern Netherlands). Three hundred and ten unselected women were visited at 12 and 32 weeks gestation and 4, 12, 20, 28 and 36 weeks post partum. Serial thyroid stimulating hormone (TSH), free thyroxine (fT 4 ) and TPOAb testing was performed. Thyroid dysfunction (TD) was defined as abnormal TSH either in combination with abnormal fT 4 (overt TD) or without abnormal fT 4 (subclinical TD). PPTD was defined as overt TD post partum. Multivariate regression analysis was performed for determining independent risk factors for PPTD. The sensitivity and specificity of TPOAb at different time points and at different concentrations were calculated and presented in receiver operating characteristic (ROC) curves. Women who had experienced PPTD were followed for 2.5-3 years. Results: Data from 291 women were available for analysis. Serum fT 4 declined during pregnancy and returned to baseline values post partum. TD in gestation was present in 23 women (7.9%): serum TSH was transiently decreased in 13 (6 had overt gestational thyrotoxicosis (2.1%)) and increased in 10 (2 had TPOAb). Both point prevalence and concentration of TPOAb decreased during gestation and returned to baseline levels within 12 weeks post partum. TD in post partum was present in 36 women (12.4%): 21 had subclinical and 15 overt TD. Out of the 15 women with overt TD (incidence of PPTD: 5.2%) 10 were positive for TPOAb (TPOAbþ); 9 had thyrotoxicosis (4 TPOAbþ), 5 hypothyroidism (5 TPOAbþ) and 1 thyrotoxicosis followed by hypothyroidism (TPOAbþ). Independent risk factors for PPTD were TPOAb (relative risk (RR) ¼ 27.2), bottle feeding (RR ¼ 11.1) and smoking habits (ever smoked: RR ¼ 3.1; women with PPTD had smoked more cigarettes for a longer period of time). The sensitivity of TPOAb testing was highest at 12 weeks gestation (0.67). The ppv of TPOAb was 0.31-0.75 (depending on time of testing and concentration), increasing slightly to 0.38-0.80 when combined with bottle feeding or smoking habits. There appeared to be an autoimmune form of PPTD in 2/3 of cases and a nonautoimmune form; women with the autoimmune form were at risk for developing permanent hypothyroidism. Conclusions: A maximum of 2/3 of PPTD cases can be predicted from the presence of TPOAb because 1/3 remained negative for TPOAb. The most appropriate time for TPOAb testing is in the first trimester of pregnancy. The combination of TPOAb testing with anamnestic determinants of PPTD does not increase ppv substantially.

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Section: Discussionmentioning

confidence: 47%

Prediction of post partum thyroid dysfunction: can it be improved?

Kuijpens¹,

Pop

Vader³

et al. 1998

Eur J Endocrinol

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“…[20][21][22][23][24][25] Cigarette smoking has been linked with increased disease activity in SLE. 26 Cigarette smoking has been suspected to increase the risk and the activity of SLE 20,32 and CLE.…”

Section: Discussionmentioning

confidence: 99%

“…25,[27][28][29] There is an association between cigarette smoking and autoimmune disease, including DLE. [20][21][22][23][24][25] The prevalence of smoking in patients with DLE was found to be 82%, vs. 22% in controls matched for age and gender. 23 About 84.2% of discoid patients with DLE are smokers vs. 33.5% of healthy controls.…”

Section: Discussionmentioning

confidence: 99%

“…[20][21][22][23][24][25] A review of 28 patients with DLE in a private dermatology practice found the prevalence of smoking to be 82% in patients with DLE, compared with 22% in age-and sex-matched controls. 23 Interestingly, a meta-analysis of seven case-control studies and two cohort studies found a slightly increased risk of LE posed by current smoking, although no increased risk was associated with past smoking.…”

Section: Association Between Smoking and Increased Disease Activity Imentioning

confidence: 99%

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Hydroxychloroquine and smoking in patients with cutaneous lupus erythematosus

Ezra

Jorizzo

2012

Clinical and Experimental Dermatology

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SummaryAntimalarials, such as chloroquine and hydroxychloroquine, have been used to treat cutaneous and systemic lupus erythematosus for decades with excellent therapeutic efficacy. Smoking seems to inhibit the therapeutic efficacy of antimalarials when treating cutaneous lupus erythematosus (CLE), but the reason behind this observation is unclear. In addition, antimalarials have been associated with several potentially serious adverse effects, including irreversible loss of vision. The aim of this literature review is to discuss the evidence for how cigarette smoking interferes with antimalarial efficacy in the treatment of CLE. Evidence-based data with long-term follow-up will allow determination of the aetiology for diminished antimalarial response, and enable selection of the best treatment to maximize long-term remission in CLE.

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“…4 George et al observaram diminuição na atividade dos linfócitos T supressores em fumantes em comparação ã de não fumantes. 16 A gené-tica, portanto, determinaria quais reações imunes seriam desencadeadas pelo cigarro. 17 Freemer cigarros durante toda a vida.…”

Section: Discussionunclassified

Associação entre lúpus eritematoso e tabagismo

Araújo

Oliveira

Cedrim

et al. 2008

An. Bras. Dermatol.

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Resumo: FUNDAMENTOS -O lúpus eritematoso é doença crônica, auto-imune, que reúne manifestações exclusivamente cutâneas ou multissistêmicas, caracterizada pela produção de auto-anticorpos contra vários constituintes celulares. OBJETIVO -Avaliar aspectos epidemiológicos, clínicos e, em especial, tabagismo em um estudo envolvendo lúpus eritematoso. MÉTODOS -Foram estudados, retrospectivamente, 80 pacientes com lúpus eritematoso do ambulatório de Dermatologia do Hospital Universitário da Universidade Federal de Juiz de Fora no período de 2002 a 2006. RESULTADOS -A média de idade da instalação da doença foi 40 anos, com acometimento mais freqüen-te do sexo feminino em relação ao masculino (5,6:1) e a maioria dos pacientes era leucodérmica (60%). Quanto às variedades clínicas, houve predomínio do lúpus eritematoso cutâneo discóide (45%), seguido de lúpus eritematoso agudo (43,75%), lúpus eritematoso subagudo (6,25%), lúpus eritematoso profundo (1,25%), pérnio (1,25%) e túmido (2,5%). A maioria dos pacientes portadores de lúpus eritematoso, 57 (71,25%), era tabagista, 6,25% deles eram ex-tabagistas, e 22,5%, não fumantes. CONCLUSÃO -Corroboram-se as evidências de que o tabagismo seja fator de risco importante para o desenvolvimento de lúpus eritematoso cutâneo, com ou sem acometimento sistêmico, em indivíduos geneticamente predispostos. Palavras-chave: Doenças do colágeno; Lúpus eritematoso cutâneo; Lúpus eritematoso sistêmico; Tabagismo Abstract: -BACKGROUND -Lupus erythematosus is a chronic multifactorial auto-immune and

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Smoking and Immunity: an Additional Player in the Mosaic of Autoimmunity

Cited by 74 publications

References 32 publications

Prediction of post partum thyroid dysfunction: can it be improved?

Prediction of post partum thyroid dysfunction: can it be improved?

Hydroxychloroquine and smoking in patients with cutaneous lupus erythematosus

Associação entre lúpus eritematoso e tabagismo

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