Vittecoq Olivier, Lequerré Thierry, Goëb Vincent, Le Loët Xavier, Abdesselam Tassadit Ait, Klemmer Nathalie
Department of Rheumatology, Rouen University Hospital & Inserm U905, Rouen, France.
Best Pract Res Clin Rheumatol. 2008 Oct;22(5):923-35. doi: 10.1016/j.berh.2008.09.011.
Smoking has an impact on the development and outcome of rheumatoid arthritis (RA) and lupus. In RA, smoking is associated with the development of the anti-cyclic citrullinated peptide (CCP2)-positive subset. This risk is increased in heavy smokers carrying at least one copy of the HLA DRB1 shared epitope (SE) alleles. Whereas this interaction between smoking and SE relevant in northern Europe, discrepant results have been observed in other geographic locations, suggesting the involvement of other environmental stimuli and/or gene polymorphisms. There is no interaction between tobacco exposure and PTPN22 1858T for the development of anti-CCP-positive or anti-CCP-negative RA. A strong association exists between smoking and the occurrence of extra-articular manifestations (subcutaneous nodules and cardiovascular events), but smoking has no influence on radiographic outcome. In lupus, tobacco exposure has an impact on the production of anti-double-stranded Desoxyribonuclic (dsDNA) and possibly on the development of the disease, as well as on disease activity/severity. In both diseases, smoking might interfere with drug efficacy.
吸烟对类风湿关节炎（RA）和狼疮的发展及预后有影响。在类风湿关节炎中，吸烟与抗环瓜氨酸肽（CCP2）阳性亚群的发展有关。携带至少一份HLA DRB1共享表位（SE）等位基因的重度吸烟者，这种风险会增加。虽然吸烟与SE之间的这种相互作用在北欧具有相关性，但在其他地理位置观察到了不一致的结果，这表明还涉及其他环境刺激和/或基因多态性。对于抗CCP阳性或抗CCP阴性类风湿关节炎的发展，烟草暴露与PTPN22 1858T之间不存在相互作用。吸烟与关节外表现（皮下结节和心血管事件）的发生密切相关，但吸烟对影像学结果没有影响。在狼疮中，烟草暴露对抗双链脱氧核糖核酸（dsDNA）的产生有影响，可能对疾病的发展以及疾病活动度/严重程度也有影响。在这两种疾病中，吸烟可能会干扰药物疗效。
