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Arthritis Res Ther. 2009;11(4):238. doi: 10.1186/ar2751. Epub 2009 Aug 3.

Rheumatoid arthritis and smoking: putting the pieces together.

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1
Department of Genetics, Cell and Immunobiology, Semmelweis University, Nagyvárad tér 4, Budapest, Hungary. zsuzsannabaka@gmail.com

Abstract

Besides atherosclerosis and lung cancer, smoking is considered to play a major role in the pathogenesis of autoimmune diseases. It has long been known that there is a connection between rheumatoid factor-positive rheumatoid arthritis and cigarette smoking. Recently, an important gene-environment interaction has been revealed; that is, carrying specific HLA-DRB1 alleles encoding the shared epitope and smoking establish a significant risk for anti-citrullinated protein antibody-positive rheumatoid arthritis. We summarize how smoking-related alteration of the cytokine balance, the increased risk of infections (the possibility of cross-reactivity) and modifications of autoantigens by citrullination may contribute to the development of rheumatoid arthritis.

PMID:
19678909
PMCID:
PMC2745780
DOI:
10.1186/ar2751
[Indexed for MEDLINE]
Free PMC Article
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