ArticleArthritis & rheumatology (Hoboken, N.J.)2019
Complex Relationships of Smoking, HLA-DRB1 Genes, and Serologic Profiles in Patients With Early Rheumatoid Arthritis: Update From a Swedish Population-Based Case-Control Study.
Article in Arthritis & rheumatology (Hoboken, N.J.), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 5 of them syntheses that pooled it.
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Who cites it
38 citing papers in PubMed, 5 syntheses or guidelines pooled it, 63 citations in OpenAlex.
- Causal risk and protective factors for rheumatoid arthritis: a comprehensive mendelian randomization systematic review and meta-analysis.Frontiers in genetics · 2026Pooled it
- Meta-analysis identifies the major impact of patient classification on the ACPA association with rheumatoid arthritis-associated interstitial lung disease (RA-ILD).Arthritis research & therapy · 2025Pooled it
- Assessment of anti-malondialdehyde-acetaldehyde antibody frequencies in rheumatoid arthritis with new data from two independent cohorts, meta-analysis, and meta-regression.Arthritis research & therapy · 2023Pooled it
- Determining in which pre-arthritis stage HLA-shared epitope alleles and smoking exert their effect on the development of rheumatoid arthritis.Annals of the rheumatic diseases · 2022Pooled it
- A predominant involvement of the triple seropositive patients and others with rheumatoid factor in the association of smoking with rheumatoid arthritis.Scientific reports · 2020Pooled it
- Improved classification of rheumatoid arthritis with a score including anti-acetylated ornithine antibodies.Scientific reports · 2020Trial
- Mediterranean diet and remission in rheumatoid arthritis: findings from the EIRA study.EULAR rheumatology open · 2026Article
- Sex matters: mechanistic insights into sex-driven patterns of autoimmunity and implications for pharmacotherapy.Naunyn-Schmiedeberg's archives of pharmacology · 2026Review
- Diet, Lifestyle Factors, and Quality of Life in Patients with Rheumatic Diseases: A Cross-Sectional Study.Nutrients · 2025Article
- Smoking as a risk factor for rheumatoid arthritis: predominant association with IgA autoantibodies - comprehensive analysis of anti-modified protein antibodies with smoking and genetic risk factors in rheumatoid arthritis.Arthritis research & therapy · 2025Article
- Multidimensional bioinformatics perspective on smoking-linked driver genes and immune regulatory mechanisms in non-small cell lung cancer.Journal of translational medicine · 2025Article
- Causal Relationships Between Environmental Exposures, Iron Metabolism, Hematuria Markers, and Rheumatoid Arthritis: An Investigation Using Mendelian Randomization.Biomedicines · 2025Article
- Citrullinated peptides as drug candidates for rheumatoid arthritis.Frontiers in immunology · 2025Review
- The peculiar features, diversity and impact of citrulline-reactive autoantibodies.Nature reviews. Rheumatology · 2024Review
- The Lung in Rheumatoid Arthritis-Friend or Enemy?International journal of molecular sciences · 2024Review
- Rheumatoid arthritis epidemiology: a nationwide study in Poland.Rheumatology international · 2024Article
- Untangling the relationship between smoking and systemic sclerosis: an analysis of the EUSTAR cohort.RMD open · 2024Article
- Article
- The Causal Relationship between Immune-Mediated Inflammatory Diseases and Aortic Aneurysm: A Bidirectional Two-Sample Mendelian Randomization Study.Journal of immunology research · 2024Article
- Smoking is a Risk Factor for Autoimmune Hepatitis: An English Registry-Based Case-Control Study.Clinical epidemiology · 2024Article
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Authors and funding
4 authors at 3 institutions in 1 country.
Funding
Abstract
objectiveSmoking is associated with an increased risk of rheumatoid arthritis (RA) in subsets of patients defined according to the presence or absence of anti-citrullinated protein antibodies (ACPAs) and rheumatoid factors (RFs). Moreover, an interaction between smoking and the HLA-DRB1 shared epitope (SE) has been demonstrated to be a risk factor for seropositive RA. The aim of this study was to investigate the interplay between smoking and the HLA-DRB1 SE with regard to risk of RA in different patient subsets based on ACPA and RF status.
methodsIncident cases of RA (3,645 cases, 5,883 matched controls) were divided into 4 subgroups based on the presence or absence of RF and anti-cyclic citrullinated peptide 2 (anti-CCP2) antibodies. The influence of smoking on the risk of disease was determined in each RA subgroup, using logistic regression models with calculation of odds ratios and 95% confidence intervals (95% CIs). The potential interaction between smoking and HLA-DRB1 SE genes was evaluated by calculating the attributable proportion due to interaction (AP).
resultsIn the RF+/anti-CCP2+ subset of RA patients, both smoking and the presence of the HLA-DRB1 SE conferred independent disease risks, and there was a strong interaction between the 2 risk factors (AP 0.4, 95% CI 0.3, 0.5). In the RF-/anti-CCP2+ patient subset, the HLA-DRB1 SE conferred an increased risk of RA, whereas the independent influence of smoking was limited. However, there was a significant interaction between the HLA-DRB1 SE and smoking (AP 0.2, 95% CI 0.02, 0.5). In the RF+/anti-CCP2- patient subset, there was an increased risk of disease among smokers, which was only marginally affected by the presence of the HLA-DRB1 SE, and no interaction between the 2 factors was observed (AP 0.002, 95% CI -0.3, 0.3). In the RF-/anti-CCP2- patient subset, neither smoking nor the presence of the HLA-DRB1 SE conferred an increased risk of RA.
conclusionThese findings demonstrate different effects of smoking and HLA-DRB1 in the 4 serologically defined RA subsets.
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