Home » Rheumatic diseases, new clues to the influence of smoke and pollution

Rheumatic diseases, new clues to the influence of smoke and pollution

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The congress dedicated to rheumatological diseases Eular 2021, in virtual mode, has just ended. Among the many interventions presented there were some that concerned the possible impact of exposure to pollutants on rheumatological diseases, both those more strictly environmental and those related to smoking. In both cases, there were already indications of their possible involvement in rheumatological diseases, and the two studies presented to Eular point in the same direction, albeit concerning different aspects.

On the one hand, in fact, we look at the possible role of passive smoking in the onset of diseases, on the other at what environmental pollutants could have on the effectiveness of therapies. The first of the two studies in question is that of a team of French researchers who analyzed the data of almost 80 thousand women followed for several years, recording habits (such as exposure to passive smoking, both as children and adults) and incidence of rheumatoid arthritis. Smoking is already known to be a risk factor for rheumatoid arthritis, especially in certain subtypes of patients, experts recall. What about secondhand smoke? By comparing data on exposure and disease onset, both secondhand smoke to which children were exposed and that experienced as adults were generally associated with an increased risk of rheumatoid arthritis, especially, writes the French team, among women. who had never smoked. The link between smoking and rheumatic diseases would therefore seem complex.

On the other hand, an Italian study is paired with the French one, which instead tried to understand if the change of therapy with biological drugs (both within the same category and with others of completely different mechanism), due to the progression of the disease, was in some way related to pollution. If you need to change therapy because it is no longer effective, does the environment have anything to do with it? In this case, various rheumatological diseases were analyzed, on a sample of over 1200 patients (with rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis). The data of these patients were crossed with those of the pollution of the area, with particular attention to those of the month or two months preceding a possible change of therapy. The main results that emerged from this study were two: on the one hand, a higher level of pollutants (PM10) was associated with a higher level of inflammation, tested by measuring the levels of C-reactive protein. On the other hand, the Italian team writes, the levels of pollutants (not only PM10 but also PM 2.5 nitrogen oxides and carbon monoxide, for example) were higher before a change of therapy due to lack of efficacy of the one in progress.

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In both cases we are talking about associations, but they add to the already known negative effects of smoking and pollution on health.

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