Effect of Tobacco Smoking on The Clinical, Histopathological, and Serological Manifestations of Sjögren's Syndrome

Donald U. Stone, Dustin Fife, Michael Brown, Keith E. Earley, Lida Radfar, C. Erick Kaufman, David M. Lewis, Nelson L. Rhodus, Barbara M. Segal, Daniel J. Wallace, Michael H. Weisman, Swamy Venuturupalli, Michael T. Brennan, Christopher J. Lessard, Courtney G. Montgomery, R. Hal Scofield, Kathy L. Sivils, Astrid Rasmussen

Research output: Contribution to journalArticle

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Abstract

OBJECTIVES: To assess the association of smoking habits with the clinical, serological, and histopathological manifestations of Sjögren's syndrome (SS) and non-Sjögren's sicca (non-SS sicca).

METHODS: Cross-sectional case-control study of 1288 patients with sicca symptoms (587 SS and 701 non-SS sicca) evaluated in a multi-disciplinary research clinic. Smoking patterns were obtained from questionnaire data and disease-related clinical and laboratory data were compared between current, past, ever, and never smokers.

RESULTS: Current smoking rates were 4.6% for SS patients compared to 14.1% in non-SS sicca (p = 5.17x10E-09), 18% in a local lupus cohort (p = 1.13x10E-14) and 16.8% in the community (p = 4.12x10E-15). Current smoking was protective against SS classification (OR 0.35, 95%CI 0.22-0.56, FDR q = 1.9E10-05), focal lymphocytic sialadenitis (OR 0.26, 95%CI 0.15-0.44, FDR q = 1.52x10E-06), focus score ≥1 (OR 0.22, 95%CI 0.13-0.39, FDR q = 1.43x10E-07), and anti-Ro/SSA(+) (OR 0.36, 95%CI 0.2-0.64, FDR q = 0.0009); ever smoking was protective against the same features and against anti-La/SSB(+) (OR 0.52, 95%CI 0.39-0.70, FDR q = 5.82x10E-05). Duration of smoking was inversely correlated with SS even after controlling for socioeconomic status, BMI, alcohol and caffeine consumption.

CONCLUSIONS: Current tobacco smoking is negatively and independently associated with SS, protecting against disease-associated humoral and cellular autoimmunity. The overall smoking rate amongst SS patients is significantly lower than in matched populations and the effects of smoking are proportional to exposure duration. In spite of the protective effects of tobacco on SS manifestations, it is associated with other serious comorbidities such as lung disease, cardiovascular risk and malignancy, and should thus be strongly discouraged in patients with sicca.

Original languageEnglish (US)
Pages (from-to)e0170249
JournalPloS one
Volume12
Issue number2
DOIs
StatePublished - Jan 1 2017

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smoking (habit)
Tobacco
Smoking
Pulmonary diseases
Caffeine
Alcohols
autoimmunity
socioeconomic status
caffeine
case-control studies
respiratory tract diseases
signs and symptoms (animals and humans)
exposure duration
protective effect
tobacco
questionnaires
alcohols
Sialadenitis
duration
Autoimmunity

Cite this

Stone, D. U., Fife, D., Brown, M., Earley, K. E., Radfar, L., Kaufman, C. E., ... Rasmussen, A. (2017). Effect of Tobacco Smoking on The Clinical, Histopathological, and Serological Manifestations of Sjögren's Syndrome. PloS one, 12(2), e0170249. https://doi.org/10.1371/journal.pone.0170249

Effect of Tobacco Smoking on The Clinical, Histopathological, and Serological Manifestations of Sjögren's Syndrome. / Stone, Donald U.; Fife, Dustin; Brown, Michael; Earley, Keith E.; Radfar, Lida; Kaufman, C. Erick; Lewis, David M.; Rhodus, Nelson L.; Segal, Barbara M.; Wallace, Daniel J.; Weisman, Michael H.; Venuturupalli, Swamy; Brennan, Michael T.; Lessard, Christopher J.; Montgomery, Courtney G.; Scofield, R. Hal; Sivils, Kathy L.; Rasmussen, Astrid.

In: PloS one, Vol. 12, No. 2, 01.01.2017, p. e0170249.

Research output: Contribution to journalArticle

Stone, DU, Fife, D, Brown, M, Earley, KE, Radfar, L, Kaufman, CE, Lewis, DM, Rhodus, NL, Segal, BM, Wallace, DJ, Weisman, MH, Venuturupalli, S, Brennan, MT, Lessard, CJ, Montgomery, CG, Scofield, RH, Sivils, KL & Rasmussen, A 2017, 'Effect of Tobacco Smoking on The Clinical, Histopathological, and Serological Manifestations of Sjögren's Syndrome', PloS one, vol. 12, no. 2, pp. e0170249. https://doi.org/10.1371/journal.pone.0170249
Stone, Donald U. ; Fife, Dustin ; Brown, Michael ; Earley, Keith E. ; Radfar, Lida ; Kaufman, C. Erick ; Lewis, David M. ; Rhodus, Nelson L. ; Segal, Barbara M. ; Wallace, Daniel J. ; Weisman, Michael H. ; Venuturupalli, Swamy ; Brennan, Michael T. ; Lessard, Christopher J. ; Montgomery, Courtney G. ; Scofield, R. Hal ; Sivils, Kathy L. ; Rasmussen, Astrid. / Effect of Tobacco Smoking on The Clinical, Histopathological, and Serological Manifestations of Sjögren's Syndrome. In: PloS one. 2017 ; Vol. 12, No. 2. pp. e0170249.
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abstract = "OBJECTIVES: To assess the association of smoking habits with the clinical, serological, and histopathological manifestations of Sj{\"o}gren's syndrome (SS) and non-Sj{\"o}gren's sicca (non-SS sicca).METHODS: Cross-sectional case-control study of 1288 patients with sicca symptoms (587 SS and 701 non-SS sicca) evaluated in a multi-disciplinary research clinic. Smoking patterns were obtained from questionnaire data and disease-related clinical and laboratory data were compared between current, past, ever, and never smokers.RESULTS: Current smoking rates were 4.6{\%} for SS patients compared to 14.1{\%} in non-SS sicca (p = 5.17x10E-09), 18{\%} in a local lupus cohort (p = 1.13x10E-14) and 16.8{\%} in the community (p = 4.12x10E-15). Current smoking was protective against SS classification (OR 0.35, 95{\%}CI 0.22-0.56, FDR q = 1.9E10-05), focal lymphocytic sialadenitis (OR 0.26, 95{\%}CI 0.15-0.44, FDR q = 1.52x10E-06), focus score ≥1 (OR 0.22, 95{\%}CI 0.13-0.39, FDR q = 1.43x10E-07), and anti-Ro/SSA(+) (OR 0.36, 95{\%}CI 0.2-0.64, FDR q = 0.0009); ever smoking was protective against the same features and against anti-La/SSB(+) (OR 0.52, 95{\%}CI 0.39-0.70, FDR q = 5.82x10E-05). Duration of smoking was inversely correlated with SS even after controlling for socioeconomic status, BMI, alcohol and caffeine consumption.CONCLUSIONS: Current tobacco smoking is negatively and independently associated with SS, protecting against disease-associated humoral and cellular autoimmunity. The overall smoking rate amongst SS patients is significantly lower than in matched populations and the effects of smoking are proportional to exposure duration. In spite of the protective effects of tobacco on SS manifestations, it is associated with other serious comorbidities such as lung disease, cardiovascular risk and malignancy, and should thus be strongly discouraged in patients with sicca.",
author = "Stone, {Donald U.} and Dustin Fife and Michael Brown and Earley, {Keith E.} and Lida Radfar and Kaufman, {C. Erick} and Lewis, {David M.} and Rhodus, {Nelson L.} and Segal, {Barbara M.} and Wallace, {Daniel J.} and Weisman, {Michael H.} and Swamy Venuturupalli and Brennan, {Michael T.} and Lessard, {Christopher J.} and Montgomery, {Courtney G.} and Scofield, {R. Hal} and Sivils, {Kathy L.} and Astrid Rasmussen",
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T1 - Effect of Tobacco Smoking on The Clinical, Histopathological, and Serological Manifestations of Sjögren's Syndrome

AU - Stone, Donald U.

AU - Fife, Dustin

AU - Brown, Michael

AU - Earley, Keith E.

AU - Radfar, Lida

AU - Kaufman, C. Erick

AU - Lewis, David M.

AU - Rhodus, Nelson L.

AU - Segal, Barbara M.

AU - Wallace, Daniel J.

AU - Weisman, Michael H.

AU - Venuturupalli, Swamy

AU - Brennan, Michael T.

AU - Lessard, Christopher J.

AU - Montgomery, Courtney G.

AU - Scofield, R. Hal

AU - Sivils, Kathy L.

AU - Rasmussen, Astrid

PY - 2017/1/1

Y1 - 2017/1/1

N2 - OBJECTIVES: To assess the association of smoking habits with the clinical, serological, and histopathological manifestations of Sjögren's syndrome (SS) and non-Sjögren's sicca (non-SS sicca).METHODS: Cross-sectional case-control study of 1288 patients with sicca symptoms (587 SS and 701 non-SS sicca) evaluated in a multi-disciplinary research clinic. Smoking patterns were obtained from questionnaire data and disease-related clinical and laboratory data were compared between current, past, ever, and never smokers.RESULTS: Current smoking rates were 4.6% for SS patients compared to 14.1% in non-SS sicca (p = 5.17x10E-09), 18% in a local lupus cohort (p = 1.13x10E-14) and 16.8% in the community (p = 4.12x10E-15). Current smoking was protective against SS classification (OR 0.35, 95%CI 0.22-0.56, FDR q = 1.9E10-05), focal lymphocytic sialadenitis (OR 0.26, 95%CI 0.15-0.44, FDR q = 1.52x10E-06), focus score ≥1 (OR 0.22, 95%CI 0.13-0.39, FDR q = 1.43x10E-07), and anti-Ro/SSA(+) (OR 0.36, 95%CI 0.2-0.64, FDR q = 0.0009); ever smoking was protective against the same features and against anti-La/SSB(+) (OR 0.52, 95%CI 0.39-0.70, FDR q = 5.82x10E-05). Duration of smoking was inversely correlated with SS even after controlling for socioeconomic status, BMI, alcohol and caffeine consumption.CONCLUSIONS: Current tobacco smoking is negatively and independently associated with SS, protecting against disease-associated humoral and cellular autoimmunity. The overall smoking rate amongst SS patients is significantly lower than in matched populations and the effects of smoking are proportional to exposure duration. In spite of the protective effects of tobacco on SS manifestations, it is associated with other serious comorbidities such as lung disease, cardiovascular risk and malignancy, and should thus be strongly discouraged in patients with sicca.

AB - OBJECTIVES: To assess the association of smoking habits with the clinical, serological, and histopathological manifestations of Sjögren's syndrome (SS) and non-Sjögren's sicca (non-SS sicca).METHODS: Cross-sectional case-control study of 1288 patients with sicca symptoms (587 SS and 701 non-SS sicca) evaluated in a multi-disciplinary research clinic. Smoking patterns were obtained from questionnaire data and disease-related clinical and laboratory data were compared between current, past, ever, and never smokers.RESULTS: Current smoking rates were 4.6% for SS patients compared to 14.1% in non-SS sicca (p = 5.17x10E-09), 18% in a local lupus cohort (p = 1.13x10E-14) and 16.8% in the community (p = 4.12x10E-15). Current smoking was protective against SS classification (OR 0.35, 95%CI 0.22-0.56, FDR q = 1.9E10-05), focal lymphocytic sialadenitis (OR 0.26, 95%CI 0.15-0.44, FDR q = 1.52x10E-06), focus score ≥1 (OR 0.22, 95%CI 0.13-0.39, FDR q = 1.43x10E-07), and anti-Ro/SSA(+) (OR 0.36, 95%CI 0.2-0.64, FDR q = 0.0009); ever smoking was protective against the same features and against anti-La/SSB(+) (OR 0.52, 95%CI 0.39-0.70, FDR q = 5.82x10E-05). Duration of smoking was inversely correlated with SS even after controlling for socioeconomic status, BMI, alcohol and caffeine consumption.CONCLUSIONS: Current tobacco smoking is negatively and independently associated with SS, protecting against disease-associated humoral and cellular autoimmunity. The overall smoking rate amongst SS patients is significantly lower than in matched populations and the effects of smoking are proportional to exposure duration. In spite of the protective effects of tobacco on SS manifestations, it is associated with other serious comorbidities such as lung disease, cardiovascular risk and malignancy, and should thus be strongly discouraged in patients with sicca.

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