https://doi.org/10.4081/reumatismo.2024.1572

The impact of nicotine smoking on spondyloarthritis and rheumatoid arthritis

Vol. 76 No. 2 (2024)
Submitted: 2 March 2023
Accepted: 18 March 2024
Published: 24 June 2024
Cigarette smoking, autoimmunity, spondyloarthritis, rheumatoid arthritis, pathophysiology, treatment
Abstract Views: 2661
PDF: 1058
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Authors

G. El Hasbani
george.hasbany@lau.edu
https://orcid.org/0000-0003-2571-1450
Department of Medicine, Hartford HealthCare St. Vincent’s Medical Center, Bridgeport, CT, United States.
J. E Nassar
https://orcid.org/0000-0002-2475-4996
Faculty of Medicine, American University of Beirut, Lebanon.
A.M. Elsayed Ali
https://orcid.org/0000-0002-1661-3018
Faculty of Medicine, American University of Beirut, Lebanon.
I. Uthman
https://orcid.org/0000-0001-8285-6483
Department of Internal Medicine, American University of Beirut Medical Center, Lebanon.
A. Jawad
Department of Rheumatology, Royal London Hospital, United Kingdom.

Objective. Nicotine has major side effects on human health through numerous mechanisms, one of which is the alteration of the immune system and its genetic components. Such alteration can be a predisposing factor for autoimmune diseases such as spondyloarthritis (SpA) and rheumatoid arthritis (RA). This review aims to shed light on the effects of nicotine smoking on the pathophysiology, clinical presentation, and management of SpA and RA.

Methods. This review looked into the studies, excluding case reports and series, which were cited by PubMed/MEDLINE.

Results. Patients with established autoimmune conditions may have a different underlying pathophysiology and disease course when exposed to nicotine through cigarette smoking. Through the involvement of several cytokines, endothelial dysfunction, and epigenetic mechanisms, the severity of SpA is more prominent in smokers. The global health status, pain, and fatigue are worse in SpA patients. The evidence on the effect of nicotine smoking on the treatment of SpA is still limited. Nicotine can contribute to RA via the disruption of cellular regulatory activity, inflammatory responses, morphological, physiological, biochemical, and enzymatic responses. As such, smokers with RA have higher disease activity and are more likely to be seropositive through the citrullination of peptides. In addition, these patients are at risk of achieving a suboptimal response to tumor necrosis factor inhibitors.

Conclusions. Cigarette smoking can substantially affect the pathophysiology and clinical presentation of patients with SpA and RA. The impact of nicotine on the management of these diseases still needs to be further studied.

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How to Cite

El Hasbani, G., E Nassar, J., Elsayed Ali, A., Uthman, I., & Jawad, A. (2024). The impact of nicotine smoking on spondyloarthritis and rheumatoid arthritis. Reumatismo, 76(2). https://doi.org/10.4081/reumatismo.2024.1572
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