Spondyloarthritis and smoking: towards a new insight into the disease

Abstract

In spondyloarthritis, smoking was found in several studies from the literature to be associated with earlier onset, more severe disease in activity, function, quality of life and imaging (inflammatory and structural lesions), sometimes in a dose-dependent manner. Smoking is also associated with elevated inflammatory biologic parameters (e.g., C-reactive protein). Periodontitis, associated with smoking, is more frequent in patients with ankylosing spondylitis as compared with controls. This periodontal disease may favor citrullination, as in rheumatoid arthritis. Citrullinated vimentin has been demonstrated to be associated with radiographic damage. In this line, smoking was found to be associated with matrix metalloproteinase levels, which is also a predictive factor for spinal radiographic progression. Finally, smoking has a negative influence on bronchopulmonary and cardiovascular outcomes, already impaired by the disease itself. Smoking represents a target for therapeutic impact and disease modification in spondyloarthritis.

Keywords::

• ankylosing spondylitis
• ASDAS
• BASDAI
• BASFI
• BASRI
• disease activity
• mSASSS
• outcome
• periodontitis
• radiographic progression
• smoking
• spondyloarthritis
• tobacco

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.