Association of the shared epitope, smoking and the interaction between the two with the presence of autoantibodies (anti-CCP and RF) in patients with rheumatoid arthritis in a hospital in Seville, Spain

• Published in: Reumatología clinica (Barcelona) 2019-09, Vol.15 (5), p.289-295
• Main Authors: García de Veas Silva, José Luis, González Rodríguez, Concepción, Hernández Cruz, Blanca
• Format: Article
• Language: English
• Subjects: Anticuerpos; Artritis reumatoide; Autoantibodies; Epítopo compartido; Rheumatoid arthritis; Shared epitope; Smoking; Tabaquismo
• ISSN: 2173-5743; 2173-5743
• DOI: 10.1016/j.reumae.2017.08.010

To evaluate the association of shared epitope, smoking and their interaction on the presence of autoantibodies (anti-cyclic citrullinated peptide [CCP] antibodies and rheumatoid factor) in patients with rheumatoid arthritis in our geographical area. A descriptive and cross-sectional study was carried out in a cohort of 106 patients diagnosed with RA. Odds ratios (OR) for antibody development were calculated for shared epitope, tobacco exposure and smoking dose. Statistical analysis was performed with univariate and multivariate statistics using ordinal logistic regression. Odds ratios were calculated with 95% confidence interval (95% CI) and a value of P20packs/year) (OR=8.93; 95% CI: 1.95–40.82) were associated with the presence of anti-CCP antibodies. For rheumatoid factor, the association was only significant for tobacco exposure (OR=3.89; 95% CI: 1.06–14.28) and smoking dose (OR=8.33; 95% CI: 1.05–66.22). By ordinal logistic regression analysis, an association with high titres of anti-CCP (>200U/mL) was identified with South American mestizos, patients with homozygous shared epitope, positive FR and heavy smokers. Being a South American mestizo, having a shared epitope, rheumatoid factor positivity and a smoking dose >20packs/year are independent risk factors for the development of rheumatoid arthritis with a high titre of anti-CCP (>200U/mL). In shared epitope-positive rheumatoid arthritis patients, the intensity of smoking is more strongly associated than tobacco exposure with an increased risk of positive anti-CCP. Evaluar la asociación del epítopo compartido, el tabaquismo y la interacción entre ambos sobre la presencia de autoanticuerpos (antipéptidos cíclicos citrulinados [anti-PCC] y factor reumatoide) en pacientes con artritis reumatoide en nuestra área geográfica. Estudio descriptivo y transversal realizado en una cohorte de 106 pacientes diagnosticados de artritis reumatoide. Análisis estadístico univariante y multivariante mediante regresión logística ordinal. Se calcularon odds ratios (OR) con un intervalo de confianza del 95% [IC95%] y se considero significativo un valor de p20 paquetes/año) (OR=8,