Cigarette smoking and the risk of systemic lupus erythematosus, overall and by anti-double stranded DNA antibody subtype, in the Nurses’ Health Study cohorts

摘要: Objectives Systemic lupus erythematosus (SLE) is a heterogeneous autoimmune disease, subtyped according to clinical manifestations and autoantibodies. Evidence concerning cigarette smoking SLE risk has been conflicting. We investigated risk, overall by anti-double stranded DNA (dsDNA) presence, in two prospective cohort studies. Methods The Nurses’ Health Study (NHS) enrolled 121 701 US female nurses 1976; II (NHSII) 116 430 1989. Lifestyle, environmental medical data were collected through biennial questionnaires. Incident was confirmed record review. Cox regression models estimated HRs of SLE, dsDNA subtype, association with time-varying status cumulative pack-years the 2-year cycle prior diagnosis, controlling for potential confounders. Results Among 286 cases identified (159 NHS (1978–2012) 127 NHSII (1991–2013)), mean age 49.2 (10.3) years 42% dsDNA+ at SLE diagnosis. At baseline, 45% women had ever smoked, 51% whom currently smoked. Compared never smokers, current smokers increased SLE risk (HR 1.86 (1.14–3.04)), whereas past did not 1.31 (0.85–2.00)). Women who smoked >10 (vs never) an elevated 1.60(95% CI 1.04 2.45)) compared smokers. No associations observed between or dsDNA− SLE. Conclusion Strong specific observed. This novel finding suggests involved SLE pathogenesis.