December 29, 2005
View Full PaperA new model for an etiology of rheumatoid arthritis: Smoking may trigger HLA–DR (shared epitope)–restricted immune reactions to autoantigens modified by citrullination
Structured PICO
Does smoking trigger RA-specific immune reactions to citrullinated proteins in the context of HLA-DR SE genes?
P
Population
Subset of rheumatoid arthritis (RA)
I
Intervention
Smoking (environmental exposure)
O
Outcome
RA-specific immune reactions to citrullinated proteinssurrogate
Smoking is identified as an environmental trigger for specific autoimmunity in a genetically susceptible subset of rheumatoid arthritis patients.
Abstract
We identified an environmental factor, smoking, that in the context of HLA-DR SE genes may trigger RA-specific immune reactions to citrullinated proteins. These data thus suggest an etiology involving a specific genotype, an environmental provocation, and the induction of specific autoimmunity, all restricted to a distinct subset of RA.