Smoking, environment, occupation!

*It is only for medical professionals to read for reference.
Smoking is "cool" for a while, RA "crematorium"; early diagnosis and treatment, good health and life
.

 From September 17 to 19, 2021, the 13th "International Forum on Rheumatoid Arthritis (IFRA)" was grandly held in Beijing.
Lars from Karolinska Institutet, Stockholm, Sweden Professor Klareskog shared the important regulatory role of environment and life>Figure 1 How did Professor Lars Klareskog give a lecture on RA? Environment and habits are the key! RA is a common inflammatory autoimmune disease.
In the world, about one in every 100 adults will suffer from this disease
.

RA is characterized by synovitis in the small and large joints, and the immune system attacks the joint tissues, looking for pathogenic citrullinated peptides that cause synovitis, which leads to RA
.

The chronic inflammation of RA causes the synovium to thicken, and the joints become swollen and swollen.
If not treated in time, it may lead to the destruction of cartilage and bones, leading to severe disability
.

It is a multi-factor and heterogeneous disease.
Many studies have shown that environmental factors play an important role in the etiology of the disease.
For some genetically susceptible individuals, environmental factors can induce pathological activation of the immune system.
Eventually lead to the clinical onset of RA [1]
.

Professor Lars Klareskog believes that the occurrence and treatment results of RA depend on the influence of various factors such as drugs, time, life>
.

Figure 2 The curative effect of RA depends on a variety of factors.
Smoking for a while, RA "crematorium" smoking is the most certain environmental risk factor for the development of RA [2]
.

It is estimated that smoking accounts for about 20%-30% of the environmental risk of RA
.

In addition, studies have found that smoking has the strongest correlation with anti-cyclic citrullinated peptide antibody (ACPA) positive RA.
At the same time, regardless of the occurrence of RA, smoking has always been associated with the presence of rheumatoid factor
.

This indicates that there may be biological interactions between these factors, thereby promoting the development of RA, or at least triggering RA-related autoimmunity [3]
.

Professor Lars Klareskog found that about one-third of ACPA-positive RA cases seem to be caused by smoking.
If you do not smoke, more than 20% of RA cases can be prevented [4]
.

Career selection is not good, health secretly runs away in this era of gradual work model "007", adult's life seems to be gradually occupied by work, and occupation has become a focal issue
.

What is even more unexpected is that some jobs can greatly increase the risk of RA
.

More than half a century ago, doctors first noticed that there is a significant association between silicosis of miners caused by excessive inhalation of silica powder and RA [5].
Silica particles can activate the innate immune system and promote pro-inflammatory cells.
The generation of factors [6]
.

A case-control study in Malaysia found that occupational exposure to textile dust is associated with an increased risk of RA in women[7], and studies have shown that certain agricultural pesticides may increase the risk of RA for farmers and their families[8]
.

Professor Lars Klareskog’s research also found that working in a cold environment is associated with an increased risk of ACPA-positive and ACPA-negative RA, and there is a dose-response relationship between the two [9]
.

Figure 3 Risk identification system for the dose-response relationship between working in a cold environment and the occurrence of RA, early diagnosis and treatment of good health Figure 4 A series of symptoms and signs before the occurrence of RA After the RA-related risk factors are clarified, the prevention and early stage of RA Diagnosis and early treatment are crucial
.

Professor Lars Klareskog believes that before the occurrence of RA, there will be long-term immune response, joint pain and fatigue.
Among them, 30%-40% of high-risk groups will develop RA within 2 years.
Ultrasound examination suggests that tenosynovitis is a strong predictor of RA.
Factors
.

Professor Lars Klareskog said that they are developing patient-centered, early identification of RA risk individuals, supplemented by multiple diagnosis and self-monitoring tools, mainly following the following design concepts and scientific basis: (i) In the first few episodes of joint inflammation Begin to grasp the dynamics of RA-related autoimmunity; (ii) In-depth understanding of how to trigger RA-related immune responses on the mucosal surface after induction by different environmental factors; (iii) Determine which immune features may cause the pre-symptoms of joint inflammation, And predict the risk of impending arthritis; (iv) Explore the molecular mechanism before inflammation, and look for specific and advanced targeted therapies [10]
.

Reference: [1]Pradeepkiran JA.
Insights of rheumatoid arthritis risk factors and associations.
J Transl Autoimmun.
2019;2:100012.
Published 2019 Aug 20.
doi:10.
1016/j.
jtauto.
2019.
100012[2]Klareskog L,Padyukov L ,Lorentzen J,Alfredsson L.
Mechanisms of disease:Genetic susceptibility and environmental triggers in the development of rheumatoid arthritis.
Nat Clin Pract Rheumatol.
2006;2(8):425-433.
doi:10.
1038/ncprheum0249[3]Söderlin MK, Andersson M, Bergman S; BARFOT study group.
Second-hand exposure to tobacco smoke and its effect on disease activity in Swedish rheumatoid arthritis patients.
Data from BARFOT, a multicenter study of RA.
Clin Exp Rheumatol.
2013;31(1): 122-124.
[4]Källberg H,Ding B,Padyukov L,et al.
Smoking is a major preventable risk factor for rheumatoid arthritis:estimations of risks after various exposures to cigarette smoke.
Ann Rheum Dis.
2011;70(3) :508-511.
doi:10.
1136/ard.
2009.
120899[5]Yahya A,Bengtsson C,Larsson P,et al(2014)Silica exposure is associated with an increased risk of developing ACPA-positive rheumatoid arthritis in an Asian population:evidence from the Malaysian MyEIRA case-control study.
Mod Rheumatol.
24(2)[6]Pollard KM.
Silica,Silicosis,and Autoimmunity.
Front Immunol.
2016;7:97.
Published 2016 Mar 11.
doi:10.
3389/fimmu.
2016.
00097[ 7]Too CL,Muhamad NA,Ilar A,et al.
Occupational exposure to textile dust increases the risk of rheumatoid arthritis:results from a Malaysian population-based case-control study.
Ann Rheum Dis.
2016;75(6):997 -1002.
doi:10.
1136/annrheumdis-2015-208278[8]Parks CG,Hoppin JA,De Roos AJ,Costenbader KH,Alavanja MC,Sandler DP.
Rheumatoid Arthritis in Agricultural Health Study Spouses:Associations with Pesticides and Other Farm Exposures.
Environ Health Perspect.
2016;124(11):1728-1734.
doi:10.
1289/EHP129[9]Zeng P,Bengtsson C,Klareskog L,Alfredsson L.
Working in cold environment and risk of developing rheumatoid arthritis:results from the Swedish EIRA case-control study.
RMD Open.
2017;3(2):e000488.
Published 2017 Aug 16.
doi:10.
1136/rmdopen-2017-000488[10]Hensvold A,Klareskog L.
Towards prevention of autoimmune diseases:The example of rheumatoid arthritis.
Eur J Immunol .
2021;51(8):1921-1933.
doi:10.
1002/eji.
202048952 Source of this article: Medical Rheumatism Channel Author: Fan Zhihua Review of this article: Chen Xinpeng Deputy Chief Physician Editor: Cassette Copyright Statement -End-The medical community strives for the accuracy and reliability of its published content when it is reviewed and approved, but does not make any promises or guarantees on the timeliness of the published content, and the accuracy and completeness of the cited information (if any), nor does it make any promises or guarantees.
Take any responsibility for the fact that the content is out of date, the cited information may be inaccurate or incomplete, etc.
Published 2017 Aug 16.
doi:10.
1136/rmdopen-2017-000488[10]Hensvold A,Klareskog L.
Towards prevention of autoimmune diseases:The example of rheumatoid arthritis.
Eur J Immunol.
2021;51(8):1921-1933.
doi:10.
1002/eji.
202048952 Source of this article: Medical Rheumatism Channel Author: Fan Zhihua Review of this article: Chen Xinpeng, Deputy Chief Physician Responsible Editor: Cassette Copyright Statement The timeliness is accurate and reliable, but it does not make any promises or guarantees on the timeliness of the published content, as well as the accuracy and completeness of the cited materials (if any), and does not assume that the content may be outdated and the cited materials may be outdated.
Any liability arising from the inaccuracy or incompleteness ofPublished 2017 Aug 16.
doi:10.
1136/rmdopen-2017-000488[10]Hensvold A,Klareskog L.
Towards prevention of autoimmune diseases:The example of rheumatoid arthritis.
Eur J Immunol.
2021;51(8):1921-1933.
doi:10.
1002/eji.
202048952 Source of this article: Medical Rheumatism Channel Author: Fan Zhihua Review of this article: Chen Xinpeng, Deputy Chief Physician Responsible Editor: Cassette Copyright Statement The timeliness is accurate and reliable, but it does not make any promises or guarantees on the timeliness of the published content, as well as the accuracy and completeness of the quoted materials (if any), and does not assume that the contents may be outdated and the quoted materials may be outdated.
Any liability arising from the inaccuracy or incompleteness of
.

Relevant parties are requested to check separately when adopting or using this as a basis for decision-making
.