EXTENDED REPORT

Association of smoking with dsDNA autoantibody production in systemic lupus erythematosus

M M Freemer¹, T E King, Jr¹, L A Criswell²

¹ Department of Medicine, Division of Pulmonary and Critical Care Medicine, San Francisco General Hospital, University of California, San Francisco, CA, USA
² Rosalind Russell Medical Research Center for Arthritis, Department of Medicine, University of California, San Francisco, CA, USA

Correspondence to:
Dr L A Criswell
374 Parnassus Avenue, Box 0500, University of California, San Francisco, San Francisco, CA 94143-0500, USA; Lindsey.Criswella{at}ucsf.edu

Objective: To determine whether exposure to tobacco smoke is associated with double stranded DNA (dsDNA) seropositivity in patients with systemic lupus erythematosus (SLE).

Methods: Medical record review was used to confirm the diagnosis of SLE and evaluate dsDNA antibody status. Smoking status at the time of autoantibody testing was assessed by patients’ questionnaire responses. Multivariate regression analysis was used to determine whether exposure to tobacco smoke is associated with dsDNA seropositivity, while controlling for sex and age at SLE diagnosis.

Results: A significantly higher risk of dsDNA seropositivity in current smokers than never smokers (odds ratio (OR) = 4.0, 95% confidence interval (CI) 1.6 to 10.4) was shown by multivariate analysis. Current smokers were found to be at higher risk for dsDNA seropositivity than former smokers (OR = 3.0, 95% CI 1.3 to 7.1). The association between current smoking and dsDNA seropositivity remained significant after adjustment for sex, age at SLE diagnosis, amount smoked, age when smoking began, and the duration of smoking cessation (for former smokers).

Conclusion: The association of smoking with dsDNA seropositivity provides insight into the potential mechanisms underlying autoantibody formation. This information may also serve as a possible point of intervention to prevent disease or target treatment.

Abbreviations: CI, confidence interval; dsDNA, double stranded DNA; OR, odds ratio; ROS, reactive oxidative species; SLE, systemic lupus erythematosus; UCSF, University of California, San Francisco

Keywords: dsDNA; autoantibody production; smoking; systemic lupus erythematosus

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