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Cadmium the missing link between smoking and increased rheumatoid disease activity?
  1. Matthew Cates,
  2. David Hutchinson
  1. Treliske Hospital, Cornwall, UK
  1. Correspondence to Dr David Hutchinson, Royal Cornwall Hospital, Rheumatology Department, Truro, Cornwall, UK; david.hutchinson@rcht.cornwall.nhs.uk

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Ospelt et al1 have observed a number of important and interesting observations in their paper “Smoking induces transcription of the heat shock protein system in the joints”. It was observed that when synovial fibroblasts were incubated with 5% cigarette smoke extract there was a significant upregulation of the heat shock proteins DnaJA4, DnaJB4, DnaJC6, HspB8 and Hsp70. This important scientific work follows on from the overwhelming epidemiological evidence that smoking is associated with rheumatoid arthritis (RA). A meta-analysis of seven case control and …

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