World No-Tobacco Day: How Cigarette Smoking Increases The Risk Of Autoimmune Diseases

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World No-Tobacco Day: Cigarette smoking can increase the risk of several autoimmune diseases, including systemic lupus erythematosus, Graves’ hyperthyroidism, rheumatoid arthritis, and primary biliary cirrhosis, among others. Tobacco can interact with genetic and immunological factors, leading to autoimmune diseases, according to the US National Institutes of Health’s National Library of Medicine. For instance, smoking can trigger the formation of autoantibodies, which will may attack the body’s healthy cells.

Nicotine, which is present in tobacco, can trigger autoimmune diseases by researchers increasing the production of free radicals, which provoke DNA alterations, and lead to autoimmunity. 

How cigarette smoking leads to autoimmune diseases

According to experts, cigarette smoke triggers an inflammatory response, which starts in the lungs, and then spreads through the blood to different parts of the body. The toxic chemicals interact with immune cells, and trigger an abnormal immune response.

“The association between tobacco smoking and cancer, lung diseases and cardiovascular diseases is very well known and well established. However, the impact of smoking on the immune system and the development of autoimmune disorders is under-appreciated and under-recognised. Cigarette smoke has pro-inflammatory effects that trigger an inflammatory response. This starts in the lungs and then spreads through the blood to different parts of the body. The toxic chemicals present in cigarette smoke interact with various different types of immune cells, triggering off an abnormal immune response. This involves a myriad of cytokines (signalling molecules released by immune cells) and other biological molecules that regulate inflammation. This results in the formation of certain antibodies that attack the normal cells of the human body. These antibodies are called the autoantibodies and they result in the development of the various autoimmune disorders,” Dr Vivek Nangia, Principal Director & Head – Pulmonology, Max Super Speciality Hospital, Saket, told ABP Live.

He said that the common autoimmune diseases associated with smoking are rheumatoid arthritis, systemic lupus erythematosus, inflammatory bowel disease, spondyloarthritis, psoriasis, and autoimmune thyroiditis, among others. “The risk of rheumatoid arthritis is four times higher in smokers than in people who have never smoked.

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Rheumatoid arthritis affects the lining of joints, causing a painful swelling that can result in bone erosion and joint deformity. 

Systemic lupus erythematosus is the most common type of lupus in which the person experiences widespread inflammation and tissue damage in the joints, skin, brain, lungs, kidneys and blood vessels. 

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Inflammatory bowel disease refers to disorders involving chronic inflammation and pain of the tissues in the digestive tract. Crohn’s disease is a type of inflammatory bowel disease which causes swelling of the tissues in the digestive tract, leading to abdominal pain, severe diarrhoea, fatigue, and weight loss. Ulcerative colitis is another type of inflammatory bowel disease in which abnormal reactions of the immune system cause inflammation and ulcers on the inner lining of the large intestine. 

Thus, Crohn’s disease causes inflammation of the full thickness of the bowel wall, in any part of the digestive tract from the mouth to the anus, while ulcerative colitis causes inflammation of the inner lining of the large bowel, which includes the colon and rectum. 

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Spondyloarthritis refers to diseases characterised by inflammation, pain and stiffness of the spine and joints. Ankylosing spondylitis is a type of spondyloarthritis.

Ankylosing spondylitis is a form of painful, ongoing joint inflammation, or chronic inflammatory arthritis and an autoimmune disease that causes inflammatory lower back pain, and eventually impairs spinal mobility severely due to structural changes leading to spinal fusion. 

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Ankylosing spondylitis is caused by a combination of environmental and genetic factors, the HLA-B27 gene playing a significant role in increasing the risk of the disease. 

The disease mainly affects the spine, and is characterised by symptoms such as chronic back pain and stiffness. Early symptoms of the disease usually arrive between the ages of 15 and 30, according to the United States National Institutes of Health (NIH). People who lead a sedentary lifestyle experience more pain due to the disease compared to others, but can manage the symptoms through regular physical activity.

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Autoimmune thyroiditis is also known as Hashimoto’s thyroiditis. Hashimoto’s thyroiditis causes hypothyroidism, or the reduced production of the thyroid hormone, because cell- and antibody-mediated immune processes destroy thyroid cells, according to the NIH. 

According to experts, cigarette smoking increases the risk of autoimmune diseases because the dangerous chemicals present inside tobacco smoke can interfere with the smoker’s immune system, and alter its equilibrium.

“Cigarette smoking is associated with numerous diseases and poses a serious challenge to the current healthcare system worldwide. Tobacco contains numerous harmful chemicals, including carbon monoxide, nicotine, and nitrogen oxides. Cigarette smoking results in chronic inflammation and affects autoimmunity at a systemic level. It has been linked to the development of many autoimmune diseases, like rheumatoid arthritis, psoriasis, Systemic lupus erythematosus (SLE), and multiple sclerosis, among others. A cigarette contains more than 1000 chemical compounds which can interfere significantly with a smoker’s immune system. Smoking can alter the balance or the equilibrium of the immune system, suppressing it and making a smoker more susceptible to health problems,” Dr Sandeep Nayar, Senior Director & HOD, Chest & Respiratory Diseases, BLK-Max Super Speciality Hospital, New Delhi, told ABP Live.

He explained that many studies describe cellular and molecular mechanisms responsible for immunoregulation induced by smoking but the exact mechanisms underlying smoking-associated immunopathology is still not clear. 

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Therefore, as experts have said, it is important to quit smoking because harmful chemicals such as nicotine can trigger an abnormal immune response, and form autoantibodies, causing the immune system to attack healthy cells of the body.

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