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• Smoking Raises Arthritis Risk and Makes It Harder to Treat  

Smoking cigarettes can lead to the development of rheumatic diseases and make them harder to treat, according to three new studies presented this week at the 2009 annual meeting of the American College of Rheumatology in Philadelphia.

The first study focused on what happens when people with rheumatoid arthritis light up while being treated for the disease.

Researchers looked at the medical records of 1,756 rheumatoid arthritis (RA) patients in Sweden, determined their smoking history or lack thereof and then looked at their response to methotrexate or anti-TNF therapy - two common RA treatments. . . .

Mark Fisher, MD, MPH, a rheumatologist at Massachusetts General Hospital in Boston says he found this the most impressive study of the three. "There aren't any studies that show smoking has an effect on response to methotrexate and it was a really well done study. So for those reasons I think it's significant," Dr. Fisher says.

A second study found that smoking is associated with organ damage and disease activity in people with systemic lupus erythematosus, a chronic inflammatory disease that can affect the skin, joints, kidneys, lungs, nervous system and other organs.

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Risk Factors and Viruses Associated With Hospitalization Due to Lower Respiratory Tract Infections in Canadian Inuit Children: A Case-Control Study 

Conclusions: Smoking during pregnancy, place of residence, Inuit race, lack of breast-feeding, and overcrowding were all independently associated with increased risk of hospital admission for LRTI among Inuit children less than 2 years of age. Future research on the role of adoption and genetics on the health of Inuit children are required.

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Tobacco leading cause of rheumatism: Study 

PUNE: Among the 8,000 people surveyed in Pune city, about 10 per cent complained of one or the other kind of rheumatic pain. The data, which is part of an ongoing study, revealed that most of the people surveyed consumed tobacco in one form or the other.

"The study to measure burden of rheumatism on the Indian population at 17 cities/towns shows that at least 10-15 per cent of the population suffers from arthritis or some form of rheumatism. And the use of tobacco has emerged as a leading risk factor for rheumatic pains. This public health issue is yet to be recognised by the Indian medical faculty and community," said rheumatologist Arvind Chopra.

Chopra has combined his skills with that of the gram panchayat at Bhigwan village, where too 9,000 people were surveyed, to create an exemplary community model of rheumatic disease.

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Autoimmune condition, especially combined with smoking and oral contraceptive use, massively increases risk of stroke and heart attack in young women 

Autoimmune condition, especially combined with smoking and oral contraceptive use, massively increases risk of stroke and heart attack in young women

The autoimmune condition antiphospholipid syndrome mainly affects young women. An Article published Online First and in the November edition of the Lancet Neurology shows that women with a particular subtype of antibody called lupus anticoagulant (LA) have a more than 40-fold increased risk of stroke and 5-fold increased risk of heart attack compared with the general population (of young women). Smoking and oral contraceptive use increase the risk of these events even more. The Article is written by Dr Rolf Urbanus and Dr Philip de Groot, University Medical Centre Utrecht, Netherlands, together with colleagues from the Leiden University Medical Centre.

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Antiphospholipid antibodies and risk of myocardial infarction and ischaemic stroke in young women in the RATIO study: a case-control study 

Interpretation

Our results suggest that lupus anticoagulant is a major risk factor for arterial thrombotic events in young women, and the presence of other cardiovascular risk factors increases the risk even further.

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• Autoimmune Condition, Especially Combined With Smoking And Oral Contraceptive Use, Massively Increases Risk Of Stroke And Heart Attack In Young Women 

The autoimmune condition antiphospholipid syndrome mainly affects young women. An Article published Online First and in the November edition of The Lancet Neurology shows that women with a particular subtype of antibody called lupus anticoagulant (LA) have a more than 40-fold increased risk of stroke and 5-fold increased risk of heart attack compared with the general population (of young women). Smoking and oral contraceptive use increase the risk of these events even more. The Article is written by Dr Rolf Urbanus and Dr Philip de Groot, University Medical Centre Utrecht, Netherlands, together with colleagues from the Leiden University Medical Centre.

Antiphospholipid syndrome occurs when autoantibodies* bind to cell membranes, interfering with the regular clotting mechanism of the blood. Diagnosis occurs when young women (under 50 years) suffer a thrombotic event such as a stroke or heart attack, and antiphospholipid antibodies are tested. Although it is known that this condition causes thrombosis, bleeding, and repeat miscarriage in women, the extent of the increased risk for stroke and heart attack was unknown before this study. . . .

In an accompanying Reflection and Reaction, Dr Kathryn Kirchoff-Torres and Dr Steven R Levine, Stroke Center, Mount Sinai School of Medicine, New York, NY, USA, say that the most important aspect of the study is its conclusion that young women with LA need to be warned about the dangers of smoking and use of oral contraceptives.

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Second-hand smoke exposure in cars and respiratory health effects in children 

We examined potential associations of ever asthma, and symptoms of wheeze (past 12 months), hay fever, eczema and bronchitis (cough with phlegm) among school children exposed to second-hand smoke (SHS) in cars, using a modified Irish International Study of Asthma and Allergies in Childhood (ISAAC) protocol. . . .

Approximately one in seven Irish schoolchildren are exposed to SHS in cars and could have adverse respiratory health effects. Further studies are imperative to explore such associations across different population settings.

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• Passive smoking in cars linked to hayfever and wheezing in children 

Children who are regularly exposed to second-hand tobacco smoke when traveling by car have significantly higher rates of hayfever and wheezing than those without such exposure, results of an Irish study show.

Writing in the European Respiratory Journal, Luke Clancy, from the Tobacco Free Research Institute in Dublin, and team explain: “Children may be more vulnerable to second-hand smoke-induced respiratory diseases due to smaller airways and greater oxygen demand, as well as a less-mature immune system.”

But they add that “there is no evidence quantifying second-hand smoke-induced respiratory health effects in children exposed to second-hand smoke in cars.”

To address this, the team studied 2809 children, aged 13–14 years, selected randomly from schools throughout Ireland.

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Quit smoking to keep your teeth 

Smokers are more likely to develop gum disease than non-smokers, according to a German non-profit organization that promotes oral health.

Deutsche Parodontose Hilfe says smoking can cause periodontitis, or gum disease, and recommends quitting smoking.

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• Treating COPD Early Improves Outcomes  

Although there is no cure for chronic obstructive pulmonary disease (COPD), starting treatment early may slow progression of the illness and add years to the lives of sufferers, new research finds.

COPD is a progressive, destructive disease of the lungs that is usually brought on by years of smoking. Symptoms include restricted breathing, secretion of mucus, oxidative stress and airway inflammation. It is estimated that as many as 24 million Americans have COPD, and the number is rising.

Three reports published in the Aug. 29 issue of The Lancet, a special issue devoted to COPD, offer new insight into treatments, including a new anti-inflammatory drug that shows promise.

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Quitting Smoking Sparks an Anti-inflammatory Response  

If you asked a hundred smokers how they quit – or why they couldn’t – you may get an equal number of different answers. Christine Metz, PhD, is a scientist at The Feinstein Institute for Medical Research who is trying to identify some of the factors that play into a smoker’s decision to quit.

In collaboration with the Center for Tobacco Control of the North Shore-LIJ Health System, she is examining the effect of smoking cessation on inflammatory responses in female smokers at risk for cardiovascular disease. The grant, funded by the American Heart Association, could lead to improved understanding of the smoking cessation process and the development of more effective smoking cessation programs. Heart disease is the number one killer in women, and behavioral changes can go a long way to prevent many of these deaths. Smoking is a major risk factor. Smoking, Dr. Metz and others have shown, triggers the release of a cascade of inflammatory mediators that can, in turn, increase a person’s chances of developing heart disease. Here is how the story unfolds. Smoking is associated with an elevation of inflammatory substances in the body, including tumor necrosis factor, tumor necrosis factor receptors and C-reactive protein (CRP) -- major markers of inflammation. Elevated levels of these mediators suggest that inflammation is brewing somewhere in the body, Dr. Metz said. . . .

The results of the study were published in the July 30 issue of Chest.

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Tobacco Plants Yield First Vaccine For Dreaded 'Cruise Ship Virus' 

Scientists have used a new vaccine production technology to develop a vaccine for norovirus, a dreaded cause of diarrhea and vomiting that may be the second most common viral infection in the United States after the flu. Sometimes called the "cruise ship virus," this microbe can spread like wildfire through passenger liners, schools, offices and military bases.

The new vaccine is unique in its origin -- it was "manufactured" in a tobacco plant using an engineered plant virus. Researchers are enlisting plants in the battle against norovirus, swine flu, bird flu, and other leading infectious diseases. This plant biotechnology opens the door to more efficient, inexpensive ways to bring vaccines quickly to the public, especially critical in times when viruses mutate into unpredictable new strains, said Charles Arntzen, Ph.D., who reported on the topic today at the 238th National Meeting of the American Chemical Society (ACS).

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• Smokers Risk Swine Flu Complications Like Pneumonia, Data Show  

Smokers may be prone to developing life-threatening complications from swine flu, according to patient data from Hong Kong, where tobacco use was noted in almost half of severe cases.

Twelve of 27 swine flu patients who developed pneumonia and other serious illnesses were either current or former smokers and some had no other known risk factors, Thomas Tsang, acting controller of Hong Kong’s Centre for Health Protection, told a medical meeting in Beijing yesterday.

“The proportion of smokers among the serious cases is pretty high,” Tsang said in an interview. “So far this is just one observation that stands out and we need to investigate it.”

Tsang’s findings may shed more light on a mystery that doctors are grappling with: why the new flu remains mild for a majority of people and is severe enough to kill in others. Worldwide, about 1,800 people infected with H1N1 have died since the virus was discovered in April.

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Tobacco might produce vaccine for stomach virus 

Tobacco plants might yield a cheap and easy-to-administer vaccine against a pesky stomach virus called norovirus, U.S. researchers reported on Tuesday.

They found a way to make tobacco produce a protein that can be used to make a nasal vaccine against norovirus, which causes diarrhea and vomiting, especially on cruise ships, in restaurants, schools and on military bases.

"Under appropriate medical care it is not life-threatening. It is just very, very inconvenient," Charles Arntzen, a plant biologist at Arizona State University, told a news conference at a meeting of the American Chemical Society.

The U.S. Centers for Disease Control and Prevention estimates that 23 million cases a year of acute gastroenteritis -- stomach and intestinal upset -- are due to norovirus, also known as Norwalk virus.

Arntzen and colleagues used a genetically engineered plant virus called the tobacco mosaic virus to start their vaccine.

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• 'Cruise Ship Virus' Vaccine Stems From Tobacco  

Scientists have developed a vaccine for the common viral infection norovirus from a novel source: a tobacco plant.

The new vaccine was "manufactured" in a tobacco plant using a bioengineered plant virus.

This plant biotechnology opens the door to faster, more inexpensive ways to bring vaccines to the public quickly, especially in times when viruses mutate into unpredictable new strains, said Charles Arntzen, who reported on the vaccine at the American Chemical Society annual meeting, in Washingtopn, D.C.

"The recent outbreak of H1N1 influenza virus has once again reminded us of the ability of disease-causing agents to mutate into new and dangerous forms," Arntzen said.

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