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흡연과 베체트병의 임상증상 발현과의 관련성 고찰

The association between smoking and clinical manifestations in patients with Behçet’s disease

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Background/Aims: There is controversy related to the role of smoking in affecting the clinical features of patients with Behçet’s disease (BD). The aim of this study was to investigate the effect of smoking on clinical manifestations in Korean BD patients. Methods: We enrolled 131 patients with BD who fulfilled the International Study Group (ISG) criteria of 1990. The disease-related clinical features of BD―oral ulcers, genital ulcers, ocular lesions, arthritis, vascular lesions, gastrointestinal lesions―and central nerve lesions, smoking history, disease duration, and the presence of HLA-B51 were retrospectively assessed through medical record reviews and patient interviews. Statistical analysis was performed using Chi-square, Fisher’s exact, or student t-test, if appropriate. Results: The frequencies of vascular and gastrointestinal lesions in smokers were significantly increased compared to those in non-smokers (p=0.040, OR=3.341, 95% CI 1.083-10.305; p=0.012, OR=3.878, 95% CI 1.379-10.906, respectively). Male smokers developed vascular lesions more frequently compared to female smokers, male non-smokers, and female non-smokers (p=0.025, OR=3.896, 95% CI 1.245-12.196). Moreover, smoking, male sex, and positive HLA-B51 may be risk factors for the development of gastrointestinal lesions in BD. Venous lesions were more frequently found in male smokers compared with other patients (p=0.038). Conclusions: Smoking may be associated with the development of vascular and gastrointestinal lesions in Korean BD patients. A large population prospective assessment of the clinical effect of smoking on BD is needed. (Korean J Med 75:202-209, 2008)

Abstract

Background/Aims: There is controversy related to the role of smoking in affecting the clinical features of patients with Behçet’s disease (BD). The aim of this study was to investigate the effect of smoking on clinical manifestations in Korean BD patients. Methods: We enrolled 131 patients with BD who fulfilled the International Study Group (ISG) criteria of 1990. The disease-related clinical features of BD―oral ulcers, genital ulcers, ocular lesions, arthritis, vascular lesions, gastrointestinal lesions―and central nerve lesions, smoking history, disease duration, and the presence of HLA-B51 were retrospectively assessed through medical record reviews and patient interviews. Statistical analysis was performed using Chi-square, Fisher’s exact, or student t-test, if appropriate. Results: The frequencies of vascular and gastrointestinal lesions in smokers were significantly increased compared to those in non-smokers (p=0.040, OR=3.341, 95% CI 1.083-10.305; p=0.012, OR=3.878, 95% CI 1.379-10.906, respectively). Male smokers developed vascular lesions more frequently compared to female smokers, male non-smokers, and female non-smokers (p=0.025, OR=3.896, 95% CI 1.245-12.196). Moreover, smoking, male sex, and positive HLA-B51 may be risk factors for the development of gastrointestinal lesions in BD. Venous lesions were more frequently found in male smokers compared with other patients (p=0.038). Conclusions: Smoking may be associated with the development of vascular and gastrointestinal lesions in Korean BD patients. A large population prospective assessment of the clinical effect of smoking on BD is needed. (Korean J Med 75:202-209, 2008)

참고문헌 (36)

  1. Sakane T, "Behcet's disease", N Engl J Med, 341, pp.1284~1291 (1999)
  2. Gül A, "Behçet's disease: an update on the pathogenesis", Clin Exp Rheumatol, 19(5), pp.6~12 (2001)
  3. Ezzati M, "stimates of global mortality attributable to smoking in 2000", Lancet, 362, pp.847~852 (2003)
  4. Freiman A, "Cutaneous effects of smoking", J Cutan Med Surg, 8, pp.415~423 (2004)
  5. Washio M, "Smoking, drinking, sleeping habits, and other lifestyle factors and the risk of systemic lupus erythematosus in Japanese females", Mod Rheumatol, 16, pp.143~150 (2006)
  6. Klareskog L, "A new model for an etiology of rheumatoid arthritis: smoking may trigger HLA-DR (shared epitope)-restricted immune reactions to autoantigens modified by citrullination", Arthritis Rheum, 54, pp.38~46 (2006)
  7. Kaklamani VG, "Could nicotine be beneficial for Behçet's disease?", Clin Rheumatol, 21, pp.341~342 (2002)
  8. Soy M, "Smoking and Behçet's disease", Clin Rheumatol, 19, pp.508~509 (2000)
  9. Rizvi SW, "The therapeutic effect of cigarette smoking on oral", genital aphthosis and other manifestations of Behçet's disease, 2001, pp.19, 77~78
  10. Kaklamani VG, "The effect of smoking on the clinical features of Adamantiades-Behçet's disease", Adv Exp Med Biol, 528, pp.323~327 (2003)
  11. Kalayciyan A, "Nicotine and biochanin A, but not cigarette smoke, induce anti-inflammatory effects on keratinocytes and endothelial cells in patients with Behçet's disease", J Invest Dermatol, 127, pp.81~89 (2007)
  12. Aramaki K, "HLA-B51 and cigarette smoking as risk factors for chronic progressive neurological manifestations in Behçet's disease", Mod Rheumatol, 17, pp.81~82 (2007)
  13. International Study Group for Behcet’ Di, "Criteria for diagnosis of Behcet’ disease", Lancet, 335, pp.1078~1080 (1990)
  14. HyunKyuChang, "The Clinical Significance of a Pathergy Reaction in Patients with Behcet’s Disease", Journal of Korean Medical Science, 17(3), pp.371~374 (2002), 대한의학회
  15. Linn-Rasker SP, "Smoking is a risk factor for anti-CCP antibodies only in rheumatoid arthritis patients who carry HLA-DRB1 shared epitope alleles", Ann Rheum Dis, 65, pp.366~371 (2006)
  16. Jorizzo JL, "Mucocutaneous criteria for the diagnosis of Behçet's disease: an analysis of clinicopathologic data from multiple international centers", J Am Acad Dermatol, 32, pp.968~976 (1995)
  17. Ergun T, "The histopathology of pathergy: a chronologic study of skin hyperreactivity in Behçet's disease", Int J Dermatol, 37, pp.929~933 (1998)
  18. Lakatos PL, "Smoking in inflammatory bowel diseases: good, bad or ugly?", World J Gastroenterol, 13, pp.6134~6139 (2007)
  19. Mahid SS, "Smoking and inflammatory bowel disease: a meta-analysis", Mayo Clin Proc, 81, pp.1462~1471 (2006)
  20. Bergmann S, "Even moderate cigarette smoking influences the pattern of circulating monocytes and the concentration of sICAM-1", Respir Physiol, 114, pp.269~275 (1998)
  21. Blann AD, "The influence of smoking on soluble adhesion molecules and endothelial cell markers", Thromb Res, 85, pp.433~438 (1997)
  22. Direskeneli H, "Anti-endothelial cell antibodies, endothelial proliferation and von Willebrand factor antigen in Behcet’ disease", Clin Rheumatol, 14, pp.55~61 (1995)
  23. Verity DH, "Soluble adhesion molecules in Behcet’ disease", Ocul Immunol Inflamm, 6, pp.81~92 (1998)
  24. Şenel K, "The profile of soluble adhesion molecules in patients with Behcet’ disease: a possible association with disease activity", Pain Clin, 13, pp.203~209 (2002)
  25. Koç Y, "Vascular involvement in Behçet's disease", J Rheumatol, 19, pp.402~410 (1992)
  26. Espinosa G, "Vascular involvement in Behçet's disease: relation with thrombophilic factors, coagulation activation, and thrombomodulin", Am J Med, 112, pp.37~43 (2002)
  27. Gül A, "Procoagulant mutations and venous thrombosis in Behcet’ disease", Rheumatology, 38, pp.1298~1299 (1999)
  28. Verity DH, "Factor V Leiden mutation is associated with ocular involvement in Behçet disease", Am J Ophthalmol, 128, pp.352~356 (1999)
  29. Tapson VF, "The role of smoking in coagulation and thromboembolism in chronic obstructive pulmonary disease", Proc Am Thorac Soc, 2, pp.71~77 (2005)
  30. Imamura Y, "Involvement of Th1 cells and heat shock protein 60 in the pathogenesis of intestinal Behcet's disease", Clin Exp Immunol, 139, pp.371~378 (2005)
  31. Tolia V, "A case of Behcet's disease with intestinal involvement due to Crohn's disease", Am J Gastroenterol, 84, pp.322~325 (1989)
  32. Naganuma M, "A case of Behçet's disease accompanied by colitis with longitudinal ulcers and granuloma", J Gastroenterol Hepatol, 17, pp.105~108 (2002)
  33. Hayasaki N, "Neutrophilic phlebitis is characteristic of intestinal Behçet's disease and simple ulcer syndrome", Histopathology, 45, pp.377~383 (2004)
  34. Verity DH, "Behçet's disease, the Silk Road and HLA-B51: historical and geographical perspectives", Tissue Antigens, 54, pp.213~220 (1999)
  35. Mizuki N, "Microsatellite polymorphism between the tumor necrosis factor and HLA-B genes in Behçet's disease", Hum Immunol, 43, pp.129~135 (1995)
  36. Chajek-Shaul T, "HLA-B51 may serve as an immunogenetic marker for a subgroup of patients with Behçet's syndrome", Am J Med, 83, pp.666~672 (1987)

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