Introduction: Smoking is an established risk factor for both lung diseases and rheumatoid arthritis (RA). Chronic mucosal airway inflammation may result in immune tolerance loss, neoantigen formation, and production of RA-related autoantibodies that increase the subsequent risk of RA. In this review, we aimed to summarize the current evidence supporting the role of obstructive lung diseases and subsequent risk of RA.Areas covered: We identified scientific articles discussing the biologic mechanisms linking mucosal airway inflammation and RA risk. We also identified studies investigating asthma, chronic obstructive pulmonary disease, bronchiectasis, cystic fibrosis, chronic tuberculous and nontuberculous mycobacterial infections, and interstitial lung disease with subsequent risk for RA.Expert opinion: The current evidence supports the hypothesis that mucosal airway inflammation may increase the risk of developing RA. However, most studies investigating this relationship have been retrospective and may not have adequately addressed the role of smoking. Larger prospective studies may provide stronger evidence for obstructive lung disease and RA risk. Determining the role of obstructive lung disease in RA pathogenesis may provide opportunity for RA prevention and screening strategies, while identifying novel biologic mechanisms that could offer targets to improve treatment and outcomes.

中文翻译：

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阻塞性肺部疾病和类风湿性关节炎的风险。

简介：吸烟是肺部疾病和类风湿性关节炎 (RA) 的既定危险因素。慢性粘膜气道炎症可能导致免疫耐受性丧失、新抗原形成和 RA 相关自身抗体的产生，从而增加 RA 的后续风险。在这篇综述中，我们旨在总结支持阻塞性肺病的作用和随后的 RA 风险的当前证据。涵盖的领域：我们确定了讨论黏膜气道炎症和 RA 风险之间的生物学机制的科学文章。我们还确定了调查哮喘、慢性阻塞性肺病、支气管扩张、囊性纤维化、慢性结核性和非结核性分枝杆菌感染以及间质性肺病以及随后发生 RA 风险的研究。 专家意见：目前的证据支持粘膜气道炎症可能增加患 RA 风险的假设。然而，大多数调查这种关系的研究都是回顾性的，可能没有充分说明吸烟的作用。更大规模的前瞻性研究可能为阻塞性肺病和 RA 风险提供更有力的证据。确定阻塞性肺病在 RA 发病机制中的作用可能为 RA 预防和筛查策略提供机会，同时确定可以提供目标以改善治疗和结果的新生物学机制。更大规模的前瞻性研究可能为阻塞性肺病和 RA 风险提供更有力的证据。确定阻塞性肺病在 RA 发病机制中的作用可能为 RA 预防和筛查策略提供机会，同时确定可以提供目标以改善治疗和结果的新生物学机制。更大规模的前瞻性研究可能为阻塞性肺病和 RA 风险提供更有力的证据。确定阻塞性肺病在 RA 发病机制中的作用可能为 RA 预防和筛查策略提供机会，同时确定可以提供目标以改善治疗和结果的新生物学机制。