Association of antinuclear antibody seropositivity with inhaled environmental exposures in patients with interstitial lung disease.

Autor:	Biblowitz K; Division of Pulmonary and Critical Care, Dept of Medicine, Thomas Jefferson University, Philadelphia, PA, USA., Lee C; Section of Pulmonology and Critical Care Medicine, University of Chicago, Chicago, IL, USA., Zhu D; Pulmonary and Critical Care Medicine, University of Virginia, Charlottesville, VA, USA., Noth I; Pulmonary and Critical Care Medicine, University of Virginia, Charlottesville, VA, USA., Vij R; Section of Pulmonology and Critical Care Medicine, University of Chicago, Chicago, IL, USA., Strek ME; Section of Pulmonology and Critical Care Medicine, University of Chicago, Chicago, IL, USA., Bellam SK; Division of Pulmonary and Critical Care, Dept of Medicine, NorthShore University HealthSystem, Evanston, IL, USA., Adegunsoye A; Section of Pulmonology and Critical Care Medicine, University of Chicago, Chicago, IL, USA.
Jazyk:	angličtina
Zdroj:	ERJ open research [ERJ Open Res] 2021 Nov 08; Vol. 7 (4). Date of Electronic Publication: 2021 Nov 08 (Print Publication: 2021).
DOI:	10.1183/23120541.00254-2021
Abstrakt:	Background: Interstitial lung diseases (ILDs) are diffuse parenchymal lung disorders that cause substantial morbidity and mortality. In patients with ILD, elevated antinuclear antibody (ANA) titres may be a sign of an autoimmune process. Inhalational exposures contribute to ILD pathogenesis and affect prognosis and may trigger autoimmune disease. The association of inhalational exposures with ANA seropositivity in ILD patients is unknown. Methods: This was a retrospective cohort study of adult ILD patients from five centres in the United States. Exposures to tobacco, inhaled organic antigens and inhaled inorganic particles were extracted from medical records. A multivariable logistic regression model was used to analyse the effects of confounders including age, ILD diagnosis, gender and exposure type on ANA seropositivity. Results: Among 1265 patients with ILD, there were more ANA-seropositive (58.6%, n=741) than ANA-seronegative patients (41.4%, n=524). ANA-seropositive patients had lower total lung capacity (69% versus 75%, p<0.001) and forced vital capacity (64% versus 70%, p<0.001) than patients who were ANA-seronegative. Among patients with tobacco exposure, 61.4% (n=449) were ANA-positive compared to 54.7% (n=292) of those without tobacco exposure. In multivariable analysis, tobacco exposure remained independently associated with increased ANA seropositivity (OR 1.38, 95% CI 1.12-1.71). This significant difference was similarly demonstrated among patients with and without a history of inorganic exposures (OR 1.52, 95% CI 1.12-2.07). Conclusion: Patients with ILD and inhalational exposure had significantly higher prevalence of ANA-seropositivity than those without reported exposures across ILD diagnoses. Environmental and occupational exposures should be systematically reviewed in patients with ILD, particularly those with ANA-seropositivity. Competing Interests: Conflict of interest: K. Biblowitz has nothing to disclose. Conflict of interest: C. Lee has nothing to disclose. Conflict of interest: D. Zhu has nothing to disclose. Conflict of interest: I. Noth has nothing to disclose. Conflict of interest: R. Vij has nothing to disclose. Conflict of interest: M.E. Strek has received institutional support to conduct interstitial lung disease clinical trials for Boehringer Ingelheim and Galapagos, fees for clinical trial adjudication committee service from Fibrogen, and editorial support from Boehringer Ingelheim. Conflict of interest: S.K. Bellam has received speaking and advisory board fees from Genentech. Conflict of interest: A. Adegunsoye has received speaking and advisory board fees from Genentech and Boehringer Ingelheim, and is supported by a career development award from the National Heart, Lung, and Blood Institute (NHLBI K23HL146942). (Copyright ©The authors 2021.)
Databáze:	MEDLINE
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