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Allergic manifestations in patients with rheumatoid arthritis
Linköping University, Department of Molecular and Clinical Medicine, Occupational and Environmental Medicine. Linköping University, Department of Molecular and Clinical Medicine, Rheumatology. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Molecular and Clinical Medicine, Occupational and Environmental Medicine. Linköping University, Faculty of Health Sciences.ORCID iD: 0000-0002-8234-5461
Linköping University, Department of Molecular and Clinical Medicine, Rheumatology. Linköping University, Faculty of Health Sciences.ORCID iD: 0000-0002-0153-9249
Department of Internal Medicine, Västervik Hospital, Västervik.
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2003 (English)In: Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS), ISSN 0903-4641, E-ISSN 1600-0463, Vol. 111, no 10, 940-944 p.Article in journal (Refereed) Published
Abstract [en]

A functional dichotomy between Th1- and Th2-type immune responses has been suggested. This study was performed to investigate whether rheumatoid arthritis (RA), a disease with indications of Th1-deviated immune activation, is inversly related to atopic conditions which are Th2-mediated. Two hundred and sixty-three adult cases of RA, fulfilling the American Rheumatism Association (ARA) 1987 Revised Classification Criteria for RA, were identified in 1995 and compared with 541 randomly selected population referents. The presence of atopic manifestations was established through a postal questionnaire and by demonstrating circulating IgE antibodies to common allergens. RA was inversely associated with certain manifestations of rhinitis, which were regarded as the most reliable indicators of atopic disease in the present study. However, no negative association was seen between RA and asthma and eczema, respectively. The main results give some support for an inverse relationship between RA and rhinitis. The prevalence of circulating IgE antibodies was however similar in cases and controls, suggesting that the T-cell commitment mainly occurs in the affected organs.

Place, publisher, year, edition, pages
2003. Vol. 111, no 10, 940-944 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-26436DOI: 10.1034/j.1600-0463.2003.1111004.xLocal ID: 10979OAI: oai:DiVA.org:liu-26436DiVA: diva2:246985
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
In thesis
1. Occupational and environmental aspects on the aetiology of rheumatoid arthritis
Open this publication in new window or tab >>Occupational and environmental aspects on the aetiology of rheumatoid arthritis
2003 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Two questionnaire-based case-referent studies were performed to primarily assess the impact from occupational and environmental exposures on the aetiology of rheumatoid arthritis (RA). The two studies included prevalent and incident cases of RA, respectively. All determinants were evaluated separately for the two materials, and potential occupational risk factors were also analysed after pooling of the two studies. Most associations found between occupational exposures and RA regarded men. Increased risks for RA were seen for exposure to asphalt (OR 6.0, 95% CI 1.6-27.7), vibrations (OR 2.1, 95% CI 1.4-3.3), crops and/or forage (OR 2.0, 95% CI 1.3-3.0), mineral dust (OR 1.8, 95 % CI 1.0-3.2). and mineral oil (OR 1.5, 95 % CI 1.0-2.3 ), with dose-response relationships between RA and exposure to mineral dust and vibrations. Occupational categories at increased risk of RA among men were conductors, freight and transport workers (OR 4.6, 95 % CI 1.4-15.0), pulp and paper workers (OR 3.9, 95 % CI 1.2-12.8), and farmers (OR 2.3, 95 % CI 1.4-3.5). Regarding women, increased risks for RA were seen for exposure to meat (OR 2.2, 95 % CI 1.0-4.9), hairdressing chemicals (OR 1.7, 95 % CI 0.7-4.5), and for hairdressers (OR 1.7, 95 % CI 0.7-4.0). The results refer to the pooled material.

Regarding leisure-time activities, an increased risk was seen for mineral oil exposure among men in the study with incident cases (OR 2.0, 95 % CI 0. 7-6.2 ). In this study, an association was also seen for men for having ever used a private well (OR 1.5, 95 % CI 0.8-2.9). In the study with prevalent cases, associations were seen for both sexes for having been exposed to water from a private well at time of birth (OR 1.5, 95 % CI 0.9-2.4 for women, and OR 2.8, 95 % CI 1.5-5.2 for men). The risk of RA was increased for men with previous exposure to mould indoors (OR 4.6, 95 % CI 1,1-20.2 ), and an association was also seen for long time use of hair dyes and/or bleach among women (OR 1.9, 95 % CI 0.8-4.5). In the study with incident cases, the risk for RA was increased among men with previous use of skin lotion (OR 3.0, 95 % CI 0.9-9.8).

For both sexes, increased risks for RA were seen for current and previous smoking, with even higher ORs for seropositive cases among men. In the study with incident cases, male subjects with more than 20 pack years of smoking had an OR of 2.5 (95 % CI 1.2-5.1), corresponding to an OR of 1.6 (95% CI 0.9-3.1) among women. There was a tendency towards increasing risks with increasing number of pack years for men in both studies, with significant tests for trend in the study with prevalent cases. For both sexes, higher schooling resulted in a decreased risk for RA.

The relationship between RA and allergy was evaluated more extensively in a cross-sectional study, and negative associations between RA and certain manifestations of hay fever were found. An almost significantly decreased risk for allergy was found in the study with prevalent cases with both sexes included in the analysis (OR 0.6, 95 % CI 0.4-1.0). Regarding other comorbidity, there were positive associations between RA and self-repotted thyroid conditions (OR 3.5. 95 % CI 1.1-10.8) and previous treatment with insulin (OR 10.2, 95 % CI 1.7-60.8) among women in the study with prevalent cases. In the cross-sectional study, there was an association between RA and diabetes (OR 2.8. 95 & CI 0.9-8.9), with both sexes included in the analysis. Associations were seen between previous joint trauma and RA for women in both case-referent studies (OR 2.5, 95 % CI 1.0-6.6 in the study with prevalent cases) as well as for men in the study with incident cases (OR 2.2, 95% CI 0.6-7.1).

Altogether, the determinants conveying the risk for RA differ between sexes. RA is a condition most often affecting women. but the present studies, as well as previous research, have established that most extemal factors evaluated so far seem to be of more importance for men than women.

Place, publisher, year, edition, pages
Linköping: Linköpings universitet, 2003. 94 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 807
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-26666 (URN)11232 (Local ID)91-7373-494-2 (ISBN)11232 (Archive number)11232 (OAI)
Public defence
2003-10-09, Aulan, Hälsans hus, Universitetssjukhuset, Linköping, 09:00 (Swedish)
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Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2012-10-16Bibliographically approved

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Reckner Olsson, ÅsaWingren, GunSkogh, ThomasErnerudh, Jan

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