Introduction
The condition known as psoriatic arthritis (PsA) is heterogeneous, exhibiting a range of clinical symptoms. Smoking is considered one of the environmental and genetic factors that have been impacting the progression of psoriatic arthritis. Smoking has been known to increase the chance of developing several immune-mediated disorders, including psoriatic arthritis.
According to studies, smokers with psoriatic arthritis have higher levels of weakness and joint discomfort than nonsmokers in the broader population. The chances of getting psoriatic arthritis and making it worse are higher the longer one smokes. Additionally, smoking might exacerbate psoriasis.
According to studies, smoking increases inflammation, which either precipitates or exacerbates autoimmune illnesses like psoriatic arthritis.
How Does Smoking Affect Psoriatic Arthritis?
Psoriatic arthritis is more likely to develop in smokers, according to numerous studies. One study indicated that, compared to people who have never smoked, long-term smokers have a nearly doubled risk of developing psoriatic arthritis. According to another study, the likelihood of having psoriatic arthritis is doubled for chronic smokers.
Psoriatic arthritis can result from smoking for a variety of reasons, including:
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Oxidative Stress and Free Radical Generation: Free radical generation and oxidative stress are two effects of smoking. These two factors impact the autoimmune-related pathways in the body.
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Affects the Immune System: Smoking affects the immune system's cellular and humoral components. These effects include leukocytosis, a decrease in leukocyte function, an increase in some cytokines and soluble receptors (such as vascular endothelial growth factor receptor, interleukin (IL) 15, IL-1Ra, IL-6, and sIL-6R), as well as the production of reactive oxygen species. These proteins have an impact on the interactions between the cells.
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Nicotine: Nicotine is a harmful substance present in cigarettes. Upon smoking nicotine triggers the release of cytokines which causes the release of free radicals. Moreover, nicotine binds to cholinergic receptors on keratinocytes, endothelial cells, dendritic cells, and macrophages. Angiogenesis, uncontrolled keratinocyte proliferation, and increased expression of vascular adhesion molecule-1 and intercellular adhesion molecule-1 on endothelial cells cause inflammation and immune stimulation of Th1-cells, which in turn causes severe leukocyte migration to the skin. These radicals cause inflammation of the cells and cell damage, leading to joint pain, stiffness, and activation of the immune response of psoriatic arthritis.
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Tissue Hypoxia: Smoking may have an effect on mechanical stress on cells by inducing tissue hypoxia and raising danger signals. This causes cell injury and cell death, leading to pain and erosion of the joints.
What Are the Risk Factors for Psoriatic Arthritis?
Apart from smoking, many risk factors will aggravate the disease. These may not have a direct influence on disease; however, individuals' smoking habits, along with these risk factors, promote greater damage to the body. The following risk factors include
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Genetic Influence: If psoriatic arthritis runs in the family, one might be genetically predisposed to the illness. Smoking can activate these genes. According to experts, smoking alters the DNA's aryl hydrocarbon receptors. The body produces more inflammatory cytokines as a result of this. This may increase the risk if one has a hereditary predisposition to psoriatic arthritis.
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Age: Individuals who are older and have been chronic smokers were found to have greater risks of psoriatic arthritis, and prognosis in such patients was also very poor.
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Passive Smoking: Early exposure to smoking in childhood, during prenatal or pregnancy, may increase the chance of psoriatic arthritis in later stages of life.
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Increased Weight: Individuals with greater weight gain or BMI (body mass index) are more likely to develop psoriatic arthritis.
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Presence of Comorbidities: Individuals with smoking habits and other systemic conditions such as hypertension, diabetes, respiratory infections, or other types of cancer may be a risk factor for psoriatic arthritis.
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Infections: Individuals who smoke while receiving psoriasis treatment may be more susceptible to dangerous infections.
Does E-Cigarettes Reduce Psoriatic Arthritis?
Electronic cigarettes that run on batteries are referred to as e-cigarettes or vaping. They function by creating steam by heating flavored liquids, which release chemicals and nicotine. Because they believe e-cigarettes to be less dangerous, many people smoke them. E-cigarettes are nonetheless harmful to health even though they could contain fewer toxins than traditional cigarettes. E-cigarettes have been connected to decreased heart rate and blood pressure, decreased bone density and mineral loss, and decreased drug efficacy.
Does Smoking Affect the Treatment of Psoriatic Arthritis?
Psoriatic arthritis medication may be less effective if one smokes. According to research, individuals with diseases who smoke appear to respond less well to medications and are less likely to stick to their treatment regimen. According to one study, nonsmokers with psoriatic arthritis receiving biological therapy responded to treatment more favorably than smokers did. It is thought that smoking may have an impact on the body's capacity to absorb these drugs.
Studies confirm that PsA treatments may work better for individuals if they stop smoking.
Can Quitting Smoking Help With Psoriatic Arthritis?
If one smokes, then they should discuss quitting with their physician. This holds particular significance for those with psoriatic arthritis. Apart from quitting smoking, improving the lifestyle by incorporating exercise, a healthy diet, and managing stress has proven significant improvement in treatment outcomes.
The risk of developing psoriatic arthritis is higher than that of nonsmokers, even if they recently stopped smoking. Do not give up, though. If they give up smoking, there are still plenty of health advantages.
It is conceivable that psoriatic arthritis symptoms will improve once they give up smoking. Furthermore, the psoriatic arthritis treatment will function better, which may result in less severe symptoms. According to one study, one could considerably reduce their chance of developing psoriatic arthritis over time. The risk of developing psoriatic arthritis may be almost equal to that of someone who has never smoked if they stopped and have not smoked in 20 years.
Conclusion
Psoriatic arthritis and smoking have a complicated relationship. Smoking raises the likelihood of comorbidities, decreases the effectiveness of treatment, and exacerbates inflammation. To manage psoriatic arthritis, enhance treatment outcomes, and improve general health and well-being, quitting smoking is essential. To promote a smoke-free lifestyle and the best possible management of disease and enhance the quality of life for patients, healthcare providers are essential in helping psoriatic arthritis patients quit smoking.
