Rheumatoid arthritis-associated autoantibodies and subclinical interstitial lung disease: the Multi-Ethnic Study of Atherosclerosis

Elana J Bernstein; R Graham Barr; John H M Austin; Steven M Kawut; Ganesh Raghu; Jessica L Sell; Eric A Hoffman; John D Newell; Jubal R Watts; P Hrudaya Nath; Sushil K Sonavane; Joan M Bathon; Darcy S Majka; David J Lederer

doi:10.1136/thoraxjnl-2016-208932

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Rheumatoid arthritis-associated autoantibodies and subclinical interstitial lung disease: the Multi-Ethnic Study of Atherosclerosis

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Rheumatoid arthritis-associated autoantibodies and subclinical interstitial lung disease: the Multi-Ethnic Study of Atherosclerosis

Elana J Bernstein, R Graham Barr, John H M Austin, Steven M Kawut, Ganesh Raghu, Jessica L Sell, Eric A Hoffman, John D Newell, Jubal R Watts, P Hrudaya Nath, …

Thorax, Vol.71(12), pp.1082-1090

12/2016

DOI: 10.1136/thoraxjnl-2016-208932

PMCID: PMC5342945

PMID: 27609750

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Abstract

BackgroundAdults with interstitial lung disease (ILD) often have serologic evidence of autoimmunity of uncertain significance without overt autoimmune disease. We examined associations of rheumatoid arthritis (RA)-associated antibodies with subclinical ILD in community-dwelling adults.MethodsWe measured serum rheumatoid factor (RF) and anticyclic citrullinated peptide antibody (anti-CCP) and high attenuation areas (HAAs; CT attenuation values between −600 and −250 Hounsfield units) on cardiac CT in 6736 community-dwelling US adults enrolled in the Multi-Ethnic Study of Atherosclerosis. We measured interstitial lung abnormalities (ILAs) in 2907 full-lung CTs at 9.5-year median follow-up. We used generalised linear and additive models to examine associations between autoantibodies and both HAA and ILA, and tested for effect modification by smoking.ResultsIn adjusted models, HAA increased by 0.49% (95% CI 0.11% to 0.86%) per doubling of RF IgM and by 0.95% (95% CI 0.50% to 1.40%) per RF IgA doubling. ILA prevalence increased by 11% (95% CI 3% to 20%) per RF IgA doubling. Smoking modified the associations of both RF IgM and anti-CCP with both HAA and ILA (interaction p values varied from 0.01 to 0.09). Among ever smokers, HAA increased by 0.81% (95% CI 0.33% to 1.30%) and ILA prevalence increased by 14% (95% CI 5% to 24%,) per RF IgM doubling; and HAA increased by 1.31% (95% CI 0.45% to 2.18%) and ILA prevalence increased by 13% (95% CI 2% to 24%) per anti-CCP doubling. Among never smokers, no meaningful associations were detected.ConclusionsRA-related autoimmunity is associated with both quantitative and qualitative subclinical ILD phenotypes on CT, particularly among ever smokers.

Details

Title: Subtitle: Rheumatoid arthritis-associated autoantibodies and subclinical interstitial lung disease: the Multi-Ethnic Study of Atherosclerosis
Creators: Elana J Bernstein - Department of Medicine, Columbia University Medical Center, New York, New York, USA
R Graham Barr - Department of Epidemiology, Columbia University Medical Center, New York, New York, USA
John H M Austin - Department of Radiology, Columbia University Medical Center, New York, New York, USA
Steven M Kawut - Department of Medicine and Center for Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
Ganesh Raghu - Department of Medicine, University of Washington, Seattle, Washington, USA
Jessica L Sell - Department of Medicine, Columbia University Medical Center, New York, New York, USA
Eric A Hoffman - Department of Radiology, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
John D Newell - Department of Radiology, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
Jubal R Watts - Department of Radiology, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA
P Hrudaya Nath - Department of Radiology, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA
Sushil K Sonavane - Department of Radiology, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA
Joan M Bathon - Department of Medicine, Columbia University Medical Center, New York, New York, USA
Darcy S Majka - Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
David J Lederer - Department of Epidemiology, Columbia University Medical Center, New York, New York, USA
Resource Type: Journal article
Publication Details: Thorax, Vol.71(12), pp.1082-1090
DOI: 10.1136/thoraxjnl-2016-208932
PMID: 27609750
PMCID: PMC5342945
ISSN: 0040-6376
eISSN: 1468-3296
Grant note: DOI: 10.13039/100000050, name: National Heart, Lung, and Blood Institute, award: N01-HC-95159, N01-HC-95160, N01-HC-95161, N01-HC-95162, N01-HC-95163, N01-HC-95164, N01-HC-95165, R01-HL077612, R01-HL093081, R01-HL103676, R01-HL104047, RC1-HL100543; DOI: 10.13039/100000980, name: Arthritis Foundation; DOI: 10.13039/100003284, name: Pulmonary Fibrosis Foundation; DOI: 10.13039/100000097, name: National Center for Research Resources, award: UL1-TR-000040, UL1-TR-001079
Language: English
Date published: 12/2016
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Radiology; Internal Medicine
Record Identifier: 9984051591202771

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