According to a recent study published in the Rheumatology by Oxford Academia, there is a significant longitudinal reciprocal association between RA and COPD, which is partially mediated by systemic inflammation.
Dr. Yang and colleagues investigated the bidirectional relationship between RA and COPD, as well as the role of systemic inflammation as a mediator among 40,304 individuals recruited from the UK Biobank to investigate the association between RA and COPD over time. They utilized a cross-lagged panel model, Cox-proportional hazard regression, and logistic regression models to examine the link between baseline RA and COPD during follow-up and vice versa. The study also explored the mediating roles of 160 systemic inflammatory biomarkers in the bidirectional relationship using causal mediation analysis.
The researchers noted that 1.2% of individuals were diagnosed with RA and 1.7% with COPD at baseline. The results of the cross-lagged panel model showed a two-way association between RA and COPD. The risk of future COPD was found to be higher in RA patients in the non-COPD population, and baseline COPD was associated with a higher risk of RA in the non-RA population. The path from RA to COPD was mediated by five inflammatory factors, and C-reactive protein was found to mediate the path from COPD to RA.
These findings are consistent with a comprehensive systematic review by Ma et al., which demonstrated the high prevalence of COPD in RA patients. It is recommended that patients with RA should quit smoking, and rheumatologists should monitor COPD to prevent and control its progression.
The researchers have uncovered a significant association between RA and COPD, with systemic inflammation playing a partial mediating role. This discovery highlights the need for further research to elucidate the intricate cellular and molecular mechanisms underlying this association. A deeper understanding of these mechanisms can pave the way for more targeted and effective interventions, ultimately improving the management and care of individuals affected by both RA and COPD.
References
- Yang K, Wang L, Chen S, Chen R. Longitudinal reciprocal association between rheumatoid arthritis and chronic obstructive pulmonary disease and mediation of inflammation. Rheumatology. 2023 Nov 6; kead594.
- Ma Y, Tong H, Zhang X, Wang M, Yang J, Wu M, et al. Chronic obstructive pulmonary disease in rheumatoid arthritis: a systematic review and meta-analysis. Respiratory Research. 2019 Jul 9;20(1):144.