Association of combined pulmonary fibrosis and emphysema in rheumatoid arthritis with high titer of rheumatoid factor and autoimmunity to the lung
BackgroundCombined pulmonary fibrosis and emphysema (CPFE) commonly coexists with connective tissue diseases (CTD), such as rheumatoid arthritis (RA). However, the risk factors contributing to the development of CTD-CPFE remain largely unidentified. This study aimed to characterize CPFE using a larg...
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Frontiers Media S.A.
2025-02-01
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| Series: | Frontiers in Immunology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2025.1514552/full |
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| author | Aiping Ma Renliang Huang Jiaxi Guo Guangdong Wang Heqing Huang Xinze Li Shan Zhong Yan Huang Shaowei Lin Yikai Lin Qiaomiao Zhou Susanne Krauss-Etschmann Frank Petersen Zhanxiang Wang Xinhua Yu Xinhua Yu |
| author_facet | Aiping Ma Renliang Huang Jiaxi Guo Guangdong Wang Heqing Huang Xinze Li Shan Zhong Yan Huang Shaowei Lin Yikai Lin Qiaomiao Zhou Susanne Krauss-Etschmann Frank Petersen Zhanxiang Wang Xinhua Yu Xinhua Yu |
| author_sort | Aiping Ma |
| collection | DOAJ |
| description | BackgroundCombined pulmonary fibrosis and emphysema (CPFE) commonly coexists with connective tissue diseases (CTD), such as rheumatoid arthritis (RA). However, the risk factors contributing to the development of CTD-CPFE remain largely unidentified. This study aimed to characterize CPFE using a large cohort of consecutive RA patients and to elucidate potential risk factors associated with RA- CPFE development.MethodsA total of 976 RA patients were enrolled in this cross-sectional study to characterize RA-CPFE. Multiple logistic analyses were conducted to identify potential risk factors for RA-CPFE development. Patient IgG and IgM autoantibodies to primary human bronchial epithelial cells (HBEC) from healthy donors were assessed using flow cytometry.FindingsAmong the 976 RA patients, 414 (42.4%) developed interstitial lung disease (ILD), with 74 (7.6%) experiencing CPFE. In comparison to RA-CPFE patients with centrilobular or paraseptal emphysema, those with panacinar emphysema had higher emphysema scores and decreased pulmonary function parameters. Multiple logistic regression analysis revealed that male gender, cigarette smoking, occupational exposure to dust, high ILD score, high rheumatoid factor (RF) titers, and the presence of anti-SSA were associated with an increased risk for RA-CPFE. Additionally, levels of IgG and IgM autoantibodies to HBEC were elevated in RA-CPFE patients compared to healthy controls and positively correlated with RF levels.InterpretationThis study is the first to demonstrate the association of RA-CPFE with high titer of RF and the presence of autoantibodies against HBEC, suggesting a link between autoimmunity to the lung and RA-CPFE. |
| format | Article |
| id | doaj-art-bfee7eb6bbe644389f697320b635f54a |
| institution | Kabale University |
| issn | 1664-3224 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Immunology |
| spelling | doaj-art-bfee7eb6bbe644389f697320b635f54a2025-02-05T07:33:02ZengFrontiers Media S.A.Frontiers in Immunology1664-32242025-02-011610.3389/fimmu.2025.15145521514552Association of combined pulmonary fibrosis and emphysema in rheumatoid arthritis with high titer of rheumatoid factor and autoimmunity to the lungAiping Ma0Renliang Huang1Jiaxi Guo2Guangdong Wang3Heqing Huang4Xinze Li5Shan Zhong6Yan Huang7Shaowei Lin8Yikai Lin9Qiaomiao Zhou10Susanne Krauss-Etschmann11Frank Petersen12Zhanxiang Wang13Xinhua Yu14Xinhua Yu15Department of Respiratory and Critical Medicine, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, ChinaDepartment of Genetics and Prenatal Diagnosis, Hainan Women and Children’s Medical Center, Haikou, Hainan, ChinaDepartment of Respiratory and Critical Medicine, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, ChinaDepartment of Respiratory and Critical Medicine, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, ChinaDepartment of Rheumatology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, ChinaNHC Key Laboratory of Tropical Disease Control, School of Tropical Medicine, Hainan Medical University, Haikou, Hainan, ChinaDepartment of Pathology, The First Affiliated Hospital, School of Medicine, Xiamen University, Xiamen, ChinaDepartment of Pathology, The First Affiliated Hospital, School of Medicine, Xiamen University, Xiamen, ChinaDepartment of Nuclear Medicine, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, ChinaDepartment of Radiology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, ChinaDepartment of Genetics and Prenatal Diagnosis, Hainan Women and Children’s Medical Center, Haikou, Hainan, ChinaPriority Area Chronic Lung Diseases, Research Center Borstel, Borstel, GermanyPriority Area Chronic Lung Diseases, Research Center Borstel, Borstel, GermanyDepartment of Neurosurgery, The First Affiliated Hospital of Xiamen University, Xiamen, ChinaDepartment of Genetics and Prenatal Diagnosis, Hainan Women and Children’s Medical Center, Haikou, Hainan, ChinaPriority Area Chronic Lung Diseases, Research Center Borstel, Borstel, GermanyBackgroundCombined pulmonary fibrosis and emphysema (CPFE) commonly coexists with connective tissue diseases (CTD), such as rheumatoid arthritis (RA). However, the risk factors contributing to the development of CTD-CPFE remain largely unidentified. This study aimed to characterize CPFE using a large cohort of consecutive RA patients and to elucidate potential risk factors associated with RA- CPFE development.MethodsA total of 976 RA patients were enrolled in this cross-sectional study to characterize RA-CPFE. Multiple logistic analyses were conducted to identify potential risk factors for RA-CPFE development. Patient IgG and IgM autoantibodies to primary human bronchial epithelial cells (HBEC) from healthy donors were assessed using flow cytometry.FindingsAmong the 976 RA patients, 414 (42.4%) developed interstitial lung disease (ILD), with 74 (7.6%) experiencing CPFE. In comparison to RA-CPFE patients with centrilobular or paraseptal emphysema, those with panacinar emphysema had higher emphysema scores and decreased pulmonary function parameters. Multiple logistic regression analysis revealed that male gender, cigarette smoking, occupational exposure to dust, high ILD score, high rheumatoid factor (RF) titers, and the presence of anti-SSA were associated with an increased risk for RA-CPFE. Additionally, levels of IgG and IgM autoantibodies to HBEC were elevated in RA-CPFE patients compared to healthy controls and positively correlated with RF levels.InterpretationThis study is the first to demonstrate the association of RA-CPFE with high titer of RF and the presence of autoantibodies against HBEC, suggesting a link between autoimmunity to the lung and RA-CPFE.https://www.frontiersin.org/articles/10.3389/fimmu.2025.1514552/fullcombined pulmonary fibrosis and emphysema (CPFE)connective tissue diseases (CTD)rheumatoid arthritis (RA)autoimmunityrheumatoid factor (RF)human bronchial epithelial cells (HBEC) |
| spellingShingle | Aiping Ma Renliang Huang Jiaxi Guo Guangdong Wang Heqing Huang Xinze Li Shan Zhong Yan Huang Shaowei Lin Yikai Lin Qiaomiao Zhou Susanne Krauss-Etschmann Frank Petersen Zhanxiang Wang Xinhua Yu Xinhua Yu Association of combined pulmonary fibrosis and emphysema in rheumatoid arthritis with high titer of rheumatoid factor and autoimmunity to the lung Frontiers in Immunology combined pulmonary fibrosis and emphysema (CPFE) connective tissue diseases (CTD) rheumatoid arthritis (RA) autoimmunity rheumatoid factor (RF) human bronchial epithelial cells (HBEC) |
| title | Association of combined pulmonary fibrosis and emphysema in rheumatoid arthritis with high titer of rheumatoid factor and autoimmunity to the lung |
| title_full | Association of combined pulmonary fibrosis and emphysema in rheumatoid arthritis with high titer of rheumatoid factor and autoimmunity to the lung |
| title_fullStr | Association of combined pulmonary fibrosis and emphysema in rheumatoid arthritis with high titer of rheumatoid factor and autoimmunity to the lung |
| title_full_unstemmed | Association of combined pulmonary fibrosis and emphysema in rheumatoid arthritis with high titer of rheumatoid factor and autoimmunity to the lung |
| title_short | Association of combined pulmonary fibrosis and emphysema in rheumatoid arthritis with high titer of rheumatoid factor and autoimmunity to the lung |
| title_sort | association of combined pulmonary fibrosis and emphysema in rheumatoid arthritis with high titer of rheumatoid factor and autoimmunity to the lung |
| topic | combined pulmonary fibrosis and emphysema (CPFE) connective tissue diseases (CTD) rheumatoid arthritis (RA) autoimmunity rheumatoid factor (RF) human bronchial epithelial cells (HBEC) |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2025.1514552/full |
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