Psoriasis and smoking: links and risks.
Psoriasis and smoking: links and risks.
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DOI：
10.2147/ptt.s85189
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发表时间：
2016
期刊：
影响因子：
--
通讯作者：
Naldi L
中科院分区：
文献类型：
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作者：
Naldi L
吸烟是一种受遗传、环境和社会因素影响的复杂环境暴露。尼古丁是烟草中介导烟草制品成瘾作用的主要生物碱。烟草是7 000多种化学物质的混合物，吸烟被认为是人类许多疾病的风险因素，包括心血管和肺部疾病以及几种癌症，并且是全世界最可预防的死亡原因。许多炎症性免疫相关疾病与吸烟有关，包括牛皮癣。牛皮癣的症状有哪些？在25项病例对照研究的汇总分析中，吸烟者中银屑病的比值比为1.78（95%置信区间[CI]：1.53-2.06）。还记录了剂量-效应关系。在对三项队列研究的汇总分析中，每天吸烟1-14支的患者发生银屑病的风险为1.81（95% CI：1.38-2.36），每天吸烟≥25支的患者为2.29（95% CI：1.74-3.01）。吸烟还影响银屑病的临床严重程度，其对治疗的反应，并解释了一些相关的合并症，例如心血管疾病，炎症性肠病和几种癌症（特别是呼吸道癌症）。吸烟在银屑病关节炎中作用的数据与银屑病相关数据相比不太一致。几种病理生理学机制可以解释银屑病与吸烟的关系，包括氧化应激、与银屑病中活跃的信号通路的相互作用以及血管影响。总之，牛皮癣只是与吸烟有关的许多疾病之一，但它是可见的和致残的。皮肤科医生可以通过影响患者改变他们的行为，在减少吸烟的健康负担方面发挥重要作用。
Smoking is a complex environmental exposure influenced by genetic, environmental, and social factors. Nicotine is the principal alkaloid in tobacco that mediates the addicting effects of tobacco products. Tobacco is a mixture of more than 7,000 chemicals, and smoking is recognized as a risk factor for many diseases in humans, including cardiovascular and pulmonary disease and several cancers, and is the single most preventable cause of mortality worldwide. A number of inflammatory immune-related conditions have been associated with smoking, including psoriasis. Smoking affects the onset of psoriasis. In a pooled analysis of 25 case–control studies, the odds ratio of psoriasis among smokers was 1.78 (95% confidence interval [CI]: 1.53–2.06). A dose–effect relationship is also documented. In a pooled analysis of three cohort studies, the risk of incident psoriasis was 1.81 (95% CI: 1.38–2.36) in those who smoked 1–14 cigarettes per day, and 2.29 (95% CI: 1.74–3.01) in those who smoked ≥25 cigarettes per day. Smoking also impacts on the clinical severity of psoriasis, its response to treatment, and explains some of the associated comorbidities, eg, cardiovascular disease, inflammatory bowel disease, and several cancers (especially those of the respiratory tract). Data on the role of smoking in psoriatic arthritis are less consistent compared with those concerning psoriasis. Several pathophysiological mechanisms may explain the association of psoriasis with smoking, including oxidative stress, interaction with signaling pathways active in psoriasis, and vascular influences. In conclusion, psoriasis is just one of the many diseases associated with smoking, but it is visible and disabling. Dermatologists could play a major role in reducing the health burden of smoking by influencing the patients to change their behavior.