Document Type
Article
Publication Date
11-8-2021
Abstract
Background: Interstitial lung diseases (ILDs) are diffuse parenchymal lung disorders that cause substantial morbidity and mortality. In patients with ILD, elevated antinuclear antibody (ANA) titres may be a sign of an autoimmune process. Inhalational exposures contribute to ILD pathogenesis and affect prognosis and may trigger autoimmune disease. The association of inhalational exposures with ANA seropositivity in ILD patients is unknown.
Methods: This was a retrospective cohort study of adult ILD patients from five centres in the United States. Exposures to tobacco, inhaled organic antigens and inhaled inorganic particles were extracted from medical records. A multivariable logistic regression model was used to analyse the effects of confounders including age, ILD diagnosis, gender and exposure type on ANA seropositivity.
Results: Among 1265 patients with ILD, there were more ANA-seropositive (58.6%, n=741) than ANA-seronegative patients (41.4%, n=524). ANA-seropositive patients had lower total lung capacity (69% versus 75%, p<0.001) and forced vital capacity (64% versus 70%, p<0.001) than patients who were ANA-seronegative. Among patients with tobacco exposure, 61.4% (n=449) were ANA-positive compared to 54.7% (n=292) of those without tobacco exposure. In multivariable analysis, tobacco exposure remained independently associated with increased ANA seropositivity (OR 1.38, 95% CI 1.12-1.71). This significant difference was similarly demonstrated among patients with and without a history of inorganic exposures (OR 1.52, 95% CI 1.12-2.07).
Conclusion: Patients with ILD and inhalational exposure had significantly higher prevalence of ANA-seropositivity than those without reported exposures across ILD diagnoses. Environmental and occupational exposures should be systematically reviewed in patients with ILD, particularly those with ANA-seropositivity.
Recommended Citation
Biblowitz, K.; Lee, Cathryn; Zhu, Daisy; Noth, Imre; Vij, Rekha; Strek, Mary E; Bellam, Shashi K; and Adegunsoye, Ayodeji, "Association of antinuclear antibody seropositivity with inhaled environmental exposures in patients with interstitial lung disease" (2021). Division of Pulmonary and Critical Care Medicine Faculty Papers. Paper 21.
https://jdc.jefferson.edu/pulmcritcarefp/21
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License
PubMed ID
34761002
Language
English
Comments
This article is the author’s final published version in ERJ Open Research, Volume 7, Issue 4, November 2021, Article number 00254-2021.
The published version is available at https://doi.org/10.1183/23120541.00254-2021. Copyright © Biblowitz et al.