Smoking as a Cause of Autoimmune Disease

Smoking can be a "trigger" for autoimmune disease specifically Multiple Sclerosis. There is an article below makes that association.

The question is why? No one knows the answer for sure, just like no one knows what triggers autoimmune disease to start in otherwise healthy people.

However it is known that identical twins do not both get an autoimmune disease at the same time or one might not get an autoimmune disesease the other has at all.

There are many instances of identical twins with one affected and the other not. One identical twin goes his/her whole long life with no sign of autoimmune and the other twin is horribly affected for decades before dying. Identical twins have identical genes, so how could this happen?

Epigenetics. This is a newly discovered environmental effect on our genes as we age.

Infection or CHEMICALS cause permanent changes to our genes during our lifetimes by turning off or on certain of our genes. These changes can be measured. Studies that measure these changes have been done on identical twins. It seems that twins are most similar at birth. The older identical twins get the more differences in gene expression they have. Gene expression is a measure of which genes are turned on and turned off. Environmental insults cause epigenetic changes to our genes which are seen as changes in gene expression.

Cigarette smoke is one such environmental insult. There are many others. You can pretty much guess what they are pesticides, cleaning chemicals, environmental smoke, diesel exhaust, etc.

Good news is there are proven medication that can reverse epigenetic changes. (HDAC is one.)These meds are in clinical trials for cancer right now.

Bad news the FDA is delaying the approval of this revolution in reversing epigenetic changes with red tape causing clinical trials to be too specific and too long lasting. The interference is no different than the FDA throws at the stem cell revolution and at new more effective autoimmune disease modifying drugs like ustekinumab.

Here are the articles. The first is about cigarette smoking associated with MS. The next about how lung cancer rates drop when cigarette smoking drops. The third is about President Obama's struggle to stop smoking.

Contact: Jenine Anderson
janderson@aan.com
American Academy of Neurology
Young smokers increase risk for multiple sclerosis
Young Smokers Increase Risk for Multiple Sclerosis

SEATTLE – People who start smoking before age 17 may increase their risk for developing multiple sclerosis (MS), according to a study released today that will be presented at the American Academy of Neurology's 61st Annual Meeting in Seattle, April 25 to May 2, 2009.
The study involved 87 people with MS who were among more than 30,000 people in a larger study. The people with MS were divided into three groups: non-smokers, early smokers (smokers who began before age 17), and late smokers (those who started smoking at 17 or older), and matched by age, gender, and race to 435 people without MS.

Early smokers were 2.7 times more likely to develop MS than nonsmokers. Late smokers did not have an increased risk for the disease. More than 32 percent of the MS patients were early smokers, compared to 19 percent of the people without MS.

"Studies show that environmental factors play a prominent role in multiple sclerosis," said study author Joseph Finkelstein, MD, PhD, of Johns Hopkins University School of Medicine, in Baltimore, MD, which conducted the study in collaboration with Veterans Affairs MS Center for Excellence. "Early smoking is an environmental factor that can be avoided."
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The American Academy of Neurology, an association of more than 21,000 neurologists and neuroscience professionals, is dedicated to promoting the highest quality patient-centered neurologic care. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as multiple sclerosis, restless legs syndrome, Alzheimer's disease, narcolepsy, and stroke.

For more information about the American Academy of Neurology, visit www.aan.com.
The AAN 61st Annual Meeting, the world's largest gathering of neurology professionals, takes place April 25 to May 2, 2009, in Seattle. Visit www.aan.com/am for more information.
Editor's Note: Study authors are available for interviews. Please contact Jenine Anderson, janderson@aan.com or Jay Mac Bride, jmacbride@aan.com.

To access 2009 AAN Annual Meeting abstracts available February 25, 2009, visit http://www.aan.com/go/science/abstracts.

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Experts predict 20 per cent drop in lung cancer rate

Published: Thursday, 19-Feb-2009
http://www.news-medical.net/print_article.asp?id=45976

Cancer Reserach UK experts are predicting that lung cancer rates will drop by nearly a fifth over the next 20 years, according to new figures.

Successful anti-smoking measures - such as the tobacco advertising ban and the legislation making public places smokefree - have meant the number of smokers has continued to drop.

But, although lung cancer rates will continue to fall - from around 50 people per 100,000 to around 40 by 2024 - the overall number of people diagnosed with the disease looks set to increase.

People living longer, combined with the delay between smoking and the onset of lung cancer means cases in the UK are expected to rise from around 38,500 to more than 41,600 by 2024.
Smoking causes around 90 per cent of lung cancers so as smoking rates have fallen so has the rate of lung cancer. The difference in lung cancer trends for men and women is dramatically mirrored by the smoking patterns for each sex.

More men than women have been diagnosed with lung cancer since records began. This is because more men have smoked. By 2024 women's lung cancer rate will drop, reflecting the female smoking rate falling by half between the mid-70s and today. But, the number of women diagnosed in the UK each year is expected to increase from around 15,500 today to more than 18,000 by 2024.

Men's lung cancer rates were highest in the early 1970s with more than 150 men in every 100,000 diagnosed with lung cancer. This reflected the peak in smoking rates in the 1940s and 50s. Even though the male lung cancer rate is set to drop by more than a quarter between now and 2024 the number of cases diagnosed in the future will remain similar to those diagnosed today - around 22,000.

Professor Max Parkin, co-author of the report, said: "These predictions are based on what we know to date about the current figures and trends for lung cancer. We can see that lung cancer rates should continue to drop but the number of cases will increase.

"This increase will mostly be in women which reflects the peak rates of smoking among women back in the 1970s. Lung cancer is unique in that we can track the reduction in cases with a reduction in the number of people exposed to a specific product - cigarette smoke. As fewer people smoke we should see a lower rate of the disease."

Jean King, Cancer Research UK's director of tobacco control, said: "These figures highlight just how effective tobacco control measures can be and how important it is for work to continue in this area. We know that nine in ten cases of lung cancer are caused by smoking but that one in five people still smoke, so it's vital we all work to protect future generations from this scourge.

"We want to see tobacco products put out of sight and out of mind in the upcoming tobacco control legislation. We would like a commitment from the government to introduce a comprehensive and well funded tobacco control strategy - one that stops young people from beginning an addiction that kills half of all long term smokers, and fully supports smokers to quit."
http://www.cancerresearchuk.org/

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http://www.ama-assn.org/amednews/2009/01/19/hlsa0119.htm

Obama on front lines in battle to stop smoking
Experts say his efforts to quit illustrate how difficult it is.
By Victoria Stagg Elliott, AMNews staff. Posted Jan. 19, 2009.

Physicians and other smoking-cessation advocates have found a high-profile illustration of the challenges of quitting tobacco: President-elect Barack Obama.

"His honesty should help a lot of people, because it's just not that easy to quit smoking," said Anthony Atkins, MD, a family physician and director of minority health and community outreach for the Lima Community Health Center in Lima, Ohio.

Obama has smoked intermittently for years, tried to quit several times and chewed nicotine gum, according to a report on his health compiled by his primary care physician, David L. Scheiner, MD, and released in May 2008 by his presidential campaign. According to more recent news reports, he still lights up occasionally but has pledged to respect the ban on smoking in the White House. To those who work on smoking issues, his situation is a very public example of how difficult quitting can be and how much effort it can require.

"He has not given up, and people should not give up or feel that they are failures if they do not quit smoking on the first or second or third attempt. They should just continue to try until they get it," said Carolyn Barley Britton, MD, president of the National Medical Assn.

Many physicians also hope he will be a role model for African-American men in particular. This demographic group tends to smoke more than do white males, although the numbers for white and black women are comparable. African-Americans experience a disproportionate rate of disease associated with tobacco use. The reason for this is unclear, but data from the National Cancer Institute's Surveillance Epidemiology and End Results indicate that African-Americans are 17% more likely than Caucasians to develop lung cancer.

Many experts praised Obama for taking all the right steps, even if it appears he has not yet been successful.

"This is an incredible opportunity to help educate the majority of smokers in America who want to quit, and those who have tried to quit and have failed, that this is a chronic medical condition and there are evidence-based treatments available," said Michael C. Fiore, MD, MPH, director of the Center for Tobacco Research and Intervention at the University of Wisconsin in Madison.

The American Medical Association encourages physicians to use practice guidelines to help patients with smoking cessation, such as Treating Tobacco Use and Dependence: 2008 Update.
Dr. Fiore chaired the panel that authored the document, which was released in May 2008 by the U.S. Public Health Service. It recognized tobacco dependence as a chronic disease that often requires more than one intervention and several attempts to quit.

African-Americans are 17% more likely than Caucasians to develop lung cancer.

The Update also advocates using existing treatments to improve the chance of success.
In addition, anti-smoking advocates are optimistic that Obama's personal experience with attempting to give up tobacco will trigger more interest in legislation amenable to reducing the number of smokers.

"My hope is that his firsthand knowledge of the power of tobacco will influence his administration in confronting tobacco dependence in our society," Dr. Fiore said.
According to the report on Obama's health, he exercises regularly and eats a balanced diet. His blood pressure is 90/60 and his pulse 60 beats per minute. His triglycerides are 44, total cholesterol 173, HDL cholesterol 68 and LDL cholesterol 96. Dr. Scheiner rated his health as excellent.

The print version of this content appeared in the Jan. 26, 2009