Burn Pit, Waste Exposure Linked to Anti-CCP Antibodies in RA

THURSDAY, Oct. 29, 2020 — For patients with rheumatoid arthritis (RA), military burn pit and military waste disposal exposures are associated with the presence of anti-cyclic citrullinated peptide (anti-CCP) antibodies, according to a study published online Oct. 15 in Arthritis & Rheumatology.

Ariadne V. Ebel, D.O., from the VA Nebraska-Western Iowa Health Care System & University of Nebraska Medical Center in Omaha, and colleagues surveyed participants in the Veterans Affairs Rheumatoid Arthritis Registry to examine occupational, agricultural, and military inhalant exposures; questionnaires were returned by 797 participants. The associations between inhalant exposures and RA-related factors were examined.

The researchers found that independent of other factors, veterans exposed to burn pits and military waste disposal more often had anti-CCP positivity (odds ratios, 1.66 and 1.74, respectively). Burn pit and military waste disposal exposures were numerically more strongly associated with anti-CCP positivity among those positive for HLA-DRB1 shared epitope status (odds ratios, 5.69 and 5.05, respectively). There were associations noted for several inhalant exposures with the presence of chronic lung disease, but not rheumatoid factor or disease activity.

“These findings support emerging evidence that various inhalant exposures may contribute to the generation of RA autoantibodies such as anti-citrullinated protein antibodies,” the authors write. “Prospective cohort studies comprehensively evaluating the impact of inhalant exposures, including military burn pits and waste disposal, and genetic risk factors on RA risk are needed.”

One author disclosed financial ties to Regeneron.

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