{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T15:11:13Z","timestamp":1791213073624,"version":"4.1.0"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2012,7,23]],"date-time":"2012-07-23T00:00:00Z","timestamp":1343001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/2.0\/"},{"start":{"date-parts":[[2012,7,23]],"date-time":"2012-07-23T00:00:00Z","timestamp":1343001600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/2.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Arthritis Res Ther"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The purpose of this research was to study the influence of cigarette smoking and alcohol consumption on immune response to heptavalent pneumococcal conjugate vaccine, immunoglobulin levels (Ig) and markers of systemic inflammation in patients with rheumatoid arthritis (RA) or spondylarthropathy (SpA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In total, 505 patients were vaccinated. Six pre-specified groups were enrolled: RA on methotrexate (MTX) treatment in some cases other disease-modifying antirheumatic drugs (DMARDs) (I); RA on anti-tumour necrosis factor (TNF) as monotherapy (II); RA on anti-TNF+MTX+ possibly other DMARDs (III); SpA on anti-TNF as monotherapy (IV); SpA on anti-TNF+MTX+ possibly other DMARDs (V); and SpA on nonsteroidal anti-inflammatory drugs (NSAIDs) and\/or analgesics (VI). Smoking (pack-years) and alcohol consumption (g\/week) were calculated from patient questionnaires. Ig, C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were determined at vaccination. IgG antibodies against serotypes 23F and 6B were measured at vaccination and after four to six weeks using standard ELISA. Immune response (ratio between post- and pre-vaccination antibodies; immune response (IR)) and positive immune response (\u22652-fold increase in pre-vaccination antibodies; posIR) were calculated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Eighty-eight patients (17.4%) were current smokers. Smokers had higher CRP and ESR, lower IgG and lower IR for both serotypes (\n                      <jats:italic>P<\/jats:italic>\n                      between 0.012 and 0.045). RA patients on MTX who smoked \u22651pack-year had lower posIR for both serotypes (\n                      <jats:italic>P<\/jats:italic>\n                      = 0.021; OR 0.29; CI 0.1 to 0.7) compared to never-smokers. Alcohol consumption was associated with lower CRP (\n                      <jats:italic>P<\/jats:italic>\n                      = 0.05) and ESR (\n                      <jats:italic>P<\/jats:italic>\n                      = 0.003) but did not influence IR or Ig levels.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Smoking predicted impaired immune response to pneumococcal conjugate vaccine in RA patients on MTX. Smokers with arthritis had higher inflammatory markers and lower IgG regardless of diagnosis and treatment. Low to moderate alcohol consumption was related to lower levels of inflammation markers but had no impact on immune response.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>\n                      EudraCT EU 2007-006539-29 and\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.clinicaltrials.gov\/ct2\/show\/NCT00828997\">NCT00828997<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/ar3923","type":"journal-article","created":{"date-parts":[[2012,7,23]],"date-time":"2012-07-23T06:14:41Z","timestamp":1343024081000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["The effect of smoking and alcohol consumption on markers of systemic inflammation, immunoglobulin levels and immune response following pneumococcal vaccination in patients with arthritis"],"prefix":"10.1186","volume":"14","author":[{"given":"Carmen","family":"Roseman","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lennart","family":"Truedsson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meliha Crnkic","family":"Kapetanovic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2012,7,23]]},"reference":[{"key":"3657_CR1","first-page":"1102","volume":"59","author":"Centers for Disease Control and Prevention (CDC); Advisory Committee on Immunization Practices","year":"2010","unstructured":"Centers for Disease Control and Prevention (CDC); Advisory Committee on Immunization Practices: Updated recommendations for prevention of invasive pneumococcal disease among adults using the 23-valent pneumococcal polysaccharide vaccine (PPSV23). MMWR Morb Mortal Wkly Rep. 2010, 59: 1102-1106.","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"3657_CR2","doi-asserted-by":"publisher","first-page":"681","DOI":"10.1056\/NEJM200003093421002","volume":"342","author":"JP Nuorti","year":"2000","unstructured":"Nuorti JP, Butler JC, Farley MM, Harrison LH, McGeer A, Kolczak MS, Breiman RF: Cigarette smoking and invasive pneumococcal disease. Active Bacterial Core Surveillance Team. N Engl J Med. 2000, 342: 681-689. 10.1056\/NEJM200003093421002.","journal-title":"N Engl J Med"},{"key":"3657_CR3","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1002\/art.21575","volume":"54","author":"L Klareskog","year":"2006","unstructured":"Klareskog L, Stolt P, Lundberg K, K\u00e4llberg H, Bengtsson C, Grunewald J, R\u00f6nnelid J, Harris HE, Ulfgren AK, Rantap\u00e4\u00e4-Dahlqvist S, Eklund A, Padyukov L, Alfredsson L: A new model for an etiology of rheumatoid arthritis: smoking may trigger HLA-DR (shared epitope)-restricted immune reactions to autoantigens modified by citrullination. Arthritis Rheum. 2006, 54: 38-46. 10.1002\/art.21575.","journal-title":"Arthritis Rheum"},{"key":"3657_CR4","doi-asserted-by":"publisher","first-page":"420","DOI":"10.1093\/ije\/26.2.420","volume":"26","author":"U Sankilampi","year":"1997","unstructured":"Sankilampi U, Isoaho R, Bloigu A, Kivel\u00e4 SL, Leinonen M: Effect of age, sex and smoking habits on pneumococcal antibodies in an elderly population. Int J Epidemiol. 1997, 26: 420-427. 10.1093\/ije\/26.2.420.","journal-title":"Int J Epidemiol"},{"key":"3657_CR5","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1016\/S0378-4274(00)00270-8","volume":"118","author":"P Moszczy\u0144ski","year":"2001","unstructured":"Moszczy\u0144ski P, Zabi\u0144ski Z, Moszczy\u0144ski P, Rutowski J, S\u0142owi\u0144ski S, Tabarowski Z: Immunological findings in cigarette smokers. Toxicol Lett. 2001, 118: 121-127. 10.1016\/S0378-4274(00)00270-8.","journal-title":"Toxicol Lett"},{"key":"3657_CR6","doi-asserted-by":"publisher","first-page":"426","DOI":"10.1016\/S0264-410X(98)00213-8","volume":"17","author":"M Cruijff","year":"1999","unstructured":"Cruijff M, Thijs C, Govaert T, Aretz K, Dinant GJ, Knottnerus A: The effect of smoking on influenza, influenza vaccination efficacy and on the antibody response to influenza vaccination. Vaccine. 1999, 17: 426-432. 10.1016\/S0264-410X(98)00213-8.","journal-title":"Vaccine"},{"key":"3657_CR7","first-page":"19","volume":"59","author":"J Domagala-Kulawik","year":"2008","unstructured":"Domagala-Kulawik J: Effects of cigarette smoke on the lung and systemic immunity. J Physiol Pharmacol. 2008, 59: 19-34.","journal-title":"J Physiol Pharmacol"},{"key":"3657_CR8","doi-asserted-by":"publisher","first-page":"241","DOI":"10.1136\/thx.42.4.241","volume":"42","author":"PG Holt","year":"1987","unstructured":"Holt PG: Immune and inflammatory function in cigarette smokers. Thorax. 1987, 42: 241-249. 10.1136\/thx.42.4.241.","journal-title":"Thorax"},{"key":"3657_CR9","doi-asserted-by":"publisher","first-page":"S50","DOI":"10.1038\/sj.ejcn.1601486","volume":"56","author":"LE D\u00edaz","year":"2002","unstructured":"D\u00edaz LE, Montero A, Gonz\u00e1lez-Gross M, Vallejo AI, Romeo J, Marcos A: Influence of alcohol consumption on immunological status: a review. Eur J Clin Nutr. 2002, 56: S50-S53.","journal-title":"Eur J Clin Nutr"},{"key":"3657_CR10","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1016\/j.alcohol.2011.07.009","volume":"46","author":"A Zahs","year":"2012","unstructured":"Zahs A, Cook RT, Waldschimdt TJ, Choudhry MA, Kovacs EJ, Bird MD: Alcohol and inflammation and infection: clinical and experimental systems-summary of the 2010 Alcohol and Immunology Research Interest Group Meeting. Alcohol. 2012, 46: 147-153. 10.1016\/j.alcohol.2011.07.009.","journal-title":"Alcohol"},{"key":"3657_CR11","doi-asserted-by":"publisher","first-page":"S111","DOI":"10.1017\/S0007114507838049","volume":"98","author":"J Romeo","year":"2007","unstructured":"Romeo J, W\u00e4rnberg J, Nova E, D\u00edaz LE, G\u00f3mez-Martinez S, Marcos A: Moderate alcohol consumption and the immune system: a review. Br J Nutr. 2007, 98: S111-S115.","journal-title":"Br J Nutr"},{"key":"3657_CR12","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1016\/j.atherosclerosis.2004.03.006","volume":"175","author":"R Estruch","year":"2004","unstructured":"Estruch R, Sacanella E, Badia E, Ant\u00fanez E, Nicol\u00e1s JM, Fern\u00e1ndez-Sol\u00e1 J, Rotilio D, de Gaetano G, Rubin E, Urbano-M\u00e1rquez A: Different effects of red wine and gin consumption on inflammatory biomarkers of atherosclerosis: a prospective randomized crossover trial. Effects of wine on inflammatory markers. Atherosclerosis. 2004, 175: 117-123. 10.1016\/j.atherosclerosis.2004.03.006.","journal-title":"Atherosclerosis"},{"key":"3657_CR13","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1093\/rheumatology\/kei193","volume":"45","author":"MC Kapetanovic","year":"2006","unstructured":"Kapetanovic MC, Saxne T, Sj\u00f6holm A, Truedsson L, J\u00f6nsson G, Geborek P: Influence of methotrexate, TNF-blocker and prednisolone on antibody responses to pneumococcal polysacharide vaccine in patients with rheumatoid arthritis. Rheumatology. 2006, 45: 106-111. 10.1093\/rheumatology\/kei193.","journal-title":"Rheumatology"},{"key":"3657_CR14","doi-asserted-by":"publisher","first-page":"723","DOI":"10.1002\/art.30580","volume":"63","author":"MC Kapetanovic","year":"2011","unstructured":"Kapetanovic MC, Roseman C, J\u00f6nsson G, Truedsson L, Saxne T, Geborek P: Antibody response is reduced following vaccination with 7-valent conjugate pneumococcal vaccine in adult methotrexate-treated patients with established arthritis, but not those treated with tumour necrosis factor inhibitors. Arthritis Rheum. 2011, 63: 723-732.","journal-title":"Arthritis Rheum"},{"key":"3657_CR15","unstructured":"WHO: Training manual for Streptococcus pneumoniae serotype specific IgG (PN PS ELISA). Available at:[http:\/\/www.vaccine.uab.edu]"},{"key":"3657_CR16","doi-asserted-by":"crossref","first-page":"810","DOI":"10.1093\/oxfordjournals.aje.a115960","volume":"133","author":"E Giovannucci","year":"1991","unstructured":"Giovannucci E, Colditz G, Stampfer MJ, Rimm EB, Litin L, Sampson L, Willett WC: The assessment of alcohol consumption by a simple self-administered questionnaire. Am J Epidemiol. 1991, 133: 810-817.","journal-title":"Am J Epidemiol"},{"key":"3657_CR17","doi-asserted-by":"publisher","first-page":"1598","DOI":"10.1093\/eurheartj\/ehs047","volume":"33","author":"JK Pai","year":"2012","unstructured":"Pai JK, Mukamal KJ, Rimm EB: Long-term alcohol consumption in relation to all-cause and cardiovascular mortality among survivors of myocardial infarction: the Health Professionals Follow-up Study. Eur Heart J. 2012, 33: 1598-1605. 10.1093\/eurheartj\/ehs047.","journal-title":"Eur Heart J"},{"key":"3657_CR18","doi-asserted-by":"publisher","first-page":"1557","DOI":"10.1378\/chest.06-2179","volume":"131","author":"DG Yanbaeva","year":"2007","unstructured":"Yanbaeva DG, Dentener MA, Creutzberg EC, Wesseling G, Wouters EF: Systemic effects of smoking. Chest. 2007, 131: 1557-1566. 10.1378\/chest.06-2179.","journal-title":"Chest"},{"key":"3657_CR19","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1136\/bmj.321.7255.199","volume":"321","author":"J Danesh","year":"2000","unstructured":"Danesh J, Whincup P, Walker M, Lennon L, Thomson A, Appleby P, Gallimore JR, Pepys MB: Low grade inflammation and coronary heart disease: prospective study and updated meta-analyses. BMJ. 2000, 321: 199-204. 10.1136\/bmj.321.7255.199.","journal-title":"BMJ"},{"key":"3657_CR20","doi-asserted-by":"publisher","first-page":"132","DOI":"10.1016\/S0140-6736(10)60484-9","volume":"375","author":"S Kaptoge","year":"2010","unstructured":"Emerging Risk Factors Collaboration, Kaptoge S, Di Angelantonio E, Lowe G, Pepys MB, Thompson SG, Collins R, Danesh J: C-reactive protein concentration and risk of coronary heart disease, stroke, and mortality: an individual participant meta-analysis. Lancet. 2010, 375: 132-140.","journal-title":"Lancet"},{"key":"3657_CR21","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1038\/nrrheum.2010.5","volume":"6","author":"ES Chan","year":"2010","unstructured":"Chan ES, Cronstein BN: Methotrexate--how does it really work?. Nat Rev Rheumatol. 2010, 6: 175-178. 10.1038\/nrrheum.2010.5.","journal-title":"Nat Rev Rheumatol"},{"key":"3657_CR22","doi-asserted-by":"publisher","first-page":"3692","DOI":"10.1002\/art.30599","volume":"63","author":"J Sellam","year":"2011","unstructured":"Sellam J, Rouanet S, Hendel-Chavez H, Abbed K, Sibilia J, Tebib J, Le Lo\u00ebt X, Combe B, Dougados M, Mariette X, Taoufik Y: Blood memory B cells are disturbed and predict the response to rituximab in patients with rheumatoid arthritis. Arthritis Rheum. 2011, 63: 3692-3701. 10.1002\/art.30599.","journal-title":"Arthritis Rheum"},{"key":"3657_CR23","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1093\/acprof:oso\/9780198508564.003.0001","volume-title":"International Smoking Statistics. A Collection of Historical Data from 30 Economically Developed Countries","author":"B Forey","year":"2002","unstructured":"Forey B, Lee P: Estimation of sex-specific smoking statistics by standardized age groups and time periods. International Smoking Statistics. A Collection of Historical Data from 30 Economically Developed Countries. Edited by: Forey B, Hamling J, Lee P, Wald N. 2002, London and Oxford: Wolfson Institute of Preventative Medicine and Oxford University Press, 1-201."},{"key":"3657_CR24","doi-asserted-by":"publisher","first-page":"861","DOI":"10.1086\/323339","volume":"184","author":"B Henriques Normark","year":"2001","unstructured":"Henriques Normark B, Kalin M, Ortqvist A, Akerlund T, Liljequist BO, Hedlund J, Svenson SB, Zhou J, Spratt BG, Normark S, K\u00e4llenius G: Dynamics of penicillin-susceptible clones in invasive pneumococcal disease. J Infect Dis. 2001, 184: 861-869. 10.1086\/323339.","journal-title":"J Infect Dis"}],"container-title":["Arthritis Research &amp; Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/ar3923.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/ar3923\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/ar3923.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,8]],"date-time":"2024-10-08T06:35:35Z","timestamp":1728369335000},"score":1,"resource":{"primary":{"URL":"https:\/\/arthritis-research.biomedcentral.com\/articles\/10.1186\/ar3923"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,7,23]]},"references-count":24,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2012,8]]}},"alternative-id":["3657"],"URL":"https:\/\/doi.org\/10.1186\/ar3923","relation":{"has-review":[{"id-type":"doi","id":"10.3410\/f.717954013.793459678","asserted-by":"object"}]},"ISSN":["1478-6354"],"issn-type":[{"value":"1478-6354","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,7,23]]},"assertion":[{"value":"8 May 2012","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 July 2012","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 July 2012","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 July 2012","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}}],"article-number":"R170"}}