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. 2024 Jun 20:11:1403851.
doi: 10.3389/fmed.2024.1403851. eCollection 2024.

The causal relationship between rheumatoid arthritis and bronchiectasis: a bidirectional Mendelian randomization study

Yuanyuan Li #  1 , Weina Wang #  1 , Dengfeng Zhou  1 , Lili Li  2
Affiliations

The causal relationship between rheumatoid arthritis and bronchiectasis: a bidirectional Mendelian randomization study

Yuanyuan Li et al. Front Med (Lausanne). .

Abstract

Background: Several observational studies suggested an association between rheumatoid arthritis (RA) and bronchiectasis. Nevertheless, the presence of a causal relationship between these conditions is yet to be determined. This study aimed to investigate whether genetically predicted RA is associated with the risk of bronchiectasis and vice versa.

Methods: We obtained RA genome-wide association study (GWAS) data from FinnGen consortium, and bronchiectasis GWAS data from IEU Open GWAS project. Univariate Mendelian randomization (MR) analysis was performed using inverse variance weighted (IVW) estimation as the main method. Furthermore, bidirectional and replication MR analysis, multivariate MR (MVMR), Mediation analysis, and sensitivity analyses were conducted to validate the findings.

Results: In the UVMR analysis, the IVW results revealed that RA had an increased risk of bronchiectasis (OR = 1.18, 95% CI = 1.10-1.27; p = 2.34 × 10-6). In the reverse MR analysis, no evidence of a causal effect of bronchiectasis on the risk of RA was detected. Conversely, in the replication MR analysis, RA remained associated with an increased risk of bronchiectasis. Estimates remained consistent in MVMR analyses after adjusting for the prescription of non-steroidal anti-inflammatory drugs (NSAIDs) and glucocorticoids. Immunosuppressants were found to mediate 58% of the effect of the RA on bronchiectasis. Sensitivity analyses confirmed the stability of these associations.

Conclusion: This study demonstrated a positive causal relationship between RA and an increased risk of bronchiectasis, offering insights for the early prevention of bronchiectasis in RA patients and shedding new light on the potential role of immunosuppressants as mediators in promoting the effects of RA on bronchiectasis.

Keywords: GWAS; Mendelian randomization; bronchiectasis; causal association; rheumatoid arthritis.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Assumptions and study design of the bidirectional MR study of the associations between RA and bronchiectasis. RA, rheumatoid arthritis; MR, Mendelian randomization; SNPs, single-nucleotide polymorphisms.
Figure 2
Figure 2
Scatter plot for the causal effect of rheumatoid arthritis on the risk of bronchiectasis.
Figure 3
Figure 3
Funnel plot for the causal effect of rheumatoid arthritis on the risk of bronchiectasis.
Figure 4
Figure 4
Leave-one-out analysis for the causal effect of rheumatoid arthritis on the risk of bronchiectasis.
See this image and copyright information in PMC

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