== Characteristics of the rheumatoid arthritis cases at time of blood collection in NHS Figure 1shows the unadjusted associations between daily alcohol intake and levels of log transformed IL-6 (log IL-6) and sTNFRII. appropriate polynomial terms of alcohol consumption. == Results == After controlling for age at blood collection, smoking, parity and duration of breastfeeding, menopausal status, oral contraceptive use, BMI and the time between blood collection and RA onset, we found that the daily alcohol Rabbit Polyclonal to RGAG1 consumption showed a U-shaped association with IL-6 levels in RA patents prior to delta-Valerobetaine symptoms. We also found an inverse relationship between alcohol intake and sTNFRII levels but no associations with hsCRP and anti-CCP levels. == Conclusion == Alcohol consumption was associated with markers of inflammation including IL-6 and sTNFRII in RA patients prior to symptoms. == INTRODUCTION == Rheumatoid arthritis (RA) is an autoimmune disease, characterized by chronic, destructive, debilitating arthritis, that affects approximately 1% of the adult population (1,2). The cause of RA is unknown, but it is considered to be a multifactorial disease, resulting from the interaction of both genetic and environmental factors. (1). Epidemiological studies have suggested that moderate alcohol consumption may decrease the risk for RA and RA progression (35). One possible mechanism for this inverse association is that moderate alcohol consumption may be associated with reduced levels of inflammatory biomarkers (6). Alcohol has been shown to diminish the response to antigens in animals as well as in humans,(7,8) and to suppress the synthesis of proinflammatory cytokines and chemokines, such as TNF , IL-6 and IL-8 both in vivo and in vitro in alveolar macrophages and human blood monocytes (9,10). Studies have shown elevated autoantibodies and markers of inflammation in RA cases where blood was collected prior to RA symptoms (eg. pre-clinical RA) compared with matched controls (1114). However, little is known about the possible anti-inflammatory effect of alcohol consumption in pre-clinical RA. Our objective was to investigate the influence of alcohol consumption on autoantibodies and markers of inflammation including anticyclic citrullinated peptide (anti-CCP) antibodies, interleukin-6 (IL-6), soluble tumor necrosis factor receptor II (sTNFRII) and high-sensitivity C-reactive protein (hsCRP) in women with preclinical RA enrolled in two Nurses Health Study cohorts (NHS and NHS II). == METHODS == == Study design and participants == The Nurses Health Study delta-Valerobetaine (NHS) was established in 1976 and enrolled 121,700 US female registered nurses, ages 3055 years. A second NHS cohort, the NHS II, was established in 1989 and enrolled 116,609 female registered nurses, ages 2542 years. All women completed an initial questionnaire and have been followed biennially in the combined NHS cohorts by questionnaire to update exposures and disease diagnoses. From 1989 through 1990, 32,826 participants ages 4370 years in the NHS provided plasma samples in heparinized tubes. From 1996 through 1999, 29,611 participants ages 3251 years in NHS II provided blood samples. Collection and storage procedures for NHS II were similar to those described above for the NHS. All aspects of this study were approved by the Partners HealthCare Institutional Review Board. RA case identification in NHS and NHS II is a 2-step process. Two board-certified rheumatologists trained in chart abstraction conducted independent medical record reviews based on the American College of Rheumatology (ACR) classification criteria for RA. Detailed procedures were reported in previous research (12,15). After excluding all prevalent RA cases at the time of blood collection, we included 174 incident delta-Valerobetaine RA cases in the study (126 in NHS, 48 in NHS II) with a stored blood sample collected at least 3 months prior to the delta-Valerobetaine date of the first RA symptom documented in the medical record. == Assessment of alcohol consumption == Alcohol consumption was assessed every two years with a semi-quantitative food frequency questionnaire including separate items for beer, white wine, red wine, and liquor started from 1980 in NHS and 1989 in NHS II. We specified standard portions as a glass, bottle, or can of beer; a 4-oz glass.