Antioxidants and smoking in autoimmune disease — Opposing sides of the seesaw?

Autoimmune disorders carry significant morbidity and mortality. Reduction–oxygenation reactions and their byproduct reactive oxygen species have been suspected to influence the initiation and outcome of these disorders. It stands to reason that inhibition of these negative influences by the use of antioxidants would help control these entities. We reviewed the published works in relation to several autoimmune disorders and attempted to conclude what benefit can be achieved with the use of antioxidants. There are several reports which strengthen this notion. However, the number of interventional works is still to low for this to be unequivocal. Cigarette smoking, with its multitude of biological effects, is also implicated in the pathogenesis and course of these diseases. We tried to surmise what is the extent of its effect on the clinical and pathological course of these illnesses. Smoking was shown to increase morbidity and levels of markers for disease activity. It was also found to increase the risk of manifesting these diseases. The number of works needs to be expanded, though.