April 01, 2025
2 min read
Key takeaways:
- Patients with asthma had an increased risk for OA, especially among those socially isolated.
- Stress and altered immune responses could drive inflammation in asthma and OA, researchers hypothesized.
Patients with asthma demonstrate a heightened risk for developing osteoarthritis, a relationship that is particularly pronounced when combined with social isolation or loneliness, according to data published in Arthritis Research & Therapy.
The study follows prior research linking OA with IgE-mediated conditions, such as asthma and eczema, Ziyi Wu, of the department of orthopedics at the Second Xiangya Hospital of Central South University, in China, and colleagues wrote.
Data derived from Wu Z, et al. Arthritis Res Ther. 2025;doi:10.1186/s13075-025-03496-w.
“[A] previous study presented that OA showed a high prevalence in asthma patients, and a retrospective study observed an increased incidence of OA in patients with atopic disease,” Wu and colleagues wrote. “Additionally, A mendelian randomization study in European population showed that social isolation was causally associated with osteoarthritis. However, no prospective cohort study has tested the association of asthma with risk of incident OA, and no study has investigated the potential interactions of asthma with social isolation and loneliness in relation to OA.”
To fill these gaps, Wu and colleagues analyzed data from the U.K. Biobank cohort, excluding patients diagnosed at baseline with OA or IgE-mediated conditions. The overall analysis included 448,920 patients (mean age, 56 years; 53.6% women) representing 57,573 incident cases of OA in the knee, hip or hand, over a median follow-up time of 12.5 years.
Social isolation and loneliness scores were calculated via patient questionnaires. The three questions on social isolation asked about people in the patient’s household, how often family or friends visit them and what organizations they are involved with. For loneliness, patients were asked how often they feel lonely and how often they can confide in someone close to them.
According to the researchers, compared with patients without asthma, those with asthma demonstrated higher risks across all OA categories:
- Any OA (HR = 1.32; 95% CI, 1.29-1.35)
- Knee OA (HR = 1.21; 95% CI, 1.16-1.25)
- Hip OA (HR = 1.12; 95% CI, 1.07-1.18)
- Hand OA (HR = 1.62; 95% CI, 1.42-1.85)
The heightened risk for any OA among patients with asthma further increased with rising social isolation and loneliness scores (P < .001 for both), the researchers added. Patients’ risk for knee OA also had significant interactions with both social isolation (P < .027) and loneliness (P < .013).
“This finding aligns with previous studies suggesting a role of psychosocial factors in chronic inflammatory diseases,” Wu and colleagues wrote, adding that “the exact biological mechanisms for positive association of asthma with social isolation and loneliness in relation to incident OA remain elusive.”
“We hypothesize that increased stress and altered immune responses in socially isolated individuals may amplify the systemic inflammation seen in both asthma and OA,” they added.
Sources/Disclosures
Collapse
Disclosures:
This study was funded by the National Natural Science Foundation of China Young Scientists Fund, Hunan Provincial Natural Science Foundation, the Second Xiangya Hospital of Central South University Postdoctoral Research Start-up Fund, National Natural Science Foundation of China, Hunan Provincial Natural Science Outstanding Youth Fund and Hunan Provincial Innovation Foundation For Postgraduate and the Fundamental Research Funds for the Central Universities of Central South University. The authors report no relevant financial disclosures.