The rheumatoid arthritis is a systemic autoimmune inflammatory disease that affects multiple joints symmetrically and presents various non-specific general symptoms and extra-articular manifestations.
The characteristic symptom is persistent inflammation. Over time it destroys the joints, causing deformity and functional incapacity. The inflammation also causes stiffness and constant pain.
This disease can affect the entire body, but it has a special predilection for peripheral joints (hands, feet, wrists, shoulders, elbows, hips, and knees). Among these, its favorites are the joints in hands and feet. Peripheral and small.
As we mentioned before, it is symmetrical. It occurs on both sides of the body and usually manifests similarly on both, advancing at the same pace.
It is not a hereditary disease, although it is one of those non-hereditary diseases to which you have to add a “but”. It is due to both genetic and environmental factors, as there is a genetic predisposition. However, the specific causes that trigger the onset of the disease are unknown. Whatever it is, it causes the immune system to attack the joints.
The damage occurs primarily in the synovial membrane, a membrane found in synovial joints (those separated by a cavity). The membrane protects the cartilage from wear and tear and produces the synovial fluid (synovial is the word of the day), which acts as a lubricant. But the disease is not too picky, causing additional damage to the cartilage and the bone in the area.
It is a blatant and undisguised pathology, so it is usually diagnosed early by the symptoms. To confirm, X-rays and laboratory tests can be performed.
There is also the rheumatoid factor test, a blood test looking for specific autoantibodies found in most people with arthritis.
The initial symptoms are inflammation (zero surprises here), stiffness, tenderness, swelling, and redness, symmetrically. Over time symptoms worsen and arise in other joints.
There are considered 4 stages of the disease, each retaining and worsening the features of the previous one:
- First stage, inflammation around and inside the joint.
- Cartilage damage and erosion begin, with a decrease in the mobility of the area. Inflammation is more evident.
- We reach bone damage and visible deformities appear.
- In the final stage, inflammation decreases, but also the joint. The bones fuse, the cartilage is shattered, and the joint continues to hurt, with minimal mobility.
It is believed that 40% of affected people suffer other symptoms, in addition to the problems in the joints, such as problems in lungs, heart or eyes, due to inflammations, or carpal tunnel syndrome.
These symptoms are not constant and stable, but there are periods of remission and others in which they are especially harsh.
Unknown Cause, Known Risks
How it begins is a secret. There is even a theory that links arthritis to periodontitis, where there is also inflammation, with known causes this time. It is suspected that some of the pathogenic organisms involved in periodontitis, specifically the bacteria Porphyromonas gingivalis, could penetrate the body and even reach the joints, where they cause the autoimmune reaction.
Additionally, an individual’s genetics, although it does not cause the disease by itself, does decide the person’s predisposition to suffer from it.
Specifically, it is estimated that 40-65% of the risk of having rheumatoid arthritis is of genetic origin.
Different genes are involved in the onset of rheumatoid arthritis, so it is considered a polygenic disease. If a person has a family history, key to discerning whether a disease has a genetic component, of rheumatoid arthritis, it is considered to have a 3-5 times higher risk than a normal person of suffering from the pathology.
Just like in other autoimmune diseases, like multiple sclerosis, there are many involved genes that belong to the major histocompatibility complex. The main responsible is the HLA-DR4.
The genetic component not only participates in predisposition to the disease but is also relevant in the severity of the disease.
However, there are other risk factors that are not genetic. It has been seen that one of the environmental factors that contribute most to the appearance of rheumatoid arthritis is smoking. And it is associated both with the appearance of the disease and its severity. Nothing good ever comes out of tobacco.
But some infections, female hormones, stress, obesity, age, and type of diet can also contribute.
Speaking of female hormones, as usually happens with autoimmune diseases, it is more common in women than in men, occurring 70% of cases in women, most of them women over 55 years old.
Arthritis in Today’s Society
In 2019 it was estimated that there were 18 million people in the world living with the disease. It has a higher prevalence in industrialized countries, possibly due to greater longevity and environmental factors.
Interestingly, in recent years the disease has been increasing in incidence, but its severity, deterioration in the patient’s life, and mortality have been decreasing.
Although there is no cure for this disease, there are various pharmacological treatments that allow improving symptoms and delaying the progress of the disease.
Their objective is to reduce inflammation, alleviate pain, and, in broad terms, allow better quality of life and greater functionality for the person. There is even a category of drugs called “Disease Modifying Antirheumatic Drugs”, focused on modifying the immune system in general, and inflammation in particular.
These treatments are not only pharmacological, but there are also different mechanical devices focused on collaborating, orthopedic appliances. Sometimes even surgical operations for repair or replacement of joints are performed.
Finally, another treatment is the affected person’s own lifestyle. Firstly, quit smoking, and maintain a correct weight for a person of their condition. It is recommended that they increase physical activity as much as possible, and there are free programs where they explain which exercises are best against this pathology. We can also explain some things to you, like your predisposition, with our Advanced DNA Kit.
