Rheumatoid arthritis or RA is a systemic, chronic inflammatory disorder that may affect many organs and tissues, but mainly attacks a person’s synovial joints. These include the wrists, hands, and knees. In some cases, however, rheumatoid arthritis may also affect the eyes, nerves, blood, lungs, heart, and skin.
Approximately 1% of the world’s population is affected by RA, with women being diagnosed three times more often than men. Usually, those who are afflicted with this kind of arthritis are between ages 40 and 50. There are cases, though, when people who aren’t in the said age bracket are also affected with RA. This condition can be painful, or worse, disabling, as it can lead to substantial loss of mobility and functioning. This can be diagnosed based on signs and symptoms, but may also be detected through blood tests, particularly one called rheumatoid factor. X-rays may also be used to detect if a person has this condition.
But what exactly causes rheumatoid arthritis?
Rheumatoid arthritis is considered to be a kind of autoimmune disease. Normally, the immune system of the body fights off foreign substances such as bacteria and viruses. But when a person is afflicted with a kind of autoimmune disease, the immune system thinks the healthy tissues are foreign substances. Because of this, the immune system attacks the body.
What do studies say about factors that trigger RA?
The exact cause of this condition has yet to be discovered, but doctors think that it’s due to a combination of environmental, hormonal, and genetic factors. People who suffer from RA most likely do so because there’s an infection that triggered the autoimmune disease. There are theories suggesting that bacteria or a virus may cause an alteration in a person’s immune system, therefore triggering it to attack the joints. Certain infectious organisms that are thought to attack the joints and trigger the onset of RA include Erysipelothrix, Mycoplasma, rubella, and parvovirus B19, but these links have not been supported or even proved by epidemiological studies. There is also no convincing study for other possible triggers like allergies to certain types of food.
Moreover, there is no evidence that emotional or physical stress could trigger the onset of this condition. Research has revealed many negative findings suggesting that it might be that the trigger varies, or that it’s just a chance event brought about by the immune response.
There have been epidemiological studies confirming that there could be a link between rheumatoid arthritis and two herpes virus infections, which are Human Herpes Virus 6 and Epstein-Barr virus. Those diagnosed with this condition are more prone to have an immune response that is abnormal when attacked by a certain type of virus, specifically the Epstein-Barr kind. The allele HLA-DRB1*0404 also contributes to the development of this kind of disease.
What’s the role of genetics in triggering RA?
Research hasn’t pinpointed yet the role of genetics in triggering rheumatoid arthritis. However, there are some people afflicted with this disorder who seem to have an inherited or genetic factor that increased their risk of developing rheumatoid arthritis. Rheumatoid arthritis is also often affected by pregnancy. The symptoms improve before the woman gives birth and then worsen after delivery, which suggests that the body’s hormones can influence the disease’s development and also its progression.
There are certain genes that have also been identified to increase the risk for rheumatoid arthritis. It is said that HLA-DR4 (genetic marker) is found in around 66% of patients afflicted with rheumatoid arthritis. The HLA-DR4 is present in WBC (white blood cells) and actually helps the immune system distinguish between foreign matters such as germs and the body’s cells. Another gene, PTPN22, is also being linked with the condition.
Recent studies have revealed that genetic factors may also collaborate with an environment-based factor such as cigarette smoking in terms of putting a person at risk for this disease. Other environment-based factors have also been found to lead to the increased risk of getting afflicted with rheumatoid arthritis. Hormonal factors, on the other hand, may be responsible for the higher incidence of RA in women, frequent onset of the condition after childbirth, and the modulation of the risk of this disease by using hormonal medications.
Signs of RA
How will you know if you already have rheumatoid arthritis? One of the first manifestations of RA is inflammation of the joints. The afflicted individual will have warm, painful, swollen, and stiff joints, particularly during the early hours in the morning and during walking or after a long time of inactivity. One prominent feature of the condition is an increased stiffness during the early hours of the morning. This may last for around an hour or more. During the disease’s early stages, gentle movements may help relieve symptoms.
Other symptoms of RA include loss of appetite, fatigue, weakness, and widespread muscle aches. Those who are afflicted with this condition may also suffer from anemia due to the failure of the bone marrow to create enough RBC (red blood cells). Aside from these, other symptoms are lung inflammation, limited range of motion, deformities of the hands and feet, swollen glands, skin redness or inflammation, paleness, numbness or tingling, nodules under the skin, and eye itching, burning, and discharge.