The Causes Behind Rheumatoid Arthritis

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The Causes Behind Rheumatoid Arthritis

  1. 1. María A. Rosa Vázquez The Causes Behind Rheumatoid Arthritis Abstract This work discusses the possible causes of the disease. The immune system plays an important role in the development of RA by causing inflammation and destroying the joints. In genetics, RA is relating to the chromosome 6. Some researchers found historical evidence that the disease could have an infectious agent. The disease have been promoted by environmental factors such as smoking, lack of Vitamin D, diet and weather. Knowing the causes of the RA will help to improve or developing treatments for the disease. Table of Contents 1. Introduction .................................................................................................................1 2. Immunity .................................................................................................................2 3. Genetics .................................................................................................................2 4. Infectious .................................................................................................................3 5. Environmental factors .........................................................................................3 5.1 Smoking .....................................................................................................3 5.2 Vitamin D .....................................................................................................4 5.3 Diet and weather .........................................................................................4 6. Conclusion .................................................................................................................4 References .................................................................................................................5 1. Introduction We are in an age where technology has advanced in many ways. Despite this, many diseases have no cure, even if it is discovers at an early stage. An example of this is the Rheumatoid Arthritis (RA), a disease that affects the articular tissues and extra articular organs. This chronic, systemic and inflammatory disorder usually attacks women. Rheumatoid arthritis is a progressive disease that destructs and deforms the joint. Thus, the patient will have a dysfunctional status that can finish in premature death (Khurana and Berney, 2005). The 1
  2. 2. problem with this disorder is that Scientists and researchers have not found the causes or etiology of RA, the light or passage to finding a cure. However, there is many works that reports and found possible causes for this disease that can be use by the people to prevent it. 2. Immunity The first step to understanding RA is to introduce the major cause of it the immune system, which attacks the cells of the patients with the disease. I will be focusing in the innate immunity, which is the one that defend the body against infectious organisms. Falgaron et al. (2005) found that the macrophages and dendritic cells, which are involved in the innate immunity responses, activate the T and NK cells. The T cells regulate the inflammatory and immune responses and the NK responses against viruses that produce TNF and IL-1, which destroy the joints. They also found that the T cells reduce the elimination of macrophages that express cytokines that enhance or inhibit inflammatory responses and that play part on the cause of RA. On the other hand, the pineal neurohormone called melatonin (MLT), which coordinates the organism’s adaptation and survival affecting the immunity. Maestroni et al. (2005) present a research using rats where the old ones repair the inflammatory responses and the young ones elevate the inflammatory effect when they consumed a high dose of MLT. In humans, the concentration of melatonin is high in patients with RA than controls, which means that the features that increase the production of MLT can be part of the etiology of RA. 3. Genetics Developing a productive and healthy human body depends on many factors; but the principal one is the genetics. In RA, the HLA (human leukocyte antigen) region of the chromosome 6 has been related with the disease (Huizinga, 2003). Some researchers found that the genetic variant is present in family members with RA than in family members without the disease, using the multicase families’ analysis. Other studies have been done, but are 2
  3. 3. unclear because is not known if the people, who have the mutation, will exhibit the disease. Following that population might provide information in the future. 4. Infectious As part of human life, the infections are organism in which the immune system deal and protected body against them. Mackenzie and Dawson (2005) found a connection between the RA and some infectious agents. That connection was dated from the ancient past; this means that people living in America had RA before the Europeans arrived to the continent. That guides them to propose that the Europeans gain the disease and spread it to Europe through an infection. They also suggest that the viruses are the primary infectious agent in RA, because they usually infect the monocyte/ macrophages, which are involved in some way with the inflammatory response. Another study reports that the HTLV-1 (human T-lymphotropic virus 1) has been located in people with a form of RA (Mackenzie and Dawson, 2005), which provoke a chronic erosive lesions. Torrey and Yolken in 2001 presented the idea that the microorganism T. gondii is associated with RA. This microorganism has been usually found in cats and a researcher obtain that the people who had cats in the adolescence had the predisposition to have the disease. 5. Environmental factors The human body is always adjusting with its environment. There is now evidence that smoking, nutrition and even weather could play an important role in the development of some diseases, as RA. 5.1 Smoking The act of smoking affects the immune system and some adrenal hormones that have been identified in the etiology of RA. Krishnan (2003) in his work with data from the BRFSS (behavioral risk factor surveillance system) found that ever-smoked men has a higher risk of 3
  4. 4. develop RA than controls; but that don’t happen in young woman for the reason that menstruating ones obstruct the smoking factor that develop RA. That doesn’t occurs in postmenopausal woman, in where a study with the Iowa Women’s Health Study (Criswell et al., 2002), shows that women who smoke develop RA and were younger at menopause. 5.2 Vitamin D Recent studies researchers discover a Vitamin D receptor in the immune system, which lets them to propose that it can have immunoregulatory properties and can stop the antibody secretion and autoantibody production (Cutolo et al., 2007). Kiran and Debashish (2008) presented an investigation with mice infected with B. burgdorferi, an agent identified as a cause of arthritis. The arthritis in the experimental mice was reduced or stops using a dietary supplement of 1,25-dihydroxy Vitamin D, which is the active form of Vitamin D. Interestingly, they found that the people who live in high latitudes and were less exposed to the sunlight have a higher incidence of RA than the ones who live in the tropics. Sunlight activates Vitamin D in the body. 5.3 Diet and weather Some researches attribute the high occurrence of RA to other factors like the diet. It seems that having a wealthy diet in oily fish and vegetables will decrease the effects of the RA (Symmons, 2003). They also, suggest that low temperature weather (cold ones) and high atmospheric pressure increase the pain levels of RA patients. However, there is not scientific evidence that support those effects in the disease. 6. Conclusion 4
  5. 5. If we start to inform ourselves about the possible causes of the disease, we can prevent it by avoid those things that are risk for them. We should avert the people about them using conferences and making writings. In general, is important to have a good source of Vitamin D and take right exposure to the sun; have a diet in fish and vegetable; avoid the cold weather, do exercise and take care of the body to prevent or decrease the effects of RA. The researches about the disease will continue to know more about the effects of mutated chromosome 6 and the components of the innate immunity as the macrophages and dendritic cells, which produce the disease. Their perseverance some day will decode the unknowns of RA and develop better treatments until its cure. References Criswell LA, Merlino LA, Cerhan JR, Mikuls TR, Mudano AS, Burma M, Folsom AR, Saag KG. 2002. Cigarette smoking and the risk of rheumatoid arthritis among postmenopausal women: Results from the Iowa Women’s Health Study. The American Journal of Medicine 112:465-471. Cutolo M, Otsa K, Uprus M, Paolino S, Seriolo B. 2007. Vitamin D in rheumatoid arthritis. Autoimmunity Reviews. 7:59-64. Falgarone G, Jaen O, Boissier MC. 2005. Role for Innate Immunity in Rheumatoid Arthritis. Joint Bone Spin. 72:17-25. Huizinga TWJ. 2003. Genetics in rheumatoid arthritis. Best Practice & Research Clinical Rheumatology 17:703-716. Khurana R, Berney SM. 2005. Clinical aspects of rheumatoid arthritis. Pathophysiology.12:153-165. Kiran G, Debashish D. Vitamin D and rheumatoid arthritis: is there a link? 2008. International Journal of Rheumatic Diseases. 11:206-211. 5
  6. 6. Krishnan E. 2003. Smoking, gender and rheumatoid arthritis–epidemiological clues to etiology Results from the behavioral risk factor surveillance system. Joint Bone Spine. 70:496-502. Mackenzie AR, Dawson J. 2005. Could rheumatoid arthritis have an infectious aetiology? Drug Discovery Today: Disease Mechanisms. 2: 345-349. Maestroni GJM, Cardinali DP, Esquifino AI, Pandi-Perumal SR. 2005. Does melatonin play a disease-promoting role in rheumatoid arthritis? Journal of Neuroimmunology. 158:106-111. Symmons DPM. 2003. Environmental factors and the outcome of rheumatoid arthritis. Best Practice & Research Clinical Rheumatology. 17:717-727. Torrey EF, Yolken RH. 2001. The Schizophrenia–Rheumatoid Arthritis Connection: Infectious, Immune, or Both? Brain, Behavior, and Immunity. 15:401-410. 6

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