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8 Things You Should Know About Rheumatoid Arthritis

Most people with rheumatoid arthritis can lead a perfectly normal and active life. Discover what new medical research is saying about the potential to prevent the disease.

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1. The Outlook

Although there is no cure available for rheumatoid arthritis, the disease can sometimes stop spontaneously for no apparent reason.

Around 25 per cent of people with RA make a complete recovery. Recent studies also suggest that the number of new cases of RA may be going down. Only a minority of people become severely disabled. Most people will have to modify their lifestyle to some extent but can expect to lead a full life.

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2. The Autoimmune Process

As our understanding of rheumatoid arthritis improves, it may be possible to find new ways to prevent the disease developing or even find a cure. Many potentially productive avenues for research are looking very promising.

Scientists are trying to improve our understanding of the abnormalities found in the immune systems of those affected by rheumatoid arthritis. There may also be significant differences in the way that a woman’s immune system functions during pregnancy that makes her less vulnerable. A fuller understanding of the autoimmune process would help in the development of treatments to target these abnormalities and halt the inflammatory process.

Researchers are trying to find new drugs to suppress the inflammation that underlies rheumatoid arthritis while producing minimal side effects. The most effective current therapies target the TNF alpha protein, although many of these drugs still have significant drawbacks. The compound Interleukin-10, for example, suppresses the whole immune system when delivered intravenously; scientists are developing a nasal spray that they hope will produce a more targeted effect. Research is also underway into other possible targets including neutrophil white blood cells.

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3. The Role of Infections

Scientists have long suspected that infections by bacteria, viruses or fungi may sometimes play a role in the development of rheumatoid arthritis. If researchers can discover which infectious agents are involved or the mechanism by which the disease is triggered, it may be possible to take preventative action to limit flare-ups or even stop the disease from developing.

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4. Autoimmune Research

White blood cells perform a vital role in your immune system. Unfortunately, antibodies produced in these cells sometimes attack the body’s own tissues, causing autoimmune disorders such as rheumatoid arthritis. It may be possible to suppress inflammation by developing drugs that target these cells and antibodies.

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5. The Role of Hormones

Research into the possible role of sex hormones and their interaction with the immune system may offer further avenues for treatment. We already know that women are more likely than men to develop rheumatoid arthritis before the menopause, but that the risk is equal after the menopause when levels of oestrogen and progesterone fall.

Susceptibility varies throughout a woman’s reproductive life at times when hormone levels fluctuate significantly – the risk appears to be higher after having a baby and when breast-feeding. Fluctuations in hormones also seem to influence the timing and severity of flare-ups – the disease often improves during pregnancy. Male sex hormones may also play a role in arthritis, perhaps a protective one.

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6. The Role of Genes

Genetic abnormalities may play a role in around 60 per cent of cases of rheumatoid arthritis. As well as putting some people at increased risk of developing RA, abnormal genes may also play a part in determining the severity of the disease.

Research centres across the United States are now working together to collect information and genetic material from around 1000 families in which two or more brothers and sisters have the disease. This information will help form a picture of the role of genes in RA and may pave the way for new treatments. Eventually it may be possible to test for the presence of RA-specific genes or even to repair or replace such genes to prevent the disease developing.

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7. Emotional Wel-Being

The importance of a positive mindset should not be underestimated. Studies allied with clinical experience show that people who are happier and have a more positive outlook are likely to cope better with rheumatoid arthritis and experience symptoms that are less severe. Researchers are examining why this should work and the best ways to help patients achieve good emotional health.

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8 . Warnings

People with rheumatoid arthritis are at increased risk of osteoporosis. This particularly applies to women, who have a higher risk after the menopause in any case. Calcium and vitamin D supplements may be helpful. In some cases, other treatments for osteoporosis are required.

People with arthritis also have greater risk of heart disease, probably because they have higher rates of cardiovascular risk factors such as diabetes, high blood pressure and high cholesterol levels. The link between these risk factors may provide new avenues for research.

(Photo: iStockphoto)