Rheumatoid arthritis is an autoimmune disease, in which the immune system fails to differentiate between self and foreign cells and hence generates a faulty response by progressively attacking the body’s own tissues. It is a chronic and a systemic disease that can occur throughout the body and mostly affects the fingers, wrists, elbows, feet and ankle.
It predominantly occurs in people falling in the age group of 25 – 55 years and is more prevalent among women. People who suffer from rheumatoid arthritis often experience the pain periodically, with the symptoms worsening during certain periods called flare-ups, followed by periods of decreased disease activity called remission. Even though, the exact cause of rheumatoid arthritis remains obscure, a combination of the following causes can increase the chances of you developing this debilitating condition.
Causes of Rheumatoid Arthritis
Abnormal Auto-Immune Response
The membrane that lines the joints called synovium is attacked by antibodies produced by the immune system, which in turn, invades and destroys the adjacent joints, cartilage and bones. Prolonged inflammation in the joints leads to the accumulation of inflammatory markers and the thickening of synovium that manifests itself in the form of swelling, stiffness, limited range of motion and joint pains, which are the primary characteristics of rheumatoid arthritis.
Scientists have identified short nucleotide polymorphisms (SNPs) and mutations in certain genes that serve as genetic markers for identifying the presence of rheumatoid arthritis. These SNP’s are most often inherited from parents, thus increasing the likelihood of acquiring this disease by the descendant by about tenfold. The genes that are mostly affected are the genes that belong to the immune system and those that are involved in eliciting an inflammatory response.
Human leukocyte antigen (HLA) or major histocompatibility complex is a cluster of genes found on the surface of white blood cells and is responsible for specifically recognizing foreign antigens. Individuals possessing a genetic marker called as HLA-DR4, a mutation in the HLA gene have a five times higher probability of developing rheumatoid arthritis than individuals lacking this marker.
Also, a gene that regulates immune response called STAT4, two other genes called TRAF1 and C5 that control inflammation and PTPN22, a T-cell associated protein that governs the development of rheumatoid arthritis have all been collectively found to have a great impact on the progression of rheumatoid arthritis.
Food allergens like milk products, antibiotics, preservatives and gluten, a protein found in grains like wheat, rye, barley, oats, bread, pasta, pretzels, etc. are not easily digestible by people who develop a tolerance against these substances. These allergens over-burden the digestive system and damage the intestinal lining, thus allowing large particles like grains, fats, proteins and even bacteria to leak out into the bloodstream.
These molecules reach the joints and are attacked by the immune system, which considers them as foreign particles. This leads to an autoimmune response, which causes considerable damage to the membrane lining the joints, cartilage and the bones. Hence, people who are suffering from food allergies are at a higher risk of developing rheumatoid arthritis.
In general, people who are genetically predisposed to rheumatoid arthritis are far more susceptible to bacterial, viral or fungal infections that trigger the production of antibodies by the immune system.
It has been postulated that some of these antibodies are not highly specific to the microbial proteins and attack the tissues of the host that causes inflammation of the joints, thus aggravating the symptoms of rheumatoid arthritis. Two viruses namely Epstein-Barr virus and Human Herpes Virus 6 have been associated with rheumatoid arthritis by many epidemiological studies.
Hormonal Fluctuations in Women
The prevalence of rheumatoid arthritis is about three times more in women than in men. When the rise in men and women was compared between the years 1985-1994 and 1995-2004, it was found that the rate of incidence of rheumatoid arthritis in women increased dramatically, whereas men’s rate of incidence remained the same.
The rising rate of this disease in women has been attributed to the hormonal fluctuations that women experience across their life-span. Estrogen, a female hormone is responsible for increasing the rate of absorption of calcium by the bones, which aids in strengthening the bones and cartilage. Hence, the constant changes in the levels of estrogen during the premenopausal and postmenopausal periods in women have been attributed to the higher occurrence of rheumatoid arthritis in women.
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Deficiency of Vitamin D
Researchers have persistently found lower levels of vitamin D in patients suffering from rheumatoid arthritis. Besides, strengthening the bones through its ability to increase the absorption of calcium and phosphorous, vitamin D also possesses immunoregulatory properties and controls the movement of immune cells in the body that have vitamin D receptors on their surface.
Epidemiological evidence has suggested that geographical areas like USA, Jamaica, etc. that receive less amount of sunlight, a rich source of vitamin D, have a greater number of people suffering from rheumatoid arthritis than people living in areas like Africa, Iran, etc. that receive adequate amount of sunlight.
Both physical and emotional trauma can lead to the accumulation of toxins in the joints that stimulate the immune system to release inflammatory markers. This weakens the tendons and ligaments that support the joints and eventually, leads to a misalignment and deformity of the joints. Stress can also weaken the immune system, thus contributing to the erroneous auto-immune response generated, which in turn, attacks the joints.
Environmental risk factors like smoking can modulate the risk of acquiring rheumatoid arthritis, especially in individuals who are genetically predisposed to this disorder. Moreover, cigarette smoking can constrict blood vessels and increase the severity of the condition. It interferes with the rate of absorption of medications used for treating rheumatoid arthritis, thereby reducing the effectiveness of the treatment.
Occupational exposure to different physical and chemical agents like asbestos, silica, benzene, noise in mining industries, etc. can directly affect the development and progression of rheumatoid arthritis. Exposure to other chemical inhalants that result from air pollution can also trigger the symptoms of rheumatoid arthritis. Furthermore, the chemicals present in cosmetics like lipsticks, hairsprays, etc., may also be a matter of concern for people who are genetically predisposed to rheumatoid arthritis.
All the above-mentioned causes can lead to joint deformity and permanent disability in patients suffering from rheumatoid arthritis. Spreading in the form of lumps called rheumatoid nodules found on fingers, heels, elbows, etc., inflammation of arthritic joints can damage vital organs like heart, liver and kidneys, if left untreated. Hence, now that you are familiar with the causes, make sure that you take precautionary measures to prevent your condition from worsening.