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Autoimmune Disease and RA

Understanding the role played by the body’s immune system in the progress of rheumatoid arthritis.

What Are Autoimmune Diseases? continued...

Virginia T. Ladd, RT, is president and executive director of the American Autoimmune Related Diseases Association Inc. (AARDA). She tells WebMD it helps to think of autoimmune diseases the way we think of cancer. In other words, it helps to think of them as a disease category.

“There are more than 100 different forms of cancer,” Ladd says, “but they’re all formed by a mutant cell that the immune system allows to proliferate.” She says that autoimmune diseases also share a common disease pathway. “They’re all caused by the immune system attacking its own tissue.” For this reason, she says, we need a shift in our thinking about autoimmune diseases. In the past, these diseases have been looked at as individual “cars on a train” with too little focus on the “engine” that’s driving the train. In her view, research into autoimmunity has been stymied by specialization of medicine, which is organized by the organ - not the origin - of disease.

This is especially important because autoimmune diseases often run in families. And members of these families often develop different types of autoimmune diseases. “If you were going in to see a doctor for joint problems, would you think it mattered to mention that your brother had Crohn’s?” Ladd asks. Probably not. Most people wouldn’t put two and two together. Understanding this connection is very important, though, because early diagnosis and treatment of an autoimmune disease like RA can often make a big difference.

What Causes Autoimmune Diseases?

The causes of autoimmune diseases remain unknown. Much more research is needed to fully understand them. However, evidence is pointing to infectious agents, such as viruses and bacteria. They may be important triggers in people who have a certain genetic makeup. Smoking or drugs also may trigger these chronic diseases.

“The initiating cause can occur up to four years before any clinical symptoms appear,” Peyman says.

“Everyone should be aware that they can reduce their risk of developing these diseases,” Peyman says. “As with cardiovascular disease and many cancers, inflammation is a major factor in the dysfunction of the immune system with autoimmune diseases. A diet rich in antioxidants and smoking cessation are good places to begin in reducing inflammation, he says.

What Is Rheumatoid Arthritis?

Joint destruction is the hallmark of RA. The immune system attacks joint tissues for unknown reasons. White blood cells travel to the joint lining, or synovium, and cause inflammation known as synovitis. This leads to symptoms of warmth, redness, swelling, and pain. The chronic inflammation of RA causes the normally thin synovium to become thick and joints to become swollen and puffy.

With time, the inflamed synovium invades and destroys the cartilage and bone within the joint. Researchers studying rheumatoid arthritis now believe that it begins to damage bones during the first year or two that a person has the disease. That’s one reason why early diagnosis and treatment are so important.

About 1.3 million adults have RA. That’s down from a 1990 estimate of 2.1 million. The decrease partly reflects a more narrow definition of RA. However, the prevalence of RA does appear to be declining around the world. Women with rheumatoid arthritis still outnumber men two to one.

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