• Genetic and non-genetic basis
Genetic factors are relatively contributed about 50 % of the risk of the pathogenesis of RA (Aho et al., 1986; MacGregor et al., 2000). MHC encoding HLA-DRB1 gene is one of greater risk posing allele responsible for the 1/3rd of genetic basis (Deighton et al., 1989; Rigby et al., 1991). These alleles further subdivided and defined by the presence or absence of Anti-citrullinated protein antibodies (ACPA), also termed as ACPA positive RA and ACPA negative RA (Seegobin et al., 2014). ACPA positive RA more worsens the condition with severe erosive damage (Silman and Pearson, 2002). However, the non-genetic factors such as pregnancy, lifestyle, and obesity have been implicated in the development of RA (Colebatch
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However, the production of Matrix Metalloproteinase (MMP) is also responsible for the degradation of the extracellular matrix of synovium(Tan et al., 2006).
• Mineral oil and Adjuvant
Mineral oils and adjuvant have the potential to directly activate the innate immune system. Several studies have been conducted which proposed the relation between the RA with the adjuvant (Maradit-Kremers et al., 2005). The study also reported that adjuvant like BCG found to cause arthritic symptoms during the course of immunotherapy (Turesson, 2004).
• Opportunistic Infections
Microbial organisms are also responsible for activating the macrophages and leads to the development of the inflammatory mediators. However, inflammation caused by the microbial infections include Shigella, Clostridium difficile, Salmonella typhimurium, etc., called as Infectious Arthritis (Li et al., 2013).
2.7 Co-morbidity condition associated with RA
Rheumatic disorders are frequently complicated by co-existence of comorbidities. Co-morbidity is a medical condition that co-exists with the disease such as RA. A co-morbid condition in RA influences the progression and severity of disease which directly affects the quality of life, treatment of primary as well as secondary (Co-morbid) disease. There have been great chances arise due to the co-morbid condition for the social and economic burden,
Rheumatoid Arthritis(RA) is the most common type of autoimmune arthritis. RA is a progressive and debilitating musculoskeletal disorder that affects the joints symmetrically, causing a range of systemic effects. What it causes is still not well known; nevertheless, findings of new research points towards a believe that it is triggered by a defective immune system, which causes the release of inflammatory chemicals. These chemicals cause damage to cartilage and bone, usually affecting the wrists, the joints of the hand, including the knuckles, the middle joints of the fingers and feet. While this condition can affect any joints, besides, important body organs such as the eyes and the lungs can also be affected by the inflammation that occurs as a result of this chronic condition. Only in America 1.3 million of people are affected by this ailment, and 75 % of them are mainly women. Its onset usually occurs between fourth and sixth decades; however, RA can occur at any age("Diseases And
Rheumatoid Arthritis has been subject of numerous studies and researches in the look for a better understanding of how it effects the individuals diagnosed with it. There is a higher incident of females diagnosed with RA than male as well as a relationship with genetic and environmental factors involved. Around one percent of the world population is affected by RA; therefore, diverse studies have been performed to understand how the lives of the diagnosed patients can be impacted by the disease. For example, how RA affects the mobility, safety and activities of daily living in general as well as the development of interventions to better approach RA. On
Rheumatoid arthritis is a chronic syndrome that is characterized by inflammation of the peripheral joints, but it may also involve the lungs, heart, blood vessels, and eyes. The prevalence of this autoimmune disease is between 0.3% to 1.5% of the population in the United States (Feinberg, pp 815). It affects women two to three times more often than men, and the onset of RA is usually between 25 and 50 years of age, but it can occur at any age (Reed, pp 584). RA can be diagnosed by establishing the presence of persistent joint pain, swelling in a symmetric distribution, and prolonged morning stiffness. RA usually affects multiple joints, such as the hands, wrists, knees, elbows, feet, shoulders, hips, and small
RA begins with plasma cells overproducing rheumatic factors (RF) and antibodies to citrullinated protein antigen (ACPA). RF and ACPA can cause damage as well as activate macrophages, which play a large role in inflammation of the rheumatic synovium by drastically increasing the number of proinflammatory cytokines in the joint (Arend, 2001). Tumor necrosis factor alpha (TNF- α), interleukin-1 (IL-1) and interleukin-6 (IL-6) are the main cytokines involved in RA, which attract immune cells to the joints and cause tissue destruction (Arend, 2001). In addition, macrophages will also activate B and T cells via their MHC class II (Lee & Weinblatt, 2001). B and T cells are thought to play a role in the systemic aspects of RA but have an unclear function in synovial joints (Lee & Weinblatt, 2001).
Age and sex: The incidence of RA is typically two to three times higher in women than men. The onset of RA, in both women and men, is highest among those in their sixties.
RA is classified as a chronic, autoimmune rheumatic condition. It is caused by the immune system attacking the tissue in joints for unknown reasons, causing inflammation and swelling. The joint is a part of the body where two bones and bound by connective tissue. The ends of the bones are each surrounded by a capsule called synovium. The synovium creates a clear, lubrication substance called synovial fluid. RA is a condition that happens when the white blood cells in the immune system attack the synovium, causing swelling and pain where the joint is bound. Over
The pathophysiology of osteoarthritis is a complex mechanism that involves chondrocytes and synoviocytes each playing a role in joint degeneration (25). The initial stages of the disease are characterized by inflammation of the synovial membrane, this process is also known as synovitis, followed by the loss of the cartilage surface (25). Although the exact reason for the cause of inflammation is unclear, certain intracellular mechanisms that lead to the up-regulation of pro-inflammatory cytokines and increased oxidative stress in the cells have known to recruit macrophages and lymphocytes into the synovium. This in turn leads to an increase in the production of pro-inflammatory cytokines and degradative enzymes that can
pain is your physique's normal security in opposition to sickness and injury. It serves because the signal that some thing is mistaken in the body. Pains associated with arthritis include extreme pain from irritation of the joints, acute pain from damaged joints, and aggravated affliction brought on through continual affected by joint pains. Agony is caused by way of the gradual breakdown of cartilage, the tender material that cushions the joints. Soreness alleviation lotions are consumed by way of athletes, housewives, and the aged. At the same time there are various reasons and illnesses that may make a contribution to joint affliction, the most customary are osteoarthritis and sports injuries. Joint suffering from osteoarthritis
Rheumatoid Arthritis is a disease that affects some 2 million people in the United States, roughly 1 to 2% of the population. It continues to be a mystery to many that study its origin. Rheumatoid Arthritis is commonly referred to as RA. It does not discriminate, it can wreak havoc on a wide range of people. It doesn’t care what your skin color is or where you reside or even your age. It is most common in people between the age of 40 and 60, but has been diagnosed in children as well. RA does seem to affect women more so than men. Some people say women are 3 times more likely to have it than men. This research paper examines Rheumatoid Arthritis in regards to: potential causes, its symptoms, how it is diagnosed, and how people cope/live with it. RA is being studied around the world, various trails and experiments continue to test new developments. Some people experience symptoms like joint stiffness at a very young age. Not everyone that has RA experiences the same symptoms. Treatment can be so different from one Rheumatologist to another. Based on this research there is still quite a bit to learn about RA.
Thus, RA is a disease that affects the joints. It embodied by a flare up and remission. Although, this disease often occur in more than one joint and can affect any joint in the body. People with this disease may physically exhaust or fatigued experience fevers. Furthermore, RA is by far the most serious,
Rheumatoid arthritis or (RA) can be difficult to diagnose for several reasons and there are many ways to diagnose it. Since there is no single test for the disease, there are just three ways to specify whether the patient has the disease or not. In addition, the symptoms of rheumatoid arthritis and other types of arthritis diseases can be similar that makes the diagnosing process inaccurate. Moreover, the symptoms vary from patient to another and it develops over time, so it can be severe in some people than the others can. As a result, doctors use several ways to diagnose this disease and to rule out the others. At the beginning, doctors always ask the patients to describe the symptoms and if it changed over time or not. In addition, they
Rheumatoid Arthritis is an autoimmune disease and chronic inflammatory illness that causes the body’s immune system to attack its joints rather than the usual foreign substances such as viruses and bacteria (Arthritis Foundation, 2015; Mayo Foundation, 1998-2015). Unlike wear-and-tear osteoarthritis, Rheumatoid Arthritis attacks the lining of the joints and often other body tissues such as the heart, skin, eyes and lungs (Arthritis Foundation, 2015; May Foundation, 1998-2015). Due to the body’s normal immune response, redness, inflammation, pain, and swelling, arise and can ultimately result in the destruction of bone and joint, causing for deformity (Mayo Foundation, 1998-2015). In the United States, about 1.5 million people have Rheumatoid Arthritis (Arthritis Foundation, 2015). Within this population, women are three times more likely to experience this than men. It has been noted to commonly occur between the ages of 30-60 for women and later in life for men (Arthritis Foundation, 2015). Men may be protected by hormonal factors and require a stronger genetic component to develop disease. Rheumatoid Arthritis is thought to stem from a combination of genetic susceptibility and exposure to an appropriate environmental trigger. (Ollier, W. E., Harrison, B., & Symmons, D. 2001). Within the aspect of genetics it is most likely hereditary. Although infectious triggers of RA have long been suspected, no definitive evidence has been obtained. Previous blood transfusion,
IL-1β induces other cytokines, such as IL-6, IL-8 and leukaemia inducing factor (LIF), causing a catabolic event by stimulating either an additive or synergistic effects (11, 24). IL-1β also cause nociceptive sensitisation through activation of intracellular kinase or the production of kinins and prostanoids (25). Hyperalgesia and hypersensitivity in joints is also associated with IL-6; primary afferent neurons responds to IL-6 and plays a role in pain transmission (1, 24). Similarly, TNF-α activates sensory neurons causing neuropathic pain via the receptors TNFR1 and TFNR2, which initiates a cascade of inflammatory responses through the production of IL cytokines (9,
Rheumatoid Arthritis is often referred to as RA. It is the most common inflammatory joint disease. It causes pain,swelling,and stiffiness in the joints. It can affect everybody no matter the gender or age. It is treatable but there is no cure for it.