Rheumatoid arthritis is a common chronic autoimmune disease that is the focus of extensive research aimed at improving its treatment and the quality of life of patients with the condition. Italian researchers conducted a review of the most recent publications relating to the condition.
A common autoimmune disease that is still being explored
In France, around 300,000 people have rheumatoid arthritis. The management of this common rheumatic disease is based on both medicinal and non-medicinal treatments aimed at reducing its symptoms and improving the quality of life of those affected. The chronic autoimmune disease mainly affects women and is characterized by joint inflammation and extra-articular involvement. These problems are caused by the symmetrical and inflammatory destruction of distal joints.1
Rheumatoid arthritis (RA) is caused by genetic and environmental factors, which are not always easy to identify. The recent discovery of new gene polymorphisms, in particular, gives a clearer insight into the pathogenesis of RA.
Genetic and environmental factors
A team of Italian researchers conducted a review of publications produced in 2020.2 In terms of genetic factors, the team notably highlights that, among the various cytokines regulating the pathogenesis of RA, the IL-12 cytokine appears to modulate the processes involved in the immune response. The “rs17860508” polymorphism of the IL12B gene specifically was recently linked to a genetic susceptibility in a study conducted in the Bulgarian population. In addition, according to the researchers, numerous genetic variants may be associated with specific clinical aspects and increase vulnerability to the disease, as well as the severity of its symptoms. In particular, this is the case for the RARB gene, thought to be responsible for the development of subclinical atherosclerosis in RA.
In addition to genetic aspects, environmental factors, such as smoking, air pollution, diet, obesity and infections, are known to be responsible for triggering RA in genetically susceptible individuals. A recent prospective study of a sample of women confirms the link between active smoking and the risk of developing RA and also demonstrates, for the first time, the effects of passive exposure to smoking in childhood. Other studies also demonstrate the role of certain polluting particles in the development of RA. The Italian researchers also identified the existence of a recent meta-analysis confirming a higher risk of RA in people who are overweight or obese compared to people with a normal BMI. In addition to weight, a healthy diet and physical activity also appear to play an important role in the prevention of RA. Finally, viral infections, including coronavirus infection, may play a key part in the development of RA. New studies are required to confirm the latter point.2 The researchers hope that advances in our knowledge of RA will result in the discovery of new, more targeted therapies.
Wang J, Yan S, Yang J, Lu H, Xu D, Wang Z. Non-coding RNAs in Rheumatoid Arthritis: From Bench to Bedside. Front Immunol. 2020 Jan 28;10:3129. doi: 10.3389/fimmu.2019.03129. PMID: 32047497; PMCID: PMC6997467.
Giannini D, Antonucci M, Petrelli F, Bilia S, Alunno A, Puxeddu I. One year in review 2020: pathogenesis of rheumatoid arthritis. Clin Exp Rheumatol. 2020 May-Jun;38(3):387-397. Epub 2020 Apr 23. PMID: 32324123.