What Is Rheumatoid Arthritis?

Rheumatoid Arthritis (RA) is one of many chronic autoimmune diseases. Some symptoms of RA include swollen and painful joints. Though there is no clear answer as to why patients develop rheumatoid arthritis, it is believed that it is from the combination of one’s environment and genetics (1).

Key Terms To Understanding Rheumatoid Arthritis

To better understand what could be a confusing disease, we will define chronic, autoimmune, rheumatoid, and arthritis. First, we have chronic, which the US government defines as a condition lasting equal to or more than a year that also needs medical attention (2). In addition, though the person may be able to continue with their day-to-day life, it is most often hindered in some way. Next is the word autoimmune, which has to do with antibodies and white blood cells that our body uses to protect from death and disease. A common characteristic of autoimmune disorders is when our own body forgets to recognize the good cells from the bad cells (3). Moving forward, when you break down rheumatoid into ‘Rheuma’ and ‘Toid’, you get definitions of connective tissue (tendons, ligaments, muscles) and ‘relating to’ respectively. When applied to ‘Arthr’ and ‘Itis,’ you get definitions of joints and inflammation respectively. Thus, when we put each part together, we highlight what is rheumatoid arthritis. A disorder relating to antibodies that affect the connective tissue cells located in your joints which ultimately cause inflammation. 

Overall, though it may seem daunting, taking each piece of information offered in bits and pieces can help understand the factors surrounding rheumatoid arthritis. With that being said, below are some facts and factors that are important to understanding, treating, preventing, and treating RA.

Figure 1: Overview Of Rheumatoid Arthritis

5 Facts You Need To Know About Rheumatoid Arthritis

1. Certain antibodies or markers can lead to different types of rheumatoid arthritis.

There are antibodies in the blood that determines what type of rheumatoid arthritis a patient has. Also, some antibodies can be detected years before patients develop symptoms of RA. Though there are many types of antibodies, the most common are Anti-citrullinated protein antibodies and Rheumatoid factor (4). An example of the effect of antibodies is seen with seropositive and seronegative rheumatoid arthritis. When certain antibodies are present, the condition is referred to as seropositive rheumatoid arthritis. When certain antibodies are absent, it is called seronegative rheumatoid arthritis. Overall, antibodies play a big role in the formation and detection of rheumatoid arthritis.  The management is the same whether someone has seropositive or seronegative rheumatoid arthritis.

2. Rheumatoid arthritis can lead to other organ involvement.

There can be multiple organs and body systems involved when it comes to rheumatoid arthritis.  Typically, rheumatoid arthritis attacks the joints. However, rheumatoid arthritis can involve organs beyond the joints  Depression, obesity, and brain fog can be common in patients with rheumatoid arthritis (5). Patients with RA can also see an increased risk for heart disease (1). Furthermore, patients with Rheumatoid Arthritis can also have their eyes affected. An autoimmune attack on the eyes with manifestation of scleritis can occur in rheumatoid arthritis.  Patients who experience scleritis usually have symptoms of redness of the eyes, pain, blurry vision, and extreme sensitivity to light (6). Overall, rheumatoid arthritis is a condition that leads to a higher risk of developing other types of conditions and disorders.

3. Diet plays a big role in developing and treating rheumatoid arthritis.

In a study on RA, it was found that those who had less risk for Rheumatoid Arthritis drank 1 glass of freshly squeezed orange juice a day and often had a diet avoiding food high in fat (7).  This could be due to oranges containing beta-cryptoxanthin, a carotenoid. Furthermore, in another study, it was seen that a diet of fish, fruits, and vegetables often led to a lower risk of developing rheumatoid arthritis (8). Again, this could be due to the presence of a variety of vitamins, minerals, and fiber which help fuel the body and protect its bodily functions. Vitamin D, in particular, is important because patients with RA often have low levels of it (9). Overall, because rheumatoid arthritis is a condition that not only leads to joint pain but also a disease of inflammation, supplementing the body with the necessary nutrients is essential for prevention and treatment.

4. A healthy mouth can help prevent rheumatoid arthritis.

The human body is made up of a variety of environments in which trillions of bacteria live. Due to this, the body is designed to work within a set range of environmental factors. One such factor is the oral (or mouth) biome. Many tiny organisms exist in this place, and often it is regulated by our saliva. Thus, depending on certain habits, new foreign bacteria can enter this environment and disrupt it. These events are what can lead to your mouth developing various antibodies, which eventually lead to the development of rheumatoid arthritis (10). Overall, just like eating a bad meal can upset your gut, certain behaviors can upset your mouth.

Figure 2: Rheumatoid Arthritis And The Oral Microbiome

5. Smoking and second-hand smoking can increase the risk for RA.

Similar to heart disease, and other diseases, smoking is a major factor in the development of Rheumatoid Arthritis. In a study on Smoking and the oral microbiome, smokers were seen to have a very different set of microbes as well as much more microbes than non-smokers in their mouth (10). This change in the oral microbiome could result in the creation of antibodies that increase the risk of Rheumatoid Arthritis (10). In addition, cigarette smoke can result in oxidative stress, disrupting the ability of our bodies to detoxify our bodies (12). This again can increase the risk for inflammation in rheumatoid arthritis. Overall, smoking and second-hand smoking can increase the risk of RA by disrupting our body and introducing bad particulates.

Conclusion

Overall, these five facts above are both important and play a role in the overall health of our body. Though rheumatoid arthritis has many factors that can lead to its development, these factors often start with our diet. A balanced diet that is filled with fruits and vegetables can be a great starting point for rheumatoid arthritis as well as the health of our oral and gut microbiome.

References

1. Chauhan K, Jandu JS, Goyal A, et al. Rheumatoid Arthritis. [Updated 2021 Oct 7]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441999/
2. US Department of Health and Human Services. Multiple chronic conditions — a strategic framework: optimum health and quality of life for individuals with multiple chronic conditions. Washington (DC): 2010. http://www.hhs.gov/ash/initiatives/mcc/mcc_framework.pdf. Accessed February 21, 2013.
3. Wang, L., Wang, F. S., & Gershwin, M. E. (2015). Human autoimmune diseases: a comprehensive update. Journal of internal medicine, 278(4), 369–395. https://doi.org/10.1111/joim.12395
4. Derksen, V., Huizinga, T., & van der Woude, D. (2017). The role of autoantibodies in the pathophysiology of rheumatoid arthritis. Seminars in immunopathology, 39(4), 437–446. https://doi.org/10.1007/s00281-017-0627-z
5. CDC. (2020, July 27). Rheumatoid arthritis (RA). Centers for Disease Control and Prevention. Retrieved February 11, 2022, from https://www.cdc.gov/arthritis/basics/rheumatoid-arthritis.html
6. Promelle, V., Goeb, V., & Gueudry, J. (2021). Rheumatoid Arthritis Associated Episcleritis and Scleritis: An Update on Treatment Perspectives. Journal of clinical medicine, 10(10), 2118. https://doi.org/10.3390/jcm10102118
7. Skoczyńska, M., & Świerkot, J. (2018). The role of diet in rheumatoid arthritis. Reumatologia, 56(4), 259–267. https://doi.org/10.5114/reum.2018.77979
8. Vadell, A., Bärebring, L., Hulander, E., Gjertsson, I., Lindqvist, H. M., & Winkvist, A. (2020). Anti-inflammatory Diet In Rheumatoid Arthritis (ADIRA)-a randomized, controlled crossover trial indicating effects on disease activity. The American journal of clinical nutrition, 111(6), 1203–1213. https://doi.org/10.1093/ajcn/nqaa019
9. Sukharani, N., Dev, K., Rahul, F., Bai, P., Ali, A., Avinash, F., Kammawal, Y., Kumar, N., & Rizwan, A. (2021). Association Between Rheumatoid Arthritis and Serum Vitamin D Levels. Cureus, 13(9), e18255. https://doi.org/10.7759/cureus.18255
10. Nikitakis, N. G., Papaioannou, W., Sakkas, L. I., & Kousvelari, E. (2017). The autoimmunity-oral microbiome connection. Oral diseases, 23(7), 828–839. https://doi.org/10.1111/odi.12589
11. Chang, K., Yang, S. M., Kim, S. H., Han, K. H., Park, S. J., & Shin, J. I. (2014). Smoking and rheumatoid arthritis. International journal of molecular sciences, 15(12), 22279–22295. https://doi.org/10.3390/ijms151222279
12. Pizzino, G., Irrera, N., Cucinotta, M., Pallio, G., Mannino, F., Arcoraci, V., Squadrito, F., Altavilla, D., & Bitto, A. (2017). Oxidative Stress: Harms and Benefits for Human Health. Oxidative medicine and cellular longevity, 2017, 8416763. https://doi.org/10.1155/2017/8416763