Are there early warning signs before rheumatoid arthritis symptoms appear?
Rheumatoid arthritis (RA) is one of many autoimmune diseases that affects a patient's joints, eventually causing long-term damage and possible disability from the musculoskeletal damage. Research has yet to determine the cause of RA, but associations have been found with certain genes, infections, and hormonal changes. Even though RA mostly affects older individuals, a study led by the University of Colorado Anschutz revealed that RA disease progression can silently begin years before symptoms first appear.
This study follows individuals with anti-CCP antibodies—a biomarker for RA risk—to observe their immune changes over time. One key finding in this study is that at-risk individuals experienced body-wide inflammation even before symptoms and joint swelling began. There were also immune cell shifts, where B cells promoted inflammation and T helper cells became overactive, attacking healthy tissues. Even T cells that had not yet encountered threats exhibited changes in gene activity, hinting at early signs of autoimmune behavior.
Another finding was that monocytes—a type of white blood cell that plays a crucial role in the immune system—produced inflammatory molecules that resembled cells found in RA-affected joints. This suggests that the immune system was already preparing to target joint tissues. Before any symptoms that would allow a formal diagnosis, the body had already begun fighting an internal battle, "like a volcano building pressure beneath the surface."
Interestingly, a second study by University of Colorado Anschutz researchers found that hydroxychloroquine (Plaquenil) did not significantly prevent the onset of RA in patients with elevated anti-CCP antibodies over the course of a 3-year period.
With these key discoveries, healthcare providers can identify which at-risk individuals are more likely or on the path to develop RA. Earlier detection means early intervention strategies can be employed to delay or potentially halt the progression of RA. While researchers have ruled out certain early intervention drugs, these study findings may nevertheless help researchers identify more effective prevention strategies.
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