Nine Potential Rheumatoid Arthritis Causes
With contributions from Lana and Effie.
At this time, while there is ongoing research being conducted to try and identify the exact causes of rheumatoid arthritis (RA), there are still no concrete rheumatoid arthritis causes. From various findings, there is typically more than one reason as discussed in greater depth below.
The Role of Genetics
One theory is that genes and genetics are a factor. It can be difficult to say if this means RA is explicitly passed down or an umbrella of autoimmune diseases is passed from one generation to another.
It is often the case that autoimmune diseases in general run in families. So, if a parent has rheumatoid arthritis, their child may develop the disease or an entirely different health issue. Sometimes there are cases where a child may never develop the condition, showing that environmental triggers can be a big factor in turning on certain genes.
There is also some evidence that RA itself runs in families, but this hasn’t been easy to pinpoint for a variety of reasons. Namely, because RA can be challenging to diagnose, there may be people who don’t know they have the disease or have a propensity for it.
Likewise, because reaching a definite RA diagnosis is difficult, it isn’t a disease that was widely diagnosed or treated before the last 20 to 30 years or so, making it even more difficult to observe genetic patterns.
There are also some theories to suggest that while genes do play a part, they are not the be all and end all of having the disease. Instead, some doctors believe that genes make a person susceptible to the disease, but that they can only get it due to outside factors.
These environmental triggers can mean being exposed to a certain infectious disease, such as a virus which is known to be a cause for juvenile idiopathic arthritis in children, smoking cigarettes or being around second-hand smoke, stress, emotional trauma, food allergies, and sensitivities.
The National Rheumatoid Arthritis Society in the UK says no one gene causes RA, but “more than 100 genes have now been identified and work is currently in progress to establish exactly what these genes do and how they interact with one another and environmental factors.”
The society also states that there isn’t one specific environmental factor that causes RA on its own.
“We can think of RA as being like a plant. First, it needs the soil in which to grow. The soil is equivalent to the genetic factors. Then there are the seeds which have to be planted in the soil. The seeds are equivalent to the non-genetic risk factors. The richer the soil such as the more genes associated with RA a person has, the fewer the quantity of seeds needed for a plant to grow.”
Also, since each person’s body is different and not everyone has the same factors that impact them, finding targeted treatments that work for the long-haul has been a challenge for many patients, doctors, and researchers.
While some have achieved remission on medications on the market now, many are still in the trial-and-error phase where they need to bounce from one medicine to another, because either of bad side effects or the body gets used to the medication and it stops working as efficiently.
When patients find themselves at this plateau, they either move on to another drug or add another pharmaceutical to their existing regime under a doctor’s supervision.
Microbiome is the name of the bacteria that live in the intestinal tract. Some microbiomes are good bacteria while others are not. Every person regardless if they have a particular illness or not, are hosts to trillions of these microbiomes.
Researchers have identified gut bacteria that may trigger RA. A type of intestinal bacteria called Prevotella copri has been linked to the onset of RA, according to researchers from NYU Langone Medical Center and New York University School of Medicine.
While the bacteria have been found in people with new-onset, untreated rheumatoid arthritis, other findings tell that those patients with chronic treated rheumatoid arthritis showed a significant decrease in the amount of this bacteria.
According to a study done by Dr. Dan Littman and researchers at New York University School of Medicine, they examined DNA in 114 stool samples from both healthy people and those who had rheumatoid arthritis or psoriatic arthritis. The study explains that they identified gut bacteria by taking DNA from these samples to compare and analyze a specific gene that plays on bacteria.
The conclusion of the study found that “75 percent of people with new-onset, untreated rheumatoid arthritis had the bacterium Prevotella copri in their intestinal microbiome. In comparison, it was present in 12 percent of people with chronic, treated rheumatoid arthritis, 38 percent of people with psoriatic arthritis, and 21 percent of those in the control group.”
This further explains how the body can change over time. If a chronic, treated rheumatoid arthritis patient isn’t showing high markers of Prevotella copri, they may have other bacterial microbiomes that are impacting their RA symptoms and progression of the disease.