From timesofindia.indiatimes.com
The immune system of the body is like the defence force of a country. It fights against bacterial and viral infections and protects us from multiple diseases. The soldiers at work here are the ‘antibodies’ produced by the immune system to protect the body against external threats. In some people, however, these antibodies attack the body’s own cells. This is the hidden ‘battle’ that begins to take place in our bodies. This is known as ‘autoimmunity’ and it gives rise to different conditions depending on which part of the body comes under attack.
Rheumatoid arthritis or RA is one of the most common autoimmune disorders in which proteins of a certain kind are wrongly recognized by the body as ‘invaders’ and a specific type of antibodies are produced against these proteins. These proteins are commonly found in the joints, and this is the reason why the part of the body worst affected by RA are the joints such as in the hands, feet, knees and ankles. The first symptoms of RA are pain, warmth, swelling, and stiffness in these joints.
During the initial stages of RA, the pain and swelling occur in one joint which can subside for 2-3 days and then the same symptoms appear in another joint. It is important to start the treatment at this stage. If this is not done, then the disease can begin to destroy the bones and can lead to permanent deformities. In later stages of RA, other parts of the body such as lungs, heart, skin, blood vessels, eyes, nerves, and kidneys can also get affected. If the inflammation in RA is not controlled by medication, it leads to permanent deformities and later makes patients prone to heart diseases and stroke. Insomnia and depression also occur because of long standing uncontrolled disease.
In RA, the one question that comes to mind and needs an answer is why does our body produce antibodies against its own proteins? Right now, we do not have a firm explanation for this. But we do know that it involves complex interactions between genetic, behavioural, and environmental factors to initiate the process of autoimmunity. People born with specific genes known as human leukocyte antigen (HLA) are more at risk to develop RA. But not everyone with this gene develops it. Overall, women are more vulnerable to this condition than men. Some studies have shown that it is 3 times more common in women than men. Research has also shown that this difference is because of the effect of the female hormone, oestrogen on the immune system. In some women, this hormone can stimulate the immune system to become overactive and produce antibodies that are not required. RA is common in the age group of 40 to 60 years, but it can occur at any age. RA sometimes develops after childbirth. In some people, infections such as E. coli, Epstein-Barr virus and cytomegalovirus have been identified as triggers for an ‘hyper-response’ of the immune system. When people with the HLA gene smoke or are obese, they are at the highest risk to develop RA.
Since we have not been able to identify a direct cause for this condition it is difficult to recommend any preventive measures. But we can say with greater assurance that it cannot be cured. Therefore, to minimise risk particularly for those people who may have a family history of RA, it is advisable to reduce weight and stop smoking. Even though most patients are females, they need to understand that they can lead normal lives, get married, become pregnant and have healthy children. There are medicines which can be safely given during pregnancy and breast feeding. For others the advice is to start treatment as soon as the first symptoms appear so that the condition can be controlled, and complications prevented.
People who suffer from frequent joint pain and stiffness need to visit their doctors even if the symptoms are not continuous. A doctor can diagnose the condition based on the symptoms, clinical examination of the joints and a few diagnostic tests. If diagnosed early, there are medicines available known as ‘disease-modifying anti-rheumatic drugs’ (DMARDs) which can slow down the damage to the joints and prevent deformities. We also recommend exercise and physiotherapy which can complement these medicines. Regular follow-ups with the doctor are required to monitor progress and make any required modifications in the medicines. It is best to get treated by specialists called ‘rheumatologists’ because of the challenging nature of the condition. They are specially trained to manage RA and can help patients lead a good-quality life.
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