Rheumatoid arthritis is a chronic systemic inflammation disease that is characterized by chronic symmetrical irritation of multiple peripheral joints. It’s among the most well-known Rheumatic diseases that are inflammatory and distinguished by the growth of the chronic inflammation of the synovial linings that line diarthrodial joints. This leads to a rapid destruction of cartilage and progressive bone erosion.
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When left untreated, rheumatoid arthritis results in joint degeneration that is progressive as well as disability and death. The prevalence of rheumatoidarthritis across the United States is around 1 percent of the general population with comparable prevalence rates being observed across the globe.
The disorder is seen three times more frequently for females than males, and is most prevalent in beginning in the fifth or six-year age range. Similar to SLE, rheumatoid arthritis is an autoimmune systemic disease through which an abnormal activation of T cells, as well as immune system effectors that are innate occur. Contrary to SLE the bulk of inflammation in rheumatoid arthritis is located in the synovium of joints.
Although the cause of rheumatoid arthritis isn’t known the complex mix of environmental and genetic causes may contribute to the disease susceptibility. Since the prevalence of rheumatoidarthritis has been seen to increase in diverse cultures and geographical areas across the globe we can conclude that the environmental factors that trigger rheumatoid arthritis should be widespread.
The early stages of rheumatoid arthritis are closely resembled by transient inflammatory osteoarthritis that is caused by a range of pathogens that are microbial. Thus, even though an infection-related role in the development of rheumatoid osteoarthritis has long been speculated, it has not yet confirmed.
Particularly class II MHCalleles (HLA-DR4) that share an unanimity QKRAA motif in the peptide binding groove, have been found to be connected to the susceptibility of illness and to a higher severity of osteoarthritis rheumatoid. A significant part of the pathological damage that is characteristic of rheumatoid arthritis is located close to the synovial linings that line joints.
Synovium typically consists of a cellular lining (one to three layers) and an interstitium beneath that is a blood vessel but a few cells. The synovium typically provides nutrients and lubrication to the adjacent cartilage articular. The synovium of rheumatoid arthritis, however, is quite unusual, and has a substantially increased the lining layers (8-10 thickness of tissue) comprised of activated tissue and an interstitium that is highly inflamed that is brimming with B cells T cells, macrophages, as well as vascular changes (including the neovascularization and thrombosis).
On sites in which articular and synovial cartilage are connected the synovial tissue of rheumatoid arthritis (called the pannus) invades and damages adjacent bone and cartilage. Although the reasons behind osteoarthritis rheumatoid are not known, several of the key components of pathogenesis are well-known.
As previously mentioned it is important to differentiate the initiating and spreading phases from the disease and also to understand the way in which the rheumatoid arthritis characteristic is a self-sustaining, increased inflammatory state. In twins, the rates of agreement vary between 15 to 35% indicating genetic factors as the cause of Rheumatoid Arthritis.
The most striking genetic factors identified to date includes a distinct portion of MHC class II alleles, whose presence can be seen to significantly reveal the severity of the disease (sufferers homozygous for alleles associated with disease are the ones with the worst illness). These MHC molecules act as antigen-presenting scaffolds. They provide peptides to T cells of CD4 tissues.
Alleles that are associated with disease (belonging to the HLA-DR4/DR1 serotypes) have a common sequence in their antigen-presenting groove. This is known as”the “shared epitope.” It is possible that these alleles have important antigens that target T tissues, which are involved in initiating and accelerating the progression of the disease. But there are no antigens specific to this disease that have been discovered.