Rheumatoid Arthritis : A Brief Overview of Pathogenesis with Associated Risk Factors and Clinical Treatment

Authors(9) :-Aarif Ali, Mashooq Ahmad Dar, Parvaiz Ahmad Dar, Bashir Ahmad Malla, Aadil Ayaz, Peerzada Tajamul, Mudasar Nabi, Muzamil Farooq, Tashook Ahmad Dar

Rheumatoid arthritis (RA) is a chronic, systemic autoimmune inflammatory disease that is characterised by joint pain, stiffness, and swelling. The etiology of Rheumatoid arthritis is unknown, however medical studies have reported that genetic and individual risk factors or prolonged exposure to environmental triggers is responsible for the development of rheumatoid arthritis. In the development of RA a key role is played by the T cells, B cells and the orchestrated interaction of pro-inflammatory. Rheumatoid arthritis (RA) was regarded as a major clinical problem, however treatments involving biologics have revolutionized the management of this inflammatory disease. The therapeutic objective in patients with rheumatoid arthritis (RA) is reduction of disease activity with an ultimate goal of disease remission. Diverse strategies to develop novel treatments for rheumatoid arthritis which specifically target those patients who do not respond to available medications, including biologics, are currently being explored. The main aim of writing this review is to give a strong knowledge about the epidemiology, risk factors, clinical manifestations, diagnosis and a few of the many treatment strategies currently being evaluated, which are hoped to lead to greater benefits and better disease management in the clinical setting.

Authors and Affiliations

Aarif Ali
Department of Biochemistry, University of Kashmir, J&K, India
Mashooq Ahmad Dar
Department of Biochemistry, University of Kashmir, J&K, India
Parvaiz Ahmad Dar
Department of Biochemistry, University of Kashmir, J&K, India
Bashir Ahmad Malla
Department of Biochemistry, University of Kashmir, J&K, India
Aadil Ayaz
Department of Zoology and Biotechnology, Hemwati Nandan Bahuguna Garhwal University, Uttarakhand, India
Peerzada Tajamul
Department of Biochemistry, Jaipur National University, Rajasthan, India
Mudasar Nabi
Department of Biochemistry, University of Kashmir, J&K, India
Muzamil Farooq
Department of Biochemistry, University of Kashmir, J&K, India
Tashook Ahmad Dar
Department of Zoology, University of Kashmir, J&K, India

Rheumatoid arthritis(RA), risk factors, clinical manifestations, treatment.

  1. Estelle Bajtner,Kutty S Nandakumar, Ak? Engstr?m? and Rikard Holmdahl Chronic development of collagen?induced arthritis is associated witharthritogenic antibodies against specific epitopes on type II collagenArthritis Research & Therapy2005.
  2. Szekanecz Z, Kim J, Koch AE. Chemokines and chemokine receptors in rheumatoid arthritis. Semin Immunol 2003;15:15?21.
  3. Charlotte Hua, Claire I Daien, Bernard Combe, Robert Landewe.? Diagnosis, prognosis and classi?cation of early arthritis: results of a systematic review informing the 2016 update of the EULAR recommendations for the management of early arthritis. RMD Open 2017;3: e000406. doi:10.1136.
  4. Iain B. McInnes, F.R.C.P., Ph.D., and Georg Schett, M.D. The Pathogenesis of Rheumatoid Arthritis. The new england journal of medicine 2011;365:2205-19.
  5. Karlson EW, Deane K. Environmental and gene-environment interactions and risk of rheumatoid arthritis. Rheum Dis Clin North Am 2012;38:405?26.
  6. Lahiri M, Morgan C, Symmons DP, Bruce IN. Modifiable risk factors for RA: prevention, better than cure? Rheumatology (Oxford) 2012;51:499?512.
  7. Okada Y, Wu D, Trynka G, Raj T, Terao C, Ikari K, et al. Genetics of rheumatoid arthritis contributes to biology and drug discovery. Nature 2014;506:376?81.
  8. Kulveer Mankia and Paul Emery. Preclinical Rheumatoid Arthritis. Progress Toward Prevention. ARTHRITIS & RHEUMATOLOGY 2016;? 68( 4):779?788.
  9. Gregersen PK, Silver J, Winchester RJ. The shared epitope hypothesis: an approach to understanding the molecular genetics of susceptibility to rheumatoid arthritis. Arthritis Rheum 1987;30:1205-
  10. Rod Hughes.? Rheumatoid arthritis: clinical review | GPonline (2016).
  11. Yamamoto K, Y. Okada, A. Suzuki, and Y. Kochi, “Genetic studies of rheumatoid arthritis,” Proceedings of the Japan Academy, Series B, vol. 91, no. 8, pp. 410?422, 2015.
  12. MerlinoL. A., J. Curtis,T.R.Mikuls, J. R. Cerhan,L.A.Criswell, and K. G. Saag, “Vitamin D intake is inversely associated with rheumatoid arthritis: results from the Iowa Women’s Health Study,” Arthritis and Rheumatism,vol.50, no.1,pp. 72?77, 2004.
  13. Stolt P., H. K? allberg, I. Lundberg, B. Sj? ogren, L. Klareskog, and L. Alfredsson, “Silica exposure is associated with increased risk of developing rheumatoid arthritis: results from the Swedish EIRA study,” Annals of the Rheumatic Diseases, vol. 64, no. 4, pp. 582?586, 2005.
  14. Bassett A., S. Cooper, C. Wu, and A. Travers, “?e folding and unfolding of eukaryotic chromatin,” Current Opinion in Genetics and Development, vol. 19, no. 2, pp. 159?165, 2009.
  15. Victoria Furer , Jeffrey D. Greenberg, Mukundan Attu, Steven B. Abramson , Michael H. Pillinger.The role of microRNA in rheumatoid arthritis and other autoimmune diseases. Clinical Immunology (2010) 136, 1?15.
  16. Wang MJ, Huang Y, Huang RY, et al. Determination of role of thromboxane A2 in rheumatoid arthritis. Discov Med. 2015;19:23?32.
  17. Korczowska I. Rheumatoid arthritis susceptibility genes: an overview. World J Orthop. 2014;5:544?549.
  18. McInnes IB, Schett G. The pathogenesis of rheumatoid arthritis. N Engl J Med. 2011;365:2205?2219.
  19. Huang RY, Huang QC, Burgering BM. Novel insight into the role of alpha-actinin-1 in rheumatoid arthritis. Discov Med. 2014;17:75?80.
  20. Symmons D, Turner G, Webb R et al. The incidence of rheumatoid arthritis in the United
  21. Kingdom: results from the Norfolk Arthritis Register. Br J Rheumatol 1994; 33(8): 735-9.
  22. Kaplan MJ. Cardiovascular complications of rheumatoid arthritis: Assessment, prevention, and treatment. Rheum Dis Clin N Am 2010;36(2):405?426.
  23. Hooghof, J.T., Mellema, J.J., Posthumus, M.D. and van Raaij, J.J., 2016. A Woman with Rheumatoid Arthritis and a Bilateral Fracture of the Proximal Tibia. Case Rep Orthop 2016, 5094906.
  24. Auger I, Roudier J. A function for the QKRAA amino acid motif: mediating binding of DnaJ to DnaK: implications for the association of rheumatoid arthritis with HLA-DR4. J Clin Invest 1997;99:1818-22.
  25. Kamphuis S, Kuis W, de Jager W, et al. Tolerogenic immune responses to novel
  26. T-cell epitopes from heat-shock protein 60 in juvenile idiopathic arthritis. Lancet 2005;366:50-6.
  27. Ann Pittier. Current Advances in Rheumatoid Arthritis Therapy. TSMJ May 2000 Volume 1. Review l Pharmacology.
  28. BerkantAvci A, Feist E, Burmester GR. Biologicals in rheumatoid arthritis: current and future. RMD Open. 2015.
  29. Smolen JS, Weinblatt ME, Sheng S, Zhuang Y, Hsu B. Sirukumab, a human anti-interleukin-6 monoclonal antibody: a randomised, 2-part (proofof-concept and dose-finding), phase II study in patients with active rheumatoid arthritis despite methotrexate therapy. Ann Rheum Dis. 2014; 73: 1616-1625.
  30. Balsa A, Cabez?n A, Orozco G, et al. Influence of HLA DRB1 alleles in the susceptibility of rheumatoid arthritis and the regulation of antibodies against citrullinated proteins and rheumatoid factor. Arthritis Res Ther. 2010; 12(2): R62.
  31. Scott DL, Wolfe F, Huizinga TW. Rheumatoid arthritis. Lancet. 2010; 376(9746): 1094-1108.
  32. Ravelli A, Felici E, Magni-Manzoni S, et al. Patients with antinuclear antibody-positive juvenile idiopathic arthritis constitute a homogeneous subgroup irrespective of the course of joint disease. Arthritis Rheum. 2005; 52(3): 826-832.
  33. Aletaha D, Neogi T, Silman AJ, et al. 2010 rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative [published correction appears in Ann Rheum Dis. 2010; 69(10): 1892]. Ann Rheum Dis. 2010; 69(9): 1580-1588.
  34. Joachim. R. Kalden. Emerging Therapies for Rheumatoid Arthritis. Rheumatol Ther (2016) 3:31?42 DOI 10.1007/s40744-016-0032-4.
  35. Krzysztof Kanecki, Piotr Tyszko Environmental and personal risk factors for the development of rheumatoid arthritis. Med Rodz (2015) 1(18): 12-17.
  36. Balsamo S et al. Exercise and fatigue in rheumatoid arthritis. Isr Med Assoc J. 2014;16(1):57-60.
  37. Tob?n GJ, Youinou P, Saraux A. The environment, geo-epidemiology, and autoimmune disease: rheumatoid arthritis. J Autoimmun. 2010;35:10?4.
  38. Carmona L, Villaverde V, Hern?ndez-Garc?a C, Ballina J, Gabriel R, Laffon A, et al. The prevalence of rheumatoid arthritis in the general population of Spain. Rheumatology (Oxford). 2002;41:88?95.
  39. Guillemin F, Saraux A, Guggenbuhl P, Roux CH, Fardellone P, Le Bihan E, et al. Prevalence of rheumatoid arthritis in France: 2001. Ann Rheum Dis. 2005;64:1427?30.
  40. Molokhia M, McKeigue P. Risk for rheumatic disease in relation to ethnicity and admixture. Arthritis Res. 2000;2:115?25.
  41. El-Gabalawy HS, Robinson DB, Daha NA, Oen KG, Smolik I, Elias B, et al. Non-HLA genes modulate the risk of rheumatoid arthritis associated with HLA-DRB1 in a susceptible North American Native population. Genes Immun. 2011: 568?74.
  42. Yukawa N, Fujii T, Kondo-Ishikawa S, Yoshifuji H, Kawabata D, Nojima T, et al. Correlation of antinuclear antibody and anti-double-stranded DNA antibody with clinical response to in?iximab in patients with rheumatoid arthritis: a retrospective clinical study. Arthritis Res Ther 2011;13:R213.
  43. Usman Ahmed , Attia Anwar, Richard S. Savage, Paul J. Thornalley and Naila Rabbani. Protein oxidation, nitration and glycation biomarkers for early-stage diagnosis of osteoarthritis of the knee and typing and progression of arthritic disease. Arthritis Research & Therapy.(2016). DOI 10.1186/s13075-016-1154-3.
  44. Medlink and Vet-Medlink 2014. Stem cell treatments of rheumatoid arthritis and the implications of their use in treating the condition. Research paper based on pathology lectures.

Publication Details

Published in : Volume 3 | Issue 8 | November-December 2017
Date of Publication : 2017-12-31
License:  This work is licensed under a Creative Commons Attribution 4.0 International License.
Page(s) : 273-278
Manuscript Number : IJSRST173855
Publisher : Technoscience Academy

Print ISSN : 2395-6011, Online ISSN : 2395-602X

Cite This Article :

Aarif Ali, Mashooq Ahmad Dar, Parvaiz Ahmad Dar, Bashir Ahmad Malla, Aadil Ayaz, Peerzada Tajamul, Mudasar Nabi, Muzamil Farooq, Tashook Ahmad Dar, " Rheumatoid Arthritis : A Brief Overview of Pathogenesis with Associated Risk Factors and Clinical Treatment", International Journal of Scientific Research in Science and Technology(IJSRST), Print ISSN : 2395-6011, Online ISSN : 2395-602X, Volume 3, Issue 8, pp.273-278, November-December-2017.
Journal URL : http://ijsrst.com/IJSRST173855

Article Preview