Modifiable risk factors linked to the development of rheumatoid arthritis: evidence, immunological mechanisms and prevention

Abstract

Rheumatoid Arthritis (RA) is a common autoimmune disease that targets the synovial joints leading to arthritis. Although the etiology of RA remains largely unknown, it is clear that numerous modifiable risk factors confer increased risk to developing RA. Of these risk factors, cigarette smoking, nutrition, obesity, occupational exposures and periodontal disease all incrementally increase RA risk. However, the precise immunological mechanisms by which these risk factors lead to RA are not well understood. Basic and translational studies have provided key insights into the relationship between inflammation, antibody production and the influence in other key cellular events such as T cell polarization in RA risk. Improving our general understanding of the mechanisms which lead to RA will help identify targets for prevention trials, which are underway in at-risk populations. Herein, we review the modifiable risk factors that are linked to RA development and describe immune mechanisms that may be involved. We highlight the few studies that have sought to understand if modification of these risk factors reduces RA risk. Finally, we speculate that modification of risk factors may be an appealing avenue for prevention for some at-risk individuals, specifically those who prefer lifestyle interventions due to safety and economic reasons.

Genetic risk assessment of HLA DRB1 alleles (01, 04, 12 and 15) with Rheumatoid arthritis susceptibility among the Pashtun population of Khyber Pakhtunkhwa, Pakistan

“…RA is mostly caused by interaction of genetic and environmental factors [4][5][6]. Other risk factors include age, gender and environmental exposure i.e., smoking, different air pollutants and infectious agents [7,8]. RA is typically classi ed into two types seropositive or seronegative.…”

Editorial: Immunological processes in maxillofacial bone pathology

“…). Studies have identified periodontitis as a modifiable risk factor of rheumatoid arthritis ( 9 ), the treatment of which is strongly associated with a reduction of inflammatory parameters( ( 10 ), Peng et al. , Gao et al.…”