Although everyone has likely heard
of Rheumatoid arthritis (RA), people still do not understand what it is and how
it effects the lives of the people who have it. Therefore, to begin, Rheumatoid
arthritis (RA) is an autoimmune disease that can be characterized by synovial inflammation,
hyperplasia (swelling), cartilage and bone destruction and autoantibody
production (McInnes & Schett, 2011). It affects roughly 1% of the
population and can begin to present itself at any age, but commonly appears in
people between the ages of 40-70 (Lee & Weinblatt, 2001). The medical field still does
not know why people develop RA, but it is estimated that “60% of a population’s
predisposition can be accounted for by genetic factors” (Lee & Weinblatt, 2001).
I have seen firsthand accounts of RA
because my father has had moderate/severe RA since he was 26 years old and began
to lose strength in his hands and have swollen knuckles. For the last 33 years
he has had to change his medication nine times because he is allergic or the
medication starts to attack his kidneys, liver and joints if used too long or his
body builds a tolerance for the medication or it interferes with his ability to
do his job. A few years after he was diagnosed, he developed Rheumatoid nodules
that eventually had to be surgically removed. Not long after that, his right eye
became red and swollen from inflammation caused by his RA and was left with a
red scar on his eye. Every time it seems like a medication is finally going to
work long term, my dad gets worse joint deterioration or he begins having more
flare ups that cause throbbing pain and swelling in his hands, wrists,
shoulders and feet. A few years back, he experienced a server flare up that brought
him to the hospital where the doctors discovered a thick sludgy liquid that was
filling up his lungs. To this day, the doctors can still not identify the liquid,
even after two culture attempts but have come to the conclusion that it was RA related. Interestingly, my dad has never tested positive for Rheumatoid factors,
which is a key indicator for the disease.
There is still so much that needs
to be understood about RA and more works need to be done on RA medications to
better elevate the symptoms people like my dad face every day (beneficence).
Lee, D. M., &
Weinblatt, M. E. (2001). Rheumatoid arthritis, 358, 903–911.
McInnes, I. B., &
Schett, G. (2011). The pathogenesis of rheumatoid arthritis. The New England
Journal of Medicine, 365(23), 2205–2219.
https://doi.org/10.1056/NEJMra1004965
Thanks for sharing about this. Is it possible that your dad has seronegative rheumatoid arthritis? This type of RA is categorized by people who have negative RF tests such as your dad and negative anti-CCP. I found a paper on PubMed (Choi & Lee 2018) stating that those with seronegative RA actually have the more active disease.
ReplyDeleteChoi S, Lee KH. Clinical management of seronegative and seropositive rheumatoid arthritis: A comparative study. PLoS One. 2018 Apr 6;13(4):e0195550. doi: 10.1371/journal.pone.0195550. Erratum in: PLoS One. 2018 Jun 18;13(6):e0199468. PMID: 29624625; PMCID: PMC5889180.
That is a really good question Kathy, I had never heard of this type before you introduced it. After reading your question I talked more with my father and he said that although he does fit the criteria of a negative RF test result, he has always had positive anti-CCP levels. Due to his ani-CCP levels I am not sure that he has seronegative rheumatoid arthritis, but I am glad that you brought it to my attention because there is a high chance that I will develop RA due to my genetics and this could maybe be a type that I develop if I do in fact start to experience RA.
DeleteElyse, I am so sorry to read about your dad's experience with RA. My dad actually has palindromic rheumatism, which is similar to RA in that he has rheumatic joint pain, but it travels from joint to joint and he has no symptoms in between flares. An issue that I see with a lot of autoimmune disorders like RA or palindromic rheumatism is that the medications that are prescribed are more of a bandaid to prevent joint damage rather than addressing the real root of the problem. For example, my dad takes Humira which is used for treating psoriasis, Crohn's disease, ankylosing spondylitis, etc. This drug is a biologic that suppresses the action of the inflammatory TNF cytokines to prevent joint damage. It works for my dad, but it does not address the root cause of his disease. Do you see any feasible next steps in the research to find a cure for autoimmune disease?
ReplyDeleteHUMIRA® (adalimumab) | A Biologic Treatment Option. (n.d.). Retrieved October 4, 2020, from https://www.humira.com/
Moriah, I am sorry to hear about your father’s condition, I know it must be difficult on him to live with that condition. I also agree with you that the prescribed medications are really only a “band aid” for symptoms. Like your father, my father also took Humira for six years and was told that it not only helped with symptoms but slowed down the deterioration of joints. However, his body became used to it and it no longer worked for him. In order to find a cure of autoimmune disease, I think we first have to better understand why people even develop these diseases because if it is genetic, perhaps we can use something like CRISPR to “cut out” the genes that cause these conditions. Once we better understand the root of the cause we can do more experimentation with drugs that specifically target this disease rather than using already existing drugs that have a general list of purposes or effects.
Delete