Abstract
Rheumatoid arthritis (RA) is the most common systemic inflammatory rheumatic disease. It is associated with significant burden at the patient and societal level. Extensive efforts have been devoted to identifying a potential cause for the development of RA. Epidemiological studies have thoroughly investigated the association of several factors with the risk and course of RA. Although a precise etiology remains elusive, the current understanding is that RA is a multifactorial disease, wherein complex interactions between host and environmental factors determine the overall risk of disease susceptibility, persistence and severity. Risk factors related to the host that have been associated with RA development may be divided into genetic; epigenetic; hormonal, reproductive and neuroendocrine; and comorbid host factors. In turn, environmental risk factors include smoking and other airborne exposures; microbiota and infectious agents; diet; and socioeconomic factors. In the present narrative review, aimed at clinicians and researchers in the field of RA, we provide a state-of-the-art overview of the current knowledge on this topic, focusing on recent progresses that have improved our comprehension of disease risk and development.
Highlights
Rheumatoid arthritis (RA) is a chronic immune-mediated multisystemic disease that mainly localizes to the joints
The prognosis of RA patients has been dramatically improved by the expansion of knowledge on the etiology and pathophysiology of the disease that paved the way for the development of a number of currently available effective drugs [4]
It should be noted that despite most of these amino acids being located outside the shared epitope (SE) region, all are found in the peptide binding grooves of human leukocyte antigen (HLA), strengthening the importance of antigen presentation to T cells [both cluster of differentiation (CD) 4+ and CD8+] for the pathogenesis of RA
Summary
Etiology and Risk Factors for Rheumatoid Arthritis: A State-of-the-Art Review. Rheumatoid arthritis (RA) is the most common systemic inflammatory rheumatic disease. It is associated with significant burden at the patient and societal level. A precise etiology remains elusive, the current understanding is that RA is a multifactorial disease, wherein complex interactions between host and environmental factors determine the overall risk of disease susceptibility, persistence and severity. Risk factors related to the host that have been associated with RA development may be divided into genetic; epigenetic; hormonal, reproductive and neuroendocrine; and comorbid host factors. In the present narrative review, aimed at clinicians and researchers in the field of RA, we provide a state-of-the-art overview of the current knowledge on this topic, focusing on recent progresses that have improved our comprehension of disease risk and development
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