Prevention Of Rheumatoid Arthritis Research Articles

Prevention of Rheumatoid Arthritis in At-Risk Individuals: Current Status and Future Prospects.

Early intervention has been the cornerstone of improving outcomes in patients with rheumatoid arthritis. Over the past decade, the boundaries have been pushed in an attempt to achieve effective prevention strategies in those who are at high risk of developing rheumatoid arthritis. Core risk factors including the presence of serum anti-citrullinated protein antibodies, arthralgia and subclinical inflammation on imaging are highly predictive of arthritis development. The influence of air pollution, diet and the role of microbiome on disease progression are less clear. In turn, therapeutic focus has shifted to an earlier pre-arthritis phase of the disease continuum where the clinically apparent arthritis may potentially be intercepted. Seven proof-of-concept interventional trials in at-risk individuals have been conducted so far. Whether true prevention of rheumatoid arthritis is possible remains elusive. Promising signals towards permanent disease modulation and improvement in symptom burden were seen with some immunomodulatory therapies, whilst others were unsuccessful. Long-term follow-up is required to ascertain a true effect. Looking forward, a better understanding of the natural history and underlying biological mechanisms of arthritis development and more accurate, validated risk stratification is needed.

Targeting Therapeutic Windows for Rheumatoid Arthritis Prevention.

Rheumatoid arthritis (RA) is a worldwide public health problem. Interventions to delay or prevent the onset of RA have attracted much attention in recent years, and researchers are now exploring various prevention strategies. At present, there is still no unified consensus for RA prevention, but targeting therapeutic windows and implementing interventions for at-risk individuals are extremely important. Due to the limited number of clinical trials on pharmacologic interventions, further studies are needed to explore and establish optimal intervention regimens and effective measures to prevent progression to RA. In this review, we introduce the RA disease process and risk factors, and present research on the use of both Western and Chinese medicine from clinical perspectives regarding RA prevention. Furthermore, we describe several complete and ongoing clinical studies on the use of Chinese herbal formulae for the prevention of RA.

Potential Role of Dietary Phenolic Compounds in the Prevention and Treatment of Rheumatoid Arthritis: Current Reports.

Rheumatoid arthritis (RA) is a complex illness with both hereditary and environmental components. Globally, in 2019, 18 million people had RA. RA is characterized by persistent inflammation of the synovial membrane that lines the joints, cartilage loss, and bone erosion. Phenolic molecules are the most prevalent secondary metabolites in plants, with a diverse spectrum of biological actions that benefit functional meals and nutraceuticals. These compounds have received a lot of attention recently because they have antioxidant, anti-inflammatory, immunomodulatory, and anti-rheumatoid activity by modulating tumor necrosis factor, mitogen-activated protein kinase, nuclear factor kappa-light-chain-enhancer of activated B cells, and c-Jun N-terminal kinases, as well as other preventative properties. This article discusses dietary polyphenols, their pharmacological properties, and innovative delivery technologies for the treatment of RA, with a focus on their possible biological activities. Nonetheless, commercialization of polyphenols may be achievable only after confirming their safety profile and completing successful clinical trials.

Biological ageing: a promising target for prevention and management of rheumatoid arthritis

Biological ageing: a promising target for prevention and management of rheumatoid arthritis

Prevention and treatment of rheumatoid arthritis through traditional Chinese medicine: role of the gut microbiota.

Recently, despite the increasing availability of treatments for Rheumatoid arthritis (RA), the incidence of RA and associated disability-adjusted life years have been on the rise globally in the late decades. At present, accumulating evidence has been advanced that RA is related to the gut microbiota, therefore, the therapeutic approaches for RA by regulating the gut microbiota are anticipated to become a new means of treatment. Traditional Chinese medicine (TCM) can regulate immunity, reduce inflammation and improve quality of life in various ways. Moreover, it can treat diseases by affecting the gut microbiota, which is a good way to treat RA. In this review, we mainly explore the relationship between TCM and gut microbiota regarding the perspective of treating RA. Moreover, we comprehensively summarize the roles of gut microbiota in the onset, development, progression, and prognosis of RA. Additionally, we elucidate the mechanism of TCM prevention and treatment of RA by the role of microbiota. Finally, we provide an evidence-based rationale for further investigation of microbiota-targeted intervention by TCM.

(105) The Discovery of New Incredible Positive Actions of Hormone Replacement Therapy and Sex in Menopause

Abstract Introduction Every year, two or more benefits of the use of hormone replacement therapy (HRT) in menopause and andropause appear in medical literature. We present an extensive review of the literature describing the classical and novel benefits of hormonal replacement therapy and sex in menopause. Additionally, we present recent findings from our own patient population. Objective To contribute to the presently known benefits of the use of HRTs, and additionally to present new findings from our own practice not previously described. Methods We conducted an extensive literature review and described our own experience and findings within our centers. Results `- In the area of prevention and treatment of genitourinary syndrome of menopause, we have found: - Prevention and treatment of false positive cervical dysplasia in perimenopause. - Prevention and treatment of vulvar, labial, and vaginal occlusion in late menopause. - Prevention and treatment of recurrent urinary tract infections in geriatric patients for prevention of sepsis, secondary pneumonia, and even death. - Prevention and treatment of clitoral atrophy, phimosis, and urethral caruncles - Dermatology: We have found: - Prevention and treatment of wrinkles, alopecia related, postmenopause. - Prevention in prostrated geriatric patients of decubitus ulcers. - Internal Medicine: prevention of obesity, decreased metabolic rate, and insulin resistance. - Ophthalmology: - Prevention and treatment of macular degeneration. - Prevention of glaucoma (increased intraocular pressure), most notably in primary open- angle glaucoma. - The prevention of aging of optic nerve and neuroprotection of retinal cells. - Oncology: - Prevention of kidney cancers, and breast cancer (only estrogen hormone replacement therapy). - Enhanced visualization of the transformation zone during cervical cancer screening - Gastroenterology: protection of the gut microbiome and serum metabolome, especially in premature ovarian insufficiency - Dentistry: prevention of tooth loss through decreased gingival inflammation and periodontitis, mandibular bone loss, and oral dysesthesia. - Neurology: - Protection against intracranial aneurysm rupture in ovariectomized mice. - The prevention of Parkinson’s and Alzheimer’s disease - Rheumatology: prevention of rheumatoid arthritis. Conclusions To demonstrate the number of studies with the anti-aging mechanism of the use of HRT. How this knowledge, alongside our own findings of hundreds of menopausal women within our centers justify the generalized use of this therapy. Disclosure No

"A Blood Biomarker Panel Recommended for Personalized Prediction, Prognosis and Prevention of Rheumatoid Arthritis"

"A Blood Biomarker Panel Recommended for Personalized Prediction, Prognosis and Prevention of Rheumatoid Arthritis"

Prevention vs treatment of rheumatoid arthritis.

Whether a yet chronic and not curable disease like rheumatoid arthritis (RA) can be subject to prevention or whether available resources should be focused on treatment is a classical dilemma. Similar to the case in most other chronic diseases, the focus in research as well as in clinical practice has been on the treatment of established diseases, resulting in drugs that are efficient in eliminating most joint damage but not able to cure the disease or stop needs for continuous treatment of the disease. Less effort has been spent on identifying and implementing ways to prevent the disease. We argue in this review that knowledge concerning the longitudinal evolvement of the major, 'seropositive' subset of RA has now come to a stage where prevention should be a large part of the research agenda and that we should prepare for prevention as part of clinical practice in RA. We describe briefly the knowledge basis for broad public health-based prevention as well as for a 'precision prevention' strategy. In the latter, individuals at high risk for RA will be identified, monitored, and ultimately provided with advice on how to change lifestyle/environment or be given treatment with drugs able to delay and ultimately stop the development of RA. Whether this potential of precision prevention for RA will change the broader clinical practice will depend on whether specific and long-lasting interference with disease-inducing immunity, ultimately 'tolerance therapy', will become a reality.

Kinesitherapeutic Methods of Treatment and Prevention of Rheumatoid Arthritis

Kinesitherapeutic Methods of Treatment and Prevention of Rheumatoid Arthritis

Causal association of diet-derived circulating antioxidants with the risk of rheumatoid arthritis: A Mendelian randomization study

BackgroundAntioxidants, as scavengers of free radicals, have been proposed as potential targets for the prevention and treatment of rheumatoid arthritis (RA), however, the causal associations between antioxidants and RA are still in debate. ObjectiveThis study aims to evaluate this causal association with two-sample Mendelian randomization (MR) analysis. MethodsInverse-variance weighted was used as the major analysis method of MR. Genetic variants associated with dietary antioxidants including vitamin E (α- and γ-tocopherol), β-carotene, lycopene, vitamin C (L-ascorbic acid or ascorbate), and retinol, and their circulating metabolites were used as instrumental variables. The causal effects of the antioxidants were assessed in genome-wide association study datasets of RA from a previous publication (Okada Y. et al.) and Finngen consortium and combined with meta-analysis. ResultsWe observed that the levels of circulating retinol metabolite negatively correlates with the risk of overall RA in the dataset from Okada Y. et al. (odds ratio [OR]=0.952, 95% confidence interval [CI]=0.911−0.996, p = 0.031) and Finngen (OR=0.946, 95%CI=0.903−0.991, p = 0.020). The causal association remained consistent in the meta-analysis (OR=0.949, 95%CI=0.919−0.98, p = 0.002). Increased levels of circulating retinol metabolite also suggestively decreased the risk of seropositive RA (OR=0.936, 95%CI=0.884−0.992, p = 0.025) but not seronegative RA (OR=0.996, 95%CI=0.921−1.076, p = 0.913). No causal effects of other dietary antioxidants on RA were identified in our analyses. ConclusionsOur study suggested a protective effect of circulating retinol metabolites, but not other antioxidants, on overall RA and seropositive RA. Dietary supplementation of retinol may be an effective measure for the primary prevention of RA.

Where traditional Chinese medicine meets Western medicine in the prevention of rheumatoid arthritis.

Chinese medicine has a long tradition of use against rheumatoid arthritis (RA). The formulations are based on combinations of typically 5-10 plants, which are usually boiled and administered as a decoction or tea. There are few clinical trials performed so the clinical evidence is sparse. One fundamental of traditional medicine is to prevent disease. RA is an autoimmune, inflammatory and chronic disease that primarily affects the joints of 0.5%-1% of the population. In two out of three of the cases, the patients are characterised by the presence of autoantibodies such as the rheumatoid factor and the more disease-specific autoantibody against citrullinated proteins, so-called 'ACPA' (anticitrullinated protein/peptide antibodies). ACPA positivity is also strongly associated with specific variations in the HLA-DRB1 gene, the shared epitope alleles. Together with smoking, these factors account for the major risks of developing RA. In this review, we will summarise the background using certain plant-based formulations based on Chinese traditional medicine for the treatment and prevention of RA and the strategy we have taken to explore the mechanisms of action. We also summarise the major pathophysiological pathways related to RA and how these could be analysed. Finally, we summarise our ideas on how a clinical trial using Chinese herbal medicine to prevent RA could be conducted.

Towards preventive treatment of rheumatoid arthritis

Prevention of rheumatoid arthritis is an ambitious therapeutic goal. Once it has developed, rheumatoid arthritis is characterised by high chronicity and often requires lifelong treatment.1,2 Sustained drug-free remission is rare, especially in seropositive disease, which is defined by the presence of rheumatoid factor and anti-citrullinated protein antibodies (ACPA).3 Onset of rheumatoid arthritis, characterised by joint swelling, is preceded by a pre-arthritis phase, in which patients show discrete symptoms (eg, pain), presence of autoantibodies (rheumatoid factor and ACPA), and subclinical signs of inflammation (eg, tenosynovitis) on an ultrasound or MRI scan.

Effect of vitamin E supplementation in rheumatoid arthritis: a systematic review and meta-analysis.

The purpose of this study was to evaluate the safety and effectiveness of vitamin E in rheumatoid arthritis patients. A computerized search of PubMed, Embase, The Cochrane Library, and Web of Science databases was conducted to find published randomized controlled trials of vitamin E in rheumatoid arthritis; the experimental group was treated with vitamin E, while the control group was treated with placebo, other drugs, or external therapy; the search period was from the time each database was established to December 31, 2021, and a meta-analysis was conducted using Rev Man 5.4 software. This research eventually comprised nine publications with a total of 39,845 patients. Vitamin E supplementation was shown to be more effective in individuals with RA for sensitive joints (MD = -1.66, 95% CI - -6.32-2.99; I2 = 93%; P < 0.00001) and swollen joints (MD = -0.46, 95% CI - -1.98-1.07; I2 = 56%; P = 0.08). Vitamin E's ability to restore the intestinal barrier and improve the gastrointestinal tract may be linked to the prevention and treatment of rheumatoid arthritis. Vitamin E supplements used on a regular basis can help individuals with RA reduce joint discomfort, edema, and stiffness, as well as enhance their overall quality of life.

Public perceptions of predictive testing for rheumatoid arthritis compared to breast cancer and early-onset Alzheimer\u2019s disease: a qualitative study

BackgroundThere is increasing research focus on prediction and prevention of rheumatoid arthritis (RA). Information about risk of RA is increasingly available via direct-to-consumer testing. However, there is limited understanding of public perceptions around predictive testing for RA. This study explores public perceptions of predictive testing for RA in comparison to breast cancer (BC) and early-onset Alzheimer’s disease (AD).MethodsFour focus groups with 21 members of the public were conducted using hypothetical vignettes about predictive testing for each disease. Transcripts of focus group proceedings were analysed inductively using thematic analysis.ResultsThematic analysis of the data produced three key themes: decision-making factors, consequences, and consumer needs. Factors suggested that might influence decision-making about predictive testing included family history, fear, and perceived severity and treatability of the illness. RA was perceived to be less severe and more treatable than BC/AD. Potential consequences of predictive testing across all diseases included lifestyle modification, planning for the future and discrimination by employers or insurers. Predictive testing for RA was perceived to have less potential for negative psychological consequences than other diseases. Participants highlighted that individuals undertaking predictive testing should be signposted to appropriate support services and receive information on the accuracy of predictive testing. It was suggested that strategies to mitigate concerns regarding communication and confidentiality of risk results are required.ConclusionsThe findings of this study reflect public misunderstandings regarding RA that may impact the uptake of and responses to predictive testing, and key informational needs of individuals considering a predictive test. Predictive strategies should be accompanied by awareness-raising initiatives and informational resources.

Dietary Fibre and the Prevention of Rheumatoid Arthritis

Rheumatoid arthritis is an autoimmune disease that results in painful and swollen joints, among other complications. Although treatment can alleviate the symptoms, more research is needed to understand the underlying causal mechanisms that could be exploited to prevent it. Dr Mario Zaiss the University of Erlangen-Nürnberg has carried out extensive research in this field and focuses on the impact of diet. He has made the exciting and important discovery that a high-fibre diet produces metabolites that play a vital role in preventing the onset of rheumatoid arthritis.

Pterostilbene Coupled with Physical Exercise Effectively Mitigates Collagen-Induced Articular Synovial by Correcting the PI3K/Akt/NF-κB Signal Pathway.

Studies have revealed that a novel anti-inflammatory mediator─maresin-1 (MaR1)─can reduce the level of inflammatory factors. There is evidence that physical exercise (PE) promotes the biosynthesis of MaR1, leading to the prevention of rheumatoid arthritis (RA). Previously, we have proven that resveratrol can mitigate the formation of RA. Pterostilbene (Pte) is an analogue of resveratrol, but it is around four times more bioavailable. Hence, we hypothesize that Pte could be more effective in preventing RA, in particular, when accompanied by moderate PE. Based on this hypothesis, we explored the preventive effect of Pte combined with PE on a bovine type II collagen (BIIC)-stimulated rat RA model and its underlying molecular mechanism. Compared with the BIIC-stimulated group, the serum content of MaR1 with continuous intervention of Pte plus PE for 8 weeks was significantly increased to 46.3 pg/mL from 7.2 pg/mL in BIIC-treated alone. Besides, the variation in the relative expression levels of p-NF-κB and p-Akt was reversed with the administration of Pte plus PE. More importantly, the in vitro results confirmed that the treatment of Pte plus MaR1 inhibited proliferation and apoptosis and promoted the autophagy of the interleukin (IL)-1β-stimulated primary rat synovial cells through the PI3K/Akt/NF-κB signal pathway. Collectively, the oral administration of Pte plus moderate PE helped to ameliorate the pathological process of RA by correcting the PI3K/Akt/NF-κB signal pathway.

Antioxidant, anti-cancer and anti-arthritic activities of acetogenin-rich extract of avocado pulp

Avocado is an oil-rich fruit pleasant organoleptic characteristic, high nutritional value and health benefits due to its content of bioactive molecules. The objective of the current study was assessment of the antioxidant, anti-cancer and anti-arthritic activities of acetogenin-rich extract of avocado pulp. Total phenolic, total flavonoids, fatty acids profile, phytosterols and hydrocarbons of the extract were determined. Acetogenin was detected using GC-MS. The antioxidant activity of the extract was determined using DPPH, ABTS and FRAP assay. The cytotoxicity of the extract was assessed in different cancer cell lines (liver, colorectal and breast carcinoma cells). The anti-arthritic activity of the extract was evaluated in adjuvant induced arthritis (AIA) model in rats. The results revealed that acetogenin-rich extract of avocado contains phenolic compound (58.6±0.579 mg GAE/g extract) and total flavonoids (10.8±0.449 mg QE/g extract). GC-MS analysis revealed the presence of persediene as one of acetogenin compounds by 1.1% in the extract. The extract possessed antioxidant activity in all the studied methods and the maximum activity was against ABTS free radical. The IC50 of the extract against hepatocellular carcinoma cells (HEPG2), breast adenocarcinoma cells (MCF7) and colorectal cancer cells (HT29) was 8.1, 52.1 and 11.3 µg/ml, respectively. The extract showed significant anti-arthritic activity in rats through reduction of inflammation volume, improvement in the antioxidant status of arthritic rats as observed by reduction of plasma levels of malondiadehyde and elevation of the antioxidant enzymes (SOD, catalase and glutathione peroxidase) in association with reduction of the inflammatory marker TNF-α. The extract showed significant improvement in the histopatological studies of the joint tissue of arthritic rats. In conclusion: Acetogenin-rich extract of avocado pulp can be used as alternative treatment for prevention or treatment of cancer and rheumatoid arthritis due to its antioxidant and anti-inflammatory activities.

Vitamin K2 Supplementation for the Prevention and Treatment of Rheumatoid Arthritis

ObjectivesTo investigate the effects of vitamin K2 supplementation on the prevention and treatment of rheumatoid arthritis(RA). MethodsVitamin K2 and rheumatoid arthritis were searched in Pubmed from inception until December 2020. ResultsStudy 1: Vitamin K2 inhibited the proliferation of mitogen-activated PBMCs of RA patients with an IC50 value of 3,288.47 ± 4,910.02 ng/mL. There was a significant correlation between IC50 values of vitamin K2 and patient-related factors of RA patients (p < 0.05), such as C-reactive protein (CRP), rheumatoid factor, anti-cyclic citrullinated peptide antibody (ACPA), matrix metalloproteinase-3, Pre-DAS-28 (CRP), and ∆DAS-28 (CRP). Methotrexate inhibited the proliferation of mitogen-activated PBMCs of RA patients with a IC50 value of 22.83 ± 12.47 ng/mL. IC50 values of methotrexate only showed significant correlation with ACPA (p = 0.0158, r = 0.6905); Study 2: A significant decrease in MK-7 treated group for the levels of undercarboxylated osteocalcin (ucOC), erythrocyte sedimentation rate (ESR), disease activity score assessing 28 joints with ESR (DAS28-ESR), C-reactive protein (CRP) and matrix metalloproteinase (MMP-3) was found. In MK-7 treated group, a marked decrease in RA clinical and biochemical markers for moderate and good response compared to non-responders was observed in ucOC, ESR and DAS28-ESR. A marked increase in the levels of MK-7 for the moderate and good responders compared to non-responders was observed; Study 3: as compared to the MK-4-naïve group, the MK-4-treated group showed lower serum CRP (1.7 ± 0.2 vs. 0.5 ± 0.1 mg/dl; P < 0.001), MMP-3 (220.4 ± 21.9 vs. 118.0 ± 14.4 ng/ml; P < 0.001), and DAS28-CRP (2.9 ± 0.1 vs. 2.4 ± 0.1; P < 0.05). The patients who were additionally treated with MK-4 showed significant decreases in serum CRP (1.1 ± 0.2 to 0.6 ± 0.2 mg/dl; P < 0.001), MMP-3 (160.1 ± 25.6 to 125.0 ± 17.8 ng/ml; P < 0.05), and DAS28-CRP (3.1 ± 0.2 to 2.4 ± 0.1; P < 0.001). ConclusionsVitamin K2 supplementation could provide a benefit for the prevention and treatment of RA patients via its immunosuppressive function and improving disease activity. Funding SourcesNo.

How to enhance recruitment of individuals at risk of rheumatoid arthritis into trials aimed at prevention: understanding the barriers and facilitators

ObjectivesSeveral trials to test the efficacy of a pharmacological intervention aimed at primary prevention of rheumatoid arthritis (RA) are ongoing or have recently been completed. A common issue in these...

A New Peracetylated Oleuropein Derivative Ameliorates Joint Inflammation and Destruction in a Murine Collagen-Induced Arthritis Model via Activation of the Nrf-2/Ho-1 Antioxidant Pathway and Suppression of MAPKs and NF-κB Activation.

Oleuropein (OL), an olive tree secoiridoid and its peracetylated derivate (Per-OL) have exhibited several beneficial effects on LPS-stimulated macrophages and murine experimental systemic lupus erythematosus (SLE). This study was designed to evaluate dietary Per-OL in comparison with OL supplementation effects on collagen-induced arthritis (CIA) murine model. Three-weeks-old DBA-1/J male mice were fed from weaning with a standard commercial diet or experimental enriched-diets in 0.05 % (w/w) OL, 0.05% and 0.025% Per-OL. After six weeks of pre-treatment, arthritis was induced by bovine collagen type II by tail base injection (day 0) and on day 21, mice received a booster injection. Mice were sacrificed 42 days after the first immunization. Both Per-OL and OL diets significantly prevented histological damage and arthritic score development, although no statistically significant differences were observed between both compounds. Also, serum collagen oligomeric matrix protein (COMP), metalloprotease (MMP)-3 and pro-inflammatory cytokines levels were ameliorated in paws from secoiridoids fed animals. Mitogen-activated protein kinases (MAPK)s and nuclear transcription factor-kappa-B (NF-κB) activations were drastically down-regulated whereas nuclear factor E2-related factor 2 (Nrf2) and heme-oxygenase-1 (HO-1) protein expressions were up-regulated in those mice fed with OL and Per-OL diets. We conclude that both Per-OL and its parent compound, OL, supplements might provide a basis for developing a new dietary strategy for the prevention of rheumatoid arthritis.