Posts Tagged ‘autoimmune diseases’

Rheumatoid Arthritis: Cause Hidden, Treatment Ignored

Rheumatoid arthritis (RA) is the most common of several autoimmune diseases that primarily affect the joints.

It is characterized by abnormal inflammatory responses that damage the synovial lining of the joints and other tissues. Components of the immune system mistakenly identify normal body tissues as potentially harmful organisms and attack them causing substantial collateral damage.

This results in joint pain, swelling and permanent damage to joint cartilage and the underlying bone. Other parts of the body such as the blood, nerves and heart may also be affected in severe cases.

Moreover the conventional drugs used in the treatment of RA often cause as many health problems as the disease itself. Bone marrow and immune suppression, liver toxicity, osteoporosis and stomach ulcer are some of the common side effects produced by these drugs.

While antibiotics also have potential side effects, they are generally fewer and milder than those associated with the conventional drugs used in the treatment of RA.

TYPES OF INFECTIONS CAUSING RHEUMATOID ARTHRITIS

Most scientists agree that infections initiate the abnormal inflammatory response seen in RA patients. The theory is that the immune system reacts to an infection of some sort and then becomes confused between the antigens on the pathogenic organism and similar antigens on normal body tissues. The conventional view is that the infection is only a transient trigger of the autoimmune response and not a persistent factor underlying its chronic progression.

However, countless studies have shown that there are indeed a number of chronic, “hidden” infections underlying RA. Some of the pathogenic organisms have been found in the joints of RA patients but mostly these low-grade infections occur in areas such as the genito-urinary tract, mouth or intestines. They work indirectly from these areas by sustaining the aberrant inflammatory response so characteristic of RA.

Mycoplasma, chlamydia, E.coli, and proteus are all bacteria that are capable of causing the low-grade, asymptomatic urinary tract infections that underlie RA. Porphyromonas gingivalis is a bacteria that causes gingivitis and periodontitis and also has a strong association with RA.

Although lab tests often confirm the presence of one or more of these infections, negative results do not preclude an infectious cause of an individual’s disease.

Because many of the infections underlying RA are so difficult to find, even those patients who do not have positive lab tests should be treated with antibiotics.

ANTBIOTICS USED TO TREAT RHEUMATOID ARTHRITIS

For many years the mainstay of antibiotic treatment for RA has been minocycline or other tetracycline antibiotics such as doxycycline. These of antibiotics are still very useful as they also have anti-inflammatory properties and stimulate the regeneration of damaged joint cartilage.

However many bacteria have developed resistance to the tetracyclines and it is now common practice to use combinations with other antibacterials such as azithromycin, clindamycin, metronidazole, levofloxacin and others.

RESULTS OF ANTIBIOTIC TREATMENT FOR RA

Patients may notice improvements in their symptoms anywhere from days, weeks or months, depending on how long they have the disease. They must also expect to remain on the antibiotics for several months to over a year until full remission occurs.

Information from doctors who have used this treatment for many years show that at least 80% of patients benefit from this relatively simple therapeutic modality.

WHY IS THIS EFFECTIVE TREATMENT NOT WIDELY AVAILABLE

There are two reasons for the delay in getting this “new” treatment more widely accepted:

Firstly there is the research “time-lag effect” ? the period it takes from the time a new medical discovery is made until it is accepted and implemented by the majority of doctors. This interval may be over 20 years long.

Secondly, in spite of extensive evidence that certain organisms are associated with RA and other autoimmune diseases, no one specific organism has been shown to be responsible for this group of diseases. This is because autoimmune diseases comprise a spectrum of overlapping conditions that can be caused by several types of microbes located in various parts of the body.

REFERENCES

1. Effects of clarithromycin in patients with active rheumatoid arthritis, Curr Med Res Opin. 2007 Mar;23(3):515-22

2. Levofloxacin treatment in patients with rheumatoid arthritis receiving methotrexate, M Ogrendik, South Med J. 2007 Feb;100(2):135-9.

3. Single-blind randomized trial of combination antibiotic therapy in rheumatoid arthritis, Gompels LL, Smith A, Charles PJ, Rogers W, Soon-Shiong J, Mitchell A, Dore C, Taylor PW, Mackworth-Young CG. J Rheumatol. 2006 Feb;33(2):224-7.

4. Treatment of early seropositive rheumatoid arthritis: Doxycycline plus methotrexate versus methotrexate alone. O’dell JR, Elliott JR, Mallek JA, Mikuls TR, Weaver CA, Glickstein S, Blakely KM, Hausch R, Leff RD, , Arthritis Rheum. 2006 Feb;54(2):621-7. University of Nebraska Medical Center, Omaha.

5. Treatment of early seropositive rheumatoid arthritis: a two-year, double-blind comparison of minocycline and hydroxychloroquine. O’Dell JR, Blakely KW, Mallek JA, Eckhoff PJ, Leff RD, Wees SJ, Sems KM, Fernandez AM, Palmer WR, Klassen LW, Paulsen GA, Haire CE, Moore GF – Arthritis & Rheumatism 2001 Oct;44(10):2235-41

What Are The Symptoms Of Rheumatoid arthritis?

RA or Rheumatoid arthritis is an autoimmune disorder that is chronic in nature. It weakens the immune system and the body joints start getting weaker. RA causes inflammation and eventually destroys the joints. It also affects the other organs like the lungs and the skin in rare cases.

A person suffering from rheumatoid arthritis tends to feel some sort of disability and tremendous pain in the joints. It leads to substantial loss of mobility and mostly the patients should confine to resting. This disease can be diagnosed through blood tests and also by X-rays. The test is known as rheumatoid factor and this is generally carried out by the rheumatologists. They are specialists who treat diseases related to joints and the connective tissues.

This disease can be treated in a variety of ways. The non pharmacological therapies include physical and occupational therapies. The various drugs involved in treating this disorder include Analgesia and drugs with anti inflammatory properties. Steroids are used in suppressing the symptoms of RA.

Drugs known as disease modifying antirheumatic drugs is used in reversing the whole process of the disease and also helps in preventing long term effects. In the recent times biologists have developed a lot of new treatment techniques that are used extensively to treat rheumatoid arthritis.

Symptoms

Rheumatoid arthritis is mainly caused because of synovitis which is an inflammation of synovial membrane. Due to this the joints become swollen and a little stiff. The joints also become slightly warm and soft. It mainly occurs in the joints of hands, cervical spine, and also the feet. Bigger joints like shoulder and the knee joint can also get affected. Synovitis leads to the erosion of joint surfaces and may lead to deformity and also loss of functionality.

The inflammation of the joints occurs that would make the joints soft, and kind of doughy. It would also cause pain and palpation on the joints. This can be used to distinguish between RA and other inflammatory diseases like osteoarthritis. In RA, the joints will be affected in a symmetrical fashion and later turn asymmetrical. Rheumatoid arthritis is bound to affect different parts of the body apart from the joints like skin, lungs, kidney, heart and the blood vessels.

Diagnosis of RA

RA can be diagnosed with different techniques. X ray is used for diagnosing rheumatoid arthritis. X-ray of both, hands and feet is carried out on people who are having polyarthritis. The x-ray will help in checking whether there is any erosion or resorption. Blood test will help in immunological studies of RA. Blood test will help in testing the presence of antibodies like rheumatoid factor. If the blood tests are positive then the person has RA.

A negative report does not really mean that the person is not having RA. In a lot of cases the initial tests are declared negative but after a while they turn out to be positive. Loads of criterions have to be followed while performing diagnostic tests. At least four of the criteria should be met in order to prove that a person is an RA patient. Rheumatoid arthritis does have cure and proper treatment can heal the case completely or to an extent.