Can early intervention alter the course of rheumatoid arthritis?

New research on rheumatoid arthritis (RA) has focused on the early stages of the disease when intervention may help prevent or mitigate the disease. Dr. V. Michael Holers explains that autoimmune diseases like RA develop over time through a combination of genetic predisposition and environmental factors.

Environmental factors play a significant role in RA risk, with exposures such as smoking, air pollution, and diet influencing disease development. For instance, silica inhalation in mining activities increases RA risk, whereas diets rich in omega-3 fatty acids may grant protection. Understanding and altering these environmental exposures could offer strategies to delay or possibly halt disease progression before symptoms emerge.

"Environmental factors are modifiable, and if you are able to eliminate one of those factors, there is potential to stop the disease from developing or to keep it from developing as severely,” says Dr. Holers.

Dr. Holers's research focuses on the development of RA before diagnosis, specifically highlighting the role of autoantibodies. In one of his longitudinal studies, he found elevated levels of autoantibodies in those who later developed RA, up to 17 years before diagnosis. This insight underscores the possibility of identifying at-risk individuals and intervening before the full onset of disease. Ultimately, the goal is to develop proactive healthcare approaches that target this high-risk period, potentially altering the course of the disease for affected individuals.

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