The Biomarker Handbook is a curated series that seeks to provide readers with insights on each biomarker we cover in our blood test packages and its relation to our body.
Rheumatoid arthritis is a debilitating chronic inflammatory joint disease for which there is no cure. Early diagnosis and treatment are mandatory for the prevention of generalised progression, functional disability and unfavourable disease outcome in rheumatoid arthritis (RA). To screen for the presence of this disease and its progress, there are 2 different types of biomarkers generally used. One type is the so-called inflammatory biomarkers (namely ESR and CRP, as RA is a generalised inflammatory joint disease) and the other type is autoimmune biomarkers (looking for the presence of certain autoantibodies: rheumatoid factors (RF) and anticitrullinated peptides antibodies (ACPA)).
When tracked, biomarkers for rheumatoid arthritis allows for earlier and better management of the condition, especially because we can now treat it with disease modifying anti-rheumatic drugs.
The importance of tracking biomarkers for rheumatoid arthritis
Patients in whom disease modifying anti-rheumatic drug therapy is introduced early have better function and radiological outcome in the long-term than those in whom it is delayed. This goes back to the basic premise of early disease detection, even before symptoms are present. And RA is a classic example of a disease where existing biomarkers make such a difference to your life if detected early. 70% of people will exhibit positive RF screening.
The inflammatory biomarkers (ESR and CRP) detect the presence of an inflammatory process in your body. The overall inflammation in your body is closely linked with your overall health. Furthermore, any inflammation you experience may be due to a variety of both chronic and acute diseases. In other words, these biomarkers tell you there is an inflammation, but don’t tell you the cause of the inflammation. In medical terms these markers are non-specific. They are, however, very sensitive and are almost always elevated when you have RA (only 70% chance of elevated RF). This is why we choose to use a combination of these biomarkers.
When someone has rheumatoid arthritis, his or her body is in an inflammatory state. In addition, certain foods are responsible for creating inflammation within the body. Examples of such foods are those that contain additives and sugar. Furthermore, refined grains can also cause inflammation and should be avoided. These ingredients are found in common foods such as pizza, cookies, muffins, cereal, bread, crackers, chips, cakes, and candy.
Therefore, in order to counter the possibility of inflammation, you will also need foods that help fight inflammation. These inflammation-fighting foods are foods rich in antioxidants such as vitamin C, vitamin E, zinc, beta-carotene and Alpha-lipolic (ALA).
In a nutshell
By monitoring biomarkers of rheumatoid arthritis, you will be able to predict relapse efficiently. Predictive biomarkers regarding treatment outcome will also allow treatment to be customised to the individual patient.
Furthermore, rheumatoid arthritis is one of the most fitting diseases for the use of personalized medicine as a high level of diversity has been observed. More research is currently being done to work towards this and in recent years, new discoveries have been unearthed.
Signs and symptoms of Rheumatoid Arthritis
The linings of your joints are affected by rheumatoid arthritis. It causes painful swelling which may eventually lead to bone loss and joint deformity. Additionally, inflammation resulting from rheumatoid arthritis may damage other parts of your body as well. Although new and improved medications available today can ease the symptoms, when left untreated, it may snowball into a more severe health risk. Unfortunately, a severe form of this condition may even cause physical disabilities.
Signs and symptoms may include:
- Joints that are tender, warm and swollen
- Joint stiffness. It is normally worse in the morning and after being idle.
- Weight loss, fever, and fatigue
- Rheumatoid arthritis in its early stages tends to affect the smaller joints first, especially the joints that join the fingers to the hands and toes to the feet.
- With the progression of the disease, symptoms frequently spread to the ankles, knees, wrists, elbows, shoulders, and hips.
- About 40% of the patients with rheumatoid arthritis also go through signs and symptoms that do not involve the joints. Non-joint structures that are affected by rheumatoid arthritis are:
- Salivary glands
- Blood vessels
- Bone marrow
- Nerve tissue
Balancing the levels of abnormal rheumatoid biomarkers
The heterogeneous nature of Rheumatoid Arthritis makes it very difficult to pinpoint a single biomarker that predicts joint damage. So far, no single biomarker has emerged as an accurate, valid predictor of joint damage.
Taking preventative measures will balance the biomarkers of Rheumatoid Arthritis.
These biomarkers we suggest for screening RA can provide a good indication of your risk of suffering from the disease. It does not, however, tell you with a degree of certainty that you will or will not suffer from RA. This needs to be in conjunction with clinical findings and possible imaging tests.
Researchers, however, do know that there is a very strong association between smoking and rheumatoid arthritis. Until more facts are discovered on prevention strategies, it’s really important that you quit smoking.
Other preventative measures are:
- Limit exposure to environmental pollutants
- Eat less of red meat, sugar, fried foods, refined flour, alcohol, gluten and processed foods
- Eat more fish; virgin olive oil
- Increase fibre intake
- Consume low-fat dairy products, such as milk, cheese, and yogurt. These foods are loaded with Vitamin D and calcium, both known to boost bone strength.
When should you see a doctor?
See your doctor immediately, if you experience:
- Sudden, unexplained pain and swelling in any joint.
- Pain in the joints is connected with a fever or rash.
- It is impossible to use the joint due to severe pain
- Neck or back pain accompanied by weakness in arms or legs
- Loss of bladder or bowel control
All in all, rheumatoid arthritis is a chronic condition that can cause irreversible joint damage and disability. Diagnosis of the disease is based on a combination of laboratory and clinical and features. Patients typically have arthritis of the small joints of the hands and feet. Additionally, this pain is accompanied by early morning stiffness and other symptoms.
Rheumatoid arthritis not only affects your joints but may also cause damage to the lungs, eyes, heart, blood vessels, skin and other organs.
Thus, the early detection through biomarker tracking is crucial for proper management and/or prevention of RA.
If you want to find out more about rheumatoid arthritis and how you can alleviate pain, take a look at our lifestyle article here!
Interested in other biomarkers, check out the rest of The Biomarker Handbook.
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