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Feckless Pain from Joint Diseases How a rheumatoid arthritis becomes chronic
Rheumatoid arthritis is the most common inflammatory joint disease. Patients suffer from movement restrictions and pain. The inflammatory reaction in the joint is extremely chronic, which is why usually a lifelong therapy is required. Researchers have now discovered why rheumatoid arthritis becomes chronic. The new findings could help to improve the therapy.
Permanently inflamed joints
According to the German Society of Rheumatology (DGRh), rheumatoid arthritis is the most common inflammatory joint disease. In the vernacular in this context is often spoken of "rheumatism". "In this disease, several joints are usually permanently inflamed. As a result, they can gradually deform and stiffen, "explains the Institute for Quality and Efficiency in Health Care (IQWiG) on its patient information portal" gesundheitsinformation.de ". Now, researchers have discovered why rheumatoid arthritis becomes chronic.
Rheumatoid arthritis is the most common inflammatory joint disease. Patients suffer from movement restrictions and pain. Researchers have now discovered why the symptoms become chronic. (Image: From Schonertagen / fotolia.com) The body's own defense cells attack the joint
In rheumatoid arthritis, there is a chronic inflammatory reaction in which the body's own defense cells attack the joint, including cartilage and bone. This process does not stop spontaneously.
An international team of researchers led by rheumatologist dr. Andreas Ramming from the Friedrich-Alexander University Erlangen-Nuremberg (FAU) has now been able to identify a cell type of the immune system that specifically controls a stop of the inflammatory reaction in arthritis.
The results of the scientists were recently published in the journal "Nature Medicine".
Mainly women affected
According to a statement from the university, around 800,000 people, predominantly women, suffer from rheumatoid arthritis in Germany.
Persistent inflammation damages the joints and bones. Patients suffer from movement restrictions and pain.
"Particularly dramatic for those affected is the fact that the inflammatory reaction in the joint is very chronic and therefore usually requires a lifelong therapy," explains Prof. Georg Schett, Director of the Medical Clinic 3 - Rheumatology and Immunology of the University Hospital Erlangen.
In the case of rheumatism, medicines are usually used which, in addition to pain relief, have the important function of preventing or at least slowing down permanent damage to the joints.
Sometimes natural remedies such as radon heat therapy in warm healing tunnels help against the pain of rheumatism. However, rheumatism can not heal so far.
Congenital lymphocytes in rheumatics in hibernation
According to scientists, too little was known about how inflammation dissipates and why this dissolution does not work for rheumatics.
By cooperating with scientists in London, Barcelona, Zurich, Indianapolis and Dublin, the Erlangen researchers have now solved this puzzle.
A cell group of the immune system, the so-called innate lymphocytes (English: Innate Lymphoid Cells), which play little research so far, assume the central role in the dissolution of inflammation, explains the immunologist Simon Rauber, first author of the study.
"In rheumatoid arthritis patients, these congenital lymphocytes are in a kind of hibernation. The inflammation therefore remains. 'If one awakens congenital lymphocytes, the inflammation stops and the damage to the joint is stopped', says study leader dr. Ramming.
The discovery of this important mechanism could represent a completely new approach to the development of innovative treatments for chronic inflammatory diseases.
New options for therapy monitoring
Already, the measurement of the number of congenital lymphocytes in the blood allows a prognosis of the course of treatment. If only a few congenital lymphocytes are present in the blood, it comes to the disease and the joint takes further damage.
However, if the congenital lymphocytes increase, this is associated with a resolution of the inflammation. By measuring them in the blood, an individual, more targeted therapy can be started at an early stage and the patient can be saved from another disease surge.
"This finding will allow us to significantly improve the quality of treatment for rheumatoid arthritis with the help of congenital lymphocytes", explains Dr. med. Ramming. (Ad)