Rheumatoid arthritis begins in silence: Early signs you can detect years before symptoms and prevent joint damage

After years of research, scientists have found that rheumatoid arthritis is often preceded by a silent stage, without obvious symptoms. The early identification of this autoimmune condition could mean reducing the painful inflammation of the joints and their damage, or even stopping the disease progression.

Rheumatoid arthritis begins in silence: Early signs detected before Shutterstock symptoms

In the following lines, you will find out what new warning signals have discovered researchers, how the immune system reacts long before diagnosis, why some patients with ACPAS antibody develop rheumatoid arthritis, and others and what hopes the preventive therapies bring.

New warning signals and the role of ACPAS antibodies in rheumatoid arthritis

Some people who develop rheumatoid arthritis (AR) are considered at risk years before the occurrence of joint (synovitis) inflammation, due to the presence of anti-protein antibodies (ACPAS) in the blood. However, not all those who have developed, and the reasons for this phenomenon were not fully clarified.

The most recent study brings new warning signals that doctors could use to identify the most exposed to risk. These include inflammatory proteins in the blood and the behavior of immune cells, which are the basis of the development of rheumatoid arthritis. The study was conducted by a team from the United States, led by researchers at the Allen Institute of Immunology, University of California, San Diego and University of Colorado Anschutz Medical Campus.

“Our results argue the idea that the specific inflammatory disease would start long before the appearance of active synovitis, earlier than clinically appreciated. This has important implications for decisions related to the right time to initiate preventive treatment for joint health“write researchers in the work published in Science translational medicine.

Study: How can T and B cells anticipate the appearance of rheumatoid arthritis

The researchers followed the evolution of 45 people considered at risk of developing rheumatoid arthritis (AR) based on the presence of ACPAS antibodies, of which 16 have come to develop the complete form of the disease. Together with the data obtained from healthy persons, the researchers had multiple biological comparison points.

In the blood of participants at risk, proteins related to the immune system were much more abundant and active, while B cells (which produce antibodies) and T cells (which coordinate the activity of cells B) had increased alert signs.

As the diagnosis of AR approached, the number of T and B cells prepared for inflammatory action increased, including T cells that would normally have been more neutral, as if the immune system “He felt” what is about to happen.

Although there is an overlap between the people who developed and those who have not developed the disease in terms of these fundamental changes, the results provide a clearer image on how the risk stage evolves to the complete clinical diagnosis.

Recent discoveries: preventive treatments and targeted therapies for rheumatoid arthritis

“These discoveries characterize the pathogenesis of the ACPA+ risk stage and support the idea that the disease begins much earlier than it would clinic.”the researchers write.

These are completely new discoveries, so the specific treatments are still far away, but understanding how the immune system is activated and actually changes their behavior before the onset would – could, in the future, help researchers aim for these changes for prevention or early treatments.

drug Abatacept (marketed under the name of Orencia, also available in Romania) is already used as a method of delaying rheumatoid arthritis in cases with high risk and there is evidence that it can reverse part of the activity of the immune system highlighted in these studies – which raises hopes for possible future treatments.

“We expect that, in the future, the discoveries of this study will support further research … To better predict who will develop, to identify possible biological targets to prevent the disease and to find ways to improve the existing treatments.”states the rheumatologist Kevin Deane from Cu Anschutz.

Conclusion: Why is it essential for the early diagnosis of rheumatoid arthritis

Recent studies show that rheumatoid arthritis begins to manifest biologically years before the appearance of clinical symptoms. Identification of ACPAS antibodies, monitoring of inflammatory proteins and T and B immune cells can provide doctors tools for early diagnosis and prevention. Although targeted treatments are still in a research phase, drugs such as Abatacept give hope for delaying or even stopping rheumatoid arthritis.

As science progresses, the possibility of recognizing people with high risk in advance and offering them personalized preventive therapies could radically transform how rheumatoid arthritis is managed.