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Rheumatology & immunology

Rheumatic diseases, do you know the different risk factors?

December 5, 2018

From smoking to DNA, arthritis can have many causes. Different types of rheumatic illnesses have different risk factors, from which you should be careful to try to save your health. Cigarette smoking and a lack of attention to oral hygiene, for example, increase the risk of falling ill with rheumatoid arthritis, while familiarity and joint overload increase the likelihood of developing ankylosing spondylitis. We talked about it with Professor Carlo Selmi, head of Rheumatology at the Istituto Clinico Humanitas and lecturer at the University of Milan.


Being a woman increases the risk of arthritis

For rheumatoid arthritis, a chronic inflammatory autoimmune disease affecting the joints, the genetic factor is crucial.

To begin with, being a woman increases the risk by 4 times: it is not by chance that 80% of patients are female. Examination of the presence of the disease in monozygotic twins has also shown that being familiar with the disease weighs about 25%. The third risk factor, finally, are cigarettes: “Smoking induces the process of citrullination, ie the modification of an amino acid within a chain of proteins and that, in turn, can induce an immune response against the proteins in the joints, triggering the disease in susceptible individuals. Another risk factor is poor oral hygiene: the presence of cavities and chronic inflammation of the gums, in fact, increase the inflammatory state in the body due to the proliferation of bacteria that can trigger autoimmunity. Clear risk factor, although it is difficult to quantify the weight, and finally the stress.


Ankylosing spondylitis is genetic

Ankylosing spondylitis, characterized by spinal pain that worsens with rest, is not related to being a woman. The main risk factor is genetic: 90% of patients with spondylitis have the HLA B27 gene inherited from their families. “The presence of this gene – emphasizes the expert – does not imply in itself to be condemned to fall ill but its positivity increases the risk. In addition, there is a connection with intestinal inflammation due to changes in the bacterial flora. Then there is a biomechanical component, that is, due to the stresses on the joints”. Finally, for both diseases, overweight ‘weighs’ twice as much. “Not only does it make the disease more aggressive – concludes the expert – but it also determines a lower ability of the body to respond to therapies”.

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