Manitoba Centre for Proteomics and Systems Biology, Department of Internal Medicine, University of Manitoba, Winnipeg, MB, Canada.
Front Immunol. 2023 Sep 12;14:1221125. doi: 10.3389/fimmu.2023.1221125. eCollection 2023.
Rheumatoid Arthritis (RA) is a common autoimmune disease that targets the synovial joints leading to arthritis. Although the etiology of RA remains largely unknown, it is clear that numerous modifiable risk factors confer increased risk to developing RA. Of these risk factors, cigarette smoking, nutrition, obesity, occupational exposures and periodontal disease all incrementally increase RA risk. However, the precise immunological mechanisms by which these risk factors lead to RA are not well understood. Basic and translational studies have provided key insights into the relationship between inflammation, antibody production and the influence in other key cellular events such as T cell polarization in RA risk. Improving our general understanding of the mechanisms which lead to RA will help identify targets for prevention trials, which are underway in at-risk populations. Herein, we review the modifiable risk factors that are linked to RA development and describe immune mechanisms that may be involved. We highlight the few studies that have sought to understand if modification of these risk factors reduces RA risk. Finally, we speculate that modification of risk factors may be an appealing avenue for prevention for some at-risk individuals, specifically those who prefer lifestyle interventions due to safety and economic reasons.
类风湿关节炎（RA）是一种常见的自身免疫性疾病，主要影响滑膜关节，导致关节炎。尽管 RA 的病因在很大程度上仍不清楚，但很明显，许多可改变的危险因素会增加患 RA 的风险。在这些危险因素中，吸烟、营养、肥胖、职业暴露和牙周病都会逐渐增加 RA 的风险。然而，这些危险因素导致 RA 的具体免疫机制尚不清楚。基础和转化研究为炎症、抗体产生与 RA 风险中 T 细胞极化等其他关键细胞事件的影响之间的关系提供了重要的见解。提高我们对导致 RA 的机制的总体认识将有助于确定针对高危人群的预防试验的目标。在此，我们回顾了与 RA 发展相关的可改变危险因素，并描述了可能涉及的免疫机制。我们强调了少数试图了解这些危险因素的改变是否会降低 RA 风险的研究。最后，我们推测，对于某些高危人群，特别是由于安全和经济原因而更喜欢生活方式干预的人群，改变危险因素可能是一种有吸引力的预防途径。
