Venetsanopoulou Aliki I, Alamanos Yannis, Voulgari Paraskevi V, Drosos Alexandros A
Department of Rheumatology, School of Health Sciences, Faculty of Medicine, University of Ioannina, Ioannina, Greece.
Institute of Epidemiology, Preventive Medicine and Public Health, Corfu, Greece.
Mediterr J Rheumatol. 2023 Dec 30;34(4):404-413. doi: 10.31138/mjr.301223.eaf. eCollection 2023 Dec.
Rheumatoid arthritis (RA) is a prevalent chronic inflammatory arthritis worldwide, significantly impacting patients and population health. The disease affects women primarily, with a female-to-male ratio of three to one. Its pathogenesis is multifactorial, including genetic and environmental risk factors. Epidemiological studies highlight the link between the environment and genetic susceptibility to RA. The so-called shared epitope is the most significant risk factor that seems to act synergetic with other environmental factors in the disease occurrence. In addition, recent findings suggest a potential role of new substantial environmental factors, such as the observed pollution of the planet's natural resources, on the susceptibility and progression of the disease. This review summarises the most decisive evidence on epidemiology and genetic, environmental, and lifestyle risk factors for RA. It shows that studying genetic and environmental factors in correlation could lead to prevention strategies that may impact the natural history of the disease.
类风湿关节炎（RA）是一种在全球范围内普遍存在的慢性炎症性关节炎，对患者和人群健康产生重大影响。该疾病主要影响女性，男女比例为三比一。其发病机制是多因素的，包括遗传和环境风险因素。流行病学研究强调了环境与RA遗传易感性之间的联系。所谓的共享表位是最显著的风险因素，似乎在疾病发生过程中与其他环境因素起协同作用。此外，最近的研究结果表明，新的重要环境因素，如观察到的地球自然资源污染，对该疾病的易感性和进展可能具有潜在作用。本综述总结了关于RA流行病学以及遗传、环境和生活方式风险因素的最具决定性的证据。结果表明，关联研究遗传和环境因素可能会带来预防策略，从而可能影响该疾病的自然病程。
