Rheumatoid arthritis genetics
P — protects the health of the nonsmoker from cigarette smoke pollution O — offers help to the smoker to quit smoking; W— warns the population about the risks associated with tobacco use; E — It imposes prohibitions on tobacco advertising, promotion, and sponsorship sponsorship and promotion ; R — increases taxes on tobacco 2. Tobacco consumption is the leading cause of premature illness and death in Europe.
In rheumatoid arthritis, methotrexate is continued while using Humira. Pentru poliartrita reumatoidătratamentul cu metotrexat este continuat în perioada în care utilizaţi Humira. Humira was evaluated in over 3, patients in all rheumatoid arthritis clinical trials. Administrarea Humira a fost evaluată la peste pacienţi în toate studiile clinice efectuate pentru poliartrita reumatoidă.
The consumption of a cigarette decreases for the moment the desire to smoke, but causes a desensitization of the nicotinic receptors and at the same time, the increase of their number, precipitating the need for the next cigarette 6. This continuous stimulation caused by tobacco consumption leads to chronic consumption 7.
Genetics of nicotine addiction The primary reason for this addiction is nicotine dependence. Tobacco dependence is influenced by genetic, environmental factors, and also by behavioral factors.
Knowing that parental smoking generates a higher incidence of smoking in children, there has been a hypothesis to show that nicotine action rheumatoid arthritis genetics at the brain level 7. A study conducted by Picciotto and Mineur in in the United States highlighted that smoking tobacco products triggered one of the strongest addictions in the human race.
Nicotine and neuromediators Acute exposures to nicotine determine rapid activation of the prefrontal cortex and thalamus concomitant with corticobasal ganglia activation.
A important difference between these pathologies is that periodontal disease results from the inflammation that develops in response to the subgingival microbiota, while the inflammation in rheumatoid arthritis stems from an exaggerated specific adaptive autoimmune response. This proinflammatory status is perpetuated by the continued bacterial challenge in periodontitis and rheumatoid arthritis genetics autoimmune response triggered in RA, culminating in the progressive durere genunchi alergare of tissues that eventually lead to the signs and symptoms of the disease. Despite the differences in mechanisms of etiological initiation, the idea of polymorphisms of genes that encode certain cytokines which results in connective tissue damage and bone metabolism alterations in the two pathologies mentioned is a bridge which links these diseases. Additionally, there is evidence that both periodontitis and RA are manifested as persistent levels of proinflammatory cytokines and associated molecules. In addition, therapeutic strategies based on blocking proinflammatory cytokines in RA have been shown to have an impact on the overall periodontal status.
Nicotine that stimulates acetylcholine nicotinic receptors causes the release of dopamine, but also of norepinephrine, acetylcholine, gamma-aminobutyric acid GABAand endorphins 8. Dopamine is released from the neurons located in the mesolimbic system. The ability of nicotine to potentiate glutamatergic signals at neuronal level was demonstrated by Mansvelder and McGehee rheumatoid arthritis genetics and further augmented in by Tang and Dani in their studies 9.
Thus, nicotine, considered a high potency drug, induces a dose-dependent impairment of synaptic terminations related to learning and memory.
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Nicotine, however, stimulates both the GABA receptor and the glutamatergic receptors in the hippocampus, an area of the brain considered responsible for addictive addictions 8 Another explanation for the effect of nicotine is that it stimulates nicotinic acetylcholine receptors nAChRsbut equally desensitizes them, as demonstrated by the studies of Grady, Picciotto, and Pidoplichko 7 Repeated exposure to nicotine causes desensitization of dopamine-releasing receptors.
This mixed response, both sensitization and desensitization, can be explained by the existence of several subtypes of acetylcholine nicotinic receptors, which determines the varied response of each individual to the consumption of tobacco products Chromosomal mutations The results of the latest meta-analyses on smoking in genetics rheumatoid arthritis genetics concluded that the variation of the individual response is generated by the variability of the receptor subtypes These mutations of chromosome 15q Other chromosome variations involved in tobacco product response variability cause mutations in chromosomes 8p Exposure to smoking during pregnancy or early childhood causes an increase in smoking incidence at older ages.
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It has not been shown, however, whether this is due to genetic inheritance rheumatoid arthritis genetics parents of the same types of acetylcholine sub-receptors or because of the behavioral loan. Role and Berg demonstrated in that nAChRs contribute to normal neuronal development, and nicotine can disturb this balance In research studies, used as a medicine, nicotine causes attention to increase, diminishes anxiety and can be used even as an easy analgesic.
Repeated exposure at nicotine triggers the phenomenon of tolerance to some of the physiological effects of nicotine and repeated exposure and cumulative doses do not maintain these effects 9 This effect can be explained by the desensitization of dopaminergic receptors following their initial stimulation by nicotine 11 The interaction of the environment with genetic determinism is influenced by CHRNA5 mutations and confirmed by the association between nicotine dependence and rs This allele mutation rs is responsible for increased addiction in adulthood to those who initiated smoking before 16 years of age.
Thus, those who have the present mutation and initiate smoking under the age of 16 have an rheumatoid arthritis genetics risk of becoming heavy smokers. Finnish FinnTwin12 study on twin families has augmented that the importance of smoking genetics in adolescents is decreasing and the importance of the environment is rheumatoid arthritis genetics 1112 Thus, although genetic determinism is not the only triggering factor of nicotine addiction, continuous increasing of rheumatoid arthritis genetics and mortality due to smoking requires a development of all research that can prevent this endemic pathology 1216 Low amplitude systemic inflammation is demonstrated in all smokers and it is confirmed in adults by elevated levels of C-reactive protein, fibrinogen, Interleukin-6, and increased leukocyte levels.
Moreover, coagulation and endothelial function markers such as hematocrit, plasma or blood viscosity, D-dimers, circulating adhesion molecules, tissue plasminogen activator, have also modified values at adult smokers 17 A study developed in Quebec in demonstrated for the first time the association between elevated levels of C reactive protein and smoker status in adolescents. Moreover, adolescents who declared themselves to be heavy smokers in the last month had even higher values of C- reactive protein This biomarker was considered the most accurate regarding the inflammatory profile in the adolescents and young population.
Although most of the smoking-induced inflammatory changes are reversible after withdrawal, some of the biomarkers, for example, C-reactive protein, still remain at high levels for former smokers for a variable period, sometimes 10—20 years after smoking cessation, suggesting a low but persistent inflammation 1819 There is a demonstrated correlation between exposure to cigarette smoke particles and airway sensitization by inflammation, clinically expressed by bronchial hyperreactivity 21 Rheumatoid arthritis genetics effector cells involved in inflammation in the bronchial tree are neutrophils, macrophages, dendritic cells, and eosinophils Exposure to secondhand smoking and third-hand smoking has been recognized as a risk factor for adults dureri de sold ma doare mersul the development of bronchopulmonary cancer in nonsmokers This risk can be assessed by the use of specific biomarkers such as 4- methylnitrosamino 3-pyridyl butanol and 1- methylnitrosamino 3pyridyl butan iso-NNAL The association between smoking and cardiovascular disease is well known.
Thus, studies conducted by Libby and Ross in the early s have shown that both cardiovascular disease and atherosclerosis per se have a major inflammatory component 18 The association between smoking and cardiovascular pathology in adults has been demonstrated by persistently elevated levels of adult C- reactive protein.
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Smoking associated with these autoimmune pathologies worsens the progression of the disease and influences the response to treatment. Therefore, the interrelation between inflammatory biomarkers and smoking has become a certain area of interest, correlating smoking with increased rates of morbidity and mortality through various pathologies 2627 Although the C- reactive protein appears to be the inflammatory biomarker with the highest correlation with the nicotinic dependence level, there are other inflammatory biomarkers whose value can guide the level of inflammation, such as a tumor necrosis factor a, interleukin 1, 6, 8, 12 29 However, the level of C-reactive protein may also be influenced by other factors, such as age, body mass index, weight, and condition or deconditioning of the body 19 ,
Afişare articol Articol The role of rheumatoid arthritis genetic susceptibility markers in the prediction of erosive disease in patients with early inflammatory polyarthritis: results from the Norfolk Arthritis Register Objectives. Recent whole-genome and candidate gene association studies in RA have identified a number of single nucleotide polymorphisms SNPs that predispose to disease with moderate risk. It remains poorly understood how recently identified genetic factors may contribute to RA severity. We therefore sought to investigate the role of recently identified RA susceptibility SNP markers in predicting erosive outcome in patients with recent-onset inflammatory polyarthritis IP. Demographic and clinical data were recorded at inclusion, and at yearly assessments thereafter.