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A new study has shown that rheumatoid arthritis (RA) begins developing long before any outward signs appear, offering hope for earlier diagnosis and prevention.
RA is a serious autoimmune condition that damages the joints and causes painful inflammation.
The research, published in ‘Science Translational Medicine’, reveals that in its earliest stage, RA triggers a hidden immune response throughout the body.
Instead of being confined to the joints, the activity resembles the widespread inflammation seen in people already suffering from the disease.
Mark Gillespie of the Allen Institute in the US said the findings prove RA develops much earlier than thought, and could help shape new ways to block its progress.
“Overall, we hope this study raises awareness that rheumatoid arthritis begins much earlier than previously thought and that it enables researchers to make data-driven decisions on strategies to disrupt disease development,” Gillespie asserted.
Over seven years, the team followed people who carried ACPA antibodies, which signal a higher risk of RA. They also uncovered new clues, such as broad inflammation, immune cells going off-track, and reprogramming at the cellular level.
One finding was that B cells, which normally produce helpful antibodies, had switched into a more harmful, inflammatory state.
T helper cells, especially a subgroup known as Tfh17, found to be far more active than normal.
Even ‘naive’ T cells, which had never fought an infection before, showed changes linked to RA.
The researchers also detected monocytes releasing unusually high levels of inflammatory substances.
These cells looked strikingly similar to macrophages seen in the swollen joints of RA patients, suggesting the disease was already preparing to attack.
The work identifies fresh warning signs in the blood that could allow doctors to spot who among at-risk groups is most likely to develop RA.
Experts say catching the condition early could prevent years of pain and disability.
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