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Understanding Arthritis and Inflammation

Understanding Arthritis and Inflammation

The body’s white blood cells and substances that they produce to protect our bodies from infection by foreign organisms, such as bacteria and viruses. In some inflammatory diseases, however, the body’s defense system, the immune system, triggers a response when there are no foreign substances to fight off. In these diseases, called autoimmune disorders, the body’s normally protective immune system causes damage to its own tissues. The body responds as if normal tissues are infected or somehow abnormal.


Understanding the relationship between arthritis and inflammation is key to managing these conditions. In simple terms, all arthritis involves the joints, but not all arthritis is primarily driven by inflammation. Inflammation is a core player in many, but not all, types of arthritis.

Some, but not all, types of arthritis are the result of misdirected inflammation. Arthritis is a general term that describes inflammation in the joints. Some types of arthritis associated with inflammation include the following:
Rheumatoid arthritis
Psoriatic arthritis
Gouty arthritis
Other painful conditions of the joints and musculoskeletal system that may not be associated with inflammation include osteoarthritis, fibromyalgia, muscular low back pain, and muscular neck pain.


Inflammation occurs when substances from the body’s white blood cells are released into the blood or affected tissues to protect your body from foreign invaders. This release of chemicals increases the blood flow to the area of injury or infection, and may result in redness and warmth. Some of the chemicals cause a leak of fluid into the tissues, resulting in swelling. This protective process may stimulate nerves and cause pain. The increased number of cells and inflammatory substances within the joint cause irritation, swelling of the joint lining, and eventual wearing down of cartilage (cushions at the end of bones).

Inflammatory diseases are diagnosed after careful evaluation of the following:
Complete medical history and physical exam with attention to the location of painful joints
Presence of joint stiffness in the morning
Evaluation of accompanying symptoms and signs
Results of X-rays and laboratory tests


Can Inflammation Affect Internal Organs?
Inflammation can affect organs as part of an autoimmune disorder. The type of symptoms experienced depends on which organs are affected. For example:
Inflammation of the heart (myocarditis) may cause shortness of breath or fluid retention.
Inflammation of the small tubes that transport air to the lungs may cause shortness of breath.
Inflammation of the kidneys (nephritis) may cause high blood pressure or kidney failure.
Pain may not be a primary symptom of an inflammatory disease, because many organs do not have pain-sensitive nerves. Treatment of organ inflammation is directed at the cause of inflammation whenever possible.

There are several treatment options for inflammatory diseases, including medications, rest, exercise, and surgery to correct joint damage. The type of treatment prescribed will depend on several factors, including the type of disease, the person’s age, the type of medications they are taking, overall health, medical history, and severity of symptoms.


The goals of treatment are the following:

Correct, control, or slow down the underlying disease process
Avoid or modify activities that aggravate pain
Relieve pain through pain medications and anti-inflammatory drugs
Maintain joint movement and muscle strength through physical therapy
Decrease stress on the joints by using braces, splints, or canes as needed

Reference:
https://my.clevelandclinic.org/health/diseases/12061-arthritis
https://www.webmd.com/arthritis/understanding-arthritis-treatment
https://www.mayoclinic.org/diseases-conditions/arthritis/symptoms-causes/syc-20350772

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Clinical test may predict best rheumatoid arthritis biologic for each individual

Clinical test may predict best rheumatoid arthritis biologic for each individual

A clinical test to predict the best rheumatoid arthritis (RA) biologic for each individual could revolutionize personalized medicine in rheumatology. While no universally validated test exists yet, several promising approaches are being explored:

1. Biomarker-Based Prediction

Researchers are investigating biomarkers that may predict response to specific biologics, such as:

  • Anti-CCP antibodies & RF status: May influence response to rituximab (anti-CD20) or TNF inhibitors.
  • Gene expression profiles: Certain immune signatures (e.g., interferon-high vs. IL-6-driven) may favor JAK inhibitors (tofacitinib, baricitinib) or IL-6 blockers (tocilizumab).
  • Serum cytokine levels: High IL-6 may predict better response to tocilizumab, while TNF-α dominance may favor TNF inhibitors (adalimumab, infliximab).

2. Genetic & Pharmacogenomic Testing

  • HLA-DRB1 shared epitope: May predict response to TNF inhibitors.
  • Fcγ receptor polymorphisms: Could influence response to rituximab.
  • GWAS (Genome-Wide Association Studies): Identifying genetic variants linked to drug metabolism and efficacy.

3. Machine Learning & AI Models

  • Algorithms analyzing electronic health records, lab data, and imaging to predict optimal biologics.
  • PRECISE-RA (Precision Medicine in RA) and other trials are testing AI-driven decision tools.

4. Synovial Tissue Analysis (Emerging)

  • Biopsy-driven profiling of joint inflammation (e.g., B-cell vs. macrophage dominance) may guide therapy (e.g., rituximab for B-cell-rich synovitis).

Current Limitations & Future Outlook

  • No single test is FDA-approved for RA biologic selection yet.
  • Trial-and-error remains common, but multi-omics approaches (genomics, proteomics, metabolomics) may soon enable precision prescribing.

Reference:

https://pmc.ncbi.nlm.nih.gov/articles/PMC10654285

https://www.medicalnewstoday.com/articles/clinical-test-may-predict-best-rheumatoid-arthritis-biologic-individual

https://www.sciencedirect.com/science/article/pii/S0049017223001713

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Low magnesium levels lead to an increased risk of chronic diseases.

Low magnesium levels lead to an increased risk of chronic diseases.

Because it lowers the risk of DNA damage and chronic degenerative disorders, a diet high in magnesium is beneficial for human health according to a recent Australian study. Researchers at the University of South Australia examined blood samples from 172 middle-aged adults. They discovered a significant correlation between elevated levels of the genotoxic amino acid homocysteine and low magnesium levels. Because of the harm this toxic combination causes to the body’s genes, individuals are more vulnerable to diabetes, gastrointestinal disorders, cancers, Alzheimer’s and Parkinson’s disease, and other illnesses. Foods high in magnesium, such as whole grains, dark green leafy vegetables, nuts, beans, and dark chocolate, support the body’s ability to create energy, maintain healthy teeth and bones, control blood pressure and sugar levels, and support the healthy operation of the heart, muscles, and kidneys.

A low magnesium intake (less than 300 mg per day), according to UniSA molecular biologist Dr. Permal Deo, can raise the risk of many diseases; however, its function in preventing DNA damage in humans has not yet been thoroughly investigated. According to co-author Professor Michael Fenech, a persistent magnesium deficiency is likely to impair the body’s capacity to generate energy and power cells, hastening the aging process of tissue and increasing the risk of developing some diseases at an earlier age. The fourth most common mineral in the human body is magnesium. It is needed as a co-factor by over 600 enzymes and as a trigger for nearly 200 vital bodily functions. Finding the ideal magnesium dietary intake—whether from food or supplements and how it might affect the development or course of cancer and other chronic illnesses are the next steps, according to Prof. Fenech.

Even after controlling for age and gender, our research revealed a clear link between elevated DNA damage and blood magnesium levels below 18 mg/L. Measurements of blood levels of magnesium, homocysteine (Hcy), folate, and vitamin B12 revealed a positive correlation between magnesium and vitamin B12 and an inverse relationship between magnesium and Hcy.

This suggests that homocysteine toxicity, which is exacerbated in cases of folate and vitamin B12 deficiency, increases the levels of magnesium in the blood to dangerous levels. Symptoms of magnesium deficiency include tremors, twitches, and cramping in the muscles. In severe cases, a deficiency may even result in convulsions or seizures. Researchers think that these symptoms are brought on by increased calcium entry into nerve cells, which causes the muscle nerves to become overexcited or hyper-stimulated.

Numerous symptoms, such as hypocalcemia, hypokalaemia, and cardiac and neurological problems, can be brought on by magnesium deficiency. The body uses magnesium for numerous functions in every organ and cell, and a chronic low magnesium state has been linked to some chronic diseases, such as diabetes, hypertension, coronary heart disease, and osteoporosis. We frequently hear less about magnesium and more about other electrolytes like calcium, potassium, and sodium.

However, magnesium, like these other electrolytes, is essential to our metabolism and general well-being. It is particularly crucial for the heart’s electrical conduction system and nervous system. Hypomagnesemia, or low or inadequate magnesium levels, can result in some issues. Certain ones are more severe than others. We’ll talk about this condition’s symptoms, causes, diagnosis, and treatment here. Different body parts may experience a variety of symptoms due to low magnesium levels. Numerous symptoms are related to issues with electrical conduction in the heart and nervous system.

Hypomagnesemia can cause a variety of symptoms, such as weakness, exhaustion, tremors or twitches in the muscles, cramping in the heart, palpitations or arrhythmias, numbness, seizures, confusion, or mood swings. Low magnesium is frequently linked to low levels of other crucial electrolytes. Particularly common are low calcium and potassium levels. This is because there are common causes for low levels of these electrolytes. Magnesium is necessary for every organ in the body, but it is especially important for the heart, muscles, and kidneys. It also plays a role in the synthesis of bones and teeth. Many processes in the body require magnesium. This encompasses the bodily chemical and physical processes known as metabolism that transform or utilize energy. Low magnesium can cause symptoms to appear when the body’s magnesium levels fall below normal.

REFERENCES:

https://medlineplus.gov/ency/article/000315.htm
https://www.goodrx.com/conditions/magnesium-deficiency/hypomagnesemia-magnesium-deficiency
https://www.healthline.com/nutrition/magnesium-deficiency-symptoms#twitches-cramps

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