"Arthritis"

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Arthritis is a group of disorders causing joint inflammation, pain, and stiffness. There are over 100 types, but the most common include:

  • Osteoarthritis (OA): Degenerative joint disease caused by cartilage breakdown.
  • Rheumatoid Arthritis (RA): Autoimmune disorder causing joint inflammation and erosion.
  • Psoriatic Arthritis: Associated with psoriasis, affecting skin and joints.
  • Gout: Caused by uric acid crystal buildup in joints.
  • Ankylosing Spondylitis: Inflammatory arthritis affecting the spine.

Pathophysiology:

  • OA: Mechanical stress damages cartilage, leading to bone-on-bone contact.
  • RA: Autoimmune response targets synovial membranes, causing chronic inflammation and joint destruction.
  • Gout: Uric acid crystals trigger an inflammatory response.

Immunological Mechanisms:

  • In RA, T-cells, B-cells, and macrophages release cytokines (e.g., TNF-α, IL-6) that drive inflammation.
  • Synovial fibroblasts proliferate abnormally, contributing to pannus formation.

Genetic Factors:

  • HLA-DR4 is strongly associated with RA.
  • Certain gene variants in URAT1 and ABCG2 increase gout risk.

Biomarkers:

  • RA: Rheumatoid factor (RF), anti-CCP antibodies, elevated ESR and CRP.
  • OA: Elevated cartilage oligomeric matrix protein (COMP).
  • Gout: High serum uric acid levels.

Advanced Diagnostics:

  • Imaging: MRI and ultrasound for detecting early joint erosion.
  • Multi-omics: Integrating genomics, transcriptomics, and proteomics to identify disease subtypes.
  • AI in Radiology: Automated detection of joint changes and prediction of disease progression.

Emerging Therapies:

  • Biologics: TNF inhibitors (e.g., infliximab, adalimumab) for RA.
  • JAK Inhibitors: Target intracellular pathways (e.g., tofacitinib).
  • Gene Therapy: Experimental approaches to modulate inflammatory pathways.
  • CRISPR: Potential future applications for editing genes linked to autoimmunity.
  • Regenerative Medicine: Stem cell therapies to rebuild cartilage in OA.

Links to Systemic Diseases:

  • RA: Increased risk of cardiovascular diseases due to chronic inflammation.
  • Psoriatic Arthritis: Associated with metabolic syndrome.
  • Gout: Strongly linked to kidney disease and diabetes.

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