RHEUMATOID ARTHRITIS (RA) Jiang Lindi (hongshan Hospital)
RHEUMATOID ARTHRITIS （RA） Jiang Lindi (Zhongshan Hospital)
What is rA? Ra is a chronic polyarticular inf lammatory arthritis that involves not only small joints of the hands and feet but also systemic organs Pathologic change: chronic synovitis with pannus (IfEa 翳) ormation It will cause bony destruction deformation disability if joint inflammation repeatedly occur v RF is present in the sera of more than 75%of patients The prevalence rate of ra has been estimated to be 0. 327-0.36% in China, Women appear to be affected three times more commonly than men
What is RA? ✓ RA is a chronic polyarticular inflammatory arthritis that involves not only small joints of the hands and feet but also systemic organs. ✓ Pathologic change: chronic synovitis with pannus (血管 翳)formation. ✓ It will cause bony destruction, deformation, disability if joint inflammation repeatedly occur. ✓ RF is present in the sera of more than 75%of patients. ✓ The prevalence rate of RA has been estimated to be 0.32%-0.36% in China, Women appear to be affected three times more commonly than men
ETIOLOGY 1. Infectious agents: Epstein-Barr virus mycop lasma, macobacteria, retroviruses T lymphocyte and macrophage activation B lymphocyte activation Change of the gene expression Molecular mimicry
ETIOLOGY 1. Infectious agents: Epstein-Barr virus, mycoplasma, macobacteria, retroviruses – T lymphocyte and macrophage activation – B lymphocyte activation – Change of the gene expression – Molecular mimicry
2. Genetic factors Y A high incidence among monozygotic twins(30% x50%), first-degree relative Y Role of hla-dr4 in the susceptibility to and severi of ra 70% RA patients, a relative risk of having Ra with HLa DR4 of 4 to 5 The susceptibility epitope( shared epitope共同表位) QKRAA或 QRRAA It was considered to be related with the severity of established ra
2. Genetic factors ✓ A high incidence among monozygotic twins (30% ~50%),first-degree relative ✓ Role of HLA-DR4 in the susceptibility to and severity of RA − 70% RA patients ，a relative risk of having RA with HLADR4 of 4 to 5 − The susceptibility epitope (shared epitope 共同表位): QKRAA或QRRAA − It was considered to be related with the severity of established RA
3. Gender Predominance in women Improvement or remission of ra during y regnant 4.Induced factors: tiredness, humid cold, mulnutrition psychical stimuli
3. Gender: – Predominance in women – Improvement or remission of RA during pregnancy 4.Induced factors: tiredness, humidity, cold, mulnutrition, psychical stimuli