Rheumatoid Arthritis  

The most common systemic autoimmune disease is RA, affecting 1% of the population.

Rheumatoid arthritis is an inflammatory disease that may affect many joints in the body. A minority of patients have severe disease and fail to be controlled by conventional treatments. In the short term, uncontrolled RA results in pain and stiffness, but long-term consequences are irreversible joint destruction, disability, reduced quality of life, and a shortened life expectancy. Rheumatoid arthritis is a chronic disease, mainly characterized by inflammation of the lining, or synovium, of the joints. It can lead to long-term joint damage, resulting in chronic pain, loss of function and disability.

Rheumatoid arthritis may start in any joint but ferquently affects the smaller joints in the hands. Joint involvement is always symmetrical meaning that joints on both sides (right & left) of the body are affected at the same time. The disease can also affect the eyes, lungs, heart and blood vessels.

Common symptoms include:

* Fatigue.

* Joint stiffness, particularly in the morning and when sitting for long periods of time. * Rheumatoid nodules, or lumps of tissue under the skin. These appear in about one-fifth of people with RA.

* Loss of appetite, depression, weight loss, anemia, cold and/or sweaty hands and feet.

* Involvement of the glands around the eyes and mouth, causing decreased production o f tears and saliva.

The exact cause of RA is not known but we do know that the immune system plays an important part in RA. In a healthy immune system the white blood cells produce anitbodies that protect the body against foriegn substances. In Rheumatoid arthritis the immune system mistakes healthy tissue for a foriegn invader and attacks it. In addition to the inflammation of the synovial lining the surrounding muscles and tendons also are weakend.

The success of stem cell therapy has led to the development of other so-called biological agents targeted at cytokines and cytokine-receptors (eg, interleukin-1 receptor antagonists). The effectiveness of these therapies reduces the number of patients with severe, resistant disease in whom immunoablation and autologous SCT could be considered.

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