Rheumatoid arthritis symptoms appear much after changes in immune system, finds study

Rheumatoid arthritis, the study results suggest, develops gradually, in a hidden phase where the immune system is already attacking the body before any physical signs appear (Image: Pexels)

Rheumatoid arthritis, it was believed for long, only starts when joints ache or stiffen. However, scientists now seem to disagree. According to a new study, RA begins silently, with the immune system already gearing up for attack long before you notice any pain. Other early signs may be subtle or even invisible, but the body is already in a state of systemic inflammation.

Researchers from the Allen Institute, CU Anschutz, UC San Diego, and Benaroya Research Institute followed people with RA-linked antibodies, called ACPA, over seven years. Their study, published in Science Translational Medicine, tracked how the immune system changes before symptoms arise.

What the  study found

• Widespread inflammation: People at risk for RA already show body-wide inflammatory activity, not just in joints.
• Immune cell dysfunction: B cells (normally protective) became pro-inflammatory, while T helper cells, especially Tfh17-like cells, expanded beyond normal levels.
• Cellular reprogramming: Even “naive” T cells, which have never encountered pathogens, had epigenetic changes—altered gene activity preparing them to misfire.
• Joint-like inflammation in the blood: Monocytes, a type of white blood cell, were producing inflammatory molecules similar to the macrophages found in RA-affected joints.

These findings reveal that RA develops gradually, in a hidden phase where the immune system is already attacking the body before any physical signs appear.

“This study raises awareness that rheumatoid arthritis begins much earlier than previously thought,” said Mark Gillespie, Ph.D., co-senior author. Kevin Deane, M.D./Ph.D., added, “The findings may help predict who will develop RA, identify biological targets for prevention, and improve treatment for those already affected.”

By identifying these early immune signatures, doctors could one day detect RA before joint damage occurs, monitor at-risk patients closely, and even intervene to prevent the disease. This approach represents a shift from reacting to joint damage to preventing RA at its earliest stages, potentially saving patients years of pain and disability.

Also read | Unhealthy diets to injuries, 5 ways you are unknowingly inviting arthritis into your life in 20s and 40s

Why early detection matters:

• Catching RA early could allow treatment before joint damage begins.
• Immune system changes occur years before pain shows up.
• Monitoring biomarkers could help identify high-risk individuals.
• Preventive strategies may reduce long-term disability.
• Understanding the silent phase gives new insights into autoimmune disease.

FAQs on Rheumatoid Arthritis

Rheumatoid arthritis is an autoimmune disease causing systemic inflammation, often starting silently before symptoms like joint ache or stiffness appear.

2. How does RA develop?

RA begins with immune system changes, causing body-wide inflammation and immune cell dysfunction, often years before any physical symptoms manifest.

3. Why is early detection of RA important?

Early detection allows for timely intervention, potentially preventing joint damage and reducing long-term disability associated with RA.

4. What are the early signs of RA?

Early signs include subtle or invisible symptoms, with the immune system already in an inflammatory state before noticeable pain.

5. How can early RA be monitored?

Monitoring biomarkers and immune signatures can help identify individuals at high risk for RA, enabling early preventive strategies and closer monitoring.

Disclaimer: This article, including health and fitness advice, only provides generic information. Don’t treat it as a substitute for qualified medical opinion. Always consult a specialist for specific health diagnosis.