Autoimmune conditions affecting the musculoskeletal system include rheumatoid arthritis and ankylosing spondylitis. A range of factors contribute to the development of autoimmunity including infections, genetics and dietary factors.
Contributing factors
The British medical journal reported that patients with RA had significantly higher incidences of pulmonary disease than the rest of the population. The lungs remained sub clinically infected after previous infections of bronchitis, pneumonia and pleurisy. This led people to believe that toxins present in the infected lung could provoke inflammatory changes in the rheumatoid joints.
Modern rheumatology now accepts that rather than toxic influences, the idea of ‘immunological cross reactivity’ is considered a leading factor.
What is immunological cross reactivity?
This occurs when antibodies recognise antigens that are structurally similar to each other, for example recognising bacterial or viral antigens as the body’s own and the body attacks both. The phenomenon of molecular mimicry (where invading organisms resemble their host to evade detection) drives immunological cross reactivity.
Infectious agents
A more controversial (albeit widely accepted) notion is that infectious agents are regarded as the main environmental factor of arthritic inflammation.
For example, patients with RA have been found to have increased frequency of periodontal disease compared to healthy patients. Molecular mimicry between autoimmune autoantigens and P. gingivalis proteins could be a causative factor. There have also been links with proteus infections in the urinary tract and RA. Another factor includes viral infections which have triggered an autoimmune response. Epstein Barr virus (EBV) has long been suspected in the pathogenesis of RA.
Historical evidence
Archaeological findings suggest an infectious trigger for RA, as skeletal remains in ancient Europe do not show signs of RA. RA was first evidenced in Europe in 17th century art and the first case reported in 1676, this suggests it could be linked to an infectious agent which came from the New World to the Old world. Specimens dating back thousands of years from Native American tribes in North America show evidence of the disease, with a high prevalence continuing in this ethnic group today.
Supportive measures
Chronic inflammatory diseases are complex and are most effectively treated on a case by case basis, however there are a number of promising pathways for support.
These diseases can often be accompanied by compromised defences, and treatment could exacerbate the condition. The approach adopted by the practitioner should be to gently peel layers away one by one and avoid exacerbation. The practitioner will take special care to apply strategies that recouperate and restore the immune system.
Willow bark has long been used in traditional medicine for rheumatic ocondtions to provide symptomatic relief.
More recent research has found further anti-inflammatory actions wamongst plant constituents including terpenoids, steroids, phenolics, flavonoids, fatty acids, polysaccharides and alkaloids.
Boswellia has been shown to relieve symptoms of RA.
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