REVIEW - Risk factors for the development of RA

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Scandinavian Journal of Rheumatology

Issue: Volume 35, Number 3 / May 2006

Risk factors for the development of rheumatoid arthritis

J. E. Oliver A1 and A. J. Silman A1

A1 arc Epidemiology Unit, Manchester University, School of

Epidemiology and Health Sciences, Manchester, UK

Abstract:

There is increasing interest in attempting to understand what the risk

factors are that lead to the development of rheumatoid arthritis (RA). Twin

studies have proved a genetic role but also quantified the non-genetic risk.

There is thus scope for identifying environmental predictors that might

offer a strategy to prevent the disease. Changes in the female hormonal

environment such as in pregnancy, breastfeeding and the use of the oral

contraceptive (OC) pill appear to have a role. Of the traditional lifestyle

exposures, cigarette smoking has been associated with a consistently

increased risk that might also apply to the passive inhalation of smoke.

Occupation probably has a minor influence, although exposure to silica dust

is of aetiological importance. Recent studies have highlighted a role for

diet, with suggestions that diets high in caffeine, low in antioxidants and

high in red meat may contribute to an increased risk. The most plausible

environmental exposure is infection and although several decades of study

have produced few definitive candidate organisms, Epstein-Barr virus (EBV)

remains an interesting target.

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Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

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