Re: Hutch experts discover why pregnancy curbs arthritis

[Guest guest]

a, Interested to know if you have any researach info on hormones and how

they are connected with RA. I know many women are diagnosed at around 50 just

when we are experiencing hormone changes and also the lessening of symptoms

during pregnancy when hormone changes happen. I have always felt there was a

connection in my case because just as menopause hit so did the RA. Looking back

I probably had some mild symptoms for several years but also was in the

perimenopause stage for several years. Thanks for all the info you and

provide us with. in TN

a Papola <a54@...> wrote: Hutch experts discover why pregnancy

curbs arthritis

By Warren King

Seattle Times medical reporter

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PHOTOS BY THOMAS JAMES HURST / THE SEATTLE TIMES

Swanson, a special-education teacher in Seattle, says all of

the symptoms of her rheumatoid arthritis disappeared when she was

pregnant.

Enlarge this photo

Rheumatoid arthritis like Swanson's can be debilitating,

eventually deforming joints and making walking and using the hands

very difficult.

When Swanson developed rheumatoid arthritis nearly three

decades ago, it was like a sudden storm of pain, swelling and fatigue.

It was excruciating for the then-21-year-old college student just to

pick up her backpack. She couldn't even write. Medication eased her

pain and stiffness, but not much.

" I would move like an old lady, " said Swanson, now a 49-year-old

special-education teacher in Seattle. " It was scary. "

But then a few years later Swanson and her husband, Tom, did

something that happened to bring total relief from the devastating

disease: They decided to have a baby. All of Swanson's symptoms

disappeared about a month after she became pregnant.

" With all the things you're supposed to cope with in pregnancy, this

was a joy, " Swanson said. " I really did well. I felt like [my

arthritis] had gone away forever. "

Scientists — and many new mothers — have long known that pregnancy

relieves rheumatoid arthritis. What hasn't been entirely clear is why.

Now researchers at Seattle's Fred Hutchinson Cancer Research Center

have delved deeper toward an answer, for the first time identifying

that DNA from dead cells naturally sloughing off the growing fetuses

probably results in the pregnant women getting relief from their

arthritis.

" The bottom line is we could see a specific effect on the arthritis, "

said Dr. Lee , an expert on pregnancy and immunology, and

leader of the recent study reported in the journal Arthritis &

Rheumatism.

" If we can understand this better, we could possibly work toward

specific treatments for autoimmune diseases. "

DNA

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Rheumatoid arthritis occurs when the immune system attacks the

synovial membrane, tissue that lines the joints. Some researchers

believe this autoimmune reaction happens after an infection in

someone who is genetically susceptible to arthritis.

The Fred Hutchinson scientists looked at the amount of DNA from the

fetus circulating in the blood of 25 pregnant women with arthritis

and found that the fetal DNA was plentiful in the blood of almost all

the women. Those with higher DNA levels had significant relief from

the disease. Four who had little or no relief had low levels of the DNA.

Then, about two to four months after delivery, almost all the women

with arthritis relief experienced a return of the painful disease.

Pregnancy has also been known to relieve the symptoms of multiple

sclerosis and Graves' disease, a thyroid disorder, both of which also

are autoimmune diseases.

The Hutchinson scientists speculate that the fetal DNA acts as a sort

of decoy: The mother's immune system focuses on the fetal DNA instead

of the mother's synovial membrane cells. Immune cells decide the

fetal DNA is OK, so they back off their attack on the mother's joints.

Fetal DNA is technically " foreign " to the body, but the immune cells

are programmed not to attack DNA from cells that have died as the

result of a natural process, rather than from infection or another

cause, said Drs. a and Zhen Yan, other researchers on

the study.

Swanson found arthritis relief through three pregnancies. But after

each delivery — with Graham, now 20; Isaac, now 17; and now 12

— her arthritis returned after about two months. When participating

in the Hutchinson study with her last two pregnancies, the

researchers found the measured fetal DNA levels dropped soon after

delivery, and her hands were soon too stiff to manipulate diaper pins

or even hold her baby to nurse.

" I would get stiff and more and more uncomfortable, " Swanson said.

Swanson's medications for arthritis have ranged from aspirin and

several other anti-inflammatory drugs, to shots of gold, which acts

more broadly on the immune system. The medications have controlled

her arthritis fairly well, but she has suffered side effects,

including mouth sores, stomach problems, raised blood pressure and

weight gain.

1 percent

About 1 percent of the population has rheumatoid arthritis or

juvenile arthritis, and women are more than twice as likely to have

it as men, experts estimate. The diseases can be debilitating,

eventually deforming joints and making walking and using the hands

very difficult.

Women with the disease are more likely to deliver prematurely or by

Caesarean section and may have longer hospitalizations, other recent

research has indicated. A drug that would better target the basic

autoimmune process of rheumatoid arthritis would be welcomed by

millions of patients like Swanson, said.

and her colleagues are the first to examine the role of fetal

DNA in arthritis remission during pregnancy. Other scientists have

investigated how the genetics of the fetus and biochemicals that

regulate the immune system influence arthritis.

Next, the Hutchinson scientists hope to expand the study to examine

the activity of immune cells and look more closely at fetal proteins

that may help trigger the immune system's response.

predicts that a medication could be developed in about five

years, depending on drug-company interest.

This latest research was financed by the National Institutes of

Health and the Washington Women's Foundation, which awards grants for

work in health, social services, arts and culture, education and the

environment.

http://seattletimes.nwsource.com/html/health/

2003207473_arthritis18m.html