Please choose from the following list of questions for information about gene therapy, an experimental technique that uses genetic material to treat or prevent disease.

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Gene therapy is an experimental technique that uses genes to treat or prevent disease. In the future, this technique may allow doctors to treat a disorder by inserting a gene into a patients cells instead of using drugs or surgery. Researchers are testing several approaches to gene therapy, including:

Replacing a mutated gene that causes disease with a healthy copy of the gene.

Inactivating, or knocking out, a mutated gene that is functioning improperly.

Introducing a new gene into the body to help fight a disease.

Although gene therapy is a promising treatment option for a number of diseases (including inherited disorders, some types of cancer, and certain viral infections), the technique remains risky and is still under study to make sure that it will be safe and effective. Gene therapy is currently only being tested for the treatment of diseases that have no other cures.

MedlinePlus from the National Library of Medicine offers a list of links to information about genes and gene therapy.

Educational resources related to gene therapy are available from GeneEd.

The Genetic Science Learning Center at the University of Utah provides an interactive introduction to gene therapy and a discussion of several diseases for which gene therapy has been successful.

The Centre for Genetics Education provides an introduction to gene therapy, including a discussion of ethical and safety considerations.

KidsHealth from Nemours offers a fact sheet called Gene Therapy and Children.

Additional information about gene therapy is available from the National Genetics and Genomics Education Centre of the National Health Service (UK)

Gene therapy is designed to introduce genetic material into cells to compensate for abnormal genes or to make a beneficial protein. If a mutated gene causes a necessary protein to be faulty or missing, gene therapy may be able to introduce a normal copy of the gene to restore the function of the protein.

A gene that is inserted directly into a cell usually does not function. Instead, a carrier called a vector is genetically engineered to deliver the gene. Certain viruses are often used as vectors because they can deliver the new gene by infecting the cell. The viruses are modified so they cant cause disease when used in people. Some types of virus, such as retroviruses, integrate their genetic material (including the new gene) into a chromosome in the human cell. Other viruses, such as adenoviruses, introduce their DNA into the nucleus of the cell, but the DNA is not integrated into a chromosome.

The vector can be injected or given intravenously (by IV) directly into a specific tissue in the body, where it is taken up by individual cells. Alternately, a sample of the patients cells can be removed and exposed to the vector in a laboratory setting. The cells containing the vector are then returned to the patient. If the treatment is successful, the new gene delivered by the vector will make a functioning protein.

Researchers must overcome many technical challenges before gene therapy will be a practical approach to treating disease. For example, scientists must find better ways to deliver genes and target them to particular cells. They must also ensure that new genes are precisely controlled by the body.

A new gene is injected into an adenovirus vector, which is used to introduce the modified DNA into a human cell. If the treatment is successful, the new gene will make a functional protein.

The Genetic Science Learning Center at the University of Utah provides information about various technical aspects of gene therapy in Gene Delivery: Tools of the Trade. They also discuss other approaches to gene therapy and offer a related learning activity called Space Doctor.

The Better Health Channel from the State Government of Victoria (Australia) provides a brief introduction to gene therapy, including the gene therapy process and delivery techniques.

Penn Medicines Oncolink describes how gene therapy works and how it is administered to patients.

Gene therapy is under study to determine whether it could be used to treat disease. Current research is evaluating the safety of gene therapy; future studies will test whether it is an effective treatment option. Several studies have already shown that this approach can have very serious health risks, such as toxicity, inflammation, and cancer. Because the techniques are relatively new, some of the risks may be unpredictable; however, medical researchers, institutions, and regulatory agencies are working to ensure that gene therapy research is as safe as possible.

Comprehensive federal laws, regulations, and guidelines help protect people who participate in research studies (called clinical trials). The U.S. Food and Drug Administration (FDA) regulates all gene therapy products in the United States and oversees research in this area. Researchers who wish to test an approach in a clinical trial must first obtain permission from the FDA. The FDA has the authority to reject or suspend clinical trials that are suspected of being unsafe for participants.

The National Institutes of Health (NIH) also plays an important role in ensuring the safety of gene therapy research. NIH provides guidelines for investigators and institutions (such as universities and hospitals) to follow when conducting clinical trials with gene therapy. These guidelines state that clinical trials at institutions receiving NIH funding for this type of research must be registered with the NIH Office of Biotechnology Activities. The protocol, or plan, for each clinical trial is then reviewed by the NIH Recombinant DNA Advisory Committee (RAC) to determine whether it raises medical, ethical, or safety issues that warrant further discussion at one of the RACs public meetings.

An Institutional Review Board (IRB) and an Institutional Biosafety Committee (IBC) must approve each gene therapy clinical trial before it can be carried out. An IRB is a committee of scientific and medical advisors and consumers that reviews all research within an institution. An IBC is a group that reviews and approves an institutions potentially hazardous research studies. Multiple levels of evaluation and oversight ensure that safety concerns are a top priority in the planning and carrying out of gene therapy research.

Information about the development of new gene therapies and the FDAs role in overseeing the safety of gene therapy research can be found in the fact sheet Human Gene Therapies: Novel Product Development Q&A.

The Genetic Science Learning Center at the University of Utah explains challenges related to gene therapy.

The NIHs Office of Biotechnology Activities provides NIH guidelines for biosafety.

Because gene therapy involves making changes to the bodys set of basic instructions, it raises many unique ethical concerns. The ethical questions surrounding gene therapy include:

How can good and bad uses of gene therapy be distinguished?

Who decides which traits are normal and which constitute a disability or disorder?

Will the high costs of gene therapy make it available only to the wealthy?

Could the widespread use of gene therapy make society less accepting of people who are different?

Should people be allowed to use gene therapy to enhance basic human traits such as height, intelligence, or athletic ability?

Current gene therapy research has focused on treating individuals by targeting the therapy to body cells such as bone marrow or blood cells. This type of gene therapy cannot be passed on to a persons children. Gene therapy could be targeted to egg and sperm cells (germ cells), however, which would allow the inserted gene to be passed on to future generations. This approach is known as germline gene therapy.

The idea of germline gene therapy is controversial. While it could spare future generations in a family from having a particular genetic disorder, it might affect the development of a fetus in unexpected ways or have long-term side effects that are not yet known. Because people who would be affected by germline gene therapy are not yet born, they cant choose whether to have the treatment. Because of these ethical concerns, the U.S. Government does not allow federal funds to be used for research on germline gene therapy in people.

The National Human Genome Research Institute discusses scientific issues and ethical concerns surrounding germline gene therapy.

A discussion of the ethics of gene therapy and genetic enhancement is available from the University of Missouri Center for Health Ethics.

Gene therapy is currently available only in a research setting. The U.S. Food and Drug Administration (FDA) has not yet approved any gene therapy products for sale in the United States.

Hundreds of research studies (clinical trials) are under way to test gene therapy as a treatment for genetic conditions, cancer, and HIV/AIDS. If you are interested in participating in a clinical trial, talk with your doctor or a genetics professional about how to participate.

You can also search for clinical trials online. ClinicalTrials.gov, a service of the National Institutes of Health, provides easy access to information on clinical trials. You can search for specific trials or browse by condition or trial sponsor. You may wish to refer to a list of gene therapy trials that are accepting (or will accept) participants.

Next: The Human Genome Project

Read more from the original source:
Gene Therapy - Genetics Home Reference

Recommendation and review posted by Bethany Smith

Forty years ago, viable monoclonal antibodies, imperceptibly small magic bullets, became available for the first time. First produced in 1975 by Csar Milstein and Georges Khler at the Laboratory of Molecular Biology in Cambridge, England (where Watson and Crick unraveled the structure of DNA), Mabs have had a phenomenally far-reaching effect on our society and daily life. The Lock and Key of Medicine is the first book to tell the extraordinary yet unheralded history of monoclonal antibodies, or Mabs. Though unfamiliar to most nonscientists, these microscopic protein molecules are everywhere, quietly shaping our lives and healthcare. They have radically changed understandings of the pathways of disease, enabling faster, cheaper, and more accurate clinical diagnostic testing. And they lie at the heart of the development of genetically engineered drugs such as interferon and blockbuster personalized therapies such as Herceptin.

Historian of medicine Lara V. Marks recounts the risks and opposition that a daring handful of individuals faced while discovering and developing Mabs, and she addresses the related scientific, medical, technological, business, and social challenges that arose. She offers a saga of entrepreneurs who ultimately changed the healthcare landscape and brought untold relief to millions of patients. Even so, controversies over Mabs remain, which the author explores through the current debates on their cost-effectiveness.

Read more:
What is Biotechnology?

Recommendation and review posted by sam

Are you aging prematurely? Do you suffer from fine lines, wrinkles, crow feet or skin allergies? Or are you plagued by acne and have tried all kinds of facial creams to no avail.

The first principle in keeping your skin healthy and young is to do no harm to your skin. Smoking and over exposure to the sun are 2 major culprits in causing premature aging. Do you know that your skin is the largest organ in your body and therefore very susceptible to absorbing toxins into our body which ultimately affects how we look? If you dont observe this principle, the best anti-aging skin care in the world will not produce the optimal result you desire.

There is a longlist ofbeauty products or skincare products to choose from: Organic skin care products, Japanese skin care products, Korean skin care products to plant stem cell skincare, etc. There is an equally long listof cosmetic brands or skin care brands to choose from: Elizabeth Arden, SK-II, Kiehls, Origins, Philosophy, etc. Which anti aging creams actually work? Which one is suitable for you? Or what worked for you 5 years ago, may not work for you today. What worked for you as a teenager may not work for you as a middle aged adult. What worked for you when you lived in a tropical country like Singapore or Malaysia may not work for you when you relocate to a city like Beijing or Chicago with its harsh winter climate.

The best skin care product is the one that works for you in all climates whether you live in Singapore, Malaysia, Taiwan, China, Australia or the US. It should also work for you regardless of your age or your race.

If you are looking for an anti aging serum to rejuvenate your skin, or a facial cream to repair your damaged skin, you should consider the Jeunesse Luminesce skin care products manufactured by Jeunesse Global.

Jeunesse is a French word for youth. Jeunesse Luminesce skin care range of products is entirely based on stem cell technology. Stem cell technology is the latest in cutting edge technology in health science. The scientist behind the Jeunesse Luminesce skin care range is Dr. Nathan Newman, a world-renowned cosmetic surgeon who also pioneered Stem Cell Lift cutting edge cosmetic surgery, without cutting. The philosophy behind Jeunesse Luminesce skin care products is simple: it must really work, it must be safe and it must be based on proven cutting edge health science(stem cell technology).

The potential of stem cell technology is immense. It holds the promise that one day it will change the world, but today, it will rejuvenateyour skins.

Unfortunately a lot of the skin care or beauty products out in the market are based on voodoo science. Some products work quite fast but are extremely toxic to the body causing long term damage to your vital organs. If you are using any skin care products which contain harmful chemicals, please stop immediately. Start using Jeunesse Luminesce Cellular Rejuvenation Serum and experience the rejuvenation yourself.

It is simply the best anti aging serum that really works. When you update your Facebook photo, dont be surprised if your friends ask you if you had a facelift.

Read this article:
Best Stem Cell Skincare By Jeunesse: Key to Skin Renewal

Recommendation and review posted by sam

I have used some of the methods described in the book over the last 25 plus years. I get carded at clubs, unless I grow a light beard, because there's a little grey there. I feel fantastic, my mood is nearly always good, my mental and physical performance are top-knotch!! To my knowledge, nothing in the book has been proved harmful, although some material mas been improved upon or supplemented by more recent research. But you will not find this vast repository of knowledge in any other single place. The Authors are Ivy League, Ph.d level scientists who have been involved with NASA research, nutritional supplement patents, extraction of petroleum from shale, authored countless peer-reviewed, scientific articles! They are literally two of the top 300 most intelligent people in the world! This book, even today, is revolutionary! It will save your life, no matter how old you are!

I still have the copy I purchased in 1984 A.D., and I still refer to it. The Grace of Almighty God led me to the research done by these two scientists, which literally transformed and preserved me!

Continued here:
Life Extension: Durk Pearson, Sandy Shaw: 9780446512299 ...

Recommendation and review posted by Bethany Smith

Proper diet may be an effective way to minimize systemic inflammation and improve your health.

If you've ever jammed your finger, scraped your knee, or sprained your ankle, you're already familiar with inflammation. The accompanying redness, swelling, and pain are sure signs that inflammation is taking place. Inflammation is part of your body's response to nearly any type of physical injury. It's one of the ways that your body protects itself, and begins its repair process.

Inflammation is not always as obvious or benign as the above examples. It can silently involve every cell in your body and, over time, negatively affect your health and abilities. For example, allergies, joint pain, and premature aging are just a few of the common ailments linked to "systemic inflammation." But if you can't see inflammation, how do you measure it?

The levels of certain chemicals in your blood are known to increase with increased levels of inflammation. One of these chemical markers for inflammation is a protein called C-reactive protein (CRP). CRP is often measured in conjunction with other blood tests, and normal values are well established. From a clinical standpoint, a CRP level of less than 5 milligrams per liter of blood is considered normal. "Normal" may not be optimal, though. Many medical researchers believe that even slight elevations of CRP are tied to increased risk for heart attack, stroke, and many other diseases.

Your body creates both inflammatory and anti-inflammatory chemicals, called "prostaglandins" from nutrients in the food that you eat. Imbalances in your diet can lead to the creation of excessive amounts of inflammatory prostaglandins, which fuel your body's inflammatory response. Conversely, the consumption of certain nutrients, like omega-3 fatty acids, allows your body to produce more anti-inflammatory prostaglandins, which it uses to reduce inflammation.

Modern nutrition experts, including Andrew Weil, Nicholas Perricone, and Barry Sears, have written many books about diet's link to inflammation, and have promoted the increased consumption of omega-3 fatty acids, antioxidants, and other nutrients that help control or reduce inflammation.

Read the original here:
Inflammation NutritionData.com

Recommendation and review posted by Bethany Smith

Shana Novak Collection/Photodisc/Getty Images

Updated March 25, 2015.

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

By reducing chronic inflammation also known as low-grade or systemic inflammation you may be able to boost your defense against several major diseases. In addition to fine-tuning your diet and overall self-care, you can reduce chronic inflammation with the help of certain natural substances and alternative therapies.

Here's a look at several approaches to reducing inflammation naturally:

1) Omega-3 Fatty Acids

Maintaining a diet high in omega-3 fatty acids (naturally available in foods like fish oil and flaxseed oil) and low in certain omega-6 fatty acids found in foods like red meat and dairy products may help lower inflammation and guard against diseases like breast cancer, rheumatoid arthritis, heart disease, and asthma, according to a research review published in 2002.

Shown to thwart the production of pro-inflammatory substances, omega-3 fatty acids are also available in supplement form.

Find out more about using Omega-3 Fatty Acids.

2) Herbs

Preliminary research suggests that some herbs may help reduce inflammation. In an animal study published in 2007, for instance, scientists discovered that curcumin (a compound found in the curry spice turmeric) can overpower pro-inflammatory proteins called cytokines. And in test-tube research published in 2005, investigators found ginger may reduce inflammation more effectively than non-steroidal anti-inflammatory drugs (such as aspirin).

In fresh or dried form, both turmeric and ginger can be used in cooking. If you're considering the use of any type of herbal supplement in your efforts to reduce inflammation, make sure you consult your physician before starting your supplement regimen.

3) Yoga

People who regularly practice yoga may have reduced levels of interleukin-6 (a marker of inflammation), according to a 2010 study of 50 women.

Analyzing blood samples from the participants, researchers observed that those who practiced yoga had 41 percent lower levels of interleukin-6 than those who didn't practice yoga.

More about the Health Benefits of Yoga.

4) Anti-Inflammatory Diet

Following a diet that focuses on anti-inflammatory foods is also considered essential to reducing inflammation. Find out more about foods to eat on an anti-inflammatory diet.

Making healthy changes to your diet and lifestyle should be your first step in reducing inflammation. The following approaches may have an inflammation-fighting effect:

Unlike acute inflammation (in which the immune system responds to infection or injury by activating inflammatory chemicals that combat foreign substances), chronic inflammation isn't beneficial for the body. Often resulting from lifestyle factors like stress and poor diet, chronic inflammation occurs when the immune system continually releases those inflammatory chemicals -- even when there are no foreign invaders to fight off.

By working to reduce chronic inflammation, you may be able to protect against a number of conditions shown to be inflammation-related, including:

If you're considering using diet, supplement, or any form of alternative medicine for inflammation, make sure to consult your physician first. Self-treating any condition and avoiding or delaying standard care may have serious consequences.

Sources:

Akiyama H, Barger S, Barnum S, Bradt B, Bauer J, Cole GM, Cooper NR, Eikelenboom P, Emmerling M, Fiebich BL, Finch CE, Frautschy S, Griffin WS, Hampel H, Hull M, Landreth G, Lue L, Mrak R, Mackenzie IR, McGeer PL, O'Banion MK, Pachter J, Pasinetti G, Plata-Salaman C, Rogers J, Rydel R, Shen Y, Streit W, Strohmeyer R, Tooyoma I, Van Muiswinkel FL, Veerhuis R, Walker D, Webster S, Wegrzyniak B, Wenk G, Wyss-Coray T. "Inflammation and Alzheimer's disease." Neurobiol Aging. 2000 21(3):383-421.

American Heart Association. "Inflammation, Heart Disease and Stroke: The Role of C-Reactive Protein".

Barbara G, De Giorgio R, Stanghellini V, Cremon C, Corinaldesi R. "A role for inflammation in irritable bowel syndrome?" Gut. 2002 51 Suppl 1:i41-4.

Duncan BB, Schmidt MI, Pankow JS, Ballantyne CM, Couper D, Vigo A, Hoogeveen R, Folsom AR, Heiss G; Atherosclerosis Risk in Communities Study. "Low-grade systemic inflammation and the development of type 2 diabetes: the atherosclerosis risk in communities study." Diabetes. 2003 52(7):1799-805.

Grzanna R, Lindmark L, Frondoza CG. "Ginger--an herbal medicinal product with broad anti-inflammatory actions." Journal of Medicinal Food 2005 8(2):125-32.

Kiecolt-Glaser JK, Christian L, Preston H, Houts CR, Malarkey WB, Emery CF, Glaser R. "Stress, inflammation, and yoga practice." Psychosom Med. 2010 72(2):113-21.

Mayo Clinic Health Letter, "Buzzed on Inflammation".

Reyes-Gordillo K, Segovia J, Shibayama M, Vergara P, Moreno MG, Muriel P. "Curcumin protects against acute liver damage in the rat by inhibiting NF-kappaB, proinflammatory cytokines production and oxidative stress." Biochimica et Biophysica Acta 2007 1770(6):989-96.

Simopoulos AP. "The importance of the ratio of omega-6/omega-3 essential fatty acids." Biomed Pharmacother. 2002 56(8):365-79.

Van Hove CL, Maes T, Joos GF, Tournoy KG. "Chronic inflammation in asthma: a contest of persistence vs resolution." Allergy. 2008 63(9):1095-109.

Disclaimer: The information contained on this site is intended for educational purposes only and is not a substitute for advice, diagnosis or treatment by a licensed physician. It is not meant to cover all possible precautions, drug interactions, circumstances or adverse effects. You should seek prompt medical care for any health issues and consult your doctor before using alternative medicine or making a change to your regimen.

Originally posted here:
Reducing Inflammation Ways to Reduce It Naturally

Recommendation and review posted by Bethany Smith

Inflammation is a localized protective response of a body's living tissue to injury, infection, irritation, or allergy. Inflammation is characterized by the following quintet: Redness (rubor), heat (calor), swelling (tumor), pain (dolor), and dysfunction of the organs involved (functio laesa). The first four characteristics have been known since ancient times and are attributed to Roman encyclopedist Celsus (25 B.C.E.50); functio laesa was added to the definition of inflammation by Rudolf Virchow, in 1858.

Inflammation is part of the innate immune system, that is, the immediate "first-line" of defense to illness or pathogens, which is also known as a nonspecific defense. This is as opposed to the adaptive (acquired) immunity involving antibodies or T-cells that specifically target particular pathogens, but which takes time, usually days, to develop. Inflammation reveals a stunning complexity and harmony to the body, where such actions take place as blood vessels dilating upstream of an infection and constricting downstream, movement of fluid and white blood cells into the area, release of protein and peptide signaling compounds, and so forth.

Inflammation is usually indicated by using the English suffix "-itis," such as appendicitis, laryngitis, pancreatitis, hepatitis, and encephalitis for inflammation of the appendix, larynx, pancreas, liver, and brain, respectively.

Inflammation is not "healthy" nor "unhealthy" on its own. Inflammation helps fight disease or injury, such as by removing pathogens and debris, and walling off infection from spreading. However, it comes at the cost of suspending the body's normal immune and catabolic processes. In the short term, this is often a valid trade-off, but in the long term it causes progressive damage.

Inflammation is not a synonym for infection. Even in cases when it is caused by infection it is incorrect to use the terms as synonymsInfection is caused by an outside agent, while inflammation is the body's response.

Inflammation has two main components: Cellular and exudative.

The cellular component involves the movement of white blood cells, or leukocytes, from blood vessels into the inflamed tissue. The white blood cells take on an important role in inflammation; they extravasate (filter out) from the capillaries into tissue, and act as phagocytes, picking up bacteria and cellular debris. They may also aid by walling off an infection and preventing its spread.

Various leukocytes are involved in the initiation and maintenance of inflammation. Generally speaking, acute inflammation is mediated by granulocytes or polymorphonuclear leukocytes, while chronic inflammation is mediated by mononuclear cells, such as monocytes and macrophages. These cells can be further stimulated to maintain inflammation through the action of an adaptive cascade involving lymphocytes: T cells, B cells, and antibodies. These inflammatory cells are:

The exudative component of inflammation involves the movement of fluid, usually containing many important proteins such as fibrin and immunoglobulins (antibodies). (An exudate is any fluid that filters from the circulatory system into lesions or areas of inflammation.) Blood vessels are dilated upstream of an infection (causing redness and heat) and constricted downstream, while capillary permeability to the affected tissue is increased, resulting in a net movement of blood plasma into the tissue, giving rise to edema or swelling. The swelling distends the tissues, compresses nerve endings, and thus causes pain. Inflammation can be recognized by nitric oxide.

If inflammation of the affected site persists, released cytokines IL-1 and TNF will activate endothelial cells to up-regulate receptors VCAM-1, ICAM-1, E-selectin, and L-selectin for various immune cells. (Cytokines are a group of proteins and peptides that are used in organisms as signaling compounds, allowing one cell to communicate with another.) Receptor upregulation increases extravasation of neutrophils, monocytes, activated T-helper, and T-cytotoxic, and memory T, and B cells to the infected site.

Neutrophils are characteristic of inflammation in the early stages. They are the first cells to appear in an infected area, and any section of recently inflamed (within a couple of days or so) tissue viewed under a microscope will appear packed with them. They are easily identified by their multilobed nuclei and granular cytoplasm and perform many important functions, including phagocytosis and the release of extracellular chemical messengers. Neutrophils only live for a couple days in these interstitial areas, so if the inflammation persists for a longer duration then they are gradually replaced by longer lived monocytes.

The outcome in a particular circumstance will be determined by the tissue in which the injury has occurred and the injurious agent that is causing it.

There are four possible results to inflammation:

When inflammation overwhelms the whole organism, systemic inflammatory response syndrome (SIRS) is diagnosed. When it is due to infection, the term sepsis is applied. Vasodilation (where blood vessels in the body become wider, reducing blood pressure) and organ dysfunction are serious problems that may lead to septic shock and death.

With the discovery of interleukins (group of cytokines, secreted signaling molecules), another concept of systemic inflammation developed. Although the processes involved are identical, this form of inflammation is not confined to a particular tissue but involves the endothelium (lining of blood vessels) and many other organ systems. High levels of several inflammation-related markers such as IL-6, IL-8, and TNF- are associated with obesity (Bastard et al. 2000, Mohamed-Ali 2001). These levels are reduced in association with increased levels of anti-inflammatory molecules within four weeks after patients begin a very low calorie diet (Clement 2004). The role of systemic inflammation as a cause and/or result of insulin resistance and atherosclerosis is the subject of intense research. It has little direct bearing on clinical care.

Inflammation is usually indicated by adding the suffix "-itis," as shown below. However, some conditions such as asthma and pneumonia do not follow this convention.

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Inflammation - New World Encyclopedia

Recommendation and review posted by Bethany Smith

Inflammation is the new medical buzzword. It seems as though everyone is talking about it, especially the fact that inflammation appears to play a role in many chronic diseases. The July issue of Mayo Clinic Health Letter highlights inflammation's role in cardiovascular disease.

Of course, inflammation isn't entirely bad. Acute inflammation the kind that protects and heals the body after an injury or infection is essential and normal. In the wake of a nasty cut or broken bone, the battle is on! Immediately, a biochemical cascade improves blood flow to the area. Nerve endings and other cells at the site of the injury or infection send out signaling molecules and other chemical components to recruit the body's equivalent of the Superhero white blood cells that fight off foreign bodies. It's an amazing process that from the surface looks like swelling and can hurt, but it's all part of making things better. That's acute inflammation. It's necessary and normal for good health.

The other kind chronic inflammation, also known as low-grade or systemic inflammation can play a more puzzling and long-lasting role in the body. Consider the vast array of autoimmune disorders such as rheumatoid arthritis, lupus and polymyalgia rheumatica where the body's immune system mistakenly initiates an inflammatory response even though there's no apparent inflammation to fight off. Chronic inflammation plays a more obvious role in diseases such as asthma and the inflammatory bowel diseases ulcerative colitis and Crohn's disease.

And what about the not-so-obvious role of chronic inflammation? Consider the possible connection between gum disease and cardiovascular disease. Research indicates that heart disease, clogged arteries, stroke and bacterial endocarditis may be linked to oral health. Although more study is needed to confirm this possible link, some scientists believe that bacteria from gum disease can enter the bloodstream and make its way to the heart.

Even less obvious but of enormous interest to researchers is the part inflammation plays in cancer. For instance, chronic bladder inflammation due to repeated urinary infections or cystitis may increase risk of a squamous cell bladder cancer. In some areas of the world, this type of cancer is linked to chronic inflammation caused by infection with a parasite.

Just what does all this mean for you? Can you actually do something to reduce your risk of chronic inflammation that may play a part in disease? That depends. At present, it's still too early in the science to reasonably conclude that reducing inflammation leads to a reduction in cancer risk. Many of the questions concerning cause and effect with cancer have yet to be proven.

What you can do, though, is make a point to avoid certain things that cause inflammation and are proven unhealthy. Prime examples are smoking and excessive alcohol use.

Some people advocate an "anti-inflammatory diet." Although there's less evidence such diets work to directly thwart inflammation, most of the recommended foods are typical of the Mediterranean style of eating and in principle are good choices. Key components of the Mediterranean diet include:

You may wonder if nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen and naproxen would be helpful, as the drug class name would seem to imply. Research is underway into NSAID use as a possible new strategy for potentially treating or preventing cancer. The prospects are intriguing, but the data isn't solid. If you take aspirin or another NSAID under a doctor's direction for a health-related concern such as preventing heart attack or relieving chronic pain, that's an accepted and appropriate use for this class of drugs. As always, the risks of gastrointestinal bleeding have to be considered with regular NSAID use.

And then there's the huge area of dietary supplements, which is largely uncharted when it comes to carefully done clinical trials for safety and effectiveness. Unlike prescription drugs, dietary supplements are not regulated by the Food and Drug Administration for safety and effectiveness. With that caveat, here are some that may be of interest:

My best advice concerning chronic inflammation is to stay tuned. This is a huge area of interest in the medical world and there are bound to be discoveries down the road that can improve well-being and the quality of health.

Go here to read the rest:
Buzzed on inflammation - Mayo Clinic

Recommendation and review posted by Bethany Smith

Eating healthy foods is important for everyone. When you have arthritis or a related condition, getting the right nutrients can help to alleviate pain and inflammation and positively affect overall health. Research suggests that what you eat may influence the progression and symptoms of certain types of arthritis and related conditions.

A diet high in sugary, high-fat and processed food fuels inflammation and sets the stage for developing other chronic diseases as well as arthritis. Also, poor nutrition habits can cause you to become overweight or obese. Fat cells, or adipocytes, release proteins called cytokines that, in excess, cause constant, low-grade inflammation throughout the body. And excess weight puts added stress on painful and swollen joints.

Although there is no magic potion at the supermarket, studies have shown that certain foods have anti-inflammatory properties and specific benefits for rheumatoid arthritis (RA), osteoarthritis, gout and osteoporosis symptoms.

RA

Researchers have found a diet rich in omega-3 fatty acids, antioxidants and phytochemicals supplies the body with powerful anti-inflammatory nutrients. These foods are commonly part of a Mediterranean-style diet of fish, such as salmon, sardines, mackerel, herring and tuna;olive oil, fruits, vegetables, nuts/seeds and beans. This diet has been analyzed in small studies for its impact on RA symptoms. Results showed improvements in pain, morning stiffness, disease activity and physical function. Studies published in 2015 in the Journal of Nutritional Biochemistry and the European Journal of Nutrition looked at the benefits of oleocanthal, a key compound in extra virgin olive oil, for rheumatoid arthritis. Researchers found that this compound had a significant impact not only on chronicinflammationbut on acute inflammatory processes, and helps reduce joint cartilage damage. Earlier studies showed that the pain-relieving properties of oleocanthal, prevent the production of pro-inflammatory COX-1 and COX-2 enzymes the same way ibuprofen works.

In the 1990s, a combination vegetarian/vegan diet for arthritis was the focus of a small study of 53 RA patients. The participants started with a vegan diet that excluded gluten, refined sugar, citrus, meat, fish, eggs, dairy, alcohol, coffee, tea, salt, strong spices and preservatives. Milk, dairy and gluten were reintroduced after nine months for participants who didnt have an intolerance to these foods. After one year, participants sustained improvements in tender, swollen joints, pain, duration of morning stiffness and overall health causing study investigators to suggest that some people with RA may benefit from a vegetarian diet. Since then, additional small studies have reported symptom improvement among very small groups of patients.

The National Institutes of Health has funded animal studies on the impact of green tea for RA. The researchers found that green tea significantly reduced the severity ofarthritis by causing changes in various immune responses including suppressing cytokine IL-17 (an inflammatory substance) and increasing cytokine IL-10 (an anti-inflammatory substance). They also showed that an antioxidant in green tea called epigallocatechin-3-gallate (EGCG) blocks the production of molecules that cause joint damage in people with RA. In May 2015, researchers reported in theInternational Journal of Rheumatic Diseases on the superior anti-inflammatory effect of green tea when compared with black tea.

C-reactive protein (CRP) in the blood is a marker of inflammation associated with RA. Several studies have reported that a high fiber diet helps to reduce CRP levels. Oatmeal, brown and wild rice, beans, barley and quinoa are excellent sources of whole grains.

Osteoarthritis

Having a balanced, nutritious diet is an important part of achieving and maintaining a healthy weight. That's good news for your joints, not just your wardrobe. A small study published in Arthritis in 2015 reported on a 6-week intervention of 40 individuals with osteoarthritis who were placed on a whole foods, plant-based diet of fruits, vegetables, legumes (beans, peas, lentils) and whole grains. The group experiencedsignificantly reduced pain and improved physical function.

Experts have long known that milk is good for bones, but its effects on joints were less clear. A study reported in Arthritis Care & Research in 2015 showed that women with knee OA who drank milk regularly had less OA progression than those who didnt. But high cheese consumption appeared to make OA worse.

An earlier study published in Arthritis & Rheumatism in 2013, revealed that a compound called sulforaphane, found in Brussels sprouts and cabbage but especially in broccoli, could be key inslowing the progress of OA and the destruction of joint cartilage.

A 2010 study in BMC Musculoskeletal Disorders reported that people who regularly eat foods from the alium family like garlic, onions and leeks, showed fewer signs of early OA. Researchers think the compound diallyl disulphine found in these foods may limit cartilage-damaging enzymes in human cells making it a great choice if you have OA.

Gout

Of all the forms of arthritis, gout has the most obvious dietary link. When the body breaks down purine, a substance found in many foods, uric acid forms. People who have gout have trouble eliminating uric acid or they produce too much uric acid cause inflammation and severe pain in the joints.

A study published in the Scandanavian Journal of Rheumatology in 2012 showed that a Mediterranean diet decreased uric acid levels and the risk of getting gout. But there have been studies on a few key foods as well. Researchers suspect the anthocyanins in cherries have an anti-inflammatory effect and may help reduce the frequency of gout attacks. Anthocyanins are found in other red and purple fruits, including strawberries, raspberries, blueberries and blackberries (some of the best low-sugar fruits). However, tart cherries have higher levels.

Using data from the 14,809 participants in the Third National Health and Nutrition Examination Survey, researchers from Harvard Medical School confirmed that coffee (but not tea) and low-fat dairy product consumption is associated with lower uric acid levels.

Avoiding foods that contain high levels of purines is a critical part of managing gout. These foods include meats (particulary beef, pork and lamb), most seafood (both fish and shellfish) and meat-based broths and gravies. Sugar-sweetened soft drinks and food with fructose also increase uric acid levels. There is a strong association between alcohol intake, especially beer, and an increased risk of gout attacks.

Osteoporosis

Protect bone health with calcium-rich foods, including low-fat dairy products; green, leafy vegetables; shellfish; and calcium-fortified foods. Vitamin D-rich foods, such as salmon, tuna and mackerel, cheese and egg yolks, are equally important since Vitamin D help your body absorb calcium from food. Unfortunately, its nearly impossible to get all of the vitamin D your body needs from food sources. On the plus side, the body can make 10,000 international units (IU) of vitamin D in just 15 minutes of unprotected exposure to sunshine. A staple of the Mediterranean diet, virgin olive oil, when combined with vitamin D, may protect against bone loss based on the results of an animal study published in the peer-reviewed journal, PLOSOne in 2014.

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Foods That Fight Inflammation | Anti Inflammatory Diet ...

Recommendation and review posted by Bethany Smith

OVERVIEW

The inflammatory response is very familiar. TRY IT YOURSELF --A mild example can be produced at your convenience. Firmly scrape the skin on your forearm, and then watch as redness (with possibly some mild swelling and heat) develops over the next few minutes.

Inflammation is characterized by several familiar signs, redness, swelling, heat and pain. To understand inflammation is to understand how and why these signs develop.

These signs represent a response that is programmed into your tissue. This response is one of your body's principal defense reactions, designed to anticipate, intercept and destroy invading microorganisms. Inflammation is best appreciated by understanding your body's functioning at the level of cells and tissues. Subsequent processes of tissue repair (healing) involve cell growth and division, cell movement and differentiation, and manufacture of extracellular material.

We go through life separated from our environment by a cellular boundary. This boundary --including the epidermis of our skin and the epithelia of our various mucous membranes--covers all our body's surfaces, even the internal surfaces of lungs, gut and glandular ducts. Nothing enters or leaves the body except by passing through or between the cells which form this epithelial boundary.

Whenever this epithelial boundary is broken, as it often is by scrapes and cuts and insect bites, two unfortunate things can happen. Good stuff like blood can leak out. And bad stuff like germs (microorganisms) can creep in. Plugging the leak can be fairly straightforward, with a quick patch (a blood clot) preventing significant loss of bodily substance. But a quick patch is not enough to prevent serious infection. Because germs are alive, they can grow and proliferate. So even a few microbes invading your body at the moment of injury could, if left unmolested, rapidly convert your warm, moist, well-oxygenated tissues into a thriving bacterial culture. Inflammation helps avoid this result.

Unfortunately, inflammation is uncomfortable. And inflammation can sometimes be triggered inappropriately (e.g., by allergies or autoimmune diseases). Many common medical treatments (e.g., aspirin and other "anti-inflammatory agents") are intended to relieve the discomfort and/or reduce the attendant tissue disturbance that inflammation may cause.

Any tissue or organ can become inflamed. Inflammation of a particular body part is named according to the site, with the "-itis" suffix appended (e.g., tonsillitis, appendicitis, dermatitis, arthritis, sinusitis, etc.). Thus many disease names are really just words that identify sites of inflammation. (Examples)

Tissue repair. Following inflammation, injured tissue is usually replaced by new cells and extracellular materials, with undamaged surrounding cells proliferating and migrating to fill the void. Although some tissues, especially surface epithelium, can grow back quite efficiently, complex organization is seldom matched in the regenerated site. Gaps are quickly filled by collagen fibers produced by proliferating fibroblasts. A mass of collagen which replaces tissue that has been destroyed is known as a scar. Scars in the skin appear white because collagen is colorless, and healing often creates a more compact arrangement of collagen with fewer capillaries than the surrounding tissue. Scars in other organs also exist as firm masses of collagen in which normal organ function cannot occur. For example, cirrhosis of the liver represents extensive replacement by collagen of damaged liver cells.

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CARDINAL SIGNS OF INFLAMMATION

The four cardinal signs of inflammation --the four "ORs" -- are:

Where do these signs come from? What is happening to your body during inflammation? As you understand inflammation, you should be able to answer the following specific questions.

PHYSIOLOGY OF INFLAMMATION

The four cardinal signs of inflammation are readily explained by the behavior of the underlying cells and tissues. The inflammatory response consists of several physiological processes (illustration from WebPath), all of which are triggered by the release of pharmacologically active substances such as histamine and heparin. These triggers of acute inflammation are released by mast cells, sensitive cells which are scattered throughout ordinary connective tissues and which react to tissue damage or other disturbance.

Chronic inflammation is maintained by more complex interactions among several cell types; diagram from WebPath.

The basic components of the inflammatory response are:

See illustration from WebPath.

Vasodilation (increased vascular perfusion).

Increased vascular permeability.

Note that edema can take a variety of forms. The following links will take you to gross images at WebPath.

Emigration of leukocytes.

Pain and/or itching (dolor) is caused by direct action on nerve endings of the chemical agents released during inflammation.

INFLAMMATORY INFILTRATE (Introduction to inflammation)

The inflammatory or leukocytic infiltrate consists of white blood cells which leave the blood and enter (infiltrate) the inflamed connective tissue

Cells of the inflammatory infiltrate include neutrophils, lymphocytes and monocytes. Immigration of these cells into peripheral tissues is one of the principal purposes for inflammation, bringing to a site of injury the immune-system cells which can combat infection and clean up damaged tissue.

Neutrophils (neutrophilic leukocytes) are the first white blood cells to enter the tissue during acute inflammation. Neutrophils are anti-bacterial cells which lyse (break down) bacterial cells by releasing lysosomal enzymes. Neutrophils recognize bacteria as foreign by the antibody molecules which have attached to the bacterial surface. Antibody molecules (molecules which bind to one specific antigen or foreign substance which the body has previously encountered) are found in blood plasma and interstitial fluid.

Neutrophils are the most numerous of the leukocytes, about 60% of the white blood cell count. They are about 12 m in diameter in blood smear preparations (about twice the size of red blood cells), and are polymorphonuclear (meaning their nuclei have a variable shape with several lobes; neutrophils are also called PMNs or polys, short for polymorphonuclear neutrophilic leukocytes). The cytoplasm contains many lysosomal granules (vesicles containing stored lysosomal enzymes) whose specific staining properties give these cells their name. The granules are neutrophilic, meaning they do not show a special affinity for either acidic or basic stains, but are stained mildly by both. This is in contrast to the specific granules of eosinophils, which stain red with eosin, and basophils, which stain with basic stains. Severe inflammation may increase the numbers of neutrophils in blood, resulting in neutrophilia(blood smear image from WebPath). To view an electron micrograph, see WebPath.

Neutrophils are only occasionally seen in tissue sections outside blood (except, of course, in inflamed tissue). Here they may be most easily recognized by their lobed nuclei. One neutrophil nucleus might be mistaken for a cluster of very small nuclei, but each of the lobes is much smaller than any whole nucleus--only two or three m across, much smaller than the nuclei of lymphocytes which are among the smallest cells.

[More on blood cells.]

Lymphocytes accumulate somewhat later during the inflammatory process. Their presence in large numbers indicates the continuing presence of antigen and thus may suggest an established infection. Lymphocytes produce the multitude of diverse antibody molecules (one specific type of antibody per lymphocyte) which provide the mechanism for chemical recognition of foreign materials (distinguishing between self and non-self) and so for mediating and regulating immune responses.

Lymphocytes travel in the blood, but they routinely leave capillaries and wander through connective tissue. Therefore, lymphocytes may be normally encountered at any time in any location. They even enter epithelial tissue, crawling between the epithelial cells. They reenter circulation via lymphatic system channels (hence their name). Lymph channels drain into lymph nodes, where dense aggregations of lymphocytes form lymph nodules. Each lymph nodule has a "germinal center", where activated lymphocytes proliferate. Lymph nodules with proliferating lymphocytes also characterize the tonsils and the appendix and may be encountered in other sites as well.

[Recent research suggests that some types of lymphocytes are compartmentalized to particular tissues or body regions.]

Lymphocytes are small cells, 7-9 m in diameter in blood smears, and are the second most common white blood cell type (about 30% of the WBCs). They have a round heterochromatic (deeply staining) nucleus surrounded by a relatively thin rim of cytoplasm. Lymphocytes are most easily recognized in histological sections as small "naked" nuclei (the cytoplasm is usually inconspicuous) which occur here and there in most tissues and especially commonly near mucous membranes. Lymphocytes are found densely packed in lymphoid tissue--spleen and lymph nodes. To view an electron micrograph, see WebPath.

Plasma cells are lymphocytes which are specialized for mass production and secretion of circulating antibodies. Plasma cells have more extensive cytoplasm filled with rough endoplasmic reticulum (for synthesizing protein, specifically antibody molecules). This cytoplasm is distinctly basophilic, a consequence of the large numbers of ribosomes associated with the rER, and typically forms a lopsided bulge on one side of the nucleus. The heterochromatin of plasma cells is typically clumped in a characteristic "spoke-wheel" arrangement which also aids plasma cell recognition. To view an electron micrograph, see WebPath.

[More on blood cells.]

Monocytes are phagocytic cells which circulate in the blood. An equivalent cell type, called the macrophage, is a resident cell in connective tissue.

Monocytes/macrophages engulf and digest foreign microorganisms, dead or worn-out cells, and other tissue debris. They interact closely with lymphocytes to recognize and destroy foreign substances.

Resident macrophages normally remain at rest (rather than circulating in and out of tissues like the lymphocytes). But the normal number of fixed macrophages is supplemented during inflammation by the influx of many monocytes from the blood. When faced with a target too big for one cell, a splinter for example, several macrophages may fuse together for a single huge multinucleate mass called a "foreign body giant cell."

Monocytes are the largest of the leukocytes, and constitute about 5% of the white blood cell population. Their nuclei are typically indented, with a kidney-bean shape, in blood smears. Tissue macrophages are diverse in appearance and not easily distinguished from the more common fibroblasts. Macrophages are generally larger, and may contain brown pigment granules which represent indigestible residue in tertiary lysosomes. In electron micrographs macrophages are generally recognized by the presence of numerous lysosomes of various sizes, including large heterophagic vesicles.

[More on blood cells.]

For more about the immune system, including outside links, see CRR Lymphatic System.

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EXAMPLES of inflammation

Microscopically, inflammation shows up most clearly as increased numbers of white blood cells (i.e., the inflammatory infiltrate which results from emigration of leukocytes).

Images of inflammatory infiltrate in skin.

The WebPath website offers a number of illustrative examples of inflammation, including:

Also see specimens at Virtual Slidebox of Histopathology, University of Iowa Department of Pathology.

Note that appreciating inflamed tissue samples, such as those listed above, calls for some prior familiarity with normal histological appearance.

For more about the immune system, see outside links and CRR Lymphatic System.

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Comments and questions: dgking@siu.edu

SIUC / School of Medicine / Anatomy / David King

http://www.siumed.edu/~dking2/intro/inflam.htm Last updated: 1 January 2013 / dgk

Excerpt from:
Inflammation SIU SOM Histology INTRO - SIU School of Medicine

Recommendation and review posted by Bethany Smith

About 1 out of every 5 US adults has doctor-diagnosed arthritis. The term arthritis includes more than 100 different rheumatic diseases and conditions, the most common of which is osteoarthritis. Other forms of arthritis that occur often are rheumatoid arthritis, lupus, fibromyalgia, and gout.

Symptoms include pain, aching, stiffness, and swelling in or around the joints. Some forms of arthritis, such as rheumatoid arthritis and lupus, can affect multiple organs and cause widespread symptoms.

Many people think of arthritis as a disease that only affects the elderly, but it affects people of all ages, including children. Although the risk of developing arthritis increases with age, nearly two-thirds of people with arthritis are younger than 65. Arthritis is more common among women (26%) than men (19%), and it affects members of all racial and ethnic groups.

As the US population ages, the number of adults with arthritis is expected to increase to 67 million by 2030. The Centers for Disease Control and Prevention (CDC) is leading the nations efforts to help the millions of adults with arthritis to live well and manage their condition.

Read more:
Arthritis | At A Glance Reports | Publications | Chronic ...

Recommendation and review posted by simmons

You've probably heard the word "arthritis" before. And now, you may be wondering if it could be affecting you. By definition, arthritis means "joint inflammation," and it's used to describe more than 100 different diseases and conditions that affect joints, the tissues that surround joints, and other connective tissue.

Arthritis can affect people differently. It's common in adults 65 and older, but it can affect people of all ages, races, and ethnic groups. In fact, about 1 out of every 5 adults in the United States around 50 million people has reported being diagnosed by their doctor with some form of arthritis.

Osteoarthritis and rheumatoid arthritis have different causes, risk factors, and effects on the body:

Even though they have these differences, osteoarthritis and rheumatoid arthritis often share common symptoms:

Sometimes arthritis symptoms make it harder to do certain activities. By talking to your doctor about your symptoms, he or she may help you find other ways to continue doing some of those activities.

Your doctor can also help evaluate your current treatment and may recommend other, more effective ways to help you manage your arthritis. The sooner you take action and talk to your doctor, the sooner you can start managing your arthritis symptoms more effectively.

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About Arthritis

Recommendation and review posted by simmons

Common Mental Health Drug Could Be Used to Treat Arthritis July 16, 2015 Lithium chloride which is used as a mood stabiliser in the treatment of mental health problems, mainly bipolar disorder, could be used to treat arthritis according to a new ... read more Rheumatoid Arthritis: Novel Approach Identifies Unique DNA Signature July 14, 2015 Researchers have for the first time identified disease-associated changes to the DNA epigenome in joint fluid cells from patients with rheumatoid ... read more Arthritis Drug Could Be Used to Treat Blood Cancer Sufferers July 5, 2015 Scientists have discovered that a common drug given to arthritis sufferers could also help to treat patients with blood cancers, and is one thousandth of the cost of another drug that works in the ... read more New Test Could Predict Arthritis Drug Failure in Patients July 3, 2015 It may be possible to predict early which rheumatoid arthritis patients will fail to respond to the biologic drugs given to treat them, a study of 311 patients has found.These findings could help ... read more Vitamin B12 Supplement Linked to Pimply Skin June 24, 2015 Vitamin B12 tweaks how genes behave in the facial bacteria of some people who normally enjoy clear skin, leading to pimples, new research ... read more Patients With Primary Hand Osteoarthritis Should Not Be Prescribed Hydroxychloroquine, Study Suggests June 13, 2015 The results of an interventional trial showed that use of the disease-modifying anti-rheumatic drug hydroxychloroquine for 24 weeks did not diminish mild-moderate pain from primary hand ... read more Biologics Improve Productivity and Reduce Missed Workdays in Rheumatic Disease June 12, 2015 The results of a systematic review of published studies showed that biologics improve both absenteeism (not showing up for work) and presenteeism (being at work but not functioning fully) in patients ... read more Low Birth Weight and Childhood Infections Predict Ankylosing Spondylitis June 11, 2015 The results of a new study showed that a diagnosis of ankylosing spondylitis can be predicted by low birth weight, having older siblings and hospitalization for infection between the ages of 5-16 ... read more Physical Trauma Associated With Onset of Psoriatic Arthritis Among Psoriasis Patients June 11, 2015 The results of a large population study showed an increased risk of developing Psoriatic Arthritis among psoriasis patients exposed to physical trauma, particularly when the trauma involved bone ... read more Ultrasound-Defined Tenosynovitis Identified as Strong Predictor of Early Rheumatoid Arthritis June 10, 2015 A new study showed that ultrasound diagnosis of tenosynovitis (inflammation of the tendon sheath) was superior to clinical symptoms and signs in the prediction of early Rheumatoid ... read more Intensive Initial Therapy With Triple DMARDs Improves Functional Ability in Early Rheumatoid Arthritis June 10, 2015 New research showed that initial therapy with combination DMARDs significantly improves measures of disease activity and functional ability in patients with early rheumatoid ... read more Stem Cell Discovery Paves Way for Targeted Treatment for Osteoarthritis June 9, 2015 Scientists have made a significant advance that could make cell-based treatments for arthritis less of a lottery. 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Arthritis News -- ScienceDaily

Recommendation and review posted by simmons

Arthritis,inflammation of the joints and its effects. Arthritis is a general term, derived from the Greek words arthro-, meaning joint, and -itis, meaning inflammation. Arthritis can be a major cause of disability. In the United States, for example, data collected from 2007 to 2009 indicated that 21 million adults were affected by arthritis and experienced limited activity as a result of their condition. Overall, the incidence of arthritis was on the rise in that country, with 67 million adults expected to be diagnosed by 2030. Likewise, each year in the United Kingdom, arthritis and related conditions caused more than 10 million adults to consult their doctors. Although the most common types of arthritis are osteoarthritis and rheumatoid arthritis, a variety of other forms exist, including those secondary to infection and metabolic disturbances.

Osteoarthritis, also known as degenerative joint disease, is the most common form of arthritis, affecting nearly one-third of people over age 65. It is characterized by joint pain and mild inflammation due to deterioration of the articular cartilage that normally cushions joints. Joint pain is gradual in onset, occurring after prolonged activity, and is typically deep and achy in nature. One or multiple joints may be affected, predominantly involving the knee, hips, spine, and fingers.

Approximately 90 percent of individuals experience crepitus (crackling noises) in the affected joint with motion. Muscle weakness and joint laxity or stiffness can occur as people become reluctant to move painful joints. Patients tend to have decreased joint stability and are predisposed to injuries such as meniscal and anterior cruciate ligament tears. Hip arthritis can affect gait, while arthritis of the hands can lead to decreased dexterity. Enlargement of the bony processes surrounding affected joints, called osteophytes (bone spurs), are common.

Joint trauma, increased age, obesity, certain genetic factors and occupations, and hobbies or sports that result in excessive joint stresses can result in the cartilaginous changes leading to osteoarthritis. Damage begins with the development of small cracks in the cartilage that are perpendicular to the joint. Eventually, cartilage erodes and breaks off, facilitating painful bone-on-bone contact. In due course, pathologic bony changes, such as osteophytes and subchondral bone cysts, develop and further restrict joint movement and integrity.

Osteoarthritis may be divided into two types, primary and secondary osteoarthritis. Primary osteoarthritis is age-related, affecting 85 percent of individuals 7579 years of age. Although the etiology is unknown, primary osteoarthritis is associated with decreased water-retaining capacity in the cartilage, analogous to a dried-up rubber band that can easily fall apart. Secondary osteoarthritis is caused by another condition, such as joint trauma, congenital joint malalignment, obesity, hormonal disorders, and osteonecrosis. Treatment for osteoarthritis is directed toward reducing pain and correcting joint mechanics and may include exercise, weight loss, nonsteroidal anti-inflammatory drugs, steroids, and total joint replacement surgery.

Autoimmune arthritis is characterized by joint inflammation and destruction caused by ones own immune system. Genetic predisposition and inciting factors, such as an infection or trauma, can trigger the inappropriate immune response. Rheumatoid arthritis, which is an autoimmune disease, is often associated with elevations in the serum level of an autoantibody called rheumatoid factor, whereas the seronegative arthropathies are not.

Rheumatoid arthritis is a progressive inflammatory condition that can lead to decreased mobility and joint deformities. The worldwide prevalence is 0.8 percent, with a 2:1 predilection for women over men. Disease onset, mainly occurring in the third and fourth decades of life, may be acute or slowly progressive with initial symptoms of fatigue, weakness, malaise, weight loss, and mild, diffuse joint pain. Rheumatoid arthritis tends to affect the hips, knees, elbows, ankles, spine, hands, and feet symmetrically. The disease course is characterized by periods of remission, followed by progressive exacerbations in which specific joints become warm, swollen, and painful. Morning stiffness, typically lasting about two hours, is a hallmark feature of rheumatoid arthritis. Patients with rheumatoid arthritis tend to complain of joint pain after prolonged periods of inactivity, whereas osteoarthritis is typically exacerbated with extended activity. Rheumatoid arthritis can be severely debilitating, resulting in a variety of deformities. Some patients experience complete remission, which typically occurs within two years of disease onset.

Although the exact cause is unknown, rheumatoid arthritis results from the inflammation of the tissues surrounding the joint space. The thin lining of the joint space becomes thick and inflamed, taking on the form of a mass with fingerlike projections (pannus), which invades the joint space and surrounding bone. Initially, this results in joint laxity. However, with progression, the bones can actually undergo fusion (ankylosis), limiting motion.

The effect rheumatoid arthritis has on the hands is a defining characteristic. Clinically, it can be distinguished from osteoarthritis based on the distribution of joints affected in the hands. Rheumatoid arthritis tends to affect the more proximal joints, whereas osteoarthritis tends to affect the more distal joints of the hands and fingers. In severe cases, joint laxity and tendon rupture result in a characteristic deformity of the fingers and wrist.

Rheumatoid nodules are thick fibrous nodules that form as a result of excessive tissue inflammation in rheumatoid arthritis. These nodules are typically present over pressure points, such as the elbows, Achilles tendon, and flexor surfaces of the fingers. Destruction of peripheral blood vessels (vasculitis) from the inflammatory process can occur in any organ, leading to renal failure, myocardial infarction (heart attack), and intestinal infarction (death of part of the intestine). In addition, rheumatoid arthritis is also associated with an increased risk of infections, osteoporosis (thinning of bones), and atherosclerosis (hardening of arteries).

Diagnosis of rheumatoid arthritis is based on the presence of several clinical features: rheumatoid nodules, elevated levels of rheumatoid factor, and radiographic changes. Although rheumatoid factor is found in 70 to 80 percent of people with rheumatoid arthritis, it cannot be used alone as a diagnostic tool, because multiple conditions can be associated with elevated levels of rheumatoid factor.

Since no therapy cures rheumatoid arthritis, treatment is directed toward decreasing symptoms of pain and inflammation. Surgical treatment may include total joint replacement, carpal tunnel release (cutting of the carpal ligament), and tendon repair. Hand splints are used to slow the progression of finger and wrist deformations.

The overall life span of individuals with rheumatoid arthritis is typically shortened by 510 years and is highly dependent on disease severity. Disease severity and the likelihood of extra-articular manifestations are each directly related to serum rheumatoid factor levels.

Several rheumatoid arthritis variants exist. In Sjgren syndrome the characteristic symptoms include dry eyes, dry mouth, and rheumatoid arthritis. Felty syndrome is associated with splenomegaly (enlarged spleen), neutropenia (depressed white blood cell levels), and rheumatoid arthritis. Juvenile rheumatoid arthritis is the most common form of childhood arthritis. Disease etiology and clinical course typically differ from that of adult-onset rheumatoid arthritis, and sufferers are prone to the development of other rheumatologic diseases, including rheumatoid arthritis.

Ankylosing spondylitis, Reiter syndrome, psoriatic arthritis, and arthritis associated with inflammatory bowel disease are a subset of conditions known as spondyloarthropathies. Typically affected are the sacrum and vertebral column, and back pain is the most common presenting symptom. Enthesitis, inflammation at the insertion of a tendon or ligament into bone, is a characteristic feature of spondyloarthropathy. Unlike rheumatoid arthritis, spondyloarthropathies are not associated with elevated levels of serum rheumatoid factor. Spondyloarthropathies occur most frequently in males and in individuals with a genetic variation known as HLA-B27.

Ankylosing spondylitis is the most common type of spondyloarthropathy, affecting 0.1 to 0.2 percent of the population in the United States. In a region of Turkey, prevalence was found to be 0.25 percent, and in the United Kingdom prevalence is estimated to range from 0.1 to 2 percent. In all regions, the condition occurs more frequently in males than in females and typically strikes between ages 15 and 40. Genetic studies have shown that more than 90 percent of all patients with ankylosing spondylitis who are white and of western European descent are HLA-B27 positive.

Ankylosing spondylitis is characterized by arthritis of the spine and sacroiliac joints. Extensive inflammation of the spinal column is present, causing a characteristic bamboo spine appearance on radiographs. Arthritis first occurs in the sacroiliac joints and gradually progresses up the vertebral column, leading to spinal deformity and immobility. Typical symptoms include back pain, which lessens with activity, and heel pain due to enthesitis of the plantar fascia and Achilles tendon. Hip and shoulder arthritis may occur early in the course of the disease.

Reiter syndrome, a type of reactive arthritis, is characterized by the combination of urethritis, conjunctivitis, and arthritis. Patients typically develop acute oligoarthritis (two to four joints affected) of the lower extremities within weeks of gastrointestinal infection or of acquiring a sexually transmitted disease. Reiter arthritis is not considered an infectious arthritis, because the joint space is actually free of bacteria. Instead, an infection outside the joint triggers this form of arthritis. Other symptoms can include fever, weight loss, back pain, enthesitis of the heel, and dactylitis (sausage-shaped swelling of the fingers and toes). Most cases resolve within one year; however, 1530 percent of patients develop chronic, sometimes progressive arthritis. Occurring almost exclusively in men, Reiter syndrome is strongly linked to the HLA-B27 gene variant, which is present in 65 to 96 percent of symptomatic individuals.

Psoriasis is an immune-mediated inflammatory skin condition characterized by raised red plaques with an accompanying silvery scale, which can be painful and itchy at times. Though typically seen on the elbow, knees, scalp, and ears, plaques can occur on any surface of the body. About 10 percent of people with psoriasis (possibly as many as 30 percent in some regions of the world) develop a specific type of arthritis known as psoriatic arthritis.

Psoriatic arthritis typically occurs after psoriasis has been present for many years. In some cases, however, arthritis may precede psoriasis; less often, the two conditions appear simultaneously. Estimates on the prevalence of psoriatic arthritis vary according to population. However, overall, it is thought to affect nearly 1 percent of the general population, with a peak age of onset between 30 and 55. Usually less destructive than rheumatoid arthritis, psoriatic arthritis tends to be mild and slowly progressive, though certain forms, such as arthritis mutilans, can be quite severe. Occasionally the onset of symptoms associated with psoriatic arthritis is acute, though more often it is insidious, initially presenting as oligoarthritis with enthesitis. Over time, arthritis begins to affect multiple joints (polyarthritis), especially the hands and feet, resulting in dactylitis. Typically, the polyarticular pattern of psoriatic arthritis affects a different subset of finger joints than rheumatoid arthritis. It is not until years after peripheral arthritis has occurred that psoriatic arthritis may affect the axial joints, causing inflammation of the sacroiliac joint (sacroiliitis) and intervertebral joints (spondylitis).

Arthritis mutilans is a more severe and much less common pattern (seen in fewer than 5 percent of psoriatic arthritis cases) resulting in bone destruction with characteristic telescoping of the fingers or toes. In addition, individuals with psoriatic arthritis necessitate more aggressive treatment if the onset of the condition occurs before age 20, if there is a family history of psoriatic arthritis, if there is extensive skin involvement, or if the patient has the HLA-DR4 genotype.

Crohn disease and ulcerative colitis, two types of inflammatory bowel disease, are complicated by a spondyloarthropathy in as many as 20 percent of patients. Although arthritis associated with inflammatory bowel disease typically occurs in the lower extremities, up to 20 percent of cases demonstrate symptoms identical to ankylosing spondylitis. Arthritis is usually exacerbated in conjunction with inflammatory bowel disease exacerbations and lasts several weeks thereafter.

Joint inflammation, destruction, and pain can occur as a result of the precipitation of crystals in the joint space. Gout and pseudogout are the two primary types of crystalloid arthritis caused by different types of crystalloid precipitates.

Gout is an extremely painful form of arthritis that is caused by the deposition of needle-shaped monosodium urate crystals in the joint space (urate is a form of uric acid). Initially, gout tends to occur in one joint only, typically the big toe (podagra), though it can also occur in the knees, fingers, elbows, and wrists. Pain, frequently beginning at night, can be so intense that patients are sensitive to even the lightest touch. Urate crystal deposition is associated with the buildup of excess serum uric acid (hyperuricemia), a by-product of everyday metabolism that is filtered by the kidneys and excreted in the urine. Causes of excess uric acid production include leukemia or lymphoma, alcohol ingestion, and chemotherapy. Kidney disease and certain medications, such as diuretics, can depress uric acid excretion, leading to hyperuricemia. Although acute gouty attacks are self-limited when hyperuricemia is left untreated for years, such attacks can recur intermittently, involving multiple joints. Chronic tophaceous gout occurs when, after about 10 years, chalky, pasty deposits of monosodium urate crystals begin to accumulate in the soft tissue, tendons, and cartilage, causing the appearance of large round nodules called tophi. At this disease stage, joint pain becomes a persistent symptom.

Gout is most frequently seen in men in their 40s, due to the fact that men tend to have higher baseline levels of serum uric acid. In the early 21st century the prevalence of gout appeared to be on the rise globally, presumably because of increasing longevity, changing dietary and lifestyle factors, and the increasing incidence of insulin-resistant syndromes.

Pseudogout is caused by rhomboid-shaped calcium pyrophosphate crystals deposition (CPPD) into the joint space, which leads to symptoms that closely resemble gout. Typically occurring in one or two joints, such as the knee, ankles, wrists, or shoulders, pseudogout can last between one day and four weeks and is self-limiting in nature. A major predisposing factor is the presence of elevated levels of pyrophosphate in the synovial fluid. Because pyrophosphate excess can result from cellular injury, pseudogout is often precipitated by trauma, surgery, or severe illness. A deficiency in alkaline phosphatase, the enzyme responsible for breaking down pyrophosphate, is another potential cause of pyrophosphate excess. Other disorders associated with synovial CPPD include hyperparathyroidism, hypothyroidism, hemochromatosis, and Wilson disease. Unlike gout, pseudogout affects both men and women, with more than half at age 85 and older.

Infectious arthritides are a set of arthritic conditions caused by exposure to certain microorganisms. In some instances the microorganisms infiltrate the joint space and cause destruction, whereas in others an infection stimulates an inappropriate immune response leading to reactive arthritis. Typically caused by bacterial infections, infectious arthritis may also result from fungal and viral infections.

Septic arthritis usually affects a single large joint, such as the knee. Although a multitude of organisms may cause arthritis, Staphylococcus aureus is the most common pathogen. Neisseria gonorrhoeae, the bacteria that causes gonorrhea, is a common pathogen affecting sexually active young adults.

The most common way by which bacteria enter the joint space is through the circulatory system after a bloodstream infection. Microorganisms may also be introduced into the joint by penetrating trauma or surgery. Factors that increase the risk of septic arthritis include very young or old age (e.g., infants and the elderly), recent surgery or skin infection, preexisting arthritic condition, immunosuppression, chronic renal failure, and the presence of a prosthetic joint.

Postinfectious arthritis is seen after a variety of infections. Certain gastrointestinal infections, urinary tract infections, and upper respiratory tract infections can lead to arthritic symptoms after the infections themselves have resolved. Examples include Reiter syndrome and arthritis associated with rheumatic fever.

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chronicpain. Photo by Frances Twitty (iStockphoto) Recognizing Early Symptoms

Early arthritis symptoms can be vague and confusing, but they are important to recognize. Newly diagnosed patients quickly realize that early symptoms are just the first layer to be uncovered before a definitive diagnosis and treatment plan for arthritis can be established.

Arthritis can affect any joint. Certain types of arthritis are associated with a specific pattern of joint disease. For example, rheumatoid arthritis is usually symmetric -- affecting the same joint on both sides of the body. Other types of arthritis typically affect a single joint. It's important to tell the doctor about all of your symptoms and every joint that hurts.

An accurate diagnosis precedes appropriate treatment of arthritis. With over 100 types of arthritis, early symptoms can overlap and diagnosis can be difficult. Your doctor will look for very specific signs, symptoms, and disease characteristics. Your doctor will also consider your medical history, physical examination, blood tests, and imaging studies.

Doctors play an essential role in the diagnosis and treatment of arthritis. Good communication between a doctor and patient is essential. It's important to know what to expect from your doctor and what your doctor expects from you. It's your doctor's job to assess your symptoms, gain more information from your medical history and a current physical examination, order diagnostic tests, and put together a treatment plan. It's your job to provide your doctor with as much pertinent information as possible. The goal is mutual - to improve your health.

Arthritis literally means joint inflammation. Arthritis is not a single disease. Arthritis refers to a group of more than 100 rheumatic diseases and other conditions that can cause pain, stiffness and swelling in the joints. Some types of arthritis affect more than the joints. There can be systemic effects associated with rheumatoid arthritis, lupus, and other types of arthritis.

Rheumatoid arthritis (RA) is an autoimmune inflammatory type of arthritis. Rheumatoid arthritis affects 2.1 million Americans and three times as many women as men. There are important facts you should know about rheumatoid arthritis.

Osteoarthritis is considered the most common type of arthritis. About 21 million Americans have osteoarthritis. The disease causes limited range of motion, joint pain, and stiffness which affect daily living activities. Osteoarthritis is caused by progressive deterioration of joint cartilage. Typically, osteoarthritis develops gradually.

Psoriatic arthritis is an inflammatory type of arthritis associated with the chronic skin condition psoriasis. Psoriatic arthritis usually develops when people are between 30 and 50 years old, but it can begin in childhood. Men and women seem to be equally affected by psoriatic arthritis. Psoriatic arthritis symptoms occur in variable patterns and with variable intensity.

Gout symptoms can develop when there is excess uric acid in the body. Monosodium urate crystals that form in the joints due to excess uric acid cause gout symptoms. Uric acid is a waste product normally present in the blood as a result of the breakdown of purines. Pseudogout is a condition that develops when calcium pyrophosphate crystals accumulate in a joint and the surrounding tissues.

Ankylosing spondylitis is a type of arthritis which is primarily characterized by chronic inflammation of the joints and ligaments of the spine, causing pain and stiffness in the spine. In severe cases, bones in the spine may fuse (also referred to as ankylosis) resulting in a rigid and inflexible spine. Abnormal posture may be a consequence. Other joints may also be involved including hips, knees, ankles, neck, or shoulders. The disease may also have systemic effects.

The most popular misconception about arthritis is that it is an old person's disease. In reality, arthritis affects people of all ages including over 285,000 American children. The course of juvenile rheumatoid arthritis, or JRA, in children is usually different than is the course of arthritis in adults. Children experience different symptoms and generally have a more favorable prognosis.

In lupus, the immune system of the body attacks its own cells and tissues. The joints, skin, kidneys, lungs, heart, nervous system, and other organs of the body may be affected. There are 5 types of lupus - a disease that affects 10 times more women than men.

Fibromyalgia is an arthritis-related syndrome which can be difficult to diagnose. Fibromyalgia syndrome is a chronic condition characterized by body aches, widespread pain, sleep problems, extreme fatigue, depression, anxiety, and other symptoms, in combination with tenderness of specific areas (muscles and tender points) on the body.

Scleroderma literally means "hard skin". Referred to often as a single disease, scleroderma is actually a symptom of a group of diseases complicated by an abnormal growth of connective tissue which supports the skin and internal organs.

Arthritis and joint pain can occur during late stage Lyme disease. Learn how an infectious disease transmitted by a tick bite can lead to arthritis in some people.

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What Is It?

Arthritis is a joint disorder that causes mild to severe inflammation, stiffness, and pain. The condition is common among older adults but can also affect younger adults and even children. The condition can limit your flexibility and range of motion and can cause pain that ranges from mild to extreme. The symptoms tend to be more common and pronounced among older adults as a result of the natural aging process.

There are over one hundred types of arthritis that occur for a variety of reasons. Some result from underlying conditions like autoimmune attacks, infections, or viruses, and others result from injury or old age. For some people, arthritis is a lifelong condition that is incurable and untreatable. For others, arthritis is treatable or can resolve itself.

Arthritis can be difficult to live with. For most people, the condition becomes worse and difficult to treat. It is unhealthy to keep taking over-the-counter medications, and prescription drugs are not feasible options for everyone.

Emotionally, living with arthritis can be tough. Slowly and steadily, you may notice that you have more trouble with your occupation and other daily activities. You may not be able to control flare-ups that limit your range of motion by causing stiffness and pain.

There are more than one hundred types of arthritis, making arthritis one of the most common chronic conditions in the world. Arthritis can occur for a variety of reasons that include autoimmune diseases, viruses, bacterial infections, old age, and injury. The most common types of arthritis include osteoarthritis, rheumatoid arthritis, gout, ankylosing spondylitis, psoriatic arthritis, systemic lupus erythematosus, and juvenile arthritis.

Some forms of arthritis occur naturally as a result of age because of wear and tear on the bones, while other forms of arthritis occur because of an underlying condition that is a virus, bacterial infection, or inheritable disease.

Arthritis types run in the family, so there is a likelihood that you will develop the types of arthritis that your parents or immediate family members experienced.

Some autoimmune conditions can cause arthritis in addition to a low-grade fever.

Swelling, joint pain, limited joint movement, stiffness, redness, extreme tenderness, and warmth over the joint are some of the common symptoms of arthritis. In rheumatic forms of arthritis, swollen glands, fatigue, weight loss, and other general symptoms are present. Kidney problems can also be a symptom if systemic forms of arthritis. If you start to experience chronic pain and swelling in the same joint areas, you may have arthritis. Over time, mild symptoms can worsen.

It is normal for people with some forms of arthritis to develop a low-grade fever during a flare-up, especially if the condition is autoimmune. If your fever persists, or if your fever spikes, you should see a doctor as soon as possible since you may be experiencing another underlying infection.

The causes and risk factors depend on the type of arthritis. Injury and age put a person more at risk for osteoarthritis, while systemic diseases like lupus and rheumatoid arthritis don't have clear cut causes or risks. Heredity is also a major risk factor. Diseases like rheumatoid arthritis can affect children as well as adults, while osteoarthritis is more likely to affect an older person.

Certain types of arthritis, such as autoimmune conditions, are genetic. Check to see whether arthritis runs in your family.

Regular, low impact exercise can help prevent arthritis. If you are moving and stretching, you are less likely to feel stiff. In any case, most types of arthritis are impossible to prevent, especially if they are related to an autoimmune condition, disease, or injury.

Treatment for arthritis will vary based on the type of arthritis. Physical therapy can effectively treat some forms of arthritis. Other treatments include medications, anti-inflammatory drugs, herbal supplements, support splints, immunosuppressant drugs, paraffin wax drips, hot packs, cold packs, and surgery.

To diagnose arthritis, a doctor will conduct a physical examination and ask questions about your personal and family medical history. X-rays can show damage from osteoarthritis and group. Blood and urine tests can assess damage to organs and other bodily systems. A rheumatologist is a specialist who treats arthritis and related conditions.

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You may have heard about arthritis (say: ar-thry-tis), which is a disease that causes swelling and pain in a person's joints.

But isn't it something that only old people get?

Actually, kids can get a kind of arthritis called juvenile idiopathic arthritis or JIA (it's also called juvenile rheumatoid arthritis, or JRA). Juvenile means young, so this means that JIA is different from the arthritis that adults get. Kids can have many different types of arthritis, but this is the most common.

Joints are the places where bones meet. Arthritis can prevent people from moving their joints properly. JIA affects kids under age 16, who have arthritis in one or more joints.

Many problems can cause pain and swelling of the joints, so a doctor will want to know how long these problems have been going on. To be considered JIA, a kid must have swelling and pain for at least 6 weeks.

Seven types of juvenile idiopathic arthritis can affect kids:

No one really knows what causes JIA. Something in the environment such as a virus may trigger the disease in kids that already have certain genes that make it more likely for them to get it. JIA is not contagious, so you can't catch it from someone else.

Arthritis is an autoimmune (say: aw-toe-i-myoon) disease. Normally, a kid's immune system sends out white blood cells to protect the body and fight outside invaders like bacteria and viruses that can make a kid sick. With JIA, the immune system makes a mistake and targets healthy cells as if they were harmful.

Instead of recognizing the healthy cells and saying, "Hi, nice to see you," the immune system thinks the healthy cells need to be destroyed and releases chemicals to fight the healthy cells. The chemicals the immune system releases cause the pain and swelling that a kid with arthritis experiences.

Just because a joint hurts doesn't mean a kid has JIA. A joint might hurt for a lot of different reasons, which is why it's important to see a doctor to figure out what the problem is.

The doctor will ask a lot of questions: How long has the kid had joint problems? Does he or she feel stiff when getting up or after resting? Are the joints swollen? Was there an injury? Could another problem be causing arthritis, such as Lyme disease? Is there a family history of arthritis or other autoimmune diseases?

Getting these answers and doing a physical exam, blood tests, and X-rays will help the doctor figure out if it is JIA. If your doctor suspects that you may have it, he or she may send you to see a doctor who specializes in the diagnosis and treatment of arthritis. This kind of doctor is called a rheumatologist (say: roo-muh-tol-oh-jist).

Some kids who have JIA might take medicine such as ibuprofen to help control pain and inflammation. If the arthritis is more severe, they may need to take additional medicines to decrease pain and inflammation and to slow the progression of the disease. Some of these medicines are pills, but others are shots.

It is important that kids with JIA keep their joints moving. Often a kid will see a physical therapist or occupational therapist. In addition to working with children to move their joints and strengthen their muscles, these therapists can help create special exercise programs for home or school that can help a kid stay active.

In addition to joint problems, JIA may cause uveitis (say: yoo-vee-eye-tus), an inflammation of the eye that can lead to problems with vision if it's not treated. It's more common in kids with oligoarticular arthritis but all kids diagnosed with JIA should get their eyes checked by an ophthalmologist, a doctor who specializes in diagnosing and treating eye problems. If the eyes are affected, they may be treated with eye drops.

A kid can do a few things to help with the symptoms of JIA besides taking medicines:

Kids with JIA can have a lot of stiffness when they first wake up in the morning. Once their joints warm up, they can usually move more easily. That's why you might notice that someone with JIA has trouble moving early in the day, but seems better later on.

It's important to find a good balance between activity (which helps kids stay flexible) and rest (which everyone needs). Swimming is a great exercise for someone with JIA. It stretches a lot of different muscles and tendons and helps keep a kid moving and flexible. It's important to stay active even when a kid isn't having symptoms.

Sometimes kids with JIA can go a long time, even months or years, without the disease bothering them. Then it comes back. This is called a flare-up or flare. Flare-ups just happen and can't be prevented. It can be frustrating if a flare-up happens on a day when the kid would like to be doing something fun, like attending a birthday party.

If you know someone with JIA, you may offer to carry books or give other help, if needed. It's also OK if the person doesn't want help.

The good news is that many kids with JIA will outgrow it. Kids with oligoarticular JIA generally do better than kids with polyarticular arthritis, but as many as 7 out of 10 kids with polyarticular JIA may not require treatment as adults.

And even when the arthritis is active, almost all kids with JIA can control it with medicine and other treatments, which means they can do most things that other kids can do.

Reviewed by: AnneMarie C. Brescia, MD Date reviewed: January 2012

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Canine arthritis, also known as osteoarthritis or degenerative joint disease, is characterized by pain and inflammation in a dogs joints. Arthritis is caused by the breaking down of smooth cartilage that covers and protects the bones that form a joint. Once the bones are exposed, painful wear and tear can occur.

Dogs who have canine arthritis may:

A veterinarian may conduct a physical exam, take radiographs and perform other diagnostic tests to help determine the cause of your dogs pain. He or she will also check your dogs medical history for previous injuries and consider possible inherited conditions.

Canine arthritis can occur as a result of:

Note: If a larger dog suffers any injuries or sprains during his growth period, this can cause him to develop arthritis later in life.

Although certain larger breed dogs such as mastiffs and Great Danes are susceptible to arthritis, the condition can develop in all breeds and mixed breeds as the result of joint infection, dislocation, trauma or family genetics. Elder dogs also often develop arthritis as a result of aging.

Keeping your dog fit with exercise and proper nutrition may, in some cases, help prevent arthritis, or possibly slow its progression once the condition has set in. In fact, if your dog is a larger breed, it's necessary to monitor the type and amount of food given when his bones are still growing. However, arthritic conditions cannot always be predicted or prevented, especially those that are inherited.

Once symptoms of arthritis set in, there is no cure. Its important for you to work with your veterinarian to create a program to minimize your dogs pain while keeping him healthy. Some general treatment options may include:

Note: Please do not give your dog human medication without first checking with your vet.

Generally, dogs with arthritis should engage in daily low-impact exercise such as walking or, if possible, swimming.

If your dog has arthritis, here are a few ways that you can make her more comfortable.

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Arthritis, or inflammation of the joints, is the most common extraintestinal complication of IBD. It may affect as many as 25% of people with Crohns disease or ulcerative colitis. Although arthritis is typically associated with advancing age, in IBD it often strikes the youngest patients. In addition to joint pain, arthritis also causes swelling of the joints and a reduction in flexibility.

In IBD, arthritis may appear in three different forms. These are:

Peripheral arthritis usually affects the large joints of the arms and legs, including the elbows, wrists, knees, and ankles. The discomfort may be migratory, moving from one joint to another. If left untreated, the pain may last from a few days to several weeks. Peripheral arthritis tends to be more common among people who have ulcerative colitis or Crohns disease of the colon. The level of inflammation in the joints generally mirrors the extent of inflammation in the colon. Although no specific test can make a definitive diagnosis, various diagnostic methodsincluding analysis of joint fluid, blood tests, and X-raysare used to rule out other causes of joint pain. Fortunately, IBD-related peripheral arthritis usually does not cause any lasting damage.

Also known as spondylitis or spondyloarthropathy, axial arthritis produces pain and stiffness in the lower spine and sacroiliac joints (at the bottom of the back). Interestingly, and especially in young people, these symptoms may come on months or even years before the symptoms of IBD appear. Unlike peripheral arthritis, axial arthritis may cause permanent damage if the bones of the vertebral column fuse togetherthereby creating decreased range of motion in the back. In some cases, a restriction in rib motion may make it difficult for people to take deep breaths. Active spondylitis generally subsides by age 40. Therapy for people with axial arthritis is geared toward improving range of motion in the back. Stretching exercises are recommended, as is the application of moist heat to the back.

A more severe form of spinal arthritis, ankylosing spondylitis (AS) is a rare complication, affecting between 2% and 3% of people with IBD. It is seen more often in Crohns disease than in ulcerative colitis. In addition to causing arthritis of the spine and sacroiliac joints, ankylosing spondylitis can cause inflammation of the eyes, lungs, and heart valves. The cause of AS is not known, but most affected individuals share a common genetic marker. In some cases, the disease occurs in genetically predisposed people after exposure to bowel or urinary tract infections. Occasionally, AS foretells the development of IBD. AS typically strikes people under the age of 30, mainly adolescents and young adult males, appearing first as a dramatic loss of flexibility in the lower spine. Rehabilitation therapy is essential to help maintain joint flexibility. But even with optimal therapy, some people will develop a stiff or ankylosed spine. Symptoms of AS may continue to worsen even after surgical removal of the colon.

It is not always easy to determine whether the arthritis is linked to the intestinal condition. In general, the arthritis that complicates IBD is not as severe as rheumatoid arthritis. The joints do not ordinarily undergo destructive changes, and joint involvement is not symmetric (affecting the same joints on both sides of the body). Except for ankylosing spondylitis, arthritis associated with IBD usually improves as intestinal symptoms improve.

In the general population, people with peripheral arthritis may use nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce pain and swelling of the joints. However, as a rule, these medicationswhich include aspirin and ibuprofen are not an option for everyone with IBD because they can prompt a disease flare by irritating the intestinal lining and intensifying the inflammation. (It should be noted, though, that some people with IBD can tolerate NSAIDs and find these medications helpful in relieving symptoms of arthritis.) Corticosteroids also may be used to treat the arthritis symptoms as well as IBD.

In most cases, doctors manage the symptoms of peripheral arthritis by controlling the inflammation within the colon. Once that has subsided after a course of a medication such as prednisone or sulfasalazine, joint pain generally disappears. Similarly, the newer biologic agents such as infliximab (Remicade) have also been shown to be effective in reducing joint inflammation and swelling. Infliximab has even shown good results as a treatment for ankylosing spondylitis. Only axial arthritis seems not to improve as the intestinal inflammation resolves. Unlike peripheral arthritis, there is no correlation between treatment of the underlying IBD and improvement in axial arthritis symptoms.

In addition to medication, doctors may recommend resting the affected joint as well as the occasional use of moist heat. Range of motion exercises, as demonstrated by a physical therapist, may also be helpful.

The Crohns & Colitis Foundation of America provides information for educational purposes only. We encourage you to review this educational material with your health care professional. The Foundation does not provide medical or other health care opinions or services. The inclusion of another organizations resources or referral to another organization does not represent an endorsement of a particular individual, group, company or product.

For further information, call CCFA at our IBD Help Center: 888.MY.GUT.PAIN (888.694.8872).

The Crohn's & Colitis Foundation of America provides information for educational purposes only. We encourage you to review this educational material with your health care professional. The Foundation does not provide medical or other health care opinions or services. The inclusion of another organization's resources or referral to another organization does not represent an endorsement of a particular individual, group, company or product.

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Rheumatoid Arthritis Rheumatoid Arthritis Overview

Rheumatoid arthritis is a chronic joint disease that damages the joints of the body. It is also a systemic disease that potentially affects internal organs of the body and leads to disability. The joint damage is caused by inflammation of the joint lining tissue. Inflammation is normally a response by the body's immune system to "assaults" such as infections, wounds, and foreign objects. In rheumatoid arthritis, the inflammation is misdirected to attack the joints. Rheumatoid arthritis is often referred to as RA.

Rheumatoid arthritis can be confused with other forms of arthritis, such as osteoarthritis or arthritis associated with infections. Rheumatoid arthritis is an autoimmune disease. This means that the body's immune system mistakenly attacks the tissues it is supposed to protect.

Rheumatoid arthritis most often affects the smaller joints, such as those of the hands and/or feet, wrists, elbows, knees, and/or ankles, but any joint can be affected. The symptoms often lead to significant discomfort and disability.

Although rheumatoid arthritis most often affects the joints, it is a disease of the entire body. It can affect many organs and body systems besides the joints. Therefore, rheumatoid arthritis is referred to as a systemic disease.

Medically Reviewed by a Doctor on 5/11/2015

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Arthritis is a condition associated with swelling and inflammation of the joints, which often results in pain and restriction of movement. The most common forms of arthritis are osteoarthritis, which is a breakdown of the cartilage in the joints, and rheumatoid arthritis, which is an inflammation of the tissue lining the joints and in severe cases inflammation of other body tissues. In the joints, sustained inflammation leads to hypertrophy of the synovium and the formation of a "pannus", which spreads over the joint causing erosive destruction of the bone and cartilage. Rheumatoid arthritis occurs when the body's immune system starts attacking it's own organs (joints, bones, internal organs).

Arthritis is a result of a breakdown in cartilage or inflammation.

Cartilage protects joints and enables smooth movement by absorbing shock when pressure is placed on a joint. Without the usual amount of cartilage, the bones rub together and this causes pain, swelling (inflammation), and stiffness.

Joint inflammation can occur for a variety of reasons, including:

Often, the inflammation goes away once the injury has healed, the disease is treated, or once the infection has been cleared. However, with some injuries and diseases, the inflammation does not go away or the cartilage is destroyed and long-term pain and deformity results. When this happens, the disease is called chronic arthritis.

Osteoarthritis is the most common type of arthritis and is more likely to occur with increasing age. It can occur in any of the joints but is most common in the hips, knees or fingers.

Risk factors for osteoarthritis include:

Arthritis can occur in both men and women and in individuals of all ages. Some forms of arthritis also affect children.

As mentioned earlier, the most common forms of arthritis are Osteoarthritis and Rheumatoid arthritis. However, there are numerous forms of arthritis, including:

A person suffering from arthritis may experience any of the following:

A doctor will first note your symptoms and will then look at your medical history in detail to see if arthritis or another musculoskeletal problem is the likely cause of those symptoms.

Your doctor will then perform a thorough physical examination to see if there is any fluid collecting around the joint (an abnormal build up of fluid around a joint is called "joint effusion."). The joint may be tender when gently pressed, and it may also be warm and red (especially if you have infectious arthritis or autoimmune arthritis). You may also find it painful or difficult to rotate the joints in some directions (this is known as "limited range-of-motion").

After this initial physical examination, your doctor may then ask you to undertake a number of different tests, depending on what they suspect to be the cause of your symptoms. Often, you will need to have a blood test and joint x-rays. You may also need to have a test where joint fluid is removed from the joint with a needle; the fluid will then be examined under a microscope to check for infection and for other causes of arthritis, such as crystals, which cause gout.

If arthritis is diagnosed and treated early, you can prevent joint damage. Find out if you have a family history of arthritis and share this information with your doctor, even if you have no joint symptoms. In some autoimmune forms of arthritis, the joints may become deformed if the disease is not treated. Osteoarthritis may be more likely to develop if you over-use your joints. Take care not to overwork a damaged or sore joint. Similarly, avoid excessive repetitive motions. Excess weight also increases the risk for developing osteoarthritis in the knees, and possibly in the hips and hands.

The treatment of arthritis depends on the particular cause of the disease, on the joints that are affected, on the severity of the disorder and on the effect it has on your daily activities. Your age and occupation will also be taken into consideration when your doctor works with you to create a treatment plan.

If possible, treatment will focus on eliminating the underlying cause of the arthritis. However, sometimes the cause is NOT curable, as with osteoarthritis and rheumatoid arthritis. In this case, the aim of treatment will be to reduce pain and discomfort and prevent further disability. Symptoms of osteoarthritis and other long-term types of arthritis can often be improved without medications. Making lifestyle changes without medications is preferable for osteoarthritis and other forms of joint inflammation. If needed, medications should be used in addition to lifestyle changes.

Your doctor will select the most appropriate medication for your form of arthritis.

Most people can take acetaminophen without any problems so long as they do not exceed the recommended dose of 4 grams in 24 hours (taken in 4 divided doses every 4 to 6 hours). It reduces mild pain but does not help with inflammation or swelling. Acetaminophen is available as a combination with other mild pain relief medicines for mild osteoarthritic pain, and with narcotics for severe pain. Acetaminophen with aspirin and or caffeine are over-the-counter medicines. Acetaminophen with codeine, propoxyphene or narcotics are prescription medicines.

Although NSAIDs work well, long-term use of these medicines can cause gastrointestinal problems, such as stomach ulcers and bleeding. In April 2005, the FDA asked manufacturers of NSAIDs to include a warning label on their products that alerts users of an increased risk of cardiovascular events (heart attacks and strokes) and gastrointestinal bleeding.

Taking a combination of NSAIDs or NSAIDs and aspirin together increases the incidence of stomach ulcers or bleeding.

These contain a non steroidal anti-inflammatory drug and a stomach protecting agent, to prevent or treat the gastrointestinal side effects which may be caused by NSAIDs.

COX-2 inhibitors block an inflammation-promoting enzyme called COX-2. This class of drugs was initially believed to work as well as traditional NSAIDs, but with fewer stomach problems. However, numerous reports of heart attacks and strokes have prompted the FDA to re-evaluate the risks and benefits of the COX-2 inhibitors. Rofecoxib (Vioxx) and valdecoxib (Bextra) have been withdrawn from the U.S. market following reports of heart attacks in some patients taking the drugs. The available medicines in this class have been labeled with strong warnings and a recommendation that these be prescribed at the lowest possible dose and for the shortest duration possible.

Corticosteroids have been used to reduce inflammation in rheumatoid arthritis for more than 40 years but it is not known whether they can slow down the progression of disease. It can be used in conjunction with other rheumatoid arthritis medicine.

Potential long-term side effects of corticosteroids limit the use of oral corticosteroids to short courses and low doses where possible. Side effects may include bruising, psychosis, cataracts, weight gain, susceptibility to infections and diabetes, high blood pressure and thinning of the bones (osteoporosis). A number of medications can be administered with steroids to minimize the risk of osteoporosis.

Intra-articular steroid injections can effectively relieve pain, reduce inflammation, increase mobility and reduce deformity in one or a few joints. If repeated injections are required then the dose of DMARDs should be increased.

Corticosteroids suppress the immune system and also reduce pain and inflammation. They are commonly used in severe cases of osteoarthritis and they can be given orally or by injection. Steroid injections are given directly into the joint (intra-articular). Steroids are used to treat autoimmune forms of arthritis but they should be avoided if you have infectious arthritis. Steroids have multiple side effects, including upset stomach and gastrointestinal bleeding, high blood pressure, thinning of bones, cataracts, and increased infections. The risks are most pronounced when steroids are taken for long periods of time or at high doses. Close supervision by a physician is essential.

DMARDs are the most effective agents available for controlling rheumatoid arthritis, but they all have a slow onset of action. Mechanisms of action for most of these agents are not known and they all are different but they all appear to slow or stop the changes in the joints. They can alter laboratory characteristics of disease activity and delay the progression of bone damage.

Patients taking DMARDs generally show some response within 8 to 10 weeks. However, this is variable depending on the patient and drug. Dose of DMARDs is titrated up as far as side effects allow. An additional DMARD is added when the maximum dose is reached, or the initial DMARD is stopped and switched to another.

Most DMARDs require monitoring (such as full blood count, liver function test, urea and electrolyte level test) to ensure drug safety, as the majority can cause bone marrow toxicity and some can cause liver toxicity as well. Regular blood or urine tests should also be done to determine how well medications are working.

Methotrexate is probably the most commonly used DMARD. It is effective in reducing signs and symptoms of rheumatoid arthritis and slows down damage to the joint. Results can be seen in 6 to 8 weeks. Other DMARDs such as hydroxychloroquine and sulfasalazine can used in conjunction with methotrexate.

Hydroxychloroquine, an antimalarial drug, is effective in the treatment of rheumatoid arthritis. It is usually used in combination with methotrexate and sulfasalazine for added benefits.

Sulfasalazine is also an effective DMARD. It can reduce symptoms and slow down the joint damage.

Leflunomide shows similar effectiveness to methotrexate and can be used in patients who cannot take methotrexate.

Tumor necrosis factor (TNF) inhibitors are a relatively new class of medications used to treat autoimmune disease. They include etanercept, infliximab, adalimumab, tocilizumab, certolizumab and golimumab. TNF Inhibitors are also called "Biologics" biological response modifiers.

Tumor necrosis factor alpha is produced by macrophages and lymphocytes, and acts on many cells in the joints and in other organs and body systems. It is a pro-inflammatory cytokine known to mediate most of the joint damage. In rheumatoid arthritis it is produced by the synovial macrophages and lymphocytes. By inhibiting TNF alpha the inflammation process, which attacks or damages the joint tissue, is halted or slowed.

Methotrexate can be used with TNF inhibitors to increase the effectiveness of therapy.

Gold is also effective in the treatment of rheumatoid arthiritis, particularly when given intramuscularly. It isn't used as often now due to its side effects and slow onset of action. Oral gold preparation is available but is less efficacious compared to the intramuscular preparation.

Abatacept decreases T cell proliferation and inhibits the production of the cytokines tumor necrosis factor (TNF) alpha, interferon-?, and interleukin-2.

Rituximab depletes the B cells, which have several functions in the immune response. Rituximab has reduced signs and symptoms of rheumatoid arthritis, and manages to slow down the joint destruction.

The Interleukin-1 Inhibitor, Anakinra, is a new synthetic protein that blocks the inflammatory protein interleukin-1. Anakinra is used to slow progression of moderate to severe active rheumatoid arthritis in patients who have not responded to one or more of the DMARDs.

Alkylating agents, such as cyclophosphamide, are drugs that suppress the immune system and are sometimes used in people who have failed other therapies. These medications are associated with toxic side effects and usually reserved for severe cases of rheumatoid arthritis.

Many people find that over-the-counter nutraceuticals and vitamins, such as glucosamine and chondroitin sulfate help relieve the symptoms of osteoarthritis. There is some evidence that these supplements are helpful in controlling pain, although they do not appear to grow new cartilage.

Bioflavonoids are found in the rind of green citrus fruits and in rose hips and black currants. They have been used historically in a variety of disease states including rheumatic fever, habitual abortion, poliomyelitis, prevention of bleeding, rheumatoid arthritis, periodontal disease, diabetic retinitis, and others.

Diclofenac topical is a non-steroidal anti-inflammatory drug. Although it is applied topically it is still absorbed systemically and may cause systemic effects such as gastrointestinal side effects.

Trolamine salicylate is a topical salicylate pain reliever, used for minor pain and inflammation. It works by reducing swelling and inflammation in the muscle and joints.

Capsaicin is extracted from chillies (genus Capsicum). Capsaicin topical causes a decrease in a substance (substance P) in the body that causes pain. It is used to relieve minor aches and pains of muscle and joints associated with arthritis, simple backache, strains and sprains.

Hyaluronic acid is normally present in joint fluid, and in osteoarthritis sufferers this gets thin. Hyaluronic acid can be injected into the joint to help protect it. This may relieve pain for up to six months.

Non-drug treatment is also important. It is important to make lifestyle changes. Exercise helps maintain joint and overall mobility. Ask your health care provider to recommend an appropriate home exercise routine. Water exercises, such as swimming, are especially helpful. You also need to balance rest with activity. Non-drug pain relief techniques may help to control pain. Heat and cold treatments, protection of the joints and the use of self-help devices are recommended. Good nutrition and careful weight control are important. Weight loss for overweight individuals will reduce the strain placed on the knee and ankle joints.

Physical therapy can be useful for improving muscle strength and motion at stiff joints. Therapists have many techniques for treating osteoarthritis. If therapy does not make you feel better after 3-6 weeks, then it is likely that it will not work at all.

Splints and braces can sometimes support weakened joints. Some prevent the joint from moving, while others allow some movement. You should use a brace only when your doctor or therapist recommends one. The incorrect use of a brace can cause joint damage, stiffness and pain.

Surgery to replace or repair damaged joints may be needed in severe, debilitating cases.

Surgical options include:

Arthroplasty - total or partial replacement of the deteriorated joint with an artificial joint e.g. knee arthroplasty, hip arthroplasty.

Arthroscopic - surgery to trim torn and damaged cartilage and wash out the joint.

Cartilage Restoration - For some younger patents with arthritis, cartilage restoration is a surgical option to replace the damaged or missing cartilage.

Osteotomy - change in the alignment of a bone to relieve stress on the bone or joint.

Arthrodesis - surgical fusion of bones, usually in the spine.

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Arthritis Information from Drugs.com

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Arthritis is a general term for more than 100 diseases that cause inflammation, pain, stiffness and swelling of joints. Common types of arthritis include:

Osteoarthritis - an ongoing, progressive disease that affects the joints as cartilage breaks down over time. Osteoarthritis is also called degenerative joint disease.

Rheumatoid arthritis - an autoimmune disease that affects the joints of the body with episodes of painful inflammation. Rheumatoid arthritis also affects other organs of the body and can result in the destruction of joints, disability, and, in severe cases, life-threatening complications.

Septic arthritis - arthritis caused by the infection of a joint by microorganisms, such as bacteria or fungi.

Complications of all forms of arthritis can be serious and include destruction of the joints, leading to disability. Rheumatoid arthritis and septic arthritis can also lead to serious or life-threatening complications that can affect almost any organ in the body.

Seek prompt medical care if you have symptoms of arthritis, such as inflammation, pain, stiffness, and swelling of joints. Early diagnosis and treatment can minimize discomfort and reduce the risk of serious complications.

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Image Medical Multimedia Group What is Arthritis?

Arthritis is a condition that causes inflammation of joint. While there are many types of arthritis, all types cause joint inflammation. Common complaints of people with arthritis include joint pain, swelling, and stiffness.

Arthritis come in many different types, and can affect any joint. Determining the best treatment for your arthritis will depend on identifying the type of arthritis and determining which joints are affected.

Common symptoms of arthritis include joint pain, swelling, and limited movement. The severity of symptoms of arthritis tends to correspond to the degree of inflammation of the joint.

Once you have determined the type of arthritis, you can review potential treatments for your condition. Most often, doctors will recommend trying simpler treatments for arthritis first to determine if your condition can be managed with minimal intervention.

Joint replacement surgery is generally considered a last-step treatment for the most severe cases of joint arthritis. Joint replacement surgery uses artificial joints to take the place of your worn out joint.

The best way to avoid problems associated with arthritis is to try to prevent progression of the condition. For people who have had arthritis in one joint, it is important to prevent the progression of arthritis in other joints.

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Arthritis & Joint Pain - Orthopedics Advice from About.com

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Arthritis is a common cause of knee pain. J. M. Horrillo / Getty Images

Updated December 20, 2014.

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Arthritis of the knee joint is one of the most common causes of knee pain. There are different types of arthritis that can affect the knee joint, and the treatments may vary depending on the condition that is causing the symptoms.

Osteoarthritis is the most common type of knee arthritis. Also called wear-and-tear arthritis or degenerative joint disease, osteoarthritis is characterized by progressive wearing away of the cartilage in the joint. As the protective cartilage is worn away, bone is exposed, the knee becomes swollen and painful, and activities become increasingly painful.

Knee arthritis typically affects patients as they get older. Symptoms are more common in patients who are overweight, and weight loss tends to reduce the severity of pain associated with knee arthritis.

There is also a genetic component, meaning knee arthritis can be passed down within a family. Other factors that can contribute to developing knee arthritis include injuries to the knee, torn cartilage, and fractures to the bone around the joint.

Knee arthritis symptoms tend to gradually progress as the condition worsens, however, symptoms may suddenly worsen with minor injury or overuse. Some patients report long episodes of mild symptoms, with sudden changes that increase the severity of their symptoms. Often patients report good months and bad months, or symptoms that fluctuate with the weather. This is important to understand because comparing the symptoms of arthritis on one particular day may not accurately represent the overall progression of the condition. Since there is not a cure for arthritis, learning ways to slow the progression of arthritis is also important.

The most common symptoms of knee arthritis include:

BJ Cole and CD Harner "Degenerative arthritis of the knee in active patients: evaluation and management" J. Am. Acad. Ortho. Surg., Nov 1999; 7: 389 - 402.

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Knee Arthritis - Diagnosis and Treatment of Wear and Tear

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Millions of people suffer from painful and swollen joints associated with arthritis. In the past, many doctors told arthritis patients that dietary changes would not help them. However, this conclusion was based on older research with diets that included dairy products, oil, poultry, or meat.1,2 New research shows that foods may be a more frequent contributor to arthritis than is commonly recognized. It is clear that, at least for some people, a healthier menu is the answer.

Arthritis is actually a group of different diseases. Osteoarthritis is a gradual loss of cartilage and overgrowth of bone in the joints, especially the knees, hips, spine, and fingertips. Over 20 million Americans, mostly over age 45, suffer from osteoarthritis, which seems to be the result of accumulated wear and tear. Although it can cause painful episodes, it is characterized by only transient stiffness and does not cause major interference with the use of the hands.

Rheumatoid arthritis, which affects over 2 million people, is a more aggressive form of the disease. It causes painful, inflamed joints, which sometimes become damaged.

Rheumatoid arthritis is one of medicine's mysteries. There were no medical reports of the disease until the early 1800s. Some have suspected that a virus or bacterium may play a role, perhaps by setting off an autoimmune reaction. Genetics may also be a factor, in that it may influence susceptibility to the disease.

For years people have suspected that foods are an important factor in the development of rheumatoid arthritis. Many notice an improvement in their condition when they avoid dairy products, citrus fruits, tomatoes, eggplant and certain other foods.

Initially, the evidence was anecdotal. A woman from the Midwest once suffered from painful arthritis. Today she is a picture of health, thin and athletic, and her arthritis is totally gone. It seemed that dairy products were to blame for her arthritis, for when she eliminated them from her diet, the arthritis disappeared completely.

Another woman, from Wisconsin, also found that her arthritis was clearly linked to dairy products. Although she had been raised on a dairy farm, she learned that staying away from dairy products was the key to relieving her symptoms.

A 1989 survey of over one thousand arthritis patients revealed that the foods most commonly believed to worsen the condition were red meat, sugar, fats, salt, caffeine, and nightshade plants (e.g., tomatoes, eggplant).3 Once the offending food is eliminated completely, improvement usually comes within a few weeks. Dairy foods are one of the principle offenders, and the problem is the dairy protein, rather than the fat, so skim products are as much a problem as whole milk.4

An increasing volume of research shows that certain dietary changes do in fact help. For example, polyunsaturated oils and omega-3 supplements have a mild beneficial effect, and researchers have found that vegan diets are beneficial.5 One 2002 study looked at the influence of a very low-fat vegan diet on subjects with moderate-to-severe RA. After only four weeks on the diet, almost all measures of RA symptoms decreased significantly.6 The journal Rheumatology published a study that found a gluten-free vegan diet improved the signs and symptoms of RA.7 An uncooked vegan diet, rich in antioxidants and fiber was shown in another study to decrease joint stiffness and pain in patients with RA.8 Some research studies have looked at fasting followed by a vegetarian or vegan diet. A review of multiple research studies concluded that this dietary treatment might be useful in the treatment of RA.9

Vegan diets dramatically reduce the overall amount of fat in the diet, and alter the composition of fats. This in turn can affect the immune processes that influence arthritis. The omega-3 fatty acids in vegetables may be a key factor, along with the near absence of saturated fat. The fact that patients also lose weight on a vegan diet contributes to the improvement.

In addition, vegetables are rich in antioxidants, which can neutralize free radicals. Oxygen free radicals attack many parts of the body and contribute to heart disease and cancer, and intensify the aging processes generally, including of the joints.

Iron acts as a catalyst, encouraging the production of these dangerous molecules. Vitamins C and E, which are plentiful in a diet made of vegetables and grains, help neutralize free radicals. Meats supply an overload of iron, no vitamin C, and very little vitamin E, whereas vegetables contain more controlled amounts of iron, and generous quantities of antioxidant vitamins.

As well as being helpful in preventing arthritis, antioxidants may also have a role in reducing its symptoms. Some arthritis treatments, including non-steroidal anti-inflammatory drugs, work at least in part by neutralizing free radicals. For the most part, however, vitamins and other antioxidants will be of more use in preventing damage before it occurs, rather than in treating an inflamed joint.10

A diet drawn from fruits, vegetables, grains, and beans therefore appears to be helpful in preventing and, in some cases, ameliorating arthritis.

For four weeks, include generous amounts of foods from the pain-safe list in your routine.

At the same time, scrupulously avoid the major triggers.

It is important to avoid these foods completely, as even a small amount can cause symptoms.

Foods that are not on either list can be consumed, so long as you are emphasizing the arthritis-safe foods and scrupulously avoiding the major triggers.

You may well experience benefits earlier than four weeks, but for some people it can take this long for chronically inflamed joints to cool down.

Pain-safe foods virtually never contribute to arthritis or other painful conditions. These include

After four weeks, if your symptoms have improved or disappeared, the next step is to nail down which one or more of the trigger foods has been causing your problem. Simply reintroduce the foods you have eliminated back into your diet one at a time, every two days.

Have a generous amount of each newly reintroduced food, and see whether your joints flare up again. If so, eliminate the food that seems to have caused the problem, and let your joints cool down again. Then continue to reintroduce the other foods. Wait at least two weeks before trying a problem food a second time. Many people have more than one food trigger.

It is not recommended to bring meats, dairy products, or eggs back into your diet. Not only are they major triggers, but they also encourage hormone imbalances that may contribute to joint pain, and also lead to many other health problems.

1. Dairy products* 2. Corn 3. Meats** 4. Wheat, oats, rye 5. Eggs 6. Citrus fruits 7. Potatoes 8. Tomatoes 9. Nuts 10. Coffee *All dairy products should be avoided: skim or whole cows milk, goats milk, cheese, yogurt, etc. **All meats should be avoided: beef, pork, chicken, turkey, fish, etc.

For some arthritis patients, supplements of certain essential fatty acids have been helpful. They should be thought of as a medicine, rather than a food. A typical regimen would include a tablespoon of flaxseed oil with 500 mg of blackcurrant oil (or three capsules of evening primrose oil) twice each day. If it is helpful, it should be reduced to the lowest effective dose. Some people also benefit from an herb called feverfew, taken two to three times per day. (Caution: Do not take feverfew if you are pregnant.)

These supplements are available in health food stores.

References 1. Panush RS, Carter RL, Katz P, Kowsari B, Longley S, Finnie S. Diet therapy for rheumatoid arthritis. Arthritis and Rheumatism. 1983;26:462-471. 2. Lithell H, Bruce A, Gustafsson IB, et al. A fasting and vegetarian diet treatment trial on chronic inflammatory disorders. Acta Derm Venereol. 1983;63:397-403. 3. Sobel D. Arthritis: What Works. New York, St. Martin's Press, 1989. 4. Skoldstam L, Larsson L, Lindstrom FD. Effects of fasting and lactovegetarian diet on rheumatoid arthritis. Scand J Rheumatol. 1979;8:249-255. 5. Skoldstam L. Fasting and vegan diet in rheumatoid arthritis. Scand J Rheumatol. 1986;15:219-223. 6. McDougall J, Bruce B, Spiller G, Westerdahl J, McDougall M. Effects of a very low-fat, vegan diet in subjects with rheumatoid arthritis. J Altern Complement Med. 2002;8(1):71-75. 7. Hafstrom I, Ringertz B, Spangberg A, von Zweigbergk L, Brannemark S, Nylander I, Ronnelid J, Laasonen L, Klareskog L. A vegan diet free of gluten improves the signs and symptoms of rheumatoid arthritis: the effects on arthritis correlate with a reduction in antibodies to food antigens. Rheumatology (Oxford). 2001;40(10):1175-1179. 8. Hanninen, Kaartinen K, Rauma AL, Nenonen M, Torronen R, Hakkinen AS, Adlercreutz H, Laakso J. Antioxidants in vegan diet and rheumatic disorders. Toxicology. 2000;155(1-3):45-53. 9. Muller H, de Toledo FW, Resch KL. Fasting followed by vegetarian diet in patients with rheumatoid arthritis: a systematic review. Scand J Rheumatol. 2001;30(1):1-10. 10. Merry P, Grootveld M, Lunec J, Blake DR. Oxidative damage to lipids within the inflamed human joint provides evidence of radical-mediated hypoxic-reperfusion injury. Am J Clin Nutr. 1991;53:362S-369S.

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