There are many different types of arthritis. A slew of them. Old age arthritis, due to wear and tear is Osteoarthritis. That ain't my problem.

Unfortunately, with Rheumatoid Arthritis (RA), one doesn't just heal up. Ironically, in fact, the disease is caused by your own stupid immune system thinking your own joint tissue is a foreign invader and attacks it, stupidly thinking it is "healing" your joints.

That is called "autoimmunity", self immunity, where one becomes immune to one's own little self. A military analogy is the Identification Friend or Foe system gets screwed up.

The immune system is one heck of a complex system, and the details of it is a discipline unto itself. There are all sorts of different immune responses, and different types of autoimmunity and when I read about it, my eyes soon glaze over at the complexity.

But as best as I can understand it, the leading theory of RA autoimmunity is there is a genetic factor that predisposes one to it, but a trigger is required to get it started. None of this is proven beyond a doubt, mind you, but this is what the current thinking is and there is a lot of evidence to support it. But there are other theories as well.

Here's a rough analogy: Your immune system is the police force of a small town. Some criminal comes into town and start committing some petty crimes. Nothing all that bad, most likely, just petty little crap. The police identify the criminal, say he's male, 5'9 and red headed.

Only problem is, the cops have a Rambo streak and are in need of glasses and decide all 5'9 readheaded male citizens are the same criminal and start going after those innocent citizens. Their vision is so bad, they can't tell the difference between the innocent citizens and the actual criminal, and just go after all of 'em willy nilly. They won't stop until they've eliminated all the 5'9" redheaded men in town.

That is about the picture of RA autoimmunity according to the current theorizing.

-Richard

Yup. It's why many colitis and Crohn's sufferers also tend towards rheumatoid arthritis.

The overzealous cop analogy is a clever one, Publius.

I usually end up describing it as my (former) large intestine and joints both being allergic, after a fashion, to something produced by my own white blood cells. That is a rather gross oversimplification, but most folks "get" allergies. It meant my health issues, as relayed far and wide by my exceptionally gossipy family members (read: mother), never really got in the way of my normal interpersonal relationships, unlike, say, cancer, missing limbs, or the really exotic and unpronounceable scary-sounding diseases.

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"your going to regret that one. You are now a colonoscope...
- Chrissy, corrupting PraedSt's wish.

It seems like autoimmune diseases run in my family. My aunt had a crippling case of rheumatoid arthritis (she looked a lot like a Pak Protector). I have Crohn's disease, and (this one is getting pretty scary), it now is looking like my mother has Wegener's. *sigh*

They haven't - so far - found indicators of RA in me, but I have Crohn's related arthritis that goes very closely with general Crohn's activity. Luckily, my activity took a big drop after a one time infusion of Remicade several years ago.

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For a lot of chronic diseases, you just don't get over it. All you can do is try to manage it, and sometimes you use drugs knowing full well that they can have nasty side effects, because the alternative is worse. With a number of the autoimmune diseases, there are periods of attack and remission. That is, sometimes the activity gets bad (for unknown reasons) and other times the immune system seems to rest. Drugs like prednisone are often used during the attacks. Sometimes (as with my experience with Remicade) they seem to reset the activity level of the immune system. Of course, the immune system can decide to attack again later. I've had an unusually long period of relatively low activity, and most people get maybe a couple good months out of Remicade.

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I say there is an invisible elf in my backyard. How do you prove that I am wrong?

Disclaimer: Avatar is not an official NASA image and does not imply any specific interplanetary or interstellar capability.

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is it wrong to hope that he can heal?

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"I will do my best to understand and explain the universe from big to small without invoking miracles, unrepeatable events, or divine intervention. In place of those things I will use observations, mathematics, and science."


-Cross
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No, but now you understand that isn't really an option, right? There is a lot of misunderstanding about chronic disease, like RA or Crohn's. You might do better, but you don't really heal.

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I say there is an invisible elf in my backyard. How do you prove that I am wrong?

Disclaimer: Avatar is not an official NASA image and does not imply any specific interplanetary or interstellar capability.

The Leif Ericson Cruiser

Crosscountry,

I hope you weren't offended by our responses, and I do thank you for the sentiment. I thank you indeed. Our point was that autoimmune diseases just don't heal up like some "regular" type disease, and things just don't work exactly you might think. Again, I didn't mean to offend, and certainly thank you for hoping I get better.

Speaking of heroic measures, they've apparently managed to "cure" RA in some extreme cases via extraordinary means involving stem cells and flat out "rebooting" the immune system for scratch.

Some poor guy in Australia I believe it was had a severe case of intractable RA, affecting over 30 joints. He was just 39 or so and had already had total hip replacements and others.

He had an indentical twin brother who didn't have RA (this type of behavior is what seems to show that a trigger is required).

Well, since his case was so severe, they used a highly experimental proceduure. They used high dose chemotherapy agents to flat out destroy his own immune system. I mean wiped it out. That would've killed him otherwise.

They then took stem cells and some other immune cells from his twin brother and essentially cloned that brother's immune system and its state in the first brother.

And it apparently worked. He's been symptom free ever since. But that was an incredibly risky procedure to say the least. Basically a cutting edge medical experiment. And it only had a chance because of the twin brother's immune cells being so genetically close to his own.

And I believe they've done one or two other similiar procedures in other extraordinary cases.

As it is, that wouldn't work for most people. Most people don't have twins of course, but even if they did, it would be far too dangerous for most people. In those cases, they were so "eaten up" with it, that the risk was worth it.

But, hopefully they will gain knowledge that might lead to safer ways to "reboot" the immune system and get it to forget the autoimmunity but otherwise remember all the real foreign antigens and pathogens.

-Richard

That is amazing...

That's the funniest and best explanation I've every heard. Someone get the ACLU to get in there and take my immune system to court.

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man, if we can give people new hearts, new knees, and new immune systems it won't be long before we can transplant brains!

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"I will do my best to understand and explain the universe from big to small without invoking miracles, unrepeatable events, or divine intervention. In place of those things I will use observations, mathematics, and science."


-Cross
My travel blog

Some of my Astrophotography


Those that lack education have a hard time understanding its value. - Cross

Why? Do you want to change your mind?

"I've changed my mind"
"Well, I hope this one works for you"

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You want a misunderstanding about a chronic disease, I was diagnosed with Fibromyalgia. What makes this particularly frustrating, is the lack of a specific factor in any test. You also look as though there is nothing wrong with you. The only way to diagnose it is to do all the test for all of the other similar problems, and if they all come out negative, they finally check the "pressure points" and if the "pressure points" react, you have fibro. In my case, it only took them about 2.5 years to figure it out, which is relativly quickly.
I got to do the pred, mexo, and for pain, hydrocodone, oxycontin, and several others, I was, at one point, taking about 28 pills a day, and while it helped day to day, nothing helped during a flareup. And the side effects caused severasl problems, socially.

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Tensor,

Fibro? Sorry to hear that. Well, misery loves company and know I can sympathize with you buddy. Hmmmpph. When I was a young buck, I used to get sort of disgusted hearing the old timers (well, how I characterized them at the time -- I wouldn't say they were so old now. ) go on about all their complaints. Well, now I'm in the same boat. Karma, I guess.


Back to RA and autoimmune diseases. As I mentioned, the above is the current best theory. However, there are others. One is a theory, well hypothesis would be better, that RA is actually caused by an infectious agent, a mycoplasma I believe.

With this, using the cops in the small town analogy, rather than having poor eyesight, they have darn good eyesight, and note something strange about those 5'9" redheaded citizens. Think Invasion of the Body Snatchers or something. They've been taken over by mycoplasma aliens.

There has been some success in treating RA by using high dose, long term antibiotic therapy (IV infusions over a long time), using antibiotics known to be effective against mycoplasmas.

But the majority of the rheumatologists and experts in the field dismiss that, and, IIRC, say any effectiveness comes from the fact the antibiotics and how they are used may have an immunosuppresive effect. However, the proponents point to evidence of mycoplasma DNA and other markers found in the synovial (joint) fluid of some RA patients.

So there you go. That's what's so maddenning about this, especially when you have it and similiar. They're just not completely sure what it is -- the evidence isn't 100% consistent and clear cut. And that goes double or an order of magnitude for something like fibromyalgia.

One alarming thing is certain, though, autoimmune diseases (and allergies, another type of immune system screw up) are on the rise, and why is the question. Is there something enviromental getting our immune systems screwed up

-Richard

http://en.wikipedia.org/wiki/Trevor_Marshall

This is one of the "maverick" theories about autoimmune diseases. I stumbled on this "Marshall Protocol" trying to find more information about the microbial theory of RA/other autoimmune diseases.

I'd botch it big time trying to describe, but the theory is basically that those with autoimmune diseases (of a certain class which includes RA) do have a defect in their immune systems. But this defect allows a certain type of mutated bacteria (no cell walls, I think, but this is all well outside my knowledge) to thrive. And these pathogens are then what causes the disease to thrive -- the immune system just can't fight it properly and the response is inappropriate, sort of destroying the village in order to save it.

Marshall's "cure" is some pretty radical stuff. It involves using some drug that modifies the Vitamin D "system" of the immune system. Apparently, when undergoing this treatement protocol, you become ridiculously sensitive to sunlight. Terribly so. And then certain antibiotics are used.

Note this has apparently helped people with some severe autoimmune diseases. So there may be something to it -- it may at least be part of a bigger puzzle not completely understood.

Me, with just my bum knee (only, knock on wood), I'm nowhere near bad enough to try something this radical, but if I were, I might just give it a shot. But to do it, you need docs and other experts well versed in this theory and the treatment, that's for sure.

-Richard