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Introduction: Rheumatoid arthritis (RA) is an autoimmune inflammatory disease that mainly affects joints, causing pain and functional loss. With a prevalence between 0.5% and 1%, it is more common in women, with a peak incidence between 40 and 60 years old. Early diagnosis and modern treatments, such as DMARDs and JAK inhibitors, are essential to improve the quality of life. Methodology: The study on "Rheumatoid Arthritis: Pathogenesis, Diagnosis and Therapeutic Approaches" conducted searches in scientific bases from 2014 to 2024, using specific criteria. Articles on pathogenesis, diagnosis and multidisciplinary treatment were prioritized. The critical analysis of the data evaluated the quality of the studies, identifying effective and collaborative clinical practices to improve the management of the disease. Results and discussions: Rheumatoid arthritis affects joints and systemic tissues. Genetic factors, such as HLA-DRB1, combined with environmental influences, promote the production of autoantibodies, chronic inflammation and joint destruction. Early diagnosis and innovative treatments, such as DMARDs and JAK inhibitors, improve the prognosis. Personalized approaches and lifestyle interventions, such as anti-inflammatory diets, complement the therapy, offering a more effective and holistic management. Final considerations: Advances in understanding molecular mechanisms and the use of biomarkers, such as ACPA and rheumatoid factor, have allowed early diagnosis and more effective treatments in rheumatoid arthritis. Biological therapies and JAK inhibitors have revolutionized management, while personalized and holistic approaches contribute to a better quality of life. Challenges persist in the search for new biomarkers and innovative therapies.
References
ALETAHA, D.; SMOLEN, J. S. Diagnosis and Management of Rheumatoid Arthritis. JAMA, v. 320, n. 13, p. 1360–1372, 2 out. 2018. Disponível em: <https://arthritis-research.biomedcentral.com/articles/10.1186/s13075-023-03018-6>. Acesso em: 21/09/2024.
ALUNNO, A. et al. Cytokines in the pathogenesis of rheumatoid arthritis: new players and therapeutic targets. BMC Rheumatology, v. 1, n. 1, 28 nov. 2017. Disponível em: <https://bmcrheumatol.biomedcentral.com/articles/10.1186/s41927-017-0001->. Acesso em: 05/09/2024.
ALWARITH, J. et al. Nutrition Interventions in Rheumatoid Arthritis: The Potential Use of Plant-Based Diets. A Review. Frontiers in Nutrition, v. 6, 10 set. 2019. Disponível em: <https://doi.org/10.3389/fnut.2019.00141>. Acesso em: 11/09/2024.
BIDDLE, K.; WHITE, J. P.; SOFAT, N. JAK Inhibitors in Rheumatoid Arthritis. EMJ Allergy & Immunology, 11 ago. 2022. Disponível em: <https://www.emjreviews.com/allergy-immunology/article/jak-inhibitors-in-rheumatoid-arthritis-j01121/>. Acesso em: 11/09/2024.
DISSANAYAKE, K. et al. Potential applicability of cytokines as biomarkers of disease activity in rheumatoid arthritis: Enzyme-linked immunosorbent spot assay-based evaluation of TNF-α, IL-1β, IL-10 and IL-17A. PLOS ONE, v. 16, n. 1, p. e0246111, 26 jan. 2021. Disponível em: <https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0246111>. Acesso em: 06/09/2024.
FUJII, T. et al. Management and treatment outcomes of rheumatoid arthritis in the era of biologic and targeted synthetic therapies: evaluation of 10-year data from the KURAMA cohort. Arthritis Research & Therapy, v. 26, n. 1, 9 jan. 2024. Disponível em: <https://arthritis-research.biomedcentral.com/articles/10.1186/s13075-023-03251-z>. Acesso em: 09/09/2024.
GIOIA, C. et al. Dietary Habits and Nutrition in Rheumatoid Arthritis: Can Diet Influence Disease Development and Clinical Manifestations? Nutrients, v. 12, n. 5, p. 1456, 18 maio 2020. Disponível em: <https://www.mdpi.com/2072-6643/12/5/1456>. Acesso em: 11/09/2024.
HE, J.; JU, J.; WANG, X. The current status of anti-citrullinated protein antibodies and citrullinated protein-reactive B cells in the pathogenesis of rheumatoid arthritis. Molecular Biology Reports, v. 49, n. 3, p. 2475–2485, 2 dez. 2021. Disponível em: <https://link.springer.com/article/10.1007/s11033-021-07034-0>. Acesso em: 25/08/2024.
HU, C. et al. Proteome Profiling Identifies Serum Biomarkers in Rheumatoid Arthritis. Frontiers in Immunology, v. 13, 6 maio 2022. Disponível em: <https://doi.org/10.3389/fimmu.2022.865425>. Acesso em: 08/09/2024.
JONSSON, M. K. et al. The role of anti-citrullinated protein antibody reactivities in an inception cohort of patients with rheumatoid arthritis receiving treat-to-target therapy. Arthritis Research & Therapy, v. 20, n. 1, 13 jul. 2018. Disponível em: <https://arthritis-research.biomedcentral.com/articles/10.1186/s13075-018-1635-7>. Acesso em: 20/09/2024.
KAJETAN KIElBOWSKI et al. JAK Inhibitors in Rheumatoid Arthritis: Immunomodulatory Properties and Clinical Efficacy. International Journal of Molecular Sciences, v. 25, n. 15, p. 8327–8327, 30 jul. 2024. Disponível em: <https://www.mdpi.com/1422-0067/25/15/8327>. Acesso em: 09/09/2024.
KRONZER, V. L.; DAVIS, J. M. Etiologies of Rheumatoid Arthritis: Update on Mucosal, Genetic, and Cellular Pathogenesis. Current Rheumatology Reports, v. 23, n. 4, 1 mar. 2021. Disponível em: <https://link.springer.com/article/10.1007/s11926-021-00993-0>. Acesso em: 17/08/2024.
LAUTWEIN, A. et al. Musculoskeletal ultrasound as a screening-tool for rheumatoid arthritis: results of the “Rheuma-Truck” screening and awareness initiative. Advances in Rheumatology, v. 62, n. 1, 4 jan. 2022. Disponível em: <https://advancesinrheumatology.biomedcentral.com/articles/10.1186/s42358-021-00233-0>. Acesso em: 01/09/2024.
LIU, B. et al. The association between systemic immune-inflammation index and rheumatoid arthritis: evidence from NHANES 1999–2018. Arthritis Research & Therapy, v. 25, n. 1, 4 mar. 2023. Disponível em: <https://arthritis-research.biomedcentral.com/articles/10.1186/s13075-023-03018-6>. Acesso em: 21/09/2024.
MA, H. et al. The role of anti-citrullinated protein antibody in pathogenesis of RA. Clinical and Experimental Medicine, v. 24, n. 1, 8 jul. 2024. Disponível em: <https://link.springer.com/article/10.1007/s10238-024-01359-3>. Acesso em: 01/09/2024.
MIAN, A. et al. A systematic review of guidelines for managing rheumatoid arthritis. BMC Rheumatology, v. 3, n. 1, 22 out. 2019. Disponível em: <https://doi.org/10.3389/fnut.2019.00141>. Acesso em: 19/09/2024.
MO, H. et al. Screening for early rheumatoid arthritis using high-frequency ultrasound, serum RANKL, and OPG detection. Clinical Rheumatology, 5 dez. 2023. Disponível em: <https://link.springer.com/article/10.1007/s10067-023-06830-2>. Acesso em: 04/09/2024.
MUN, S. et al. Serum biomarker panel for the diagnosis of rheumatoid arthritis. Arthritis Research & Therapy, v. 23, n. 1, 18 jan. 2021. Disponível em: <https://arthritis-research.biomedcentral.com/articles/10.1186/s13075-020-02405-7>. Acesso em: 06/09/2024.
PADYUKOV, L. Genetics of rheumatoid arthritis. Seminars in Immunopathology, v. 44, n. 1, p. 47–62, jan. 2022. Disponível em: <https://link.springer.com/article/10.1007/s00281-022-00912-0>. Acesso em: 17/08/2024.
RAAD, T. et al. Dietary Interventions with or without Omega-3 Supplementation for the Management of Rheumatoid Arthritis: A Systematic Review. Nutrients, v. 13, n. 10, p. 3506, 4 out. 2021. Disponível em: <https://www.mdpi.com/2072-6643/13/10/3506>. Acesso em: 11/09/2024.
ROCHA, S. D. B. et al. Clinical and pathophysiologic relevance of autoantibodies in rheumatoid arthritis. Advances in Rheumatology, v. 59, n. 1, 17 jan. 2019. Disponível em: <https://advancesinrheumatology.biomedcentral.com/articles/10.1186/s42358-018-0042-8>. Acesso em: 15/08/2024.
ŠENOLT, L.; GRASSI, W.; SZODORAY, P. Laboratory biomarkers or imaging in the diagnostics of rheumatoid arthritis? BMC Medicine, v. 12, n. 1, 18 mar. 2014. Disponível em: <https://bmcmedicine.biomedcentral.com/articles/10.1186/1741-7015-12-49>. Acesso em: 22/09/2024.
SOKOLOVE, J. Rheumatoid Arthritis Pathogenesis and Pathophysiology. Respiratory medicine, p. 19–30, 29 nov. 2017. Disponível em: <https://link.springer.com/chapter/10.1007/978-3-319-68888-6_2>. Acesso em: 20/09/2024.
TAMAI, H. et al. Serum cytokines and bone metabolic markers in patients with rheumatoid arthritis treated with biological disease modifying anti-rheumatic drugs. Clinical Rheumatology, 26 set. 2022. Disponível em: <https://link.springer.com/article/10.1007/s10067-022-06390-x>. Acesso em: 08/09/2024.
VIATTE, S.; BARTON, A. Genetics of rheumatoid arthritis susceptibility, severity, and treatment response. Seminars in Immunopathology, v. 39, n. 4, p. 395–408, 1 jun. 2017. Disponível em: <https://link.springer.com/article/10.1007/s00281-017-0630-4>. Acesso em: 05/08/2024.
WU, C.-Y. et al. Anti-Citrullinated Protein Antibodies in Patients with Rheumatoid Arthritis: Biological Effects and Mechanisms of Immunopathogenesis. International Journal of Molecular Sciences, v. 21, n. 11, 4 jun. 2020. Disponível em: <https://www.mdpi.com/1422-0067/21/11/4015>. Acesso em: 25/08/2024.
WYSOCKI, T. et al. Current Understanding of an Emerging Role of HLA-DRB1 Gene in Rheumatoid Arthritis–From Research to Clinical Practice. Cells, v. 9, n. 5, p. 1127, 2 maio 2020. Disponível em: <https://www.mdpi.com/2073-4409/9/5/1127>. Acesso em: 05/08/2024.
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Copyright (c) 2024 Anna Claudia Mascari, Julia Zanin Caldas, Alberto Ferreira Rocha de Aguiar, Leonardo Suhre Cadore, João Henrique de Oliveira Aurich, Eduardo Carvalho Couto, Maria Claudia Nogueira Saraiva, Lucas Auceliano Coelho Pinheiro, Paola Soares França Costa e Silva, Luana Andrade Afonso , Davi Marinho Porto Lima, GUILHERME PAZA FERREIRA
