A link between rheumatoid arthritis and abnormal bowel function may provide a unified theory as to the cause of rheumatoid arthritis. Sufferers of rheumatoid arthritis have increased intestinal permeability (‘leakiness’ of the gut). Food allergies are considered to contribute greatly to increased intestinal permeability in rheumatoid arthritis.
A leaky gut results in an increased absorption of large dietary and bacterial molecules. These molecules are normally prevented from being absorbed because they are too large, but in rheumatoid arthritis, they are absorbed into the body, and, as a response, the body forms antibodies to bind them. Antibodies are released by white blood cells to bind to foreign molecules such as those seen on bacteria, viruses, and cancer cells. This results in the formation of an immune complex.
In rheumatoid arthritis, food and bacterial molecules act as antigens that are being bound by the antibodies. The resulting immune complex triggers the immune system to release compounds to destroy it. These compounds, when deposited in joint tissues, destroy not only the immune complex, but surrounding joint tissue also.
The presence of immune complexes in joint tissues is one of the major contributory factors in the development of rheumatoid arthritis, and results in much inflammation and joint destruction. As the joint tissues are destroyed, large molecules that are normally protected from the immune system by cell membranes and connective tissue are exposed. The body can then develop antibodies to the exposed antigens.
The body may also develop antibodies to its own tissue by developing ‘cross-reacting’ antibodies. The increased intestinal permeability and altered bacterial flora result in the absorption of antigens similar to those in joint tissues. Antibodies formed to these antigens would ‘cross-react’ with the antigens in the joint tissues.
Physicians use the presence of immune complexes to monitor rheumatoid arthritis patients, as the serum and joint fluid of almost all sufferers contain the ‘rheumatoid factor’ (RF). The RF represents the formation of multiple immune complexes, and is mostly formed locally in the affected joints by white blood cells. The level of RF can be measured in the blood, and usually corresponds to the severity of arthritis symptoms.
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