What is arthritis? Arthritis affects the musculoskeletal system, specifically the joints.

It is the main cause of disability among people over fifty-five years of age in industrialized countries. The word arthritis comes from the Greek arthron meaning "joint" and the Latin it is meaning "inflammation". The plural of arthritis is arthritides. Arthritis is not a single disease - it is a term that covers over 100 medical conditions. What causes arthritis? In order to better understand what is going on when a person suffers from some form of arthritis, let us look at how a joint works.

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Basically, a joint is where one bone moves on another bone. Ligaments hold the two bones together. The ligaments are like elastic bands, while they keep the bones in place your muscles relax or contract to make the joint move. Cartilage covers the bone surface to stop the two bones from rubbing directly against each other. The covering of cartilage allows the joint to work smoothly and painlessly. A capsule surrounds the joint. The space within the joint - the joint cavity - has synovial fluid. Synovial fluid nourishes the joint and the cartilage. The synovial fluid is produced by the synovium (synovial membrane) which lines the joint cavity.

Arthritis occur when the cartilage is: 1. 2. 3. 4. wearing away Osteoarthritis a lack of fluid autoimmunity (your body attacking itself) Rheumatoid arthritis infection - Infectious arthritis (septic arthritic)

5. A combination of many factors. In 2002, Dr. Julia Ying Wang of Brigham & Women's Hospital in Boston and Harvard Medical School and colleague Dr. Michael H. Roehrl of Harvard conducted a study of RA. However, Rheumatoid arthritis research which preceded the work of Wang and Roehrl largely focused on peptides, or fragments of protein. The Harvard researchers suggest instead that glycosaminoglycans, or GAGs, are the lead suspect in what causes rheumatoid arthritis In Wang and Roehrl's study, mice were injected with GAGs. The mice developed chronic rheumatoid arthritis-like symptoms including:

inflammation swelling bone erosions

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But why? GAGs are located primarily on the surface of cells or in the extracellular matrix (ECM). Along with the high viscosity of GAGs comes low compressibility, which makes these molecules ideal for a lubricating fluid in the joints. At the same time, their rigidity provides structural integrity to cells and provides passageways between cells, allowing for cell migration. Glycosaminoglycans are naturally-occurring polysaccharides found in: the cartilage connective tissue joint fluid the skin

Connective tissue comprises thin layers of cells separated by extracellular matrices, which contain primarily proteoglycans consisting of glycosaminoglycans (GAGs) covalently linked to tissue-specific core proteins. GAGs include hyaluronic acid (HA), chondroitin sulfate A (CSA), B (CSB), and C (CSC), heparin (HP), heparan sulfate, and keratan sulfate. Hyaluronic acid is a major component of synovial tissues and fluid, as well as other soft tissues, and endows their environments with remarkable rheological properties. For example, solutions of hyaluronic acid are known to be viscoelastic, and viscosity changes with sheer stress. The aforementioned rheological properties of solutions of hyaluronic acid make it ideal for lubricating joints and surfaces that move along each other, such as cartilage. RA is an autoimmune disease in which the immune system is triggered off inappropriately, and the body starts to reject its own tissue. Degeneration of the cartilage within joints, and inflammation of the bone exposed by the damaged cartilage, which is aggravated by injury and overuse of joint and

caused by the loss of chondroitin sulfate (most abundant form of GAG in the ECM) is a major cause of osteoarthritis.

Patients with RA have elevated concentrations of GAGs in blood and synovial fluid, and destruction of involved joints in RA patients correlates positively with high GAG levels in synovial fluid. The obvious explanation is that GAGs originate from the metabolism of the joint cartilage damaged by erosion. Simply stated, Wang's theory proposes that immune system cells, or antibodies, target glycosaminoglycans. The antibodies bind to GAGs, accumulate in the joints, and trigger the pain and inflammation associated with rheumatoid arthritis.

Summary of the findings:

GAG antibodies may develop as a result of bacterial infection. High levels of GAG may result when bacteria produce enzymes which break down connective tissue and release carbohydrates. Many bacteria have GAG on their cell surface. In rheumatoid arthritis, immune cells may mistakenly target naturally-occurring GAGs in the body's tissues in the same way they would target GAG on the surface of bacterial invaders. The systematic antibodies reactive to glycosaminoglycans (GAGs), the carbohydrate components of proteoglycans that are released in large amounts from degrading cartilage.

References: 1. Journal: Wang J.Y., M.H. Roehrl, (2002). Glycosaminoglycans are a potential cause of rheumatoid arthritis. Channing Laboratory, Department of Medicine, Brigham and

Women's Hospital, and Department of Biological Chemistry and Molecular Pharmacology, Harvard Medical School, Boston, MA 02115. Communicated by John J. Mekalanos, Harvard Medical School, Boston, MA (received for review July 19, 2002) Campo G.M. 1, A. Avenoso1, S. Campo1, A. M Ferlazzo2, D. Altavilla3 and A.Calatroni1, (2002). "Efficacy of treatment with glycosaminoglycans on experimental collagen-induced arthritis in rats. 1Department of Biochemical, Physiological and Nutritional Sciences, School of Medicine, University of Messina, Messina, Italy. 2Department of Morphology, Biochemistry, Physiology and Animal Production, School of Veterinary Medicine, University of Messina, Messina, Italy. 3 Department of Experimental and Clinical Medicine and Pharmacology, School of Medicine, University of Messina, Messina, Italy. Accepted: 12 Feb 2003 Published: 6 Mar 2003 Arthritis Res Ther 2003, 5:R122-R131 (DOI 10.1186/ar748) 2003 Campo et al., licensee BioMed Central Ltd (Print ISSN 1478-6354; Online ISSN 1478-6362). Bence Gyrgy, Lszl Tthfalusi, Gyrgy Nagy, Mria Pszti, Pl Gher, Zsolt Lrinc, Anna Polgr5, Bernadett Rojkovich3, Ilona Ujfalussy3, Gyula Por5, Pter Pcza1, Zoltn Wiener1, Petra Misjk1, Agnes Koncz6, Andrs Falus and Edit I Buzs1* Natural autoantibodies reactive with glycosaminoglycans in rheumatoid arthritis. Arthritis Research & Therapy 2008, 10:R110 doi:10.1186/ar2507. 2008 Gyrgy et al.; licensee BioMed Central Ltd. 2. Websites: Arthritis Foundation Statement on GAGs Class of Carbohydrates, Arthritis Foundation; Carbohydrates May Be Culprit Behind Painful Rheumatoid Arthritis, Anita Manning, USA TODAY, 8/22/02; Carbohydrate Attack May Be Arthritis Culprit, Anne Harding REUTERS HEALTH, 8/21/02 First published: 08/26/2002. Nordqvist, Christian. "What is Arthritis? What Causes Arthritis?." Medical News Today. MediLexicon, Intl., 28 Mar. 2009. Web. 3 Jul. 2013. <http://www.medicalnewstoday.com/articles/7621.php>