There is a theory that has been put out there that environmental triggers leading to airway and lung tissue inflammation result in the production of autoantibodies that result in the development of rheumatoid arthritis (RA). This hypothesis is made more plausible when you consider that mortality due to respiratory problems is elevated in patients with RA.
We know that patients with RA often develop scarring in the tissue of the lung called fibrosis but more extensive investigations have been conducted to determine if the airways in these patients are also affected. Using data collected from the use of pulmonary function tests, high resolution CT scans of the chest and a radiologic technique called quantitative CT (QCT) analysis researchers have found a high rate of airways disease in patients with RA even if they have never smoked or do not complain of shortness of breath. Airways obstruction and emphysema were often found.
What does this mean for patients? There is a higher mortality for patients with RA if they have underlying airway or lung tissue disease. Therefore, the detection of airways disease in this patient population is crucial. Another interesting corollary is that findings of RA antibodies may indicate that the airways disease may respond to the treats for RA itself.
This is just another example of how all things are connected. Without this type of investigation who would have thought that joint disease from RA and airway disease of the lungs would be connected.
