Rheumatoid
Arthritis, Lupus and Pregnancy
by Barbara D. Allan
Author of Conquering Arthritis
It has long been known that women with Rheumatoid
Arthritis (RA) often experience a remission while pregnant.
Pregnancy improves the symptoms of RA in about 75% of
pregnant women, but 90% of these women experience a
relapse within six months postpartum.
In contrast, about 50% of pregnant women with lupus
experience a flare of the disease during pregnancy,
although this not associated with permanent aggravation
of the disease.
Several studies published in the last few months are
shedding some light on why this is so.
Within the human body, there are two types of cells,
called T-helper-cells, that are important
in inflammation. They are called Th1 and Th2. Th1 cells
are one of the main factors in RA. Th2 cells are one
of the main factors associated with lupus.
During pregnancy there is a progressive increase in
estrogens, which reach a peak level in the third trimester
of pregnancy. At these high levels, estrogens suppress
Th1 mediated responses and stimulate Th2 mediated responses.
That is why RA tends to get better and lupus tends
to get worse.
Very interesting work, but so far this is not enough
on its own to result in any treatments for RA that might
work outside of pregnancy (or for lupus during pregnancy).
Oral contraceptives were tried for RA because they
generate a condition of pseudopregnancy. Several controlled
studies have found oral contractive pills don't seem
to have much effect on either reducing the risk of developing
RA or in treating already established RA.
Luckily medical research has resulted in further insights
that have resulted in some promising new therapies.
I will discuss them in next week's newsletter.
Next: Hormone
Therapy for Rheumatoid Arthritis
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