Chronic Alcohol Consumption Induces Osteoarthritis-Like Pathological Changes in an Experimental Mouse Model PMC
Rheumatoid arthritis is an autoimmune disease in which the body’s immune system mistakenly attacks the joints, causing inflammation. Immune cells called cytokines are involved in the inflammatory process, and excess alcohol consumption may promote higher levels. In a 2020 study, researchers found a significant association between alcohol consumption and RA risk in women but not men. Among women, every 10 grams (g) increase in alcohol consumption significantly increased the risk of developing the condition.
- Whether or not to consume alcohol when you have RA hinges not just only on its impact on your symptoms, but on what medications you are taking.
- Paradoxically, alcohol has also been a consistent protective factor against the development of autoimmune diseases such as type 1 diabetes, multiple sclerosis, systemic lupus erythematosus, and rheumatoid arthritis (RA).
- Whilst we analysed studies grouped by absence or presence of confounder adjustment, the adjustment methodology varied significantly between individual studies.
In support of this, analysis of studies adjusted for confounders eradicated any significant associations and suggested that alcohol had no significant association with OA. We further attempted to reduce heterogeneity by assessing adjustment by different covariates but were not successful. Most of the heterogeneity seem to arise from the OA joint of interest, as hand OA and hip OA groups both demonstrated low heterogeneity alone and did not show a significant association.
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It is first metabolized to acetaldehyde by alcohol dehydrogenase (ADH), then acetaldehyde is metabolized to acetate by aldehyde dehydrogenase (ALDH) by various cells of the body. Acetaldehyde is particularly toxic, but its lifetime is limited as it is readily metabolized further to acetate [3,4]. Fast metabolism of alcohol leads to increased serum acetate levels in chronic alcohol drinkers how to avoid another alcohol relapse [5,6]. Due to alcohol’s fast metabolism to toxic acetaldehyde, then important metabolic intermediary such as acetate, the interest of its effects on human health has risen. Diseases such as high blood pressure; heart disease; liver disease; cancers of the mouth, throat, liver, etc.; and mental health issues, including addiction, are examples of alcohol-mediated disease [2,7,8].
For example, a 2018 study in the Scandinavian Journal of Rheumatology looked at alcohol’s effect on joint erosion or joint space narrowing (radiological progression) in the hands, wrists, and feet of people with RA. Researchers used periodic X-rays to track radiological progression over time. Thus far, scientists haven’t been able to produce definitive evidence of either a negative or positive effect of alcohol on RA. However, if there are any health benefits, they’re likely minimal at best. Current research does not point to a specific amount of alcohol that makes RA symptoms worse. A person should also avoid consuming high amounts of alcohol to avoid increasing the risk of liver problems.
When studies were grouped by adjustment, an analysis of the 16 studies that contributed unadjusted data revealed an OR of 0.70 (0.55–0.89). This was a more negative association than that of the primary analysis which reported an OR of 0.79 (0.68–0.93). When grouped by any adjustment, this negative association was no longer observed. Regression analyses showed that mean age, % female within the study and sample size were covariates that demonstrated a significant association with the ORs of association between alcohol use and OA reported by individual studies (Table (Table3).3). All the included studies (Table (Table1)1) were observational in design; 16 were cross-sectional [24–39], 10 were cohort [40–49] and 3 were case–control studies [14, 50, 51]. There is still debate regarding the pathogenic relationship between alcohol intake and osteoarthritis (OA).
Alcohol may make you drowsy, but it messes with sleep quality, says Dr Manno. By Lana Barhum
Lana Barhum has been a freelance medical writer since 2009. The following sections of this article discuss what the research says about alcohol and how it affects RA. Current research is mixed, and the link are you an enabler between alcohol and RA appears to differ depending on how much a person drinks and their medications. If you don’t already drink, don’t start just because of a possible heart-health benefit. We look forward to learning more so we can guide our patients better in the future,” says Dr. Bolster.
3 Radiographic assessment
The datasets generated during and/or analyzed during the present study are publicly available. To identify participants with newly diagnosed rheumatoid arthritis during the follow-up period, we used the Outpatient Register and the Swedish Rheumatology Register. All data collection was fully in compliance with the Declaration of Helsinki and both the data collection and the analysis were approved by the St Vincent’s University Hospital ethics committee. AS, ankylosing spondylitis; DAS28, Disease Activity Score 28; PsA, psoriatic arthritis; RA, rheumatoid arthritis.
A broad search was conducted across four databases to identify all possible citations and included both abstracts and conference presentations. The double extraction protocol used for article selection minimizes selection bias and allows for a thorough evaluation. While the heterogeneity of studies was high, a random effects model to calculate pooled statistics was used. This how to start a sober living home business in 2023 model relaxes the assumption that the true relationship between alcohol consumption and disease activity does not vary between studies, however it does not alone control for confounding36. Therefore, regression was performed to assess the relationship between alcohol consumption and other demographic information such as gender, smoking status, and RF/ACPA positivity.
If you have gout, you know that levels of uric acid in your blood are directly related to the disease. Alcohol, especially beer, distilled liquor and some wine, increases uric acid levels, which is why people with gout are advised to limit or omit alcohol. Fatigue and disrupted sleep can be part of living with arthritis, and alcohol is known to have a negative effect on the quality and quantity of sleep. While you may fall asleep faster after a drink, alcohol disrupts body chemicals and rhythms that help you stay asleep and get restorative sleep.
Alcohol Consumption in Rheumatoid Arthritis: A Path through the Immune System
In our laboratory, we aimed to delineate alcohol’s effects by investigating alcohol’s main metabolite, acetate, as well. Consumed alcohol is metabolized to acetate, and in turn, acetate is metabolized to acetyl-CoA [3,101]. In fed state, generation of additional acetyl-CoA leads to an expansion of secondary functions of acetyl-CoA [101]. It was therefore interesting to follow the effects of acetate on the immune responses during CIA. TFH cells play a central role in supporting B cell activation, class switch, affinity maturation, and GC maintenance [102,103].
Alcohol and RA Benefit
On a quest to identify the specific mechanism by which alcohol acts upon immune system, one must take into consideration not only alcohol, but also the products of alcohol’s metabolism. Recently, in our laboratory, we were able to show that modulation of intestinal tight junction can affect onset of RA in the preclinical collagen-induced arthritis (CIA) model of RA [40]. Another metabolite of alcohol, acetate, is a central molecule in cellular metabolism, post-translational modifications, and transcription in its biologically active acetyl-CoA form [41]. Alcohol has been shown to contribute to increased acetylation of histones in the brain upon alcohol consumption [42,43].
The Good—And Bad—Health Effects Of Alcohol
In our laboratory, we have shown a major effect of acetate on the immune system, which is discussed later in this review. A more recent study showed that alcohol might help with RA through its effect on certain immune cells. The thinking is moderate amounts of alcohol might help to keep those cells from overreacting and causing inflammation in people with RA.
“If you want to have a glass of wine, I’d rather talk about it and you can have that wine and really enjoy it instead of having misconceptions about the risk,” says Dr. Manno. Follow these guidelines to avoid experiencing negative side effects of drinking alcohol on your arthritis. Methotrexate, leflunomide, and some other DMARDs and biologics can elevate liver enzymes and, in some cases, lead to fibrosis and other liver damage. The answer may largely depend on what medications you take to treat your arthritis — as well as how as how much/often you drink, and what your other personal risk factors are.
Upon acute alcohol intoxication of people, peripheral blood lymphocytes were shown to upregulate MHC-I molecules [55]. Dendritic cells (DC) are one of the professional APCs that also play a key role in self-tolerance and have been found in the synovium of RA patients, contributing to proinflammatory process [12]. Mandrekar and colleagues were able to show that alcohol-exposed DCs produced less IL-12, expressed reduced levels of costimulatory molecules CD80 and CD86, and primed CD4+ T cells that were hyporesponsive to secondary untreated DC stimulation [57]. Following this finding, alcohol-fed mice were shown to have dose-dependent decrease in plasmacytoid DCs (pDCs) and myeloid DCs (mDCs), along with decreased CD40 expression and IL-12 production [58]. Langerhans cells are also affected by alcohol consumption as alcohol-fed mice exhibited decreased cell density and migration to lymph nodes (LN), but interestingly showed no change in MHC-II or CCR7 expression [60].
One 2019 study published in the journal Arthritis Care & Research looked at whether there was any connection between alcohol consumption and RA symptoms. The researchers relied on a semi-annual survey of up to 17,000 people with the disease. The current research on alcohol consumption in people with RA does suggest that alcohol may not be as harmful as researchers used to think. Still, many of these studies conflict with one another and raise concern over related inflammation.
Rheumatoid arthritis is an autoimmune disease in which the body’s immune system mistakenly attacks the joints, causing inflammation. Immune cells called cytokines are involved in the inflammatory process, and excess alcohol consumption may promote higher levels. In a 2020 study, researchers found a significant association between alcohol consumption and RA risk in women but not…