Rheumatoid arthritis (RA) is a chronic inflammatory disease in which the progressive destruction of joint causes morbidity. It
is also associated with an increased risk of atherosclerosis, which can result in cardiovascular disease and mortality. The therapeutic goal
is to control the systemic inflammation to obtain not only the remission of symptoms, but also improve general state of health. Although
recent biologic immunosuppressive therapies targeting pro-inflammatory cytokines have spawned a paradigm shift regarding the prognosis
of RA, these therapies possess inherent side effects. Also, early diagnosis of the disease remains confounded by uncertainty. While the
mechanisms responsible for the onset of RA remain unclear, reactive oxygen species (ROS) play a significant role in the pathogenesis of
RA. ROS play a central role both upstream and downstream of NF-κB and TNFα pathways, which are located at the center of the inflammatory
response. Among the ROS, the hydroxyl radical is the most harmful, and molecular hydrogen (H2) is a selective scavenger
for this species. Recently, it has been shown that H2 is useful when administered along with the conventional therapy in RA as it acts to
reduce oxidative stress in the patients. Especially in the early stage, H2 showed significant therapeutic potential, which also seemed to assist
diagnosis and treatment decisions of RA. The possible expectations regarding the potential benefits of H2 by reducing the oxidative
stress, resulting from inflammatory factors, are raised and discussed here. They include prevention of RA and related atherosclerosis, as
well as therapeutic validity for RA.
Keywords: Rheumatoid, atherosclerosis, prevention, Oxidative Stress, 5 ppm, Molecular Hydrogen, 8-hydroxylguanine, Hydroxyl Radical.
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