Pathogenesis of RA continued
Besides the possible underlying miasmatic etiology in rheumatoid arthritis, other possible causative agents may be genetic and environmental factors. RA has a strong possibility of being inherited, with the human leukocyte antigen (HLA) antigens being the most probable risk factor. There are many examples of virus infections that persist despite provoking a wide range of immune responses. In consideration of the relationship between HLA and RA, retroviruses may use HLA antigens as receptors to enter host cells to evade the immune response.
From the point of view of the miasms we could consider the possibility that HLA antigens are miasmatic markers that make that particular cell susceptible to invasion by the retrovirus. On the other hand, there is also the possibility that the retrovirus itself, after having successfully entered the cell, may alter the cell to determine HLA antigens. This is especially possible if we think of the retrovirus as being synonymous with miasmatic infection and if we remember that the retrovirus may remain latent for years and be passed on from generation to generation. When a latent miasm is awakened, immunosuppression may be one of its expressions. The immunosuppression may allow replication of previously latent retroviruses. These retroviruses may be the object of the autoimmune response.
There are other possible etiological agents such as metabolic or nutritional factors, a neurological imbalance or an endocrine disturbance. The fact that aspirin and other NSAID have beneficial effects in the relief of the acute manifestations of synovial inflammation implies a possible pathogenetic role for the prostaglandins. Physical or psychological stress can also be the initiating factor of the inflammatory process of RA. Likewise, injury to a joint of its associated structures is often followed by development of RA or osteoarthritis in that joint. This is due to the prolonged immobility of the joint after the injury.
The observation that RA occurs more frequently in women may have something to do with suppression or disturbance of the process of menstruation since that is an important cleansing process. As Allen writes: “The genital canal is one of the waste gates of the body. When vaginal discharges are suppressed, the organism becomes affected unfavorably…we see leucorrhea to be only a symptom, a cleansing and sanitary process to eliminate that which taints the streams of life.” It is not uncommon for women who are suffering from joint pains and arthritic symptoms to give the history of one or more abortions, a recent delivery or curettage or the onset of menopause. It must be remembered that behind every physiological cleansing process underlies the subtle energy force of apana vayu. Therefore, if the process of menstruation is suppressed for one reason or another, this force will have to find another outlet. If the suppression is mild and temporary, the substitute outlet will be the organ that is the closest or most similar to the uterus in embryological origin.
. . . to be continued
Dr. Barbara Bova, HOD, Department of Homeopathy