Rheumatoid arthritis (RA) is a painful and disabling autoimmune disease that affects millions of people around the world.
It often causes swelling, pain, and damage in the joints. Until now, many researchers believed that the immune system ages as a result of this disease.
But a new study from the University of Birmingham offers a different view. It shows that signs of immune system aging can be seen even before a person is officially diagnosed with RA.
This discovery is important because it could help doctors identify people who are at risk of developing RA before the disease takes hold. That means treatment might be able to start earlier, possibly preventing the disease from becoming serious.
The research team studied 224 people at different stages of RA development. Some had early joint pain, others had a condition called undifferentiated arthritis, and some had already been diagnosed with RA. The scientists looked at their immune systems, focusing on certain immune cells that usually change as people get older.
One of the key findings was that people with early joint problems already had signs of an older immune system. Their immune cells showed fewer “naïve” T cells—these are young immune cells that help the body respond to new threats.
They also had lower “thymic output,” which means their bodies were producing fewer new T cells overall. These are common signs of immune aging.
The researchers also found higher levels of inflammation in people before they developed RA. This included increased amounts of substances like IL-6, TNFα, and CRP, which are known to fuel inflammation. These clues suggest that the immune system starts aging faster in people who are on the path to developing RA.
According to the study’s senior author, Dr. Niharika Duggal, this early aging of the immune system may not be a result of RA—but a cause. She explained that spotting these signs early could allow doctors to take action before RA fully develops.
One idea is to use treatments that slow aging in the immune system. These could include boosting the body’s natural clean-up process, called autophagy, which helps remove damaged cells.
As the disease progresses, even more changes appear. People with diagnosed RA showed signs of advanced immune aging, including the presence of “senescent” T cells—old and worn-out immune cells that don’t work properly—and Th17 cells that trigger inflammation.
The researchers are hopeful that drugs aimed at slowing aging could be used to stop RA from developing.
These treatments are already being studied for other conditions and include spermidine, which helps with autophagy; senolytics, which clear out old immune cells; and metformin, a drug commonly used for diabetes that also helps reduce inflammation and support cell repair.
In summary, this study offers new hope for people at risk of developing rheumatoid arthritis. By focusing on how the immune system ages, scientists may find new ways to stop RA before it starts, leading to better outcomes and less suffering for future patients.
The study is published in eBioMedicine.
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