Doctor...What Are The Effects Of Alcohol On Rheumatoid Arthritis?

Could a glass of wine at dinner time be the next majormineral density associated with CIA.
arthritis breakthrough?"The major surprise in this study was the outstanding
Possibly... according to a recent Swedish study. A dieteffect of ethanol on saving cartilage and bone,
of 10% ethanol had a protective effect on mice thatsuggesting that apart from regulation of inflammatory
would otherwise have developed collagen-inducedmediators, matrix metalloproteinases (i.e., tissue
arthritis (CIA), Swedish researchers report indestroying enzymes) might be a direct target for
Proceedings of the National Academy of Sciences.ethanol," commented Dr. Tarkowski.
CIA is often used as an animal model of humanDr. Tarkowski cautions, "This dose of ethanol was
rheumatoid arthritis (RA.)chosen for mice with an exact knowledge regarding
Andrej Tarkowski, MD, the senior author and a facultythe toxicity. This was further confirmed by intact liver
member in the department of rheumatology andfunction at the end of experiments. In contrast,
inflammation research, Goteborg University, in Sweden,exchanging water for 10% ethanol in humans
stated that the primary finding was that, in male mice,eventually will lead to liver disease (cirrhosis). Thus, the
long term consumption of 10% ethanol delayed theoptimal dose of ethanol in the human setting to prevent
onset and progression of CIA.delay RA is presently unknown. For practical purposes,
The underlying mechanism appears to be a reductionone could speculate on the use of doses of ethanol
in inflammation due to decreased NF-kB activation (asimilar to those sometimes suggested for prevention
primary inflammatory pathway) caused byof cardiovascular diseases--i.e., something in the range
upregulation- or increased production -of testosteroneof 1 to 2 glasses of wine per day," he suggested.
secretion."We are presently analyzing whether female mice with
The research team fused a CIA model in mice byarthritis have the same effect from ethanol.
immunizing male DBA/1 mice with collagen type II (CII).The investigators also compared castrated to intact
To determine whether drinking ethanol has any impactmale mice and found that mice drinking 10% ethanol
on the development of CIA, the mice were providedhad significantly elevated levels of testosterone and
with either 10% ethanol or water alone to drink. Micedecreased levels of IGF1 and cortisol. "These
were sacrificed after 5 to 6 weeks. All four pawsobservations, considered together with the cellular
from DBA/1 mice were sectioned, stained, andanti-inflammatory properties of testosterone that lead
examined for inflammation of the joint includingto a decrease of NF-kB activation, point to
damage to the joint lining and erosion of bone andtestosterone as a potential link mediating the
cartilage.anti-inflammatory effects of ethanol."
The investigators report that development of arthritisSo... what are the implications for patients with RA?
due to inflammation was markedly reduced in theThe first is that perhaps, a prescription of a glass or
ethanol-drinking mice. Ethanol had no such effect ontwo of wine a day is not necessarily bad.
mice with arthritis induced by injection with a mixture ofHowever, there are cautions. The first is that patients
four monoclonal anti-CII antibodies. "These datawho are taking methotrexate need to absolutely limit
suggest that ethanol affects the start or initiation rathertheir consumption of alcoholic beverages because of
than the perpetuation of immune responsivenessthe danger of developing cirrhosis. Second, patients
during CIA," mentioned the researchers.taking non-steroidal anti-inflammatory drugs are at
Joints from the water-drinking mice developedincreased risk for developing stomach ulcers and
frequent bone and cartilage erosions. Those from thealcohol increases that risk.
ethanol-drinking mice were "histologically ...intact,"(Jonsson I-M, Verdrengh M, Brissiert M, et al. Ethanol
meaning no significant damage occurred. In addition,prevents development of destructive arthritis. PNAS.
ethanol prevented the arthritis-induced loss of bone