Environmental and gene-environment interactions and risk of rheumatoid arthritis

Rheum Dis Clin North Am. 2012 May;38(2):405-26. doi: 10.1016/j.rdc.2012.04.002. Epub 2012 May 30.


Multiple environmental factors including hormones, dietary factors, infections, and exposure to tobacco smoke, as well as gene-environment interactions, have been associated with increased risk for rheumatoid arthritis (RA). The growing understanding of the prolonged period before the first onset of symptoms of RA suggests that these environmental and genetic factors are likely acting to drive the development of RA-related autoimmunity long before the appearance of the first joint symptoms and clinical findings that are characteristic of RA. This article reviews these factors and interactions, especially those that have been investigated in a prospective fashion before the symptomatic onset of RA.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Arthritis, Rheumatoid / chemically induced*
  • Arthritis, Rheumatoid / diagnosis
  • Arthritis, Rheumatoid / genetics*
  • Delayed Diagnosis
  • Gene-Environment Interaction*
  • Genetic Predisposition to Disease*
  • Hazardous Substances / adverse effects*
  • Humans
  • Risk Factors


  • Hazardous Substances