ABSTRACT
Arthritis, an inflammatory disease, occurs as rheumatoid arthritis (RA), osteoarthritis (OA), and juvenile rheumatoid arthritis (JRA). The disease is characterized by pain in joints, swelling, and degenerative changes in the joint. Increased oxidative stress and inflammation are the major cellular defects that initiate and promote arthritis. Therefore, attenuation of these two cellular defects may reduce the risk of developing arthritis among high-risk populations. Previous studies on human arthritis with single antioxidants produced inconsistent results. The potential reasons for the inconsistent results are discussed. Increasing the levels of antioxidant enzymes through activating the Nrf2/ARE pathway, as well as the levels of dietary and endogenous antioxidants by supplementation is essential for reducing these cellular defects. A mixture of micronutrients to achieve the above goal is proposed. This micronutrient mixture may reduce the risk of developing arthritis. Methotrexate (MTX) alone or in combination with anti-cytokine therapy has improved the symptoms of arthritis; however, they produce severe side effects in some individuals. The proposed micronutrients in combination with standard therapy may help in improved management of arthritis. The effectiveness proposed micronutrient mixture in prevention and improved management of arthritis should be tested by a well-designed clinical trial.
