Neurotransmitter status and remission of rheumatoid arthritis in pregnancy

Hormonal, immunological and neural factors contribute, but none exclusively, to the remission of rheumatoid arthritis (RA) in pregnant women. It is proposed (1) that a reset of neurotransmitter status early in pregnancy (associated with enhanced dopaminergic (DA) activity and subtly modified norepinephrinergic-DA functional interrelationships, and altered cholinergic function) initiates and maintains specific changes in immunological responses and in the endocrine system; that these changes collectively impose an alternative order of efficient physiological function and metabolism which is inimical to the progress of RA and promotes remission and, as reported, also prevents onset of the disease in normal pregnancy; (2) that pregnancy converges the ANS profile of Caucasians on the profile normally observed in nonpregnant Africans and is accompanied by the emergence of resemblances in certain aspects of metabolism; (3) that the reported low incidence of RA in non-pregnant Africans and suppression of onset and remission of the disease in pregnant Caucasians underline the proposed major influence of a specific neurotransmitter profile in determining the risk for and course of RA.