• In 2020, an estimated 17.6 million people globally were living with rheumatoid arthritis, an autoimmune disease that causes painful inflammation and swelling in the joints.

• Scientists are still not sure of the exact cause of rheumatoid arthritis. New research suggests that certain changes in the gut microbiome may be linked to the development of this condition.

• The study authors believe their findings provide a potential new avenue for new early prevention strategies for rheumatoid arthritis.

From 2020, approximately 17.6 million people throughout the world they lived with rheumatoid arthritis — one autoimmune disease where the body’s immune system mistakenly attacks the tissues lining the joints of the hands and feet, causing painful inflammation and swelling.

Researchers are still unclear about the exact cause of rheumatoid arthritis. However, previous studies show that genetics, environmental factors, smokingand obesity may increase a person’s risk of developing the disease.

“There is still much we do not understand about the development of rheumatoid arthritis, and unfortunately there are few or no prevention strategies available.” Christopher Rooney, MD, PhDsaid a researcher at the Leeds Institute of Medical Research at the University of Leeds in the United Kingdom Today’s medical news.

Rooney is the lead author of a new study that reports that certain changes to the intestinal microbiome may be linked to the development of rheumatoid arthritis, potentially opening a new avenue for disease prevention strategies.

The study was recently published in the journal Annals of rheumatic diseases.

Why focus on the gut microbiome in rheumatoid arthritis?

For this study, researchers recruited 124 people at risk of developing rheumatoid arthritis, seven people who had recently been diagnosed with the condition, and 22 healthy controls.

Scientists tracked changes in the gut microbiome of all participants over 15 months.

“Signals in the blood of (rheumatoid arthritis) patients suggest that inflammation may start in places outside the joints, such as the gut,” Rooney explained.

“The gut microbiome is in constant conversation with the immune system, so local inflammation can cascade through the immune system and cause systemic effects,” he added.

Antibody levels in the microbiome are linked to rheumatoid arthritis

During the study, 30 of the 124 participants at risk developed rheumatoid arthritis.

Among these 30 participants, the researchers observed that their microbial diversity was significantly reduced compared to that of healthy controls, particularly in an area known as alpha diversitywhich has been linked to precursor levels anti-cyclic citrullinated protein (anti-CCP) antibodies..

The researchers found that participants with low levels of anti-CCP antibodies in their gut microbiome were comparable to that found in the healthy control group.

“Anti-CCP antibodies are a type of protein produced by the immune system, usually in response to inflammation,” Rooney said.

“In people who can develop (rheumatoid arthritis), these antibodies can appear in the blood long before any symptoms, such as joint pain or stiffness, become visible. Essentially, the presence of anti-CCP antibodies acts as an early warning signal for (rheumatoid arthritis), helping doctors identify people at higher risk of developing the condition,” he explained.

“This finding is significant because it opens the door to earlier monitoring and allows us to study the disease before its onset,” Rooney continued. “Knowing that someone has these antibodies allows healthcare professionals to monitor them more closely and consider strategies that could slow or alter the course of the disease, even before it becomes fully developed.”

Certain gut bacteria can “prime” the immune system for rheumatoid arthritis

Rooney and his team also identified specific bacteria in the gut microbiome that may be involved in the progression of rheumatoid arthritis.

For example, scientists have discovered that a specific strain of bacteria species Prevotellaceae sp — (ASV2058) most likely bacteria Prevotella copri — was abundant in the microbiome of participants who experienced progression of rheumatoid arthritis during the study, as well as in those in the newly diagnosed group, but was not seen in the microbiome of those in the healthy control group.

The researchers also observed an increase in another strain (ASV1867) of P. cover at the start of the study in the microbiome of participants who progressed to rheumatoid arthritis, possibly suggesting certain strains of .P cover may play different roles in the progression of rheumatoid arthritis.

“These two strains exemplify how a patient’s underlying risk, for example their genetics, is related to changes in the gut microbiome in (rheumatoid arthritis) progression,” Rooney told us.

“The significance of this finding lies in the idea that certain bacteria in our gut could play a role in ‘priming’ the immune system in ways that could eventually lead to (rheumatoid arthritis). By identifying these strains, we gain a better understanding of how the gut microbiome might influence (rheumatoid arthritis) risk,” he noted.

Are New Rheumatoid Arthritis Treatment Options on the Horizon?

Rooney said these findings could one day lead to new treatment options for rheumatoid arthritis.

“Our findings suggest that certain bacteria in the gut microbiome may be involved in triggering the immune changes that lead to rheumatoid arthritis,” he explained. “If we can confirm and better understand this link, it could pave the way for new treatment approaches that target the microbiome.”

“One potential strategy could be to develop therapies that specifically alter or ‘rebalance’ the gut microbiome, possibly by using probioticdietary interventions or microbiome-based drugs,” Rooney continued.

“Our next steps involve studying how these specific bacteria influence immune activity in detail to confirm their role in the development of rheumatoid arthritis,” he added. “We will also explore interventions that could alter the gut microbiome in those at risk, such as targeted probiotics or dietary changes, with the aim of understanding whether these approaches could prevent or delay the onset of disease.”

See the original article on Today’s medical news