Researchers have identified changes in the gut microbiome makeup that lead to the onset of rheumatoid arthritis, providing an opportunity for targeted treatment.
Researchers from the University of Leeds and Leeds Teaching Hospitals NHS Trust found that bacterial overgrowth was associated with inflammation in the gut about 10 months before patients developed clinical rheumatoid arthritis.
The findings could help identify people at risk and pave the way for prevention and personalized treatment strategies, the team said.
To better understand, researchers followed 124 people at risk of developing arthritis for 15 months. Of these, 7 were newly diagnosed and 22 were healthy. Changes in gut microbiome profiles were assessed using stool and blood samples at 5 different time points.
The presence of precursor anti-cyclic citrullinated protein (anti-CCP) antibodies – which attack healthy cells and are specific for rheumatoid arthritis – and joint pain in the previous 3 months were identified as major risk factors.
During the study period, 30 of 124 in the at-risk group progressed to rheumatoid arthritis. Compared to the healthy comparison group, their microbial diversity was also reduced.
Recognized genetic, blood and imaging risk factors for developing arthritis were also significantly associated with lower microbial diversity, as was steroid use.
In people who progressed to rheumatoid arthritis, and who were diagnosed with a specific strain of the newly discovered Prevotellaceae sp.- (ASV2058), Prevotella copri – was found to be highly prevalent.
Another strain of P. copri (ASV1867) also grew at the start of the study, suggesting that gut bacteria may play a role in the development of rheumatoid arthritis, the researchers said.
“Individuals at risk for [rheumatoid arthritis] have a distinctive gut microbial composition, including, but not limited to, an abundance of Prevotellaceae species. These microbial signatures are consistent and correlate with traditional risk factors. are,” said research published online in the Annals of the Annals. Rheumatic diseases.
While the findings suggest that changes in the gut microbiome are a late-stage phenomenon, this is an observational study and warrants further studies.