Modification of Gut Microbiota in Inflammatory Arthritis: Highlights and Future Challenges

Area of Science:

• Microbiome research
• Immunology
• Rheumatology

Background:

• The gut microbiota and its metabolites are implicated in the pathogenesis of rheumatoid arthritis (RA) in both animal models and humans.
• Intestinal microbiota modulation presents a novel strategy for suppressing autoimmunity in RA.

Purpose of the Study:

• To review current information on modifying the microbiota through diet, prebiotics, probiotics, and drugs.
• To assess the association between microbiota modulation and arthritis severity in animals and humans.
• To highlight potential therapeutic applications of microbiota modulation in RA.

Main Methods:

• Review of existing literature on microbiota interventions in arthritis.
• Analysis of studies involving animal models and human subjects.
• Evaluation of the impact of diet, prebiotics, probiotics, and drugs on gut microbiota composition and RA severity.

Main Results:

• Modifying the gut microbiota with various interventions (drugs, diet, probiotics, prebiotics) can impact RA symptom severity in animal models.
• These modifications are linked to alterations in immune responses.
• Dysbiosis precedes clinical arthritis, suggesting interventions may be more effective in the preclinical stage.
• Microbiota-modulating therapies showed limited success in reversing established arthritis or curing the disease.
• Interventions like acarbose, probiotics, and prebiotics may reduce disease incidence rather than treat existing RA.

Conclusions:

• Gut microbiota modulation is a promising area for RA management, especially for preventing disease onset.
• Therapeutic strategies targeting the microbiota could offer significant benefits in the preclinical stages of arthritis.
• While effective in influencing symptoms and potentially incidence, current microbiota-modulating therapies do not reverse or cure established RA.