Molecular Mimicry Between Gut Microbiome and Rheumatoid Arthritis: Current Concepts

Area of Science:

• Immunology
• Microbiology
• Gastroenterology

Background:

• Rheumatoid arthritis (RA) is an autoimmune disease influenced by genetic and environmental factors, including the gut microbiome (GMB).
• RA patients exhibit altered GMB composition, marked by reduced diversity and specific bacterial changes.
• The GMB plays a crucial role in overall health and disease development.

Purpose of the Study:

• To explore the detailed involvement of the GMB in rheumatoid arthritis pathogenesis.
• To examine the oral-gut microbiome axis's role in RA, including ACPA production via molecular mimicry.
• To discuss the implications of GMB dysbiosis on immune responses, disease activity, and drug efficacy.

Main Methods:

• Review of current literature on the gut microbiome and rheumatoid arthritis.
• Analysis of the oral-gut microbiome axis and its role in ACPA production.
• Investigation of GMB's influence on immune cells (Tregs), cytokine levels, and RA disease activity.
• Exploration of pharmacomicrobiomics in the context of RA drug response and toxicity.

Main Results:

• Gut microbiome dysbiosis is associated with decreased diversity and specific bacterial alterations in RA patients.
• The oral-gut microbiome axis contributes to RA pathogenesis through molecular mimicry and ACPA production.
• Dysbiosis impacts regulatory T cells (Tregs), cytokine profiles, and RA disease activity.
• Gut microbiota composition influences the efficacy and toxicity of RA medications, leading to the field of pharmacomicrobiomics.

Conclusions:

• The gut microbiome is intricately involved in rheumatoid arthritis pathogenesis and disease activity.
• Targeting the gut microbiome presents potential strategies for personalized RA management and inflammation control.
• Further research is needed to address challenges like microbial variability, causality, confounding factors, and clinical translation for microbiome-targeted therapies.