Rheumatoid Arthritis And Gut Bacteria

What is Rheumatoid Arthritis?

Rheumatoid arthritis is a chronic inflammatory disease that can cause pain, swelling, stiffness, and loss of function in the finger, wrist, and other joints throughout the body. It happens when the immune system mistakenly attacks the body's own tissue, like the membranes which line the joints.

According to CDC, Rheumatoid arthritis (RA) affects over 1.5 million adults. This illness can affect anyone, but it most often affects women between the ages of 40 and 60 years old. Chronic inflammation from RA can cause severe pain, swelling, stiffness causing the loss of function on your fingers, wrists, feet, knees, or other joints.

The causes of rheumatoid arthritis are not completely known. Genes tied to the immune system may be the main factor. Environmental factors, such as cigarette smoking, stress, diet, and obesity may also play a part in triggering the disease. Conventional treatments include medications to relieve pain and decrease inflammation. But they do not get to the root cause.

What happens in RA?

You share your body with trillions of microbes - many of these beneficial bacteria living in your intestinal tract. Collectively referred to as the microbiome, these bugs affect health and disease through complicated interactions with your immune system. Many times, their function is protective, guarding against inflammation and pathogens. But increasingly strong evidence indicates that disruptions in the microbial ecosystem can cause or contribute to many chronic diseases, such as rheumatoid arthritis (RA).

These repeated attacks cause inflammation in the tissue which lines the interior of your joints, called the synovium, which is a really thin layer of cells that help your joints move easily. Persistent inflammation leads to thickening of the synovium and you get swelling and swelling in and around your joints. Ordinarily, the synovial lining is just a few cells thick but it may be up to eight to ten cells thick in someone with RA because of the swelling and thickening. 

Does gut bacteria cause RA?

But what's the specific nature of the relationship between the intestine microbiome, immune system, and disease? Can gut bacteria, coupled with other environmental and genetic factors, affect the onset and development of certain pathologic conditions? The answers are mostly unknown and have prompted investigation into the interplay between the host microbiome and immune system.

Recent research has demonstrated a strong correlation between an overgrowth of gut bacteria and the onset of rheumatoid arthritis. While it hasn't yet been proven as the only reason for rheumatoid arthritis, it's certainly suspected that the gut bacteria, Prevotella copri and Proteus mirabilis, play a substantial role in the onset of rheumatoid arthritis and psoriatic arthritis. Gut bacteria, like P. cpori and P. mirabilis, can lead to leaky gut, which can be a frequent cause of immune dysfunction and inflammation in the body.

Besides bacteria, the Epstein-Barr virus is also thought to be a possible cause of rheumatoid arthritis. Quite often, the antibodies seeking out this virus mistakenly attack joint tissue, through a process called molecular mimicry. This permits fluid and immune complexes to accumulate in the joints, causing inflammation and pain.

Research on gut bacteria & RA

The presence of a certain sort of gut bacteria correlates with rheumatoid arthritis in newly diagnosed, untreated men and women. The finding suggests a possible role for the germs in this autoimmune disorder.

Rheumatoid arthritis is a chronic inflammatory disease that can cause pain, swelling, stiffness, and loss of function in the finger, wrist, and other joints throughout the body. It happens when the immune system mistakenly attacks the body's own tissue, like the membranes which line the joints.

The causes of rheumatoid arthritis are not completely known. Genes tied to the immune system may lead. Environmental factors, such as cigarette smoking, stress and diet, may also play a part in triggering the disease. Treatments include medications to relieve pain and decrease inflammation.

The immune system is affected by the microbiome, a system of germs that live in and around the human body. These microbes outnumber the body's cells by 10 to 1. Trillions of germs -- both harmful and helpful - live in the digestive tract. The gut microbiome was associated with arthritis in animal research.

To determine if these microbes could also be associated with rheumatoid arthritis in humans, Dr. Dan Littman of NYU School of Medicine led a group of researchers that analyzed DNA in 114 feces samples from both healthy individuals and people who had rheumatoid or psoriatic arthritis. The group identified gut bacteria by extracting DNA from the samples and then assessing a bacteria-specific gene known as the 16S ribosomal RNA gene. The study was funded in part by NIH's National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), National Institute of Allergy and Infectious Diseases (NIAID), and National Human Genome Research Institute (NHGRI). Results appeared on the internet on November 5, 2013, in eLife.

The researchers found that 75 percent of individuals with new-onset, untreated rheumatoid arthritis experienced the bacterium Prevotella copri in their intestinal microbiome. In contrast, it was present in 12 percent of individuals with chronic, treated rheumatoid arthritis, 38 percent of people with psoriatic arthritis, and 21 percent of those in the control group. Elevated levels of P. copri correlated with reductions in a number of groups of beneficial microbes, such as Bacteroides. The researchers conducted more comprehensive DNA sequencing on a subset of samples and identified unique Prevotella genes that correlated with rheumatoid arthritis.

Summary

Although it isn't sure whether gut health is connected to RA, researchers are working hard to discover . Meanwhile, adopting a healthier gluten-free diet and adding probiotics into your routine, yoga, exercise, not smoking, and embracing a healthy lifestyle couldn't hurt. Functional medicine experts specialize in this sort of thing – so schedule a call.

References

1. Bedaiwi MK, Inman RD. Microbiome and probiotics: link to arthritis. Curr Opin Rheumatol. 2014;26(4):410-415.

2. Shreiner AB, Kao JY, Young VB. The gut microbiome in health and in disease. Curr Opin Gastroenterol. 2015;31(1):69-75.

3. Scofield RH. Rheumatic disease and the microbiome. Int J Rheum Dis. 2014;17(5):489-492.

4. Jethwa H, Abraham S. The evidence for microbiome manipulation in inflammatory arthritis. Rheumatology (Oxford). 2017;56:1452-1460.

5. Chen J, Wright K, Davis JM, et al. An expansion of rare lineage intestinal microbes characterizes rheumatoid arthritis. Genome Med. 2016;8(1):43.

6. Zhang X, Zhang D, Jia H, et al. The oral and gut microbiomes are perturbed in rheumatoid arthritis and partly normalized after treatment. Nat Med. 2015;21(8):895-905.

7. Scher JU, Sczesnak A, Longman RS, et al. Expansion of intestinal Prevotella copri correlates with enhanced susceptibility to arthritis. Elife. 2013;2:e01202.

8. https://www.nih.gov/news-events/nih-research-matters/gut-microbes-linked-rheumatoid-arthritis

9. http://blog.arthritis.org/rheumatoid-arthritis/gut-bacteria-rheumatoid-arthritis-ra/

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