New research suggests that changes in the gut microbiome before the development of rheumatoid arthritis could provide an opportunity for preventative treatments. A longitudinal study conducted by Leeds researchers found that bacteria associated with inflammation is present in higher amounts in the gut roughly ten months before patients develop clinical rheumatoid arthritis. Rheumatoid arthritis is a chronic disease that affects more than half a million people in the UK, causing swelling, pain, and stiffness in the joints due to the immune system mistakenly attacking the body’s healthy cells. Previous research has linked rheumatoid arthritis to the gut microbiome, and this new study reveals a potential intervention point for preventative measures.
Lead researcher Dr Christopher Rooney, from the University of Leeds and Leeds Teaching Hospitals NHS Trust, explains that patients at risk of rheumatoid arthritis often experience symptoms such as fatigue and joint pain, leading to feelings of hopelessness or avoidance of testing due to the lack of a known cure. The research findings suggest a major opportunity to act sooner to prevent the onset of rheumatoid arthritis. The longitudinal study, funded by Versus Arthritis, involved 19 patients at risk of rheumatoid arthritis, with samples taken five times over a 15-month period. Five of these patients progressed to clinical arthritis, showing gut instability with higher amounts of bacteria associated with rheumatoid arthritis before progression, while the remaining 14 had stable amounts of bacteria.
Potential treatments that researchers want to test at the ten-month window of opportunity include dietary changes, such as increasing fiber intake, taking prebiotics or probiotics, and improving dental hygiene to prevent harmful bacteria from periodontal disease reaching the gut. The relationship between gut inflammation and rheumatoid arthritis development is still unclear, with some patients in the study experiencing gut changes before any joint changes were observed. More research is needed to determine the influence between gut bacteria and joint health. The researchers emphasize that while bacteria are associated with rheumatoid arthritis, there is no evidence that it is contagious.
Director for research and health intelligence at Versus Arthritis, Lucy Donaldson, highlights the potential importance of the study findings in providing a window of opportunity for clinicians to delay or prevent the onset of rheumatoid arthritis through personalized treatments. The research was a collaborative effort involving the National Institute for Health Research Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Versus Arthritis, and Leeds Hospitals Charity. Patients at Chapel Allerton Hospital were involved in designing research methods to make stool sampling easier for participants. The initial data analysis of 124 individuals at risk of rheumatoid arthritis showed that the gut microbiome was less diverse in the at-risk group compared to healthy individuals.
The longitudinal study that followed 19 patients over 15 months revealed changes in gut bacteria occurring approximately ten months before progression to rheumatoid arthritis. The research team plans to analyze treatments that have already been trialed to inform future testing at this potential intervention point. Overall, the study sheds light on the potential role of the gut microbiome in the development of rheumatoid arthritis and offers hope for early interventions to prevent the onset of this chronic disease. Further research will be crucial in understanding the relationship between gut health and joint inflammation, providing avenues for personalized treatments and preventative measures.
