Summary: Researchers at the University of Leeds have discovered that changes in gut bacteria could signal the onset of rheumatoid arthritis about ten months before clinical symptoms appear. This finding opens a potential window for preventative treatments in at-risk patients. The study reveals that individuals who develop rheumatoid arthritis show increased levels of inflammation-associated bacteria in their gut microbiome before disease onset.
Journal: Annals of the Rheumatic Diseases, November 7, 2024 | Reading time: 6 minutes
A New Hope for Early Intervention
For the more than half a million people in the UK living with rheumatoid arthritis, the search for better treatments has taken an unexpected turn – toward the gut. A groundbreaking study published in the Annals of the Rheumatic Diseases has revealed that changes in gut bacteria might provide an early warning system for this debilitating autoimmune condition.
“Patients at risk of rheumatoid arthritis are already experiencing symptoms such as fatigue and joint pain, and they may know someone in their family who has developed the disease. As there is no known cure, at-risk patients often feel a sense of hopelessness, or even avoid getting tested,” explains Dr Christopher Rooney, NIHR Academic Clinical Lecturer at the University of Leeds and Leeds Teaching Hospitals NHS Trust.
Tracking Changes in the Gut
The research team conducted a detailed longitudinal study following 19 at-risk patients over 15 months, taking samples at five different points. Their findings were remarkable: the five patients who eventually developed clinical arthritis showed significant changes in their gut bacteria approximately ten months before their diagnosis.
These patients exhibited higher levels of specific bacteria, including Prevotella, which has been previously associated with rheumatoid arthritis. In contrast, the 14 patients who didn’t develop the condition maintained relatively stable bacterial levels throughout the study period.
A Window of Opportunity
This ten-month warning period could prove crucial for preventative interventions. The research team is already exploring potential treatments that could be implemented during this window, including dietary modifications such as increased fiber intake, pre- and probiotic supplementation, and improved dental hygiene to prevent harmful bacteria from entering the gut.
Lucy Donaldson, director for research and health intelligence at Versus Arthritis, notes: “At Versus Arthritis, we welcome the findings of this study which could give the clinicians of the future a crucial window of opportunity to delay – or even prevent – the onset of rheumatoid arthritis.”
The Broader Picture
The study began with a larger sample of 124 individuals who showed high levels of CCP+, an antibody that attacks healthy cells and indicates risk for rheumatoid arthritis. When compared to 22 healthy individuals and seven newly diagnosed rheumatoid arthritis patients, the at-risk group showed less diversity in their gut microbiome.
While the exact relationship between gut inflammation and rheumatoid arthritis development remains unclear, the researchers emphasize that there is no evidence the condition is contagious, despite its association with bacteria.
Glossary:
– Microbiome: The community of microorganisms living in a particular environment, such as the gut
– CCP+: An antibody that attacks healthy cells in the blood, indicating risk for rheumatoid arthritis
– Prevotella: A type of bacteria associated with inflammation and rheumatoid arthritis
– Longitudinal study: A research method that involves repeated observations of the same subjects over time
– Probiotics: Live beneficial bacteria that can be consumed to improve gut health
Quiz:
1. How many months before clinical symptoms appear do gut bacteria changes become noticeable?
Answer: Ten months
2. How many patients in the longitudinal study progressed to clinical arthritis?
Answer: Five patients
3. What specific type of bacteria was found in higher amounts in patients who developed arthritis?
Answer: Prevotella
4. What antibody indicates risk for rheumatoid arthritis?
Answer: CCP+
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