Can Signals from Gut Transform RA Treatment? Study Sheds Light - Video

Bacteria associated with inflammation is found in the gut in higher amounts roughly ten months before patients develop clinical rheumatoid arthritis, a longitudinal study by Leeds researchers has found. Findings are published in the Annals of the Rheumatic Diseases.

Lead researcher Dr Christopher Rooney, NIHR Academic Clinical Lecturer at the University of Leeds and Leeds Teaching Hospitals NHS Trust, said: "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.

"This new research might give us a major opportunity to act sooner to prevent rheumatoid arthritis."

The longitudinal study was conducted on 19 patients at risk of rheumatoid arthritis, with samples taken five times during a 15-month period. Five of these patients progressed to clinical arthritis, and the research showed they had gut instability with higher amounts of bacteria including Prevotella, which is associated with rheumatoid arthritis, about ten months before progression. The remaining 14, whose disease didn't progress, had largely stable amounts of bacteria in their gut.

The study initially took data from 124 individuals who had high levels of CCP+, an antibody that attacks healthy cells in the blood, which indicates risk of developing rheumatoid arthritis. The researchers compared their samples to 22 healthy individuals and seven people who had a new rheumatoid arthritis diagnosis.

The findings from this larger group showed that the gut microbiome was less diverse in the at-risk group, compared to the healthy control group. The longitudinal study, which took samples from 19 patients over 15 months, revealed the changes in bacteria at ten months before progression to rheumatoid arthritis.

Reference: Rooney CM, Jeffery IB, Mankia K, et al, Dynamics of the gut microbiome in individuals at risk of rheumatoid arthritis: a cross-sectional and longitudinal observational study, Annals of the Rheumatic Diseases Published Online First: 08 November 2024. doi: 10.1136/ard-2024-226362