What the gut reveals about RA progression and treatment

If you have any sort of gastrointestinal problem, you know how important it is to maintain the health of your gut microbiome. In addition to helping with digestion, these trillions of microbes help regulate the immune system and fend off disease-causing pathogens.

Studies have also shown a definite connection between gut health and that of other parts of the body like the brain, heart and skin. Additionally, changes in our friendly gut flora can help trigger seemingly unrelated illnesses like Parkinson’s disease, diabetes, heart disease and rheumatoid arthritis (RA).

So, it’s not surprising that scientists have had suspicions for some time about the potential role the gut microbiome plays in RA and other inflammatory and autoimmune diseases.

In fact, one study found a particular bacterium, Prevotella copri, present in the gut of three-quarters of participants with untreated RA. By contrast, the microbe was only present in 12 percent of those with treated RA and 21 percent of those in a control group who did not have RA at all.

As researchers continue to investigate this link, they are discovering the gut may not only be involved in the onset of RA — it may indicate whether a patient’s RA will improve over the long term…

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Differences in gut microbiome could influence RA symptoms and treatment

A study by Mayo Clinic researchers found it may be possible to determine a patient’s RA prognosis by examining the gut microbiome.

“By looking at patients’ baseline gut microbiome profiles, we observed significantly different microbiome traits between patients who eventually showed improvement and those who did not,” says Dr. John Davis, a clinical rheumatologist at Mayo Clinic with a specialty interest in inflammatory arthritis and co-senior author of the study.

“What was surprising is that our data suggest that depending on the eventual clinical outcome, gut microbiomes not only start at different ecological states, but also grow and develop differently,” adds fellow co-senior author Dr. Jaeyun Sung, a computational biologist within Mayo Clinic’s Center for Individualized Medicine.

The investigators then used deep-learning artificial intelligence (AI) to see if they could predict clinical improvement in each RA patient. Their predictions were 90 percent accurate, indicating that combining gut microbiome information with AI technology could potentially be another way to predict disease course in rheumatoid arthritis.

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The researchers point out that every person has a unique microbiome made up of a complex mix of genetic, dietary and environmental influences. These differences could be why symptoms can vary so widely among RA patients, making treatment a challenge and predicting a clinical outcome difficult.

“Ultimately, our study reveals that modifying the gut microbiome to enhance clinical outcome may hold promise as a future treatment for rheumatoid arthritis,” Dr. Sung says. 

Support your gut and fight RA

Of course, the best way to protect your gut health is to make sure you’re getting plenty of probiotics. Fermented foods like yogurt, kimchi, kefir, kombucha, natto and sauerkraut are your best source for probiotics. Try adding at least one or two of these foods to your daily diet to maintain good gut health.

If you have trouble getting enough of these foods, a good-quality probiotic supplement is your best bet. However, if you have RA, you probably want to know exactly which probiotics can enhance your gut health in a way that helps ease your symptoms.

So far, studies have indicated some strains of Lactobacillus and Bifidobacteria have beneficial effects on RA disease activity in humans. Out of these, Lactobacillus casei (L. casei), was identified as the strongest candidate for use as a supporting therapy in RA patients.

L. casei is present in some yogurts and yogurt-like fermented milk products, as well as some cheeses. It’s also included in many probiotic supplements.

Sources:

Mayo researchers link gut microbiome to rheumatoid arthritis prognosis — Mayo Clinic

Probiotic Supplementation for Rheumatoid Arthritis: A Promising Adjuvant Therapy in the Gut Microbiome Era — Frontiers in Pharmacology

Why You Should Use the Probiotic Lactobacillus Casei — Healthline