RA affects millions worldwide and over half a million people in the United Kingdom, according to the World Health Organization (WHO). Because RA can be a lifelong condition, scientists have been searching for ways to understand its early development. A major focus of recent research has been on gut bacteria and their role in the beginning of RA.
A recent observational study from the University of Leeds was published in the rheumatology journal The Annals of the Rheumatic Diseases. This study has shown that certain changes in the gut microbiome—bacteria in the digestive system—may be connected to the early stages of rheumatoid arthritis (RA). This research could help scientists understand how RA begins and find new ways to predict or prevent it.
The researchers aimed to resolve unclear findings from past studies about the role of certain gut bacteria, specifically the family known as Prevotellaceae, which might play a part in RA development. They wanted to observe how the gut microbiome changes over time in people who are at risk of developing RA compared to those who are not.
The researchers began by collecting baseline samples from 124 people who tested positive for anti-CCP antibodies, often found in people at risk for RA. These individuals also reported new musculoskeletal symptoms, though they did not yet have any joint swelling.
Over time, 30 of these participants went on to develop RA. For a more detailed look, the study tracked 19 people over a period of 15 months, collecting samples at five different points in time. Out of these 19 people, five eventually developed RA.
In the group that went on to develop RA, the researchers found certain differences in the abundance of Prevotellaceae bacteria at the beginning of the study. The presence of these bacteria seemed to be influenced by various factors, including each person’s unique risk level for RA and the time it took to progress to the disease.
Over the 15-month period, they noticed that people who developed RA experienced a disruption, or instability, in their gut bacteria starting about ten months before they actually showed symptoms of the disease. This pattern was not seen in those who did not develop RA.
The findings suggest that this microbial shift could be a sign of an impending onset of RA. Although Prevotellaceae bacteria played a role, they were not the only factor; other bacterial changes also contributed to this instability.
In people who progressed to RA, there were shifts in the gut microbiome’s structure and an increase in amino acid metabolism—an important process where the body breaks down proteins. Within the Prevotellaceae family, some strains of bacteria became more common, while others declined, depending on each person’s risk level and how close they were to developing RA.
The study’s results might help explain why previous research has shown conflicting results regarding Prevotellaceae bacteria and RA. These mixed findings may be because people at different points along the disease spectrum could have different bacterial patterns. This study suggests that changes in the gut bacteria align with a person’s risk profile and their progression from being at risk to actually developing RA.
Understanding how the gut microbiome changes over time in people at risk for RA could lead to major improvements in RA prediction, prevention, and individualized treatment plans. If further research confirms these results, scientists may eventually develop ways to target the gut microbiome in people who are at high risk for RA, potentially stopping or slowing down the disease before it fully develops.
Also Read: Gut Bacteria Can Be a Potential Game-Changer for Rheumatoid Arthritis