Potential 10-Month Intervention Point Uncovered in Rheumatoid Arthritis Detection, Treatment

A longitudinal study out of Leeds, UK, found bacteria associated with inflammation in the gut microbiome roughly 10 months before patients developed clinical rheumatoid arthritis.

Rheumatoid arthritis affects more than half a million people in the United Kingdom, causing swelling, pain, and stiffness in the joints when the immune system mistakenly attacks the body’s healthy cells.

The study, published in Annals of Rheumatic Disease, introduces a potential intervention point in managing and treating rheumatoid arthritis. Nineteen patients at risk for rheumatoid arthritis were included and had samples taken five times over a 15-month span.

Of them, five participants progressed to clinical rheumatoid arthritis and showed gut instability, with higher amounts of rheumatoid arthritis-associated Prevotella, about 10 months before clinical progression. The remaining 14 patients whose disease did not progress maintained largely stable amounts of gut bacteria.

Lead researcher Dr. Christopher Rooney, NIHR Academic Clinical Lecturer at the University of Leeds and Leeds Teaching Hospitals NHS Trust, noted, “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.”

Based on these data, the researchers aim to test at the 10-month window changes to diet such as eating more fiber, taking pre- or probiotics, and improving dental hygiene to keep periodontal disease away from the gut. However, the exact relationship between gut inflammation and rheumatoid arthritis remains unclear. Though bacteria is associated with rheumatoid arthritis, the researchers made clear that there is no evidence that this is contagious.

The Leeds team will now carry out an analysis of treatments that have already been trialed to inform future testing of treatments and this potential 10-month intervention point.