A new study published in the Annals of the Rheumatic Diseases has reported on a connection between changes in gut microbiota to the early onset of rheumatoid arthritis (RA), suggesting that specific bacterial strains in the gut could serve as early indicators for RA in high-risk individuals.
The study observed 124 individuals over 15 months, with 30 eventually developing rheumatoid arthritis. Researchers found that changes in certain bacterial strains, particularly from the Prevotellaceae family, became apparent around 10 months before the onset of clinical RA.
In individuals with high anti-cyclic citrullinated protein (anti-CCP) antibodies, a known marker of RA risk, the diversity of gut microbiota, or “alpha diversity,” was significantly reduced. This microbial composition appeared unique to RA-prone individuals, aligning with traditional RA risk factors such as rheumatoid factor antibodies and genetic markers. Notably, patients with new-onset RA exhibited distinct shifts in metabolic pathways related to amino acid and energy processing, further emphasizing the unique microbial and metabolic profile associated with RA progression.
This cross-sectional and longitudinal study profiled the gut microbiome of at-risk individuals through 16S RNA and metagenomic sequencing. Though limited by a small longitudinal sample size, the findings suggest that microbial instability in the gut occurs as a later event before diagnosis. While causality between gut microbiome changes and RA development cannot yet be confirmed, this study underscores the potential of gut microbiota as a preventive target for those with higher risk of developing RA.
Implications for Practice:
The microbial signature in RA-prone individuals, particularly in high anti-CCP patients, presents a new avenue for early identification and personalized treatment. The study’s authors advocate for further exploration of the gut microbiome’s role in RA, especially in high-risk patients, to refine preventive strategies and interventions.
