Gut Bacteria May Cause Rheumatoid Arthritis

An estimated 1.3 million Americans suffer from rheumatoid arthritis (RA), which causes your immune system to attack tissues, inflaming joints, and damaging organs. Scientists can’t predict what triggers this mysterious and painful autoimmune disorder. But mounting evidence points to an intriguing new suspect: the trillions of microbes living and working inside your intestines.

How Microbes Influence Your Health

Bacteria and other microbes, such as viruses and fungi, form the microbiota network that resides in your gut. These germs outnumber your body’s cells 10 to one, helping you break down food and overpowering infectious germs. In exchange for keeping your immune system and body functioning well, you give them a nice place to live. When bad bacteria enter your body and proliferate, upsetting your internal ecosystem, health problems may arise. Research suggests that gut bacteria changes affect many physiological processes including metabolism, digestion, and the nutrients we consume. They may play a role in everything from obesity and circadian cycles to irritable bowel syndrome and multiple sclerosis. Microbiota also can impact the immune system profoundly. Animal models have indicated that intestinal bacteria can influence the development of some autoimmune diseases. Dysbiosis, the abundance of certain bacteria from factors like stress and diet, can change your profile and trigger inflammation. If unfriendly bacteria outnumber good ones, your immune system cells secrete a lot more pro-inflammatory cell-signaling molecules. This may be the cause of rheumatoid arthritis, according to emerging research.

Study Determines Which Bacterium Affects Your Immune System

The relationship between bacteria and the immune system begins at birth as the baby passes through the birth canal, collecting microbes that will colonize its body. Bacteria change along with the child’s environment and food habits. If an immune system dysfunction occurs, an imbalance can cause disease and inflammation, noted , M.D., Ph.D., professor of pathology and microbiology at the New York University School of Medicine and investigator at the Howard Hughes Medical Institute. Using a sophisticated analysis technique, Littman’s team of laboratory scientists and rheumatology researchers removed the DNA from 114 subjects’ fecal samples. They examined participants’ 16S ribosomal RNA genes and compared their gut bacteria. Prevotella copri, a bacterial species, was more abundant in subjects with newly diagnosed RA (75 percent) than in people with psoriatic arthritis (38 percent), healthy controls (21 percent), and patients with chronic but treated RA (12 percent). The investigators associated P. copri overgrowth with fewer beneficial bacteria. Then they tested their theory on mice. Those that received P. copri developed more severe inflammatory symptoms than the control group. The researchers concluded that this bacterial species causes inflammatory symptoms. Now, this NYU team is busy developing tools that can confirm the link between rheumatoid arthritis and intestinal Provotella copri. Even if this microbe can trigger this disease, Littman said that they don’t know if doctors can treat it once RA begins. Speculation has been rampant about the association between autoimmune diseases and microbiota changes or disturbances. This study is the first to show that disturbances in the human digestive tract may play a role in autoimmune attacks on joints. Littman called his team’s results “the clearest association with a particular microbe to date.”

Other Experts Respond

Next, must figure out if microbes are an RA cause or consequence, advised Yasmine Belkaid, senior investigator and chief of the Laboratory of Parasitic Diseases’ Mucosal Immunology Section at the National Institute of Allergy and Infectious Diseases. Then they may need to develop ways to remove one microbe from a complex microbiota selectively. RA has a strong genetic component. But not all patients carry the genes, so environmental factors like smoking, hormones, aging, and infections also may be contributing factors, said researcher Veena Taneja, an associate professor of immunology at the Mayo Clinic. “The gut seems to be the common link,” she said. Her work examines the possibility of manipulating bacteria to change the course of disease because daily gene exposure influences the gut microbiome. Scientists hope that this type of research will lead them to novel diagnostic methods, treatments, and perhaps, cures for many chronic diseases including rheumatoid arthritis.

Controlling Your RA

Making an RA management plan with your doctor is the first step toward relief. He may prescribe Celebrex (Celecoxib), a NSAID that reduces joint pain. Studies show that patients who take active roles in their treatment experience less discomfort and function better. Also try these tips from to help control your RA symptoms.

• Avoid activities that require repetitive motions, heavy lifting, and joint strain.
• Minimize stress and anxiety with hypnosis, guided imagery, deep breathing, and muscle relaxation.
• Know your limits. Take breaks to relax and stretch regularly. Rest when you’re tired.
• Recognize your symptoms and take appropriate actions promptly when they occur.
• Apply cold or heat to joints or painful areas. Cold dulls pain and decreases muscle spasms. Heat eases pain, relaxes tense muscles, and increases blood flow.
• Eat a balanced, healthy diet that helps you maintain optimal weight.
• Exercise reduces pain, stiffness, and stress while increasing strength and flexibility.
• Don’t smoke.
• Maintain good posture.
• Wear comfortable cushioned shoes that support your weight properly.
• Adequate sleep encourages your body to produce pain-regulating chemicals.
• Develop a support system.
• Continue life as normally as possible. People who can work and socialize despite their pain do best.