In dealing with autoimmune diseases, researchers are always looking for warning signs prior to symptoms onset so that we can prevent disease and damage before they happen. By the time autoimmune diseases like rheumatoid arthritis have caused joint pain, they have already damaged tissues and organs in ways that can’t be repaired. If we in medicine can identify the early warning signs before the disease causes such damage, we can do a lot more for patients than waiting until the harm has taken place. In a study by British researchers, the report found changes in gut bacteria 10 months before the onset of rheumatoid arthritis symptoms.
Over recent years, countless other studies have linked our gut with the onset of autoimmune diseases. Science tells us that the portion of the immune system which watches the gut borders of our bodies is a prime location for wayward reactions to trigger autoimmunity elsewhere. Besides the contribution of leaky gut to such systemic conditions, the billions of gut bacteria living in our colons also play a role in such conditions. Most live peacefully in our GI tract, helping to digest food or even produce some vitamins. Many provide our immune system with gentle stimulation so that it stays active and healthy. Some, however, go much further and trigger reactions that cause our bodies to attack themselves.
This situation of autoimmunity usually involves antibodies being produced by our immune B cells which attack our tissues rather than an invader such as a bacteria or virus. Beyond the wayward antibody responses, cellular reactions of the immune system can also trigger inflammation of our own tissues and thus autoimmune diseases. Gut bacteria can initiate either of these pathologic processes.
In functional medicine, we work a lot on gut health, trying to support healthy gut barriers, good bacteria in the colon, and a calm but ready-to-act immune system. This includes mostly a healthy diet, but can also necessitate further therapies like herbals, increased vitamins or minerals, fiber support, and probiotics. Therefore, studies like this do not surprise us.
In the first wave of the research, they compared individuals with a specific rheumatoid arthritis antibody to those without the antibody. They found less gut bacterial diversity in those with the disease-associated antibodies.
In the most recent wave of the study, they used this information from the initial wave to prospectively evaluate 19 patients who were known to be at risk of developing rheumatoid arthritis. Over a 15-month period, samples of stool bacteria were taken from each of these 19 study participants. Over this period, 5 developed rheumatoid arthritis and 14 did not. When they compared the gut bacteria between those who did and those who did not develop disease, they found clear differences.
In those who developed disease, the gut bacteria were less diverse, meaning they had fewer types of different bacteria. The biggest changes were in Prevotella bacteria predominating in those with disease progression. They also saw increased amino acid metabolism in these patients.
From here, the researchers hope to pinpoint interventions that can be implemented when such gut bacterial changes are happening before the disease fully develops. They are considering whether dietary changes or nutritional interventions might make a difference. Those of us in functional medicine for years look forward to more research like this supporting our long-held contention that the gut is a key battleground for dealing with autoimmune diseases. Helping our patients today live a healthier, more abundant life means keeping the gut in mind every time we care for someone with autoimmune disease.
Original Article:
Christopher M Rooney, Ian B Jeffery, Kulveer Mankia, Mark H Wilcox, Paul Emery. Dynamics of the gut microbiome in individuals at risk of rheumatoid arthritis: a cross-sectional and longitudinal observational study. Annals of the Rheumatic Diseases, 2024; ard-2024-226362 DOI: 10.1136/ard-2024-226362
Thanks to Science Daily:
University of Leeds. “Signals from the gut could transform rheumatoid arthritis treatment.” ScienceDaily. ScienceDaily, 8 November 2024. <www.sciencedaily.com/releases/2024/11/241108113743.htm>.
Sanctuary Functional Medicine, under the direction of Dr Eric Potter, IFMCP MD, provides functional medicine services to Nashville, Middle Tennessee and beyond. We frequently treat patients from Kentucky, Alabama, Mississippi, Georgia, Ohio, Indiana, and more... offering the hope of healthier more abundant lives to those with chronic illness.
