Diet, Microbiota, and Gut Permeability—The Unknown Triad in Rheumatoid Arthritis

Guerreiro, Catarina Sousa; Calado, Ângelo; Sousa, Joana; Fonseca, João Eurico

doi:10.3389/fmed.2018.00349

Cited by 96 publications

(77 citation statements)

References 61 publications

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“…Antioxidants can reduce oxidative stress and thereby possibly symptoms and inflammation in RA [ 48 ]. In addition, dietary fiber, prebiotics or probiotics could have beneficial effects on disease activity in RA through modification of the microbiota [ 49 ]. Specific nutrients and alterations to microbiota can also affect the intestinal permeability, which may affect the immune response.…”

Section: Discussionmentioning

confidence: 99%

Do Interventions with Diet or Dietary Supplements Reduce the Disease Activity Score in Rheumatoid Arthritis? A Systematic Review of Randomized Controlled Trials

et al. 2020

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The aim was to compile the evidence from Randomized Controlled Trials (RCTs) of diet or dietary supplements used to reduce disease activity in adults with Rheumatoid Arthritis (RA). Searches were performed in the databases PubMed, Scopus and Cochrane. Only RCT studies of diets, foods or dietary supplements, looking at effects on the Disease Activity Score in 28 joints (DAS28) among adults with RA, published in peer-reviewed journals, were included. A total of 27 articles were included—three of whole diets (Mediterranean diet, raw food and anti-inflammatory diet), five of food items, five of n-3 fatty acids, five of single micronutrient supplements, four of single antioxidant supplements and five of pre-, pro- or synbiotics. Studies that showed moderate strength evidence for positive effects on disease activity in RA included interventions with a Mediterranean diet, spices (ginger powder, cinnamon powder, saffron), antioxidants (quercetin and ubiquinone), and probiotics containing Lactobacillus Casei. Other diets or supplements had either no effects or low to very low strength of evidence. In conclusion, RCT studies on diet or dietary supplements are limited in patients with RA, but based on the results in this review there is evidence that some interventions might have positive effects on DAS28.

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Section: Discussionmentioning

confidence: 99%

Do Interventions with Diet or Dietary Supplements Reduce the Disease Activity Score in Rheumatoid Arthritis? A Systematic Review of Randomized Controlled Trials

et al. 2020

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“…increased mucosal barrier permeability and Th17 cells. Elements known to influence the mucosal barrier integrity include bacteria, their by-products and diet ( Horta-Baas et al, 2017 ; Guerreiro et al, 2018 ). Microbial by-products particularly short chain fatty acids (SCFA), including acetate, propionate, and butyrate have been linked to amelioration of arthritis development in CIA models ( Mizuno et al, 2017 ; Kim et al, 2018 ).…”

Section: The Gut Microbiome and Ramentioning

confidence: 99%

The Role of the Microbiome in Driving RA-Related Autoimmunity

Rooney

Mankia

Emery

2020

Front. Cell Dev. Biol.

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Once referred to as “normal commensal flora” the human microbiome plays an integral role between health and disease. The host mucosal surface replete with a multitude of immune cells is a vast arena constantly sensing and responding to antigen presentation and microbial by-products. It is this key role that may allow the microbiome to prime or protect the host from autoimmune disease. Rheumatoid arthritis (RA) is a chronic, disabling inflammatory condition characterized by a complex multifactorial etiology. The presence of certain genetic markers has been proven to increase susceptibility to RA however it does not guarantee disease development. Given low concordance rates demonstrated in monozygotic twin studies there is a clear implication for the involvement of external players in RA pathogenesis. Since the historical description of rheumatoid factor, numerous additional autoantibodies have been described in the sera of RA patients. The presence of anti-cyclic citrullinated protein antibody is now a standard test, and is associated with a more severe disease course. Interestingly these antibodies are detectable in patient’s sera long before the clinical signs of RA occur. The production of autoantibodies is driven by the lack of tolerance of the immune system, and how tolerance is broken is a crucial question for understanding RA development. Here we review current literature on the role of the microbiome in RA development including periodontal, gut and lung mucosa, with particular focus on proposed mechanisms of host microbiome interactions. We discuss the use of Mendelian randomization to assign causality to the microbiome and present considerations for future studies.

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“…The role of the intestinal microflora, the microbiome, has taken a center stage as a co-pathogenic mechanism in many diseases and is discussed later [53][54][55][56][57]. Both temperature and latitude itself have been suggested to alter the microbiome.…”

Section: Other Possible Effects Of Latitudementioning

confidence: 99%

Relationship(s) between obesity and inflammatory bowel diseases: possible intertwined pathogenic mechanisms

Szilagyi

2019

Clin J Gastroenterol

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The inflammatory bowel diseases, Crohn's and ulcerative colitis have increased in incidence and prevalence from the mideighteen to the late nineteen centuries. From then to the current twenty-first century there has been a more rapid expansion of these disease to areas previously experiencing low rates. This latter expansion coincides with the current obesity pandemic which also began toward the end of the last century. Although the two diseases have radically different frequencies, there are interesting links between them. Four areas link the diseases. On an epidemiological level, IBD tends to follow a northsouth gradient raising the importance of vitamin D in protection. Obesity has very weak relationship with latitude, but both diseases follow adult lactase distributions colliding in this plane. Is it possible that obesity (a low vitamin D condition with questionable response to supplements) reduces effects in IBD? On a pathogenic level, pro-inflammatory processes mark both IBD and obesity. The similarity raises the question of whether obesity could facilitate the development of IBD. Features of the metabolic syndrome occur in both, with or without obesity in IBD. The fourth interaction between the two diseases is the apparent effect of obesity on the course of IBD. There are suggestions that obesity may reduce the efficacy of biologic agents. Yet there is some suggestion also that obesity may reduce the need for hospitalization and surgery. The apparent co-expansion of both obesity and IBD suggests similar environmental changes may be involved in the promotion of both.

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Diet, Microbiota, and Gut Permeability—The Unknown Triad in Rheumatoid Arthritis

Cited by 96 publications

References 61 publications

Do Interventions with Diet or Dietary Supplements Reduce the Disease Activity Score in Rheumatoid Arthritis? A Systematic Review of Randomized Controlled Trials

Do Interventions with Diet or Dietary Supplements Reduce the Disease Activity Score in Rheumatoid Arthritis? A Systematic Review of Randomized Controlled Trials

The Role of the Microbiome in Driving RA-Related Autoimmunity

Relationship(s) between obesity and inflammatory bowel diseases: possible intertwined pathogenic mechanisms

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