Regulating Gut Microbiome: Therapeutic Strategy for Rheumatoid Arthritis During Pregnancy and Lactation

Abstract

Rheumatoid arthritis (RA) is an autoimmune disease characterized by synovial inflammation and bone destruction. Microbial infection is considered to be the most important inducement of RA. The pregnancy planning of women in childbearing age is seriously affected by the disease activity of RA. Gut microbiome, related to immunity and inflammatory response of the host. At present, emerging evidence suggested there are significant differences in the diversity and abundance of gut microbiome during pregnancy and lactation, which may be associated with the fluctuation of RA disease activity. Based on these research foundations, we pioneer the idea of regulating gut microbiome for the treatment of RA during pregnancy and lactation. In this review, we mainly introduce the potential treatment strategies for controlling the disease activity of RA based on gut microbiome during pregnancy and lactation. Besides, we also briefly generalize the effects of conventional anti-rheumatic drugs on gut microbiome, the effects of metabolic changes during pregnancy on gut microbiome, alteration of gut microbiome during pregnancy and lactation, and the effects of anti-rheumatic drugs commonly used during pregnancy and lactation on gut microbiome. These will provide a clear knowledge framework for researchers in immune-related diseases during pregnancy. Regulating gut microbiome may be a potential and effective treatment to control the disease activity of RA during pregnancy and lactation.

The Macrophage-Osteoclast Axis in Osteoimmunity and Osteo-Related Diseases

“…Studies indicated that the reconstitution of VLDLR expression in macrophages of VLDLR-deficient mice promotes the occurrence and development of atherosclerosis, which may be due to the accumulation of atherosclerotic lipoproteins caused by the knockout of VLDLR (124,125). The physical state of the mother has a profound impact on the health of the fetus (126,127). Maternal-fetal interface studies suggest that VLDLR can induce osteoclasts differentiation and inhibit the inflammatory response of macrophages (128)(129)(130).…”

Short‐chain fatty acids regulate B cells differentiation via the FFA2 receptor to alleviate rheumatoid arthritis

“…Specifically, changes in the oral and intestinal microbiota are associated with loss of tolerance to self-antigens and increased inflammatory events that promote joint damage (du Teil et al, 2019). Therefore, regulation of the oral or gut microbiota may be a strategy to treat or prevent the development of RA (Yao, Cai, Fei, Ren et al, 2020).…”

Short-Chain Fatty Acids-A Healthy Bus between Gut Microbiota and Organs beyond the Gut

“…Rheumatoid arthritis is an immune-mediated chronic joint inflammation and injury featured by bone destruction and synovial hyperplasia [146]. In contrast, SCFAs, as modulators of the immune system [146], can alleviate arthritic symptoms and are emerging as a novel treatment strategy for RA.…”

“…Rheumatoid arthritis is an immune-mediated chronic joint inflammation and injury featured by bone destruction and synovial hyperplasia [146]. In contrast, SCFAs, as modulators of the immune system [146], can alleviate arthritic symptoms and are emerging as a novel treatment strategy for RA. gen-induced arthritis (CIA) model, found significantly higher SCFAs levels in the stool of mice after treated with SCFAs and reduced inflammatory cell infiltration and synovial hyperplasia in the knee and ankle joint cavities of mice [147].…”