The Role of the Microbiome in Driving RA-Related Autoimmunity

Abstract

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.

The Traditional Chinese Medicine Compound Huangqin Qingre Chubi Capsule Inhibits the Pathogenesis of Rheumatoid Arthritis Through the CUL4B/Wnt Pathway

“…According to statistics, RA has been worldwide incidence, the average incidence rate is 1%, the prevalence rate of China is 0.3-0.4%. If not diagnosed and treated in time, 70% patients will be disabled after 2 years, and the average life expectancy will be shortened by 10-15 years (Rooney et al, 2020;Deane and Holers, 2021). In order to prevent and slow down the destruction of joints and improve the long-term disease status of patients, anti rheumatic drugs are used to improve the disease tend to be used clinically, and the disease symptoms of patients have been better improved, but the condition of most patients can not be effectively controlled for a long time.…”

Rheumatoid arthritis and oxidative stress, a review of a decade

“…This evidence, together with those previously described, supports the notion that the role of the intestinal microbiota in the susceptibility to or the development of RA is not only related to the homeostasis of the immune system but also OS. On the other hand, the microbiota of the oral mucosa has been extensively evaluated in RA patients due to the role of periodontitis in the disease (65). There is already evidence related to the use of prebiotics and/or probiotics as an adjuvant treatment for RA patients.…”

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“…Inhibit Cyclooxygenase-2 Heart Attack and Stokes [56][57][58][59] Surgical treatment Psychological disadvantages, post-operative site-specific infections [60][61][62] TNF-α: Tumour Necrosis Factor-α, RA: Rheumatoid arthritis, IL: Interleukin [73][74][75] Thunder God Vine Tripterygium wilfordii (Celastraceae)…”