Imbalance Of Gut Bacteria In Rheumatoid Arthritis, A Trigger
What Happens In RA?
Nearly 1.5 million people in the United States have rheumatoid arthritis, according to the Centers for Disease Control and Prevention. RA is an autoimmune disease. This means that in RA, the immune system, which is supposed to protect the body from bacteria, viruses and other foreign pathogens, mistakenly attacks the joints.
These repeated attacks cause inflammation in the tissue that lines the inside of your joints, known as the synovium, which is a very thin layer of cells that help your joints move smoothly. Constant inflammation leads to thickening of the synovium and you get swelling and pain in and around your joints. Normally, the synovial lining is only one to three cells thick but it can be up to eight to ten cells thick in someone with RA due to the swelling and thickening. Chronic inflammation from RA can cause:
- Loss of function in your fingers
- Wrists or other joints.
Leaky Gut And Rheumatoid Arthritis?
Scientists have a limited understanding of the processes that trigger RA, but new research suggests bacteria in your gut may influence the development of rheumatoid arthritis.
Trillions of microorganisms live in the human gut. Some are pathogens that can lead to disease, of course, but many others perform jobs beneficial to the human body. Friendly gut flora, known collectively as the microbiota, performs a number of tasks essential to good health, including:
- Helping your stomach and small intestine digest certain foods
- Aiding in the production of vitamins B and K
- Fighting off unhealthy microorganisms
- Maintaining the health of the innermost lining of the gastrointestinal tract
- Helping your immune system create a barrier between you and unfriendly pathogens
Now scientists think the microbiota plays a role in the development of rheumatoid arthritis. “There is more recognition that gut microbes play a bigger role in our health than we once thought,” explains Katherine Zeratsky, a registered dietician at Mayo Clinic. “All of the beneficial bacteria help keep the bad bacteria in check, and that’s good for your overall health.”
“There is an intimate relationship between [the gut microbiota] and disease,” explains Jeremy P. Burton, PhD, assistant professor at the Canadian Centre for Human Microbiome and Probiotics. “Whenever there is a chronic disease that impacts the intestinal tract, including [autoimmune types of] arthritis, there is the potential to treat it with probiotics.”
A team of researchers, led by an immunologist at Mayo Clinic’s Center for Individualized Medicine, published a pair of studies that connected the dots between RA and gut microbiota. Results from one study performed on RA patients, their relatives and a control group, found that an abundance of certain rare bacteria in rheumatoid arthritis patients. The researchers built on the results by performing mouse studies; they found an association between the microbe Collinsella and RA. The results suggest the presence of this bacterium may somehow trigger the autoimmune response leading to joint inflammation associated with RA.
Scientists could expand on what the researchers found in hopes that doctors could someday measure gut microbes to predict which patients will develop RA and how the disease will progress in patients with this joint disease.
In the second study, the same research team investigated the use of beneficial microbes as a safer, more effective treatment for RA. The scientists gave Prevotella histicola, a common supplement, to a test group of mice then compared that test group with the control group of mice that did not receive a supplement. The researchers found that mice who received beneficial bacteria supplement, also known as a probiotic, had fewer and less severe RA flare-ups. Probiotic treatment also produced fewer side effects, such as weight gain and poor absorption of nutrition in the gut, than traditional treatments.
Probiotics For Rheumatoid Arthritis Symptoms In Humans
Scientists perform mouse studies and other types of research to explain the mechanisms behind diseases like RA and their treatments. They need human studies to determine appropriate uses and dosages for RA treatments.
One human study demonstrates the effectiveness of probiotics in reducing joint pain in people suffering from Crohn’s disease and ulcerative colitis. These conditions are forms of inflammatory bowel disease, or IBD, a digestive condition that can cause joint pain. Researchers wanted to find out if probiotics would reduce joint pain so they enrolled 29 people into a trial. The subjects took two probiotic packets containing 450 billion viable lyophilized bacteria of three strains of Bifidobacterium, four strains of Lactobacillus, and one strain of Streptococcus salivarius subsp. Thermophilus each day for three months. After receiving these probiotics, the participants said their joint problems – and their general well-being – improved.
Doctors and nutrition specialists refer to doses of probiotics in terms of Colony Forming Units (CFU). One dose may contain 100 million CFU, which health professionals describe with the shorthand 10^8, 10(8) or 108 CFU. Doses containing 200 million CFU may be described as 2×10^8 CFU.
A study published in the professional journal Nutrition shows that probiotic supplementation can improve inflammation in patients with RA. Scientists enrolled 46 patients with RA into two groups. Participants in the test group took one capsule containing a minimum of 10(8) CFU of Lactobacillus casei 01 each day for eight weeks. Subjects in the control group took capsules filled with maltodextrin each day for the same length of time. All participants filled out questionnaires and underwent laboratory testing. Doctors weighed participants and measured body mass index (BMI), and a rheumatologist assessed the subjects at the beginning of the study and again at the end.
At the end of the 8-week study, the group that received probiotics showed marked improvement in inflammation symptoms and reduced markers in their blood samples as well.
Another study, published in the International Journal of Rheumatic Diseases, found that taking a probiotic supplement for eight weeks could have beneficial effects on disease activity scores and blood chemistry associated with RA, including blood insulin levels, serum high-sensitivity C-reactive protein (hs-CRP) concentrations and homeostatic model assessment-B cell function (HOMA-B). Subjects in the test group took a daily capsule containing 2 × 109 CFU Lactobacillus acidophilus, 2 × 109 CFU Lactobacillus casei, and 2 × 109 CFU Bifidobacterium bifidum for 8 weeks. Subjects in the placebo group took capsules containing cellulose for the same period.
The researchers took fasting blood samples and assessed participants at the beginning of the study and again at the end. Participants taking probiotic supplements showed improved disease activity scores, insulin levels, HOMA-B and hs-CRP levels.
The results of these studies support the theory that bacterial imbalances in the gut could cause RA, and that probiotic supplementation can correct these imbalances to improve signs and symptoms of rheumatoid arthritis.
So What Should You Do?
Share this information with your doctor for sure. If you want to use a probiotic supplement to help with your RA, choose one that has several types of good bacteria, in the right numbers. Remember that in studies, it seems that the best results take up to 8 weeks. And if you have serious food allergies that may have caused a “leaky gut and rheumatoid arthritis” situation, please use probiotics with care, in consultation with your medical practitioner. There are several other dietary supplements that can help support arthritis sufferers too. Empower yourself with the power of nature. Here’s to your great joint health!