In a new study from UCL, researchers found that damage to the lining of the gut plays an important role in the development of rheumatoid arthritis, paving the way for a new approach to treating the disease.
They used mouse models and patient samples and found that restoration of the gut barrier could offer a new treatment to reduce the severity of Rheumatoid arthritis (RA) symptoms.
Rheumatoid arthritis is a chronic disease that causes joint pain, swelling, and inflammation.
Despite the understanding of some of the genetic and environmental factors that might be involved in the development of arthritis, scientists still do not completely understand what initiates disease and how it accelerates.
In the study, the team examined how the bacteria in the gut might be involved in the development of arthritis, and they suggest that the growth of ‘bad’ bacteria in the gut might play a part in initiating the disease.
They found that blood markers of gut damage were raised compared to healthy people even at the earliest stages of arthritis and that these markers of damage got higher the more the disease progressed; and, unexpectedly, there were distinct signs of inflammation, as might be seen in inflammatory bowel disease.
The team also showed that the lining of the gut became ‘leaky,’ potentially allowing the passage of bacteria to cross the gut lining into the body, enhancing inflammation both in the gut and potentially in the joints.
These findings suggest that the intestinal lining is a therapeutic target.
Importantly, the team found that using existing drugs that restore the gut-barrier integrity i.e., prevent the gut from becoming leaky or inhibit inflammatory cells from moving to and from the gut, could reduce the severity of arthritis.
The team says current treatments for rheumatoid arthritis don’t appear to correct the problems in the gut and so may leave the patient susceptible to reactivation of disease from the continuing inflammation in that area.
Going forward, scientists need to evaluate the therapeutic impact of treating the intestinal lining of rheumatoid arthritis patients in addition to their joints.
Maintaining gut health both through diet and pharmacological intervention may be a valuable new strategy.
For more information about gut diseases, please see recent studies about causes and treatments of common gut pain, gassiness, bloating and results showing that this type of gut bacteria may cause bowel cancer.
The study is published in Med. One author of the study is Professor Claudia Mauri.
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