Rheumatoid Arthritis should be prevented by improving gut microbiota (Vitamin D, probiotics, etc.) – March 2023

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Gut microbiota in pre-clinical rheumatoid arthritis: From pathogenesis to preventing progression

Journal of Autoimmunity 15 March 2023, 103001 https://doi.org/10.1016/j.jaut.2023.103001
Liyan Lin a, Keyi Zhang a, Qiao Xiong b, Junlong Zhang a, Bei Cai a, Zhuochun Huang a, Bin Yang a, Bin Wei a, Jie Chen a, Qian Niu a

Highlights

• Pre-clinical RA stage is the window of opportunity in RA treatment.
• Gut microbiota alteration may promote immune system dysfunction and joint damage.
• Balancing gut microbiota may restore immune system dysfunction.
• Combination therapy target on microbiota need to be developed.
• Microbiota based intervention is promising in prevent RA development.

PDF Table of Contents

Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by progressive polyarthritis that leads to cartilage and bone damage. Pre-clinical RA is a prolonged state before clinical arthritis and RA develop, in which autoantibodies (antibodies against citrullinated proteins, rheumatoid factors) can be present due to the breakdown of immunologic self-tolerance. As early treatment initiation before the onset of polyarthritis may achieve sustained remission, optimize clinical outcomes, and even prevent RA progression, the pre-clinical RA stage is showing the prospect to be the window of opportunity for RA treatment.

Growing evidence has shown the role of the gut microbiota in inducing systemic inflammation and polyarthritis via multiple mechanisms, which may involve molecular mimicry, impaired intestinal barrier function, gut microbiota-derived metabolites mediated immune regulation, modulation of the gut microbiota's effect on immune cells, intestinal epithelial cells autophagy, and the interaction between the microbiome and human leukocyte antigen alleles as well as microRNAs.

Since gut microbiota alterations in pre-clinical RA have been reported, potential therapies for modifying the gut microbiota in pre-clinical RA, including natural products, antibiotic therapy, fecal microbiota transplantation, probiotics, microRNAs therapy, vitamin D supplementation, autophagy inducer-based treatment, prebiotics, and diet, holds great promise for the successful treatment and even prevention of RA via altering ongoing inflammation.

In this review, we summarized current studies that include pathogenesis of gut microbiota in RA progression and promising therapeutic strategies to provide novel ideas for the management of pre-clinical RA and possibly preventing arthritis progression.

 Download the PDF from VitaminDWiki

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VitaminDWiki – Rheumatoid Arthritis category contains

111 RA items     See also Overview Rheumatoid Arthritis   Autoimmune  Inflammation   Pain - Chronic

    Highlights of RA studies in VitaminDWiki
RA worse if low Vitamin D

• Rheumatoid arthritis pain was 5.8 X more likely if low vitamin D – Aug 2017
• Adaptive and innate immune system, vitamin D genes, and Rheumatoid Arthritis – June 2019
• Every patient with rheumatoid arthritis had low vitamin D, severity was proportional to degree of deficiency – June 2014
• Active Rheumatologic disease was 5X more likely with low vitamin D – June 2013
• Rheumatoid Arthritis strongly associated with low vitamin D – meta-analysis April 2016
• Rheumatoid Arthritis associated with lower vitamin D and higher latitude – meta-analysis Jan 2016

RA and Vitamin D Receptor (auto-updated)

RA Treated by Vitamin D

• Rheumatoid Arthritis pain reduced by monthly 100,000 IU of Vitamin D – Oct 2018
• Rheumatoid arthritis reduced by 440,000 IU of Vitamin D over 4 months – Oct 2015
• Connective tissue disorders (Lupus, RA, etc) treated by vitamin D – May 2016
• 43 percent of Rheumatoid Arthritis patients have Vitamin D prescriptions (15 countries) – June 2017
• Big increase in vitamin D supplementation in just 2 years after Swiss rheumatology report – Dec 2013
• High dose vitamin reduced pain of fibromyalgia, osteoarthritis, and rheumatoid arthritis - July 2015
  • Note: Vitamin D receptor problems (such as RA) are best treated by infrequent large doses of Vitamin D

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7 Meta-analyses of Rheumatoid Arthritis and Vitamin D

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52,000+ studies include "rheumatoid arthritis" and microbiota (both gut and oral)

[https://scholar.google.com/scholar?q=rheumatoid+arthritis%22+microbiota&hl=en&as_sdt=0,48|Google Scholar

• Role of Gut Microbiota in Rheumatoid Arthritis - June 2017 FREE PDF
• Host–microbiota interactions in rheumatoid arthritis - Dec 2019 FREE PDF
• Associations between gut microbiota and genetic risk for rheumatoid arthritis in the absence of disease: a cross-sectional study - July 2020 FREE PDF

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VitaminDWiki Vitamin D is aided by probiotics (review of RCTs) – Dec 2020