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Rheumatoid arthritis

Rheumatoid arthritis is a chronic inflammatory joint disease that affects many joints. One of the suspected causes is the interaction of intestinal flora with a specific genetic predisposition.

Around 1% of the adult population suffers from rheumatoid arthritis (RA), with women affected more frequently than men.

An autoimmune disease that progresses in flares

RA is an autoimmune disease that develops in flares that cause persistent inflammation in the joints, primarily in the feet and hands. Swelling, pain, and stiffness of the joints are the primary symptoms. Without medical treatment, RA spreads to new joints and progressively deforms or even destroys them. 

A genetic predisposition paired with microbiota imbalance

Although there are genes for RA predisposition, they are not enough to cause the disease. They interact with environmental factors, among which the intestinal and buccal microbiota are increasingly being considered. Indeed, patients present microbial imbalances (dysbioses) very similar to those observed in patients affected by inflammatory bowel diseases and which diminish with treatment.

Probiotics as adjuvant therapy

No current treatment cures RA, but there are means of slowing its progression and relieving symptoms: pain medications, control therapy (immunosuppressors or biopharmaceuticals), rehabilitation (physical therapy, ergotherapy, balneotherapy, etc.). Probiotics have recently been used as supplemental therapy, which is considered a promising approach.

Sources:
Zhang X, Zhang D, Jia H, et al. The oral and gut microbiomes are perturbed in rheumatoid arthritis and partly normalized after treatment. Nat Med 2015 ; 21 : 895-905.
Schaeverbeke T, Truchetet ME, Richez C. Gut metagenome and spondyloarthritis. Joint Bone Spine 2013 ; 80 : 349-52.
Scher JU, Bretz WA, Abramson SB. Periodontal disease and subgingival microbiota as contributors for rheumatoid arthritis pathogenesis : modifiable risk factors? Curr Opin Rheumatol 2014 ; 26 : 424-9.
Breban M. Gut microbiota and inflammatory joint diseases. Joint Bone Spine. 2016;83(6):645-649.
Société Française de Rhumatologie. Les traitements de fond des rhumatismes inflammatoires. http://public.larhumatologie.fr/les-traitements-de-fond-des-rhumatismes-inflammatoires
Wang P, Tao JH, Pan HF. Probiotic bacteria: a viable adjuvant therapy for relieving symptoms of rheumatoid arthritis. Inflammopharmacology. 2016 Oct;24(5):189-196. Epub 2016 Aug 31.