Dr. Faria and Pr. Pimentel-Santos (Portugal winner 2020): Microbiota & spondyloarthritis and rheumatoid arthritis therapy
To celebrate #WorldMicrobiomeDay, the Biocodex Microbiota Institute is handing the floor to national grant winners.
About this article
Dr. Ana Faria & Pr. Fernando Pimentel-Santos
Dr. Ana Faria
Researcher and teacher in Nova Medical School. Her research interests are strategies for microbiota modulation with impact in health and disease, particularly as a putative predictor of disease outcome and therapeutic efficacy.
Pr. Fernando Pimentel-Santos
PI of the Rheumatic Diseases Lab and Professor of Rheumatology in NOVA Medical School. The identification of clinical, genetic, proteic and microbiota biomarkers for diagnosis and therapeutic purposes is the main topic of his research.
What has the national grant allowed to discover in your microbiota research area?
Spondyloarthritis (SpA) and Rheumatoid arthritis (RA) are among the most common chronic inflammatory rheumatic diseases and these diseases progression can lead to irreversible joint and bone damage. SpA and RA are major causes of functional disability, with severe impact in daily activities, in mental health and in patient’s quality of life. The introduction of biological disease-modifying antirheumatic drugs (bDMARDs), such as TNF inhibitors (TNFi) has started a new era in the treatment of SpA and RA, with remarkably efficacy. Neverthless, a significant percentage of patients develop severe adverse events or are still non responders or incomplete responders to these expensive treatments. Biocodex Microbiota Foundation grant allow us to characterize microbiota in patient starting bDMARDs and after 14 weeks. This represents the possibility to identify biomarkers at baseline contributing to the identification of patients with more potential to respond to TNFi therapy.
What are the consequences for the patient?
The identification of microbiota profiles before treatment that can be related to therapeutic efficacy of bDMARDs are crucial to guide therapeutic decision. Patients will benefit of a more precise treatment. In a near future we expect to promote corrective actions to directed microbiota and with these actions to improve bDMARDs therapeutic efficacy.
In your point of view, what is the biggest breakthrough related to microbiota these last years?
We can’t say it is the biggest breakthrough, but we find very interesting the hypothesis of dysbiotic microbiota being a transmissible factor. This hypothesis was raised in the paper published in Science in 20201, showing that dysbiotic microbiota fulfill Koch postulates and can be transmitted to other individuals, altering their microbiota and contributing to the susceptibility of disease and spread of noncommunicable disease.
Do you think there is a growing interest on microbiota recently?
Microbiota has gain attention in the last two decades because it has become evident that its role in the host goes beyond fermentation. The association of a modified, less abundant, less rich microbiota with disease brought up and motivated scientific studies that has imposed and highlighted microbiota’s importance, as in the case of the rheumatic diseases.
Do you have a tip for taking care of our microbiota?
The most know modifiable factor besides antibiotics is diet. So, a healthy dietary pattern such as Mediterranean diet can be an easy way to take care of our microbiota. There are also increasing evidence for the possibility to modulate microbiota which represent a fantastic therapeutic option.