Annemarie Schorpion1, Sharon L Kolasinski2. 1. Division of Rheumatology, University of Pennsylvania Perelman School of Medicine , Penn Musculoskeletal Center, 3737 Market Street, Philadelphia, PA, 19104, USA. 2. Division of Rheumatology, University of Pennsylvania Perelman School of Medicine , Penn Musculoskeletal Center, 3737 Market Street, Philadelphia, PA, 19104, USA. Sharon.kolasinski@uphs.upenn.edu.
Abstract
PURPOSE OF REVIEW: The purpose of this review is to frame the discussion of the potential use of probiotics for the management of rheumatoid arthritis (RA) in the historical and scientific context linking the human microbiota to the etiology, pathogenesis, and treatment of RA. Given this context, the review then details the clinical trials that have been carried out so far that have tried to address the question. RECENT FINDINGS: A variety of laboratory and clinical observations link the flora of the oral cavity and lower gastrointestinal tract with citrullination, as well as immunological alterations that may contribute to the risk of developing RA. Clinical trials to date have been small and mostly short term. Statistically significant change in certain disparate clinical endpoints has been reported, but these endpoints have varied from study to study and have been of limited clinical significance. No consistent, robust impact on patient reported, or laboratory outcome measures has emerged from clinical trials so far. There remain theoretical reasons to further investigate the use of probiotics as adjunctive therapies for autoimmune disease, but changes in trial design may be needed to reveal the benefit of this intervention.
PURPOSE OF REVIEW: The purpose of this review is to frame the discussion of the potential use of probiotics for the management of rheumatoid arthritis (RA) in the historical and scientific context linking the human microbiota to the etiology, pathogenesis, and treatment of RA. Given this context, the review then details the clinical trials that have been carried out so far that have tried to address the question. RECENT FINDINGS: A variety of laboratory and clinical observations link the flora of the oral cavity and lower gastrointestinal tract with citrullination, as well as immunological alterations that may contribute to the risk of developing RA. Clinical trials to date have been small and mostly short term. Statistically significant change in certain disparate clinical endpoints has been reported, but these endpoints have varied from study to study and have been of limited clinical significance. No consistent, robust impact on patient reported, or laboratory outcome measures has emerged from clinical trials so far. There remain theoretical reasons to further investigate the use of probiotics as adjunctive therapies for autoimmune disease, but changes in trial design may be needed to reveal the benefit of this intervention.
Entities:
Keywords:
Citrullination; Dysbiosis; Human microbiome; Lactobacillus; Porphyromonas; Probiotic; Rheumatoid arthritis
Authors: Steven R Gill; Mihai Pop; Robert T Deboy; Paul B Eckburg; Peter J Turnbaugh; Buck S Samuel; Jeffrey I Gordon; David A Relman; Claire M Fraser-Liggett; Karen E Nelson Journal: Science Date: 2006-06-02 Impact factor: 47.728
Authors: Désirée van der Heijde; Edward C Keystone; Jeffrey R Curtis; Robert B Landewé; Michael H Schiff; Dinesh Khanna; Tore K Kvien; Lucian Ionescu; Leon M Gervitz; Owen R Davies; Kristel Luijtens; Daniel E Furst Journal: J Rheumatol Date: 2012-05-15 Impact factor: 4.666
Authors: Ali Akgul; Massimo Maddaloni; Sang Mu Jun; Andrew S Nelson; Vanessa Aguilera Odreman; Carol Hoffman; Ella Bhagyaraj; Alexandria Voigt; Jeffrey R Abbott; Cuong Q Nguyen; David W Pascual Journal: Arthritis Res Ther Date: 2021-04-06 Impact factor: 5.156