Not just joints
To combat rheumatoid arthritis, it is necessary to treat the intestines
Scientists at University College London have found that damage to the intestinal mucosa plays an important role in the development of rheumatoid arthritis. Their discovery indicated a new way to treat this disease.
Rheumatoid arthritis refers to autoimmune diseases. Human lymphocytes begin to attack not the pathogens that have entered the body, but their own cells, which leads to inflammation. The interleukin-1 secreted by cells of the immune system activates osteoclasts – cells that should destroy bone tissue. They begin to destroy the part of the bone heads lying directly under the articular cartilage and feeding it. Gradually, a special type of tissue grows in the joint, destroying both the cartilage and the surface of the bone. As a result, a person's joints swell and hurt, then they deform, making it difficult to move. The exact causes of rheumatoid arthritis are unknown, but it is assumed that an important factor triggering the disease may be infection. Recent research in this area has focused on how bacteria in the intestine can participate in the development of arthritis, while scientists have suggested that the growth of the number of "bad" bacteria in the intestine may play a role in the occurrence of the disease.
"We wanted to find out what is happening in the intestine and whether changes in the intestinal mucosa, which usually acts as a barrier to protect the body from bacteria, are a sign of the disease and contribute to its development," says Professor Claudia Mauri, one of the lead authors of the current study.
Working with laboratory mice and samples obtained from patients, the scientists found that markers of intestinal damage in the blood increased compared to healthy people even at the earliest stages of rheumatoid arthritis, and that these markers became higher as the disease progressed. Scientists have found that damage to the mucous membrane allows bacteria to penetrate from the intestinal cavity into the body.
Figure from the press release Targeting the gut to relieve rheumatoid arthritis – VM.
"Our results show that the intestinal mucosa is a therapeutic target. It is important to note that we have found that the use of existing drugs that restore the integrity of the intestinal barrier, that is, prevent the movement of inflammatory cells into the intestine and back, reduces the severity of arthritis in preclinical models, says Professor Mauri. – Modern methods of treating rheumatoid arthritis do not seem to eliminate problems in the intestine and therefore may make the patient susceptible to reactivation of the disease due to ongoing inflammation in this area. In the future, we need to evaluate the therapeutic effects of bowel treatment in patients with rheumatoid arthritis in addition to the treatment of their joints. Maintaining gut health through diet and pharmacological intervention may be a valuable new strategy."
The study was published in the journal Med (Matei et al., Intestinal barrier dysfunction plays an integral role in arthritis pathology and can be targeted to ameliorate disease).
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