Altered gut microbiota in patients with early rheumatoid arthritis

Background The pathophysiology of rheumatoid arthritis (RA) is complex and not fully elucidated, involving interactions among genetic, environmental, and immunological factors. Emerging evidence suggests a potential role of gut microbiota in RA pathogenesis. Aim of the work To assess alterations in the fecal abundance of selected gut microbiota: Collinsella, Eggerthella, Faecalibacterium, Lactobacillus, Bifidobacterium, Bacteroides, Prevotella, and Atopobium in patients with RA, and to evaluate their association with RA-related autoantibodies and disease activity. Patients and methods The study included 30 patients with early RA and 20 healthy first-degree relatives as controls. Stool samples were collected for quantitative analysis of gut microbiota using real-time polymerase chain reaction (PCR). Laboratory assessments in RA patients included erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF), and anti-cyclic citrullinated peptide (anti-CCP) antibodies. Disease activity was evaluated using the disease activity score (DAS28). Results The mean age of RA patients was 49.27 ± 13.48 years. The female-to-male ratio was 4:1. RA patients showed a significant increase in the fecal abundance of Collinsella and Lactobacillus ( p < 0.001) and Atopobium ( p = 0.031) compared to controls. No significant associations were found between alterations in the gut microbiota and RA autoantibody levels (RF, anti-CCP) or disease activity (DAS28). Conclusion Alterations in gut microbiota composition may contribute to the pathogenesis of RA; however, their relationship with disease activity and serological markers appears limited.