Microbiome and Probiotics: Link to Arthritis

Mohamed K. Bedaiwi; Robert D. Inman


Curr Opin Rheumatol. 2014;26(4):410-415. 

In This Article

Abstract and Introduction


Purpose of review The gut microbiome plays an integral role in the development and maintenance of the host immune system. Expanding knowledge about this microbial microenvironment has raised the possibility of new treatments based on this knowledge. In this review, we describe the recent evidence of the impact of the gut microbiome on arthritis and possible novel therapeutic approaches to alter the gut flora.

Recent findings Recent studies support the growing evidence of microbiome as a causative agent underlying certain rheumatic diseases like ankylosing spondylitis and rheumatoid arthritis. There is intriguing yet still inconclusive evidence to support the use of probiotics as a treatment for these diseases.

Summary There is recently a new level of understanding how the microbiome interacts with the immune system. Gene–environment interaction is another important element that sets the stage for initiation of autoimmune disease, which calls for further investigation. Probiotics could be an appealing therapeutic strategy, but further interventional studies exploring the dynamic interaction of microbiome and probiotics are still needed.


Although most rheumatic diseases have a significant heritable component, predisposing genetic factors may require some environmental trigger to initiate the immunopathological events responsible for disease manifestation. A variety of investigations implicate a relationship between the gut microbiome and the development of certain rheumatic diseases. It is known that the microorganisms which populate the gastrointestinal tract profoundly influence the host immune system. However, despite intensive study of these organisms, there is as yet no definitive proof that bacteria play a causal role in rheumatoid arthritis (RA) or ankylosing spondylitis (AS). Yet, many studies of the microbiome have provided new understanding of the complexities of the host commensal microbiota.[1]

This article reviews the recent evidence for the potential role of microbiota in the pathogenesis of RA and AS, and addresses the possibility of therapeutic modulation of the gut microbiome.