There has been a significant increase in the incidence of autoimmune disorders over the past several decades. Most individuals have a less-than-perfect diet and over the years Americans have lost much of the diversity in their diet which plays an essential role in the gut microbiome and a contributing factor in the epidemic of autoimmune disorders. More and more research demonstrates that the food one eats affects what bacteria populations are in their gut.

A significant environmental trigger in autoimmune disease is the diet. Dietary approaches provide the most effective means to returning balance and dysfunction with the gastrointestinal system. 

According to a new review published 3 days ago in the Journal of Autoimmunity, researchers investigated the the role of the gut microbiome in pre-clinical rheumatoid arthritis.

Studies published over the past several years have demonstrated the correlation between gut microbiome and pre-clinical RA. The research on the microbiome in patients with RA suggests the presence of alterations in the gut microbiota and a potential link between RA development and intestinal dysbiosis. Recent clinical studies of pre-clinical RA individuals (including those with autoantibodies or genetic risk factors) showed that the dysbiosis occurs before the onset of RA.

The function of the intestinal barrier also plays a significant role in autoimmunity. An impaired intestinal barrier can increase intestinal permeability leading to a leaky gut. The disruption of intestinal barrier function and increased intestinal permeability were reported in RA patients, especially those with higher disease activity.

The most used approaches to treat RA include glucocorticoids, NSAIDs, and TNF-a inhibitors but these carry significant side effects.

Dietary supplements and prebiotics are commonly used by functional medicine practitioners and nutritionists for the support of RA by rebalancing the gut microbiota composition. Prophylactic treatment with dietary supplements and prebiotics can regulate T cell polarization, improve Treg and Th1/Th17 levels, reduce pro-inflammatory cytokine levels, and reduce the risk of RA. Probiotic supplementation can competitively inhibit the colonization of pathogenic Prevotella and suppress autoantibody production.

In addition to an anti-inflammatory or Mediterranean diet, other nutrients to consider include vitamin D, fish oil, resveratrol, curcumin, and probiotics.

Autoimmunity can occur a few different ways. It is also important to look at any environmental triggers such as food sensitivities, nutrient status, toxins, and gut health. Each person’s biochemical individuality exerts a major influence on his or her health. The level of nutrient intake, lifestyle choices and environmental exposures filtered through genetic predisposition are major factors in the expression of disease, and a successful treatment approach must investigate these factors.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Lin Liyan, Zhang K, et al. Gut microbiota in pre-clinical rheumatoid arthritis: From pathogenesis to preventing progression. J Autoimmun. 2023 Mar 15;103001. doi: 10.1016/j.jaut.2023.103001.

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