Microbiome can influence autoimmune diseases such as rheumatoid arthritis, IBD
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ORLANDO — Altered gut flora has the potential to impact autoimmune diseases such as rheumatoid arthritis and inflammatory bowel disease, noted a speaker at the 2022 Rheumatology Nurses Society Conference.
“As far as autoimmune diseases go, I will just say that the literature is a little bit more fruitful with inflammatory bowel disease, as well as rheumatoid arthritis,” Kamrin Macki, NP, of the gastroenterology and hepatology group at Altru Health Systems, in North Dakota, told attendees. “But there are a lot of other autoimmune diseases that they are now researching as well.”
Macki described the way in which altered gut flora, or dysbiosis, can have a triggering effect on various autoimmune diseases, and described a “tight barrier junction” present on the intestinal mucosal cells.
Potential triggers for loosening cells in the tight junction include stress, toxins, pathogens, food particles, drugs and various infections, Macki said.
“As things alter our gut flora, those junction proteins allow our epithelial cells to separate,” she said. “As they separate, those pathogens then can seep downward.”
The resulting events can result in inflammatory responses, Macki said.
“With autoimmune diseases, that defect in gastrointestinal permeability leads to T- and B-cell activations and the expression of cytokines, interferons, the anti-TNFs, the interleukins, all of which are producing inflammation,” Macki said.
Using drugs such as TNF inhibitors and interleukin inhibitors not only lessens symptoms in patients with autoimmune diseases, but also disrupts natural processes occurring in the body, which can make people more susceptible to various infections and complications.
Prevotella copri is present in roughly 75% of patients with new RA, according to Macki. Although that bacterium is commonly found in the gut, patients with RA exhibit higher levels of bacteria activity.
To promote healthy and functional gut microbiomes, Macki suggested pre- and probiotics. Prebiotics, found in foods such as oatmeal, wheat, rue, leafy greens, legumes and many more, are nondigestible and promote fermentation, production of short-chain fatty acids and mineral absorption, Macki said. Probiotics can strengthen the immune system and increase efficiency of vitamin and mineral absorption, she said.
“What can we do to improve out gut health?” Macki said. “The biggest thing is to change your diet.”
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Macki K. What in the gut? How bacteria, fungi, and viruses are tied to autoimmune diseases. Presented at: Rheumatology Nurses Society annual conference; August 3-6, 2022 (virtual meeting).
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