Gut Microbiome Traits Linked With RA Improvement

Certain taxonomic and functional signatures of the gut microbiome are associated with clinically important improvement in patients with rheumatoid arthritis (RA), according to a study published online in Genome Medicine.

“Looking ahead, possible solutions to treat chronic autoimmune or inflammatory diseases could well involve modifying the gut microbiome to an ecological state primed to enhance clinical outcome,” wrote researchers from the Mayo Clinic and the University of Minnesota.

The study compared baseline gut microbiome compositions between 12 patients with RA who, over the course of a year, showed minimum clinically important improvement in disease activity and 20 patients who did not improve.

According to the study, the 2 groups of patients had significantly different microbiome traits. Researchers found higher levels of alpha-diversity, which is associated with good health, and beta-diversity in patients who achieved clinical improvement compared with patients who did not. They also identified several microbial taxa and 15 biochemical pathways that differed between the 2 groups.

Findings also showed significantly different fold-changes, from baseline to follow-up, in several microbial taxa and biochemical pathways between patient groups.

“These results could suggest that, depending on the clinical course, gut microbiomes not only start at different ecological states, but also are on separate trajectories,” researchers wrote.

Machine-learning technology was highly effective at predicting which patients achieved clinically important improvement, the authors noted.

“With further development, such prognostic biomarkers could identify patients who will achieve minimum clinically important improvement with a given therapy earlier on, thereby sparing them the expense and risk of other therapies that are less likely to be effective,” the authors wrote. “Conversely, such tools can detect patients whose disease symptoms are less likely to improve, and perhaps allow clinicians to target and monitor them more closely.”

—Jolynn Tumolo

Reference

Gupta VK, Cunningham KY, Hur B, et al. Gut microbial determinants of clinically important improvement in patients with rheumatoid arthritis. Genome Med. 2021;13(1):149.