Gut-Joint Axis in Rheumatic Diseases: Insights into Pathogenesis and Therapeutic Strategies

Rheumatoid arthritis (RA) is a chronic autoimmune condition that mostly affects the joints. It is believed that microbial infections play a contributing role in the development of RA. Individuals with preclinical and established RA have altered intestinal bacterial compositions, which imply that the gut microbiota plays a crucial part in the immune dysfunction that defines RA. Endotoxemia and a pro-inflammatory condition brought on by decreased gut integrity can exacerbate RA by triggering autoimmunity, which induces migration of autoreactive cells to joints, causing damage to the synovial membrane and joints. However, little is known about the exact pathways via which gut dysbiosis causes RA. A variety of RA treatment methods may change the diversity of the gut microbiota, indicating that RA prevention or treatment may benefit from gut microbiota modulation. This review gives an overview of the pathogenesis of RA due to gut dysbiosis and therapeutic strategies that may help to guide further research in this field.