An overview of the role of diet in the treatment of rheumatoid arthritis

O’Connor, Á.

doi:10.1111/nbu.12041

Cited by 8 publications

(5 citation statements)

References 80 publications

(133 reference statements)

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“…Vitamin B6 plays a role in the maintenance of vitamin homeostasis in colonocytes 42 43. It has been found to modulate colonic inflammation and several studies that have investigated the role of vitamin B6 for the treatment of inflammation in patients with RA 44–49. Evidence from case-control studies show that patients with RA have low vitamin B6 status compared with healthy controls, however, intervention studies have yielded inconsistent findings, possibly due to the dose of the administered vitamin B6.…”

Section: Discussionmentioning

confidence: 99%

Shotgun metagenomics reveals an enrichment of potentially cross-reactive bacterial epitopes in ankylosing spondylitis patients, as well as the effects of TNFi therapy upon microbiome composition

Yin

Sternes²,

Wang

et al. 2020

Annals of the Rheumatic Diseases

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ObjectivesDiverse evidence including clinical, genetic and microbiome studies support a major role of the gut microbiome in the common immune-mediated arthropathy, ankylosing spondylitis (AS). We set out to (1) further define the key microbial characteristics driving disease, and (2) examine the effects of tumour necrosis factor-inhibitor (TNFi) therapy upon the microbiome.MethodsThe stools from a case–control cohort of 250 Han-Chinese subjects underwent shotgun metagenomic sequencing. All subjects were genotyped using the Illumina CoreExome SNP microarray.ResultsPrevious reports of gut dysbiosis in AS were reconfirmed and several notable bacterial species and functional categories were differentially abundant. TNFi therapy was correlated with a restoration the perturbed microbiome observed in untreated AS cases to that of healthy controls, including several important bacterial species that have been previously associated with AS and other related diseases. Enrichment of bacterial peptides homologous to HLA-B27-presented epitopes was observed in the stools of patients with AS, suggesting that either HLA-B27 fails to clear these or that they are involved in driving HLA-B27-associated immune reactions. TNFi therapy largely restored the perturbed microbiome observed in untreated AS cases to that of healthy controls, including several important bacterial species that have been previously associated with AS and other related diseases. TNFi therapy of patients with AS was also associated with a reduction of potentially arthritogenic bacterial peptides, relative to untreated patients.ConclusionThese findings emphasise the key role that the gut microbiome plays in driving the pathogenesis of AS and highlight potential therapeutic and/or preventative targets.

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Section: Discussionmentioning

confidence: 99%

Shotgun metagenomics reveals an enrichment of potentially cross-reactive bacterial epitopes in ankylosing spondylitis patients, as well as the effects of TNFi therapy upon microbiome composition

Yin

Sternes²,

Wang

et al. 2020

Annals of the Rheumatic Diseases

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“…The elimination diet is a diet that purposefully avoids particular nutrients found to be associated with certain symptoms in a disease. It is generally based on the idea that removing a food from the diet should result in some improvement if it ever plays a role in the pathogenesis of the disease (8,23). After a few weeks of deprivation, restricted nutrients are reintroduced to the patients gradually to determine if any of them has an aggravating effect on the RA.…”

Section: Dietary Approaches In Ramentioning

confidence: 99%

An Evaluation of Dietary Approaches Used in the Clinical Management of Rheumatoid Arthritis

DENGİZEK>

Yeşilkaya

2023

Kocatepe Tıp Dergisi

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Rheumatoid arthritis (RA) is a chronic autoimmune disorder characterized by systemic inflammation, persistent synovitis, and other comorbidities, that affects 0.5-1.0% of the overall population. Long-term active RA causes severe joint damage, disabling pain and diminished life quality. The etiology of RA is not accurately understood, but it is thought to be due to an interaction between the responses of the innate and acquired immune systems. RA is characterized by the presence of Rheumatoid Factor (RF) and anti citrullinated peptide antibodies in the blood circulation. Also the composition of intestinal the gut microbiome is claimed to be critical in immune responses associated with RA. Changes in the microbiota are thought to be related to the risk and severity of the disease. Three regions; primarily the lungs, oral mucosa and gastrointestinal tract have been associated with changes in the microbiota. Commonly, the pharmaceutical treatment of RA includes non-steroidal anti-inflammatory drugs (NSAIDs) that are used to manage the pain and inflammation associated with RA and disease-modifying anti-rheumatic drugs that reduces pain by slowing down the disease. Unfortunately, remission is not likely in many patients. Moreover, side effects related to drugs are commonly reported. Some alterations in the patients’ life and environment are thought to aggravate symptoms, thus influencing severity of RA. For example RA patients, the participants asserted that consumption of red meat, alcoholic and non-alcoholic beverages worsen their symptoms, while nutrients such as fish and blueberries help alleviate the symptoms. To manage the adverse effects of RA, particular dietary alterations are suggested to be effective in reducing inflammation, increasing antioxidant levels, and improving lipid profiles. Antigenic load and food intolerance are thought to play a role in both the onset of Rheumatoid Arthritis. Besides, it has been shown that the intestinal mucosa of the patients would have become more permeable to allergens due to long term NSAIDs use. In this sense, Elimination Diet, Mediterranean Diet, Vegan/Vegetarian Diet approach, Omega-3 Fatty acids, Vitamin D and probiotic supplementation is thought to reduce disease activity. The purpose of this review is to evaluate the efficiency of certain dietary approaches and supplements used for lessening the RA related symptoms, based on the scientific evidence found in the literature.

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“…Low vitamin D levels have been implicated in a number of chronic diseases (such as the metabolic syndrome and diabetes etc.) including RA [59].…”

Section: Vitamin Dmentioning

confidence: 99%

Micronutrients Deficiencies in Rheumatoid Arthritis Patients

Silva

Reis²,

Cozzolino³

2016

Int J Pathol Clin Res

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Rheumatoid arthritis (RA) is a chronic inflammatory disease that predominantly involves synovial joints and affects up to2% of adults worldwide. Poor nutrient status in RA patients has been reported and some drug therapies, such as nonsteroidal anti-inflammatory drugs (NSAIDs), prescribed to alleviate RA symptoms, may increase the requirement for some nutrients and reduce their absorption. The importance of micronutrients in this disease is related to their cofactor role in immune system functions and in different metabolic processes in articular tissues. Dietary interventions can assist with the management of disease symptoms that accompany RA, such as pain, tender swollen joints, stiffness, and associated disability and disease progression. This paper reviews the scientific evidence for the role of diet and nutrient supplementation in the management of RA, by alleviating symptoms or decreasing progression of the disease.

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An overview of the role of diet in the treatment of rheumatoid arthritis

Cited by 8 publications

References 80 publications

Shotgun metagenomics reveals an enrichment of potentially cross-reactive bacterial epitopes in ankylosing spondylitis patients, as well as the effects of TNFi therapy upon microbiome composition

Shotgun metagenomics reveals an enrichment of potentially cross-reactive bacterial epitopes in ankylosing spondylitis patients, as well as the effects of TNFi therapy upon microbiome composition

An Evaluation of Dietary Approaches Used in the Clinical Management of Rheumatoid Arthritis

Micronutrients Deficiencies in Rheumatoid Arthritis Patients

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