Gut Microbiome Profile Could Help Predict Patient’s Rheumatoid Arthritis Prognosis

Part of an important indicator of whether a patient with rheumatoid arthritis will improve over the course of the disease may lie in their gut, according to a new study from the Mayo Clinic Center for Individualized Medicine.

The study, published in Genome medicine, discovered that it was possible to predict a patient’s future prognosis for rheumatoid arthritis by focusing on the trillions of bacteria, viruses, and fungi that inhabit their gastrointestinal tract, known as the gut microbiome . The results suggest that gut microbes and the course of rheumatoid arthritis in a patient are related.

This is the first study to date that uses data from the gut microbiome to predict clinical improvement in rheumatoid arthritis activity regardless of the initial measurement of their condition or previous treatment. “

Jaeyun Sung, Ph.D., computational biologist at the Mayo Clinic Center for Individualized Medicine and study co-lead author

Rheumatoid arthritis is a chronic disease characterized by inflammation and pain in the joints that can eventually lead to erosion of bones and cartilage, joint deformity, and loss of mobility. This complex disease affects nearly 1.3 million people in the United States

Focus on the microbiome

For the study, the team performed comprehensive, precision genomic analysis, called “shotgun metagenomic sequencing,” on stool samples from 32 rheumatoid arthritis patients during two separate clinical visits. The team studied the link between the gut microbiome and the smallest significant changes in clinical disease activity. The team discovered several traits of the gut microbiome related to future prognosis.

“By examining the basic gut microbiome profiles of patients, we observed significantly different microbiome traits between patients who ultimately showed improvement and those who did not,” says John M. Davis III, MD , clinical rheumatologist at the Mayo Clinic with a specialization interest in inflammatory arthritis. Dr Davis is the co-lead author of the study.

“What was surprising was that our data suggested that depending on the possible clinical outcome, the gut microbiomes not only start in different ecological states, but also grow and develop differently,” adds Dr Sung.

Then, using deep learning artificial intelligence (AI), the researchers examined whether they could predict whether a patient was achieving clinical improvement. Overall, the predictive performance resulted in 90% accuracy, demonstrating the proof of concept that integrating the gut microbiome and AI technology could theoretically be a way to predict the course of the disease. disease in rheumatoid arthritis.

Path to treatment

“With further developments, such prognostic biomarkers could identify patients who will achieve early clinical improvement with a given therapy, thus sparing them the expense and risk of other therapies less likely to be effective,” says Dr. Davis. “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. Much remains to be done, but we are well on the way to advancing our understanding of this issue. disease in order to individualize the medicine of patients with rheumatoid arthritis.

Scientists have suspected for some time that the gut microbiome plays a role in rheumatoid arthritis, as well as many other inflammatory and autoimmune diseases. The huge population of microbes helps digest food, regulate the immune system, and protect against pathogenic bacteria.

Researchers point out that each person’s microbiome is unique and consists of a complex mix of genetic, dietary, and environmental influences. These differences highlight the reasons why symptoms vary widely in patients with rheumatoid arthritis, which makes it so difficult to treat and predict clinical outcomes.

The study is the second recent survey into rheumatoid arthritis conducted by Drs. Sung and Davis, emphasizing the essential partnership between computational biologists and clinicians in solving complex problems in medicine. Together, they are on the path to developing a suite of new data-driven tools to aid in the early detection, diagnosis, prognosis and treatment of rheumatoid arthritis. As such, the researchers plan to explore ways to translate their findings into new biomarkers and therapies.

“Ultimately, our study reveals that altering the gut microbiome to improve clinical outcomes may hold promise as a future treatment for rheumatoid arthritis,” said Dr. Sung. “It could revolutionize the way we care for our patients.”