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. 2018 Sep 27;19(10):2938.
doi: 10.3390/ijms19102938.

Analysis of Gut Microbiota in Rheumatoid Arthritis Patients: Disease-Related Dysbiosis and Modifications Induced by Etanercept

Andrea Picchianti-Diamanti  1 , Concetta Panebianco  2 , Simonetta Salemi  3 , Maria Laura Sorgi  4 , Roberta Di Rosa  5 , Alessandro Tropea  6 , Mayla Sgrulletti  7 , Gerardo Salerno  8 , Fulvia Terracciano  9 , Raffaele D'Amelio  10 , Bruno Laganà  11 , Valerio Pazienza  12
Affiliations

Analysis of Gut Microbiota in Rheumatoid Arthritis Patients: Disease-Related Dysbiosis and Modifications Induced by Etanercept

Andrea Picchianti-Diamanti et al. Int J Mol Sci. .

Abstract

A certain number of studies were carried out to address the question of how dysbiosis could affect the onset and development of rheumatoid arthritis (RA), but little is known about the reciprocal influence between microbiota composition and immunosuppressive drugs, and how this interaction may have an impact on the clinical outcome. The aim of this study was to characterize the intestinal microbiota in a groups of RA patients treatment-naïve, under methotrexate, and/or etanercept (ETN). Correlations between the gut microbiota composition and validated immunological and clinical parameters of disease activity were also evaluated. In the current study, a 16S analysis was employed to explore the gut microbiota of 42 patients affected by RA and 10 healthy controls. Disease activity score on 28 joints (DAS-28), erythrocyte sedimentation rate, C-reactive protein, rheumatoid factor, anti-cyclic citrullinated peptides, and dietary and smoking habits were assessed. The composition of the gut microbiota in RA patients free of therapy is characterized by several abnormalities compared to healthy controls. Gut dysbiosis in RA patients is associated with different serological and clinical parameters; in particular, the phylum of Euryarchaeota was directly correlated to DAS and emerged as an independent risk factor. Patients under treatment with ETN present a partial restoration of a beneficial microbiota. The results of our study confirm that gut dysbiosis is a hallmark of the disease, and shows, for the first time, that the anti-tumor necrosis factor alpha (TNF-α) ETN is able to modify microbial communities, at least partially restoring a beneficial microbiota.

Keywords: anti-TNF-α; disease activity; etanercept; methotrexate; microbiota; rheumatoid arthritis.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Box plots of Shannon diversity index (A) and species richness (B) of microbiota of healthy controls and different treatment groups of rheumatoid arthritis (RA) patients. The triangle represents the median value.
Figure 2
Figure 2
Microbiota composition of healthy controls and different treatment groups of RA patients at the phylum (A), class (B), and order (C) levels. The mean value of the eight top taxonomic classifications at each level is represented.
Figure 3
Figure 3
Microbiota composition of healthy controls and different treatment groups of RA patients at the family (A), genus (B), and species (C) levels. The mean value of the eight top taxonomic classifications at each level is represented.
Figure 4
Figure 4
Association of gut microbiota profile with clinical pathological features in RA patients at the phylum (A), class (B), order (C), family (D), genus (E), and species (F) levels.
See this image and copyright information in PMC

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