Harnessing the Microbiome: A Comprehensive Review on Advancing Therapeutic Strategies for Rheumatic Diseases

Abstract

Rheumatic diseases are a group of disorders that affect the joints, muscles, and bones. These diseases, such as rheumatoid arthritis, lupus, and psoriatic arthritis, can cause pain, stiffness, and swelling, leading to reduced mobility and disability. Recent studies have identified the microbiome, the diverse community of microorganisms that live in and on the human body, as a potential factor in the development and progression of rheumatic diseases. Harnessing the microbiome offers a promising new avenue for developing therapeutic strategies for these debilitating conditions. There is growing interest in the role of oral and gut microbiomes in the management of rheumatoid arthritis and other autoimmune disease. Microbial metabolites have immunomodulatory properties that could be exploited for rheumatic disorders. A wide range of microorganisms are present in the oral cavity and are found to be vulnerable to the effects of the environment. The physiology and ecology of the microbiota become intimately connected with those of the host, and they critically influence the promotion of health or progression toward disease. This article aims to provide a comprehensive overview of the current state of knowledge on oral and gut microbiome and its potential future role in the management of rheumatic diseases. This article will also discuss newer treatment strategies such as bioinformatic analyses and fecal transplantation.

Keywords: autoimmune connective tissue disease; autoimmune rheumatic diseases; future therapeutic strategies; human microbiome; intestinal microbiome.

Figure 1. Graphical description of the possible mechanism of Gram-negative anaerobic bacillus Porphyromonas gingivalis for triggering autoimmune diseases

Image credit: Reproduced with permission from Huang et al. [27]. ACPAs: Anti-citrullinated protein antibodies; PADs: Peptidylarginine deiminases; PDC-E2: Pyruvate dehydrogenase complex E2; IBD: Inflammatory bowel disease; RA: Rheumatoid arthritis.

Figure 2. Treatment strategy for balancing oral microbiota to prevent autoimmune diseases

Image credit: Reproduced with permission from Huang et al. [27]. SCFA: Short-chain fatty acids; OMT: Oral microbiota transplantation.