Gut microbiota-immune axis in the regulation of rheumatoid arthritis: from mechanism to precision probiotic strategies

Aug 29, 2025Modern rheumatology

How gut bacteria and the immune system may influence rheumatoid arthritis and guide targeted probiotic treatments

AI simplified

Gut-Brain Axis on OpenScience ↗PubMed ↗DOI ↗

Abstract

Rheumatoid Arthritis (RA) is associated with gut dysbiosis characterized by increased pro-inflammatory bacteria and decreased anti-inflammatory species.

Gut dysbiosis disrupts immune balance, leading to increased levels of inflammation and joint damage in RA.
The imbalance in gut microbiota is linked to mechanisms such as immune system disruption and weakened gut barrier function.
Probiotics may offer therapeutic benefits by restoring gut microbiota composition and enhancing immune regulation.
Efficacy of probiotics varies based on individual factors like genetics and existing gut microbiota composition.
Combining multi-omics approaches with targeted probiotic strategies may facilitate the development of personalized treatments for RA.
Current challenges include the complexity of gut-immune interactions and the need for further clinical validation.

AI simplified

Rheumatoid Arthritis (RA) is a progressive autoimmune disorder with substantial global health and economic impacts. Despite advancements in conventional therapies, biologics, and targeted drugs, challenges such as adverse effects, cost, and interindividual heterogeneity underscore the need for safer, precision-based treatments. Notably, emerging evidence highlights the pivotal role of the gut microbiota-immune axis in RA pathogenesis. Affected individuals typically exhibit gut dysbiosis, marked by increased pro-inflammatory taxa and reduced anti-inflammatory species, which disrupts immune homeostasis through Th17/Treg imbalance, molecular mimicry, and compromised gut barrier integrity. These processes drive systemic inflammation, exacerbating both articular destruction and extra-articular manifestations. Probiotics demonstrate therapeutic potential by modulating this axis via microbiota restoration, barrier reinforcement, and immune regulation. Strain-specific effects have been documented in both preclinical and clinical studies, although efficacy varies depending on host genetics, baseline microbiota composition, and intervention protocols-a variability underscoring the need for personalized probiotic selection. This review consolidates current knowledge on gut microbiota-immune crosstalk in RA and explores probiotics as precision therapeutics. Integrating multi-omics (metagenomics, metabolomics) with targeted probiotic strategies could enable the development of personalized interventions. While translational obstacles persist, including mechanistic complexity and limited clinical validation, the gut microbiota-immune axis offers a novel paradigm for RA management. Future priorities include large-scale trials, biomarker discovery, and combinatorial approaches to advancing microbiome-guided precision medicine in autoimmune diseases.

Full Text

Full text is available at the source.

View full text (PDF) ↗View full text ↗

Gut microbiota-immune axis in the regulation of rheumatoid arthritis: from mechanism to precision probiotic strategies

Abstract

Full Text

You found one interesting study. We’ll send the next 7.

what lands in your inbox each week:

Recent issues from the gut-brain axis brief

Abstract

Full Text

Related papers

You found one interesting study. We’ll send the next 7.

what lands in your inbox each week:

Recent issues from the gut-brain axis brief