Microbiota and osteoarthritis: the role of intestinal microbiota in the development of osteoarthritis - Microbiota Care
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Introduction

The study of gut microbiota and its impact on human health is a rapidly expanding area of research. The 'intestine-articulation' axis, which explores the relationship between the intestinal microbiota and joint pathologies such as osteoarthritis, is attracting growing interest within the scientific community. In this article, we will examine the mechanisms by which intestinal dysbiosis can influence the development of osteoarthritis, as well as the therapeutic prospects linked to the intestinal microbiota.

Mechanisms of influence of the intestinal microbiota on osteoarthritis

Systemic inflammation

Intestinal dysbiosis can lead to increased intestinal permeability, allowing bacteria and their by-products to enter the bloodstream. This bacterial translocation activates the immune system and leads to systemic inflammation, which can contribute to the development of osteoarthritis. The pro-inflammatory molecules released during this reaction can directly or indirectly affect joint tissues, causing progressive degradation of cartilage and chronic inflammation of the joints.

Metabolic syndrome

The intestinal microbiota plays a key role in nutrient metabolism and can directly influence the development of metabolic syndrome, characterised by obesity, high blood pressure and insulin resistance. This syndrome is a major risk factor in the development of osteoarthritis. Excess body fat can exert mechanical pressure on the joints, while adipokines (proteins secreted by fat cells) can modulate inflammation and the immune response.

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Obesity

The composition of the intestinal microbiota can favour the storage of fat or, on the contrary, its use as a source of energy. Intestinal dysbiosis can therefore contribute to obesity, another major risk factor for the onset and progression of osteoarthritis. Studies have shown that certain intestinal bacteria are capable of breaking down dietary fibre into short-chain fatty acids (SCFAs), which have beneficial effects on body weight regulation and insulin sensitivity.

Studies in mice and humans

Studies in mice have shown that specific alterations in the microbiota can induce local inflammatory changes that can affect joints. For example, an increase in the number of pro-inflammatory bacteria such as Prevotella copri was associated with a worsening of arthritic symptoms in a mouse model of collagen-induced arthritis.

In humans, some studies have identified indirect markers of microbiota associated with an increased risk of osteoarthritis. A recent meta-analysis revealed that patients with rheumatoid arthritis have a different composition of intestinal microbiota compared with healthy controls, with an increase in certain potentially pathogenic bacterial species and a decrease in those with anti-inflammatory properties.

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Therapeutic perspectives linked to the intestinal microbiota

The use of probiotics or prebiotics to restore or maintain a favourable balance in the microbiota could be a promising therapeutic approach for preventing or effectively treating osteoarthritis. Further research is needed to better understand how to specifically target the intestinal microbiota in this context.

Clinical trials exploring the efficacy of probiotics and prebiotics in the treatment of rheumatoid arthritis have shown encouraging results, with significant improvements in clinical and biological parameters in patients receiving these interventions. However, it is important to emphasise that modulating the intestinal microbiota is only one part of an overall strategy aimed at addressing the multiple factors involved in the development and progression of osteoarthritis.

Methods of studying microbiota and their importance for human health

  • Modern methods for studying the microbiome allow in-depth analysis of its taxonomic composition and metabolic functions. These techniques include high-throughput sequencing of 16S ribosomal RNA and metagenomics.
  • The microbiota influences various physiological processes such as food digestion, vitamin synthesis, immune maturation, etc., underlining its crucial importance for our overall health.
  • Its dysbiosis has been associated not only with gastrointestinal diseases but also with various extra-intestinal pathologies, some of which affect the joints, as described above with the specific example of rheumatoid arthritis.

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Summary table: Mechanisms involved in the link between microbriota and rheumatoid arthritis

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Systemic inflammation
Bacterial translocation -> Activation of the immune system -> Systemic inflammation

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Metabolic syndrome
Glucose/lipid regulation -> Obesity/HTA/Insulin resistance -> Rheumatoid arthritis

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Dysbiosis & Microbial pathogenicity
Growth of pro-inflammatory micro-organisms (Bacteroidetes) - Reduction of anti-inflammatory micro-organisms (Firmicutes)
Fungicidal mycotoxins (Candida albicans)
Altered Th17/Treg balance
(Zhang X., Zhang D., Jia H., Feng Q., Wang D., Liang D., Wu X., Li J.,
Tang L.*, Li Y.*, Lan Z.* and Chen B.* Gut Dysbiosis in Rheumatoid Arthritis: A cross-sectional study of two cohorts and a meta-analysis of published studies EBioMedicine DOI:
https://doi.org/10.1016/j.ebiom.2016)

It is therefore crucial that we study our own microbial population closely in order to improve our understanding of the complex interactions between our bodies and these essential beneficial microbes.
In conclusion, the potentially crucial role of the microbriota as a central player in certain inflammatory processes underlying autoimmune diseases is now well documented thanks to recent technological advances, particularly from omics techniques (metatranscriptomies,) Future therapeutical strategies to combat these diseases will have to take more serious account of this hitherto neglected digestive dimension.
Particularly in the light of this focus on our invisible symbiotic partners, it now seems essential to take account of this interdisciplinary, integrative dimension.
This study also offers hope for a number of other serious medical conditions that frequently co-occur with them, such as type II diabetes, scleroderma, etc.
There is a need for a collective awareness of the potential political implications of these results, which have been emerging for some years now.

We hope this partial summary has convinced you. If you haven't already done so, don't hesitate to consult the many scientific articles published on PubMed!
Thank you very much!
If you have any questions, please contact us at [email protected]

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