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How does rheumatoid arthritis affect the gut microbiome?

Rheumatoid arthritis (RA) is an autoimmune disease. Medications to treat RA usually suppress the immune and inflammatory responses. A large portion of the immune system lives in and near the gut, and the immune system has been shown to be modulated in part by the gut microbiome. 

Research shows that the health of the gut microbiome plays a large part in the development, progression, and control of RA. There is recent evidence that new-onset, untreated RA sufferers had a dysbiosis (gut imbalance). Diet and intestinal permeability have also been linked to RA.

There is some evidence that probiotics can alleviate RA symptoms. Also, it has been shown that some of the medications used for RA appear to help the gut microbiome recover some of its colonies. There is enough data to indicate that RA may be triggered by a combination of genetics and dysbiosis, and that repairing the microbiome can help control the symptoms.