Insights & Discussion
Rheumatoid arthritis-specific inflammation can be linked directly to the intestinal microbiota, thus, nutritional interventions against gut dysbiosis could function as a causal therapeutic approach.
The study initiated by reducing the intestinal microbiome in 20 Rheumatoid Arthritis patients through bowel cleansing and a week of fasting, limiting the intake to 250 kcal/day. It also employed immune monitoring and sequencing of the microbiome. A control group constituting patients with metabolic syndrome was incorporated to serve as a non-inflammatory baseline. To understand the fluctuation and impact on disease activity, disease activity scores were calculated and cytometric profiling was performed, tracing up to 46 different surface markers. Additionally, serum levels of certain cytokines and indicators of mucosal barrier disruption were monitored.
The change in intestinal microbiota, i.e., the effect of fasting on arthritogenic bacteria and the shift in microbial composition, was analyzed using sequencing. The detection of more eukaryotic, predominantly fungal colonizers in RA patients was also observed to understand their potential involvement. Finally, the study investigated the observed increase in endogenous cortisol levels during fasting.
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Despite diet being key in shaping gut microbiota, it surprisingly does not impact the treatment outcomes in individuals with Rheumatoid Arthritis.
2024 Rheumatology International Re-evaluation of dietary interventions in rheumatoid arthritis: can we improve patient conversations around food choices? Sharma P, Brown S, Sokoya EM
Review Article Diet Rheumatoid Arthritis
The process used to understand this paradox involved an umbrella review. This is an examination of multiple research studies and papers that address a similar question, in this case, the effects of diet on Rheumatoid Arthritis (RA). Through a comprehensive analysis of various scientific studies, researchers sought to determine if there was a meaningful link between diet and outcomes in RA patients.
The results of this study revealed an unexpected conclusion. Despite the gut microbiota's critical role in shaping the risk of RA, the data showed that diet, which is a dominant factor in shaping our gut microbiota, did not appear to affect the treatment outcomes in individuals with RA. This finding is surprising given the generally accepted understanding of the influence of diet on gut health and correlates with disease states. This conclusion introduces a new perspective in the understanding of RA and its relationship with diet.
Pomegranate juice consumption appears to somewhat enhance inflammatory status and complete blood count in hospitalized COVID-19 patients.
2023 Complementary Therapies in Medicine Adjuvant pomegranate juice intake improves the inflammatory status of hospitalized COVID-19 patients: A randomized and placebo-controlled trial Yousefi M, Sadriirani M, Mahmoodi S, Samimi B, Pourmahmoudi A, Hosseinikia M, et al.
Randomised Controlled Trial COVID-19 CRP Inflammation
The study was a randomized, double-blinded placebo-controlled trial involving 48 patients and had two parallel arms. As part of their standard hospital care, patients were either given 500 mL of whole pomegranate juice daily or a placebo for a period of 14 days. The researchers focused on measuring inflammatory indicators and complete blood counts both at the start of the study and at the end of the 14-day intervention period.
Following the 14-day intervention, there was a distinguishable decrease in primary outcomes including inflammatory markers such as C reactive protein, interleukin-6, and erythrocyte sedimentation rate in the group that consumed pomegranate juice as compared to the readings before the intervention. In addition, considerable changes were also observed in secondary outcomes such as neutrophils, lymphocytes, platelets, platelets-to-lymphocyte and neutrophils-to-lymphocyte ratios in the pomegranate juice group compared to the parameters before the intervention. Finally, the mean changes in levels of interleukin-6, white blood cells, neutrophils, lymphocyte, platelets, platelets-to-lymphocyte ratio, blood oxygen saturation and MCV were significantly different between the two groups by the end of intervention, while no significant difference was noted in other blood indices.
Intermittent fasting may potentially influence autoimmune diseases like type 1 diabetes and rheumatoid arthritis, by reducing inflammation and supporting cellular repair mechanisms.
2023 Autoimmunity Reviews Intermittent fasting: A promising dietary intervention for autoimmune diseases Barati M, Ghahremani A, Namdar Ahmadabad H
Systematic Review Autoimmune Diseases Intermittent Fasting Rheumatoid Arthritis
Extensive research was done through several electronic databases such as PubMed, Scopus, Embase, and Web of Science. Rigorous inclusion criteria were applied to filter the most relevant studies on the effects of intermittent fasting on autoimmune diseases. No reference to further research trials was mentioned in the methodology.
The results indicate a potential link between intermittent fasting and the management of certain autoimmune diseases. Autoimmune diseases like type 1 diabetes, rheumatoid arthritis, and systemic lupus erythematosus exhibited improvements owing to the reduction in inflammatory markers, improvement in gut microbiota, and enhanced cellular repair resulting from autophagy induced by intermittent fasting. However, results concerning other autoimmune diseases like multiple sclerosis, systemic lupus erythematosus, thyroid diseases, and psoriasis were inconclusive.
Acupuncture shows promising results in managing autoimmune diseases by potentially regulating immune responses.
2022 The American Journal of Chinese Medicine Therapeutic Effect and Mechanism of Acupuncture in Autoimmune Diseases Jing Wang, Fangyi Zhu, Wei Huang, Zhengyi Chen, Ping Zhao, Yanting Lei, et al.
Review Article Multiple Sclerosis Rheumatoid Arthritis
The methodology of the study involved a comprehensive review of how acupuncture, a form of traditional Chinese medicine, may be employed as a treatment method for autoimmune diseases such as multiple sclerosis, rheumatoid arthritis, and inflammatory bowel disease. The research was based on existing knowledge and accumulating data, investigating the role of acupuncture in regulating immune responses during these conditions.
The discussion of the results revealed that acupuncture showed promise in managing these diseases. It was noted that the positive outcomes observed might be linked to the potential of acupuncture to regulate abnormal immune responses which are characteristic of autoimmune diseases. Despite the fact that the precise mechanism through which this achieved is not fully understood, the findings indicate a promising alternative method of managing autoimmune conditions.
Omega-3 fatty acids can help prevent and manage chronic inflammatory diseases, including ulcerative colitis and rheumatoid arthritis, through influencing gut microbiota.
2022 Journal of Medicinal Food Omega-3 Fatty Acids and Balanced Gut Microbiota on Chronic Inflammatory Diseases: A Close Look at Ulcerative Colitis and Rheumatoid Arthritis Pathogenesis Zorgetto-Pinheiro VA, Machate DJ, Figueiredo PS, Marcelino G, Hiane PA, Pott A, et al.
Review Article Gut Microbiota Rheumatoid Arthritis
The study primarily encompasses a review of both experimental and clinical studies on the influence of omega-3 fatty acids on chronic inflammatory conditions, with the attention being specifically focused on those diseases with an autoimmune background. The study highlights the role of these fatty acids in maintaining bodily homeostasis, as well as the enzymatic processes they trigger within the body upon ingestion. Natural sources of omega-3 are also explored, emphasizing the importance of maintaining a healthy and balanced diet.
In their exploration of omega-3's impact on inflammatory conditions, the researchers revisit the pathogenesis of ulcerative colitis and rheumatoid arthritis under the theoretical approach of gut microbiota dysbiosis. This approach emphasizes the role of the gut in maintaining health and identifies how imbalances can contribute to the development and persistence of these conditions. The researchers propose that omega-3 fatty acids are able to prevent and control these conditions, which are significant contributors to global chronic health burden and can lead to severe complications and disabilities if not treated. The potential of omega-3's to prevent severe illness in cases of COVID-19 infection through immune system modulation and control of the inflammatory process is also briefly explored.
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