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Source: Thailand Medical News  Nov 20, 2019  4 years ago
Emerging Studies Link Antibiotics With Increase the Risk of Arthritis
Emerging Studies Link Antibiotics With Increase the Risk of Arthritis
Source: Thailand Medical News  Nov 20, 2019  4 years ago
Rheumatoid arthritis (RA) is a chronic inflammatory disorder that can affect more than just your joints. In some people, the condition can damage a wide variety of body systems, including the skin, eyes, lungs, heart and blood vessels. An autoimmune disorder, rheumatoid arthritis occurs when your immune system mistakenly attacks your own body's tissues. The condition is characterized by pain and stiff joints.

Unlike the wear-and-tear damage of osteoarthritis, rheumatoid arthritis affects the lining of your joints, causing a painful swelling that can eventually result in bone erosion and joint deformity. Another typical feature of this disorder is the presence of autoantibodies in the serum and synovial fluid. Synovial fluid is the fluid that lubricates the synovial joints.

The detailed mechanism by which patients develop rheumatoid arthritis is unknown; however, a combination of genetic and environmental factors is likely. Autoimmune antibody production is proposed to be the main mechanism responsible for bone and joint destruction, and the related rheumatoid arthritis pathology. Infections, hormonal alterations, and stress are some potential triggers of rheumatoid arthritis.

Emerging research suggests an association between antibiotic use, gut microbiota changes, and rheumatoid arthritis flares.

Typically, antibiotics are widely used for the treatment of bacterial infections associated with the respiratory system, gastrointestinal system, and urinary tract. Although antibiotics act against pathogenic bacteria, they can also modify the normal gut microbiota.

The human gut microbiota is a diverse system of microorganisms residing in the gastrointestinal tract of the human body. Gut microbiota plays a vital role in maintaining the body’s digestive health. Gut microbiota is also involved in the immune system and the synthesis of vitamin B and vitamin K.

Many  new  epidemiological studies have demonstrated associations between the occurrence of bacterial infections and rheumatoid arthritis. Furthermore, microbiome alterations have been indicated as a potential mechanism for the effect of infection in  rheumatoid arthritis pathogenesis. Antibiotics substantially disturb the gut microbiome, with studies demonstrating significant microbial shifts in the gastrointestinal tract following their use.

The drastic alterations in the gut microbiome may last up to a year after treatment periods of only one week. As per a recent study by Nagra et al., the risk of rheumatoid arthritis flare was significantly increased in the 1–12 months after commencing treatment on sulphonamide and trimethoprim antibiotics.

Thailand  Medical News has come across new research suggests that infections are potential risk factors for rheumatoid arthritis pathogenesis and flares. Respiratory infections have been particularly linked with the development of rheumatoid arthritis. Antibodies to citrullinated peptide antigens (ACPA) are one of the autoantibodies associated with rheumatoid arthritis.

ACPAs have been found to be produced in response to certain bacterial components, which suggests the potential role of infections in rheumatoid arthritis pathogenesis. As per a population-based study published in 2019, respiratory tract pathogens such as Chlamydia pneumoniae are associated with elevated circulating autoimmune antibodies.

Many study analysis found that the strongest association of infections and  rheumatoid arthritis was identified only in subjects treated with an antibiotic and not in untreated subjects. These findings suggest that antibiotic use may be the probable reason for the increased occurrence of rheumatoid arthritis.

The studies conclude that Individuals exposed to one or more antibiotic prescriptions were 60% more likely to develop rheumatoid arthritis than their unexposed counterparts.

Though several studies have described the potential role of antibiotic use on the microbiome, which is potentially disrupted in rheumatoid arthritis, further research is required to explore the exact mechanism responsible for the same.


-Sultan, A. A., Mallen, C., Muller, S., Hider, S., Scott, I., Helliwell, T., & Hall, L. J. (2019). Antibiotic use and the risk of rheumatoid arthritis: a population-based case-control study. BMC medicine, 17(1), 154. doi:10.1186/s12916-019-1394-6

-Nagra, N. S., Robinson, D. E., Douglas, I., Delmestri, A., Dakin, S. G., Snelling, S., … Prieto-Alhambra, D. (2019). Antibiotic treatment and flares of rheumatoid arthritis: a self-controlled case series study analysis using CPRD GOLD. Scientific reports, 9(1), 8941. doi:10.1038/s41598-019-45435-1

-Yoshii, K., Hosomi, K., Sawane, K., & Kunisawa, J. (2019). Metabolism of Dietary and Microbial Vitamin B Family in the Regulation of Host Immunity. Frontiers in nutrition, 6, 48. doi:10.3389/fnut.2019.00048 


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