Rheumatoid arthritis (RA) is a chronic inflammatory disease that mainly affects joints and is characterized by joint swelling, discomfort, tightness, and bone deterioration. The global incidence of RA is between 0.5% and 1%, making it one of the most common chronic inflammatory diseases in adults. Diabetes, heart disease, nephritis, lung cancer, chronic obstructive pulmonary disease (COPD), psychological problems, high blood pressure, asthma, and cancer are particularly prominent among RA patients, resulting in an increased death rate.

Chronic inflammatory diseases such as rheumatoid arthritis are mostly inflammatory symptoms caused by pro-inflammatory cytokines induced by type 1 helper T cells (Th1), which belong to an autoimmune disease. The human microflora plays an important role in autoimmune diseases. It already been found that some bacteria in the intestine have immune regulation functions, especially some of the bacterial metabolites, such as butyrate and other short-chain fatty acids can promote the differentiation of regulatory T cells to achieve the effect of immune regulation. Therefore, the specific intestinal microflora environment will affect the body's response to specific antigens, whether it is immune activation or immune tolerance. Many studies have shown that intestinal flora, as an important environmental factor, can affect the onset of rheumatoid arthritis and even aggravate the disease. Other studies have observed that individuals with rheumatoid arthritis have increased intestinal penetration due to inflammation of the gastrointestinal (GI) tract, resulting in the transmission of food antigens and highly dangerous microorganisms through the blood. It was found that antibodies against such antigens increase in individuals with rheumatoid arthritis, causing immune complexes to be produced in the blood vessels supplying the joints, causing an inflammatory response.

An association analysis study on the intestinal flora of patients with rheumatoid arthritis was completed by the Department of Rheumatology and Immunology of Peking Union Medical College Hospital and BGI (Beijing BGI Gene Research Center), which confirmed that the intestinal flora in rheumatoid arthritis patients has an important role in pathology and disaese control. A number of other studies have also shown that patients with rheumatoid arthritis have flora imbalance in intestine. Its main characteristics are the number of beneficial bacteria decreases, while the number of harmful bacteria increases. A clinical study in China showed that on the basis of regular treatment, test group were given live bifidobacteria at a dose of 3 times a day, 3 tablets each time, for a total of 12 weeks. The clinical symptoms and laboratory indicators of the test group improved more significantly than the control group. Therefore, probiotic supplement therapy can alleviate the clinical symptoms of rheumatoid arthritis, improve inflammation indicators, and achieve the effect of controlling the disease. A meta-analysis study also showed that patients with rheumatoid arthritis taking probiotics can significantly reduce the pro-inflammatory cytokine IL-6 (pro-inflammatory cytokine IL-6), which is also the destruction of joints in patients with rheumatoid arthritis' key indicators.

According to the expected cause and scientific research findings of rheumatoid arthritis, probiotics have great potential and can effectively relieve the disease, especially considering the active participation of the microbiome, which can lead to immune regulation and reduction of inflammation. In general, there are currently few studies on the effectiveness of probiotics in rheumatoid disease, and the mechanism of action has not been clear yet. More prospective studies may be needed to help determine the role of probiotics in rheumatoid arthritis and which probiotics provide the most benefits.

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