Koh Jung Hee Lee, Eun Ha Cha, Kwang Hyun PAN, CHEOL HO Kim Donghyun Kim Wan-Uk 2024-01-12T02:31:23Z 2024-01-12T02:31:23Z 2023-03-29 2023-03 1478-6354 https://pubs.kist.re.kr/handle/201004/75768 BackgroundWe aimed to investigate the gut microbiota of patients with established rheumatoid arthritis (RA) who have been managed with disease-modifying anti-rheumatic drugs (DMARDs) for a long time. We focused on factors that might affect composition of the gut microbiota. Furthermore, we investigated whether gut microbiota composition predicts future clinical responses to conventional synthetic DMARDs (csDMARDs) in patients with an insufficient response to initial therapy.MethodsWe recruited 94 patients with RA and 30 healthy participants. Fecal gut microbiome was analyzed by 16S rRNA amplificon sequencing; the resulting raw reads were processed based on QIIME2. Calypso online software was used for data visualization and to compare microbial composition between groups. For RA patients with moderate-to-high disease activity, treatment was changed after stool collection, and responses were observed 6 months later.ResultsThe composition of the gut microbiota in patients with established RA was different from that of healthy participants. Young RA patients (< 45 years) had reduced richness, evenness, and distinct gut microbial compositions when compared with older RA patients and healthy individuals. Disease activity and rheumatoid factor levels were not associated with microbiome composition. Overall, biological DMARDs and csDMARDs, except sulfasalazine and TNF inhibitors, respectively, were not associated with the gut microbial composition in patients with established RA. However, the combination of Subdoligranulum and Fusicatenibacter genera was associated with a future good response to second-line csDMARDs in patients who showed an insufficient response to first-line csDMARDs.ConclusionGut microbial composition in patients with established RA is different from that in healthy individuals. Thus, the gut microbiome has the potential to predict responses of some RA patients to csDMARDs. English BioMed Central Factors associated with the composition of the gut microbiome in patients with established rheumatoid arthritis and its value for predicting treatment responses Article 10.1186/s13075-023-03013-x 1 Arthritis Research & Therapy, v.25, no.1 Arthritis Research & Therapy 25 1 Y scie scopus 000942848000001 Rheumatology Rheumatology SULFASALAZINE INDUCTION TOXICITY CRITERIA DISEASE Microbiota Rheumatoid arthritis Anti-rheumatic agents Treatment response Age