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Gut Bacteria: A Potential Solution for Juvenile Idiopathic Arthritis?

Updated: Jan 27

Juvenile Idiopathic Arthritis (JIA) is a broad term that refers to all types of chronic arthritis in patients with an idiopathic etiology. These patients, who are under the age of 16, have symptoms that have lasted longer than six weeks. JIA occurs in 16–50 people out of every 100,000 people (1). JIA comes in a variety of forms, such as oligoarticular JIA, polyarticular JIA-Rheumatoid Factor Negative or Positive, psoriatic JIA, etc. Patients with JIA may experience a variety of symptoms, although they all fall under the general headings of uveitis, skin changes, fever, and growth issues (2) . Genetic variables, such as the existence of HLA 4, also play a significant role in addition to a number of environmental factors. In addition to an array of environmental influences, genetic factors, such as the existence of HLA-4, also play an important role in the pathogenesis of JIA. (3) Trials using glucocorticoid injections, NSAIDs, and disease-modifying antirheumatic drugs (DMARDs) are part of the current treatment for JIA (4).These treatment options merely improve the symptoms but do not cure the disease. In recent years, research has been conducted on gut bacteria, which may be an important breakthrough for many JIA patients.

Gut bacteria, indeed! Recent research suggests that the gut bacteria might play an important role in the management of children with juvenile idiopathic arthritis. Firmicutes, Bacteroidetes, Proteobacteria, and Actinobacteria made up the majority of the gut bacteria under study (5). According to an article, a change in the patient's gut bacteria can result in JIA. One of the risk factors, for instance, is having a C-section during delivery. In individuals who had undergone a C-section, it was observed that the gut flora had changed. The use of bottles for feeding and antibiotic exposure are other risk factors. The change in gut bacteria in the early stages of life is seen to influence the immune system, therefore making them more susceptible to developing autoimmune diseases like JIA (6).

Numerous studies were conducted on JIA patients to test the relationship between JIA and the gut microbiome in hopes of discovering a potential wholesome management for these patients. In two studies that were conducted in the USA, there was a decrease in the fecal abundance of Faecalibacterium Prausnitzii in patients with Enthesitis-Related Arthritis. It is said that this organism is supposed to be anti-inflammatory because of its production of short-chain fatty acids. (6)

According to a recent paper, the discovery of the relationship between the gut microbiome and JIA can lead to numerous modalities for the management and treatment of JIA. This may result in the development of JIA screening tools, which may enable rapid intervention, according to Angelica Ahrens, a co-author of one of the studies. Additionally, "targeted treatments" and other preventive measures may be developed as a result of these investigations (7). All of these techniques can improve the management of JIA.

JIA is an autoimmune disorder that is usually seen in people under the age of 16. Other symptoms these patients can experience are uveitis, skin changes, fever, and problems with growth. There are various types of JIA, but the known treatment includes NSAIDs, DMARDs, and Glucocorticoids. Though these drugs can help with symptomatic relief, they do not solve the root cause of the problem. For many years, doctors and researchers did not know the cause of this condition; hence, it was "Idiopathic". Recently, it was found that there is a probable relationship between the Gut Microbiome and JIA. This association is likely due to alterations in the immune system early in life. This could be due to C-Section delivery, Bottle feeding, or Antibiotic administration. Scientists believe that this discovery will lead to the development of potential screening tests, targeted treatments, and preventive measures. However, there is still a substantial amount of research that needs to be done before there is any advancement in the care of patients with JIA. But, you know what they say: "Every Journey needs a first step!"

Written By: Vineetha Sheggari

Edited By: Vidhi Parikh


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