THE ROLE OF THE INTESTINAL MICROBIOTA IN THE DEVELOPMENT OF AUTOIMMUNE RHEUMATIC DISEASES

Abstract

Introduction: The gut microbiota plays an important role in developing rheumatoid arthritis (RA), ankylosing spondylitis
(AS), psoriatic arthritis (PsA), juvenile idiopathic arthritis (JIA) and others rheumatic diseases. Its studies promote new
opportunities for improving the early diagnosis, and possibly the prevention of severe autoimmune rheumatic diseases, as
well as correcting the tactics of a personalized approach to treatment.
Aim: This review evaluates the relevant information on the relationship between changes in the microbiota and the
development of rheumatic diseases in children and adults.
Search strategy: Literature search was carried out using PubMed (Medline), Scopus databases, eLibrary.ru, Google
Scholar by keywords: “gut microbiome”, “microbiota”, “rheumatoid arthritis”, “rheumatic diseases”, “spondyloarthropathies”.
The search depth is 20 years (2000-2021). The original language is English. Inclusion criteria: reports of randomized and
cohort studies conducted on large populations, meta-analyses and systematic reviews. Exclusion criteria: articles describing
single cases, series of cases, as well as experimental work on animals. Out of 113 literary sources, 78 were selected as
analytical material for this article.
Summary: Analysis of the sources showed that the conducted studies revealed deviations in the diversity of intestinal
microflora in patients with rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis. The main attention was paid to
cataloging the microorganisms present, identifying the relationship between microbial species and diseases. Differences in
the composition of the microbiota in children and adults have been established. Currently, the relationship of various factors,
such as gender, age, race, living conditions, geographical location, remains not completely explored. However, there are no
long-term studies with the collection of samples of the intestinal microbiome in several time intervals: before and after the
appointment of basic anti-inflammatory therapy, against the background of ineffective therapy, as well as tracking the
relationship with the nature of the course, the activity of the disease or the intensity of symptoms.