Exploring the Potential of Probiotics and Gut Microbiota Modulation in the Management of Rheumatoid Arthritis: A Review of Current Mechanisms and Therapeutic Strategies

Summary: Background: Rheumatoid arthritis (RA) is a persistent autoimmune disorder that attacks the joints, resulting in inflammation and potential joint deterioration over time. This disease impacts roughly 1% of the global population, occurs more frequently in women, and arises from both inherited and environmental factors. Main Body: Even though disease-modifying antirheumatic drugs (DMARDs) and nonsteroidal anti-inflammatory drugs (NSAIDs) are widely available, their effectiveness is often hampered by side effects, toxicity concerns, and high costs. Researchers are increasingly focusing on the pre-clinical phase of rheumatoid arthritis (RA) as a key opportunity for intervention. Growing evidence underscores the gut microbiome's pivotal influence on RA's onset. An imbalance in gut bacteria—known as dysbiosis—appears to trigger autoimmunity in conditions like RA, possibly via molecular mimicry and other pathways that fuel immune overreactions. Probiotics, especially strains from Lactobacillus and Bifidobacterium, offer hope by restoring gut balance, dialing down inflammation, and easing RA symptoms. Both animal models and human trials back this up, showing drops in inflammatory markers like pro-inflammatory cytokines and C-reactive protein (CRP), alongside real-world relief from issues such as swollen joints and pain. Conclusion: This review explores how gut microbes contribute to the development of rheumatoid arthritis (RA) and highlights the encouraging potential of probiotics for easing RA symptoms. On top of that, dietary strategies—like the Mediterranean diet, which can reshape the gut microbiome—hold promise for better RA control by curbing inflammation and boosting overall disease outcomes. Keywords: Rheumatoid arthritis, gut microbiota, probiotics, Lactobacillus, Bifidobacterium