PROBIOTICS AS ADDITIONAL TREATMENT OF RHEUMATOID ARTHRITIS. A REVIEW.

Abstract

Relevance. Rheumatoid arthritis (RA) is a condition with an unclear cause, marked by inflammation affecting the synovial tissue of joints, cartilage, and bone. RA can extend to areas outside the joints, autoantibodies production and progressive disability. Rheumatoid arthritis affects approximately 0.24% to 1% of adults globally, with women being affected 2 to 3 times more frequently than men. In recent years numerouse studies showed the significant role of micribiome in RA developement. Regardless of using disease-modifying anti-rheumatic drugs (DMARDs) and biologic therapies, a significant number of patients with RA fail to achieve remission. These two facts have prompted interest in targeting the microbiome as a therapeutic strategy for RA. Aim: To analyze the effectiveness of probiotics in the treatment of RA according to contemporary literature. Search strategy: A search for scientific publications was carried out in the following databases of scientific publications and specialized search engines: PubMed, Google Scholar, Web of Science Core Collection, Cochrane Library. A number of original publicly available publications on the research topic were analyzed. The search depth was 10 years. As a result of the search, we studied 579 foreign publications, of which 84 publications were included in this review. Inclusion criteria: meta-analyses, systematic reviews, cohort and cross-sectional studies. Exclusion criteria: short reports, newspaper articles and expert opinion in the form of short reports. Results and conclusions: The review revealed that probiotics can influence the microbiome and immune system of RA patients through various mechanisms of action. In addition, it has been found that the use of L. Casei alone and in combination with L. acidophilus, L. Lactis, B. Lactis and B. bifidum, as well as Bacillus coagulans can improve the course of RA, reduce the level of inflammatory markers and pro-inflammatory cytokines. Given the conflicting evidence regarding the effectiveness of probiotics in the treatment of RA, further research is needed.