Objectives Rheumatoid arthritis (RA) has been associated with a relative expansion of faecal Prevotellaceae. To determine the microbiome composition and prevalence of Prevotella spp. in a group of individuals at increased risk for RA, but prior to the development of the disease.
Methods In an ongoing cohort study of first-degree relatives (FDRs) of patients with RA, we identified ‘FDR controls’, asymptomatic and without autoantibodies, and individuals in pre-clinical RA stages, who had either developed anticitrullinated peptide antibodies or rheumatoid factor positivity and/or symptoms and signs associated with possible RA. Stool sampling and culture-independent microbiota analyses were performed followed by descriptive statistics and statistical analyses of community structures.
Results A total of 133 participants were included, of which 50 were categorised as ‘FDR controls’ and 83 in ‘pre-clinical RA stages’. The microbiota of individuals in ‘pre-clinical RA stages’ was significantly altered compared with FDR controls. We found a significant enrichment of the bacterial family Prevotellaceae, particularly Prevotella spp., in the ‘pre-clinical RA’ group (p=0.04).
Conclusions Prevotella spp. enrichment in individuals in pre-clinical stages of RA, before the onset of RA, suggests a role of intestinal dysbiosis in the development of RA.
- rheumatoid arthritis
- epidemiology of ra
- pre-clinical stages of ra
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DA-R and TRL are joint first authors.
AF and TS contributed equally.
Handling editor Josef S Smolen
Correction notice This article has been corrected sinceit published Online First. The equal contributor statement has been added and the correspondence details updated.
Contributors DAR, TRL, AF and TS designed the study. DAR, ER, CL and AF were involved in patient recruitment, samples and data collecting. TRL, AG and TS were involved in samples processing and analysis. DAR, AF, TS and TRL were involved in statistical analyses and interpretation of data. All authors were involved in writing the manuscript and approved the final version. The first authors and corresponding authors had full access to all the data in the study and had final responsibility for the decision to submit for publication.
Funding DAR granted the Abbvie Grant 2016 and the Swiss Government Excellence Scholarship for PhD studies of The Federal Commission for Scholarships for Foreign Students. The work was supported by grants from the EU (StG337251) and Helmholtz Association (VH-NG-933) to TS. No other specific funding was received to carry out the work described in this article.
Competing interests None declared.
Patient consent for publication Obtained.
Ethics approval The protocol was approved by the ethics committee.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement Raw data are available upon request from the corresponding author.
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