![]() In addition, systemic inflammation may impact other organs and systems, such as the cardiovascular, pulmonary, skeletal bone, and brain ( McInnes and Schett, 2011). ![]() The inflammatory process underlying this disease causes cartilage and bone destruction, damaging the joint structure and ( Kang et al., 2017) leading to functional disability ( Firestein, 2003 Smolen et al., 2016 Kalinkovich et al., 2018). Rheumatoid Arthritis (RA) is a chronic immune-mediated inflammatory disorder that involves the synovial membranes of multiple joints ( Sewell and Trentham, 1993 McInnes and Schett, 2017). Finally, the role of fermented foods is discussed as a possible alternative to probiotic supplements since they have also been reported to have health benefits. We also review the proposed mechanisms whereby probiotics regulate inflammation. In this review, we highlight the role of GM in the development and progression of RA and summarize the current knowledge on the use of probiotics as a potential adjuvant therapy for RA. As of now, L.casei probiotic bacteria seems to be the strongest candidate for application as adjuvant therapy for RA patients. Several different strains of Lactobacillus and Bifidobacteria, as single species or in mixed culture, have been investigated, and some have demonstrated beneficial effects on disease activity in RA human subjects. Benefits of probiotic supplementation were reported in animal models of arthritis and human studies, but the current evidence regarding the effect of probiotic supplementation in the management of RA remains insufficient to make definite recommendations. ![]() Of interest, patients with RA have significant changes in the intestinal microbiota compared to healthy controls, and several studies have suggested the use of probiotics as a possible adjuvant therapy for RA. Although the exact etiology of RA is not fully understood, it is well established that gut microbiota (GM) plays a vital role in the pathogenesis of RA, with accumulating evidence suggesting that gut dysbiosis induces a chronic inflammatory response that may be linked to disease development. Rheumatoid arthritis (RA) is a chronic immune-mediated inflammatory disease that ultimately leads to joint destruction and functional disability.
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