Intestinal dysbiosis and increased intestinal permeability as a potential risk factor for the development and progression of rheumatoid arthritis

Rheumatoid arthritis (RA) is one of the most common autoimmune diseases. Factors affecting the development of the disease result from a coincidence of environmental factors, including so-called trigger factors and genetic predisposition which lead to impaired immune tolerance and autoimmune phenomena. The detailed etiopathogenesis of the disease is unclear. Evidence indicates the potential role of the gut microbiome, increased intestinal permeability and disturbed immune response faciliate the development of autoimmune diseases including RA. The paper is reviewing scientific data on the role of the gut microbiota and increased intestinal permeability in the development and progression of RA. Attention is also focused on factors disrupting the physiological microbial colonization and other factors related to the modern lifestyle in industrialized countries affecting the gut microbiota. All reported data suggested the role of the gut microbiota in the pathogenesis of RA and further work is necessary to determine whether modulation of the microbiota can serve as a clinical tool to regulate intestinal permeability and influence the development and clinical course of RA.