Do you have ongoing joint pain and aches — maybe migrating from your knees to your elbows to your shoulders? Maybe you've been diagnosed with rheumatoid arthritis and are wondering: can rheumatoid arthritis be cured?
In this article we're going to discuss that specific question. We'll also look at a new study on a bacteria in the gut that's been associated with rheumatoid arthritis, and what that might mean for treatment and diagnostics.
With rheumatoid arthritis — or any autoimmune disease — you have to consider the long-term consequences of upregulated immune activity on the joints and tissues. The lack of symptoms like pain or discomfort doesn't necessarily mean there's no immune activity in the joints themselves.
You may have elevated rheumatoid factor, relatively high C-reactive protein, sed rate, and other autoantibodies in your blood while your joint pain stays manageable with over-the-counter anti-inflammatories. It would be a mistake to assume there's no ongoing joint damage just because the pain is mild. So "cured" can't just mean no symptoms — we also want the absence of elevated RA markers in the blood.
From a conventional rheumatology perspective, RA generally cannot be cured — it's managed with biologics and immune-suppressing medications that decrease the effect on the joints.
In alternative medicine there are lots of claims about dietary changes, treating leaky gut, and similar approaches as ways to treat and potentially cure RA. These are things I've actually witnessed in my practice: the absence of symptoms, and signs in the blood — C-reactive protein, rheumatoid factor and others — going down to very low levels, well within normal ranges. Once you get there you're always going to be susceptible to the condition, but it would be said to be in remission, or quiescent.
With that context, here's some new research that puts pieces of the puzzle together and may give hope that there's a way to treat this condition more permanently.
A study published in Arthritis & Rheumatology looked at the association between antibodies to a gut bacteria called Prevotella copri and the risk of developing rheumatoid arthritis. It included people at risk for developing RA, people with early RA, and people with established RA, and measured antibody levels to this bacteria in all of them.
The findings: people with higher levels of antibodies to Prevotella copri were more likely to go on to develop RA. Antibody levels were also higher in those with early RA and established RA compared to those simply at risk. The authors concluded this antibody may be an early biomarker for RA diagnosis — with the usual caveat that more research is needed before it can be used to predict who develops the disease or to build treatments around it.
What I found most interesting: the researchers noted that the molecular structure of one of the common RA antibodies — the anti-CCP antibody — is similar to the antibody to Prevotella copri. The bacteria carries proteins that overlap with tissue in our body, particularly the tissue targeted by anti-CCP.
This suggests the antibodies may be produced in response to that bacteria pushing through the digestive lining, with the immune system working to keep it in check. Through molecular mimicry, the immune system can make a mistake: an antibody built to target the bacteria, off by just an amino acid or a few, ends up targeting your own CCP tissue instead. Once that mistake is made, you can't really unwind it — every time the immune system attacks that bacteria, it will likely also produce antibodies to your own tissue.
Another relatively recent study found that people with rheumatoid arthritis were more likely to have a leaky gut than people without it. There's plenty of debate about what leaky gut is and how to diagnose it, so I wouldn't take that as definitive — but it adds to the supporting evidence that intestinal permeability and this bacterial issue may contribute to, or drive, rheumatoid arthritis. There are also studies showing antibiotic treatment improving symptoms and signs in people with RA.
All in all, these studies suggest leaky gut, and Prevotella copri in particular, may play an important role in the development and severity of rheumatoid arthritis. More research is needed to confirm the findings and develop diagnostics around this bacteria. For me, it adds to the growing knowledge that the gut and the immune system are an important part of treating and reducing the signs and symptoms of autoimmune disease.
Treatment along these lines is nuanced and should be done under the supervision of a doctor or qualified medical professional — please don't take it into your own hands. If gut testing and repair is where you want to start, our digestive health program is built for exactly this kind of work.
If you have RA or another autoimmune condition and want to explore the gut-immune connection properly, schedule an appointment.