Can the differences in the microbiome be used to understand the effectiveness of drugs in rheumatoid arthritis?

Disease - Rheumatoid arthritis

Lead applicant - Professor Frances Williams

Organisation - King's College London

Type of grant - Special Strategic Award

Status of grant - Active

Amount of the original award - £934,445.02

Start date - 1 November 2016

Reference - 21227

Public Summary

What are the aims of this research?

The aim of this research is to investigate how the microorganisms that live on and within humans, known as the microbiome, differ in people with rheumatoid arthritis and how this might affect or predict their response to treatment.

Why is this research important?

Recent research has shown that the microbiome in people with rheumatoid arthritis differs from that of healthy individuals, however it is not known whether this difference is a cause or a consequence of disease. The TwinsUK resource is the largest adult twin registry in the UK, which is used to study the effects of genetics and environmental factors on diseases. This valuable resource can be used to investigate diseases such as rheumatoid arthritis by looking at twins where only one twin has the condition. Since twins are genetically identical, studying this group can provide valuable information about the environmental causes of disease. The microbiomes of these twins will be compared to see how they differ.

The microbiome may also be linked to the way in which people with rheumatoid arthritis respond to disease modifying anti-rheumatic drugs (DMARDs) such as methotrexate and sulfasalazine. By investigating the links between the microbiome, genetic factors and DMARD responsiveness in rheumatoid arthritis, scientists hope to understand the reasons why people develop this condition.

How will the findings benefit patients?

Understanding the patterns of different microbiomes and how these are linked to the development of rheumatoid arthritis has the potential to improve treatment and lead to more personalised care. Looking at different microbiome patterns may enable doctors to predict responses to treatment and identify individuals most at risk of severe symptoms, both of which could be used to guide future treatment. This research may also enable the development of new treatments which can alter the microbiome of an individual to improve their responsiveness to DMARDs.