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Abstract

This study investigates the role of the intestinal microbiome in the development of autoimmune arthritides, including rheumatoid arthritis (RA), psoriatic arthritis (PsA), and ankylosing spondylitis (AS). A comparative analysis of gut microbiota composition was performed in 120 patients with various forms of arthritis and 40 healthy volunteers. Using 16S rRNA gene sequencing, disease-specific alterations were identified: a significant increase in Prevotella copri up to 18.3% in RA, predominance of Bacteroides vulgatus (12.6%) in PsA, and elevated levels of Klebsiella pneumoniae (9.8%) in AS. Strong correlations were established between microbiome changes and clinical disease activity parameters. The highest correlation was observed between Prevotella copri levels and anticitrullinated peptide antibody titers (r = 0.62) in RA patients. The therapeutic part of the study demonstrated the efficacy of targeted microbiome correction using specific probiotic strains, resulting in a 1.8–2.1-point reduction in disease activity according to standard assessment indices. These results support the development of innovative diagnostic and therapeutic strategies based on microbiota modification and validate the critical role of the intestinal microbiome in the pathophysiology of autoimmune arthritides. The study significantly contributes to understanding the mechanisms of autoimmune joint diseases and opens new avenues for personalized therapy‎.

Keywords: Intestinal microbiome, Autoimmune arthritis, Dysbiosis, probiotics, Molecular mimicry, Personalized medicine

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