Patients in the preclinical stages of rheumatoid arthritis (RA) show Prevotella spp. enrichment that may indicate a role of intestinal dysbiosis in the development of RA, according to study results published in Annals of the Rheumatic Diseases.

The study included participants from another ongoing cohort study of first-degree relatives of patients with RA. The researchers identified first-degree relative control patients who were asymptomatic and without antibodies. They also identified participants in preclinical RA stages who had either developed anti-citrullinated peptide antibodies, rheumatoid factor positivity, or symptoms and signs associated with possible RA.

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The researchers performed stool sampling and culture-independent microbiota analyses in each participant. They then performed descriptive statistics and statistical analyses of community structures.

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Of 133 participants, 50 were first-degree relative control participants and 83 were in preclinical RA stages.

Compared with first-degree relative control participants, the researchers found that the microbiota of participants in the preclinical RA group was significantly altered.

The results indicated that participants in the preclinical RA group had significant enrichment of the Prevotellaceae bacterial family, particularly Prevotella spp (P =.04).

The researchers analyzed the relative abundance of Prevotellaceae and associated taxa in order to determine whether all the participants in the preclinical RA group showed an enrichment of Prevotellaceae. While a larger percentage of participants in the preclinical group showed significant levels of Prevotellaceae compared with controls (53% vs 30%), Prevotellaceae was not present in all participants.

“Our results, together with previous studies in patients with early RA and recent mechanistic studies, support the mucosal origins hypothesis and the role of intestinal dysbiosis in the development of RA,” the researchers wrote.


Alpizar-Rodriguez D, Lesker TR, Gronow A, et al. Prevotella copri in individuals at risk for rheumatoid arthritis [published online February 15, 2019]. Ann Rheum Dis. doi:10.1136/annrheumdis-2018-214514