Wild Garden of Gut Bacteria Cuts OA in Obese Patients!! | Orthopedics This Week

Wild Garden of Gut Bacteria Cuts OA in Obese Patients!!

The Wild Garden of Gut Bacteria / Source: Wikimedia Commons and Nicola Fawcett

Researchers from the University of Rochester Medical Center (URMC) have conducted the first-ever study on the impact of the gut microbiome on the progression of osteoarthritis (OA).

Their study, “Targeting the gut microbiome to treat the osteoarthritis of obesity,” was published in the April 19, 2018 edition of JCI Insight.

First author Eric Schott, Ph.D., postdoctoral fellow in the Centers of Musculoskeletal Research (CMSR) and soon-to-be clinical research scientist at Solarea Bio, Inc., told OTW, “Osteoarthritis (OA) is the greatest cause of disability in the U.S., and obesity is a major risk factor for its development. Despite the comorbid association, the mechanisms linking obesity to the development of OA have not been fully elucidated.”

“Recently, the gut microbiome has become a hot topic across multiple areas of disease research, including obesity.”

“In obese subjects, the gut microbiome is significantly different from that of lean, healthy patients, characterized by less diversity and an increase in bacteria associated with inflammation.”

“The obese gut microbiome has been suggested as causal in adipose tissue accumulation and elevated levels of circulating proinflammatory cytokines. Moreover, these alterations are correctable through the use of prebiotic supplements, which are non-digestible dietary fibers that promote the proliferation of beneficial, commensal microbes.”

“Thus, we hypothesized that targeting the gut microbial community in obesity could be useful to address the accelerated joint degeneration in this context.”

“In most cases, studies investigating the impact of prebiotics on obesity and type 2 diabetes initiate the prebiotic supplementation at a young age, coinciding with the initiation of the high-fat diet.”

“In these studies, the mice on a high-fat diet supplemented with prebiotic do not gain as much weight as mice on control supplement and have improved glucose tolerance.”

“In our experiment, we did not want weight to be a variable, so we delayed initiation of prebiotic supplementation until the mice were already obese. Remarkably, mice supplemented with oligofructose were protected from OA progression despite not losing weight, so weight was not a factor in OA progression.”

“This study is the first to investigate the impact of the gut microbiome on the progression of osteoarthritis.”

“We found that from the colon, to the circulation, to the knee specifically, oligofructose was able to reduce inflammation, presumably through increases in certain populations of bifidobacteria.”

“The most significant finding was that obese mice supplemented with oligofructose were completely protected from the accelerated cartilage degeneration following injury typically observed in the OA of obesity.”

“Even though prebiotic and control supplemented mice had equal body mass and body fat percentage, obese mice on oligofructose had significantly more cartilage remaining at the end of the experiment.”

“These results provide the first direct evidence that gut microbiome shifts can influence inflammation and degeneration in diarthrodial joints, and support targeting of the gut microbiome as a viable disease modifying therapeutic strategy to address the OA of obesity that warrants deeper investigation.”

“This study has laid the foundation for the development of new OA therapeutic targets. Currently, there are no disease modifying therapeutic options for OA. This study provides evidence that manipulation of the gut microbiome is a novel therapeutic strategy to address the OA of obesity.

“If orthopedic surgeons take nothing else away from this study, it is important to understand how important diet can be to the progression of OA. I don’t think they can stress enough to their patients how important it is to eat a healthy diet that promotes a healthy gut microbiome.”


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