Abstract| Volume 28, SUPPLEMENT 1, S15, April 2020

From Gut To OA

      Purpose: As well all know, osteoarthritis (OA) is a disease of diarthrodial joints that leads to joint degeneration, inflammation, and pain. OA is the most prevalent disabling disease globally. Despite efforts to develop a disease modifying treatment, the only accepted and available clinical approaches involve palliation. While many factors contribute to the development of OA, the gut microbiome has recently emerged as an important pathogenic factor in OA initiation and progression, particularly in the context of obesity. This presentation will provide an up-to-date review of the literature regarding the link between the gut microbiome and OA.
      Literature and Data to be Discussed: Studies showing correlations between serum levels of bacterial metabolites and joint degeneration were the first links connecting a dysbiosis of the gut microbiome with OA. Further investigations have demonstrated that microbial community shifts induced by antibiotics, a germ-free environment or high fat diet are important underlying factors in joint homeostasis and OA. In fact, key pro-inflammatory species have been linked to joint pain in humans with knee OA. Data will also be presented that suggests the action of ‘joint protective’ nutraceuticals may be via shifts in the gut microbiome. It follows that strategies to manipulate the microbiome have demonstrated efficacy in mitigating joint degeneration in OA, and may represent a new strategic approach to address disease modification for this disease.
      Summary: While role of the microbiome in OA is an area of intense study, no clear mechanism of action has been determined. Increased understanding of how the two factors interact may provide mechanistic insight into OA and lead to disease modifying treatments.