THE STATE OF MICROBIOTA OF THE LARGE INTESTINE IN PATIENTS WITH RHEUMATOID ARTHRITIS ASSOCIATED WITH BORRELIA BURGDORFERI

Smiyan S.I., Yuskevych V.V., Makhovska O.S.

• I. Horbachevsky Ternopil National Medical University

Summary. Gut microbiota and the pathology of inflammatory joint disease in rheumatology are interrelated. On the one hand, it is a violation of the quantitative and qualitative composition of the large intestine microbiota with the development of marked dysbiosis after long-term receiving of pharmacological medication, and on the other hand — the role of gut microflora in the pathogenesis of autoimmune rheumatological diseases. The aim of the study is to determine the features of the gut microbiota in patients with rheumatoid arthritis (RA) associated with Borrelia burgdorferi (B. burgdorferi). Materials and methods. We have examined 96 patients which were divided into two groups: 52 (the 1^st group) — patients with RA associated with B. burgdorferi, 44 (the 2^nd group) — isolated RA aged from 21 to 78 years. The diagnosis of RA has been verified according to the classification criteria (ACR/EULAR 2010). Specific IgM and IgG in the serum of patients of the 1 st group to B. burgdorferi complex were confirmed by immunoblot. In addition, all patients underwent bacteriological examination of feces and the degree of intestinal dysbiosis was established. Results and discussion. Patients with RA associated with B. burgdorferi were observed to have a significant decrease in bifidobacteria (p=0.012), lactobacteria (p=0.013), Escherichia coli (p=0.04). The content of fungi of the genus Candida in patients with existing B. burgdorferi was almost 1.5 times higher than in patients with isolated RA (p=0.002). IV degree dysbiosis was not detected in any of the patients with isolated RA, whereas 3 (6.1%) patients with existing B. burgdorferi were diagnosed dysbiosis in the III stage (59.2%). More than half of the patients (57.9%) with isolated RA, were observed to have the dysbiosis of the II stage. Conclusions. Patients with detectable B. burgdorferi, before the treatment, have more expressive disorders of the gut microbiota with the development of a harder stage of dysbiosis than patients with isolated RA who received basic anti-rheumatic medication, non-steroidal anti-inflammatory, and biologic medications that also has some negative influence on the composition of the microbiome, however, it provoked less dysbiotic changes in patients.