To synthesize current evidence on the role of gut microbiota in elderly-onset rheumatoid arthritis (EORA) and evaluate the therapeutic potential of microbiota-targeted interventions, including dietary modifications, nutraceuticals, and fecal microbiota transplantation.
Key Findings:
EORA presents distinct clinical challenges, including more refractory disease activity and higher comorbidity burden compared to younger-onset RA, which may complicate treatment strategies.
The interplay between immunosenescence, inflammaging, and gut microbiota dysbiosis is implicated in the pathogenesis of EORA, suggesting potential targets for intervention.
Immunosenescence is characterized by T cell exhaustion and alterations in immune cell functionality, contributing to the unique pathophysiology of RA in the elderly, which may require tailored therapeutic approaches.
Inflammaging is associated with elevated systemic levels of pro-inflammatory mediators, which may exacerbate RA progression, highlighting the need for anti-inflammatory strategies.
Interpretation:
The review highlights the need for further exploration of the immune system and gut microbiota characteristics in EORA to optimize clinical management and develop targeted therapies.
Limitations:
Insufficient exploration of the immune system and gut microbiota in EORA, which may limit understanding of disease mechanisms.
Exclusion of non-English articles and studies not relevant to aging or microbiota may introduce bias in the findings.
Conclusion:
The review provides a comprehensive overview of the current evidence linking gut microbiota and EORA, emphasizing the potential for microbiota-targeted therapeutic strategies and the urgent need for further research.
