May 05, 2017
1 min read

Researchers find link between gut microbiome, osteoarthritis pain

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LAS VEGAS — Researchers from the Netherlands who presented their results at the Osteoarthritis Research Society International World Congress found a link between gut microbiome and pain in patients with osteoarthritis.

“We know that obesity is a well-known risk factor for osteoarthritis, especially knee osteoarthritis,” Cindy Boer, MSc, from Erasmus Medical Center in the Netherlands, said in her presentation. “If you are obese, you have an increased intestinal permeability, meaning that, for instance, bacterial endotoxins produced by the microbiome can more often enter from your gut into your bloodstream. The hypothesis is that these bacterial endotoxins, which are increased if you are obese, can activate your immune system and cause a systemic low-grade inflammation which can, in turn, increase the severity of your osteoarthritis or increase the risk for osteoarthritis.”

Cindy Boer
Cindy Boer

Using 16S ribosomal RNA-sequencing, Boer and colleagues assessed the gut microbial composition of 1,444 study participants. They found no association between overall variation of the gut microbiome and osteoarthritis (OA). However, among single microbial taxonomies, there were six significant associations with OA after adjustment for BMI, age and gender. Two families from the Clostridiales order were associated with both hip WOMAC and Kellgren-Lawrence scores. The only species with an association with OA was Streptococcus, which was associated with knee WOMAC scores.

“Even though Streptococcus is a gram-positive bacterium, some subspecies can create membrane vesicles and we know that these vesicles can go from your gut and into your bloodstream,” Boer said. “Our hypothesis is that these vesicles can activate our immune system, such as macrophages through the TLR4 receptors, and these activated macrophages in turn cause low-grade systemic inflammation within the joint that will cause inflammation and joint damage that will lead to pain.” – by Will A. Offit


Boer CG, et al. Paper #4. Presented at: Osteoarthritis Research Society International World Congress; April 27-30, 2017; Las Vegas.

Disclosure: The researchers report no relevant financial disclosures.