THE ROLE OF GUT MICROBIOTA IN MODULATING IMMUNE RESPONSE IN PATIENTS WITH CHRONIC INFLAMMATORY DISEASES

Abstract

Background

Chronic inflammatory diseases, including rheumatoid arthritis and inflammatory bowel disease, are characterised by persistent immune activation and progressive tissue damage. Increasing evidence suggests that the gut microbiota plays a critical role in regulating immune responses; however, data from South Asian populations remain limited. Understanding microbiota–immune interactions in diverse clinical settings is essential for developing context-specific therapeutic strategies.

Objective

 This research investigates the relationship between gut microbiota composition and immune system regulation in patients with chronic inflammatory conditions such as rheumatoid arthritis and inflammatory bowel disease. It aims to determine whether gut health interventions can help modulate inflammatory responses.

Methods

A hospital-based cross-sectional study was conducted involving 220 adult patients diagnosed with rheumatoid arthritis or inflammatory bowel disease. Stool samples were analysed using 16S ribosomal RNA gene sequencing to assess microbial diversity and taxonomic composition. Systemic inflammation and immune response were evaluated through serum inflammatory markers, cytokine profiling, and immune cell analysis. Statistical analyses were performed to examine associations between microbial patterns, immune parameters, and disease activity.

Results

Both disease groups exhibited significant gut microbiota dysbiosis, characterised by reduced microbial diversity and altered taxonomic composition. Patients with inflammatory bowel disease demonstrated more pronounced loss of beneficial short-chain fatty acid–producing bacteria and increased abundance of pro-inflammatory taxa compared to those with rheumatoid arthritis. Reduced microbial diversity was independently associated with elevated inflammatory markers and an imbalance between pro-inflammatory and regulatory immune responses. Distinct microbial signatures correlated with disease activity severity in both conditions.

Conclusion

The findings indicate a strong association between gut microbiota dysbiosis and immune dysregulation in chronic inflammatory diseases within a South Asian tertiary care setting. Disease-specific microbial patterns and their links to inflammatory burden highlight the gut microbiota as a potential modifiable factor in disease management. These results support further investigation into microbiota-targeted interventions as adjunctive strategies for improving outcomes in chronic inflammatory diseases.