By Meagan Chriswell, University of Colorado Anschutz Medical Campus

Aurora (The Conversation)(PTI): Rheumatoid arthritis affects 1 in 100 people worldwide. It causes inflamed, painful and swollen joints, often in the hands and wrists, and can lead to loss of joint function as well as chronic pain and joint deformities and damage.

What causes this condition has been unknown.

In our recently published study, my colleagues and I found an important clue to a potential culprit behind this disease: the bacteria in your gut.

What causes rheumatoid arthritis?

Rheumatoid arthritis is an autoimmune condition, meaning it develops when the body's immune system starts to attack itself. Proteins called antibodies, which usually help fight off viruses and bacteria, begin to attack the joints instead.

The origins of the antibodies that cause rheumatoid arthritis have been an area of study for many years.

Some research has shown that these antibodies can start forming at sites like the mouth, lung and intestines over 10 years before symptoms arise.

But until now, it was unclear why researchers were finding these antibodies in these particular areas.

We wanted to investigate what could trigger the formation of these antibodies. Specifically, we wondered if bacteria in the microbiome, a community of microorganisms that live in the intestines, might be the ones activating the immune response that leads to rheumatoid arthritis.

Since microbes commonly live at the same sites as the antibodies driving rheumatoid arthritis, we hypothesised that these bacteria could be triggering the production of these antibodies.

We reasoned that though these antibodies were meant to attack the bacteria, rheumatoid arthritis develops when they spread beyond the intestines to attack the joints.

First, we sought to identify the intestinal bacteria targeted by these antibodies. To do this, we exposed the bacteria in the feces of a subset of people at risk for developing rheumatoid arthritis to these antibodies, allowing us to isolate just the bacterial species that reacted and bound to the antibodies.

We found that one previously unknown species of bacteria was present in the intestines of around 20 per cent of people who were either diagnosed with rheumatoid arthritis or produce the antibodies that cause the disease.

As a member of the Cherokee Nation of Oklahoma, I suggested we name this species Subdoligranulum didolesgii ( didolesgii means arthritis or rheumatism in Cherokee) as a nod to the contributions that other Indigenous scholars have made to science as well as the fact that rheumatoid arthritis affects Indigenous people at a higher rate than other populations.

Subdoligranulum didolesgii has not been detected in the feces of healthy people before, and it is currently unknown how prevalent this bacteria is in the general population.

We also found that these bacteria can activate specialised immune cells called T cells in people with rheumatoid arthritis.

T cells drive inflammatory responses in the body, and have been linked to the development of different autoimmune diseases.

These findings suggest that these gut bacteria may be activating the immune systems of people with rheumatoid arthritis. But instead of attacking the bacteria, their immune system attacks the joints.

Why this bacteria?

It is still unknown why people with rheumatoid arthritis develop an immune response to Subdoligranulum didolesgii.

But we think it may be the culprit when it comes to rheumatoid arthritis because this bacteria is found only in the intestines of people with rheumatoid arthritis, and not in the intestines of healthy people.

While many immune responses happen in the intestines, they are usually self-contained and do not spread to other areas of the body.

However, we believe that a particularly strong intestinal immune response against Subdoligranulum didolesgii could allow antibodies to bypass the intestinal firewall and spread to the joints.

To confirm our hypothesis, we gave mice an oral dose of Subdoligranulum didolesgii and monitored their reaction.

Within 14 days, the mice began to develop joint swelling and antibodies that attacked their joints.

The future of rheumatoid arthritis treatment

My colleagues and I hope this research can shed light on the origins of rheumatoid arthritis.

Our next goal is to discover how common these bacteria are in the general population and test whether the presence of these bacteria in the gut may lead to the development of rheumatoid arthritis in people.

It's important to note that antibiotics are unlikely to be helpful treatment for the microbiomes of patients with rheumatoid arthritis.

Although Subdoligranulum didolesgii may be triggering an autoimmune response for some people with rheumatoid arthritis, antibiotics eliminate both helpful and harmful bacteria in the gut.

Additionally, removing the bacteria won't necessarily stop the immune system from attacking the joints once it has started.

Nevertheless, we believe that these bacteria can be used as tools to develop treatments for rheumatoid arthritis and hopefully ways to prevent disease from happening in the first place.

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Chicago/Washington (PTI): Former US president Donald Trump was injured after being shot in the ear during an apparent assassination attempt at an election rally in Pennsylvania after which a male attacker was shot and killed by a member of the Secret Service.

Trump, 78, was hit by a bullet in the upper part of his right ear when the suspected shooter fired multiple shots toward the stage from an elevated position outside of the rally venue in Butler on Saturday, the US Secret Service said.

The attacker killed one spectator at the rally, and two others were critically injured.

Secret Service agents swarmed Trump and ducked behind the podium. Blood could be seen on his right ear of Trump as agents surrounded him and led him off the stage to a waiting vehicle to whisk him away.

Trump said, “Let me get my shoes,” as he was escorted to the safe place. He was seen pumping his fist to the shocked supporters.

The shooting is being investigated as an attempted assassination.

“US Secret Service personnel neutralised the shooter, who is now deceased. The US Secret Service quickly responded with protective measures and Former President Trump is safe,” Anthony Guglielmi, Secret Service spokesperson said in a statement.

"This incident is currently under investigation. and the Secret Service has notified the FBI,” he said after the incident.

The suspect fired from between 200ft and 300ft away on an elevated shed with an AR-style rifle, multiple law enforcement officers told CBS News.

The FBI said they were not prepared to identify the attacker and they have not yet identified a motive behind the crime. It called the shooting at Trump’s rally Saturday night an attempted assassination.

“This evening, we had what we’re calling an assassination attempt against our former President Donald Trump. It’s still an active crime scene,” said Kevin Rojek, the special agent in charge of the FBI’s Pittsburgh field office, speaking at a news conference in Butler, Pennsylvania.

He said authorities are “working feverishly to attempt to identify the individual who did this and any motives behind why this was done,” and asked the public to reach out with any information that might help.

The FBI has deployed investigative agents, evidence response teams, and other personnel from across the country, he said.

Lt Col George Bivens from the Pennsylvania State Police said officers at the scene had acted "heroically" to respond to the shooter.

He said there is no reason to believe there was any further "existing threat out there".

Law enforcement say they could release the name of a suspected shooter within the next few hours.

Trump is "fine," a spokesperson said.

“As was communicated earlier this evening, President Trump is doing well and grateful to law enforcement and first responders for their fast action,” his campaign said.

The incident happened two days before the start of the Republican National Convention in Milwaukee, where Trump will formally become the party’s nominee for the November 5 presidential election.

“President Trump looks forward to joining you all in Milwaukee as we proceed with our convention to nominate him to serve as the 47th President of the United States. As our party's nominee, President Trump will continue to share his vision to Make America Great Again,” his campaign said.

Trump said he was "shot with a bullet that pierced the upper part of my right ear".

"I knew immediately that something was wrong in that I heard a whizzing sound, shots, and immediately felt the bullet ripping through the skin." the former president posted on his Truth Social account.

"Much bleeding took place, so I realised then what was happening."

The suspected shooter at the rally did not have identification, reports said.

US President Joe Biden spoke to Trump, his November election opponent, a White House official said.

The White House official did not say what the two spoke about.

Biden also talked with Pennsylvania Governor Josh Shapiro and Butler Mayor Bob Dandoy, the White House said.

Biden was scheduled to be in Delaware for the weekend but changed his plans to return to the White House.

Biden earlier said that “everybody must condemn” the suspected assassination attempt.

Addressing the nation about two hours after the shooting, he said “We cannot allow this to be happening,” Biden said. “The idea that there's violence in America like this is just unheard of."

Thousands of Trump supporters were attending the rally when the shooting, which was captured live on news channels, happened. The shooting created chaos with people in the back of the venue immediately running to the exits.

Vice President Kamala Harris and former presidents, Barack Obama, George W Bush and Bill Clinton have condemned the attack on Trump.

Harris says she is "relieved" Trump was not seriously injured.

by this senseless shooting," Harris said in a statement.

"Violence such as this has no place in our nation. We must all condemn this abhorrent act and do our part to ensure that it does not lead to more violence," she said.

Trump's daughter, Ivanka Trump, also issued a statement.

"Thank you for your love and prayers for my father and for the other victims of today's senseless violence in Butler, Pennsylvania," she said in a statement on X.

"I am grateful to the Secret Service and all the other law enforcement officers for their quick and decisive actions today. I continue to pray for our country. I love you Dad, today and always."

Trump also thanked the Secret Service and other law enforcement "for their rapid response to the shooting that just took place".

"Most importantly, I want to extend my condolences to the family of the person at the rally who was killed, and also to the family of another person that was badly injured," he said in the post.

"It is incredible that such an act can take place in our country. Nothing is known at this time about the shooter, who is now dead," he added.

He ended the post with, "GOD BLESS AMERICA!"