The brain–gut–joint axis in arthritis: crosstalk, treatment, and future perspectives

Arthritis is an inflammatory disease that affects the joints and often leads to disability and dysfunction, significantly impacting human health. The brain-gut-joint axis is a complex regulatory network that involves the joints and has a profound influence on the development of arthritic diseases by regulating the microenvironment at joint sites. There is a lack of comprehensive reviews on the interplay of the brain-gut-joint axis and its impact on the onset and progression of arthritis, as well as on the innovative therapies for treating the condition. Consequently, the purpose of this review is to uncover the communication between the brain, gut, and joints and to explore their influence on the pathogenesis and progression of arthritis. These interactions can affect the joint microenvironment by modulating various physiological systems, including the immune, metabolic, and nervous systems. Furthermore, therapeutic strategies aimed at improving arthritis by regulating the gut microbiota and maintaining brain health are discussed. This review offers a novel perspective on the development, diagnosis, and treatment of arthritic diseases, with significant implications for enhancing patient well-being. The translational potential of this article: This paper reviews the interactions within the brain-gut-joint axis and its pivotal role in the pathogenesis and progression of arthritis (involving immune, endocrine, neural, and metabolic pathways). It also discusses emerging therapeutic approaches for arthritis based on maintaining the balance of the brain-gut-joint axis, along with future research prospects. These insights will provide direction for exploring emerging therapies for arthritis while further refining clinical strategies for managing the condition.