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Scientists target gut microbiome to treat rheumatoid arthritis in world-first clinical trial

Professor Peter Nash with Carol Pocklington, who has lived with rheumatoid arthritis for more than 20 years. (ABC Sunshine Coast: Jessica Ross)

When Carol Pocklington was diagnosed with rheumatoid arthritis in 2000, it had a rapid and devastating effect on her health. 

"My knees gave out when I was on holiday … I just thought I had a strained muscle," Ms Pocklington said.

"I went to my doctor, he took a blood test and it indicated I had chronic rheumatoid arthritis.

"Within a matter of weeks, I was in a wheelchair and couldn't move … nobody could touch me … I then became virtually bedridden."

Rheumatoid arthritis, or RA, attacks the joints, causing pain, swelling and loss of function.

Ms Pocklington left her job, and her husband John left his to become her full-time carer.

Ms Pocklington (right), pictured at a friend's wedding, feared she would never walk again after losing function in her knees. (Supplied: Carol Pocklington)

They moved from Sydney to the Sunshine Coast, believing they had little time left.

But shortly after the move, Ms Pocklington met rheumatologist Professor Peter Nash, who encouraged her to take part in a clinical trial of a new arthritis drug.

"And I said absolutely yes, not because I understood it but because I was so desperate," Ms Pocklington said.

"And that's really what saved me."

John and Carol Pocklington now lead an active life, after Ms Pocklington endured a frightening health battle. (ABC Sunshine Coast: Jessica Ross)

Two decades on, Ms Pocklington, now 77, has had two knee replacements but can still walk well.

She still sees Professor Nash.

The rheumatologist said while major advancements have been made in the treatment of RA, there was always an "unmet need" of people who had tried everything and failed to respond.

"And wouldn't it be nice to get to the root cause ... and turn the root cause off, especially early on before things become triggered or established?" he said.

Gut could hold key

Professor Nash is the principal investigator in a new clinical trial being run by biotherapeutics company Servatus, also based on the Sunshine Coast.

The company has been delving deep into the gut microbiome, which is home to trillions of microbes — including bacteria.

The gut is home to trillions of microbes, including bacteria that can trigger disease. (Supplied: Servatus)

Some microbes are helpful but others can be harmful, triggering disease.

Servatus chief executive Wayne Finlayson said they were using a "consortium" of bacteria to treat immune diseases in the trial.

"They're actually live bacteria common to your immune system and your body," Dr Finlayson said.

"We're developing these drugs to modulate the microbiome and rebalance it … other drugs can be quite nasty and the body tolerates them but after a certain amount of time patients have to switch drugs.

"Hopefully we can provide a much gentler and natural form of treatment."

Dr Finlayson says preclinical studies involving animals have shown promising results. (ABC Sunshine Coast: Meg Bolton)

Dr Finlayson said the gut microbiome had been a focus in the scientific community for some time.

"I guess the medical profession is just catching up … everyone's starting to talk about gut health," he said.

"The microbiome is really the next evolution in medicine."

The missing link

The company is looking for more participants, ideally located on or close to the Sunshine Coast, to take part in the trial.

Dr Finlayson hoped the research could lead to figuring out what triggers the disease, which affected around 456,000 Australians.

"We work with a company in Norway, experts in what's called biomarkers, and they can look at what people have in their microbiome and say, 'Well, you may be predisposed to getting this'," Dr Finlayson said.

Professor Nash says the trial is exciting because it will help the medical profession understand what causes the condition. (ABC Sunshine Coast: Jessica Ross)

Professor Nash has been involved in arthritis clinical trials since 1988 and said, while RA could be hereditary, it could also affect anyone.

"We can control it, we can induce remission, we can stop damage, we can control pain, we can improve quality of life," Professor Nash said.

"But the next step is doing something about prevention and cure … that's the big step that's not here yet."

Anyone interested to learn more about the clinical study, or to check if they're eligible to participate, is encouraged to visit the study's website or call (07) 3130 0820.

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