The focus of my research is on the development and course of rheumatoid arthritis. This development takes place over several years and involves inflammation of mucous membranes (mouth, lung, gut) leading to production of ant-citrullinated protein and other autoantibodies, after which the disease translocates to the joints. Early aggressive treatment appoaches have made a huge difference in maintaining joint integrity and function, and such appoaches are now tested in individuals at high risk for RA.

Recent data point to an overlap in risk factors for the development and outcome of both rheumatoid arthritis (RA) and cardiovascular diseases (CVD), as well as other chronic inflammatory diseases. In analogy to a successful life style intervention in CVD, a the 'Plants for Joints' trial was performed in Reade, comprising a whole foods plant-based diet combined with exercise and stress management for patients with active RA, and also in patients with osteoarthritis and metabolic syndrome. A group of patients at risk for RA received the same intervention as a pilot study. The trial was successful in both diseases, with good results maintained one year later. Analysis of MRI (liver, muscle) and gut microbiome will lead to a better understanding of the roles of microbiota and metabolism in the development of arthritis.