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Background Immigrants are exposed to numerous risk factors that may contribute to the development of chronic musculoskeletal pain. Recent political and environmental crises in North Africa and the Middle East have led to an increase in immigration to Europe that has challenged the healthcare system and especially the management of chronic conditions. Objective The aims of this scoping review are to investigate the burden, prevalence, and associated factors of chronic musculoskeletal pain in immigrants from North Africa and the Middle East in Europe during the last decade. The intentions of the review are to inform healthcare policymakers, to identify gaps in the literature, and aid the planning of future research. Design Online databases Medline, Embase, PubMed and Web of Science were used to identify epidemiological studies published from2012–2022 examining chronic pain in populations from North Africa and the Middle East with a migration background residing in Europe. Results In total eleven studies were identified conducted in Norway ( n  = 3), Denmark ( n  = 3), Germany ( n  = 1), Austria ( n  = 1), Sweden ( n  = 1), and Switzerland ( n  = 1). Among the identified studies, eight studies were cross-sectional ( n  = 8), two were prospective cohort studies ( n  = 2) and one was a retrospective cohort study ( n  = 1). Data suggested that chronic pain is more prevalent, more widespread, and more severe in people with than without a migration background. Furthermore, immigrants who have resided in the destination country for a longer period experience a higher prevalence of chronic pain compared to those in the early phases of migration. The following factors were found to be associated with chronic pain in this population: female gender, lower education, financial hardship, being underweight or obese, time in transit during migration, experience of trauma, immigration status, anxiety, depression, and post-traumatic stress disorder. Conclusion Several gaps in the literature were identified. Research is limited in terms of quantity and quality, does not reflect actual immigration trends, and does not account for immigration factors. Prospective cohort studies with long follow-ups would aid in improving prevention and management of chronic pain in populations with a migration background. In particular, they should reflect actual immigration trajectories, account for immigration factors, and have valid comparison groups in the countries of origin, transit and destination. Key points • Chronic pain is more prevalent in populations with a migration background than without. • Immigrant women are a particularly susceptible group in developing chronic pain. • Length of stay, socio-economic class and mental health are other associated factors. • Current research does not reflect the magnitude and geography of the issue.

Abstract The close bidirectional relationship between the microbiome and the immune system is well supported, and a role of gut dysbiosis has been implied in many systemic autoimmune diseases. This review aims to provide a critical summary and appraisal of 6 murine studies and 16 clinical studies. The findings of the literature review suggest that gut dysbiosis precedes arthritis and that local intestinal inflammation leads to systemic inflammation in genetically predisposed individuals. However, the exact mechanism by which microorganisms provoke immune responses at distal sites remains to be elucidated. Although a characteristic RA microbiome was not identified, there were some common findings among studies: overabundance of Prevotella copri in early RA patients, and proliferation of the genus Collinsela and some Lactobacillus species. Three mechanisms by which microbiota might contribute to RA pathogenesis were proposed: inflammatory responses (P. copri and Lactobacillus), molecular mimicry (P. copri) and loss of intestinal barrier integrity (Collinsella). Larger longitudinal studies are required in order to shed light on the mechanisms involved and unravel the therapeutic potential of the microbiome, and clinical trials are needed to evaluate the safety and efficacy of the implied therapeutic interventions. Lay Summary What does this mean for patients? The human body harbours a huge and diverse population of small organisms collectively called the microbiome, mainly residing in the gut. The microbiome differs among individuals, but also within the same individual over time, for various reasons, including diet and the use of antibiotics. The small organisms living in our bodies are essential for our health because they play an important role for digestion and protection. Studies in mice and humans have shown that the microbiome and the immune system, the body’s protective system, influence and determine each other. It is therefore not surprising that it has been hypothesized that disruptions in the microbiome might be linked to diseases of the immune system. Recent technological advancements are establishing the specific role of the microbiome in RA. RA is an autoimmune disease in which the immune system attacks healthy cells, which affects the whole body but is characterized mainly by joint pain and inflammation. Although alterations in the microbiome are well reported in RA patients, it remains unclear which organisms (present or absent) contribute (and how) to the development of RA. This review looks at studies in both mice and humans aiming to reveal the role of the microbiome in the development of RA. It is concluded that studies in mice show that changes in the microbiome activate immune cells locally, which then enter the body circulation and migrate to joints, causing distraction. The results of studies in humans are extensive, complex and not consistent. However, all studies demonstrate alterations in the microbiome of RA patients, implying that the microbiome plays a central role in RA. These are important findings because they imply the therapeutic value of minimally invasive treatments, such as diet and supplementation.