How the microbiota shapes rheumatic diseases

Abstract

The human gut harbours a tremendously diverse and abundant microbial community that correlates with, and even modulates, many health-related processes. The mucosal interfaces are particularly active sites of microorganism-host interplay. Growing insight into the characteristic composition and functionality of the mucosal microbiota has revealed that the microbiota is involved in mucosal barrier integrity and immune function. This involvement affects proinflammatory and anti-inflammatory processes not only at the epithelial level, but also at remote sites such as the joints. Here, we review the role of the gut microbiota in shaping local and systemic immune responses and how disturbances in the host-microorganism interplay can potentially affect the development and progression of rheumatic diseases. Increasing our understanding of how to promote host-microorganism homeostasis could therefore reveal novel strategies for the prevention or alleviation of rheumatic disease.

Robust interferon signature and suppressed tissue repair gene expression in synovial tissue from patients with postinfectious,Borrelia burgdorferi‐induced Lyme arthritis

“…Although synovectomy was important in the resolution of arthritis in the patients reported here, postinfectious LA eventually resolves in all patients (Steere & Angelis, 2006). We postulate that without "danger signals" (Arvikar et al, 2013;Potempa, Mydel, & Koziel, 2017), dysbiosis within the gut Van de Wiele, Van Praet, Marzorati, Drennan, & Elewaut, 2016), or smoking-related lung fibrosis (Antoniou et al, 2013). However, in RA, autoimmunity usually develops into a life-long immune disorder, which does not happen in postinfectious LA, implying that in RA, antigenic triggers remain.…”

“…The relationships between chronic vascular damage, tissue fibrosis, and autoimmunity seen in postinfectious LA may have broader implications for development of pathogenic autoimmunity in other conditions such as RA. An association between tissue damage signals and autoimmunity has been observed in RA (Nefla, Holzinger, Berenbaum, & Jacques, ), which may be initiated at sites of extra‐articular inflammation and tissue damage from periodontal disease within the oral cavity (Arvikar et al, ; Potempa, Mydel, & Koziel, ), dysbiosis within the gut (Pianta et al, ; Van de Wiele, Van Praet, Marzorati, Drennan, & Elewaut, ), or smoking‐related lung fibrosis (Antoniou et al, ). However, in RA, autoimmunity usually develops into a life‐long immune disorder, which does not happen in postinfectious LA, implying that in RA, antigenic triggers remain.…”

Systematic review: the effects of proton pump inhibitors on the microbiome of the digestive tract—evidence from next‐generation sequencing studies

“…coverage is required for obtaining resolutions down to species level, and there are concerns regarding reproducibility between the established sequencing platforms and computational tools. [38][39][40] The application of next-generation sequencing indicated numerous associations between gastrointestinal conditions and altered composition of the microbiome, for example in inflammatory bowel disease 41 and C difficile infection, 42 and a wide range of non-intestinal diseases such as type 1 and 2 diabetes, 43,44 liver and cardiovascular disease, 45,46 rheumatic diseases, 47 multiple sclerosis 48 and autism-spectrum disorders. 49 Microbiome compositions that differ from a balanced, healthy state are often referred to as dysbiosis, although there is no consensus on the composition of a eubiotic, healthy microbiome, nor is there a widely agreed definition of the term dysbiosis.…”

From germ theory to germ therapy

“…Dysbiosis can represent a change in the numbers of microbes or a change in the diversity of the microbiota that may be related to certain diseases and health conditions. In this section, we highlight a few of the recent findings on the role of the microbiota in particular diseases or conditions, but we cannot touch on all of the emerging findings in a multitude of other diseases, including but not limited to autoimmune disease, colorectal cancer, liver disease, and diabetes …”