The microbiome in rheumatology: Where are we and where should we go?

Manasson, Julia; Blank, Rebecca B.; Scher, Jose U.

doi:10.1136/annrheumdis-2019-216631

Cited by 59 publications

(40 citation statements)

References 134 publications

(98 reference statements)

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“…The mechanisms conferring protections by microbiome include antigenic competition, the role of lymphocyte homeostasis against pathogens, and the effect on immune regulatory pathway favoring the anti-inflammatory milieu with IL-10 and TGF-β secretion from the regulatory cells and TLR mediated receptor desensitization [87]. Disturbance in this microbiome is evident in the pathogenesis of autoimmune disorders including RA, SLE, and inflammatory bowel disease [88]. Over practice of distancing and antimicrobial sanitizers may lead to dysbiosis triggering autoimmunity.…”

Section: Population Behavioral Modification With Covid-19mentioning

confidence: 99%

Autoimmune and rheumatic musculoskeletal diseases as a consequence of SARS-CoV-2 infection and its treatment

et al. 2020

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The coronavirus disease-2019 (COVID-19) pandemic is likely to pose new challenges to the rheumatology community in the near and distant future. Some of the challenges, like the severity of COVID-19 among patients on immunosuppressive agents, are predictable and are being evaluated with great care and effort across the globe. A few others, such as atypical manifestations of COVID-19 mimicking rheumatic musculoskeletal diseases (RMDs) are being reported. Like in many other viral infections, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection can potentially lead to an array of rheumatological and autoimmune manifestations by molecular mimicry (cross-reacting epitope between the virus and the host), bystander killing (virus-specific CD8 + T cells migrating to the target tissues and exerting cytotoxicity), epitope spreading, viral persistence (polyclonal activation due to the constant presence of viral antigens driving immune-mediated injury) and formation of neutrophil extracellular traps. In addition, the myriad of antiviral drugs presently being tried in the treatment of COVID-19 can result in several rheumatic musculoskeletal adverse effects. In this review, we have addressed the possible spectrum and mechanisms of various autoimmune and rheumatic musculoskeletal manifestations that can be precipitated by COVID-19 infection, its therapy, and the preventive strategies to contain the infection. Keywords Coronavirus disease-2019 (COVID-19) • Rheumatic musculoskeletal diseases (RMDs) • Autoimmunity • Rheumatology Abbreviations AAV Anti-neutrophil cytoplasmic antibodyassociated vasculitis ACE2 Angiotensin-converting enzyme 2 ANA Antinuclear antibodies AIDS Acquired immunodeficiency syndrome APCs Antigen-presenting cells APS Antiphospholipid antibody syndrome ARDS Acute respiratory distress syndrome CAHA Coronavirus-associated hemostatic lung abnormality CART Chimeric antigen receptor T cell CCL2 Chemokine (C-C motif) ligand 2 CK Creatine kinase COVID-19 Coronavirus disease-2019 CSF Cerebrospinal fluid CRS Cytokine release syndrome CXCL8 C-X-C motif chemokine ligand 8 DADA-2 Deficiency of adenosine deaminase-2 DIC Disseminated intravascular coagulation Rheumatology INTERNATIONAL Sanket Shah and Debashish Danda have contributed equally as first authors.

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Section: Population Behavioral Modification With Covid-19mentioning

confidence: 99%

Autoimmune and rheumatic musculoskeletal diseases as a consequence of SARS-CoV-2 infection and its treatment

et al. 2020

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“…Mi-PART study design acknowledges the heterogeneous manifestations of rheumatic diseases, particularly PsA. Previously, this has led to inaccuracies in the recruitment of patients for clinical studies [41]. All the recruitments in our study fulfil CASPAR Criteria [42] which has been proven the most feasible, specific and sensible for PsA diagnosis [43].…”

Section: Discussionmentioning

confidence: 99%

Longitudinal profiling of the gut microbiome in patients with psoriatic arthritis and ankylosing spondylitis: a multicentre, prospective, observational study

et al. 2020

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Background Psoriasis is a chronic inflammatory disease of the skin affecting 2–3% of UK population. 30% of people affected by psoriasis will develop a distinct form of arthritis within 10 years of the skin condition onset. Although the pathogenesis of psoriatic arthritis is still unknown, there is a genetic predisposition triggered by environmental factors. Limited but convincing evidence link the gut microbiome to psoriatic arthritis. The Microbiome in Psoriatic ARThritis (Mi-PART) study propose is to characterise the microbiome-metabolic interface in patients affected by psoriatic arthritis to deepen our understanding of the pathogenesis of the disease. Methods This is a multicentre, prospective, observational study. Psoriatic arthritis (n = 65) and ankylosing spondylitis (n = 30) patients will be recruited in addition to a control group of healthy volunteers (n = 30). Patients eligibility will be evaluated against the Criteria for Psoriatic Arthritis (CASPAR), the Bath Ankylosing Spondylitis Activity Index (BASDAI) and the healthy volunteers who fulfil study inclusion and exclusion criteria. Information regarding their medical and medication history, demographics, diet and lifestyle will be collected. All the participants in the study will be asked to complete a 7-day food diary, to provide stool samples and to complete quality of life questionnaires. Routine clinical laboratory tests will be performed on blood and urine samples. Patients and healthy volunteers with gastrointestinal symptoms, previous history of cancer, gastrointestinal surgery in the previous 6 months or alcohol abuse will be excluded from the study. Discussion The aim of this trial is to characterise the microbiome of psoriatic arthritis patients and to compare it with microbiome of healthy volunteers and of patient with ankylosing spondylitis in order to define if different rheumatologic conditions are associated with characteristic microbiome profiles. Investigating the role of the microbiome in the development of psoriatic arthritis could deepen our understanding of the pathogenesis of the disease and potentially open the way to new therapies.

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“…In addition, we publish a review article on 'The microbiome in rheumatology' by one of today's premier research groups in the field of metagenomics. 4 COVID-19 has not only had an important influence on people, governments, economy, healthcare systems, travel and lastly the organisation of meetings but also has an influence on submissions of manuscripts to journals. Just entering the search term "COVID-19" in the PubMed.…”

Section: Josef S Smolenmentioning

confidence: 99%

Greetings from the editor

Smolen

2020

Ann Rheum Dis

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The microbiome in rheumatology: Where are we and where should we go?

Cited by 59 publications

References 134 publications

Autoimmune and rheumatic musculoskeletal diseases as a consequence of SARS-CoV-2 infection and its treatment

Autoimmune and rheumatic musculoskeletal diseases as a consequence of SARS-CoV-2 infection and its treatment

Longitudinal profiling of the gut microbiome in patients with psoriatic arthritis and ankylosing spondylitis: a multicentre, prospective, observational study

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