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Role of Microorganisms in Pathogenesis and Management of Autoimmune Diseases pp 387–417Cite as

Microorganisms in Pathogenesis and Management of Rheumatoid Arthritis

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Abstract

Interactions between genetic and environmental factors are implicated in the onset of rheumatoid arthritis (RA). There is an increasing appreciation for the association between intestinal microbiome and RA susceptibility. Alterations in intestinal microbiome in untreated patients and patients with established RA on treatment when compared to healthy individuals suggest that intestinal microbiota can be used as a predictor for risk as well as for treatment response. Intestinal microbial composition is strongly influenced by many factors including diet and infections. There is limited information on the use of diet and probiotics to manipulate microbiome and manage RA. Current treatments for RA produce variable response, and responders rarely achieve sustained remission requiring ongoing therapies. Biomarkers that can predict prognosis and therapeutic responses are lacking. Deciphering the use of endogenous commensals with probiotic-like properties and designing probiotics with targeted proteins would help manage RA without the side effects of immunosuppressive treatments. This chapter presents the key concepts of microbial interactions with the host immune system in pathogenicity of rheumatoid arthritis. Also discussed are treatment opportunities using novel treatment strategies such as the use of endogenous commensals and deliberated possible next-generation microbial therapeutics.

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Abbreviations

AA:

Amino acids

ACPs:

Anti-citrullinated antibodies

AD:

African descent

APCs:

Antigen-presenting cells

BAFF:

B cell-activating factor

BM:

Bone marrow

CIA:

Collagen-induced arthritis

CRP:

C-reactive protein

DCs:

Dendritic cells

DMARDs:

Disease-modifying antirheumatic drugs

DNA:

Deoxyribonucleic acid

DSS:

Dextran sulfate sodium

EBV:

Epstein–Barr virus

EBVNA1:

EBV nuclear antigen 1

ED:

European descent

FMT:

Fecal microbiota transplantation

GF:

Germ-free

GMPs:

Genetically modified probiotics

GPCRs:

G-protein-coupled receptors

GWAS:

Genome-wide association studies

HLA :

Histocompatibility antigens

IBD :

Inflammatory bowel disease

IFN:

Interferon

IgA:

Immunoglobulin A

IL:

Interleukin

ILC3s :

Group 3 innate lymphoid cells

IRAK :

IL-1R-associated kinase

MCP:

Monocyte chemoattractant protein

MHC:

Major histocompatibility complex

MS:

Multiple sclerosis

MTX:

Methotrexate

MUFAs:

Monosaturated fatty acids

NGBTs:

Next-generation bacterial therapeutics

NLRs:

Nod-like receptors

NORA:

New-onset RA

PAD:

Peptidyl arginine deiminase

PAMPs:

Pathogen-associated molecular patterns

PRRs:

Pathogen recognition receptors

PUFAs:

Polyunsaturated fatty acids

RA:

Rheumatoid arthritis

RNA:

Ribonucleic acid

SCFAs:

Short-chain fatty acids

SFB:

Segmented filamentous bacteria

SLE:

Systemic lupus erythematosus

T1D:

Type 1 diabetes

Th17:

T helper 17

TIR:

Toll/interleukin-1 receptor

TLRs:

Toll-like receptors

TNF:

Tumor necrosis factor

TRAF6:

TNF- associated factor 6

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Acknowledgments

The work was supported by the funds from the Department of Defense W81XWH-10-1-0257 and W81XWH-15-1-0213 and Mayo Clinic.

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  1. Department of Immunology, Mayo Clinic, Rochester, MN, USA

    Baskar Balakrishnan & Veena Taneja

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  1. Baskar Balakrishnan
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  2. Veena Taneja
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Correspondence to Veena Taneja .

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  1. C.G. Bhakta Institute of Biotechnology, Uka Tarsadia University, Surat, Gujarat, India

    Mitesh Kumar Dwivedi

  2. C.G. Bhakta Institute of Biotechnology, Uka Tarsadia University, Surat, Gujarat, India

    N. Amaresan

  3. Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK

    E. Helen Kemp

  4. Zabludowizc Center for Autoimmunity, Sheba Medical Center, Tel-Hashomer, Israel

    Yehuda Shoenfeld

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Balakrishnan, B., Taneja, V. (2022). Microorganisms in Pathogenesis and Management of Rheumatoid Arthritis. In: Dwivedi, M.K., Amaresan, N., Kemp, E.H., Shoenfeld, Y. (eds) Role of Microorganisms in Pathogenesis and Management of Autoimmune Diseases. Springer, Singapore. https://doi.org/10.1007/978-981-19-1946-6_16

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