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Rheumatoid arthritis: proposal for the use of anti-microbial therapy in early cases

Alan Ebringer1, Taha Rashid, Clyde Wilson

  • 1Division of Life Sciences, Infection and Immunity Group, King's College London, UK. alan.ebringer@kcl.ac.uk

Scandinavian Journal of Rheumatology
|March 15, 2003
PubMed

Insights

Rheumatoid arthritis (RA) may stem from Proteus urinary tract infections. Targeting this bacteria with antibiotics or cranberry may aid RA management alongside standard treatments.

Area of Science:

  • Immunology
  • Microbiology
  • Rheumatology

Background:

  • Rheumatoid arthritis (RA) is a chronic autoimmune disease disproportionately affecting women.
  • RA pathogenesis is linked to HLA-DR molecules with specific
  • shared epitope
  • amino acid sequences (EQK/RRAA).
  • Proteus mirabilis exhibits molecular mimicry to the
  • shared epitope
  • and hyaline cartilage collagen.

Purpose of the Study:

  • To investigate the hypothesis that recurrent Proteus upper urinary tract infections contribute to rheumatoid arthritis development.
  • To explore potential adjunctive therapies for RA management targeting Proteus infections.

Main Methods:

  • Review of existing studies reporting elevated antibodies to P. mirabilis in RA patients (1375 patients across 14 countries).
  • Analysis of P. mirabilis isolation from RA patient urine cultures.
  • Evaluation of anti-Proteus measures for potential RA management.

Main Results:

  • Elevated antibodies to P. mirabilis were found in a significant number of RA patients globally.
  • P. mirabilis was isolated from urine cultures of RA patients.
  • Anti-Proteus measures like antibiotics, hydration, and cranberry extracts show efficacy in urinary tract infection treatment.

Conclusions:

  • Recurrent Proteus upper urinary tract infections are a plausible etiological factor in rheumatoid arthritis.
  • Anti-Proteus strategies could serve as supplementary treatments for RA.
  • Further prospective studies are warranted to evaluate anti-Proteus measures in RA management.

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