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Bacterial agents in spondyloarthritis: a destiny from diversity?
1Department of Internal Medicine, University of South Florida, Division of Rheumatology, Tampa, FL 33612, USA. jocarter@health.usf.edu
Abstract:
The spondyloarthritides (SpAs) are a group of diseases that share clinical, radiographic and laboratory features; these arthritides also display a tendency for family aggregation. Given the intimate relationship that these types of arthritis share, it suggests that the SpAs might share a common aetiology. Of all the SpAs, the role of bacteria is most clearly defined in reactive arthritis. Tremendous recent insights into the pathophysiology of reactive arthritis have been made, demonstrating that the causative bacteria play a much more complex role than previously thought. The bacteria that are proven to cause reactive arthritis, one of the five types of SpA, will be reviewed and their role in the pathophysiology of reactive arthritis will be examined. The speculative data suggesting links between various other bacteria and the other types of SpAs will be critically analysed. Although these data are not definitive, when viewed using the paradigm that the SpAs might actually represent a common end point from several diverse starting points, they are provocative, suggesting that bacteria might, indeed, be aetiological for the entire group of SpAs.
Insights
Bacteria may cause spondyloarthropathies (SpAs), a group of related inflammatory diseases. Research explores the complex role of bacteria in reactive arthritis and speculates on their role in other SpAs.
Area of Science:
- Immunology
- Microbiology
- Rheumatology
Background:
- Spondyloarthropathies (SpAs) are a group of related diseases with shared features.
- A familial aggregation suggests a potential common cause for SpAs.
- The role of bacteria is most clearly established in reactive arthritis, a type of SpA.
Purpose of the Study:
- To review bacteria proven to cause reactive arthritis.
- To examine the role of these bacteria in reactive arthritis pathophysiology.
- To critically analyze speculative data linking other bacteria to different SpAs.
Main Methods:
- Literature review of causative bacteria in reactive arthritis.
- Analysis of pathophysiological mechanisms involving bacteria.
- Critical evaluation of evidence for bacterial links to other SpAs.
Main Results:
- Recent insights reveal a complex role for causative bacteria in reactive arthritis.
- Speculative data suggest potential bacterial involvement in other SpAs.
- The concept of SpAs as a common endpoint from diverse bacterial triggers is proposed.
Conclusions:
- Bacteria play a significant, complex role in the pathophysiology of reactive arthritis.
- Bacteria are a potential etiological factor for the broader group of spondyloarthropathies.
- Further research is warranted to confirm bacterial links across all SpA types.
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