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Rheumatoid arthritis is caused by a Proteus urinary tract infection

Alan Ebringer1, Taha Rashid

  • 1Analytical Sciences Group, King's College, London, UK.

APMIS : Acta Pathologica, Microbiologica, Et Immunologica Scandinavica
|September 3, 2013
PubMed

Insights

Rheumatoid arthritis (RA) may stem from Proteus mirabilis urinary infections. Early antibiotic treatment targeting Proteus could prevent joint damage by addressing cross-reactive antibodies.

Area of Science:

  • Microbiology
  • Immunology
  • Rheumatology

Background:

  • Rheumatoid arthritis (RA) affects 1% of the population in developed countries.
  • Genetic and molecular studies suggest an infectious etiology for RA.
  • Elevated antibodies against Proteus mirabilis are found globally in RA patients.

Purpose of the Study:

  • To investigate the causal link between Proteus mirabilis infection and rheumatoid arthritis.
  • To elucidate the pathogenetic mechanism involving cross-reactive autoantibodies.
  • To propose early therapeutic interventions for RA.

Main Methods:

  • Analysis of genetic, molecular, and biological data.
  • Identification of specific microbial sequences (ESRRAL, IRRET) in Proteus.
  • Investigation of the role of peptidyl arginine deiminase in antibody formation.

Main Results:

  • Proteus mirabilis infection is indicated as a cause of RA.
  • A six-stage pathogenetic mechanism triggered by cross-reactive autoantibodies was proposed.
  • Arginine doublets in Proteus sequences explain anti-citrullinated protein antibody development.

Conclusions:

  • Proteus mirabilis is a causative agent of rheumatoid arthritis.
  • Early treatment with anti-Proteus antibiotics and biological agents is recommended.
  • Intervention can prevent irreversible joint damage in RA patients.
Keywords:
ProteusRheumatoid arthritisurinary tract infection

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