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The Role of the Microbiome in Rheumatic Diseases

  • RHEUMATOID ARTHRITIS (LW MORELAND, SECTION EDITOR)
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Abstract

There is a growing understanding of the mechanisms by which the influence of the microbiota projects beyond sites of primary mucosal occupation to other human body systems. Bacteria present in the intestinal tract exert a profound effect on the host immune system, both locally and at distant sites. The oral cavity has its own characteristic microbiota, which concentrates in periodontal tissues and is in close association with a permeable epithelium. In this review we examine evidence which supports a role for the microbiome in the aetiology of rheumatic disease. We also discuss how changes in the composition of the microbiota, particularly within the gastrointestinal tract, may be affected by genetics, diet, and use of antimicrobial agents. Evidence is presented to support the theory that an altered microbiota is a factor in the initiation and perpetuation of inflammatory diseases, including rheumatoid arthritis (RA), spondyloarthritis (SpA), and inflammatory bowel disease (IBD). Mechanisms through which the microbiota may be involved in the pathogenesis of these diseases include altered epithelial and mucosal permeability, loss of immune tolerance to components of the indigenous microbiota, and trafficking of both activated immune cells and antigenic material to the joints. The potential to manipulate the microbiome, by application of probiotics and faecal microbial transplant (FMT), is now being investigated. Both approaches are in their infancy with regard to management of rheumatic disease but their potential is worthy of consideration, given the need for novel therapeutic approaches, and the emerging recognition of the importance of microbial interactions with human hosts.

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Authors and Affiliations

  1. Department of Medicine, Dunedin School of Medicine, University of Otago, P O Box 913, Dunedin, 9053, New Zealand

    Nigel Yeoh & Simon Stebbings

  2. Human Microbiology and Probiotics, Lawson Health Research Institute, St Joseph’s Health Care, London, ON, Canada

    Jeremy P. Burton & Gregor Reid

  3. School of Dentistry, University of Otago, Dunedin, New Zealand

    Praema Suppiah

  4. Department of Microbiology and Immunology, The University of Western Ontario, London, ON, Canada

    Gregor Reid

  5. Division of Urology, Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada

    Jeremy P. Burton

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  1. Nigel Yeoh
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  2. Jeremy P. Burton
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  3. Praema Suppiah
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  4. Gregor Reid
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  5. Simon Stebbings
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Correspondence to Simon Stebbings.

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This article is part of the Topical Collection on Rheumatoid Arthritis

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Yeoh, N., Burton, J.P., Suppiah, P. et al. The Role of the Microbiome in Rheumatic Diseases. Curr Rheumatol Rep 15, 314 (2013). https://doi.org/10.1007/s11926-012-0314-y

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