CHICAGO—At the 2018 ACR/ARHP Annual Meeting, Allen C. Steere, MD, delivered the Rheumatology Research Foundation Memorial Lecture honoring the late Charles M. Plotz, MD: Linking Gut Microbial Immunity with Autoimmunity in Joints in Patients with Rheumatoid Arthritis. Dr. Steere is professor of medicine at Harvard Medical School, Boston, and director of translational research in rheumatology at Massachusetts General Hospital. His ongoing research focuses on the possible role of infectious agents in the microbiome, particularly Prevatella copri, in the initiation and perpetuation of pathogenic immune responses in rheumatoid arthritis (RA).
Explore this issueMarch 2019
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Bacterial Colonies in the Gut
Rheumatologists have made great progress in understanding RA’s genetic risk factors, but are only now identifying its environmental factors, said Dr. Steere. His lecture focused on the gut as a potential site of immune stimulation.
“Most of the microbiota is in the gut—more than 1,000 bacterial species and over 1 trillion bacterial cells,” he said. Dysbiosis, or a disruption of the normal balance in the microbial commensal ecosystem, with narrowing diversity, may result in disease.2 Gut dysbiosis has been demonstrated in rheumatic diseases like RA, ankylosing spondylitis, psoriatic arthritis and reactive arthritis. Implicated organisms in these diseases vary, but one common feature is reduction in diversity, allowing expansion of certain species.