There is no cure for rheumatoid arthritis or for most autoimmune diseases for that matter. This is primarily because the specific underlying causes of autoimmune diseases are unknown.
The germ theory of disease, the idea that diseases are caused by microorganisms such as bacteria and viruses, was hypothesized by Louis Pasteur[i] and further described by Robert Koch via his Postulates.[ii] While not applicable to all diseases, the theory has been successfully applied to a myriad of diseases leading to amazing treatments, cures, and vaccines.
Microorganisms, primarily bacteria, have been hypothesized as a cause of rheumatoid arthritis for years. In fact, some early treatments of RA included antibiotics and similar drugs like sulphasalazine (still prescribed today). But, using Koch’s Postulates, no germ could be isolated or identified as triggering the disease. Some still propose using antibiotic protocol to treat RA (see http://www.roadback.org/). I’m curious about this approach and plan to write about it in the future. Now bacteria, as a possible trigger of RA, are back in the scientific news.
As I wrote about in an earlier post, researchers taking a systems approach hypothesize that there are three possible triggers of autoimmune diseases – genetics, bacteria, and a “leaky gut” (proteins from food leaking through intestinal wall and causing an immune response). This work is primarily directed by Dr. Fasano at the University of Maryland.[iii] Now researchers from Harvard University and New York University report research on mice that demonstrated a relationship between the presence of a common bacteria found in the gut and an immune response leading to arthritis.[iv] [v] Mice genetically susceptible to autoimmune arthritis were raised in germ-free environments. They demonstrated a lack of arthritic symptoms. The mice were then exposed to a single type of gut bacterium and they immediately began to show symptoms of arthritis. They also found that a certain type of T cell connected to the production of arthritis-causing antibodies was connected to the presence of bacteria. The researchers argued that the mice didn’t “catch” arthritis from bacteria, but that there’s an interaction between the genetic make-up of the mouse and the autoimmune response to bacteria. This finding supports Fasano’s work and also lends evidence to the genetic link due to the fact that all people don’t get autoimmune diseases when exposed to certain bacteria.
What does this mean for those of us with RA? Probably nothing for the immediate future. We can’t live in germ-free environments like the mice in the study. A general wiping out of bacteria in the gut would wreck havoc on the digestive system and current antibiotic treatments don’t work for everyone with RA. But perhaps this research will spark more attention and funding on these issues leading to potential discoveries of causes of autoimmune diseases leading to the development of effective treatments.
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