Can intestinal bacteria trigger rheumatological diseases?
What is this research project about?
Spondyloarthritis (SpA) is a group of frequent chronic rheumatological diseases which start in young adults and lead to disability of the patients. Current therapies are not efficient enough in stopping the progressive impairment of the musculoskeletal system. There is evidence that the microbiome of the gut is involved in triggering the disease. Clarifying the role of infections and the microbiome composition in the pathogenesis of SpA and its subform reactive arthritis may pave the way to new treatment modalities with better efficacy and less side effects.
What’s the current status?
With respect to a potential pathomechanism linking microbial colonization with autoimmunity and induction of SpA, it has been demonstrated that antibodies against Shigella flexneri, Klebsiella pneumoniae and Yersinia enterocolitica may crossreact with HLA-B27, the dominant genetic risk factor of SpA, and that antibodies against Klebsiella were found to be cytotoxic for cells expressing HLA-B27. Whether similar autoantibodies are induced by other members of the microbiota and if yes, under which conditions remains unresolved.
The image shows: Shigella flexneri (Shigellen), group of bacteria. Transmission electron microscopy, negative contrast. Scale = 1 μm. Source: Hans R. Gelderblom, Gabi Schlier, Rolf Reissbrodt/RKI

How do we get there?
In the project RHEUMA-VOR we recruit a large number of patients from Lower Saxony with acute onset of SpA and control diseases. Stool, serum and DNA samples as well as PBMC and, when a joint aspiration was clinically indicated, synovial fluid (SF) and SF cells will be obtained and stored, and various disease-related clinical data as well as dietary habits will be collected. The patients from this inception cohort will be followed for > 2 years, and response to therapy, disease activity and disease progression will be monitored.
The photo shows Professor Strowig in his laboratory. © HZI/Waldthausen & Kreibig
