Abstract

Strong epidemiologic, clinical, and basic science studies have identified a number of factors that may lead to rheumatoid arthritis (RA) onset and progression, particularly involving the complex interplay between genomics, environmental risk factors, the breakdown of immune self-tolerance, and microbiome dysbiosis. A chronic state of inflammation established by infectious agents has long been suspected to set the stage for the development of RA. The purpose of this article is to review the contribution of the gut, lung, and oral microbiomes to the pathogenesis of RA and consider the importance of supplementing the preliminary treatment regime of RA patients with antibiotics, in particular, minocycline. Minocycline has been used in the treatment of RA due to its bacteriostatic, as well as immunomodulatory and anti-inflammatory properties. Ultimately, a short course of antibiotic treatment with minocycline may eliminate pathogenic organisms contributing to the development and progression of RA.

Highlights

  • BackgroundRheumatoid arthritis (RA) is a common autoimmune condition that is present in approximately 1% of the world's population [1]

  • A short course of antibiotic treatment with minocycline may eliminate pathogenic organisms contributing to the development and progression of rheumatoid arthritis (RA)

  • Clinical, and basic science studies have identified a number of factors that may lead to disease onset and progression, involving the complex interplay between genomics, environmental risk factors, breakdown of immune self-tolerance, and microbiome dysbiosis [4]

Read more

Summary

Introduction

Rheumatoid arthritis (RA) is a common autoimmune condition that is present in approximately 1% of the world's population [1]. They have been shown to inhibit metalloproteinases which play a role in cartilage degradation [31] Given these properties and their potential in modulating RA-induced inflammation, joint destruction, and arthritis, a number of clinical trials assessing tetracycline use in the treatment of RA have been performed [33,34,35,36,37,38,39,40,41,42,43]. The second study included 10 RA patients who received 400 mg of oral minocycline for 16 weeks [38] Both studies showed statistically significant improvement in the Disease Activity Score-28 (DAS-28). While minocycline showed some benefit, the combination of tetracycline [39] and doxycycline [4042] showed no benefit with studies demonstrating no statistically significant difference in reducing DAS-28 when comparing RA patients to those who received a placebo. The use of chronic tetracyclines may be associated with an increased risk of developing breast cancer in women or prostate cancer in men [49,50]

Conclusions
Disclosures
Findings
Firestein GS
Full Text
Paper version not known

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call