title: Decrease in anti-Proteus mirabilis but not anti-Escherichia coli antibody levels in rheumatoid arthritis patients treated with fasting and a one year vegetarian diet.
abstract: OBJECTIVE
  To measure Proteus mirabilis and Escherichia coli antibody levels in patients with rheumatoid arthritis (RA) during treatment by vegetarian diet.
  
  
  METHODS
  Sera were collected from 53 RA patients who took part in a controlled clinical trial of fasting and a one year vegetarian diet. P mirabilis and E coli antibody levels were measured by an indirect immunofluorescence technique and an enzyme immunoassay, respectively.
  
  
  RESULTS
  The patients on the vegetarian diet had a significant reduction in the mean anti-proteus titres at all time points during the study, compared with baseline values (all p < 0.05). No significant change in titre was observed in patients who followed an omnivorous diet. The decrease in anti-proteus titre was greater in the patients who responded well to the vegetarian diet compared with diet non-responders and omnivores. The total IgG concentration and levels of antibody against E coli, however, were almost unchanged in all patient groups during the trial. The decrease from baseline in proteus antibody levels correlated significantly (p < 0.001) with the decrease in a modified Stoke disease activity index.
  
  
  CONCLUSIONS
  The decrease in P mirabilis antibody levels in the diet responders and the correlation between the decrease in proteus antibody level and decrease in disease activity supports the suggestion of an aetiopathogenetic role for P mirabilis in RA.
authors.affiliation: Institute of Immunology and Rheumatology, National Hospital, Oslo, Norway.
authors.forename: J
authors.initials: J
authors.lastname: Kjeldsen-Kragh
authors.forename: T
authors.initials: T
authors.lastname: Rashid
authors.forename: A
authors.initials: A
authors.lastname: Dybwad
authors.forename: M
authors.initials: M
authors.lastname: Sioud
authors.forename: M
authors.initials: M
authors.lastname: Haugen
authors.forename: O
authors.initials: O
authors.lastname: Førre
authors.forename: A
authors.initials: A
authors.lastname: Ebringer
mesh_terms: D000907:Antibodies, Bacterial / Q000097:blood*; D001172:Arthritis, Rheumatoid / Q000178:diet therapy / Q000276:immunology / Q000382:microbiology*; D014676:Diet, Vegetarian; D004926:Escherichia coli / Q000276:immunology*; D005215:Fasting; D005500:Follow-Up Studies; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D011513:Proteus mirabilis / Q000276:immunology*; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000907:Antibodies, Bacterial; D007074:Immunoglobulin G