Oral antibiotics as a novel therapy for arthritis: evidence for a beneficial effect of intestinal Escherichia coli.
OBJECTIVE
The intestinal flora is thought to play an important role in regulation of immune responses. We investigated the effects of changing the intestinal flora on the course of adjuvant-induced arthritis (AIA) and on experimental autoimmune encephalomyelitis (EAE) by the use of oral antibiotics.


METHODS
Oral treatment with either vancomycin or vancomycin, tobramycin, and colistin was started after AIA and EAE induction. Clinical symptoms of AIA and EAE were monitored, and microbial analysis of ileal samples was performed.


RESULTS
Oral vancomycin treatment after disease induction significantly decreased clinical symptoms of AIA. Simultaneously, increased concentrations of Escherichia coli were detected in the distal ileum of vancomycin-treated rats. Ileal concentrations of E coli were inversely related to disease scores in rats with AIA. Coadministration of colistin/tobramycin to prevent the increase in E coli abrogated the beneficial effect of vancomycin on AIA. Vancomycin treatment also reduced the clinical symptoms of EAE.


CONCLUSIONS
We propose oral vancomycin as a novel therapeutic strategy in autoimmune diseases.
Nieuwenhuis
E E
EE
Wilhelmina Children's Hospital, Utrecht, The Netherlands.
Visser
M R
MR
Kavelaars
A
A
Cobelens
P M
PM
Fleer
A
A
Harmsen
W
W
Verhoef
J
J
Akkermans
L M
LM
Heijnen
C J
CJ
D000284:Administration, Oral; D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001169:Arthritis, Experimental / Q000188:drug therapy; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D003345:Corticosterone / Q000097:blood; D004681:Encephalomyelitis, Autoimmune, Experimental / Q000188:drug therapy; D004926:Escherichia coli / Q000187:drug effects / Q000302:isolation & purification; D007082:Ileum / Q000382:microbiology; D007422:Intestines / Q000382:microbiology; D008297:Male; D051381:Rats; D011917:Rats, Inbred Lew; D012720:Severity of Illness Index; D013601:T-Lymphocytes / Q000187:drug effects / Q000502:physiology; D014640:Vancomycin / Q000494:pharmacology / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D014640:Vancomycin; D003345:Corticosterone