title: Mononuclear cell response to enterobacteria and Gram-positive cell walls of normal intestinal microbiota in early rheumatoid arthritis and other inflammatory arthritides.
abstract: OBJECTIVE
  To study whether enterobacteria and Gram-positive bacterial cell walls (BCW) derivedfrom normal intestinal microbiota are involved in the etiopathogenesis of early rheumatoid arthritis (RA).
  
  
  METHODS
  Peripheral blood mononuclear cells (PBMC) and synovial fluid mononuclear cells (SFMC) were isolatedfrom patients with early RA (the average duration of 5 months) and the controls (other types of inflammatory arthritis). The mononuclear cell proliferation and tumor necrosis factor-alpha (TNF-alpha) responses to heat-killed Salmonella enteritidis (SE). Yersinia enterocolitica (YE), and Escherichia coli (EC), and to Gram-positive BCW derived from four common intestinal indigenous bacteria, Eubacterium aerofaciens (EA), Eubacterium limosum (EL), Lactobacillus casei (LC), and Lactobacillus fermentum (LF), and a BCW derived from a pathogen, Streptococcus pyogenes (SP) were investigated.
  
  
  RESULTS
  39% or 56% of patients with early RA showed significant proliferation responses by PBMC or SFMC against enterobacteria, respectively. In other types of arthritis, corresponding figures were 59% or 66%. When BCW were used as antigens, 8.1% or 23% of patients with early RA showed proliferation responses by PBMC or SFMC, respectively. In other types of arthritis the corresponding figures were 7.5% or 35%, respectively. However, TNF-alpha production by SFMC stimulated by EA BCW, SE, YE or EC, was significantly higher in early RA than in other types of arthritis.
  
  
  CONCLUSIONS
  These results suggest that SFMC reacting with enterobacteria or BCW exist in some patients with early RA, but also in other types of inflammatory arthritis. Intestinal bacterial agents may play a role in the etiopathogenesis of RA, but the effect appears to be non-specific.
authors.affiliation: Department of Medical Microbiology, Turku Immunology Center, Turku University, Finland. tonche@utu.fi
authors.forename: T
authors.initials: T
authors.lastname: Chen
authors.forename: M
authors.initials: M
authors.lastname: Rimpiläinen
authors.forename: R
authors.initials: R
authors.lastname: Luukkainen
authors.forename: T
authors.initials: T
authors.lastname: Möttönen
authors.forename: U
authors.initials: U
authors.lastname: Yli-Kerttula
authors.forename: R
authors.initials: R
authors.lastname: Saario
authors.forename: P
authors.initials: P
authors.lastname: Toivanen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000276:immunology / Q000382:microbiology*; D002473:Cell Wall / Q000276:immunology; D004755:Enterobacteriaceae / Q000276:immunology*; D005260:Female; D006094:Gram-Positive Bacteria / Q000276:immunology*; D006801:Humans; D007422:Intestines / Q000382:microbiology; D007963:Leukocytes, Mononuclear / Q000276:immunology / Q000382:microbiology*; D008297:Male; D008875:Middle Aged; D013582:Synovial Fluid / Q000276:immunology / Q000382:microbiology