title: The Microbiome: a Revolution in Treatment for Rheumatic Diseases?
abstract: The microbiome is the term that describes the microbial ecosystem that cohabits an organism such as humans. The microbiome has been implicated in a long list of immune-mediated diseases which include rheumatoid arthritis, ankylosing spondylitis, and even gout. The mechanisms to account for this effect are multiple. The clinical implications from observations on the microbiome and disease are broad.
  
  
  
  A growing number of microbiota constituents such as Prevotella copri, Porphyromonas gingivalis, and Collinsella have been correlated or causally related to rheumatic disease. The microbiome has a marked effect on the immune system. Our understanding of immune pathways modulated by the microbiota such as the induction of T helper 17 (Th17) cells and secretory immunoglobulin A (IgA) responses to segmented filamentous bacteria continues to expand. In addition to the gut microbiome, bacterial communities of other sites such as the mouth, lung, and skin have also been associated with the pathogenesis of rheumatic diseases. Strategies to alter the microbiome or to alter the immune activation from the microbiome might play a role in the future therapy for rheumatic diseases.
authors.affiliation: Casey Eye Institute, Oregon Health & Science University, Portland, OR, 97239, USA. rosenbaj@ohsu.edu.|Division of Arthritis and Rheumatic Diseases, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239, USA. rosenbaj@ohsu.edu.|Legacy Devers Eye Institute, 1040 NW 22nd Ave, Suite 200, Portland, OR, 97210, USA. rosenbaj@ohsu.edu.
authors.forename: James T
authors.initials: JT
authors.lastname: Rosenbaum
authors.affiliation: Division of Arthritis and Rheumatic Diseases, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239, USA.
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Asquith
mesh_terms: D006801:Humans; D064307:Microbiota / Q000276:immunology*; D012216:Rheumatic Diseases / Q000276:immunology / Q000382:microbiology / Q000628:therapy*
keywords: Ankylosing spondylitis; Microbiome; Mucosal immunity; Psoriatic arthritis; Rheumatoid arthritis