Joint inflammation and microbes in scale from microbiome to septic arthritis

Czech version

Authors: Z. Hrnčíř
Authors‘ workplace: II. interní gastroenterologická klinika, Lékařská fakulta Univerzity Karlovy a Fakultní nemocnice, Hradec Králové
Published in: Čes. Revmatol., 25, 2017, No. 4, p. 164-171.
Category: Review Article

Overview

Essential relation of arthritis to microbial agent is not identical to usual conception of microbial infection, because abnormal microbiome may participate in pathway of joint pathology. Normal mucosal microbiome of digestive system (i. e. especially oral and intestinal) is a symbiotic part of „superorganism“ with host system, but sequential analysis of microbiotic DNA demonstrated oral/intestinal dysbiosis, important in pathway of autoimmunity, especially as „gut-joint“ axis in rheumatoid arthritis and celiac disease. On the contrary, dysbiosis should not be always a pathogenic phenomenon. For example, using a special manipulation with P. histocoli in humanized HLA DQ8+ mice model, the risk of arthritis was suppressed, and possibility of novel strategy in prophylaxis/therapy was proposed. This observation should be important in rheumatoid arthritis, because preclinical and early phases are „hot spots“ of this disease. In relation to reactive arthritis is actual, that especially enteropathic form is associated to HLA B27+ Ag, i. e. a typical biomarker of spondyloarthritis family. It appears in this connection, that namely Y. enterocolitica related reactive arthritis is actual in daily practice. Native (non-gonococcal) septic arthritis is persistently a serious emergency in rheumatology with ~ 30 % mortality in case of comorbid arthropathy; augmented frequency of this disorder in gout (acute gouty attacks, periarticular urate deposits, ect.) is accentuated. The most important predictors of fatal prognosis in native (non-gonococcal) septic arthritis may be defined as a triade: age over 65 y., polyarticular manifestation, and especially confusional presentation. In precise at time diagnosis, the rheumatologist is specialist of first line; the review should be a help also in this responsible task..

Keywords:
Oral/intestinal microbiome, dysbiosis and autoimmunity, gut-joint axis, rheumatoid arthritis, reactive arthritis, septic arthritis

Sources

1. Mathew AJ, Ravindran V. Infections and arthritis. Best Pract Res Clin Rheumatol 2014; 28: 935–959.

2. Lederberg J. Infectious history. Science 2000; 288: 287–293.

3. Kohoutová D, Rejchrt S, Drahošová M, Förstl M, Morávková M, Šmajs D, et al. Střevní mikrobiota u idiopatických střevních zánětů a kolorektálních neoplázií. Nucleus HK, vyd. 1, Hradec Králové, 2013, s. 126.

4. Scher JU, Littman DR, Abramson SB. Microbiome in inflamatory arthritis and human rheumatic diseases. Arthritis Rheum 2016; 60: 35–45.

5. Krejsek J, Andrýs C, Krčmová I. Imunologie člověka. Garamon, vyd. 1, Hradec Králové, 2016, s. 496.

6. Simkin PA. The human knee: A window on the microvasculature. Tissue Barriers 2015; 3: e9700465-1-5. www.Iandesbioscience.com

7. Kim D, Kim WU. Can Prevotella copri be a causative pathobiont in rheumatoid arthritis? Arthritis Rheum 2016; 68: 2565–2567.

8. Santegoets KMC, Wenink MH, Braga FAV, Cossu M, Lambers-Karnebeek FBG, van Riel PLCM, et al. Impaired Pophyromonas gingivalis-induced Tumor Necrosis Factor production by dentritic cells typifies patients with rheumatoid arthritis. Arthritis Rheum 2016; 68: 795–804.

9. Valesini G, Gerardi MC, Iannuccelli C, Paducci VA, Pendolino M, Shoenfeld Y. Citrullination and autoimmunity. Autoimmunity Rew 2015; 14: 490–497.

10. Koning F, Thomas R, Rossjohn J, Toes RE. Coeliac disease and rheumatoid arthritis: similar mechanisms, different antigens. Nat Rev Rheumatol 2015;11: 450–461.

11. Gutierrez-Achury J, Zorro MM, Ricaňo-Ponte I, Zhermakova DV. Coeliac Disease Immunoship Consortium, RACI Consortium, et al. Functional implications of disease-specific variants in loci jointly associated with coeliac disease and rheumatoid arthritis. Human Mol Genetics 2016; 25:180–190.

12. Lerner A, Matthias T. Rheumatoid arthritis-celiac disease relationship: joints get that gut feeling. Autoimmunity Rev 2018; 14:1038–1047.

13. Toes REM, Huizinga TJW. Update on autoantibodies to modified proteins. Curr Opin Rheumatol 2015; 27: 262–267.

14. Dobeš J. Nové regulační mechanismy imunitní tolerance a homeostázy ve střevě. Imunol zpravodaj 2016; 31: 42–54.

15. Chen J, Wright K, Davis JM, Jeraldo P, Marietta EV, Murray J et al. An expansion of rare lineage intestinal microbes characterized rheumatoid arthritis. Genome Med 2016; 8: 43. DOI 10.1186/sl3037-016-0299-7.

16. Marietta EV, Murray JA, Luckey DH, Jenaldo PR, Lambda A, Patel R, et al. Suppression of inflammatory arthritis by human gut-derived Prevotella histicola in humanized mice. Arthritis Rheum 2016; 68: 2878–2888.

17. van Steenbergen HW, Huizinga TWJ, van der Helm-van Mil AHM. The preclinical phase of rheumatoid arthritis. Arthritis Rheum 2013; 65: 2219–2232.

18. Koszarny A, Majdan M, Suszek D, Dryglewska M, Tabarkiewich J. Autoantibodies against gliadin in rheumatoid arthritis and primary Sjögren´s syndrome patients. Wiad Lek 2015; 68: 242–247.

19. Scher JU, Ubeda C, Artacho A, Attur M, Isaac S, Redy SM, et al. Decreased bacterial diversity characterizes the altered gut microbiota in patients with psoriatic arthritis resembling dysbiosis in inflammatory bowel disease. Arthritis Rheum 2015; 67: 128–139.

20. Conti V, Leone MC, Casato M, Nicoli M, Granata G, Carlesimo M. High prevalence of gluten sensitivity in a cohort of patients with undifferentiated connective tissue disease. Eur Ann Allergy Clin Immunol 2015; 47: 54–57.

21. Žurek M, Horák P. Reaktivní artritidy. Čes Revmatol 2017; 25: 91–98.

22. Tradulo D, Mangualde J, Cremers I, Oliviera APOD. Reactive arthritis mimicking inflammatory bowel disease arthritis: a challenging diagnosis. Acta Rheumatol Port 2014; 39: 188–192.

23. Bauer T, Boisrenoult P, Jenny JY: Post-arthroscopy septic arthritis: current data and practical recommendations. Orthop Traumatol Surg Res 2015;01 (Suppl 8): S347-350.

24. Sian Yik Lim, Na Lu, Hyon K Choi. Septic arthritis in gouty patients: a population-based cohort study. Rheumatology 2015; 54: 2095–2099.

25. Ahmed I, Gertner E. Safety of arthrocentesis and joint injection in patients receiving anticoagulation at therapeutic levels. Amer J Med 2012; 125: 265–269.

26. Coakley G, Mathews C, Field M, Jones A, Kingsley G, Walker D, et al. BSR, BHPR, BOA, RCGP and BSAC guidelines for management of the hot swollen joint in adults. Rheumatology 20016; 45: 1039–1041.

27. Yui JC, Preskill C, Greenlund LS. Arthrocentesis and joint injection in patients receiving direct oral anticoagulants. Mayo Clin Procc 2017; 92: 1223–1226.

28. Bureš J, Řehulová E, Kalinová M, Hrnčíř Z. Stafylokoková sepse s purulentní artritidou jako fatální komplikace progresivní polyartritidy. Lék zprávy (Hradec Králové) 1982; 27: 13–21.

29. Vardakas KZ, Kontopidis I, Gkegkes ID, Rafailidis PI, Falagas ME. Incidence, characteristics, and outcomes of patients with bone and joint infections due to community-associated methicilin-resistant Staphylococcus aureus: a systematic review. Eur J Clin Microbiol Infect Dis 2013; 32: 711–721.

30. Sky K, Arroyo RA, Collamer AN. Salmonella septic arthritis in a patient receiving etanecerpt: case report and review of the literature. Mil Med 2013; 178: 384–387.

31. Bubonja-Sonje M, Rubinic D, Anic F, Novak S, Vuckovic D, Abram M. Salmonella enterica arthritis in a patient with rheumatoids arthritis receiving anti-tumor necrosis factor therapy. West Indian Med J 2013; 62: 270–272.

32. Coutlakis PJ, Robets WN, Wise ChM. Another look at synovial fluid leukocytosis and infection. J Clin Rheumatol 2002; 8: 67–71.

33. Trampuz A, Hanssen AD, Osmon DR, Mandrekar J, Steckelberg JM, Patel R. Synovial fluid leukocyte count and differential for the diagnosis of prosthetic knee infection. Amer J Med 2004; 117: 556–562.

34. Deirmengian C, Kardos K, Kilmartin P, Gulati S, Citrano P, Booth Jr RE. The alpha-defensin test for periprosthetic joint infection responds to a wide spectrum of organisms. Clin Orthop Relat Res 2015; 473: 2229–2235.

35. Mathews CJ, Kingsley G, Field M, Jones A, Weston VC, Phillips M, et al. Management of septic arthritis: a systematic review. Ann Rheum Dis 2007; 66: 440–445.

36. Albert JD, Monbet V, Jilivet-Gougeon A, Fatih N, Le Corvec M, et al. A novel method for a fast diagnosis of septic arthritis using mid infrared and deported spectroscopy. J Bone Spine 2016; 83: 318–323.

37. Yu KH, Luo SF, Liou LB, Wu JJ, Tsai WP, Chen JY, et al. Concomitant sepsic and gouty arthritis – an analysis of 30 cases. Rheumatology 2003; 42: 1062–1066.

38. Huppertz A, Hermann KGA, Dietkhoff T, Wagner M, Hamm B, Schmidt WA. Systemic staging for urate crystal deposits with dual-energy CT and ultrasound in patients with suspected gout. Rheumatol Int 2014; 34: 763–771.

39. Gordon TP, Bertouch JV, Walsh BR, Brooks PM. Monosodium urate crystals in asymptomatic knee joints. J. Rheumatol 1982; 9: 967–969.

40. Weston VC, Jones AC, Bradbury N, Fawthrop F, Doherty M. Clinical freatures and outcome of septic arthritis in a single UK health district. Ann Rheum Dis 1999; 58: 214–219.

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Dermatology & STDs Paediatric rheumatology Physiotherapist, university degree Internal medicine Cardiology Orthopaedics Rheumatology

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Article was published in

Czech Rheumatology

2017 Issue 4