Clyde Wilson, Taha Rashid and Alan Ebringer
Rheumatoid arthritis (RA) is a systemic and arthritic autoimmune disease affecting millions of people throughout the world. During the last 4 decades extensive data indicate that subclinical urinary tract infection by Proteus mirabilis has a role in the aetiopathogenesis of RA based on cross-reactivity or molecular mimicry between Proteus haemolysin and RA-associated HLA-DRB1 alleles as well as between Proteus urease and type XI collagen. Studies from 15 countries have shown that antibodies against Proteus microbes were elevated significantly in patients with active RA in comparison to healthy and non-RA disease controls. Proteus microbes could also be isolated more frequently in the urine of patients with RA than in controls. It is suggested that treatment of RA by using antibiotics and increased daily fluid intake in order to eradicate Proteus bacteria from urinary tract could be implemented in conjunction with the currently used immunosuppressant’s and biologicals.
