Human Microbiome and Proteus Mirabilis in the Development and Treatment of Rheumatoid Arthritis

Nova Southeastern University, Davie, Florida, USA

Objective. This study was conducted to determine the significance of Proteus mirabilis as a trigger for the development of Rheumatoid Arthritis based on the human microbiome theory. Background. Earlier research has demonstrated the connection between the oral microbiota and the development of Rheumatoid arthritis through the development of citrullinated auto-antigens. However, Proteus mirabilis, classically known as a trigger for UTIs has also been shown to lead to higher levels of anti-citrullinated antibodies in RA patients via specific genetic sequences. Methods. This retrospective case study evaluates the new research linking Proteus mirabilis to the development of Rheumatoid Arthritis, expanding upon Ebringer’s theorical model and comparing his research to new findings. The research supports the use of shared epitope sequences IRRET and ESRRAL, demonstrating molecular mimicry. Results: These patients were also found to have higher levels of the IRRET and ESSRAL sequences in P. mirabilis, via molecular mimicry to type XI collagen, a part of hyaline cartilage. These findings indicate that a trigger such as a UTI that increases P. mirabilis levels disrupts the natural composition of the human microbiome. Conclusion. Current treatment of P. mirabilis involves typical uncomplicated UTI antibiotic theory. However, due to increasing antimicrobial resistance and to limit potential side effects, the development of plant based therapy may have positive future indications in treatment. It has been found that resveratrol, an anti-inflammatory antioxidant from South African plants has been shown to control both P. mirabilis and P. vulgaris. Grants: N/A.