Study of the Relation Between Intestinal Flora and Rheumatoid Arthritis (RA)
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- Category: Vol. 78, June 2010
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Study of the Relation Between Intestinal Flora and Rheumatoid Arthritis (RA),NADIA SAYED, HAYAM M. HUSSIEN, SAMUEL T. MELEK, SAHAR K.A. DARWISH and GABER A. EL-AZIZ MOHAMAD
Abstract
Background/Aim: Rheumatoid arthritis (RA) is a chronic, systemic disease characterized by persistent inflammatory synovitis that typically involves peripheral joints in a symmetric distribution. The joint arthritis is due to synovitis, which is the inflammation of the synovial membrane that covers the joint. Synovitis leads to erosion of the joint surface, causing deformity and loss of function. The bacterial load from the intestinal flora as a whole may well be a trigger for autoimmune rheumatoid synovitis.
Study Design: Isolation and identification of some bacteria from normal flora was carried out in microbiological laboratory in NODCAR in year 2007. The biochemical markers for rheumatoid arthritis in patients were observed as CRP (33.391±15.189 mg/dl), RF (49.565±15.805 IU/ml), ANA were positive in 78.3 of patients (30.417±18.528 IU/ml) and Anti-CCP2 (42.391±7.590 U/ml). An aqueous suspension of outer membrane (OM) was isolated from the cell wall frag-ments (CWF) of bacterial flora isolates were prepared accord-ing to Severijnen, et al., 1990. Physical and chemical mea-surements of outer membrane as determined the molecular weight by SDS polyacrylamide gel electrophoresis and deter-mination of the outer membrane total proteins. Arthritis was induced in rats with a single intraperitoneal injection of an aqueous suspension of outer membrane (OM) was isolated from the cell walls of isolates are found in the normal flora of arthritic and non-arthritic human intestines. Some of these rats leave for 30 days and others for 60 days after induction of arthritis.
Results: Biochemical and histological parameters were made for all groups of rats. CRP, RF, ANA and anti-CCP2 were highly significance increase in positive control of OM-induced arthritic rats for 30-days (32.0±8.76 mg/dl, 50.0±10.95 IU/ml, 50.0±24.49 IU/ml and 33.833±5.382 U/ml, p<0.01 respectively), and for 60-days (37.33±9.24 mg/dl, 53.33±11.56 IU/ml, 53.34±23.10 IU/ml and 37.833±5.345 U/ml, p<0.01 respectively) when compared to the control group. Also, there were significant increase in CRP, RF, ANA and Anti-CCP2 in OM-induced arthritic rats before treatment with Echinacea exract (Immunvita) (24.0±6.753 mg/dl, 45.0±10.00 IU/ml, 30.00±11.55 IU/ml and 35.50±4.203 U/ml, p<0.05, respec-tively) when compared to that after treatment (10.67±4.62 mg/dl, 33.34±11.56 IU/ml, 16.67±5.78 IU/ml and 16.667± 2.517 U/ml, p<0.05 respectively) for 30-days, also to control group (p<0.05). Similar results obtained before Glucosamine (Genuphil) treatment (26.0±4.0 mg/dl, 45.0±10.0 IU/ml, 22.5±12.59 IU/ml and 35.00±3.367 U/ml, respectively) when compared to that after treatment (10.67±4.62 mg/dl, 16.67±5.78 IU/ml, 13.34±5.78 IU/ml and 16.60±1.673 U/ml, p<0.05 respectively) for 30-days, also to control group (p<0.05). Also, in 60 days OM-induced arthritic rats, CRP, RF, ANA and Anti-CCP2 were significance increase before treatment with Echinacea exract (Immunvita) (26.0±4.53 mg/dl, 45.0±10.00 IU/ml, 23.00±12.55 IU/ml and 37.20±4.438 U/ml, p<0.05, respectively) when compared to that after treatment (12.00±4.62 mg/dl, 35.00±10.00 IU/ml, 15.00±5.78 IU/ml and 19.80±2.168 U/ml, p<0.05 respectively), also to control group (p<0.05) & with Glucosamine (Genuphil), before treatment (24.0±6.0 mg/dl, 45.0±10.0 IU/ml, 29.5±11.59 IU/ml and 35.75±4.992 U/ml, respectively) when compared to that after treatment (13.37±4.63 mg/dl, 26.67±11.56 IU/ml, 16.67±5.78 IU/ml and 19.75±2.986 U/ml, p<0.05 respectively), also to control group. Histologically, the arthritis lesions produced by OM in the paw of the inspected animals were of mild degree.
Conclusion: The OM prepared from the selected strains from human intestinal flora induced acute and chronic arthritis in rat models. Serum concentrations of antibodies against cyclic citrullinated peptide (anti-CCP) seem to be just as sensitive and more specific than rheumatoid factor for diag-nosing rheumatoid arthritis and predicting its progression. The two treatments of Echinacea and glucosamine showed reduction in the inflammatory cell influx and joint damage.