The possible role of infectious microoganisms in the disease process of both arthritis and autoimmunity continue to attract both basic and clinical researchers. However, proving a causal role for these suspects is a very difficult and complicated task. This article provides an update on various mechanisms in which microbes may play roles as inciting or perpetuating factors in the pathogenesis of connective tissue disease. It also focuses on current theories that specific microorganisms may play a role in rheumatoid arthritis and ankylosing spondylitis.
Division of Rheumatology, Department of Medicine, University of Toronto, and the University Health Network, Toronto, Canada.
Correspondence to Robert Inman, MD, FP1-221 Toronto Western Hospital, 399 Bathurst St., Toronto, Ontario, M5T2S8, Canada; e-mail: email@example.com