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The human microbiome and autoimmunity

Proal, Amy D.a; Albert, Paul J.b; Marshall, Trevor G.c

Current Opinion in Rheumatology: March 2013 - Volume 25 - Issue 2 - p 234–240
doi: 10.1097/BOR.0b013e32835cedbf

Purpose of review To demonstrate how dysbiosis of the human microbiome can drive autoimmune disease.

Recent findings Humans are superorganisms. The human body harbors an extensive microbiome, which has been shown to differ in patients with autoimmune diagnoses. Intracellular microbes slow innate immune defenses by dysregulating the vitamin D nuclear receptor, allowing pathogens to accumulate in tissue and blood. Molecular mimicry between pathogen and host causes further dysfunction by interfering with human protein interactions. Autoantibodies may well be created in response to pathogens.

Summary The catastrophic failure of human metabolism observed in autoimmune disease results from a common underlying pathogenesis – the successive accumulation of pathogens into the microbiome over time, and the ability of such pathogens to dysregulate gene transcription, translation, and human metabolic processes. Autoimmune diseases are more likely passed in families because of the inheritance of a familial microbiome, rather than Mendelian inheritance of genetic abnormalities. We can stimulate innate immune defenses and allow patients to target pathogens, but cell death results in immunopathology.

aAutoimmunity Research Foundation, Sunnyside, New York

bWeill Cornell Medical College, New York, USA

cMurdoch University, Murdoch, Australia

Correspondence to Amy D. Proal, Autoimmunity Research Foundation, 47–09 Skillman Avenue, apt G6, Sunnyside, NY 11104, USA. Tel: +1 917 848 0238; e-mail:

© 2013 Lippincott Williams & Wilkins, Inc.