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Microbiome and autoimmune diseases

cause and effect relationship

Nogueira, Ana Ritaa,b,c; Shoenfeld, Yehudac,d

doi: 10.1097/BOR.0000000000000628

Purpose of review The human body is the host of trillions of different prokaryotic microorganisms that colonize the skin and the mucosae. The interaction between human cells and these organisms is mediated by the immune system, sustaining a very complex and fragile balance. The immune cells need to prevent uncontrolled growth of pathogenic microbes and promote tolerance toward the existence of the beneficial ones. Growing evidence associates the disruption of this symbiotic relationship with the development of autoimmune diseases.

Recent findings Human studies led to the identification of gut dysbiosis patterns in patients with rheumatoid arthritis, lupus and multiple sclerosis. Interestingly, the inoculation of pathogenic bacteria in animal models was associated with the development of these autoimmune diseases.

Summary A better understanding of the microbiota–human interaction will enable the development of novel treatment choices. Currently, new molecules using helminth compounds are under investigation and have already revealed promising results.

aFaculty of Medicine, University of Coimbra

bInternal Medicine Unit, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal

cZabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Affiliated to Tel Aviv University, Tel HaShomer, Israel

dI.M Sechenov First Moscow State Medical University of the Ministry of Health of Russia Federation ( Sechenov University), Moscow, Russia

Correspondence to Yehuda Shoenfeld, MD, FRCP, MaACR, Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center (Affiliated to Tel Aviv University), Tel HaShomer 5265601, Israel. Tel: +972 3 5352855; fax: +972 52 6669020; e-mail:

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