Autoimmune Diseases / 2015 / Article / Tab 1

Review Article

Slipping through the Cracks: Linking Low Immune Function and Intestinal Bacterial Imbalance to the Etiology of Rheumatoid Arthritis

Table 1

Internal and exogenous factors possibly involved in the pathogenesis of RA and other ADs: two unrelated types of risk factors apparently contribute to the development of ADs: the first is environmental exogenous factors, and the second is the host’s physical condition. In addition, ADs such as RA might be classified into two types, autoantibody-mediated and non-antibody-mediated. Regardless of whether the disease is mediated by autoantibodies or not, bacterial toxins absorbed from the intestine directly trigger and exacerbate an inflammatory reaction.

Types of risk factorsAntibody-mediated

Exogenous factorsPossible risk agents
 Mimic antigensDietary collagen [29, 30],
Cartilage PG [94]
 Pathogenic and nonpathogenic
PAMPs [13, 14, 95]  PAMPs [13, 14, 95] 
Arthritogenic PG-PS [96]
 Bacterial toxinsLPS [28, 97],
MAM [28, 98], and SEB [99]
LPS [30], SEB [3]
 Foods and drugsHigh fat diet [90],  
Proteinase inhibitor, and NSAID [30]
High fat diet [90],  
Proteinase inhibitor, and NSAID [30]

Host’s physical conditionPossible risk events
 Immune functionImmunosenescence [47, 49]  
GI disorders [44]
Immunosenescence [47, 49]  
GI disorders [44]
 Mucosal barrier functionStress [41, 42, 100]  
GI disorders [44]
Stress [41, 42, 100]  
GI disorders [44]
 Intestinal bacterial balanceBacterial imbalance [16, 18, 75]  
High toxin level in GI tract
Bacterial imbalance [16, 18, 75]  
High toxin level in GI tract

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