Dr. Jose U. Scher, a current Arthritis Foundation-funded investigator, has been looking at the relationship between bacteria and inflammatory diseases for more than 10 years. Dr. Scher’s current Arthritis Foundation funded project, “Pan-Microbiome in At-Risk Subjects and New-Onset Rheumatoid Arthritis (RA),” looks at the relationship of bacteria (or “microbiome” in the mouth, lungs, and intestines) and the development ofRA.
“Different areas of the body have different populations of microbes,” Dr. Scher explained. “What is important is the diversity, or different types and numbers of bacteria. When we look at the bacteria found in the mouth, lungs, and gut of healthy individuals and compare them to those found in new RA patients who have not been treated yet, we see differences. The diversity of bacteria in each area changes in the RA patient. Certain bacteria may disappear and others may increase in numbers. In a healthy individual, there is a balance in the diversity of bacteria. It makes us question whether certain bacteria are triggering the body to produce an immune response.”
Dr. Scher began his work in immunology, looking at potential triggering factors for autoimmune diseases, specifically microbiomes and triggering effects. “We are asking: can you modify the microbiome in order to treat or prevent autoimmunity?” he explained. “Pharmaceutical companies are looking for the cocktail of microbes that can help patients. But what if it is not the microbes themselves, but the metabolites (chemicals) they produce that is important? Are some of the metabolites produced by certain bacteria beneficial? These are questions that need to be answered before we can come up with a safe and effective therapy.”
In a paper published in the November 2016 issue of BioMed CentralMicrobiome在美国，舍尔博士研究了肺部细菌类型和数量与风湿性关节炎可能发展的关系。这项研究观察了从未经治疗的早期RA患者、健康患者和肺结节病(一种主要影响肺部的炎症性疾病)患者收集的肺液。研究发现，与健康患者相比，RA患者肺部的细菌种类和数量都更少。未接受治疗的早期RA患者的肺部细菌种类和数量与结节病患者相似。结论是，在某些情况下，肺部的细菌可能会推动类风湿性关节炎的发展。
Dr. Scher also presented the results from a different study looking at the relationship between methotrexate, bacteria, and RA at the November 2016 ACR annual meeting. The results of that study showed that some bacteria respond more positively to methotrexate than others. “This offers the potential for a personalized medicine approach,” Dr. Scher explained. “By testing which bacteria are present in the gut, we can predict who will respond best to methotrexate. This could save some patients a lot of time and money if they knew they would be less likely to respond to that type of treatment.”
虽然舍尔对微生物组研究的未来感到乐观，但他也警告人们。“在概念的发展、研究和找到真正的治疗之间有很多步骤。这需要时间。我非常感谢关节炎基金会允许我们成为他们的合作伙伴来进行这项重要的研究。”
Dr. Scher is a rheumatologist at New York University Langone Medical Center.