The Role of Infectious Agents in the Etiopathogenesis of Chronic Rheumatic Diseases

Abstract

Many rheumatic diseases are classic examples for chronic disorders in which a specific etiological factor has not been identified. Thus, therapy of many patients with chronic rheumatic diseases is limited to the attempt to relieve pain symptomatically and prevent extensive destruction. Lacking knowledge of the pathogenic mechanisms leading to arthritis is intimately linked to the lack of curative therapeutic interventions. Throughout the history of rheumatic diseases, researchers have been intrigued by the idea that infectious agents represent the etiological factor initiating chronic rheumatic diseases. However, despite extensive investigation of bacteriologists, virologists and immunologists, only rarely has an infectious microorganism been isolated from inflammatory tissue. With waxing and waning interest researchers over the last decade have searched for infectious causes of rheumatic diseases. It is no surprise that newly described microorganisms have initiated yet another search for their potential role in triggering of rheumatic diseases. Early this century, spirochetes were suspected to play a crucial role. When the researchers’ interests focused on other families of bacteria, the pathogenetic models adapted and included new microorganisms as potential etiological factors or rheumatic diseases. The 80’s have brought major interest in retroviruses, and we expect that the increasing knowledge on these viruses will be associated with new models of a virally induced pathomechanism resulting in arthritis.

Supported by the Mayo Foundation.