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© 1977 British Society for Rheumatology

other

CAN CHRONIC AND SELF-PERPETUATING ARTHRITIS IN THE HUMAN BE CAUSED BY ARTHROTROPIC UNDEGRADED MICROBIAL CELL WALL CONSTITUANTS? A WORKING HYPOTHESIS

I. GINSBURG

Department of Oral Biology, Hebrew University, Hadassah School of Dental Medicine founded by the Alpha Omega Fraternity Jerusalem, Israel

Although the aetiological agents responsible for the initiation of rheumatoid arthritis in the human are not known, the possibility that this disease is of bacterial origin has been considered.

The bacterial factors involved may be small fragments of undegraded wall components which persist for long periods within macrophages and trigger the active release of lysosomal enzymes which cause tissue destruction. The failure to identify such wall components in diseased tissues may be due to the lack of adequate sensitive techniques to detect minute amounts of these wall components, shown to trigger chronic destructive arthritis in laboratory animals.

Two models of arthritis caused by mycobacterial and streptococcal wall components are described and the possible role played by immune responses, to the persisting bacterial factors, in the pathogenesis of human arthritis is discussed.


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