Professor Emeritus Garth Nicolson discusses the role of intracellular bacteria and the relationship of such infections with rheumatic diseases in a Letter to the Editor (May 2017) in the Open Journal of Tropical Medicine. Identification of bacteria that are capable of parasitizing host cells, like Mycoplasma and Borrelia species, have been documented prolifically in the scientific literature. Professor Nicolson surmises whether these infections are simply coincidental bystanders, confusing the diagnostic picture as co-morbid infections, or if they play a critical role in the cause and development of rheumatic diseases, requiring targeted antimicrobial therapies.
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What Role Do Intracellular Bacteria Like Mycoplasma Play In Rheumatic Diseases?

Professor Emeritus Garth L. Nicolson, Ph.D, M.D. (H)
Although the causes of rheumatic diseases have remained relatively unknown, systemic intracellular bacterial infections are commonly found in rheumatic disease patients, and because of this, certain infections have been confused with co-morbid conditions. Often patients with rheumatic diseases have co-morbidities, and some authors have concluded that this can include chronic infections. There is a link between certain types of infections and rheumatic diseases. For example, infections with Mycoplasma species, Borrelia species and other intracellular bacteria have been linked to various rheumatic diseases. In addition, animal models of rheumatic disease have been established by infection with Mycoplasma species. Outbreaks of rheumatic disease, such as polyarthritis, have been traced to infections by Mycoplasma species, and arthritis in animals and humans caused by Mycoplasma species infections closely resemble the signs and symptoms found in patients with rheumatoid arthritis.
The pathogenesis of rheumatoid arthritis appears to be linked to immunological features of infection(s) involving host recognition of foreign antigens that mimic host antigens or host antigens that are incorporated into microorganism structures and the presence of localized immune complexes and the influences of environmental conditions. Standard long-term treatments for chronic infections like mycoplasma have yielded remissions, but not in every case. Thus, chronic infections like mycoplasma and other intracellular bacteria do not appear to be co-morbid conditions in rheumatic diseases.
To read more: Nicolson, G.L. Mycoplasma and other intracellular bacterial infections in rheumatic diseases: comorbid condition or cause? Open J. Trop. Med. 2017; 1: 016-017.
The Institute for Molecular Medicine