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THE MYCOPLASMA CAUSE OF ARTHRITISBy Harold Clark, Ph. D. Mycoplasma is the name given to a unique group of the smallest free-living organisms, unlike the bacteria and virus. The primary differences are that bacteria have a solid cell-wall structure that is inhibited by the penicillins and grow in the simplest culture media. Mycoplasmas, on the other hand like a jellyfish have a very pliable and sticky membrane, taking on different shapes and sizes that make them difficult to capture their natural morphology. The first strains were isolated from cattle with arthritis and pneumonia 100 years. ago (1898) at the Pasteur Institute and for 64 years were called Pleuropneumonia-like organisms (PPLO). Although frequently isolated from arthritic animals the first human strain was isolated in 1932 from an ovarian abscess. The first reported isolation of a mycoplasma from a rheumatoid patient was made in 1939 by Drs. Swift and Brown. Newer techniques have helped to identify many different mycoplasma strains that are essentially species specific; avian (chicken & turkeys), rodents(mice & rats), feline, canine, porcine, goats, sheep, elephants etc. The non-human primates (great apes)were found to be infected with the human mycoplasma strains, which made the closely related arthritic gorillas the ideal animal model for humans. When tetracycline antibiotics became available in 1947 they were found to inhibit mycoplasma growth and also more effective and less toxic than the gold salts that controlled rheumatoid arthritis. Mycoplasmas, unlike viruses, can grow in tissue fluids (blood, joint, heart, lungs, and spinal ) and grow in viable tissue cell cultures without killing the cells - as viruses and bacteria will do. Mycoplasma are frequently isolated from the oral and genitourinary tracts of both symptomatic and normal populations and are found to infect females 4 times more often than males, which happens to be the same incidence rate in rheumatoid arthritis and related autoimmune disorders. Mycoplasma can attach to specific cell receptors making them difficult to isolate and their infection can go undetected. No symptoms suggest no disease. The attachment of mycoplasmas to the susceptible cell membranes acts like a living thorn, a persistent foreign substance, causing the host's immune defense mechanism to wage war. This allergic type response often results in warm, swollen, and painful inflamed tissues. As in animal models, the mycoplasmas may not be isolated from the inflamed tissues but could be detected by the host's blood antibody level indicating that mycoplasma has or is infecting the host. A positive mycoplasma test would require antibiotic antimycoplasma treatment. As indicated by laboratory tests mycoplasma growth is also suppressed by gold salts, Plaquinil, and even bee venom all of which are being used in the treatment of rheumatoid arthritis even though they are far more toxic and less effective than the tetracyclines. Unfortunately mycoplasmas (PPLO) never became a part of the medical schools curriculum or textbooks until the late '50s and were considered to be some oddity until one viral-like strain (Mycoplasma pneumoniae) was identified as the cause of atypical pneumonia in humans. This strain of mycoplasma and others have been implicated as a cause of rheumatoid diseases. These diseases are considered to be the results of an autoimmune complex (mycoplasma + host-antibody) and also the self-destructive autoimmune reaction of mycoplasma + host protein complex. For example a host protein will not react with the host unless it is altered by attaching to a foreign substance. Recent studies are now supporting the role and mechanism of mycoplasmas as both an immune complex and as an autoantigen when attached to a specific tissue protein. If this proves to be the case we may soon see mycoplasmas associated with many other immunologic disorders besides the rheumatoid diseases, i.e. Alzheimer's, diabetes, multiple sclerosis, etc. Mycoplasma Properties Supporting their Role in Rheumatoid Arthritis and other Autoimmune Diseases. 1) Mycoplasmas are recognized as causing arthritis, respiratory, neurological, and genital-urinary tract diseases in most animals with species specificity, including humans. Each species has several different strains that only infect their own species. 2) Mycoplasma isolation from human respiratory and genital-urinary tracts is a common occurrence, infecting four times as many females than males, a predilection that RA is 4 times more common in females. 3) Mycoplasmas, the smallest free-living microbes that lack a ridged cell wall have unusual physical, and chemical variations with special growth requirements that makes their detection and identification in host tissues difficult. 4) Mycoplasmas, unlike bacteria and viruses, can grow undetected in tissue cell cultures without causing tissue cell damage or pathogenicity. 5) Sensitive to growth inhibiting antibiotics, Mycoplasmas still remain difficult to eliminate from the host tissues. 6) The low Mycoplasma antibody response in humans is often undetected in the presence of other infections and anti-antibody titer. 7) A rise in antibody titer to specific mycoplasmas following a flare or antimycoplasma therapy indicates a release of antigen (mycoplasma) causing a temporary Herxheimer flare reaction. 8) Mycoplasma's composition mimics its host tissue media that could contribute to the production of autoimmune antigens acting as an altered tissue component. 9) Persisting mycoplasma antibodies are found in specific synovial fluids of rheumatoid arthritis patients indicating localized joint infection. 10) Injected Mycoplasmas can cause inflammatory delayed-type skin tests indicating host hypersensitivity as in a TB skin test. 11) Immuno suppressive effect of mycoplasmas on peripheral T lymphocytes (white blood cells) compares with the suppressor activity in autoimmune responses. 12) The variety of medications used to treat RA patients, i.e. Antimalarials, gold salts, bee venom, & tetracyclines also inhibit mycoplasma growth, and induce a Jarisch Herxheimer flare reaction indicated by a rise in mycoplasmal antibody titer. |
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