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A special issue of Microorganisms (ISSN 2076-2607). This special issue belongs to the section "Medical Microbiology".

Deadline for manuscript submissions: closed (30 September 2020) | Viewed by 45138

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Prof. Dr. Raffaele D'Amelio

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Department of Clinical and Molecular Medicine, University of Rome, 00189 Rome, Italy
Interests: vaccines; microbiota
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

We invite submissions to a Special Issue on the topic “Microbial and Autoimmune Disease”.

Main topics will include the followings, but are not limited:

Microbiota and autoimmune disease,
Infections in patients with autoimmune disease,
Infections mimicking autoimmune disease,
Infectious agents as inducer/promoter of autoimmune disease,
Differential diagnosis between either spontaneous or infection-induced flares in autoimmune disease.

Reviews, original researches, and communications focused on microbial and autoimmune disease will be welcome.

Prof. Dr. Raffaele D'Amelio
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Microorganisms is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

microbiota
infection
diagnosis
autoimmune disease

Published Papers (12 papers)

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Editorial

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6 pages, 396 KiB

Open AccessEditorial

Editorial for Special Issue: Microbial and Autoimmune Disease

by Raffaele D’Amelio

Microorganisms 2021, 9(9), 1800; https://doi.org/10.3390/microorganisms9091800 - 24 Aug 2021

Cited by 1 | Viewed by 1484

Abstract

The relationship between microbial and autoimmune disease is reciprocal and multifaceted, thus it may be interpreted in many ways and developed along different, even opposite, lines (Box 1) [...] Full article

(This article belongs to the Special Issue Microbial and Autoimmune Disease)

Research

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10 pages, 2064 KiB

Open AccessArticle

Oral Lactobacillus Species in Systemic Sclerosis

by Daniela Melchiorre, Maria Teresa Ceccherini, Eloisa Romano, Laura Cometi, Khadija El-Aoufy, Silvia Bellando-Randone, Angela Roccotelli, Cosimo Bruni, Alberto Moggi-Pignone, Davide Carboni, Serena Guiducci, Gemma Lepri, Lorenzo Tofani, Giacomo Pietramellara and Marco Matucci-Cerinic

Microorganisms 2021, 9(6), 1298; https://doi.org/10.3390/microorganisms9061298 - 15 Jun 2021

Cited by 5 | Viewed by 2054

Abstract

In systemic sclerosis (SSc), the gastrointestinal tract (GIT) plays a central role in the patient’s quality of life. The microbiome populates the GIT, where a relationship between the Lactobacillus and gastrointestinal motility has been suggested. In this study, the analysis of oral Lactobacillus species in SSc patients and healthy subjects using culture-independent molecular techniques, together with a review of the literature on microbiota and lactobacilli in SSc, has been carried out. Twenty-nine SSc female patients (mean age 62) and twenty-three female healthy subjects (HS, mean age 57.6) were enrolled and underwent tongue and gum swab sampling. Quantitative PCR was conducted in triplicate using Lactobacillus specific primers rpoB1, rpoB1o and rpoB2 for the RNA-polymerase β subunit gene. Our data show significantly (p = 0.0211) lower LactobacillusspprpoB sequences on the tongue of patients with SSc compared to HS. The mean value of the amount of Lactobacillus ssprpoB gene on the gumsofSSc patients was minor compared to HS. A significant difference between tongue and gums (p = 0.0421) was found in HS but not in SSc patients. In conclusion, our results show a lower presence of Lactobacillus in the oral cavity of SSc patients. This strengthens the hypothesis that Lactobacillus may have both a protective and therapeutic role in SSc patients. Full article

(This article belongs to the Special Issue Microbial and Autoimmune Disease)

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11 pages, 988 KiB

Open AccessArticle

The Role of Lung Colonization in Connective Tissue Disease-Associated Interstitial Lung Disease

by Alberto Ricci, Alessandra Pagliuca, Morgana Vermi, Dario Pizzirusso, Marta Innammorato, Raffaele Sglavo, Francesco Scarso, Simonetta Salemi, Bruno Laganà, Roberta Di Rosa and Michela D’Ascanio

Microorganisms 2021, 9(5), 932; https://doi.org/10.3390/microorganisms9050932 - 27 Apr 2021

Cited by 7 | Viewed by 2227

Abstract

Connective tissue diseases (CTDs) may frequently manifest with interstitial lung disease (ILD), which may severely impair quality and expectation of life. CTD-ILD generally has a chronic clinical course, with possible acute exacerbations. Although several lines of evidence indicate a relevant role of infections in the acute exacerbations of CTD-ILD, little information is available regarding the prevalence of infections in chronic CTD-ILD and their possible role in the clinical course. The aim of the present retrospective study was the identification of lung microbial colonization in broncho-alveolar lavage from patients affected by stable CTD-ILD with radiologically defined lung involvement. We demonstrated that 22.7% of patients with CTD-ILD display microbial colonization by Pseudomonas aeruginosa, Haemophilus influenzae, and non-tuberculous mycobacteria. Moreover, these patients display a major radiologic lung involvement, with higher impairment in lung function tests confirmed in a multivariate logistic regression analysis. Overall, the present study provides new information on lung colonization during CTD-ILD and its possible relationship with lung disease progression and severity. Full article

(This article belongs to the Special Issue Microbial and Autoimmune Disease)

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14 pages, 1865 KiB

Open AccessArticle

Impact of Mediterranean Diet on Disease Activity and Gut Microbiota Composition of Rheumatoid Arthritis Patients

by Andrea Picchianti Diamanti, Concetta Panebianco, Gerardo Salerno, Roberta Di Rosa, Simonetta Salemi, Maria Laura Sorgi, Giorgia Meneguzzi, Maria Benedetta Mariani, Alessandra Rai, Dalila Iacono, Giorgio Sesti, Valerio Pazienza and Bruno Laganà

Microorganisms 2020, 8(12), 1989; https://doi.org/10.3390/microorganisms8121989 - 14 Dec 2020

Cited by 36 | Viewed by 6499

Abstract

Rheumatoid arthritis (RA) is an autoimmune disorder in which gut and oral microbiota play a crucial role. Diet is a modifiable factor that can influence both microbiota composition and arthritis outcome; previous studies have suggested associations between dietary habits and RA, with contrasting results. We investigate the protective effect of the Mediterranean diet (MD) on disease activity and the gut microbiota profile in RA patients. Sixty consecutive RA patients were enrolled upon filling a validated 14-item questionnaire for the assessment of adherence to the Mediterranean diet (Prevention with Mediterranean Diet-PREDIMED). Then, 16S analysis was employed to explore the gut microbiota within the two cohorts of patients. Patients with high adherence to MD (20) had a significantly lower C-reactive protein (p < 0.037) and disease activity (p < 0.034) than the 40 patients with low/moderate adherence to MD. An inverse association between MD and disease activity was confirmed by multivariate analysis after adjustments for all the different demographic, clinical and serologic variables. A healthier gut microbiota composition was observed in the high adherence group, with a significant decrease in Lactobacillaceae and an almost complete absence of Prevotella copri with respect to the low/moderate adherence group. In conclusion, our findings support the protective role of MD on disease activity and microbiota composition in RA patients, and suggest the feasibility of shifting the habitual diet to modulate the gut microbiota and promote the benefits associated with MD. Full article

(This article belongs to the Special Issue Microbial and Autoimmune Disease)

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13 pages, 303 KiB

Open AccessArticle

Psychological Distress in Patients with Autoimmune Arthritis during the COVID-19 Induced Lockdown in Italy

by Andrea Picchianti Diamanti, Maria Sofia Cattaruzza, Roberta Di Rosa, Flavia Del Porto, Simonetta Salemi, Maria Laura Sorgi, Luis Severino Martin Martin, Alessandra Rai, Dalila Iacono, Giorgio Sesti, Guido Alessandri and Bruno Laganà

Microorganisms 2020, 8(11), 1818; https://doi.org/10.3390/microorganisms8111818 - 18 Nov 2020

Cited by 21 | Viewed by 2493

Abstract

Lockdowns imposed by governments worldwide as a way to limit the spread of severe atypical respiratory syndrome-coronavirus-2 (SARS-CoV2) have had heavy psychological and economic consequences. Arthritis patients are a vulnerable population at an increased risk of peritraumatic stress. This could be due to several reasons, including the fear of shortage of medicine and difficulty receiving periodical medical checks. In the present case-control study, psychological distress in patients with autoimmune arthritis during the coronavirus disease 2019 (COVID-19) pandemic were investigated. An electronic survey was conducted to gather information on the perceived change in the emotional state, general health (GH), fatigue, joint pain, and disease activity during the lockdown, in 100 patients with autoimmune arthritis and 100 controls. Mental health status was measured using the Depression, Anxiety and Stress Scale (DASS-21). The COVID-19 Peritraumatic Distress Index (CPDI) was used to assess the frequency of peritraumatic stress disorders related to COVID-19. Patients reported a significant worsening of perceived GH (36% vs. 7%; p < 0.001), a significantly higher mean CPDI score (p < 0.001) than controls. Using multivariate analysis, arthritis patients had significantly higher CPDI scores (+3.67 points; p = 0.019), independent of depression, anxiety, and stress symptoms, comorbidities, and sociodemographic and lifestyle characteristics. Logistic regression analysis showed that the risk of reporting worsened GH was 9-fold higher in patients than controls (p < 0.001). Patients with autoimmune arthritis are at higher risk of psychological distress related to COVID-19 pandemic; thus targeted intervention should be designed to strengthen coping capacity in this vulnerable population. Full article

(This article belongs to the Special Issue Microbial and Autoimmune Disease)

12 pages, 684 KiB

Open AccessArticle

Prevalence of Hepatitis B Virus Markers in Patients with Autoimmune Inflammatory Rheumatic Diseases in Italy

by Marco Canzoni, Massimo Marignani, Maria Laura Sorgi, Paola Begini, Michela Ileen Biondo, Sara Caporuscio, Vincenzo Colonna, Francesca Della Casa, Paola Conigliaro, Cinzia Marrese, Eleonora Celletti, Irene Modesto, Mario Stefano Peragallo, Bruno Laganà, Andrea Picchianti-Diamanti, Roberta Di Rosa, Claudia Ferlito, Simonetta Salemi, Raffaele D’Amelio and Tommaso Stroffolini

Microorganisms 2020, 8(11), 1792; https://doi.org/10.3390/microorganisms8111792 - 16 Nov 2020

Cited by 7 | Viewed by 2619

Abstract

Chronic hepatitis B virus (HBV) infection may be reactivated by immunosuppressive drugs in patients with autoimmune inflammatory rheumatic diseases. This study evaluates HBV serum markers’ prevalence in rheumatic outpatients belonging to Spondyloarthritis, Chronic Arthritis and Connective Tissue Disease diagnostic groups in Italy. The study enrolled 302 subjects, sex ratio (M/F) 0.6, mean age ± standard deviation 57 ± 15 years, 167 (55%) of whom were candidates for immunosuppressive therapy. The Spondyloarthritis group included 146 subjects, Chronic Arthritis 75 and Connective Tissue Disease 83 (two patients had two rheumatic diseases; thus, the sum is 304 instead of 302). Ten subjects (3%) reported previous anti-HBV vaccination and tested positive for anti-HBs alone with a titer still protective (>10 IU/mL). Among the remaining 292 subjects, the prevalence of positivity for HBsAg, isolated anti-HBc, anti-HBc/anti-HBs, and any HBV marker was 2%, 4%, 18%, and 24%, respectively. A total of 26/302 (9%) patients with γ-globulin levels ≤0.7 g/dL were more frequently (p = 0.03455) prescribed immunosuppressive therapy, suggesting a more severe rheumatic disease. A not negligible percentage of rheumatic patients in Italy are at potential risk of HBV reactivation related to immunosuppressive therapy. Before starting treatment, subjects should be tested for HBV markers. Those resulting positive should receive treatment or prophylaxis with Nucleos (t) ides analogue (NUCs) at high barrier of resistance, or pre-emptive therapy, according to the pattern of positive markers. HB vaccination is recommended for those who were never exposed to the virus. Full article

(This article belongs to the Special Issue Microbial and Autoimmune Disease)

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Review

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13 pages, 1354 KiB

Open AccessReview

MAIT Cells and Microbiota in Multiple Sclerosis and Other Autoimmune Diseases

by Rosella Mechelli, Silvia Romano, Carmela Romano, Emanuele Morena, Maria Chiara Buscarinu, Rachele Bigi, Gianmarco Bellucci, Roberta Reniè, Giulia Pellicciari, Marco Salvetti and Giovanni Ristori

Microorganisms 2021, 9(6), 1132; https://doi.org/10.3390/microorganisms9061132 - 24 May 2021

Cited by 13 | Viewed by 3613

Abstract

The functions of mucosal-associated invariant T (MAIT) cells in homeostatic conditions include the interaction with the microbiota and its products, the protection of body barriers, and the mounting of a tissue-repair response to injuries or infections. Dysfunction of MAIT cells and dysbiosis occur in common chronic diseases of inflammatory, metabolic, and tumor nature. This review is aimed at analyzing the changes of MAIT cells, as well as of the microbiota, in multiple sclerosis and other autoimmune disorders. Common features of dysbiosis in these conditions are the reduced richness of microbial species and the unbalance between pro-inflammatory and immune regulatory components of the gut microbiota. The literature concerning MAIT cells in these disorders is rather complex, and sometimes not consistent. In multiple sclerosis and other autoimmune conditions, several studies have been done, or are in progress, to find correlations between intestinal permeability, dysbiosis, MAIT cell responses, and clinical biomarkers in treated and treatment-naïve patients. The final aims are to explain what activates MAIT cells in diseases not primarily infective, which interactions with the microbiota are potentially pathogenic, and their dynamics related to disease course and disease-modifying treatments. Full article

(This article belongs to the Special Issue Microbial and Autoimmune Disease)

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15 pages, 674 KiB

Open AccessReview

Intravenous Immunoglobulins at the Crossroad of Autoimmunity and Viral Infections

by Carlo Perricone, Paola Triggianese, Roberto Bursi, Giacomo Cafaro, Elena Bartoloni, Maria Sole Chimenti, Roberto Gerli and Roberto Perricone

Microorganisms 2021, 9(1), 121; https://doi.org/10.3390/microorganisms9010121 - 7 Jan 2021

Cited by 25 | Viewed by 4170

Abstract

Intravenous immunoglobulins (IVIG) are blood preparations pooled from the plasma of donors that have been first employed as replacement therapy in immunodeficiency. IVIG interact at multiple levels with the different components of the immune system and exert their activity against infections. Passive immunotherapy includes convalescent plasma from subjects who have recovered from infection, hyperimmune globulin formulations with a high titer of neutralizing antibodies, and monoclonal antibodies (mAbs). IVIG are used for the prevention and treatment of several infections, especially in immunocompromised patients, or in case of a poorly responsive immune system. The evolution of IVIG from a source of passive immunity to a powerful immunomodulatory/anti-inflammatory agent results in extensive applications in autoimmune diseases. IVIG composition depends on the antibodies of the donor population and the alterations of protein structure due to the processing of plasma. The anti-viral and anti-inflammatory activity of IVIG has led us to think that they may represent a useful therapeutic tool even in COVID-19. The human origin of IVIG carries specific criticalities including risks of blood products, supply, and elevated costs. IVIG can be useful in critically ill patients, as well as early empirical treatment. To date, the need for further well-designed studies stating protocols and the efficacy/tolerability profile of IVIG and convalescent plasma in selected situations are awaited. Full article

(This article belongs to the Special Issue Microbial and Autoimmune Disease)

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12 pages, 452 KiB

Open AccessReview

Autoimmune Gastritis and Gastric Microbiota

by Laura Conti, Bruno Annibale and Edith Lahner

Microorganisms 2020, 8(11), 1827; https://doi.org/10.3390/microorganisms8111827 - 19 Nov 2020

Cited by 26 | Viewed by 7972

Abstract

Autoimmune atrophic gastritis is an organ-specific immune-mediated condition characterized by atrophy of the oxyntic mucosa. Autoimmune atrophic gastritis (AIG) is characterized by a progressive loss of acid-secreting parietal cells leading to hypo-achlorhydria. Due to this peculiar intra-gastric environment, gastric microbiota composition in individuals with autoimmune atrophic gastritis was first supposed and then recently reported to be different from subjects with a normal acidic healthy stomach. Recent data confirm the prominent role of Helicobacter pylori as the main bacterium responsible for gastric disease and long-term complications. However, other bacteria than Helicobacter pylori, for example, Streptococci, were found in subjects who developed gastric cancer and in subjects at risk of this fearful complication, as well as those with autoimmune gastritis. Gastric microbiota composition is challenging to study due to the acidic gastric environment, the difficulty of obtaining representative samples of the entire gastric microbiota, and the possible contamination by oral or throat microorganisms, which can potentially lead to the distortion of the original gastric microbial composition, but innovative molecular approaches based on the analysis of the hyper-variable region of the 16S rRNA gene have been developed, permitting us to obtain an overall microbial composition view of the RNA gene that is present only in prokaryotic cells. Full article

(This article belongs to the Special Issue Microbial and Autoimmune Disease)

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14 pages, 890 KiB

Open AccessReview

Gut Microbiome and Its Interaction with Immune System in Spondyloarthritis

by Jacqueline So and Lai-Shan Tam

Microorganisms 2020, 8(11), 1727; https://doi.org/10.3390/microorganisms8111727 - 4 Nov 2020

Cited by 19 | Viewed by 3686

Abstract

Emerging evidence suggests there is a gut-joint axis in spondyloarthritis (SpA). In a study, subclinical gut inflammation occurred in nearly 50% of SpA. Chronic gut inflammation also correlated with disease activity in SpA. Trillions of microorganisms reside in the human gut and interact with the human immune system. Dysbiosis affects gut immune homeostasis and triggers different autoimmune diseases including SpA. The absence of arthritis in HLA-B27 germ-free mice and the development of arthritis after the introduction of commensal bacteria to HLA-B27 germ-free mice proved to be the important role of gut bacteria in shaping SpA, other than the genetic factor. The recent advance in gene sequencing technology promotes the identification of microorganisms. In this review, we highlighted current evidence supporting the link between gut and axial SpA (axSpA). We also summarized available findings of gut microbiota and its interaction with the immune system in axSpA. Future research may explore the way to modulate gut microorganisms in axSpA and bring gut microbiome discoveries towards application. Full article

(This article belongs to the Special Issue Microbial and Autoimmune Disease)

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19 pages, 714 KiB

Open AccessReview

Role of Infections in the Pathogenesis of Rheumatoid Arthritis: Focus on Mycobacteria

by Marco Bo, Seyedesomaye Jasemi, Giuseppe Uras, Gian Luca Erre, Giuseppe Passiu and Leonardo A. Sechi

Microorganisms 2020, 8(10), 1459; https://doi.org/10.3390/microorganisms8101459 - 23 Sep 2020

Cited by 29 | Viewed by 4111

Abstract

Rheumatoid arthritis (RA) is a systemic inflammatory autoimmune disease characterized by chronic erosive polyarthritis. A complex interaction between a favorable genetic background, and the presence of a specific immune response against a broad-spectrum of environmental factors seems to play a role in determining susceptibility to RA. Among different pathogens, mycobacteria (including Mycobacterium avium subspecies paratuberculosis, MAP), and Epstein–Barr virus (EBV), have extensively been proposed to promote specific cellular and humoral response in susceptible individuals, by activating pathways linked to RA development. In this review, we discuss the available experimental and clinical evidence on the interplay between mycobacterial and EBV infections, and the development of the immune dysregulation in RA. Full article

(This article belongs to the Special Issue Microbial and Autoimmune Disease)

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Other

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10 pages, 1030 KiB

Open AccessCase Report

May Bacterial Infections Trigger Bullous Pemphigoid? Case Report and Review of Literature

by Michela Ileen Biondo, Chiara Fiorentino, Severino Persechino, Antonella Tammaro, Angela Koverech, Armando Bartolazzi, Salvatore Raffa, Marco Canzoni, Andrea Picchianti-Diamanti, Roberta Di Rosa, Giovanni Di Zenzo, Enrico Scala, Giorgia Meneguzzi, Claudia Ferlito, Milica Markovic, Sara Caporuscio, Maria Laura Sorgi, Simonetta Salemi and Bruno Laganà

Microorganisms 2021, 9(6), 1235; https://doi.org/10.3390/microorganisms9061235 - 7 Jun 2021

Cited by 3 | Viewed by 3134

Abstract

Bullous pemphigoid (BP) is an autoimmune blistering skin disease, mainly observed in the elderly. Infections have been suggested as possible disease triggers. However, infections may even heavily influence the disease clinical course and mortality. A 75-year-old woman was admitted to hospital for severe erythematosus blistering disease, accompanied by hyper-eosinophilia and hyper-IgE. The culture of bullous fluid was positive for Enterococcus faecalis, the blood culture was positive for Staphylococcus aureus, and the urine culture was positive for Proteus mirabilis and Escherichia coli. Moreover, circulating anti-BP180 IgG was present and the histopathological/ultrastructural examination of a lesional skin biopsy was compatible with BP. High eosinophil levels (up to 3170/µL) were found throughout the clinical course, while values below 1000/µL were associated with clinical improvement. The total IgE was 1273 IU/mL, and specific anti-G/V-penicillin/ampicillin IgE antibodies were positive. The patient had a complete clinical recovery in two months with methyl-prednisolone (40 then 20 mg/day) and low-dose azathioprine (50 mg/day) as a steroid-sparing agent. The steroid treatment was tapered until interruption during a one-year period and intravenous immunoglobulins have been administered for three years in order for azathioprine to also be interrupted. The patient stopped any treatment five years ago and, in this period, has always been in good health. In this case, the contemporaneous onset of different bacterial infections and BP is suggestive of bacterial infections acting as BP trigger(s), with allergic and autoimmune pathways contributing to the disease pathogenesis. Full article

(This article belongs to the Special Issue Microbial and Autoimmune Disease)

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