THE EVOLUTION OF VIEWS ON THE PATHOGENESIS OF AUTOIMMUNE DISEASES IN THE ERA OF MICROBIOME

The modern treatment of autoimmune diseases (AIDs) is based on the use of drugs reducing inflammation and inhibiting the immune responses. This strategy leads to the short-term reduction of disease activity but does not change long-term outcomes. Thus, analyses of several large cohorts of patients with rheumatoid arthritis (RA) showed that active use of synthetic and biological disease modifying antirheumatic drugs in the last 20 years did not reduce RA-related disability and all-cause mortality. The discovery of human microbiome allows to reevaluate the nature of autoimmune diseases and suggests that dysbiosis and chronic infection with previously poorly-known/unknown microorganisms are major factor for AIDs development and persistence. In conclusion, in order to develop eff ective treatment of AIDs we need to rethink our general views on the AIDs pathogenesis in the light of new data of human microbiome.