Review article: Role of the enteric microflora in the pathogenesis of intestinal inflammation and arthritis

Strong associations exist between intestinal inflammation and arthritis, ranging from infections with enteric pathogens to idiopathic inflammatory bowel disease. Increased exposure of the lamina propia and systemic circulation to enteric microflora and their products are a result of increased proliferation of the luminal bacteria, pathogenic invasion or enhanced mucosal permeability. Data suggest that anaerobic bacteria and other constituents of the normal luminal microbial flora induce and sustain chronic intestinal inflammation and arthritis. However, the normal host develops a tolerance to such bacteria and maintains homeostasis through a controlled inflammatory response and an almost impermeable mucosal barrier.