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Microbial triggers have been implicated in RA (Zhang et al., 2015).
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Trigger: Have a "trigger" right before you do your habit.
Differential diagnosis of hyperthermia on the ICU includes microbial triggers of the systemic inflammatory process, which could have been the case in this patient, where an infection might have been suspected.
Recently, CD1c+ mDCs were described to have an immunoregulatory function in response to certain microbial triggers [ 16, 17].
The ensuing T-cell mediated disease is furT-cell mediatedthrough exposure to microbial triggers.
The most direct causal evidence for microbial triggers for ReA derives from a demonstration of microbial antigens in the joint [ 16].
Sandy and the Broken MachIne.
Analyses of microbial communities have shown that elevated concentrations of ammonia in biogas reactors trigger the syntrophic acetate oxidation pathway, where acetate is transformed to CO2 and H2 before methane is produced by hydrogenotrophic methanogens [ 8, 9].
The role of infection as a triggering factor is implicated with varying degrees of certainty amongst the SpA subcategories, with ReA having the most clear evidence for a microbial trigger [ 15].
These findings are suggestive of host responses that may be triggered by metabolic or cellular components of the endogenous microbiota, but to date no specific microbial molecules have been identified as causative.
Molecules of microbial origin have been found in the joints of patients with RA [ 14, 15], where they can trigger inflammatory reactions through PRRs.
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