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Modulation of immune function by dietary lectins in rheumatoid arthritis

Published online by Cambridge University Press:  09 March 2007

Loren Cordain ,
L. Toohey ,
M. J. Smith  and
M. S. Hickey
Loren Cordain*
Affiliation:
Department of Health and Exercise Science, Colorado State University, Fort Collins, CO 80523, USA
L. Toohey
Affiliation:
Department of Health and Exercise Science, Colorado State University, Fort Collins, CO 80523, USA
M. J. Smith
Affiliation:
Department of Health and Exercise Science, Colorado State University, Fort Collins, CO 80523, USA
M. S. Hickey
Affiliation:
Department of Health and Exercise Science, Colorado State University, Fort Collins, CO 80523, USA
*
*Corresponding author: Dr Loren Cordain, fax +1 970 491 0445, email cordain@cahs.colostate.edu
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Abstract

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Despite the almost universal clinical observation that inflammation of the gut is frequently associated with inflammation of the joints and vice versa, the nature of this relationship remains elusive. In the present review, we provide evidence for how the interaction of dietary lectins with enterocytes and lymphocytes may facilitate the translocation of both dietary and gut-derived pathogenic antigens to peripheral tissues, which in turn causes persistent peripheral antigenic stimulation. In genetically susceptible individuals, this antigenic stimulation may ultimately result in the expression of overt rheumatoid arthritis (RA) via molecular mimicry, a process whereby foreign peptides, similar in structure to endogenous peptides, may cause antibodies or T-lymphocytes to cross-react with both foreign and endogenous peptides and thereby break immunological tolerance. By eliminating dietary elements, particularly lectins, which adversely influence both enterocyte and lymphocyte structure and function, it is proposed that the peripheral antigenic stimulus (both pathogenic and dietary) will be reduced and thereby result in a diminution of disease symptoms in certain patients with RA.

Keywords

Rheumatoid arthritisLectinsImmune function
Type
Review article
Information
British Journal of Nutrition , Volume 83 , Issue 3 , March 2000 , pp. 207 - 217
Copyright
Copyright © The Nutrition Society 2000

References

Albani, S and Carson, DA (1996) A multistep molecular mimicry hypothesis for the pathogenesis of rheumatoid arthritis. Immunology Today 17, 466–470.CrossRefGoogle ScholarPubMed
Albani, S, Tuckwell, J, Esparza, L, Carson, DA and Roudier, J (1992) The susceptibility sequence to rheumatoid arthritis is a cross-reactive B epitope shared by the Escherichia coli heat shock protein DnaJ and the HLA DRB1*0401 molecule. Journal of Clinical Investigation 89, 327–331.CrossRefGoogle Scholar
Auger, I and Roudier, J (1997) A function for the QKRAA amino acid motif: mediating binding of DnaJ to DnaK. Implications for the association of rheumatoid arthritis with HLA-DR4. Journal of Clinical Investigation 99, 1818–1822.CrossRefGoogle ScholarPubMed
Banwell, JG, Howard, R, Kabir, I and Costerton, JW (1988) Bacterial overgrowth by indigenous microflora in the phytohemagglutinin-fed rat. Canadian Journal of Microbiology 34, 1009–1013.CrossRefGoogle ScholarPubMed
Baum, H, Davies, H and Peakman, M (1996) Molecular mimicry in the MHC: hidden clues to autoimmunity. Immunology Today 17, 64–70.CrossRefGoogle ScholarPubMed
Baum, H and Staines, NA (1997) MHC-derived peptides and the CD4+ T-cell repertoire: implications for autoimmune disease. Cytokines, Cellular and Molecular Therapy 3, 115–126.Google ScholarPubMed
Benno, P, Alam, M, Henriksson, K, Norin, E, Uribe, A and Midtvedt, T (1994) Abnormal colonic microbial function in patients with rheumatoid arthritis. Scandinavian Journal of Rheumatology 23, 311–315.CrossRefGoogle ScholarPubMed
Berg, RD (1992) Bacterial translocation from the gastrointestinal tract. Journal of Medicine 23, 217–244.Google ScholarPubMed
Beri, D, Malaviya, AN, Shandilya, R and Singh, RR (1988) Effect of dietary restrictions on disease activity in rheumatoid arthritis. Annals of the Rheumatic Diseases 47, 69–77.CrossRefGoogle ScholarPubMed
Bevan, MJ, Hogquist, KA and Jameson, SC (1994) Selecting the T-cell repertoire. Science 264, 796–797.CrossRefGoogle Scholar
Bjarnason, I and Peters, TJ (1996) Influence of anti-rheumatic drugs on gut permeability and on the gut associated lymphoid tissue. Baillières Clinical Rheumatology 10, 165–176.CrossRefGoogle ScholarPubMed
Bjarnason, I, Peters, TJ and Wise, RJ (1984) The leaky gut of alcoholism: possible route of entry for toxic compounds. Lancet i, 179–182.CrossRefGoogle Scholar
Bourne, JT, Kumar, P, Huskison, EC, Maged, R, Unsworth, DJ and Wojtulewski, JA (1985) Arthritis and coeliac disease. Annals of the Rheumatic Diseases 44, 592–594.CrossRefGoogle ScholarPubMed
Brady, PG, Vannier, AM and Banwell, JG (1978) Identification of the dietary lectin, wheat germ agglutinin, in human intestinal contents. Gastroenterology 75, 236–239.CrossRefGoogle ScholarPubMed
Brauer, RThoss, KHenzgen, S & Waldman, G (1985) Lectin-induced arthritis of rabbit as a model of rheumatoid arthritis. In Lectins, vol. IV:, pp. 29–38 [Bog-Hansen, TC and van Driessche, E, editors]. Berlin: Walter de Gruyter & Company.Google Scholar
Buchanan, HM, Preston, SJ, Brooks, PM and Buchanan, WW (1991) Is diet important in rheumatoid arthritis?. British Journal of Rheumatology 30, 125–134.CrossRefGoogle ScholarPubMed
Cao, W, Tykodi, SS, Esser, MT, Braciale, VL and Braciale, TJ (1995) Partial activation of CD8+ T cells by a self-derived peptide. Nature 378, 295–298.CrossRefGoogle ScholarPubMed
Charkravarty, K and Scott, DGI (1992) Oligoarthritis — a presenting feature of occult coeliac disease. British Journal of Rheumatology 31, 349–350.CrossRefGoogle Scholar
Chicz, RM, Urban, RG, Gorga, JC, Vignali, DA, Lane, WS and Strominger, JL (1993) Specificity and promiscuity among naturally processed peptides bound to HLA-DR alleles. Journal of Experimental Medicine 178, 27–47.CrossRefGoogle ScholarPubMed
Clevers, HC, De Bresser, A, Kleinveld, H, Gmelig-Meyling, FHJ and Ballieux, RE (1986) Wheat germ agglutinin activates human T lymphocytes by stimulation of phosphoinositide hydrolysis. Journal of Immunology 136, 3180–3183.CrossRefGoogle Scholar
Collin, P and Maki, M (1994) Associated disorders in coeliac disease: clinical aspects. Scandinavian Journal of Gastroenterology 29, 769–775.CrossRefGoogle ScholarPubMed
Crissinger, KD, Kvietys, PR and Granger, DN (1990) Pathophysiology of gastrointestinal mucosal permeability. Journal of Internal Medicine 732 (Suppl.), 145–154.CrossRefGoogle ScholarPubMed
Dalton, TA and Bennett, JC (1992) Autoimmune disease and the major histocompatibility complex: therapeutic implications. American Journal of Medicine 92, 183–188.CrossRefGoogle ScholarPubMed
Darlington, LG, Ramsey, NW and Mansfield, JR (1986) Placebo-controlled, blind study of dietary manipulation therapy in rheumatoid arthritis. Lancet i, 236–238.CrossRefGoogle Scholar
Doherty, M and Barry, RE (1981) Gluten-induced mucosal changes in subjects without overt small-bowel disease. Lancet i, 517–520.CrossRefGoogle Scholar
Eerola, E, Mottonen, T, Hannonen, P, Luukkainen, R, Kantola, I, Vuori, K, Tuominen, J and Toivanen, P (1994) Intestinal flora in early rheumatoid arthritis. British Journal of Rheumatology 33, 1030–1038.CrossRefGoogle ScholarPubMed
Fabia, R Ar'Rajab A, Johansson, ML, Willen, R, Andersson, R, Molin, G and Bengmark, S (1993) The effect of exogenous administration of. Lactobacillus reuteri R2LC and oat fiber on acetic acid-induced colitis in the rat. Scandinavian Journal of Gastroenterology 28, 155–162.CrossRefGoogle ScholarPubMed
Firestein, GS, Alvaro-Gracia, JM and Maki, R (1990) Quantitative analysis of cytokine gene expression in rheumatoid arthritis. Journal of Immunology 144, 33347–33353.Google ScholarPubMed
Goronzy, JJ and Weyland, CM (1993) Interplay of T lymphocytes and HLA-DR molecules in rheumatoid arthritis. Current Opinion in Rheumatology 5, 169–177.CrossRefGoogle ScholarPubMed
Grant, G, More, LJ McKenzie NH and Pusztai, A (1982) The effect of heating on the haemagglutinating activity and nutritional properties of bean (. Phaseolus vulgaris) seeds. Journal of the Science of Food and Agriculture 33, 1324–1326.CrossRefGoogle ScholarPubMed
Greer, F and Pusztai, A (1985) Toxicity of kidney bean (. Phaseolus vulgaris) in rats: changes in intestinal permeability. Digestion 32, 42–46.CrossRefGoogle ScholarPubMed
Griffiths, RJ (1992) Characterisation and pharmacological sensitivity of antigen arthritis induced by methylated bovine serum albumin in the rat. Agents and Actions 35, 88–95.CrossRefGoogle ScholarPubMed
Grossman, JM and Brahn, E (1997) Rheumatoid arthritis: current clinical and research directions. Journal of Womens Health 6, 627–638.CrossRefGoogle ScholarPubMed
Hamilton, I, Cobden, I, Rothwell, J and Axon, ATR (1982) Intestinal permeability in coeliac disease: the response to gluten withdrawal and single-dose gluten challenge. Gut 23, 202–210.CrossRefGoogle ScholarPubMed
Haugen, MA, Kjeldsen-Dragh, J and Forre, O (1994) A pilot study of the effect of an elemental diet in the management of rheumatoid arthritis. Clinical and Experimental Rheumatology 12, 275–279.Google ScholarPubMed
Hazenberg, MP, Klassen, IS, Kool, J Ruseler-van Embden, JG and Severijnen, AJ (1992) Are intestinal bacteria involved in the etiology of rheumatoid arthritis?. APMIS 100, 1–9.CrossRefGoogle ScholarPubMed
Henriksson, AE, Blomquist, L, Nord, CE, Midtvedt, T and Uribe, A (1993) Small intestinal bacterial overgrowth in patients with rheumatoid arthritis. Annals of the Rheumatic Diseases 52, 503–510.CrossRefGoogle ScholarPubMed
Husby, S, Jensenius, JC and Svehag, SE (1985) Passage of undegraded dietary antigen into the blood of healthy adults. Scandinavian Journal of Immunology 22, 83–92.CrossRefGoogle ScholarPubMed
Jameson, SC, Hogquist, KA and Bevan, MJ (1995) Positive selection and thymocytes. Annual Review of Immunology 13, 93–126.CrossRefGoogle ScholarPubMed
Karska, K, Tuckova, L, Steiner, L, Tlaskalova-Hogenova, H and Michalak, M (1995) Calreticulin — the potential autoantigen in celiac disease. Biochemical and Biophysical Research Communications 209, 597–605.CrossRefGoogle ScholarPubMed
Katz, KD and Hollander, D (1989) Intestinal mucosal permeability and rheumatological diseases. Baillières Clinical Rheumatology 3, 271–284.CrossRefGoogle ScholarPubMed
Kavanaghi, R, Workman, E, Nash, P, Smith, M, Hazleman, BL and Hunter, JO (1995) The effects of elemental diet and subsequent food reintroduction on rheumatoid arthritis. British Journal of Rheumatology 34, 270–273.CrossRefGoogle ScholarPubMed
Keshavarzian, A, Fields, JZ, Vaeth, J and Holmes, EW (1994) The differing effects of acute and chronic alcohol on gastric and intestinal permeability. American Journal of Gastroenterology 89, 2205–2211.Google ScholarPubMed
Kjeldsen-Kragh, J, Haugen, M, Borchgrevink, CF, Laerum, E, Eek, M, Mowinkel, P, Hovi, K and Forre, O (1991) Controlled trial of fasting and one-year vegetarian diet in rheumatoid arthritis. Lancet 338, 899–902.CrossRefGoogle ScholarPubMed
Klasen, IS, Melief, MJ van Halteren, AG, Schouten, WR van Blankenstein, M, Hoke, G, de Visser, H, Hooijkaas, H and Hazenberg, MP (1994) The presence of peptidoglycan-polysaccharide complexes in the bowel wall and the cellular responses to these complexes in Crohn's disease. Clinical Immunology and Immunopathology 71, 303–308.CrossRefGoogle Scholar
Koch, AE, Shah, MR, Harlow, LA, Lovis, RM and Pope, RM (1994) Soluble intercellular adhesion molecule-1 in arthritis. Clinical Immunology and Immunopathology 71, 208–215.CrossRefGoogle ScholarPubMed
Kool, J Gerits-Boeye MY, Severijnen, AJ and Hazenberg, MP (1992) Immunohistology of joint inflammation induced in rats by cell wall fragments of. Eubacterium aerofaciens. Scandinavian Journal of Immunology 36, 497–506.CrossRefGoogle ScholarPubMed
La Cava, A, Nelson, JL, Ollier, WER, MacGregor, A, Keystone, EC, Thorne, JC, Scavulli, JF, Berry, CC, Carson, DA and Albani, S (1997) Genetic bias in immune responses to a cassette shared by different microorganisms in patients with rheumatoid arthritis. Journal of Clinical Investigation 100, 658–663.CrossRefGoogle ScholarPubMed
Lepore, L, Martelossi, S, Pennesi, M, Falcini, F, Ermini, ML, Ferrari, R, Perticarari, S, Presani, G, Lucchesi, A, Lapini, M and Ventura, A (1996) Prevalence of celiac disease in patients with juvenile arthritis. Journal of Pediatrics 129, 311–313.CrossRefGoogle Scholar
Lepore, L, Pennesi, M, Ventura, A, Torre, G, Falcini, F, Lucchesi, A and Perticarari, S (1993) Anti-alpha-gliadin antibodies are not predictive of coeliac disease in juvenile chronic arthritis. Acta Paediatrica 82, 569–573.CrossRefGoogle Scholar
Liener, IE (1986) Nutritional significance of lectins in the diet. In The Lectins: Properties, Functions and Applications in Biology and Medicine, pp. 527–552 [Liener, IE, Sharon, N and Goldstein, IJ, editors]. Orlando, FL: Academic Press.CrossRefGoogle Scholar
Lowes, JR, Radwan, P, Priddle, JD and Jewell, DP (1992) Characterisation and quantification of mucosal cytokine that induces epithelial histocompatibility locus antigen-DR expression in inflammatory bowel disease. Gut 33, 315–319.CrossRefGoogle ScholarPubMed
Lunardi, C, Bambara, LM, Biasi, D, Venturini, G, Nicholis, F, Pachor, ML and DeSandre, G (1988) Food allergy and rheumatoid arthritis. Clinical and Experimental Rheumatology 6, 423–426.Google ScholarPubMed
Mageed, RA, Borretzen, M, Moyes, SP, Thompson, KM and Natvig, JB (1997) Rheumatoid factor autoantibodies in health and disease. Annals of the New York Academy of Sciences 815, 296–311.CrossRefGoogle ScholarPubMed
Mehta, SK, Kaur, S, Avasthi, G, Wig, NN and Chhuttani, PN (1972) Small intestinal deficit in pellagra. American Journal of Clinical Nutrition 25, 545–549.CrossRefGoogle ScholarPubMed
Mielants, H (1990) Reflections on the link between intestinal permeability and inflammatory joint disease. Clinical and Experimental Rheumatology 8, 523–524.Google ScholarPubMed
Mowat, AM (1987) The regulation of immune responses to dietary protein antigens. Immunology Today 8, 93–98.CrossRefGoogle ScholarPubMed
Nardella, FA, Oppliger, IR, Stone, GC, Sasso, EH, Mannik, M, Sjoquist, J, Schroder, AK, Christensen, P, Johansson, PJ and Bjork, L (1998) Fc epitopes for human rheumatoid factors and the relationships of rheumatoid factors to the Fc binding proteins of microorganisms. Scandinavian Journal of Rheumatology 75 (Suppl.), 190–198.Google Scholar
Nardella, FA, Teller, DC, Barber, CV and Mannik, M (1985) IgG rheumatoid factors and staphylococcal protein A bind to a common molecular site on IgG. Journal of Experimental Medicine 162, 1811–1824.CrossRefGoogle ScholarPubMed
Nossal, GJV (1994) Negative selection of lymphocytes. Cell 76, 229–239.CrossRefGoogle ScholarPubMed
Odeh, M (1997) New insights into the pathogenesis and treatment of rheumatoid arthritis. Clinical Immunology and Immunopathology 83, 103–116.CrossRefGoogle ScholarPubMed
O'dell, JR, Haire, CE, Palmer, W, Drymalski, W, Wees, S, Blakely, K, Churchill, M, Eckhoff, PJ, Weaver, A, Doud, D, Erikson, N, Dietz, F, Olson, R, Maloley, P, Klassen, LW and Moore, GF (1997) Treatment of early rheumatoid arthritis with minocylcline or placebo: results of a randomized, double-blind, placebo-controlled trial. Arthritis and Rheumatism 40, 842–848.CrossRefGoogle ScholarPubMed
O'Farrelly, C, Marten, D, Melcher, D, McDougall, B, Price, R, Goldstein, AJ, Sherwood, R and Fernandes, L (1988) Association between villous atrophy in rheumatoid arthritis and a rheumatoid factor and gliadin-specific IgG. Lancet ii, 819–822.CrossRefGoogle Scholar
O'Farrelly, C, Price, R McGillivray AJ and Fernandes, L (1989) IgA rheumatoid factor and IgG dietary protein antibodies are associated in rheumatoid arthritis. Immunology Investigations 18, 753–764.CrossRefGoogle ScholarPubMed
Ohashi, F, Shimada, T, Sakaurai, M, Ishihara, S, Kuwamura, M, Yamate, J and Ota, M (1996) The production of arthritis in beagles by an immunological reaction to bovine serum albumin. Experimental Animals 45, 299–307.CrossRefGoogle ScholarPubMed
Oldstone, MBA (1987) Molecular mimicry and autoimmune disease. Cell 50, 819–820.CrossRefGoogle ScholarPubMed
Ostenstad, B, Dybwad, A, Lea, T, Forre, O, Vinje, O and Sioud, M (1995) Evidence for monoclonal expansion of synovial T cells bearing V alpha 2.1/V beta 5.5 gene segments and recognizing a synthetic peptide that shares homology with a number of putative autoantigens. Immunology 86, 168–175.Google ScholarPubMed
Panush, RS, Stroud, RM and Webster, EM (1986) Food-induced (allergic) arthritis. Inflammatory arthritis exacerbated by milk. Arthritis and Rheumatism 29, 220–226.CrossRefGoogle ScholarPubMed
Parke, AL and Hughes, GRV (1981) Rheumatoid arthritis and food: a case study. British Medical Journal 282, 2027–2029.CrossRefGoogle ScholarPubMed
Perez-Maceda, B, Lopez-Bote, JP, Langa, C and Bernabeu, C (1991) Antibodies to dietary antigens in rheumatoid arthritis — possible molecular mimicry mechanism. Clinica Chimica Acta 203, 153–165.CrossRefGoogle ScholarPubMed
Peumans, WJ & Cammue, BPA (1986) Gramineae lectins: a special class of plant lectins. In Lectins — Biology, Biochemistry, Clinical Biochemistry, vol. 5, pp. 31–37 [Bog-Hansen, TC and van Driessche, E, editors]. Berlin: Walter de Gruyter & Company.Google Scholar
Piccinini, LA, Mackenzie, WA, Platzer, M and Davis, TF (1987) Lymphokine regulation of HLA-DR gene expression in human thyroid cell monolayers. Journal of Clinical Endocrinology and Metabolism 64, 543–548.CrossRefGoogle ScholarPubMed
Pusztai, A (1989) Transport of proteins through the membranes of the adult gastrointestinal tract — a potential for drug delivery?. Advances in Drug Delivery Reviews 3, 215–228.CrossRefGoogle Scholar
Pusztai, A (1989 b) Lectins. In Toxicants of Plant Origin, vol. III, pp. 29–71 [Cheeke, PR, editor]. Boca Raton, FL: CRC Press.Google Scholar
Pusztai, A (1993) Dietary lectins are metabolic signals for the gut and modulate immune and hormone functions. European Journal of Clinical Nutrition 47, 691–699.Google ScholarPubMed
Pusztai, A, Ewen, SWB, Grant, G, Brown, DS, Stewart, JC, Peumans, WJ, Van Damme, EJM and Bardocz, S (1993) Antinutritive effects of wheat-germ agglutinin and other. N-acetylglucosamine-specific lectins. British Journal of Nutrition 70, 313–321.CrossRefGoogle ScholarPubMed
Pusztai, A, Ewen, SWB, Grant, G, Peumans, WJV, an Damme, EJM, Rubio, LA & Bardocz, S (1991) Plant (food) lectins as signal molecules: effects on the morphology and bacterial ecology of the small intestine. In Lectin Reviews, vol. 1, pp. 1–15 [Kilpatrick, DC, Van Driessche, E and Bog-Hansen, TC, editors]. St Louis, MO: Sigma.Google Scholar
Pusztai, A, Grant, G, Spencer, RJ, Duguid, TJ, Brown, DS, Ewen, SWB, Peumans, WJ, Van Damme, EJM and Bardocz, S (1993) Kidney bean lectin-induced. Escherichia coli overgrowth in the small intestine is blocked by GNA, a mannose-specific lectin. Journal of Applied Bacteriology 75, 360–368.CrossRefGoogle ScholarPubMed
Pusztai, A, Greer, F and Grant, G (1989) Specific uptake of dietary lectins into the systemic circulation of rats. Biochemical Society Transcations 17, 527–528.Google Scholar
Rath, HC, Herfarth, H, Ikeda, JS, Grenther, WB, Hamm, TE, Balish, E, Taurog, JD, Hammer, RE, Wilson, KH and Sartor, B (1996) Normal luminal bacteria, especially bacteroides species, mediate chronic colitis, gastritis, and arthritis in HLA-B27/Human B2 microglobulin transgenic rats. Journal of Clinical Investigation 98, 945–953.CrossRefGoogle Scholar
Rattray, EAS, Palmer, R and Pusztai, A (1974) Toxicity of kidney beans (Phaseolus vulgaris L.) to conventional and gnotobiotic rats. Journal of the Science of Food and Agriculture 25, 1035–1040.CrossRefGoogle ScholarPubMed
Riordan, AM, Hunter, JO, Cowan, RE, Crampton, JR, Davidson, AR, Dickinson, RJ, Dronfield, MW, Fellows, IW, Hishon, S and Kerrigan, GN (1993) Treatment of active Crohn's disease by exclusion diet: East Anglian multicentre controlled trial. Lancet 342, 1131–1134.CrossRefGoogle ScholarPubMed
Roudier, J, Petersen, J, Rhodes, G, Luka, J and Carson, DA (1989) Susceptibility to rheumatoid arthritis maps to a T cell epitope shared by the HLA Dw4 DR beta 1 chain and the Epstein Barr virus glucoprotein gp110. Proceedings of the National Academy of Sciences USA 86, 5104–5108.CrossRefGoogle Scholar
Routsias, JG, Tzioufas, AG Sakarellos-Daitsiotis M, Sakarellos, C and Moutsopoulos, HM (1993) Calreticulin synthetic peptide analogues: anti-peptide antibodies in autoimmune rheumatic diseases. Clinical and Experimental Immunology 91, 437–441.CrossRefGoogle ScholarPubMed
Rowley, MJ, Stockman, A, Brand, CA, Tait, BD, Rowley, GL, Sherritt, MA, Mackay, IR, Muirden, KD and Bernard, CC (1997) The effect of HLA-DRB1 disease susceptibility markers on the expression of RA. Scandinavian Journal of Rheumatology 26, 448–455.CrossRefGoogle ScholarPubMed
Ryder, SD, Smith, JA and Rhodes, JM (1992) Peanut lectin: a mitogen for normal human colonic epithelium and human HT29 colorectal cancer cells. Journal of the National Cancer Institute 84, 1410–1416.CrossRefGoogle ScholarPubMed
Sartor, RB (1989) Importance of intestinal mucosal immunity and luminal bacterial cell wall polymers in the aetiology of inflammatory joint disease. Baillières Clinical Rheumatology 3, 223–245.CrossRefGoogle Scholar
Sartor, RB, Rath, HC, Lichtman, SN and van Tol, EA (1996) Animal models of intestinal and joint inflammation. Baillières Clinical Rheumatology 10, 55–76.CrossRefGoogle ScholarPubMed
Shatin, R (1964) Preliminary report of the treatment of rheumatoid arthritis with high protein gluten free diet and supplementation. Medical Journal of Australia 2, 169–172.CrossRefGoogle Scholar
Shingú, M, Hashimoto, M, Nobunaga, M, Isayama, T, Yasutake, C and Naono, T (1994) Production of soluble ICAM-1 by mononuclear cells from patients with rheumatoid arthritis. Inflammation 18, 23–34.CrossRefGoogle ScholarPubMed
Sjolander, A, Magnusson, KE and Latkovic, S (1984) The effect of concanavalin A and wheat germ agglutinin on the ultrastructure and permeability of rat intestine. International Archives of Allergy and Applied Immunology 75, 230–236.CrossRefGoogle ScholarPubMed
Sjolander, A, Magnusson, KE and Latkovic, S (1986) Morphological changes of rat small intestine after short-time exposure to concanavalin A or wheat germ agglutinin. Cell Structure and Function 11, 285–293.CrossRefGoogle ScholarPubMed
Smith, MD, Gibson, RA and Brooks, PM (1985) Abnormal bowel permeability in ankylosing spondylitis and rheumatoid arthritis. Journal of Rheumatology 12, 299–305.Google ScholarPubMed
Sutton, BJ, Corper, AL, Sohi, MK, Jefferis, R, Beale, D and Taussig, MJ (1998) The structure of a human rheumatoid factor bound to IgG Fc. Advances in Experimental Medicine and Biology 435, 41–50.CrossRefGoogle ScholarPubMed
Taurog, JD, Richardson, JA, Croft, JT, Simmons, WA, Zhou, M Fernandez-Sueiro JL, Balish, E and Hammer, RE (1994) The germfree state prevents development of gut and joint inflammatory disease in HLA-B27 transgenic rats. Journal of Experimental Medicine 180, 2359–2364.CrossRefGoogle ScholarPubMed
Thomsen, P, Bjursten, LM, Ahlstedt, S, Bagge, U and Ericson, LE (1985) Proliferative synovitis in rabbit knee joints induced by antigen and preformed immune complexes. Scandinavian Journal of Rheumatology 14, 239–251.CrossRefGoogle ScholarPubMed
Travis, S and Menzies, I (1992) Intestinal permeability: functional assessment and significance. Clinical Science 82, 471–488.CrossRefGoogle ScholarPubMed
Trentham, DE and Dynesius-Trentham, RA (1995) Antibiotic therapy for rheumatoid arthritis. Scientific and anecdotal appraisals. Rheumatic Disease Clinics in North America 21, 817–834.CrossRefGoogle ScholarPubMed
Tsuda, M (1979) Purification and characterization of a lectin from rice bran. Journal of Biochemistry 86, 1451–1461.CrossRefGoogle ScholarPubMed
Udey, MC, Chaplin, DD, Wedner, HJ and Parker, CW (1980) Early activation events in lectin stimulated human lymphocytes: evidence that wheat germ agglutinin and mitogenic lectins cause similar early changes in lymphocyte metabolism. Journal of Immunology 125, 1544–1550.CrossRefGoogle ScholarPubMed
van de Laar, MA and van der Korst, JK (1992) Food intolerance in rheumatoid arthritis. I. A double blind, controlled trial of the clinical effects of elimination of milk allergens and azo dyes. Annals of the Rheumatoid Diseases 51, 298–302.CrossRefGoogle Scholar
van den Bourne, BE, Kijkmans, BA, de Rooij, HH, le Cessie, S and Verweij, CL (1997) Chloroquine and hydroxychloroquine equally affect tumor necrosis factor-alpha, interleukin-6, and interferon-gamma production by peripheral blood mononuclear cells. Journal of Rheumatology 24, 55–60.Google Scholar
Verreck, FA, Elferink, D, Vermeulen, CJ, Amons, R, Breedveld, F, de Vries, RR and Koning, F (1995) DR4Dw4/DR53 molecules contain a peptide from the autoantigen calreticulin. Tissue Antigens 45, 270–275.CrossRefGoogle ScholarPubMed
von Herrath, MG and Oldstone, MBA (1995) Role of viruses in the loss of tolerance to self-antigens and in autoimmune diseases. Trends in Microbiology 3, 424–430.CrossRefGoogle ScholarPubMed
Wagner, U, Kaltenhauser, S, Sauer, H, Arnold, S, Seidel, W, Hantzschel, H, Kalden, JR and Wassmuth, R (1997) HLA markers and prediction of clinical course and outcome in rheumatoid arthritis. Arthritis and Rheumatism 40, 341–351.CrossRefGoogle ScholarPubMed
Weetman, AP, Volkman, DJ, Burman, KD, Gerrard, TL and Fauci, AS (1985) The in vitro regulation of human thyrocyte HLA-DR antigen expression. Journal of Clinical Endocrinology and Metabolism 61, 817–824.CrossRefGoogle ScholarPubMed
Welsh, CJ, Hanglow, AC, Conn, P, Barker, TH and Coombs, RR (1985) Early rheumatoid-like synovial lesions in rabbits drinking cow's milk. Joint pathology. International Archives of Allergy and Applied Immunology 78, 145–151.CrossRefGoogle ScholarPubMed
Weyland, CM and Goronzy, JJ (1997) Pathogenesis of rheumatoid arthritis. Medical Clinics of North America 81, 29–55.CrossRefGoogle Scholar
Williams, R (1981) Rheumatoid arthritis and food: a case study. British Medical Journal 283, 563.CrossRefGoogle ScholarPubMed
Williams, RC (1992) Rheumatoid factors: historical perspective, origins and possible role in disease Journal of Rheumatology 32 (Suppl.), 42–45.Google Scholar
Williams, RC (1996) Autoimmune mechanisms involved in the pathogenesis of rheumatoid arthritis. Advances in Dental Research 10, 47–51.CrossRefGoogle ScholarPubMed
Wilson, AB, King, TP, Clarke, EMW and Pusztai, A (1980) Kidney bean (Phaseolus vulgaris) lectin-induced lesions in the small intestine. II. Microbiological studies. Journal of Comparative Pathology 90, 597–602.CrossRefGoogle Scholar
Wilson, C, Tiwana, H and Ebringer, A (1997) HLA-DR4 restriction, molecular mimicry and rheumatoid arthritis. Immunology Today 18, 96–97.CrossRefGoogle ScholarPubMed
Ziff, M (1983) Diet in the treatment of rheumatoid arthritis. Arthritis and Rheumatism 26, 457–461.CrossRefGoogle ScholarPubMed