yep - interesting article - and some very original work in there - this is the first i have seen that references the extra cellular biofilm components as powerful triggers for auto-immunity.
so as well as intracellular bacteria causing autoimmunity - it seems like biofilms in the body are rocket fuel for triggering auto-immunity.
we could speculate that both of these instances are driven by the same kind of problem - one of physical barriers ( cell walls or biofilms) preventing the immune system from eradicating the source of the infection - but exposing the host to high levels of immune activation from the pro-inflammatory chemicals they create - and hence causing the host immune system to be chronically "switched on" - something we have known for a long time causes auto-immunity
the way i read the paper though - this is not necessarily happening when biofilms are inside the gut - as i understand it all bacteria that colonise the gut ( good ones not just bad ones ) will form biofilms as part of their normal biology - and when they are where they should be - on the external side of the self / non-self barrier - that's fine - this is the normal state in all higher organisms we are adapted for this.
there is immune tolerance mechanisms, also active selection of preferred microbes in the healthy gut by the host immune system via antimicrobial peptide secretion and immune cell activities, and there is also physical separation mechanisms in the gut - ie continuous mucous secretion from the gut lining that forms a physical barrier between the host and the bacteria living in the gut.
so in the normal healthy state of affairs the bacteria do not really come into contact with or invade the host system and remain essentially on the outside ( all of the contents of the gut are in a continuous tube from mouth to anus that are actually part of the outside environment - not a part of the host )
although they do interact - sharing information bath ways - that is another topic.
one of the things that was interesting in that paper is that individual elements of the bacterial biofilms they tested stimulated auto-immunity only a little - whereas when both the extracellular matrix and bacterial DNA were present outside of the gut - then auto-immunity was powerfully triggered
so this sees to fit with the above - bits of digested bacteria and their biofilms are kind of OK - but actual biofilm outside of the gut is a powerful trigger for auto-immunity - so this seems to fit with the above model.
note - any time the gut barrier is damaged, the mucosal layer gone and direct bacterial invasion of gut tissues - eg as in IBD/Crohn's - the bacteria are effectively in the host / no longer in the gut
so what that paper is indicating is in line with many of the things we already know ( or at least findings of other researchers )
-the presence of extracellular matrix and dna of bacterial biofilms inside the host tissues is a major trigger for auto-immunity ( this bit is new to me )
-some gut bacterial biofilms seem to be more stimulating of auto-immunity than others
-gut barrier integrity compromise is involved / or at least highly associated with auto-immunity
-the source for some of these bacterial biofilms communities inside the host may well be from the gut - due to compromise in the intestinal barrier ( interesting aside - this seems to be the mechanism involved in CFS/<ME - if the new theory of CFS by Igor Markov - discussed in the other thread turns out to be true - and there are many parallels between CFS and chronic lyme )
this mechanism could explain why so many people have chromic mysterious illnesses that seem to occur after a viral illness or other infection in the gut ( eg protozoal infection in the gut as mentioned by bluelyme), or food poisoning, - even respiratory viruses like flu or even covid - many many viruses in fact even those thought to be respiratory viruses can compromise the gut barrier if only temporarily - this may be enough to allow the establishment of a biofilm bacterial infection inside the host tissues somewhere - and and trigger the cycle of auto-immunity
this potential for the existence of long lived chronic bacterial biofilm producing infection inside the host is largely played down by conventional medicine for reasons that are not at all clear
and we are likely to be told that if we have taken antibiotics for 2-3 weeks this cannot be the case
but there are now so many instances where this is clearly at odds with what we can see for ourselves that it is clearly utterly false
the following are now documented to involve bacterial biofilms surviving long term in human tissues that are highly resistant to even long term treatment with multiple antibiotics
-middle ear infections ( my partner had one of these when she was a girl - took abx for years -no cure)
-osteomyelitis
-chronic interstitial cystitis
-cystic fibrosis ( biofilm forming bacterial lung infection)
-chronic rhinosinusitis
-endocarditis and vegetations
-benign prostate hyperplasia (usually culture negative but bacteria present by PCR and staining)
-diabetic wounds
-periodontal disease
-surgical implant infections / failures ( actually the normal routine cause of failure )
-catheter infections
some references here
https://www.ncbi.nlm.nih.gov/pmc/articles/pmc6312881/but that's just one example - there are hundreds of papers on biofilms in humans on PubMed
many of these conditions can last for years -despite treatment with antibiotics - so much so the standard of care is often surgical excision ( if its possible ) and yet there is still an under appreciation of their existence and role in chronic illness.
what can be done about
them is still very much a grey area - with much research still to be done - and ultimately altogether new antimicrobials that work against biofilms are needed
but we start to see possibilities - like biofilm disrupters in the research - and also efforts to strengthen the immune system against biofilms - after all this is not a new phenomenon - mammals will have been in an arms race with bacterial biofilms for millions of years - so our immune systems have some of the tools - possibly all of the tools to deal with them - if they are in tip top shape.
it could be that we are seeing an exponential rise in chronic disease and in particular auto-immunity - die to dysregulation of our immune systems by the modern world - eg the changes in our diet and lifestyle and environment vs the ancestral template weakening our immune function.
if the Markov theory and vaccine approach turns out to be effective - this could be a very promising avenue to pursue to ramp up specific immune activities to dismantle the bacterial communities over time with minimal damage to the host vs surgery or pharma drugs