Pathogenetic role of Chlamydia, Yersinia and Borrelia in undifferentiated oligoarthritis.
We studied the cellular and humoral immune response to Chlamydia trachomatis, Yersinia enterocolitica and Borrelia burgdorferi in paired samples of peripheral blood and synovial fluid (SF) in undifferentiated oligoarthritis, reactive arthritis (ReA) and rheumatoid arthritis. Antigen specific lymphocyte proliferation was found in SF of 43% of patients with ReA and 34% of patients with undifferentiated oligoarthritis. C. trachomatis was the most frequent single agent. HLA-B27 was positive in 83% of patients with ReA and in 62% of patients with undifferentiated oligoarthritis with antigen specific lymphocyte proliferation. Antigen specific lymphocyte proliferation correlated poorly with the specific antibody response. Only chlamydial antigen was detected in SF cells using monoclonal antibodies. We conclude that some patients with undifferentiated oligoarthritis may have a forme fruste of ReA. This finding is important in view of recent evidence supporting the efficacy of antibiotic therapy in ReA.
Sieper
J
J
Department of Medicine, Free University of Berlin, Germany.
Braun
J
J
Brandt
J
J
Miksits
K
K
Heesemann
J
J
Laitko
S
S
Sörensen
H
H
Distler
A
A
Kingsley
G
G
D000328:Adult; D000907:Antibodies, Bacterial / Q000032:analysis / Q000276:immunology; D000911:Antibodies, Monoclonal / Q000032:analysis / Q000276:immunology; D000917:Antibody Formation; D000942:Antigens, Bacterial / Q000032:analysis / Q000276:immunology; D001168:Arthritis / Q000276:immunology / Q000382:microbiology*; D016918:Arthritis, Reactive / Q000276:immunology / Q000382:microbiology; D001172:Arthritis, Rheumatoid / Q000276:immunology / Q000382:microbiology; D001899:Borrelia Infections / Q000276:immunology; D015748:Borrelia burgdorferi Group / Q000276:immunology / Q000502:physiology*; D002690:Chlamydia Infections / Q000276:immunology; D002692:Chlamydia trachomatis / Q000276:immunology / Q000502:physiology*; D005260:Female; D005455:Fluorescent Antibody Technique; D015796:HLA-B27 Antigen / Q000032:analysis; D006801:Humans; D008214:Lymphocytes / Q000276:immunology / Q000502:physiology; D008297:Male; D008875:Middle Aged; D000091402:Prohibitins; D013582:Synovial Fluid / Q000166:cytology / Q000276:immunology; D015009:Yersinia Infections / Q000276:immunology; D015008:Yersinia enterocolitica / Q000276:immunology / Q000502:physiology*
D000907:Antibodies, Bacterial; D000911:Antibodies, Monoclonal; D000942:Antigens, Bacterial; D015796:HLA-B27 Antigen; C000717331:PHB2 protein, human; D000091402:Prohibitins