The role of infectious agents in the spondylarthropathies.
The clinical similarities of the spondylarthropathies and their frequent association with both HLA B27 and microbial infections suggest common pathogenetic mechanisms. The latter may include deposition of immune complexes containing bacterial antigens. or cross-reactivity of such antigens with host target tissue or responding cell antigens. Enteric bacteria, chlamydia and mycoplasma are all candidate etiologic agents, but proof is difficult because they are often found as normal flora, although only genetically susceptible individuals may acquire disease, and many patients have been treated with antibiotics before they can be studied. Nonetheless, a role for endogenous bacteria in reactive arthritis at least seems certain, and should stimulate further investigation into similar pathogenetic mechanisms in other chronic arthritides.
Phillips
P E
PE
Department of Medicine, SUNY-Health Science Center, Syracuse 13210.
D001168:Arthritis / Q000209:etiology* / Q000276:immunology; D001424:Bacterial Infections / Q000276:immunology; D003429:Cross Reactions; D015235:HLA-B Antigens; D015796:HLA-B27 Antigen; D006801:Humans; D013122:Spinal Diseases / Q000209:etiology* / Q000276:immunology
D015235:HLA-B Antigens; D015796:HLA-B27 Antigen