Ureaplasma urealyticum in Reiter's syndrome.
OBJECTIVE
To evaluate the role of Ureaplasma urealyticum (Uu) in the pathogenesis of Reiter's syndrome (RS).


METHODS
Infection with Uu was determined in 31 patients with RS and 28 patients with other arthritides by urethral, cervical and synovial fluid (SF) culture and by measuring anti-Uu serum antibody. Infection with Chlamydia trachomatis was determined by examining SF by a direct immunofluorescence technique, by a polymerase chain reaction and by measuring anti-C. trachomatis serum antibody. The proliferative response of SF and peripheral blood mononuclear cells (PBMC) to Uu antigens in patients with RS was compared to that of a control group. The effect that treatment of 6 patients with RS with ciprofloxacin had on repeated cultures, on titer of anti-Uu antibody and on mononuclear cell reactivity was measured sequentially.


RESULTS
The colonization rate of Uu in patients with RS (74%) was significantly greater than in patients with other arthritides (14%). Genital C. trachomatis isolation and serum anti-C. trachomatis antibody were uncommon in both groups (11 and 13%, respectively). SF mononuclear cells of the patients with RS proliferated specifically in response to Uu antigens [up to 6.9 stimulation index (SI)], as did their PBMC (up to 14.5 SI). In some patients, high anti-Uu antibody titers were measured in the serum. Clinical remission was observed in 4 of 6 patients and correlated with eradication of Uu, decrease in antibody titers and disappearance of mononuclear cell reactivity to Uu antigens.


CONCLUSIONS
Our findings suggest that Uu might be a causative agent or a trigger in the development of sexually acquired RS.
Horowitz
S
S
Department of Microbiology and Immunology, Soroka Medical Center, Faculty of Health Sciences, Ben-Gurion University Beer-Sheva, Israel.
Horowitz
J
J
Taylor-Robinson
D
D
Sukenik
S
S
Apte
R N
RN
Bar-David
J
J
Thomas
B
B
Gilroy
C
C
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000907:Antibodies, Bacterial / Q000097:blood; D000918:Antibody Specificity; D016918:Arthritis, Reactive / Q000150:complications / Q000382:microbiology*; D002584:Cervix Uteri / Q000382:microbiology; D002692:Chlamydia trachomatis / Q000302:isolation & purification; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013582:Synovial Fluid / Q000382:microbiology; D016869:Ureaplasma Infections / Q000150:complications / Q000188:drug therapy / Q000382:microbiology*; D016990:Ureaplasma urealyticum / Q000302:isolation & purification*; D014521:Urethra / Q000382:microbiology
D000900:Anti-Bacterial Agents; D000907:Antibodies, Bacterial