title: Detection of multiple viral DNA species in synovial tissue and fluid of patients with early arthritis.
abstract: OBJECTIVE
  Viruses have a role in the pathogenesis of various forms of arthritis. This study aimed at determining whether viral DNA can be detected in joint samples in the early stages of idiopathic arthritides.
  
  
  METHODS
  Synovial fluid (SF) and synovial tissue (ST) samples were obtained from 73 patients, with undifferentiated arthritis (n=22), rheumatoid arthritis (n=13), spondyloarthropathy (n=17), crystal arthropathy (n=8), osteoarthritis (n=7), septic arthritis (n=5), and trauma (n=1). The presence of viral DNA was investigated by polymerase chain reaction analysis.
  
  
  RESULTS
  Cytomegalovirus was present in 25 patients, parvovirus B19 in 15 patients, Epstein-Barr virus in 12 patients, and herpes simplex virus in 16 patients (in ST, SF, or both), respectively. The joint samples were negative for viral DNA from adenovirus and varicella-zoster virus. In ST, eight patients were double positive for parvovirus B19 and another viral DNA, with herpes simplex virus being the most prevalent. Seven patients were double positive for other viruses (cytomegalovirus, herpes simplex virus, Epstein-Barr virus). In SF, four patients were double or triple positive for viral DNA. Paired samples were available in 56 patients. In these, viral DNA was detected in 37 patients in ST, as compared with 19 in SF.
  
  
  CONCLUSIONS
  These data show that one or more viruses can be detected in the synovial specimens of patients with early arthritis, irrespective of the clinical diagnosis. This observation might be explained by migration of inflammatory cells harbouring viral DNA into the inflamed joints.
authors.affiliation: Institute of Clinical Immunology and Transfusion Medicine, University of Leipzig, Leipzig, Germany.
authors.forename: H D
authors.initials: HD
authors.lastname: Stahl
authors.forename: B
authors.initials: B
authors.lastname: Hubner
authors.forename: B
authors.initials: B
authors.lastname: Seidl
authors.forename: U G
authors.initials: UG
authors.lastname: Liebert
authors.forename: I M
authors.initials: IM
authors.lastname: van der Heijden
authors.forename: B
authors.initials: B
authors.lastname: Wilbrink
authors.forename: M C
authors.initials: MC
authors.lastname: Kraan
authors.forename: F
authors.initials: F
authors.lastname: Emmrich
authors.forename: P P
authors.initials: PP
authors.lastname: Tak
mesh_terms: D001168:Arthritis / Q000821:virology*; D003587:Cytomegalovirus / Q000235:genetics / Q000302:isolation & purification; D004279:DNA, Viral / Q000032:analysis*; D004854:Herpesvirus 4, Human / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D016732:Parvovirus B19, Human / Q000235:genetics / Q000302:isolation & purification; D016133:Polymerase Chain Reaction; D018139:Simplexvirus / Q000235:genetics / Q000302:isolation & purification; D013582:Synovial Fluid / Q000821:virology; D013583:Synovial Membrane / Q000821:virology*
chemical_list: D004279:DNA, Viral