title: Analysis of bacterial DNA in synovial tissue of Tunisian patients with reactive and undifferentiated arthritis by broad-range PCR, cloning and sequencing.
abstract: BACKGROUND
  Bacteria and/or their antigens have been implicated in the pathogenesis of reactive arthritis (ReA). Several studies have reported the presence of bacterial antigens and nucleic acids of bacteria other than those specified by diagnostic criteria for ReA in joint specimens from patients with ReA and various arthritides. The present study was conducted to detect any bacterial DNA and identify bacterial species that are present in the synovial tissue of Tunisian patients with reactive arthritis and undifferentiated arthritis (UA) using PCR, cloning and sequencing.
  
  
  METHODS
  We examined synovial tissue samples from 28 patients: six patients with ReA and nine with UA, and a control group consisting of seven patients with rheumatoid arthritis and six with osteoarthritis (OA). Using broad-range bacterial PCR producing a 1,400-base-pair fragment from the 16S rRNA gene, at least 24 clones were sequenced for each synovial tissue sample. To identify the corresponding bacteria, DNA sequences were compared with sequences from the EMBL (European Molecular Biology Laboratory) database.
  
  
  RESULTS
  Bacterial DNA was detected in 75% of the 28 synovial tissue samples. DNA from 68 various bacterial species were found in ReA and UA samples, whereas DNA from 12 bacteria were detected in control group samples. Most of the bacterial DNAs detected were from skin or intestinal bacteria. DNA from bacteria known to trigger ReA, such as Shigella flexneri and Shigella sonnei, were detected in ReA and UA samples of synovial tissue and not in control samples. DNA from various bacterial species detected in this study have not previously been found in synovial samples.
  
  
  CONCLUSIONS
  This study is the first to use broad-range PCR targeting the full 16S rRNA gene for detection of bacterial DNA in synovial tissue. We detected DNA from a wide spectrum of bacterial species, including those known to be involved in ReA and others not previously associated with ReA or related arthritis. The pathogenic significance of some of these intrasynovial bacterial DNAs remains unclear.
authors.affiliation: Laboratoire de Recherche 'Micro-organismes et Pathologie Humaine', EPS Habib Bourguiba, Rue El Ferdaous, 3029 Sfax, Tunisie. mariamsiela@voila.fr
authors.forename: Mariam
authors.initials: M
authors.lastname: Siala
authors.forename: Benoit
authors.initials: B
authors.lastname: Jaulhac
authors.forename: Radhouane
authors.initials: R
authors.lastname: Gdoura
authors.forename: Jean
authors.initials: J
authors.lastname: Sibilia
authors.forename: Hela
authors.initials: H
authors.lastname: Fourati
authors.forename: Mohamed
authors.initials: M
authors.lastname: Younes
authors.forename: Sofien
authors.initials: S
authors.lastname: Baklouti
authors.forename: Naceur
authors.initials: N
authors.lastname: Bargaoui
authors.forename: Slaheddine
authors.initials: S
authors.lastname: Sellami
authors.forename: Abir
authors.initials: A
authors.lastname: Znazen
authors.forename: Cathy
authors.initials: C
authors.lastname: Barthel
authors.forename: Elody
authors.initials: E
authors.lastname: Collin
authors.forename: Adnane
authors.initials: A
authors.lastname: Hammami
authors.forename: Abdelghani
authors.initials: A
authors.lastname: Sghir
mesh_terms: D000328:Adult; D016918:Arthritis, Reactive / Q000382:microbiology*; D003001:Cloning, Molecular; D004269:DNA, Bacterial / Q000032:analysis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D000091402:Prohibitins; D012336:RNA, Ribosomal, 16S / Q000032:analysis; D015231:Sexually Transmitted Diseases, Bacterial / Q000150:complications; D013583:Synovial Membrane / Q000382:microbiology*; D014416:Tunisia
chemical_list: D004269:DNA, Bacterial; C000717331:PHB2 protein, human; D000091402:Prohibitins; D012336:RNA, Ribosomal, 16S