title: Detection and frequency of Chlamydia trachomatis DNA in synovial samples from Tunisian patients with reactive arthritis and undifferentiated oligoarthritis.
abstract: We aimed to determine the frequency of Chlamydia trachomatis DNA in the synovial compartment of 34 arthritic patients. Chlamydia trachomatis DNA was detected using a nested PCR targeting the cryptic plasmid, the 16S rRNA gene and the outer membrane protein 1 gene. The presence of serum immunoglobulin (Ig)G and IgA antibodies against C. trachomatis was studied by a microimmunofluorescence assay and by an enzyme-linked immunosorbent assay, respectively. Synovial samples from 20 of 34 (59%) patients [nine with reactive arthritis (ReA), seven with undifferentiated oligoarthritis (UOA), two with rheumatoid arthritis and two with osteoarthritis] were positive for at least one C. trachomatis DNA sequence by nested PCR. The high sensitivity results most likely from the combination of a standardized automated MagNA Pure extraction method, PCR targeting three different C. trachomatis genes and the screening for C. trachomatis in synovial tissue and fluid samples. There was no correlation between the presence of C. trachomatis DNA in the joint and a Chlamydia-specific serologic response. Our data support that PCR is the method of choice to establish the diagnosis of Chlamydia-induced arthritis in patients with ReA. We suggest that this diagnosis might also be considered in C. trachomatis-positive patients previously classified as UOA.
authors.affiliation: Laboratoire de Recherche 'Micro-organismes et Pathologie Humaine', EPS Habib Bourguiba, Sfax, Tunisia.
authors.forename: Mariam
authors.initials: M
authors.lastname: Siala
authors.forename: Radhouane
authors.initials: R
authors.lastname: Gdoura
authors.forename: Mohamed
authors.initials: M
authors.lastname: Younes
authors.forename: Hela
authors.initials: H
authors.lastname: Fourati
authors.forename: Ilhem
authors.initials: I
authors.lastname: Cheour
authors.forename: Nihel
authors.initials: N
authors.lastname: Meddeb
authors.forename: Naceur
authors.initials: N
authors.lastname: Bargaoui
authors.forename: Sofien
authors.initials: S
authors.lastname: Baklouti
authors.forename: Slaheddine
authors.initials: S
authors.lastname: Sellami
authors.forename: Markus
authors.initials: M
authors.lastname: Rihl
authors.forename: Adnene
authors.initials: A
authors.lastname: Hammami
mesh_terms: D000328:Adult; D000368:Aged; D000907:Antibodies, Bacterial / Q000032:analysis / Q000097:blood; D016918:Arthritis, Reactive / Q000382:microbiology*; D002692:Chlamydia trachomatis / Q000235:genetics / Q000302:isolation & purification*; D004269:DNA, Bacterial / Q000235:genetics / Q000302:isolation & purification*; D004275:DNA, Ribosomal / Q000235:genetics; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect / Q000379:methods; D006801:Humans; D007070:Immunoglobulin A / Q000032:analysis / Q000097:blood; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D008875:Middle Aged; D010957:Plasmids; D016133:Polymerase Chain Reaction / Q000379:methods; D018272:Porins / Q000235:genetics; D000091402:Prohibitins; D012336:RNA, Ribosomal, 16S / Q000235:genetics; D013582:Synovial Fluid / Q000276:immunology / Q000382:microbiology; D014416:Tunisia; D055815:Young Adult
chemical_list: D000907:Antibodies, Bacterial; D004269:DNA, Bacterial; D004275:DNA, Ribosomal; D007070:Immunoglobulin A; D007074:Immunoglobulin G; C000717331:PHB2 protein, human; D018272:Porins; D000091402:Prohibitins; D012336:RNA, Ribosomal, 16S; C071677:omp1 protein, Chlamydia trachomatis